UnitedHealthcareMedium ImpactAdministrative

Pennsylvania Medicaid: Certification now required for community health workers

Published June 3, 2026Effective January 1, 2026

AI Summary

Effective January 1, 2026, Pennsylvania Medicaid requires all community health workers (CHWs) working with managed care organizations, community-based organizations, vendors, and provider partners to be certified through the Pennsylvania Certification Board. CHWs employed outside of UnitedHealthcare have until December 31, 2026, to obtain certification, with quarterly progress updates required.

Action Required

By December 31, 2026: Any practice employing community health workers (CHWs) for Pennsylvania Medicaid patients must ensure all CHWs obtain certification through the Pennsylvania Certification Board. Submit quarterly certification progress updates to the MCO as requested. CHWs already certified are exempt from this requirement.

Plan Types

Medicaid

States

PA

Specialties

all-specialties