MedicaidAdministrativeLow impact
MAB2025123001
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Pennsylvania's Medical Assistance program is updating provider handbooks to standardize language around Provider Preventable Conditions (PPCs), Healthcare Acquired Conditions (HCACs), and Other Provider Preventable Conditions (OPPCs). This is a formatting update only - no policy or reporting procedure changes are being made.
Action Required
By January 1, 2026: Pennsylvania providers should review updated PROMISe Provider Handbooks for Professional/CMS-1500, Institutional/UB-04, and Dental claim forms to familiarize themselves with reformatted PPC sections. Continue existing PPC reporting procedures - no workflow changes required as this is formatting only.