MedicaidCoverageMedium impact
MAB2023122002
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Dec 20, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) is retroactively reinstating full coverage for beneficiaries who were incorrectly moved to Medicare Buy-In programs during COVID-19. Providers can now submit claims for services from November 1, 2020 onward without normal 180-day filing limits and will receive payment for previously uncovered services.
Action Required
Immediately: Contact affected patients who received notices of retroactive coverage reinstatement to obtain their new effective dates. Submit all unpaid claims for services provided from November 1, 2020 onward through PROMISe system - these claims bypass normal 180-day filing limits and prior authorization requirements. Refund any out-of-pocket payments made by patients for services now covered by reinstated Medicaid benefits. Use Provider Inquiry Service Center (1-800-537-8862, Option 2-6-1) to verify eligibility dates.