MedicaidAdministrativeMedium impact
MAB2023072601
Pennsylvania Medicaid (DHS)·PA · OB-GYN, Urology, General Surgery·Provider Bulletin
Effective date
Jul 25, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance has updated the Sterilization Consent Form (MA 31) to extend the expiration date from the previous version to July 31, 2025. Providers performing sterilization procedures must use the new form effective immediately for all fee-for-service Medicaid claims.
Action Required
Immediately: Download and implement the updated MA 31 Sterilization Consent Form from the PA DHS website. Replace all existing MA 31 forms with the new version (expiration date 7/31/2025). Ensure all staff performing sterilization procedures use only the updated form. The original form goes to the physician, with copies to hospital, patient, and DHS Office of Medical Assistance Programs.