MedicaidCoverageHigh impact
MAB2022020901
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid Fee-for-Service beneficiaries must obtain all specialty pharmacy medications exclusively through Chartwell Pennsylvania starting July 1, 2022. Other pharmacies will no longer be reimbursed for specialty drugs, though prescribers can still bill for administration of these medications.
Action Required
By July 1, 2022: Prescribers must redirect all specialty medication prescriptions for Pennsylvania Medicaid Fee-for-Service patients to Chartwell Pennsylvania (833-710-0211). Update staff training to inform patients about the mandatory specialty pharmacy change. Billing team should note that specialty drug dispensing claims will be denied if submitted to other pharmacies, but administration codes can still be billed by prescribers.