MedicaidAdministrativeHigh impact
MAB 99-16-06 Revalidation of Medical Assistance (MA) Providers
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Apr 15, 2016
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) providers who enrolled before September 24, 2011 must complete revalidation by September 25, 2016, or face disenrollment from the program. This extends the original March 24, 2016 deadline based on updated CMS guidance.
Action Required
By September 25, 2016: All Pennsylvania Medical Assistance providers who enrolled before September 24, 2011 must submit complete PROMISe Provider Enrollment Applications for every active service location. Applications can be submitted online, by email (Ra-ProvApp@pa.gov), fax (717-265-8284), or mail. Allow 60-90 days for processing. Failure to complete revalidation will result in provider disenrollment from the Medical Assistance Program.