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MedicaidAdministrativeMedium impact

d 005747

Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Oct 3, 2011
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid is extending payment hold periods for institutional claims (inpatient, outpatient, long-term care) from 11 days to 18 days over 7 monthly increments starting October 3, 2011. This will delay payment by approximately one week for affected claim types.

Action Required

Action needed
By October 3, 2011: Billing teams submitting institutional claims (UB04/837-I format) to Pennsylvania Medicaid should adjust cash flow expectations as payment will be delayed by 1-7 additional days depending on the month. Monitor remittance advice dates which will progressively extend from current timing through May 2012 when the full 18-day hold takes effect.