MedicaidAdministrativeMedium impact
UPMC for You has been awarded a Medicaid Managed Care Contract for all five Physical HealthChoices zones across the Commonwealth of Pennsylvania
UPMC Health Plan·PA·Education
Effective date
Sep 1, 2022
We identified it
Aug 7, 2026
Summary
UPMC for You has been awarded a Medicaid Managed Care Contract covering all five Physical HealthChoices zones in Pennsylvania, with a planned go-live date of September 1, 2022. Billing teams should review training materials and FAQs to prepare for this network expansion, though implementation dates remain subject to change at the discretion of the Pennsylvania Department of Human Services.
Action Required
By August 15, 2022: Billing team and credentialing staff should review UPMC for You's comprehensive online training and FAQ resources at upmchp.us/ProviderFAQ to understand coverage policies, billing procedures, and member eligibility under the new five-zone Medicaid contract. Verify that billing software includes UPMC for You as an active Medicaid plan effective September 1, 2022. Update internal documentation and provider communications regarding network changes. Monitor Pennsylvania Department of Human Services announcements for any changes to the go-live date or implementation timeline, as these remain subject to modification.