Pa. has eliminated its Medicaid provider application backlog, removing barriers to care | Opinion

The move allows providers to do what they do best: Care for people

Lung cancer concept. doctor explaining results of lung check up from x-ray scan chest on digital tablet screen to patient.

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By Val Arkoosh  and Cheri Rinehart 

Every Pennsylvanian deserves access to high-quality, affordable, local health care, and the dignity and peace of mind of knowing they can get care when they need it.

The Commonwealth has no shortage of health care professionals who want to provide care through the Medicaid program, which serves more than 3.6 million Pennsylvanians, including children, seniors, and people with disabilities.

However, until recently, long wait times to be approved by the state were often a barrier for providers who wanted to offer services through Medicaid.

This backlog had real consequences: not only did potential Medicaid providers face a barrier in providing critical services, but Medicaid recipients could not receive those services. Recognizing the importance of this issue, the Shapiro Administration and Pennsylvania Department of Human Services (DHS) staff and leadership prioritized eliminating the backlog of provider enrollment applications to help ensure Pennsylvanians can get the care they need.

DHS was able to decrease that backlog by 75 percent in the first 100 days of the Shapiro administration,  and is happy to report that that backlog has now been fully eliminated.

By federal law, providers are unable to offer care to patients under the Medicaid program until they are enrolled or revalidated. DHS must also revalidate Medicaid service providers every five years.

As of January 2023, there was a backlog of more than 35,000 provider applications that were more than 30 days old. For many providers, they were forced to weed through various levels of bureaucracy when all they wanted to do was provide the best care for their patients.

The Shapiro administration and the Department of Human Services (DHS) saw this backlog and acted quickly to address it, prioritizing removing roadblocks to processing applications quickly and cutting red tape.

With that backlog now eliminated, more providers are part of the Medicaid program, and Medicaid recipients have more options for healthcare.

By removing a barrier for providers and patients, DHS is proving its commitment to being an efficient and effective partner to providers who want to offer services within the Medicaid program.

By eliminating the backlog in provider enrollment, DHS is enabling more providers to do what they do best: care for their fellow Pennsylvanians.

Dr. Val Arkoosh is the acting Secretary of the Pennsylvania Department of Human Services. Cheri Rinehart is the  president and CEO, Pennsylvania Association of Community Health Centers. They write from Harrisburg. 

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Capital-Star Guest Contributor
Capital-Star Guest Contributor

The Pennsylvania Capital-Star welcomes opinion pieces from writers who share our goal of widening the conversation on how politics and public policy affects the day-to-day lives of people across the commonwealth.