Medicaid Plan

The Medicaid Services Info You Need



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Pennsylvania Medicaid

The Pennsylvania Medicaid Program Covers PA residents who qualify.The Office of Medical Assistance Programs administers the joint state/federal Medical Assistance (also known as Medicaid) program that purchases health care for close to 1.9 million Pennsylvania residents. Local County Assistance Offices determine eligibility for Medical Assistance.

Medical Assistance purchases services through contracts with managed-care organizations and under an indemnity, or traditional, fee-for-service system. Facility based services are reimbursed under case-mix for long-term care for the elderly, while other facilities are paid on a prospective, or cost, basis. A medical provider is required to enroll in the program and must meet applicable national, federal and state licensing and credential requirements.

The Office of Medical Assistance Programs is also responsible for enrolling providers, processing provider claims, establishing rates and fees, contracting and monitoring of managed care organizations, and detecting and deterring provider and recipient fraud and abuse.The Pennsylvania Medicaid Program Covers PA residents who qualify.