PA Medical Assistance change to payment for health care services
As of Wednesday, Jan. 1, 2025, Geisinger Health Plan pays doulas and FQHC and RHC providers who see GHP Family members no less than the amounts listed in PA’s Medical Assistance (MA) fee schedule.
Additionally, as of Jan. 1, 2024, Geisinger Health Plan pays ambulance providers who service GHP Family members no less than the amounts listed in PA’s MA fee schedule.
What’s happening?
In accordance with the PA Department of Human Services (DHS) HealthChoices contract, Geisinger Health Plan must pay all doulas, FQHC and RHC and ambulance providers who see GHP Family members no less than 100% of the FFS Prospective Payment System (PPS) rates, as determined by DHS.
GHP Family has implemented this change in accordance with the HealthChoices contract, effective as follows:
- Ambulance — Jan. 1, 2024
- Doulas and FQHC/RHC — Jan. 1, 2025
For most, this change is largely unnoticeable. This bulletin simply memorializes GHP Family’s commitment to these payment changes outlined in the HealthChoices contract.
Your organization’s agreement with Geisinger Health Plan may include a lesser of provision that the HealthChoices contract overrides for the provider types listed above.
Questions?
Contact our Provider Care Team: 844-GHP-PROV (844-447-7768). This Operations Bulletin and the information contained herein amend your agreement with Geisinger Health Plan and the GHP Participating Provider Guide.