The following Provider Directory (web page) URL domain name has changed:

https://provider.directory.dhs.pa.gov

Please be sure to update your saved links or Favorites.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

The following Provider Enrollment application (web page) URL domain name has changed:

https://provider.enrollment.dhs.pa.gov/

Please be sure to update your saved links or Favorites.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Please disregard the notice for the URL change for persons using the TPL Tools Application. This change was a backend change and requires NO change of your current procedures for accessing the TPL Tools Application.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

The following TPL Tools application (web page) URL domain name has changed:

https://tools.tpl.dhs.pa.gov

Please be sure to update your saved links or Favorites.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

The following provider application (web page) URL domain name has changed:
PROMISe(tm) Internet Portal > Home
https://promise.dhs.pa.gov/portal/provider/Home/tabid/135/Default.aspx
Please be sure to update your saved links or Favorites.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Good afternoon,

In accordance with DHS rebranding and the Governor's Office Customer Service Transformation Initiative, the Office of Medical Assistance Programs will be implementing changes to the old URLs to reach PROMISe hosted applications and websites. The old URLs, using a domain naming convention of dpw.state.pa.us, will be changing to dhs.pa.gov in phased implementations beginning August 7th, 2024, and wrapping up in October 2024. Please review the attached pdf containing the impacted production environment URLs. 

[More ...]

View In Browser<https://maestro.pa.gov/list/k3hdw2n4/240718C/7os582xzsu6y.vib?a2=5scbc7ua&a1=stmeyer%40PA.GOV&a0=325>

[https://maestro.pa.gov/list/img/pic?t=HTML_IMAGE&lui=k3hdw2n4&j=240718C&i=lyrgxyur5argi90jne2]
Bridges to Success:
Keystones of Health for Pennsylvania

1115 Program Administrator RFI

[https://maestro.pa.gov/list/img/pic?t=HTML_IMAGE&lui=k3hdw2n4&j=240718C&i=lyrh24vn6vsfju78kuj]

1115 Program Administrator RFI

The Department of Human Services has released a new Request for Information (RFI) to assist in determining possible implementation needs for the Commonwealth’s proposed 1115 Demonstration Waiver titled, Bridges to Success: Keystones of Health for Pennsylvania. This RFI will help inform a potential scope of work for private, public, and non-profit organizations that could serve in the future as a Program Administrator for the program. If approved and implemented, Keystones of Health would bring new resources to Pennsylvania’s Medicaid 

[More ...]

Good afternoon,

In partnership with the Governor's Office and the Commonwealth's web development vendor, the Department of Human Services will move to a new public-facing website platform. Deployment of the new platform is scheduled for this evening, Tuesday, May 28. This transition will only affect dhs.pa.gov, and will not affect COMPASS, CWIS, PROMISe, PELICAN, or any other custom developed platforms. 

[More ...]

Please find attached the DUR Board minutes from the April 26, 2023 meeting.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Attached are the DUR Board meeting minutes from the November 3, 2021 meeting.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

The Department of Human Services is issuing an important reminder that major changes are being made to the HealthChoices Physical Health Managed Care Organizations (MCOs) offering Medical Assistance benefits on September 1, 2022.

A large number of Medical Assistance consumers must select a new MCO by August 16, 2022. If they do not make a selection, a new MCO will be automatically chosen for them. 

[More ...]

Attached is the DUR Board meeting minutes from the October 21, 2020 meeting.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Good Morning,

We are pleased to announce the MMIS 2020 Platform Project website is now live! The direct link to the MMIS 2020 homepage is: 30T30TUUhttps://www.dhs.pa.gov/MMIS/Pages/default.aspx<https://www.dhs.pa.gov/MMIS/Pages/default.aspx>UU30T30T.

You may have also noticed the previous MMIS 2020 webpage link, located within the 30T30TProviders > Sort by Industry section<https://www.dhs.pa.gov/providers/Pages/Sort-by-Industry.aspx>30T30T of the DHS website, now appears as "*New* MMIS 2020." This link will now take you to the new MMIS 2020 website. 

[More ...]

Attached is the DUR Board meeting minutes from the September 13, 2019 meeting.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

The March 19, 2020 DUR Board meeting has been cancelled and will be rescheduled.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[Logo - Community Health Choices]

Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are 21 years of age or older and have both Medicare and Medicaid or receive long-term services and supports through Medicaid. One of CHC's goals is to improve coordination between Medicare and Medicaid so participants experience better services and outcomes. Billing will not change for Medicare services, but it may change how service providers bill Medicaid and Medicare for coinsurance and deductibles. For more information on Medicaid and Medicare billing, view the attached fact sheet. 

[More ...]

[Logo - Community Health Choices]

Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are 21 years of age or older and have both Medicare and Medicaid or receive long-term services and supports through Medicaid. It is important that providers verify eligibility for all participants seeking services to ensure services are being billed to the correct entity. The PROMISe(tm) Eligibility Verification System (EVS) allows providers to determine a participant's eligibility and scope of coverage. For more information on EVS, view the attached fact sheet. 

[More ...]

[Logo - Community Health Choices]

Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are 21 years of age or older and have both Medicare and Medicaid or receive long-term services and supports through Medicaid. Third party liability (TPL) is when responsibility for all or part of a participant's health care expenses rests with an individual entity or program other than the CHC managed care organization (CHC-MCO), such as Medicare or commercial insurance. For more information on TPL and coordination of benefits, view the attached fact sheet. 

[More ...]

Over the next few weeks, the Department of Human Services will launch a redesigned website. The format of this website will match other state agencies under the Governor's jurisdiction. At this time, this migration only affects pages under the www.dhs.pa.gov website. Our homepage will still be accessible at www.dhs.pa.gov, but existing hyperlinks will change under the new structure. If you have bookmarked pages, they may no longer work. If you are trying to access a page and the link no longer works, please go to the DHS homepage at www.dhs.pa.gov and use the search function to find the page you 

[More ...]

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[Logo - Community Health Choices]

Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are dually eligible for Medicare (Part A and/or Part B) and Medicaid. CHC also covers individuals 21 years of age or older with physical disabilities who receive long-term services and supports through Medicaid.

For more about who is eligible for CHC, view the attached fact sheet. 

[More ...]

[cid:image001.png@01D54B9A.78C96910]
(Logo, Community HealthChoices)
Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are dually eligible for Medicare and Medicaid and individuals 21 years of age or older with physical disabilities who receive long-term services and supports through Medicaid. CHC participants have protections if they do not agree with a CHC managed care organization's (CHC-MCO) decision to deny, decrease, or approve a service or item different than what was requested. Participants can also voice dissatisfaction with their CHC-MCO or a provider. These concerns or issues can be voiced through the complaints and grievance process. 

[More ...]

[cid:image001.png@01D5414B.4059D780]
(Logo, Community HealthChoices)
Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are dually eligible for Medicare and Medicaid and individuals 21 years of age or older with physical disabilities who receive long-term services and supports through Medicaid. Under CHC, long-term care services and each participant's person-centered service plan are managed by a service coordinator. Service coordinators work with the CHC managed care organizations as a single point-of-contact to help participants obtain health services and supports. 

[More ...]

Please register for EVV Public Meeting on Jul 16, 2019 1:00 PM EDT at:

https://attendee.gotowebinar.com/register/2796917188088350987

After registering, you will receive a confirmation email containing information about joining the webinar.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[cid:image001.png@01D53897.BB763100]
(Logo, Community HealthChoices)
Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are dually eligible for Medicare and Medicaid and individuals 21 years of age or older with physical disabilities who receive long-term services and supports through Medicaid. Through this program, individuals previously served by the Aging Waiver and individuals residing in a nursing facility are eligible for behavioral health services through Behavioral HealthChoices. 

[More ...]

[cid:image003.png@01D52D99.D3E5B2F0]
(Logo, Community HealthChoices)

On June 30, 2019, the continuity of care period for long-term services and supports in the Southeast Region ended. This impacts approximately 50,000 participants.

This may prompt questions from CHC participants on:
* A change to their service provider due to the managed care organization (CHC-MCO) ending their contact with a provider;
* A change in service coordinator due to their CHC-MCO ending its contract with a service coordination entity;
* A change to the amount, duration, or frequency of service they are receiving.
A CHC-MCO must alert the Office of Long-Term Living in writing of 

[More ...]

Valued partner,
Thank you for your initial feedback on draft updates to the Department of Human Services' website. We are now seeking opinions on a second option developed from this initial feedback. Can you please take this brief survey<https://pa-interactive.optimalworkshop.com/questions/dhs_wayfinding> (https://pa-interactive.optimalworkshop.com/questions/dhs_wayfinding) to help us evaluate a potential navigation design?

We would appreciate your feedback by Friday, May 31. If you have technical difficulties with the survey, please email [log in to unmask]<mailto:[log in to unmask]> and our staff will try to assist, but this is a test platform so issues will not be reflected in any future changes DHS' website. 

[More ...]

[cid:image001.png@01D515FA.618178E0]
Community HealthChoices (CHC) is Pennsylvania's mandatory managed care program for individuals who are dually-eligible for Medicare and Medicaid and individuals 21 years of age or older with physical disabilities. Managed care is new for long-term services and supports, but Pennsylvania has provided physical and behavioral health care through a managed care model for many years. 

[More ...]

Valued partner,
The Department of Human Services is evaluating options to make our website more accessible for citizens, providers, and stakeholders. This is a long-term transition, and changes will not be implemented until Fall 2019. As we consider options, we want to consider feedback from partners who use our website most often. Can you please take this brief survey (https://pa-interactive.optimalworkshop.com/questions/dhs_sitemenu) to help us evaluate a potential navigation design? We would appreciate your feedback by Friday, May 17.
Thank you for your assistance!
The Department of Human Services Communications Office 

[More ...]

[cid:image001.png@01D4EF96.6F2278D0]

(Logo, Community HealthChoices)

Registration is now open for the upcoming Community HealthChoices (CHC) Educational Provider Sessions for Phase Three regions. Locations for each region are available at the RSVP pages:

* May 13-15: Lehigh/Capital Region Provider Summits<https://docs.google.com/forms/d/e/1FAIpQLScTzVMnKnPTUOnABeneogbhyBExfbe_KIOpBeywhPgxZIz-Eg/viewform?usp=sf_link>

* May 20-22: Northwest Region Provider Summits<https://docs.google.com/forms/d/e/1FAIpQLSeVpPTG5iUqdKEqSEDron0faLogVAYP714CmTvMjX5VDWqpDw/viewform?usp=sf_link>

* June 4-6: Northeast Region Provider Summits<https://docs.google.com/forms/d/e/1FAIpQLSfvmIFmbLZCMvrxcuuXEUJIcEaHuqxKZ9I4HUtkI70Bq7kaBQ/viewform?usp=sf_link>

Additionally, one day-long transportation summit will be held in each region. RSVP for this summit here<https://docs.google.com/forms/d/e/1FAIpQLScouLqGWRfH1GZ_9ERsnsSGlxvdOOO6ADV3Pk3uXP3WH182uQ/viewform?usp=sf_link>. 

[More ...]

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[cid:image001.png@01D4A426.9A22EE40]
(Logo, Community HealthChoices)
Approximately 94 percent of Community HealthChoices (CHC) participants are dually eligible for both Medicare and Medicaid. Better coordination between both entities is one of the primary goals of CHC.

Under CHC, Medicaid remains the payer of last resort for dual-eligibles, and providers who previously billed frequently to Medicaid must enroll in Medicaid per federal guidance. The CHC Managed Care Organization (CHC-MCO) will encourage providers to enroll. CHC-MCOs will also offer companion managed care plans for dually eligible participants. 

[More ...]

Dear valued stakeholder,

The Department of Human Services (DHS) recently released a Request for Information (RFI) to explore existing individual or family needs assessments, methods of connecting individuals and families to community resources, and models for providing whole-person or whole-family case management. Our goal is to build a system that addresses each family's needs and amplifies the work of health care providers and community organizations. 

[More ...]

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[cid:image001.png@01D46200.73E00410]

(Logo, Community HealthChoices)
The PROMISe Eligibility Verification System (EVS) enables providers to determine a participant's Medical Assistance eligibility, as well as the participant's scope of coverage. It is vital for providers to check EVS to verify a participant's eligibility each time services are provided because a participant's eligibility is subject to change. EVS methods, inquiries, and response formats will not change with the implementation of Community HealthChoices (CHC). 

[More ...]

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[cid:image001.png@01D414FD.44CC2D20]
(Logo, Community HealthChoices)

On June 30, 2018, the continuity of care period for long-term services and supports in the Southwest Region ended. This impacts approximately 19,000 participants.

This may prompt questions from CHC participants on:

* A change to their service provided due to the managed care organization (CHC-MCO) ending their contact with a provider;
* A change in service coordinator due to their CHC-MCO ending its contract with a service coordination entity;
* A change to the amount, duration, or frequency of service they are receiving.
A CHC-MCO must alert the Office of Long-Term Living in writing of 

[More ...]

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

[cid:image002.jpg@01D3CCE9.D5F5AC10]

Bucks, Chester, Delaware, Montgomery,
and Philadelphia counties.
Community HealthChoices (CHC) is coming in January 2019.

Here is what you need to know: 

[More ...]

The Wolf Administration is committed to serving more people in the community. Community HealthChoices (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes that rolled out in the southwest region on January 1, 2018.

CHC was developed to: (1) enhance access to and improve coordination of medical care and; (2) create a person-driven, long-term support system in which people have choice, control, and access to a full array of quality services that provide independence, health, and quality of life. Long-term services and supports help eligible individuals to 

[More ...]

Please find the attached Community HealthChoices (CHC) one pager on eligibility.
Additionally, please click here<http://www.healthchoices.pa.gov/info/about/community/commpart/index.htm> to find our most recent participant document, "CHC: Here's What You Need to Know." That document is available for download in English and Spanish.
If you have any questions, please visit www.HealthChoices.pa.gov<http://www.HealthChoices.pa.gov> or call our CHC Provider Hotline at 833-735-4417. 

[More ...]

[cid:image001.png@01D336B8.BC75B770]

Coming to the Southwest Zone in January 2018
The Department of Human Services (DHS) is committed to open and frequent communication to educate and inform individuals who will move to Community HealthChoices (CHC). It is critical that they are aware of the upcoming changes and are able to make an informed decision on their plan selection. We are using multiple channels to get the message out, and want to ensure that you are aware of upcoming information that potential participants will receive. 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
March 22, 2017
10:00am - 4:00pm
Meeting Outcomes

Board Members Present:
Dale Adair, MD
Cheston Berlin, MD
Gene Bishop, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only)
Jessica Daw, PharmD
Bernard DiCasimirro, DO
Heather Gross, PharmD
James Hancovsky, RPh, MBA
David Kelley, MD
Jeffrey Kreitman, PharmD
Jaymie Lako, PharmD
Geoff Neimark, MD
Mirza Perez, PharmD
James Schuster, MD, Vice Chair
Jeanne Spencer, MD
Jenny Sunwoo, PharmD
Kevin Szczecina, RPh
Lloyd Wertz, Behavioral Health Consumer Advocate 

[More ...]

Community HealthChoices includes provisions to help maintain continuity of care and avoid interruptions of service for participants when they are first enrolled, as well as when choosing to switch from one managed care organization (CHC-MCO) to another.
Please find the attached one pager on continuity of care.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

In March 2017, the Pennsylvania Department of Health amended its regulations to school immunizations, which became effective Aug. 1, 2017. The regulations changed the department's existing requirements for school immunizations, and are based in part upon recommendations of the Advisory Committee on Immunization Practices (ACIP), an advisory committee of the federal Centers for Disease Control and Prevention (CDC). 

[More ...]

Later today we will mail out the attached flyer to Community HealthChoices (CHC) participants in the Southwest - the first to transition to CHC in January 2018.

In order to better prepare you for the potential questions you, as providers, may receive, we drafted the attached "How to Talk to Participants about Community HealthChoices." Additional training information will be made available to you within the next few weeks. 

[More ...]

Please find the attached document with information on the delivery of service coordination for Community HealthChoices (CHC).

Service coordination includes activities to identify, coordinate, and assist participants in obtaining access to needed health services and in-home supports, as well as social and housing services needed to help participants live in their communities. Under CHC, a service coordinator is a managed care organization's (CHC-MCO) designated, accountable point-of-contact for each participant receiving long-term care services, their person-centered service plan (PCSP), and service coordination. 

[More ...]

[cid:image001.jpg@01D2FB21.D71AB530]

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Attached please find a one-page summary on Third Party Liability (TPL). TPL is when the financial responsibility for all or part of a participant's health care expense rests with an individual entity or program other than the Community HealthChoices managed care organization, such as Medicare or commercial insurance. Please forward to all relevant parties in your organization. 

[More ...]

Community HealthChoices (CHC) is coming to the Southwest zone in January 2018. In preparation, we are hosting three Southwest Provider Summits in July.

The Southwest zone is comprised of Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland.

These events are open to all providers in the Southwest zone and will be held on the following dates/locations: 

[More ...]

For years, Pennsylvania has provided physical and behavioral health care through a managed care delivery model. That did not include long-term services and supports - that is changing. Pennsylvania will be providing services for older adults and persons with physical disabilities through three Community HealthChoices managed care organizations (CHC MCOs). The Department of Human Services (DHS) will have full, ongoing oversight and monitoring. DHS will review and approve processes, policies, manuals, and procedures of each CHC MCO. 

[More ...]

Community HealthChoices (CHC) is a managed care program that will better coordinate the way participants receive their physical health services and long-term services and supports (LTSS) so that Pennsylvania can serve more people in their homes and their communities. CHC will serve Medicaid participants 21 years of age or older who also receive Medicare, need LTSS in their home or community, or are in nursing facilities. Today, there are five waivers in which participants receive LTSS. In the future there will be two ways. 

[More ...]

For your information, please find an attached letter that was sent to the House and Senate Appropriations Committees on April 26, 2017 expressing our concerns about the budget recently passed by the House Republican Caucus (House Bill 218, Printer's Number 1236).

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

The Wolf Administration is committed to serving more people in the community. Community HealthChoices (CHC) is a new initiative that will increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes.

CHC was developed to: (1) enhance access to and improve coordination of medical care and; (2) create a person-driven, long-term support system in which people have choice, control, and access to a full array of quality services that provide independence, health, and quality of life. Long-term services and supports help eligible individuals to perform daily activities in their home such as bathing, dressing, preparing 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
September 26, 2016
10:00am - 4:00pm
Meeting Outcomes

Board Members Present:
Ivonne Acrich, MD
Dale Adair, MD
Cheston Berlin, MD
Sevdalina Boshnakov, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only)
Jessica Daw, PharmD
Bernard DiCasimirro, DO
Heather Gross, PharmD
Rosemary Keffer, MD
David Kelley, MD
Jeffrey Kreitman, PharmD
Jaymie Lako, PharmD
Mirza Perez, PharmD
Jeanne Spencer, MD
Jenny Sunwoo, PharmD
Kevin Szczecina, RPh
Margery Wasko, MD 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
March 23, 2016
10:00am - 4:00pm
Meeting Outcomes

Board Members Present: Board Members Absent: Department Staff in Attendance:
Dale Adair, MD Ivonne Acrich, MD Amanda Smith, PharmD
Cheston Berlin, MD Thuy Bui, MD Laura Zulli, PharmD
Gene Bishop, MD Bernard DiCasimirro, MD
Sevdalina Boshnakov, MD Rosemary Keffer, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only) Jeanne Spencer, MD
Jessica Daw, PharmD Rajiv Vyas, MD
Heather Gross, PharmD
James Hancovsky, RPh, MBA
Kristin Hoover, PharmD (Non-Voting)
David Kelley, MD
Jeffrey Kreitman, PharmD
Geoff Neimark, MD
Lisa Nogrady, RPh
Mirza Perez, PharmD
Manuel Reich, DO
James 

[More ...]

The Pennsylvania Department of Human Services Drug Utilization Review (DUR) Board Meeting date has been changed from September 21st, 2016 to September 26th, 2016 from 10 am to 4 pm at the Child Welfare Training Center in Mechanicsburg, PA. Please update your calendar.

NOTICE: This confidential message/attachment contains information intended for a specific individual(s) and purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete the message.

Drug Utilization Review
(DUR) Board Meeting
September 10, 2015
10:00am �C 4:00pm
Meeting Outcomes

Board Members Present: Board Members Absent: Department Staff in Attendance:
Dale Adair, MD Ivonne Acrich, MD Suzanne Love
Sandra Ajisafe, PharmD Gene Bishop, MD Amanda Smith, PharmD
Cheston Berlin, MD Rosemary Keffer, MD Laura Zulli, PharmD Sevdalina Boshnakov, MD Manuel Reich, DO
Thuy Bui, MD Jeanne Spencer, MD Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only) Margery Wasko, MD
Jessica Daw, PharmD Matthew Zimmerman, PharmD
Heather Gross, PharmD
Kristin Hoover, PharmD (Non-Voting)
David Kelley, MD
Jeffrey Kreitman, PharmD
Geoff Neimark, MD
Mirza Perez, PharmD
James Schuster, MD, 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
September 10, 2014
10:00am �C 4pm
Meeting Outcomes

Board Members Present: Board Members Absent: Department Staff in Attendance:
Cheston Berlin, MD Cibbey Abraham, PharmD Suzanne Love
Gene Bishop, MD Ivonne Acrich, MD Laura Zulli, PharmD
Sevdalina Boshnakov, MD Dale Adair, MD
Thuy Bui, MD Shiva Chandrasekaran, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only) Rosemary Keffer, MD
Jessica Daw, PharmD Yvette Long
Heather Gross, PharmD Dan McConnell, PharmD
Kristin Hoover, PharmD (Non-Voting) Sandy Zebrowski, MD
David Kelley, MD
Jeffrey Kreitman, PharmD
Pam McCarter, MD
Geoff Neimark, MD
Marion Pardes, BS Pharm, MBA
Mirza Perez, 

[More ...]

Traditional Medicaid expansion is coming to Pennsylvania! This will allow us to provide health care coverage in a streamlined manner to Pennsylvanians who are most in need.
There are several milestones that we want you to know about.

Public Notice of the Adult Benefit Package
Public notice of the new Adult benefit package is now available on the DHS website at http://www.dhs.state.pa.us/cs/groups/webcontent/documents/document/c_158047.pdf.
This notice begins the public comment period on the transition to the traditional Medicaid expansion and the new adult benefit package.
You are encouraged to make comments as early as possible to ensure we are able to address 

[More ...]

Dear Stakeholders:

I am pleased to share with you that today Governor Wolf announced Pennsylvania's transition to a simple traditional Medicaid expansion plan. Below is the press release with more information on the transition. It's important to note that no coverage will be immediately impacted. As we transition individuals to traditional Medicaid, they will be notified. 

[More ...]

To my friends and colleagues:

I wanted to take this time to thank everyone for the wonderful partnerships and friendships we have formed over my tenure as Secretary for the Department of Human Services.

This has been an amazing year and a half as secretary and an amazing year and a half prior to that as the deputy secretary for our Office of Children, Youth and Families - three years that I will treasure and look back on fondly. 

[More ...]

Valued Stakeholders,
As we continue implementation of Healthy PA, The Commonwealth remains dedicated to effectively serving the citizens of Pennsylvania through the final stages of federal approval. As part of this, we want to ensure that you have the information and resources you need.

The Department has issued a Medical Assistance Bulletin outlining an interim benefit plan and scope of benefits for those individuals currently eligible for the Healthy benefit plan. Effective January 1, 2015 and until CMS approves the proposed Healthy benefit plan, the Department will apply the State's current categorically needy scope of benefits and limits and benefit 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
March 25, 2014
9:30am – 4pm
Meeting Outcomes

Board Members Present: Board Members Absent: Department Staff in Attendance:
Cibbey Abraham, PharmD Shiva Chandrasekaran, MD Ritu Light, PharmD
Ivonne Acrich, MD Heather Gross, PharmD Suzanne Love
Dale Adair, MD Yvette Long Laura Zulli, PharmD
Cheston Berlin, MD Mirza Perez, PharmD
Gene Bishop, MD Sandy Zebrowski, MD
Sevdalina Boshnakov, MD
Thuy Bui, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only)
Jessica Daw, PharmD
Kristin Hoover, PharmD (Non-Voting)
Rosemary Keffer, MD
David Kelley, MD
Jeffrey Kreitman, PharmD
Pam McCarter, MD
Dan McConnell, PharmD
Geoff Neimark, MD
Marion 

[More ...]

Dear Stakeholders,

The Commonwealth has been working hard to get ready for the implementation of Healthy PA, getting the word out about the changes that are coming, and training staff so we are ready to help the people of Pennsylvania. As part of this, we want to ensure that you have the information and resources you need. 

[More ...]

Dear Stakeholders,

I am thrilled to let you know that we have an agreement with the federal government to implement Healthy Pennsylvania. So many dedicated DPW staff worked for months and, in some cases, years to make this happen. I can't thank them, and you, enough for the continued commitment to helping improve the quality of life for Pennsylvania's individuals and families! 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
September 18, 2013
10:00am - 4pm
Meeting Outcomes

Board Members Present: Board Members Absent: Guests in Attendance:
Cibbey Abraham, PharmD Shiva Chandrasekaran, MD Ritu Light, PharmD
Ivonne Acrich, MD Yvette Long Suzanne Love
Dale Adair, MD Laura Zulli, PharmD
Cheston Berlin, MD
Gene Bishop, MD
Sevdalina Boshnakov, MD
Nicholas Casale, PharmD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only)
Jessica Daw, PharmD
Heather Gross, PharmD
Kristin Hoover, PharmD (Non-Voting)
Rosemary Keffer, MD
David Kelley, MD
Jeffrey Kreitman, PharmD
Pam McCarter, MD
Dan McConnell, PharmD
Geoff Neimark, MD
Marion Pardes, BS Pharm, MBA
Mirza Perez, PharmD
 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
March 20, 2013
10:00am �C 4pm
Meeting Outcomes

Board Members Present: Board Members Absent: Guests in Attendance:
Dale Adair, MD Ivonne Acrich, MD Ritu Light, PharmD
Cheston Berlin, MD Leesa Allen Suzanne Love
Gene Bishop, MD Shiva Chandrasekaran, MD Laura Zulli, PharmD
Sevdalina Boshnakov, MD James Jones, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only) Rosemary Keffer, MD
James Hancovsky, MBA, RPh Yvette Long
Deborah Hartman, CRNP
Kristin Hoover, PharmD
David Kelley, MD
Andrew Maiorini, PharmD
Pam McCarter, MD
Valerie Minnich, RPh
Mirza Perez, PharmD
James Schuster, MD, Vice Chair
Lloyd Wertz
Jean Whitehead, 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
September 19th, 2012
10:00am �C 4pm
Meeting Outcomes

Board Members Present: Board Members Absent: Guests in Attendance:
Dale Adair, MD Ivonne Acrich, MD Suzanne Love
Leesa Allen Shiva Chandrasekaran, MD Jeffery Miller, MD (by phone)
Michael Baer, MD James Jones, MD Shubhra Shetty, MD (by phone)
Cheston Berlin, MD Rosemary Keffer, MD Laura Zulli, PharmD
Gene Bishop, MD Yvette Long
Sevdalina Boshnakov, MD Andrew Maiorini, PharmD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only) Valerie Minnich, RPh
James Hancovsky, MBA, RPh
Deborah Hartman, CRNP
Kristin Hoover, PharmD
Mark Jacobson, DO
David Kelley, MD
Pam McCarter, 

[More ...]

DRUG UTILIZATION REVIEW

(DUR) BOARD MEETING

June 2, 2010

10am - 4pm

Meeting Outcomes

Agenda Item

Major Discussion Points/Decisions

Motions/Follow-up Needed

Welcome and Introduction

Dr. Terri Cathers, Chair, welcomed the Board members and members introduced themselves.

The meeting was called to order at 10 am.

Administrative / Old Business

§ Review of December 2, 2009 DUR Board Minutes

§ Disclosure of Interest Statement 

[More ...]

Drug Utilization Review
(DUR) Board Meeting
March 30, 2011
9:30am – 4pm
Meeting Outcomes

Board Members Present: Board Members Absent:
Ivonne Acrich, MD James Jones, MD
Dale Adair, MD Rosemary Keffer, MD
Leesa Allen
Jennifer Aro, MD
Michael Baer, MD
Cheston Berlin, MD Guests in Attendance:
Gene Bishop, MD Tiberiu F. Bodea Crisan, MD
Terri Cathers, PharmD, Chair (Tie-Breaker Vote Only) Ritu Light, PharmD
Shiva Chandrasekaran, MD Suzanne Love
James Hancovsky, MBA, RPh Valerie Minnich, RPh
Deborah Hartman, CRNP Anthony Rostain,MD
Kristin Hoover, PharmD Laura Zulli, PharmD
Mark Jacobson, DO
David Kelley, MD
Yvette Long
Andrew Maiorini, PharmD
Pam McCarter, 

[More ...]

PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
Drug Utilization Review (DUR) Board Meeting
Wednesday, March 30, 2011, 9:30 am

Location: Child Welfare Training Center
Mechanicsburg, PA

I. Welcome and Introduction

II. Administrative Business

A. Review and Approve June 2nd , 2010 meeting minutes
B. Disclosure of Interest Statements
C. APS Access Plus Presentation
III. Discussion/Action Items

A. Review of Prior Authorization Guidelines:
i) Thiazolidinediones: Avandia
ii) Multiple Sclerosis Agents: Ampyra and Gilenya
iii) Tysabri
iv) Xolair
v) Anticoagulants: Pradaxa
vi) Antihyperuricemics: Colcrys
vii) Methadone for opiate addiction and contraindicated medications
viii) Xyrem
ix) Cymbalta for chronic musculoskeletal pain
x) Stimulant use in 

[More ...]