The 2020 PA HealthChoices Agreement: What You Need to Know
The PA HealthChoices program is a managed care program that provides health care coverage to individuals who are eligible for Medicaid in Pennsylvania. The program is designed to help improve the quality of care for recipients while also controlling costs associated with healthcare services. Recently, the Department of Human Services (DHS) announced the signing of a new agreement with the managed care organizations (MCOs) that participate in the HealthChoices program for the year 2020. Here`s what you need to know about the 2020 PA HealthChoices Agreement.
Changes in Coverage
One of the biggest changes in coverage for the 2020 HealthChoices agreement is the addition of telemedicine services. This will allow recipients to receive medical services remotely, which will be particularly useful in rural areas where access to healthcare can be limited. In addition, the agreement includes a focus on addressing the opioid epidemic through increased access to medication-assisted treatment and substance abuse programs.
New Participant in the Program
For the first time, a new MCO, UPMC Health Plan, will participate in the HealthChoices program beginning in 2020. This will give recipients even more options when it comes to choosing a health plan that meets their needs.
Provider Network Requirements
Under the new agreement, MCOs will be required to maintain a network of providers that meets certain standards for accessibility and quality of care. Providers will be required to maintain certain credentials and meet performance standards to ensure that recipients receive high-quality care. Additionally, the agreement includes additional standards for behavioral health providers, such as increased access to psychiatrists and other mental health professionals.
The 2020 HealthChoices agreement includes specific dates for enrollment and plan changes. Open enrollment for the program will begin on October 7, 2019 and end on December 13, 2019. During this time, recipients can choose a new MCO or make changes to their current plan. Recipients will also have the option to choose a new plan during the month of their re-enrollment.
In conclusion, the 2020 PA HealthChoices agreement includes several important changes designed to improve the quality of care for Medicaid recipients in Pennsylvania. The addition of telemedicine services, increased access to substance abuse treatment, and new provider network requirements will all contribute to better health outcomes for those who participate in the program. With the addition of UPMC Health Plan as a participating MCO, recipients will have even more options when it comes to choosing a plan that meets their needs. Open enrollment for the program begins on October 7, 2019, so now is the time to research your options and choose the plan that is right for you.