During his first month in office, Pennsylvania Governor Josh Shapiro signed an Executive Order directing all state agencies to compile a catalog of the licenses, certificates, and permits they administer – including the length of time it takes them to process applications and the application fee charged by each agency – with the goal of transforming how the Commonwealth delivers vital services, issues certifications to combat workforce shortages, and supports entrepreneurs who want to start businesses.

The Shapiro Administration has proudly announced the successful elimination of a long-standing backlog in Medicaid provider enrollment and revalidation applications. This milestone not only streamlines the process for healthcare providers to join the Medicaid program but also enhances the array of healthcare options available to Medicaid recipients. This accomplishment builds upon the earlier progress made by the Department of Human Services (DHS), reducing the provider backlog by 75% within the first 100 days of Governor Shapiro’s term, as reported in late April.

filling out a credentialing applications

As of January 2023, the backlog included more than 35,000 provider applications and revalidation requests that were over 30 days old. Thanks to the focused efforts of the Administration, this number was significantly reduced by 75% in the initial 100 days, bringing the waiting applicants down to under 8,500, and subsequently, the entire backlog has been eradicated.

Dr. Val Arkoosh, Acting Secretary of DHS, expressed her gratitude, stating, “Pennsylvania is fortunate to have so many caring, high-quality health care providers and professionals who want to be part of the Medicaid program and care for some of our most vulnerable friends, neighbors, and loved ones. I want to thank them and DHS staff who worked so diligently on this issue. They have helped to ensure that Medicaid recipients in the Commonwealth can continue to get the care they need and deserve.”

Federal regulations dictate that organizations cannot provide care to patients under the Medicaid program unless they are officially enrolled as providers. Furthermore, DHS is responsible for revalidating Medicaid service providers every five years. Any delays in processing applications mean that providers eager to serve Medicaid recipients must wait until their applications are approved.

The Medicaid program in Pennsylvania caters to the healthcare needs of more than 3.7 million individuals, including children, seniors, and people with disabilities. Acknowledging the significance of the backlog and its impact on Pennsylvanians, the Shapiro Administration, along with DHS staff and leadership, acted swiftly to address the issue. They removed obstacles hindering the rapid processing of applications and minimized bureaucratic red tape.

Cheri Rinehart, President and CEO of the Pennsylvania Association of Community Health Centers, praised the swift mobilization of DHS, saying, “Because DHS mobilized quickly and provided additional resources to this effort, Pennsylvania’s Community Health Centers (also known as federally qualified health centers) have been able to ensure that they are there for the more than one million Pennsylvanians who count on them for access to quality, affordable medical, behavioral, dental, vision care, and other healthcare services. Access to health care services is paramount to having healthy communities.”

The Shapiro Administration is steadfast in its commitment to reforming Pennsylvania’s government to better serve its residents efficiently. The efforts of DHS to reduce and eliminate wait times and backlogs for Medicaid service providers complement Governor Shapiro’s Executive Order aimed at improving the Commonwealth’s licensing, permitting, and certification processes.

National Credentialing Solutions is an outsourced credentialing service assisting healthcare practitioners enroll/credential and contract with payor networks including Medicare, Medicaid, and commercial insurance throughout the country. To speak with someone about your credentialing needs, please visit our information request form here or call our office today at 423.443.4525 and select the option to speak with our sales team.