Changes to the Medicaid Program in Pennsylvania

Attorney Michael Hynum discusses changes in the Medicaid Program including "Community Health Choices". For your convenience, the transcription for the video is included below.

Changes to the Medicaid Program in Pennsylvania

“Hi, this is Mike Hynum, with Hynum Law in Harrisburg, Pennsylvania. Today I’d like to talk to you a little bit about something that probably most of you have not heard about, which is changes that are coming to the Medicaid program in Pennsylvania.

How the Affordable Healthcare Act Changed PA

As we know there have been a lot of changes with the Affordable Care Act, otherwise known as Obamacare, and the fact that the budgetary process has been such an issue - and the fact that also Medicaid spending is such a large portion of the Pennsylvania budget. Last year the governor issued a document that said we were going to move to something in Pennsylvania called Community Health Choices or CHC.

Community Health Choices

There are about 130,000 or more older adults in Pennsylvania who receive some kind of long-term support and services. Much of which is in a nursing home or personal care home, some of which is in home and community-based services. What’s going to happen through the Community Health program, or the Community Health Choices, is that they’re going to be what are called MCOs, which are Managed Care Organizations, that are going to be bidding to take over essentially running the payments for the Medicaid program in Pennsylvania.

The Timeline of Change

In January of 2017, we’re going to start out in the southwestern region, where already high mark and several other managed care companies are running a lot of the Medicaid payments already, and I believe that is why they’re starting in southwest Pennsylvania.

In January 2018, they’ll be moving to the southeast region, Philadelphia, and surrounding counties, and by January of 2019, the plan is to have managed care organizations in place to handle all of the Medicaid processing, payments, eligibility, and everything for anyone who needs long-term support and care services in Pennsylvania.

Private Companies Taking on Healthcare

It’s going to be a big change that we’re going to now have private companies doing a lot of functions that government used to do. So if you want to know more about this, you can learn more at the Department of Human Services website, at the Commonwealth of Pennsylvania, but there’s going to be a lot of changes coming to the way the Medicaid system works in Pennsylvania, beginning in January 2017.

Again, this is Mike Hynum, Hynum Law in Harrisburg Pennsylvania. If you’d like to know more about this, or any other issue, please don’t hesitate to give us a call at (717) 801-1105 or contact us, look us up on our website, at Thank you for watching.”