The Pennsylvania Department of Human Services (Department) is implementing the Affordable Care Act provision that requires all providers who render services to Children?s Health Insurance Program (CHIP) members be enrolled with the Department as a CHIP provider by January 1, 2018. A letter detailing the enrollment process can be found here.

The appropriate application and all required documents must be submitted to the Department by November 1, 2017. This will allow for timely processing of all applications. CHIP providers who are already enrolled in the Pennsylvania Medical Assistance (MA) Program do not need to enroll again. However, if providers are enrolled with another state?s Medicaid or CHIP Program, they must enroll with the Department.

The following attachments, as referenced in the letter, are available to assist you with the enrollment process:

• Attachment A: CHIP Provider Types and Specialties for Enrollment
• Attachment B: Provider Types Required to Obtain a Criminal Background Check
• Attachment C: Provider Types Required to Pay the Enrollment Application Fee
• Attachment D: Hardship Exception Request Form

There will be no change to our claims processing procedure. However, beginning January 1, 2018, any claims submitted to Keystone Health Plan East by a non-enrolled provider for services provided to a CHIP member will not receive payment.

All applications, requirements, and step-by-step instructions are available on the Pennsylvania Department of Human Services website.