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Member Redetermination Data Available

As you may know, effective April 1, 2023, the Pennsylvania Department of Human Services (DHS) returned to pre-pandemic renewal processing procedures for Medical Assistance and CHIP. All Medical Assistance and CHIP recipients need to complete an annual renewal to determine if they are still eligible for coverage. Renewals will be completed over 12 months. Individuals who don’t complete the renewal process will lose their coverage.

To assist you with ensuring your patients complete their renewals timely, we have added a new data element to our member roster to identify the redetermination date (if available) for your assigned Medicaid and CHIP patients. The redetermination date may not be available for all patients. We have also added a column that lists the assessed risk of a member losing eligibility. A "High" highlights those members who are at a higher risk of losing their eligibility and should have priority focus as you outreach to members to assist them in their recertification process

To access your patient roster, sign in to your HP Connect portal account at HPPlans.com/providerportal. From the Office Management dropdown, select “Document Manager” and search keyword “member roster” in the Name search field.

As a reminder, additional information about this important change can be found at HPPlans.com/Renewals. We continue to encourage providers and staff to inform your patients to update their contact information with DHS so they can receive important updates on their benefits and obtain their renewal as quickly as possible. They can make sure their information is up to date and report any changes through:

More information is also available at https://www.dhs.pa.gov/PHE/Pages/Stakeholder-Resources.aspx.