Medicaid providers cannot charge patients for PPE

PPE is a supply and part of the provider’s overhead and cost of doing business

The Department of Human Services advised Medicaid providers that Medicaid recipients may not be charged for Personal Protective Equipment used in connection with medical or dental services.

“While we are moving in the right direction in managing the COVID-19 public health crisis, people still need to be able to access health care coverage to protect themselves and their family,” said DHS Secretary Teresa Miller. “No one should go without seeking health care because they cannot afford an extra charge. That’s why we are reminding providers of their responsibility in continuing to provide access to health care, and that they are prohibited from seeking or receiving any additional payments for PPE they may use.”

While not a widespread issue, DHS has heard that a small number of providers were considering billing patients for PPE used during care. DHS has determined that PPE is a supply and is part of the provider’s overhead and cost of doing business. Providers cannot charge Medicaid beneficiaries for any PPE that is used in connection with a Medicaid-covered medical or dental service. More information for providers can be found here.

Medicaid and CHIP enroll individuals through the year and do not have a limited or special enrollment time, so people needing health coverage can apply for these programs at any time. There are income limits for Medicaid, but all children qualify for coverage through CHIP.

To apply for Medicaid or CHIP, visit compass.state.pa.us or, if preferred, paper documentation can be mailed to their local County Assistance Office or left in a CAO’s secure drop box, if available. While CAOs remain closed, work processing applications, determining eligibility, and issuing benefits continues.