Office of Medical Assistance Programs

Our Mission and Goals:

Service - We will provide responsive, timely, and quality service to consumers and stakeholders (families, providers, advocates, employees and business partners).

Partnership - We will recognize the needs of consumers and stakeholders through the use of open and public input and feedback processes.

Stewardship - We will be prudent and efficient in our use of public resources. Innovation - We will seek and adopt creative solutions to improve performance.

Respect - We will value different perspectives, and appreciate the contributions of all consumers, stakeholders and employees.

Goals

  • Continued innovation of our operations to maintain customer service focus, promote efficiencies and leverage information technology.
  • Continued exploration of cutting edge solutions to improve quality, outcomes and access for our customers and increase cost-effectiveness and value in our health care delivery system.
  • Continued work with other agencies to improve and promote transformational changes in the delivery of health care services.

Apply for Benefits ButtonThe Office of Medical Assistance Programs administers the joint state/federal Medical Assistance (also known as Medicaid) program that purchases health care for Pennsylvania residents.

Local County Assistance Offices determine eligibility for Medical Assistance.

Medical Assistance purchases services through contracts with managed-care organizations and under an indemnity, or traditional, fee-for-service system. Facility based services are reimbursed under case-mix for long-term care for the elderly, while other facilities are paid on a prospective, or cost, basis. A medical provider is required to enroll in the program and must meet applicable national, federal and state licensing and credential requirements.

The Office of Medical Assistance Programs is also responsible for enrolling providers, processing provider claims, establishing rates and fees, contracting and monitoring of managed care organizations, and detecting and deterring provider and recipient fraud and abuse.

We will recognize the needs of consumers and stakeholders through the use of open and public input and feedback processes. We will be prudent and efficient in our use of public resources. We will seek and adopt creative solutions to improve performance. We will value different perspectives, and appreciate the contributions of all consumers, stakeholders and employees.

Learn about the Medical Assistance Advisory Committees

Please use the links in the "Related Topics" sidebar to view information about our individual bureaus.