Withdraw From 17 Voluntary Counties Serving the Medicaid Population on September 30, 2010
IMPORTANT NOTICE
July 8, 2010
Dear Provider:
Gateway Health Plan® has made the difficult decision to no longer provide healthcare coverage as of October 1, 2010 for Medicaid recipients who reside in the following 17 Voluntary Counties.
- Cambria
- Carbon
- Clarion
- Columbia
- Franklin
- Jefferson
- Lackawanna
- Luzerne
- Mercer
- Monroe
- Montour
- Northumberland
- Pike
- Schuylkill
- Somerset
- Susquehanna
- Wyoming
Both Blair and Erie counties will remain part of the Gateway’s Voluntary County service area. In addition, Gateway will continue to provide benefits to Medicaid recipients in all of the following 22 HealthChoices Counties.
- Adams
- Allegheny
- Armstrong
- Beaver
- Berks
- Blair
- Butler
- Cumberland
- Dauphin
- Erie
- Fayette
- Greene
- Indiana
- Lancaster
- Lawrence
- Lebanon
- Lehigh
- Northampton
- Perry
- Washington
- Westmoreland
- York
Also, please be aware that this change WILL HAVE NO EFFECT on Gateway Health Plan Medicare Assured® HMO SNP members residing in the Voluntary Counties or other counties currently in the service area. Gateway Health Plan Medicare Assured® HMO SNP, a Special Needs Plan for those eligible for both Medicare and Medical Assistance, WILL continue to provide coverage for dual eligibles in the following 27 Counties:
- Adams
- Allegheny
- Armstrong
- Beaver
- Berks
- Blair
- Butler
- Cambria
- Cumberland
- Dauphin
- Erie
- Fayette
- Indiana
- Lackawanna
- Lancaster
- Lawrence
- Lebanon
- Lehigh
- Mercer
- Northampton
- Northumberland
- Perry
- Schuylkill
- Somerset
- Washington
- Westmoreland
- York
Affected Gateway Medicaid members will receive notification regarding this change in their healthcare coverage and instructions on how to enroll with a new MCO or ACCESS Plus. If your patients have questions, please direct them to call the Enrollment Services line to enroll in another plan or ACCESS Plus. The toll free number is 1-800-440-3989 (TTY 1-800-618-4225).
If you have a current Gateway patient involved in an active course of treatment for chronic or acute medical conditions or is pregnant, treatment may continue under the member’s new health care plan during the transition period. Contact Gateway’s Utilization Management Department by calling 1-800-392-1146 for information.
We value you as a Gateway Health Plan® network provider. Since you are credentialed and have an ongoing contract, you will be reimbursed according to your contract for approved services for any Gateway Health Plan® member you see in the future. Primary Care Physicians will be reimbursed on a Fee-For-Service basis for approved services.
If you have any questions, please contact Gateway’s Provider Services Department at 1-800-392-1145 between 8:30am and 4:30pm. You may also contact your Provider Relations Representative directly.
Thank you for your years of support of Gateway Health Plan® and its mission.
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