Pennsylvania Insurance Department policy updates
Track new and updated Pennsylvania Insurance Department policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| OLTL Home and Community Based Waiver Services — Fee Schedule (Rates Effective July 1, 2026) | Pennsylvania Insurance Department | Reimbursement | — | Modified | Jul 1, 2026 |
| Summary of Public Comments Received and ODP Responses Regarding the Proposed Fee Schedule Rates for Supports Coordination and Targeted Support Management Services | Pennsylvania Insurance Department | Reimbursement | — | Modified | Jul 1, 2026 |
| Prior Authorization of Sickle Cell Anemia Agents - Pharmacy Services | Pennsylvania Insurance Department | Clinical | Pharmacy & Specialty Drugs | Modified | Mar 30, 2026 |
| PDA Caregiver Support Program — Reimbursement Percentage Guide (Appendix F.2) | Pennsylvania Insurance Department | Reimbursement | — | Modified | Jan 16, 2026 |
| Health Information Exchange Trust Community Committee (HIETCC) Participation Policy | Pennsylvania Insurance Department | Administrative | — | Modified | Jan 1, 2026 |
| P3N Auditing Policy | Pennsylvania Insurance Department | Administrative | — | Modified | Jan 1, 2026 |
| P3N Policy #3 Certification Policy and Process | Pennsylvania Insurance Department | Administrative | — | Modified | Jan 1, 2026 |
| P3N Policy #2 Documentation Change Management | Pennsylvania Insurance Department | Administrative | — | Modified | Jan 1, 2026 |
| P3N Privacy Policy (PA eHealth Partnership Program) | Pennsylvania Insurance Department | Administrative | — | Modified | Jan 1, 2026 |
| P3N Reporting Policy | Pennsylvania Insurance Department | Administrative | — | Modified | Jan 1, 2026 |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.