Hi Chris:

I'm in Pennsylvania (Elkins Park-Montgomery County).
The FI's for PA are:

Part A: Veritus Medicare (Pittsburgh) - www.veritusmedicare.com

Part B: HGSAdministrators (Harrisburg) -
www.hgsa.com

Yes, the manuals do differ from state to state. This due to Local Medical Review Policy, Demographic specific information, state (healthcare) legislation, direct provider involvement in health issues, and the medical societies.

Thus, the FI information for each carrier has a general basis for information which is the Centers for Medicare and Medicaid Services.

The Pennsylvania Office of Medical Asistance administers Pennsylvania's MA program. Also, you will find Managed Medicaid information on this site.

www.dpw.state.pa.us/omap/...romise.asp

Just an FYI: 90% of Pennsylvania's Medicaid population is enrolled in Managed Care programs contracted to commercial managed care plans.

You can find specific information about the Mediciad Managed Care plans on the payor's website. For example the following companies contract with the state to administer their MA programs:

Keystone Mercy www.keystonemercy.com

Health Partners www.healthpart.com

AmeriChoice (owned by UnitedHealth Group) www.americhoice.com

I hope this information was helpful. If you need anymore help, just let me know.

Viola