Highmark Wholecare providers are contractually required to participate/adhere to Highmark Wholecare Quality Improvement (QI) Programs, including, but not limited to, complying with the regulations found in Title 28, Chapter 27, §27.21a “Reporting of cases by health care practitioners and health care facilities” of the Pennsylvania Code.

Providers are informed of these requirements through the agreement to participate, the Highmark Wholecare Provider Policy and Procedure Manual, Provider Newsletter, Highmark Wholecare website, and direct provider notices. The regulations which include the list of reportable conditions, can be found at the Pennsylvania Code website, www.pacode.com, or directly at  http://www.pacode.com/secure/data/028/chapter27/s27.21a.html

Highmark Wholecare is required by the State to ensure providers are compliant to report any case of a qualifying disease, infection or condition within the required timeframe as specified in the PA Code.