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Authors Posts by Fady Sahhar

Fady Sahhar

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Fady is responsible for policy and regulatory matters related to Physical Disabilities and Aging, with primary focus on personal assistance, employment services, and service coordination. Emphasis is placed on engaging the Office of Long-Term Living and the Community HealthChoices Managed Care Organizations, coordination of care with Behavioral HealthChoices MCOs, and collaborations with other advocacy and provider associations. Fady is also the President / CEO of ProVantaCare, an RCPA-affiliated company focused on contracting with MCOs, and is the President of XtraGlobex, a consulting firm focused on Value-Based Payment contracting. He brings extensive experience in the advocacy and operations of human services providers in physical disabilities and aging, from his role at Liberty Resources, Inc., and his service with a number of nonprofit services providers. He earned an MBA in Marketing from The University of Tennessee and a PhD in Organizational Leadership from Capella University.

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The Bureau of Human Services Licensing (BHSL) has received a small number of reports of issues with faxing the updated Documentation of Medical Evaluation (DME) forms. These reports indicate that some fax machines cannot pick up the contrast in the grey shaded areas. You will find both DME forms with the grey areas lightened significantly. These forms are also being added to the BHSL website.

Please note, BHSL has fax-tested both versions of these forms and did not encounter any issues. Issues with faxing may be related to the age/condition or settings of individual fax machines. Online faxing services that do not require the use of a fax machine are widely available, as are alternative methods of form transmission, such as in-person drop off, email, online drop boxes, or the United States Postal Service.

Questions about this communication may be sent electronically.

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On July 14, the National MLTSS Health Plan Association submitted comments on the “Preserving Medicaid Funding for Vulnerable Population – Closing a Health Care-Related Tax Loophole” proposed rule. Per the Association:

This rule proposes to refine how CMS evaluates whether a health care-related tax is considered “generally redistributive.”

In our comments, we noted that we appreciate CMS’ efforts to strengthen the oversight and quality of Medicaid programs but raised concerns about the timelines and administrative burden on states, as well as the potential impact on individuals receiving long term-services and supports (LTSS).

The recommendations included:

  • Extending the transition period to three years for all states.
  • Providing clear implementation guidance and technical assistance to states.
  • Postponing finalization of the rule until further research and data analysis on provider-related taxes and impacts are conducted.

Read the full letter here.

In Pennsylvania, this rule would impact participants’ funding of approximately $1B in federal matching funds for HealthChoices, Community HealthChoices, and Behavioral HealthChoices. No immediate action is required. If you have any questions, contact Fady Sahhar.

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The Pennsylvania Department of Human Services’ Office of Long-Term Living (OLTL) is offering a webinar on the PA Achieving a Better Life Experience (ABLE) Savings Program. A PA ABLE savings account gives individuals with qualified disabilities (Eligible Individuals) and their families and friends a tax-free way to save for a wide range of disability-related expenses while maintaining important benefits. The state and federal tax-free investment options are offered to encourage Eligible Individuals and their families to save private funds to support health, independence, and quality of life.

Some of the topics OLTL will discuss include eligibility requirements for opening a PA ABLE account; federal and state tax benefits of PA ABLE; and how a PA ABLE account interacts with current benefits.

OLTL Service Coordinators, Direct Service Providers, Community HealthChoices Managed Care Organization staff, and any individuals who work in employment supports are strongly encouraged to participate in this webinar, as it will help them understand the PA ABLE Program and how it can benefit the OLTL participants they serve.

Please register for the PA ABLE Savings Program webinar scheduled for July 23, 2025, from 12:00 pm – 1:00 pm using this registration link. After registering, you will receive a confirmation email containing information about joining the webinar.

If you require accommodations to participate in this webinar, please send them electronically.

If you have questions regarding this email, please contact Randy Loss at OLTL.

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Image by Werner Moser from Pixabay

The Office of Long-Term Living (OLTL) is sharing the message below from the Pennsylvania Department of Aging (PDA):

As part of Aging Our Way, PA, PDA is conducting an evaluation of the PA Link to inform the design of a strategic plan. The goal is to improve and redesign the program to better serve older adults, people with disabilities, and caregivers. The entire project was informed by extensive stakeholder engagement, including consultation of an advisory committee.

Please use the Public Comment Form to review the DRAFT Evaluation Report and DRAFT Recommendation report. You will then be able to upload your comments.

The public comment period will close on Monday, July 28, 2025, and all comments will be considered in the creation of the final strategic plan to refresh the PA Link.

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In a strategic move to tackle persistent healthcare workforce shortages, the Shapiro Administration has announced that Pennsylvania will officially implement the Physical Therapy Compact (PT Compact) and the Nurse Licensure Compact (NLC) starting July 7, 2025.

These compacts will allow licensed practical nurses (LPN), registered nurses (RN), and physical therapists (PT) who reside in Pennsylvania to obtain multi-state privileges, enabling them to practice across state lines in any member state. This expansion of licensure flexibility is expected to bolster provider mobility, support faster deployment of qualified professionals, and relieve staffing gaps, especially in underserved and rural communities.

By reducing regulatory barriers and enabling a more fluid workforce, these licensure compacts provide a critical tool for healthcare systems facing staffing crises, travel demands, and surging patient needs. It also opens new opportunities for Pennsylvania clinicians to access broader job markets without the need for duplicative licensure.

For healthcare providers and employers seeking relief from workforce shortages, the PT Compact and NLC represent a step toward a more agile and responsive healthcare system.

To learn more, visit the PT Compact website or the NLC information page. To read the full announcement from the Shapiro Administration, visit here.

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On July 2, the U.S. Department of Labor (DOL) took an important step to restore fairness and flexibility in the home care industry by issuing a proposed rule that would rescind restrictive provisions introduced in 2013 under the Obama administration. Those earlier changes, fully enforced in 2015, significantly narrowed the “companionship services” exemption under the Fair Labor Standards Act (FLSA), adding complex and costly wage requirements for home care agencies and Medicaid-funded services.

The 2013 rule redefined key terms, eliminated the exemption for third-party employers, and imposed overtime obligations on agency-employed direct care workers — contributing to increased costs and administrative burdens. These unintended consequences have strained both providers and public programs, particularly in Medicaid-funded home and community-based services (HCBS).

Now, DOL is proposing to correct course. In its justification, the Department noted that the previous regulations “might not reflect the best interpretation of the FLSA and might discourage essential companionship services by making these services more expensive.”

Why This Matters
This proposed rule is a welcome change for providers, participants, and state Medicaid leaders alike. Overtime costs are a major driver of financial pressure in long-term services and supports. When direct care workers live in the same home as the individuals they serve, current law allows participant-directed employers to avoid overtime pay. However, because of the 2013 changes, agency-employed workers doing the exact same job do not receive the same treatment — creating an inequitable and unsustainable two-tiered system.

If finalized, the proposed rule would allow third-party agency employers to once again access the same companionship exemption. This would create consistency across employer types and make it easier to recruit and retain direct care staff — particularly in shared living or live-in arrangements that are vital to participant independence and stability.

Act Now: Submit a Letter of Support
The DOL is accepting public comments on this proposed rule, and it is crucial that the provider community raise its voice. RCPA encourages home care agencies, managed care partners, and Medicaid stakeholders to submit letters of support highlighting how this change will:

  • Increase flexibility in service delivery;
  • Align federal and state wage policy;
  • Promote cost-effective care models;
  • Support direct care worker retention; and
  • Sustain vital programs that keep individuals in their homes.

Your voice matters. Together, we can ensure federal policy reflects the realities and needs of today’s home and community-based care system. View a sample letter for public comments here.

How to Submit Your Letter of Support
Visit the Regulations government website and search for the DOL proposed rule on companionship services. Comments must be submitted by July 31, 2025

If you have any questions, contact Fady Sahhar, RCPA PD&A Division Director.

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The Centers for Medicare & Medicaid Services (CMS) issued an alert about a fraud scheme that uses phishing fax requests, which falsely claim to be from CMS staff, to obtain medical records and documentation for auditing purposes.

CMS does not initiate audits by requesting medical records via fax, and if you receive a suspicious request, do not respond. If you have additional questions about this alert, please reach out to Karissa Bjorkgren of CMS via email.

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Photo by Hannah Skelly on Unsplash

There are more than 700,000 veterans in Pennsylvania, and over half of them are age 60 and older. Veterans may be eligible for a wide array of benefits from both the Pennsylvania Department of Military and Veterans Affairs (DMVA) and the U.S. Department of Veterans Affairs (USDVA or VA). One such benefit is a VA pension.

Unfortunately, there are unscrupulous people who are preying on veterans, particularly older veterans, to profit from the veteran’s desire to apply for the benefits they earned while defending our country and our freedoms.

The Pennsylvania Department of Military and Veterans Affairs (DMVA) wants you to know that free and safe assistance is available to help veterans and their beneficiaries apply for veteran benefits including VA pension.

You can access the Pension Poaching Toolkit, filled with educational materials for you and your community to print and post, or continue sharing electronically.

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