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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 Office of Developmental Programs (ODP) has shared ODPANN 25-071. This announcement states that registration for the September – December 2025 Certified Investigator (CI) Initial Certification Course classes (also known as cohorts) is now open on the MyODP website. Please view the announcement for details and to register for the course.

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The Office of Developmental Programs (ODP) is proud to partner with the Office of Long-Term Living (OLTL), the Office of Mental Health and Substance Abuse Services (OMHSAS), and the Office of Medical Assistance Programs (OMAP) to announce the launch of the DHS Choking Prevention web page, a dedicated online resource hub aimed at preventing choking events among all Pennsylvanians. This new platform provides all interested stakeholders with a myriad of practical tools and educational materials to promote safer mealtime environments as well as how to recognize and respond to the potential safety risks for someone who has swallowing issues. This new website is a crucial step in ODP’s continued efforts to ensure safety, dignity, and health for individuals with intellectual disability and autism.

The DHS Choking Prevention web page is now available. ODP encourages all interested stakeholders to visit the site and access the available resources to implement into daily use as needed. Questions about this communication should be directed to your ODP Regional Office.

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Christopher Boyle has been named President and CEO of Children’s Service Center of Wyoming Valley, effective July 1. He succeeds Mike Hopkins who led the organization since 2008. The two leaders have worked closely over 17 years, facilitating unprecedented growth to now serve 15,000 people of all ages annually. Boyle previously served as Chief Operating Officer overseeing mental health and primary care operations, and as Chief Human Resources Officer since 2008. Prior to CSC, Boyle worked in progressive leadership roles in human resources and financial management at American Asphalt and Pride Mobility Products Corporation. He graduated from Delaware Valley College with a bachelor’s degree in business administration and a focus in accounting.

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The Office of Developmental Programs (ODP) has shared ODPANN 25-069. This communication announces:

  • A direct path to annual training requirements for IM and protective services for Providers and Supports Coordination Organizations (SCO) as outlined in the Chapter 6100 Regulations.
  • A new condensed IM training module that meets 6100.143 (c) (4) requirements.

The module can be found on MyODP by navigating to the “topics” tab and clicking on “Incident and Risk Management” in the dropdown, then clicking on Incident Management Annual training as pictured below OR by this link.

Please view the announcement for additional information and details.

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The passage of the “One Big Beautiful Bill Act” has made significant changes to Medicaid, the Children’s Health Insurance Program, and Medicare, with strict requirements to maintain Federal support and criteria to qualify and maintain enrollment in Federal healthcare programs. There are several key provisions that will result in hundreds of thousands of Pennsylvanians losing access to healthcare:

  • “Community Engagement” Requirements which will require able-bodied adults to study, work, or volunteer for a minimum of 80 hours per month for expansion enrollees aged 19 – 64.
    • There are exceptions to these work requirements for people who are: enrolled in Medicare; incarcerated (and for 90 days following incarceration); pregnant or receiving postpartum coverage; Urban and California Indians; are caretakers of dependents under the age of 14; veterans with a total disability rating; are “medically frail”; participate in SNAP and are not exempt from its work requirements; or who have a substance use disorder or a disabling mental disorder (though neither of those exemptions are clearly defined). In addition, individuals who are participating in a drug or alcohol treatment and rehabilitation program (as defined in section 3(h) of the Food and Nutrition Act [FNA] of 2008) are exempt. However, FNA defines drug addiction or alcoholic treatment and rehabilitation programs as “any such program conducted by a private nonprofit organization or institution.” With no clear guidance at this point on how an individual is determined to qualify as having an SUD, the definition of drug addiction or alcoholic treatment and rehabilitation program could be an issue for for-profit providers.
    • States may request an exemption for 2027 and 2028 if they show a “good faith” effort to implement the program.
  • Limits to certain non-citizen access to federal health services, which will prevent certain individuals from enrolling in or receiving Medicaid or CHIP benefits. Medicaid will no longer be available to refugees, asylees, victims of trafficking, or other people under temporary protected status, with certain exceptions.
  • Eligibility redeterminations must be made every six months for Expansion enrollees. Individuals who are exempt from the community engagement requirements are also exempt from the bi-annual eligibility redeterminations.

Additional Resources:

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