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Tags Posts tagged with "DHS"

DHS

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As the Pennsylvania Department of Human Services (DHS) prepares for the upcoming changes in the federal Medicaid standards set for implementation in January 2027, DHS has convened a statewide HR1 Steering Committee. This group is tasked with reviewing policy and practice drafts from the Department as it relates to their response to the pending Medicaid changes, including new eligibility and work requirements for recipients and communicating the implementation of Pennsylvania’s overall plan.

The steering committee is comprised of state leadership, advocates, and payers. RCPA providers will be represented by RCPA President and CEO Richard Edley. RCPA’s involvement will bolster our role as a lead advocate for members and stakeholders as it relates to Medicaid HR 1 activities. Additionally, RCPA has contracted with former Pennsylvania Medicaid Director Leesa Allen to assist in developing our internal strategies and advocacy platform.

The steering committee had its initial meeting yesterday, March 5, 2026, to lay out the groundwork for the group and presented an initial PowerPoint presentation that looks at some of the foundational information around Medicaid, CHIP, and SNAP changes.

If you have questions or feedback, please contact your respective RCPA Policy Director or COO Jim Sharp.

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Hole torn in a dollar bill with medicaid text

The U.S. House Energy and Commerce Committee recently sent a letter to Governor Josh Shapiro and DHS Secretary Valerie Arkoosh requesting information about fraud, waste, and abuse prevention in Pennsylvania’s Medicaid program. The request is part of a broader federal oversight effort examining Medicaid program integrity following recent fraud investigations in multiple states. Similar letters were also sent to officials in ME, NE, NY, OR, WA, VT, CO, CA, and MA.

The Committee is seeking details on Pennsylvania’s fraud prevention efforts, including audits, provider screening processes, improper payment recovery, enforcement actions, and oversight of Medicaid programs, such as Home and Community-Based Services.

The letter references several recent Medicaid fraud prosecutions in Pennsylvania. However, it also highlights that Pennsylvania’s Medicaid Fraud Control Section charged more fraud cases than any other state in FY 2024 and ranked third nationally in criminal convictions. The fact that these cases were identified and prosecuted demonstrates that Pennsylvania’s fraud, waste, and abuse prevention systems are actively working to detect and address wrongdoing.

RCPA recognizes that this new federal focus on Medicaid program integrity may intersect with our ongoing advocacy to eliminate the requirement for signed encounter forms in Medicaid-funded services. RCPA has long maintained that the current requirement is administratively burdensome and does not meaningfully strengthen program integrity compared to other documentation and verification mechanisms already in place. While our advocacy continues, increased federal scrutiny around fraud prevention may influence how state and federal policymakers evaluate documentation and verification requirements moving forward.

The Pennsylvania Department of Human Services must submit responses to the Committee by March 17, 2026. RCPA will continue to monitor developments and provide updates as appropriate.

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Over the past few months, there have been important changes to SNAP that may affect Pennsylvanians’ eligibility for the program.

To help SNAP recipients and those who work with them understand what’s new, the PA Department of Human Services (DHS) has posted a new video to their YouTube channel. The video explains changes to SNAP over the past six months, including who is subject to new work and reporting requirements, how to meet those requirements, and tools that are available to help Pennsylvanians meet the requirements.

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On February 28, 2026, the Department of Human Services (DHS) Office of Long-Term Living (OLTL) published a notice in the Pennsylvania Bulletin announcing a change in the fee schedule rates in the OBRA Waiver and the Act 150 Program for Participant-Directed Personal Assistance Services (PAS) procedure codes W1792 and W1792 TU. This fee schedule rate change is effective January 1, 2026. A revised fee schedule is available here.

Written comments regarding these fee schedule rates can be sent to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be submitted via email. Comments received within the 30-day comment period will be considered in subsequent revisions to the fee schedule.

OLTL previously issued a listserv on December 19, 2025, confirming the Fiscal Year 2025/26 budget, signed into law on November 12, 2025, which included a $21 million investment to strengthen the workforce through increased wages for direct care workers (DCW) providing services in the Participant-Directed model for OLTL Fee-for-Service programs.

To support the January 1, 2026, effective date, OLTL updated the PROMISe™ system and the Home and Community Services Information System (HCSIS) with the revised rates. Service Coordinators (SC) did not need to make any service plan updates for the rate change, as a HCSIS system-wide update was implemented to make the necessary service data rate updates to the affected service plans.

SCs are encouraged to reach out to OBRA Waiver and Act 150 Program participants that utilize Participant-Directed PAS to ensure they are aware of the rate change and that their DCWs may receive increases in their pay rates.

SCs may also receive specific questions from OBRA Waiver and Act 150 Program participants that utilize Participant-Directed PAS supported by Financial Management Services (FMS) through the FMS vendor Public Partnerships, LLC (PPL). SCs should refer participants to the PPL Customer Service hotline at 877-908-1750 for specific questions about how the rate increase in the OBRA Waiver and Act 150 Program will impact the pay of their DCWs.

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Message from the PA Department of Human Services (DHS):

Under the current federal administration, the U.S. Department of Homeland Security (U.S. DHS) has lifted restrictions that previously prohibited Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) officers from carrying out immigration enforcement actions, including arrests, in protected areas such as medical and behavioral health care facilities and social services establishments. It is now possible that U.S. DHS may attempt to conduct immigration enforcement activities in these settings.

The Pennsylvania Department of Human Services, along with the departments of Aging, Drug and Alcohol Programs, and Health, has prepared a non-regulatory advisory to provide general information about federal law applicable to immigration enforcement activities at health care and social services facilities. We also advise facility leadership and counsel to develop a written policy and standard operating procedures for what to do if immigration enforcement agents arrive on facility property or seek information about individuals you serve for immigration enforcement reasons.

In developing these policies and procedures, the Pennsylvania Department of Human Services advises that you consider:

  • Designating legal and administrative point person(s) by name and phone number who will interact with immigration agents and review legal documents;
  • Planning for how your facility will respond to requests for information, requests to enter non-public spaces to conduct an arrest, and immigration enforcement activity in public spaces;
  • Engaging in advance with stakeholders and necessary resources; and
  • Minimizing disruption to individuals served.

This advisory does not provide legal advice. Consult a licensed attorney or accredited representative for legal questions about a specific situation.

Thank you for your service to Pennsylvania.

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