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Legislation

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Message from Rep. Dan Williams’s Office:

HARRISBURG, June 24 – Bipartisan legislation introduced by state Rep. Dan Williams, D-Chester, that would help Pennsylvanians take advantage of new federal Medicaid rules that give patients and clinicians more telehealth options for behavioral health services passed the PA House today with overwhelming support.

“The longstanding and outdated ‘four walls’ requirement has limited Medicaid reimbursement to services within the physical walls of a clinic,” said Williams. “This only creates barriers to care, particularly in rural areas and regions experiencing mental health workforce shortages.”

The Centers for Medicare and Medicaid Services gave states the option to waive the requirement on Jan. 1. In response, the Pennsylvania Department of Human Services has submitted a State Plan Amendment to adopt this flexibility, which is currently awaiting federal approval.

House Bill 1590 would repeal state regulations that conflict with the new federal flexibility. Importantly, the bill would not change existing rules requiring in-person treatment hours for outpatient behavioral health clinics.

“Under this bill, Pennsylvania can fully implement the change, expanding access to behavioral health services and reducing care gaps for our vulnerable populations across the Commonwealth,” Williams said.

The bill now moves to the state Senate for consideration.

It is important to note that, at this time, OMHSAS is awaiting approval from CMS. To address the Federal Medicaid payment conditions in the Pennsylvania statute, there was a need for this legislation to permit services be covered under Medicaid, and HB 1590 would achieve this. It is also important to reiterate that this bill will not change outpatient behavioral health clinic rules requiring in-person treatment hours. The passage of this bill will address these conditions for outpatient clinics as well as the delivery of SUD services.

Both the CMS SPA approval and the legislation would be retroactive to January 1, 2025.

Until then, the completion of both the SPA and the legislation on 4 walls flexibilities will remain in place. RCPA is grateful to have partnered with OMHSAS, House legislators, and other stakeholder associations on the development of this bill. We will continue our efforts in getting the legislation to the Governor’s desk.

If you have any questions, please contact RCPA COO and Director of Mental Health Services Jim Sharp.

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Message from Rep. Dan Williams’s Office:

HARRISBURG, June 24 – Bipartisan legislation introduced by state Rep. Dan Williams, D-Chester, that would help Pennsylvanians take advantage of new federal Medicaid rules that give patients and clinicians more telehealth options for behavioral health services passed the PA House today with overwhelming support.

“The longstanding and outdated ‘four walls’ requirement has limited Medicaid reimbursement to services within the physical walls of a clinic,” said Williams. “This only creates barriers to care, particularly in rural areas and regions experiencing mental health workforce shortages.”

The Centers for Medicare and Medicaid Services gave states the option to waive the requirement on Jan. 1. In response, the Pennsylvania Department of Human Services has submitted a State Plan Amendment to adopt this flexibility, which is currently awaiting federal approval.

House Bill 1590 would repeal state regulations that conflict with the new federal flexibility. Importantly, the bill would not change existing rules requiring in-person treatment hours for outpatient behavioral health clinics.

“Under this bill, Pennsylvania can fully implement the change, expanding access to behavioral health services and reducing care gaps for our vulnerable populations across the Commonwealth,” Williams said.

The bill now moves to the state Senate for consideration.

It is important to note that, at this time, OMHSAS is awaiting approval from CMS. To address the Federal Medicaid payment conditions in the Pennsylvania statute, there was a need for this legislation to permit services be covered under Medicaid, and HB 1590 would achieve this. It is also important to reiterate that this bill will not change outpatient behavioral health clinic rules requiring in-person treatment hours. The passage of this bill will address these conditions for outpatient clinics as well as the delivery of SUD services.

Both the CMS SPA approval and the legislation would be retroactive to January 1, 2025.

Until then, the completion of both the SPA and the legislation on 4 walls flexibilities will remain in place. RCPA is grateful to have partnered with OMHSAS, House legislators, and other stakeholder associations on the development of this bill. We will continue our efforts in getting the legislation to the Governor’s desk.

If you have any questions, please contact RCPA COO and Director of Mental Health Services Jim Sharp.

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Senator Carolyn Comitta and Senator Lindsey Williams shared the following message with all Senate members. You may want to contact your local legislator requesting their support.

Posted: January 6, 2025, 12:56 pm
From: Senator Carolyn T. Comitta and Sen. Lindsey M. Williams
To: All Senate members
Subject: ID/A Market Index for DSP Services

Making our government more efficient and effective often means innovating ways to more closely align bureaucratic processes with best practice solutions. Pennsylvania’s method of compensating our invaluable Direct Support Professionals (DSPs) is one such opportunity. Over 55,000 Pennsylvanians with intellectual disabilities and autism need some assistance during the day to reach their highest level of independence and opportunity. These people and their families rely upon our committed DSPs to support some of the most personal tasks and make sure they live safely while engaging in the community. Often, our DSPs become like family to their clients.

Sadly, if you looked at the pay DSPs receive in Pennsylvania you would not know how critical they are to those who need their services. Despite best efforts, too many great staff leave the profession due to necessity in order to support themselves and their families. This often leads to a very high staff turnover rate even amongst our best providers, which has a negative effect on their clients.

Regulation requires a three-year refresh of market-based data in order to adopt a fee schedule, but there is no requirement for Pennsylvania to change rates at all – no matter what happens to inflation. Under this process, rates are already a year behind by the time they become effective. Last year’s rate increase was 3-4% below actual inflation, without any guarantee of correction for at least 3 years. For many providers, annual increases to health insurance, worker’s compensation, liability and other factors far exceed the available funds.

To help stabilize this workforce and provide better care for individuals with intellectual disabilities and autism, Senator Lindsey Williams and I will soon introduce legislation to amend the Human Services Code requiring that rates annually be set based on a national market consumer index. The adoption of a nationally recognized market index will help provide stability to this system and also support the hard-working DSPs that are essential to the delivery of services for Pennsylvanians with intellectual disabilities and autism. This legislation was SB684 and a companion to Rep. Miller’s HB661 in the 2023-24 session.

We hope you will join us in cosponsoring this important legislation.

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