ANCOR Issues Response to Robert F. Kennedy, Jr.’s Concerning Remarks About HCBS
Medicaid
ODP Shares Important Reminder on Maintaining and Verifying Medicaid Eligibility
The Office of Developmental Programs (ODP) has shared a reminder of the importance of supporting individuals in maintaining their eligibility for Medicaid and in verifying an individual’s eligibility for Medicaid prior to delivering services.
Each month, the Office of Developmental Programs (ODP) generates an “MA Reapplications Due Soon” report for each Administrative Entity (AE) and Supports Coordination Organization (SCO). The report is uploaded to the internet version of DocuShare and can be found using the following path:
AEs: ODP –> Division of Program Analysis –> Select Region Folder –> Select County/Joinder Folder –> County Dashboards
Intellectual Disability/Autism (ID/A) SCOs: ODP –> Division of Program Analysis –> ID/A Supports Coordination Organization –> Select Region Folder –> Select the ID/A SCO
Adult Autism Waiver (AAW) SCOs: ODP’s Bureau of Supports for Autism and Special Populations (BSASP) sends each SCO a monthly report of impacted individuals they serve for follow-up. Please note that AAW SCOs who are serving individuals whose MA is not coming due within the next four months will not receive a monthly report.
Please view ODPANN 25-097 for additional details and information.
Attachments:
RCPA to Host Virtual H.R. 1 Medicaid Summit on May 11
On Monday, May 11, 2026, RCPA will be hosting a virtual H.R. 1 Medicaid Summit for all members, non-members, and stakeholders from 9:00 am – 10:00 am. This summit will feature guest panelists who will provide Federal and State updates on the implementation and impacts of the pending Medicaid changes. We will also explore the role of providers, advocates, and stakeholders in the process to ensure access and care for vulnerable Pennsylvanians. Register for the summit here.
As part of the event, we will have a Q&A segment. If you have any questions you would like to ask during the Q&A segment, or if you have any general questions regarding the virtual summit, please forward them to RCPA Behavioral Health Policy Associate Emma Sharp.
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RCPA Shares Updates on DHS H.R. 1 Committee, Eligibility, and SNAP Requirements
National Council Shares White Paper and Recommendations on HR1 Work Requirements
CMS Issues Guidance on Medicaid Eligibility Determinations
DHS HR 1 Medicaid Steering Committee Update
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.
Federal Committee Requests Information From PA on Medicaid Program Integrity
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.
CMS Delays Enforcement of Grievance System Requirements of Access Rule
