HR Committee: August 13 Meeting Follow-Up
Medicaid
ADvancing States Shares Findings From National Survey of Adult Protective Services
RCPA Announces New Keynote Speaker for the 2025 Conference Strive to Thrive!
With a little less than a month before kick-off, RCPA is excited to announce a new keynote speaker in our lineup at the 2025 Annual Conference Strive to Thrive! We will now be kicking off our conference with Al Guida, JD, Owner of Guide Consulting Services, Inc., to discuss Impacts of Federal Issues on the Human Services System. Guida is a nationally recognized advocate and strategist who has provided valuable federal policy and regulatory solutions for Guide Consulting Service’s health care clients in the provider, technology, and public health sectors. He has helped clients realize measurable goals in mental health parity, biomedical research, child poverty, and child welfare, and his legislative portfolio includes successful collaborations with major Congressional committees, the Department of Veterans Affairs, and the Department of Health and Human Services. Working together, the Guide Consulting Services team have established and secured funding for Mental Health First Aid, Certified Community Behavioral Health Clinics, and the 988 National Suicide Prevention Coordinating Office. In 2024, Guida was recognized as one of DC’s 500 Most Influential People.
With the current confusion and chaos surrounding federal policies, Medicaid, future funding, and their effects on the health and human services landscape, you won’t want to miss this informative opener!
Following Al Guida will be Pennsylvania’s DHS Secretary Val Arkoosh. Attendees will shift their focus from the federal level to the state, with the DHS Secretary highlighting key issues facing PA providers, including trends, impacts of federal policy at the local level, and current initiatives related to Performance-Based Contracting and value-based purchasing.
All this and more on the very first day of the Conference! Register today to reserve your seat, and view the Registration Brochure for complete details regarding our schedule, booking a hotel room, and more!
OMAP Deputy Secretary Kozak Recognized for Excellence in Medicaid Leadership
Pennsylvania’s Office of Medical Assistance Programs (OMAP) Deputy Secretary Sally Kozak has been featured in the Center for Health Care Strategies’ Lessons in Leadership series, which shares stories from public sector leaders from across the country. Deputy Secretary Kozak shares how she has prioritized mentorship in her career to ensure sustainability beyond any one person and offers a blueprint for how intentional, adaptive mentoring can create lasting change for individuals and the institutions they serve.
Read the full article here.
Join RCPA at Our 2025 Annual Conference and Stay Up-to-Date on Federal and State Policy
The field of health and human services is shifting at a rapid pace, and it is vital for providers, advocates, and legal experts to remain up-to-date on policy as well as involved in the advocacy process. Among the over sixty workshops available, the RCPA 2025 Annual Conference Strive to Thrive will be holding several workshops tackling the federal landscape. Register today and join us at the Hershey Lodge September 9 – 12, 2025, to gain access to these informative workshops, which include:
- National Outlook: The Turbulent Landscape of 2025/26
- How To Survive a Payer Billing Audit — Straight From an Auditor’s Mouth
- Expanding Revenue Beyond Medicaid: New Funding Strategies for I/DD Providers
- Building Sustainable Community Advisory Councils for Impactful Legislative Advocacy
At a local level, the RCPA Conference is working with the Department of Human Services to bring information straight to attendees, with workshops such as:
- State of the State
- Office of Developmental Programs Policy Updates and Forecast for 2026
- PA Navigate: Connecting Pennsylvanians to Needed Social Services
- Updates and Discussion With the Office of Long-Term Living
- Behavioral Health Treatment in Pennsylvania: Where We Are, Where We Are Going
Early bird registration rates end this Friday, August 8, so don’t delay in reserving your spot for these workshops and more! View our Registration Brochure for complete details of the conference schedule and speakers, and be sure to check the RCPA Conference website regularly for details and updates to the schedule, registration, and sponsors/exhibitors. Register today!
Opportunities for sponsorships and advertising are still available, but EXHIBIT BOOTHS ARE OFFICIALLY SOLD OUT! We are grateful to all our sponsors and exhibitors who help make the conference happen. If your organization is interested in sponsoring or advertising at our conference, all information is available in our Sponsor, Exhibit, and Advertise Brochure. Contact Carol Ferenz, Conference Coordinator, for more details.
Thank you to our Sponsors and Exhibitors! We are grateful for your support!
HB 1590 “4 Walls” Telehealth Legislation Passes House
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.
Rep. Dan Miller to Host Virtual Lunch & Learn Series on Changes to Medicaid and SNAP
Join Representative Dan Miller for a series of Virtual Lunch & Learn Sessions to see what the upcoming changes to Medicaid and SNAP may look like. Experts and advocates from Just Harvest, J Badger Consulting, Pennsylvania Health Action Network, Pennsylvania Health Law Project, St. Clair Health, and more will be on hand to help lead the discussion! Hear from experts and advocates how recent federal changes are likely to impact access and create challenges for the people who rely upon the generational promises they represent.
Visit here for more information.
National MLTSS Health Plan Association Submits Comments on Provider Taxes Proposed Rule
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.
RCPA Shares Update on Medicaid and the “One Big Beautiful Bill”
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:
- For a summary of the entirety of the Big Beautiful Bill, view the Comprehensive Holland and Knight Analysis.
- For a complete timeline, impacts on enrollees, providers, and the State, visit here.
Federal Medicaid Advocacy Opportunity From the National Council
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