Tim Sohosky • January 8, 2026

ANCOR Shares Implementation Timeline: Access Rule and Budget Reconciliation Law

Author

Tim Sohosky

Date

January 8, 2026

Share

The HCBS Access Rule and the 2025 Budget Reconciliation Law made significant changes to how Medicaid-funded supports for people with intellectual and developmental disabilities (I/DD) are structured, delivered, reported, and financed. Implementation of major provisions of both the rule and the law began in 2025 and will continue to be phased in through the end of 2034. To help prepare for these new regulatory and statutory requirements, ANCOR developed this timeline summarizing the major provisions of both the rule and the law along with their respective implementation dates. Please contact Tim Sohosky for any follow-up or inquiries related to this update.

THIS IS PORTAL AUTHENTICATOR WIDGET. THIS WON'T BE VISIBLE ON PUBLISHED PAGE.
PA ODP logo with dark blue border
By Tim Sohosky May 29, 2026
On Thursday, May 28, the Office of Developmental Programs (ODP) provided an update to the Medical Assistance Advisory Committee (MAAC) regarding current policies and upcoming regulatory changes following a recent Commonwealth Court decision. On February 17, 2026, the PA Commonwealth Court issued a decision in Dunkelberger v. Department of Human Services that determined that ODP’s limitations on provider model services (specifically the 40/60-hour caps and 90-day travel maximums) were null and void. The decision was based on process rather than policy validity; the Court found that these limitations were not properly promulgated as regulations in accordance with the Commonwealth Documents Law and Regulatory Review Act. To maintain a balanced approach between flexibility and oversight, ODP is moving forward with the following actions: Regulatory Amendments: ODP will amend regulations to establish formal authority for setting service delivery limits that support individual welfare and program integrity. Self-Directed Model Agreements: ODP has already modified agreements for self-directed models to clarify limits on overtime, combined relative service provision, and travel restrictions. Travel Restrictions: Due to the inability to monitor services effectively over long distances, service provision will now be limited to Pennsylvania and contiguous states. Waiver Changes: ODP will seek modifications through the amendment process to the Consolidated, P/FDS, Community Living, and Adult Autism Waivers to include: New requirements for agencies providing IHCS and Companion services to disclose a DSP's relationship to participants; and Strengthened programmatic oversight and integrity measures. Life Sharing Alternative: For participants requiring more than 60 hours of paid care from a relative, the Life Sharing (24/7) service model remains the recommended alternative. ODP anticipates a public comment period for these proposed waiver changes beginning in January 2027.
Yellow screen with the words
By Cathy Barrick May 28, 2026
The Office of Developmental Programs (ODP) has shared ODPANN 26-039 . The purpose of this communication is to provide updated details about the Residential Performance-Based Contracting (PBC) Pay-for-Performance (P4P) initiatives for Fiscal Year 2026/27. Updates are provided in red . Please review the announcement for more details. Visit here to access the Pay for Performance (P4P): Residential Rural Capacity Expansion Plan template .