PA Commonwealth Court Invalidates DHS CHC Procurement
Home Policy Areas
State Lawmaker Highlights Bill That Would Fund Social Services During a Budget Impasse
CMS Releases FY 2027 IRF PPS Proposed Rule
The Centers for Medicare and Medicaid Services (CMS) has released the fiscal year (FY) 2027 inpatient rehabilitation facility prospective payment system (IRF PPS) proposed rule.
The proposed rule includes some technical proposals that would modify the IRF coverage and documentation requirements as well as IRF QRP submission deadlines. The proposed rule does not include any proposals to modify the existing IRF transfer policy. The proposed rule does, however, include several Requests for Information (RFI) that could indicate potential future impactful changes.
On the FY 2027 payment side, the rule would provide an overall 2.8% increase to estimated payments per discharge, compared to the 2.6% payment update that CMS finalized for FY 2026.
FY 2027 Payment Updates
- Aggregate Estimated Payment Increase: 2.8% / $355 million (field-wide)
- Market Basket Update (with Productivity Adjustment): 2.4%
- Labor-Related Share: 74.5%
- Standard Payment Conversion Factor: $19,881
- Outlier Threshold: $8,689 (from $10,141 in FY 2026)
FY 2027 Coverage, Payment, and Documentation Policy Changes
Initiation of Therapy Requirement
CMS proposes to clarify the requirement that therapy be initiated within 36 hours of midnight of the day of admission to the IRF.
Documenting Function in Preadmission Screen
CMS proposes to expand the elements required in the preadmission screening (PAS) to include “current functional status” as well as prior level of function.
Timing of Interdisciplinary Team Meeting
CMS proposes to tighten the requirement for the timing of the weekly interdisciplinary team meeting by requiring an initial interdisciplinary team meeting to occur “on or before the fourth day from midnight on the date the patient is admitted” and subsequent team meetings to occur “at least once per week after the date of the prior team meeting.”
Request for Information on Future IRF Payment Reform
The rule includes an extensive Request for Information (RFI) on future IRF payment reform, specifically two major areas of reform:
- Refining the current IRF patient classification system by creating a draft list of IRF-specific clinical categories; and
- Creating a new system of comorbidity scoring to better account for the severity and number of comorbidities for IRF patients.
The RFI does not propose any of these changes be implemented in FY 2027 but requests stakeholder feedback on both areas. CMS also references two new technical reports addressing their PPS changes under consideration; these are available for download as part of the rule’s associated data files here.
FY 2027 Quality Reporting Program Updates
Proposal to Revise Data Submission Deadlines for the IRF QRP
For the FY 2029 IRF QRP, which will be based upon Calendar Year 2027 data, CMS is proposing to reduce this timeline to the “15th day of the second month following the end of calendar quarter.”
The proposed rule will be published in the Federal Register on April 6, 2026. Comments on the proposed rule are due by June 1, 2026.
OMHSAS Issues Correction to Bulletin on Payment Regulations for Psychiatric Rehabilitation Services
The Office of Mental Health and Substance Abuse (OMHSAS) is issuing a correction to the OMHSAS-26-01 Payment for Psychiatric Rehabilitation Services bulletin that was originally issued on February 6, 2026.
This correction addresses a typo in the service description for Psychiatric Rehab Mobile – Group. The previous bulletin incorrectly listed the group size limit as two (2). The correct maximum group size is no more than five (5) individuals in alignment with the licensing standard in § 5230.54 (a)(2). This update corrects the group size limit to five in the service description for procedure code H0036.
Please refer to the updated version of the Payment for Psychiatric Rehabilitation Services.
If you have any questions, please contact OMHSAS for further clarification. Members may also direct questions to RCPA COO and Mental Health Policy Director Jim Sharp.
ODP To Hold FMSA Webinar for Individuals and Families May 29, 2026
In 2022, the Office of Developmental Programs (ODP) created the new waiver service Family Medical Support Assistance (FMSA). ODP is scheduling webinars to explain what this service entails, how it works, and who it applies to. ODP is encouraging individuals and families to attend this webinar to learn about this waiver service; there will be time during the webinar for questions to be asked directly to ODP.
Who should attend?
Individuals and Families
Date and Time:
Friday, May 29, 2026
10:00 am – 11:30 am
ODP encourages professionals to share this webinar broadly with the individuals and families they support.
Please note that this session is intended specifically for individuals and families. ODP is offering a sperate session for professionals.
A recording of the webinar will be made available on MyODP following the event.
ODP Issues Details on Residential P4P for FY 2026/27
The Office of Developmental Programs (ODP) has released Announcement 26-039 and its accompanying attachment, detailing the Pay-for-Performance (P4P) initiatives under Performance-Based Contracting (PBC) for the 2026/27 fiscal year. These initiatives provide supplemental payments to eligible residential providers who meet or exceed specific performance benchmarks.
Providers of Residential Habilitation, Life Sharing, and Supported Living services provided through the Consolidated and Community Living Waivers that are assigned to the Primary, Select, or Clinically Enhanced tiers are eligible to participate.
P4P Initiative Areas:
- Staff Credentialing: Focuses on stabilizing the workforce by incentivizing DSP and FLS credentialing.
- Criteria: Providers must have 25–30% of DSPs and 45–50% of FLSs credentialed by December 31, 2026.
- Payment: 0.3% of the prior calendar year’s residential revenue, paid in May 2027.
- Rural Capacity Expansion: Supports increasing service capacity in designated rural counties.
- Criteria: Development and approval of a Rural Capacity Expansion Plan with Administrative Entities (AE).
- Payment: Tiered milestone payments (Planning: $10,000; Implementation: $15,000; Stability: $25,000).
- Transition to Independent Living: Incentivizes moving individuals from licensed Residential Habilitation (4 or fewer people) to Life Sharing or Supported Living.
- Payment: Two payments of $15,000 (totaling $30,000 per individual) based on successful transition and six-month retention.
- Remote Supports: Allows providers to retain savings when utilizing remote supports while billing the daily fee schedule rate.
Important Deadlines:
- Credentialing Data Submission: February 15, 2027 – March 15, 2027.
- Rural Capacity Milestones: Submission deadlines vary by milestone (October 2026, January 2027, and April 2027).
Providers should review the detailed criteria in the ODP announcement attachment to ensure internal tracking systems are aligned with the required reporting metrics for 2026/27.
Questions can be directed via email.
ODP to Hold Appeal and Fair Hearing Webinar May 1, 2026
The Office of Developmental Programs (ODP) is anticipating the release of a new bulletin on the Appeal and Fair Hearing process. ODP is scheduling this webinar for individuals, families, and Supports Coordinators (SC). This webinar will explain the information that is included in the bulletin, the process of appealing a decision, and what a Fair Hearing is.
This webinar was developed for individuals and families, but we encourage SCs to attend so they understand the Appeal and Fair Hearing process. Supports Coordinators are responsible for understanding this process so they can assist their individuals and families when they have questions. There will be time throughout the webinar for individuals and families or SCs to ask questions directly to ODP staff about the topic.
Who should attend?
Individuals, Families, and Supports Coordinators
Date and Time:
Friday, May 1, 2026
11:00 am – 12:30 pm
ODP encourages professionals to share this webinar broadly with the individuals and families they support.
Please note that this session is intended specifically for individuals and families. We respectfully ask that professionals refrain from attending, as ODP’s goal is to communicate directly with and hear feedback from these audiences.
A recording of the webinar will be made available on MyODP following the event.
RCPA Member Keystone Human Services Announces Merger With Mikayla’s Voice
OLTL Releases Revision to Participant Review Tool
The Office of Long-Term Living (OLTL) released Bulletin 59-26-03, which updates the standardized Participant Review Tool (PRT) for Service Coordinators (SC). The bulletin provides additional clarification on the location of face-to-face visits with participants when completing the PRT. The bulletin also provides guidance to SCs on when increased face-to-face visits with program participants should be scheduled to protect their health, safety, and welfare.
This bulletin rescinds OLTL Bulletin 59-26-02 and any other OLTL policy documents or parts of policy documents that are inconsistent with this bulletin’s contents.
This bulletin applies to enrolled Service Coordination Entities (SCE) performing services in OLTL Medical Assistance Home and Community-Based Services (HCBS) for the OBRA waiver and the Act 150 Program.
Join RCPA’s Growing List of Sponsors, Exhibitors, and Advertisers for Our 2026 Conference!
RCPA is hosting our Annual Conference, Power in Purpose: Promoting Possibilities, at the Hershey Lodge from September 29 – October 2. This event will be a highlight for the Pennsylvania behavioral health, brain injury, children’s, early intervention, intellectual and developmental disabilities, medical rehabilitation, and physical disabilities and aging provider communities.
This year’s Sponsor, Exhibitor, and Advertiser Brochure features many opportunities to get in on the action and network with providers. Booth self-selection will also be available for exhibitors and exhibiting sponsors. In order to be considered for self-selection, a completed contract with payment must be submitted.
Exciting Sponsorship Opportunities
RCPA is privileged to have the backing of the finest organizations in the field for our conference. Through the use of sponsorship circles, RCPA is able to honor all supporting organizations.
Network and Compete in Connections Hall
Connections Hall activities take place during the two busiest days of the conference, and many networking opportunities are available throughout the event. You’ll also be able to compete and have a chance to win “Best of Show!”
Sign Up Now!
Sponsors, exhibitors, and advertisers who wish to be listed on the website, on the mobile app, and in the conference program must submit all materials by Tuesday, September 8. If questions remain, please contact Carol Ferenz, Conference Coordinator.
Visit Our List of Sponsors and Exhibitors!
RCPA thanks those that have committed their support to our 2026 Conference. You help make our conference an extraordinary, educational, and meaningful event for Pennsylvania’s provider communities!
