Cathy Barrick • April 17, 2026

ODP Shares Important Reminder on Maintaining and Verifying Medicaid Eligibility

Author

Cathy Barrick

Date

April 17, 2026

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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:

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 .