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    Medicaid Waivers

    2026 OBRA Waiver Amendment

    Effective July 1, 2026

    The Department of Human Services (DHS) Office of Long-Term Living (OLTL) will be submitting a renewal for the OBRA home and community-based services waiver with an effective date of July 1, 2026. The Department proposes the following substantive and technical changes to the OBRA waiver:

    • Add a teleservice option to the following waiver services:
      • Behavior Therapy
      • Benefits Counseling
    • Revise outdated language regarding the OLTL quality improvement strategy and quality monitoring processes.
    • Add language regarding the need for a service coordinator to reassess a participant due to a trigger event.
    • Add language to specifically address teleservice delivery of waiver services and the Home and Community Based Settings Rule based on new sections in the waiver application.
    • Add language to comply with the CMS Ensuring Access to Medicaid Services Final Rule (Access Rule) to update the complaint process for the fee-for-service waiver and update the timeframe to resolve a complaint from 45 to 60 days due to the additional requirements of the Access Rule.
    • Update OLTL’s goals for unduplicated number of waiver participants who are expected to elect participant-direction.
    • Performance measures - modify performance measures AA-2 and QP-2 and divide SP-5 into 3 separate performance measures: SP-5 (amount, frequency, and duration), SP-9 (type) and SP-10 (scope).
    • Remove and modify outdated language throughout waiver.

    Comments

    Download the OBRA Waiver Comment Form

    Interested persons are invited to submit written comments regarding the proposed waiver amendment to:

    Department of Human Services
    Office of Long-Term Living, Bureau of Policy Development and Communications Management
    Attention: OBRA 2025 Waiver Amendment
    P.O. Box 8025, Harrisburg, PA 17105-8025

    Comments may also be submitted to the Department at RA-waiverstandard@pa.gov. Please use “OBRA 2025 Waiver Amendment” as the subject line. Comments received by close of business on July 14, 2024, will be reviewed and considered for revisions to the proposed waiver amendments. Please use the OBRA Waiver Comment Form.

    The OBRA waiver amendment public notice was published on Saturday, June 15, 2024, in the Pennsylvania Bulletin. View the public notice here.