Lawsuit Challenges New Pennsylvania I/DD Waiver Rates For Community Participation Support Services

On November 13, 2019, a group of provider organizations and two individuals sued the Pennsylvania Department of Human Services (DHS) after the Office of Developmental Programs (ODP) implemented a new reimbursement system for community participation support (CPS) waiver services provided to people with intellectual/developmental disabilities (I/DD). The new DHS/ODP rates were published on May 25, 2019, and went into effect on July 1, 2019, for the Consolidated, Person/Family Directed Support, and Community Living waivers. The plaintiffs alleged that the new rate structure methodology does not align with current Medicaid waiver rate setting requirements, and that the . . .