Pennsylvania Code & Bulletin

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 23-1657



Proposed Federal Section 1115 Demonstration for Medicaid Coverage of Health-Related Social Needs and Continuous Eligibility for Young Children

[53 Pa.B. 7448]
[Saturday, December 2, 2023]

 The Department of Human Services (Department) is making available for public review and comment the proposed Federal Section 1115 Demonstration application (Demonstration), entitled Bridges to Success: Keystones of Health for Pennsylvania (Keystones of Health), which proposes Medicaid coverage for Health-Related Social Needs (HRSN), reentry supports and multiyear continuous eligibility for young children.

 The purpose of this Demonstration is to further the objectives of Medicaid to expand access to care, improve health outcomes, drive innovation, and engage partners and communities through targeted, time-limited interventions to address HRSNs.

 The goals of this Demonstration are to:

 1. Address the Commonwealth's Medicaid beneficiaries' HRSNs, such as food and housing, to improve health outcomes and quality of life with interventions that are both lifesaving and cost saving.

 2. Provide HRSN services to support beneficiaries, especially those experiencing life transitions, to reduce avoidable hospitalizations and medical utilization and increase recommended or preventive care.

 3. Reduce churn and gaps in coverage for children enrolled in Medicaid.

 4. Expand Medicaid coverage to improve services to beneficiaries as they prepare to leave incarceration and provide continued support as beneficiaries transition back into the community.

 Under Keystones of Health, services are proposed to be provided in the following areas:

 • Reentry from correctional facilities: Improve transitions to the community for beneficiaries reentering society from correctional facilities. The available services, which will require a legislative amendment, will focus on improving transitions to community-based health care and social services with a particular emphasis on those with significant health care needs such as serious mental illness and substance use disorder.

 • Housing supports: Add new Medicaid services to help beneficiaries without stable housing find and keep a place to live. Having stable housing makes it easier to find and use health care. These services will focus on beneficiaries with behavioral health issues and chronic conditions where health outcomes are greatly impacted by improved consistency of care and medication access.

 • Food and nutrition supports: Provide food and nutrition services to specific Medicaid populations facing food insecurity, including pregnant beneficiaries and beneficiaries with diet-sensitive conditions. Services would include direct food support such as medically-tailored meals or groceries with a goal of also connecting eligible beneficiaries to long-term food assistance, like the Supplemental Nutrition Assistance Program.

 • Multiyear continuous coverage for children under 6 years of age: Provide continuous Medicaid coverage for children from birth or older but under 6 years of age to reduce gaps in coverage that interrupt access to essential health care services, such as preventive care. This proposal provides eligibility from birth, or when a child first receives Medicaid, through the last day of the month in which they turn 6 years of age. This proposal will make it easier for children to get the important early childhood health care they need.

 The Demonstration application is available at Keystones-of-Health. In addition, copies of the application are available upon written request to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120.

Public Hearing Schedule

 The Department will hold three virtual public hearings to receive comments regarding the proposed Demonstration. The Department will also receive comments on the Demonstration application at the Income Maintenance Advisory Council meeting on December 5, 2023, the Medical Assistance Advisory Committee meeting on December 7, 2023, and the Information Sharing and Advisory Committee Hub meeting on December 12, 2023.

 The public hearings will be held as follows:

December 11, 2023, from 12 p.m. to 1 p.m.

 Register for Session 1:

 Join by phone only: (312) 626-6799; Webinar ID: 982 3951 9594

December 12, 2023, from 6 p.m. to 7 p.m.

 Register for Session 2:

 Join by phone only: (312) 626-6799; Webinar ID: 980 3834 3590

December 15, 2023, from 9 a.m. to 10 a.m.

 Register for Session 3:

 Join by phone only: (312) 626-6799; Webinar ID: 951 7040 4572

 Register to participate virtually. When an individual registers, there will be an option to add the Public Forum to their calendar. Registration is not necessary to join by phone. Closed captioning will be provided during each public forum.

Public Comment

 The Department seeks public input on the proposed Demonstration application for Medicaid coverage of HRSNs, reentry supports and multiyear continuous eligibility for young children. The 30-day public comment period will take place from December 2, 2023, through January 2, 2024.

 Individuals may submit written comments at, by e-mail at or to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

 The Department will consider all comments received by January 2, 2024, in developing the final Demonstration application.


[Pa.B. Doc. No. 23-1657. Filed for public inspection December 1, 2023, 9:00 a.m.]

No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.