“The changes the Shapiro administration rolled out following the court rulings this year apply to people in participant-directed services models, which can give people with disabilities or their representatives more control over how care is provided, including by hiring support service professionals.
The revised work–hour rule, known as the “40/60 Rule,” limits the number of hours that Medicaid will pay relatives, legal guardians, and others for certain services. The hours are generally capped at 40 hours per week for a single worker — and 60 hours per week when multiple relatives or legal guardians do the work.
The rule affects in-home and companionship supports, ones in which a caregiver provides supervision and assistance with daily activities, such as eating, toileting, bathing, or dressing, according to the lawsuit. The lawsuit says the new version of the rule is “essentially identical” to the previous one canceled out by Commonwealth Court.
The other rule involves travel, and generally requires waiver-funded services to occur within Pennsylvania. That’s a stricter geographic limit than what the Shapiro administration enforced earlier this year, according to court records. The administration has said that people “may choose to pay for services using private funds” or “reach out to the county to discuss whether there are options for service delivery.”
Rules for Medicaid recipients spark lawsuit | Local News | standard-journal.com