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Pennsylvania Keystones of Health Section 1115 Demonstration Approval Period: December 26, 2024 through December 31, 2029 Page 2 of 90 Medicaid Requirements Not Applicable to the Medicaid Expenditure Authority for Pre- Release and HRSN Services:

Statewideness

Section 1902(a)(1)

To enable the state to provide pre-release services, as authorized under this demonstration, to qualifying individuals on a geographically limited basis, in accordance with the Reentry Demonstration Initiative Implementation Plan.

To enable the state to provide HRSN services only in certain geographic areas of the state, as specified in the HRSN Implementation Plan (STC 6.19).

Comparability; Amount, Duration and Scope;

Section 1902(a)(10)(B) and Provision of Medical Assistance

Section 1902(a(17)

To enable the state to provide only a limited set of pre-release services, as specified in these STCs, to qualifying individuals that is different than the services available to all other individuals outside of correctional facility settings in the same eligibility groups authorized under the state plan or demonstration authority.

To the extent necessary to allow the state to offer HRSN services and to vary the amount, duration, and scope of HRSN services covered for a subset of beneficiaries, depending on beneficiary needs as determined by the application of qualifying criteria, as specified in Section 6.6 of the STCs.

Freedom of Choice

Section 1902(a)(23)(A)

To enable the state to require qualifying individuals to receive pre-release services, as authorized under this demonstration, through only certain providers.