By Pittsburgh Senior Advisor Care Team · October 13, 2026
On April 2, 2026, a Pennsylvania appeals court threw out DHS's 2024 selection of five Community HealthChoices plans and ordered the selection redone. For current members nothing changes for now: AmeriHealth Caritas, PA Health & Wellness and UPMC Community HealthChoices continue.
What happened?
In August 2024 the Department of Human Services announced five managed care organizations selected to run Community HealthChoices, Pennsylvania's Medicaid managed long-term services program, after a re-procurement. Plans that were not selected challenged the decision.
On April 2, 2026, an appeals court found DHS had not followed its own scoring rules, calling its actions arbitrary, capricious and contrary to law, canceled the awards and ordered DHS to start the selection over. The Pennsylvania Health Law Project reported the ruling on May 1, 2026.
Which CHC plans are available now?
The three existing plans continue to operate: AmeriHealth Caritas, PA Health & Wellness, and UPMC Community HealthChoices. DHS's own CHC application page lists the same three.
| Plan | Status in fall 2026 |
|---|---|
| AmeriHealth Caritas | operating |
| PA Health & Wellness | operating |
| UPMC Community HealthChoices | operating |
| 2024-selected plans (five) | awards canceled; selection to be redone |
Do members need to do anything?
No. According to the Pennsylvania Health Law Project, coverage, plans and services are not affected by the decision for now. Members keep their current plan, service coordinator and services.
If DHS later completes a new selection that changes plan options, members would be notified and given a chance to choose. Until then, plan changes follow the normal rules through the Independent Enrollment Broker at 1-877-550-4227.
Who is in Community HealthChoices?
CHC covers Medicaid enrollees 21 and older who are either dual eligible for Medicare and Medical Assistance, or who need long-term services and supports because they meet a nursing-facility level of care. People in the Office of Developmental Programs' service system and residents of state-operated nursing facilities, including state veterans homes, are not in CHC.
For older adults around Pittsburgh, CHC is the main Medicaid route to help at home, alongside the LIFE program.
How does CHC differ from regular HealthChoices?
Pennsylvania runs two Medicaid managed care programs. HealthChoices covers most children and working-age adults on Medical Assistance. Community HealthChoices covers adults 21 and older who are dual eligible for Medicare and Medicaid or who need long-term services and supports. The 2026 court ruling concerned Community HealthChoices.
Behavioral health services for CHC members are delivered separately by behavioral health managed care organizations, which the ruling did not change.
What should a new applicant do now?
Someone who needs long-term services and supports should contact the Independent Enrollment Broker at 1-877-550-4227, which arranges the functional eligibility assessment and helps with the Medical Assistance application. Financial eligibility is decided by the county assistance office, and applications can also be filed through COMPASS or by calling 1-866-550-4355.
Once eligible, the applicant chooses one of the three current plans. If no choice is made, a plan is assigned.
How do you choose among the three plans?
Compare the plans on the things that matter day to day: whether current doctors and the preferred hospital system are in network, which home care agencies the plan contracts with in your county, and how the service coordinator assigned to you communicates. Around Pittsburgh, the hospital network question often decides it, because UPMC and Allegheny Health Network patients have long relationships with their physicians.
The CHC Helpline and the Independent Enrollment Broker can explain plan differences, and PA MEDI counselors can help with the Medicare side.
Where can members get help with a CHC problem?
Start with the plan's member services line and the service coordinator assigned to you. If a service is reduced or denied, the plan must send a written notice explaining how to appeal, and appeal deadlines are short, so act quickly. Free legal help for Medical Assistance and CHC problems is available from the Pennsylvania Health Law Project, which reported the 2026 ruling.
For complaints about a nursing home or personal care home where a CHC member lives, the long-term care ombudsman at 717-783-8975 is another route.
What does this mean for someone choosing care now?
Nothing about the ruling changes what CHC pays for. CHC long-term services include personal assistance, respite, home-delivered meals and service coordination, and CHC still does not pay room and board in a personal care home or assisted living residence.
If you are comparing CHC with LIFE, compare the networks: a UPMC CHC member keeps different doctors than an AmeriHealth Caritas member, while LIFE participants use the LIFE team. The CHC Helpline is 1-844-824-3655.
The 2026 CHC ruling: what it did and did not do
| It did | It did not | |
|---|---|---|
| 2024 plan selection | throw out the five awards | end Community HealthChoices |
| Current plans | leave AmeriHealth Caritas, PA Health & Wellness and UPMC CHC in place | move members to new plans |
| DHS | require the selection to be redone | set a public timeline in the reports we reviewed |
| Benefits | leave services unchanged for now | add room and board coverage |
Frequently asked questions
Did my CHC plan change because of the court ruling?
No. The three existing plans continue, and the Pennsylvania Health Law Project reported that coverage, plans and services are not affected for now.
When will DHS redo the selection?
The court ordered DHS to start over but the reports we reviewed give no schedule. Members would be notified of any plan changes.
Who do I call about CHC?
The CHC Helpline at 1-844-824-3655, or the Independent Enrollment Broker at 1-877-550-4227 for enrollment and plan changes.
Does CHC pay for a personal care home?
CHC can pay for some services for eligible members but not room and board in a personal care home or assisted living residence.
