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§ 1406. Restrictions on provider charges and payments

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 62 P.S. Poor Persons and Public Welfare

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 62 P.S. Poor Persons and Public Welfare (Refs & Annos)
Chapter 1. Human Services Code (Refs & Annos)
Article XIV. Fraud and Abuse Control (Refs & Annos)
62 P.S. § 1406
§ 1406. Restrictions on provider charges and payments
(a) All payments made to providers under the medical assistance program shall constitute full reimbursement to the provider for covered services rendered. Providers may not seek or request supplemental or additional payments from recipients for covered services unless authorized by law or regulation; nor may a provider charge a recipient for other services to supplement a covered service paid for by the department. However, nothing in this act shall preclude charges for uncovered services rendered to a recipient.
(b) Charges made to the department by a provider for covered services or items furnished shall not exceed, in any case, the usual and customary charges made to the general public by such provider for the same services or items.

Credits

1967, June 13, P.L. 31, § 1406, added 1980, July 10, P.L. 493, No. 105, § 3, effective in 60 days.
62 P.S. § 1406, PA ST 62 P.S. § 1406
Current through 2022 Regular Session Act 20. Some statute sections may be more current, see credits for details.
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