§ 3803. Retroactive denial of reimbursement
Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 Pa.C.S.A. InsuranceEffective: January 3, 2017
Effective: January 3, 2017
40 Pa.C.S.A. § 3803
§ 3803. Retroactive denial of reimbursement
(a) General rule.--Except as provided in section 3804 (relating to exceptions to retroactive denial of reimbursement), an insurer may not retroactively deny reimbursement as a result of an overpayment determination more than 24 months after the date the insurer initially paid the health care provider. An insurer that retroactively denies reimbursement to a health care provider under this chapter shall do so based upon coding guidelines and policies in effect at the time the service subject to the retroactive denial was rendered.
Credits
2016, Nov. 4, P.L. 1144, No. 146, § 1, effective in 60 days [Jan. 3, 2017].
40 Pa.C.S.A. § 3803, PA ST 40 Pa.C.S.A. § 3803
Current through Act 11 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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