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§ 1402. Special provider participation requirements

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 62 P.S. Poor Persons and Public WelfareEffective: July 7, 2005

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)
Effective: July 7, 2005
62 P.S. § 1402
§ 1402. Special provider participation requirements
(a) As a condition of participation in the medical assistance program, a medical facility shall be required to disclose to the department upon execution of a new provider agreement or renewal thereof the name and social security number of any person who has a direct or indirect ownership or control interest of five percent or more in such medical facility; such disclosure shall include the identity of any such person who has been convicted of a criminal offense under section 14071 and the specific nature of the offense involved. In addition to the disclosure required upon execution of a provider agreement, any change in such ownership or control interest of five percent or more shall be reported to the department within thirty days of the date such change occurs. Failure to submit a complete and accurate report shall constitute a deceptive practice under section 1407(a)(1) and will justify a termination of the provider agreement by the department.
(b) As a second condition of participation in the medical assistance program, a provider must maintain for a minimum of four years appropriate medical and financial records to fully support his claims and charges for payment under the medical assistance program. Such records shall at reasonable times be made available for inspection, review and copying by the department or by other authorized State officers.
(c) Payments under the medical assistance program will be made directly to providers who have signed a provider agreement with the department. Providers shall not factor, assign, reassign or execute a power of attorney for the rights to any claims or payments for services rendered under the medical assistance program. Notwithstanding the above stated language a provider may use accounts receivables as collateral at a certified lending institution.
(d) Each nursing facility shall maintain a complete and accurate record of all receipts and disbursements for medical assistance recipients' personal funds and shall furnish each such patient a quarterly report of all transactions recorded for that recipient.
(e) Each nursing facility shall be inspected at least twice annually for compliance with this act and regulations of the department.

Credits

1967, June 13, P.L. 31, No. 21, art. 14, § 1402, added 1980, July 10, P.L. 493, No. 105, § 3, effective in 60 days. Amended 2005, July 7, P.L. 177, No. 42, § 7.1, imd. effective.

Footnotes

62 P.S. § 1407.
62 P.S. § 1402, PA ST 62 P.S. § 1402
Current through 2022 Regular Session Act 20. Some statute sections may be more current, see credits for details.
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