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Current as of January 01, 2025 | Updated by Findlaw Staff
(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 1407 1 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.
Cite this article: FindLaw.com - Pennsylvania Statutes Title 62 P.S. Poor Persons and Public Welfare § 1402. Special provider participation requirements - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-62-ps-poor-persons-and-public-welfare/pa-st-sect-62-1402/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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