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Pennsylvania Statutes Title 71 P.S. State Government § 611.14. Medical assistance payments (Adm. Code § 2334)

Current as of January 01, 2025 | Updated by Findlaw Staff

(a) It is the general purpose of this section to provide for a continuum of alcohol and drug detoxification and rehabilitation services to persons eligible for medical assistance. Facilities serving as appropriate treatment settings include hospital and nonhospital drug detoxification and rehabilitation facilities, hospital and nonhospital alcohol detoxification and rehabilitation facilities, and hospital and nonhospital drug and alcohol detoxification and rehabilitation facilities and outpatient services licensed by the Office of Drug and Alcohol Programs of the Department of Health. The General Assembly recognizes that the fluctuating nature of alcohol and drug dependency, in combination with the associated physical complications often arising from long-term use of alcohol and drugs, necessitates that a variety of treatment modalities and settings be made available to persons eligible for medical assistance. The availability of a new service in this area is in no way intended to limit access to or funding of services available currently.

(b) Consistent with section 2301,  1 the Department of Public Welfare shall:

(1) Provide, on behalf of persons eligible for medical assistance, medical assistance coverage for detoxification, treatment and care in a nonhospital alcohol detoxification facility, nonhospital drug detoxification facility, nonhospital alcohol and drug detoxification facility, or a nonhospital treatment facility which can provide services for either drug or alcohol detoxification or treatment or for both, provided that the facility is licensed by the Office of Drug and Alcohol Programs in the Department of Health.

(2) Use criteria developed by the Office of Drug and Alcohol Programs for governing the type, level and length of care or treatment, including hospital detoxification, as a basis for the development of standards for services provided under clause (1).

(3) Notwithstanding clause (1), provide by regulation for gradual implementation of medical assistance coverage under this subsection to client populations which shall be identified in cooperation with the Department of Health. The regulations shall provide for full implementation of clause (1) to all medical assistance eligibles in phases over a period of time not to exceed five years from the effective date of the regulations. The program phases shall be structured so as to allow for independent evaluation of each phase on an ongoing basis. Initial regulations adopted pursuant to this subsection shall not be subject to review pursuant to the act of June 25, 1982 (P.L. 633, No. 181), known as the “Regulatory Review Act,”  2 except that the regulations may be reviewed under section 5(h) of that act. 3

(c) The Department of Public Welfare, the Department of Health and the Office of Drug and Alcohol Programs shall jointly provide for an independent evaluation of the program authorized by this section in accordance with specific evaluation criteria, which shall include, but not be limited to: (i) comparison of medical costs before and after program implementation; (ii) employment history; and (iii) involvement with other programs of the Department of Health, the Department of Public Welfare, the Department of Corrections and any other appropriate agencies. The evaluation shall be conducted in compliance with all applicable Federal and State confidentiality requirements.

1 71 P.S. § 591.
2 71 P.S. § 745.1 et seq.
3 71 P.S. § 745.5(h) deleted by 1989, June 30, P.L. 73, No. 19, § 1.
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Cite this article: FindLaw.com - Pennsylvania Statutes Title 71 P.S. State Government § 611.14. Medical assistance payments (Adm. Code § 2334) - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-71-ps-state-government/pa-st-sect-71-611-14/

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