Pennsylvania Code
Title 55 - HUMAN SERVICES
Part I - Department of Human Services
Subpart E - Home and Community-based Services
Chapter 52 - LONG-TERM LIVING HOME AND COMMUNITY-BASED SERVICES
Subchapter B - PROVIDER QUALIFICATIONS AND PARTICIPATION
Section 52.12 - Prerequisites for existing provider enrolling in a new service
Universal Citation: 55 PA Code ยง 52.12
Current through Register Vol. 54, No. 12, March 23, 2024
(a) If an existing provider enrolled in a waiver program wants to enroll to provide an additional waiver service, the provider shall submit the following to the Department:
(1) A written request to enroll as a provider
of the additional service.
(2) A
copy of the license required to provide the service if the service requires
licensure.
(3) A completed and
signed waiver addendum to the MA provider agreement for the new
service.
(b) The provider shall submit the written request to enroll in an additional service to the Department in a form and manner prescribed by the Department.
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