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 52.28 - Conflict free service coordination
Universal Citation: 55 PA Code ยง 52.28
Current through Register Vol. 54, No. 12, March 23, 2024
(a) An SCE may not provide other waiver or Act 150 services if the SCE provides service coordination services unless one of the following is applicable:
(1) The SCE
is providing the service as an OHCDS under §
52.53 (relating to organized
health care delivery system).
(2)
The SCE is providing community transition services to a participant
transitioning from a nursing facility or an ICF/ORC.
(3) The SCE is providing financial management
services to a participant.
(b) If an SCE operates as an OHCDS, then the SCE may not require a participant to use that OHCDS as a condition to receive the service coordination services of the SCE.
(c) An SCE may not require a participant to choose the SCE as the participant's community transition service provider as a condition to receive service coordination services.
(d) An SCE and a provider of a service other than service coordination may not share any of the following:
(1) Chief executive officer or
equivalent.
(2) Executive
board.
(3) Bank account.
(4) Supervisory staff.
(5) Tax identification number.
(6) MA provider agreement.
(7) Master provider index number.
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