55 Pa. Code § 52.53. Organized health care delivery system.

§ 52.53. Organized health care delivery system.

(a)  An OHCDS shall be an SCE in compliance with this chapter.
(b)  An OHCDS may not be reimbursed for rendering service coordination services if it contracts with an entity which is listed on the LEIE, EPLS or Medicheck list.
(c)  An OHCDS may not be reimbursed for rendering service coordination services if the OHCDS contracts with an entity which employs a person who is listed on the LEIE or EPLS.
(d)  An OHCDS shall complete and sign an OHCDS enrollment form.

Cross References

   This section cited in 55 Pa. Code §  52.28 (relating to conflict free service coordination).

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