55 Pa. Code § 1187.1 - Policy

(a) This chapter applies to nursing facilities, and to the extent specified in Chapter 1189 (relating to county nursing facility services), to county nursing facilities.

(b) This chapter governs MA payments to nursing facilities on the basis of the Commonwealth's approved State Plan for reimbursement.

(c) The MA Program provides payment for nursing facility services provided to eligible recipients by enrolled nursing facilities. Payment for services is made subject to this chapter and Chapter 1101 (relating to general provisions).

(d) Extensions of time will be as follows:

(1) The time limits established by this chapter for the filing of a cost report, resident assessment data, an appeal or an amended appeal cannot be extended, except as provided in this section.

(2) Extensions of time in addition to the time otherwise prescribed for nursing facilities by this chapter with respect to the filing of a cost report, resident assessment data, an appeal or an amended appeal may be permitted only upon a showing of fraud, breakdown in the Department's administrative process or an intervening natural disaster making timely compliance impossible or unsafe.

(3) This subsection supersedes 1 Pa. Code §31.15 (relating to extensions of time).

Notes

55 Pa. Code § 1187.1

The provisions of this § 1187.1 amended June 23, 2006, effective 7/1/2006, 36 Pa.B. 3207.

The provisions of this § 1187.1 amended under sections 201(2), 206(2), 403(b) and 443.1(5) of the Public Welfare Code (62 P.S. §§ 201(2), 206(2), 403(b) and 443.1(5)).

This section cited in 55 Pa. Code § 41.33 (relating to appeals nunc pro tunc); 55 Pa. Code § 1187.73 (relating to annual reporting); 55 Pa. Code § 1187.75 (relating to final reporting); and 55 Pa. Code § 1187.141 (relating to nursing facility's right to appeal and to a hearing).