55 Pa. Code § 52.12 - Prerequisites for existing provider enrolling in a new service
(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.
Notes
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