55 Pa. Code § 52.28 - Conflict free service coordination
(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.
Notes
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