Current through Register Vol. 54, No. 24, June 15, 2024
Section 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.(5) Tax identification number.(6) MA provider agreement.(7) Master provider index number.The provisions of this § 52.28 effective 6/27/2012, 42 Pa.B. 4545.