Current through Register Vol. 54, No. 44, November 2, 2024
Section 3042.68 - Verification of circumstances relating to a decrease in copaymentAcceptable verification of circumstances relating to a decrease in copayment includes any of the following:
(1) Verification of a decrease in income as specified in § 3042.65 (relating to verification of income).(2) Verification of a change in family size and composition as specified in § 3042.71 (relating to verification of family size).(3) Verification of maternity and family leave as indicated by one of the following: (ii) The Department's medical assessment form.(iii) A medical record or a written statement from a licensed physician, physician's assistant, CRNP or psychologist.(iv) A written statement or other documentation completed by a licensed physician, physician's assistant, CRNP or psychologist that describes the inability to work or participate in education or training and includes a date of anticipated return to work.(v) A written statement from the employer or an education or training representative.(vi) A collateral contact as specified in § 3042.62 (relating to collateral contact).(vii) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).(4) Verification relating to inability to work due to a disability as specified in § 3042.70 (relating to verification of inability to work due to a disability).Adopted by Pennsylvania Bulletin, Vol 53, No. 50. December 16, 2023, effective 12/16/2023