Current through Register Vol. 54, No. 25, June 22, 2024
Section 6210.62 - Level of care criteria(a) There are three fundamental criteria which shall be met prior to an applicant or recipient qualifying for an ICF/ID level of care. The ICF/ID level of care shall be indicated only when the applicant or recipient: (1) Requires active treatment.(2) Has a diagnosis of an intellectual disability.(3) Has been recommended for an ICF/ID level of care based on a medical evaluation.(b) A physician shall certify the ICF/ID level of care on a form specified by the Department and that ICF/ID services are needed, for each applicant and current ICF/ID resident. Before the facility requests payment from MA, the certification shall have been made at the time of admission, or at the time a resident applied for assistance while in an ICF/ID.(c) For purposes of an ICF/ORC, subsection (a)(2) means a diagnosis of other related condition.The provisions of this § 6210.62 amended June 17, 2016, effective 6/18/2016, 46 Pa.B. 3177.The provisions of this § 6210.62 amended under section 443.1(2) and (3) of the Human Services Code (62 P.S. § 443.1(2) and (3)).