Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 8238 (December 30, 2023).

55 Pa. Code § 2070.33. Validity of eligibility information provided by applicants or clients.

§ 2070.33. Validity of eligibility information provided by applicants or clients.

 (a)  Except for the information contained on the Medical Services Eligibility Card, the provider shall accept as valid, the information provided verbally by the applicant or client when determining or redetermining the need for services unless the provider has cause to doubt the validity of this information.

 (b)  If the provider has cause to doubt the validity of the information given by an applicant or client, the provider may require documentation of that information.

 (c)  The provider shall deny service or terminate from service immediately, any applicant or client who:

   (1)  Refuses to show a medical services eligibility card;

   (2)  Refuses to provide the documentation requested to determine need;

   (3)  Refuses to attest to validity of the information the applicant or client provided; or

   (4)  Is found to be ineligible on the basis of the documented information.



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