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 § 6210.52. Payment pending appeal.

§ 6210.52. Payment pending appeal.

 If the recipient or the facility acting on behalf of the recipient appeals an action of the Department to change the level of care for which payment is authorized within 10 calendar days from the date the notice is mailed, the Department will make payment to the facility for the level of care the recipient is presently receiving pending the outcome of the hearing. If the Department is sustained in its action, the Department will recover from the facility payment in excess of the amount that would have been made if the action of the Department had not been appealed. The period for which the Department will recover excess payment runs from 10 calendar days from the date the notice is mailed, to the date that the appropriate change in the level of care for which payment is authorized is made.

Cross References

   This section cited in 55 Pa. Code §  6210.107 (relating to recipient right of appeal of alternate care determinations).



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