Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 3392 (June 24, 2023).

31 Pa. Code § 152.7. Restricted benefit—limited purpose preferred provider organizations.

§ 152.7. Restricted benefit—limited purpose preferred provider organizations.

 A risk-assuming preferred provider organization which limits its arrangements to only one class of preferred providers for the purpose of providing a limited scope or range of covered services to covered persons (for example, a dental benefits preferred provider organization or vision service benefits preferred provider organization) shall reflect the fact in the structure and function of its quality assurance system.

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