Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 5070 (August 3, 2024).

55 Pa. Code § 4226.13. Payor of last resort.

§ 4226.13. Payor of last resort.

 (a)  Unless otherwise permitted or mandated by Federal law, State early intervention funds may not be used to satisfy a financial commitment for early intervention services if another public or private funding source is available to pay for the services.

 (b)  Unless otherwise permitted or mandated by Federal law, private insurance may be used with the consent of the parent to pay for early intervention services as long as such use will not result in a cost to the family, including but not limited to the following:

   (1)  A decrease in available lifetime coverage or any other benefit under an insurance policy.

   (2)  An increase in premiums or the discontinuation of the policy.

   (3)  An out-of-pocket expense such as the payment of a deductible amount in filing a claim.

 (c)  Services on the IFSP may not be denied or delayed because another public or private funding source, including Medicaid, is unavailable.

Cross References

   This section cited in 55 Pa. Code §  4226.14 (relating to documentation of other funding sources).



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