Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 488 (January 27, 2024).

55 Pa. Code § 4310.5. Sequential order of payors and persons liable for costs of service.

PAYORS RESPONSIBLE FOR THE COSTS OF SERVICE


§ 4310.5. Sequential order of payors and persons liable for costs of service.

 (a)  The sequential order of payors responsible for the costs of service is:

   (1)  Medicare.

   (2)  Third-party insurance.

   (3)  Client/LLR.

   (4)  MA.

 (b)  The sequential order of persons liable for costs of service is:

   (1)  The client, based on income and/or assets.

   (2)  The client’s spouse, for 120 days of continuous inpatient hospitalization, based on income.

   (3)  The client’s parents, if the client is under the age of 18 and not eligible for SSI, based on income.

Source

   The provisions of this §  4310.5 adopted December 3, 1982, effective December 4, 1982, 12 Pa.B. 4149.



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