62 Pa. Stat. § 1406

Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 1406 - Restrictions on provider charges and payments
(a) All payments made to providers under the medical assistance program shall constitute full reimbursement to the provider for covered services rendered. Providers may not seek or request supplemental or additional payments from recipients for covered services unless authorized by law or regulation; nor may a provider charge a recipient for other services to supplement a covered service paid for by the department. However, nothing in this act shall preclude charges for uncovered services rendered to a recipient.
(b) Charges made to the department by a provider for covered services or items furnished shall not exceed, in any case, the usual and customary charges made to the general public by such provider for the same services or items.

62 P.S. § 1406

1967, June 13, P.L. 31, § 1406, added 1980, July 10, P.L. 493, No. 105, § 3, effective in 60 days.