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OLTL Bulletin 05-13-05 et al. — Clarification of Type, Scope, Amount, Duration and Frequency of Services
Pennsylvaniasub_regulatoryPA Department of Human Services, Office of Long-Term Living· effective 2013-05-16
What this rule requires your agency to do
- 1When ordered services are not fully delivered, the provider must document a reasonable acceptable reason (e.g., participant refused, participant ill, family delivered service in lieu of provider); provider unavailability is not an acceptable reason.(OLTL Bulletin 05-13-05 et al. — Clarification of Type, Scope, Amount, Duration and Frequency of Services)
- 2Documentation showing that services were provided in the correct amount, duration, and frequency (or, if not, why not) must be maintained and kept accessible for OLTL monitoring.(OLTL Bulletin 05-13-05 et al. — Clarification of Type, Scope, Amount, Duration and Frequency of Services)
- 3A provider may only render and bill for a waiver service it is qualified and enrolled to provide (correct 'type'), and the delivered service must match the service definition (correct 'scope').(OLTL Bulletin 05-13-05 et al. — Clarification of Type, Scope, Amount, Duration and Frequency of Services)
- 4A provider must deliver the number of units (amount), the scheduled time (duration), and the scheduled number of occurrences (frequency) ordered on the participant's service plan, and may not bill for units, time, or occurrences not actually delivered.(OLTL Bulletin 05-13-05 et al. — Clarification of Type, Scope, Amount, Duration and Frequency of Services)
Applies to: personal care
OLTL bulletin clarifying the meaning of type, scope, amount, duration, and frequency of services under 55 Pa. Code Chapter 52 and the documentation providers must keep to support billed services.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.