Section 540.10 - Claims for State aid.

540.10 Claims for State aid. (a) General.

(1) Claims for State (and Federal) aid in behalf of expenditures for medical care shall be prepared and submitted in accordance with departmental regulations with respect thereto.

(2) The internal controls established by the public welfare official for the examination and verification prior to payment of bills for medical services rendered shall identify and isolate any payments or portions of payments that exceed limits stipulated by State regulations and the claims for State (and Federal) aid prepared and submitted by the agency shall exclude from calculations of such aid any such amounts, as required by departmental regulations governing the preparation and submission of claims. Other elements requiring case expenditure analysis entering into the development of proper claims, such as program and residence status, shall also be provided for in the internal analysis and processing of medical services payments.

(3) Where claims and rolls for State aid purposes must be supported by vouchers or statements of services paid for medical care, the public welfare agency must ensure, in its operating procedures, that sufficient copies of the appropriate documents are developed to meet both its internal needs and the roll and claim requirements.

 

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