Pennsylvania § 3803 - Retroactive denial of reimbursement.
Full text of Pennsylvania Pennsylvania Consolidated Statutes § 3803 — Retroactive denial of reimbursement., with citation guidance and answers to common questions.
§ 3803. Retroactive denial of reimbursement.
(a) General rule.--Except as provided in section 3804 (relating to exceptions to retroactive denial of reimbursement), an insurer may not retroactively deny reimbursement as a result of an overpayment determination more than 24 months after the date the insurer initially paid the health care provider. An insurer that retroactively denies reimbursement to a health care provider under this chapter shall do so based upon coding guidelines and policies in effect at the time the service subject to the retroactive denial was rendered.
(b) Written notice.--An insurer that retroactively denies reimbursement to a health care provider under subsection (a) shall provide the health care provider with a written statement specifying the basis for the retroactive denial.
Cross References. Section 3803 is referred to in sections 3804, 3806 of this title.
Source: official Pennsylvania text · Last verified 2026-08-27
Frequently Asked Questions About Pennsylvania § 3803
What does Pennsylvania Consolidated Statutes § 3803 cover?
Section 3803 ("Retroactive denial of reimbursement.") is part of the Pennsylvania Consolidated Statutes, the codified statutory law of Pennsylvania. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Pennsylvania § 3803?
A common citation format is "Pennsylvania Consolidated Statutes § 3803" (Pennsylvania). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Pennsylvania law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Pennsylvania official source linked on this page or consult a licensed Pennsylvania attorney.
How does Pennsylvania § 3803 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Pennsylvania can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Pennsylvania.