Pennsylvania

Quality Assurance Review

Quality assurance reviews are a service provided by Leader for the purpose of measuring how well LEAs have utilized Leader's training materials and whether the LEAs' records and internal procedures would pass a state and/or federal Medicaid audit. The Medicaid Reimbursement Program's requirements are governed by several sources, including state legislation, Centers for Medicare and Medicaid Services (formerly HCFA) directives, and Pennsylvania Department of Public Welfare (DPW)/Office of Medical Assistance billing instructions. There are seven rules for direct service billing, and LEAs are checked for compliance with all seven rules.

Reviews are "user friendly" and consultative in nature. Any areas of noncompliance will result in a corrective plan of action being provided to the LEA. No punitive actions occur as a result of any review conducted by Leader. However, results are made available to the Pennsylvania Department of Education.

The number of LEAs to be reviewed is chosen based on the terms of the Pennsylvania contractual agreement. LEAs are distributed geographically across the state and are selected randomly or by request. All reviews and written reports are completed by June 30th of the current school year.

To request a review, please send an e-mail to bhenry@leaderservices.com or use our Contact page.