Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 6142 (September 30, 2023).

31 Pa. Code § 69.51. Authority.


§ 69.51. Authority.

 A PRO has the authority to evaluate the reasonableness and medical necessity of care, and the professional standards of performance including the appropriateness of the setting where the care is rendered, and the appropriateness of the delivery of the care rendered.

Cross References

   This section cited in 31 Pa. Code §  69.55 (relating to criteria for Department approval of a PRO).

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