Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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

55 Pa. Code § 1130.91. Provider misutilization.

ADMINISTRATIVE SANCTIONS


§ 1130.91. Provider misutilization.

 If the Department determines that a provider billed for services inconsistent with this chapter and Chapter 1101 (relating to general provisions), provided incorrect information on the billing invoice regarding a recipient’s diagnosis or the services provided during the period the recipient was under the care of the hospice or otherwise violated the standards set forth in the provider agreement, the provider is subject to the sanctions described in Chapter 1101.



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