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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 § 1140.71. Scope of claims review procedures.


§ 1140.71. Scope of claims review procedures.

 A claim submitted for payment under the MA Program is subject to the utilization review procedures established in Chapter 1101 (relating to general provisions). In addition, HBP providers are instructed by the recordkeeping, quality assurance and program evaluation provisions of Section X, ‘‘Provider Accountability,’’ of the HBP Maternity Manual.

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