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55 Pa. Code § 1151.77. Medical care evaluation studies.

§ 1151.77. Medical care evaluation studies.

 (a)  The utilization review committee shall conduct Medical Care Evaluation (MCE) studies in accordance with this section.

 (b)  MCE studies shall identify and analyze medical or administrative factors related to patient care rendered in the inpatient psychiatric facility and, when indicated, make recommendations for changes that would be beneficial to patients, staff, the facility and the community.

 (c)  MCE studies shall include analysis of at least the following:

   (1)  Admissions.

   (2)  Durations of stay.

   (3)  Diagnostic categories.

   (4)  Ancillary services, including drugs and biologicals.

   (5)  Professional services performed in the facility.

 (d)  At least one MCE study shall be in progress at any time.

 (e)  At least one MCE study shall be completed each calendar year.

 (f)  The results of each MCE study shall be documented.

 (g)  Documentation shall be made describing how the MCE study results have been used to institute improvements in the quality of care and to promote the efficient and effective use of inpatient psychiatric facilities.


   The provisions of this §  1151.77 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. § §  201 and 443.1(1)).


   The provisions of this §  1151.77 adopted September 30, 1983, effective July 1, 1983, 13 Pa.B. 2796; amended June 18, 1993, effective July 1, 1993, 23 Pa.B. 2917. Immediately preceding text appears at serial pages (150079) to (150080).

Cross References

   This section cited in 55 Pa. Code §  1151.61 (relating to payment conditions: general); 55 Pa. Code §  1151.67 (relating to payment conditions related to the recipient’s continued need for care); 55 Pa. Code §  1151.72 (relating to inpatient psychiatric facility utilization review plan); and 55 Pa. Code §  1151.74 (relating to responsibilities of the inpatient psychiatric facility utilization review committee).

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