Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 1032 (February 24, 2024).

55 Pa. Code § 1163.471. Scope of claim review process.

UTILIZATION CONTROL


§ 1163.471. Scope of claim review process.

 All cost reimbursed services provided to MA recipients are subject to the utilization review procedures set forth in this chapter and in Chapter 1101 (relating to general provisions).

Source

   The provisions of this §  1163.471 adopted June 22, 1984, effective July 1, 1984, 14 Pa.B. 2185.

Cross References

   This section cited in 55 Pa. Code §  1163.454 (relating to limitations on payment); 55 Pa. Code §  1163.457 (relating to payment policies relating to out-of-State hospitals); and 55 Pa. Code §  1163.458 (relating to payment policies relating to same-calendar-day admissions and discharges).



No part of the information on this site may be reproduced for profit or sold for profit.


This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.