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COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 6234 (September 28, 2024).

55 Pa. Code § 6210.101. Scope of claims review procedures.

UTILIZATION CONTROL


§ 6210.101. Scope of claims review procedures.

 Claims submitted for payment under the MA Program are subject to the utilization review procedures established in Chapter 1101 (relating to general provisions). In addition, the Department will perform the reviews specified in this section and § §  6210.102—6210.109 for controlling the utilization of ICF/ID services.

Authority

   The provisions of this §  6210.101 amended under section 443.1(2) and (3) of the Human Services Code (62 P.S. §  443.1(2) and (3)).

Source

   The provisions of this §  6210.101 amended June 17, 2016, effective June 18, 2016, 46 Pa.B. 3177. Immediately preceding text appears at serial pages (276210) to (276211).


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