GENERAL PROVISIONS
§ 1163.1. Policy.
The MA Program provides payment for medically necessary covered inpatient services provided to eligible recipients by a general hospital enrolled as a provider under the MA Program. Payment for these services is subject to this chapter and Chapter 1101 (relating to general provisions).
Source The provisions of this § 1163.1 adopted September 23, 1983, effective September 24, 1983, 13 Pa.B. 2881; amended June 22, 1984, effective July 1, 1984, 14 Pa.B. 2185. Immediately preceding text appears at serial page.
Notes of Decisions Because petitioner hospital’s special rates were challenged in the first year of implementation of the new prospective rate system, the petitioners were entitled to a retroactive adjustment based on a published statement of the Department of Public Welfare in the Pennsylvania Bulletin. Hazleton St. Joseph Medical Center v. Department of Public Welfare, 532 A.2d 521 (Pa. Cmwlth. 1987); appeal denied 541 A.2d 748 (Pa. 1988).
The prospective payment rate has replaced the cost reimbursement system previously utilized by the Commonwealth. Hazleton St. Joseph Medical Center v. Department of Public Welfare, 532 A.2d 521 (Pa. Cmwlth. 1987).
Cross References This section cited in 55 Pa. Code § 1101.31 (relating to scope).
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