Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1101 - GENERAL PROVISIONS
FEES AND PAYMENTS
- Section 1101.61 - Reimbursement policies
- Section 1101.62 - Maximum fees
- Section 1101.63 - Payment in full
- Section 1101.63a - Full reimbursement for covered services rendered-statement of policy
- Section 1101.64 - Third-party medical resources (TPR)
- Section 1101.65 - Method of payment
- Section 1101.66 - Payment for rendered, prescribed or ordered services
- Section 1101.66a - Clarification of the terms "written" and "signature"-statement of policy
- Section 1101.67 - Prior authorization
- Section 1101.68 - Invoicing for services
- Section 1101.69 - Overpayment-underpayment
- Section 1101.69a - Establishment of a uniform period for the recoupment of overpayments from providers (COBRA)
- Section 1101.70 - Reserved
- Section 1101.71 - Utilization control
- Section 1101.72 - Invoice adjustment
- Section 1101.73 - Provider misutilization and abuse
- Section 1101.74 - Provider fraud
- Section 1101.75 - Provider prohibited acts
- Section 1101.75a - Business arrangements between nursing facilities and pharmacy providers-statement of policy
- Section 1101.76 - Criminal penalties
- Section 1101.77 - Enforcement actions by the Department
- Section 1101.77a - Termination for convenience and best interests of the Department-statement of policy
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