Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1126 - AMBULATORY SURGICAL CENTER SERVICES AND HOSPITAL SHORT PROCEDURE UNIT SERVICES
ADMINISTRATIVE SANCTIONS
Section 1126.81 - Provider misutilization
Universal Citation: 55 PA Code ยง 1126.81
Current through Register Vol. 54, No. 44, November 2, 2024
If the Department determines that a provider billed for services inconsistent with this chapter and Chapter 1101 (relating to general provisions), provided incorrect information on the billing invoice regarding a patient's diagnosis or procedures performed during the period of hospitalization or otherwise violated the standards in the provider agreement, the provider is subject to the sanctions in Chapter 1101.
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