Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1151 - INPATIENT PSYCHIATRIC SERVICES
UTILIZATION CONTROL
Section 1151.77 - Medical care evaluation studies
Current through Register Vol. 54, No. 44, November 2, 2024
(a) The utilization review committee shall conduct Medical Care Evaluation (MCE) studies in accordance with this section.
(b) MCE studies shall identify and analyze medical or administrative factors related to patient care rendered in the inpatient psychiatric facility and, when indicated, make recommendations for changes that would be beneficial to patients, staff, the facility and the community.
(c) MCE studies shall include analysis of at least the following:
(d) At least one MCE study shall be in progress at any time.
(e) At least one MCE study shall be completed each calendar year.
(f) The results of each MCE study shall be documented.
(g) Documentation shall be made describing how the MCE study results have been used to institute improvements in the quality of care and to promote the efficient and effective use of inpatient psychiatric facilities.
The provisions of this §1151.77 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. §§ 201 and 443.1(1)).
This section cited in 55 Pa. Code § 1151.61 (relating to payment conditions: general); 55 Pa. Code § 1151.67 (relating to payment conditions related to the recipient's continued need for care); 55 Pa. Code § 1151.72 (relating to inpatient psychiatric facility utilization review plan); and 55 Pa. Code § 1151.74 (relating to responsibilities of the inpatient psychiatric facility utilization review committee).
