Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1163 - INPATIENT HOSPITAL SERVICES
Subchapter A - ACUTE CARE GENERAL HOSPITALS UNDER THE PROSPECTIVE PAYMENT SYSTEM
ADMINISTRATIVE SANCTIONS
Section 1163.91 - Provider misutilization
Universal Citation: 55 PA Code ยง 1163.91
Current through Register Vol. 54, No. 44, November 2, 2024
If the Department determines that a provider billed for services inconsistent with this part, 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 set forth in the provider agreement, the provider is subject to the sanctions described in Chapter 1101 (relating to general provisions).
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