Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1181 - NURSING FACILITY CARE
Subchapter A - NURSING FACILITY CARE
ADMINISTRATIVE SANCTIONS
Section 1181.95 - Failure to adhere to medical evaluation requirements
Universal Citation: 55 PA Code ยง 1181.95
Current through Register Vol. 54, No. 44, November 2, 2024
If the facility fails to comply with the requirements that the physician perform a medical evaluation before admission or before authorization for payment, as described under § 1181.53 (relating to payment conditions related to the recipient's initial need for care), which results in a penalty being imposed by DHHS on the Department, the penalty will be imposed on the facility.
This section cited in 55 Pa. Code § 1181.215 (relating to efficiency incentive); 55 Pa. Code § 1181.216 (relating to depreciation and interest reimbursement); and 55 Pa. Code § 1181.224 (relating to final per diem rate).
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