Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1245 - AMBULANCE TRANSPORTATION
UTILIZATION CONTROL
Section 1245.71 - Scope of claims review procedures
Universal Citation: 55 PA Code ยง 1245.71
Current through Register Vol. 54, No. 12, March 23, 2024
Claims submitted for payment under the MA Program are subject to the utilization control procedures established in Chapter 1101 (relating to general provisions). Providers shall fully cooperate with audits and reviews made by the Department for the purpose of determining the validity and claims, the reasonableness and necessity of services provided and charges made to the general public.
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