Pennsylvania Code
Title 55 - HUMAN SERVICES
Part VIII - Intellectual Disability and Autism Manual
Subpart C - Administration and Fiscal Management
Chapter 6210 - PARTICIPATION REQUIREMENTS FOR THE INTERMEDIATE CARE FACILITIES FOR THE INTELLECTUAL DISABILITY PROGRAM
UTILIZATION CONTROL
Section 6210.109 - Provider misutilization

Facilities determined to have billed for services inconsistent with MA Program regulations, to have provided services outside the scope of customary standards of practice or to have otherwise violated the standards set forth in the provider agreement, are subject to the sanctions described in this chapter and Chapter 1101 (relating to general provisions).

This section cited in 55 Pa. Code § 6210.101 (relating to scope of claims review procedures).