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Fees and Payments | Midpage
Collections
Pennsylvania Code
Title 55
Part III
Chapter 1101
Fees and Payments
Fees and Payments
1101.61
Reimbursement policies.
1101.62
Maximum fees.
1101.63
Payment in full.
1101.63a
Full reimbursement for covered services rendered—statement of policy.
1101.64
Third-party medical resources (TPR).
1101.65
Method of payment.
1101.66
Payment for rendered, prescribed or ordered services.
1101.66a
Clarification of the terms ‘‘written’’ and ‘‘signature’’—statement of policy.
1101.67
Prior authorization.
1101.68
Invoicing for services.
1101.69
Overpayment—underpayment.
1101.69a
Establishment of a uniform period for the recoupment of overpayments from providers (COBRA).
1101.70
{Reserved}.
1101.71
Utilization control.
1101.72
Invoice adjustment.
1101.73
Provider misutilization and abuse.
1101.74
Provider fraud.
1101.75
Provider prohibited acts.
1101.75a
Business arrangements between nursing facilities and pharmacy providers—statement of policy.
1101.76
Criminal penalties.
1101.77
Enforcement actions by the Department.
1101.77a
Termination for convenience and best interests of the Department—statement of policy.
1101.81
{Reserved}.
1101.82
Re-enrollment.
1101.83
Restitution and repayment.
1101.84
Provider right of appeal.
1101.91
Recipient misutilization and abuse.
1101.92
Recipient prohibited acts, criminal penalties and civil penalties.
1101.93
Restitution by recipient.
1101.94
Recipient right of appeal.
1101.95
Conflicts between general and specific provisions.