The Department does not pay dialysis facilities for:
- (1) Services that do not conform to this chapter.
- (2) Services provided by a dialysis facility that does not meet the Federal Medicare requirements at 42 CFR 405.2100 (relating to scope of subpart).
- (3) Services and items to the extent that payment is available through Medicare, other health insurance programs or financial resources.
- (4) Diagnostic or therapeutic procedures solely for experimental, research or educational purposes.
- (5) Procedures that are not listed in the MA Program fee schedule.
- (6) Services that are not medically necessary.
- (7) Services provided to recipients who are hospital inpatients.