Learn More
Log In
Sign Up
Acute Care General Hospitals under the Prospective Payment System | Midpage
Collections
Pennsylvania Code
Title 55
Part III
Chapter 1163
Acute Care General Hospitals under the Prospective Payment System
Acute Care General Hospitals under the Prospective Payment System
1163.1
Policy.
1163.2
Definitions.
1163.21
Scope of benefits for the categorically needy.
1163.22
Scope of benefits for the medically needy.
1163.23
Scope of benefits for State Blind Pension recipients.
1163.24
Scope of benefits for General Assistance recipients.
1163.31
[Reserved].
1163.32
Hospital units excluded from the DRG prospective payment system.
1163.41
General participation requirements.
1163.42
[Reserved].
1163.43
Ongoing responsibilities of providers.
1163.51
General payment policy.
1163.52
Prospective payment methodology.
1163.52a
Assignment of DRG—statement of policy.
1163.53
[Reserved].
1163.53a
Prospective capital reimbursement system.
1163.54
[Reserved].
1163.55
Payments for direct medical education for Fiscal Years 1993-94 and 1994-95.
1163.56
Outliers.
1163.57
Payment policy for readmissions.
1163.58
Payment policy for transfers.
1163.59
Noncompensable services, items and outlier days.
1163.59a
Utilization guidelines for inpatient hospital drug and alcohol services under the MA Program—statement of policy.
1163.60
Payment conditions for sterilizations.
1163.61
Payment conditions for hysterectomies.
1163.62
Payment conditions for abortions.
1163.63
Billing requirements.
1163.64
Cost reports.
1163.65
Payment for out-of-State hospital services.
1163.66
Third-party liability.
1163.67
Disproportionate share payments.
1163.70
Changes of ownership or control.
1163.71
Scope of utilization review process.
1163.72
Utilization review: general.
1163.73
Hospital utilization review plan.
1163.74
Requirements for hospital utilization review committees.
1163.75
Responsibilities of the hospital utilization review committee.
1163.76
Plan of care.
1163.77
Admission review requirements.
1163.78
[Reserved].
1163.78a
Review requirements for day outliers.
1163.78b
Review requirements for cost outliers.
1163.79
Medical Care Evaluation studies.
1163.80
Adverse determinations.
1163.81
[Reserved].
1163.91
Provider misutilization.
1163.92
Administrative sanctions.
1163.101
Provider right to appeal.
1163.121
[Reserved].
1163.122
Determination of DRG relative values.
1163.123
[Reserved].
1163.124
[Reserved].
1163.125
[Reserved].
1163.126
Computation of hospital specific base payment rates.
1163.127
[Reserved].