ADMINISTRATIVE SANCTIONS

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

Source

The provisions of this § 1221.81 adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4599.

APPENDIX AMEDICAL EMERGENCYCARE SYMPTOMS Allergy Reactions, Acute (Except Allergy Tests)Glaucoma, Severe Headache, Severe Appendicitis, AcuteHeart Attack, Suspected Asthma, AcuteHemorrhage Breathing Difficulties or Shortness of BreathHysteria Insulin Shock (Overdose) Bronchitis, SevereKidney Stones Bursitis, Severe OnsetMaternity Complications, such Chest Pain, Severe as Suspected Miscarriage ChokingPain, Sudden or Severe Onset ColitisPleurisy ComaPneumonitis Convulsions and/or SeizuresPoisoning (including overdose) CystitisPyelitis Dermatitis or Hives (Resulting from Internal or Unknown Causes)Pyelonephritis (Shock) Spasms, Cerebral or Cardiac Spontaneous Pneumothorax Diabetic ComaStomach Pains, Severe Diarrhea, SevereStrangulated Hernia Drug ReactionStroke Earache, SevereSunstroke Epistaxis (nosebleed)Swollen Ring Finger FaintingTachycardia Fecal Impaction, SevereThrombosis and/or Phlebitis Food PoisoningUnconsciousness Frost BiteUrinary Retention, Acute Gall Bladder, Acute AttackVision loss, Sudden Onset GastritisVomiting, Severe Gastro-intestinal Conditions Acute

Source

The provisions of this Appendix A adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4599; amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932. Immediately preceding text appears at serial page (79331).

APPENDIX B. [Reserved]

Source

The provisions of this Appendix B adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4599; amended August 7, 1981, effective August 8, 1981, 11 Pa.B. 2770; reserved December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932. Immediately preceding text appears at serial pages (79331) to (79332).

APPENDIX C. [Reserved]

Source

The provisions of this Appendix C adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4599; reserved December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932. Immediately preceding text appears at serial pages (79332) and (60960).

APPENDIX D. [Reserved]

Source

The provisions of this Appendix D adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4599; amended February 13, 1981, effective February 15, 1981, 11 Pa.B. 657; reserved December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932. Immediately preceding text appears at serial pages (60960) to (60965).