Payment will not be made for:

1. (1) Services provided to a recipient who no longer requires the level of care for which payment is authorized by the CAO.
2. (2) Reserved bed days that exceed the limits specified in § 6210.71 (relating to limitations on payment for reserved bed days).
3. (3) Services provided to a recipient occupying a bed which is not certified for the level of care for which payment is authorized by the CAO.
4. (4) Services covered but disallowed by Medicare.
5. (5) Services rendered by a provider that do not meet the conditions for payment established by this chapter and Chapters 1101 and 6211 (relating to general provisions; and allowable cost reimbursement for non-State operated intermediate care facilities for individuals with an intellectual disability).
6. (6) Services directly reimbursable under the MA Program.

Authority

The provisions of this § 6210.75 amended under section 443.1(2) and (3) of the Human Services Code (62 P.S. § 443.1(2) and (3)).

Source

The provisions of this § 6210.75 amended June 17, 2016, effective June 18, 2016, 46 Pa.B. 3177. Immediately preceding text appears at serial page (276206).