55 Pa. Code § 1245.71 - Scope of claims review procedures

Current through Register Vol. 51, No. 52, December 25, 2021

Claims submitted for payment under the MA Program are subject to the utilization control procedures established in Chapter 1101 (relating to general provisions). Providers shall fully cooperate with audits and reviews made by the Department for the purpose of determining the validity and claims, the reasonableness and necessity of services provided and charges made to the general public.


55 Pa. Code § 1245.71
The provisions of this § 1245.71 adopted October 31, 1980, effective November 1, 1980, 10 Pa.B. 4257.

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