Pa. Code tit. 55, pt. III, ch. 1101 - GENERAL PROVISIONS

This chapter cited in 55 Pa. Code § 52.3 (relating to definitions); 55 Pa. Code § 52.14 (relating to ongoing responsibilities of providers); 55 Pa. Code § 52.22 (relating to provider monitoring); 55 Pa. Code § 52.24 (relating to quality management); 55 Pa. Code § 52.42 (relating to payment policies); 55 Pa. Code § 52.65 (relating to appeals); 55 Pa. Code § 283.31 (relating to funeral director violations); 55 Pa. Code § 1102.1 (relating to policy); 55 Pa. Code § 1102.41 (relating to provider participation and enrollment); 55 Pa. Code § 1102.71 (relating to scope of claims review procedures); 55 Pa. Code § 1102.81 (relating to prohibited acts of a shared health facility and providers practicing in the shared health facility); 55 Pa. Code § 1121.1 (relating to policy); 55 Pa. Code § 1121.11 (relating to types of services covered); 55 Pa. Code § 1121.12 (relating to outpatient services); 55 Pa. Code § 1121.24 (relating to scope of benefits for GA recipients); 55 Pa. Code § 1121.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1121.51 (relating to general payment policy); 55 Pa. Code § 1121.71 (relating to scope of claims review procedures); 55 Pa. Code § 1121.81 (relating to provider misutilization); 55 Pa. Code § 1123.1 (relating to policy); 55 Pa. Code § 1123.11 (relating to types of services covered); 55 Pa. Code § 1123.12 (relating to outpatient services); 55 Pa. Code § 1123.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1123.24 (relating to scope of benefits for GA recipients); 55 Pa. Code § 1123.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1123.51 (relating to general payment policy); 55 Pa. Code § 1123.71 (relating to scope of claim review procedures); 55 Pa. Code § 1123.81 (relating to provider misutilization); 55 Pa. Code § 1126.1 (relating to policy); 55 Pa. Code § 1126.24 (relating to scope of benefits for GA recipients); 55 Pa. Code § 1126.41 (relating to participation requirements); 55 Pa. Code § 1126.51 (relating to general payment policy); 55 Pa. Code § 1126.71 (relating to scope of utiliza-tion review process); 55 Pa. Code § 1126.81 (relating to provider misutilization); 55 Pa. Code § 1126.82 (relating to administrative sanctions); 55 Pa. Code § 1126.91 (relating to provider right of appeal); 55 Pa. Code § 1127.1 (relating to policy); 55 Pa. Code § 1127.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1127.51 (relating to general payment policy); 55 Pa. Code § 1128.1 (relating to policy); 55 Pa. Code § 1128.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1128.51 (relating to general payment policy); 55 Pa. Code § 1128.81 (relating to provider misutilization); 55 Pa. Code § 1129.1 (relating to policy); 55 Pa. Code § 1129.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1129.41 (relating to participation requirements); 55 Pa. Code § 1129.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1129.71 (relating to scope of claims review procedures); 55 Pa. Code § 1129.81 (relating to provider misutilization); 55 Pa. Code § 1130.2 (relating to policy); 55 Pa. Code § 1130.23 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1130.81 (relating to scope of utilization review process); 55 Pa. Code § 1130.91 (relating to provider misutilization); 55 Pa. Code § 1130.101 (relating to hospice right of appeal); 55 Pa. Code § 1140.1 (relating to purpose); 55 Pa. Code § 1140.41 (relating to participation requirements); 55 Pa. Code § 1140.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1140.51 (relating to general payment policy); 55 Pa. Code § 1140.71 (relating to scope of claims review procedures); 55 Pa. Code § 1140.81 (relating to provider misutilization); 55 Pa. Code § 1141.1 (relating to policy); 55 Pa. Code § 1141.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1141.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1141.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1141.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1141.51 (relating to general payment policy); 55 Pa. Code § 1141.71 (relating to scope of claims review procedures); 55 Pa. Code § 1141.81 (relating to provider misutilization); 55 Pa. Code § 1142.1 (relating to policy); 55 Pa. Code § 1142.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1142.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1142.51 (relating to general payment policy); 55 Pa. Code § 1142.71 (relating to scope of claims review procedures); 55 Pa. Code § 1142.81 (relating to provider misutilization); 55 Pa. Code § 1143.1 (relating to policy); 55 Pa. Code § 1143.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1143.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1143.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1143.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1143.51 (relating to general payment policy); 55 Pa. Code § 1143.71 (relating to scope of claims review procedures); 55 Pa. Code § 1143.81 (relating to provider misutilization); 55 Pa. Code § 1144.1 (relating to policy); 55 Pa. Code § 1144.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1144.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1144.51 (relating to general payment policy); 55 Pa. Code § 1144.71 (relating to scope of claims review procedures); 55 Pa. Code § 1144.81 (relating to provider misutilization); 55 Pa. Code § 1145.1 (relating to policy); 55 Pa. Code § 1145.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1145.41 (relating to participation requirements); 55 Pa. Code § 1145.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1145.51 (relating to general payment policy); 55 Pa. Code § 1145.71 (relating to scope of claims review procedures); 55 Pa. Code § 1145.81 (relating to provider misutilization); 55 Pa. Code § 1147.1 (relating to policy); 55 Pa. Code § 1147.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1147.41 (relating to participation requirements); 55 Pa. Code § 1147.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1147.51 (relating to general payment policy); 55 Pa. Code § 1147.53 (relating to limitations on payment); 55 Pa. Code § 1147.71 (relating to scope of claims review procedures); 55 Pa. Code § 1147.81 (relating to provider misutilization); 55 Pa. Code § 1149.1 (relating to policy); 55 Pa. Code § 1149.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1149.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1149.23 (relating to scope of benefits for State Blind Pension recipients); 55 Pa. Code § 1149.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1149.43 (relating to requirements for dental records); 55 Pa. Code § 1149.51 (relating to general payment policy); 55 Pa. Code § 1149.54 (relating to payment policies for orthodontic services); 55 Pa. Code § 1149.71 (relating to scope of claims review procedures); 55 Pa. Code § 1149.81 (relating to provider misutilization); 55 Pa. Code § 1150.1 (relating to policy); 55 Pa. Code § 1150.51 (relating to general payment policies); 55 Pa. Code § 1150.61 (relating to guidelines for fee schedule changes); 55 Pa. Code § 1151.1 (relating to policy); 55 Pa. Code § 1151.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1151.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1151.24 (relating to scope of benefits for GA recipients); 55 Pa. Code § 1151.31 (relating to participation requirements); 55 Pa. Code § 1151.33 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1151.41 (relating to general payment policy); 55 Pa. Code § 1151.70 (relating to scope of claim review process); 55 Pa. Code § 1151.91 (relating to provider abuse); 55 Pa. Code § 1151.101 (relating to provider right of appeal); 55 Pa. Code § 1153.1 (relating to policy); 55 Pa. Code § 1153.12 (relating to outpatient services); 55 Pa. Code § 1153.41 (relating to participation requirements); 55 Pa. Code § 1153.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1153.51 (relating to general payment policy); 55 Pa. Code § 1153.71 (relating to scope of claims review procedures); 55 Pa. Code § 1153.81 (relating to provider misutilization); 55 Pa. Code § 1155.1 (relating to policy); 55 Pa. Code § 1155.21 (relating to participation requirements); 55 Pa. Code § 1155.22 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1155.31 (relating to general payment policy); 55 Pa. Code § 1155.41 (relating to scope of claims review procedures); 55 Pa. Code § 1155.51 (relating to provider misutilization); 55 Pa. Code § 1163.1 (relating to policy); 55 Pa. Code § 1163.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1163.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1163.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1163.41 (relating to general participation requirements); 55 Pa. Code § 1163.43 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1163.51 (relating to general payment policy); 55 Pa. Code § 1163.63 (relating to billing requirements); 55 Pa. Code § 1163.71 (relating to scope of utilization review process); 55 Pa. Code § 1163.91 (relating to provider misutilization); 55 Pa. Code § 1163.101 (relating to provider right to appeal); 55 Pa. Code § 1163.401 (relating to policy); 55 Pa. Code § 1163.402 (relating to definitions); 55 Pa. Code § 1163.421 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1163.422 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1163.424 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1163.441 (relating to general participation requirements); 55 Pa. Code § 1163.443 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1163.451 (relating to general payment policy); 55 Pa. Code § 1163.456 (relating to third-party liability); 55 Pa. Code § 1163.471 (relating to scope of claim review process); 55 Pa. Code § 1163.491 (relating to provider misutilization); 55 Pa. Code § 1163.501 (relating to provider right to appeal); 55 Pa. Code § 1181.1 (relating to policy); 55 Pa. Code § 1181.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1181.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1181.25 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1181.41 (relating to provider participation requirements); 55 Pa. Code § 1181.45 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1181.51 (relating to general payment policy); 55 Pa. Code § 1181.62 (relating to noncompensable services); 55 Pa. Code § 1181.74 (relating to auditing requirements related to cost reports); 55 Pa. Code § 1181.81 (relating to scope of claims review procedures); 55 Pa. Code § 1181.86 (relating to provider misutilization); 55 Pa. Code § 1181.231 (relating to standards for general and selected costs); 55 Pa. Code Chapter 1181 Appendix O (relating to OBRA sanctions); 55 Pa. Code § 1187.1 (relating to policy); 55 Pa. Code § 1187.11 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1187.12 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1187.21 (relating to nursing facility participation requirements); 55 Pa. Code § 1187.22 (relating to ongoing responsibilities of nursing facilities); 55 Pa. Code § 1187.77 (relating to auditing requirements related to cost report); 55 Pa. Code § 1187.101 (relating to general payment policy); 55 Pa. Code § 1187.155 (relating to exceptional DME grants-payment conditions and limitations); 55 Pa. Code § 1189.1 (relating to policy); 55 Pa. Code § 1189.74 (relating to auditing requirements related to MA cost report); 55 Pa. Code § 1189.101 (relating to general payment policy for county nursing facilities); 55 Pa. Code § 1221.1 (relating to policy); 55 Pa. Code § 1221.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1221.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1221.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1221.41 (relating to participation requirements); 55 Pa. Code § 1221.46 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1221.51 (relating to general payment policy); 55 Pa. Code § 1221.71 (relating to scope of claims review procedures); 55 Pa. Code § 1221.81 (relating to provider misutilization); 55 Pa. Code § 1223.1 (relating to policy); 55 Pa. Code § 1223.12 (relating to outpatient services); 55 Pa. Code § 1223.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1223.41 (relating to participation requirements); 55 Pa. Code § 1223.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1223.51 (relating to general payment policy); 55 Pa. Code § 1223.71 (relating to scope of claims review procedures); 55 Pa. Code § 1223.81 (relating to provider misutilization); 55 Pa. Code § 1225.1 (relating to policy); 55 Pa. Code § 1225.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1225.41 (relating to general participation requirements); 55 Pa. Code § 1225.45 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1225.51 (relating to general payment policy); 55 Pa. Code § 1225.71 (relating to scope of claims review procedures); 55 Pa. Code § 1225.81 (relating to provider misutilization); 55 Pa. Code § 1229.1 (relating to policy); 55 Pa. Code § 1229.41 (relating to participation requirements); 55 Pa. Code § 1229.71 (relating to scope of claims review procedures); 55 Pa. Code § 1229.81 (relating to provider misutilization); 55 Pa. Code § 1230.1 (relating to policy); 55 Pa. Code § 1230.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1230.41 (relating to participation requirements); 55 Pa. Code § 1230.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1230.51 (relating to general payment policy); 55 Pa. Code § 1230.71 (relating to scope of claim review procedures); 55 Pa. Code § 1230.81 (relating to provider misutilization); 55 Pa. Code § 1241.1 (relating to policy); 55 Pa. Code § 1241.41 (relating to participation requirements); 55 Pa. Code § 1241.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1241.71 (relating to scope of claims review procedures); 55 Pa. Code § 1241.81 (relating to provider misutilization); 55 Pa. Code § 1243.1 (relating to policy); 55 Pa. Code § 1243.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1243.41 (relating to participation requirements); 55 Pa. Code § 1243.51 (relating to general payment policy); 55 Pa. Code § 1243.71 (relating to scope of claims review procedures); 55 Pa. Code § 1243.81 (relating to provider misutilization); 55 Pa. Code § 1245.1 (relating to policy); 55 Pa. Code § 1245.2 (relating to definitions); 55 Pa. Code § 1245.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1245.41 (relating to participation requirements); 55 Pa. Code § 1245.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1245.51 (relating to general payment policy); 55 Pa. Code § 1245.71 (relating to scope of claims review procedures); 55 Pa. Code § 1245.81 (relating to provider misutilization); 55 Pa. Code § 1247.1 (relating to policy); 55 Pa. Code § 1247.41 (relating to participation requirements); 55 Pa. Code § 1247.71 (relating to scope of claim review procedures); 55 Pa. Code § 1247.81 (relating to provider misutilization); 55 Pa. Code § 1249.1 (relating to policy); 55 Pa. Code § 1249.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1249.41 (relating to participation requirements); 55 Pa. Code § 1249.42 (relating to ongoing responsibilities of providers); 55 Pa. Code § 1249.51 (relating to general payment policy); 55 Pa. Code § 1249.71 (relating to scope of claims review procedures); 55 Pa. Code § 1249.81 (relating to provider misutilization); 55 Pa. Code § 1251.1 (relating to policy); 55 Pa. Code § 1251.24 (relating to scope of benefits for General Assistance recipients); 55 Pa. Code § 1251.71 (relating to scope of claims review procedures); 55 Pa. Code § 1251.81 (relating to provider misutilization); 55 Pa. Code § 5221.11 (relating to provider participation); 55 Pa. Code § 5221.41 (relating to recordkeeping); 55 Pa. Code § 5221.42 (relating to payment); 55 Pa. Code § 6100.81 (relating to HCBS provider requirements); 55 Pa. Code § 6100.482 (relating to payment); 55 Pa. Code § 6210.2 (relating to applicability); 55 Pa. Code § 6210.11 (relating to payment); 55 Pa. Code § 6210.21 (relating to categorically needy and medically needy recipients); 55 Pa. Code § 6210.75 (relating to noncompensable services); 55 Pa. Code § 6210.82 (relating to annual adjustment); 55 Pa. Code § 6210.93 (relating to auditing requirements related to cost reports); 55 Pa. Code § 6210.101 (relating to scope of claims review procedures); 55 Pa. Code § 6210.109 (relating to provider misutilization); and 55 Pa. Code § 6211.2 (relating to applicability).