Section 1130.91. Provider misutilization  


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  • If the Department determines that a provider billed for services inconsistent with this chapter and Chapter 1101 (relating to general provisions), provided incorrect information on the billing invoice regarding a recipient’s diagnosis or the services provided during the period the recipient was under the care of the hospice or otherwise violated the standards set forth in the provider agreement, the provider is subject to the sanctions described in Chapter 1101.