Section 1163.401. Policy

Section 1163.402. Definitions

Section 1163.421. Scope of benefits for the categorically needy

Section 1163.422. Scope of benefits for the medically needy

Section 1163.423. Scope of benefits for State Blind Pension recipients

Section 1163.424. Scope of benefits for General Assistance recipients

Section 1163.441. General participation requirements

Section 1163.442. Requirements for reimbursement under this subchapter

Section 1163.443. Ongoing responsibilities of providers

Section 1163.451. General payment policy

Section 1163.451a. Clarification of the term ‘‘in writing’’—statement of policy

Section 1163.452. Payment methods and rates

Section 1163.453. Allowable and nonallowable costs

Section 1163.454. Limitations on payment

Section 1163.455. Noncompensable services and items

Section 1163.455a. Utilization guidelines for inpatient hospital drug and alcohol services under the MA Program—statement of policy

Section 1163.456. Third-party liability

Section 1163.457. Payment policies relating to out-of-State hospitals

Section 1163.458. Payment policies relating to same-calendar-day admissions and discharges

Section 1163.459. Disproportionate share payments

Section 1163.471. Scope of claim review process

Section 1163.472. Concurrent hospital review

Section 1163.473. Hospital utilization review plan

Section 1163.474. Requirements for hospital utilization review committees

Section 1163.475. Responsibilities of the hospital utilization review committee

Section 1163.476. Plan of care

Section 1163.477. Admission review requirements

Section 1163.478. Continued stay review requirements

Section 1163.479. Medical Care Evaluation studies

Section 1163.480. Adverse determinations

Section 1163.481. Utilization review sanctions

Section 1163.491. Provider misutilization

Section 1163.492. Payment policy relating to administrative sanctions

Section 1163.501. Provider right to appeal

Section 1163.511. Change of ownership or control