Section 1181.62. Noncompensable services

Payment will not be made to a nursing facility for:

(1) Services provided to a recipient who no longer requires the level of care for which payment is authorized by the County Assistance Office.

(2) Reserved bed days that exceed the limits set for the different levels of care in § 1181.56 (relating to limitations on payment for reserved beds).

(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 County Assistance Office.

(4) Services covered but disallowed by Medicare.

(5) Services rendered by a provider that do not meet the conditions for payment established by this chapter and Chapter 1101 (relating to general provisions).

The provisions of this § 1181.62 codified July 24, 1981, effective July 25, 1981, 11 Pa.B. 2610; amended March 10, 1989, effective immediately and applies retroactively to February 23, 1988, 19 Pa.B. 999; amended March 10, 1989, effective immediately and applies retroactively to January 1, 1989, 19 Pa.B. 1005. Immediately preceding text appears at serial page (117427).

Notation

Cross References

This section cited in 55 Pa. Code § 1181.52 (relating to payment conditions).