Section 1181.95. Failure to adhere to medical evaluation requirements  


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  • If the facility fails to comply with the requirements that the physician perform a medical evaluation before admission or before authorization for payment, as described under § 1181.53 (relating to payment conditions related to the recipient’s initial need for care), which results in a penalty being imposed by DHHS on the Department, the penalty will be imposed on the facility.

The provisions of this § 1181.95 codified July 24, 1981, effective July 25, 1981, 11 Pa.B. 2610.

Notation

Cross References

This section cited in 55 Pa. Code § 1181.215 (relating to efficiency incentive); 55 Pa. Code § 1181.216 (relating to depreciation and interest reimbursement); and 55 Pa. Code § 1181.224 (relating to final per diem rate).