Claims submitted for payment under the MA Program are subject to the utilization review procedures established in Chapter 1101 (relating to general provisions). In addition, the Department will perform the reviews specified in this section and §§ 6210.102-6210.109 for controlling the utilization of ICF/ID services.
55 Pa. Code § 6210.101
The provisions of this §6210.101 amended under section 443.1(2) and (3) of the Human Services Code (62 P.S. § 443.1(2) and (3)).