28 Pa. Code § 9.677
Current through Register Vol. 54, No. 24, June 15, 2024
The definition of "medical necessity" shall be the same in the plan's provider contracts, enrollee contracts and other materials used to evaluate appropriateness and to determine coverage of health care services. The definition shall comply with the HMO Act, the PPO Act, Act 68 and this chapter.
28 Pa. Code § 9.677