Current through Register Vol. 54, No. 24, June 15, 2024
Section 1163.454 - Limitations on payment(a) Payment for blood will be limited to the first three pints of whole blood provided during a period of hospitalization. An exception to this limit is made only if the patient has hemophilia, in which case payment is made for the amount of whole blood or blood products the patient requires.(b) Payment for cost reimbursed drug and alcohol detoxification-rehabilitation services in a general hospital will be limited to days certified under § 1163.471 (relating to scope of claims review process) during which the inidividual with a drug or alcohol diagnosis is a patient in a drug and alcohol detoxification rehabilitation unit approved by the Department of Health.(c) A recipient is limited to two periods of therapeutic leave per calendar month. Neither of these periods of therapeutic leave may exceed 12 hours in a calendar day.The provisions of this § 1163.454 adopted June 22, 1984, effective 7/1/1984, 14 Pa.B. 2185; amended July 12, 1985, effective 7/13/1985, 15 Pa.B. 2572, and will apply to reimbursement for services for FY 1984-85 for each fiscal year thereafter; amended November 7, 1986, effective 7/1/1986, 16 Pa.B. 4384; amended June 18, 1993, effective 7/1/1993, 23 Pa.B. 2917; amended October 29, 1993, effective 7/1/1993, 23 Pa.B. 5241.The provisions of this § 1163.454 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. §§ 201 and 443.1(1)).
This section cited in 55 Pa. Code § 1163.451 (relating to general payment policy); 55 Pa. Code § 1163.455 (relating to noncompensable services and items); and 55 Pa. Code § 1163.457 (relating to payment policies relating to out-of-State hospitals).