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Medicare Data Requirements in Pennsylvania

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        Providers and health care facilities participating in Medicare are also required to maintain medical records and patient data.1  Medical records must be maintained for at least four years.2

        Numerous types of health care facilities are required by Pennsylvania law to submit their Medicare cost reports to the Department of Welfare3 or the Health Care Cost Containment Council.  These include ambulatory service facilities,4 hospitals,5 nursing facilities,6 and inpatient psychiatric facilities.7

 

Footnotes

  • 1. 62 Pa. Stat. Ann. § 1403
  • 2. 62 Pa. Stat. Ann. § 1402
  • 3. 55 Pa. Code § 1163.64
  • 4. 28 Pa. Code § 912.63
  • 5. 55 Pa. Code § 1163.64
  • 6. 55 Pa. Code § 1187.71
  • 7. 55 Pa. Code §1151.47

 

Medicare Data Requirements in Pennsylvania

Subtopic Statute/Regulation Description
Medicare Data Requirements Annual audited financial statements - 28 Pa. Code § 912.61 Hospitals and ambulatory service facilities must annually file audited and certified financial statements within 120 days after the close of the...
Annual cost reporting - 55 Pa. Code § 1151.47 Inpatient psychiatric facilities must complete form MA 336 (Financial Report for Hospital and Hospital-Health Care Complex Under the Medical...
Cost reporting - 55 Pa. Code § 1181.64 Each nursing facility must submit a cost report to the department of welfare within 90 days of the close of each fiscal year.  The cost report...
Cost reporting - 55 Pa. Code § 1187.71 Nursing facilities must report costs to the medical assistance program by filing an acceptable MA-11 with the department of welfare, which includes...
Cost reports - 55 Pa. Code § 1163.64 Hospitals must complete form MA 336 (Financial Report for Hospital and Hospital-Health Care Complex Under the Medical Assistance Program of the...
Medicare cost reports and Medical Assistance Form 336 - 28 Pa. Code § 912.63 Hospitals and ambulatory care facilities must quarterly report summary utilization and financial reports to the council. 28 Pa. Code Chapter 912,...
Required data elements - 28 Pa. Code § 912.21 Health care facilities must quarterly submit the following data elements:1         Those contained in health...
Special participation requirements for shared health facilities - 62 Pa. Stat. Ann. § 1403 The minimum care requirements for a shared health facility are as follows: Maintain proper recipient records which contain the following...
Special Provider Participation Requirements - 62 Pa. Stat. Ann. § 1402 As a condition of participation in the medical assistance program, a provider must maintain appropriate medical and financial records to fully...
Click on the individual state law in the table above to see our summary of the individual law.


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