Subpart B - MEDICAL PROVIDER PARTICIPATION

  1. § 140.11 - Enrollment Conditions for Medical Providers
  2. § 140.12 - Participation Requirements for Medical Providers
  3. § 140.13 - Definitions
  4. § 140.14 - Denial of Application to Participate in the Medical Assistance Program
  5. § 140.15 - Suspension and Denial of Payment, Recovery of Money and Penalties
  6. § 140.16 - Termination, Suspension or Exclusion of a Vendor's Eligibility to Participate in the Medical Assistance Program
  7. § 140.17 - Suspension of a Vendor's Eligibility to Participate in the Medical Assistance Program
  8. § 140.18 - Effect of Termination, Suspension, Exclusion or Revocation on Persons Associated with Vendor
  9. § 140.19 - Application to Participate or for Reinstatement Subsequent to Termination, Suspension, Exclusion or Barring
  10. § 140.20 - Submittal of Claims
  11. § 140.21 - Reimbursement for QMB Eligible Medical Assistance Recipients and QMB Eligible Only Recipients and Individuals Who Are Entitled to Medicare Part A or Part B and Are Eligible for Some Form of Medicaid Benefits
  12. § 140.22 - Magnetic Tape Billings (Repealed)
  13. § 140.23 - Payment Of Claims
  14. § 140.24 - Payment Procedures
  15. § 140.25 - Overpayment or Underpayment of Claims
  16. § 140.26 - Payment to Factors Prohibited
  17. § 140.27 - Assignment of Vendor Payments
  18. § 140.28 - Record Requirements for Medical Providers
  19. § 140.30 - Audits
  20. § 140.31 - Emergency Services Audits
  21. § 140.32 - Prohibition on Participation, and Special Permission for Participation
  22. § 140.33 - Publication of List of Sanctioned Entities
  23. § 140.35 - False Reporting and Other Fraudulent Activities
  24. § 140.40 - Prior Approval for Medical Services or Items
  25. § 140.41 - Prior Approval in Cases of Emergency
  26. § 140.42 - Limitation on Prior Approval
  27. § 140.43 - Post Approval for Items or Services When Prior Approval Cannot Be Obtained
  28. § 140.44 - Withholding of Payments Due to Fraud or Misrepresentation
  29. § 140.45 - Withholding of Payments Upon Provider Audit, Quality of Care Review, Credible Allegation of Fraud or Failure to Cooperate
  30. § 140.55 - Electronic Data Interchange Service
  31. § 140.71 - Reimbursement for Medical Services Through the Use of a C-13 Invoice Voucher Advance Payment and Expedited Payments
  32. § 140.72 - Drug Manual (Recodified)
  33. § 140.73 - Drug Manual Updates (Recodified)
  34. § 140.74 - Resolution of Claims Related to Inaccurate or Updated Enrollment Information
  35. § 140.75 - Managed Care - Disputed Provider Claims Resolution Process

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