Legislation


35 Pa. Cons. Stat. § 449.6 – Pennsylvania

Status: Enacted
Link: https://govt.westlaw.com/pac/Document/NAA61D44064E511DE91F5EACF50AC3B69?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default)

Authorizes the PHC4 to collect data on provider quality and provider services under the Uniform Claims and Billing Form that the PHC4 maintains. The Council is required to collect, among other things, patient demographic information, procedure information, health care facility identifiers, physician identifiers, total charges broken down by category, actual payments to the health care facility and physician receives, and the identity of the primary payer. According to the APCD Council, Pennsylvania is actively working on developing a product to better deploy the payment data online. This section also mandates that providers must submit, in addition to the foregoing, audited annual financial statements, Medicare cost reports, and any other data the council requires to carry out its responsibilities. Implementing regulations under this section can be found here.


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