Code of Federal Regulations (Last Updated: October 10, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter C - Medical Assistance Programs |
Part 456 - Utilization Control |
Subpart C - Utilization Control: Hospitals |
Ur Plan: Review of Need for Continued Stay |
§ 456.132 - Evaluation criteria for continued stay.
Latest version.
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§ 456.132 Evaluation criteria for continued stay.
The UR plan must provide that -
(a) The committee develops written medical care criteria to assess the need for continued stay.
(b) The committee develops more extensive written criteria for cases that its experience shows are -
(1) Associated with high costs;
(2) Associated with the frequent furnishing of excessive services; or
(3) Attended by physicians whose patterns of care are frequently found to be questionable.