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 Admission |
§ 456.126 - Time limits for final decision and notification of adverse decision.
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§ 456.126 Time limits for final decision and notification of adverse decision.
Except as required under § 456.127, the UR plan must provide that the committee makes a final decision on a beneficiary's need for admission and gives notice of an adverse final decision -
(a) Within two working days after admission, for an individual who is receiving Medicaid at that time; or
(b) Within two working days after the hospital is notified of the application for Medicaid, for an individual who applies while in the hospital.