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Code of Federal Regulations (Last Updated: May 6, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter C - Medical Assistance Programs |
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Part 456 - Utilization Control |
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Subpart H - Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals |
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Ur Plan: Remote Facility Variances from Time Requirements |
§ 456.520 - Definitions.
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§ 456.520 Definitions.
As used in §§ 456.521 through 456.525 of this subpart:
Available physician or other professional personnel means an individual who -
(a) Is professionally qualified;
(b) Is not precluded from participating in UR under § 456.107 of subpart C; or § 456.207 of subpart D; and
(c) Is not precluded from effective participation in UR because he requires more than approximately 1 hour to travel between the remote facility and his place of work.
Remote facility means a facility located in an area that does not have enough available physicians or other professional personnel to perform UR as required under subparts C or D of this part, and for which the State requests a variance.
Variance means permission granted by the Administrator to the Medicaid agency for a specific remote facility to use time periods different from those specified for the start and completion of reviews of all cases under the following sections: §§ 456.125, 456.126, 456.136, and 456.137 of subpart C; and § 456.238 of subpart D.
[43 FR 45266, Sept. 29, 1978, as amended at 61 FR 38399, July 24, 1996]