§ 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]