Subpart D - Utilization Control: Mental Hospitals  


§ 456.150 - Scope.
§ 456.151 - Definitions.
Medical, Psychiatric, and Social Evaluations and Admission Review
§ 456.170 - Medical, psychiatric, and social evaluations.
§ 456.171 - [Reserved]
Plan of Care
§ 456.180 - Individual written plan of care.
§ 456.181 - Reports of evaluations and plans of care.
Ur Plan: Medical Care Evaluation Studies
§ 456.241 - Purpose and general description.
§ 456.242 - UR plan requirements for medical care evaluation studies.
§ 456.243 - Content of medical care evaluation studies.
§ 456.244 - Data sources for studies.
§ 456.245 - Number of studies required to be performed.
Utilization Review (Ur) Plan: General Requirements
§ 456.200 - Scope.
§ 456.201 - UR plan required for inpatient mental hospital services.
Ur Plan: Informational Requirements
§ 456.211 - Beneficiary information required for UR.
§ 456.212 - Records and reports.
§ 456.213 - Confidentiality.
Certification of Need for Care
§ 456.160 - Certification and recertification of need for inpatient care.
Ur Plan: Review of Need for Continued Stay
§ 456.231 - Continued stay review required.
§ 456.232 - Evaluation criteria for continued stay.
§ 456.233 - Initial continued stay review date.
§ 456.234 - Subsequent continued stay review dates.
§ 456.235 - Description of methods and criteria: Continued stay review dates; length of stay modification.
§ 456.236 - Continued stay review process.
§ 456.237 - Notification of adverse decision.
§ 456.238 - Time limits for final decision and notification of adverse decision.
Ur Plan: Administrative Requirements
§ 456.205 - UR committee required.
§ 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.