SUBPART C—Utilization Control: Hospitals (§456.50 to §456.145)
- 456.50—Scope.
- 456.51—Definitions.
- 456.60—Certification and recertification of need for inpatient care.
- 456.80—Individual written plan of care.
- 456.100—Scope.
- 456.101—UR plan required for inpatient hospital services.
- 456.105—UR committee required.
- 456.106—Organization and composition of UR committee; disqualification from UR committee membership.
- 456.111—Recipient information required for UR.
- 456.112—Records and reports.
- 456.113—Confidentiality.
- 456.121—Admission review required.
- 456.122—Evaluation criteria for admission review.
- 456.123—Admission review process.
- 456.124—Notification of adverse decision.
- 456.125—Time limits for admission review.
- 456.126—Time limits for final decision and notification of adverse decision.
- 456.127—Pre-admission review.
- 456.128—Initial continued stay review date.
- 456.129—Description of methods and criteria: Initial continued stay review date; close professional scrutiny; length of stay modification.
- 456.131—Continued stay review required.
- 456.132—Evaluation criteria for continued stay.
- 456.133—Subsequent continued stay review dates.
- 456.134—Description of methods and criteria: Subsequent continued stay review dates; length of stay modification.
- 456.135—Continued stay review process.
- 456.136—Notification of adverse decision.
- 456.137—Time limits for final decision and notification of adverse decision.
- 456.141—Purpose and general description.
- 456.142—UR plan requirements for medical care evaluation studies.
- 456.143—Content of medical care evaluation studies.
- 456.144—Data sources for studies.
- 456.145—Number of studies required to be performed.