§456.122. Evaluation criteria for admission review.

42 C.F.R. § 456.122

The UR plan must provide that—

(a)

The committee develops written medical care criteria to assess the need for admission; and

(b)

The committee develops more extensive written criteria for cases that its experience shows are—

(1)

Associated with high costs;

(2)

Associated with the frequent furnishing of excessive services; or

(3)

Attended by physicians whose patterns of care are frequently found to be questionable.

Notes, amendments, and revision history

Authority: 42 U.S.C. 1302.

Source: 43 FR 45266, Sept. 29, 1978, unless otherwise noted.