US Codex
C.F.R.
Browse by date

View an earlier version

Latest
2026-08-27
Browse all versions by date
Notes

42 C.F.R. §§ 456.141–456.145

5 sections in range

§456.141. Purpose and general description.

42 C.F.R. § 456.141

(a)
The purpose of medical care evaluation studies is to promote the most effective and efficient use of available health facilities and services consistent with patient needs and professionally recognized standards of health care.
(b)
Medical care evaluation studies—
(1)
Emphasize identification and analysis of patterns of patient care; and
(2)
Suggest appropriate changes needed to maintain consistently high quality patient care and effective and efficient use of services.
Notes, amendments, and revision history

Authority

Authority: 42 U.S.C. 1302.

Source

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

§456.142. UR plan requirements for medical care evaluation studies.

42 C.F.R. § 456.142

(a)
The UR plan must describe the methods that the committee uses to select and conduct medical care evaluation studies under paragraph (b)(1) of this section.
(b)
The UR plan must provide that the UR committee—
(1)
Determines the methods to be used in selecting and conducting medical care evaluation studies in the hospital;
(2)
Documents for each study—
(i)
Its results; and
(ii)
How the results have been used to make changes to improve the quality of care and promote more effective and efficient use of facilities and services;
(3)
Analyzes its findings for each study; and
(4)
Takes action as needed to—
(i)
Correct or investigate further any deficiencies or problems in the review process for admissions or continued stay cases;
(ii)
Recommend more effective and efficient hospital care procedures; or
(iii)
Designate certain providers or categories of admissions for review prior to admission.
Notes, amendments, and revision history

Authority

Authority: 42 U.S.C. 1302.

Source

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

§456.143. Content of medical care evaluation studies.

42 C.F.R. § 456.143

Each medical care evaluation study must—
(a)
Identify and analyze medical or administrative factors related to the hospital's patient care;
(b)
Include analysis of at least the following—
(1)
Admissions;
(2)
Durations of stay;
(3)
Ancillary services furnished, including drugs and biologicals;
(4)
Professional services performed in the hospital; and
(c)
If indicated, contain recommendations for changes beneficial to patients, staff, the hospital, and the community.
Notes, amendments, and revision history

Authority

Authority: 42 U.S.C. 1302.

Source

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

§456.144. Data sources for studies.

42 C.F.R. § 456.144

Data that the committee uses to perform studies must be obtained from one or more of the following sources:
(a)
Medical records or other appropriate hospital data;
(b)
External organizations that compile statistics, design profiles, and produce other comparative data;
(c)
Cooperative endeavors with—
(1)
QIOs;
(2)
Fiscal agents;
(3)
Other service providers; or
(4)
Other appropriate agencies.
Notes, amendments, and revision history

Amendments

[43 FR 45266, Sept. 29, 1978, as amended at 51 FR 43198, Dec. 1, 1986]

Authority

Authority: 42 U.S.C. 1302.

Source

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

Amendments

[43 FR 45266, Sept. 29, 1978, as amended at 51 FR 43198, Dec. 1, 1986]

§456.145. Number of studies required to be performed.

42 C.F.R. § 456.145

The hospital must, at least, have one study in progress at any time and complete one study each calendar year.
Notes, amendments, and revision history

Authority

Authority: 42 U.S.C. 1302.

Source

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