§456.23. Post-payment review process.

42 C.F.R. § 456.23

The agency must have a post-payment review process that—

(a)

Allows State personnel to develop and review—

(1)

Beneficiary utilization profiles;

(2)

Provider service profiles; and

(3)

Exceptions criteria; and

(b)

Identifies exceptions so that the agency can correct misutilization practices of beneficiaries and providers.

Notes, amendments, and revision history

Authority: 42 U.S.C. 1302.

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