---
kind: "section"
citation: "42 C.F.R. § 456.406"
title: "42"
number: "456.406"
heading: "Description of UR review function: Who performs UR; disqualification from performing UR."
url: "https://uscodex.org/cfr/42/456.406"
---

# §456.406. Description of UR review function: Who performs UR; disqualification from performing UR.

- (a) The UR plan must include a written description of who performs UR in the ICF.
- (b) UR must be performed using a method specified under [§ 456.401(b)](/cfr/42/456.401.md?p=b) by a group of professional personnel that includes—
  - (1) At least one physician;
  - (2) In an ICF that cares primarily for mental patients, at least one individual knowledgeable in the treatment of mental diseases; and
  - (3) In an institution for individuals with intellectual disabilities, a least one individual knowledgeable in the treatment of intellectual disability.
- (c) The group performing UR may not include any individual who—
  - (1) Is directly responsible for the care of the beneficiary whose care is being reviewed;
  - (2) Is employed by the ICF; or
  - (3) **Has a financial interest in any ICF.**

## Notes

### Authority

Authority: 42 U.S.C. 1302.

### Source

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