Ala. Admin. Code r. 560-X-5-.07

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-5-.07 - Utilization Review (UR) Plan

As a condition of participation in the Title XIX Medicaid program, each psychiatric facility shall:

(1) Have in effect a written UR Plan that provides for review of each recipient's need for services that the facility furnishes to him. This written UR Plan must meet the requirements under 42 C.F.R. Section 456.201 through Section 456.245;

(2) Maintain recipient information required for the UR Plan under 42 C.F.R. Section 456.211, which shall include the certification of need for service and the plan of care; and

(3) Provide a copy of the UR Plan and any subsequent revisions to Medicaid for review and approval.

Author:

Ala. Admin. Code r. 560-X-5-.07

New Rule: Filed September 6, 1995; effective October 12, 1995.

Statutory Authority:42 C.F.R. Section 456.200 - 456.245.