42 C.F.R. § 456.432

Current through October 31, 2024

Section 456.432 - Evaluation criteria for continued stay

The UR plan must provide that-

(a) The group performing UR develops written criteria to assess the need for continued stay.

(b) The group 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.

42 C.F.R. §456.432