42 C.F.R. § 456.520

Current through November 30, 2024

Section 456.520 - Definitions

As used in §§ 456.521 through 456.525 of this subpart:

Available physician or other professional personnel means an individual who-

(a) Is professionally qualified;

(b) Is not precluded from participating in UR under § 456.107 of subpart C; or § 456.207 of subpart D; and

(c) Is not precluded from effective participation in UR because he requires more than approximately 1 hour to travel between the remote facility and his place of work.

Remote facility means a facility located in an area that does not have enough available physicians or other professional personnel to perform UR as required under subparts C or D of this part, and for which the State requests a variance.

Variance means permission granted by the Administrator to the Medicaid agency for a specific remote facility to use time periods different from those specified for the start and completion of reviews of all cases under the following sections: §§ 456.125 , 456.126 , 456.136 , and 456.137 of subpart C; and § 456.238 of subpart D.

42 C.F.R. §456.520

43 FR 45266, Sept. 29, 1978, as amended at 61 FR 38399, July 24, 1996