Current through November 30, 2024
Section 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services(a) The State plan must provide that-(1) UR is performed for each ICF that furnishes inpatient services under the plan;(2) Each ICF has on file a written UR plan that provides for review of each beneficiary's need for the services that the ICF furnishes him; and(3) Each written ICF UR plan meets requirements under §§ 456.401 through 456.438 .(b) The State plan must specify the method used to perform UR, which may be- (1) Review conducted by the facility;(2) Direct review in the facility by individuals-(i) Employed by the medical assistance unit of the Medicaid agency; or(ii) Under contract to the Medicaid agency; or