42 C.F.R. § 456.23

Current through September 30, 2024
Section 456.23 - Post-payment review process

The agency must have a post-payment review process that-

(a) Allows State personnel to develop and review-
(1) Beneficiary utilization profiles;
(2) Provider service profiles; and
(3) Exceptions criteria; and
(b) Identifies exceptions so that the agency can correct misutilization practices of beneficiaries and providers.

42 C.F.R. §456.23