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- 42 CFR 455.240 · Conflict of interest resolution.
- 42 CFR 455.300 · Purpose.
- 42 CFR 455.301 · Definitions.
- 42 CFR 455.304 · Condition for Federal financial participation (FFP).
- 42 CFR 455.400 · Purpose.
- 42 CFR 455.405 · State plan requirements.
- 42 CFR 455.410 · Enrollment and screening of providers.
- 42 CFR 455.412 · Verification of provider licenses.
- 42 CFR 455.414 · Revalidation of enrollment.
- 42 CFR 455.416 · Termination or denial of enrollment.
- 42 CFR 455.417 · Termination periods and termination database periods.
- 42 CFR 455.420 · Reactivation of provider enrollment.
- 42 CFR 455.422 · Appeal rights.
- 42 CFR 455.432 · Site visits.
- 42 CFR 455.434 · Criminal background checks.
- 42 CFR 455.436 · Federal database checks.
- 42 CFR 455.440 · National Provider Identifier.
- 42 CFR 455.450 · Screening levels for Medicaid providers.
- 42 CFR 455.452 · Other State screening methods.
- 42 CFR 455.460 · Application fee.
- 42 CFR 455.470 · Temporary moratoria.
- 42 CFR 455.500 · Purpose.
- 42 CFR 455.502 · Establishment of program.
- 42 CFR 455.504 · Definitions.
- 42 CFR 455.506 · Activities to be conducted by Medicaid RACs and States.
- 42 CFR 455.508 · Eligibility requirements for Medicaid RACs.
- 42 CFR 455.510 · Payments to RACs.
- 42 CFR 455.512 · Medicaid RAC provider appeals.
- 42 CFR 455.514 · Federal share of State expense of the Medicaid RAC program.
- 42 CFR 455.516 · Exceptions from Medicaid RAC programs.
- 42 CFR 455.518 · Applicability to the territories.
- 42 CFR 456.1 · Basis and purpose of part.
- 42 CFR 456.2 · State plan requirements.
- 42 CFR 456.3 · Statewide surveillance and utilization control program.
- 42 CFR 456.4 · Responsibility for monitoring the utilization control program.
- 42 CFR 456.5 · Evaluation criteria.
- 42 CFR 456.6 · Review by State medical agency of appropriateness and quality of services.
- 42 CFR 456.21 · Scope.
- 42 CFR 456.22 · Sample basis evaluation of services.
- 42 CFR 456.23 · Post-payment review process.
- 42 CFR 456.50 · Scope.
- 42 CFR 456.51 · Definitions.
- 42 CFR 456.60 · Certification and recertification of need for inpatient care.
- 42 CFR 456.80 · Individual written plan of care.
- 42 CFR 456.100 · Scope.
- 42 CFR 456.101 · UR plan required for inpatient hospital services.
- 42 CFR 456.105 · UR committee required.
- 42 CFR 456.106 · Organization and composition of UR committee; disqualification from UR committee membership.
- 42 CFR 456.111 · Beneficiary information required for UR.
- 42 CFR 456.112 · Records and reports.
- 42 CFR 456.113 · Confidentiality.
- 42 CFR 456.121 · Admission review required.
- 42 CFR 456.122 · Evaluation criteria for admission review.
- 42 CFR 456.123 · Admission review process.
- 42 CFR 456.124 · Notification of adverse decision.
- 42 CFR 456.125 · Time limits for admission review.
- 42 CFR 456.126 · Time limits for final decision and notification of adverse decision.
- 42 CFR 456.127 · Pre-admission review.
- 42 CFR 456.128 · Initial continued stay review date.
- 42 CFR 456.129 · Description of methods and criteria: Initial continued stay review date; close professional scrutiny; length of stay modification.
- 42 CFR 456.131 · Continued stay review required.
- 42 CFR 456.132 · Evaluation criteria for continued stay.
- 42 CFR 456.133 · Subsequent continued stay review dates.
- 42 CFR 456.134 · Description of methods and criteria: Subsequent continued stay review dates; length of stay modification.
- 42 CFR 456.135 · Continued stay review process.
- 42 CFR 456.136 · Notification of adverse decision.
- 42 CFR 456.137 · Time limits for final decision and notification of adverse decision.
- 42 CFR 456.141 · Purpose and general description.
- 42 CFR 456.142 · UR plan requirements for medical care evaluation studies.
- 42 CFR 456.143 · Content of medical care evaluation studies.
- 42 CFR 456.144 · Data sources for studies.
- 42 CFR 456.145 · Number of studies required to be performed.
- 42 CFR 456.150 · Scope.
- 42 CFR 456.151 · Definitions.
- 42 CFR 456.160 · Certification and recertification of need for inpatient care.
- 42 CFR 456.170 · Medical, psychiatric, and social evaluations.
- 42 CFR 456.171 · [Reserved]
- 42 CFR 456.180 · Individual written plan of care.
- 42 CFR 456.181 · Reports of evaluations and plans of care.
- 42 CFR 456.200 · Scope.
- 42 CFR 456.201 · UR plan required for inpatient mental hospital services.
- 42 CFR 456.205 · UR committee required.
- 42 CFR 456.206 · Organization and composition of UR committee; disqualification from UR committee membership.
- 42 CFR 456.211 · Beneficiary information required for UR.
- 42 CFR 456.212 · Records and reports.
- 42 CFR 456.213 · Confidentiality.
- 42 CFR 456.231 · Continued stay review required.
- 42 CFR 456.232 · Evaluation criteria for continued stay.
- 42 CFR 456.233 · Initial continued stay review date.
- 42 CFR 456.234 · Subsequent continued stay review dates.
- 42 CFR 456.235 · Description of methods and criteria: Continued stay review dates; length of stay modification.
- 42 CFR 456.236 · Continued stay review process.
- 42 CFR 456.237 · Notification of adverse decision.
- 42 CFR 456.238 · Time limits for final decision and notification of adverse decision.
- 42 CFR 456.241 · Purpose and general description.
- 42 CFR 456.242 · UR plan requirements for medical care evaluation studies.
- 42 CFR 456.243 · Content of medical care evaluation studies.
- 42 CFR 456.244 · Data sources for studies.
- 42 CFR 456.245 · Number of studies required to be performed.
- 42 CFR 456.350 · Scope.