Federal regulations · Through 2026-08-25 · Newer source version available

42 CFR 456.431: Continued stay review required.

Where this section sits in the code

Title 42—Public Health
CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS
PART 456—UTILIZATION CONTROL
Subpart F—Utilization Control: Intermediate Care Facilities

(a) The UR plan must provide for a review of each beneficiaries continued stay in the ICF at least every 6 months to decide whether it is needed.

(b) The UR plan requirement for continued stay review may be met by—

(1) Reviews that are performed in accordance with the requirements of §§ 456.432 through 456.437; or

(2) Reviews that meet on-site inspection requirements under subpart I if—

(i) The composition of the independent professional review team under subpart I meets the requirements of § 456.406; and

(ii) Reviews are conducted as frequently as required under §§ 456.433 and 456.434.

Collected 2026-08-27T02:26:11Z. Source file · JSON