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

42 CFR 456.6: Review by State medical agency of appropriateness and quality of services.

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Where this section sits in the code
  1. Title 42—Public Health
  2. CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  3. SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS
  4. PART 456—UTILIZATION CONTROL
  5. Subpart A—General Provisions

(a) The Medicaid agency must have an agreement with the State health agency or other appropriate State medical agency, under which the health or medical agency is responsible for establishing a plan for the review by professional health personnel of the appropriateness and quality of Medicaid services.

(b) The purpose of this review plan is to provide guidance to the Medicaid agency in the administration of the State plan and, where applicable, to the State licensing agency described in § 431.610.

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

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