{"data":{"id":"us/42-cfr-456.122","jurisdiction":"us","citation":"42 CFR 456.122","heading":"Evaluation criteria for admission review.","body":"The UR plan must provide that—\n(a) The committee develops written medical care criteria to assess the need for admission; and\n(b) The committee develops more extensive written criteria for cases that its experience shows are—\n(1) Associated with high costs;\n(2) Associated with the frequent furnishing of excessive services; or\n(3) Attended by physicians whose patterns of care are frequently found to be questionable.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS","PART 456—UTILIZATION CONTROL","Subpart C—Utilization Control: Hospitals"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"e4f8c945925b6665a5dd139bb453fd176fb61ed055d5d9a24d142802463e486a","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-456.121","next":"us/42-cfr-456.123"},"notice":"GroundRules: Original legal text. Not legal advice."}