{"data":{"id":"us/42-cfr-456.501","jurisdiction":"us","citation":"42 CFR 456.501","heading":"UR plans as a condition for FFP.","body":"(a) Except when waived under §§ 456.505 through 456.508, FFP is not available in expenditures for Medicaid services furnished by a hospital or mental hospital unless the facility has in effect a UR plan that meets the utilization review requirements for Medicare under section 1861(k) of the Act.\n(b) A facility that participates in Medicare and Medicaid must use the same UR standards and procedures and review committee for Medicaid as it uses for Medicare.\n(c) A facility that does not participate in Medicare must meet the UR plan requirements in subpart C or D of this part, which are equivalent to the Medicare UR plan requirements in §§ 405.1137, 482.30, and 482.60 of this chapter.","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 H—Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental 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":"141c02ffb5f2e29db0d3f524af8e8a38a4dc4d59d5536631df99fba6f49a92e4","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-456.500","next":"us/42-cfr-456.505"},"notice":"GroundRules: Original legal text. Not legal advice."}