[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR483.108]



[Page 534]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 483_REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES--Table 

of Contents

 

 Subpart C_Preadmission Screening and Annual Review of Mentally Ill and 

                      Mentally Retarded Individuals

 

Sec. 483.108  Relationship of PASARR to other Medicaid processes.



    (a) PASARR determinations made by the State mental health or mental 

retardation authorities cannot be countermanded by the State Medicaid 

agency, either in the claims process or through other utilization 

control/review processes or by the State survey and certification 

agency. Only appeals determinations made through the system specified in 

subpart E of this part may overturn a PASARR determination made by the 

State mental health or mental retardation authorities.

    (b) In making their determinations, however, the State mental health 

and mental retardation authorities must not use criteria relating to the 

need for NF care or specialized services that are inconsistent with this 

regulation and any supplementary criteria adopted by the State Medicaid 

agency under its approved State plan.

    (c) To the maximum extent practicable, in order to avoid duplicative 

testing and effort, the PASARR must be coordinated with the routine 

resident assessments required by Sec. 483.20(b).