[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR456.132]



[Page 347]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 456_UTILIZATION CONTROL--Table of Contents

 

                Subpart C_Utilization Control: Hospitals

 

Sec.  456.132  Evaluation criteria for continued stay.



    The UR plan must provide that--

    (a) The committee develops written medical care criteria to assess 

the need for continued stay.

    (b) The committee develops more extensive written criteria for cases 

that its experience shows are--

    (1) Associated with high costs;

    (2) Associated with the frequent furnishing of excessive services; 

or

    (3) Attended by physicians whose patterns of care are frequently 

found to be questionable.