[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: 42CFR456.6]



[Page 343]

 

                         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 A_General Provisions

 

Sec.  456.6  Review by State medical agency of appropriateness and 



quality of services.



    (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 Sec.  431.610.