[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: 42CFR456.60]



[Page 344]

 

                         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.  456.60  Certification and recertification of need for inpatient 



care.



    (a) Certification. (1) A physician must certify for each applicant 

or recipient that inpatient services in a hospital are or were needed.

    (2) The certification must be made at the time of admission or, if 

an individual applies for assistance while in a hospital, before the 

Medicaid agency authorizes payment.

    (b) Recertification. (1) A physician, or physician assistant or 

nurse practitioner (as defined in Sec.  491.2 of this chapter) acting 

within the scope of practice as defined by State law and under the 

supervision of a physician, must recertify for each applicant or 

recipient that inpatient services in a hospital are needed.

    (2) Recertifications must be made at least every 60 days after 

certification.



[46 FR 48561, Oct. 1, 1981]



                              Plan of Care