Title 42

PART 456 SUBPART D

Subpart D - Utilization Control: Mental Hospitals

• Sec. 1102 of the Social Security Act (42 U.S.C. 1302), unless otherwise noted.
• 43 FR 45266, Sept. 29, 1978, unless otherwise noted.

42:4.0.1.1.14.4.151	SUBJGRP 151	Certification of Need for Care
42:4.0.1.1.14.4.151.1	SECTION 456.150	456.150 Scope.
42:4.0.1.1.14.4.151.2	SECTION 456.151	456.151 Definitions.
42:4.0.1.1.14.4.151.3	SECTION 456.160	456.160 Certification and recertification of need for inpatient care.
42:4.0.1.1.14.4.152	SUBJGRP 152	Medical, Psychiatric, and Social Evaluations and Admission Review
42:4.0.1.1.14.4.152.4	SECTION 456.170	456.170 Medical, psychiatric, and social evaluations.
42:4.0.1.1.14.4.152.5	SECTION 456.171	456.171 [Reserved]
42:4.0.1.1.14.4.153	SUBJGRP 153	Plan of Care
42:4.0.1.1.14.4.153.6	SECTION 456.180	456.180 Individual written plan of care.
42:4.0.1.1.14.4.153.7	SECTION 456.181	456.181 Reports of evaluations and plans of care.
42:4.0.1.1.14.4.154	SUBJGRP 154	Utilization Review (UR) Plan: General Requirements
42:4.0.1.1.14.4.154.8	SECTION 456.200	456.200 Scope.
42:4.0.1.1.14.4.154.9	SECTION 456.201	456.201 UR plan required for inpatient mental hospital services.
42:4.0.1.1.14.4.155	SUBJGRP 155	UR Plan: Administrative Requirements
42:4.0.1.1.14.4.155.10	SECTION 456.205	456.205 UR committee required.
42:4.0.1.1.14.4.155.11	SECTION 456.206	456.206 Organization and composition of UR committee; disqualification from UR committee membership.
42:4.0.1.1.14.4.156	SUBJGRP 156	UR Plan: Informational Requirements
42:4.0.1.1.14.4.156.12	SECTION 456.211	456.211 Beneficiary information required for UR.
42:4.0.1.1.14.4.156.13	SECTION 456.212	456.212 Records and reports.
42:4.0.1.1.14.4.156.14	SECTION 456.213	456.213 Confidentiality.
42:4.0.1.1.14.4.157	SUBJGRP 157	UR Plan: Review of Need for Continued Stay
42:4.0.1.1.14.4.157.15	SECTION 456.231	456.231 Continued stay review required.
42:4.0.1.1.14.4.157.16	SECTION 456.232	456.232 Evaluation criteria for continued stay.
42:4.0.1.1.14.4.157.17	SECTION 456.233	456.233 Initial continued stay review date.
42:4.0.1.1.14.4.157.18	SECTION 456.234	456.234 Subsequent continued stay review dates.
42:4.0.1.1.14.4.157.19	SECTION 456.235	456.235 Description of methods and criteria: Continued stay review dates; length of stay modification.
42:4.0.1.1.14.4.157.20	SECTION 456.236	456.236 Continued stay review process.
42:4.0.1.1.14.4.157.21	SECTION 456.237	456.237 Notification of adverse decision.
42:4.0.1.1.14.4.157.22	SECTION 456.238	456.238 Time limits for final decision and notification of adverse decision.
42:4.0.1.1.14.4.158	SUBJGRP 158	UR Plan: Medical Care Evaluation Studies
42:4.0.1.1.14.4.158.23	SECTION 456.241	456.241 Purpose and general description.
42:4.0.1.1.14.4.158.24	SECTION 456.242	456.242 UR plan requirements for medical care evaluation studies.
42:4.0.1.1.14.4.158.25	SECTION 456.243	456.243 Content of medical care evaluation studies.
42:4.0.1.1.14.4.158.26	SECTION 456.244	456.244 Data sources for studies.
42:4.0.1.1.14.4.158.27	SECTION 456.245	456.245 Number of studies required to be performed.

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