Title 42

PART 456 SUBPART F

Subpart F - Utilization Control: Intermediate Care Facilities

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

42:4.0.1.1.14.6.159	SUBJGRP 159	Certification of Need for Care
42:4.0.1.1.14.6.159.1	SECTION 456.350	456.350 Scope.
42:4.0.1.1.14.6.159.2	SECTION 456.351	456.351 Definition.
42:4.0.1.1.14.6.159.3	SECTION 456.360	456.360 Certification and recertification of need for inpatient care.
42:4.0.1.1.14.6.160	SUBJGRP 160	Medical, Psychological, and Social Evaluations and Admission Review
42:4.0.1.1.14.6.160.4	SECTION 456.370	456.370 Medical, psychological, and social evaluations.
42:4.0.1.1.14.6.160.5	SECTION 456.371	456.371 Exploration of alternative services.
42:4.0.1.1.14.6.160.6	SECTION 456.372	456.372 Medicaid agency review of need for admission.
42:4.0.1.1.14.6.161	SUBJGRP 161	Plan of Care
42:4.0.1.1.14.6.161.7	SECTION 456.380	456.380 Individual written plan of care.
42:4.0.1.1.14.6.161.8	SECTION 456.381	456.381 Reports of evaluations and plans of care.
42:4.0.1.1.14.6.162	SUBJGRP 162	Utilization Review (UR) Plan: General Requirement
42:4.0.1.1.14.6.162.9	SECTION 456.400	456.400 Scope.
42:4.0.1.1.14.6.162.10	SECTION 456.401	456.401 State plan UR requirements and options; UR plan required for intermediate care facility services.
42:4.0.1.1.14.6.163	SUBJGRP 163	UR Plan: Administrative Requirements
42:4.0.1.1.14.6.163.11	SECTION 456.405	456.405 Description of UR review function: How and when.
42:4.0.1.1.14.6.163.12	SECTION 456.406	456.406 Description of UR review function: Who performs UR; disqualification from performing UR.
42:4.0.1.1.14.6.163.13	SECTION 456.407	456.407 UR responsibilities of administrative staff.
42:4.0.1.1.14.6.164	SUBJGRP 164	UR Plan: Informational Requirements
42:4.0.1.1.14.6.164.14	SECTION 456.411	456.411 Beneficiary information required for UR.
42:4.0.1.1.14.6.164.15	SECTION 456.412	456.412 Records and reports.
42:4.0.1.1.14.6.164.16	SECTION 456.413	456.413 Confidentiality.
42:4.0.1.1.14.6.165	SUBJGRP 165	UR Plan: Review of Need for Continued Stay
42:4.0.1.1.14.6.165.17	SECTION 456.431	456.431 Continued stay review required.
42:4.0.1.1.14.6.165.18	SECTION 456.432	456.432 Evaluation criteria for continued stay.
42:4.0.1.1.14.6.165.19	SECTION 456.433	456.433 Initial continued stay review date.
42:4.0.1.1.14.6.165.20	SECTION 456.434	456.434 Subsequent continued stay review dates.
42:4.0.1.1.14.6.165.21	SECTION 456.435	456.435 Description of methods and criteria: Continued stay review dates.
42:4.0.1.1.14.6.165.22	SECTION 456.436	456.436 Continued stay review process.
42:4.0.1.1.14.6.165.23	SECTION 456.437	456.437 Notification of adverse decision.
42:4.0.1.1.14.6.165.24	SECTION 456.438	456.438 Time limits for notification of adverse decision.

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