Title 42

SECTION 456.432

456.432 Evaluation criteria for continued stay.

§ 456.432 Evaluation criteria for continued stay.

The UR plan must provide that -

(a) The group performing UR develops written criteria to assess the need for continued stay.

(b) The group 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.

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