Ala. Admin. Code r. 560-X-41-.07

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-41-.07 - Utilization Review (UR) Plan

As a condition of participation in the Title XIX Medicaid program, each psychiatric facility shall:

(a) Have in effect a written UR plan that provides for review of each recipient's need for services that the facility furnishes to him. This written UR plan must meet the requirements under 42 C.F.R. §§ 456.201 through 42 C.F.R. 456.245;

(b) Maintain recipient information required for UR under 42 C.F.R. § 456.211, which shall include the certification of need for service and the plan of care; and

(c) Provide a copy of the UR plan and any subsequent revisions to Medicaid for review and approval.

Authors: Gwen Williams, Vicki W. Huff

Ala. Admin. Code r. 560-X-41-.07

Rule effective October 1, 1988. Amended effective September 13, 1989.

Statutory Authority:42 C.F.R. §§456.200 through 456.245.