Subchapter C - UTILIZATION REVIEW
- Section 371.200 - Inpatient Hospital Utilization Review Program
- Section 371.201 - Case Selection Process
- Section 371.203 - TMRP Review Process
- Section 371.204 - Hospital Screening Criteria for TMRP, TEFRA, and Facility-Specific Per Diem Methodology Reviews
- Section 371.206 - Denials and Recoupments for TMRP, TEFRA Hospitals, and Facility-Specific Per Diem Methodology Reviews
- Section 371.208 - Appeals Related to Utilization Review Department Review Decisions
- Section 371.210 - Inpatient Utilization Review for Hospitals Reimbursed Under TMRP and TEFRA Principles of Reimbursement and Facility-Specific Per Diem Methodology Reviews
- Section 371.212 - Utilization Review of Nursing Facilities
- Section 371.214 - HHSC-Approved Online RUG or Other HHSC-Required Training Course
- Section 371.216 - Nursing Facility Clinical Records
- Section 371.218 - Onsite and Desk Utilization Reviews of Nursing Facilities
- Section 371.220 - Exit Conferences
- Section 371.222 - Reconsideration of Utilization Review Results
- Section 371.224 - Appeals of Reconsideration Results
- Section 371.226 - Calculation of Overpayments and Underpayments
- Section 371.228 - Recoveries
- Section 371.230 - Waiver of Extrapolation