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Title 42

Displaying title 42, up to date as of 7/16/2026. Title 42 was last amended 7/01/2026.
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  1. Title 42 —Public Health
  2. Chapter IV —Centers for Medicare & Medicaid Services, Department of Health and Human Services
  3. Subchapter C —Medical Assistance Programs
  4. Part 456 —Utilization Control
  5. Subpart D   View Full Text
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eCFR Content

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Title 42Public HealthPart / Section
Chapter IVCenters for Medicare & Medicaid Services, Department of Health and Human Services400 – 699
Subchapter CMedical Assistance Programs430 – 456
Part 456Utilization Control456.1 – 456.725
Subpart DUtilization Control: Mental Hospitals456.150 – 456.245
§ 456.150Scope.
§ 456.151Definitions.
Certification of Need for Care456.160
§ 456.160Certification and recertification of need for inpatient care.
Medical, Psychiatric, and Social Evaluations and Admission Review456.170 – 456.171
§ 456.170Medical, psychiatric, and social evaluations.
§ 456.171 [Reserved]
Plan of Care456.180 – 456.181
§ 456.180Individual written plan of care.
§ 456.181Reports of evaluations and plans of care.
Utilization Review (UR) Plan: General Requirements456.200 – 456.201
§ 456.200Scope.
§ 456.201UR plan required for inpatient mental hospital services.
UR Plan: Administrative Requirements456.205 – 456.206
§ 456.205UR committee required.
§ 456.206Organization and composition of UR committee; disqualification from UR committee membership.
UR Plan: Informational Requirements456.211 – 456.213
§ 456.211Beneficiary information required for UR.
§ 456.212Records and reports.
§ 456.213Confidentiality.
UR Plan: Review of Need for Continued Stay456.231 – 456.238
§ 456.231Continued stay review required.
§ 456.232Evaluation criteria for continued stay.
§ 456.233Initial continued stay review date.
§ 456.234Subsequent continued stay review dates.
§ 456.235Description of methods and criteria: Continued stay review dates; length of stay modification.
§ 456.236Continued stay review process.
§ 456.237Notification of adverse decision.
§ 456.238Time limits for final decision and notification of adverse decision.
UR Plan: Medical Care Evaluation Studies456.241 – 456.245
§ 456.241Purpose and general description.
§ 456.242UR plan requirements for medical care evaluation studies.
§ 456.243Content of medical care evaluation studies.
§ 456.244Data sources for studies.
§ 456.245Number of studies required to be performed.
eCFR Content