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| UR Plan: Informational Requirements | 456.411 – 456.413 | ||||||||||
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43 FR 45266, Sept. 29, 1978, unless otherwise noted.
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Subscribe to: 42 CFR Part 456 Subpart F - UR Plan: Informational Requirements
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The UR plan must provide that each beneficiary's record include information needed to perform UR required under this subpart. This information must include, at least, the following:
(a) Identification of the beneficiary.
(b) The name of the beneficiary's physician.
(c) The name of the qualified Intellectual Disability professional (as defined under § 442.401 of this subchapter), if applicable.
(d) Date of admission, and dates of application for and authorization of Medicaid benefits if application is made after admission.
(e) The plan of care required under § 456.372;
(f) Initial and subsequent continued stay review dates described under §§ 456.433 and 456.434.
(g) Reasons and plan for continued stay, if the attending physician or qualified Intellectual Disability professional believes continued stay is necessary.
(h) Other supporting material that the UR group believes appropriate to be included in the record.
The UR plan must describe—
(a) The types of records that are kept by the group performing UR; and
(b) The type and frequency of reports made by the UR group, and arrangements for distribution of the reports to appropriate individuals.
The UR plan must provide that the identities of individual beneficiaries in all UR records and reports are kept confidential.