Time limits for final decision and notification of adverse decision.

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medical Assistance Programs
  6. Utilization Control
  7. Utilization Control: Hospitals
  8. Ur Plan: Review of Need for Continued Stay
  9. Time limits for final decision and notification of adverse decision.

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§ 456.137 Time limits for final decision and notification of adverse decision.

The UR plan must provide that -

(a) The committee makes a final decision on a beneficiary's need for continued stay and gives notice under § 456.136 of an adverse final decision within 2 working days after the assigned continued stay review dates, except as required under paragraph (b) of this section.

(b) If the committee makes an adverse final decision on a beneficiary's need for continued stay before the assigned review date, the committee gives notice under § 456.136 within 2 working days after the date of the final decision.


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