42 CFR § 456.3 - Statewide surveillance and utilization control program.
The Medicaid agency must implement a statewide surveillance and utilization control program that -
(a) Safeguards against unnecessary or inappropriate use of Medicaid services and against excess payments;
(b) Assesses the quality of those services;
(c) Provides for the control of the utilization of all services provided under the plan in accordance with subpart B of this part; and
(d) Provides for the control of the utilization of inpatient services in accordance with subparts C through I of this part.
The following state regulations pages link to this page.
- 10 CCR 2505-10 8.000 - 10 CCR 2505-10 8.000 - MEDICAL ASSISTANCE - SECTION 8.000 Emergency Medical Transportation, Program Integrity
- 12 Va. Admin. Code § 30-130-810 - 12VAC30-130-810 - Client Medical Management Program for individuals.