42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.
(a) The State plan must provide that -
(1) UR is performed for each ICF that furnishes inpatient services under the plan;
(2) Each ICF has on file a written UR plan that provides for review of each beneficiary's need for the services that the ICF furnishes him; and
(3) Each written ICF UR plan meets requirements under §§ 456.401 through 456.438.
(b) The State plan must specify the method used to perform UR, which may be -
(1) Review conducted by the facility;
(2) Direct review in the facility by individuals -
(i) Employed by the medical assistance unit of the Medicaid agency; or
(ii) Under contract to the Medicaid agency; or
(3) Any other method.