42 CFR § 456.60 - Certification and recertification of need for inpatient care.

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§ 456.60 Certification and recertification of need for inpatient care.

(a)Certification.

(1) A physician must certify for each applicant or beneficiary that inpatient services in a hospital are or were needed.

(2) The certification must be made at the time of admission or, if an individual applies for assistance while in a hospital, before the Medicaid agency authorizes payment.

(b)Recertification.

(1) A physician, or physician assistant or nurse practitioner (as defined in § 491.2 of this chapter) acting within the scope of practice as defined by State law and under the supervision of a physician, must recertify for each applicant or beneficiary that inpatient services in a hospital are needed.

(2) Recertifications must be made at least every 60 days after certification.

[46 FR 48561, Oct. 1, 1981]