CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS (parts 430 to 456) > PART 456—UTILIZATION CONTROL > SUBPART C—Utilization Control: Hospitals (§456.50 to §456.145) > 456.60—Certification and recertification of need for inpatient care.

456.60—Certification and recertification of need for inpatient care.

(a) Certification. (1) A physician must certify for each applicant or recipient 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 recipient 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]