Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1151 - INPATIENT PSYCHIATRIC SERVICES
UTILIZATION CONTROL
Section 1151.73 - Requirements for inpatient psychiatric utilization review committees
Current through Register Vol. 54, No. 12, March 23, 2024
(a) Each inpatient psychiatric facility shall have a utilization review committee composed of two or more physicians knowledgeable in the diagnosis and treatment of mental diseases and other professional personnel as required under 42 CFR 456.206 (relating to organization and composition of UR committee; disqualification from UR committee membership). Committee members need not be members of the hospital medical staff.
(b) A member of the utilization review committee may not participate in the review of a patient's case if the member is or was directly responsible for the care of that patient.
(c) A member of the utilization review committee may not have a direct or indirect financial interest in a hospital.
The provisions of this § 1151.73 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. §§ 201 and 443.1(1)).
This section cited in 55 Pa. Code § 1151.61 (relating to payment conditions: general); 55 Pa. Code § 1151.67 (relating to payment conditions related to the recipient's continued need for care); and 55 Pa. Code § 1151.72 (relating to inpatient psychiatric facility utilization review plan).
