42 CFR 456.3
§ 456.3 Statewide surveillance and utilization control program.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 456.3, § 456.3 Statewide surveillance and utilization control program, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/206596
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Full text
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.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.