55 Pa. Code § 1163.74. Requirements for hospital utilization review committees.

§ 1163.74. Requirements for hospital utilization review committees.

(a)  A hospital shall have a utilization review committee composed of two or more physicians, and assisted by other professional personnel as required under 42 CFR 456.106 (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 hospital utilization review committee may not participate in the review of a patient’s case if he is or was responsible for the care of that patient.
(c)  A member of the hospital utilization review committee may not have a direct or indirect financial interest in any hospital.

Source

   The provisions of this §  1163.74 adopted September 23, 1983, effective September 24, 1983, 13 Pa.B. 2881; amended June 22, 1984, effective July 1, 1984, 14 Pa.B. 2185. Immediately preceding text appears at serial pages (85055) to (85056).

Cross References

   This section cited in 55 Pa. Code §  1163.73 (relating to hospital utilization review plan).

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