Code of Federal Regulations Title 42. Public Health § 42.456.406 Description of UR review function:  Who performs UR;  disqualification from performing UR

(1) At least one physician;

(2) In an ICF that cares primarily for mental patients, at least one individual knowledgeable in the treatment of mental diseases;  and

(3) In an institution for individuals with intellectual disabilities, a least one individual knowledgeable in the treatment of intellectual disability.

(1) Is directly responsible for the care of the beneficiary whose care is being reviewed;

(2) Is employed by the ICF;  or

(3) Has a financial interest in any ICF.