Code of Federal Regulations Title 42. Public Health § 42.456.411 Beneficiary information required for UR

(a) Identification of the beneficiary.

(b) The name of the beneficiary's physician.

(c) The name of the qualified Intellectual Disability professional (as defined under § 442.401 of this subchapter), if applicable.

(d) Date of admission, and dates of application for and authorization of Medicaid benefits if application is made after admission.

(e) The plan of care required under § 456.372;

(f) Initial and subsequent continued stay review dates described under §§ 456.433 and 456.434.

(g) Reasons and plan for continued stay, if the attending physician or qualified Intellectual Disability professional believes continued stay is necessary.

(h) Other supporting material that the UR group believes appropriate to be included in the record.