Code of Federal Regulations Title 42. Public Health § 42.456.51 Definitions

(a) Include—

(b) Exclude services provided in mental hospitals. Utilization control requirements for mental hospitals appear in subpart D.

Medical care appraisal norms or norms means numerical or statistical measures of usually observed performance.

Medical care criteria or criteria means predetermined elements against which aspects of the quality of a medical service may be compared. These criteria are developed by health professionals relying on their expertise and the professional health care literature.