(a) PASARR determinations made by the State mental health or intellectual disability
authorities cannot be countermanded by the State Medicaid agency, either in the claims
process or through other utilization control/review processes or by the State survey
and certification agency. Only appeals determinations made through the system specified in subpart E of this
part may overturn a PASARR determination made by the State mental health or intellectual
(b) In making their determinations, however, the State mental health and intellectual
disability authorities must not use criteria relating to the need for NF care or specialized
services that are inconsistent with this regulation and any supplementary criteria
adopted by the State Medicaid agency under its approved State plan.
(c) To the maximum extent practicable, in order to avoid duplicative testing and effort,
the PASARR must be coordinated with the routine resident assessments required by § 483.20(b).
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