1. (a) Each inpatient psychiatric facility shall have a utilization review committee composed of two or more physicians knowledgeable in the diagnosis and treatment of mental diseases and other professional personnel as required under 42 CFR 456.206 (relating to organization and composition of UR committee; disqualification from UR committee membership). Committee members need not be members of the hospital medical staff.
2. (b) A member of the utilization review committee may not participate in the review of a patient’s case if the member is or was directly responsible for the care of that patient.
3. (c) A member of the utilization review committee may not have a direct or indirect financial interest in a hospital.

Authority

The provisions of this § 1151.73 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. § § 201 and 443.1(1)).

Source

The provisions of this § 1151.73 adopted September 30, 1983, effective July 1, 1983, 13 Pa.B. 2796; amended June 18, 1993, effective July 1, 1993, 23 Pa.B. 2917; amended October 29, 1993, effective July 1, 1993, 23 Pa.B. 5241. Immediately preceding text appears at serial pages (150075) to (150076).

Cross References

This section cited in 55 Pa. Code § 1151.61 (relating to payment conditions: general); 55 Pa. Code § 1151.67 (relating to payment conditions related to the recipient’s continued need for care); and 55 Pa. Code § 1151.72 (relating to inpatient psychiatric facility utilization review plan).