Section 1163.74. Requirements for hospital utilization review committees

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(a) A hospital shall have a utilization review committee composed of two or more physicians, and assisted by other professional personnel as required under 42 CFR 456.106 (relating to organization and composition of UR committee; disqualification from UR committee membership). Committee members need not be members of the hospital medical staff.
(b) A member of the hospital utilization review committee may not participate in the review of a patient’s case if he is or was responsible for the care of that patient.
(c) A member of the hospital utilization review committee may not have a direct or indirect financial interest in any hospital.

The provisions of this § 1163.74 adopted September 23, 1983, effective September 24, 1983, 13 Pa.B. 2881; amended June 22, 1984, effective July 1, 1984, 14 Pa.B. 2185. Immediately preceding text appears at serial pages (85055) to (85056).

Notation

Cross References

This section cited in 55 Pa. Code § 1163.73 (relating to hospital utilization review plan).

                    
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