42 C.F.R. § 456.714 DUR/surveillance and utilization review relationship.
Title 42 - Public Health
(a) The retrospective DUR requirements in this subpart parallel a portion of the surveillance and utilization review (SUR) requirements in subpart A of this part and in part 455 of this chapter. (b) A State agency may direct DUR staffs to limit review activities to those that focus on what constitutes appropriate and medically necessary care to avoid duplication of activities relating to fraud and abuse under the SUR program. [59 FR 48825, Sept. 23, 1994]
Title 42: Public Health
PART 456—UTILIZATION CONTROL
Subpart K—Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims
§ 456.714 DUR/surveillance and utilization review relationship.
