Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 120. Waivered Services
8/3/2020

12VAC30-120-1660. Utilization Review.

A. DMAS shall conduct utilization reviews of the services billed to DMAS and interview individuals living in the facility and the legally authorized representative to ensure that services are being provided and billed in accordance with DMAS policies and procedures.

B. On a regular basis, DMAS shall conduct quality management reviews of the services provided and interview individuals for all facilities providing services in this waiver to ensure the individuals' health and safety in this waiver. All quality management and level of care reviews will be performed on a regular basis.

Statutory Authority

§§ 32.1-324 and 32.1-325 of the Code of Virginia.

Historical Notes

Derived from Volume 23, Issue 20, eff. July 11, 2007; amended, Virginia Register Volume 28, Issue 20, eff. July 5, 2012.

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