42 CFR § 456.23 - Post-payment review process.

---
identifier: "/us/cfr/t42/s456.23"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 456.23 - Post-payment review process."
title_number: 42
title_name: "Public Health"
section_number: "456.23"
section_name: "Post-payment review process."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "C"
subchapter_name: "MEDICAL ASSISTANCE PROGRAMS"
part_number: "456"
part_name: "UTILIZATION CONTROL"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302."
regulatory_source: "43 FR 45266, Sept. 29, 1978, unless otherwise noted."
cfr_part: "456"
---


# 456.23 Post-payment review process.

The agency must have a post-payment review process that—

(a) Allows State personnel to develop and review—

(1) Beneficiary utilization profiles;

(2) Provider service profiles; and

(3) Exceptions criteria; and

(b) Identifies exceptions so that the agency can correct misutilization practices of beneficiaries and providers.