42 C.F.R. § 456.3 : Public Health — CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES — MEDICAL ASSISTANCE PROGRAMS — UTILIZATION CONTROL — GENERAL PROVISIONS — Statewide surveillance and utilization control program

The Medicaid agency must implement a statewide surveillance and utilization control program that-

(a) Safeguards against unnecessary or inappropriate use of Medicaid services and against excess payments;
(b) Assesses the quality of those services;
(c) Provides for the control of the utilization of all services provided under the plan in accordance with subpart B of this part; and
(d) Provides for the control of the utilization of inpatient services in accordance with subparts C through I of this part.

42 C.F.R. §456.3