Title 42

PART 441

Part 441 - Services: Requirements And Limits Applicable To Specific Services

PART 441 - SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Authority:42 U.S.C. 1302. Source:43 FR 45229, Sept. 29, 1978, unless otherwise noted.

• Authority: 42 U.S.C. 1302.
• Source: 43 FR 45229, Sept. 29, 1978, unless otherwise noted.

42:4.0.1.1.10.0.100.1	SECTION 441.1	441.1 Purpose.
42:4.0.1.1.10.1	SUBPART A	Subpart A - General Provisions
42:4.0.1.1.10.1.100.1	SECTION 441.10	441.10 Basis.
42:4.0.1.1.10.1.100.2	SECTION 441.11	441.11 Continuation of FFP for institutional services.
42:4.0.1.1.10.1.100.3	SECTION 441.12	441.12 Inpatient hospital tests.
42:4.0.1.1.10.1.100.4	SECTION 441.13	441.13 Prohibitions on FFP: Institutionalized individuals.
42:4.0.1.1.10.1.100.5	SECTION 441.15	441.15 Home health services.
42:4.0.1.1.10.1.100.6	SECTION 441.16	441.16 Home health agency requirements for surety bonds; Prohibition on FFP.
42:4.0.1.1.10.1.100.7	SECTION 441.17	441.17 Laboratory services.
42:4.0.1.1.10.1.100.8	SECTION 441.18	441.18 Case management services.
42:4.0.1.1.10.1.100.9	SECTION 441.20	441.20 Family planning services.
42:4.0.1.1.10.1.100.10	SECTION 441.21	441.21 Nurse-midwife services.
42:4.0.1.1.10.1.100.11	SECTION 441.22	441.22 Nurse practitioner services.
42:4.0.1.1.10.1.100.12	SECTION 441.25	441.25 Prohibition on FFP for certain prescribed drugs.
42:4.0.1.1.10.1.100.13	SECTION 441.30	441.30 Optometric services.
42:4.0.1.1.10.1.100.14	SECTION 441.35	441.35 Organ transplants.
42:4.0.1.1.10.1.100.15	SECTION 441.40	441.40 End-stage renal disease.
42:4.0.1.1.10.2	SUBPART B	Subpart B - Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) of Individuals Under Age 21
42:4.0.1.1.10.2.100.1	SECTION 441.50	441.50 Basis and purpose.
42:4.0.1.1.10.2.100.2	SECTION 441.55	441.55 State plan requirements.
42:4.0.1.1.10.2.100.3	SECTION 441.56	441.56 Required activities.
42:4.0.1.1.10.2.100.4	SECTION 441.57	441.57 Discretionary services.
42:4.0.1.1.10.2.100.5	SECTION 441.58	441.58 Periodicity schedule.
42:4.0.1.1.10.2.100.6	SECTION 441.59	441.59 Treatment of requests for EPSDT screening services.
42:4.0.1.1.10.2.100.7	SECTION 441.60	441.60 Continuing care.
42:4.0.1.1.10.2.100.8	SECTION 441.61	441.61 Utilization of providers and coordination with related programs.
42:4.0.1.1.10.2.100.9	SECTION 441.62	441.62 Transportation and scheduling assistance.
42:4.0.1.1.10.3	SUBPART C	Subpart C - Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases
42:4.0.1.1.10.3.100.1	SECTION 441.100	441.100 Basis and purpose.
42:4.0.1.1.10.3.100.2	SECTION 441.101	441.101 State plan requirements.
42:4.0.1.1.10.3.100.3	SECTION 441.102	441.102 Plan of care for institutionalized beneficiaries.
42:4.0.1.1.10.3.100.4	SECTION 441.103	441.103 Alternate plans of care.
42:4.0.1.1.10.3.100.5	SECTION 441.105	441.105 Methods of administration.
42:4.0.1.1.10.3.100.6	SECTION 441.106	441.106 Comprehensive mental health program.
42:4.0.1.1.10.4	SUBPART D	Subpart D - Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs
42:4.0.1.1.10.4.100.1	SECTION 441.150	441.150 Basis and purpose.
42:4.0.1.1.10.4.100.2	SECTION 441.151	441.151 General requirements.
42:4.0.1.1.10.4.100.3	SECTION 441.152	441.152 Certification of need for services.
42:4.0.1.1.10.4.100.4	SECTION 441.153	441.153 Team certifying need for services.
42:4.0.1.1.10.4.100.5	SECTION 441.154	441.154 Active treatment.
42:4.0.1.1.10.4.100.6	SECTION 441.155	441.155 Individual plan of care.
42:4.0.1.1.10.4.100.7	SECTION 441.156	441.156 Team developing individual plan of care.
42:4.0.1.1.10.4.100.8	SECTION 441.180	441.180 Maintenance of effort: General rule.
42:4.0.1.1.10.4.100.9	SECTION 441.181	441.181 Maintenance of effort: Explanation of terms and requirements.
42:4.0.1.1.10.4.100.10	SECTION 441.182	441.182 Maintenance of effort: Computation.
42:4.0.1.1.10.4.100.11	SECTION 441.184	441.184 Emergency preparedness.
42:4.0.1.1.10.5	SUBPART E	Subpart E - Abortions
42:4.0.1.1.10.5.100.1	SECTION 441.200	441.200 Basis and purpose.
42:4.0.1.1.10.5.100.2	SECTION 441.201	441.201 Definition.
42:4.0.1.1.10.5.100.3	SECTION 441.202	441.202 General rule.
42:4.0.1.1.10.5.100.4	SECTION 441.203	441.203 Life of the mother would be endangered.
42:4.0.1.1.10.5.100.5	SECTION 441.204-441.205	441.204-441.205 [Reserved]
42:4.0.1.1.10.5.100.6	SECTION 441.206	441.206 Documentation needed by the Medicaid agency.
42:4.0.1.1.10.5.100.7	SECTION 441.207	441.207 Drugs and devices and termination of ectopic pregnancies.
42:4.0.1.1.10.5.100.8	SECTION 441.208	441.208 Recordkeeping requirements.
42:4.0.1.1.10.6	SUBPART F	Subpart F - Sterilizations
42:4.0.1.1.10.6.100.1	SECTION 441.250	441.250 Applicability.
42:4.0.1.1.10.6.100.2	SECTION 441.251	441.251 Definitions.
42:4.0.1.1.10.6.100.3	SECTION 441.252	441.252 State plan requirements.
42:4.0.1.1.10.6.100.4	SECTION 441.253	441.253 Sterilization of a mentally competent individual aged 21 or older.
42:4.0.1.1.10.6.100.5	SECTION 441.254	441.254 Mentally incompetent or institutionalized individuals.
42:4.0.1.1.10.6.100.6	SECTION 441.255	441.255 Sterilization by hysterectomy.
42:4.0.1.1.10.6.100.7	SECTION 441.256	441.256 Additional condition for Federal financial participation (FFP).
42:4.0.1.1.10.6.100.8	SECTION 441.257	441.257 Informed consent.
42:4.0.1.1.10.6.100.9	SECTION 441.258	441.258 Consent form requirements.
42:4.0.1.1.10.6.100.10	SECTION 441.259	441.259 Review of regulations.
42:4.0.1.1.10.6.100.11.1	APPENDIX	Appendix to Subpart F of Part 441 - Required Consent Form
42:4.0.1.1.10.7	SUBPART G	Subpart G - Home and Community-Based Services: Waiver Requirements
42:4.0.1.1.10.7.100.1	SECTION 441.300	441.300 Basis and purpose.
42:4.0.1.1.10.7.100.2	SECTION 441.301	441.301 Contents of request for a waiver.
42:4.0.1.1.10.7.100.3	SECTION 441.302	441.302 State assurances.
42:4.0.1.1.10.7.100.4	SECTION 441.303	441.303 Supporting documentation required.
42:4.0.1.1.10.7.100.5	SECTION 441.304	441.304 Duration, extension, and amendment of a waiver.
42:4.0.1.1.10.7.100.6	SECTION 441.305	441.305 Replacement of beneficiaries in approved waiver programs.
42:4.0.1.1.10.7.100.7	SECTION 441.306	441.306 Cooperative arrangements with the Maternal and Child Health program.
42:4.0.1.1.10.7.100.8	SECTION 441.307	441.307 Notification of a waiver termination.
42:4.0.1.1.10.7.100.9	SECTION 441.308	441.308 Hearings procedures for waiver terminations.
42:4.0.1.1.10.7.100.10	SECTION 441.310	441.310 Limits on Federal financial participation (FFP).
42:4.0.1.1.10.8	SUBPART H	Subpart H - Home and Community-Based Services Waivers for Individuals Age 65 or Older: Waiver Requirements
42:4.0.1.1.10.8.100.1	SECTION 441.350	441.350 Basis and purpose.
42:4.0.1.1.10.8.100.2	SECTION 441.351	441.351 Contents of a request for a waiver.
42:4.0.1.1.10.8.100.3	SECTION 441.352	441.352 State assurances.
42:4.0.1.1.10.8.100.4	SECTION 441.353	441.353 Supporting documentation required.
42:4.0.1.1.10.8.100.5	SECTION 441.354	441.354 Aggregate projected expenditure limit (APEL).
42:4.0.1.1.10.8.100.6	SECTION 441.355	441.355 Duration, extension, and amendment of a waiver.
42:4.0.1.1.10.8.100.7	SECTION 441.356	441.356 Waiver termination.
42:4.0.1.1.10.8.100.8	SECTION 441.357	441.357 Hearing procedures for waiver denials.
42:4.0.1.1.10.8.100.9	SECTION 441.360	441.360 Limits on Federal financial participation (FFP).
42:4.0.1.1.10.8.100.10	SECTION 441.365	441.365 Periodic evaluation, assessment, and review.
42:4.0.1.1.10.9	SUBPART I	Subpart I - Community Supported Living Arrangements Services
42:4.0.1.1.10.9.100.1	SECTION 441.400	441.400 Basis and purpose.
42:4.0.1.1.10.9.100.2	SECTION 441.402	441.402 State plan requirements.
42:4.0.1.1.10.9.100.3	SECTION 441.404	441.404 Minimum protection requirements.
42:4.0.1.1.10.10	SUBPART J	Subpart J - Optional Self-Directed Personal Assistance Services Program
42:4.0.1.1.10.10.100.1	SECTION 441.450	441.450 Basis, scope, and definitions.
42:4.0.1.1.10.10.100.2	SECTION 441.452	441.452 Self-direction: General.
42:4.0.1.1.10.10.100.3	SECTION 441.454	441.454 Use of cash.
42:4.0.1.1.10.10.100.4	SECTION 441.456	441.456 Voluntary disenrollment.
42:4.0.1.1.10.10.100.5	SECTION 441.458	441.458 Involuntary disenrollment.
42:4.0.1.1.10.10.100.6	SECTION 441.460	441.460 Participant living arrangements.
42:4.0.1.1.10.10.100.7	SECTION 441.462	441.462 Statewideness, comparability and limitations on number served.
42:4.0.1.1.10.10.100.8	SECTION 441.464	441.464 State assurances.
42:4.0.1.1.10.10.100.9	SECTION 441.466	441.466 Assessment of need.
42:4.0.1.1.10.10.100.10	SECTION 441.468	441.468 Service plan elements.
42:4.0.1.1.10.10.100.11	SECTION 441.470	441.470 Service budget elements.
42:4.0.1.1.10.10.100.12	SECTION 441.472	441.472 Budget methodology.
42:4.0.1.1.10.10.100.13	SECTION 441.474	441.474 Quality assurance and improvement plan.
42:4.0.1.1.10.10.100.14	SECTION 441.476	441.476 Risk management.
42:4.0.1.1.10.10.100.15	SECTION 441.478	441.478 Qualifications of providers of personal assistance.
42:4.0.1.1.10.10.100.16	SECTION 441.480	441.480 Use of a representative.
42:4.0.1.1.10.10.100.17	SECTION 441.482	441.482 Permissible purchases.
42:4.0.1.1.10.10.100.18	SECTION 441.484	441.484 Financial management services.
42:4.0.1.1.10.11	SUBPART K	Subpart K - Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice)
42:4.0.1.1.10.11.100.1	SECTION 441.500	441.500 Basis and scope.
42:4.0.1.1.10.11.100.2	SECTION 441.505	441.505 Definitions.
42:4.0.1.1.10.11.100.3	SECTION 441.510	441.510 Eligibility.
42:4.0.1.1.10.11.100.4	SECTION 441.515	441.515 Statewideness.
42:4.0.1.1.10.11.100.5	SECTION 441.520	441.520 Included services.
42:4.0.1.1.10.11.100.6	SECTION 441.525	441.525 Excluded services.
42:4.0.1.1.10.11.100.7	SECTION 441.530	441.530 Home and Community-Based Setting.
42:4.0.1.1.10.11.100.8	SECTION 441.535	441.535 Assessment of functional need.
42:4.0.1.1.10.11.100.9	SECTION 441.540	441.540 Person-centered service plan.
42:4.0.1.1.10.11.100.10	SECTION 441.545	441.545 Service models.
42:4.0.1.1.10.11.100.11	SECTION 441.550	441.550 Service plan requirements for self-directed model with service budget.
42:4.0.1.1.10.11.100.12	SECTION 441.555	441.555 Support system.
42:4.0.1.1.10.11.100.13	SECTION 441.560	441.560 Service budget requirements.
42:4.0.1.1.10.11.100.14	SECTION 441.565	441.565 Provider qualifications.
42:4.0.1.1.10.11.100.15	SECTION 441.570	441.570 State assurances.
42:4.0.1.1.10.11.100.16	SECTION 441.575	441.575 Development and Implementation Council.
42:4.0.1.1.10.11.100.17	SECTION 441.580	441.580 Data collection.
42:4.0.1.1.10.11.100.18	SECTION 441.585	441.585 Quality assurance system.
42:4.0.1.1.10.11.100.19	SECTION 441.590	441.590 Increased Federal financial participation.
42:4.0.1.1.10.12	SUBPART L	Subpart L - Vaccines for Children Program
42:4.0.1.1.10.12.100.1	SECTION 441.600	441.600 Basis and purpose.
42:4.0.1.1.10.12.100.2	SECTION 441.605	441.605 General requirements.
42:4.0.1.1.10.12.100.3	SECTION 441.610	441.610 State plan requirements.
42:4.0.1.1.10.12.100.4	SECTION 441.615	441.615 Administration fee requirements.
42:4.0.1.1.10.13	SUBPART M	Subpart M - State Plan Home and Community-Based Services for the Elderly and Individuals with Disabilities
42:4.0.1.1.10.13.100.1	SECTION 441.700	441.700 Basis and purpose.
42:4.0.1.1.10.13.100.2	SECTION 441.705	441.705 State plan requirements.
42:4.0.1.1.10.13.100.3	SECTION 441.710	441.710 State plan home and community-based services under section 1915(i)(1) of the Act.
42:4.0.1.1.10.13.100.4	SECTION 441.715	441.715 Needs-based criteria and evaluation.
42:4.0.1.1.10.13.100.5	SECTION 441.720	441.720 Independent assessment.
42:4.0.1.1.10.13.100.6	SECTION 441.725	441.725 Person-centered service plan.
42:4.0.1.1.10.13.100.7	SECTION 441.730	441.730 Provider qualifications.
42:4.0.1.1.10.13.100.8	SECTION 441.735	441.735 Definition of individual's representative.
42:4.0.1.1.10.13.100.9	SECTION 441.740	441.740 Self-directed services.
42:4.0.1.1.10.13.100.10	SECTION 441.745	441.745 State plan HCBS administration: State responsibilities and quality improvement.

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