Title 42

VOLUME 4

Title 42 - Public Health--Volume 4

42:4  Public Health--Volume 4
42:4.0.1CHAPTER IV - CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)
      PARTS 430 - 481
42:4.0.1.1  SUBCHAPTER C - MEDICAL ASSISTANCE PROGRAMS
      PARTS 430 - 456
42:4.0.1.1.2.5.8      General Provisions [SUBJGRP]
42:4.0.1.1.2.5.9      Notice [SUBJGRP]
42:4.0.1.1.2.5.10      Right to Hearing [SUBJGRP]
42:4.0.1.1.2.5.11      Procedures [SUBJGRP]
42:4.0.1.1.2.5.12      Federal Financial Participation [SUBJGRP]
42:4.0.1.1.2.12.13      Medicaid Eligibility Quality Control (MEQC) Program [SUBJGRP]
42:4.0.1.1.2.12.14      Medicaid Quality Control (MQC) Claims Processing Assessment System [SUBJGRP]
42:4.0.1.1.4.4.17      Assignment of Rights to Benefits [SUBJGRP]
42:4.0.1.1.4.4.18      Cooperative Agreements and Incentive Payments [SUBJGRP]
42:4.0.1.1.6.2.48      Mandatory Coverage of Families and Children [SUBJGRP]
42:4.0.1.1.6.2.49      Mandatory Coverage of Pregnant Women, Children Under 19, and Newborn Children [SUBJGRP]
42:4.0.1.1.6.2.50      Mandatory Coverage of Qualified Family Members [SUBJGRP]
42:4.0.1.1.6.2.51      Mandatory Coverage for Individuals Age 19 Through 64 [SUBJGRP]
42:4.0.1.1.6.2.52      Mandatory Coverage of the Aged, Blind, and Disabled [SUBJGRP]
42:4.0.1.1.6.2.53      Mandatory Coverage of Certain Aliens [SUBJGRP]
42:4.0.1.1.6.2.54      Mandatory Coverage of Adoption Assistance and Foster Care Children [SUBJGRP]
42:4.0.1.1.6.2.55      Mandatory Coverage of Special Groups [SUBJGRP]
42:4.0.1.1.6.3.56      Options for Coverage of Families and Children and the Aged, Blind, and Disabled [SUBJGRP]
42:4.0.1.1.6.3.57      Options for Coverage of Families and Children [SUBJGRP]
42:4.0.1.1.6.3.58      Options for Coverage of the Aged, Blind, and Disabled [SUBJGRP]
42:4.0.1.1.6.6.59      Age [SUBJGRP]
42:4.0.1.1.6.6.60      Blindness [SUBJGRP]
42:4.0.1.1.6.6.61      Disability [SUBJGRP]
42:4.0.1.1.6.9.62      Medically Needy Income Standard [SUBJGRP]
42:4.0.1.1.6.9.63      Medically Needy Income Eligibility [SUBJGRP]
42:4.0.1.1.6.9.64      Medically Needy Resource Standard [SUBJGRP]
42:4.0.1.1.6.9.65      Determining Eligibility on the Basis of Resources [SUBJGRP]
42:4.0.1.1.6.10.66      General Methods of Administration [SUBJGRP]
42:4.0.1.1.6.10.67      Applications [SUBJGRP]
42:4.0.1.1.6.10.68      Determination of Medicaid Eligibility [SUBJGRP]
42:4.0.1.1.6.10.69      Redeterminations of Medicaid Eligibility [SUBJGRP]
42:4.0.1.1.6.10.70      Furnishing Medicaid [SUBJGRP]
42:4.0.1.1.6.10.71      Income and Eligibility Verification Requirements [SUBJGRP]
42:4.0.1.1.6.11.72      FFP in Expenditures for Determining Eligibility and Providing Services [SUBJGRP]
42:4.0.1.1.6.11.73      Limitations on FFP [SUBJGRP]
42:4.0.1.1.6.11.74      Requirements for State Supplements [SUBJGRP]
42:4.0.1.1.6.11.75      FFP for Premium Assistance [SUBJGRP]
42:4.0.1.1.7.3.88      Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women [SUBJGRP]
42:4.0.1.1.7.3.89      Options for Coverage of the Aged, Blind, and Disabled [SUBJGRP]
42:4.0.1.1.7.6.90      Dependency [SUBJGRP]
42:4.0.1.1.7.6.91      Age [SUBJGRP]
42:4.0.1.1.7.6.92      Blindness [SUBJGRP]
42:4.0.1.1.7.6.93      Disability [SUBJGRP]
42:4.0.1.1.7.9.94      Medically Needy Income Standard [SUBJGRP]
42:4.0.1.1.7.9.95      Medically Needy Income Eligibility and Liability for Payment of Medical Expenses [SUBJGRP]
42:4.0.1.1.7.9.96      Medically Needy Resource Standard [SUBJGRP]
42:4.0.1.1.7.9.97      Determining Eligibility on the Basis of Resources [SUBJGRP]
42:4.0.1.1.7.11.98      FFP for Expenditures for Determining Eligibility and Providing Services [SUBJGRP]
42:4.0.1.1.7.12.99      Presumptive Eligibility for Children [SUBJGRP]
42:4.0.1.1.12.1.109      Medicaid Premiums and Cost Sharing [SUBJGRP]
42:4.0.1.1.12.3.110      Payment Rates [SUBJGRP]
42:4.0.1.1.12.3.111      Federal Financial Participation [SUBJGRP]
42:4.0.1.1.12.3.112      Upper Limits [SUBJGRP]
42:4.0.1.1.12.3.113      Swing-Bed Hospitals [SUBJGRP]
42:4.0.1.1.12.6.114      Outpatient Hospital and Clinic Services [SUBJGRP]
42:4.0.1.1.12.6.115      Other Inpatient and Outpatient Facilities [SUBJGRP]
42:4.0.1.1.12.6.116      Prepaid Capitation Plans [SUBJGRP]
42:4.0.1.1.12.6.117      Rural Health Clinic Services [SUBJGRP]
42:4.0.1.1.14.3.143      Certification of Need for Care [SUBJGRP]
42:4.0.1.1.14.3.144      Plan of Care [SUBJGRP]
42:4.0.1.1.14.3.145      Utilization Review (UR) Plan: General Requirement [SUBJGRP]
42:4.0.1.1.14.3.146      UR Plan: Administrative Requirements [SUBJGRP]
42:4.0.1.1.14.3.147      UR Plan: Informational Requirements [SUBJGRP]
42:4.0.1.1.14.3.148      UR Plan: Review of Need for Admission 1 /> [SUBJGRP]
42:4.0.1.1.14.3.149      UR Plan: Review of Need for Continued Stay [SUBJGRP]
42:4.0.1.1.14.3.150      UR Plan: Medical Care Evaluation Studies [SUBJGRP]
42:4.0.1.1.14.4.151      Certification of Need for Care [SUBJGRP]
42:4.0.1.1.14.4.152      Medical, Psychiatric, and Social Evaluations and Admission Review [SUBJGRP]
42:4.0.1.1.14.4.153      Plan of Care [SUBJGRP]
42:4.0.1.1.14.4.154      Utilization Review (UR) Plan: General Requirements [SUBJGRP]
42:4.0.1.1.14.4.155      UR Plan: Administrative Requirements [SUBJGRP]
42:4.0.1.1.14.4.156      UR Plan: Informational Requirements [SUBJGRP]
42:4.0.1.1.14.4.157      UR Plan: Review of Need for Continued Stay [SUBJGRP]
42:4.0.1.1.14.4.158      UR Plan: Medical Care Evaluation Studies [SUBJGRP]
42:4.0.1.1.14.6.159      Certification of Need for Care [SUBJGRP]
42:4.0.1.1.14.6.160      Medical, Psychological, and Social Evaluations and Admission Review [SUBJGRP]
42:4.0.1.1.14.6.161      Plan of Care [SUBJGRP]
42:4.0.1.1.14.6.162      Utilization Review (UR) Plan: General Requirement [SUBJGRP]
42:4.0.1.1.14.6.163      UR Plan: Administrative Requirements [SUBJGRP]
42:4.0.1.1.14.6.164      UR Plan: Informational Requirements [SUBJGRP]
42:4.0.1.1.14.6.165      UR Plan: Review of Need for Continued Stay [SUBJGRP]
42:4.0.1.1.14.8.166      UR Plan: Waiver of Requirements [SUBJGRP]
42:4.0.1.1.14.8.167      UR Plan: Remote Facility Variances from Time Requirements [SUBJGRP]
42:4.0.1.2  SUBCHAPTER D - STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs)
      PARTS 457 - 457
42:4.0.1.2.15.12.175      General Provisions [SUBJGRP]
42:4.0.1.2.15.12.176      State Responsibilities [SUBJGRP]
42:4.0.1.2.15.12.177      Enrollee Rights and Protections [SUBJGRP]
42:4.0.1.2.15.12.178      MCO, PIHP, and PAHP Standards [SUBJGRP]
42:4.0.1.2.15.12.179      Quality Measurement and Improvement; External Quality Review [SUBJGRP]
42:4.0.1.2.15.12.180      Grievance System [SUBJGRP]
42:4.0.1.2.15.12.181      Sanctions [SUBJGRP]
42:4.0.1.3  SUBCHAPTER E - PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
      PARTS 460 - 460
42:4.0.1.4  SUBCHAPTER F - QUALITY IMPROVEMENT ORGANIZATIONS
      PARTS 475 - 481
42:4.0.1.4.18.3.184      General Provisions [SUBJGRP]
42:4.0.1.4.18.3.185      QIO Review Functions [SUBJGRP]
42:4.0.1.4.20.2.191      General Provisions [SUBJGRP]
42:4.0.1.4.20.2.192      QIO Access to Information [SUBJGRP]
42:4.0.1.4.20.2.193      QIO Responsibilities [SUBJGRP]
42:4.0.1.4.20.2.194      Disclosure of Nonconfidential Information [SUBJGRP]
42:4.0.1.4.20.2.195      Disclosure of Confidential Information [SUBJGRP]