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| 42:4.0.1.1 | SUBCHAP C
| SUBCHAPTER C - MEDICAL ASSISTANCE PROGRAMS | |
| 42:4.0.1.1.1 | PART 430
| PART 430 - GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS | |
| 42:4.0.1.1.2 | PART 431
| PART 431 - STATE ORGANIZATION AND GENERAL ADMINISTRATION | |
| 42:4.0.1.1.2.5.8 | SUBJGRP 8
| General Provisions | |
| 42:4.0.1.1.2.5.9 | SUBJGRP 9
| Notice | |
| 42:4.0.1.1.2.5.10 | SUBJGRP 10
| Right to Hearing | |
| 42:4.0.1.1.2.5.11 | SUBJGRP 11
| Procedures | |
| 42:4.0.1.1.2.5.12 | SUBJGRP 12
| Federal Financial Participation | |
| 42:4.0.1.1.2.12.13 | SUBJGRP 13
| Medicaid Eligibility Quality Control (MEQC) Program | |
| 42:4.0.1.1.2.12.14 | SUBJGRP 14
| Medicaid Quality Control (MQC) Claims Processing Assessment System | |
| 42:4.0.1.1.3 | PART 432
| PART 432 - STATE PERSONNEL ADMINISTRATION | |
| 42:4.0.1.1.4 | PART 433
| PART 433 - STATE FISCAL ADMINISTRATION | |
| 42:4.0.1.1.4.4.17 | SUBJGRP 17
| Assignment of Rights to Benefits | |
| 42:4.0.1.1.4.4.18 | SUBJGRP 18
| Cooperative Agreements and Incentive Payments | |
| 42:4.0.1.1.5 | PART 434
| PART 434 - CONTRACTS | |
| 42:4.0.1.1.6 | PART 435
| PART 435 - ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA | |
| 42:4.0.1.1.6.2.48 | SUBJGRP 48
| Mandatory Coverage of Families and Children | |
| 42:4.0.1.1.6.2.49 | SUBJGRP 49
| Mandatory Coverage of Pregnant Women, Children Under 19, and Newborn Children | |
| 42:4.0.1.1.6.2.50 | SUBJGRP 50
| Mandatory Coverage of Qualified Family Members | |
| 42:4.0.1.1.6.2.51 | SUBJGRP 51
| Mandatory Coverage for Individuals Age 19 Through 64 | |
| 42:4.0.1.1.6.2.52 | SUBJGRP 52
| Mandatory Coverage of the Aged, Blind, and Disabled | |
| 42:4.0.1.1.6.2.53 | SUBJGRP 53
| Mandatory Coverage of Certain Aliens | |
| 42:4.0.1.1.6.2.54 | SUBJGRP 54
| Mandatory Coverage of Adoption Assistance and Foster Care Children | |
| 42:4.0.1.1.6.2.55 | SUBJGRP 55
| Mandatory Coverage of Special Groups | |
| 42:4.0.1.1.6.3.56 | SUBJGRP 56
| Options for Coverage of Families and Children and the Aged, Blind, and Disabled | |
| 42:4.0.1.1.6.3.57 | SUBJGRP 57
| Options for Coverage of Families and Children | |
| 42:4.0.1.1.6.3.58 | SUBJGRP 58
| Options for Coverage of the Aged, Blind, and Disabled | |
| 42:4.0.1.1.6.6.59 | SUBJGRP 59
| Age | |
| 42:4.0.1.1.6.6.60 | SUBJGRP 60
| Blindness | |
| 42:4.0.1.1.6.6.61 | SUBJGRP 61
| Disability | |
| 42:4.0.1.1.6.9.62 | SUBJGRP 62
| Medically Needy Income Standard | |
| 42:4.0.1.1.6.9.63 | SUBJGRP 63
| Medically Needy Income Eligibility | |
| 42:4.0.1.1.6.9.64 | SUBJGRP 64
| Medically Needy Resource Standard | |
| 42:4.0.1.1.6.9.65 | SUBJGRP 65
| Determining Eligibility on the Basis of Resources | |
| 42:4.0.1.1.6.10.66 | SUBJGRP 66
| General Methods of Administration | |
| 42:4.0.1.1.6.10.67 | SUBJGRP 67
| Applications | |
| 42:4.0.1.1.6.10.68 | SUBJGRP 68
| Determination of Medicaid Eligibility | |
| 42:4.0.1.1.6.10.69 | SUBJGRP 69
| Redeterminations of Medicaid Eligibility | |
| 42:4.0.1.1.6.10.70 | SUBJGRP 70
| Furnishing Medicaid | |
| 42:4.0.1.1.6.10.71 | SUBJGRP 71
| Income and Eligibility Verification Requirements | |
| 42:4.0.1.1.6.11.72 | SUBJGRP 72
| FFP in Expenditures for Determining Eligibility and Providing Services | |
| 42:4.0.1.1.6.11.73 | SUBJGRP 73
| Limitations on FFP | |
| 42:4.0.1.1.6.11.74 | SUBJGRP 74
| Requirements for State Supplements | |
| 42:4.0.1.1.6.11.75 | SUBJGRP 75
| FFP for Premium Assistance | |
| 42:4.0.1.1.7 | PART 436
| PART 436 - ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS | |
| 42:4.0.1.1.7.3.88 | SUBJGRP 88
| Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women | |
| 42:4.0.1.1.7.3.89 | SUBJGRP 89
| Options for Coverage of the Aged, Blind, and Disabled | |
| 42:4.0.1.1.7.6.90 | SUBJGRP 90
| Dependency | |
| 42:4.0.1.1.7.6.91 | SUBJGRP 91
| Age | |
| 42:4.0.1.1.7.6.92 | SUBJGRP 92
| Blindness | |
| 42:4.0.1.1.7.6.93 | SUBJGRP 93
| Disability | |
| 42:4.0.1.1.7.9.94 | SUBJGRP 94
| Medically Needy Income Standard | |
| 42:4.0.1.1.7.9.95 | SUBJGRP 95
| Medically Needy Income Eligibility and Liability for Payment of Medical Expenses | |
| 42:4.0.1.1.7.9.96 | SUBJGRP 96
| Medically Needy Resource Standard | |
| 42:4.0.1.1.7.9.97 | SUBJGRP 97
| Determining Eligibility on the Basis of Resources | |
| 42:4.0.1.1.7.11.98 | SUBJGRP 98
| FFP for Expenditures for Determining Eligibility and Providing Services | |
| 42:4.0.1.1.7.12.99 | SUBJGRP 99
| Presumptive Eligibility for Children | |
| 42:4.0.1.1.8 | PART 438
| PART 438 - MANAGED CARE | |
| 42:4.0.1.1.9 | PART 440
| PART 440 - SERVICES: GENERAL PROVISIONS | |
| 42:4.0.1.1.10 | PART 441
| PART 441 - SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES | |
| 42:4.0.1.1.11 | PART 442
| PART 442 - STANDARDS FOR PAYMENT TO NURSING FACILITIES AND INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES | |
| 42:4.0.1.1.12 | PART 447
| PART 447 - PAYMENTS FOR SERVICES | |
| 42:4.0.1.1.12.1.109 | SUBJGRP 109
| Medicaid Premiums and Cost Sharing | |
| 42:4.0.1.1.12.3.110 | SUBJGRP 110
| Payment Rates | |
| 42:4.0.1.1.12.3.111 | SUBJGRP 111
| Federal Financial Participation | |
| 42:4.0.1.1.12.3.112 | SUBJGRP 112
| Upper Limits | |
| 42:4.0.1.1.12.3.113 | SUBJGRP 113
| Swing-Bed Hospitals | |
| 42:4.0.1.1.12.6.114 | SUBJGRP 114
| Outpatient Hospital and Clinic Services | |
| 42:4.0.1.1.12.6.115 | SUBJGRP 115
| Other Inpatient and Outpatient Facilities | |
| 42:4.0.1.1.12.6.116 | SUBJGRP 116
| Prepaid Capitation Plans | |
| 42:4.0.1.1.12.6.117 | SUBJGRP 117
| Rural Health Clinic Services | |
| 42:4.0.1.1.13 | PART 455
| PART 455 - PROGRAM INTEGRITY: MEDICAID | |
| 42:4.0.1.1.14 | PART 456
| PART 456 - UTILIZATION CONTROL | |
| 42:4.0.1.1.14.3.143 | SUBJGRP 143
| Certification of Need for Care | |
| 42:4.0.1.1.14.3.144 | SUBJGRP 144
| Plan of Care | |
| 42:4.0.1.1.14.3.145 | SUBJGRP 145
| Utilization Review (UR) Plan: General Requirement | |
| 42:4.0.1.1.14.3.146 | SUBJGRP 146
| UR Plan: Administrative Requirements | |
| 42:4.0.1.1.14.3.147 | SUBJGRP 147
| UR Plan: Informational Requirements | |
| 42:4.0.1.1.14.3.148 | SUBJGRP 148
| UR Plan: Review of Need for Admission 1 | |
| 42:4.0.1.1.14.3.149 | SUBJGRP 149
| UR Plan: Review of Need for Continued Stay | |
| 42:4.0.1.1.14.3.150 | SUBJGRP 150
| UR Plan: Medical Care Evaluation Studies | |
| 42:4.0.1.1.14.4.151 | SUBJGRP 151
| Certification of Need for Care | |
| 42:4.0.1.1.14.4.152 | SUBJGRP 152
| Medical, Psychiatric, and Social Evaluations and Admission Review | |
| 42:4.0.1.1.14.4.153 | SUBJGRP 153
| Plan of Care | |
| 42:4.0.1.1.14.4.154 | SUBJGRP 154
| Utilization Review (UR) Plan: General Requirements | |
| 42:4.0.1.1.14.4.155 | SUBJGRP 155
| UR Plan: Administrative Requirements | |
| 42:4.0.1.1.14.4.156 | SUBJGRP 156
| UR Plan: Informational Requirements | |
| 42:4.0.1.1.14.4.157 | SUBJGRP 157
| UR Plan: Review of Need for Continued Stay | |
| 42:4.0.1.1.14.4.158 | SUBJGRP 158
| UR Plan: Medical Care Evaluation Studies | |
| 42:4.0.1.1.14.6.159 | SUBJGRP 159
| Certification of Need for Care | |
| 42:4.0.1.1.14.6.160 | SUBJGRP 160
| Medical, Psychological, and Social Evaluations and Admission Review | |
| 42:4.0.1.1.14.6.161 | SUBJGRP 161
| Plan of Care | |
| 42:4.0.1.1.14.6.162 | SUBJGRP 162
| Utilization Review (UR) Plan: General Requirement | |
| 42:4.0.1.1.14.6.163 | SUBJGRP 163
| UR Plan: Administrative Requirements | |
| 42:4.0.1.1.14.6.164 | SUBJGRP 164
| UR Plan: Informational Requirements | |
| 42:4.0.1.1.14.6.165 | SUBJGRP 165
| UR Plan: Review of Need for Continued Stay | |
| 42:4.0.1.1.14.8.166 | SUBJGRP 166
| UR Plan: Waiver of Requirements | |
| 42:4.0.1.1.14.8.167 | SUBJGRP 167
| UR Plan: Remote Facility Variances from Time Requirements | |
| 42:4.0.1.2 | SUBCHAP D
| SUBCHAPTER D - STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) | |
| 42:4.0.1.2.15 | PART 457
| PART 457 - ALLOTMENTS AND GRANTS TO STATES | |
| 42:4.0.1.2.15.12.175 | SUBJGRP 175
| General Provisions | |
| 42:4.0.1.2.15.12.176 | SUBJGRP 176
| State Responsibilities | |
| 42:4.0.1.2.15.12.177 | SUBJGRP 177
| Enrollee Rights and Protections | |
| 42:4.0.1.2.15.12.178 | SUBJGRP 178
| MCO, PIHP, and PAHP Standards | |
| 42:4.0.1.2.15.12.179 | SUBJGRP 179
| Quality Measurement and Improvement; External Quality Review | |
| 42:4.0.1.2.15.12.180 | SUBJGRP 180
| Grievance System | |
| 42:4.0.1.2.15.12.181 | SUBJGRP 181
| Sanctions | |
| 42:4.0.1.3 | SUBCHAP E
| SUBCHAPTER E - PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) | |
| 42:4.0.1.3.16 | PART 460
| PART 460 - PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) | |
| 42:4.0.1.4 | SUBCHAP F
| SUBCHAPTER F - QUALITY IMPROVEMENT ORGANIZATIONS | |
| 42:4.0.1.4.17 | PART 475
| PART 475 - QUALITY IMPROVEMENT ORGANIZATIONS | |
| 42:4.0.1.4.18 | PART 476
| PART 476 - QUALITY IMPROVEMENT ORGANIZATION REVIEW | |
| 42:4.0.1.4.18.3.184 | SUBJGRP 184
| General Provisions | |
| 42:4.0.1.4.18.3.185 | SUBJGRP 185
| QIO Review Functions | |
| 42:4.0.1.4.19 | PART 478
| PART 478 - RECONSIDERATIONS AND APPEALS | |
| 42:4.0.1.4.20 | PART 480
| PART 480 - ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION | |
| 42:4.0.1.4.20.2.191 | SUBJGRP 191
| General Provisions | |
| 42:4.0.1.4.20.2.192 | SUBJGRP 192
| QIO Access to Information | |
| 42:4.0.1.4.20.2.193 | SUBJGRP 193
| QIO Responsibilities | |
| 42:4.0.1.4.20.2.194 | SUBJGRP 194
| Disclosure of Nonconfidential Information | |
| 42:4.0.1.4.20.2.195 | SUBJGRP 195
| Disclosure of Confidential Information | |
| 42:4.0.1.4.21 | PART 481
| PART 481 [RESERVED] | |