Title 42

Volume 5 CHAPTER IV SUBCHAP G

Subchapter G - Standards And Certification

42:5.0.1.1.1	PART 482	PART 482 - CONDITIONS OF PARTICIPATION FOR HOSPITALS
42:5.0.1.1.1.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.1.1.4.1	SECTION 482.1	482.1 Basis and scope.
42:5.0.1.1.1.1.4.2	SECTION 482.2	482.2 Provision of emergency services by nonparticipating hospitals.
42:5.0.1.1.1.2	SUBPART B	Subpart B - Administration
42:5.0.1.1.1.2.4.1	SECTION 482.11	482.11 Condition of participation: Compliance with Federal, State and local laws.
42:5.0.1.1.1.2.4.2	SECTION 482.12	482.12 Condition of participation: Governing body.
42:5.0.1.1.1.2.4.3	SECTION 482.13	482.13 Condition of participation: Patient's rights.
42:5.0.1.1.1.2.4.4	SECTION 482.15	482.15 Condition of participation: Emergency preparedness.
42:5.0.1.1.1.3	SUBPART C	Subpart C - Basic Hospital Functions
42:5.0.1.1.1.3.4.1	SECTION 482.21	482.21 Condition of participation: Quality assessment and performance improvement program.
42:5.0.1.1.1.3.4.2	SECTION 482.22	482.22 Condition of participation: Medical staff.
42:5.0.1.1.1.3.4.3	SECTION 482.23	482.23 Condition of participation: Nursing services.
42:5.0.1.1.1.3.4.4	SECTION 482.24	482.24 Condition of participation: Medical record services.
42:5.0.1.1.1.3.4.5	SECTION 482.25	482.25 Condition of participation: Pharmaceutical services.
42:5.0.1.1.1.3.4.6	SECTION 482.26	482.26 Condition of participation: Radiologic services.
42:5.0.1.1.1.3.4.7	SECTION 482.27	482.27 Condition of participation: Laboratory services.
42:5.0.1.1.1.3.4.8	SECTION 482.28	482.28 Condition of participation: Food and dietetic services.
42:5.0.1.1.1.3.4.9	SECTION 482.30	482.30 Condition of participation: Utilization review.
42:5.0.1.1.1.3.4.10	SECTION 482.41	482.41 Condition of participation: Physical environment.
42:5.0.1.1.1.3.4.11	SECTION 482.42	482.42 Condition of participation: Infection prevention and control and antibiotic stewardship programs.
42:5.0.1.1.1.3.4.12	SECTION 482.43	482.43 Condition of participation: Discharge planning.
42:5.0.1.1.1.3.4.13	SECTION 482.45	482.45 Condition of participation: Organ, tissue, and eye procurement.
42:5.0.1.1.1.4	SUBPART D	Subpart D - Optional Hospital Services
42:5.0.1.1.1.4.4.1	SECTION 482.51	482.51 Condition of participation: Surgical services.
42:5.0.1.1.1.4.4.2	SECTION 482.52	482.52 Condition of participation: Anesthesia services.
42:5.0.1.1.1.4.4.3	SECTION 482.53	482.53 Condition of participation: Nuclear medicine services.
42:5.0.1.1.1.4.4.4	SECTION 482.54	482.54 Condition of participation: Outpatient services.
42:5.0.1.1.1.4.4.5	SECTION 482.55	482.55 Condition of participation: Emergency services.
42:5.0.1.1.1.4.4.6	SECTION 482.56	482.56 Condition of participation: Rehabilitation services.
42:5.0.1.1.1.4.4.7	SECTION 482.57	482.57 Condition of participation: Respiratory care services.
42:5.0.1.1.1.4.4.8	SECTION 482.58	482.58 Special requirements for hospital providers of long-term care services (“swing-beds”).
42:5.0.1.1.1.5	SUBPART E	Subpart E - Requirements for Specialty Hospitals
42:5.0.1.1.1.5.4	SUBJGRP 4	General Requirements for Transplant Centers
42:5.0.1.1.1.5.4.1	SECTION 482.60	482.60 Special provisions applying to psychiatric hospitals.
42:5.0.1.1.1.5.4.2	SECTION 482.61	482.61 Condition of participation: Special medical record requirements for psychiatric hospitals.
42:5.0.1.1.1.5.4.3	SECTION 482.62	482.62 Condition of participation: Special staff requirements for psychiatric hospitals.
42:5.0.1.1.1.5.4.4	SECTION 482.68	482.68 Special requirement for transplant programs.
42:5.0.1.1.1.5.4.5	SECTION 482.70	482.70 Definitions.
42:5.0.1.1.1.5.4.6	SECTION 482.72	482.72 Condition of participation: OPTN membership.
42:5.0.1.1.1.5.4.7	SECTION 482.74	482.74 Condition of participation: Notification to CMS.
42:5.0.1.1.1.5.4.8	SECTION 482.76	482.76 Condition of participation: Pediatric Transplants.
42:5.0.1.1.1.5.4.9	SECTION 482.78	482.78 Condition of participation: Emergency preparedness for transplant programs.
42:5.0.1.1.1.5.5	SUBJGRP 5	Transplant Center Data Submission, Clinical Experience, and Outcome Requirements
42:5.0.1.1.1.5.5.10	SECTION 482.80	482.80 Condition of participation: Data submission, clinical experience, and outcome requirements for initial approval of transplant programs.
42:5.0.1.1.1.5.6	SUBJGRP 6	Transplant Program Process Requirements
42:5.0.1.1.1.5.6.11	SECTION 482.90	482.90 Condition of participation: Patient and living donor selection.
42:5.0.1.1.1.5.6.12	SECTION 482.92	482.92 Condition of participation: Organ recovery and receipt.
42:5.0.1.1.1.5.6.13	SECTION 482.94	482.94 Condition of participation: Patient and living donor management.
42:5.0.1.1.1.5.6.14	SECTION 482.96	482.96 Condition of participation: Quality assessment and performance improvement (QAPI).
42:5.0.1.1.1.5.6.15	SECTION 482.98	482.98 Condition of participation: Human resources.
42:5.0.1.1.1.5.6.16	SECTION 482.100	482.100 Condition of participation: Organ procurement.
42:5.0.1.1.1.5.6.17	SECTION 482.102	482.102 Condition of participation: Patient and living donor rights.
42:5.0.1.1.1.5.6.18	SECTION 482.104	482.104 Condition of participation: Additional requirements for kidney transplant programs.
42:5.0.1.1.2	PART 483	PART 483 - REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES
42:5.0.1.1.2.1	SUBPART A	Subpart A [Reserved]
42:5.0.1.1.2.2	SUBPART B	Subpart B - Requirements for Long Term Care Facilities
42:5.0.1.1.2.2.7.1	SECTION 483.1	483.1 Basis and scope.
42:5.0.1.1.2.2.7.2	SECTION 483.5	483.5 Definitions.
42:5.0.1.1.2.2.7.3	SECTION 483.10	483.10 Resident rights.
42:5.0.1.1.2.2.7.4	SECTION 483.12	483.12 Freedom from abuse, neglect, and exploitation.
42:5.0.1.1.2.2.7.5	SECTION 483.15	483.15 Admission, transfer, and discharge rights.
42:5.0.1.1.2.2.7.6	SECTION 483.20	483.20 Resident assessment.
42:5.0.1.1.2.2.7.7	SECTION 483.21	483.21 Comprehensive person-centered care planning.
42:5.0.1.1.2.2.7.8	SECTION 483.24	483.24 Quality of life.
42:5.0.1.1.2.2.7.9	SECTION 483.25	483.25 Quality of care.
42:5.0.1.1.2.2.7.10	SECTION 483.30	483.30 Physician services.
42:5.0.1.1.2.2.7.11	SECTION 483.35	483.35 Nursing services.
42:5.0.1.1.2.2.7.12	SECTION 483.40	483.40 Behavioral health services.
42:5.0.1.1.2.2.7.13	SECTION 483.45	483.45 Pharmacy services.
42:5.0.1.1.2.2.7.14	SECTION 483.50	483.50 Laboratory, radiology, and other diagnostic services.
42:5.0.1.1.2.2.7.15	SECTION 483.55	483.55 Dental services.
42:5.0.1.1.2.2.7.16	SECTION 483.60	483.60 Food and nutrition services.
42:5.0.1.1.2.2.7.17	SECTION 483.65	483.65 Specialized rehabilitative services.
42:5.0.1.1.2.2.7.18	SECTION 483.70	483.70 Administration.
42:5.0.1.1.2.2.7.19	SECTION 483.73	483.73 Emergency preparedness.
42:5.0.1.1.2.2.7.20	SECTION 483.75	483.75 Quality assurance and performance improvement.
42:5.0.1.1.2.2.7.21	SECTION 483.80	483.80 Infection control.
42:5.0.1.1.2.2.7.22	SECTION 483.85	483.85 Compliance and ethics program.
42:5.0.1.1.2.2.7.23	SECTION 483.90	483.90 Physical environment.
42:5.0.1.1.2.2.7.24	SECTION 483.95	483.95 Training requirements.
42:5.0.1.1.2.3	SUBPART C	Subpart C - Preadmission Screening and Annual Review of Mentally Ill and Mentally Retarded Individuals
42:5.0.1.1.2.3.7.1	SECTION 483.100	483.100 Basis.
42:5.0.1.1.2.3.7.2	SECTION 483.102	483.102 Applicability and definitions.
42:5.0.1.1.2.3.7.3	SECTION 483.104	483.104 State plan requirement.
42:5.0.1.1.2.3.7.4	SECTION 483.106	483.106 Basic rule.
42:5.0.1.1.2.3.7.5	SECTION 483.108	483.108 Relationship of PASARR to other Medicaid processes.
42:5.0.1.1.2.3.7.6	SECTION 483.110	483.110 Out-of-State arrangements.
42:5.0.1.1.2.3.7.7	SECTION 483.112	483.112 Preadmission screening of applicants for admission to NFs.
42:5.0.1.1.2.3.7.8	SECTION 483.114	483.114 Annual review of NF residents.
42:5.0.1.1.2.3.7.9	SECTION 483.116	483.116 Residents and applicants determined to require NF level of services.
42:5.0.1.1.2.3.7.10	SECTION 483.118	483.118 Residents and applicants determined not to require NF level of services.
42:5.0.1.1.2.3.7.11	SECTION 483.120	483.120 Specialized services.
42:5.0.1.1.2.3.7.12	SECTION 483.122	483.122 FFP for NF services.
42:5.0.1.1.2.3.7.13	SECTION 483.124	483.124 FFP for specialized services.
42:5.0.1.1.2.3.7.14	SECTION 483.126	483.126 Appropriate placement.
42:5.0.1.1.2.3.7.15	SECTION 483.128	483.128 PASARR evaluation criteria.
42:5.0.1.1.2.3.7.16	SECTION 483.130	483.130 PASARR determination criteria.
42:5.0.1.1.2.3.7.17	SECTION 483.132	483.132 Evaluating the need for NF services and NF level of care (PASARR/NF).
42:5.0.1.1.2.3.7.18	SECTION 483.134	483.134 Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).
42:5.0.1.1.2.3.7.19	SECTION 483.136	483.136 Evaluating whether an individual with intellectual disability requires specialized services (PASARR/IID).
42:5.0.1.1.2.3.7.20	SECTION 483.138	483.138 Maintenance of services and availability of FFP.
42:5.0.1.1.2.4	SUBPART D	Subpart D - Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants
42:5.0.1.1.2.4.7.1	SECTION 483.150	483.150 Statutory basis; Deemed meeting or waiver of requirements.
42:5.0.1.1.2.4.7.2	SECTION 483.151	483.151 State review and approval of nurse aide training and competency evaluation programs.
42:5.0.1.1.2.4.7.3	SECTION 483.152	483.152 Requirements for approval of a nurse aide training and competency evaluation program.
42:5.0.1.1.2.4.7.4	SECTION 483.154	483.154 Nurse aide competency evaluation.
42:5.0.1.1.2.4.7.5	SECTION 483.156	483.156 Registry of nurse aides.
42:5.0.1.1.2.4.7.6	SECTION 483.158	483.158 FFP for nurse aide training and competency evaluation.
42:5.0.1.1.2.4.7.7	SECTION 483.160	483.160 Requirements for training of paid feeding assistants.
42:5.0.1.1.2.5	SUBPART E	Subpart E - Appeals of Discharges, Transfers, and Preadmission Screening and Annual Resident Review (PASARR) Determinations
42:5.0.1.1.2.5.7.1	SECTION 483.200	483.200 Statutory basis.
42:5.0.1.1.2.5.7.2	SECTION 483.202	483.202 Definitions.
42:5.0.1.1.2.5.7.3	SECTION 483.204	483.204 Provision of a hearing and appeal system.
42:5.0.1.1.2.5.7.4	SECTION 483.206	483.206 Transfers, discharges and relocations subject to appeal.
42:5.0.1.1.2.6	SUBPART F	Subpart F - Requirements That Must be Met by States and State Agencies, Resident Assessment
42:5.0.1.1.2.6.7.1	SECTION 483.315	483.315 Specification of resident assessment instrument.
42:5.0.1.1.2.7	SUBPART G	Subpart G - Condition of Participation for the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21
42:5.0.1.1.2.7.7.1	SECTION 483.350	483.350 Basis and scope.
42:5.0.1.1.2.7.7.2	SECTION 483.352	483.352 Definitions.
42:5.0.1.1.2.7.7.3	SECTION 483.354	483.354 General requirements for psychiatric residential treatment facilities.
42:5.0.1.1.2.7.7.4	SECTION 483.356	483.356 Protection of residents.
42:5.0.1.1.2.7.7.5	SECTION 483.358	483.358 Orders for the use of restraint or seclusion.
42:5.0.1.1.2.7.7.6	SECTION 483.360	483.360 Consultation with treatment team physician.
42:5.0.1.1.2.7.7.7	SECTION 483.362	483.362 Monitoring of the resident in and immediately after restraint.
42:5.0.1.1.2.7.7.8	SECTION 483.364	483.364 Monitoring of the resident in and immediately after seclusion.
42:5.0.1.1.2.7.7.9	SECTION 483.366	483.366 Notification of parent(s) or legal guardian(s).
42:5.0.1.1.2.7.7.10	SECTION 483.368	483.368 Application of time out.
42:5.0.1.1.2.7.7.11	SECTION 483.370	483.370 Postintervention debriefings.
42:5.0.1.1.2.7.7.12	SECTION 483.372	483.372 Medical treatment for injuries resulting from an emergency safety intervention.
42:5.0.1.1.2.7.7.13	SECTION 483.374	483.374 Facility reporting.
42:5.0.1.1.2.7.7.14	SECTION 483.376	483.376 Education and training.
42:5.0.1.1.2.8	SUBPART H	Subpart H [Reserved]
42:5.0.1.1.2.9	SUBPART I	Subpart I - Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual Disabilities
42:5.0.1.1.2.9.7.1	SECTION 483.400	483.400 Basis and purpose.
42:5.0.1.1.2.9.7.2	SECTION 483.405	483.405 Relationship to other HHS regulations.
42:5.0.1.1.2.9.7.3	SECTION 483.410	483.410 Condition of participation: Governing body and management.
42:5.0.1.1.2.9.7.4	SECTION 483.420	483.420 Condition of participation: Client protections.
42:5.0.1.1.2.9.7.5	SECTION 483.430	483.430 Condition of participation: Facility staffing.
42:5.0.1.1.2.9.7.6	SECTION 483.440	483.440 Condition of participation: Active treatment services.
42:5.0.1.1.2.9.7.7	SECTION 483.450	483.450 Condition of participation: Client behavior and facility practices.
42:5.0.1.1.2.9.7.8	SECTION 483.460	483.460 Condition of participation: Health care services.
42:5.0.1.1.2.9.7.9	SECTION 483.470	483.470 Condition of participation: Physical environment.
42:5.0.1.1.2.9.7.10	SECTION 483.475	483.475 Condition of participation: Emergency preparedness.
42:5.0.1.1.2.9.7.11	SECTION 483.480	483.480 Condition of participation: Dietetic services.
42:5.0.1.1.3	PART 484	PART 484 - HOME HEALTH SERVICES
42:5.0.1.1.3.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.3.1.7.1	SECTION 484.1	484.1 Basis and scope.
42:5.0.1.1.3.1.7.2	SECTION 484.2	484.2 Definitions.
42:5.0.1.1.3.2	SUBPART B	Subpart B - Patient Care
42:5.0.1.1.3.2.7.1	SECTION 484.40	484.40 Condition of participation: Release of patient identifiable OASIS information.
42:5.0.1.1.3.2.7.2	SECTION 484.45	484.45 Condition of participation: Reporting OASIS information.
42:5.0.1.1.3.2.7.3	SECTION 484.50	484.50 Condition of participation: Patient rights.
42:5.0.1.1.3.2.7.4	SECTION 484.55	484.55 Condition of participation: Comprehensive assessment of patients.
42:5.0.1.1.3.2.7.5	SECTION 484.58	484.58 Condition of participation: Discharge planning.
42:5.0.1.1.3.2.7.6	SECTION 484.60	484.60 Condition of participation: Care planning, coordination of services, and quality of care.
42:5.0.1.1.3.2.7.7	SECTION 484.65	484.65 Condition of participation: Quality assessment and performance improvement (QAPI).
42:5.0.1.1.3.2.7.8	SECTION 484.70	484.70 Condition of participation: Infection prevention and control.
42:5.0.1.1.3.2.7.9	SECTION 484.75	484.75 Condition of participation: Skilled professional services.
42:5.0.1.1.3.2.7.10	SECTION 484.80	484.80 Condition of participation: Home health aide services.
42:5.0.1.1.3.3	SUBPART C	Subpart C - Organizational Environment
42:5.0.1.1.3.3.7.1	SECTION 484.100	484.100 Condition of participation: Compliance with Federal, State, and local laws and regulations related to the health and safety of patients.
42:5.0.1.1.3.3.7.2	SECTION 484.102	484.102 Condition of participation: Emergency preparedness.
42:5.0.1.1.3.3.7.3	SECTION 484.105	484.105 Condition of participation: Organization and administration of services.
42:5.0.1.1.3.3.7.4	SECTION 484.110	484.110 Condition of participation: Clinical records.
42:5.0.1.1.3.3.7.5	SECTION 484.115	484.115 Condition of participation: Personnel qualifications.
42:5.0.1.1.3.4	SUBPART D	Subpart D [Reserved]
42:5.0.1.1.3.5	SUBPART E	Subpart E - Prospective Payment System for Home Health Agencies
42:5.0.1.1.3.5.7.1	SECTION 484.200	484.200 Basis and scope.
42:5.0.1.1.3.5.7.2	SECTION 484.202	484.202 Definitions.
42:5.0.1.1.3.5.7.3	SECTION 484.205	484.205 Basis of payment.
42:5.0.1.1.3.5.7.4	SECTION 484.215	484.215 Initial establishment of the calculation of the national, standardized prospective payment rates.
42:5.0.1.1.3.5.7.5	SECTION 484.220	484.220 Calculation of the case-mix and wage area adjusted prospective payment rates.
42:5.0.1.1.3.5.7.6	SECTION 484.225	484.225 Annual update of the unadjusted national, standardized prospective payment rates.
42:5.0.1.1.3.5.7.7	SECTION 484.230	484.230 Low-utilization payment adjustments.
42:5.0.1.1.3.5.7.8	SECTION 484.235	484.235 Partial payment adjustments.
42:5.0.1.1.3.5.7.9	SECTION 484.240	484.240 Outlier payments.
42:5.0.1.1.3.5.7.10	SECTION 484.245	484.245 Requirements under the Home Health Quality Reporting Program (HH QRP).
42:5.0.1.1.3.5.7.11	SECTION 484.250	484.250 OASIS data.
42:5.0.1.1.3.5.7.12	SECTION 484.260	484.260 Limitation on review.
42:5.0.1.1.3.5.7.13	SECTION 484.265	484.265 Additional payment.
42:5.0.1.1.3.6	SUBPART F	Subpart F - Home Health Value-Based Purchasing (HHVBP) Model Components for Competing Home Health Agencies Within State Boundaries
42:5.0.1.1.3.6.7.1	SECTION 484.300	484.300 Basis and scope of subpart.
42:5.0.1.1.3.6.7.2	SECTION 484.305	484.305 Definitions.
42:5.0.1.1.3.6.7.3	SECTION 484.310	484.310 Applicability of the Home Health Value-Based Purchasing (HHVBP) Model.
42:5.0.1.1.3.6.7.4	SECTION 484.315	484.315 Data reporting for measures and evaluation and the public reporting of model data under the Home Health Value-Based Purchasing (HHVBP) Model.
42:5.0.1.1.3.6.7.5	SECTION 484.320	484.320 Calculation of the Total Performance Score.
42:5.0.1.1.3.6.7.6	SECTION 484.325	484.325 Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.
42:5.0.1.1.3.6.7.7	SECTION 484.330	484.330 Process for determining and applying the value-based payment adjustment under the Home Health Value-Based Purchasing (HHVBP) Model.
42:5.0.1.1.3.6.7.8	SECTION 484.335	484.335 Appeals process for the Home Health Value-Based Purchasing (HHVBP) Model.
42:5.0.1.1.4	PART 485	PART 485 - CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS
42:5.0.1.1.4.1	SUBPART A	Subpart A [Reserved]
42:5.0.1.1.4.2	SUBPART B	Subpart B - Conditions of Participation: Comprehensive Outpatient Rehabilitation Facilities
42:5.0.1.1.4.2.7.1	SECTION 485.50	485.50 Basis and scope.
42:5.0.1.1.4.2.7.2	SECTION 485.51	485.51 Definition.
42:5.0.1.1.4.2.7.3	SECTION 485.54	485.54 Condition of participation: Compliance with State and local laws.
42:5.0.1.1.4.2.7.4	SECTION 485.56	485.56 Condition of participation: Governing body and administration.
42:5.0.1.1.4.2.7.5	SECTION 485.58	485.58 Condition of participation: Comprehensive rehabilitation program.
42:5.0.1.1.4.2.7.6	SECTION 485.60	485.60 Condition of participation: Clinical records.
42:5.0.1.1.4.2.7.7	SECTION 485.62	485.62 Condition of participation: Physical environment.
42:5.0.1.1.4.2.7.8	SECTION 485.64	485.64 [Reserved]
42:5.0.1.1.4.2.7.9	SECTION 485.66	485.66 Condition of participation: Utilization review plan.
42:5.0.1.1.4.2.7.10	SECTION 485.68	485.68 Condition of participation: Emergency preparedness.
42:5.0.1.1.4.2.7.11	SECTION 485.70	485.70 Personnel qualifications.
42:5.0.1.1.4.2.7.12	SECTION 485.74	485.74 Appeal rights.
42:5.0.1.1.4.3	SUBPART C	Subparts C-E [Reserved]
42:5.0.1.1.4.4	SUBPART F	Subpart F - Conditions of Participation: Critical Access Hospitals (CAHs)
42:5.0.1.1.4.4.7.1	SECTION 485.601	485.601 Basis and scope.
42:5.0.1.1.4.4.7.2	SECTION 485.603	485.603 Rural health network.
42:5.0.1.1.4.4.7.3	SECTION 485.604	485.604 Personnel qualifications.
42:5.0.1.1.4.4.7.4	SECTION 485.606	485.606 Designation and certification of CAHs.
42:5.0.1.1.4.4.7.5	SECTION 485.608	485.608 Condition of participation: Compliance with Federal, State, and local laws and regulations.
42:5.0.1.1.4.4.7.6	SECTION 485.610	485.610 Condition of participation: Status and location.
42:5.0.1.1.4.4.7.7	SECTION 485.612	485.612 Condition of participation: Compliance with hospital requirements at the time of application.
42:5.0.1.1.4.4.7.8	SECTION 485.616	485.616 Condition of participation: Agreements.
42:5.0.1.1.4.4.7.9	SECTION 485.618	485.618 Condition of participation: Emergency services.
42:5.0.1.1.4.4.7.10	SECTION 485.620	485.620 Condition of participation: Number of beds and length of stay.
42:5.0.1.1.4.4.7.11	SECTION 485.623	485.623 Condition of participation: Physical plant and environment.
42:5.0.1.1.4.4.7.12	SECTION 485.625	485.625 Condition of participation: Emergency preparedness.
42:5.0.1.1.4.4.7.13	SECTION 485.627	485.627 Condition of participation: Organizational structure.
42:5.0.1.1.4.4.7.14	SECTION 485.631	485.631 Condition of participation: Staffing and staff responsibilities.
42:5.0.1.1.4.4.7.15	SECTION 485.635	485.635 Condition of participation: Provision of services.
42:5.0.1.1.4.4.7.16	SECTION 485.638	485.638 Conditions of participation: Clinical records.
42:5.0.1.1.4.4.7.17	SECTION 485.639	485.639 Condition of participation: Surgical services.
42:5.0.1.1.4.4.7.18	SECTION 485.640	485.640 Condition of participation: Infection prevention and control and antibiotic stewardship programs.
42:5.0.1.1.4.4.7.19	SECTION 485.641	485.641 Condition of participation: Quality assessment and performance improvement program.
42:5.0.1.1.4.4.7.20	SECTION 485.642	485.642 Condition of participation: Discharge planning.
42:5.0.1.1.4.4.7.21	SECTION 485.643	485.643 Condition of participation: Organ, tissue, and eye procurement.
42:5.0.1.1.4.4.7.22	SECTION 485.645	485.645 Special requirements for CAH providers of long-term care services (“swing-beds”)
42:5.0.1.1.4.4.7.23	SECTION 485.647	485.647 Condition of participation: psychiatric and rehabilitation distinct part units.
42:5.0.1.1.4.5	SUBPART G	Subpart G [Reserved]
42:5.0.1.1.4.6	SUBPART H	Subpart H - Conditions of Participation for Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
42:5.0.1.1.4.6.7.1	SECTION 485.701	485.701 Basis and scope.
42:5.0.1.1.4.6.7.2	SECTION 485.703	485.703 Definitions.
42:5.0.1.1.4.6.7.3	SECTION 485.705	485.705 Personnel qualifications.
42:5.0.1.1.4.6.7.4	SECTION 485.707	485.707 Condition of participation: Compliance with Federal, State, and local laws.
42:5.0.1.1.4.6.7.5	SECTION 485.709	485.709 Condition of participation: Administrative management.
42:5.0.1.1.4.6.7.6	SECTION 485.711	485.711 Condition of participation: Plan of care and physician involvement.
42:5.0.1.1.4.6.7.7	SECTION 485.713	485.713 Condition of participation: Physical therapy services.
42:5.0.1.1.4.6.7.8	SECTION 485.715	485.715 Condition of participation: Speech pathology services.
42:5.0.1.1.4.6.7.9	SECTION 485.717	485.717 Condition of participation: Rehabilitation program.
42:5.0.1.1.4.6.7.10	SECTION 485.719	485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed by other than salaried organization personnel.
42:5.0.1.1.4.6.7.11	SECTION 485.721	485.721 Condition of participation: Clinical records.
42:5.0.1.1.4.6.7.12	SECTION 485.723	485.723 Condition of participation: Physical environment.
42:5.0.1.1.4.6.7.13	SECTION 485.725	485.725 Condition of participation: Infection control.
42:5.0.1.1.4.6.7.14	SECTION 485.727	485.727 Condition of participation: Emergency preparedness.
42:5.0.1.1.4.6.7.15	SECTION 485.729	485.729 Condition of participation: Program evaluation.
42:5.0.1.1.4.7	SUBPART I	Subpart I [Reserved]
42:5.0.1.1.4.8	SUBPART J	Subpart J - Conditions of Participation: Community Mental Health Centers (CMHCs)
42:5.0.1.1.4.8.7.1	SECTION 485.900	485.900 Basis and scope.
42:5.0.1.1.4.8.7.2	SECTION 485.902	485.902 Definitions.
42:5.0.1.1.4.8.7.3	SECTION 485.904	485.904 Condition of participation: Personnel qualifications.
42:5.0.1.1.4.8.7.4	SECTION 485.910	485.910 Condition of participation: Client rights.
42:5.0.1.1.4.8.7.5	SECTION 485.914	485.914 Condition of participation: Admission, initial evaluation, comprehensive assessment, and discharge or transfer of the client.
42:5.0.1.1.4.8.7.6	SECTION 485.916	485.916 Condition of participation: Treatment team, person-centered active treatment plan, and coordination of services.
42:5.0.1.1.4.8.7.7	SECTION 485.917	485.917 Condition of participation: Quality assessment and performance improvement.
42:5.0.1.1.4.8.7.8	SECTION 485.918	485.918 Condition of participation: Organization, governance, administration of services, and partial hospitalization services.
42:5.0.1.1.4.8.7.9	SECTION 485.920	485.920 Condition of participation: Emergency preparedness.
42:5.0.1.1.5	PART 486	PART 486 - CONDITIONS FOR COVERAGE OF SPECIALIZED SERVICES FURNISHED BY SUPPLIERS
42:5.0.1.1.5.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.5.1.13.1	SECTION 486.1	486.1 Basis and scope.
42:5.0.1.1.5.2	SUBPART B	Subpart B [Reserved]
42:5.0.1.1.5.3	SUBPART C	Subpart C - Conditions for Coverage: Portable X-Ray Services
42:5.0.1.1.5.3.13.1	SECTION 486.100	486.100 Condition for coverage: Compliance with Federal, State, and local laws and regulations.
42:5.0.1.1.5.3.13.2	SECTION 486.102	486.102 Condition for coverage: Supervision by a qualified physician.
42:5.0.1.1.5.3.13.3	SECTION 486.104	486.104 Condition for coverage: Qualifications, orientation and health of technical personnel.
42:5.0.1.1.5.3.13.4	SECTION 486.106	486.106 Condition for coverage: Referral for service and preservation of records.
42:5.0.1.1.5.3.13.5	SECTION 486.108	486.108 Condition for coverage: Safety standards.
42:5.0.1.1.5.3.13.6	SECTION 486.110	486.110 Condition for coverage: Inspection of equipment.
42:5.0.1.1.5.4	SUBPART D	Subparts D-F [Reserved]
42:5.0.1.1.5.5	SUBPART G	Subpart G - Requirements for Certification and Designation and Conditions for Coverage: Organ Procurement Organizations
42:5.0.1.1.5.5.13	SUBJGRP 13	Requirements for Certification and Designation
42:5.0.1.1.5.5.13.1	SECTION 486.301	486.301 Basis and scope.
42:5.0.1.1.5.5.13.2	SECTION 486.302	486.302 Definitions.
42:5.0.1.1.5.5.13.3	SECTION 486.303	486.303 Requirements for certification.
42:5.0.1.1.5.5.13.4	SECTION 486.304	486.304 Requirements for designation.
42:5.0.1.1.5.5.13.5	SECTION 486.306	486.306 OPO service area size designation and documentation requirements.
42:5.0.1.1.5.5.13.6	SECTION 486.308	486.308 Designation of one OPO for each service area.
42:5.0.1.1.5.5.13.7	SECTION 486.309	486.309 Re-certification from August 1, 2006 through July 31, 2010.
42:5.0.1.1.5.5.13.8	SECTION 486.310	486.310 Changes in control or ownership or service area.
42:5.0.1.1.5.5.14	SUBJGRP 14	Re-Certification and De-Certification
42:5.0.1.1.5.5.14.9	SECTION 486.312	486.312 De-certification.
42:5.0.1.1.5.5.14.10	SECTION 486.314	486.314 Appeals.
42:5.0.1.1.5.5.14.11	SECTION 486.316	486.316 Re-certification and competition processes.
42:5.0.1.1.5.5.15	SUBJGRP 15	Organ Procurement Organization Outcome Requirements
42:5.0.1.1.5.5.15.12	SECTION 486.318	486.318 Condition: Outcome measures.
42:5.0.1.1.5.5.16	SUBJGRP 16	Organ Procurement Organization Process Performance Measures
42:5.0.1.1.5.5.16.13	SECTION 486.320	486.320 Condition: Participation in Organ Procurement and Transplantation Network.
42:5.0.1.1.5.5.16.14	SECTION 486.322	486.322 Condition: Relationships with hospitals, critical access hospitals, and tissue banks.
42:5.0.1.1.5.5.16.15	SECTION 486.324	486.324 Condition: Administration and governing body.
42:5.0.1.1.5.5.16.16	SECTION 486.326	486.326 Condition: Human resources.
42:5.0.1.1.5.5.16.17	SECTION 486.328	486.328 Condition: Reporting of data.
42:5.0.1.1.5.5.16.18	SECTION 486.330	486.330 Condition: Information management.
42:5.0.1.1.5.5.16.19	SECTION 486.342	486.342 Condition: Requesting consent.
42:5.0.1.1.5.5.16.20	SECTION 486.344	486.344 Condition: Evaluation and management of potential donors and organ placement and recovery.
42:5.0.1.1.5.5.16.21	SECTION 486.346	486.346 Condition: Organ preparation and transport.
42:5.0.1.1.5.5.16.22	SECTION 486.348	486.348 Condition: Quality assessment and performance improvement (QAPI).
42:5.0.1.1.5.5.16.23	SECTION 486.360	486.360 Condition for Coverage: Emergency preparedness.
42:5.0.1.1.5.6	SUBPART H	Subpart H - [Reserved]
42:5.0.1.1.5.7	SUBPART I	Subpart I - Requirements for Home Infusion Therapy Suppliers
42:5.0.1.1.5.7.17	SUBJGRP 17	General Provisions
42:5.0.1.1.5.7.17.1	SECTION 486.500	486.500 Basis and scope.
42:5.0.1.1.5.7.17.2	SECTION 486.505	486.505 Definitions.
42:5.0.1.1.5.7.18	SUBJGRP 18	Standards for Home Infusion Therapy
42:5.0.1.1.5.7.18.3	SECTION 486.520	486.520 Plan of care.
42:5.0.1.1.5.7.18.4	SECTION 486.525	486.525 Required services.
42:5.0.1.1.6	PART 488	PART 488 - SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES
42:5.0.1.1.6.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.6.1.21.1	SECTION 488.1	488.1 Definitions.
42:5.0.1.1.6.1.21.2	SECTION 488.2	488.2 Statutory basis.
42:5.0.1.1.6.1.21.3	SECTION 488.3	488.3 Conditions of participation, conditions for coverage, conditions for certification and long term care requirements.
42:5.0.1.1.6.1.21.4	SECTION 488.4	488.4 General rules for a CMS-approved accreditation program for providers and suppliers.
42:5.0.1.1.6.1.21.5	SECTION 488.5	488.5 Application and re-application procedures for national accrediting organizations.
42:5.0.1.1.6.1.21.6	SECTION 488.6	488.6 Providers or suppliers that participate in the Medicaid program under a CMS-approved accreditation program.
42:5.0.1.1.6.1.21.7	SECTION 488.7	488.7 Release and use of accreditation surveys.
42:5.0.1.1.6.1.21.8	SECTION 488.8	488.8 Ongoing review of accrediting organizations.
42:5.0.1.1.6.1.21.9	SECTION 488.9	488.9 Validation surveys.
42:5.0.1.1.6.1.21.10	SECTION 488.10	488.10 State survey agency review: Statutory provisions.
42:5.0.1.1.6.1.21.11	SECTION 488.11	488.11 State survey agency functions.
42:5.0.1.1.6.1.21.12	SECTION 488.12	488.12 Effect of survey agency certification.
42:5.0.1.1.6.1.21.13	SECTION 488.13	488.13 Loss of accreditation.
42:5.0.1.1.6.1.21.14	SECTION 488.14	488.14 Effect of QIO review.
42:5.0.1.1.6.1.21.15	SECTION 488.18	488.18 Documentation of findings.
42:5.0.1.1.6.1.21.16	SECTION 488.20	488.20 Periodic review of compliance and approval.
42:5.0.1.1.6.1.21.17	SECTION 488.24	488.24 Certification of noncompliance.
42:5.0.1.1.6.1.21.18	SECTION 488.26	488.26 Determining compliance.
42:5.0.1.1.6.1.21.19	SECTION 488.28	488.28 Providers or suppliers, other than SNFs, NFs, and HHAs with deficiencies.
42:5.0.1.1.6.1.21.20	SECTION 488.30	488.30 Revisit user fee for revisit surveys.
42:5.0.1.1.6.2	SUBPART B	Subpart B - Special Requirements
42:5.0.1.1.6.2.21.1	SECTION 488.52	488.52 [Reserved]
42:5.0.1.1.6.2.21.2	SECTION 488.54	488.54 Temporary waivers applicable to hospitals.
42:5.0.1.1.6.2.21.3	SECTION 488.56	488.56 Temporary waivers applicable to skilled nursing facilities.
42:5.0.1.1.6.2.21.4	SECTION 488.60	488.60 Special procedures for approving end stage renal disease facilities.
42:5.0.1.1.6.2.21.5	SECTION 488.61	488.61 Special procedures for approval and re-approval of organ transplant programs.
42:5.0.1.1.6.2.21.6	SECTION 488.64	488.64 Remote facility variances for utilization review requirements.
42:5.0.1.1.6.2.21.7	SECTION 488.68	488.68 State Agency responsibilities for OASIS collection and data base requirements.
42:5.0.1.1.6.3	SUBPART C	Subpart C - Survey Forms and Procedures
42:5.0.1.1.6.3.21.1	SECTION 488.100	488.100 Long term care survey forms, Part A.
42:5.0.1.1.6.3.21.2	SECTION 488.105	488.105 Long term care survey forms, Part B.
42:5.0.1.1.6.3.21.3	SECTION 488.110	488.110 Procedural guidelines.
42:5.0.1.1.6.3.21.4	SECTION 488.115	488.115 Care guidelines.
42:5.0.1.1.6.4	SUBPART D	Subpart D - Reconsideration of Adverse Determinations - Deeming Authority for Accreditation Organizations and CLIA Exemption of Laboratories Under State Programs
42:5.0.1.1.6.4.21.1	SECTION 488.201	488.201 Reconsideration.
42:5.0.1.1.6.4.21.2	SECTION 488.203	488.203 Withdrawal of request for reconsideration.
42:5.0.1.1.6.4.21.3	SECTION 488.205	488.205 Right to informal hearing.
42:5.0.1.1.6.4.21.4	SECTION 488.207	488.207 Informal hearing procedures.
42:5.0.1.1.6.4.21.5	SECTION 488.209	488.209 Hearing officer's findings.
42:5.0.1.1.6.4.21.6	SECTION 488.211	488.211 Final reconsideration determination.
42:5.0.1.1.6.5	SUBPART E	Subpart E - Survey and Certification of Long-Term Care Facilities
42:5.0.1.1.6.5.21.1	SECTION 488.300	488.300 Statutory basis.
42:5.0.1.1.6.5.21.2	SECTION 488.301	488.301 Definitions.
42:5.0.1.1.6.5.21.3	SECTION 488.303	488.303 State plan requirement.
42:5.0.1.1.6.5.21.4	SECTION 488.305	488.305 Standard surveys.
42:5.0.1.1.6.5.21.5	SECTION 488.307	488.307 Unannounced surveys.
42:5.0.1.1.6.5.21.6	SECTION 488.308	488.308 Survey frequency.
42:5.0.1.1.6.5.21.7	SECTION 488.310	488.310 Extended survey.
42:5.0.1.1.6.5.21.8	SECTION 488.312	488.312 Consistency of survey results.
42:5.0.1.1.6.5.21.9	SECTION 488.314	488.314 Survey teams.
42:5.0.1.1.6.5.21.10	SECTION 488.318	488.318 Inadequate survey performance.
42:5.0.1.1.6.5.21.11	SECTION 488.320	488.320 Sanctions for inadequate survey performance.
42:5.0.1.1.6.5.21.12	SECTION 488.325	488.325 Disclosure of results of surveys and activities.
42:5.0.1.1.6.5.21.13	SECTION 488.330	488.330 Certification of compliance or noncompliance.
42:5.0.1.1.6.5.21.14	SECTION 488.331	488.331 Informal dispute resolution.
42:5.0.1.1.6.5.21.15	SECTION 488.332	488.332 Investigation of complaints of violations and monitoring of compliance.
42:5.0.1.1.6.5.21.16	SECTION 488.334	488.334 Educational programs.
42:5.0.1.1.6.5.21.17	SECTION 488.335	488.335 Action on complaints of resident neglect and abuse, and misappropriation of resident property.
42:5.0.1.1.6.6	SUBPART F	Subpart F - Enforcement of Compliance for Long-Term Care Facilities with Deficiencies
42:5.0.1.1.6.6.21.1	SECTION 488.400	488.400 Statutory basis.
42:5.0.1.1.6.6.21.2	SECTION 488.401	488.401 Definitions.
42:5.0.1.1.6.6.21.3	SECTION 488.402	488.402 General provisions.
42:5.0.1.1.6.6.21.4	SECTION 488.404	488.404 Factors to be considered in selecting remedies.
42:5.0.1.1.6.6.21.5	SECTION 488.406	488.406 Available remedies.
42:5.0.1.1.6.6.21.6	SECTION 488.408	488.408 Selection of remedies.
42:5.0.1.1.6.6.21.7	SECTION 488.410	488.410 Action when there is immediate jeopardy.
42:5.0.1.1.6.6.21.8	SECTION 488.412	488.412 Action when there is no immediate jeopardy.
42:5.0.1.1.6.6.21.9	SECTION 488.414	488.414 Action when there is repeated substandard quality of care.
42:5.0.1.1.6.6.21.10	SECTION 488.415	488.415 Temporary management.
42:5.0.1.1.6.6.21.11	SECTION 488.417	488.417 Denial of payment for all new admissions.
42:5.0.1.1.6.6.21.12	SECTION 488.418	488.418 Secretarial authority to deny all payments.
42:5.0.1.1.6.6.21.13	SECTION 488.422	488.422 State monitoring.
42:5.0.1.1.6.6.21.14	SECTION 488.424	488.424 Directed plan of correction.
42:5.0.1.1.6.6.21.15	SECTION 488.425	488.425 Directed inservice training.
42:5.0.1.1.6.6.21.16	SECTION 488.426	488.426 Transfer of residents, or closure of the facility and transfer of residents.
42:5.0.1.1.6.6.21.17	SECTION 488.430	488.430 Civil money penalties: Basis for imposing penalty.
42:5.0.1.1.6.6.21.18	SECTION 488.431	488.431 Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF-only facilities.
42:5.0.1.1.6.6.21.19	SECTION 488.432	488.432 Civil money penalties imposed by the State: NF-only.
42:5.0.1.1.6.6.21.20	SECTION 488.433	488.433 Civil money penalties: Uses and approval of civil money penalties imposed by CMS.
42:5.0.1.1.6.6.21.21	SECTION 488.434	488.434 Civil money penalties: Notice of penalty.
42:5.0.1.1.6.6.21.22	SECTION 488.436	488.436 Civil money penalties: Waiver of hearing, reduction of penalty amount.
42:5.0.1.1.6.6.21.23	SECTION 488.438	488.438 Civil money penalties: Amount of penalty.
42:5.0.1.1.6.6.21.24	SECTION 488.440	488.440 Civil money penalties: Effective date and duration of penalty.
42:5.0.1.1.6.6.21.25	SECTION 488.442	488.442 Civil money penalties: Due date for payment of penalty.
42:5.0.1.1.6.6.21.26	SECTION 488.444	488.444 Civil money penalties: Settlement of penalties.
42:5.0.1.1.6.6.21.27	SECTION 488.446	488.446 Administrator sanctions: long-term care facility closures.
42:5.0.1.1.6.6.21.28	SECTION 488.447	488.447 Civil Money Penalties imposed for failure to comply with 42 CFR 483.80(g)(1) and (2).
42:5.0.1.1.6.6.21.29	SECTION 488.450	488.450 Continuation of payments to a facility with deficiencies.
42:5.0.1.1.6.6.21.30	SECTION 488.452	488.452 State and Federal disagreements involving findings not in agreement in non-State operated NFs and dually participating facilities when there is no immediate jeopardy.
42:5.0.1.1.6.6.21.31	SECTION 488.454	488.454 Duration of remedies.
42:5.0.1.1.6.6.21.32	SECTION 488.456	488.456 Termination of provider agreement.
42:5.0.1.1.6.7	SUBPART G	Subpart G [Reserved]
42:5.0.1.1.6.8	SUBPART H	Subpart H - Termination of Medicare Coverage and Alternative Sanctions for End-Stage Renal Disease (ESRD) Facilities
42:5.0.1.1.6.8.21.1	SECTION 488.604	488.604 Termination of Medicare coverage.
42:5.0.1.1.6.8.21.2	SECTION 488.606	488.606 Alternative sanctions.
42:5.0.1.1.6.8.21.3	SECTION 488.608	488.608 Notice of alternative sanction and appeal rights: Termination of coverage.
42:5.0.1.1.6.8.21.4	SECTION 488.610	488.610 Notice of appeal rights: Alternative sanctions.
42:5.0.1.1.6.9	SUBPART I	Subpart I - Survey and Certification of Home Health Agencies
42:5.0.1.1.6.9.21.1	SECTION 488.700	488.700 Basis and scope.
42:5.0.1.1.6.9.21.2	SECTION 488.705	488.705 Definitions.
42:5.0.1.1.6.9.21.3	SECTION 488.710	488.710 Standard surveys.
42:5.0.1.1.6.9.21.4	SECTION 488.715	488.715 Partial extended surveys.
42:5.0.1.1.6.9.21.5	SECTION 488.720	488.720 Extended surveys.
42:5.0.1.1.6.9.21.6	SECTION 488.725	488.725 Unannounced surveys.
42:5.0.1.1.6.9.21.7	SECTION 488.730	488.730 Survey frequency and content.
42:5.0.1.1.6.9.21.8	SECTION 488.735	488.735 Surveyor qualifications.
42:5.0.1.1.6.9.21.9	SECTION 488.740	488.740 Certification of compliance or noncompliance.
42:5.0.1.1.6.9.21.10	SECTION 488.745	488.745 Informal Dispute Resolution (IDR).
42:5.0.1.1.6.10	SUBPART J	Subpart J - Alternative Sanctions for Home Health Agencies With Deficiencies
42:5.0.1.1.6.10.21.1	SECTION 488.800	488.800 Statutory basis.
42:5.0.1.1.6.10.21.2	SECTION 488.805	488.805 Definitions.
42:5.0.1.1.6.10.21.3	SECTION 488.810	488.810 General provisions.
42:5.0.1.1.6.10.21.4	SECTION 488.815	488.815 Factors to be considered in selecting sanctions.
42:5.0.1.1.6.10.21.5	SECTION 488.820	488.820 Available sanctions.
42:5.0.1.1.6.10.21.6	SECTION 488.825	488.825 Action when deficiencies pose immediate jeopardy.
42:5.0.1.1.6.10.21.7	SECTION 488.830	488.830 Action when deficiencies are at the condition-level but do not pose immediate jeopardy.
42:5.0.1.1.6.10.21.8	SECTION 488.835	488.835 Temporary management.
42:5.0.1.1.6.10.21.9	SECTION 488.840	488.840 Suspension of payment for all new patient admissions.
42:5.0.1.1.6.10.21.10	SECTION 488.845	488.845 Civil money penalties.
42:5.0.1.1.6.10.21.11	SECTION 488.850	488.850 Directed plan of correction.
42:5.0.1.1.6.10.21.12	SECTION 488.855	488.855 Directed in-service training.
42:5.0.1.1.6.10.21.13	SECTION 488.860	488.860 Continuation of payments to an HHA with deficiencies.
42:5.0.1.1.6.10.21.14	SECTION 488.865	488.865 Termination of provider agreement.
42:5.0.1.1.6.11	SUBPART K	Subpart K - [Reserved]
42:5.0.1.1.6.12	SUBPART L	Subpart L - Accreditation of Home Infusion Therapy Suppliers
42:5.0.1.1.6.12.21	SUBJGRP 21	General Provisions
42:5.0.1.1.6.12.21.1	SECTION 488.1000	488.1000 Basis and scope.
42:5.0.1.1.6.12.21.2	SECTION 488.1005	488.1005 Definitions.
42:5.0.1.1.6.12.22	SUBJGRP 22	Approval and Oversight of Home Infusion Therapy Supplier Accrediting Organizations
42:5.0.1.1.6.12.22.3	SECTION 488.1010	488.1010 Application and reapplication procedures for national home infusion therapy accrediting organizations.
42:5.0.1.1.6.12.22.4	SECTION 488.1015	488.1015 Resubmitting a request for reapproval.
42:5.0.1.1.6.12.22.5	SECTION 488.1020	488.1020 Public notice and comment.
42:5.0.1.1.6.12.22.6	SECTION 488.1025	488.1025 Release and use of home infusion therapy accreditation surveys.
42:5.0.1.1.6.12.22.7	SECTION 488.1030	488.1030 Ongoing review of home infusion therapy accrediting organizations.
42:5.0.1.1.6.12.22.8	SECTION 488.1035	488.1035 Ongoing responsibilities of a CMS-approved home infusion therapy accrediting organization.
42:5.0.1.1.6.12.22.9	SECTION 488.1040	488.1040 Onsite observations of home infusion therapy accrediting organization operations.
42:5.0.1.1.6.12.22.10	SECTION 488.1045	488.1045 Voluntary and involuntary termination.
42:5.0.1.1.6.12.22.11	SECTION 488.1050	488.1050 Reconsideration.
42:5.0.1.1.7	PART 489	PART 489 - PROVIDER AGREEMENTS AND SUPPLIER APPROVAL
42:5.0.1.1.7.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.7.1.23.1	SECTION 489.1	489.1 Statutory basis.
42:5.0.1.1.7.1.23.2	SECTION 489.2	489.2 Scope of part.
42:5.0.1.1.7.1.23.3	SECTION 489.3	489.3 Definitions.
42:5.0.1.1.7.1.23.4	SECTION 489.10	489.10 Basic requirements.
42:5.0.1.1.7.1.23.5	SECTION 489.11	489.11 Acceptance of a provider as a participant.
42:5.0.1.1.7.1.23.6	SECTION 489.12	489.12 Decision to deny an agreement.
42:5.0.1.1.7.1.23.7	SECTION 489.13	489.13 Effective date of agreement or approval.
42:5.0.1.1.7.1.23.8	SECTION 489.18	489.18 Change of ownership or leasing: Effect on provider agreement.
42:5.0.1.1.7.2	SUBPART B	Subpart B - Essentials of Provider Agreements
42:5.0.1.1.7.2.23.1	SECTION 489.20	489.20 Basic commitments.
42:5.0.1.1.7.2.23.2	SECTION 489.21	489.21 Specific limitations on charges.
42:5.0.1.1.7.2.23.3	SECTION 489.22	489.22 Special provisions applicable to prepayment requirements.
42:5.0.1.1.7.2.23.4	SECTION 489.23	489.23 Specific limitation on charges for services provided to certain enrollees of fee-for-service FEHB plans.
42:5.0.1.1.7.2.23.5	SECTION 489.24	489.24 Special responsibilities of Medicare hospitals in emergency cases.
42:5.0.1.1.7.2.23.6	SECTION 489.25	489.25 Special requirements concerning CHAMPUS and CHAMPVA programs.
42:5.0.1.1.7.2.23.7	SECTION 489.26	489.26 Special requirements concerning veterans.
42:5.0.1.1.7.2.23.8	SECTION 489.27	489.27 Beneficiary notice of discharge rights.
42:5.0.1.1.7.2.23.9	SECTION 489.28	489.28 Special capitalization requirements for HHAs.
42:5.0.1.1.7.2.23.10	SECTION 489.29	489.29 Special requirements concerning beneficiaries served by the Indian Health Service, Tribal health programs, and urban Indian organization health programs.
42:5.0.1.1.7.3	SUBPART C	Subpart C - Allowable Charges
42:5.0.1.1.7.3.23.1	SECTION 489.30	489.30 Allowable charges: Deductibles and coinsurance.
42:5.0.1.1.7.3.23.2	SECTION 489.31	489.31 Allowable charges: Blood.
42:5.0.1.1.7.3.23.3	SECTION 489.32	489.32 Allowable charges: Noncovered and partially covered services.
42:5.0.1.1.7.3.23.4	SECTION 489.34	489.34 Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects.
42:5.0.1.1.7.3.23.5	SECTION 489.35	489.35 Notice to intermediary.
42:5.0.1.1.7.4	SUBPART D	Subpart D - Handling of Incorrect Collections
42:5.0.1.1.7.4.23.1	SECTION 489.40	489.40 Definition of incorrect collection.
42:5.0.1.1.7.4.23.2	SECTION 489.41	489.41 Timing and methods of handling.
42:5.0.1.1.7.4.23.3	SECTION 489.42	489.42 Payment of offset amounts to beneficiary or other person.
42:5.0.1.1.7.5	SUBPART E	Subpart E - Termination of Agreement and Reinstatement After Termination
42:5.0.1.1.7.5.23.1	SECTION 489.52	489.52 Termination by the provider.
42:5.0.1.1.7.5.23.2	SECTION 489.53	489.53 Termination by CMS.
42:5.0.1.1.7.5.23.3	SECTION 489.54	489.54 Termination by the OIG.
42:5.0.1.1.7.5.23.4	SECTION 489.55	489.55 Exceptions to effective date of termination.
42:5.0.1.1.7.5.23.5	SECTION 489.57	489.57 Reinstatement after termination.
42:5.0.1.1.7.6	SUBPART F	Subpart F - Surety Bond Requirements for HHAs
42:5.0.1.1.7.6.23.1	SECTION 489.60	489.60 Definitions.
42:5.0.1.1.7.6.23.2	SECTION 489.61	489.61 Basic requirement for surety bonds.
42:5.0.1.1.7.6.23.3	SECTION 489.62	489.62 Requirement waived for Government-operated HHAs.
42:5.0.1.1.7.6.23.4	SECTION 489.63	489.63 Parties to the bond.
42:5.0.1.1.7.6.23.5	SECTION 489.64	489.64 Authorized Surety and exclusion of surety companies.
42:5.0.1.1.7.6.23.6	SECTION 489.65	489.65 Amount of the bond.
42:5.0.1.1.7.6.23.7	SECTION 489.66	489.66 Additional requirements of the surety bond.
42:5.0.1.1.7.6.23.8	SECTION 489.67	489.67 Term and type of bond.
42:5.0.1.1.7.6.23.9	SECTION 489.68	489.68 Effect of failure to obtain, maintain, and timely file a surety bond.
42:5.0.1.1.7.6.23.10	SECTION 489.69	489.69 Evidence of compliance.
42:5.0.1.1.7.6.23.11	SECTION 489.70	489.70 Effect of payment by the Surety.
42:5.0.1.1.7.6.23.12	SECTION 489.71	489.71 Surety's standing to appeal Medicare determinations.
42:5.0.1.1.7.6.23.13	SECTION 489.72	489.72 Effect of review reversing determination.
42:5.0.1.1.7.6.23.14	SECTION 489.73	489.73 Effect of conditions of payment.
42:5.0.1.1.7.6.23.15	SECTION 489.74	489.74 Incorporation into existing provider agreements.
42:5.0.1.1.7.7	SUBPART G	Subparts G-H [Reserved]
42:5.0.1.1.7.8	SUBPART I	Subpart I - Advance Directives
42:5.0.1.1.7.8.23.1	SECTION 489.100	489.100 Definition.
42:5.0.1.1.7.8.23.2	SECTION 489.102	489.102 Requirements for providers.
42:5.0.1.1.7.8.23.3	SECTION 489.104	489.104 Effective dates.
42:5.0.1.1.8	PART 491	PART 491 - CERTIFICATION OF CERTAIN HEALTH FACILITIES
42:5.0.1.1.8.1	SUBPART A	Subpart A - Rural Health Clinics: Conditions for Certification; and FQHCs Conditions for Coverage
42:5.0.1.1.8.1.23.1	SECTION 491.1	491.1 Purpose and scope.
42:5.0.1.1.8.1.23.2	SECTION 491.2	491.2 Definitions.
42:5.0.1.1.8.1.23.3	SECTION 491.3	491.3 Certification procedures.
42:5.0.1.1.8.1.23.4	SECTION 491.4	491.4 Compliance with Federal, State and local laws.
42:5.0.1.1.8.1.23.5	SECTION 491.5	491.5 Location of clinic.
42:5.0.1.1.8.1.23.6	SECTION 491.6	491.6 Physical plant and environment.
42:5.0.1.1.8.1.23.7	SECTION 491.7	491.7 Organizational structure.
42:5.0.1.1.8.1.23.8	SECTION 491.8	491.8 Staffing and staff responsibilities.
42:5.0.1.1.8.1.23.9	SECTION 491.9	491.9 Provision of services.
42:5.0.1.1.8.1.23.10	SECTION 491.10	491.10 Patient health records.
42:5.0.1.1.8.1.23.11	SECTION 491.11	491.11 Program evaluation.
42:5.0.1.1.8.1.23.12	SECTION 491.12	491.12 Emergency preparedness.
42:5.0.1.1.9	PART 493	PART 493 - LABORATORY REQUIREMENTS
42:5.0.1.1.9.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.9.1.32.1	SECTION 493.1	493.1 Basis and scope.
42:5.0.1.1.9.1.32.2	SECTION 493.2	493.2 Definitions.
42:5.0.1.1.9.1.32.3	SECTION 493.3	493.3 Applicability.
42:5.0.1.1.9.1.32.4	SECTION 493.5	493.5 Categories of tests by complexity.
42:5.0.1.1.9.1.32.5	SECTION 493.15	493.15 Laboratories performing waived tests.
42:5.0.1.1.9.1.32.6	SECTION 493.17	493.17 Test categorization.
42:5.0.1.1.9.1.32.7	SECTION 493.19	493.19 Provider-performed microscopy (PPM) procedures.
42:5.0.1.1.9.1.32.8	SECTION 493.20	493.20 Laboratories performing tests of moderate complexity.
42:5.0.1.1.9.1.32.9	SECTION 493.25	493.25 Laboratories performing tests of high complexity.
42:5.0.1.1.9.2	SUBPART B	Subpart B - Certificate of Waiver
42:5.0.1.1.9.2.32.1	SECTION 493.35	493.35 Application for a certificate of waiver.
42:5.0.1.1.9.2.32.2	SECTION 493.37	493.37 Requirements for a certificate of waiver.
42:5.0.1.1.9.2.32.3	SECTION 493.39	493.39 Notification requirements for laboratories issued a certificate of waiver.
42:5.0.1.1.9.2.32.4	SECTION 493.41	493.41 Condition: Reporting of SARS-CoV-2 test results.
42:5.0.1.1.9.3	SUBPART C	Subpart C - Registration Certificate, Certificate for Provider-performed Microscopy Procedures, and Certificate of Compliance
42:5.0.1.1.9.3.32.1	SECTION 493.43	493.43 Application for registration certificate, certificate for provider-performed microscopy (PPM) procedures, and certificate of compliance.
42:5.0.1.1.9.3.32.2	SECTION 493.45	493.45 Requirements for a registration certificate.
42:5.0.1.1.9.3.32.3	SECTION 493.47	493.47 Requirements for a certificate for provider-performed microscopy (PPM) procedures.
42:5.0.1.1.9.3.32.4	SECTION 493.49	493.49 Requirements for a certificate of compliance.
42:5.0.1.1.9.3.32.5	SECTION 493.51	493.51 Notification requirements for laboratories issued a certificate of compliance.
42:5.0.1.1.9.3.32.6	SECTION 493.53	493.53 Notification requirements for laboratories issued a certificate for provider-performed microscopy (PPM) procedures.
42:5.0.1.1.9.4	SUBPART D	Subpart D - Certificate of Accreditation
42:5.0.1.1.9.4.32.1	SECTION 493.55	493.55 Application for registration certificate and certificate of accreditation.
42:5.0.1.1.9.4.32.2	SECTION 493.57	493.57 Requirements for a registration certificate.
42:5.0.1.1.9.4.32.3	SECTION 493.61	493.61 Requirements for a certificate of accreditation.
42:5.0.1.1.9.4.32.4	SECTION 493.63	493.63 Notification requirements for laboratories issued a certificate of accreditation.
42:5.0.1.1.9.5	SUBPART E	Subpart E - Accreditation by a Private, Nonprofit Accreditation Organization or Exemption Under an Approved State Laboratory Program
42:5.0.1.1.9.5.32.1	SECTION 493.551	493.551 General requirements for laboratories.
42:5.0.1.1.9.5.32.2	SECTION 493.553	493.553 Approval process (application and reapplication) for accreditation organizations and State licensure programs.
42:5.0.1.1.9.5.32.3	SECTION 493.555	493.555 Federal review of laboratory requirements.
42:5.0.1.1.9.5.32.4	SECTION 493.557	493.557 Additional submission requirements.
42:5.0.1.1.9.5.32.5	SECTION 493.559	493.559 Publication of approval of deeming authority or CLIA exemption.
42:5.0.1.1.9.5.32.6	SECTION 493.561	493.561 Denial of application or reapplication.
42:5.0.1.1.9.5.32.7	SECTION 493.563	493.563 Validation inspections - Basis and focus.
42:5.0.1.1.9.5.32.8	SECTION 493.565	493.565 Selection for validation inspection - laboratory responsibilities.
42:5.0.1.1.9.5.32.9	SECTION 493.567	493.567 Refusal to cooperate with validation inspection.
42:5.0.1.1.9.5.32.10	SECTION 493.569	493.569 Consequences of a finding of noncompliance as a result of a validation inspection.
42:5.0.1.1.9.5.32.11	SECTION 493.571	493.571 Disclosure of accreditation, State and CMS validation inspection results.
42:5.0.1.1.9.5.32.12	SECTION 493.573	493.573 Continuing Federal oversight of private nonprofit accreditation organizations and approved State licensure programs.
42:5.0.1.1.9.5.32.13	SECTION 493.575	493.575 Removal of deeming authority or CLIA exemption and final determination review.
42:5.0.1.1.9.6	SUBPART F	Subpart F - General Administration
42:5.0.1.1.9.6.32.1	SECTION 493.602	493.602 Scope of subpart.
42:5.0.1.1.9.6.32.2	SECTION 493.606	493.606 Applicability of subpart.
42:5.0.1.1.9.6.32.3	SECTION 493.638	493.638 Certificate fees.
42:5.0.1.1.9.6.32.4	SECTION 493.639	493.639 Fee for revised certificate.
42:5.0.1.1.9.6.32.5	SECTION 493.643	493.643 Fee for determination of program compliance.
42:5.0.1.1.9.6.32.6	SECTION 493.645	493.645 Additional fee(s) applicable to approved State laboratory programs and laboratories issued a certificate of accreditation, certificate of waiver, or certificate for PPM procedures.
42:5.0.1.1.9.6.32.7	SECTION 493.646	493.646 Payment of fees.
42:5.0.1.1.9.6.32.8	SECTION 493.649	493.649 Methodology for determining fee amount.
42:5.0.1.1.9.7	SUBPART G	Subpart G [Reserved]
42:5.0.1.1.9.8	SUBPART H	Subpart H - Participation in Proficiency Testing for Laboratories Performing Nonwaived Testing
42:5.0.1.1.9.8.32	SUBJGRP 32	Proficiency Testing by Specialty and Subspecialty for Laboratories Performing Tests of Moderate Complexity (Including the Subcategory), High Complexity, or Any Combination of These Tests
42:5.0.1.1.9.8.32.1	SECTION 493.801	493.801 Condition: Enrollment and testing of samples.
42:5.0.1.1.9.8.32.2	SECTION 493.803	493.803 Condition: Successful participation.
42:5.0.1.1.9.8.32.3	SECTION 493.807	493.807 Condition: Reinstatement of laboratories performing nonwaived testing.
42:5.0.1.1.9.8.32.4	SECTION 493.821	493.821 Condition: Microbiology.
42:5.0.1.1.9.8.32.5	SECTION 493.823	493.823 Standard; Bacteriology.
42:5.0.1.1.9.8.32.6	SECTION 493.825	493.825 Standard; Mycobacteriology.
42:5.0.1.1.9.8.32.7	SECTION 493.827	493.827 Standard; Mycology.
42:5.0.1.1.9.8.32.8	SECTION 493.829	493.829 Standard; Parasitology.
42:5.0.1.1.9.8.32.9	SECTION 493.831	493.831 Standard; Virology.
42:5.0.1.1.9.8.32.10	SECTION 493.833	493.833 Condition: Diagnostic immunology.
42:5.0.1.1.9.8.32.11	SECTION 493.835	493.835 Standard; Syphilis serology.
42:5.0.1.1.9.8.32.12	SECTION 493.837	493.837 Standard; General immunology.
42:5.0.1.1.9.8.32.13	SECTION 493.839	493.839 Condition: Chemistry.
42:5.0.1.1.9.8.32.14	SECTION 493.841	493.841 Standard; Routine chemistry.
42:5.0.1.1.9.8.32.15	SECTION 493.843	493.843 Standard; Endocrinology.
42:5.0.1.1.9.8.32.16	SECTION 493.845	493.845 Standard; Toxicology.
42:5.0.1.1.9.8.32.17	SECTION 493.849	493.849 Condition: Hematology.
42:5.0.1.1.9.8.32.18	SECTION 493.851	493.851 Standard; Hematology.
42:5.0.1.1.9.8.32.19	SECTION 493.853	493.853 Condition: Pathology.
42:5.0.1.1.9.8.32.20	SECTION 493.855	493.855 Standard; Cytology: gynecologic examinations.
42:5.0.1.1.9.8.32.21	SECTION 493.857	493.857 Condition: Immunohematology.
42:5.0.1.1.9.8.32.22	SECTION 493.859	493.859 Standard; ABO group and D (Rho) typing.
42:5.0.1.1.9.8.32.23	SECTION 493.861	493.861 Standard; Unexpected antibody detection.
42:5.0.1.1.9.8.32.24	SECTION 493.863	493.863 Standard; Compatibility testing.
42:5.0.1.1.9.8.32.25	SECTION 493.865	493.865 Standard; Antibody identification.
42:5.0.1.1.9.9	SUBPART I	Subpart I - Proficiency Testing Programs for Nonwaived Testing
42:5.0.1.1.9.9.33	SUBJGRP 33	Proficiency Testing Programs by Specialty and Subspecialty
42:5.0.1.1.9.9.33.1	SECTION 493.901	493.901 Approval of proficiency testing programs.
42:5.0.1.1.9.9.33.2	SECTION 493.903	493.903 Administrative responsibilities.
42:5.0.1.1.9.9.33.3	SECTION 493.905	493.905 Nonapproved proficiency testing programs.
42:5.0.1.1.9.9.33.4	SECTION 493.909	493.909 Microbiology.
42:5.0.1.1.9.9.33.5	SECTION 493.911	493.911 Bacteriology.
42:5.0.1.1.9.9.33.6	SECTION 493.913	493.913 Mycobacteriology.
42:5.0.1.1.9.9.33.7	SECTION 493.915	493.915 Mycology.
42:5.0.1.1.9.9.33.8	SECTION 493.917	493.917 Parasitology.
42:5.0.1.1.9.9.33.9	SECTION 493.919	493.919 Virology.
42:5.0.1.1.9.9.33.10	SECTION 493.921	493.921 Diagnostic immunology.
42:5.0.1.1.9.9.33.11	SECTION 493.923	493.923 Syphilis serology.
42:5.0.1.1.9.9.33.12	SECTION 493.927	493.927 General immunology.
42:5.0.1.1.9.9.33.13	SECTION 493.929	493.929 Chemistry.
42:5.0.1.1.9.9.33.14	SECTION 493.931	493.931 Routine chemistry.
42:5.0.1.1.9.9.33.15	SECTION 493.933	493.933 Endocrinology.
42:5.0.1.1.9.9.33.16	SECTION 493.937	493.937 Toxicology.
42:5.0.1.1.9.9.33.17	SECTION 493.941	493.941 Hematology (including routine hematology and coagulation).
42:5.0.1.1.9.9.33.18	SECTION 493.945	493.945 Cytology; gynecologic examinations.
42:5.0.1.1.9.9.33.19	SECTION 493.959	493.959 Immunohematology.
42:5.0.1.1.9.10	SUBPART J	Subpart J - Facility Administration for Nonwaived Testing
42:5.0.1.1.9.10.34.1	SECTION 493.1100	493.1100 Condition: Facility administration.
42:5.0.1.1.9.10.34.2	SECTION 493.1101	493.1101 Standard: Facilities.
42:5.0.1.1.9.10.34.3	SECTION 493.1103	493.1103 Standard: Requirements for transfusion services.
42:5.0.1.1.9.10.34.4	SECTION 493.1105	493.1105 Standard: Retention requirements.
42:5.0.1.1.9.11	SUBPART K	Subpart K - Quality System for Nonwaived Testing
42:5.0.1.1.9.11.34	SUBJGRP 34	General Laboratory Systems
42:5.0.1.1.9.11.34.1	SECTION 493.1200	493.1200 Introduction.
42:5.0.1.1.9.11.34.2	SECTION 493.1201	493.1201 Condition: Bacteriology.
42:5.0.1.1.9.11.34.3	SECTION 493.1202	493.1202 Condition: Mycobacteriology.
42:5.0.1.1.9.11.34.4	SECTION 493.1203	493.1203 Condition: Mycology.
42:5.0.1.1.9.11.34.5	SECTION 493.1204	493.1204 Condition: Parasitology.
42:5.0.1.1.9.11.34.6	SECTION 493.1205	493.1205 Condition: Virology.
42:5.0.1.1.9.11.34.7	SECTION 493.1207	493.1207 Condition: Syphilis serology.
42:5.0.1.1.9.11.34.8	SECTION 493.1208	493.1208 Condition: General immunology.
42:5.0.1.1.9.11.34.9	SECTION 493.1210	493.1210 Condition: Routine chemistry.
42:5.0.1.1.9.11.34.10	SECTION 493.1211	493.1211 Condition: Urinalysis.
42:5.0.1.1.9.11.34.11	SECTION 493.1212	493.1212 Condition: Endocrinology.
42:5.0.1.1.9.11.34.12	SECTION 493.1213	493.1213 Condition: Toxicology.
42:5.0.1.1.9.11.34.13	SECTION 493.1215	493.1215 Condition: Hematology.
42:5.0.1.1.9.11.34.14	SECTION 493.1217	493.1217 Condition: Immunohematology.
42:5.0.1.1.9.11.34.15	SECTION 493.1219	493.1219 Condition: Histopathology.
42:5.0.1.1.9.11.34.16	SECTION 493.1220	493.1220 Condition: Oral pathology.
42:5.0.1.1.9.11.34.17	SECTION 493.1221	493.1221 Condition: Cytology.
42:5.0.1.1.9.11.34.18	SECTION 493.1225	493.1225 Condition: Clinical cytogenetics.
42:5.0.1.1.9.11.34.19	SECTION 493.1226	493.1226 Condition: Radiobioassay.
42:5.0.1.1.9.11.34.20	SECTION 493.1227	493.1227 Condition: Histocompatibility.
42:5.0.1.1.9.11.34.21	SECTION 493.1230	493.1230 Condition: General laboratory systems.
42:5.0.1.1.9.11.34.22	SECTION 493.1231	493.1231 Standard: Confidentiality of patient information.
42:5.0.1.1.9.11.34.23	SECTION 493.1232	493.1232 Standard: Specimen identification and integrity.
42:5.0.1.1.9.11.34.24	SECTION 493.1233	493.1233 Standard: Complaint investigations.
42:5.0.1.1.9.11.34.25	SECTION 493.1234	493.1234 Standard: Communications.
42:5.0.1.1.9.11.34.26	SECTION 493.1235	493.1235 Standard: Personnel competency assessment policies.
42:5.0.1.1.9.11.34.27	SECTION 493.1236	493.1236 Standard: Evaluation of proficiency testing performance.
42:5.0.1.1.9.11.34.28	SECTION 493.1239	493.1239 Standard: General laboratory systems quality assessment.
42:5.0.1.1.9.11.35	SUBJGRP 35	Preanalytic Systems
42:5.0.1.1.9.11.35.29	SECTION 493.1240	493.1240 Condition: Preanalytic systems.
42:5.0.1.1.9.11.35.30	SECTION 493.1241	493.1241 Standard: Test request.
42:5.0.1.1.9.11.35.31	SECTION 493.1242	493.1242 Standard: Specimen submission, handling, and referral.
42:5.0.1.1.9.11.35.32	SECTION 493.1249	493.1249 Standard: Preanalytic systems quality assessment.
42:5.0.1.1.9.11.36	SUBJGRP 36	Analytic Systems
42:5.0.1.1.9.11.36.33	SECTION 493.1250	493.1250 Condition: Analytic systems.
42:5.0.1.1.9.11.36.34	SECTION 493.1251	493.1251 Standard: Procedure manual.
42:5.0.1.1.9.11.36.35	SECTION 493.1252	493.1252 Standard: Test systems, equipment, instruments, reagents, materials, and supplies.
42:5.0.1.1.9.11.36.36	SECTION 493.1253	493.1253 Standard: Establishment and verification of performance specifications.
42:5.0.1.1.9.11.36.37	SECTION 493.1254	493.1254 Standard: Maintenance and function checks.
42:5.0.1.1.9.11.36.38	SECTION 493.1255	493.1255 Standard: Calibration and calibration verification procedures.
42:5.0.1.1.9.11.36.39	SECTION 493.1256	493.1256 Standard: Control procedures.
42:5.0.1.1.9.11.36.40	SECTION 493.1261	493.1261 Standard: Bacteriology.
42:5.0.1.1.9.11.36.41	SECTION 493.1262	493.1262 Standard: Mycobacteriology.
42:5.0.1.1.9.11.36.42	SECTION 493.1263	493.1263 Standard: Mycology.
42:5.0.1.1.9.11.36.43	SECTION 493.1264	493.1264 Standard: Parasitology.
42:5.0.1.1.9.11.36.44	SECTION 493.1265	493.1265 Standard: Virology.
42:5.0.1.1.9.11.36.45	SECTION 493.1267	493.1267 Standard: Routine chemistry.
42:5.0.1.1.9.11.36.46	SECTION 493.1269	493.1269 Standard: Hematology.
42:5.0.1.1.9.11.36.47	SECTION 493.1271	493.1271 Standard: Immunohematology.
42:5.0.1.1.9.11.36.48	SECTION 493.1273	493.1273 Standard: Histopathology.
42:5.0.1.1.9.11.36.49	SECTION 493.1274	493.1274 Standard: Cytology.
42:5.0.1.1.9.11.36.50	SECTION 493.1276	493.1276 Standard: Clinical cytogenetics.
42:5.0.1.1.9.11.36.51	SECTION 493.1278	493.1278 Standard: Histocompatibility.
42:5.0.1.1.9.11.36.52	SECTION 493.1281	493.1281 Standard: Comparison of test results.
42:5.0.1.1.9.11.36.53	SECTION 493.1282	493.1282 Standard: Corrective actions.
42:5.0.1.1.9.11.36.54	SECTION 493.1283	493.1283 Standard: Test records.
42:5.0.1.1.9.11.36.55	SECTION 493.1289	493.1289 Standard: Analytic systems quality assessment.
42:5.0.1.1.9.11.37	SUBJGRP 37	Postanalytic Systems
42:5.0.1.1.9.11.37.56	SECTION 493.1290	493.1290 Condition: Postanalytic systems.
42:5.0.1.1.9.11.37.57	SECTION 493.1291	493.1291 Standard: Test report.
42:5.0.1.1.9.11.37.58	SECTION 493.1299	493.1299 Standard: Postanalytic systems quality assessment.
42:5.0.1.1.9.12	SUBPART L	Subpart L [Reserved]
42:5.0.1.1.9.13	SUBPART M	Subpart M - Personnel for Nonwaived Testing
42:5.0.1.1.9.13.38	SUBJGRP 38	Laboratories Performing Provider-Performed Microscopy (PPM) Procedures
42:5.0.1.1.9.13.38.1	SECTION 493.1351	493.1351 General.
42:5.0.1.1.9.13.38.2	SECTION 493.1353	493.1353 Scope.
42:5.0.1.1.9.13.38.3	SECTION 493.1355	493.1355 Condition: Laboratories performing PPM procedures; laboratory director.
42:5.0.1.1.9.13.38.4	SECTION 493.1357	493.1357 Standard; laboratory director qualifications.
42:5.0.1.1.9.13.38.5	SECTION 493.1359	493.1359 Standard; PPM laboratory director responsibilities.
42:5.0.1.1.9.13.38.6	SECTION 493.1361	493.1361 Condition: Laboratories performing PPM procedures; testing personnel.
42:5.0.1.1.9.13.38.7	SECTION 493.1363	493.1363 Standard: PPM testing personnel qualifications.
42:5.0.1.1.9.13.38.8	SECTION 493.1365	493.1365 Standard; PPM testing personnel responsibilities.
42:5.0.1.1.9.13.39	SUBJGRP 39	Laboratories Performing Moderate Complexity Testing
42:5.0.1.1.9.13.39.9	SECTION 493.1403	493.1403 Condition: Laboratories performing moderate complexity testing; laboratory director.
42:5.0.1.1.9.13.39.10	SECTION 493.1405	493.1405 Standard; Laboratory director qualifications.
42:5.0.1.1.9.13.39.11	SECTION 493.1406	493.1406 Standard; Laboratory director qualifications on or before February 28, 1992.
42:5.0.1.1.9.13.39.12	SECTION 493.1407	493.1407 Standard; Laboratory director responsibilities.
42:5.0.1.1.9.13.39.13	SECTION 493.1409	493.1409 Condition: Laboratories performing moderate complexity testing; technical consultant.
42:5.0.1.1.9.13.39.14	SECTION 493.1411	493.1411 Standard; Technical consultant qualifications.
42:5.0.1.1.9.13.39.15	SECTION 493.1413	493.1413 Standard; Technical consultant responsibilities.
42:5.0.1.1.9.13.39.16	SECTION 493.1415	493.1415 Condition: Laboratories performing moderate complexity testing; clinical consultant.
42:5.0.1.1.9.13.39.17	SECTION 493.1417	493.1417 Standard; Clinical consultant qualifications.
42:5.0.1.1.9.13.39.18	SECTION 493.1419	493.1419 Standard; Clinical consultant responsibilities.
42:5.0.1.1.9.13.39.19	SECTION 493.1421	493.1421 Condition: Laboratories performing moderate complexity testing; testing personnel.
42:5.0.1.1.9.13.39.20	SECTION 493.1423	493.1423 Standard; Testing personnel qualifications.
42:5.0.1.1.9.13.39.21	SECTION 493.1425	493.1425 Standard; Testing personnel responsibilities.
42:5.0.1.1.9.13.40	SUBJGRP 40	Laboratories Performing High Complexity Testing
42:5.0.1.1.9.13.40.22	SECTION 493.1441	493.1441 Condition: Laboratories performing high complexity testing; laboratory director.
42:5.0.1.1.9.13.40.23	SECTION 493.1443	493.1443 Standard; Laboratory director qualifications.
42:5.0.1.1.9.13.40.24	SECTION 493.1445	493.1445 Standard; Laboratory director responsibilities.
42:5.0.1.1.9.13.40.25	SECTION 493.1447	493.1447 Condition: Laboratories performing high complexity testing; technical supervisor.
42:5.0.1.1.9.13.40.26	SECTION 493.1449	493.1449 Standard; Technical supervisor qualifications.
42:5.0.1.1.9.13.40.27	SECTION 493.1451	493.1451 Standard: Technical supervisor responsibilities.
42:5.0.1.1.9.13.40.28	SECTION 493.1453	493.1453 Condition: Laboratories performing high complexity testing; clinical consultant.
42:5.0.1.1.9.13.40.29	SECTION 493.1455	493.1455 Standard; Clinical consultant qualifications.
42:5.0.1.1.9.13.40.30	SECTION 493.1457	493.1457 Standard; Clinical consultant responsibilities.
42:5.0.1.1.9.13.40.31	SECTION 493.1459	493.1459 Condition: Laboratories performing high complexity testing; general supervisor.
42:5.0.1.1.9.13.40.32	SECTION 493.1461	493.1461 Standard: General supervisor qualifications.
42:5.0.1.1.9.13.40.33	SECTION 493.1462	493.1462 General supervisor qualifications on or before February 28, 1992.
42:5.0.1.1.9.13.40.34	SECTION 493.1463	493.1463 Standard: General supervisor responsibilities.
42:5.0.1.1.9.13.40.35	SECTION 493.1467	493.1467 Condition: Laboratories performing high complexity testing; cytology general supervisor.
42:5.0.1.1.9.13.40.36	SECTION 493.1469	493.1469 Standard: Cytology general supervisor qualifications.
42:5.0.1.1.9.13.40.37	SECTION 493.1471	493.1471 Standard: Cytology general supervisor responsibilities.
42:5.0.1.1.9.13.40.38	SECTION 493.1481	493.1481 Condition: Laboratories performing high complexity testing; cytotechnologist.
42:5.0.1.1.9.13.40.39	SECTION 493.1483	493.1483 Standard: Cytotechnologist qualifications.
42:5.0.1.1.9.13.40.40	SECTION 493.1485	493.1485 Standard; Cytotechnologist responsibilities.
42:5.0.1.1.9.13.40.41	SECTION 493.1487	493.1487 Condition: Laboratories performing high complexity testing; testing personnel.
42:5.0.1.1.9.13.40.42	SECTION 493.1489	493.1489 Standard; Testing personnel qualifications.
42:5.0.1.1.9.13.40.43	SECTION 493.1491	493.1491 Technologist qualifications on or before February 28, 1992.
42:5.0.1.1.9.13.40.44	SECTION 493.1495	493.1495 Standard; Testing personnel responsibilities.
42:5.0.1.1.9.14	SUBPART N	Subparts N-P [Reserved]
42:5.0.1.1.9.15	SUBPART Q	Subpart Q - Inspection
42:5.0.1.1.9.15.41.1	SECTION 493.1771	493.1771 Condition: Inspection requirements applicable to all CLIA-certified and CLIA-exempt laboratories.
42:5.0.1.1.9.15.41.2	SECTION 493.1773	493.1773 Standard: Basic inspection requirements for all laboratories issued a CLIA certificate and CLIA-exempt laboratories.
42:5.0.1.1.9.15.41.3	SECTION 493.1775	493.1775 Standard: Inspection of laboratories issued a certificate of waiver or a certificate for provider-performed microscopy procedures.
42:5.0.1.1.9.15.41.4	SECTION 493.1777	493.1777 Standard: Inspection of laboratories that have requested or have been issued a certificate of compliance.
42:5.0.1.1.9.15.41.5	SECTION 493.1780	493.1780 Standard: Inspection of CLIA-exempt laboratories or laboratories requesting or issued a certificate of accreditation.
42:5.0.1.1.9.16	SUBPART R	Subpart R - Enforcement Procedures
42:5.0.1.1.9.16.41.1	SECTION 493.1800	493.1800 Basis and scope.
42:5.0.1.1.9.16.41.2	SECTION 493.1804	493.1804 General considerations.
42:5.0.1.1.9.16.41.3	SECTION 493.1806	493.1806 Available sanctions: All laboratories.
42:5.0.1.1.9.16.41.4	SECTION 493.1807	493.1807 Additional sanctions: Laboratories that participate in Medicare.
42:5.0.1.1.9.16.41.5	SECTION 493.1808	493.1808 Adverse action on any type of CLIA certificate: Effect on Medicare approval.
42:5.0.1.1.9.16.41.6	SECTION 493.1809	493.1809 Limitation on Medicaid payment.
42:5.0.1.1.9.16.41.7	SECTION 493.1810	493.1810 Imposition and lifting of alternative sanctions.
42:5.0.1.1.9.16.41.8	SECTION 493.1812	493.1812 Action when deficiencies pose immediate jeopardy.
42:5.0.1.1.9.16.41.9	SECTION 493.1814	493.1814 Action when deficiencies are at the condition level but do not pose immediate jeopardy.
42:5.0.1.1.9.16.41.10	SECTION 493.1816	493.1816 Action when deficiencies are not at the condition level.
42:5.0.1.1.9.16.41.11	SECTION 493.1820	493.1820 Ensuring timely correction of deficiencies.
42:5.0.1.1.9.16.41.12	SECTION 493.1826	493.1826 Suspension of part of Medicare payments.
42:5.0.1.1.9.16.41.13	SECTION 493.1828	493.1828 Suspension of all Medicare payments.
42:5.0.1.1.9.16.41.14	SECTION 493.1832	493.1832 Directed plan of correction and directed portion of a plan of correction.
42:5.0.1.1.9.16.41.15	SECTION 493.1834	493.1834 Civil money penalty.
42:5.0.1.1.9.16.41.16	SECTION 493.1836	493.1836 State onsite monitoring.
42:5.0.1.1.9.16.41.17	SECTION 493.1838	493.1838 Training and technical assistance for unsuccessful participation in proficiency testing.
42:5.0.1.1.9.16.41.18	SECTION 493.1840	493.1840 Suspension, limitation, or revocation of any type of CLIA certificate.
42:5.0.1.1.9.16.41.19	SECTION 493.1842	493.1842 Cancellation of Medicare approval.
42:5.0.1.1.9.16.41.20	SECTION 493.1844	493.1844 Appeals procedures.
42:5.0.1.1.9.16.41.21	SECTION 493.1846	493.1846 Civil action.
42:5.0.1.1.9.16.41.22	SECTION 493.1850	493.1850 Laboratory registry.
42:5.0.1.1.9.17	SUBPART S	Subpart S [Reserved]
42:5.0.1.1.9.18	SUBPART T	Subpart T - Consultations
42:5.0.1.1.9.18.41.1	SECTION 493.2001	493.2001 Establishment and function of the Clinical Laboratory Improvement Advisory Committee.
42:5.0.1.1.10	PART 494	PART 494 - CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES
42:5.0.1.1.10.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.10.1.41.1	SECTION 494.1	494.1 Basis and scope.
42:5.0.1.1.10.1.41.2	SECTION 494.10	494.10 Definitions.
42:5.0.1.1.10.1.41.3	SECTION 494.20	494.20 Condition: Compliance with Federal, State, and local laws and regulations.
42:5.0.1.1.10.2	SUBPART B	Subpart B - Patient Safety
42:5.0.1.1.10.2.41.1	SECTION 494.30	494.30 Condition: Infection control.
42:5.0.1.1.10.2.41.2	SECTION 494.40	494.40 Condition: Water and dialysate quality.
42:5.0.1.1.10.2.41.3	SECTION 494.50	494.50 Condition: Reuse of hemodialyzers and bloodlines.
42:5.0.1.1.10.2.41.4	SECTION 494.60	494.60 Condition: Physical environment.
42:5.0.1.1.10.2.41.5	SECTION 494.62	494.62 Condition of participation: Emergency preparedness.
42:5.0.1.1.10.3	SUBPART C	Subpart C - Patient Care
42:5.0.1.1.10.3.41.1	SECTION 494.70	494.70 Condition: Patients' rights.
42:5.0.1.1.10.3.41.2	SECTION 494.80	494.80 Condition: Patient assessment.
42:5.0.1.1.10.3.41.3	SECTION 494.90	494.90 Condition: Patient plan of care.
42:5.0.1.1.10.3.41.4	SECTION 494.100	494.100 Condition: Care at home.
42:5.0.1.1.10.3.41.5	SECTION 494.110	494.110 Condition: Quality assessment and performance improvement.
42:5.0.1.1.10.3.41.6	SECTION 494.120	494.120 Condition: Special purpose renal dialysis facilities.
42:5.0.1.1.10.3.41.7	SECTION 494.130	494.130 Condition: Laboratory services.
42:5.0.1.1.10.4	SUBPART D	Subpart D - Administration
42:5.0.1.1.10.4.41.1	SECTION 494.140	494.140 Condition: Personnel qualifications.
42:5.0.1.1.10.4.41.2	SECTION 494.150	494.150 Condition: Responsibilities of the medical director.
42:5.0.1.1.10.4.41.3	SECTION 494.160	494.160 [Reserved]
42:5.0.1.1.10.4.41.4	SECTION 494.170	494.170 Condition: Medical records.
42:5.0.1.1.10.4.41.5	SECTION 494.180	494.180 Condition: Governance.
42:5.0.1.1.11	PART 495	PART 495 - STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM
42:5.0.1.1.11.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.11.1.41.1	SECTION 495.2	495.2 Basis and purpose.
42:5.0.1.1.11.1.41.2	SECTION 495.4	495.4 Definitions.
42:5.0.1.1.11.1.41.3	SECTION 495.5	495.5 Requirements for EPs seeking to reverse a hospital-based determination under § 495.4.
42:5.0.1.1.11.1.41.4	SECTION 495.20	495.20 Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs before 2015.
42:5.0.1.1.11.1.41.5	SECTION 495.22	495.22 Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs for 2015 through 2018.
42:5.0.1.1.11.1.41.6	SECTION 495.24	495.24 Stage 3 meaningful use objectives and measures for EPs, eligible hospitals and CAHs for 2019 and subsequent years.
42:5.0.1.1.11.1.41.7	SECTION 495.40	495.40 Demonstration of meaningful use criteria.
42:5.0.1.1.11.1.41.8	SECTION 495.60	495.60 Participation requirements for EPs, eligible hospitals, and CAHs.
42:5.0.1.1.11.2	SUBPART B	Subpart B - Requirements Specific to the Medicare Program
42:5.0.1.1.11.2.41.1	SECTION 495.100	495.100 Definitions.
42:5.0.1.1.11.2.41.2	SECTION 495.102	495.102 Incentive payments to EPs.
42:5.0.1.1.11.2.41.3	SECTION 495.104	495.104 Incentive payments to eligible hospitals.
42:5.0.1.1.11.2.41.4	SECTION 495.106	495.106 Incentive payments to CAHs.
42:5.0.1.1.11.2.41.5	SECTION 495.108	495.108 Posting of required information.
42:5.0.1.1.11.2.41.6	SECTION 495.110	495.110 Preclusion on administrative and judicial review.
42:5.0.1.1.11.3	SUBPART C	Subpart C - Requirements Specific to Medicare Advantage (MA) Organizations
42:5.0.1.1.11.3.41.1	SECTION 495.200	495.200 Definitions.
42:5.0.1.1.11.3.41.2	SECTION 495.202	495.202 Identification of qualifying MA organizations, MA-EPs and MA-affiliated eligible hospitals.
42:5.0.1.1.11.3.41.3	SECTION 495.204	495.204 Incentive payments to qualifying MA organizations for qualifying MA-EPs and qualifying MA-affiliated eligible hospitals.
42:5.0.1.1.11.3.41.4	SECTION 495.206	495.206 Timeframe for payment to qualifying MA organizations.
42:5.0.1.1.11.3.41.5	SECTION 495.208	495.208 Avoiding duplicate payment.
42:5.0.1.1.11.3.41.6	SECTION 495.210	495.210 Meaningful EHR user attestation.
42:5.0.1.1.11.3.41.7	SECTION 495.211	495.211 Payment adjustments effective for 2015 and subsequent MA payment years with respect to MA EPs and MA-affiliated eligible hospitals.
42:5.0.1.1.11.3.41.8	SECTION 495.212	495.212 Limitation on review.
42:5.0.1.1.11.4	SUBPART D	Subpart D - Requirements Specific to the Medicaid Program
42:5.0.1.1.11.4.41.1	SECTION 495.300	495.300 Basis and purpose.
42:5.0.1.1.11.4.41.2	SECTION 495.302	495.302 Definitions.
42:5.0.1.1.11.4.41.3	SECTION 495.304	495.304 Medicaid provider scope and eligibility.
42:5.0.1.1.11.4.41.4	SECTION 495.306	495.306 Establishing patient volume.
42:5.0.1.1.11.4.41.5	SECTION 495.308	495.308 Net average allowable costs as the basis for determining the incentive payment.
42:5.0.1.1.11.4.41.6	SECTION 495.310	495.310 Medicaid provider incentive payments.
42:5.0.1.1.11.4.41.7	SECTION 495.312	495.312 Process for payments.
42:5.0.1.1.11.4.41.8	SECTION 495.314	495.314 Activities required to receive an incentive payment.
42:5.0.1.1.11.4.41.9	SECTION 495.316	495.316 State monitoring and reporting regarding activities required to receive an incentive payment.
42:5.0.1.1.11.4.41.10	SECTION 495.318	495.318 State responsibilities for receiving FFP.
42:5.0.1.1.11.4.41.11	SECTION 495.320	495.320 FFP for payments to Medicaid providers.
42:5.0.1.1.11.4.41.12	SECTION 495.322	495.322 FFP for reasonable administrative expenses.
42:5.0.1.1.11.4.41.13	SECTION 495.324	495.324 Prior approval conditions.
42:5.0.1.1.11.4.41.14	SECTION 495.326	495.326 Disallowance of FFP.
42:5.0.1.1.11.4.41.15	SECTION 495.328	495.328 Request for reconsideration of adverse determination.
42:5.0.1.1.11.4.41.16	SECTION 495.330	495.330 Termination of FFP for failure to provide access to information.
42:5.0.1.1.11.4.41.17	SECTION 495.332	495.332 State Medicaid health information technology (HIT) plan requirements.
42:5.0.1.1.11.4.41.18	SECTION 495.334	495.334 [Reserved]
42:5.0.1.1.11.4.41.19	SECTION 495.336	495.336 Health information technology planning advance planning document requirements (HIT PAPD).
42:5.0.1.1.11.4.41.20	SECTION 495.338	495.338 Health information technology implementation advance planning document requirements (HIT IAPD).
42:5.0.1.1.11.4.41.21	SECTION 495.340	495.340 As-needed HIT PAPD update and as-needed HIT IAPD update requirements.
42:5.0.1.1.11.4.41.22	SECTION 495.342	495.342 Annual HIT IAPD requirements.
42:5.0.1.1.11.4.41.23	SECTION 495.344	495.344 Approval of the State Medicaid HIT plan, the HIT PAPD and update, the HIT IAPD and update, and the annual HIT IAPD.
42:5.0.1.1.11.4.41.24	SECTION 495.346	495.346 Access to systems and records.
42:5.0.1.1.11.4.41.25	SECTION 495.348	495.348 Procurement standards.
42:5.0.1.1.11.4.41.26	SECTION 495.350	495.350 State Medicaid agency attestations.
42:5.0.1.1.11.4.41.27	SECTION 495.352	495.352 Reporting requirements.
42:5.0.1.1.11.4.41.28	SECTION 495.354	495.354 Rules for charging equipment.
42:5.0.1.1.11.4.41.29	SECTION 495.356	495.356 Nondiscrimination requirements.
42:5.0.1.1.11.4.41.30	SECTION 495.358	495.358 Cost allocation plans.
42:5.0.1.1.11.4.41.31	SECTION 495.360	495.360 Software and ownership rights.
42:5.0.1.1.11.4.41.32	SECTION 495.362	495.362 Retroactive approval of FFP with an effective date of February 18, 2009.
42:5.0.1.1.11.4.41.33	SECTION 495.364	495.364 Review and assessment of administrative activities and expenses of Medicaid provider health information technology adoption and operation.
42:5.0.1.1.11.4.41.34	SECTION 495.366	495.366 Financial oversight and monitoring of expenditures.
42:5.0.1.1.11.4.41.35	SECTION 495.368	495.368 Combating fraud and abuse.
42:5.0.1.1.11.4.41.36	SECTION 495.370	495.370 Appeals process for a Medicaid provider receiving electronic health record incentive payments.
42:5.0.1.1.12	PART 498	PART 498 - APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT AFFECT THE PARTICIPATION OF ICFs/IID AND CERTAIN NFs IN THE MEDICAID PROGRAM
42:5.0.1.1.12.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.12.1.41.1	SECTION 498.1	498.1 Statutory basis.
42:5.0.1.1.12.1.41.2	SECTION 498.2	498.2 Definitions.
42:5.0.1.1.12.1.41.3	SECTION 498.3	498.3 Scope and applicability.
42:5.0.1.1.12.1.41.4	SECTION 498.4	498.4 NFs subject to appeals process in part 498.
42:5.0.1.1.12.1.41.5	SECTION 498.5	498.5 Appeal rights.
42:5.0.1.1.12.1.41.6	SECTION 498.10	498.10 Appointment of representatives.
42:5.0.1.1.12.1.41.7	SECTION 498.11	498.11 Authority of representatives.
42:5.0.1.1.12.1.41.8	SECTION 498.13	498.13 Fees for services of representatives.
42:5.0.1.1.12.1.41.9	SECTION 498.15	498.15 Charge for transcripts.
42:5.0.1.1.12.1.41.10	SECTION 498.17	498.17 Filing of briefs with the ALJ or Departmental Appeals Board, and opportunity for rebuttal.
42:5.0.1.1.12.2	SUBPART B	Subpart B - Initial, Reconsidered, and Revised Determinations
42:5.0.1.1.12.2.41.1	SECTION 498.20	498.20 Notice and effect of initial determinations.
42:5.0.1.1.12.2.41.2	SECTION 498.22	498.22 Reconsideration.
42:5.0.1.1.12.2.41.3	SECTION 498.23	498.23 Withdrawal of request for reconsideration.
42:5.0.1.1.12.2.41.4	SECTION 498.24	498.24 Reconsidered determination.
42:5.0.1.1.12.2.41.5	SECTION 498.25	498.25 Notice and effect of reconsidered determination.
42:5.0.1.1.12.3	SUBPART C	Subpart C - Reopening of Initial or Reconsidered Determinations
42:5.0.1.1.12.3.41.1	SECTION 498.30	498.30 Limitation on reopening.
42:5.0.1.1.12.3.41.2	SECTION 498.32	498.32 Notice and effect of reopening and revision.
42:5.0.1.1.12.4	SUBPART D	Subpart D - Hearings
42:5.0.1.1.12.4.41.1	SECTION 498.40	498.40 Request for hearing.
42:5.0.1.1.12.4.41.2	SECTION 498.42	498.42 Parties to the hearing.
42:5.0.1.1.12.4.41.3	SECTION 498.44	498.44 Designation of hearing official.
42:5.0.1.1.12.4.41.4	SECTION 498.45	498.45 Disqualification of Administrative Law Judge.
42:5.0.1.1.12.4.41.5	SECTION 498.47	498.47 Prehearing conference.
42:5.0.1.1.12.4.41.6	SECTION 498.48	498.48 Notice of prehearing conference.
42:5.0.1.1.12.4.41.7	SECTION 498.49	498.49 Conduct of prehearing conference.
42:5.0.1.1.12.4.41.8	SECTION 498.50	498.50 Record, order, and effect of prehearing conference.
42:5.0.1.1.12.4.41.9	SECTION 498.52	498.52 Time and place of hearing.
42:5.0.1.1.12.4.41.10	SECTION 498.53	498.53 Change in time and place of hearing.
42:5.0.1.1.12.4.41.11	SECTION 498.54	498.54 Joint hearings.
42:5.0.1.1.12.4.41.12	SECTION 498.56	498.56 Hearing on new issues.
42:5.0.1.1.12.4.41.13	SECTION 498.58	498.58 Subpoenas.
42:5.0.1.1.12.4.41.14	SECTION 498.60	498.60 Conduct of hearing.
42:5.0.1.1.12.4.41.15	SECTION 498.61	498.61 Evidence.
42:5.0.1.1.12.4.41.16	SECTION 498.62	498.62 Witnesses.
42:5.0.1.1.12.4.41.17	SECTION 498.63	498.63 Oral and written summation.
42:5.0.1.1.12.4.41.18	SECTION 498.64	498.64 Record of hearing.
42:5.0.1.1.12.4.41.19	SECTION 498.66	498.66 Waiver of right to appear and present evidence.
42:5.0.1.1.12.4.41.20	SECTION 498.68	498.68 Dismissal of request for hearing.
42:5.0.1.1.12.4.41.21	SECTION 498.69	498.69 Dismissal for abandonment.
42:5.0.1.1.12.4.41.22	SECTION 498.70	498.70 Dismissal for cause.
42:5.0.1.1.12.4.41.23	SECTION 498.71	498.71 Notice and effect of dismissal and right to request review.
42:5.0.1.1.12.4.41.24	SECTION 498.72	498.72 Vacating a dismissal of request for hearing.
42:5.0.1.1.12.4.41.25	SECTION 498.74	498.74 Administrative Law Judge's decision.
42:5.0.1.1.12.4.41.26	SECTION 498.76	498.76 Removal of hearing to Departmental Appeals Board.
42:5.0.1.1.12.4.41.27	SECTION 498.78	498.78 Remand by the Administrative Law Judge.
42:5.0.1.1.12.4.41.28	SECTION 498.79	498.79 Timeframes for deciding an enrollment appeal before an ALJ.
42:5.0.1.1.12.5	SUBPART E	Subpart E - Departmental Appeals Board Review
42:5.0.1.1.12.5.41.1	SECTION 498.80	498.80 Right to request Departmental Appeals Board review of Administrative Law Judge's decision or dismissal.
42:5.0.1.1.12.5.41.2	SECTION 498.82	498.82 Request for Departmental Appeals Board review.
42:5.0.1.1.12.5.41.3	SECTION 498.83	498.83 Departmental Appeals Board action on request for review.
42:5.0.1.1.12.5.41.4	SECTION 498.85	498.85 Procedures before the Departmental Appeals Board on review.
42:5.0.1.1.12.5.41.5	SECTION 498.86	498.86 Evidence admissible on review.
42:5.0.1.1.12.5.41.6	SECTION 498.88	498.88 Decision or remand by the Departmental Appeals Board.
42:5.0.1.1.12.5.41.7	SECTION 498.90	498.90 Effect of Departmental Appeals Board decision.
42:5.0.1.1.12.5.41.8	SECTION 498.95	498.95 Extension of time for seeking judicial review.
42:5.0.1.1.12.6	SUBPART F	Subpart F - Reopening of Decisions Made by Administrative Law Judges or the Departmental Appeals Board
42:5.0.1.1.12.6.41.1	SECTION 498.100	498.100 Basis, timing, and authority for reopening an ALJ or Board decision.
42:5.0.1.1.12.6.41.2	SECTION 498.102	498.102 Revision of reopened decision.
42:5.0.1.1.12.6.41.3	SECTION 498.103	498.103 Notice and effect of revised decision.

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