42 CFR - Code of Federal Regulations - Title 42: Public Health

CHAPTER IV: CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBCHAPTER C: MEDICAL ASSISTANCE PROGRAMS

PART 431: STATE ORGANIZATION AND GENERAL ADMINISTRATION

Subpart Q: Requirements for Estimating Improper Payments in Medicaid and CHIP

42 CFR 431.974 - Basic elements of Medicaid and CHIP eligibility reviews.

42 CFR 431.978 - Eligibility sampling plan and procedures.

42 CFR 431.980 - Eligibility review procedures.

42 CFR 431.988 - Eligibility case review completion deadlines and submittal of reports.

42 CFR 431.992 - Corrective action plan.

42 CFR 431.998 - Difference resolution and appeal process.

Subpart Q: Requirements for Estimating Improper Payments in Medicaid and CHIP

42 CFR 431.960 - Types of payment errors.

42 CFR 431.972 - Claims sampling procedures.

PART 433: STATE FISCAL ADMINISTRATION

Subpart A: Federal Matching and General Administration Provisions

42 CFR 433.8 -

42 CFR 433.20 - Rates of FFP for administration: Reimbursement for school-based administrative expenditures.

PART 434: CONTRACTS

Subpart B: Contracts with Fiscal Agents and Private Nonmedical Institutions

42 CFR 434.14 -

PART 435: ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA

Subpart C: Options for Coverage as Categorically Needy

: Options for Coverage of Families and Children

42 CFR 435.221 -

Subpart E: General Eligibility Requirements

42 CFR 435.402 -

42 CFR 435.407 - Types of acceptable documentary evidence of citizenship.

Subpart G: General Financial Eligibility Requirements and Options

42 CFR 435.604 -

42 CFR 435.606 -

Subpart K: Federal Financial Participation

: Requirements for State Supplements

42 CFR 435.1012 - Requirement for maintenance of optional State supplement expenditures.

PART 436: ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS

Subpart E: General Eligibility Requirements

42 CFR 436.402 -

42 CFR 436.407 - Types of acceptable documentary evidence of citizenship.

Subpart G: General Financial Eligibility Requirements and Options

42 CFR 436.604 -

42 CFR 436.606 -

Subpart K: Federal Financial Participation (FFP)

: Ffp for Expenditures for Determining Eligibility and Providing Services

42 CFR 436.1006 - Definitions relating to institutional status.

PART 447: PAYMENTS FOR SERVICES

Subpart F: Payment Methods for Other Institutional and Noninstitutional Services

: Other Inpatient and Outpatient Facilities

42 CFR 447.342 -

Subpart B: Payment Methods: General Provisions

42 CFR 447.206 - Cost limit for providers operated by units of government.

42 CFR 447.207 - Retention of payments.

Subpart I: Payment for Drugs

42 CFR 447.500 - Basis and purpose.

42 CFR 447.502 - Definitions.

42 CFR 447.504 - Determination of AMP.

42 CFR 447.505 - Determination of best price.

42 CFR 447.506 - Authorized generic drugs.