42 CFR 431.10 - Single State agency
| Cite as | 42 CFR 431.10 |
-
- This document is available in original version only for vLex customers
View this document and try vLex for 7 days - TRY VLEX
- This document is available in original version only for vLex customers
152 practice notes
-
Securing Updated and Necessary Statutory Evaluations Timely
...and Section 1332 waivers and Home & Community-Based Services (HCBS) waivers. Fair Hearings for Applicants and Beneficiaries requirements in 42 CFR 431 Subpart Confidentiality regulations in 42 CFR part 431 Subpart F. Regulations relating to comparability or services for groups of [[Page 573......
-
Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment
...date for the additions of 42 CFR 435.118, 435.603, 435.911, 435.949, 435.956, 435.1200, 457.315, 457.330 and 457.348; amendments to 42 CFR 431.10, 431.11, 435.110, 435.116, 435.119, 435.907, 435.916, 435.940, 435.945, 435.948, 435.952, 457.340 and 457.350; the removal of 42 CFR 435.953 and ......
-
Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing
...by a government agency. We believe this potential change is consistent with current state practices and plans. Thus, we are proposing at 42 CFR 431.10 to delete the provision at (c)(3) added by the Medicaid eligibility final rule which provided that Exchanges operated as nongovernmental ent......
-
Guggenberger v. Minnesota, Civil No. 15-3439 (DWF/BRT)
...has ultimate responsibility for the State's provision of Waiver Services under both federal Medicaid law and Minnesota statutes. See 42 C.F.R. §§ 431.10(b), 431.10(e), 435.903; see also Minn. Stat. §§ 256.01,Page 101 subd. 2(a); 256B.04, subd.1; 256B.05, subd. 1. If a county fails to proper......
Request a trial to view additional results
139 cases
-
Guggenberger v. Minnesota, Civil No. 15-3439 (DWF/BRT)
...has ultimate responsibility for the State's provision of Waiver Services under both federal Medicaid law and Minnesota statutes. See 42 C.F.R. §§ 431.10(b), 431.10(e), 435.903; see also Minn. Stat. §§ 256.01,Page 101 subd. 2(a); 256B.04, subd.1; 256B.05, subd. 1. If a county fails to proper......
-
Cal. Hosp. Ass'n v. Maxwell–jolly, Civ No. 10–3465 FCD/EFB.
...services to Medi–Cal beneficiaries in compliance with the State Plan and with federal and state laws and regulations. 42 C.F.R. §§ 431.1, 431.10. In its capacity as administrator of the state Medi–Cal plan, DHCS determined that the freeze complied with federal Medicaid law and began impleme......
-
San Lazaro Ass'n, Inc. v. Connell, No. 00-55065
...for that of the Medicaid agency with respect to the application of policies, rules, and regulations issued by the Medicaid agency. 42 C.F.R. § 431.10(e). 2. Payment and verification of provider Under the Medicaid Act, "the state plan is required to establish ... a scheme for reimbursing hea......
-
Cal. Ass'n of Rural Health Clinics v. Douglas, Nos. 10–17574
...the Centers for Medicare and Medicaid Services (“CMS”) for review and approval. 42 U.S.C. § 1396a(a)(5); 42 C.F.R. §§ 430.10, 430.12, 430.14, 431.10. The Department also ensures that Medi–Cal provides covered services to eligible beneficiaries and reimburses providers for their services. 42......
Request a trial to view additional results
3 firm's commentaries
-
ColoradoCare Stands to Significantly Alter Health Care Services
...plans sponsored by employers or employee organizations and known as “employee welfare benefit plans.” The scope of ERISA includes: 16 42 C.F.R. § 431.10(b). 17 Amendment 69, § 3(1). June 9, 2016 Page 8 52693552.6 [A]ny plan, fund, or program which was heretofore or is hereafter established ......
-
Medicare/caid Contracts: When the Contract Can Benefit the Provider
...in Idaho. Optum is managing Medicaid dollars, which makes it the Agent of the “single State agency,” the Department of Health of Idaho. 42 C.F.R. 431.10. See blog. The Optum provider contract states that – “It is agreed that the parties knowingly and voluntarily waive any right to a Dispute......
-
Audit the Medicare Payors…It’s Not Always the Providers That Commit Fraud
...to auditing MCOs and MAs. Let’s get these RAC, ZPIC, and TPE auditors focused on the stewards of our tax dollars, the prepaid entities. 42 CFR §431.10 dictates a single state agency for Medicaid, which is the Department in each State. CMS is the single agency in Medicare. CMS and State Depa......
3 provisions
-
HB 365 – State Agency Realignment
...Corporation; (b) the Housing and Community Development Division; and (c) local housing authorities[.]; (12) in accordance with 42 C.F.R. Sec. 431.10, develop non-clinical eligibility policy and procedures to implement the eligibility state plan, waivers, and administrative rules developed a......
-
Act 562, SB 788 – TO AMEND THE MEDICAID FAIRNESS ACT TO STRENGTHEN DUE PROCESS FOR PROVIDERS WHO DELIVER SERVICES; AND TO DECLARE AN EMERGENCY
...Services shall request a waiver from the Centers for Medicare and Medicaid Services of the single state agency requirement contained in 42 C.F.R. 431.10 to allow final decisions in Medicaid provider administrative appeals to be issued by an administrative law judge in a separate (B) An admi......
-
Chapter 422, HB 365 – State Agency Realignment
...Corporation; (b) the Housing and Community Development Division; and (c) local housing authorities[.]; (12) in accordance with 42 C.F.R. Sec. 431.10, develop non-clinical eligibility policy and procedures to implement the eligibility state plan, waivers, and administrative rules developed a......