42 CFR 440.230 - Sufficiency of amount, duration, and scope
| Cite as | 42 CFR 440.230 |
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229 practice notes
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Securing Updated and Necessary Statutory Evaluations Timely
...or services for groups of [[Page 5735]] beneficiaries and sufficiency of amount, duration, and scope of Medicaid services, found at 42 CFR 440.230-440.250. The Medicaid balanced billing regulation at 42 CFR Regulations that shape children's access to care in a wide range of areas, including......
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Cruz v. Zucker, 14-cv-4456 (JSR)
...More broadly, "[e]ach service must be sufficient in amount, duration, and scope to reasonably achieve its purpose." 42 C.F.R. § 440.230(b). Although "[t]he [Medicaid] agency may place appropriate limits on a service based on criteria such as medical necessity or on utilizatio......
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Cruz v. Zucker, No. 14–cv–4456 (JSR).
...of the Medicaid Act); (III) violation of 42 U.S.C. §§ 1396a(a)(17), 1396a(a)(10)(B)(i) and their implementing regulation, 42 C.F.R. § 440.230(c) (the "Reasonable Standards Requirement" of the Medicaid Act); (IV) violation of Article I, Section 11 of the New York State Constitution......
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Roe v. Casey, Nos. 79-1108
...of a required service . . . to an otherwise eligible recipient solely because of the diagnosis, type of illness, or condition." 42 C.F.R. § 440.230 (1979). In White v. Beal, supra, this court construed a predecessor version of the regulation containing the identical operative language ......
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221 cases
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Premiertox, Inc. v. Kentucky Spirit Health Plan, Inc., 053012 KYWDC, 1:12CV-00010-JHM
...to the motion to remand, Defendants contend that the services in question were not "medically necessary" as defined in 42 C.F.R. § 440.230 and 42 U.S.C. § 1396d. According to Defendants, the Notice of Amendment defines "medically necessary" or "medical necessity&quo......
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661 F.Supp.2d 871 (M.D.Tenn. 2009), 3:98-0168, John B. v. Goetz
...of medically needy" and " [e]ach service must be sufficient in amount, duration and scope to achieve its purpose." 42 C.F.R. § 440.230(a) and Plaintiffs assert the following statutes under the Medicaid Act, 42 U.S.C. § 1396a(a)(43), 42 U.S.C. § 1396d(a), 42 U.S.C. § 1396(r)(1......
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177 F.Supp.2d 78 (D.N.H. 2001), Civ. 99-558, Bryson v. Shumway
...judgment on Counts II, VI, and VII. The court considers each count in turn. I. Count I: 42 U.S.C. §§ 1396a(a) (17) and (19) & 42 C.F.R. §§ 440.230(b) and (d)--Right to Effective Service In Count I, plaintiffs claim that they have been denied effective services to which they are entitled......
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410 F.Supp.2d 18 (D.Mass. 2006), Civ. A. 01-30199, Rosie D. v. Romney
...303, 105 S.Ct. 712, 83 L.Ed.2d 661 (1985), Page 25 quoted in Pharm. Research & Mfrs., 538 U.S. at 665, 123 S.Ct. 1855; see also 42 C.F.R. § 440.230(d) (2005) (allowing states to "place appropriate limits on service based on such criteria as medical necessity or on utilization contr......
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1 books & journal articles
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Removing the Constraints to Coverage of Gender-Confirming Healthcare by State Medicaid Programs
...and 440.70); Beal v. Doe, 432 U.S. 438, 440–41 (1977) (citing 42 U.S.C. §§ 1396a(a)(13)(B), 1396a(a)(1)–(5) (1970)). 64. 42 C.F.R. § 440.230(a)(1)–(2). 65. Id. § 440.230(d). 66. Beal v. Doe, 432 U.S. at 444–45. 67. See, e.g. , Hern v. Beye, 57 F.3d 906, 911 (10th Cir. 1995) (“The purpose of......
9 provisions
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Securing Updated and Necessary Statutory Evaluations Timely
...or services for groups of [[Page 5735]] beneficiaries and sufficiency of amount, duration, and scope of Medicaid services, found at 42 CFR 440.230-440.250. The Medicaid balanced billing regulation at 42 CFR Regulations that shape children's access to care in a wide range of areas, including......
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Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revisions Related to Third Party Liability
...to delete ``be expected to'' as it is used relative to services reasonably achieving their results and align with the FFS standard in 42 CFR 440.230. We propose that existing paragraph (a)(3)(iii) be redesignated as (a)(4) and existing paragraphs (a)(3)(iii)(A) and (B) be redesignated witho......
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Agency Information Collection Activities: Submission for OMB Review; Comment Request and Correction
...with provisions of section 1902 of the Act on state-wideness (42 CFR 431.50), freedom of choice (42 CFR 431.51) or comparability (42 CFR 440.230). The template may be used by states to easily modify their state plans if they choose to implement the provisions of section 1932(a)(1)(A); Form ......
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Agency Information Collection Activities: Proposed Collection; Comment Request
...with provisions of section 1902 of the Act on statewideness (42 CFR 431.50), freedom of choice (42 CFR 431.51) or comparability (42 CFR 440.230). The template may be used by states to easily modify their state plans if they choose to implement the provisions of section 1932(a)(1)(A); Form N......
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