2005 CFR Title 42, Volume 3

Title 42--Public Health CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PART 431--STATE ORGANIZATION AND GENERAL ADMINISTRATION
	431.1	Purpose.
	431.10	Single State agency.
	431.11	Organization for administration.
	431.12	Medical care advisory committee.
	431.15	Methods of administration.
	431.16	Reports.
	431.17	Maintenance of records.
	431.18	Availability of agency program manuals.
	431.20	Advance directives.
	431.40	Basis and scope.
	431.50	Statewide operation.
	431.51	Free choice of providers.
	431.52	Payments for services furnished out of State.
	431.53	Assurance of transportation.
	431.54	Exceptions to certain State plan requirements.
	431.55	Waiver of other Medicaid requirements.
	431.56	Special waiver provisions applicable to American Samoa and the Northern Mariana Islands.
	431.57	Waiver of cost-sharing requirements.
	431.105	Consultation to medical facilities.
	431.107	Required provider agreement.
	431.108	Effective date of provider agreements.
	431.110	Participation by Indian Health Service facilities.
	431.115	Disclosure of survey information and provider or contractor evaluation.
	431.120	State requirements with respect to nursing facilities.
	431.151	Scope and applicability.
	431.152	State plan requirements.
	431.153	Evidentiary hearing.
	431.154	Informal reconsideration for ICFs/MR.
	431.200	Basis and scope.
	431.201	Definitions.
	431.202	State plan requirements.
	431.205	Provision of hearing system.
	431.206	Informing applicants and recipients.
	431.210	Content of notice.
	431.211	Advance notice.
	431.213	Exceptions from advance notice.
	431.214	Notice in cases of probable fraud.
	431.220	When a hearing is required.
	431.221	Request for hearing.
	431.222	Group hearings.
	431.223	Denial or dismissal of request for a hearing.
	431.230	Maintaining services.
	431.231	Reinstatement of services.
	431.232	Adverse decision of local evidentiary hearing.
	431.233	State agency hearing after adverse decision of local evidentiary hearing.
	431.240	Conducting the hearing.
	431.241	Matters to be considered at the hearing.
	431.242	Procedural rights of the applicant or recipient.
	431.243	Parties in cases involving an eligibility determination.
	431.244	Hearing decisions.
	431.245	Notifying the applicant or recipient of a State agency decision.
	431.246	Corrective action.
	431.250	Federal financial participation.
	431.300	Basis and purpose.
	431.301	State plan requirements.
	431.302	Purposes directly related to State plan administration.
	431.303	State authority for safeguarding information.
	431.304	Publicizing safeguarding requirements.
	431.305	Types of information to be safeguarded.
	431.306	Release of information.
	431.307	Distribution of information materials.
	431.610	Relations with standard-setting and survey agencies.
	431.615	Relations with State health and vocational rehabilitation agencies and title V grantees.
	431.620	Agreement with State mental health authority or mental institutions.
	431.621	State requirements with respect to nursing facilities.
	431.625	Coordination of Medicaid with Medicare part B.
	431.630	Coordination of Medicaid with QIOs.
	431.635	Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children (WIC).
	431.636	Coordination of Medicaid with the State Children's Health Insurance Program (SCHIP).
	431.700	Basis and purpose.
	431.701	Definitions.
	431.702	State plan requirement.
	431.703	Licensing requirement.
	431.704	Nursing homes designated by other terms.
	431.705	Licensing authority.
	431.706	Composition of licensing board.
	431.707	Standards.
	431.708	Procedures for applying standards.
	431.709	Issuance and revocation of license.
	431.710	Provisional licenses.
	431.711	Compliance with standards.
	431.712	Failure to comply with standards.
	431.713	Continuing study and investigation.
	431.714	Waivers.
	431.715	Federal financial participation.
	431.800	Scope of subpart.
	431.802	Basis.
	431.804	Definitions.
	431.806	State plan requirements.
	431.808	Protection of recipient rights.
	431.810	Basic elements of the Medicaid eligibility quality control (MEQC) program.
	431.812	Review procedures.
	431.814	Sampling plan and procedures.
	431.816	Case review completion deadlines and submittal of reports.
	431.818	Access to records: MEQC program.
	431.820	Corrective action under the MEQC program.
	431.822	Resolution of differences in State and Federal case eligibility or payment findings.
	431.830	Basic elements of the Medicaid quality control (MQC) claims processing assessment system.
	431.832	Reporting requirements for claims processing assessment systems.
	431.834	Access to records: Claims processing assessment systems.
	431.836	Corrective action under the MQC claims processing assessment system.
	431.865	Disallowance of Federal financial participation for erroneous State payments (for annual assessment periods ending after July 1, 1990).