Title 42--Public Health

CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)

PART 457--ALLOTMENTS AND GRANTS TO STATES

TEXT PDF457.1 Program description.
TEXT PDF457.2 Basis and scope of subchapter D.
TEXT PDF457.10 Definitions and use of terms.
TEXT PDF457.30 Basis, scope, and applicability of subpart A.
TEXT PDF457.40 State program administration.
TEXT PDF457.50 State plan.
TEXT PDF457.60 Amendments.
TEXT PDF457.65 Effective date and duration of State plans and plan amendments.
TEXT PDF457.70 Program options.
TEXT PDF457.80 Current State child health insurance coverage and coordination.
TEXT PDF457.90 Outreach.
TEXT PDF457.110 Enrollment assistance and information requirements.
TEXT PDF457.120 Public involvement in program development.
TEXT PDF457.125 Provision of child health assistance to American Indian and Alaska Native children.
TEXT PDF457.130 Civil rights assurance.
TEXT PDF457.135 Assurance of compliance with other provisions.
TEXT PDF457.140 Budget.
TEXT PDF457.150 CMS review of State plan material.
TEXT PDF457.160 Notice and timing of CMS action on State plan material.
TEXT PDF457.170 Withdrawal process.
TEXT PDF457.200 Program reviews.
TEXT PDF457.202 Audits.
TEXT PDF457.203 Administrative and judicial review of action on State plan material.
TEXT PDF457.204 Withholding of payment for failure to comply with Federal requirements.
TEXT PDF457.206 Administrative appeals under SCHIP.
TEXT PDF457.208 Judicial review.
TEXT PDF457.210 Deferral of claims for FFP.
TEXT PDF457.212 Disallowance of claims for FFP.
TEXT PDF457.216 Treatment of uncashed or canceled (voided) SCHIP checks.
TEXT PDF457.218 Repayment of Federal funds by installments.
TEXT PDF457.220 Public funds as the State share of financial participation.
TEXT PDF457.222 FFP for equipment.
TEXT PDF457.224 FFP: Conditions relating to cost sharing.
TEXT PDF457.226 Fiscal policies and accountability.
TEXT PDF457.228 Cost allocation.
TEXT PDF457.230 FFP for State ADP expenditures.
TEXT PDF457.232 Refunding of Federal Share of SCHIP overpayments to providers and referral of allegations of waste, fraud or abuse to the Office of Inspector General.
TEXT PDF457.236 Audits.
TEXT PDF457.238 Documentation of payment rates.
TEXT PDF457.300 Basis, scope, and applicability.
TEXT PDF457.301 Definitions and use of terms.
TEXT PDF457.305 State plan provisions.
TEXT PDF457.310 Targeted low-income child.
TEXT PDF457.320 Other eligibility standards.
TEXT PDF457.340 Application for and enrollment in a separate child health program.
TEXT PDF457.350 Eligibility screening and facilitation of Medicaid enrollment.
TEXT PDF457.353 Monitoring and evaluation of screening process.
TEXT PDF457.355 Presumptive eligibility.
TEXT PDF457.380 Eligibility verification.
TEXT PDF457.401 Basis, scope, and applicability.
TEXT PDF457.402 Definition of child health assistance.
TEXT PDF457.410 Health benefits coverage options.
TEXT PDF457.420 Benchmark health benefits coverage.
TEXT PDF457.430 Benchmark-equivalent health benefits coverage.
TEXT PDF457.431 Actuarial report for benchmark-equivalent coverage.
TEXT PDF457.440 Existing comprehensive State-based coverage.
TEXT PDF457.450 Secretary-approved coverage.
TEXT PDF457.470 Prohibited coverage.
TEXT PDF457.475 Limitations on coverage: Abortions.
TEXT PDF457.480 Preexisting condition exclusions and relation to other laws.
TEXT PDF457.490 Delivery and utilization control systems.
TEXT PDF457.495 State assurance of access to care and procedures to assure quality and appropriateness of care.
TEXT PDF457.500 Basis, scope, and applicability.
TEXT PDF457.505 General State plan requirements.
TEXT PDF457.510 Premiums, enrollment fees, or similar fees: State plan requirements.
TEXT PDF457.515 Co-payments, coinsurance, deductibles, or similar cost-sharing charges: State plan requirements.
TEXT PDF457.520 Cost sharing for well-baby and well-child care services.
TEXT PDF457.525 Public schedule.
TEXT PDF457.530 General cost-sharing protection for lower income children.
TEXT PDF457.535 Cost-sharing protection to ensure enrollment of American Indians and Alaska Natives.
TEXT PDF457.540 Cost-sharing charges for children in families with incomes at or below 150 percent of the FPL.
TEXT PDF457.555 Maximum allowable cost-sharing charges on targeted low-income children in families with income from 101 to 150 percent of the FPL.
TEXT PDF457.560 Cumulative cost-sharing maximum.
TEXT PDF457.570 Disenrollment protections.
TEXT PDF457.600 Purpose and basis of this subpart.
TEXT PDF457.602 Applicability.
TEXT PDF457.606 Conditions for State allotments and Federal payments for a fiscal year.
TEXT PDF457.608 Process and calculation of State allotments for a fiscal year.
TEXT PDF457.610 Period of availability for State allotments for a fiscal year.
TEXT PDF457.614 General payment process.
TEXT PDF457.616 Application and tracking of payments against the fiscal year allotments.
TEXT PDF457.618 Ten percent limit on certain State Children's Health Insurance Program expenditures.
TEXT PDF457.622 Rate of FFP for State expenditures.
TEXT PDF457.626 Prevention of duplicate payments.
TEXT PDF457.628 Other applicable Federal regulations.
TEXT PDF457.630 Grants procedures.
TEXT PDF457.700 Basis, scope, and applicability.
TEXT PDF457.710 State plan requirements: Strategic objectives and performance goals.
TEXT PDF457.720 State plan requirement: State assurance regarding data collection, records, and reports.
TEXT PDF457.740 State expenditures and statistical reports.
TEXT PDF457.750 Annual report.
TEXT PDF457.800 Basis, scope, and applicability.
TEXT PDF457.805 State plan requirement: Procedures to address substitution under group health plans.
TEXT PDF457.810 Premium assistance programs: Required protections against substitution.
TEXT PDF457.900 Basis, scope and applicability.
TEXT PDF457.902 Definitions
TEXT PDF457.910 State program administration.
TEXT PDF457.915 Fraud detection and investigation.
TEXT PDF457.925 Preliminary investigation.
TEXT PDF457.930 Full investigation, resolution, and reporting requirements.
TEXT PDF457.935 Sanctions and related penalties.
TEXT PDF457.940 Procurement standards.
TEXT PDF457.945 Certification for contracts and proposals.
TEXT PDF457.950 Contract and payment requirements including certification of payment-related information.
TEXT PDF457.955 Conditions necessary to contract as a managed care entity (MCE).
TEXT PDF457.960 Reporting changes in eligibility and redetermining eligibility.
TEXT PDF457.965 Documentation.
TEXT PDF457.980 Verification of enrollment and provider services received.
TEXT PDF457.985 Integrity of professional advice to enrollees.
TEXT PDF457.1000 Basis, scope, and applicability.
TEXT PDF457.1003 CMS review of waiver requests.
TEXT PDF457.1005 Cost-effective coverage through a community-based health delivery system.
TEXT PDF457.1010 Purchase of family coverage.
TEXT PDF457.1015 Cost-effectiveness.
TEXT PDF457.1100 Basis, scope and applicability.
TEXT PDF457.1110 Privacy protections.
TEXT PDF457.1120 State plan requirement: Description of review process.
TEXT PDF457.1130 Program specific review process: Matters subject to review.
TEXT PDF457.1140 Program specific review process: Core elements of review.
TEXT PDF457.1150 Program specific review process: Impartial review.
TEXT PDF457.1160 Program specific review process: Time frames.
TEXT PDF457.1170 Program specific review process: Continuation of enrollment.
TEXT PDF457.1180 Program specific review process: Notice.
TEXT PDF457.1190 Application of review procedures when States offer premium assistance for group health plans.

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