Source: https://www.law.cornell.edu/cfr/text/42/457.500
Timestamp: 2017-05-29 09:52:57
Document Index: 217579142

Matched Legal Cases: ['art 457', '§ 457', '§ 1302', 'art 457', 'arts 431', 'arts 431', 'arts 407', 'arts 431', 'art 457', 'arts 431', '§\u2009438', '§\u2009433', 'arts 431', 'arts 438', 'arts 405', 'arts 431', 'arts 430', '§ 431', '§ 431', '§ 435', '§ 435', '§ 457', '§ 457', '§ 457', 'arts 431']

42 CFR 457.500 - Basis, scope, and applicability. | US Law | LII / Legal Information Institute
CFR › Title 42 › Chapter IV › Subchapter D › Part 457 › Subpart E › Section 457.500 42 CFR 457.500 - Basis, scope, and applicability.
§ 457.500 Basis, scope, and applicability.
(a)Statutory basis. This subpart implements - (1) Section 2101(a) of the Act, which provides that the purpose of title XXI is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner; and
(2) Section 2103(e) of the Act, which sets forth provisions regarding State plan requirements and options for cost sharing. (b)Scope. This subpart consists of provisions relating to the imposition under a separate child health program of cost-sharing charges including enrollment fees, premiums, deductibles, coinsurance, copayments, and similar cost-sharing charges. (c)Applicability. The requirements of this subpart apply to separate child health programs. This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.United States CodeU.S. Code: Title 42 - THE PUBLIC HEALTH AND WELFARE§ 1302 - Rules and regulations; impact analyses of Medicare and Medicaid rules and regulations on small rural hospitals
Title 42 published on 19-Apr-2017 03:51The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR Part 457 after this date.2017-01-26; vol. 82 # 16 - Thursday, January 26, 201782 FR - Medicaid and Children&apos;s Health Insurance Programs: Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Other Provisions Related to Eligibility and Enrollment for Medicaid and CHIP
typeregulations.gov FR Doc.C1-2016-27848 RIN0938-AS55 CMS-2334-P2 DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 42 CFR Parts 431, 435 and 457 Summary
2017-01-03; vol. 82 # 1 - Tuesday, January 3, 201782 FR 37 - Medicaid and Children&apos;s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability; Corrections
typeregulations.gov FR Doc.2016-31650 RIN-0938-AS25 CMS-2390-F3 DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule; correcting amendment. Effective Date: This correcting document is effective December 30, 2016. Applicability Date: The corrections indicated in this document are applicable beginning immediately. 42 CFR Parts 431, 433, 438, 440, 457, and 495 SummaryThis document corrects technical errors that appeared in the final rule published in the May 6, 2016 Federal Register (81 FR 27498 through 27901) entitled, “Medicaid and Children&apos;s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability.” The effective date for the rule was July 5, 2016.
2016-11-30; vol. 81 # 230 - Wednesday, November 30, 201681 FR 86382 - Medicaid and Children&apos;s Health Insurance Programs: Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Other Provisions Related to Eligibility and Enrollment for Medicaid and CHIP
typeregulations.gov FR Doc.2016-27844 RIN0938-AS27 CMS-2334-F2 DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule. These regulations are effective on January 20, 2017. 42 CFR Parts 407, 430, 431, 433, 435, and 457 SummaryThis final rule implements provisions of the Affordable Care Act that expand access to health coverage through improvements in Medicaid and coordination between Medicaid, CHIP, and Exchanges. This rule finalizes most of the remaining provisions from the “Medicaid, Children&apos;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; Proposed Rule” that we published in the January 22, 2013, Federal Register . This final rule continues our efforts to assist states in implementing Medicaid and CHIP eligibility, appeals, and enrollment changes required by the Affordable Care Act.
typeregulations.gov FR Doc.2016-27848 RIN0938-AS55 CMS-2334-P2 DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Proposed rule. To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on January 23, 2017. 42 CFR Parts 431, 435, and 457 SummaryThis proposed rule proposes to implement provisions of the Medicaid statute pertaining to Medicaid eligibility and appeals. This proposed rule continues our efforts to assist states in implementing Medicaid and CHIP eligibility, appeals, and enrollment changes required by the Affordable Care Act.
2016-07-20; vol. 81 # 139 - Wednesday, July 20, 201681 FR 47045 - Medicaid and Children&apos;s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability; Correcting Amendment
typeregulations.gov FR Doc.2016-17157 RIN-0938-AS25 CMS-2390-F2 DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule; correcting amendment. Effective Date: This correcting document is effective July 18, 2016. Applicability Date: The corrections indicated in this document are applicable beginning July 5, 2016. 42 CFR Part 457 SummaryThis document corrects a technical error that appeared in the final rule published in the May 6, 2016 Federal Register (81 FR 27498 through 27901) entitled, “Medicaid and Children&apos;s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability.” The effective date for the rule was July 5, 2016.
2016-06-22; vol. 81 # 120 - Wednesday, June 22, 201681 FR 40596 - Medicaid/CHIP Program; Medicaid Program and Children&apos;s Health Insurance Program (CHIP); Changes to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement Programs in Response to the Affordable Care Act
typeregulations.gov FR Doc.2016-14536 RIN0938-AS74 CMS-6068-P DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Proposed rule. To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on August 22, 2016. 42 CFR Parts 431 and 457 SummaryThis proposed rule would update the Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) programs based on the changes to Medicaid and the Children&apos;s Health Insurance Program (CHIP) eligibility under the Patient Protection and Affordable Care Act. This proposed rule would also implement various other improvements to the PERM program.
2016-05-06; vol. 81 # 88 - Friday, May 6, 201681 FR 27498 - Medicaid and Children&apos;s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability
typeregulations.gov FR Doc.2016-09581 RIN0938-AS25 CMS-2390-F DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule. Except for 42 CFR 433.15(b)(10) and § 438.370, these regulations are effective on July 5, 2016. The amendments to §§ 433.15(b)(10) and 438.370, are effective May 6, 2016. Compliance Date: See the Compliance section of the Supplementary Information . 42 CFR Parts 431, 433, 438, 440, 457 and 495 SummaryThis final rule modernizes the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems. The final rule aligns, where feasible, many of the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans; implements statutory provisions; strengthens actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates; and promotes the quality of care and strengthens efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries. It also ensures appropriate beneficiary protections and enhances policies related to program integrity. This final rule also implements provisions of the Children&apos;s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and addresses third party liability for trauma codes.
2016-03-30; vol. 81 # 61 - Wednesday, March 30, 201681 FR 18390 - Medicaid and Children&apos;s Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children&apos;s Health Insurance Program (CHIP), and Alternative Benefit Plans
typeregulations.gov FR Doc.2016-06876 RIN0938-AS24 CMS-2333-F DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule. These regulations are effective on May 31, 2016. 42 CFR Parts 438, 440, 456, and 457 SummaryThis final rule will address the application of certain requirements set forth in the Public Health Service Act, as amended by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, to coverage offered by Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and Children&apos;s Health Insurance Programs.
2016-03-01; vol. 81 # 40 - Tuesday, March 1, 201681 FR 10720 - Medicare, Medicaid, and Children&apos;s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process
typeregulations.gov FR Doc.2016-04312 RIN0938-AS84 CMS-6058-P DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Proposed rule. To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on April 25, 2016. 42 CFR Parts 405, 424, 455, and 457 SummaryThis proposed rule would implement sections of the Affordable Care Act that require Medicare, Medicaid, and Children&apos;s Health Insurance Program (CHIP) providers and suppliers to disclose certain current and previous affiliations with other providers and suppliers. This proposed rule would also provide CMS with additional authority to deny or revoke a provider&apos;s or supplier&apos;s Medicare enrollment. In addition, this proposed rule would require that to order, certify, refer or prescribe any Part A or B service, item or drug, a physician or, when permitted, an eligible professional must be enrolled in Medicare in an approved status or have validly opted-out of the Medicare program.
2013-07-15; vol. 78 # 135 - Monday, July 15, 201378 FR 42160 - Medicaid and Children&apos;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
typeregulations.gov FR Doc.2013-16271 RIN0938-AR04 CMS-2334-F DEPARTMENT OF HEALTH AND HUMAN SERVICES, Office of the Secretary, Centers for Medicare & Medicaid Services Final rule. The effective 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 435.955; and the redesignation of 42 CFR 435.911 through 435.914 as 42 CFR 435.912 through 435.915 in CMS-2349 (FR Doc. 2012-6560) published on March 23, 2012, which were to become effective in January 1, 2014 are now effective October 1, 2013. Other provisions of this final rule that are codified in title 42 of the Code of Federal Regulations are effective January 1, 2014 with the exception of amendments to the following which are effective on October 1, 2013: 42 CFR 431.10, 431.11, 431.201, 431.205, 431.206, 431.211, 431.213, 431.230, 431.231, 431.240, 435.119, 435.603, 435.907, 435.918, 435.1200, 457.110, 457.348, and 457.350; and the addition of 42 CFR 435.1205 and 457.370, which are effective on October 1, 2013. Regulations in this final rule that are codified in title 45 of Code of Federal Regulations are effective on September 13, 2013. 42 CFR Parts 431, 435, 436, 438, 440, 447, and 457 SummaryThis final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act. This final rule finalizes new Medicaid eligibility provisions; finalizes changes related to electronic Medicaid and the Children&apos;s Health Insurance Program (CHIP) eligibility notices and delegation of appeals; modernizes and streamlines existing Medicaid eligibility rules; revises CHIP rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; and amends requirements for benchmark and benchmark-equivalent benefit packages consistent with sections 1937 of the Social Security Act (which we refer to as “alternative benefit plans”) to ensure that these benefit packages include essential health benefits and meet certain other minimum standards. This rule also implements specific provisions including those related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also updates and simplifies the complex Medicaid premium and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities. It includes transition policies for 2014 as applicable.
2012-05-29; vol. 77 # 103 - Tuesday, May 29, 201277 FR 31499 - Medicaid and Children&apos;s Health Insurance Programs; Disallowance of Claims for FFP and Technical Corrections
typeregulations.gov FR Doc.2012-12637 RIN0938-AQ32 CMS-2292-F DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule. Effective Date: These regulations are effective on June 28, 2012. 42 CFR Parts 430, 433, 447, and 457 SummaryThis final rule reflects the Centers for Medicare & Medicaid Services&apos; commitment to the general principles of the President&apos;s Executive Order 13563 released January 18, 2011, entitled “Improving Regulation and Regulatory Review.” This rule will: implement a new reconsideration process for administrative determinations to disallow claims for Federal financial participation (FFP) under title XIX of the Act (Medicaid); lengthen the time States have to credit the Federal government for identified but uncollected Medicaid provider overpayments and provide that interest will be due on amounts not credited within that time period; make conforming changes to the Medicaid and Children&apos;s Health Insurance Program (CHIP) disallowance process to allow States the option to retain disputed Federal funds through the new administrative reconsideration process; revise installment repayment standards and schedules for States that owe significant amounts; and provide that interest charges may accrue during the new administrative reconsideration process if a State chooses to retain the funds during that period. This final rule will also make a technical correction to reporting requirements for disproportionate share hospital payments, revise internal delegations of authority to reflect the term “Administrator or current Designee,” remove obsolete language, and correct other technical errors.
2012-03-23; vol. 77 # 57 - Friday, March 23, 201277 FR 17144 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010
typeregulations.gov FR Doc.2012-6560 RIN0938-AQ62 CMS-2349-F DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services Final rule; Interim final rule. Effective Date: These regulations are effective on January 1, 2014. Comment Date: Certain provisions of this final rule are being issued as interim final. We will consider comments from the public on the following provisions: § 431.300(c)(1) and (d), § 431.305(b)(6), § 435.912, § 435.1200, § 457.340(d), § 457.348 and § 457.350(a), (b), (c), (f), (i), (j), and (k). To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. Eastern Standard Time (EST) on May 7, 2012. 42 CFR Parts 431, 435, and 457 SummaryThis final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children&apos;s Health Insurance (CHIP) programs, the establishment of Affordable Insurance Exchanges (“Exchanges”), and the assurance of coordination between Medicaid, CHIP, and Exchanges. This final rule codifies policy and procedural changes to the Medicaid and CHIP programs related to eligibility, enrollment, renewals, public availability of program information and coordination across insurance affordability programs.