42 CFR 447.71 - Alternative premium and cost sharing exemptions and protections for individuals with family incomes at or below 100 percent of the FPL.

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There is 1 rule appearing in the Federal Register for 42 CFR 447. View below or at eCFR (GPOAccess)
§ 447.71 Alternative premium and cost sharing exemptions and protections for individuals with family incomes at or below 100 percent of the FPL.
(a) The State may not impose premiums under the State plan on individuals whose family income is at or below 100 percent of the FPL.
(b) The State may not impose cost sharing under the State plan on individuals whose family income is at or below 100 percent of the FPL, with the following exceptions:
(1) The State may impose cost sharing under authority provided under section 1916 of the Act and consistent with the levels described in such section and § 447.54.
(2) The State may impose cost sharing for non-preferred drugs that does not exceed the nominal amount as defined in § 447.54.
(3) The State may impose cost sharing for non-emergency services furnished in a hospital emergency department that does not exceed the nominal amount as defined in § 447.54 as long as the services are available in a timely manner without cost sharing through an outpatient department or other alternative non-emergency services health care provider in the geographic area of the hospital emergency department involved.
(c) Aggregate cost sharing under sections 1916 and 1916A of the Act for all individuals in the family enrolled in Medicaid may not exceed the maximum permitted under § 447.78(b).
(d) The State may not impose alternative premiums and cost sharing in accordance with section 1916A of the Act on individuals whose family income is at or below 100 percent of the FPL, but may impose cost sharing that does not exceed the nominal amount as defined at § 447.54 and section 1916 of the Act.
[73 FR 71851, Nov. 25, 2008, as amended at 75 FR 30264, May 28, 2010]

Title 42 published on 2013-10-01

The following are only the Rules published in the Federal Register after the published date of Title 42.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2014-01-16; vol. 79 # 11 - Thursday, January 16, 2014
    1. 79 FR 2948 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Home and Community-Based Setting Requirements for Community First Choice and Home and Community-Based Services (HCBS) Waivers
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule.
      Effective Date: These regulations are effective on March 17, 2014.
      42 CFR Parts 430, 431, 435, 436, 440, 441 and 447

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United States Code

Title 42 published on 2013-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR 447 after this date.

  • 2014-01-16; vol. 79 # 11 - Thursday, January 16, 2014
    1. 79 FR 2948 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Home and Community-Based Setting Requirements for Community First Choice and Home and Community-Based Services (HCBS) Waivers
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule.
      Effective Date: These regulations are effective on March 17, 2014.
      42 CFR Parts 430, 431, 435, 436, 440, 441 and 447