Exceptions

(c) Exceptions. Paragraph (b) of this section does not prohibit the agency from (1) Establishing the fees it will pay providers for Medicaid services; (2) Setting reasonable standards relating to the qualifications of providers; or (3) Subject to paragraph (b)(2) of this section, restricting beneficiaries' free choice of providers in accordance with one or more of the exceptions set forth in 431.54, or under a waiver as provided in 431.55; or (4) Limiting the providers who are available to furnish targeted case management services defined in 440.169 of this chapter to target groups that consist solely of individuals with developmental disabilities or with chronic mental illness. This limitation may only be permitted so that the providers of case management services for eligible individuals with developmental disabilities or with chronic mental illness are capable of ensuring that those individuals receive needed services.

Source

42 CFR § 431.51


Scoping language

None
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