42 C.F.R. § 431.210
Content of notice
A notice required under § 431.206 (c)(2), (c)(3), or (c)(4) of this subpart must contain—
(a) A statement of what action the agency, skilled nursing facility, or nursing facility intends to take and the effective date of such action;
(b) A clear statement of the specific reasons supporting the intended action;
(c) The specific regulations that support, or the change in Federal or State law that requires, the action;
(d) An explanation of—
(1) The individual's right to request a local evidentiary hearing if one is available, or a State agency hearing; or
(2) In cases of an action based on a change in law, the circumstances under which a hearing will be granted; and
(e) An explanation of the circumstances under which Medicaid is continued if a hearing is requested.
Notes of Decisions
Cited in 86
cases (10 in the last 5 years), 1979–2024 · leading case: Henry Pashby v. Albert Delia, 709 F.3d 307 (4th Cir. 2013).
Henry Pashby v. Albert Delia, 709 F.3d 307 (4th Cir. 2013). “2005) (holding that Medicaid termination notices did not violate 42 C.F.R. § 431.210 or due process when they did not include “specific, individualized reasons supporting the agency’s conclusions”).”
Davis v. Shah, 821 F.3d 231 (2d Cir. 2016). “See 42 C.F.R. §§ 431.210 (d)(2), (e). Under such circumstances, NYSDH’s failure to abide by the procedural requirements of the Medicaid Act’s due process provision was hardly “harmless.”
Soskin v. Reinertson, 353 F.3d 1242 (10th Cir. 2004). “Furthermore, 42 C.F.R. § 431.210 states that the notice must contain— (a) A statement of what action the State .”
K.W. Ex Rel. D.W. v. Armstrong, 789 F.3d 962 (9th Cir. 2015). “” 42 C.F.R. § 431.210 (b). The 2011 Budget Notices did not specify why individual budgets had decreased.”
Rosen v. Tennessee Comm'r of Fin. & Admin., 280 F. Supp. 2d 743 (M.D. Tenn. 2002). “” 42 C.F.R. § 431.210 (a)(b) and (c). The term “action” is defined as “a termination, suspension, or reduction of Medicaid eligibility or covered services.”
Jones v. Blinziner, 536 F. Supp. 1181 (N.D. Ind. 1982). “42 C.F.R. Section 431.210; see, 42 C.F.R.”
M.A. ex rel. Avila v. Norwood, 133 F. Supp. 3d 1093 (N.D. Ill. 2015). “Claim II: The Director’s written notice to the plaintiffs that their services have been terminated or reduced are inconsistent with 42 C.F.R. § 431.210 (b) and violate their right to due process in that (a) they do not adequately state the agency’s action or the reasons it and…”
NB Ex Rel. Peacock v. Dist. of Columbia, 794 F.3d 31 (D.C. Cir. 2015). “See 42 C.F.R. § 431.210 . We conclude that the regulations afford the plaintiffs no basis for relief.”
Cramer v. Chiles, 33 F. Supp. 2d 1342 (S.D. Fla. 1999). “42 C.F.R. § 431.210 . As a general rule if the recipient requests a hearing before the date of action, the agency may not terminate or reduce services pending the hearing.”
K.B. v. Michigan Dept. Of Health & Human Servs., 367 F. Supp. 3d 647 (E.D. Mich. 2019). “" The federal regulation 42 C.F.R. § 431.210 requires the State to give the individual notice of this opportunity for a hearing.”
Georgia Dep't of Behavioral Health & Developmental Disabilities v. United Cerebral Palsy of Georgia, Inc., 784 S.E.2d 781 (Ga. 2016). “, 42 CFR §§ 431.210 to 431.223. 3 DCH Rule 350-4-.”
Susan J. v. Riley, 254 F.R.D. 439 (M.D. Ala. 2008). “42 C.F.R. § 431.210 ; see also id. § 431.”
— 42 C.F.R. § 431.210(b) — 1 case
Texas Health & Human Servs. Comm'n v. Jessica Lukefahr (Tex. App. 2015).
— 42 C.F.R. § 431.210(c) — 2 cases
Schreur v. Dep't of Human Servs., 795 N.W.2d 192 (Mich. Ct. App. 2010).
Johnson v. N.M. Hum. Servs. Dep't (N.M. Ct. App. 2021).
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