Link to an amendment published at 91 FR 33469, June 3, 2026.(a) The agency may reinstate services if a beneficiary requests a hearing not more than 10 days after the date of action.
(b) The reinstated services must continue until a hearing decision unless, at the hearing, it is determined that the sole issue is one of Federal or State law or policy.
(c) The agency must reinstate and continue services until a decision is rendered after a hearing if—
(1) Action is taken without the advance notice required under § 431.211 or § 431.214 of this subpart;
(2) The beneficiary requests a hearing within 10 days from the date that the individual receives the notice of action. The date on which the notice is received is considered to be 5 days after the date on the notice, unless the beneficiary shows that he or she did not receive the notice within the 5-day period; and
(3) The agency determines that the action resulted from other than the application of Federal or State law or policy.
(d) [Reserved]
[44 FR 17932, Mar. 29, 1979, as amended at 78 FR 42302, July 15, 2013; 89 FR 22866, Apr. 2, 2024]
Notes of Decisions
Cited in
11
cases, 1979–2015 · leading case:
Stenson v. Blum, 476 F. Supp. 1331 (S.D.N.Y. 1979).
Stenson v. Blum, 476 F. Supp. 1331 (S.D.N.Y. 1979).
· cites it 4× “17,933 (1979) (to be codified at 42 C.F.R. § 431.231 ). 28 In such a case, benefits continue pending a decision reached after the hearing.”
Soskin v. Reinertson, 353 F.3d 1242 (10th Cir. 2004).
“42 C.F.R. § 431.231 ; Volume 8, Colorado Medicaid Manual § 8.”
Granato v. Bane, 841 F. Supp. 64 (N.D.N.Y. 1994).
· cites it 5× “Lastly, 42 C.F.R. § 431.231 provides: (a) The agency may reinstate services if a recipient requests a hearing not more than 10 days after the date of action.”
Cramer v. Chiles, 33 F. Supp. 2d 1342 (S.D. Fla. 1999).
“42 C.F.R. § 431.231 (c). Intermediate Care Facilities for the Developmentally Disabled The ICF/DD Program is an optional Medicaid service authorized by Title XIX of the Social Security Act.”
Granato v. Bane, 74 F.3d 406 (2d Cir. 1996).
· cites it 4× “” 42 C.F.R. § 431.231 (a) (1994) (emphasis added).”
M.A. ex rel. Avila v. Norwood, 133 F. Supp. 3d 1093 (N.D. Ill. 2015).
· cites it 2× “Failure to Adequately Inform Plaintiffs of their Rights to Continued Benefits Pending the Outcome of a Fair Hearing Plaintiffs also maintain that the Director violated 42 C.F.R. § 431.231 because the written notice lacks any information about plaintiffs’ right to continue…”
Hernandez v. Medows, 209 F.R.D. 665 (S.D. Fla. 2002).
· cites it 2× “Moreover, services must be continued until a final hearing decision if a Medicaid recipient requests a fair hearing before the date services are to be stopped or reduced, 42 C.F.R. § 431.231 (c)(2). Services also must be continued until a final hearing decision if the requisite…”
Hoardwood, Inc. v. Dep't of Pub. Aid, 529 N.E.2d 1009 (Ill. App. Ct. 1988).
“” 42 C.F.R. §431.231 (1982). It cannot be determined from the record when the notice of action was actually mailed.”
K.W. ex rel. D.W. v. Armstrong, 298 F.R.D. 479 (D. Idaho 2014).
“42 C.F.R. § 431.231 (c)(2); § 431.210. Thus, the parameters of class membership are sufficiently definite.”
Crippen v. Dempsey, 549 F. Supp. 643 (W.D. Mich. 1982).
“See 42 C.F.R. §§ 431.231 and 431.250; 435.-1003.”
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