C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 431—STATE ORGANIZATION AND GENERAL ADMINISTRATION › Subpart E—Fair Hearings for Applicants and Beneficiaries

42 C.F.R. § 431.250

Federal financial participation

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FFP is available in expenditures for—

(a) Payments for services continued pending a hearing decision;

(b) Payments made—

(1) To carry out hearing decisions; and

(2) For services provided within the scope of the Federal Medicaid program and made under a court order.

(c) Payments made to take corrective action prior to a hearing;

(d) Payments made to extend the benefit of a hearing decision or court order to individuals in the same situation as those directly affected by the decision or order;

(e) Retroactive payments under paragraphs (b), (c), and (d) of this section in accordance with applicable Federal policies on corrective payments; and

(f) Administrative costs incurred by the agency for—

(1) Transportation for the applicant or beneficiary, his representative, and witnesses to and from the hearing;

(2) Meeting other expenses of the applicant or beneficiary in connection with the hearing;

(3) Carrying out the hearing procedures, including expenses of obtaining the additional medical assessment specified in § 431.240 of this subpart; and

(4) Hearing procedures for Medicaid and non-Medicaid individuals appealing transfers, discharges and determinations of preadmission screening and annual resident reviews under part 483, subparts C and E of this chapter.

[44 FR 17932, Mar. 29, 1979, as amended at 45 FR 24882, Apr. 11, 1980; 57 FR 56506, Nov. 30, 1992]
Notes of Decisions
Cited in 13 cases (4 in the last 5 years), 1979–2025 · leading case: Stenson v. Blum, 476 F. Supp. 1331 (S.D.N.Y. 1979).
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Stenson v. Blum, 476 F. Supp. 1331 (S.D.N.Y. 1979). · cites it 2× “17,934 (1979) (to be codified at 42 C.F.R. § 431.250 (a)). These regulations clearly contemplate that state Medicaid payments to a terminated recipient must be reinstated if, but only if, the recipient requests a hearing within ten days of the mailing of notice of termination by…”
Martin v. North Carolina Dep't of Health & Human Servs., 670 S.E.2d 629 (N.C. Ct. App. 2009). “See 42 C.F.R. § 431.250 (b)2 (2006) (providing that federal financial participation is available in expenditures for “services provided within the scope of the Federal Medicaid program and made under a court order.”
State of Georgia, by Its Dep't of Med. Assistance v. Margaret M. Heckler, Sec'y, Dep't of Health & Human Servs., 768 F.2d 1293 (11th Cir. 1985). “In 1980, HHS promulgated a parallel regulation, 42 C.F.R. § 431.250 , with nearly identical wording, that was to apply solely to Medicaid.”
Hoardwood, Inc. v. Dep't of Pub. Aid, 529 N.E.2d 1009 (Ill. App. Ct. 1988). “42 C.F.R. §431.250 (1982). We, therefore, conclude that since Federal regulations expressly provide for payment for services that are continued pending a hearing decision, and there has been no determination by the Federal government of an overpayment, the trial court improperly…”
Conrad v. Perales, 92 F. Supp. 2d 175 (W.D.N.Y. 2000). “Finally, the regulations governing FFP reveal that it is meant to defray only certain kinds of costs, such as: (1) the cost of providing fair hearings for recipients who seek to challenge the denial of benefits, 42 C.F.R. § 431.250 (1999); (2) the cost of providing…”
Tinoco v. Belshe, 916 F. Supp. 974 (N.D. Cal. 1995). “” 42 C.F.R. § 431.250 (b)(2). Absent evidence to the contrary, this Court must presume that HHS will act within the law.”
Morales v. Comm'r, 465 N.E.2d 264 (Mass. App. Ct. 1984). “42 C.F.R. 431.250(b) (2) and (d) *244 (1983).”
Illinois v. United States Dep't of Health & Human Servs., 772 F.2d 329 (7th Cir. 1985). “10 (b)(3) (1978) (recodified as 42 C.F.R. § 431.250 (b)(2) (1980)), states that: Federal financial participation is available for the following items: * * * * * * (3) Payments of assistance within the scope of Federally aided public assistance programs made in accordance with a…”
Dignity Health v. Lightbourne (N.D. Cal. 2021). · cites it 2× “1995), for the proposition that a federal defendant is not necessary 24 when an interpretation of Medicaid is at issue because 42 C.F.R. § 431.250 (b)(2), which interprets 25 the Medicaid Act, requires the federal government to provide full federal financial participation 26…”
Indiana Prot. & Advocacy Servs. Comm'n v. Indiana Fam. & Soc. Servs. Admin. (7th Cir. 2025). · cites it 2× “For the first time, Plaintiffs argued that 42 C.F.R. § 431.250 (b)(2) made federal financial participation available for any payments made to Ms.”
Indiana Prot. & Advocacy Servs. Comm'n v. Indiana Fam. & Soc. Servs. Admin. (7th Cir. 2025). · cites it 2× “For the first time, Plaintiffs argued that 42 C.F.R. § 431.250 (b)(2) made federal financial participation available for any payments made to Ms.”
Indiana Prot. & Advocacy Servs. Comm'n v. Indiana Fam. & Soc. Servs. Admin. (7th Cir. 2025). · cites it 2× “For the first time, Plaintiffs argued that 42 C.F.R. § 431.250 (b)(2) made federal financial participation available for any payments made to Ms.”
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— 42 C.F.R. § 431.250(b) — 1 case
Morales v. Comm'r, 465 N.E.2d 264 (Mass. App. Ct. 1984). “42 C.F.R. 431.250(b) (2) and (d) *244 (1983).”
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