(a) Statutory basis. Section 1902(a)(1) of the Act requires a State plan to be in effect throughout the State, and section 1915 permits certain exceptions.
(b) State plan requirements. A State plan must provide that the following requirements are met:
(1) The plan will be in operation statewide through a system of local offices, under equitable standards for assistance and administration that are mandatory throughout the State.
(2) If administered by political subdivisions of the State, the plan will be mandatory on those subdivisions.
(3) The agency will ensure that the plan is continuously in operation in all local offices or agencies through—
(i) Methods for informing staff of State policies, standards, procedures, and instructions;
(ii) Systematic planned examination and evaluation of operations in local offices by regularly assigned State staff who make regular visits; and
(iii) Reports, controls, or other methods.
(c) Exceptions. (1) “Statewide operation” does not mean, for example, that every source of service must furnish the service State-wide. The requirement does not preclude the agency from contracting with a comprehensive health care organization (such as an HMO or a rural health clinic) that serves a specific area of the State, to furnish services to Medicaid beneficiaries who live in that area and chose to receive services from that HMO or rural health clinic. beneficiaries who live in other parts of the State may receive their services from other sources.
(2) Other allowable exceptions and waivers are set forth in §§ 431.54 and 431.55.
[56 FR 8847, Mar. 1, 1991; 56 FR 23022, May 20, 1991]
Notes of Decisions
Cited in
17
cases, 1983–2020 · leading case:
Sobky v. Smoley, 855 F. Supp. 1123 (E.D. Cal. 1994).
Sobky v. Smoley, 855 F. Supp. 1123 (E.D. Cal. 1994).
· cites it 5× “While it makes no direct reference to Medicaid recipients, recipients of medical services are the obvious beneficiaries of a requirement that a medical assistance plan be in effect statewide.”
Martin v. Taft, 222 F. Supp. 2d 940 (S.D. Ohio 2002).
· cites it 3× “Nonetheless, the Sixth Circuit Court of Appeals has held that requirements of the statute and the accompanying regulation, 42 C.F.R. § 431.50 32 , are too vague to *977 provide a basis for judicial enforcement.”
Hawkins v. Dep't of Health & Human Servs., 665 F.3d 25 (1st Cir. 2012).
· cites it 2× “§ 1396a(a)(1); 42 C.F.R. § 431.50 . The Department did not dispute that the lack of orthodontists in the three northern counties made those services less readily available to Medicaid patients in that part of the state.”
Boatman v. Hammons, 164 F.3d 286 (6th Cir. 1998).
· cites it 5× “§ 1396a(a)(l), which provides: (a) A state plan for medical assistance must- (1) provide that it shall be in effect in all political subdivisions of the State, and, if administered by them, be mandatory upon them; 42 C.F.R. § 431.50 (b)(1) implements the policy expressed in 42 U.”
Carr v. Wilson-Coker, 203 F.R.D. 66 (D. Conn. 2001).
· cites it 2× “§ 1396a(a)(1) and 42 C.F.R. § 431.50 (b)(1), which require that Medicaid-covered dental services be available to Medicaid recipients throughout Connecticut; 3) 42 U.”
Clark v. Kizer, 758 F. Supp. 572 (E.D. Cal. 1990).
“§ 1396a(a)(l) provides that the State Medicaid plan “shall be in effect in all political subdivisions of the State.”
Cramer v. Chiles, 33 F. Supp. 2d 1342 (S.D. Fla. 1999).
“§ 1396a(a)(1); 42 C.F.R. § 431.50 . Medicaid services must be comparable in amount, scope and duration to the medical assistance made available to individuals in other state plans, 42 U.”
Turner v. Heckler, 573 F. Supp. 867 (S.D. Ohio 1983).
· cites it 2× “§ 1396a(a)(l) and 42 C.F.R. § 431.50 (b) (1982); (7) the Secretary of HHS made no actual comparison of the new state regulation to Ohio’s Medicaid plan as it existed in 1972, as required by 42 U.”
Antrican v. Odom, 290 F.3d 178 (4th Cir. 2002).
“§ 1396a(a)(l) and 42 C.F.R. § 431.50 ; (3) denied North Carolina Medicaid beneficiaries timely dental care, in violation of 42 U.”
Rodriguez v. Debuono, 177 F.R.D. 143 (S.D.N.Y. 1997).
“§ 1396a(a)(l); 42 C.F.R. § 431.50 . Plaintiffs further contend that variations in the administration of and standards for TBA violate the requirement that a State’s Medicaid plan must "provide for a single State agency to administer or supervise the administration of the plan.”
Christy v. Ibarra, 826 P.2d 361 (Colo. Ct. App. 1991).
“” 42 C.F.R. § 431.50 (b)(1) (1990). A state may, pursuant to 42 C.”
— 42 C.F.R. § 431.50(a) — 1 case
Hawkins v. Dep't of Health & Human Servs., 665 F.3d 25 (1st Cir. 2012).
“§ 1396a(a)(1); 42 C.F.R. § 431.50 . The Department did not dispute that the lack of orthodontists in the three northern counties made those services less readily available to Medicaid patients in that part of the state.”
Annotations are extracted automatically from the opinions in the
Syfert caselaw corpus and ranked by authority, recency, and
treatment. Dots show Syfertize treatment of the citing case itself.