C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 435—ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA › Subpart K—Federal Financial Participation

42 C.F.R. § 435.1003

FFP for redeterminations

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(a) If the Social Security Administration (SSA) notifies an agency that a beneficiary has been determined ineligible for SSI, FFP is available in Medicaid expenditures for services to the beneficiary as follows:

(1) If the agency receives the SSA notice by the 10th day of the month, FFP is available under this section only through the end of the month unless the beneficiary requests a hearing under subpart E, part 431 of this subchapter.

(2) If the agency receives the SSA notice after the 10th day of the month, FFP is available only through the end of the following month, unless the beneficiary requests a hearing under subpart E, part 431 of this subchapter.

(3) If a beneficiary requests a hearing, FFP is available as specified in subpart E, part 431 of this subchapter.

(b) The agency must take prompt action to determine eligibility after receiving the SSA notice.

(c) When a change in Federal law affects the eligibility of substantial numbers of Medicaid beneficiaries, the Secretary may waive the otherwise applicable FFP requirements and redetermination time limits of this section, in order to provide a reasonable time to complete such redeterminations. The Secretary will designate an additional amount of time beyond that allowed under paragraphs (a) and (b) of this section, within which FFP will be available, to perform large numbers of redeterminations arising from a change in Federal law.

[43 FR 45204, Sept. 29, 1978, as amended at 44 FR 17939, Mar. 23, 1979; 62 FR 1685, Jan. 13, 1997]
Notes of Decisions
Cited in 4 cases, 1979–2020 · 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 3× “24 A third relevant regulation is 42 C.F.R. § 435.1003 (1979) which provides for continued Federal assistance to a state’s Medicaid program for a period of time following Federal notification to the state that a recipient has been determined ineligible for SSI.”
Crippen v. Kheder, 741 F.2d 102 (6th Cir. 1984). “2d 784 (1980), and 42 C.F.R. § 435.1003 , that Crippen's benefits must be terminated upon receipt of notice that her SSI has been terminated.”
Crippen v. Dempsey, 549 F. Supp. 643 (W.D. Mich. 1982). “” 42 C.F.R. § 435.1003 (b). This case requires the court to interpret and apply the above-cited regulations.”
D.C. & M.L. Vs. Div. of Med. Assistance & Health Servs. (Div. of Med. Assistance & Health Servs.) (N.J. Super. Ct. App. Div. 2020). · cites it 2× “916 (c), 8 and 42 C.F.R. § 435.1003 (b) 9] and held that they imposed 7 42 C.”
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