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. § 435.1008

FFP in expenditures for medical assistance for individuals who have declared citizenship or nationality or satisfactory immigration status

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(a) This section implements sections 1137 and 1902(a)(46)(B) of the Act.

(b) Except as provided in paragraph (c) of this section, FFP is not available to a State for expenditures for medical assistance furnished to individuals unless the State has verified citizenship or immigration status in accordance with § 435.956.

(c) FFP is available to States for otherwise eligible individuals whose declaration of U.S. citizenship or satisfactory immigration status in accordance with section 1137(d) of the Act and § 435.406(c) has been verified in accordance with § 435.956, who are exempt from the requirements to verify citizenship under § 435.406(a)(1)(iii), or for whom benefits are provided during a reasonable opportunity period to verify citizenship, nationality, or satisfactory immigration status in accordance with section § 435.956(b), including the time period during which an appeal is pending if the State has elected the option under § 435.956(b)(3).

[81 FR 86460, Nov. 30, 2016]
Notes of Decisions
Cited in 13 cases, 1983–2019 · leading case: Our Lady of Lourdes Hospital v. Franklin County
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Our Lady of Lourdes Hospital v. Franklin County (1993) wash · cites it 2× “42 C.F.R. §§ 435.1008 (a)(1), .1009. Thus, reference to "institutionalized" persons in RCW 74.”
Brown v. County Commissioners (1995) md · cites it 3× “Further, prior to May 3, 1985, 42 C.F.R. § 435.1008 provided that federal financial participation (FFP) “was available for noninstitutional services furnished during the month in which the individual became an inmate or patient and the last month of institutionalization.”
Granville House, Inc. v. Department of Health and Human Services, Arthur E. Noot as Commissioner of Public Welfare for t (1983) ca8 “See 42 C.F.R. §§ 435.1008 (a)(2), 440.-140(a)(1)(ii), (a)(2) & (c) (1982).”
State of Texas v. United States Department of Health and Human Services (1995) ca5 “§ 1396d(a)(14); 42 C.F.R. § 435.1008 (a)(2). As HCFA did not pursue this argument after the initial hearing and the agency's final decision does not rest upon it, we need not address its validity as a basis for denying the proposed amendment.”
Kansas Health Policy Authority v. United States Department of Health & Human Services (2011) dcd “, 42 C.F.R. §§ 435.1008 , 436.1004, 440.160 and 441.”
State of Illinois v. Heckler (1985) ilnd · cites it 7× “42 C.F.R. § 435.1008 (a), (b). IDPA argues that this provision allows FFP for the first month of all “services,” even otherwise excluded IMD services to those between 21 and 65.”
State of Illinois v. Bowen (1986) ca7 “404, Part I, 89th Congress, 1st Session (1965) at 82; Regulation at 42 CFR 435.1008(b) ). The inpatient per diem services are covered under the Medicaid program during that partial month in the same manner as the inpatient per diem services are covered in an IMD/TB for the 65…”
Illinois v. Bowen (1986) ca7 · cites it 3× “42 C.F.R. § 435.1008 (a), (b). 2 Illinois argues that this regulation allows FFP for *290 the first month of all IMD services, even services provided to persons between twenty-one and sixty-five.”
Spano v. Novello (2003) nysupct “From its inception, the Medicaid Act excludes reimbursement for services provided to patients at any institution for mental diseases (IMD) (see, 42 USC § 1396d [a] [1]; [i]; 42 CFR 435.1008 [a] [2]; 441.13 [a] [2]).”
STATE OF ILL. BY ILL. DEPT. OF PUB. AID v. Heckler (1985) ilnd · cites it 8× “42 C.F.R. § 435.1008 (a), (b). IDPA argues that this provision allows FFP for the first month of all "services," even otherwise excluded IMD services to those between 21 and 65.”
New Lifecare Hospitals of North Carolina LLC v. Cochran (2019) dcd “§ 1396d(a)(14); 42 C.F.R. §§ 435.1008 (a)(2), 441.13(a)(2).”
Kansas Health Policy Authority v. United States Department of Health and Human Services (2011) dcd “, 42 C.F.R. §§ 435.1008 , 436.1004, 440.160 and 16 441.”
Show all 13 citing cases →
— 42 C.F.R. § 435.1008(a)(2) — 2 cases
State of Illinois v. Heckler (1985) ilnd “42 C.F.R. § 435.1008 (a), (b). IDPA argues that this provision allows FFP for the first month of all “services,” even otherwise excluded IMD services to those between 21 and 65.”
STATE OF ILL. BY ILL. DEPT. OF PUB. AID v. Heckler (1985) ilnd “42 C.F.R. § 435.1008 (a), (b). IDPA argues that this provision allows FFP for the first month of all "services," even otherwise excluded IMD services to those between 21 and 65.”
— 42 C.F.R. § 435.1008(b) — 4 cases
State of Illinois v. Bowen (1986) ca7 “404, Part I, 89th Congress, 1st Session (1965) at 82; Regulation at 42 CFR 435.1008(b) ). The inpatient per diem services are covered under the Medicaid program during that partial month in the same manner as the inpatient per diem services are covered in an IMD/TB for the 65…”
State of Illinois v. Heckler (1985) ilnd “42 C.F.R. § 435.1008 (a), (b). IDPA argues that this provision allows FFP for the first month of all “services,” even otherwise excluded IMD services to those between 21 and 65.”
Illinois v. Bowen (1986) ca7 “42 C.F.R. § 435.1008 (a), (b). 2 Illinois argues that this regulation allows FFP for *290 the first month of all IMD services, even services provided to persons between twenty-one and sixty-five.”
STATE OF ILL. BY ILL. DEPT. OF PUB. AID v. Heckler (1985) ilnd “42 C.F.R. § 435.1008 (a), (b). IDPA argues that this provision allows FFP for the first month of all "services," even otherwise excluded IMD services to those between 21 and 65.”
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