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
(a) FFP is not available in expenditures for services provided to—
(1) Individuals who are inmates of public institutions as defined in § 435.1010; or
(2) Individuals under age 65 who are patients in an institution for mental diseases unless they are under age 22 and are receiving inpatient psychiatric services under § 440.160 of this subchapter.
(b) The exclusion of FFP described in paragraph (a) of this section does not apply during that part of the month in which the individual is not an inmate of a public institution or a patient in an institution for tuberculosis or mental diseases.
(c) An individual on conditional release or convalescent leave from an institution for mental diseases is not considered to be a patient in that institution. However, such an individual who is under age 22 and has been receiving inpatient psychiatric services under § 440.160 of this subchapter is considered to be a patient in the institution until he is unconditionally released or, if earlier, the date he reaches age 22.
[43 FR 45204, Sept. 29, 1978, as amended at 50 FR 13199, Apr. 3, 1985; 50 FR 38811, Sept. 25, 1985. Redesignated and amended at 71 FR 39225, July 12, 2006]
Notes of Decisions
Ohio Dep't of Medicaid v. Thomas Price (2017)
ca6 · cites it 8×
“Maryland law tied the definition of the term “inmate of a public institution” to the federal definition adopted in 1978 by 42 C.F.R. § 435.1009 , which is the same definition that exists today in 42 C.”
Brown v. County Commissioners (1995)
md · cites it 8×
“” 42 C.F.R. § 435.1009 (1993). Under the federal regulations, a person who might otherwise fall within the definition of an inmate is not considered an inmate if: “(a) He is in a public educational or vocational training institution for purposes of securing education or…”
Thomas v. Johnston (1983)
txwd · cites it 3×
“§§ 1396a(c), (d); *883 42 C.F.R. § 435.1009 ; 42 C.F.R. § 442.400 et seq.”
Lelsz v. Kavanagh (1987)
txnd · cites it 3×
“” 42 C.F.R. §§ 435.1009 , 442.-463(d). Such services shall be designed and implemented “to help the individual function at the greatest physical, intellectual, social or vocational level he can presently or potentially achieve.”
Parry by and Through Parry v. Crawford (1998)
nvd · cites it 4×
“S.C. § 1396a(a)(10)(A)(i)(II). Parry currently lives with his parents, but due to his behavioral problems, it has become increasingly difficult for his parents to care for him.”
Connecticut Department of Income Maintenance v. Heckler (1985)
scotus
“5 The Secretary’s regulations, 42 CFR §435.1009 (e) (1984), define an IMD as follows: “an institution that is primarily engaged in providing diagnosis, treatment or care of persons with mental diseases, including medical attention, nursing care and related services.”
Partlow v. Indiana Family & Social Services Administration (1999)
indctapp · cites it 2×
“42 C.F.R. § 435.1009 (1999). 3 In addition to servicing the mentally retarded or “persons with related conditions,” the ICF/MR must provide “active treatment” in order to receive federal financial participation, i.”
Boley v. Miller (1992)
wva
“” 42 C.F.R. § 435.1009 . 10 . For the last three years, the legislature has attempted to restrict the use of state monies to pay for abortions by inserting prohibitory language in the budget bill.”
Com. of Mass. v. Heckler (1985)
mad · cites it 2×
“” 42 C.F.R. § 435.1009 (b). Pursuant to state law, the Commonwealth is also required to provide special education to all school age children with special needs in Massachusetts.”
— 42 C.F.R. § 435.1009(e) — 1 case
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