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 J—Eligibility in the States and District of Columbia

42 C.F.R. § 435.905

Availability and accessibility of program information

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(a) The agency must furnish the following information in electronic and paper formats (including through the Internet Web site described in § 435.1200(f) of this part), and orally as appropriate, to all applicants and other individuals who request it:

(1) The eligibility requirements;

(2) Available Medicaid services; and

(3) The rights and responsibilities of applicants and beneficiaries.

(b) Such information must be provided to applicants and beneficiaries in plain language and in a manner that is accessible and timely to—

(1) Individuals who are limited English proficient through the provision of language services at no cost to the individual including, oral interpretation and written translations;

(2) Individuals living with disabilities through the provision of auxiliary aids and services at no cost to the individual in accordance with the Americans with Disabilities Act and section 504 of the Rehabilitation Act; and

(3) Individuals must be informed of the availability of the accessible information and language services described in this paragraph and how to access such information and services, at a minimum through providing taglines in non-English languages indicating the availability of language services.

[77 FR 17208, Mar. 23, 2012, as amended at 81 FR 86457, Nov. 30, 2016]
Notes of Decisions
Cited in 14 cases (1 in the last 5 years), 1992–2022 · leading case: Stevens v. Dep't of Soc. Welfare, 620 A.2d 737 (Vt. 1992).
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Stevens v. Dep't of Soc. Welfare, 620 A.2d 737 (Vt. 1992). · cites it 5× “If, however, the applicant spends the excess resources on allowable medical expenses, the applicant may be eligible for up to three months of retroactive benefits. Id.”
Beeker v. Olszewski, 415 F. Supp. 2d 734 (E.D. Mich. 2006). · cites it 7× “42 C.F.R. § 435.905 . The pamphlets and booklets available for Medicaid recipients do not tell recipients that they can obtain prescriptions even when they are unable to make the co-payments.”
Carroll v. DeBuono, 998 F. Supp. 190 (N.D.N.Y. 1998). · cites it 3× “42 C.F.R. § 435.905 . Additionally, “the agency must publish in quantity and make available bulletins or pamphlets that explain the rules governing eligibility and appeals in simple and understandable terms.”
Boatman v. Hammons, 164 F.3d 286 (6th Cir. 1998). · cites it 5× “42 C.F.R. § 435.905 . The Agency sends each person requesting Medicaid, and places on display in the reception area of its local offices, a pamphlet titled “Facts About Medicaid.”
Seittelman v. Sabol, 217 A.D.2d 523 (N.Y. App. Div. 1995). · cites it 2× “While it is not necessary to invalidate the Regulation insofar as it deals with the period after application, we find that the IAS Court properly determined that defendants in fact failed to provide timely and adequate written notice to Medicaid applicants and recipients, as…”
Reynolds v. Giuliani, 35 F. Supp. 2d 331 (S.D.N.Y. 1999). “§ 1396a(8); 42 C.F.R. §§ 435.905 (a)(l)-(3), 435.906, 435.”
Coleman v. Daines, 79 A.D.3d 554 (N.Y. App. Div. 2010). “7 (a) and (c), and 42 CFR 435.905, which may be addressed through CPLR 7803 (3) and an implied right of action.”
Chisholm v. Hood, 110 F. Supp. 2d 499 (E.D. La. 2000). “42 C.F.R. § 435.905 (a)(2). Additional standards apply to recipients under the age of twenty-one.”
Rosen v. Tennessee Comm'r of Fin. & Admin., 204 F. Supp. 2d 1048 (M.D. Tenn. 2001). · cites it 2× “42 C.F.R. § 435.905 (a) and (b). For the mentally ill class members who have SPMI or who are SEDC, the Tenn-Care application papers of their TennCare coverage and the Defendant’s denial letters provide inadequate notice of the reasons for the denial.”
Seittelman v. Sabol, 158 Misc. 2d 498 (N.Y. Sup. Ct. 1993). · cites it 3× “) 42 CFR 435.905, entitled "Availability of program information”, sets forth the following requirements for the Medicaid agency: "(a) The agency must furnish the following information in written form, and orally as appropriate, to all applicants and to all other individuals who…”
Hatten-Gonzales v. Scrase (D.N.M. 2022). · cites it 4× “1019) at 4 (citing 42 C.F.R. § 435.905 ). “Individuals must be informed of the availability of the accessible information and language services .”
Konstantinov v. Daines, 101 A.D.3d 520 (N.Y. App. Div. 2012). “Moreover, both federal and state regulations require Medicaid applicants to be notified of available services and the eligibility requirements for obtaining those services (see 42 CFR 435.”
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