42 C.F.R. § 440.1

Basis and purpose

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This subpart interprets and implements the following sections of the Act:

1902(a)(70), State option to establish a non-emergency medical transportation program.

1905(a) Services included in the term “medical assistance.”

1905 (c), (d), (f) through (i), (l), and (m) Definitions of institutions and services that are included in the term “medical assistance.”

1913 “Swing-bed” services. (See §§ 447.280 and 482.58 of this chapter for related provisions on “swing-bed” services.)

1915(c) Home and community-based services listed as “medical assistance” and furnished under waivers under that section to individuals who would otherwise require the level of care furnished in a hospital, NF, or ICF/IID.

1915(d) Home and community-based services listed as “medical assistance” and furnished under waivers under that section to individuals age 65 or older who would otherwise require the level of care furnished in a NF.

1915(i) Home and community-based services furnished under a State plan to elderly and disabled individuals.

[57 FR 29155, June 30, 1992, as amended at 61 FR 38398, July 24, 1996; 73 FR 77530, Dec. 19, 2008; 79 FR 3029, Jan. 16, 2014; 79 FR 27153, May 12, 2014]

Notes of Decisions

Cited in 8 cases (2 in the last 5 years), 2006–2023 · leading case: Arizona Health Care Cost Containment Sys. v. McClellan, 508 F.3d 1243 (9th Cir. 2007).

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Arizona Health Care Cost Containment Sys. v. McClellan, 508 F.3d 1243 (9th Cir. 2007). “§ 1396d(a); 42 C.F.R. § 440.1 . 6 . The DAB is a separate adjudicatoiy department within HHS that provides independent review of disputed decisions for many HHS programs.”

Sarepta Therapeutics v. Oregon Health Auth., 530 P.3d 103 (Or. Ct. App. 2023). “” 42 CFR § 440.120 (a) (in subpart A, defining “prescribed drugs”); see also 42 CFR § 440.”

United States ex rel. Dickson v. Bristol-Meyers Squibb Co., 123 F. Supp. 3d 584 (D.N.J. 2015). “42 C.F.R. § 440.1 et seq. defines various "services” within the Medicaid law; "services” includes "prescribed drugs.”

Jensen v. Missouri Dep't of Health & Senior Servs., 186 S.W.3d 857 (Mo. Ct. App. 2006). “42 C.F.R. § 440.1 (1996) and 42 C.F.R. § 440.”

Sarepta Therapeutics v. Oregon Health Auth. (Or. Ct. App. 2023). “” 42 CFR § 440.120 (a) (in subpart A, defining “prescribed drugs”); see also 42 CFR § 440.”

Wheeling Hosp. v. Charles O. Lorensen, WV Tax Comm., 742 S.E.2d 86 (W. Va. 2013). “” See 42 C.F.R. § 440.1 (2012) (stating purpose of regulations as defining “services that are included in ‘medical assistance’ ”).”

Arizona Health Care v. McClellan (9th Cir. 2007). “§ 1396d(a); 42 C.F.R. § 440.1 . ARIZONA HEALTH CARE v.”

Hampe v. Hamos, 917 F. Supp. 2d 805 (N.D. Ill. 2013). “42 C.F.R. § 440.1 et seq.; (Pls.’ Resp. to Def.”

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