(a) Specific definitions.
Inpatient means a patient who has been admitted to a medical institution as an inpatient on recommendation of a physician or dentist and who—
(1) Receives room, board and professional services in the institution for a 24 hour period or longer, or
(2) Is expected by the institution to receive room, board and professional services in the institution for a 24 hour period or longer even though it later develops that the patient dies, is discharged or is transferred to another facility and does not actually stay in the institution for 24 hours.
Outpatient means a patient of an organized medical facility, or distinct part of that facility who is expected by the facility to receive and who does receive professional services for less than a 24-hour period regardless of the hour of admission, whether or not a bed is used, or whether or not the patient remains in the facility past midnight.
Patient means an individual who is receiving needed professional services that are directed by a licensed practitioner of the healing arts toward the maintenance, improvement, or protection of health, or lessening of illness, disability, or pain. (See also § 435.1010 of this chapter for definitions relating to institutional care.)
(b) Definitions of services for FFP purposes. Except as limited in part 441, FFP is available in expenditures under the State plan for medical or remedial care and services as defined in this subpart.
[43 FR 45224, Sept. 29, 1978, as amended at 52 FR 47934, Dec. 17, 1987; 71 FR 39229, July 12, 2006]
Notes of Decisions
Anderson v. Dir., Dep't of Soc. Servs., 300 N.W.2d 921 (Mich. Ct. App. 1980).
“Except as limited in part 441, FFP is available in expenditures under the State plan for medical or remedial care and services as defined in this sub-part.”
Gruter Found., Inc. v. Bowen, 652 F. Supp. 245 (N.D. Ohio 1986).
“42 C.F.R. § 440.2 (b). Prior to 1980, the state Medicaid agency had the primary responsibility for surveying intermediate care facilities to determine if they met federal certification requirements.”
Elizabeth Blackwell Health Ctr. for Women v. Knoll, 61 F.3d 170 (3rd Cir. 1995).
“" 42 C.F.R. § 440.2 If, after a hearing, the Secretary finds that an approved state plan no l complies with the provisions of the Medicaid Act, or that the state had failed to c substantially with any applicable federal requirement, the Secretary may notify the that federal…”
Massachusetts Eye & Ear Infirmary v. Bullen, 7 Mass. L. Rptr. 101 (Mass. Super. Ct. 1997).
· cites it 4× “In contrast, federal Medicaid regulations, 42 C.F.R. §440.2 (a), specifically define inpatient as: a patient who has been admitted to a medical institution as an inpatient on recommendation of a physician or dentist and who— (1) Receives room, board and professional services in…”
United States of Am. ex rel Tali Arik, M.D. v. DVH Hosp. All., LLC, Inc. (D. Nev. 2024).
“The expert opinions that certain patients should have been transferred instead 16 of admitted as inpatients at Desert View concern the standard of care that a patient can be 17 expected to receive, not the medical necessity of the care provided, and the Supreme Court has 18 19…”
— 42 C.F.R. § 440.2(b) — 1 case
Anderson v. Dir., Dep't of Soc. Servs., 300 N.W.2d 921 (Mich. Ct. App. 1980).
“Except as limited in part 441, FFP is available in expenditures under the State plan for medical or remedial care and services as defined in this sub-part.”
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