C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 441—SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES › Subpart G—Home and Community-Based Services: Waiver Requirements

42 C.F.R. § 441.305

Replacement of beneficiaries in approved waiver programs

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(a) Regular waivers. A State's estimate of the number of individuals who may receive home and community-based services must include those who will replace beneficiaries who leave the program for any reason. A State may replace beneficiaries who leave the program due to death or loss of eligibility under the State plan without regard to any federally-imposed limit on utilization, but must maintain a record of beneficiaries replaced on this basis.

(b) Model waivers. (1) The number of individuals who may receive home and community-based services under a model waiver may not exceed 200 beneficiaries at any one time.

(2) The agency may replace any individuals who die or become ineligible for State plan services to maintain a count up to the number specified by the State and approved by CMS within the 200-maximum limit.

[59 FR 37719, July 25, 1994]
Notes of Decisions
Cited in 3 cases, 1999–2002 · leading case: Bryson v. New Hampshire, 308 F.3d 79 (1st Cir. 2002).
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Bryson v. New Hampshire, 308 F.3d 79 (1st Cir. 2002). · cites it 2× “42 C.F.R. § 441.305 (b)(1). New Hampshire’s model waiver request, however, proposed to serve a far smaller number of individuals than the 200 person maximum.”
Heartz v. Morton (D.N.H. 1999). “See 42 C.F.R. § 441.305 (b). New Hampshire has determined, however, that it cannot serve 200 recipients and remain in compliance with the requirements of the ABD waiver program.”
Heartz v. Morton (D.N.H. 1999). “See 42 C.F.R. § 441.305 (b). New Hampshire has determined, however, that it cannot serve 200 recipients and remain in compliance with the requirements of the ABD waiver program.”
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