42 C.F.R. § 447.201
State plan requirements
(a) A State plan must provide that the requirements in this subpart are met.
(b) The plan must describe the policy and the methods to be used in setting payment rates for each type of service included in the State's Medicaid program.
Notes of Decisions
Cited in 10
cases, 1983–2020 · leading case: State v. Campbell, 438 P.3d 448 (Or. Ct. App. 2019).
State v. Campbell, 438 P.3d 448 (Or. Ct. App. 2019). “15 (2017) ; 42 CFR § 447.201 (2017). Federal funds are not available for state expenditures that exceed the amounts CMS approves in the state's rate-setting plan; it creates an upper limit.”
California Ass'n for Health Serv. at Home v. State Dep't of Health Servs., 2007 Cal. Daily Op. Serv. 2822 (Cal. Ct. App. 2007). “) Federal regulations describe the state plan as a “comprehensive written statement submitted by the agency describing the nature and scope of its Medicaid program and giving assurance that it will be administered in conformity with the specific requirements of title XIX, the…”
Visiting Nurse Ass'n of North Shore, Inc. v. Bullen, 93 F.3d 997 (1st Cir. 1996). “§ 1396a(a)(30) (emphasis added); 42 C.F.R. § 447.201 (b) (“The plan must describe the policy and the methods to be used in setting payment rates for each type of service _”).”
Orthopaedic Hosp. v. Belshe, 103 F.3d 1491 (9th Cir. 1997). “42 C.F.R. § 447.201 (b). California’s state plan requires the Department to develop an evidentiary base or rate study, have a public hearing on the proposed rates, determine final rates based on the evidentiary base including public input, and adopt final rates through…”
Visiting Nurse Ass'n of North Shore, Inc. v. Bullen, 866 F. Supp. 1444 (D. Mass. 1994). “10 ; 42 C.F.R. § 447.201 (b). 3. In the event of a change in the Medicaid program, defined as a “[mjaterial ehange[ ] in state law, organization or policy, or in the state’s operation of the Medicaid program,” the state has two responsibilities, one directed to HCFA and the…”
Dep't of Med. Assistant Servs. of the Commonwealth of Virginia v. HHS, 967 F.3d 853 (D.C. Cir. 2020). “§ 1396a(a); 42 C.F.R. § 447.201 (b). Federal regulations require States to amend their plans in the event of any material change “in State law, organization, or policy, or in the State’s operation of the Medicaid program.”
Pennsylvania Med. Soc'y v. Snider, 29 F.3d 886 (3rd Cir. 1994). “§ 1396a(a)(30); 42 C.F.R. § 447.201 (b), 447.203(a) (1993).”
Florence Nightingale Nursing Home v. Blum, 570 F. Supp. 285 (S.D.N.Y. 1983). “42 C.F.R. §§ 447.201 (b), 447.301, 447.-302(b), 447.”
Pennsylvania Ass'n of Home Health Agencies v. Snider, 826 F. Supp. 948 (E.D. Pa. 1993). “§ 1396a(a)(30)(A) and 42 C.F.R. §§ 447.201 , 447.204 and 447.205 by “failing to establish .”
Visiting Nurse v. Bullen (1st Cir. 1996). “205(c)(1) as it interprets the same term in 42 C.F.R. 447.201 (providing that Plan amendment "must describe the policy and methods to be used in setting payment rates for each type of service included in the state's Medicaid program").”
— 42 C.F.R. § 447.201(b) — 1 case
Visiting Nurse v. Bullen (1st Cir. 1996). “205(c)(1) as it interprets the same term in 42 C.F.R. 447.201 (providing that Plan amendment "must describe the policy and methods to be used in setting payment rates for each type of service included in the state's Medicaid program").”
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