Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
4/26/2019

Chapter 10. State Plan under Title XIX of the Social Security Act Medical Assistance Program; General ProvisionsRead Chapter

Section 10
Designation and authority
Section 20
Organization for administration
Section 30
Statewide operation
Section 40
State Medical Care Advisory Committee
Section 50
Pediatric immunization program
Section 60
Application; determination of eligibility and furnishing Medicaid
Section 70
Coverage and conditions of eligibility
Section 80
Residence
Section 90
Blindness
Section 100
Disability
Section 110
Financial eligibility
Section 120
Medicaid furnished out of state
Section 130
Requirements for advance directives
Section 140
Amount, duration, and scope of services: Categorically needy
Section 150
Amount, duration, and scope of services: Medically needy
Section 160
Amount, duration, and scope of services: Other required special groups
Section 170
Amount, duration, and scope of services: Limited coverage for certain aliens
Section 180
Amount, duration, and scope of services: Homeless individuals
Section 190
Amount, duration, and scope of services: Presumptively eligible pregnant women
Section 200
Amount, duration, and scope of services: EPSDT services
Section 210
Amount, duration, and scope of services: Comparability of services
Section 220
Amount, duration, and scope of services: home health services
Section 230
Amount, duration, and scope of services: Assurance of transportation
Section 240
Amount, duration, and scope of services: payment for nursing facility services
Section 250
Amount, duration, and scope of services: Methods and standards to assure quality of services
Section 260
Amount, duration, and scope of services: Family planning services
Section 270
Amount, duration, and scope of services: Optometric services
Section 280
Amount, duration, and scope of services: Organ transplant procedures
Section 290
Amount, duration, and scope of services: Participation by Indian Health Service facilities
Section 300
Amount, duration, and scope of services: Respiratory care services for ventilator-dependent individuals
Section 310
Coordination of Medicaid with Medicare and other insurance: Premiums
Section 320
Coordination of Medicaid with Medicare and other insurance: Deductibles/coinsurance
Section 325
Premiums, deductibles, coinsurance and other cost sharing obligations
Section 330
Medicaid for individuals age 65 or over in institutions for mental diseases
Section 340
Special requirements applicable to sterilization procedures
Section 350
Families receiving extended Medicaid benefits
Section 360
[Reserved]
Section 400
Methods of administration
Section 410
Hearings for applicants and recipients
Section 420
Safeguarding information on applicants and recipients
Section 430
Medicaid quality control
Section 435
Medicaid prohibition on payments to institutions or entities located outside of the United States
Section 440
Medicaid Agency Fraud Detection and Investigation Program
Section 441
Medicaid agency fraud detection and investigation program
Section 445
Recovery audit contractors
Section 450
Reports
Section 460
Maintenance of records
Section 470
Availability of agency program manuals
Section 480
Reporting provider payments to Internal Revenue Service
Section 490
Free choice of providers
Section 500
Relations with standard-setting and survey agencies
Section 510
Consultation to medical facilities
Section 520
Required provider agreement
Section 530
Utilization and quality control
Section 540
Inspection of care in intermediate care facilities for the mentally retarded, facilities providing inpatient psychiatric services for individuals ...
Section 550
Relations with state health and vocational rehabilitation agencies and Title V grantees
Section 560
Liens and recoveries
Section 570
Recipient cost sharing and similar charges
Section 580
Payment for services
Section 590
Direct payments to certain recipients for physicians' or dentists' services
Section 600
Prohibition against reassignment of provider claims
Section 610
Third party liability
Section 620
Use of contracts
Section 630
[Repealed]
Section 631
Standards for payment for nursing facility and intermediate care facility for the mentally retarded services
Section 640
Program for licensing administrators of nursing homes
Section 650
Drug Utilization Review Program
Section 660
Disclosure of survey information and provider or contractor evaluation
Section 670
Appeals process
Section 680
Conflict of interest provisions
Section 690
Exclusion of providers and suspension of practitioners and other individuals
Section 700
Disclosure of information by providers and fiscal agents
Section 710
Income and eligibility verification system
Section 720
Medicaid eligibility cards for homeless individuals
Section 730
Systematic alien verification for entitlements
Section 740
[Repealed]
Section 750
[Repealed]
Section 751
Enforcement of compliance for nursing facilities
Section 760
Pharmacy services rebate agreement terms
Section 770
Required coordination between the Medicaid and WIC Programs
Section 780
Nurse aide training and competency evaluation for nursing facilities
Section 790
Preadmission screening and annual resident review in nursing facilities
Section 800
Survey and certification process
Section 810
Resident assessment for nursing facilities
Section 815
Cooperation with Medicaid Integrity Program efforts
Section 820
Employee education about false claims recoveries
Section 850
Standards of personnel administration
Section 860
[Reserved]
Section 870
Training programs; subprofessional and volunteer programs
Section 880
[Reserved]
Section 900
Fiscal policies and administration
Section 910
Cost allocation
Section 920
State financial participation
Section 930
Hospital credit balance reporting
Section 940
[Reserved]
Section 960
Plan amendments
Section 970
Nondiscrimination
Section 980
[Repealed]
Section 990
State Governor's review
Section 1000
General provider appeals

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