Chapter 20. Administration of Medical Assistance ServicesRead Chapter
- Part I.Read allMiscellaneous Provisions
- Section 10
- Attorney General's certification
- Section 20
- [Repealed]
- Section 60
- Definition of Medicaid state plan health maintenance organizations (HMOs)
- Section 70
- [Repealed]
- Section 80
- Coordination of Title XIX with Part A and Part B of Title XVIII
- Section 90
- Confidentiality and disclosure of information concerning Medicaid applicants and recipients
- Section 100
- Standards governing general and special hospitals and convalescent and nursing homes
- Section 110
- Nursing facility resident drug utilization review
- Section 120
- Cooperative arrangements with the state vocational rehabilitation agency and with Title V programs and grantees
- Part II.Read allLiens/Estate Recoveries
- Section 130
- Lien recoveries
- Section 140
- [Repealed]
- Section 141
- Estate recoveries
- Part III.Read allRecipient Cost Sharing
- Section 150
- Copayments and deductibles for categorically needy and QMBs for services other than under 42 CFR 447.53
- Section 160
- Copayments and deductibles for medically needy and QMBs for services other than under 42 CFR 447.53
- Section 170
- Basis of payment for reserving beds during a recipient's absence from an inpatient facility
- Section 180
- Definition of a claim by service
- Part IV.Read allThird Party Liability
- Section 190
- Requirements for third party liability; identifying liable resources
- Section 200
- Requirements for third party liability; payment of claims
- Section 205
- Health Insurance Premium Payment for Kids
- Section 210
- State method on cost effectiveness of qualified employer-sponsored insurance plans
- Part V.Read allSanctions, Advance Directives
- Section 215
- Sanctions for psychiatric hospitals
- Section 220
- Income and eligibility verification system procedures; requests to other state agencies
- Section 230
- Method for issuance of medicaid eligibility cards to homeless individuals
- Section 240
- Requirements for advance directives under state plans for medical assistance
- Section 249
- [Repealed]
- Part VI.Read allNursing Facility Enforcement
- Section 251
- Termination of provider agreement
- Section 252
- Temporary management
- Section 253
- Denial of payment for new admissions
- Section 254
- Civil money penalty
- Section 255
- State monitoring
- Section 256
- Transfer of residents; transfer of residents with closure of facility
- Section 257
- Required plan of correction
- Section 258
- Appeals
- Section 259
- Repeated substandard quality of care
- Part VII.Read allSpecialized Services; Categorical Determinations
- Section 260
- Definition of specialized services
- Section 270
- Categorical determinations
- Part VIII.Read allNursing Facilities Survey/Certification
- Section 272
- Survey and certification education program
- Section 274
- Process for the investigation of allegations of resident neglect and abuse and misappropriation of resident property
- Section 275
- Procedures for scheduling and conduct of standards surveys
- Section 277
- Programs to measure and reduce inconsistency
- Section 278
- Process for investigations of complaints and monitoring
- Part IX.Read allAdministration, Civil Rights
- Section 280
- Methods of administration; civil rights
- Part X.Read all[Reserved]
Part XI
[Reserved] - Section 290
- [Reserved]
- Part XII.Read allProvider Appeals
- Section 500
- Definitions
- Section 510
- [Reserved]
- Section 520
- Provider appeals: general provisions
- Section 530
- [Reserved]
- Section 540
- Informal appeals
- Section 550
- Settlement agreements
- Section 560
- Formal appeals
- Section 570
- Reconsideration of final agency decision
- FORMS
- FORMS (12VAC30-20)