[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR435.234]



[Page 126]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 435_ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN 

MARIANA ISLANDS, AND AMERICAN SAMOA--Table of Contents

 

          Subpart C_Options for Coverage as Categorically Needy

 

Sec. 435.234  Individuals receiving only optional State supplements 

in States using more restrictive eligibility requirements than SSI 

and certain States using SSI criteria.



    (a) In States using more restrictive eligibility requirements than 

SSI or in States that use SSI criteria but do not have section 1616 or 

1634 agreements with the Social Security Administration for eligibility 

determinations, the agency may provide Medicaid to individuals specified 

in paragraph (b) of this section who receive only a State supplement if 

the State supplement meets the conditions specified in paragraph (c) of 

this section.

    (b) The agency may provide Medicaid to all individuals receiving 

only State supplements if, except for their income, the individuals meet 

the more restrictive eligibility requirements under Sec. 435.121 or SSI 

criteria, or to one or more of the following classifications of 

individuals who meet these criteria:

    (1) All aged individuals.

    (2) All blind individuals.

    (3) All disabled individuals.

    (4) Only aged individuals in domiciliary facilities or other group 

living arrangements as defined under SSI.

    (5) Only blind individuals in domiciliary facilities or other group 

living arrangements as defined under SSI.

    (6) Only disabled individuals in domiciliary facilities or other 

group living arrangements as defined under SSI.

    (7) Individuals receiving a Federally-administered optional State 

supplement that meets the conditions specified in this section.

    (8) Individuals in additional classifications specified by the 

Secretary.

    (9) Reasonable groups of individuals, as specified by the State, 

receiving State-administered supplementary payments.

    (c) Payments under the optional supplement program must be:

    (1) Based on need and paid in cash on a regular basis;

    (2) Equal to the difference between the individual's countable 

income and the income standard used to determine eligibility for 

supplements. Countable income is income remaining after deductions are 

applied. The income deductions may be more restrictive than required 

under SSI (see Sec. 435.1006 for limitations on FFP in Medicaid 

expenditures for individuals receiving optional State supplements); and

    (3) Available to all individuals in each classification in paragraph 

(b) of this section and available on a statewide basis. However, the 

plan may provide for variations in the income standard by political 

subdivision according to cost-of-living differences.



[58 FR 4928, Jan. 19, 1993]