[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR430.3]



[Page 6]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 430_GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS--Table of 

 

               Subpart A_Introduction; General Provisions

 

Sec.  430.3  Appeals under Medicaid.



    Three distinct types of disputes may arise under Medicaid.

    (a) Compliance with Federal requirements. Disputes that pertain to 

whether a State's plan or proposed plan amendments, or its practice 

under the plan meet or continue to meet Federal requirements are subject 

to the hearing provisions of subpart D of this part.

    (b) FFP in Medicaid expenditures. Disputes that pertain to 

disallowances of FFP in Medicaid expenditures (mandatory grants) are 

heard by the Departmental Appeals Board (the Board) in accordance with 

procedures set forth in 45 CFR part 16.

    (c) Discretionary grants disputes. Disputes pertaining to 

discretionary grants, such as grants for special demonstration projects 

under sections 1110 and 1115 of the Act, which may be awarded to a 

Medicaid agency, are also heard by the Board. 45 CFR part 16, appendix 

A, lists all the types of disputes that the Board hears.



[53 FR 36571, Sept. 21, 1988, as amended at 56 FR 8845, Mar. 1, 1991]