[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: 42CFR431.213]



[Page 36-37]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 431_STATE ORGANIZATION AND GENERAL ADMINISTRATION--Table of Contents

 

          Subpart E_Fair Hearings for Applicants and Recipients

 

Sec.  431.213  Exceptions from advance notice.



    The agency may mail a notice not later than the date of action if--

    (a) The agency has factual information confirming the death of a 

recipient;

    (b) The agency receives a clear written statement signed by a 

recipient that--

    (1) He no longer wishes services; or

    (2) Gives information that requires termination or reduction of 

services and indicates that he understands that this must be the result 

of supplying that information;

    (c) The recipient has been admitted to an institution where he is 

ineligible under the plan for further services;

    (d) The recipient's whereabouts are unknown and the post office 

returns agency mail directed to him indicating no forwarding address 

(See Sec.  431.231 (d) of this subpart for procedure if the recipient's 

whereabouts become known);



[[Page 37]]



    (e) The agency establishes the fact that the recipient has been 

accepted for Medicaid services by another local jurisdiction, State, 

territory, or commonwealth;

    (f) A change in the level of medical care is prescribed by the 

recipient's physician;

    (g) The notice involves an adverse determination made with regard to 

the preadmission screening requirements of section 1919(e)(7) of the 

Act; or

    (h) The date of action will occur in less than 10 days, in 

accordance with Sec.  483.12(a)(5)(ii), which provides exceptions to the 

30 days notice requirements of Sec.  483.12(a)(5)(i).



[44 FR 17932, Mar. 29, 1979, as amended at 57 FR 56505, Nov. 30, 1992; 

58 FR 25784, Apr. 28, 1993]