[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: 42CFR447.205]



[Page 317-318]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 447_PAYMENTS FOR SERVICES--Table of Contents

 

              Subpart B_Payment Methods: General Provisions

 

Sec.  447.205  Public notice of changes in Statewide methods and 



standards for setting payment rates.



    (a) When notice is required. Except as specified in paragraph (b) of 

this section, the agency must provide public notice of any significant 

proposed change in its methods and standards for setting payment rates 

for services.

    (b) When notice is not required. Notice is not required if--

    (1) The change is being made to conform to Medicare methods or 

levels of reimbursement;

    (2) The change is required by court order; or

    (3) The change is based on changes in wholesalers' or manufacturers' 

prices of drugs or materials, if the agency's reimbursement system is 

based on material cost plus a professional fee.

    (c) Content of notice. The notice must--

    (1) Describe the proposed change in methods and standards;

    (2) Give an estimate of any expected increase or decrease in annual 

aggregate expenditures;

    (3) Explain why the agency is changing its methods and standards;



[[Page 318]]



    (4) Identify a local agency in each county (such as the social 

services agency or health department) where copies of the proposed 

changes are available for public review;

    (5) Give an address where written comments may be sent and reviewed 

by the public; and

    (6) If there are public hearings, give the location, date and time 

for hearings or tell how this information may be obtained.

    (d) Publication of notice. The notice must--

    (1) Be published before the proposed effective date of the change; 

and

    (2) Appear as a public announcement in one of the following 

publications:

    (i) A State register similar to the Federal Register.

    (ii) The newspaper of widest circulation in each city with a 

population of 50,000 or more.

    (iii) The newspaper of widest circulation in the State, if there is 

no city with a population of 50,000 or more.



[46 FR 58680, Dec. 3, 1981; 47 FR 8567, Mar. 1, 1982, as amended at 48 

FR 56057, Dec. 19, 1983]