[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: 42CFR457.110]



[Page 382]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 457_ALLOTMENTS AND GRANTS TO STATES--Table of Contents

 

Subpart A_Introduction; State Plans for Child Health Insurance Programs 

                         and Outreach Strategies

 

Sec.  457.110  Enrollment assistance and information requirements.



    (a) Information disclosure. The State must make accurate, easily 

understood, linguistically appropriate information available to families 

of potential applicants, applicants and enrollees, and provide 

assistance to these families in making informed decisions about their 

health plans, professionals, and facilities.

    (b) Required information. The State must make available to potential 

applicants and provide applicants and enrollees the following 

information in a timely manner:

    (1) Types of benefits, and amount, duration and scope of benefits 

available under the program.

    (2) Cost-sharing requirements as described in Sec.  457.525.

    (3) Names and locations of current participating providers.

    (4) If an enrollment cap is in effect or the State is using a 

waiting list, a description of the procedures relating to the cap or 

waiting list, including the process for deciding which children will be 

given priority for enrollment, how children will be informed of their 

status on a waiting list and the circumstances under which enrollment 

will reopen.

    (5) Information on physician incentive plans as required by Sec.  

457.985.

    (6) Review processes available to applicants and enrollees as 

described in the State plan pursuant to Sec.  457.1120.