[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: 42CFR457.70]



[Page 381]

 

                         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.  457.70  Program options.



    (a) Health benefits coverage options. A State may elect to obtain 

health benefits coverage under its plan through--

    (1) A separate child health program;

    (2) A Medicaid expansion program; or

    (3) A combination program.

    (b) State plan requirement. A State must include in the State plan 

or plan amendment a description of the State's chosen program option.

    (c) Medicaid expansion program requirements. A State plan under 

title XXI for a State that elects to obtain health benefits coverage 

through its Medicaid plan must--

    (1) Meet the requirements of--

    (i) Subpart A;

    (ii) Subpart B (to the extent that the State claims administrative 

costs under title XXI);

    (iii) Subpart F (with respect to determination of the allotment for 

purposes of the enhanced matching rate, determination of the enhanced 

matching rate, and payment of any claims for administrative costs under 

title XXI only);

    (iv) Subpart G; and

    (v) Subpart J (if the State claims administrative costs under title 

XXI and seeks a waiver of limitations on such claims based on a 

community based health delivery system).

    (2) Be consistent with the State's Medicaid State plan, or an 

approvable amendment to that plan, as required under title XIX.

    (d) Separate child health program requirements. A State that elects 

to obtain health benefits coverage under its plan through a separate 

child health program must meet all the requirements of part 457.

    (e) Combination program requirements. A State that elects to obtain 

health benefits coverage through both a separate child health program 

and a Medicaid expansion program must meet the requirements of 

paragraphs (c) and (d) of this section.