GroundRules
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- 12VAC30-40-120 · Medically needy income levels (MNILs) based on family size
- 12VAC30-40-130 · Handling of excess income; spend-down
- 12VAC30-40-140 · Methods for determining resources
- 12VAC30-40-150 · Resource standard; categorically needy
- 12VAC30-40-160 · Resource standard; medically needy
- 12VAC30-40-170 · Resource standard; qualified Medicare beneficiaries and specified low-income Medicare beneficiaries
- 12VAC30-40-180 · Qualified disabled and working individuals
- 12VAC30-40-190 · Excess resources
- 12VAC30-40-200 · Effective date of eligibility
- 12VAC30-40-210 · Transfer of resources - categorically and medically needy, qualified Medicare beneficiaries, and qualified disabled and working individuals
- 12VAC30-40-220 · Income eligibility levels
- 12VAC30-40-230 · Resource levels
- 12VAC30-40-235 · Reasonable limits on amounts for necessary medical or remedial care not covered under Medicaid
- 12VAC30-40-240 · More restrictive methods of treating resources than those of the SSI program: § 1902(f) states only
- 12VAC30-40-250 · Standards for optional state supplementary payments
- 12VAC30-40-260 · Income levels for 1902(f) states; categorically needy who are covered under requirements more restrictive than SSI
- 12VAC30-40-270 · Resource standards for 1902(f) states; categorically needy
- 12VAC30-40-280 · More liberal income disregards
- 12VAC30-40-290 · More liberal methods of treating resources under §1902(r)(2) of the Act: §1902(f) states
- 12VAC30-40-300 · Transfer of resources
- 12VAC30-40-310 · [Reserved]
- 12VAC30-40-320 · Consideration of Medicaid qualifying trust; undue hardship
- 12VAC30-40-330 · Cost effectiveness methodology for COBRA continuation beneficiaries
- 12VAC30-40-340 · Compliance with § 1924 and OBRA 90
- 12VAC30-40-347 · Asset verification system
- 12VAC30-40-348 · Adult group individual income-based determinations
- 12VAC30-40-350 · Standards for optional state supplementary payments
- 12VAC30-40-360 · Treatment of entrance fees of individuals residing in continuing care retirement communities
- 12VAC30-40-370 · Variations from the basic personal needs allowance
- 12VAC30-50-10 · Services provided to the categorically needy with limitations
- 12VAC30-50-20 · Services provided to the categorically needy without limitation
- 12VAC30-50-30 · Services not provided to the categorically needy
- 12VAC30-50-35 · Requirements relating to payment for covered outpatient drugs for the categorically needy
- 12VAC30-50-40 · Ambulatory services
- 12VAC30-50-50 · Services provided to the medically needy with limitations
- 12VAC30-50-60 · Services provided to all medically needy groups without limitations
- 12VAC30-50-70 · Services or devices not provided to the medically needy
- 12VAC30-50-75 · Requirements relating to payment for covered outpatient drugs for the medically needy
- 12VAC30-50-80 · [Reserved]
- 12VAC30-50-95 · Reimbursement of services; in general
- 12VAC30-50-100 · Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; enrolled providers
- 12VAC30-50-105 · Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; nonenrolled providers (nonparticipating/out of state)
- 12VAC30-50-110 · Outpatient hospital and rural health clinic services
- 12VAC30-50-120 · Other laboratory and x-ray services
- 12VAC30-50-130 · Nursing facility services, EPSDT, including school health services and family planning
- 12VAC30-50-131 · Services provided by certified Early Intervention practitioners under EPSDT
- 12VAC30-50-132 · Private duty nursing services under early and periodic screening, diagnostic, and treatment
- 12VAC30-50-140 · Physician's services whether furnished in the office, the patient's home, a hospital, a skilled nursing facility, or elsewhere
- 12VAC30-50-150 · Medical care by other licensed practitioners within the scope of their practice as defined by state law
- 12VAC30-50-160 · Home health services
- 12VAC30-50-165 · Durable medical equipment suitable for use in the home
- 12VAC30-50-170 · Private duty nursing services
- 12VAC30-50-180 · Clinic services
- 12VAC30-50-190 · Dental services
- 12VAC30-50-200 · Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders
- 12VAC30-50-210 · Prescribed drugs, dentures, and prosthetic devices, and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist
- 12VAC30-50-220 · Diagnostic, screening, preventive, and rehabilitative services other than those provided elsewhere in this plan
- 12VAC30-50-225 · Rehabilitative services; intensive physical rehabilitation, and CORF services
- 12VAC30-50-226 · Community mental health services
- 12VAC30-50-227 · Lead contamination
- 12VAC30-50-229 · [Reserved]
- 12VAC30-50-230 · Services for individuals age 65 or older in institutions for mental diseases
- 12VAC30-50-240 · Intermediate care services and intermediate care services for institutions for mental disease and intellectual disabilities
- 12VAC30-50-250 · Inpatient psychiatric facility services for individuals under 21 years of age
- 12VAC30-50-260 · Nurse-midwife services
- 12VAC30-50-270 · Hospice services (in accordance with § 1905 (o) of the Act)
- 12VAC30-50-280 · Case management services for high-risk pregnant women and children up to age 1, as defined in 12VAC30-50-410, in accordance with § 1915 (g)(1) of ...
- 12VAC30-50-290 · Extended services to pregnant women
- 12VAC30-50-300 · Any other medical care and any other type of remedial care recognized under state law, specified by the Secretary of Health and Human Services
- 12VAC30-50-310 · Emergency services for aliens
- 12VAC30-50-320 · Program of All-Inclusive Care for the Elderly (PACE)
- 12VAC30-50-321 · Eligibility for PACE enrollees
- 12VAC30-50-325 · Rates and payments
- 12VAC30-50-328 · PACE enrollment and disenrollment
- 12VAC30-50-330 · PACE definitions
- 12VAC30-50-335 · General PACE plan requirements
- 12VAC30-50-340 · Criteria for PACE enrollment
- 12VAC30-50-345 · PACE enrollee rights
- 12VAC30-50-350 · PACE enrollee responsibilities
- 12VAC30-50-355 · PACE plan contract requirements and standards
- 12VAC30-50-360 · PACE sanctions
- 12VAC30-50-410 · Case management services for high risk pregnant women and children
- 12VAC30-50-415 · Case management for individuals receiving early intervention (Part C) services
- 12VAC30-50-420 · Case management services for seriously mentally ill adults and emotionally disturbed children
- 12VAC30-50-430 · Case management services for youth at risk of serious emotional disturbance
- 12VAC30-50-440 · Support coordination/case management services for individuals with intellectual disability
- 12VAC30-50-480 · Case management for foster care children
- 12VAC30-50-490 · Support coordination/case management for individuals with developmental disabilities
- 12VAC30-50-491 · Substance use case management services for individuals who have a primary diagnosis of substance use disorder
- 12VAC30-50-510 · Requirements and limits applicable to specific services: expanded prenatal care services
- 12VAC30-50-520 · Drugs or drug categories which are not covered
- 12VAC30-50-530 · Methods of providing transportation
- 12VAC30-50-540 · Kidney transplantation (KT)
- 12VAC30-50-550 · Corneal transplantation
- 12VAC30-50-560 · Liver, heart, lung, allogeneic and autologous bone marrow transplantation
- 12VAC30-50-570 · High dose chemotherapy and bone marrow/stem cell transplantation (coverage for persons over 21 years of age)
- 12VAC30-50-580 · Other medically necessary transplantation procedures that are determined to not be experimental or investigational (coverage for persons younger ...
- 12VAC30-50-610 · Alternative benefit plan: Medicaid expansion
- 12VAC30-60-5 · Applicability of utilization review requirements.
- 12VAC30-60-10 · Institutional care