435.3—Basis.

(a) This part implements the following sections of the Act and public laws that mandate eligibility requirements and standards:

402(a)(22)Eligibility of deemed recipients of AFDC who receive zero payments because of recoupment of overpayments.

402(a)(37)Eligibility of individuals who lose AFDC eligibility due to increased earnings.

414(g)Eligibility of certain individuals participating in work supplementation programs.

473(b)Eligibility of children in foster care and adopted children who are deemed AFDC recipients.

1619(b)Benefits for blind individuals or those with disabling impairments whose income equals or exceeds a specific SSI limit.

1634(b)Preservation of benefit status for disabled widows and widowers who lost SSI benefits because of 1983 changes in actuarial reduction formula.

1634(d)Individuals who lose eligibility for SSI benefits due to entitlement to early widow's or widower's social security disability benefits under section 202(e) or (f) of the Act.

1902(a)(8)Opportunity to apply; assistance must be furnished promptly.

1902(a)(10)Required and optional groups.

1902(a)(12)Determination of blindness.

1902(a)(17)Standards for determining eligibility: flexibility in the application of income eligibility standards.

1902(a)(19)Safeguards for simplicity of administration and best interests of recipients.

1902(a)(34)Three-month retroactive eligibility.

1902(a) (second paragraph after (47))Eligibility despite increased monthly insurance benefits under title II.

1902(a)(55)Mandatory use of outstation locations other than welfare offices to receive and initially process applications of certain low-income pregnant women, infants, and children under age 19.

1902(b)Prohibited conditions for eligibility: Age requirement of more that 65 years;

State residence requirements excluding individuals who reside in the state; and

Citizenship requirement excluding United States citizens.

1902(e)Four-month continued eligibility for families ineligible because of increased hours or income from employment.

1902(e)(2)Minimum eligibility period for recipient enrolled in an HMO.

1902(e)(3)Optional coverage of certain disabled children being cared for at home.

1902(e)(4)Eligibility of newborn children of Medicaid eligible women.

1902(e)(5) Eligibility of pregnant woman for extended coverage for specified postpartum period after pregnancy ends.

1902(f)State option to restrict Medicaid eligibility for aged, blind, or disabled individuals to those who would have been eligible under State plan in effect in January 1972.

1902(j)Medicaid program in American Samoa.

1903(f)Income limitations for medically needy and individuals covered by State supplement eligibility requirements.

1903(v) Payment for emergency services under Medicaid provided to aliens.

1905(a) (clause following (21))Prohibitions against providing Medicaid to certain institutionalized individuals.

1905(a) (second sentence)Definition of essential person.

1905(a)(i)-(viii)List of eligible individuals.

1905(d)(2)Definition of resident of an intermediate care facility for the mentally retarded.

1905(j)Definition of State supplementary payment.

1905(k)Eligibility of essential spouses of eligible individuals.

1905(n)Definition of qualified pregnant woman and child.

1912(a)Conditions of eligibility.

1915(c)Home or community-based services.

1915(d)Home or community-based services for individuals age 65 or older.

412(e)(5) of Immigration and Nationality Act—Eligibility of certain refugees.

Pub. L. 93-66, section 230Deemed eligibility of certain essential persons.

Pub. L. 93-66, section 231Deemed eligibility of certain persons in medical institutions.

Pub. L. 93-66, section 232Deemed eligibility of certain blind and disabled medically indigent persons.

Pub. L. 93-233, section 13(c)Deemed eligibility of certain individuals receiving mandatory State supplementary payments.

Pub. L. 94-566, section 503Deemed eligibility of certain individuals who would be eligible for supplemental security income benefits but for cost-of-living increases in social security benefits.

Pub. L. 96-272, section 310(b)(1)Continued eligibility of certain recipients of Veterans Administration pensions.

Pub. L. 99-509, section 9406Payment for emergency medical services provided to aliens.

Pub. L. 99-603, section 201Aliens granted legalized status under section 245A of the Immigration and Nationality Act (8 U.S.C. 1255a) may under certain circumstances be eligible for Medicaid.

Pub. L. 99-603, section 302Aliens granted legalized status under section 210 of the Immigration and Nationality Act may under certain circumstances be eligible for Medicaid (8 U.S.C. 1160).

Pub. L. 99-603, section 303Aliens granted legal status under section 210A of the Immigration and Nationality Act may under certain circumstances be eligible for Medicaid (8 U.S.C. 1161).

(b) This part implements the following other provisions of the Act or public laws that establish additional State plan requirements:

1618Requirement for operation of certain State supplementation programs.

Pub. L. 93-66, section 212(a)Required mandatory minimum State supplementation of SSI benefits programs.

[52 FR 43071, Nov. 9, 1987; 52 FR 48438, Dec. 22, 1987, as amended at 55 FR 36819, Sept. 7, 1990; 55 FR 48607, Nov. 21, 1990; 57 FR 29155, June 30, 1992; 59 FR 48809, Sept. 23, 1994]

CFR

435.3—Basis.