Title 42
6,656 sections in this title — page 12 of 67.
§ 1395u
Provisions relating to the administration of part B
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395uu
Payments to promote closing or conversion of underutilized hospital facilities
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395v
Agreements with States
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395vv
Withholding payments from certain medicaid providers
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395w
Appropriations to cover Government contributions and contingency reserve
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395ww
Payments to hospitals for inpatient hospital services
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395w–101
Eligibility, enrollment, and information
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 1— part d eligible individuals and prescription drug benefits
§ 1395w–102
Prescription drug benefits
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 1— part d eligible individuals and prescription drug benefits
§ 1395w–103
Access to a choice of qualified prescription drug coverage
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 1— part d eligible individuals and prescription drug benefits
§ 1395w–104
Beneficiary protections for qualified prescription drug coverage
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 1— part d eligible individuals and prescription drug benefits
§ 1395w–111
PDP regions; submission of bids; plan approval
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–112
Requirements for and contracts with prescription drug plan (PDP) sponsors
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–113
Premiums; late enrollment penalty
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–114
Premium and cost-sharing subsidies for low-income individuals
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–114a
Medicare coverage gap discount program
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–114b
Manufacturer rebate for certain drugs with prices increasing faster than inflation
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–114c
Manufacturer discount program
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–114d
Selected drug subsidy program
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–115
Subsidies for part D eligible individuals for qualified prescription drug coverage
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–116
Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 2— prescription drug plans; pdp sponsors; financing
§ 1395w–131
Application to Medicare Advantage program and related managed care programs
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 3— application to medicare advantage program and treatment of employer-sponsored programs and other prescription drug plans
§ 1395w–132
Special rules for employer-sponsored programs
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 3— application to medicare advantage program and treatment of employer-sponsored programs and other prescription drug plans
§ 1395w–133
State Pharmaceutical Assistance Programs
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 3— application to medicare advantage program and treatment of employer-sponsored programs and other prescription drug plans
§ 1395w–134
Coordination requirements for plans providing prescription drug coverage
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 3— application to medicare advantage program and treatment of employer-sponsored programs and other prescription drug plans
§ 1395w–141
Medicare prescription drug discount card and transitional assistance program
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 4— medicare prescription drug discount card and transitional assistance program
§ 1395w–151
Definitions; treatment of references to provisions in part C
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 5— definitions and miscellaneous provisions
§ 1395w–152
Miscellaneous provisions
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 5— definitions and miscellaneous provisions
§ 1395w–153
Condition for coverage of drugs under this part
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 5— definitions and miscellaneous provisions
§ 1395w–154
Improved Medicare prescription drug plan and MA–PD plan complaint system
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part D— Voluntary Prescription Drug Benefit Program › Subpart 5— definitions and miscellaneous provisions
§ 1395w–2
Intermediate sanctions for providers or suppliers of clinical diagnostic laboratory tests
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395w–21
Eligibility, election, and enrollment
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–22
Benefits and beneficiary protections
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–23
Payments to Medicare+Choice organizations
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–24
Premiums and bid amounts
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–25
Organizational and financial requirements for Medicare+Choice organizations; provider-sponsored organizations
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–26
Establishment of standards
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–27
Contracts with Medicare+Choice organizations
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–27a
Special rules for MA regional plans
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–28
Definitions; miscellaneous provisions
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part C— Medicare+Choice Program
§ 1395w–3
Competitive acquisition of certain items and services
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395w–3a
Use of average sales price payment methodology
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395w–3b
Competitive acquisition of outpatient drugs and biologicals
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395w–4
Payment for physicians’ services
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395w–5
Public reporting of performance information
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395w–6
Empowering beneficiary choices through continued access to information on physicians’ services
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part B— Supplementary Medical Insurance Benefits for Aged and Disabled
§ 1395x
Definitions
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395xx
Payment of provider-based physicians and payment under certain percentage arrangements
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395y
Exclusions from coverage and medicare as secondary payer
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395yy
Payment to skilled nursing facilities for routine service costs
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395z
Consultation with State agencies and other organizations to develop conditions of participation for providers of services
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1395zz
Provider education and technical assistance
Chapter 7— SOCIAL SECURITY › Subchapter XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part E— Miscellaneous Provisions
§ 1396
Medicaid and CHIP Payment and Access Commission
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396a
State plans for medical assistance
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396b
Payment to States
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396b–1
Payment adjustment for health care-acquired conditions
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396c
Operation of State plans
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396d
Definitions
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396e
Enrollment of individuals under group health plans
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396e–1
Premium assistance
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396f
Observance of religious beliefs
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396g
State programs for licensing of administrators of nursing homes
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396g–1
Required laws relating to medical child support
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396h
State false claims act requirements for increased State share of recoveries
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396i
Certification and approval of rural health clinics and intermediate care facilities for mentally retarded
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396j
Indian Health Service facilities
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396k
Assignment, enforcement, and collection of rights of payments for medical care; establishment of procedures pursuant to State plan; amounts retained by State
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396l
Hospital providers of nursing facility services
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396m
Withholding of Federal share of payments for certain medicare providers
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396n
Compliance with State plan and payment provisions
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396o
Use of enrollment fees, premiums, deductions, cost sharing, and similar charges
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396o–1
State option for alternative premiums and cost sharing
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396p
Liens, adjustments and recoveries, and transfers of assets
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396q
Application of provisions of subchapter II relating to subpoenas
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r
Requirements for nursing facilities
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–1
Presumptive eligibility for pregnant women
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–1a
Presumptive eligibility for children
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–1b
Presumptive eligibility for certain breast or cervical cancer patients
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–1c
Presumptive eligibility for family planning services
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–2
Information concerning sanctions taken by State licensing authorities against health care practitioners and providers
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–3
Correction and reduction plans for intermediate care facilities for mentally retarded
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–4
Adjustment in payment for inpatient hospital services furnished by disproportionate share hospitals
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–5
Treatment of income and resources for certain institutionalized spouses
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–6
Extension of eligibility for medical assistance
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396r–8
Payment for covered outpatient drugs
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396s
Program for distribution of pediatric vaccines
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396t
Home and community care for functionally disabled elderly individuals
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u
Community supported living arrangements services
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–1
Assuring coverage for certain low-income families
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–2
Provisions relating to managed care
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–3
State coverage of medicare cost-sharing for additional low-income medicare beneficiaries
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–4
Program of all-inclusive care for elderly (PACE)
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–5
Special provisions relating to medicare prescription drug benefit
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–6
Medicaid Integrity Program
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–7
State flexibility in benefit packages
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396u–8
Health opportunity accounts
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396v
References to laws directly affecting medicaid program
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396w
Asset verification through access to information held by financial institutions
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396w–1
Medicaid Improvement Fund
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396w–2
Authorization to receive relevant information
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396w–3
Enrollment simplification and coordination with State health insurance exchanges
Chapter 7— SOCIAL SECURITY › Subchapter XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS