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us/regulation/42/435/301 — General rules · Axiom

General rules

10 rules1 of 3 subsections

Official source

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Encodings · 10

postpregnancy_extended_period_days42 CFR § 435.301 (b) · parameter

42 CFR 435.301(b)(1)(iii)

name: postpregnancy_extended_period_days
kind: parameter
dtype: Count
source: 42 CFR 435.301(b)(1)(iii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/301
          excerpt: a 60-day period, beginning on the last day of pregnancy
versions:
  - effective_from: '2014-01-01'
    formula: '60'

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mandatory_child_maximum_age_exclusive42 CFR § 435.301 (b) · parameter

42 CFR 435.301(b)(1)(ii)

name: mandatory_child_maximum_age_exclusive
kind: parameter
dtype: Count
source: 42 CFR 435.301(b)(1)(ii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/301
          excerpt: under 18 years of age
versions:
  - effective_from: '2014-01-01'
    formula: '18'

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optional_young_person_maximum_age_exclusive42 CFR § 435.301 (b) · parameter

42 CFR 435.301(b)(2)(i)

name: optional_young_person_maximum_age_exclusive
kind: parameter
dtype: Count
source: 42 CFR 435.301(b)(2)(i)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/301
          excerpt: Individuals under age 21
versions:
  - effective_from: '2014-01-01'
    formula: '21'

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medically_needy_financial_requirements_met42 CFR § 435.301 (a) · derived

42 CFR 435.301(a)

name: medically_needy_financial_requirements_met
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(a)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: >-
      (income_meets_applicable_medically_needy_standard or
      incurred_medical_expenses_at_least_equal_to_income_standard_difference)

      and resources_meet_applicable_medically_needy_standard

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mandatory_medically_needy_group_member42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)

name: mandatory_medically_needy_group_member
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: predicate
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: >-
      (person_is_pregnant and
      person_except_for_income_and_resources_would_be_mandatory_or_optional_categorically_needy_under_subpart_b_or_c)

      or (person_age < mandatory_child_maximum_age_exclusive and
      person_except_for_income_and_resources_would_be_mandatory_categorically_needy_under_subpart_b)

      or (woman_received_medically_needy_medicaid_on_day_pregnancy_ends and
      month_is_within_extended_postpregnancy_period)

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mandatory_medically_needy_medicaid_required42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(1)

name: mandatory_medically_needy_medicaid_required
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_chooses_medically_needy_option
      and medically_needy_financial_requirements_met
      and mandatory_medically_needy_group_member

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postpregnancy_pregnancy_related_services_required42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(1)(iii)

name: postpregnancy_pregnancy_related_services_required
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(1)(iii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_chooses_medically_needy_option
      and medically_needy_financial_requirements_met
      and woman_received_medically_needy_medicaid_on_day_pregnancy_ends
      and month_is_within_extended_postpregnancy_period

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optional_medically_needy_group_member42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(2)

name: optional_medically_needy_group_member
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: predicate
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      (person_age < optional_young_person_maximum_age_exclusive)
      or person_is_parent_or_other_caretaker_relative
      or person_is_aged
      or person_is_blind
      or person_is_disabled

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optional_medically_needy_medicaid_may_be_provided42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(2)

name: optional_medically_needy_medicaid_may_be_provided
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_chooses_medically_needy_option
      and medically_needy_financial_requirements_met
      and optional_medically_needy_group_member

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selected_optional_group_all_eligible_members_must_be_covered42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(3)

name: selected_optional_group_all_eligible_members_must_be_covered
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(3)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_provides_medicaid_to_any_individual_in_persons_optional_group
      and medically_needy_financial_requirements_met
      and optional_medically_needy_group_member

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▸rulespec code

Shown source

regulations/42-cfr/435/301.yaml

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Rules

postpregnancy_extended_period_days

Parameter(b) in text ↖

source: 42 CFR 435.301(b)(1)(iii)

- name: postpregnancy_extended_period_days
  kind: parameter
  dtype: Count
  source: 42 CFR 435.301(b)(1)(iii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/301
            excerpt: a 60-day period, beginning on the last day of pregnancy
  versions:
    - effective_from: '2014-01-01'
      formula: '60'

mandatory_child_maximum_age_exclusive

Parameter(b) in text ↖

source: 42 CFR 435.301(b)(1)(ii)

- name: mandatory_child_maximum_age_exclusive
  kind: parameter
  dtype: Count
  source: 42 CFR 435.301(b)(1)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/301
            excerpt: under 18 years of age
  versions:
    - effective_from: '2014-01-01'
      formula: '18'

optional_young_person_maximum_age_exclusive

Parameter(b) in text ↖

source: 42 CFR 435.301(b)(2)(i)

- name: optional_young_person_maximum_age_exclusive
  kind: parameter
  dtype: Count
  source: 42 CFR 435.301(b)(2)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/301
            excerpt: Individuals under age 21
  versions:
    - effective_from: '2014-01-01'
      formula: '21'

medically_needy_financial_requirements_met

Derived(a) in text ↖

source: 42 CFR 435.301(a)

- name: medically_needy_financial_requirements_met
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(a)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        (income_meets_applicable_medically_needy_standard or
        incurred_medical_expenses_at_least_equal_to_income_standard_difference)

        and resources_meet_applicable_medically_needy_standard

mandatory_medically_needy_group_member

Derived(b) in text ↖

source: 42 CFR 435.301(b)

- name: mandatory_medically_needy_group_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        (person_is_pregnant and
        person_except_for_income_and_resources_would_be_mandatory_or_optional_categorically_needy_under_subpart_b_or_c)

        or (person_age < mandatory_child_maximum_age_exclusive and
        person_except_for_income_and_resources_would_be_mandatory_categorically_needy_under_subpart_b)

        or (woman_received_medically_needy_medicaid_on_day_pregnancy_ends and
        month_is_within_extended_postpregnancy_period)

mandatory_medically_needy_medicaid_required

Derived(b) in text ↖

source: 42 CFR 435.301(b)(1)

- name: mandatory_medically_needy_medicaid_required
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_chooses_medically_needy_option
        and medically_needy_financial_requirements_met
        and mandatory_medically_needy_group_member

postpregnancy_pregnancy_related_services_required

Derived(b) in text ↖

source: 42 CFR 435.301(b)(1)(iii)

- name: postpregnancy_pregnancy_related_services_required
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(1)(iii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_chooses_medically_needy_option
        and medically_needy_financial_requirements_met
        and woman_received_medically_needy_medicaid_on_day_pregnancy_ends
        and month_is_within_extended_postpregnancy_period

optional_medically_needy_group_member

Derived(b) in text ↖

source: 42 CFR 435.301(b)(2)

- name: optional_medically_needy_group_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        (person_age < optional_young_person_maximum_age_exclusive)
        or person_is_parent_or_other_caretaker_relative
        or person_is_aged
        or person_is_blind
        or person_is_disabled

optional_medically_needy_medicaid_may_be_provided

Derived(b) in text ↖

source: 42 CFR 435.301(b)(2)

- name: optional_medically_needy_medicaid_may_be_provided
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_chooses_medically_needy_option
        and medically_needy_financial_requirements_met
        and optional_medically_needy_group_member

selected_optional_group_all_eligible_members_must_be_covered

Derived(b) in text ↖

source: 42 CFR 435.301(b)(3)

- name: selected_optional_group_all_eligible_members_must_be_covered
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_provides_medicaid_to_any_individual_in_persons_optional_group
        and medically_needy_financial_requirements_met
        and optional_medically_needy_group_member

▸citations (8)

References

This rule cites 8 other rules.

42 CFR § 435.811inferredUS Federal › Regulations › Title 42 › § 435 › (811)
42 CFR § 435.840inferredUS Federal › Regulations › Title 42 › § 435 › (840)
42 CFR § 440.210 (c)(1)inferredUS Federal › Regulations › Title 42 › § 440 › (210)(c)(1)
42 CFR § 435.308inferredUS Federal › Regulations › Title 42 › § 435 › (308)
42 CFR § 435.310inferredUS Federal › Regulations › Title 42 › § 435 › (310)
42 CFR § 435.320inferredUS Federal › Regulations › Title 42 › § 435 › (320)
42 CFR § 435.322inferredUS Federal › Regulations › Title 42 › § 435 › (322)
42 CFR § 435.324inferredUS Federal › Regulations › Title 42 › § 435 › (324)

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General rules

10 rules1 of 3 subsections

Official source

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Whole section

Encodings · 10

postpregnancy_extended_period_days42 CFR § 435.301 (b) · parameter

42 CFR 435.301(b)(1)(iii)

name: postpregnancy_extended_period_days
kind: parameter
dtype: Count
source: 42 CFR 435.301(b)(1)(iii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/301
          excerpt: a 60-day period, beginning on the last day of pregnancy
versions:
  - effective_from: '2014-01-01'
    formula: '60'

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mandatory_child_maximum_age_exclusive42 CFR § 435.301 (b) · parameter

42 CFR 435.301(b)(1)(ii)

name: mandatory_child_maximum_age_exclusive
kind: parameter
dtype: Count
source: 42 CFR 435.301(b)(1)(ii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/301
          excerpt: under 18 years of age
versions:
  - effective_from: '2014-01-01'
    formula: '18'

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optional_young_person_maximum_age_exclusive42 CFR § 435.301 (b) · parameter

42 CFR 435.301(b)(2)(i)

name: optional_young_person_maximum_age_exclusive
kind: parameter
dtype: Count
source: 42 CFR 435.301(b)(2)(i)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/301
          excerpt: Individuals under age 21
versions:
  - effective_from: '2014-01-01'
    formula: '21'

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medically_needy_financial_requirements_met42 CFR § 435.301 (a) · derived

42 CFR 435.301(a)

name: medically_needy_financial_requirements_met
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(a)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: >-
      (income_meets_applicable_medically_needy_standard or
      incurred_medical_expenses_at_least_equal_to_income_standard_difference)

      and resources_meet_applicable_medically_needy_standard

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mandatory_medically_needy_group_member42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)

name: mandatory_medically_needy_group_member
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: predicate
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: >-
      (person_is_pregnant and
      person_except_for_income_and_resources_would_be_mandatory_or_optional_categorically_needy_under_subpart_b_or_c)

      or (person_age < mandatory_child_maximum_age_exclusive and
      person_except_for_income_and_resources_would_be_mandatory_categorically_needy_under_subpart_b)

      or (woman_received_medically_needy_medicaid_on_day_pregnancy_ends and
      month_is_within_extended_postpregnancy_period)

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mandatory_medically_needy_medicaid_required42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(1)

name: mandatory_medically_needy_medicaid_required
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_chooses_medically_needy_option
      and medically_needy_financial_requirements_met
      and mandatory_medically_needy_group_member

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postpregnancy_pregnancy_related_services_required42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(1)(iii)

name: postpregnancy_pregnancy_related_services_required
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(1)(iii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_chooses_medically_needy_option
      and medically_needy_financial_requirements_met
      and woman_received_medically_needy_medicaid_on_day_pregnancy_ends
      and month_is_within_extended_postpregnancy_period

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optional_medically_needy_group_member42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(2)

name: optional_medically_needy_group_member
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: predicate
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      (person_age < optional_young_person_maximum_age_exclusive)
      or person_is_parent_or_other_caretaker_relative
      or person_is_aged
      or person_is_blind
      or person_is_disabled

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optional_medically_needy_medicaid_may_be_provided42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(2)

name: optional_medically_needy_medicaid_may_be_provided
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_chooses_medically_needy_option
      and medically_needy_financial_requirements_met
      and optional_medically_needy_group_member

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selected_optional_group_all_eligible_members_must_be_covered42 CFR § 435.301 (b) · derived

42 CFR 435.301(b)(3)

name: selected_optional_group_all_eligible_members_must_be_covered
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.301(b)(3)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/301
versions:
  - effective_from: '2014-01-01'
    formula: |-
      agency_provides_medicaid_to_any_individual_in_persons_optional_group
      and medically_needy_financial_requirements_met
      and optional_medically_needy_group_member

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▸rulespec code

Shown source

regulations/42-cfr/435/301.yaml

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View on GitHub

Rules

postpregnancy_extended_period_days

Parameter(b) in text ↖

source: 42 CFR 435.301(b)(1)(iii)

- name: postpregnancy_extended_period_days
  kind: parameter
  dtype: Count
  source: 42 CFR 435.301(b)(1)(iii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/301
            excerpt: a 60-day period, beginning on the last day of pregnancy
  versions:
    - effective_from: '2014-01-01'
      formula: '60'

mandatory_child_maximum_age_exclusive

Parameter(b) in text ↖

source: 42 CFR 435.301(b)(1)(ii)

- name: mandatory_child_maximum_age_exclusive
  kind: parameter
  dtype: Count
  source: 42 CFR 435.301(b)(1)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/301
            excerpt: under 18 years of age
  versions:
    - effective_from: '2014-01-01'
      formula: '18'

optional_young_person_maximum_age_exclusive

Parameter(b) in text ↖

source: 42 CFR 435.301(b)(2)(i)

- name: optional_young_person_maximum_age_exclusive
  kind: parameter
  dtype: Count
  source: 42 CFR 435.301(b)(2)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/301
            excerpt: Individuals under age 21
  versions:
    - effective_from: '2014-01-01'
      formula: '21'

medically_needy_financial_requirements_met

Derived(a) in text ↖

source: 42 CFR 435.301(a)

- name: medically_needy_financial_requirements_met
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(a)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        (income_meets_applicable_medically_needy_standard or
        incurred_medical_expenses_at_least_equal_to_income_standard_difference)

        and resources_meet_applicable_medically_needy_standard

mandatory_medically_needy_group_member

Derived(b) in text ↖

source: 42 CFR 435.301(b)

- name: mandatory_medically_needy_group_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        (person_is_pregnant and
        person_except_for_income_and_resources_would_be_mandatory_or_optional_categorically_needy_under_subpart_b_or_c)

        or (person_age < mandatory_child_maximum_age_exclusive and
        person_except_for_income_and_resources_would_be_mandatory_categorically_needy_under_subpart_b)

        or (woman_received_medically_needy_medicaid_on_day_pregnancy_ends and
        month_is_within_extended_postpregnancy_period)

mandatory_medically_needy_medicaid_required

Derived(b) in text ↖

source: 42 CFR 435.301(b)(1)

- name: mandatory_medically_needy_medicaid_required
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_chooses_medically_needy_option
        and medically_needy_financial_requirements_met
        and mandatory_medically_needy_group_member

postpregnancy_pregnancy_related_services_required

Derived(b) in text ↖

source: 42 CFR 435.301(b)(1)(iii)

- name: postpregnancy_pregnancy_related_services_required
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(1)(iii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_chooses_medically_needy_option
        and medically_needy_financial_requirements_met
        and woman_received_medically_needy_medicaid_on_day_pregnancy_ends
        and month_is_within_extended_postpregnancy_period

optional_medically_needy_group_member

Derived(b) in text ↖

source: 42 CFR 435.301(b)(2)

- name: optional_medically_needy_group_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        (person_age < optional_young_person_maximum_age_exclusive)
        or person_is_parent_or_other_caretaker_relative
        or person_is_aged
        or person_is_blind
        or person_is_disabled

optional_medically_needy_medicaid_may_be_provided

Derived(b) in text ↖

source: 42 CFR 435.301(b)(2)

- name: optional_medically_needy_medicaid_may_be_provided
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_chooses_medically_needy_option
        and medically_needy_financial_requirements_met
        and optional_medically_needy_group_member

selected_optional_group_all_eligible_members_must_be_covered

Derived(b) in text ↖

source: 42 CFR 435.301(b)(3)

- name: selected_optional_group_all_eligible_members_must_be_covered
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.301(b)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/301
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        agency_provides_medicaid_to_any_individual_in_persons_optional_group
        and medically_needy_financial_requirements_met
        and optional_medically_needy_group_member

▸citations (8)

References

This rule cites 8 other rules.

42 CFR § 435.811inferredUS Federal › Regulations › Title 42 › § 435 › (811)
42 CFR § 435.840inferredUS Federal › Regulations › Title 42 › § 435 › (840)
42 CFR § 440.210 (c)(1)inferredUS Federal › Regulations › Title 42 › § 440 › (210)(c)(1)
42 CFR § 435.308inferredUS Federal › Regulations › Title 42 › § 435 › (308)
42 CFR § 435.310inferredUS Federal › Regulations › Title 42 › § 435 › (310)
42 CFR § 435.320inferredUS Federal › Regulations › Title 42 › § 435 › (320)
42 CFR § 435.322inferredUS Federal › Regulations › Title 42 › § 435 › (322)
42 CFR § 435.324inferredUS Federal › Regulations › Title 42 › § 435 › (324)

(a)An agency may provide Medicaid to individuals specified…∀ 1#

(a) An agency may provide Medicaid to individuals specified in this subpart who:

(1) Either:

(i)Have income that meets the applicable standards in §§…#

(i) Have income that meets the applicable standards in §§ 435.811 and 435.814; or

(ii)If their income is more than allowed under the…#

(ii) If their income is more than allowed under the standard, have incurred medical expenses at least equal to the difference between their income and the applicable income standard; and

(2) Have resources that meet the applicable standards in §§ 435.840 and 435.843.

(b) If the agency chooses this option, the following provisions apply:

(1) The agency must provide Medicaid to the following individuals who meet the requirements of paragraph (a) of this section:

(i) All pregnant women during the course of their pregnancy who, except for income and resources, would be eligible for Medicaid as mandatory or optional categorically needy under subparts B or C of this part;

(ii) All individuals under 18 years of age who, except for income and resources, would be eligible for Medicaid as mandatory categorically needy under subpart B of this part;

(iii) Women who, while pregnant, applied for, were eligible for, and received Medicaid services as medically needy on the day that their pregnancy ends. The agency must provide medically needy eligibility to these women for an extended period following termination of pregnancy. This period extends from the last day of the pregnancy through the end of the month in which a 60-day period, beginning on the last day of pregnancy, ends. Eligibility must be provided, regardless of changes in the woman's financial circumstances that may occur within this extended period. These women are eligible for the extended period for all services under the plan that are pregnancy-related (as defined in § 440.210(c)(1) of this subchapter).

(2) The agency may provide Medicaid to any of the following groups of individuals;

(i) Individuals under age 21 (§ 435.308).

(ii) Parents and other caretaker relatives (§ 435.310).

(iii) Aged (§§ 435.320 and 435.330).

(iv) Blind (§§ 435.322, 435.330 and 435.340).

(v) Disabled (§§ 435.324, 435.330, and 435.340).

(3) If the agency provides Medicaid to any individual in a group specified in paragraph (b)(2) of this section, the agency must provide Medicaid to all individuals eligible to be members of that group.