us/regulation/42/435/603/a

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2 rules0 of 3 subsections

(a) Basis, scope, and implementation.

(1)#

(1) This section implements section 1902(e)(14) of the Act.

(2) Effective January 1, 2014, the agency must apply the financial methodologies set forth in this section in determining the financial eligibility of all individuals for Medicaid, except for individuals identified in paragraph (j) of this section and as provided in paragraph (a)(3) of this section.

(3)#

(3) In the case of determining ongoing eligibility for beneficiaries determined eligible for Medicaid coverage to begin on or before December 31, 2013, application of the financial methodologies set forth in this section will not be applied until March 31, 2014 or the next regularly-scheduled renewal of eligibility for such individual under § 435.916 of this part, whichever is later.

in view

Whole section

Encodings · 2

legacy_beneficiary_methodology_transition_applies42 CFR § 435.603 (a) · derived

42 CFR 435.603(a)

name: legacy_beneficiary_methodology_transition_applies
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.603(a)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: >-
            beneficiaries determined eligible for Medicaid coverage to begin on
            or before December 31, 2013
      - path: versions[0].formula
        kind: effective_period
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: until March 31, 2014 or the next regularly-scheduled renewal
versions:
  - effective_from: '2014-01-01'
    formula: |-
      beneficiary_coverage_began_on_or_before_legacy_transition_cutoff
      and not methodology_transition_date_has_arrived

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magi_financial_methodologies_apply_for_medicaid_financial_eligibility42 CFR § 435.603 (a) · derived

42 CFR 435.603(a)

name: magi_financial_methodologies_apply_for_medicaid_financial_eligibility
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.603(a)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: predicate
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: >-
            the agency must apply the financial methodologies set forth in this
            section
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: except for individuals identified in paragraph (j)
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:regulations/42-cfr/435/603/j#magi_based_methods_do_not_apply_for_medicaid_eligibility
          output: magi_based_methods_do_not_apply_for_medicaid_eligibility
          hash: >-
            sha256:987414bc1d8fdf701b3090f8e82829aa6e4fb1e852dbc6cca0ccf80ce02b9d9c
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:regulations/42-cfr/435/603/a#legacy_beneficiary_methodology_transition_applies
          output: legacy_beneficiary_methodology_transition_applies
          hash: sha256:local
versions:
  - effective_from: '2014-01-01'
    formula: |-
      individual_financial_eligibility_for_medicaid_being_determined
      and not magi_based_methods_do_not_apply_for_medicaid_eligibility
      and not legacy_beneficiary_methodology_transition_applies

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▸rulespec code

Shown source

regulations/42-cfr/435/603/a.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

legacy_beneficiary_methodology_transition_applies

Derived

source: 42 CFR 435.603(a)

- name: legacy_beneficiary_methodology_transition_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(a)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: >-
              beneficiaries determined eligible for Medicaid coverage to begin on or before December
              31, 2013
        - path: versions[0].formula
          kind: effective_period
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: until March 31, 2014 or the next regularly-scheduled renewal
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        beneficiary_coverage_began_on_or_before_legacy_transition_cutoff
        and not methodology_transition_date_has_arrived

magi_financial_methodologies_apply_for_medicaid_financial_eligibility

Derived

source: 42 CFR 435.603(a)

- name: magi_financial_methodologies_apply_for_medicaid_financial_eligibility
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(a)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: the agency must apply the financial methodologies set forth in this section
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: except for individuals identified in paragraph (j)
        - path: versions[0].formula
          kind: import
          import:
            target: >-
              us:regulations/42-cfr/435/603/j#magi_based_methods_do_not_apply_for_medicaid_eligibility
            output: magi_based_methods_do_not_apply_for_medicaid_eligibility
            hash: sha256:987414bc1d8fdf701b3090f8e82829aa6e4fb1e852dbc6cca0ccf80ce02b9d9c
        - path: versions[0].formula
          kind: import
          import:
            target: us:regulations/42-cfr/435/603/a#legacy_beneficiary_methodology_transition_applies
            output: legacy_beneficiary_methodology_transition_applies
            hash: sha256:local
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        individual_financial_eligibility_for_medicaid_being_determined
        and not magi_based_methods_do_not_apply_for_medicaid_eligibility
        and not legacy_beneficiary_methodology_transition_applies

▸citations (1)

References

This rule cites 1 other rule.

42 CFR § 435.916inferredUS Federal › Regulations › Title 42 › § 435 › (916)

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us/regulation/42/435/603/a · Axiom

2 rules0 of 3 subsections

Official source

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(a) Basis, scope, and implementation.

Encodings · 2

legacy_beneficiary_methodology_transition_applies42 CFR § 435.603 (a) · derived

42 CFR 435.603(a)

name: legacy_beneficiary_methodology_transition_applies
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.603(a)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: >-
            beneficiaries determined eligible for Medicaid coverage to begin on
            or before December 31, 2013
      - path: versions[0].formula
        kind: effective_period
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: until March 31, 2014 or the next regularly-scheduled renewal
versions:
  - effective_from: '2014-01-01'
    formula: |-
      beneficiary_coverage_began_on_or_before_legacy_transition_cutoff
      and not methodology_transition_date_has_arrived

open in graph ↗

magi_financial_methodologies_apply_for_medicaid_financial_eligibility42 CFR § 435.603 (a) · derived

42 CFR 435.603(a)

name: magi_financial_methodologies_apply_for_medicaid_financial_eligibility
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.603(a)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: predicate
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: >-
            the agency must apply the financial methodologies set forth in this
            section
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/435/603/a
          excerpt: except for individuals identified in paragraph (j)
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:regulations/42-cfr/435/603/j#magi_based_methods_do_not_apply_for_medicaid_eligibility
          output: magi_based_methods_do_not_apply_for_medicaid_eligibility
          hash: >-
            sha256:987414bc1d8fdf701b3090f8e82829aa6e4fb1e852dbc6cca0ccf80ce02b9d9c
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:regulations/42-cfr/435/603/a#legacy_beneficiary_methodology_transition_applies
          output: legacy_beneficiary_methodology_transition_applies
          hash: sha256:local
versions:
  - effective_from: '2014-01-01'
    formula: |-
      individual_financial_eligibility_for_medicaid_being_determined
      and not magi_based_methods_do_not_apply_for_medicaid_eligibility
      and not legacy_beneficiary_methodology_transition_applies

open in graph ↗

▸rulespec code

Shown source

regulations/42-cfr/435/603/a.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

legacy_beneficiary_methodology_transition_applies

Derived

source: 42 CFR 435.603(a)

- name: legacy_beneficiary_methodology_transition_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(a)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: >-
              beneficiaries determined eligible for Medicaid coverage to begin on or before December
              31, 2013
        - path: versions[0].formula
          kind: effective_period
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: until March 31, 2014 or the next regularly-scheduled renewal
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        beneficiary_coverage_began_on_or_before_legacy_transition_cutoff
        and not methodology_transition_date_has_arrived

magi_financial_methodologies_apply_for_medicaid_financial_eligibility

Derived

source: 42 CFR 435.603(a)

- name: magi_financial_methodologies_apply_for_medicaid_financial_eligibility
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.603(a)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: predicate
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: the agency must apply the financial methodologies set forth in this section
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/435/603/a
            excerpt: except for individuals identified in paragraph (j)
        - path: versions[0].formula
          kind: import
          import:
            target: >-
              us:regulations/42-cfr/435/603/j#magi_based_methods_do_not_apply_for_medicaid_eligibility
            output: magi_based_methods_do_not_apply_for_medicaid_eligibility
            hash: sha256:987414bc1d8fdf701b3090f8e82829aa6e4fb1e852dbc6cca0ccf80ce02b9d9c
        - path: versions[0].formula
          kind: import
          import:
            target: us:regulations/42-cfr/435/603/a#legacy_beneficiary_methodology_transition_applies
            output: legacy_beneficiary_methodology_transition_applies
            hash: sha256:local
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        individual_financial_eligibility_for_medicaid_being_determined
        and not magi_based_methods_do_not_apply_for_medicaid_eligibility
        and not legacy_beneficiary_methodology_transition_applies

▸citations (1)

References

This rule cites 1 other rule.

42 CFR § 435.916inferredUS Federal › Regulations › Title 42 › § 435 › (916)

(1)#

(2)#

(3)#

legacy_beneficiary_methodology_transition_applies

magi_financial_methodologies_apply_for_medicaid_financial_eligibility

(1)#

(2)#

(3)#

legacy_beneficiary_methodology_transition_applies

magi_financial_methodologies_apply_for_medicaid_financial_eligibility