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92 quarterly current and accurate information on enrolled dental providers in the State to the Health Resources and Services Administration for posting on the Insure Kids Now! Website. Please update Sections 6.2-DC and 9.10 when electing this option.
Section 11. Program Integrity (Section 2101(a))
Check here if the State elects to use funds provided under Title XXI only to provide expanded eligibility under the State’s Medicaid plan, and continue to Section 12.
11.1.
The State assures that services are provided in an effective and efficient manner through free and open competition or through basing rates on other public and private rates that are actuarially sound. (Section 2101(a)) (42CFR 457.940(b))
11.2. The State assures, to the extent they apply, that the following provisions of the Social Security Act will apply under Title XXI, to the same extent they apply to a State under Title XIX: (Section 2107(e)) (42CFR 457.935(b)) (The items below were moved from section 9.8. Previously 9.8.6. - 9.8.9.)
11.2.1.
42 CFR Part 455 Subpart B (relating to disclosure of information by providers and fiscal agents) 11.2.2.
Section 1124 (relating to disclosure of ownership and related information) 11.2.3.
Section 1126 (relating to disclosure of information about certain convicted individuals) 11.2.4.
Section 1128A (relating to civil monetary penalties) 11.2.5.
Section 1128B (relating to criminal penalties for certain additional charges) 11.2.6.
Section 1128E (relating to the National health care fraud and abuse data collection program)
Section 12. Applicant and Enrollee Protections (Sections 2101(a))
Check here if the State elects to use funds provided under Title XXI only to provide expanded eligibility under the State’s Medicaid plan.
12.1. Eligibility and Enrollment Matters- Describe the review process for eligibility and enrollment matters that complies with 42 CFR 457.1120. Describe any special processes and procedures that are unique to the applicant’s rights when the State is using the Express Lane option when determining eligibility.
CA RESPONSE:
Described below is a description of California’s review process for eligibility and enrollment matters that complies with 42 CFR 457.1120. These processes reflect those in