---
kind: "section"
citation: "42 C.F.R. § 430.5"
title: "42"
number: "430.5"
heading: "Definitions."
url: "https://uscodex.org/cfr/42/430.5"
---

# §430.5. Definitions.


As used in this subchapter, unless the context indicates otherwise—

Contractor means any entity that contracts with the State agency, under the State plan, in return for a payment, to process claims, to provide or pay for medical services, or to enhance the State agency's capability for effective administration of the program.

Federal redetermination requirements means, for the purposes of [§ 430.49](/cfr/42/430.49.md), Federal requirements applicable to eligibility redeterminations outlined in [42 CFR 435.916](/cfr/42/435.916.md), including renewal strategies authorized under section 1902(e)(14)(A) of the Social Security Act or other alternative processes and procedures approved by CMS under section 1902(e)(14)(A) of the Act or [section 6008(f)(2)(A)](/cfr/42/6008.md?p=f-2-A) of the Families First Coronavirus Response Act.

Procedural disenrollment means, for the purposes of [§ 430.49](/cfr/42/430.49.md) and [45 CFR part 16](/cfr/45/part16.md), a termination of a beneficiary's Medicaid eligibility after advance notice under [subpart E of part 431](/cfr/42/part431-subpartE.md) for reasons that are unrelated to a State's determination of whether the individual meets eligibility criteria to qualify for coverage, including for failure to return a renewal form or documentation needed by the State to make a determination of eligibility.

Representative has the meaning given the term by each State consistent with its laws, regulations, and policies.


## Notes

### Amendments

[67 FR 41094, June 14, 2002, as amended at 88 FR 84733, Dec. 6, 2023]

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 53 FR 36571, Sept. 21, 1988, unless otherwise noted.

### Amendments

[67 FR 41094, June 14, 2002, as amended at 88 FR 84733, Dec. 6, 2023]