---
kind: "section"
citation: "42 C.F.R. § 431.200"
title: "42"
number: "431.200"
heading: "Basis and scope."
url: "https://uscodex.org/cfr/42/431.200"
---

# §431.200. Basis and scope.


This subpart—

- (a) Implements section 1902(a)(3) of the Act, which requires that a State plan provide an opportunity for a fair hearing to any person whose claim for assistance is denied or not acted upon promptly;
- (b) Prescribes procedures for an opportunity for a hearing if the State agency or non-emergency transportation PAHP (as defined in [§ 438.9(a)](/cfr/42/438.9.md?p=a) of this chapter) takes action, as stated in this subpart, to suspend, terminate, or reduce services, or of an adverse benefit determination by an MCO, PIHP or PAHP under [subpart F of part 438](/cfr/42/part438-subpartF.md) of this chapter; and
- (c) Implements sections 1919(f)(3) and 1919(e)(7)(F) of the Act by providing an appeals process for any person who—
  - (1) Is subject to a proposed transfer or discharge from a nursing facility; or
  - (2) Is adversely affected by the pre-admission screening or the annual resident review that are required by [section 1919(e)(7)](/cfr/42/1919.md?p=e-7) of the Act.
- (d) Implements section 1943(b)(3) of the Act and section 1413 of the Affordable Care Act to permit coordinated hearings and appeals among insurance affordability programs.

## Notes

### Amendments

[67 FR 41094, June 14, 2002, as amended at 81 FR 27852, May 6, 2016; 81 FR 86448, Nov. 30, 2016]

### Source

Source: 44 FR 17932, Mar. 29, 1979, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45188, Sept. 29, 1978, unless otherwise noted.

### Amendments

[67 FR 41094, June 14, 2002, as amended at 81 FR 27852, May 6, 2016; 81 FR 86448, Nov. 30, 2016]