---
kind: "section"
citation: "42 C.F.R. § 447.205"
title: "42"
number: "447.205"
heading: "Public notice of changes in Statewide methods and standards for setting payment rates."
url: "https://uscodex.org/cfr/42/447.205"
---

# §447.205. Public notice of changes in Statewide methods and standards for setting payment rates.

- (a) **When notice is required.** Except as specified in [paragraph (b)](#b) of this section, the agency must provide public notice of any significant proposed change in its methods and standards for setting payment rates for services.
- (b) **When notice is not required.** Notice is not required if—
  - (1) The change is being made to conform to Medicare methods or levels of reimbursement;
  - (2) The change is required by court order; or
  - (3) The change is based on changes in wholesalers' or manufacturers' prices of drugs or materials, if the agency's reimbursement system is based on material cost plus a professional fee.
- (c) **Content of notice.** The notice must—
  - (1) Describe the proposed change in methods and standards;
  - (2) Give an estimate of any expected increase or decrease in annual aggregate expenditures;
  - (3) Explain why the agency is changing its methods and standards;
  - (4) Identify a local agency in each county (such as the social services agency or health department) where copies of the proposed changes are available for public review;
  - (5) Give an address where written comments may be sent and reviewed by the public; and
  - (6) If there are public hearings, give the location, date and time for hearings or tell how this information may be obtained.
- (d) **Publication of notice.** The notice must—
  - (1) Be published before the proposed effective date of the change; and
  - (2) **Appear as a public announcement in one of the following publications—**
    - (i) A State register similar to the Federal Register.
    - (ii) **The newspaper of widest circulation in each city with a population of 50,000 or more.**
    - (iii) The newspaper of widest circulation in the State, if there is no city with a population of 50,000 or more.
    - (iv) A Web site developed and maintained by the single State agency or other responsible State agency that is accessible to the general public, provided that the Web site:
      - (A) Is clearly titled and can be easily reached from a hyperlink included on Web sites that provide general information to beneficiaries and providers, and included on the State-specific page on the Federal Medicaid Web site.
      - (B) Is updated for bulletins on a regular and known basis (for example, the first day of each month), and the public notice is issued as part of the regular update;
      - (C) Includes the actual date it was released to the public on the Web site; or
      - (D) Complies with national standards to ensure access to individuals with disabilities; and
      - (E) Includes protections to ensure that the content of the issued notice is not modified after the initial publication and is maintained on the Web site for no less than a 3-year period.

## Notes

### Amendments

[46 FR 58680, Dec. 3, 1981; 47 FR 8567, Mar. 1, 1982, as amended at 48 FR 56057, Dec. 19, 1983; 80 FR 67612, Nov. 2, 2015]

### Authority

Authority: 42 U.S.C. 1302, and 1396r-8, and Pub. L. 111-148.

### Source

Source: 43 FR 45253, Sept. 29, 1978, unless otherwise noted.

### Amendments

[46 FR 58680, Dec. 3, 1981; 47 FR 8567, Mar. 1, 1982, as amended at 48 FR 56057, Dec. 19, 1983; 80 FR 67612, Nov. 2, 2015]