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On August 14, 2014, the Federal Centers for Medicare & Medicaid Services (CMS) published this CFR 431.54 outlining Medicaid Lock-In Program Rules for states. The rules in 42 CFR 431.54 state outline exceptions to certain state requirements including:

  • statutory basis,
  • additional services under a prepayment system,
  • special procedures for purchase of medical devices and laboratory and x-ray tests,
  • lock-in of recipients who over-utilize Medicaid services, and
  • targed case management services.
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