42 CFR § 435.553

42 CFR · Public Health

§ 435.553 — Mandatory exceptions for certain applicable individuals.

eCFR · current through Aug 5, 2026

§ 435.553 Mandatory exceptions for certain applicable individuals. A State must deem an applicable individual to have demonstrated community engagement under § 435.552 for a month if—

(a)For part or all of that month, the individual was:

(1)Under the age of 19 years;

(2)Entitled to or enrolled for Medicare benefits under part A or enrolled for benefits under part B of title XVIII of the Act;

(3)Described in any mandatory coverage groups in subclauses (I) through (VII) of section 1902(a)(10)(A)(i) of the Act under the Medicaid State plan; or,

(4)A specified excluded individual as defined at § 435.554.

(b)At any point during the 3-month period ending on the first day of that month, the individual was an inmate of a public institution.

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§ 435.553 Mandatory exceptions for certain applicable individuals.

A State must deem an applicable individual to have demonstrated community engagement under § 435.552 for a month if—

(a) For part or all of that month, the individual was:

(1) Under the age of 19 years;

(2) Entitled to or enrolled for Medicare benefits under part A or enrolled for benefits under part B of title XVIII of the Act;

(3) Described in any mandatory coverage groups in subclauses (I) through (VII) of section 1902(a)(10)(A)(i) of the Act under the Medicaid State plan; or,

(4) A specified excluded individual as defined at § 435.554.

(b) At any point during the 3-month period ending on the first day of that month, the individual was an inmate of a public institution.

42 C.F.R. § 435.553 (Mandatory exceptions for certain applicable individuals.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.