Code of Federal Regulations (Last Updated: November 8, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter C - Medical Assistance Programs |
Part 435 - Eligibility in the States, District of Columbia, the Northern Mariana Islands, and American Samoa |
Subpart F - Categorical Requirements for Eligibility |
Blindness |
§ 435.531 - Determinations of blindness.
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§ 435.531 Determinations of blindness.
(a) Except as specified in paragraph (b) of this section, in determining blindness -
(1) A physician skilled in the diseases of the eye or an optometrist, whichever the individual selects, must examine him, unless both of the applicant's eyes are missing;
(2) The examiner must submit a report of examination to the Medicaid agency; and
(3) A physician skilled in the diseases of the eye (for example, an ophthalmologist or an eye, ear, nose, and throat specialist) must review the report and determine on behalf of the agency -
(i) Whether the individual meets the definition of blindness; and
(ii) Whether and when re-examinations are necessary for periodic redeterminations of eligibility, as required under § 435.916 of this part.
(b) If an agency provides Medicaid to individuals receiving SSI on the basis of blindness, this section does not apply for those individuals.
[43 FR 45204, Sept. 29, 1978, as amended at 44 FR 17937, Mar. 23, 1979]