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Facilities designated under an approved plan will be eligible for certification by the HCFA Regional Office as CAHs , in accordance with the regulations in 42 CFR Part 485 , Subpart F. Act to require the Secretary to publish the proposed and final rules that contain her proposed and final recommendations on the annual update factor applicable to the hospital payment rates by the April 1 and August 1 prior to the start of the fiscal year to which the rates apply beginning with the FY 1999 rates . 290dd-2 , and its implementing regulation , 42 CFR Part 2 , establish confidentiality requirements for patient records that are maintained in connection with the performance of any federally-assisted specialized alcohol or drug abuse program . Although the sevefral versions of the Amendment ( and the implementing regulations at 42 CFR Part 441 ) in effect during the disallowance period varied with respect to the types of abortions which could be funded , the State did not raise those differences as an issue in this case . Section 1905 ( a ) of the Act and Agency regulations at 42 CFR Part 440 describe care and services which must or may be covered in a state 's Medicaid plan . Additionally , Pennsylvania generally asserted that the Board is not bound by theimplementing regulations at 42 CFR Part 456 and could exercise itsdiscretion to detrmine that Pennsylvania had met the technical failingsexception . This special arbitration process will in no way affect the rights of the recipient to appeal an adverse action in accordance with PHS regulations of 42 CFR Part 50 , Subpart D , and DHHS regulations of 45 CFR Part 16 . This duty is implicit in the concept of a principal investigator , and is expressed in the regulations at 42 CFR Part 52 , in the Public Health Service ( PHS ) Grants Policy Statement applicable to NIH grants , and is also incorporated in the grant by the statement which a principal investigator signs on the grant application agreeing to accept this responsibility . These documents are established pursuant to pertinent sections of the Social Security and Public Health Service Acts and regulations at 42 CFR Part 493 .