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Electronic Code of Federal Regulations

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e-CFR Data is current as of July 30, 2014

TITLE 42—Public Health

CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)

SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS

PART 433—STATE FISCAL ADMINISTRATION

rule
§433.1
Purpose.

Subpart A—FEDERAL MATCHING AND GENERAL ADMINISTRATION PROVISIONS

§433.8
[Reserved]
§433.10
Rates of FFP for program services.
§433.11
Enhanced FMAP rate for children.
§433.15
Rates of FFP for administration.
§433.32
Fiscal policies and accountability.
§433.34
Cost allocation.
§433.35
Equipment—Federal financial participation.
§433.36
Liens and recoveries.
§433.37
Reporting provider payments to Internal Revenue Service.
§433.38
Interest charge on disallowed claims for FFP.
§433.40
Treatment of uncashed or cancelled (voided) Medicaid checks.
rule

Subpart B—GENERAL ADMINISTRATIVE REQUIREMENTS STATE FINANCIAL PARTICIPATION

§433.50
Basis, scope, and applicability.
§433.51
Public Funds as the State share of financial participation.
§433.52
General definitions.
§433.53
State plan requirements.
§433.54
Bona fide donations.
§433.55
Health care-related taxes defined.
§433.56
Classes of health care services and providers defined.
§433.57
General rules regarding revenues from provider-related donations and health care-related taxes.
§§433.58-433.60
[Reserved]
§433.66
Permissible provider-related donations.
§433.67
Limitations on level of FFP for permissible provider-related donations.
§433.68
Permissible health care-related taxes.
§433.70
Limitation on level of FFP for revenues from health care-related taxes.
§433.72
Waiver provisions applicable to health care-related taxes.
§433.74
Reporting requirements.
rule

Subpart C—MECHANIZED CLAIMS PROCESSING AND INFORMATION RETRIEVAL SYSTEMS

§433.110
Basis, purpose, and applicability.
§433.111
Definitions.
§433.112
FFP for design, development, installation or enhancement of mechanized claims processing and information retrieval systems.
§433.114
Procedures for obtaining initial approval; notice of decision.
§433.116
FFP for operation of mechanized claims processing and information retrieval systems.
§433.117
Initial approval of replacement systems.
§433.119
Conditions for reapproval; notice of decision.
§433.120
Procedures for reduction of FFP after reapproval review.
§433.121
Reconsideration of the decision to reduce FFP after reapproval review.
§433.122
Reapproval of a disapproved system.
§433.123
Notification of changes in system requirements, performance standards or other conditions for approval or reapproval.
§433.127
Termination of FFP for failure to provide access to claims processing and information retrieval systems.
§433.131
Waiver for noncompliance with conditions of approval and reapproval.
rule

Subpart D—THIRD PARTY LIABILITY

§433.135
Basis and purpose.
§433.136
Definitions.
§433.137
State plan requirements.
§433.138
Identifying liable third parties.
§433.139
Payment of claims.
§433.140
FFP and repayment of Federal share.

Assignment of Rights to Benefits

§433.145
Assignment of rights to benefits—State plan requirements.
§433.146
Rights assigned; assignment method.
§433.147
Cooperation in establishing paternity and in obtaining medical support and payments and in identifying and providing information to assist in pursuing third parties who may be liable to pay.
§433.148
Denial or termination of eligibility.

Cooperative Agreements and Incentive Payments

§433.151
Cooperative agreements and incentive payments—State plan requirements.
§433.152
Requirements for cooperative agreements for third party collections.
§433.153
Incentive payments to States and political subdivisions.
§433.154
Distribution of collections.
rule

Subpart E—METHODOLOGIES FOR DETERMINING FEDERAL SHARE OF MEDICAID EXPENDITURES FOR ADULT ELIGIBILITY GROUP

§433.202
Scope.
§433.204
Definitions.
§433.206
Threshold methodology.
rule

Subpart F—REFUNDING OF FEDERAL SHARE OF MEDICAID OVERPAYMENTS TO PROVIDERS

§433.300
Basis.
§433.302
Scope of subpart.
§433.304
Definitions.
§433.310
Applicability of requirements.
§433.312
Basic requirements for refunds.
§433.316
When discovery of overpayment occurs and its significance.
§433.318
Overpayments involving providers who are bankrupt or out of business.
§433.320
Procedures for refunds to CMS.
§433.322
Maintenance of Records.


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