e-CFR data is current as of April 6, 2020
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
Subpart A—FEDERAL MATCHING AND GENERAL ADMINISTRATION PROVISIONS
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| Rates of FFP for program services. |
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| Enhanced FMAP rate for children. |
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| Rates of FFP for administration. |
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| Fiscal policies and accountability. |
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| Equipment—Federal financial participation. |
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| Reporting provider payments to Internal Revenue Service. |
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| Interest charge on disallowed claims for FFP. |
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| Treatment of uncashed or cancelled (voided) Medicaid checks. |
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Subpart B—GENERAL ADMINISTRATIVE REQUIREMENTS STATE FINANCIAL PARTICIPATION
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| Basis, scope, and applicability. |
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| Public Funds as the State share of financial participation. |
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| Health care-related taxes defined. |
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| Classes of health care services and providers defined. |
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| General rules regarding revenues from provider-related donations and health care-related taxes. |
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| Permissible provider-related donations. |
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| Limitations on level of FFP for permissible provider-related donations. |
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| Permissible health care-related taxes. |
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| Limitation on level of FFP for revenues from health care-related taxes. |
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| Waiver provisions applicable to health care-related taxes. |
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Subpart C—MECHANIZED CLAIMS PROCESSING AND INFORMATION RETRIEVAL SYSTEMS
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| Basis, purpose, and applicability. |
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| FFP for design, development, installation or enhancement of mechanized processing and information retrieval systems. |
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| Procedures for obtaining initial approval; notice of decision. |
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| FFP for operation of mechanized claims processing and information retrieval systems. |
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| Initial approval of replacement systems. |
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| Conditions for reapproval; notice of decision. |
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| Procedures for reduction of FFP after reapproval review. |
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| Reconsideration of the decision to reduce FFP after reapproval review. |
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| Reapproval of a disapproved system. |
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| Notification of changes in system requirements, performance standards or other conditions for approval or reapproval. |
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| Termination of FFP for failure to provide access to claims processing and information retrieval systems. |
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| Waiver for noncompliance with conditions of approval and reapproval. |
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Subpart D—THIRD PARTY LIABILITY
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| Identifying liable third parties. |
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| FFP and repayment of Federal share. |
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Assignment of Rights to Benefits
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| Assignment of rights to benefits—State plan requirements. |
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| Rights assigned; assignment method. |
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| Cooperation in establishing the identity of a child's parents 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. |
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| Denial or termination of eligibility. |
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Cooperative Agreements and Incentive Payments
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| Cooperative agreements and incentive payments—State plan requirements. |
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| Requirements for cooperative agreements for third party collections. |
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| Incentive payments to States and political subdivisions. |
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| Distribution of collections. |
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Subpart E—METHODOLOGIES FOR DETERMINING FEDERAL SHARE OF MEDICAID EXPENDITURES FOR ADULT ELIGIBILITY GROUP
Subpart F—REFUNDING OF FEDERAL SHARE OF MEDICAID OVERPAYMENTS TO PROVIDERS
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| Applicability of requirements. |
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| Basic requirements for refunds. |
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| When discovery of overpayment occurs and its significance. |
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| Overpayments involving providers who are bankrupt or out of business. |
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| Procedures for refunds to CMS. |
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