Title 42

PART 433

Part 433 - State Fiscal Administration

PART 433 - STATE FISCAL ADMINISTRATION Authority:Sec. 1102 of the Social Security Act, (42 U.S.C. 1302). Link to an amendment published at 85 FR 87100, Dec. 31, 2020. Source:43 FR 45201, Sept. 29, 1978, unless otherwise noted.

42:4.0.1.1.4.0.17.1SECTION 433.1
   433.1 Purpose.
42:4.0.1.1.4.1SUBPART A
Subpart A - Federal Matching and General Administration Provisions
42:4.0.1.1.4.1.17.1SECTION 433.8
   433.8 [Reserved]
42:4.0.1.1.4.1.17.2SECTION 433.10
   433.10 Rates of FFP for program services.
42:4.0.1.1.4.1.17.3SECTION 433.11
   433.11 Enhanced FMAP rate for children.
42:4.0.1.1.4.1.17.4SECTION 433.15
   433.15 Rates of FFP for administration.
42:4.0.1.1.4.1.17.5SECTION 433.32
   433.32 Fiscal policies and accountability.
42:4.0.1.1.4.1.17.6SECTION 433.34
   433.34 Cost allocation.
42:4.0.1.1.4.1.17.7SECTION 433.35
   433.35 Equipment - Federal financial participation.
42:4.0.1.1.4.1.17.8SECTION 433.36
   433.36 Liens and recoveries.
42:4.0.1.1.4.1.17.9SECTION 433.37
   433.37 Reporting provider payments to Internal Revenue Service.
42:4.0.1.1.4.1.17.10SECTION 433.38
   433.38 Interest charge on disallowed claims for FFP.
42:4.0.1.1.4.1.17.11SECTION 433.40
   433.40 Treatment of uncashed or cancelled (voided) Medicaid checks.
42:4.0.1.1.4.2SUBPART B
Subpart B - General Administrative Requirements State Financial Participation
42:4.0.1.1.4.2.17.1SECTION 433.50
   433.50 Basis, scope, and applicability.
42:4.0.1.1.4.2.17.2SECTION 433.51
   433.51 Public Funds as the State share of financial participation.
42:4.0.1.1.4.2.17.3SECTION 433.52
   433.52 General definitions.
42:4.0.1.1.4.2.17.4SECTION 433.53
   433.53 State plan requirements.
42:4.0.1.1.4.2.17.5SECTION 433.54
   433.54 Bona fide donations.
42:4.0.1.1.4.2.17.6SECTION 433.55
   433.55 Health care-related taxes defined.
42:4.0.1.1.4.2.17.7SECTION 433.56
   433.56 Classes of health care services and providers defined.
42:4.0.1.1.4.2.17.8SECTION 433.57
   433.57 General rules regarding revenues from provider-related donations and health care-related taxes.
42:4.0.1.1.4.2.17.9SECTION 433.58-433.60
   433.58-433.60 [Reserved]
42:4.0.1.1.4.2.17.10SECTION 433.66
   433.66 Permissible provider-related donations.
42:4.0.1.1.4.2.17.11SECTION 433.67
   433.67 Limitations on level of FFP for permissible provider-related donations.
42:4.0.1.1.4.2.17.12SECTION 433.68
   433.68 Permissible health care-related taxes.
42:4.0.1.1.4.2.17.13SECTION 433.70
   433.70 Limitation on level of FFP for revenues from health care-related taxes.
42:4.0.1.1.4.2.17.14SECTION 433.72
   433.72 Waiver provisions applicable to health care-related taxes.
42:4.0.1.1.4.2.17.15SECTION 433.74
   433.74 Reporting requirements.
42:4.0.1.1.4.3SUBPART C
Subpart C - Mechanized Claims Processing and Information Retrieval Systems
42:4.0.1.1.4.3.17.1SECTION 433.110
   433.110 Basis, purpose, and applicability.
42:4.0.1.1.4.3.17.2SECTION 433.111
   433.111 Definitions.
42:4.0.1.1.4.3.17.3SECTION 433.112
   433.112 FFP for design, development, installation or enhancement of mechanized processing and information retrieval systems.
42:4.0.1.1.4.3.17.4SECTION 433.114
   433.114 Procedures for obtaining initial approval; notice of decision.
42:4.0.1.1.4.3.17.5SECTION 433.116
   433.116 FFP for operation of mechanized claims processing and information retrieval systems.
42:4.0.1.1.4.3.17.6SECTION 433.117
   433.117 Initial approval of replacement systems.
42:4.0.1.1.4.3.17.7SECTION 433.119
   433.119 Conditions for reapproval; notice of decision.
42:4.0.1.1.4.3.17.8SECTION 433.120
   433.120 Procedures for reduction of FFP after reapproval review.
42:4.0.1.1.4.3.17.9SECTION 433.121
   433.121 Reconsideration of the decision to reduce FFP after reapproval review.
42:4.0.1.1.4.3.17.10SECTION 433.122
   433.122 Reapproval of a disapproved system.
42:4.0.1.1.4.3.17.11SECTION 433.123
   433.123 Notification of changes in system requirements, performance standards or other conditions for approval or reapproval.
42:4.0.1.1.4.3.17.12SECTION 433.127
   433.127 Termination of FFP for failure to provide access to claims processing and information retrieval systems.
42:4.0.1.1.4.3.17.13SECTION 433.131
   433.131 Waiver for noncompliance with conditions of approval and reapproval.
42:4.0.1.1.4.4SUBPART D
Subpart D - Third Party Liability
42:4.0.1.1.4.4.17SUBJGRP 17
   Assignment of Rights to Benefits
42:4.0.1.1.4.4.17.1SECTION 433.135
   433.135 Basis and purpose.
42:4.0.1.1.4.4.17.2SECTION 433.136
   433.136 Definitions.
42:4.0.1.1.4.4.17.3SECTION 433.137
   433.137 State plan requirements.
42:4.0.1.1.4.4.17.4SECTION 433.138
   433.138 Identifying liable third parties.
42:4.0.1.1.4.4.17.5SECTION 433.139
   433.139 Payment of claims.
42:4.0.1.1.4.4.17.6SECTION 433.140
   433.140 FFP and repayment of Federal share.
42:4.0.1.1.4.4.17.7SECTION 433.145
   433.145 Assignment of rights to benefits - State plan requirements.
42:4.0.1.1.4.4.17.8SECTION 433.146
   433.146 Rights assigned; assignment method.
42:4.0.1.1.4.4.17.9SECTION 433.147
   433.147 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.
42:4.0.1.1.4.4.17.10SECTION 433.148
   433.148 Denial or termination of eligibility.
42:4.0.1.1.4.4.18SUBJGRP 18
   Cooperative Agreements and Incentive Payments
42:4.0.1.1.4.4.18.11SECTION 433.151
   433.151 Cooperative agreements and incentive payments - State plan requirements.
42:4.0.1.1.4.4.18.12SECTION 433.152
   433.152 Requirements for cooperative agreements for third party collections.
42:4.0.1.1.4.4.18.13SECTION 433.153
   433.153 Incentive payments to States and political subdivisions.
42:4.0.1.1.4.4.18.14SECTION 433.154
   433.154 Distribution of collections.
42:4.0.1.1.4.5SUBPART E
Subpart E - Methodologies for Determining Federal Share of Medicaid Expenditures for Adult Eligibility Group
42:4.0.1.1.4.5.19.1SECTION 433.202
   433.202 Scope.
42:4.0.1.1.4.5.19.2SECTION 433.204
   433.204 Definitions.
42:4.0.1.1.4.5.19.3SECTION 433.206
   433.206 Threshold methodology.
42:4.0.1.1.4.6SUBPART F
Subpart F - Refunding of Federal Share of Medicaid Overpayments to Providers
42:4.0.1.1.4.6.19.1SECTION 433.300
   433.300 Basis.
42:4.0.1.1.4.6.19.2SECTION 433.302
   433.302 Scope of subpart.
42:4.0.1.1.4.6.19.3SECTION 433.304
   433.304 Definitions.
42:4.0.1.1.4.6.19.4SECTION 433.310
   433.310 Applicability of requirements.
42:4.0.1.1.4.6.19.5SECTION 433.312
   433.312 Basic requirements for refunds.
42:4.0.1.1.4.6.19.6SECTION 433.316
   433.316 When discovery of overpayment occurs and its significance.
42:4.0.1.1.4.6.19.7SECTION 433.318
   433.318 Overpayments involving providers who are bankrupt or out of business.
42:4.0.1.1.4.6.19.8SECTION 433.320
   433.320 Procedures for refunds to CMS.
42:4.0.1.1.4.6.19.9SECTION 433.322
   433.322 Maintenance of Records.
42:4.0.1.1.4.7SUBPART G
Subpart G - Temporary FMAP Increase During the Public Health Emergency for COVID-19
42:4.0.1.1.4.7.19.1SECTION 433.400
   433.400 Continued enrollment for temporary FMAP increase.