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 J - Eligibility in the States and District of Columbia |
Redeterminations of Medicaid Eligibility |
§ 435.928 - Reduction in FMAP for failure to submit certain data.
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§ 435.928 Reduction in FMAP for failure to submit certain data.
(a) Basis. This section implements section 1902(tt)(2)(A) of the Social Security Act.
(b) Application of the FMAP reduction.
(1) FMAP means the State-specific Federal medical assistance percentage as defined in the first sentence of section 1905(b) of the Act.
(2) If CMS finds that, for a fiscal quarter in the period beginning on July 1, 2023, and ending on June 30, 2024, the State was noncompliant with the requirements of § 435.927, CMS will reduce the State's Federal medical assistance percentage (FMAP) for that fiscal quarter as described in paragraph (b)(4) of this section.
(3) A State is noncompliant in a fiscal quarter if it has failed to comply with the reporting requirements described in § 435.927 for one or more months of the quarter.
(4) The FMAP reduction under paragraph (b)(2) of this section will equal the product of 0.25 percentage points and the number of the fiscal quarters during the period from July 1, 2023, through June 30, 2024, in which the State is noncompliant with the reporting requirements described in § 435.927. When States are noncompliant in multiple quarters during that period, the FMAP reduction will increase by 0.25 percentage points for each successive quarter of noncompliance, even if nonconsecutive, but in no case will the reduction for any single quarter exceed 1 percentage point.
(c) Severability. Any provision of this section held to be invalid or unenforceable by its terms, or as applied to any person or circumstance, or stayed pending further State action, shall be severable from this section and shall not affect the remainder thereof or the application of the provision to persons not similarly situated or to dissimilar circumstances.
[88 FR 84736, Dec. 6, 2023]