[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR447.304]



[Page 327]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 447_PAYMENTS FOR SERVICES--Table of Contents

 

 Subpart F_Payment Methods for Other Institutional and Noninstitutional 

                                Services

 

Sec.  447.304  Adherence to upper limits; FFP.



    (a) The Medicaid agency must not pay more than the upper limits 

described in this subpart.

    (b) In the case of payments made under the plan for deductibles and 

coinsurance payable on an assigned Medicare claim for noninstitutional 

services, those payments may be made only up to the reasonable charge 

under Medicare.

    (c) FFP is not available for a State's expenditures for services 

that are in excess of the amounts allowable under this subpart.

    Note: The Secretary may waive any limitation on reimbursement 

imposed by subpart F of this part for experiments conducted under 

section 402 of Pub. L. 90-428, Incentives for Economy Experimentation, 

as amended by section 222(b) of Pub. L. 92-603, and under section 222(a) 

of Pub. L. 92-603.



[46 FR 48560, Oct. 1, 1981; 46 FR 54744, Nov. 4, 1981, as amended at 66 

FR 3176, Jan. 12, 2001]



                 Outpatient Hospital and Clinic Services