[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: 42CFR447.88]



[Page 316-317]

 

                         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 A_Payments: General Provisions

 

Sec.  447.88  Options for claiming FFP payment for section 1920A 



presumptive eligibility medical assistance payments.



    (a) The FMAP rate for medical assistance payments made available to 

a child during a presumptive eligibility period under section 1920A of 

the Act is the regular FMAP under title XIX, based on the category of 

medical assistance; that is, the enhanced FMAP is not available for 

section 1920A presumptive eligibility expenditures.

    (b) States have the following 3 options for identifying Medicaid 

section 1920A presumptive eligibility expenditures and the application 

of payments for those expenditures:

    (1) A State may identify Medicaid section 1920A presumptive 

eligibility expenditures in the quarter expended with no further 

adjustment based on the results of a subsequent actual eligibility 

determination (if any).



[[Page 317]]



    (2) A State may identify Medicaid section 1920A presumptive 

eligibility expenditures in the quarter expended but may adjust reported 

expenditures based on results of the actual eligibility determination 

(if any) to reflect the actual eligibility status of the individual, if 

other than presumptively eligible.

    (3) A State may elect to delay submission of claims for payments of 

section 1920A presumptive eligibility expenditures until after the 

actual eligibility determination (if any) is made and, at that time 

identify such expenditures based on the actual eligibility status of 

individuals if other than presumptively eligible. At that time, the 

State would, as appropriate, recategorize the medical assistance 

expenditures made during the section 1920A presumptive eligibility 

period based on the results of the actual eligibility determination, and 

claim them appropriately.



[65 FR 33622, May 24, 2000]