---
kind: "section"
citation: "42 C.F.R. § 433.72"
title: "42"
number: "433.72"
heading: "Waiver provisions applicable to health care-related taxes."
url: "https://uscodex.org/cfr/42/433.72"
---

# §433.72. Waiver provisions applicable to health care-related taxes.

- (a) **Bases for requesting waiver.**
  - (1) A State may submit to CMS a request for a waiver if a health care-related tax does not meet any or all of the following:
    - (i) The tax does not meet the broad based criteria specified in [§ 433.68c](/cfr/42/433.68c.md)); and/or
    - (ii) The tax is not imposed uniformly but meets the criteria specified in § [433.68(d)(2)](/cfr/42/433.68.md?p=d-2) or [(d)(3)](/cfr/42/433.68.md?p=d-3).
  - (2) When a tax that meets the criteria specified in [paragraph (a)(1)](#a-1) of this section is imposed on more than one class of health care items or services, a separate waiver must be obtained for each class of health care items and services subject to the tax.
- (b) **Waiver conditions.** In order for CMS to approve a waiver request that would permit a State to receive tax revenue (within specified limitations) without a reduction in FFP, the State must demonstrate, to CMS's satisfaction, that its tax program meets all of the following requirements:
  - (1) The net impact of the tax and any payments made to the provider by the State under the Medicaid program is generally redistributive, as described in [§ 433.68(e)](/cfr/42/433.68.md?p=e);
  - (2) The amount of the tax is not directly correlated to Medicaid payments; and
  - (3) The tax program does not fall within the hold harmless provisions specified in [§ 433.68(f)](/cfr/42/433.68.md?p=f).
- (c) **Effective date.** A waiver will be effective:
  - (1) The date of enactment of the tax for programs in existence prior to August 13, 1993 or;
  - (2) For tax programs commencing on or after August 13, 1993, on the first day in the quarter in which the waiver is received by CMS.

## Notes

### Amendments

[57 FR 55138, Nov. 24, 1992, as amended at 58 FR 43182, Aug. 13, 1993]

### Source

Source: 57 FR 55138, Nov. 24, 1992, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45201, Sept. 29, 1978, unless otherwise noted.

### Amendments

[57 FR 55138, Nov. 24, 1992, as amended at 58 FR 43182, Aug. 13, 1993]