§456.650. Basis, purpose and scope.
42 C.F.R. § 456.650
Basis. Section 1903(g) of the Act requires that FFP for long-stay inpatient services at a level of care be reduced, by a specified formula, for any quarter in which a State fails to make a satisfactory showing that it has an effective program of utilization control for that level of care.
Purpose. This subpart specifies—
What States must do to make a satisfactory showing;
How the Administrator will determine whether reductions will be imposed; and
How the required reductions will be implemented.
Scope. The reductions required by this subpart do not apply to—
Services provided under a contract with a health maintenance organization; or
Facilities in which a QIO is performing medical and utilization reviews under contract with the Medicaid agency in accordance with § 431.630 of this chapter.
Notes, amendments, and revision history
Amendments
[44 FR 56338, Oct. 1, 1979, as amended at 50 FR 15327, Apr. 17, 1985; 51 FR 43198, Dec. 1, 1986]
Authority
Authority: Secs. 1102 and 1903(g) of the Social Security Act (42 U.S.C. 1302 and 1396 b(g)).
Source
Source: 44 FR 56338, Oct. 1, 1979, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302.
Source
Source: 43 FR 45266, Sept. 29, 1978, unless otherwise noted.
Amendments
[44 FR 56338, Oct. 1, 1979, as amended at 50 FR 15327, Apr. 17, 1985; 51 FR 43198, Dec. 1, 1986]