[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

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

[CITE: 42CFR442.42]



[Page 289]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 442_STANDARDS FOR PAYMENT TO NURSING FACILITIES AND INTERMEDIATE 

CARE FACILITIES FOR THE MENTALLY RETARDED--Table of Contents

 

                      Subpart B_Provider Agreements

 

Sec. 442.42  FFP under a retroactive provider agreement following appeal.



    (a) Basic rule. Except as specified in paragraph (b) of this 

section, if an NF or ICF/MR prevails on appeal from termination or, in 

the case of an ICF/MR, nonrenewal of a provider agreement, and the State 

issues a retroactive agreement, FFP is available beginning with the 

retroactive effective date, which must be determined in accordance with 

Sec. 442.13.

    (b) Exception. This rule does not apply if CMS determines, under 

Sec. 442.30, that the agreement is not valid evidence that the facility 

meets the requirements for participation. This exclusion applies even if 

the State issues the new agreement as the result of an administrative 

hearing decision favorable to the facility or under a Federal or State 

court order.



[52 FR 32551, Aug. 28, 1987, as amended at 59 FR 56236, Nov. 10, 1994]



[[Page 290]]