[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: 42CFR441.181]



[Page 279]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 441_SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC 

 

Subpart D_Inpatient Psychiatric Services for Individuals Under Age 21 in 

                   Psychiatric Facilities or Programs

 

Sec.  441.181  Maintenance of effort: Explanation of terms and 



requirements.



    (a) For purposes of Sec.  441.182:

    (1) The base year is the 4-quarter period ending December 31, 1971.

    (2) Quarterly per capita non-Federal expenditures are expenditures 

for inpatient psychiatric services determined by reimbursement 

principles under Medicare. (See part 405, subpart D.)

    (3) The number of individuals receiving inpatient psychiatric 

services in the current quarter means--

    (i) The number of individuals receiving services for the full 

quarter; plus

    (ii) The full quarter composite number of individuals receiving 

services for less than a full quarter.

    (4) In determining the per capita expenditures for the base year, 

the Medicaid agency must compute the number of individuals receiving 

services in a manner similar to that in paragraph (a)(3) of this 

section.

    (5) Non-Federal expenditures means the total amount of funds 

expended by the State and its political subdivisions, excluding Federal 

funds received directly or indirectly from any source.

    (6) Expenditures for the current calendar quarter exclude Federal 

funds received directly or indirectly from any source.

    (b) As a basis for determining the correct amount of Federal 

payments, each State must submit estimated and actual cost data and 

other information necessary for this purpose in the form and at the 

times specified in this subchapter and by CMS guidelines.

    (c) The agency must have on file adequate records to substantiate 

compliance with the requirements of Sec.  441.182 and to ensure that all 

necessary adjustments have been made.

    (d) Facilities that did not meet the requirements of Sec. Sec.  

441.151-441.156 in the base year, but are providing inpatient 

psychiatric services under those sections in the current quarter, must 

be included in the maintenance of effort computation if, during the base 

year, they were--

    (1) Providing inpatient psychiatric services for individuals under 

age 21; and

    (2) Receiving State aid.