[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: 42CFR457.224]



[Page 389-390]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 457_ALLOTMENTS AND GRANTS TO STATES--Table of Contents

 

  Subpart B_General Administration_Reviews and Audits; Withholding for 

  Failure to Comply; Deferral and Disallowance of Claims; Reduction of 

                        Federal Medical Payments

 

Sec.  457.224  FFP: Conditions relating to cost sharing.



    (a) No FFP is available for the following amounts, even when related 

to services or benefit coverage which is or could be provided under a 

State SCHIP program--

    (1) Any cost sharing amounts that beneficiaries should have paid as 

enrollment fees, premiums, deductibles,



[[Page 390]]



coinsurance, copayments, or similar charges.

    (2) Any amounts paid by the agency for health benefits coverage or 

services furnished to individuals who would not be eligible for that 

coverage or those services under the approved State child health plan, 

whether or not the individual paid any required premium or enrollment 

fee.

    (b) The amount of expenditures under the State child health plan 

must be reduced by the amount of any premiums and other cost-sharing 

received by the State.