[Code of Federal Regulations]

[Title 45, Volume 1]

[Revised as of October 1, 2006]

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

[CITE: 45CFR95.4]



[Page 482]

 

                        TITLE 45--PUBLIC WELFARE

 

                    SUBTITLE A--DEPARTMENT OF HEALTH

                           AND HUMAN SERVICES

 

PART 95_GENERAL ADMINISTRATION_GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL 

ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS)--Table of 

Contents

 

             Subpart A_Time Limits for States To File Claims

 

Sec.  95.4  Definitions.



    In this subpart--

    Adjustment to prior year costs means an adjustment in the amount of 

a particular cost item that was previously claimed under an interim rate 

concept and for which it is later determined that the cost is greater or 

less than that originally claimed.

    Audit exception means a proposed adjustment by the responsible 

Federal agency to any expenditure claimed by a State by virtue of an 

audit.

    Claim means a request for Federal financial participation in the 

manner and format required by our program regulations, and instructions 

or directives issued thereunder.

    Court-ordered retroactive payment means either a retroactive payment 

the State makes to an assistance recipient or an individual, under a 

Federal or State court order or a retroactive payment we make to a State 

under a Federal court order. Although we may accept these claims as 

timely, this provision does not mean that we necessarily agree to be 

bound by a State or Federal decision when we were not a party to the 

action.

    Federal financial participation means the Federal government's share 

of an expenditure made by a State agency under any of the programs 

listed in Sec.  95.1.

    State means the 50 States, the District of Columbia, Guam, Puerto 

Rico, the Virgin Islands, the Commonwealth of the Northern Mariana 

Islands, American Samoa and the Trust Territories of the Pacific.

    State agency for the purposes of expenditures for financial 

assistance under title IV-A and for support enforcement services under 

title IV-D means any agency or organization of the State or local 

government which is authorized to incur matchable expenses; for purposes 

of expenditures under titles XIX and XXI, means any agency of the State, 

including the State Medicaid agency or State Child Health Agency, its 

fiscal agents, a State health agency, or any other State or local 

organization which incurs matchable expenses; for purposes of 

expenditures under all other titles, see the definitions in the 

appropriate program's regulations.

    The Act means the Social Security Act, as amended.

    We, our, and us refer to HHS'sCenters for Medicare & Medicaid 

Services, Office of Child Support Enforcement, Office of Human 

Development Services, or the Social Security Administration, depending 

on the program involved.



[46 FR 3529, Jan. 15, 1981, as amended at 65 FR 33632, May 24, 2000]