42 C.F.R. § 433.72

Current through September 30, 2024
Section 433.72 - Waiver provisions applicable to health care-related taxes
(a)Bases for requesting waiver.
(1) A State may submit to CMS a request for a waiver if a health care-related tax does not meet any or all of the following:
(i) The tax does not meet the broad based criteria specified in § 433.68c ); and/or
(ii) The tax is not imposed uniformly but meets the criteria specified in § 433.68(d)(2) or (d)(3) .
(2) When a tax that meets the criteria specified in paragraph (a)(1) of this section is imposed on more than one class of health care items or services, a separate waiver must be obtained for each class of health care items and services subject to the tax.
(b)Waiver conditions. In order for CMS to approve a waiver request that would permit a State to receive tax revenue (within specified limitations) without a reduction in FFP, the State must demonstrate, to CMS's satisfaction, that its tax program meets all of the following requirements:
(1) The net impact of the tax and any payments made to the provider by the State under the Medicaid program is generally redistributive, as described in § 433.68(e) ;
(2) The amount of the tax is not directly correlated to Medicaid payments; and
(3) The tax program does not fall within the hold harmless provisions specified in § 433.68(f) .
(c)Effective date. A waiver will be effective:
(1) The date of enactment of the tax for programs in existence prior to August 13, 1993 or;
(2) For tax programs commencing on or after August 13, 1993, on the first day in the quarter in which the waiver is received by CMS.

42 C.F.R. §433.72

57 FR 55138, Nov. 24, 1992, as amended at 58 FR 43182, Aug. 13, 1993