(a) Basic conditions. When Federal payments have been made for claims that are later found to be unallowable, the State may repay the Federal Funds by installments if the following conditions are met:
(1) The amount to be repaid exceeds 2 1/2 percent of the estimated or actual annual State share for the State CHIP program; and
(2) The State has given the Regional Administrator written notice, before total repayment was due, of its intent to repay by installments.
(b) Annual State share determination. CMS determines whether the amount to be repaid exceeds 2 1/2 percent of the annual State share as follows:
(1) If the State CHIP program is ongoing, CMS uses the annual estimated State share of State CHIP expenditures. This is the sum of the estimated State shares for four consecutive quarters, beginning with the quarter in which the first installment is to be paid, as shown on the State's latest CMS-21B form.
(2) If the State CHIP program has been terminated by Federal law or by the State, CMS uses the actual State share. The actual State share is that shown on the State's Quarterly Statement of Expenditures reports for the last four quarters before the program was terminated.
(c) Repayment amounts, schedules, and procedures—(1) Repayment amount. The repayment amount may not include any amount previously approved for installment repayment.
(2) Repayment schedule. The number of quarters allowed for repayment is determined on the basis of the ratio of the repayment amount to the annual State share of State CHIP expenditures. The higher the ratio of the total repayment amount is to the annual State share, the greater the number of quarters allowed, as follows:
Total repayment amount as percentage of State share of annual expenditures for State CHIP
Number of quarters to make repayment
2.5 pct. or less
Greater than 2.5, but not greater than 5
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Greater than 5, but not greater than 7.5
Greater than 7.5, but not greater than 10
Greater than 10, but not greater than 15
Greater than 15, but not greater than 20
Greater than 20, but not greater than 25
Greater than 25, but not greater than 30
Greater than 30, but not greater than 47.5
Greater than 47.5, but not greater than 65
Greater than 65, but not greater than 82.5
Greater than 82.5, but not greater than 100
(3) Quarterly repayment amounts. The quarterly repayment amounts for each of the quarters in the repayment schedule may not be less than the following percentages of the estimated State share of the annual expenditures for CHIP:
For each of the following quarters
Repayment installment may not be less than these percentages
1 to 4
5 to 8
9 to 12
(4) Extended schedule. The repayment schedule may be extended beyond 12 quarterly installments if the total repayment amount exceeds 100 percent of the estimated State share of annual expenditures. In these circumstances, the repayment schedule in paragraph (c)(2) of this section is followed for repayment of the amount equal to 100 percent of the annual State share. The remaining amount of the repayment is in quarterly amounts equal to not less than 17.5 percent of the estimated State share of annual expenditures.
(5) Repayment process. Repayment is accomplished through adjustment in the quarterly grants over the period covered by the repayment schedule. If the State chooses to repay amounts representing higher percentages during the early quarters, any corresponding reduction in required minimum percentages is applied first to the last scheduled payment, then to the next to the last payment, and so forth as necessary.
(6) Offsetting of retroactive claims.(i) The amount of a retroactive claim to be paid a State is offset against any amounts to be, or already being, repaid by the State in installments. Under this provision, the State may choose to:
(A) Suspend payments until the retroactive claim due the State has, in fact, been offset; or
(B) Continue payments until the reduced amount of its debt (remaining after the offset), has been paid in full. This second option would result in a shorter payment period.
(ii) A retroactive claim for the purpose of this regulation is a claim applicable to any period ending 12 months or more before the beginning of the quarter in which CMS would pay that claim.
[65 FR 33622, May 24, 2000; 65 FR 38027, June 19, 2000; 65 FR 52042, Aug. 28, 2000]
Title 42 published on 2012-10-01
no entries appear in the Federal Register after this date.
This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.