Federal/State Relationship for Provider Certification

4000 - Federal/State Relationship for Provider Certification (Rev. 1, 05-21-04) 4000A - Title XVIII - Medicare Regulations (Rev. 1, 05-21-04) Section 1864 of the Social Security Act (the Act) outlines the functional role of State survey agencies (SAs) in the Medicare program, and provides for establishing an administrative relationship based upon a formal agreement negotiated between the governor of the State and the Secretary of HHS. 4000B - Title XIX - Medicaid Regulations (Rev. 1, 05-21-04) Pursuant to Title XIX, the SA is a grantee of Federal funds, and is required under §1902 of the Act to develop and adhere to its own administrative “State plan,” for which HHS provides the major share of financing through grants, the terms of which are spelled out in §1903 of the Act. The Federal share is termed Federal financial participation (FFP). If the Secretary finds that a State is not complying with its plan (as approved by the Secretary), §1904 of the Act provides that FFP can be reduced or withheld. Extensive regulatory standards for the development and terms of the State plans, for the management of the grants, and for the standards limiting participation of health care institutions are found in 42 CFR Chapter IV, Subchapter C. However, those regulations which directly affect the State component administering the Medicaid program (known as the State Medicaid agency or the single State agency) are widely dispersed through Subchapter C. Provisions of Federal grant laws other than title XIX also impinge upon the financial administration of the SA.