§ 441.181 Maintenance of effort: Explanation of terms and requirements.

(a) For purposes of § 441.182: (1) The base year is the 4-quarter period ending December 31, 1971. (2) Quarterly per capita non-Federal expenditures are expenditures for inpatient psychiatric services determined by reimbursement principles under Medicare. (See part 405, subpart D.) (3) The number of individuals receiving inpatient psychiatric services in the current quarter means— (i) The number of individuals receiving services for the full quarter; plus (ii) The full quarter composite number of individuals receiving services for less than a full quarter. (4) In determining the per capita expenditures for the base year, the Medicaid agency must compute the number of individuals receiving services in a manner similar to that in paragraph (a)(3) of this section. (5) Non-Federal expenditures means the total amount of funds expended by the State and its political subdivisions, excluding Federal funds received directly or indirectly from any source. (6) Expenditures for the current calendar quarter exclude Federal funds received directly or indirectly from any source. (b) As a basis for determining the correct amount of Federal payments, each State must submit estimated and actual cost data and other information necessary for this purpose in the form and at the times specified in this subchapter and by CMS guidelines. (c) The agency must have on file adequate records to substantiate compliance with the requirements of § 441.182 and to ensure that all necessary adjustments have been made. (d) Facilities that did not meet the requirements of §§ 441.151-441.156 in the base year, but are providing inpatient psychiatric services under those sections in the current quarter, must be included in the maintenance of effort computation if, during the base year, they were— (1) Providing inpatient psychiatric services for individuals under age 21; and (2) Receiving State aid.