C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 430—GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS › Subpart C—Grants; Reviews and Audits; Withholding for Failure To Comply; Deferral and Disallowance of Claims; Reduction of Federal Medicaid Payments

42 C.F.R. § 430.30

Grants procedures

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(a) General provisions. (1) Once CMS has approved a State plan, it makes quarterly grant awards to the State to cover the Federal share of expenditures for services, training, and administration.

(2) The amount of the quarterly grant is determined on the basis of information submitted by the State agency (in quarterly estimate and quarterly expenditure reports) and other pertinent documents.

(b) Quarterly estimates. The Medicaid agency must submit Form CMS-37 (Medicaid Program Budget Report; Quarterly Distribution of Funding Requirements) to the central office (with a copy to the regional office) 45 days before the beginning of each quarter.

(c) Expenditure reports. (1) The State must submit Form CMS-64 (Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program) to the central office (with a copy to the regional office) not later than 30 days after the end of each quarter.

(2) This report is the State's accounting of actual recorded expenditures. The disposition of Federal funds may not be reported on the basis of estimates.

(d) Grant award—(1) Computation by CMS. Regional office staff analyzes the State's estimates and sends a recommendation to the central office. Central office staff considers the State's estimates, the regional office recommendations and any other relevant information, including any adjustments to be made under paragraph (d)(2) of this section, and computes the grant.

(2) Content of award. The grant award computation form shows the estimate of expenditures for the ensuring quarter, and the amounts by which that estimate is increased or decreased because of an underestimate or overestimate for prior quarters, or for any of the following reasons:

(i) Penalty reductions imposed by law.

(ii) Accounting adjustments.

(iii) Deferrals or disallowances.

(iv) Interest assessments.

(v) Mandated adjustments such as those required by section 1914 of the Act.

(3) Effect of award. The grant award authorizes the State to draw Federal funds as needed to pay the Federal share of disbursements.

(4) Drawing procedure. The draw is through a commercial bank and the Federal Reserve system against a continuing letter of credit certified to the Secretary of the Treasury in favor of the State payee. (The letter of credit payment system was established in accordance with Treasury Department regulations—Circular No. 1075.)

(e) General administrative requirements. With the following exceptions, the provisions of 2 CFR parts 200 and 300, which establish uniform administrative requirements and cost principles, apply to all grants made to States under this subpart:

(1) Cost sharing or matching, 2 CFR 200.306; and

(2) Financial reporting, 2 CFR 200.328.

[53 FR 36571, Sept. 21, 1988, as amended at 77 FR 31507, May 29, 2012; 81 FR 3011, Jan. 20, 2016; 89 FR 80069, Oct. 2, 2024]
Notes of Decisions
Cited in 15 cases (4 in the last 5 years), 1990–2026 · leading case: United States Ex Rel. Digital Healthcare, Inc. v. Affiliated Computer Services, Inc.
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United States Ex Rel. Digital Healthcare, Inc. v. Affiliated Computer Services, Inc. (2011) dcd · cites it 2× “§ 1396b(d)(l) (2006), 42 C.F.R. § 430.30 (a) (2010), and at the close of each quarter a state submits an accounting of its actual Medicaid expenditures, 42 C.”
United States Ex Rel. Feldman v. City of New York (2011) nysd · cites it 2× “See 42 C.F.R. §§ 430.30 . This share is determined primarily on the basis of a formula set forth in the Social Security Act, which sets the federal share anywhere from 50% to 83% of total Medicaid expenditures, depending on the per-capita income of the particular State.”
United States v. Actavis Mid Atlantic LLC (2009) mad “42 C.F.R. § 430.30 (b). As part of the budget, states provide estimates of various types of service costs including drug costs.”
Robert D. Alexander v. Merit Systems Protection Board (1999) ca6 “” 42 C.F.R. § 430.30 (a)(1) (1998) (emphasis added).”
The STATE OF LOUISIANA, Petitioner, v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, Respondent (1990) ca5 “§ 1396b(a); 42 C.F.R. § 430.30 . The Medicaid statute and the regulations promulgated thereunder charge the Secretary to ensure that state plans, including amendments, originally meet and continue to meet the federal requirements.”
State of Delaware Department of Health and Social Services, Division of Medicaid & Medical Assistance v. United States D (2017) dcd “See 42 C.F.R. §§ 430.30 (c)(1)-(2). Because the Medicaid program is a pay- or of last resort, the State is responsible for recovering payments from third-parties that were legally obligated to cover medical care that was ultimately paid for the by the State.”
Georgia Department of Community Health v. United States Department of Health and Human Services (2015) dcd · cites it 2× “(citing 42 C.F.R. § 430.30 (c)-(d); State Medicaid Manual § 2500(A)(1).”
Pressley Ridge Schools, Inc. v. Stottlemyer (1996) wvsd “42 C.F.R. §§ 430.30 (a), (b). HCFA provides approximately 72 percent of West Virginia’s Medicaid program funding.”
Massachusetts Ex Rel. Executive Office of Health & Human Services v. Sebelius (2010) mad “Title 42 C.F.R. § 430.30 (e) establishes applicability of uniform administrative requirements and cost principles (45 C.”
West Virginia Department of Health & Human Resources v. United States Department of Health & Human Services (2012) wvsd “42 C.F.R. § 430.30 (a)(1). (Docket 11 at 2) (citations altered).”
Kuzma v. Northern Arizona Healthcare Corporation (2021) azd · cites it 2× “42 C.F.R. § 430.30 (a)(2). The state draws 16 down those funds to pay providers.”
Digital Healthcare Inc v. Affilliated Computer Services Inc (2011) dcd · cites it 2× “§ 1396b(d)(1) (2006), 42 C.F.R. § 430.30 (a) (2010), and at the close of each quarter a state submits an accounting of its actual Medicaid expenditures, 42 C.”
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— 42 C.F.R. § 430.30(b) — 1 case
Georgia Department of Community Health v. United States Department of Health and Human Services (2015) dcd “(citing 42 C.F.R. § 430.30 (c)-(d); State Medicaid Manual § 2500(A)(1).”
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