State Survey and Certification of Health Care Providers and Suppliers (Title XVIII) Medicare

To provide financial assistance to any State which is able and willing to determine through its State health agency or other appropriate State agency that providers and suppliers of health care services are in compliance with Federal regulatory health and safety standards and conditions of participation.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - See Regional Agency Offices.

Contact the Regional Administrator for Centers for Medicare and Medicaid Services.

(See Appendix IV of the Catalog for listing of Regional Offices).



Selected Recipients for this Program


RecipientAmount Start DateEnd Date
Public Health, Illinois Department Of $ 982,039   2009-10-012910-09-30
Senior People With Disabilities Service Oregon $ 986,977   2014-07-012054-07-01
Health And Human Services Commission, Texas $ 33,839,429   2018-10-012019-09-30
Health Services Department $ 3,741,277   2018-10-012019-09-30
Health, Louisiana Department Of $ 288,320   2018-10-012019-09-30
Health, Maryland Department Of $ 15,800   2018-10-012019-09-30
Arkansas Department Of Human Services $ 88,594   2018-10-012019-09-30
Health And Human Services Commission, Texas $ 460,201   2018-10-012019-09-30
Arkansas Department Of Human Services $ 6,313,233   2018-10-012019-09-30
Health, Louisiana Department Of $ 7,155,627   2018-10-012019-09-30



Program Accomplishments

Not Applicable.

Uses and Use Restrictions

Funds are made available to States for the purpose of inspecting providers and suppliers of health care services, to ensure mandatory adherence to Medicare/Medicaid health and safety standards and conditions.

Funds made available under these programs are used to support or reimburse State staff for performing survey activities and for State administration of the program.

Eligibility Requirements

Applicant Eligibility

Under Title XVIII, States enter into Section 1864 agreements with the Secretary of Health and Human Services whereby the designated agency of the State will be supported or reimbursed for on-site inspection of health care providers and suppliers.

The designated State agency is usually that unit performing licensure activities within the State health department.

Beneficiary Eligibility

NA.

Credentials/Documentation

A signed 1864 Agreement for Title XVIII in order to carry out the survey function, 2 CFR 200 applies to this program. 2 CFR 200, Subpart E - Cost Principles applies to this program.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is required.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Application Procedures

This program is excluded from coverage under 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Sign an 1864 Agreement for support of Medicare/Medicaid survey and certification activities.

Award Procedures

States are provided a quarterly award based on an approved annual budget under Title XVIII, IMPACT Act, and quarterly formula grants under Title XIX. States are reimbursed for Title XVIII and Title XIX survey activities under Electronic Funds Transfer System procedures. States draw funds through the Department's Payment Management System (PMS).

Deadlines

Aug 10, 2010: By the end of the 4th quarter of the previous Fiscal Year, Annual budget proposals for Title XVIII for the upcoming Fiscal Year are requested from the appropriate State agency as negotiated with Regional Office. By the end of the 4th quarter of the previous Fiscal Year, Annual budget proposals for Title XVIII and IMPACT Act for the upcoming Fiscal Year are requested from the appropriate State agency as negotiated with Regional Office. By the end of the 4th quarter of the previous Fiscal Year, Annual budget proposals for Title XVIII and IMPACT Act for the upcoming Fiscal Year are requested from the appropriate State agency as negotiated with Regional Office.

Authorization

Social Security Act, Sections 1863, 1864, 1865, 1902, 1903, and 1919, Title XVIII, and the IMPACT Act P.L. 113-185.

Range of Approval/Disapproval Time

From 30 to 60 days. This timeline is for initial approval or disapproval.

Appeals

Title XVIII appeals are reviewed by the Armed Services Contracts Appeal Board.

Renewals

Ongoing renewals are awarded to States that are willing and able to conduct required survey activities in compliance with statutory mandate.

Assistance Considerations

Formula and Matching Requirements

This program has no statutory formula. This program has no matching requirements. This program does not have MOE requirements.

Length and Time Phasing of Assistance

Grants/cooperative agreements are generally funded on a 12-month basis, with support beyond the first year contingent upon acceptable evidence of satisfactory progress, continuing program relevance, and availability of funds. Method of awarding/releasing assistance: lump sum.

Post Assistance Requirements

Reports

Program reports are required.

Cash reports are required.

Progress reports are required.

Expenditure reports are required.

States operate under 1864 Agreement (Title XVIII).

Quarterly expenditure reports are required 30 days after the close of each quarter and monitoring is carried out by the Department of Health and Human Services.

Performance monitoring is required.

Comprehensive final reports are due no later than 90 days after termination projects.

Audits

In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503. DHHS Office of Inspector General staff or designated representatives make periodic audits of State survey agencies. In addition, under the Single State Audit Act, States may elect to conduct their own nonpartisan audits and certify the results to the Secretary of Health and Human Services.

Records

States must maintain surveyor time records, line item and expenditure documentation, which substantiate the costs relating to survey activities.

Financial Information

Account Identification

75-0511-0-1-550.

Obigations

(Direct Payments for Specified Use) FY 16 $363,816,174; FY 17 est $361,497,858; and FY 18 est $364,288,848

Range and Average of Financial Assistance

FY 15 range is from $607,409 to $45,882,611 and an average of $6,526,368 (includes IMPACT Act funding). FY16 range is from $542,819 to $46,234,033 and an average of $6,522,660 (includes IMPACT Act funding). FY17 range is from $558,610 to $46,266,103 and an average of $6,523,464 (includes IMPACT Act funding).

Regulations, Guidelines, and Literature

Title XVIII, Social Security Act as amended Sections 1863, 1864 and 1865. IMPACT Act P.L. 113-185

Information Contacts

Regional or Local Office

See Regional Agency Offices. Contact the Regional Administrator for Centers for Medicare and Medicaid Services. (See Appendix IV of the Catalog for listing of Regional Offices).

Headquarters Office

David Wright 7500 Security Blvd, Baltimore, Maryland 21244 Email: David.Wright@cms.hhs.gov Phone: 410786-9493

Criteria for Selecting Proposals

Selecting criteria for Federal funding of State certification proposals are available to State survey agencies upon request.



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