CMS-179 4.19(d)

Revision:

HCFA-PH-87- 9
AUGUST 1987

(BERC)

OMB No.: 0938-0193

State/Territory:
Citation
42 CFR Subpart C

4.19 (d)
(1) The Medicaid agency meets the requirements of
42 CFR Part 447, Subpart C, with respect to
payments for longterm care facility services and
intermediate care facility for individuals with intellectual
disabilities.
ATTACHMENT 4.19-D describes the methods and
standards used to determine rates for payment for
longterm care services and intermediate care facility for
individuals with intellectual disabilities services.
(2)

The Medicaid agency provides payment for
routine longterm care facility services furnished
by a swing-bed hospital.
At a rate established by the State, which
meets the requirements of 42 CFR Part
447, Subpart C, as applicable.
Not applicable. The agency does not
provide payment for NF services to a
swing-bed hospital.

(3)

The Medicaid agency provides payment for
routine intermediate care facility for individuals
with intellectual disabilities services furnished by
a swing-bed hospital.
At a rate established by the State, which
meets the requirements of 42 CFR Part
447, Subpart C, as applicable.
Not applicable. The agency does not
provide payment for ICF services to a
swing-bed hospital.

(4)

Section 4.19(d)(1) of this plan is not applicable
with respect to intermediate care facility services;
such services are not provided under this State
plan.
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TN No.
Supersedes
Approval Date
Effective Date
TN No.
HCFA ID: 101OP/0012P

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