{"data":{"id":"us/42-cfr-433.72","jurisdiction":"us","citation":"42 CFR 433.72","heading":"Waiver provisions applicable to health care-related taxes.","body":"(a) Bases for requesting waiver. (1) A State may submit to CMS a request for a waiver if a health care-related tax does not meet any or all of the following:\n(i) The tax does not meet the broad based criteria specified in § 433.68c); and/or\n(ii) The tax is not imposed uniformly but meets the criteria specified in § 433.68(d)(2) or (d)(3).\n(2) When a tax that meets the criteria specified in paragraph (a)(1) of this section is imposed on more than one class of health care items or services, a separate waiver must be obtained for each class of health care items and services subject to the tax.\n(b) Waiver conditions. In order for CMS to approve a waiver request that would permit a State to receive tax revenue (within specified limitations) without a reduction in FFP, the State must demonstrate, to CMS's satisfaction, that its tax program meets all of the following requirements:\n(1) The net impact of the tax and any payments made to the provider by the State under the Medicaid program is generally redistributive, as described in § 433.68(e);\n(2) The amount of the tax is not directly correlated to Medicaid payments; and\n(3) The tax program does not fall within the hold harmless provisions specified in § 433.68(f).\n(c) Effective date. A waiver will be effective:\n(1) The date of enactment of the tax for programs in existence prior to August 13, 1993 or;\n(2) For tax programs commencing on or after August 13, 1993, on the first day in the quarter in which the waiver is received by CMS.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS","PART 433—STATE FISCAL ADMINISTRATION","Subpart B—General Administrative Requirements State Financial Participation"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"8c591055f1d6d387b8f852ed6726f82a6fd8a6e87a814b0b1f934a5b3f575390","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-433.70","next":"us/42-cfr-433.74"},"notice":"GroundRules: Original legal text. Not legal advice."}