Code of Federal Regulations Title 42. Public Health § 42.433.72 Waiver provisions applicable to health care-related taxes

(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:

(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.

(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);

(2) The amount of the tax is not directly correlated to Medicaid payments;  and

(3) The tax program does not fall within the hold harmless provisions specified in § 433.68(f).

(1) The date of enactment of the tax for programs in existence prior to August 13, 1993 or;

(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.