431.57—Waiver of cost-sharing requirements.
(a)
Sections 1916(a)(3) and 1916(b)(3) of the Act specify the circumstances under which the Secretary is authorized to waive the requirement that cost-sharing amounts be nominal.
(b)
For nonemergency services furnished in a hospital emergency room, the Secretary may by waiver permit a State to impose a copayment of up to double the “nominal” copayment amounts determined under § 447.54(a)(3) of this subchapter.
(c)
Nonemergency services are services that do not meet the definition of emergency services at § 447.53(b)(4) of this subchapter.
(d)
In order for a waiver to be approved under this section, the State must establish to the satisfaction of CMS that alternative sources of nonemergency, outpatient services are available and accessible to recipients.
(e)
Although, in accordance with § 431.55(b)(3) of this part, a waiver will generally be granted for a 2-year duration, CMS will reevaluate waivers approved under this section if the State increases the nominal copayment amounts in effect when the waiver was approved.
(f)
A waiver approved under this section cannot apply to services furnished before the waiver was granted.
[59 FR 4600, Feb. 1, 1994]