Form CMS-10367 6505 SMD State Plan Preprint submitted for Clearance

Page 2 – State Medicaid Director

ENCLOSURE A

Medicaid State Plan Preprint

State/ Territory: _______________________

SECTION 4 – GENERAL PROGRAM ADMINISTRATION

4.44 Medicaid Prohibition on Payments to Institutions or Entities Located Outside of the United States

_____________________________________________________________________________

Citation

Section 1902(a)(80) of the Social Security Act, P.L. 111-148 (Section 6505)

______ The State shall not provide any payments for items or services provided under the State plan or under a waiver to any financial institution or entity located outside of the United States.

TN No._________

Supersedes

TN No._________ Approval Date: _____________ Effective Date: _____________

CMS-10367

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