{"abstract":"This final rule implements and interprets the provisions of sections 6041, 6042, and 6043 of the Deficit Reduction Act of 2005 (DRA), and section 405(a)(1) of the Tax Relief and Health Care Act of 2006 (TRHCA). The DRA was amended by the TRHCA which revised sections 6041, 6042, and 6043 of the DRA including limitations on cost sharing for individuals with family incomes at or below 100 percent of the federal poverty line. These sections amended the Social Security Act (the Act) by adding a new section 1916A to provide State Medicaid agencies with increased flexibility to impose premium and cost sharing requirements on certain Medicaid recipients. This flexibility supplements the existing authority States have to impose premiums and cost sharing under section 1916 of the Act. The DRA provisions also specifically address cost sharing for non-preferred drugs and non- emergency care furnished in a hospital emergency department.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2008/11/25/E8-27717.html","cfr_references":[{"chapter":null,"citation_url":null,"part":447,"title":42},{"chapter":null,"citation_url":null,"part":457,"title":42}],"citation":"73 FR 71828","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Date: These regulations are effective 60 days after the date of publication in the Federal Register.","disposition_notes":null,"docket_ids":["CMS-2244-F"],"dockets":[],"document_number":"E8-27717","effective_on":null,"end_page":71855,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2008/11/25/E8-27717.xml","html_url":"https://www.federalregister.gov/documents/2008/11/25/E8-27717/medicaid-program-premiums-and-cost-sharing","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/E8-27717?publication_date=2008-11-25","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2008-11-25/E8-27717/mods.xml","not_received_for_publication":null,"page_length":28,"page_views":{"count":3490,"last_updated":"2026-08-26 10:15:07 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2008-11-25/pdf/E8-27717.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2008-11-25","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2008/11/25/E8-27717.txt","regulation_id_number_info":{"0938-A047":null},"regulation_id_numbers":["0938-A047"],"regulations_dot_gov_info":{"supporting_documents":[],"comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS_FRDOC_0001","supporting_documents_count":0,"docket_id":"CMS_FRDOC_0001","regulation_id_number":null,"title":"Recently Posted CMS Rules and Notices.","checked_regulationsdotgov_at":"2011-11-15T04:16:09Z"},"regulations_dot_gov_url":null,"significant":null,"signing_date":null,"start_page":71828,"subtype":null,"title":"Medicaid Program; Premiums and Cost Sharing","toc_doc":"Premiums and Cost Sharing","toc_subject":"Medicaid Program:","topics":["Accounting","Administrative practice and procedure","Drugs","Grant programs-health","Health facilities","Health insurance","Health professions","Medicaid","Reporting and recordkeeping requirements","Rural areas"],"type":"Rule","volume":73}