General Terms and Conditions
View the Terms and Conditions Archive
These terms and conditions apply to the FY25 MFCU grant awards. Acknowledgement and acceptance of these terms and conditions are conceded automatically by drawing down funds from the Payment Management System. Individual awards are based on the application submitted to, and as approved by, OIG and are subject to the terms and conditions incorporated either directly or by reference in the following order of precedence (this order of precedence prevails in the event there are conflicting or otherwise inconsistent policies applicable to the award):
- Sections 1903(a)(6), 1903(b)(3), and 1903(q) of the Social Security Act (the Act).
- Pertinent restrictions on the expenditure of Federal funds in applicable Appropriations Acts and National Public Policy requirements.
- Title 42 CFR Part 1007 State Medicaid Fraud Control Unit (MFCU) requirements
- Title 45 CFR Part 75, except as amended by the following provisions of 2 CFR part 200:
- 2 CFR § 200.1. Definitions, “Modified Total Direct Cost”, “Equipment”, and “Supplies”
- 2 CFR § 200.313(e). Equipment, Disposition
- 2 CFR § 200.314(a). Supplies
- 2 CFR § 200.320. Procurement methods
- 2 CFR § 200.333. Fixed amount subawards
- 2 CFR § 200.344. Closeout
- 2 CFR § 200.414(f). Indirect costs, De Minimis Rate
- 2 CFR § 200.501. Audit requirements
- OIG Policy Transmittals
Recipient Responsibilities
Federal Funds Draw Down
Draw down authority for each corresponding quarter is determined based on the needs expressed in the awardee's budget. An awardee is not authorized to draw down funds until they become available as identified on the Notice of Grant Award.
An awardee must liquidate all obligations incurred under the award no later than 90 days after the end of the period of performance to coincide with the submission of the final Federal Financial Report (FFR). This deadline may be extended with prior approval.
Payment
Payment under this award will be made available through the HHS Payment Management System (PMS). PMS provides instructions for making withdrawals of Federal funds. Inquiries regarding payments should be directed to Division of Payment Management; Post Office Box 6021; Rockville, MD 20852; 1-877-614-5533; PMSSupport@psc.gov.
Recipient Share (Match)
- Section 1903(a)(6) of the Act requires the Federal Government to reimburse States that have operated a MFCU for longer than 12 quarters 75% of the costs incurred for the operation of a State's MFCU as defined by section 1903(q) of the Act. States must contribute 25% of their total MFCU expenditures as the State share of costs (non-Federal share).
- Section 1903(a)(6) of the Act requires the Federal Government to reimburse States that have operated a MFCU for less than 12 quarters 90% of the costs incurred for the operation of a State's MFCU as defined by section 1903(q) of the Act. States must contribute 10% of their total MFCU expenditures as the State share of costs (non-Federal share).
If the required non-Federal share is not met by 120 days after the project period end date OIG may take a disallowance in the amount of the proportionate Federal share.
Stevens Amendment
When issuing statements, press releases, requests for proposal, bid solicitations and other documents describing the Medicaid Fraud Control Unit (MFCU) program, the MFCU must include a statement that describes the amount and percentage of federal and non-federal funding of total MFCU program costs.
The grant award amount should reflect the amount as listed on the Notice of Award for the Federal fiscal year at the time of the public statement.
The MFCU must use the following or a similar statement:
The [Name of MFCU] receives [100/90/75] percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling [$XX] for Federal fiscal year (FY) [XXXX]. The remaining [10/25] percent, totaling [$XX] for FY [XXXX], is funded by [Name of State/territory].
Reporting Requirements
Program Reporting
42 CFR §1007.17 requires awardees to submit a reapplication for recertification at least 60 days prior to the expiration of the certification period. 42 CFR §1007.17(a) describes the information required in the reapplication.
An Annual Statistical Report (ASR) must be submitted to OIG’s Annual Statistical Report Portal (ASRP) for each Federal fiscal year (FY) by November 30 following the end of the FY.
Financial Expenditure Reporting
Quarterly financial reporting is required under this award.
You are required to electronically submit the SF-425-Federal Financial Report (FFR) in the Payment Management System (PMS). The FFR is to be prepared, certified and submitted in PMS. https://pms.psc.gov/
- Quarterly expenditure reports are due 30 days after the end of each quarter.
- All final expenditure reports are due 120 days after the end date of the project period of performance.
- If the grantee will be unable to submit the financial expenditure report by the due date, the grantee must request an extension.
Paper copies of these reports are no longer being accepted either by mail, fax or as an email attachment. Questions related to the submission of Federal Financial Report should be directed to PMSFFRSupport@psc.hhs.gov.
Program Income
Consistent with 45 CFR § 75.307, program income earned and expended should generally be reported on the SF-425 using the deduction alternative, in accordance with § 75.307(e)(1), unless the awardee receives prior approval to add program income to the Federal award. Grantees must expend program income before requesting additional Federal payments. If any funds are received from asset forfeitures, please contact the GMO for instructions to use and report.
Closeout
The final SF-425 (FFR) submitted must reconcile with the final cash drawn in PMS. Once reconciled the OIG will process a closing transaction in PMS. If applicable, the grant will be closed out using the most recently approved indirect rate, which could be the final, predetermined, fixed or provisional rate. Once the grant is closed in PMS, no upward or downward adjustments will be made if a revised rate becomes effective.
MFCU-specific Requirements
Change in Director
Rather than requiring prior approval, OIG is requiring that the grantee provide timely notification to the GMO and program analyst when there is a change in Director. This notification is to include the new or interim Director's name, start date, and contact information. If an interim Director is named, the grantee must also include status of a plan to hire a permanent Director, inform OIG when one is selected, and provide his or her name and contact information. Further, if the Director is to become disengaged from the Unit for more than three months, the Unit must provide notification to OIG.
Budget Revisions
Requests that require prior approval from the awarding office must be submitted in writing (email preferred) to the Grants Management Officer (GMO), with a cc to the assigned program analyst. Only written approvals by the GMO, acting GMO, or Office of Management and Policy Deputy Inspector General are considered valid (see 45 CFR § 75.308(j)). Approvals not signed or provided by one of these officials will not be considered binding upon OIG. Such requests include, but are not limited to (See 45 CFR §75.308 for all-inclusive list):
- Rebudgeting more than 10% of the total approved budget
- Purchase of equipment with an acquisition cost of $10,000/unit that was not originally requested in the application and approved in the notice of award
- Requesting supplemental funding
Time Limit to File Claim
In accordance with 45 CFR Part 95 Subpart A, States can receive Federal financial participation (FFP) for an expenditure only if the State files a claim for that expenditure within 2 years after the calendar quarter in which the State made the expenditure. “Claim” is defined as a request for FFP. A claim filed after 90 days following the period of performance end date (also known as the liquidation period) must be requested in writing (via email) to the GMO.
Government-wide Requirements
System for Award Management
The recipient must maintain the accuracy and currency of information in the System for Award Management (SAM) until the final financial report is submitted as required under this award or the final payment is received, whichever is later. Additionally, this term requires the entity to review and update the information at least annually after the initial registration, and more frequently if required by changes in information or another award term. For purposes of this award term, SAM means the Federal repository into which an entity must provide information required for the conduct of business as a recipient. Additional information about registration procedures may be found at https://www.sam.gov
Salary Limitation
Annual appropriations laws provide that none of the appropriated funds shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II of the Federal Executive Pay Scale. This amount is published annually by the U.S. Office of Personnel Management (OPM) and can be found on their Pay & Leave website at Salaries & Wages (opm.gov), under the pay table “Rates of Pay for the Executive Schedule.” This amount reflects an individual's base salary exclusive of fringe benefits.
The salary limitation does not apply to payments made to consultants under this award; although, as with all costs, those payments must be reasonable and consistent with the recipient's established policy. Note that an individual's base salary is not constrained by the statutory provision; the limitation simply caps the amount that may be awarded and charged to the grant. For individuals whose salary rates are in excess of Executive Level II, the non-federal entity may pay the excess from non-federal funds.
Subaward Reporting and Executive Compensation
This grant is subject to the reporting requirements of the Federal Funding Accountability and Transparency Act (FFATA) of 2006 (Pub. L. No. 109-282), as amended by Section 6202 of Public Law 110-252 and implemented by 2 CFR part 170. Recipients must report information for each first-tier subaward of $25,000 or more in Federal funds and executive total compensation for the recipient's and subrecipient's five most highly compensated executives, as outlined in Appendix A to 2 CFR part 170. Information about the FFATA Subaward Reporting System (FSRS) is available at www.fsrs.gov. For the full text of the award term, go to award term.
Federal Awardee Performance and Integrity Information System (FAPIIS)
For those recipients whose total Federal share of the Federal award is more than $10,000,000, the FAPIIS term and conditions apply. For the full text of the award term, go to award term, also located at 45 CFR part 75, Appendix XII.
Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
As described in 2 CFR § 200.216, recipients and subrecipients are prohibited to obligate or spend grant funds (to include direct and indirect expenditures as well as cost share and program) to:
- Procure or obtain,
- Extend or renew a contract to procure or obtain, or
- Enter into contract (or extend or renew contract) to procure or obtain equipment, services, or systems that use covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. As described in Pub. L. 115-232, section 889, covered telecommunications equipment or services means any of the following:
- Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities).
- For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities).
- Telecommunications or video surveillance services provided by such entities or using such equipment.
- Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise, connected to the government of a covered foreign country.
Whistleblower Protection
Under Title 41, United States Code, Section 4712, it is illegal for an employee of a Federal contractor, subcontractor, grantee, subgrantee, or personal services contractor to be discharged, demoted, or otherwise discriminated against for making a protected whistleblower disclosure. Further, under section 4712(d), all grantees, including MFCUs, must inform their employees in writing of the rights and remedies provided under section 4712, including the protection against reprisal for making a protected disclosure. MFCUs may do so by distributing to all employees the OIG's "Notice to HHS Contractors, Subcontractors, Grantees, Subgrantees, or Personal Services Contractors."
Additional information can be found at https://oig.hhs.gov/fraud/report-fraud/whistleblower/
Mandatory Disclosures
Consistent with 45 CFR §75.113, applicants and recipients must disclose in a timely manner, in writing to the HHS Office of Inspector General (OIG), all information related to violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award. Subrecipients must disclose, in a timely manner, in writing to the prime recipient (pass-through entity) and the HHS OIG, all information related to violations of Federal criminal law involving fraud, bribery, or gratuity violations affecting the Federal award. Disclosures must be sent in writing to the HHS OIG at the following addresses:
U.S. Department of Health and Human Services
Office of Inspector General
ATTN: Grants Management Officer, Alexis Crowley
330 Independence Ave, SW, Cohen Building
Room 5140
Washington, DC 20201
Email: Alexis.Crowley@oig.hhs.gov
AND
U.S. Department of Health and Human Services
Office of Inspector General
ATTN: Mandatory Grant Disclosures, Intake Coordinator
330 Independence Avenue, SW, Cohen Building
Room 5527
Washington, DC 20201
Fax: (202) 205-0604 (Include "Mandatory Grant Disclosures" in subject line) or
Email: MandatoryGranteeDisclosures@oig.hhs.gov
Failure to make required disclosures can result in any of the remedies described in 45 CFR §75.371, including suspension or debarment (See also 2 CFR parts 180 & 376 and 31 U.S.C. 3321).
Non-discrimination
You must administer your project in compliance with federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, disability, age and, in some circumstances, religion, conscience, and sex (including gender identity, sexual orientation, and pregnancy). This includes taking reasonable steps to provide meaningful access to persons with limited English proficiency and providing programs that are accessible to and usable by persons with disabilities. The HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. See https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/index.html.
- You must take reasonable steps to ensure that your project provides meaningful access to persons with limited English proficiency. For guidance on meeting your legal obligation to take reasonable steps to ensure meaningful access to your programs or activities by limited English proficient individuals, see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/index.html and https://www.lep.gov.
- For information on your specific legal obligations for serving qualified individuals with disabilities, including providing program access, reasonable modifications, and taking appropriate steps to provide effective communication, see http://www.hhs.gov/ocr/civilrights/understanding/disability/index.html.
- HHS funded health and education programs must be administered in an environment free of sexual harassment, see https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html.
- For guidance on administering your project in compliance with applicable federal religious nondiscrimination laws and applicable federal conscience protection and associated anti-discrimination laws, see https://www.hhs.gov/conscience/conscience-protections/index.html and https://www.hhs.gov/conscience/religious-freedom/index.html.