The funding threshold might be as low as $1. I would assume the distinction is based on whether a medical facility has a CONTRACT with the Federal government to facilitate payments for some or all of its patients.
On a you pay the Danegeld you never get rid of the Dane. The Feds have stolen the souls of many a State, municipal government and private entity who accepted federal grants. The Constitutional division of powers means nothing when States sell their jurisdiction for 30 pieces of silver.
I have a problem understanding how there can be laws without applicable thresholds and/or trip wires that trigger requirements, compliance, penalties, etc. I realize numbers change over time but how can there be laws without things like stipulations and limits?
Lawyers seem to love words; numbers not so much.