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42 U.S.C. § 704 — Use of allotment funds

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 704 — Use of allotment funds

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Source location: Title 42, Chapter 7, § 704; chapter-007-social-security.md

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**(a) Covered services** Except as otherwise provided under this section, a State may use amounts paid to it under [section 703 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section703&num=0&edition=prelim) for the provision of health services and related activities (including planning, administration, education, and evaluation and including payment of salaries and other related expenses of National Health Service Corps personnel) consistent with its application transmitted under [section 705(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section705/a&num=0&edition=prelim). **(b) Restrictions** Amounts described in subsection (a) may not be used for— (1) inpatient services, other than inpatient services provided to children with special health care needs or to high-risk pregnant women and infants and such other inpatient services as the Secretary may approve; (2) cash payments to intended recipients of health services; (3) the purchase or improvement of land, the purchase, construction, or permanent improvement (other than minor remodeling) of any building or other facility, or the purchase of major medical equipment; (4) satisfying any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; (5) providing funds for research or training to any entity other than a public or nonprofit private entity; or (6) payment for any item or service (other than an emergency item or service) furnished— (A) by an individual or entity during the period when such individual or entity is excluded under this subchapter or subchapter XVIII, XIX, or XX pursuant to section 1320a–7, 1320a–7a, 1320c–5, or 1395u(j)(2) of this title, or (B) at the medical direction or on the prescription of a physician during the period when the physician is excluded under this subchapter or subchapter XVIII, XIX, or XX pursuant to section 1320a–7, 1320a–7a, 1320c–5, or 1395u(j)(2) of this title and when the person furnishing such item or service knew or had reason to know of the exclusion (after a reasonable time period after reasonable notice has been furnished to the person). The Secretary may waive the limitation contained in paragraph (3) upon the request of a State if the Secretary finds that there are extraordinary circumstances to justify the waiver and that granting the waiver will assist in carrying out this subchapter. **(c) Use of portion of funds** A State may use a portion of the amounts described in subsection (a) for the purpose of purchasing technical assistance from public or private entities if the State determines that such assistance is required in developing, implementing, and administering programs funded under this subchapter. **(d) Limitation on use of funds for administrative costs** Of the amounts paid to a State under [section 703 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section703&num=0&edition=prelim) from an allotment for a fiscal year under [section 702(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section702/c&num=0&edition=prelim), not more than 10 percent may be used for administering the funds paid under such section.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 701 — Authorization of appropriations; purposes; definitions

**(a)** To improve the health of all mothers and children consistent with the applicable health status goals and national health objectives established by the Secretary under the Public Health Service Act [[42 U.S.C. 201](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section201&num=0&edition=prelim) et seq.] for the year 2000, there are authorized to be appropriated $850,000,000 for fiscal year 2001 and each fiscal year thereafter— (1) for the purpose of enabling each State— (A) to provide and to assure mothers and children (in particular those with low income or with limited availability of health services) access to quality maternal and child health services; (B) to reduce infant mortality and the incidence of preventable diseases and handicapping conditions among children, to reduce the incidence of stillbirth, to reduce the need for inpatient and long-term care services, to increase the number of children (especially preschool children) appropriately immunized against disease and the number of low income children receiving health assessments and follow-up diagnostic and treatment services, and otherwise to promote the health of mothers and infants by providing prenatal, delivery, and postpartum care for low income, at-risk pregnant women, and to promote the health of children by providing preventive and primary care services for low income children; (C) to provide rehabilitation services for blind and disabled individuals under the age of 16 receiving benefits under subchapter XVI, to the extent medical assistance for such services is not provided under subchapter XIX; and (D) to provide and to promote family-centered, community-based, coordinated care (including care coordination services, as defined in subsection (b)(3)) for chi

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 701

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 706 — Administrative and fiscal accountability

**(a) Annual reporting requirements; form, etc.** (1) Each State shall prepare and submit to the Secretary annual reports on its activities under this subchapter. Each such report shall be prepared by, or in consultation with, the State maternal and child health agency. In order properly to evaluate and to compare the performance of different States assisted under this subchapter and to assure the proper expenditure of funds under this subchapter, such reports shall be in such standardized form and contain such information (including information described in paragraph (2)) as the Secretary determines (after consultation with the States) to be necessary (A) to secure an accurate description of those activities, (B) to secure a complete record of the purposes for which funds were spent, of the recipients of such funds,,11 So in original. (C) to describe the extent to which the State has met the goals and objectives it set forth under [section 705(a)(2)(B)(i) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section705/a/2/B/i&num=0&edition=prelim) and the national health objectives referred to in [section 701(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section701/a&num=0&edition=prelim), and (D) to determine the extent to which funds were expended consistent with the State’s application transmitted under [section 705(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section705/a&num=0&edition=prelim). Copies of the report shall be provided, upon request, to any interested public agency, and each such agency may provide its views on these reports to the Congress. (2) Each annual report under paragraph (1) shall include the following information: (A) (

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 706

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Federal law — U.S. Code and appendices · legal_authorities

1 U.S.C. § 106 — Printing bills and joint resolutions

Every bill or joint resolution in each House of Congress shall, when such bill or resolution passes either House, be printed, and such printed copy shall be called the engrossed bill or resolution as the case may be. Said engrossed bill or resolution shall be signed by the Clerk of the House or the Secretary of the Senate, and shall be sent to the other House, and in that form shall be dealt with by that House and its officers, and, if passed, returned signed by said Clerk or Secretary. When such bill, or joint resolution shall have passed both Houses, it shall be printed and shall then be called the enrolled bill, or joint resolution, as the case may be, and shall be signed by the presiding officers of both Houses and sent to the President of the United States. During the last six days of a session such engrossing and enrolling of bills and joint resolutions may be done otherwise than as above prescribed, upon the order of Congress by concurrent resolution.

Source: Supplied U.S. Code snapshot — release unconfirmed · 1 U.S.C. § 106

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395k — Payments to providers of services

**(a) Determination of amount** The Secretary shall periodically determine the amount which should be paid under this part to each provider of services with respect to the services furnished by it, and the provider of services shall be paid, at such time or times as the Secretary believes appropriate (but not less often than monthly) and prior to audit or settlement by the Government Accountability Office, from the Federal Hospital Insurance Trust Fund, the amounts so determined, with necessary adjustments on account of previously made overpayments or underpayments; except that no such payments shall be made to any provider unless it has furnished such information as the Secretary may request in order to determine the amounts due such provider under this part for the period with respect to which the amounts are being paid or any prior period. **(b) Conditions** No payment shall be made to a provider of services which is a hospital for or with respect to services furnished by it for any period with respect to which it is deemed, under [section 1395x(w)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/w/2&num=0&edition=prelim), to have in effect an arrangement with a quality improvement organization for the conduct of utilization review activities by such organization unless such hospital has paid to such organization the amount due (as determined pursuant to such section) to such organization for the review activities conducted by it pursuant to such arrangements or such hospital has provided assurances satisfactory to the Secretary that such organization will promptly be paid the amount so due to it from the proceeds of the payment claimed by the hospital. Payment under this subchapter for utilization review activities

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395k

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 702 — Allotment to States and Federal set-aside

**(a) Special projects** (1) Of the amounts appropriated under [section 701(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section701/a&num=0&edition=prelim) for a fiscal year that are not in excess of $600,000,000, the Secretary shall retain an amount equal to 15 percent for the purpose of carrying out activities described in [section 701(a)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section701/a/2&num=0&edition=prelim). The authority of the Secretary to enter into any contracts under this subchapter is effective for any fiscal year only to such extent or in such amounts as are provided in appropriations Acts. (2) For purposes of paragraph (1)— (A) amounts retained by the Secretary for training shall be used to make grants to public or nonprofit private institutions of higher learning for training personnel for health care and related services for mothers and children; and (B) amounts retained by the Secretary for research shall be used to make grants to, contracts with, or jointly financed cooperative agreements with, public or nonprofit institutions of higher learning and public or nonprofit private agencies and organizations engaged in research or in maternal and child health or programs for children with special health care needs for research projects relating to maternal and child health services or services for children with special health care needs which show promise of substantial contribution to the advancement thereof. (3) No funds may be made available by the Secretary under this subsection or subsection (b) unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, be submitted in such manner, and c

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 702

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 703 — Payments to States

**(a) Statutory provisions applicable** From the sums appropriated therefor and the allotments available under [section 702(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section702/c&num=0&edition=prelim), the Secretary shall make payments as provided by [section 6503(a) of title 31](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title31-section6503/a&num=0&edition=prelim) to each State provided such an allotment under [section 702(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section702/c&num=0&edition=prelim), for each quarter, of an amount equal to four-sevenths of the total of the sums expended by the State during such quarter in carrying out the provisions of this subchapter. **(b) Unobligated allotments** Any amount payable to a State under this subchapter from allotments for a fiscal year which remains unobligated at the end of such year shall remain available to such State for obligation during the next fiscal year. No payment may be made to a State under this subchapter from allotments for a fiscal year for expenditures made after the following fiscal year. **(c) Reduction of payments; fair market value of supplies or equipment, value of salaries, travel expenses, etc.** The Secretary, at the request of a State, may reduce the amount of payments under subsection (a) by— (1) the fair market value of any supplies or equipment furnished the State, and (2) the amount of the pay, allowances, and travel expenses of any officer or employee of the Government when detailed to the State and the amount of any other costs incurred in connection with the detail of such officer or employee, when the furnishing of supplies or equipment or the detail of an officer or employee is

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 703

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 712 — Services to individuals with a postpartum condition and their families

**(a) In general** In addition to any other payments made under this subchapter to a State, the Secretary may make grants to eligible entities for projects for the establishment, operation, and coordination of effective and cost-efficient systems for the delivery of essential services to individuals with or at risk for postpartum conditions and their families. **(b) Certain activities** To the extent practicable and appropriate, the Secretary shall ensure that projects funded under subsection (a) provide education and services with respect to the diagnosis and management of postpartum conditions for individuals with or at risk for postpartum conditions and their families. The Secretary may allow such projects to include the following: (1) Delivering or enhancing outpatient and home-based health and support services, including case management and comprehensive treatment services. (2) Delivering or enhancing inpatient care management services that ensure the well-being of the mother and family and the future development of the infant. (3) Improving the quality, availability, and organization of health care and support services (including transportation services, attendant care, homemaker services, day or respite care, and providing counseling on financial assistance and insurance). (4) Providing education about postpartum conditions to promote earlier diagnosis and treatment. Such education may include— (A) providing complete information on postpartum conditions, symptoms, methods of coping with the illness, and treatment resources; and (B) in the case of a grantee that is a State, hospital, or birthing facility— (i) providing education to new mothers and fathers, and other family members as appropriate, concerning postpartum conditions before new mothers

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 712

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1320a–7a — Civil monetary penalties

**(a) Improperly filed claims** Any person (including an organization, agency, or other entity, but excluding a beneficiary, as defined in subsection (i)(5)) that— (1) knowingly presents or causes to be presented to an officer, employee, or agent of the United States, or of any department or agency thereof, or of any State agency (as defined in subsection (i)(1)), a claim (as defined in subsection (i)(2)) that the Secretary determines— (A) is for a medical or other item or service that the person knows or should know was not provided as claimed, including any person who engages in a pattern or practice of presenting or causing to be presented a claim for an item or service that is based on a code that the person knows or should know will result in a greater payment to the person than the code the person knows or should know is applicable to the item or service actually provided, (B) is for a medical or other item or service and the person knows or should know the claim is false or fraudulent, (C) is presented for a physician’s service (or an item or service incident to a physician’s service) by a person who knows or should know that the individual who furnished (or supervised the furnishing of) the service— (i) was not licensed as a physician, (ii) was licensed as a physician, but such license had been obtained through a misrepresentation of material fact (including cheating on an examination required for licensing), or (iii) represented to the patient at the time the service was furnished that the physician was certified in a medical specialty by a medical specialty board when the individual was not so certified, (D) is for a medical or other item or service furnished during a period in which the person was excluded from the Federal health c

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320a–7a

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42 U.S.C. § 1320b–10 — Prohibitions relating to references to Social Security or Medicare

**(a) Prohibited acts** (1) No person may use, in connection with any item constituting an advertisement, solicitation, circular, book, pamphlet, or other communication (including any Internet or other electronic communication), or a play, motion picture, broadcast, telecast, or other production, alone or with other words, letters, symbols, or emblems— (A) the words “Social Security”, “Social Security Account”, “Social Security System”, “Social Security Administration”, “Medicare”, “Centers for Medicare & Medicaid Services”, “Department of Health and Human Services”, “Health and Human Services”, “Supplemental Security Income Program”, “Medicaid”, “Death Benefits Update”, “Federal Benefit Information”, “Funeral Expenses”, or “Final Supplemental Plan”, the letters “SSA”, “CMS”, “DHHS”, “HHS”, or “SSI”, or any other combination or variation of such words or letters, or (B) a symbol or emblem of the Social Security Administration, Centers for Medicare & Medicaid Services, or Department of Health and Human Services (including the design of, or a reasonable facsimile of the design of, the social security card issued pursuant to [section 405(c)(2)(F) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section405/c/2/F&num=0&edition=prelim) or the Medicare card,,11 So in original. the check used for payment of benefits under subchapter II, or envelopes or other stationery used by the Social Security Administration, Centers for Medicare & Medicaid Services, or Department of Health and Human Services), or any other combination or variation of such symbols or emblems, in a manner which such person knows or should know would convey, or in a manner which reasonably could be interpreted or construed as conveying, the false impression that such

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320b–10

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1320c–3 — Functions of quality improvement organizations

**(a) Review of professional activities; determination of payment; determination of review authority; consultation with professional health care practitioners; standards of health care; other duties** Subject to subsection (b), any quality improvement organization entering into a contract with the Secretary under this part must perform one or more of the following functions: (1) The organization shall review some or all of the professional activities in the area, subject to the terms of the contract and subject to the requirements of subsection (d), of physicians and other health care practitioners and institutional and noninstitutional providers of health care services in the provision of health care services and items for which payment may be made (in whole or in part) under subchapter XVIII (including where payment is made for such services to eligible organizations pursuant to contracts under [section 1395mm of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395mm&num=0&edition=prelim), to Medicare Advantage organizations pursuant to contracts under part C, and to prescription drug sponsors pursuant to contracts under part D) for the purpose of determining whether— (A) such services and items are or were reasonable and medically necessary and whether such services and items are not allowable under subsection (a)(1) or (a)(9) of [section 1395y of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395y&num=0&edition=prelim); (B) the quality of such services meets professionally recognized standards of health care; and (C) in case such services and items are proposed to be provided in a hospital or other health care facility on an inpatient basis, such services and items could, con

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320c–3

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