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42 U.S.C. § 1397gg — Strategic objectives and performance goals; plan administration
Federal law — U.S. Code and appendices · legal_authorities
**(a) Strategic objectives and performance goals**
(1) **Description** — A State child health plan shall include a description of—
(A) the strategic objectives,
(B) the performance goals, and
(C) the performance measures,
the State has established for providing child health assistance to targeted low-income children under the plan and otherwise for maximizing health benefits coverage for other low-income children and children generally in the State.
(2) **Strategic objectives** — Such plan shall identify specific strategic objectives relating to increasing the extent of creditable health coverage among targeted low-income children and other low-income children.
(3) **Performance goals** — Such plan shall specify one or more performance goals for each such strategic objective so identified.
(4) **Performance measures** — Such plan shall describe how performance under the plan will be—
(A) measured through objective, independently verifiable means, and
(B) compared against performance goals, in order to determine the State’s performance under this subchapter.
**(b) Records, reports, audits, and evaluation**
(1) **Data collection, records, and reports** — A State child health plan shall include an assurance that the State will collect the data, maintain the records, and furnish the reports to the Secretary, at the times and in the standardized format the Secretary may require in order to enable the Secretary to monitor State program administration and compliance and to evaluate and compare the effectiveness of State plans under this subchapter.
(2) **State assessment and study** — A State child health plan shall include a description of the State’s plan for the annual assessments and reports under [section 1397hh(a) of this title](https://uscode.hou
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Source file: Laws/federal/codes/united-states-code/title-42/section-1397gg-strategic-objectives-and-performance-goals-plan-administration--bf7858663a.md
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Source location: Title 42, Chapter 7, § 1397gg; chapter-007-social-security.md
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**(a) Strategic objectives and performance goals**
(1) **Description** — A State child health plan shall include a description of—
(A) the strategic objectives,
(B) the performance goals, and
(C) the performance measures,
the State has established for providing child health assistance to targeted low-income children under the plan and otherwise for maximizing health benefits coverage for other low-income children and children generally in the State.
(2) **Strategic objectives** — Such plan shall identify specific strategic objectives relating to increasing the extent of creditable health coverage among targeted low-income children and other low-income children.
(3) **Performance goals** — Such plan shall specify one or more performance goals for each such strategic objective so identified.
(4) **Performance measures** — Such plan shall describe how performance under the plan will be—
(A) measured through objective, independently verifiable means, and
(B) compared against performance goals, in order to determine the State’s performance under this subchapter.
**(b) Records, reports, audits, and evaluation**
(1) **Data collection, records, and reports** — A State child health plan shall include an assurance that the State will collect the data, maintain the records, and furnish the reports to the Secretary, at the times and in the standardized format the Secretary may require in order to enable the Secretary to monitor State program administration and compliance and to evaluate and compare the effectiveness of State plans under this subchapter.
(2) **State assessment and study** — A State child health plan shall include a description of the State’s plan for the annual assessments and reports under [section 1397hh(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397hh/a&num=0&edition=prelim) and the evaluation required by [section 1397hh(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397hh/b&num=0&edition=prelim).
(3) **Audits** — A State child health plan shall include an assurance that the State will afford the Secretary access to any records or information relating to the plan for the purposes of review or audit.
**(c) Program development process** A State child health plan shall include a description of the process used to involve the public in the design and implementation of the plan and the method for ensuring ongoing public involvement.
**(d) Program budget** A State child health plan shall include a description of the budget for the plan. The description shall be updated periodically as necessary and shall include details on the planned use of funds and the sources of the non-Federal share of plan expenditures, including any requirements for cost-sharing by beneficiaries.
**(e) Application of certain general provisions** The following sections of this chapter shall apply to States under this subchapter in the same manner as they apply to a State under subchapter XIX:
(1) **Subchapter XIX provisions**
(A) [Section 1396a(a)(4)(C) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/4/C&num=0&edition=prelim) (relating to conflict of interest standards).
(B) [Section 1396a(a)(25) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/25&num=0&edition=prelim) (relating to third party liability).
(C) [Section 1396a(a)(39) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/39&num=0&edition=prelim) (relating to termination of participation of certain providers).
(D) [Section 1396a(a)(78) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/78&num=0&edition=prelim) (relating to enrollment of providers participating in State plans providing medical assistance on a fee-for-service basis).
(E) [Section 1396a(a)(72) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/72&num=0&edition=prelim) (relating to limiting FQHC contracting for provision of dental services).
(F) [Section 1396a(a)(73) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/73&num=0&edition=prelim) (relating to requiring certain States to seek advice from designees of Indian Health Programs and Urban Indian Organizations).
(G) Subsections (a)(77) and (kk) of [section 1396a of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a&num=0&edition=prelim) (relating to provider and supplier screening, oversight, and reporting requirements) and subsection (a)(83) of [section 1396a of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a&num=0&edition=prelim) (relating to searchable directories of the providers described in subsection (mm) of such section).
(H) [Section 1396a(a)(88) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/88&num=0&edition=prelim) (relating to address information for enrollees and prevention of simultaneous enrollments).
(I) [Section 1396a(e)(13) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/e/13&num=0&edition=prelim) (relating to the State option to rely on findings from an Express Lane agency to help evaluate a child’s eligibility for medical assistance).
(J) [Section 1396a(e)(14) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/e/14&num=0&edition=prelim) (relating to income determined using modified adjusted gross income and household income).
(K) Paragraphs (5) and (16) of [section 1396a(e) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/e&num=0&edition=prelim) (relating to the State option to provide medical assistance consisting of full benefits during pregnancy and throughout the 12-month postpartum period under subchapter XIX),11 So in original. There are two closing parentheses for the opening parenthesis preceding “relating”. if the State provides child health assistance for targeted low-income children who are pregnant or to targeted low-income pregnant women and the State has elected to apply such paragraph (16) with respect to pregnant women under subchapter XIX, the provision of assistance under the State child health plan or waiver for targeted low-income children or targeted low-income pregnant women during pregnancy and the 12-month postpartum period shall be required and not at the option of the State and shall include coverage of all items or services provided to a targeted low-income child or targeted low-income pregnant woman (as applicable) under the State child health plan or waiver).1
(L) [Section 1396a(e)(12) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/e/12&num=0&edition=prelim) (relating to 1 year of continuous eligibility for children), except that a targeted low-income child enrolled under the State child health plan or waiver may be transferred to the Medicaid program under subchapter XIX for the remaining duration of the 12-month continuous eligibility period, if the child becomes eligible for full benefits under subchapter XIX during such period.
(M) [Section 1396a(bb) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/bb&num=0&edition=prelim) (relating to payment for services provided by Federally-qualified health centers and rural health clinics).
(N) [Section 1396a(ff) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/ff&num=0&edition=prelim) (relating to disregard of certain property for purposes of making eligibility determinations).
(O) Paragraphs (2), (16), and (17) of [section 1396b(i) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b/i&num=0&edition=prelim) (relating to limitations on payment).
(P) [Section 1396b(m)(3) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b/m/3&num=0&edition=prelim) (relating to limitation on payment with respect to managed care).
(Q) Paragraph (4) of [section 1396b(v) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b/v&num=0&edition=prelim) (relating to optional coverage of categories of lawfully residing immigrant children or pregnant women), but only if the State has elected to apply such paragraph with respect to such category of children or pregnant women under subchapter XIX.
(R) [Section 1396b(v)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b/v/5&num=0&edition=prelim) (relating to payments for medical assistance furnished to aliens), except in relation to payments for services provided under [section 1397ee(a)(1)(D)(ii) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee/a/1/D/ii&num=0&edition=prelim).
(S) [Section 1396b(w) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b/w&num=0&edition=prelim) (relating to limitations on provider taxes and donations).
(T) [Section 1396r–1a of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396r-1a&num=0&edition=prelim) (relating to presumptive eligibility for children).
(U) Subsections (a)(2)(C) (relating to Indian enrollment), (d)(5) (relating to contract requirement for managed care entities), (d)(6) (relating to enrollment of providers participating with a managed care entity), and (h) (relating to special rules with respect to Indian enrollees, Indian health care providers, and Indian managed care entities) of [section 1396u–2 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396u-2&num=0&edition=prelim).
(V) [Section 1396w–2 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396w-2&num=0&edition=prelim) (relating to authorization to receive data directly relevant to eligibility determinations).
(W) [Section 1396w–3(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396w–3/b&num=0&edition=prelim) (relating to coordination with State Exchanges and the State Medicaid agency).
(2) **Subchapter XI provisions**
(A) [Section 1315 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1315&num=0&edition=prelim) (relating to waiver authority).
(B) [Section 1316 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1316&num=0&edition=prelim) (relating to administrative and judicial review), but only insofar as consistent with this subchapter.
(C) [Section 1320a–3 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320a-3&num=0&edition=prelim) (relating to disclosure of ownership and related information).
(D) [Section 1320a–5 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320a-5&num=0&edition=prelim) (relating to disclosure of information about certain convicted individuals).
(E) [Section 1320a–7a of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320a-7a&num=0&edition=prelim) (relating to civil monetary penalties).
(F) [Section 1320a–7b(d) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320a–7b/d&num=0&edition=prelim) (relating to criminal penalties for certain additional charges).
(G) [Section 1320b–2 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-2&num=0&edition=prelim) (relating to periods within which claims must be filed).
**(f) Limitation of waiver authority** Notwithstanding subsection (e)(2)(A) and [section 1315(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1315/a&num=0&edition=prelim):
(1) The Secretary may not approve a waiver, experimental, pilot, or demonstration project that would allow funds made available under this subchapter to be used to provide child health assistance or other health benefits coverage to a nonpregnant childless adult or a parent (as defined in [section 1397kk(c)(2)(A) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397kk/c/2/A&num=0&edition=prelim)), who is not pregnant, of a targeted low-income child.
(2) The Secretary may not approve, extend, renew, or amend a waiver, experimental, pilot, or demonstration project with respect to a State after February 4, 2009, that would waive or modify the requirements of [section 1397kk of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397kk&num=0&edition=prelim).
**(g) Use of blended risk pools**
(1) **In general** — Nothing in this subchapter (or any other provision of Federal law) shall be construed as preventing a State from considering children enrolled in a qualified CHIP look-alike program and children enrolled in a State child health plan under this subchapter (or a waiver of such plan) as members of a single risk pool.
(2) **Qualified CHIP look-alike program** — In this subsection, the term “qualified CHIP look-alike program” means a State program—
(A) under which children who are under the age of 19 and are not eligible to receive medical assistance under subchapter XIX or child health assistance under this subchapter may purchase coverage through the State that provides benefits that are at least identical to the benefits provided under the State child health plan under this subchapter (or a waiver of such plan); and
(B) that is funded exclusively through non-Federal funds, including funds received by the State in the form of premiums for the purchase of such coverage.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Termination of coverage for nonpregnant childless adults**
(1) **No new CHIP waivers; automatic extensions at State option through 2009** — Notwithstanding [section 1315 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1315&num=0&edition=prelim) or any other provision of this subchapter, except as provided in this subsection—
(A) the Secretary shall not on or after February 4, 2009, approve or renew a waiver, experimental, pilot, or demonstration project that would allow funds made available under this subchapter to be used to provide child health assistance or other health benefits coverage to a nonpregnant childless adult; and
(B) notwithstanding the terms and conditions of an applicable existing waiver, the provisions of paragraph (2) shall apply for purposes of any period beginning on or after January 1, 2010, in determining the period to which the waiver applies, the individuals eligible to be covered by the waiver, and the amount of the Federal payment under this subchapter.
(2) **Termination of CHIP coverage under applicable existing waivers at the end of 2009**
(A) *In general* — No funds shall be available under this subchapter for child health assistance or other health benefits coverage that is provided to a nonpregnant childless adult under an applicable existing waiver after December 31, 2009.
(B) *Extension upon State request* — If an applicable existing waiver described in subparagraph (A) would otherwise expire before January 1, 2010, notwithstanding the requirements of subsections (e) and (f) of [section 1315 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1315&num=0&edition=prelim), a State may submit, not later than September 30, 2009, a request to
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397kk
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Purpose** Except with respect to the rural health transformation program established in [section 1397ee(h) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee/h&num=0&edition=prelim), the purpose of this subchapter is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner that is coordinated with other sources of health benefits coverage for children. Such assistance shall be provided primarily for obtaining health benefits coverage through—
(1) obtaining coverage that meets the requirements of [section 1397cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397cc&num=0&edition=prelim), or
(2) providing benefits under the State’s medicaid plan under subchapter XIX,
or a combination of both.
**(b) State child health plan required** A State is not eligible for payment under subsection (a) or (g) of [section 1397ee of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee&num=0&edition=prelim) unless the State has submitted to the Secretary under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim) a plan that—
(1) sets forth how the State intends to use the funds provided under this subchapter to provide child health assistance to needy children consistent with the provisions of this subchapter, and
(2) has been approved under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim).
**(c) State entitlement** This subchapter constitutes budget authority i
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397aa
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Federal law — U.S. Code and appendices · legal_authorities
**(a)** When used in this chapter—
(1) The term “State”, except where otherwise provided, includes the District of Columbia and the Commonwealth of Puerto Rico, and when used in subchapters IV, V, VII, XI, XIX, and XXI includes the Virgin Islands and Guam. Such term when used in subchapters III, IX, and XII also includes the Virgin Islands. Such term when used in subchapter V and in part B of this subchapter also includes American Samoa, the Northern Mariana Islands, and the Trust Territory of the Pacific Islands. Such term when used in subchapters XIX and XXI also includes the Northern Mariana Islands and American Samoa. In the case of Puerto Rico, the Virgin Islands, and Guam, subchapters I, X, and XIV, and subchapter XVI (as in effect without regard to the amendment made by section 301 of the Social Security Amendments of 1972) shall continue to apply, and the term “State” when used in such subchapters (but not in subchapter XVI as in effect pursuant to such amendment after December 31, 1973) includes Puerto Rico, the Virgin Islands, and Guam. Such term when used in subchapter XX also includes the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Such term when used in subchapter IV also includes American Samoa.
(2) The term “United States” when used in a geographical sense means, except where otherwise provided, the States.
(3) The term “person” means an individual, a trust or estate, a partnership, or a corporation.
(4) The term “corporation” includes associations, joint-stock companies, and insurance companies.
(5) The term “shareholder” includes a member in an association, joint-stock company, or insurance company.
(6) The term “Secretary”, except when the context otherwise requires, means the Secretary of Health and Human Services.
(
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Waiver of State plan requirements; costs regarded as State plan expenditures; availability of appropriations** In the case of any experimental, pilot, or demonstration project which, in the judgment of the Secretary, is likely to assist in promoting the objectives of subchapter I, X, XIV, XVI, or XIX, or part A or D of subchapter IV, in a State or States—
(1) the Secretary may waive compliance with any of the requirements of section 302, 602, 654, 1202, 1352, 1382, or 1396a of this title, as the case may be, to the extent and for the period he finds necessary to enable such State or States to carry out such project, and
(2)
(A) costs of such project which would not otherwise be included as expenditures under section 303, 655, 1203, 1353, 1383, or 1396b of this title, as the case may be, and which are not included as part of the costs of projects under [section 1310 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1310&num=0&edition=prelim), shall, to the extent and for the period prescribed by the Secretary, be regarded as expenditures under the State plan or plans approved under such subchapter, or for administration of such State plan or plans, as may be appropriate, and
(B) costs of such project which would not otherwise be a permissible use of funds under part A of subchapter IV and which are not included as part of the costs of projects under [section 1310 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1310&num=0&edition=prelim), shall to the extent and for the period prescribed by the Secretary, be regarded as a permissible use of funds under such part.
In addition, not to exceed $4,000,000 of the aggregate amount appropriated for payments to States under such subch
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1315
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Determination of conformity with requirements for approval; petition for reconsideration; hearing; time limitations; review by court of appeals**
(1) Whenever a State plan is submitted to the Secretary by a State for approval under subchapter I, X, XIV, XVI, or XIX, he shall, not later than 90 days after the date the plan is submitted to him, make a determination as to whether it conforms to the requirements for approval under such subchapter. The 90-day period provided herein may be extended by written agreement of the Secretary and the affected State.
(2) Any State dissatisfied with a determination of the Secretary under paragraph (1) of this subsection with respect to any plan may, within 60 days after it has been notified of such determination, file a petition with the Secretary for reconsideration of the issue of whether such plan conforms to the requirements for approval under such subchapter. Within 30 days after receipt of such a petition, the Secretary shall notify the State of the time and place at which a hearing will be held for the purpose of reconsidering such issue. Such hearing shall be held not less than 20 days nor more than 60 days after the date notice of such hearing is furnished to such State, unless the Secretary and such State agree in writing to holding the hearing at another time. The Secretary shall affirm, modify, or reverse his original determination within 60 days of the conclusion of the hearing.
(3) Any State which is dissatisfied with a final determination made by the Secretary on such a reconsideration or a final determination of the Secretary under section 304, 1204, 1354, 1384, or 1396c of this title may, within 60 days after it has been notified of such determination, file with the United States court of appeals for the circ
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1316
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Payments**
(1) **In general** — Subject to the succeeding provisions of this section, the Secretary shall pay to each State with a plan approved under this subchapter, from its allotment under [section 1397dd of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397dd&num=0&edition=prelim), an amount for each quarter equal to the enhanced FMAP (or, in the case of expenditures described in subparagraph (D)(iv), the higher of 75 percent or the sum of the enhanced FMAP plus 5 percentage points) of expenditures in the quarter—
(A) for child health assistance under the plan for targeted low-income children in the form of providing medical assistance for which payment is made on the basis of an enhanced FMAP under the fourth sentence of [section 1396d(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396d/b&num=0&edition=prelim);
(B) [reserved]
(C) for child health assistance under the plan for targeted low-income children in the form of providing health benefits coverage that meets the requirements of [section 1397cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397cc&num=0&edition=prelim); and
(D) only to the extent permitted consistent with subsection (c)—
(i) for payment for other child health assistance for targeted low-income children;
(ii) for expenditures for health services initiatives under the plan for improving the health of children (including targeted low-income children and other low-income children);
(iii) for expenditures for outreach activities as provided in [section 1397bb(c)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397bb/c/1&num=0&edition=pre
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397ee
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment** There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as “MACPAC”).
**(b) Duties**
(1) **Review of access policies for all States and annual reports** — MACPAC shall—
(A) review policies of the Medicaid program established under this subchapter (in this section referred to as “Medicaid”) and the State Children’s Health Insurance Program established under subchapter XXI (in this section referred to as “CHIP”) affecting access to covered items and services, including topics described in paragraph (2);
(B) make recommendations to Congress, the Secretary, and States concerning such access policies;
(C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such reviews and MACPAC’s recommendations concerning such policies; and
(D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, including the implications of changes in health care delivery in the United States and in the market for health care services on such programs.
(2) **Specific topics to be reviewed** — Specifically, MACPAC shall review and assess the following:
(A) *Medicaid and CHIP payment policies* — Payment policies under Medicaid and CHIP, including—
(i) the factors affecting expenditures for the efficient provision of items and services in different sectors, including the process for updating payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of ot
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1396
Stored review status: release_metadata_unconfirmed. Explicit cross-reference supplied in source Markdown; currentness and applicability require review.
Federal law — U.S. Code and appendices · legal_authorities
**(a) Contents** A State plan for medical assistance must—
(1) provide that it shall be in effect in all political subdivisions of the State, and, if administered by them, be mandatory upon them;
(2) provide for financial participation by the State equal to not less than 40 per centum of the non-Federal share of the expenditures under the plan with respect to which payments under [section 1396b of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b&num=0&edition=prelim) are authorized by this subchapter; and, effective July 1, 1969, provide for financial participation by the State equal to all of such non-Federal share or provide for distribution of funds from Federal or State sources, for carrying out the State plan, on an equalization or other basis which will assure that the lack of adequate funds from local sources will not result in lowering the amount, duration, scope, or quality of care and services available under the plan;
(3) provide for granting an opportunity for a fair hearing before the State agency to any individual whose claim for medical assistance under the plan is denied or is not acted upon with reasonable promptness;
(4) provide (A) such methods of administration (including methods relating to the establishment and maintenance of personnel standards on a merit basis, except that the Secretary shall exercise no authority with respect to the selection, tenure of office, and compensation of any individual employed in accordance with such methods, including provision for utilization of professional medical personnel in the administration and, where administered locally, supervision of administration of the plan, and, subject to [section 1396b(i) of this title](https://uscode.house.gov/view.xhtml?req=granulei
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1396a
Stored review status: release_metadata_unconfirmed. Explicit cross-reference supplied in source Markdown; currentness and applicability require review.
Federal law — U.S. Code and appendices · legal_authorities
This chapter may be cited as the “Social Security Act”.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1305
Stored review status: release_metadata_unconfirmed. Incoming connection: Explicit cross-reference supplied in source Markdown; currentness and applicability require review.
Federal law — U.S. Code and appendices · legal_authorities
Page 4494
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1397gg
1 So in original. There are two closing parentheses for the
opening parenthesis preceding ‘‘relating’’.
(Aug. 14, 1935, ch. 531, title XXI, § 2106, as added
Pub. L. 105–33, title IV, § 4901(a), Aug. 5, 1997, 111
Stat. 563.)
§ 1397gg. Strategic objectives and performance
goals; plan administration
(a) Strategic objectives and performance goals
(1) Description
A State child health plan shall include a de-
scription of—
(A) the strategic objectives,
(B) the performance goals, and
(C) the performance measures,
the State has established for providing child
health assistance to targeted low-income chil-
dren under the plan and otherwise for maxi-
mizing health benefits coverage for other low-
income children and children generally in the
State.
(2) Strategic objectives
Such plan shall identify specific strategic
objectives relating to increasing the extent of
creditable health coverage among targeted
low-income children and other low-income
children.
(3) Performance goals
Such plan shall specify one or more perform-
ance goals for each such strategic objective so
identified.
(4) Performance measures
Such plan shall describe how performance
under the plan will be—
(A) measured through objective, independ-
ently verifiable means, and
(B) compared against performance goals,
in order to determine the State’s perform-
ance under this subchapter.
(b) Records, reports, audits, and evaluation
(1) Data collection, records, and reports
A State child health plan shall include an
assurance that the State will collect the data,
maintain the records, and furnish the reports
to the Secretary, at the times and in the
standardized format the Secretary may re-
quire in order to enable the Secretary to
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1397gg
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.