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42 U.S.C. § 1397ff — Process for submission, approval, and amendment of State child health plans
Federal law — U.S. Code and appendices · legal_authorities
**(a) Initial plan**
(1) **In general** — As a condition of receiving 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), a State shall submit to the Secretary a State child health plan that meets the applicable requirements of this subchapter.
(2) **Approval** — Except as the Secretary may provide under subsection (e), a State plan submitted under paragraph (1)—
(A) shall be approved for purposes of this subchapter, and
(B) shall be effective beginning with a calendar quarter that is specified in the plan, but in no case earlier than October 1, 1997.
**(b) Plan amendments**
(1) **In general** — A State may amend, in whole or in part, its State child health plan at any time through transmittal of a plan amendment.
(2) **Approval** — Except as the Secretary may provide under subsection (e), an amendment to a State plan submitted under paragraph (1)—
(A) shall be approved for purposes of this subchapter, and
(B) shall be effective as provided in paragraph (3).
(3) **Effective dates for amendments**
(A) *In general* — Subject to the succeeding provisions of this paragraph, an amendment to a State plan shall take effect on one or more effective dates specified in the amendment.
(B) *Amendments relating to eligibility or benefits*
(i) *Notice requirement* — Any plan amendment that eliminates or restricts eligibility or benefits under the plan may not take effect unless the State certifies that it has provided prior public notice of the change, in a form and manner provided under applicable State law.
(ii) *Timely transmittal* — Any plan amendment that eliminates or restricts eligibility or benefits under the plan shall
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Source file: Laws/federal/codes/united-states-code/title-42/section-1397ff-process-for-submission-approval-and-amendment-of-state-child-health-plan--9d39b8c45d.md
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Source location: Title 42, Chapter 7, § 1397ff; chapter-007-social-security.md
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**(a) Initial plan**
(1) **In general** — As a condition of receiving 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), a State shall submit to the Secretary a State child health plan that meets the applicable requirements of this subchapter.
(2) **Approval** — Except as the Secretary may provide under subsection (e), a State plan submitted under paragraph (1)—
(A) shall be approved for purposes of this subchapter, and
(B) shall be effective beginning with a calendar quarter that is specified in the plan, but in no case earlier than October 1, 1997.
**(b) Plan amendments**
(1) **In general** — A State may amend, in whole or in part, its State child health plan at any time through transmittal of a plan amendment.
(2) **Approval** — Except as the Secretary may provide under subsection (e), an amendment to a State plan submitted under paragraph (1)—
(A) shall be approved for purposes of this subchapter, and
(B) shall be effective as provided in paragraph (3).
(3) **Effective dates for amendments**
(A) *In general* — Subject to the succeeding provisions of this paragraph, an amendment to a State plan shall take effect on one or more effective dates specified in the amendment.
(B) *Amendments relating to eligibility or benefits*
(i) *Notice requirement* — Any plan amendment that eliminates or restricts eligibility or benefits under the plan may not take effect unless the State certifies that it has provided prior public notice of the change, in a form and manner provided under applicable State law.
(ii) *Timely transmittal* — Any plan amendment that eliminates or restricts eligibility or benefits under the plan shall not be effective for longer than a 60-day period unless the amendment has been transmitted to the Secretary before the end of such period.
(C) *Other amendments* — Any plan amendment that is not described in subparagraph (B) and that becomes effective in a State fiscal year may not remain in effect after the end of such fiscal year (or, if later, the end of the 90-day period on which it becomes effective) unless the amendment has been transmitted to the Secretary.
**(c) Disapproval of plans and plan amendments**
(1) **Prompt review of plan submittals** — The Secretary shall promptly review State plans and plan amendments submitted under this section to determine if they substantially comply with the requirements of this subchapter.
(2) **90-day approval deadlines** — A State plan or plan amendment is considered approved unless the Secretary notifies the State in writing, within 90 days after receipt of the plan or amendment, that the plan or amendment is disapproved (and the reasons for disapproval) or that specified additional information is needed.
(3) **Correction** — In the case of a disapproval of a plan or plan amendment, the Secretary shall provide a State with a reasonable opportunity for correction before taking financial sanctions against the State on the basis of such disapproval.
**(d) Program operation**
(1) **In general** — The State shall conduct the program in accordance with the plan (and any amendments) approved under subsection (c) and with the requirements of this subchapter.
(2) **Violations** — The Secretary shall establish a process for enforcing requirements under this subchapter. Such process shall provide for the withholding of funds in the case of substantial noncompliance with such requirements. In the case of an enforcement action against a State under this paragraph, the Secretary shall provide a State with a reasonable opportunity for correction before taking financial sanctions against the State on the basis of such an action.
**(e) Continued approval** An approved State child health plan shall continue in effect unless and until the State amends the plan under subsection (b) or the Secretary finds, under subsection (d), substantial noncompliance of the plan with the requirements of this subchapter.
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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) 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
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
**(a) Child health assistance** For purposes of this subchapter, the term “child health assistance” means payment for part or all of the cost of health benefits coverage for targeted low-income children that includes any of the following (and includes, in the case described in [section 1397ee(a)(1)(D)(i) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee/a/1/D/i&num=0&edition=prelim), payment for part or all of the cost of providing any of the following), as specified under the State plan:
(1) Inpatient hospital services.
(2) Outpatient hospital services.
(3) Physician services.
(4) Surgical services.
(5) Clinic services (including health center services) and other ambulatory health care services.
(6) Prescription drugs and biologicals and the administration of such drugs and biologicals, only if such drugs and biologicals are not furnished for the purpose of causing, or assisting in causing, the death, suicide, euthanasia, or mercy killing of a person.
(7) Over-the-counter medications.
(8) Laboratory and radiological services.
(9) Prenatal care and prepregnancy family planning services and supplies.
(10) Inpatient mental health services, other than services described in paragraph (18) but including services furnished in a State-operated mental hospital and including residential or other 24-hour therapeutically planned structured services.
(11) Outpatient mental health services, other than services described in paragraph (19) but including services furnished in a State-operated mental hospital and including community-based services.
(12) Durable medical equipment and other medically-related or remedial devices (such as prosthetic devices, implants, eyeglasses, hearing aids, dental devices, and adaptive devices).
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397jj
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Federal law — U.S. Code and appendices · legal_authorities
Page 4493
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1397ff
the Social Security Act (42 U.S.C. 1396b(u)) for data
required for purposes of PERM requirements, but
only if the State MEQC reviews are based on a broad,
representative sample of Medicaid applicants or en-
rollees in the States.
‘‘(f) IDENTIFICATION OF IMPROVED STATE-SPECIFIC SAM-
PLE SIZES.—The Secretary shall establish State-specific
sample sizes for application of the PERM requirements
with respect to State child health plans for fiscal years
beginning with the first fiscal year that begins on or
after the date on which the new final rule is in effect
for all States, on the basis of such information as the
Secretary determines appropriate. In establishing such
sample sizes, the Secretary shall, to the greatest extent
practicable—
‘‘(1) minimize the administrative cost burden on
States under Medicaid and CHIP; and
‘‘(2) maintain State flexibility to manage such pro-
grams.
‘‘(g) TIME FOR PROMULGATION OF FINAL RULE.—The
final rule implementing the PERM requirements under
subsection (b) shall be promulgated not later than 6
months after the date of enactment of this Act [Feb. 4,
2009].’’
[For definitions of ‘‘CHIP’’, ‘‘Medicaid’’, and ‘‘Sec-
retary’’, see section 1(c) of Pub. L. 111–3, set out as a
Definitions note under section 1396 of this title.]
§ 1397ff. Process for submission, approval, and
amendment of State child health plans
(a) Initial plan
(1) In general
As a condition of receiving payment under
section 1397ee of this title, a State shall sub-
mit to the Secretary a State child health plan
that meets the applicable requirements of this
subchapter.
(2) Approval
Except as the Secretary may provide under
subsection (e), a State plan submitted under
paragraph (1)—
(A) shal
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1397ff
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.