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42 U.S.C. § 1395w–24 — Agreements with States
Federal law — U.S. Code and appendices · legal_authorities
**(a) Duty of Secretary; enrollment of eligible individuals** The Secretary shall, at the request of a State made before January 1, 1970, or during 1981 or after 1988, enter into an agreement with such State pursuant to which all eligible individuals in either of the coverage groups described in subsection (b) (as specified in the agreement) will be enrolled under the program established by this part.
**(b) Coverage of groups to which applicable** An agreement entered into with any State pursuant to subsection (a) may be applicable to either of the following coverage groups:
(1) individuals receiving money payments under the plan of such State approved under subchapter I or subchapter XVI; or
(2) individuals receiving money payments under all of the plans of such State approved under subchapters I, X, XIV, and XVI, and part A of subchapter IV.
Except as provided in subsection (g), there shall be excluded from any coverage group any individual who is entitled to monthly insurance benefits under subchapter II or who is entitled to receive an annuity under the Railroad Retirement Act of 1974 [[45 U.S.C. 231](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title45-section231&num=0&edition=prelim) et seq.]. Effective January 1, 1974, and subject to [section 1396a(f) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/f&num=0&edition=prelim), the Secretary shall, at the request of any State not eligible to participate in the State plan program established under subchapter XVI, continue in effect the agreement entered into under this section with such State subject to such modifications as the Secretary may by regulations provide to take account of the termination of any plans of such State approved under subchapters
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Source file: Laws/federal/codes/united-states-code/title-42/section-1395w24-agreements-with-states--6d41c4b922.md
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Source location: Title 42, Chapter 7, § 1395w–24; chapter-007-social-security.md
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**(a) Duty of Secretary; enrollment of eligible individuals** The Secretary shall, at the request of a State made before January 1, 1970, or during 1981 or after 1988, enter into an agreement with such State pursuant to which all eligible individuals in either of the coverage groups described in subsection (b) (as specified in the agreement) will be enrolled under the program established by this part.
**(b) Coverage of groups to which applicable** An agreement entered into with any State pursuant to subsection (a) may be applicable to either of the following coverage groups:
(1) individuals receiving money payments under the plan of such State approved under subchapter I or subchapter XVI; or
(2) individuals receiving money payments under all of the plans of such State approved under subchapters I, X, XIV, and XVI, and part A of subchapter IV.
Except as provided in subsection (g), there shall be excluded from any coverage group any individual who is entitled to monthly insurance benefits under subchapter II or who is entitled to receive an annuity under the Railroad Retirement Act of 1974 [[45 U.S.C. 231](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title45-section231&num=0&edition=prelim) et seq.]. Effective January 1, 1974, and subject to [section 1396a(f) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/f&num=0&edition=prelim), the Secretary shall, at the request of any State not eligible to participate in the State plan program established under subchapter XVI, continue in effect the agreement entered into under this section with such State subject to such modifications as the Secretary may by regulations provide to take account of the termination of any plans of such State approved under subchapters I, X, XIV, and XVI and the establishment of the supplemental security income program under subchapter XVI.
**(c) Eligible individuals** For purposes of this section, an individual shall be treated as an eligible individual only if he is an eligible individual (within the meaning of section 1395o of this title) on the date an agreement covering him is entered into under subsection (a) or he becomes an eligible individual (within the meaning of such section) at any time after such date; and he shall be treated as receiving money payments described in subsection (b) if he receives such payments for the month in which the agreement is entered into or any month thereafter.
**(d) Monthly premiums; coverage periods** In the case of any individual enrolled pursuant to this section—
(1) the monthly premium to be paid by the State shall be determined under [section 1395r of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395r&num=0&edition=prelim) (without any increase under subsection (b) thereof);
(2) his coverage period shall begin on whichever of the following is the latest:
(A) July 1, 1966;
(B) the first day of the third month following the month in which the State agreement is entered into;
(C) the first day of the first month in which he is both an eligible individual and a member of a coverage group specified in the agreement under this section; or
(D) such date as may be specified in the agreement; and
(3) his coverage period attributable to the agreement with the State under this section shall end on the last day of whichever of the following first occurs:
(A) the month in which he is determined by the State agency to have become ineligible both for money payments of a kind specified in the agreement and (if there is in effect a modification entered into under subsection (h)) for medical assistance, or
(B) the month preceding the first month for which he becomes entitled to monthly benefits under subchapter II or to an annuity or pension under the Railroad Retirement Act of 1974 [[45 U.S.C. 231](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title45-section231&num=0&edition=prelim) et seq.].
**(e) Subsection (d)(3) terminations deemed resulting in section 1395p enrollment** Any individual whose coverage period attributable to the State agreement is terminated pursuant to subsection (d)(3) shall be deemed for purposes of this part (including the continuation of his coverage period under this part) to have enrolled under [section 1395p of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395p&num=0&edition=prelim) in the initial general enrollment period provided by [section 1395p(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395p/c&num=0&edition=prelim). The coverage period under this part of any such individual who (in the last month of his coverage period attributable to the State agreement or in any of the following six months) files notice that he no longer wishes to participate in the insurance program established by this part, shall terminate at the close of the month in which the notice is filed.
**(f) “Carrier” as including State agency; provisions facilitating deductions, coinsurance, etc., and leading to economy and efficiency of operation** With respect to eligible individuals receiving money payments under the plan of a State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, or eligible to receive medical assistance under the plan of such State approved under subchapter XIX, if the agreement entered into under this section so provides, the term “carrier” as defined in section 1395u(f) 11 See References in Text note below. of this title also includes the State agency, specified in such agreement, which administers or supervises the administration of the plan of such State approved under subchapter I, XVI, or XIX. The agreement shall also contain such provisions as will facilitate the financial transactions of the State and the carrier with respect to deductions, coinsurance, and otherwise, and as will lead to economy and efficiency of operation, with respect to individuals receiving money payments under plans of the State approved under subchapters I, X, XIV, and XVI, and part A of subchapter IV, and individuals eligible to receive medical assistance under the plan of the State approved under subchapter XIX.
**(g) Subsection (b) exclusions from coverage groups**
(1) The Secretary shall, at the request of a State made before January 1, 1970, or during 1981 or after 1988, enter into a modification of an agreement entered into with such State pursuant to subsection (a) under which the second sentence of subsection (b) shall not apply with respect to such agreement.
(2) In the case of any individual who would (but for this subsection) be excluded from the applicable coverage group described in subsection (b) by the second sentence of such subsection—
(A) subsections (c) and (d)(2) shall be applied as if such subsections referred to the modification under this subsection (in lieu of the agreement under subsection (a)), and
(B) subsection (d)(3)(B) shall not apply so long as there is in effect a modification entered into by the State under this subsection.
**(h) Modifications respecting subsection (b) coverage groups**
(1) The Secretary shall, at the request of a State made before January 1, 1970, or during 1981 or after 1988, enter into a modification of an agreement entered into with such State pursuant to subsection (a) under which the coverage group described in subsection (b) and specified in such agreement is broadened to include (A) individuals who are eligible to receive medical assistance under the plan of such State approved under subchapter XIX, or (B) qualified medicare beneficiaries (as defined in [section 1396d(p)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396d/p/1&num=0&edition=prelim)).
(2) For purposes of this section, an individual shall be treated as eligible to receive medical assistance under the plan of the State approved under subchapter XIX if, for the month in which the modification is entered into under this subsection or for any month thereafter, he has been determined to be eligible to receive medical assistance under such plan. In the case of any individual who would (but for this subsection) be excluded from the agreement, subsections (c) and (d)(2) shall be applied as if they referred to the modification under this subsection (in lieu of the agreement under subsection (a)), and subsection (d)(2)(C) shall be applied (except in the case of qualified medicare beneficiaries, as defined in [section 1396d(p)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396d/p/1&num=0&edition=prelim)) by substituting “second month following the first month” for “first month”.
(3) In this subsection, the term “qualified medicare beneficiary” also includes an individual described in [section 1396a(a)(10)(E)(iii) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/10/E/iii&num=0&edition=prelim).
**(i) Enrollment of qualified medicare beneficiaries** For provisions relating to enrollment of qualified medicare beneficiaries under part A, see [section 1395i–2(g) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395i–2/g&num=0&edition=prelim).
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Federal law — U.S. Code and appendices · legal_authorities
**(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 direct
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Scope of benefits** The benefits provided to an individual by the insurance program established by this part shall consist of—
(1) entitlement to have payment made to him or on his behalf (subject to the provisions of this part) for medical and other health services, except those described in subparagraphs (B) and (D) of paragraph (2) and subparagraphs (E) and (F) of [section 1395u(b)(6) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395u/b/6&num=0&edition=prelim); and
(2) entitlement to have payment made on his behalf (subject to the provisions of this part) for—
(A) home health services (other than items described in subparagraph (G) or subparagraph (I));
(B) medical and other health services (other than items described in subparagraph (G) or subparagraph (I)) furnished by a provider of services or by others under arrangement with them made by a provider of services, excluding—
(i) physician services except where furnished by—
(I) a resident or intern of a hospital, or
(II) a physician to a patient in a hospital which has a teaching program approved as specified in paragraph (6) of [section 1395x(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/b&num=0&edition=prelim) (including services in conjunction with the teaching programs of such hospital whether or not such patient is an inpatient of such hospital) where the conditions specified in paragraph (7) of such section are met,
(ii) services for which payment may be made pursuant to [section 1395n(b)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395n/b/2&num=0&edition=prelim),
(iii) services described by [section 1395x(s)(2)(K)(i) of
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Federal law — U.S. Code and appendices · legal_authorities
This subchapter may be cited as the “Railroad Retirement Act of 1974”.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Old-age insurance benefits** Every individual who—
(1) is a fully insured individual (as defined in [section 414(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section414/a&num=0&edition=prelim)),
(2) has attained age 62, and
(3) has filed application for old-age insurance benefits or was entitled to disability insurance benefits for the month preceding the month in which he attained retirement age (as defined in section 416(l) of this title),
shall be entitled to an old-age insurance benefit for each month, beginning with—
(A) in the case of an individual who has attained retirement age (as defined in section 416(l) of this title), the first month in which such individual meets the criteria specified in paragraphs (1), (2), and (3), or
(B) in the case of an individual who has attained age 62, but has not attained retirement age (as defined in section 416(l) of this title), the first month throughout which such individual meets the criteria specified in paragraphs (1) and (2) (if in that month he meets the criterion specified in paragraph (3)),
and ending with the month preceding the month in which he dies. Except as provided in subsection (q) and subsection (w), such individual’s old-age insurance benefit for any month shall be equal to his primary insurance amount (as defined in [section 415(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section415/a&num=0&edition=prelim)) for such month.
**(b) Wife’s insurance benefits**
(1) The wife (as defined in [section 416(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section416/b&num=0&edition=prelim)) and every divorced wife (as defined in [section 416(d) of this title](https://uscode.house.gov/
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Federal law — U.S. Code and appendices · legal_authorities
For the purposes of this subchapter—
**(a)**
(1) The term “employer” shall include—
(i) any carrier by railroad subject to the jurisdiction of the Surface Transportation Board under part A of subtitle IV of title 49;
(ii) any company which is directly or indirectly owned or controlled by, or under common control with, one or more employers as defined in paragraph (i) of this subdivision, and which operates any equipment or facility or performs any service (except trucking service, casual service, and the casual operation of equipment or facilities) in connection with the transportation of passengers or property by railroad, or the receipt, delivery, elevation, transfer in transit, refrigeration or icing, storage, or handling of property transported by railroad;
(iii) any receiver, trustee, or other individual or body, judicial or otherwise, when in the possession of the property or operating all or any part of the business of any employer as defined in paragraph (i) or (ii) of this subdivision;
(iv) any railroad association, traffic association, tariff bureau, demurrage bureau, weighing and inspection bureau, collection agency and any other association, bureau, agency, or organization which is controlled and maintained wholly or principally by two or more employers as defined in paragraph (i), (ii), or (iii) of this subdivision and which is engaged in the performance of services in connection with or incidental to railroad transportation; and
(v) any railway labor organization, national in scope, which has been or may be organized in accordance with the provisions of the Railway Labor Act, as amended [[45 U.S.C. 151](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title45-section151&num=0&edition=prelim) et seq.], and its State and National
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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
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Eligibility** Every individual who—
(1) has not attained the age of 65;
(2)
(A) has been entitled to benefits under this part under [section 426(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section426/b&num=0&edition=prelim), and
(B)
(i) continues to have the disabling physical or mental impairment on the basis of which the individual was found to be under a disability or to be a disabled qualified railroad retirement beneficiary, or (ii) is blind (within the meaning of [section 416(i)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section416/i/1&num=0&edition=prelim)), but
(C) whose entitlement under [section 426(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section426/b&num=0&edition=prelim) ends due solely to the individual having earnings that exceed the substantial gainful activity amount (as defined in [section 423(d)(4) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section423/d/4&num=0&edition=prelim)); and
(3) is not otherwise entitled to benefits under this part,
shall be eligible to enroll in the insurance program established by this part.
**(b) Enrollment**
(1) An individual may enroll under this section only in such manner and form as may be prescribed in regulations, and only during an enrollment period prescribed in or under this section.
(2) The individual’s initial enrollment period shall begin with the month in which the individual receives notice that the individual’s entitlement to benefits under [section 426(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section426/b&num=0&edition=prelim) will end due solely to the individual h
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395p
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Federal law — U.S. Code and appendices · legal_authorities
**(a) “Skilled nursing facility” defined** In this subchapter, the term “skilled nursing facility” means an institution (or a distinct part of an institution) which—
(1) is primarily engaged in providing to residents—
(A) skilled nursing care and related services for residents who require medical or nursing care, or
(B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons,
and is not primarily for the care and treatment of mental diseases;
(2) has in effect a transfer agreement (meeting the requirements of section 1395x(l) of this title) with one or more hospitals having agreements in effect under [section 1395cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395cc&num=0&edition=prelim); and
(3) meets the requirements for a skilled nursing facility described in subsections (b), (c), and (d) of this section.
**(b) Requirements relating to provision of services**
(1) **Quality of life**
(A) *In general* — A skilled nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.
(B) *Quality assessment and assurance* — A skilled nursing facility must maintain a quality assessment and assurance committee, consisting of the director of nursing services, a physician designated by the facility, and at least 3 other members of the facility’s staff, which (i) meets at least quarterly to identify issues with respect to which quality assessment and assurance activities are necessary and (ii) develops and implements appropriate plans of action to correct identified quality deficiencies. A State or the Secretary may not require disclosure of the records of such committee except ins
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395q
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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
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Federal law — U.S. Code and appendices · legal_authorities
(1) **National Training Institute for surveyors**
(A) *In general* — The Secretary of Health and Human Services shall enter into a contract with an entity for the purpose of establishing and operating a National Training Institute for Federal and State surveyors. Such Institute shall provide and improve the training of surveyors with respect to investigating allegations of abuse, neglect, and misappropriation of property in programs and long-term care facilities that receive payments under title XVIII or XIX of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq.].
(B) *Activities carried out by the Institute* — The contract entered into under subparagraph (A) shall require the Institute established and operated under such contract to carry out the following activities:
(i) Assess the extent to which State agencies use specialized surveyors for the investigation of reported allegations of abuse, neglect, and misappropriation of property in such programs and long-term care facilities.
(ii) Evaluate how the competencies of surveyors may be improved to more effectively investigate reported allegations of such abuse, neglect, and misappropriation of property, and provide feedback to Federal and State agencies on the evaluations conducted.
(iii) Provide a national program of training, tools, and technical assistance to Federal and State surveyors on investigating reports of such abuse, neglect, and misappropriation of property.
(iv) Develop and disseminate information on best practices for the investigation of such abuse, neglect, and misappropriation of property.
(v) Assess the performance of State complaint intake systems, in orde
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395r
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