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U.S. Code as of:
01/19/04
Section 1397dd. Allotments
(a) Appropriation; total allotment
For the purpose of providing allotments to States under this
section, there is appropriated, out of any money in the Treasury
not otherwise appropriated -
(1) for fiscal year 1998, $4,295,000,000;
(2) for fiscal year 1999, $4,275,000,000;
(3) for fiscal year 2000, $4,275,000,000;
(4) for fiscal year 2001, $4,275,000,000;
(5) for fiscal year 2002, $3,150,000,000;
(6) for fiscal year 2003, $3,150,000,000;
(7) for fiscal year 2004, $3,150,000,000;
(8) for fiscal year 2005, $4,050,000,000;
(9) for fiscal year 2006, $4,050,000,000; and
(10) for fiscal year 2007, $5,000,000,000.
(b) Allotments to 50 States and District of Columbia
(1) In general
Subject to paragraph (4), of the amount available for allotment
under subsection (a) of this section for a fiscal year, reduced
by the amount of allotments made under subsection (c) of this
section (determined without regard to paragraph (4) thereof) for
the fiscal year, the Secretary shall allot to each State (other
than a State described in such subsection) with a State child
health plan approved under this subchapter the same proportion as
the ratio of -
(A) the product of (i) the number of children described in
paragraph (2) for the State for the fiscal year and (ii) the
State cost factor for that State (established under paragraph
(3)); to
(B) the sum of the products computed under subparagraph (A).
(2) Number of children
(A) In general
The number of children described in this paragraph for a
State for -
(i) each of fiscal years 1998 and 1999 is equal to the
number of low-income children in the State with no health
insurance coverage for the fiscal year;
(ii) fiscal year 2000 is equal to -
(I) 75 percent of the number of low-income children in
the State for the fiscal year with no health insurance
coverage, plus
(II) 25 percent of the number of low-income children in
the State for the fiscal year; and
(iii) each succeeding fiscal year is equal to -
(I) 50 percent of the number of low-income children in
the State for the fiscal year with no health insurance
coverage, plus
(II) 50 percent of the number of low-income children in
the State for the fiscal year.
(B) Determination of number of children
For purposes of subparagraph (A), a determination of the
number of low-income children (and of such children who have no
health insurance coverage) for a State for a fiscal year shall
be made on the basis of the arithmetic average of the number of
such children, as reported and defined in the 3 most recent
March supplements to the Current Population Survey of the
Bureau of the Census before the beginning of the calendar year
in which such fiscal year begins.
(3) Adjustment for geographic variations in health costs
(A) In general
For purposes of paragraph (1)(A)(ii), the "State cost factor"
for a State for a fiscal year equal to the sum of -
(i) 0.15, and
(ii) 0.85 multiplied by the ratio of -
(I) the annual average wages per employee for the State
for such year (as determined under subparagraph (B)), to
(II) the annual average wages per employee for the 50
States and the District of Columbia.
(B) Annual average wages per employee
For purposes of subparagraph (A), the "annual average wages
per employee" for a State, or for all the States, for a fiscal
year is equal to the average of the annual wages per employee
for the State or for the 50 States and the District of Columbia
for employees in the health services industry (SIC code 8000),
as reported by the Bureau of Labor Statistics of the Department
of Labor for each of the most recent 3 years before the
beginning of the calendar year in which such fiscal year
begins.
(4) Floors and ceilings in State allotments
(A) In general
The proportion of the allotment under this subsection for a
subsection (b) State (as defined in subparagraph (D)) for
fiscal year 2000 and each fiscal year thereafter shall be
subject to the following floors and ceilings:
(i) Floor of $2,000,000
A floor equal to $2,000,000 divided by the total of the
amount available under this subsection for all such
allotments for the fiscal year.
(ii) Annual floor of 10 percent below preceding fiscal year's
proportion
A floor of 90 percent of the proportion for the State for
the preceding fiscal year.
(iii) Cumulative floor of 30 percent below the FY 1999
proportion
A floor of 70 percent of the proportion for the State for
fiscal year 1999.
(iv) Cumulative ceiling of 45 percent above FY 1999
proportion
A ceiling of 145 percent of the proportion for the State
for fiscal year 1999.
(B) Reconciliation
(i) Elimination of any deficit by establishing a percentage
increase ceiling for States with highest annual percentage
increases
To the extent that the application of subparagraph (A)
would result in the sum of the proportions of the allotments
for all subsection (b) States exceeding 1.0, the Secretary
shall establish a maximum percentage increase in such
proportions for all subsection (b) States for the fiscal year
in a manner so that such sum equals 1.0.
(ii) Allocation of surplus through pro rata increase
To the extent that the application of subparagraph (A)
would result in the sum of the proportions of the allotments
for all subsection (b) States being less than 1.0, the
proportions of such allotments (as computed before the
application of floors under clauses (i), (ii), and (iii) of
subparagraph (A)) for all subsection (b) States shall be
increased in a pro rata manner (but not to exceed the ceiling
established under subparagraph (A)(iv)) so that (after the
application of such floors and ceiling) such sum equals 1.0.
(C) Construction
This paragraph shall not be construed as applying to (or
taking into account) amounts of allotments redistributed under
subsection (f) of this section.
(D) Definitions
In this paragraph:
(i) Proportion of allotment
The term "proportion" means, with respect to the allotment
of a subsection (b) State for a fiscal year, the amount of
the allotment of such State under this subsection for the
fiscal year divided by the total of the amount available
under this subsection for all such allotments for the fiscal
year.
(ii) Subsection (b) State
The term "subsection (b) State" means one of the 50 States
or the District of Columbia.
(c) Allotments to territories
(1) In general
Of the amount available for allotment under subsection (a) of
this section for a fiscal year, the Secretary shall allot 0.25
percent among each of the commonwealths and territories described
in paragraph (3) in the same proportion as the percentage
specified in paragraph (2) for such commonwealth or territory
bears to the sum of such percentages for all such commonwealths
or territories so described.
(2) Percentage
The percentage specified in this paragraph for -
(A) Puerto Rico is 91.6 percent,
(B) Guam is 3.5 percent,
(C) the Virgin Islands is 2.6 percent,
(D) American Samoa is 1.2 percent, and
(E) the Northern Mariana Islands is 1.1 percent.
(3) Commonwealths and territories
A commonwealth or territory described in this paragraph is any
of the following if it has a State child health plan approved
under this subchapter:
(A) Puerto Rico.
(B) Guam.
(C) The Virgin Islands.
(D) American Samoa.
(E) The Northern Mariana Islands.
(4) Additional allotment
(A) In general
In addition to the allotment under paragraph (1), the
Secretary shall allot each commonwealth and territory described
in paragraph (3) the applicable percentage specified in
paragraph (2) of the amount appropriated under subparagraph
(B).
(B) Appropriations
For purposes of providing allotments pursuant to subparagraph
(A), there is appropriated, out of any money in the Treasury
not otherwise appropriated $32,000,000 for fiscal year 1999,
$34,200,000 for each of fiscal years 2000 and 2001, $25,200,000
for each of fiscal years 2002 through 2004, $32,400,000 for
each of fiscal years 2005 and 2006, and $40,000,000 for fiscal
year 2007.
(d) Repealed. Pub. L. 106-554, Sec. 1(a)(6) [title VIII, Sec.
802(b)], Dec. 21, 2000, 114 Stat. 2763, 2763A-581
(e) 3-year availability of amounts allotted
Amounts allotted to a State pursuant to this section for a fiscal
year shall remain available for expenditure by the State through
the end of the second succeeding fiscal year; except that amounts
reallotted to a State under subsection (f) of this section shall be
available for expenditure by the State through the end of the
fiscal year in which they are reallotted.
(f) Procedure for redistribution of unused allotments
The Secretary shall determine an appropriate procedure for
redistribution of allotments from States that were provided
allotments under this section for a fiscal year but that do not
expend all of the amount of such allotments during the period in
which such allotments are available for expenditure under
subsection (e) of this section, to States that have fully expended
the amount of their allotments under this section.
(g) Rule for redistribution and extended availability of fiscal
years 1998, 1999, 2000, and 2001 allotments
(1) Amount redistributed
(A) In general
In the case of a State that expends all of its allotment
under subsection (b) or (c) of this section for fiscal year
1998 by the end of fiscal year 2000, or for fiscal year 1999 by
the end of fiscal year 2001, or for fiscal year 2000 by the end
of fiscal year 2002, or for fiscal year 2001 by the end of
fiscal year 2003, the Secretary shall redistribute to the State
under subsection (f) of this section (from the fiscal year
1998, 1999, 2000, or 2001 allotments of other States,
respectively, as determined by the application of paragraphs
(2) and (3) with respect to the respective fiscal year) the
following amount:
(i) State
In the case of one of the 50 States or the District of
Columbia, with respect to -
(I) the fiscal year 1998 allotment, the amount by which
the State's expenditures under this subchapter in fiscal
years 1998, 1999, and 2000 exceed the State's allotment for
fiscal year 1998 under subsection (b) of this section;
(II) the fiscal year 1999 allotment, the amount by which
the State's expenditures under this subchapter in fiscal
years 1999, 2000, and 2001 exceed the State's allotment for
fiscal year 1999 under subsection (b) of this section;
(III) the fiscal year 2000 allotment, the amount
specified in subparagraph (C)(i) (less the total of the
amounts under clause (ii) for such fiscal year), multiplied
by the ratio of the amount specified in subparagraph
(C)(ii) for the State to the amount specified in
subparagraph (C)(iii); or
(IV) the fiscal year 2001 allotment, the amount specified
in subparagraph (D)(i) (less the total of the amounts under
clause (ii) for such fiscal year), multiplied by the ratio
of the amount specified in subparagraph (D)(ii) for the
State to the amount specified in subparagraph (D)(iii).
(ii) Territory
In the case of a commonwealth or territory described in
subsection (c)(3) of this section, an amount that bears the
same ratio to 1.05 percent of the total amount described in
paragraph (2)(B)(i)(I) as the ratio of the commonwealth's or
territory's fiscal year 1998, 1999, 2000, or 2001 allotment
under subsection (c) of this section (as the case may be)
bears to the total of all such allotments for such fiscal
year under such subsection.
(B) Expenditure rules
An amount redistributed to a State under this paragraph -
(i) shall not be included in the determination of the
State's allotment for any fiscal year under this section;
(ii) notwithstanding subsection (e) of this section, with
respect to fiscal year 1998, 1999, or 2000, shall remain
available for expenditure by the State through the end of
fiscal year 2004;
(iii) notwithstanding subsection (e) of this section, with
respect to fiscal year 2001, shall remain available for
expenditure by the State through the end of fiscal year 2005;
and
(iv) shall be counted as being expended with respect to a
fiscal year allotment in accordance with applicable
regulations of the Secretary.
(C) Amounts used in computing redistributions for fiscal year
2000
For purposes of subparagraph (A)(i)(III) -
(i) the amount specified in this clause is the amount
specified in paragraph (2)(B)(i)(I) for fiscal year 2000,
less the total amount remaining available pursuant to
paragraph (2)(A)(iii);
(ii) the amount specified in this clause for a State is the
amount by which the State's expenditures under this
subchapter in fiscal years 2000, 2001, and 2002 exceed the
State's allotment for fiscal year 2000 under subsection (b)
of this section; and
(iii) the amount specified in this clause is the sum, for
all States entitled to a redistribution under subparagraph
(A) from the allotments for fiscal year 2000, of the amounts
specified in clause (ii).
(D) Amounts used in computing redistributions for fiscal year
2001
For purposes of subparagraph (A)(i)(IV) -
(i) the amount specified in this clause is the amount
specified in paragraph (2)(B)(i)(I) for fiscal year 2001,
less the total amount remaining available pursuant to
paragraph (2)(A)(iv);
(ii) the amount specified in this clause for a State is the
amount by which the State's expenditures under this
subchapter in fiscal years 2001, 2002, and 2003 exceed the
State's allotment for fiscal year 2001 under subsection (b)
of this section; and
(iii) the amount specified in this clause is the sum, for
all States entitled to a redistribution under subparagraph
(A) from the allotments for fiscal year 2001, of the amounts
specified in clause (ii).
(2) Extension of availability of portion of unexpended fiscal
years 1998 through 2001 allotments
(A) In general
Notwithstanding subsection (e) of this section:
(i) Fiscal year 1998 allotment
Of the amounts allotted to a State pursuant to this section
for fiscal year 1998 that were not expended by the State by
the end of fiscal year 2000, the amount specified in
subparagraph (B) for fiscal year 1998 for such State shall
remain available for expenditure by the State through the end
of fiscal year 2004.
(ii) Fiscal year 1999 allotment
Of the amounts allotted to a State pursuant to this
subsection for fiscal year 1999 that were not expended by the
State by the end of fiscal year 2001, the amount specified in
subparagraph (B) for fiscal year 1999 for such State shall
remain available for expenditure by the State through the end
of fiscal year 2004.
(iii) Fiscal year 2000 allotment
Of the amounts allotted to a State pursuant to this section
for fiscal year 2000 that were not expended by the State by
the end of fiscal year 2002, 50 percent of that amount shall
remain available for expenditure by the State through the end
of fiscal year 2004.
(iv) Fiscal year 2001 allotment
Of the amounts allotted to a State pursuant to this section
for fiscal year 2001 that were not expended by the State by
the end of fiscal year 2003, 50 percent of that amount shall
remain available for expenditure by the State through the end
of fiscal year 2005.
(B) Amount remaining available for expenditure
The amount specified in this subparagraph for a State for a
fiscal year is equal to -
(i) the amount by which (I) the total amount available for
redistribution under subsection (f) of this section from the
allotments for that fiscal year, exceeds (II) the total
amounts redistributed under paragraph (1) for that fiscal
year; multiplied by
(ii) the ratio of the amount of such State's unexpended
allotment for that fiscal year to the total amount described
in clause (i)(I) for that fiscal year.
(C) Use of up to 10 percent of retained 1998 allotments for
outreach activities
Notwithstanding section 1397ee(c)(2)(A) of this title, with
respect to any State described in subparagraph (A)(i), the
State may use up to 10 percent of the amount specified in
subparagraph (B) for fiscal year 1998 for expenditures for
outreach activities approved by the Secretary.
(3) Determination of amounts
For purposes of calculating the amounts described in paragraphs
(1) and (2) relating to the allotment for fiscal year 1998,
fiscal year 1999, fiscal year 2000, or fiscal year 2001, the
Secretary shall use the amounts reported by the States not later
than December 15, 2000, November 30, 2001, November 30, 2002, or
November 30, 2003, respectively, on HCFA Form 64 or HCFA Form 21
or CMS Form 64 or CMS Form 21, as the case may be,,)1(! as
approved by the Secretary.
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