Laws: Cases and Codes : U.S. Code : Title 42 : Section 1397ff


   
U.S. Code as of: 01/19/04
Section 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 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) of
      this section, 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) of
      this section, 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) of this
      section 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) of
    this section or the Secretary finds, under subsection (d) of this
    section, substantial noncompliance of the plan with the
    requirements of this subchapter.



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