<section xmlns="http://xml.house.gov/schemas/uslm/1.0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dcterms="http://purl.org/dc/terms/" style="-uslm-lc:I80" id="id25c969e2-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff"><num value="1397ff">§ 1397ff.</num><heading> Process for submission, approval, and amendment of State child health plans</heading><subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="id25c969e3-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/a"><num value="a" class="bold">(a)</num><heading class="bold"> Initial plan</heading><paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969e4-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/a/1"><num value="1" class="bold">(1)</num><heading class="bold"> In general</heading><content><p style="-uslm-lc:I12" class="indent1">As a condition of receiving payment under <ref href="/us/usc/t42/s1397ee">section 1397ee of this title</ref>, a State shall submit to the Secretary a State child health plan that meets the applicable requirements of this subchapter.</p>
</content>
</paragraph>
<paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969e5-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/a/2"><num value="2" class="bold">(2)</num><heading class="bold"> Approval</heading><chapeau>Except as the Secretary may provide under subsection (e) of this section, a State plan submitted under paragraph (1)—</chapeau><subparagraph style="-uslm-lc:I13" class="indent2" id="id25c969e6-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/a/2/A"><num value="A">(A)</num><content> shall be approved for purposes of this subchapter, and</content>
</subparagraph>
<subparagraph style="-uslm-lc:I13" class="indent2" id="id25c969e7-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/a/2/B"><num value="B">(B)</num><content> shall be effective beginning with a calendar quarter that is specified in the plan, but in no case earlier than <date date="1997-10-01">October 1, 1997</date>.</content>
</subparagraph>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="id25c969e8-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b"><num value="b" class="bold">(b)</num><heading class="bold"> Plan amendments</heading><paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969e9-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/1"><num value="1" class="bold">(1)</num><heading class="bold"> In general</heading><content><p style="-uslm-lc:I12" class="indent1">A State may amend, in whole or in part, its State child health plan at any time through transmittal of a plan amendment.</p>
</content>
</paragraph>
<paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969ea-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/2"><num value="2" class="bold">(2)</num><heading class="bold"> Approval</heading><chapeau>Except as the Secretary may provide under subsection (e) of this section, an amendment to a State plan submitted under paragraph (1)—</chapeau><subparagraph style="-uslm-lc:I13" class="indent2" id="id25c969eb-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/2/A"><num value="A">(A)</num><content> shall be approved for purposes of this subchapter, and</content>
</subparagraph>
<subparagraph style="-uslm-lc:I13" class="indent2" id="id25c969ec-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/2/B"><num value="B">(B)</num><content> shall be effective as provided in paragraph (3).</content>
</subparagraph>
</paragraph>
<paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969ed-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/3"><num value="3" class="bold">(3)</num><heading class="bold"> Effective dates for amendments</heading><subparagraph style="-uslm-lc:I18" class="indent4 firstIndent-2" id="id25c969ee-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/3/A"><num value="A" class="bold">(A)</num><heading class="bold"> In general</heading><content><p style="-uslm-lc:I13" class="indent2">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.</p>
</content>
</subparagraph>
<subparagraph style="-uslm-lc:I18" class="indent4 firstIndent-2" id="id25c969ef-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/3/B"><num value="B" class="bold">(B)</num><heading class="bold"> Amendments relating to eligibility or benefits</heading><clause style="-uslm-lc:I77" class="indent5 firstIndent-2" id="id25c969f0-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/3/B/i"><num value="i" class="bold">(i)</num><heading class="bold"> Notice requirement</heading><content><p style="-uslm-lc:I14" class="indent3">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.</p>
</content>
</clause>
<clause style="-uslm-lc:I77" class="indent5 firstIndent-2" id="id25c969f1-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/3/B/ii"><num value="ii" class="bold">(ii)</num><heading class="bold"> Timely transmittal</heading><content><p style="-uslm-lc:I14" class="indent3">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.</p>
</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I18" class="indent4 firstIndent-2" id="id25c969f2-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/b/3/C"><num value="C" class="bold">(C)</num><heading class="bold"> Other amendments</heading><content><p style="-uslm-lc:I13" class="indent2">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.</p>
</content>
</subparagraph>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="id25c969f3-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/c"><num value="c" class="bold">(c)</num><heading class="bold"> Disapproval of plans and plan amendments</heading><paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969f4-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/c/1"><num value="1" class="bold">(1)</num><heading class="bold"> Prompt review of plan submittals</heading><content><p style="-uslm-lc:I12" class="indent1">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.</p>
</content>
</paragraph>
<paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969f5-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/c/2"><num value="2" class="bold">(2)</num><heading class="bold"> 90-day approval deadlines</heading><content><p style="-uslm-lc:I12" class="indent1">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.</p>
</content>
</paragraph>
<paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969f6-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/c/3"><num value="3" class="bold">(3)</num><heading class="bold"> Correction</heading><content><p style="-uslm-lc:I12" class="indent1">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.</p>
</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="id25c969f7-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/d"><num value="d" class="bold">(d)</num><heading class="bold"> Program operation</heading><paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969f8-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/d/1"><num value="1" class="bold">(1)</num><heading class="bold"> In general</heading><content><p style="-uslm-lc:I12" class="indent1">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.</p>
</content>
</paragraph>
<paragraph style="-uslm-lc:I79" class="indent3 firstIndent-2" id="id25c969f9-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/d/2"><num value="2" class="bold">(2)</num><heading class="bold"> Violations</heading><content><p style="-uslm-lc:I12" class="indent1">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.</p>
</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="id25c969fa-4e00-11e3-bfbc-9f3100a4b203" identifier="/us/usc/t42/s1397ff/e"><num value="e" class="bold">(e)</num><heading class="bold"> Continued approval</heading><content><p style="-uslm-lc:I11" class="indent0">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.</p>
</content>
</subsection>
<sourceCredit id="id25c969fb-4e00-11e3-bfbc-9f3100a4b203">(<ref href="/us/act/1935-08-14/ch531">Aug. 14, 1935, ch. 531</ref>, title XXI, § 2106, as added <ref href="/us/pl/105/33/s4901/a">Pub. L. 105–33, title IV, § 4901(a)</ref>, <date date="1997-08-05">Aug. 5, 1997</date>, <ref href="/us/stat/111/563">111 Stat. 563</ref>.)</sourceCredit>
</section>