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LegalText 42 U.S.C. § 1397ff Process for submission, approval, and amendment of State child health plans us united_states_code code_section 42 THE PUBLIC HEALTH AND WELFARE 7 SOCIAL SECURITY 1397ff 42 U.S.C. § 1397ff current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc42@119-100.zip /us/usc/t42/s1397ff data/legal/raw/us/code/title-42/usc42.xml ca8cb865977f894e63967576a9aaeb7c750ffae1402eb80fa3dc3ebf6ca37766 644321055a08eb1f260a6a3e31ac157fa024756abf612a9fd6857e7e400cf24e 0f4365481b01b82da1806d1c893a272c9098c5dbd8258ef85f33394b83edeb7e 2026-07-04 official
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42 U.S.C. § 1397ff - Process for submission, approval, and amendment of State child health plans

Text

(a) Initial plan (1) In general As a condition of receiving payment under subsection (a) or (g) of 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), 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.

(Aug. 14, 1935, ch. 531, title XXI, § 2106, as added Pub. L. 10533, title IV, § 4901(a), Aug. 5, 1997, 111 Stat. 563; amended Pub. L. 11921, title VII, § 71401(b)(3), July 4, 2025, 139 Stat. 332.)

Notes

Editorial Notes

Amendments2025—Subsec. (a)(1). Pub. L. 11921 inserted “subsection (a) or (g) of” before “section 1397ee of this title”.