§1396i — Title 42 The Public Health and Welfare | U.S. Code

Summary

When the Secretary certifies a facility in a State as a rural health clinic under subchapter XVIII, that facility will be treated as meeting the certification rules for providing rural health clinic services under this subchapter. The Secretary must tell the State agency that runs Medicaid whether he approved or denied any facility’s application. The Secretary can cancel approval of an intermediate care facility for the mentally retarded if he finds it fails to meet the rules in sections 1396a(a)(31) or 1396d(d), or if there are grounds for ending the agreement under section 1395cc(b). If approval is canceled, the Secretary will notify the State agency and the facility and give a date when participation ends. Approval can only be restored after the problems are fixed and the Secretary is sure they will not happen again. A facility unhappy with the Secretary’s decision can ask for a hearing under section 405(b) and can seek court review under section 405(g); references to the Commissioner or Social Security Administration in those rules should be read as referring to the Secretary or the Department of Health and Human Services. The facility’s agreement with the State stays in effect while the time to ask for a hearing runs or while a hearing is pending, unless the Secretary finds in writing that keeping the facility approved is an immediate and serious threat to patient health and safety and that the facility was notified of the problems and did not fix them.

Title 42, §1396i

The Public Health and Welfare — Source: USLM XML via OLRC

(a)(1)Whenever the Secretary certifies a facility in a State to be qualified as a rural health clinic under subchapter XVIII, such facility shall be deemed to meet the standards for certification as a rural health clinic for purposes of providing rural health clinic services under this subchapter.

(2)The Secretary shall notify the State agency administering the medical assistance plan of his approval or disapproval of any facility in that State which has applied for certification by him as a qualified rural health clinic.

(b)(1)The Secretary may cancel approval of any intermediate care facility for the mentally retarded at any time if he finds on the basis of a determination made by him as provided in section 1396a(a)(33)(B) of this title that a facility fails to meet the requirements contained in section 1396a(a)(31) of this title or section 1396d(d) of this title, or if he finds grounds for termination of his agreement with the facility pursuant to section 1395cc(b) of this title. In that event the Secretary shall notify the State agency and the intermediate care facility for the mentally retarded that approval of eligibility of the facility to participate in the programs established by this subchapter and subchapter XVIII shall be terminated at a time specified by the Secretary. The approval of eligibility of any such facility to participate in such programs may not be reinstated unless the Secretary finds that the reason for termination has been removed and there is reasonable assurance that it will not recur.

(2)Any intermediate care facility for the mentally retarded which is dissatisfied with a determination by the Secretary that it no longer qualifies as a 11 So in original. Probably should be “an”. intermediate care facility for the mentally retarded for purposes of this subchapter, shall be entitled to a hearing by the Secretary to the same extent as is provided in section 405(b) of this title and to judicial review of the Secretary’s final decision after such hearing as is provided in section 405(g) of this title, except that, in so applying such sections and in applying section 405(l) of this title thereto, any reference therein to the Commissioner of Social Security or the Social Security Administration shall be considered a reference to the Secretary or the Department of Health and Human Services, respectively. Any agreement between such facility and the State agency shall remain in effect until the period for filing a request for a hearing has expired or, if a request has been filed, until a decision has been made by the Secretary; except that the agreement shall not be extended if the Secretary makes a written determination, specifying the reasons therefor, that the continuation of provider status constitutes an immediate and serious threat to the health and safety of patients, and the Secretary certifies that the facility has been notified of its deficiencies and has failed to correct them.

Notes & Related Subsidiaries

Editorial Notes

Amendments

1999—Pub. L. 106–113 struck out “of” after “approval of” in section catchline. 1994—Subsec. (b)(2). Pub. L. 103–296 inserted before period at end of first sentence “, except that, in so applying such sections and in applying section 405(l) of this title thereto, any reference therein to the Commissioner of Social Security or the Social Security Administration shall be considered a reference to the Secretary or the Department of Health and Human Services, respectively”. 1989—Pub. L. 101–239, § 6901(d)(5)(A), substituted “rural health clinics and intermediate care facilities for the mentally retarded” for “rural health clinics” in section catchline. Subsec. (b)(1). Pub. L. 101–239, § 6901(d)(5)(B)–(D), substituted “any intermediate care facility for the mentally retarded” for “any skilled nursing or intermediate care facility”, “section 1396a(a)(31) of this title or section 1396d(d) of this title” for “section 1396a(a)(28) of this title or section 1396r of this title or section 1396d(c) of this title”, and “the intermediate care facility for the mentally retarded” for “the skilled nursing facility or intermediate care facility”. Subsec. (b)(2). Pub. L. 101–239, § 6901(d)(5)(D), substituted “intermediate care facility for the mentally retarded” for “skilled nursing facility or intermediate care facility” in two places. 1988—Subsec. (b)(1). Pub. L. 100–360, § 411(l)(6)(F), as added by Pub. L. 100–485, § 608(d)(27)(J), inserted “or section 1396r of this title” after “1396a(a)(28) of this title”. 1987—Pub. L. 100–203 struck out “skilled nursing facilities and” before “of rural” in section catchline, redesignated subsecs. (b) and (c) as (a) and (b), respectively, and struck out former subsec. (a) which related to certification and approval of skilled nursing facilities. 1980—Subsec. (c). Pub. L. 96–499 added subsec. (c). 1977—Pub. L. 95–210 substituted “facilities and of rural health clinics” for “facilities” in section catchline, redesignated existing subsecs. (a) and (b) as (a)(1) and (2), respectively, and added subsec. (b).

Statutory Notes and Related Subsidiaries

Effective Date

of 1994 AmendmentAmendment by Pub. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Pub. L. 103–296, set out as a note under section 401 of this title.

Effective Date

of 1989 AmendmentAmendment by Pub. L. 101–239 effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1987, Pub. L. 100–203, see section 6901(d)(6) of Pub. L. 101–239, set out as a note under section 1395i–3 of this title.

Effective Date

of 1988

Amendments

Amendment by Pub. L. 100–485 effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, Pub. L. 100–360, see section 608(g)(1) of Pub. L. 100–485, set out as a note under section 704 of this title. Except as specifically provided in section 411 of Pub. L. 100–360, amendment by Pub. L. 100–360, as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, Pub. L. 100–203, effective as if included in the enactment of that provision in Pub. L. 100–203, see section 411(a) of Pub. L. 100–360, set out as a Reference to OBRA;

Effective Date

note under section 106 of Title 1, General Provisions.

Effective Date

of 1987 AmendmentAmendment by Pub. L. 100–203 applicable to nursing facility services furnished on or after Oct. 1, 1990, without regard to whether

Regulations

implementing such amendment are promulgated by such date, except as otherwise specifically provided in section 1396r of this title, with transitional rule, see section 4214(a), (b)(2) of Pub. L. 100–203, as amended, set out as an

Effective Date

note under section 1396r of this title.

Effective Date

of 1977 AmendmentAmendment by Pub. L. 95–210 applicable to medical assistance provided, under a State plan approved under subchapter XIX of this chapter, on and after first day of first calendar quarter that begins more than six months after Dec. 13, 1977, with exception for plans requiring State legislation, see section 2(f) of Pub. L. 95–210, set out as a note under section 1395cc of this title.

Effective Date

Section effective with respect to agreements filed with Secretary under section 1395cc of this title by skilled nursing facilities before, on, or after Oct. 30, 1972, but accepted by him on or after such date, see section 249A(e) of Pub. L. 92–603, set out as an

Effective Date

of 1972 Amendment note under section 1395cc of this title.

§1396i Certification and approval of rural health clinics and intermediate care facilities for mentally retarded

Summary

Title 42, §1396i

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