§1397ff Process for submission, approval, and amendment of State child health plans

Summary

To get federal payments, a State must send the Secretary a child health plan that follows the rules. The plan must be approved and it becomes effective on a calendar quarter the State names, but never earlier than October 1, 1997, unless the Secretary allows otherwise. A State can change its plan anytime by sending an amendment. The amendment must be approved and it takes effect on the date(s) the amendment says. If an amendment cuts or limits who can get care or what benefits are offered, the State must give public notice under state law before it takes effect. Such a cut or limit cannot stay in effect longer than 60 days unless the State sends the amendment to the Secretary before those 60 days end. Any other amendment that starts during a State fiscal year cannot remain after the fiscal year (or after 90 days from its start) unless it has been sent to the Secretary. The Secretary must review plans and amendments quickly to see if they meet the rules. A plan is treated as approved unless the Secretary tells the State in writing within 90 days that it is disapproved or that more information is needed. If a plan or amendment is disapproved, or the State is seriously not following the rules, the Secretary must give the State a fair chance to fix the problem before cutting or withholding federal funds. States must run the program the way their approved plan says. An approved plan stays in effect until the State changes it or the Secretary finds serious noncompliance.