§1397ff Process for Submission, Approval, and Amendment of State Child Health Plans

Summary

To get federal payments for a state child health program, a state must send the federal Secretary a child health plan that follows the law’s rules. The plan must be approved and must start on a calendar quarter the plan names, but not before October 1, 1997. A state can change its plan anytime by sending an amendment. Changes take effect on the dates the amendment says. If an amendment would cut or limit who can get services or what benefits they get, the state must give public notice under state law before the change and the change cannot stay in effect longer than 60 days unless the amendment is sent to the Secretary. Other changes that start during a state fiscal year cannot continue past that fiscal year (or past 90 days after they start) unless sent to the Secretary. The Secretary must quickly review plans and amendments. If the Secretary does not send a written disapproval or a request for more information within 90 days, the plan or amendment is treated as approved. If a plan or amendment is disapproved, the state gets a fair chance to fix problems before any financial penalties. The state must run the program the way the approved plan says. The Secretary can enforce the rules and may withhold payments for serious noncompliance, but must give the state a reasonable chance to correct things first. An approved plan stays in effect until the state amends it or the Secretary finds serious noncompliance.