Amendment of section by section 5121(a) of Puspan. L. 117–328 applicable beginning on the first day of the first calendar quarter that begins on or after the date that is 24 months after Dec. 29, 2022. See 2022 Amendment notes below.

Puspan. L. 118–42, div. G, title I, § 203, Mar. 9, 2024, 138 Stat. 403, provided that, effective on the date that is 24 months after Mar. 9, 2024, subsection (oo)(1)(B) of this section is amended as follows:

(1) in the subparagraph span, by striking “by children”;

(2) by striking “children enrolled” and inserting “children generally, children in foster care specifically, individuals over the age of 18 receiving home and community-based services (as defined in section 9817(a)(2)(B) of Public Law 117–2), and individuals over the age of 18 residing in institutional care settings (including nursing facilities, intermediate care facilities for individuals with intellectual disabilities, institutions for mental diseases, inpatient psychiatric hospitals, and other such institutional care settings) enrolled”; and

(3) by striking “not more than the age of 18 years” through the period at the end and inserting “subject to the program, including information with respect to each such category of children and individuals over the age of 18.”

See 2024 Amendment note below.

Puspan. L. 118–42, div. G, title I, § 205(a)(1)(B)–(F), (2)(B), Mar. 9, 2024, 138 Stat. 405, 406, provided that, effective Jan. 1, 2026, subsection (a)(84)(A) of this section is amended as follows:

(1) by striking “who is an eligible juvenile (as defined in subsection (nn)(2))”;

(2) by striking “because the juvenile” and inserting “because the individual”;

(3) by striking “during the period the juvenile” and inserting “during the period the individual”;

(4) by inserting “such an individual who is an eligible juvenile (as defined in subsection (nn)(2)) and” after “or in the case of”; and

(5) by striking “paragraph (31)” and inserting “the last numbered paragraph”.

See 2024 Amendment notes below.

Puspan. L. 117–328, div. FF, title V, § 5122(a)(2), (c), Dec. 29, 2022, 136 Stat. 5944, provided that, effective on the first day of the first calendar quarter that begins after the date that is 24 months after Dec. 29, 2022 and applicable to items and services furnished for periods beginning on or after such date, subsection (a)(84)(A) of this section is amended by inserting “(or in the case of a State electing the option described in the subdivision (A) following paragraph (31) of section 1396d(a) of this title, during such period beginning after the disposition of charges with respect to such individual)” after “is such an inmate”. See 2022 Amendment note below.

Puspan. L. 117–328, div. FF, title V, § 5123(span), (d), Dec. 29, 2022, 136 Stat. 5945, 5946, provided that, effective July 1, 2025, this section is amended as follows:

(1) in subsection (a), by striking paragraph (83) and inserting the following:

“(83) provide that in the case of a State plan (or waiver of the plan) that provides medical assistance on a fee-for-service basis or through a primary care case-management system described in section 1396n(span)(1) of this title, the State shall publish (and update on at least a quarterly basis or more frequently as required by the Secretary) on the public website of the State agency administering the State plan, a searchable directory of the providers described in subsection (mm) that, in addition to such other requirements as the Secretary may specify, such as making paper directories available to enrollees, includes with respect to each such provider—

“(A) the name of the provider;

“(B) the specialty of the provider;

“(C) the address at which the provider provides services;

“(D) the telephone number of the provider;

“(E) information regarding—

“(i) the provider’s cultural and linguistic capabilities, including languages (including American Sign Language) offered by the provider or by a skilled medical interpreter who provides interpretation services at the provider’s office;

“(ii) whether the provider is accepting as new patients individuals who receive medical assistance under this subchapter;

“(iii) whether the provider’s office or facility has accommodations for individuals with physical disabilities, including offices, exam rooms, and equipment;

“(iv) the Internet website of such provider, if applicable; and

“(v) whether the provider offers covered services via telehealth; and

“(F) other relevant information as required by the Secretary;”; and

(2) by striking subsection (mm) and inserting the following:

“(mm) Directory provider described

“(1) In general

“A provider described in this subsection, at a minimum, includes physicians, hospitals, pharmacies, providers of mental health services, providers of substance use disorder services, providers of long term services and supports as appropriate, and such other providers as required by the Secretary, and—

“(A) in the case of a provider or a provider type for which the State agency, as a condition of receiving payment for items and services furnished by the provider to individuals eligible to receive medical assistance under the State plan (or a waiver of the plan), requires the enrollment of the provider with the State agency, includes a provider that—

“(i) is enrolled with the agency as of the date on which the directory is published or updated (as applicable) under subsection (a)(83); and

“(ii) received payment under the State plan in the 12-month period preceding such date; and

“(B) in the case of a provider or a provider type for which the State agency does not require such enrollment, includes a provider that received payment under the State plan (or a waiver of the plan) in the 12-month period preceding the date on which the directory is published or updated (as applicable) under subsection (a)(83).

“(2) State option to include other participating providers

“At State option, a provider described in this subsection may include any provider who furnishes services and is participating under the State plan under this subchapter or under a waiver of such plan.”

See 2022 Amendment notes below.

Puspan. L. 101–508, title IV, § 4801(e)(11), Nov. 5, 1990, 104 Stat. 1388–217, provided that, effective on the date on which the Secretary promulgates standards regarding the qualifications of nursing facility administrators under section 1396r(f)(4) of this title, subsection (a)(29) of this section is repealed.

The Child Nutrition Act of 1966, referred to in subsecs. (a)(7) and (e)(13)(F)(ii)(I)(hh), is Puspan. L. 89–642, Oct. 11, 1966, 80 Stat. 885, which is classified generally to chapter 13A (§ 1771 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 1771 of this title and Tables.

The Richard B. Russell National School Lunch Act, referred to in subsecs. (a)(7) and (e)(13)(F)(ii)(I)(gg), is act June 4, 1946, ch. 281, 60 Stat. 230, which is classified generally to chapter 13 (§ 1751 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 1751 of this title and Tables.

Section 602 of this title, referred to in subsecs. (a)(10)(A)(i)(I) and (e)(10), was repealed and a new section 602 enacted by Puspan. L. 104–193, title I, § 103(a)(1), Aug. 22, 1996, 110 Stat. 2112, and, as so enacted, no longer contains subsec. (a)(37) or (a)(43).

Section 606 of this title, referred to in subsec. (a)(10)(A)(i)(I), was repealed and a new section 606 enacted by Puspan. L. 104–193, title I, § 103(a)(1), Aug. 22, 1996, 110 Stat. 2112, and, as so enacted, no longer contains a subsec. (h).

Section 682 of this title, referred to in subsec. (a)(10)(A)(i)(I), was repealed by Puspan. L. 104–193, title I, § 108(e), Aug. 22, 1996, 110 Stat. 2167.

The date of the enactment of section 211(a) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, referred to in subsec. (a)(10)(A)(i)(II)(aa), is the date of enactment of Puspan. L. 104–193, which was approved Aug. 22, 1996. Section 211(a) of the Act amended section 1382c of this title.

Section 303(a)(4)(A) of this title, referred to in subsec. (a)(20)(C), was amended generally by Puspan. L. 97–35, title XXIII, § 2353(a)(1)(A), Aug. 13, 1981, 95 Stat. 871, and, as so amended, no longer contained cls. (i) and (ii). Section 303(a)(4) was amended by Puspan. L. 103–66, title XIII, § 13741(span), Aug. 10, 1993, 107 Stat. 663, and, as so amended, no longer contains subparagraphs.

Section 1383(a)(4)(A)(i) and (ii) of this title, referred to in subsec. (a)(20)(C), is a reference to section 1383(a)(4)(A)(i) and (ii) existing prior to the general revision of subchapter XVI of this chapter by Puspan. L. 92–603, title III, § 301, Oct. 30, 1972, 86 Stat. 1465, eff. Jan. 1, 1974. The prior section (which is set out as a note under section 1383 of this title) continues in effect for Puerto Rico, Guam, and the Virgin Islands. Subsec. (a)(4) of the prior section was amended generally by Puspan. L. 97–35, title XXIII, § 2353(m)(2)(B), Aug. 13, 1981, 95 Stat. 973, and, as so amended, no longer contained clauses in subpar. (A). Subsec. (a)(4) of the prior section was also amended by Puspan. L. 103–66, title XIII, § 13741(span), Aug. 10, 1993, 107 Stat. 663, and, as so amended, no longer contains subparagraphs.

Section 6401(span)(2) of the Patient Protection and Affordable Care Act, referred to in subsecs. (a)(39) and (ll), is section 6401(span)(2) of Puspan. L. 111–148, which is set out as a note under section 1395cc of this title.

Public Law 92–336, referred to in provisions following subsec. (a)(81), is Puspan. L. 92–336, July 1, 1972, 86 Stat. 406, which amended sections 401, 403, 409, 411, 415, 427, 428, and 430 of this title and sections 165, 1401, 1402, 3101, 3111, 3121, 3122, 3125, 6413, and 6654 of Title 26, Internal Revenue Code, and enacted provisions set out as notes under sections 403, 409, 415, and 428 of this title and sections 165 and 1401 of Title 26.

The Food and Nutrition Act of 2008, referred to in subsec. (e)(13)(F)(ii)(I)(ee), is Puspan. L. 88–525, Aug. 31, 1964, 78 Stat. 703, which is classified generally to chapter 51 (§ 2011 et seq.) of Title 7, Agriculture. For complete classification of this Act to the Code, see Short Title note set out under section 2011 of Title 7 and Tables.

The Head Start Act, referred to in subsec. (e)(13)(F)(ii)(I)(ff), is subchapter B (§ 635 et seq.) of chapter 8 of subtitle A of title VI of Puspan. L. 97–35, Aug. 13, 1981, 95 Stat. 499, which is classified generally to subchapter II (§ 9831 et seq.) of chapter 105 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 9801 of this title and Tables.

The Child Care and Development Block Grant Act of 1990, referred to in subsec. (e)(13)(F)(ii)(I)(ii), is subchapter C (§ 658A et seq.) of chapter 8 of subtitle A of title VI of Puspan. L. 97–35, as added by Puspan. L. 101–508, title V, § 5082(2), Nov. 5, 1990, 104 Stat. 1388–236, which is classified generally to subchapter II–B (§ 9857 et seq.) of chapter 105 of this title. For complete classification of this Act to the Code, see section 9857(a) of this title and Tables.

The Stewart B. McKinney Homeless Assistance Act, referred to in subsec. (e)(13)(F)(ii)(I)(jj), was Puspan. L. 100–77, July 22, 1987, 101 Stat. 482. Puspan. L. 100–77 was renamed the McKinney-Vento Homeless Assistance Act by Puspan. L. 106–400, § 1, Oct. 30, 2000, 114 Stat. 1675, and is classified principally to chapter 119 (§ 11301 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 11301 of this title and Tables.

The United States Housing Act of 1937, referred to in subsec. (e)(13)(F)(ii)(I)(kk), is act Sept. 1, 1937, ch. 896, as revised generally by Puspan. L. 93–383, title II, § 201(a), Aug. 22, 1974, 88 Stat. 653, which is classified generally to chapter 8 (§ 1437 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 1437 of this title and Tables.

The Native American Housing Assistance and Self-Determination Act of 1996, referred to in subsec. (e)(13)(F)(ii)(I)(ll), is Puspan. L. 104–330, Oct. 26, 1996, 110 Stat. 4016, which is classified principally to chapter 43 (§ 4101 et seq.) of Title 25, Indians. For complete classification of this Act to the Code, see Short Title note set out under section 4101 of Title 25 and Tables.

The Internal Revenue Code of 1986, referred to in subsecs. (e)(14)(G), (K)(iv)(I)(aa), (v), (u)(3), (ss)(2), and (tt)(1)(D)(i), (ii), is classified generally to Title 26, Internal Revenue Code.

The Patient Protection and Affordable Care Act, referred to in subsecs. (e)(14)(K)(iv)(I)(aa) and (tt)(1)(D)(i), (ii), is Puspan. L. 111–148, Mar. 23, 2010, 124 Stat. 119. Title I of the Act enacted chapter 157 of Title 42, The Public Health and Welfare, and enacted, amended, and transferred numerous other sections and notes in the Code. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.

The Public Health Service Act, referred to in subsecs. (u)(3) and (aa)(3), is act July 1, 1944, ch. 373, 58 Stat. 682. Titles XV and XXII of the Act are classified generally to subchapters XIII (§ 300k et seq.) and XX (§ 300bspan–1 et seq.), respectively, of chapter 6A of this title. For complete classification of this Act to the Code, see Short Title note set out under section 201 of this title and Tables.

The Employee Retirement Income Security Act of 1974, referred to in subsec. (u)(3), is Puspan. L. 93–406, Sept. 2, 1974, 88 Stat. 829. Title VI of the Act probably means part 6 of subtitle B of title I of the Act which is classified generally to part 6 (§ 1161 et seq.) of subtitle B of subchapter I of chapter 18 of Title 29, Labor, because the Act has no title VI. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of Title 29 and Tables.

Section 2701 of the Public Health Service Act, referred to in subsec. (aa)(4), is section 2701 of act July 1, 1944, which was classified to section 300gg of this title, was renumbered section 2704, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Puspan. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(span)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and was transferred to section 300gg–3 of this title. A new section 2701 of act July 1, 1944, related to fair health insurance premiums, was added, effective for plan years beginning on or after Jan. 1, 2014, and amended, by Puspan. L. 111–148, title I, § 1201(4), title X, § 10103(a), Mar. 23, 2010, 124 Stat. 155, 892, and is classified to section 300gg of this title.

Section 1710(1) of the Government Paperwork Elimination Act, referred to in subsec. (dd), is section 1710(1) of Puspan. L. 105–277, which is set out in a note under section 3504 of Title 44, Public Printing and Documents.

The Alaska Native Claims Settlement Act, referred to in subsec. (ff)(1), is Puspan. L. 92–203, Dec. 18, 1971, 85 Stat. 688, which is classified generally to chapter 33 (§ 1601 et seq.) of Title 43, Public Lands. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of Title 43 and Tables.

Section 1395cc(j)(7) of this title, referred to in subsec. (kk)(5), was redesignated section 1395cc(j)(9) by Puspan. L. 111–152, title I, § 1304(1), Mar. 30, 2010, 124 Stat. 1058 and Puspan. L. 114–255, div. C, title XVII, § 17004(span)(2)(A)(ii), Dec. 13, 2016, 130 Stat. 1333.

The Families First Coronavirus Response Act, referred to in subsec. (tt), is Puspan. L. 116–127, Mar. 18, 2020, 134 Stat. 178. For complete classification of this Act to the Code, see Short Title note set out under section 2601 of Title 29, Labor, and Tables.

In subsec. (a)(4)(D), “chapter 21 of title 41” substituted for “section 27 of the Office of Federal Procurement Policy Act (41 U.S.C. 423)” and “section 2102(a)(3) of title 41” substituted for “subsection (a)(2) of such section of that Act” on authority of Puspan. L. 111–350, § 6(c), Jan. 4, 2011, 124 Stat. 3854, which Act enacted Title 41, Public Contracts.

2024—Subsec. (a)(84)(A). Puspan. L. 118–42, § 205(a)(1)(B)–(F), struck out “who is an eligible juvenile (as defined in subsection (nn)(2))” after “under the State plan (or waiver of such plan) for an individual”, substituted “because the individual” for “because the juvenile”, “during the period the individual” for “during the period the juvenile”, and “the last numbered paragraph” for “paragraph (31)”, and inserted “such an individual who is an eligible juvenile (as defined in subsection (nn)(2)) and” after “or in the case of”.

Puspan. L. 118–42, § 205(a)(1)(A), substituted “under the State plan (or waiver of such plan)” for “under the State plan”.

Subsec. (nn)(2)(A). Puspan. L. 118–42, § 205(c)(1), substituted “State plan (or waiver of such plan)” for “State plan”.

Subsec. (nn)(3). Puspan. L. 118–42, § 205(c)(2), substituted “the last numbered paragraph” for “paragraph (31)”.

Subsec. (oo)(1)(B). Puspan. L. 118–42, § 203(a), in span, struck out “by children” after “antipsychotic medications” and, in text, substituted “children generally, children in foster care specifically, individuals over the age of 18 receiving home and community-based services (as defined in section 9817(a)(2)(B) of Public Law 117–2), and individuals over the age of 18 residing in institutional care settings (including nursing facilities, intermediate care facilities for individuals with intellectual disabilities, institutions for mental diseases, inpatient psychiatric hospitals, and other such institutional care settings) enrolled” for “children enrolled” and “subject to the program, including information with respect to each such category of children and individuals over the age of 18.” for “not more than the age of 18 years generally and children in foster care specifically.”

2022—Subsec. (a)(10)(A). Puspan. L. 117–169, § 11405(a)(1)(A), inserted “(13)(B),” after “(5),” in introductory provisions.

Subsec. (a)(10)(C)(iv). Puspan. L. 117–169, § 11405(a)(1)(B), inserted “, (13)(B),” after “(5)”.

Subsec. (a)(25)(I)(ii). Puspan. L. 117–103, § 202(a)(1), amended cl. (ii) generally. Prior to amendment, cl. (ii) read as follows: “accept the State’s right of recovery and the assignment to the State of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under the State plan;”.

Subsec. (a)(25)(I)(iii). Puspan. L. 117–103, § 202(a)(2), substituted “not later than 60 days after receiving any inquiry” for “respond to any inquiry” and “, respond to such inquiry; and” for “; and”.

Subsec. (a)(25)(I)(iv). Puspan. L. 117–103, § 202(a)(3), substituted “a failure” for “or a failure” and inserted “, or in the case of a responsible third party (other than the original medicare fee-for-service program under parts A and B of subchapter XVIII, a Medicare Advantage plan offered by a Medicare Advantage organization under part C of such subchapter, a reasonable cost reimbursement plan under section 1395mm of this title, a health care prepayment plan under section 1395l of this title, or a prescription drug plan offered by a PDP sponsor under part D of such subchapter) a failure to obtain a prior authorization for the item or service for which the claim is being submitted” after “the basis of the claim”.

Subsec. (a)(83). Puspan. L. 117–328, § 5123(span)(1), added par. (83) and struck out former par. (83) which required a State to publish a directory of physicians for a State plan providing medical assistance on a fee-for-service basis or through a primary care case-management system, and certain other providers at State option, on the public website of the State agency administering the State plan.

Subsec. (a)(84)(A). Puspan. L. 117–328, § 5122(a)(2), inserted “(or in the case of a State electing the option described in the subdivision (A) following paragraph (31) of section 1396d(a) of this title, during such period beginning after the disposition of charges with respect to such individual)” after “is such an inmate”.

Puspan. L. 117–328, § 5121(a)(1)(A), inserted “, subject to subparagraph (D),” after “but”.

Subsec. (a)(84)(D). Puspan. L. 117–328, § 5121(a)(1)(B)–(D), added subpar. (D).

Subsec. (e)(12). Puspan. L. 117–328, § 5112(a), added par. (12) and struck out former par. (12) which read as follows: “At the option of the State, the plan may provide that an individual who is under an age specified by the State (not to exceed 19 years of age) and who is determined to be eligible for benefits under a State plan approved under this subchapter under subsection (a)(10)(A) shall remain eligible for those benefits until the earlier of—

“(A) the end of a period (not to exceed 12 months) following the determination; or

“(B) the time that the individual exceeds that age.”

Subsec. (e)(13)(I). Puspan. L. 117–328, § 5111(d)(1), substituted “2029” for “2027”.

Subsec. (gg)(2). Puspan. L. 117–328, § 5111(d)(2), substituted “through September 30, 2029” for “through September 30, 2027” in span and “2029,” for “2027” in two places in text.

Subsec. (mm). Puspan. L. 117–328, § 5123(span)(2), added subsec. (mm) and struck out former subsec. (mm) which related to directory physician or provider described.

Subsec. (nn)(3). Puspan. L. 117–328, § 5121(a)(2), substituted “(31)” for “(30)”.

Subsec. (tt). Puspan. L. 117–328, § 5131(span), added subsec. (tt).

2021—Subsec. (a)(10). Puspan. L. 117–2, § 9811(a)(2)(F), inserted before semicolon at end of concluding provisions “, and (XIX) medical assistance shall be made available during the period described in section 1396d(a)(4)(E) of this title for vaccines described in such section and the administration of such vaccines, for any individual who is eligible for and receiving medical assistance under the State plan or under a waiver of such plan (other than an individual who is eligible for medical assistance consisting only of payment of premiums pursuant to subparagraph (E) or (F) or section 1396u–3 of this title), notwithstanding any provision of this subchapter or waiver under section 1315 of this title impacting such individual’s eligibility for medical assistance under such plan or waiver to coverage for a limited type of benefits and services that would not otherwise include coverage of a COVID–19 vaccine and its administration”.

Puspan. L. 117–2, § 9811(a)(2)(E), in concluding provisions, substituted “, any service described in section 1396o(a)(2)(G) of this title that is furnished during any such portion, any vaccine described in section 1396d(a)(4)(E) of this title (and the administration of such vaccine) that is furnished during any such portion, and testing and treatments for COVID–19, including specialized equipment and therapies (including preventive therapies), and, in the case of an individual who is diagnosed with or presumed to have COVID–19, during the period such individual has (or is presumed to have) COVID–19, the treatment of a condition that may seriously complicate the treatment of COVID–19, if otherwise covered under the State plan (or waiver of such plan)” for “and any visit described in section 1396o(a)(2)(G) of this title that is furnished during any such portion”.

Puspan. L. 117–2, § 9811(a)(2)(D), in concluding provisions, inserted “and medical assistance for vaccines described in section 1396d(a)(4)(E) of this title and the administration of such vaccines during the period described in such section” after “family planning setting”.

Puspan. L. 117–2, § 9811(a)(2)(C), in concluding provisions, inserted “and medical assistance for vaccines described in section 1396d(a)(4)(E) of this title and the administration of such vaccines during the period described in such section” after “described in subsection (k)(1)”.

Puspan. L. 117–2, § 9811(a)(2)(B), in concluding provisions, inserted “and medical assistance for vaccines described in section 1396d(a)(4)(E) of this title and the administration of such vaccines during the period described in such section” after “(described in subsection (z)(2))”.

Puspan. L. 117–2, § 9811(a)(2)(A), in concluding provisions, substituted “, medical assistance for services related to other conditions which may complicate pregnancy, and medical assistance for vaccines described in section 1396d(a)(4)(E) of this title and the administration of such vaccines during the period described in such section, (VIII)” for “and to other conditions which may complicate pregnancy, (VIII)”.

Subsec. (e)(16). Puspan. L. 117–2, § 9812(a), added par. (16).

2020—Subsec. (a)(4)(A). Puspan. L. 116–260, § 209(a)(1), substituted “including provision for utilization” for “and including provision for utilization” and inserted “, and, subject to section 1396span(i) of this title, including a specification that the single State agency described in paragraph (5) will ensure necessary transportation for beneficiaries under the State plan to and from providers and a description of the methods that such agency will use to ensure such transportation” after “supervision of administration of the plan”.

Subsec. (a)(10). Puspan. L. 116–127, § 6004(a)(3)(A)(ii), in concluding provisions, substituted “, (XVII)” for “and (XVII)” and inserted before semicolon at end “, and (XVIII) the medical assistance made available to an uninsured individual (as defined in subsection (ss)) who is eligible for medical assistance only because of subparagraph (A)(ii)(XXIII) shall be limited to medical assistance for any in vitro diagnostic product described in section 1396d(a)(3)(B) of this title that is administered during any portion of the emergency period described in such section beginning on or after March 18, 2020 (and the administration of such product) and any visit described in section 1396o(a)(2)(G) of this title that is furnished during any such portion”.

Subsec. (a)(10)(A). Puspan. L. 116–260, § 210(span), substituted “(29), and (30)” for “and (29)” in introductory provisions.

Subsec. (a)(10)(A)(ii)(XXIII). Puspan. L. 116–127, § 6004(a)(3)(A)(i), added subcl. (XXIII).

Subsec. (a)(10)(E)(iii), (iv). Puspan. L. 116–260, § 402(f)(2), inserted “(including such individuals enrolled under section 1395o(span) of this title)” after “section 1396d(p)(1) of this title”.

Subsec. (a)(55). Puspan. L. 116–127, § 6004(a)(3)(B), substituted “(a)(10)(A)(ii)(IX), or (a)(10)(A)(ii)(XXIII)” for “or (a)(10)(A)(ii)(IX)” in introductory provisions.

Subsec. (a)(87). Puspan. L. 116–260, § 209(span)(4)(A), added par. (87).

Subsec. (h). Puspan. L. 116–136, § 3715, designated existing provisions as par. (1), inserted “, home and community-based services provided under subsection (c), (d), or (i) of section 1396n of this title or under a waiver or demonstration project under section 1315 of this title, self-directed personal assistance services provided pursuant to a written plan of care under section 1396n(j) of this title, and home and community-based attendant services and supports under section 1396n(k) of this title” before period at end, and added par. (2).

Subsec. (ss). Puspan. L. 116–127, § 6004(a)(3)(C), added subsec. (ss).

Subsec. (ss)(1). Puspan. L. 116–136, § 3716(1), inserted “(excluding subclause (VIII) of such subsection if the individual is a resident of a State which does not furnish medical assistance to individuals described in such subclause)” after “subsection (a)(10)(A)(i)”.

Subsec. (ss)(2). Puspan. L. 116–136, § 3716(2), inserted before period at end “, except that individuals who are eligible for medical assistance under subsection (a)(10)(A)(ii)(XII), subsection (a)(10)(A)(ii)(XVIII), subsection (a)(10)(A)(ii)(XXI), or subsection (a)(10)(C) (but only to the extent such an individual is considered to not have minimum essential coverage under section 5000A(f)(1) of the Internal Revenue Code of 1986), or who are described in subsection (l)(1)(A) and are eligible for medical assistance only because of subsection (a)(10)(A)(i)(IV) or (a)(10)(A)(ii)(IX) and whose eligibility for such assistance is limited by the State under clause (VII) in the matter following subsection (a)(10)(G), shall not be treated as enrolled in a Federal health care program for purposes of this paragraph”.

2019—Subsec. (a)(25)(F)(i). Puspan. L. 116–16, § 7(a), amended Puspan. L. 113–67, § 202(a)(2). See 2013 Amendment note below.

Subsec. (j). Puspan. L. 116–94, § 202(e)(2), substituted “, the requirement” for “or the requirement” and inserted “, or the requirement under subsection (qq)(1) (relating to data reporting)” before period at end.

Subsec. (qq). Puspan. L. 116–94, § 202(e)(1), added subsec. (qq).

Subsec. (rr). Puspan. L. 116–94, § 202(f)(4), added subsec. (rr).

2018—Subsec. (a)(10)(A). Puspan. L. 115–271, § 1006(span)(1), substituted “(28), and (29)” for “and (28)” in introductory provisions.

Subsec. (a)(10)(A)(i)(IX)(bspan). Puspan. L. 115–271, § 1002(a)(1)(A), substituted “are not described in and are not enrolled under” for “are not described in or enrolled under”.

Subsec. (a)(10)(A)(i)(IX)(cc). Puspan. L. 115–271, § 1002(a)(1)(B), substituted “responsibility of a State” for “responsibility of the State”.

Subsec. (a)(10)(A)(i)(IX)(dd). Puspan. L. 115–271, § 1002(a)(1)(C), substituted “a State plan under this subchapter or under a waiver of such a” for “the State plan under this subchapter or under a waiver of the”.

Subsec. (a)(17). Puspan. L. 115–123, § 53103(a)(1), substituted “(e)(14), (e)(15)” for “(e)(14), (e)(14)”.

Subsec. (a)(25)(B). Puspan. L. 115–123, § 53102(span)(1), repealed Puspan. L. 113–67, § 202(span)(1)(A), and provided that the provisions amended by section 202(span) shall be applied and administered as if such amendment had never been enacted. See 2013 Amendment note below.

Subsec. (a)(25)(E). Puspan. L. 115–123, § 53102(a)(1), struck out “prenatal or” after “in the case of” in introductory provisions.

Subsec. (a)(25)(H). Puspan. L. 115–123, § 53102(span)(1), repealed Puspan. L. 113–67, § 202(span)(1)(B), and provided that the provisions amended by section 202(span) shall be applied and administered as if such amendment had never been enacted. See 2013 Amendment note below.

Subsec. (a)(25)(I)(i). Puspan. L. 115–123, § 53102(d)(2), substituted “medical assistance under a State plan (or under a waiver of the plan) under this subchapter and child health assistance under subchapter XXI” for “medical assistance under the State plan under this subchapter (and, at State option, child health assistance under subchapter XXI)”.

Subsec. (a)(84). Puspan. L. 115–271, § 1001(a)(1), added par. (84).

Subsec. (a)(85). Puspan. L. 115–271, § 1004(a)(1), added par. (85).

Subsec. (a)(86). Puspan. L. 115–271, § 1007(a), added par. (86).

Subsec. (e)(13)(I). Puspan. L. 115–123, § 50101(e), substituted “2027” for “2023”.

Puspan. L. 115–120, § 3002(e), substituted “2023” for “2017”.

Subsec. (e)(14). Puspan. L. 115–120, § 3004(c)(2), redesignated par. (14), relating to exclusion of compensation for participation in a clinical trial for testing of treatments for a rare disease or condition, as (15).

Subsec. (e)(14)(J). Puspan. L. 115–120, § 3004(c)(1), which directed addition of subpar. (J) to “first” par. (14), relating to income determined using modified adjusted gross income, was executed by making the addition to what had been the second par. (14) to reflect the probable intent of Congress.

Subsec. (e)(14)(K). Puspan. L. 115–123, § 53103(a)(2), added subpar. (K).

Subsec. (e)(15). Puspan. L. 115–120, § 3004(c)(2), redesignated first par. (14), relating to exclusion of compensation for participation in a clinical trial for testing of treatments for a rare disease or condition, as (15). As redesignated, par. (15) was moved to appear after par. (14), to reflect the probable intent of Congress.

Subsec. (gg)(2). Puspan. L. 115–123, § 50101(f)(2)(B), which directed amendment of par. (2) by substituting “2027” for “2023,” wherever appearing, was executed by substituting “2027 (but during” for “2023 (but during” and “2027 only with” for “2023, only with” to reflect the probable intent of Congress.

Puspan. L. 115–123, § 50101(f)(2)(A), substituted “through september 30, 2027” for “through September 30, 2023” in span.

Puspan. L. 115–120, § 3002(f)(2), substituted “through September 30, 2023” for “until October 1, 2019” in span and “September 30, 2023 (but during the period that begins on October 1, 2019, and ends on September 30, 2023, only with respect to children in families whose income does not exceed 300 percent of the poverty line (as defined in section 1397jj(c)(5) of this title) applicable to a family of the size involved)” for “September 30, 2019,” in text.

Subsec. (nn). Puspan. L. 115–271, § 1001(a)(2), added subsec. (nn).

Subsec. (oo). Puspan. L. 115–271, § 1004(a)(2), added subsec. (oo).

Subsec. (pp). Puspan. L. 115–271, § 1007(span), added subsec. (pp).

2016—Subsec. (a)(39). Puspan. L. 114–255, § 5005(c)(2), substituted “subchapter XVIII, any other State plan under this subchapter (or waiver of the plan), or any State child health plan under subchapter XXI (or waiver of the plan) and such termination is included by the Secretary in any database or similar system developed pursuant to section 6401(span)(2) of the Patient Protection and Affordable Care Act” for “subchapter XVIII or any other State plan under this subchapter”.

Subsec. (a)(41). Puspan. L. 114–255, § 5005(a)(6), substituted “provide, in accordance with subsection (kk)(8) (as applicable), that whenever” for “provide that whenever”.

Subsec. (a)(78). Puspan. L. 114–255, § 5005(span)(1), added par. (78).

Subsec. (a)(82). Puspan. L. 114–198 added par. (82).

Subsec. (a)(83). Puspan. L. 114–255, § 5006(a), added par. (83).

Subsec. (kk)(1), (2). Puspan. L. 114–255, § 17004(span)(2)(B)(i), (ii), made technical amendment to reference in original act which appears in text as reference to section 1395cc of this title.

Subsec. (kk)(3). Puspan. L. 114–255, § 17004(span)(2)(B)(iii), made technical amendment to reference in original act which appears in text as reference to section 1395cc of this title and substituted “(j)(5)” for “(j)(4)”.

Subsec. (kk)(4)(A)(i). Puspan. L. 114–255, § 17004(span)(2)(B)(iv), made technical amendment to reference in original act which appears in text as reference to section 1395cc of this title and substituted “(j)(7)” for “(j)(6)”.

Subsec. (kk)(4)(A)(ii). Puspan. L. 114–255, § 17004(span)(1)(B), amended cl. (ii) generally. Prior to amendment, text read as follows: “A State shall not be required to comply with a temporary moratorium described in clause (i) if the State determines that the imposition of such temporary moratorium would adversely impact beneficiaries’ access to medical assistance.”

Subsec. (kk)(4)(A)(iii). Puspan. L. 114–255, § 17004(span)(1)(C), added cl. (iii).

Subsec. (kk)(8), (9). Puspan. L. 114–255, § 5005(a)(1), added par. (8) and redesignated former par. (8) as (9).

Subsec. (ll). Puspan. L. 114–255, § 5005(a)(3), added subsec. (ll).

Subsec. (mm). Puspan. L. 114–255, § 5006(span), added subsec. (mm).

2015—Subsec. (a)(10)(E)(iv). Puspan. L. 114–10, § 211(a), struck out “(but only for premiums payable with respect to months during the period beginning with January 1998, and ending with March 2015)” after “available”.

Subsec. (a)(17). Puspan. L. 114–63, § 2, repealed Puspan. L. 111–255, § 3(e). See 2010 Amendment note and Effective Date of 2015 Amendment note below.

Subsec. (e)(1). Puspan. L. 114–10, § 212(span), amended par. (1) generally. Prior to amendment, par. (1) read as follows:

“(A) Notwithstanding any other provision of this subchapter, effective January 1, 1974, subject to subparagraph (B) each State plan approved under this subchapter must provide that each family which was receiving aid pursuant to a plan of the State approved under part A of subchapter IV of this chapter in at least 3 of the 6 months immediately preceding the month in which such family became ineligible for such aid because of increased hours of, or increased income from, employment, shall, while a member of such family is employed, remain eligible for assistance under the plan approved under this subchapter (as though the family was receiving aid under the plan approved under part A of subchapter IV of this chapter) for 4 calendar months beginning with the month in which such family became ineligible for aid under the plan approved under part A of subchapter IV of this chapter because of income and resources or hours of work limitations contained in such plan.

“(B) Subparagraph (A) shall not apply with respect to families that cease to be eligible for aid under part A of subchapter IV of this chapter during the period beginning on April 1, 1990, and ending on March 31, 2015. During such period, for provisions relating to extension of eligibility for medical assistance for certain families who have received aid pursuant to a State plan approved under part A of subchapter IV of this chapter and have earned income, see section 1396r–6 of this title.”

Subsec. (e)(13)(I). Puspan. L. 114–10, § 302, substituted “2017” for “2015”.

Subsec. (e)(14). Puspan. L. 114–63, § 2, repealed Puspan. L. 111–255, § 3(e). See 2010 Amendment note and Effective Date of 2015 Amendment note below.

2014—Subsec. (a)(10)(E)(iv). Puspan. L. 113–93, § 201(a), substituted “March 2015” for “March 2014”.

Subsec. (e)(1)(B). Puspan. L. 113–93, § 202, substituted “March 31, 2015” for “March 31, 2014”.

Subsec. (e)(13)(I). Puspan. L. 113–93, § 203, substituted “September 30, 2015” for “September 30, 2014”.

2013—Subsec. (a)(10)(E)(iv). Puspan. L. 113–67, § 1201(a), substituted “March 2014” for “December 2013”.

Puspan. L. 112–240, § 621(a), substituted “2013” for “2012”.

Subsec. (a)(25)(B). Puspan. L. 113–67, § 202(span)(1)(A), which directed striking out “to the extent of such legal liability” before semicolon at end, was repealed by Puspan. L. 115–123, § 53102(span)(1).

Subsec. (a)(25)(E)(i). Puspan. L. 113–67, § 202(a)(1), which directed amendment of cl. (i) by inserting before semicolon at end “, except that the State may, if the State determines doing so is cost-effective and will not adversely affect access to care, only make such payment if a third party so liable has not made payment within 90 days after the date the provider of such services has initially submitted a claim to such third party for payment for such services”, was executed by making the insertion before “; and” to reflect the probable intent of Congress.

Subsec. (a)(25)(F)(i). Puspan. L. 113–67, § 202(a)(2), as amended by Puspan. L. 116–16, § 7(a), substituted “100 days after the date the provider of such services has initially submitted a claim to such third party for payment for such services, except that the State may make such payment within 30 days after such date if the State determines doing so is cost-effective and necessary to ensure access to care.” for “30 days after such services are furnished”.

Subsec. (a)(25)(H). Puspan. L. 113–67, § 202(span)(1)(B), which directed substituting “any payments by such third party” for “payment by any other party for such health care items or services”, was repealed by Puspan. L. 115–123, § 53102(span)(1).

Subsec. (a)(81) to (83). Puspan. L. 112–240, § 642(span)(2), redesignated par. (83) as (81) and struck out former pars. (81) and (82) which required States to comply with regulations relating to payor rules with respect to beneficiaries under both the Medicaid and CLASS programs and to take certain actions relating to workers who provide personal care services to individuals under the CLASS program.

Subsec. (e)(1)(B). Puspan. L. 113–67, § 1202, substituted “March 31, 2014” for “December 31, 2013”.

Puspan. L. 112–240, § 622, substituted “2013” for “2012”.

Subsec. (e)(13)(I). Puspan. L. 112–240, § 623, substituted “2014” for “2013”.

2012—Subsec. (a)(10)(E)(iv). Puspan. L. 112–96, § 3101(a), substituted “December 2012” for “February 2012”.

Subsec. (e)(1)(B). Puspan. L. 112–96, § 3102, substituted “December 31” for “February 29”.

2011—Subsec. (a)(10)(E)(iv). Puspan. L. 112–78, § 310(a), substituted “February 2012” for “December 2011”.

Subsec. (e)(1)(B). Puspan. L. 112–78, § 311, substituted “February 29, 2012” for “December 31, 2011”.

2010—Subsec. (a)(7). Puspan. L. 111–296, § 103(c)(1), amended par. (7) generally. Prior to amendment, par. (7) read as follows: “provide safeguards which restrict the use or disclosure of information concerning applicants and recipients to purposes directly connected with—

“(A) the administration of the plan; and

“(B) at State option, the exchange of information necessary to verify the certification of eligibility of children for free or reduced price breakfasts under the Child Nutrition Act of 1966 and free or reduced price lunches under the Richard B. Russell National School Lunch Act, in accordance with section 9(span) of that Act, using data standards and formats established by the State agency;”.

Subsec. (a)(9)(D). Puspan. L. 111–148, § 6103(d)(2), added subpar. (D).

Subsec. (a)(10). Puspan. L. 111–309, § 205(f)(1)(A), in concluding provisions, struck out “and” before “(XVI) the medical” and substituted “(XVII) if” for “(XVI) if”.

Puspan. L. 111–148, § 10201(a)(2), which directed amendment of par. (10) in the matter following subparagraph (G) by substituting “(XV)” for “and (XV)” and inserting “and (XVI) if an individual is described in subclause (IX) of subparagraph (A)(i) and is also described in subclause (VIII) of that subparagraph, the medical assistance shall be made available to the individual through subclause (IX) instead of through subclause (VIII)” before the semicolon, was executed by making the insertion only, to reflect the probable intent of Congress. The substitution could not be executed because “and (XV)” did not appear after amendment by Puspan. L. 111–148, § 2303(a)(3). See below.

Puspan. L. 111–148, § 2303(a)(3), in concluding provisions, substituted “(XV)” for “and (XV)” and inserted before semicolon at end “, and (XVI) the medical assistance made available to an individual described in subsection (ii) shall be limited to family planning services and supplies described in section 1396d(a)(4)(C) of this title including medical diagnosis and treatment services that are provided pursuant to a family planning service in a family planning setting”.

Puspan. L. 111–148, § 2001(a)(5)(A), in concluding provisions, substituted “(XIV)” for “and (XIV)” and inserted before semicolon at end “and (XV) the medical assistance made available to an individual described in subparagraph (A)(i)(VIII) shall be limited to medical assistance described in subsection (k)(1)”.

Subsec. (a)(10)(A). Puspan. L. 111–148, § 2301(span), substituted “, (21), and (28)” for “and (21)” in introductory provisions.

Subsec. (a)(10)(A)(i)(VIII). Puspan. L. 111–148, § 2001(a)(1), added subcl. (VIII).

Subsec. (a)(10)(A)(i)(IX). Puspan. L. 111–148, § 10201(a)(1), amended subcl. (IX) generally. Prior to amendment, subcl. (IX) read as follows: “who were in foster care under the responsibility of a State for more than 6 months (whether or not consecutive) but are no longer in such care, who are not described in any of subclauses (I) through (VII) of this clause, and who are under 25 years of age;”.

Puspan. L. 111–148, § 2004(a), added subcl. (IX).

Subsec. (a)(10)(A)(ii)(XX). Puspan. L. 111–148, § 2001(e)(1)(A), added subcl. (XX).

Subsec. (a)(10)(A)(ii)(XXI). Puspan. L. 111–148, § 2303(a)(1), added subcl. (XXI).

Subsec. (a)(10)(A)(ii)(XXII). Puspan. L. 111–148, § 2402(d)(1), added subcl. (XXII).

Subsec. (a)(10)(E)(iv). Puspan. L. 111–309, § 110(a), substituted “December 2011” for “December 2010”.

Subsec. (a)(13)(C). Puspan. L. 111–152, § 1202(a)(1)(A), added subpar. (C).

Subsec. (a)(17). Puspan. L. 111–255, § 3(e), which directed the repeal of the amendment made by Puspan. L. 111–255, § 3(c)(2), effective 5 years after Oct. 5, 2010, was itself repealed by Puspan. L. 114–63, § 2, effective as if included in Puspan. L. 111–255.

Puspan. L. 111–255, § 3(c)(2), inserted “(e)(14),” before “(l)(3)”.

Puspan. L. 111–148, § 2002(span), inserted “(e)(14),” before “(l)(3)”.

Subsec. (a)(23). Puspan. L. 111–309, § 205(f)(1)(B), which directed amendment by substituting “(kk)” for “(ii)”, was executed by substituting “(kk)(4)” for “(ii)(4)”, to reflect the probable intent of Congress.

Puspan. L. 111–148, § 6401(span)(3), inserted before semicolon at end “or by a provider or supplier to which a moratorium under subsection (ii)(4) is applied during the period of such moratorium”.

Subsec. (a)(39). Puspan. L. 111–148, § 6501, inserted “terminate the participation of any individual or entity in such program if (subject to such exceptions as are permitted with respect to exclusion under sections 1320a–7(c)(3)(B) and 1320a–7(d)(3)(B) of this title) participation of such individual or entity is terminated under subchapter XVIII or any other State plan under this subchapter,” after “1320a–7a of this title,”.

Subsec. (a)(42). Puspan. L. 111–148, § 6411(a)(1), substituted “provide that—” for “provide that”, inserted subpar. (A) designation before “the records” and “and” after semicolon at end, and added subpar. (B).

Subsec. (a)(47). Puspan. L. 111–148, § 2202(a), substituted “provide—” for “at the option of the State, provide”, inserted subpar. (A) designation and “at the option of the State,” before “for making ambulatory” and “and” after semicolon at end, and added subpar. (B).

Subsec. (a)(47)(A). Puspan. L. 111–148, § 2303(span)(2)(A)(i), inserted before semicolon at end “and provide for making medical assistance available to individuals described in subsection (a) of section 1396r–1c of this title during a presumptive eligibility period in accordance with such section”.

Subsec. (a)(47)(B). Puspan. L. 111–148, § 2303(span)(2)(A)(ii), substituted “1396r–1span, or 1396r–1c of this title” for “or 1396r–1span of this title”.

Subsec. (a)(74). Puspan. L. 111–148, § 4302(span)(1)(A)(i), which directed amendment of “paragraph 4)” by striking “and” at the end, was executed to par. (74) to reflect the probable intent of Congress.

Puspan. L. 111–148, § 2001(span)(1), added par. (74).

Subsec. (a)(75). Puspan. L. 111–148, § 4302(span)(1)(A)(ii), substituted “; and” for period at end.

Puspan. L. 111–148, § 2001(d)(1), added par. (75).

Subsec. (a)(76). Puspan. L. 111–148, § 4302(span)(1)(A)(iii), added par. (76).

Subsec. (a)(77). Puspan. L. 111–309, § 205(f)(1)(C), substituted “(kk)” for “(ii)”.

Puspan. L. 111–148, § 6401(span)(1)(A), added par. (77).

Subsec. (a)(78). Puspan. L. 111–309, § 205(a), struck out par. (78). Text read as follows: “provide that the State agency described in paragraph (9) exclude, with respect to a period, any individual or entity from participation in the program under the State plan if such individual or entity owns, controls, or manages an entity that (or if such entity is owned, controlled, or managed by an individual or entity that)—

“(A) has unpaid overpayments (as defined by the Secretary) under this subchapter during such period determined by the Secretary or the State agency to be delinquent;

“(B) is suspended or excluded from participation under or whose participation is terminated under this subchapter during such period; or

“(C) is affiliated with an individual or entity that has been suspended or excluded from participation under this subchapter or whose participation is terminated under this subchapter during such period;”.

Puspan. L. 111–148, § 6502, added par. (78).

Subsec. (a)(79). Puspan. L. 111–148, § 6503, added par. (79).

Subsec. (a)(80). Puspan. L. 111–148, § 6505, added par. (80).

Subsec. (a)(81). Puspan. L. 111–148, § 8002(a)(2), added par. (81).

Subsec. (a)(82). Puspan. L. 111–148, § 8002(span), added par. (82).

Subsec. (a)(83). Puspan. L. 111–148, § 3021(span), added par. (83).

Subsec. (e)(1)(B). Puspan. L. 111–309, § 111, substituted “December 31, 2011” for “December 31, 2010”.

Subsec. (e)(13)(F)(ii). Puspan. L. 111–148, § 2901(c), inserted “and indian tribes and tribal organizations” after “agencies” in span and added subcl. (IV).

Subsec. (e)(14). Puspan. L. 111–255, § 3(e), which directed the repeal of the amendment made by Puspan. L. 111–255, § 3(c)(1), effective 5 years after Oct. 5, 2010, was itself repealed by Puspan. L. 114–63, § 2, effective as if included in Puspan. L. 111–255.

Puspan. L. 111–255, § 3(c)(1), added par. (14) related to exclusion of compensation for participation in a clinical trial for testing of treatments for a rare disease or condition.

Puspan. L. 111–152, § 1004(span)(1)(A), substituted “modified adjusted gross income” for “modified gross income” wherever appearing in headings and text.

Puspan. L. 111–148, § 2002(a), added par. (14) related to income determined using modified gross income.

Subsec. (e)(14)(B). Puspan. L. 111–152, § 1004(e)(1), substituted “Subject to subparagraph (I), no type” for “No type”.

Subsec. (e)(14)(I). Puspan. L. 111–152, § 1004(e)(2), added subpar. (I).

Subsec. (k). Puspan. L. 111–148, § 2001(a)(4)(A), added pars. (2) and (3).

Puspan. L. 111–148, § 2001(a)(2)(A), added subsec. (k).

Subsec. (k)(2). Puspan. L. 111–148, § 10201(span), substituted “April 1, 2010” for “January 1, 2011”.

Subsec. (l)(2)(C). Puspan. L. 111–309, § 205(span), substituted “100 percent (or, beginning January 1, 2014, 133 percent)” for “133 percent”.

Puspan. L. 111–148, § 2001(a)(5)(B), substituted “133” for “100”.

Subsec. (gg). Puspan. L. 111–148, § 2001(span)(2), added subsec. (gg).

Subsec. (gg)(4)(A). Puspan. L. 111–152, § 1004(span)(1)(B), substituted “modified adjusted gross income” for “modified gross income” in span.

Subsec. (hh). Puspan. L. 111–148, § 2001(e)(1)(B), added subsec. (hh).

Subsec. (ii). Puspan. L. 111–309, § 205(f)(1)(E), redesignated subsec. (ii) relating to provider and supplier screening, oversight, and reporting requirements as (kk).

Puspan. L. 111–148, § 6401(span)(1)(B), added subsec. (ii) relating to provider and supplier screening, oversight, and reporting requirements.

Puspan. L. 111–148, § 2303(a)(2), added subsec. (ii) relating to State eligibility option for family planning services.

Subsec. (ii)(2). Puspan. L. 111–309, § 205(f)(1)(D), substituted “(XVI)” for “(XV)”.

Subsec. (jj). Puspan. L. 111–152, § 1202(a)(1)(B), added subsec. (jj).

Subsec. (kk). Puspan. L. 111–309, § 205(f)(1)(E), redesignated subsec. (ii) relating to provider and supplier screening, oversight, and reporting requirements as (kk).

2009—Subsec. (a)(10)(E)(iv). Puspan. L. 111–5, § 5005(a), substituted “December 2010” for “December 2009”.

Subsec. (a)(25)(I)(i). Puspan. L. 111–3, § 203(d)(3), inserted “(and, at State option, individuals who apply or whose eligibility for medical assistance is being evaluated in accordance with section 1396a(e)(13)(D) of this title)” after “with respect to individuals who are eligible” and “under this subchapter (and, at State option, child health assistance under subchapter XXI)” after “the State plan”.

Subsec. (a)(43)(D)(iii). Puspan. L. 111–3, § 501(e)(1), inserted “and other information relating to the provision of dental services to such children described in section 1397hh(e) of this title” after “receiving dental services,”.

Subsec. (a)(46). Puspan. L. 111–3, § 211(a)(1)(A)(i), designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (a)(72). Puspan. L. 111–3, § 501(d)(1), added par. (72).

Subsec. (a)(73). Puspan. L. 111–5, § 5006(e)(2)(A), added par. (73).

Subsec. (e)(1)(B). Puspan. L. 111–5, § 5004(a)(1), substituted “December 31, 2010” for “September 30, 2003”.

Subsec. (e)(4). Puspan. L. 111–3, § 211(span)(3)(B), inserted at end “Notwithstanding the preceding sentence, in the case of a child who is born in the United States to an alien mother for whom medical assistance for the delivery of the child is made available pursuant to section 1396span(v) of this title, the State immediately shall issue a separate identification number for the child upon notification by the facility at which such delivery occurred of the child’s birth.”

Puspan. L. 111–3, § 113(span)(1), struck out “so long as the child is a member of the woman’s household and the woman remains (or would remain if pregnant) eligible for such assistance” before period at end of first sentence.

Subsec. (e)(13). Puspan. L. 111–3, § 203(a)(1), added par. (13).

Subsec. (dd). Puspan. L. 111–3, § 203(c), added subsec. (dd).

Subsec. (ee). Puspan. L. 111–3, § 211(a)(1)(A)(ii), added subsec. (ee).

Subsec. (ff). Puspan. L. 111–5, § 5006(span)(1), added subsec. (ff).

2008—Subsec. (a)(10)(E)(iv). Puspan. L. 110–275 substituted “December 2009” for “June 2008”.

Subsec. (a)(71). Puspan. L. 110–252 added par. (71).

2007—Subsec. (a)(10)(E)(iv). Puspan. L. 110–173 substituted “June 2008” for “December 2007”.

Puspan. L. 110–90 substituted “December 2007” for “September 2007”.

2006—Subsec. (a)(10)(A)(i)(II). Puspan. L. 109–171, § 6065(a), inserted “(aa)” after “(II)”, substituted “and” for “) and” after “P.L. 104–193)”, substituted “section), (bspan) who are” for “section or who are”, and inserted before comma at end “, or (cc) who are under 21 years of age and with respect to whom supplemental security income benefits would be paid under subchapter XVI if subparagraphs (A) and (B) of section 1382(c)(7) of this title were applied without regard to the phrase ‘the first day of the month following’ ”.

Subsec. (a)(10)(A)(ii)(XIX). Puspan. L. 109–171, § 6062(a)(1)(A), added subcl. (XIX).

Subsec. (a)(25)(A). Puspan. L. 109–171, § 6035(a)(1), in introductory provisions, inserted “, self-insured plans” after “health insurers” and substituted “managed care organizations, pharmacy benefit managers, or other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service” for “and health maintenance organizations”.

Subsec. (a)(25)(G). Puspan. L. 109–171, § 6035(a)(2), inserted “a self-insured plan,” before “a service benefit plan” and substituted “a managed care organization, a pharmacy benefit manager, or other party that is, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service” for “and a health maintenance organization”.

Subsec. (a)(25)(I). Puspan. L. 109–171, § 6035(span), added subpar. (I).

Subsec. (a)(68). Puspan. L. 109–171, § 6032(a), added par. (68).

Subsec. (a)(69). Puspan. L. 109–171, § 6034(span), as amended by Puspan. L. 109–432, added par. (69).

Subsec. (a)(70). Puspan. L. 109–171, § 6083(a), added par. (70).

Subsec. (cc). Puspan. L. 109–171, § 6062(a)(1)(B), added subsec. (cc).

Subsec. (cc)(2). Puspan. L. 109–171, § 6062(a)(2), added par. (2).

2005—Subsec. (a)(10)(E)(iv). Puspan. L. 109–91 substituted “September 2007” for “September 2005”.

2004—Subsec. (a)(7). Puspan. L. 108–265 designated part of existing provisions as subpar. (A) and added subpar. (B).

Subsec. (a)(10)(E)(iv). Puspan. L. 108–448 substituted “2005” for “2004”.

2003—Subsec. (a)(10)(E)(iv). Puspan. L. 108–173, § 103(f)(1), substituted “ending with September 2004” for “ending with March 2004”.

Puspan. L. 108–89 substituted “March 2004” for “December 2002”, redesignated introductory provisions and subcl. (I) as cl. (iv), substituted semicolon for “, and” after “State plan”, and struck out subcl. (II) which read as follows: “for the portion of medicare cost-sharing described in section 1396d(p)(3)(A)(ii) of this title that is attributable to the operation of the amendments made by (and subsection (e)(3) of) section 4611 of the Balanced Budget Act of 1997 for individuals who would be described in subclause (I) if ‘135 percent’ and ‘175 percent’ were substituted for ‘120 percent’ and ‘135 percent’ respectively;”.

Subsec. (a)(66). Puspan. L. 108–173, § 103(a)(1), added par. (66).

Subsec. (a)(67). Puspan. L. 108–173, § 236(span)(1), added par. (67).

Subsec. (e)(1)(B). Puspan. L. 108–40 substituted “2003” for “2002”.

2002—Subsec. (a)(15). Puspan. L. 107–121, § 2(span)(2), substituted “subsection (bspan)” for “subsection (aa)”.

Subsec. (aa). Puspan. L. 107–121, § 2(span)(1), redesignated subsec. (aa) relating to payment for services provided by federally-qualified health centers and rural health clinics as subsec. (bspan).

Subsec. (aa)(4). Puspan. L. 107–121, § 2(a), inserted “, but applied without regard to paragraph (1)(F) of such section” before period at end.

Subsec. (bspan). Puspan. L. 107–121, § 2(span)(1), redesignated subsec. (aa) relating to payment for services provided by federally-qualified health centers and rural health clinics as subsec. (bspan).

2000—Subsec. (a)(10). Puspan. L. 106–354, § 2(a)(3), in concluding provisions, substituted “(XIII)” for “and (XIII)” and inserted before semicolon at end “, and (XIV) the medical assistance made available to an individual described in subsection (aa) who is eligible for medical assistance only because of subparagraph (A)(10)(ii)(XVIII) shall be limited to medical assistance provided during the period in which such an individual requires treatment for breast or cervical cancer”.

Subsec. (a)(10)(A)(ii)(XVIII). Puspan. L. 106–354, § 2(a)(1), added subcl. (XVIII).

Subsec. (a)(13)(A)(iv). Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(a)(1)(A)], inserted “and” at end.

Subsec. (a)(13)(B). Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(a)(1)(B)], struck out “and” at end.

Subsec. (a)(13)(C). Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(c)(1)], repealed Puspan. L. 105–33, § 4712(c)(1). See 1997 Amendment note below.

Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(a)(1)(C)], struck out subpar. (C) which read as follows: “(C)(i) for payment for services described in clause (B) or (C) of section 1396d(a)(2) of this title under the plan of 100 percent (or 95 percent for services furnished during fiscal year 2000, fiscal year 2001, or fiscal year 2002, 90 percent for services furnished during fiscal year 2003, or 85 percent for services furnished during fiscal year 2004) of costs which are reasonable and related to the cost of furnishing such services or based on such other tests of reasonableness, as the Secretary prescribes in regulations under section 1395l(a)(3) of this title, or, in the case of services to which those regulations do not apply, on the same methodology used under section 1395l(a)(3) of this title and (ii) in carrying out clause (i) in the case of services furnished by a Federally-qualified health center or a rural health clinic pursuant to a contract between the center and an organization under section 1396span(m) of this title, for payment to the center or clinic at least quarterly by the State of a supplemental payment equal to the amount (if any) by which the amount determined under clause (i) exceeds the amount of the payments provided under such contract;”.

Subsec. (a)(15). Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(a)(2)], added par. (15).

Subsec. (a)(47). Puspan. L. 106–354, § 2(span)(2)(A), inserted before semicolon at end “and provide for making medical assistance available to individuals described in subsection (a) of section 1396r–1span of this title during a presumptive eligibility period in accordance with such section”.

Subsec. (e)(1)(B). Puspan. L. 106–554, § 1(a)(6) [title VII, § 707(span)], substituted “2002” for “2001”.

Subsec. (aa). Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(span)], added subsec. (aa) relating to payment for services provided by Federally-qualified health centers and rural health clinics.

Puspan. L. 106–354, § 2(a)(2), added subsec. (aa) relating to certain breast or cervical cancer patients.

1999—Subsec. (a)(10)(A)(ii)(XIV). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(aa)(1)], substituted “1396d(u)(2)(B) of this title” for “1396d(u)(2)(C) of this title”.

Subsec. (a)(10)(A)(ii)(XV). Puspan. L. 106–169, § 121(c)(4)(A), redesignated subcl. (XV), related to individuals who are independent foster care adolescents, as (XVII).

Puspan. L. 106–169, § 121(a)(1)(C), added subcl. (XV), related to individuals who are independent foster care adolescents.

Puspan. L. 106–169, § 121(a)(1)(A), which directed striking out of “or” at end of subcl. (XIII), was executed by amending subcl. (XV), related to individuals who would be considered to be receiving supplemental security income, etc. See Construction of 1999 Amendment note below.

Puspan. L. 106–170, § 201(a)(1), added subcl. (XV), related to individuals who would be considered to be receiving supplemental security income, etc.

Subsec. (a)(10)(A)(ii)(XVI). Puspan. L. 106–169, § 121(a)(1)(B), which directed insertion of “or” at end of subcl. (XIV), was executed to subcl. (XVI). See Construction of 1999 Amendment note below.

Puspan. L. 106–170, § 201(a)(2)(A), added subcl. (XVI).

Subsec. (a)(10)(A)(ii)(XVII). Puspan. L. 106–169, § 121(c)(4), redesignated subcl. (XV), related to individuals who are independent foster care adolescents, as (XVII) and substituted “section 1396d(w)(1)” for “section 1396d(v)(1)”.

Subsec. (a)(10)(G). Puspan. L. 106–169, § 206(span), substituted “subsections (c) and (e) of section 1382span” for “section 1382span(e)”.

Puspan. L. 106–169, § 205(c), added subpar. (G).

Subsec. (a)(13)(C)(i). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 603(a)(1)], substituted “fiscal year 2001, or fiscal year 2002, 90 percent for services furnished during fiscal year 2003, or 85 percent for services furnished during fiscal year 2004” for “90 percent for services furnished during fiscal year 2001, 85 percent for services furnished during fiscal year 2002, or 70 percent for services furnished during fiscal year 2003”.

Subsec. (a)(30)(A). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 604(span)(1)(A)], inserted “and” at end.

Subsec. (a)(30)(B)(ii). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 604(span)(1)(B)], struck out “and” at end.

Subsec. (a)(30)(C). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 604(span)(1)(C)], struck out subpar. (C) which read as follows: “use a utilization and quality control peer review organization (under part B of subchapter XI of this chapter), an entity which meets the requirements of section 1320c–1 of this title, as determined by the Secretary, or a private accreditation body to conduct (on an annual basis) an independent, external review of the quality of services furnished under each contract under section 1396span(m) of this title, with the results of such review made available to the State and, upon request, to the Secretary, the Inspector General in the Department of Health and Human Services, and the Comptroller General;”.

Subsec. (a)(60). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(y)(2)], made technical amendment to reference in original act which appears in text as reference to section 1396g-1 of this title.

Subsec. (a)(64). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(a)], inserted “and” at end.

Subsec. (d). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 604(a)(2)(A)], struck out “(including quality review functions described in subsection (a)(30)(C) of this section)” after “medical or utilization review functions”.

Puspan. L. 106–113, § 1000(a)(6) [title VI, § 604(a)(1)], struck out “for the performance of the quality review functions described in subsection (a)(30)(C) of this section,” before “or a utilization and quality control peer review organization”.

Subsec. (j). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(span)], substituted “of” for “of of” after “numbered paragraph”.

Subsec. (l)(1)(C). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(c)(1)], substituted “children” for “children children”.

Subsec. (l)(3). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(c)(2)], struck out first comma after “(a)(10)(A)(i)(VII)” in introductory provisions.

Subsec. (l)(4)(B). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(c)(3)], inserted comma after “(a)(10)(A)(i)(IV)”.

Subsec. (v). Puspan. L. 106–113, § 1000(a)(6) [title VI, § 608(d)], struck out par. (1) designation before “A State plan may provide”.

1997—Subsec. (a). Puspan. L. 105–33, § 4454(span)(1), in second sentence of flush concluding provisions, substituted “to a religious nonmedical health care institution (as defined in section 1395x(ss)(1) of this title).” for “to a Christian Science sanatorium operated, or listed and certified, by The Commission for Accreditation of Christian Science Nursing Organizations/Facilities, Inc.”

Subsec. (a)(4)(C), (D). Puspan. L. 105–33, § 4724(c)(1), substituted “(C)” for “and (C)”, “local officer, employee, or independent contractor” for “local officer or employee”, and “such an officer, employee, or contractor” for “such an officer or employee” in two places and added subpar. (D).

Subsec. (a)(9)(C). Puspan. L. 105–33, § 4106(c), substituted “paragraphs (16) and (17)” for “paragraphs (15) and (16)”.

Subsec. (a)(10)(A)(i)(II). Puspan. L. 105–33, § 4913(a), inserted “(or were being paid as of the date of the enactment of section 211(a) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193)) and would continue to be paid but for the enactment of that section” after “subchapter XVI”.

Subsec. (a)(10)(A)(ii)(XIII). Puspan. L. 105–33, § 4733, added subcl. (XIII).

Subsec. (a)(10)(A)(ii)(XIV). Puspan. L. 105–33, § 4911(span), added subcl. (XIV).

Subsec. (a)(10)(E)(iv). Puspan. L. 105–33, § 4732(a), added cl. (iv).

Subsec. (a)(13)(A). Puspan. L. 105–33, § 4711(a)(1), added subpar. (A) and struck out former subpar. (A) which related to payment of hospital services, nursing facility services, and services in intermediate care facilities for mentally retarded by use of rates which account for various specified costs.

Subsec. (a)(13)(B). Puspan. L. 105–33, § 4711(a)(1)–(3), redesignated subpar. (D) as (B), inserted “and” at end, and struck out former subpar. (B) which read as follows: “that the State shall provide assurances satisfactory to the Secretary that the payment methodology utilized by the State for payments to hospitals can reasonably be expected not to increase such payments, solely as a result of a change of ownership, in excess of the increase which would result from the application of section 1395x(v)(1)(O) of this title;”.

Subsec. (a)(13)(C). Puspan. L. 105–33, § 4712(c)(1), which directed the repeal of subsec. (a)(13)(C), was repealed by Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(c)(1)]. See 2000 Amendment note above and Effective Date of 1997 Amendment note below.

Puspan. L. 105–33, § 4712(span)(1), designated existing provisions as cl. (i) and added cl. (ii).

Puspan. L. 105–33, § 4712(a), inserted “(or 95 percent for services furnished during fiscal year 2000, 90 percent for services furnished during fiscal year 2001, 85 percent for services furnished during fiscal year 2002, or 70 percent for services furnished during fiscal year 2003)” after “100 percent”.

Puspan. L. 105–33, § 4711(a)(1), (2), (4), redesignated subpar. (E) as (C), struck out “and” at end, and struck out former subpar. (C) which read as follows: “that the State shall provide assurances satisfactory to the Secretary that the valuation of capital assets, for purposes of determining payment rates for nursing facilities and for intermediate care facilities for the mentally retarded, will not be increased (as measured from the date of acquisition by the seller to the date of the change of ownership), solely as a result of a change of ownership, by more than the lesser of—

“(i) one-half of the percentage increase (as measured over the same period of time, or, if necessary, as extrapolated retrospectively by the Secretary) in the Dodge Construction Systems Costs for Nursing Homes, applied in the aggregate with respect to those facilities which have undergone a change of ownership during the fiscal year, or

“(ii) one-half of the percentage increase (as measured over the same period of time) in the Consumer Price Index for All Urban Consumers (United States city average);”.

Subsec. (a)(13)(D), (E). Puspan. L. 105–33, § 4711(a)(2), redesignated subpars. (D) and (E) as (B) and (C), respectively.

Subsec. (a)(13)(F). Puspan. L. 105–33, § 4711(a)(5), struck out subpar. (F) which read as follows: “for payment for home and community care (as defined in section 1396t(a) of this title and provided under such section) through rates which are reasonable and adequate to meet the costs of providing care, efficiently and economically, in conformity with applicable State and Federal laws, regulations, and quality and safety standards;”.

Subsec. (a)(23). Puspan. L. 105–33, § 4724(d), struck out “except as provided in subsection (g) and in section 1396n and except in the case of Puerto Rico, the Virgin Islands, and Guam,” after “(23)” and inserted before semicolon at end “, except as provided in subsection (g) and in section 1396n of this title, except that this paragraph shall not apply in the case of Puerto Rico, the Virgin Islands, and Guam, and except that nothing in this paragraph shall be construed as requiring a State to provide medical assistance for such services furnished by a person or entity convicted of a felony under Federal or State law for an offense which the State agency determines is inconsistent with the best interests of beneficiaries under the State plan”.

Subsec. (a)(23)(B). Puspan. L. 105–33, § 4701(d)(1), substituted “, in section 1396n of this title, and in section 1396u–2(a) of this title” for “and in section 1396n of this title”.

Puspan. L. 105–33, § 4701(span)(2)(A)(i), substituted “medicaid managed care organization” for “health maintenance organization”.

Subsec. (a)(25)(A)(ii). Puspan. L. 105–33, § 4753(span), substituted “be integrated with, and be monitored as a part of the Secretary’s review of, the State’s mechanized claims processing and information retrieval systems required under section 1396span(r) of this title;” for the dash that followed “which plan shall” and struck out subcls. (I) and (II) which read as follows:

“(I) be integrated with, and be monitored as a part of the Secretary’s review of, the State’s mechanized claims processing and information retrieval system under section 1396span(r) of this title, and

“(II) be subject to the provisions of section 1396span(r)(4) of this title relating to reductions in Federal payments for failure to meet conditions of approval, but shall not be subject to any other financial penalty as a result of any other monitoring, quality control, or auditing requirements;”.

Subsec. (a)(25)(G) to (I). Puspan. L. 105–33, § 4741(a), redesignated subpars. (H) and (I) as (G) and (H), respectively, and struck out former subpar. (G) which read as follows: “that the State plan shall meet the requirements of section 1396e of this title (relating to enrollment of individuals under group health plans in certain cases);”.

Subsec. (a)(26). Puspan. L. 105–33, § 4751(a), substituted “provide, with respect to each patient” for “provide—

“(A) with respect to each patient”

and struck out subpars. (B) and (C) which read as follows:

“(B) for periodic inspections to be made in all mental institutions within the State by one or more medical review teams (composed of physicians and other appropriate health and social service personnel) of the care being provided to each person receiving medical assistance, including (i) the adequacy of the services available to meet his current health needs and promote his maximum physical well-being, (ii) the necessity and desirability of his continued placement in the institution, and (iii) the feasibility of meeting his health care needs through alternative institutional or noninstitutional services; and

“(C) for full reports to the State agency by each medical review team of the findings of each inspection under subparagraph (B), together with any recommendations;”.

Subsec. (a)(31). Puspan. L. 105–33, § 4751(span), substituted “provide, with respect to each patient” for “provide—

“(A) with respect to each patient”

and struck out subpars. (B) and (C) which read as follows:

“(B) with respect to each intermediate care facility for the mentally retarded within the State, for periodic onsite inspections of the care being provided to each person receiving medical assistance, by one or more independent professional review teams (composed of a physician or registered nurse and other appropriate health and social service personnel), including with respect to each such person (i) the adequacy of the services available to meet his current health needs and promote his maximum physical well-being, (ii) the necessity and desirability of his continued placement in the facility, and (iii) the feasibility of meeting his health care needs through alternative institutional or noninstitutional services; and

“(C) for full reports to the State agency by each independent professional review team of the findings of each inspection under subparagraph (B), together with any recommendations;”.

Subsec. (a)(47). Puspan. L. 105–33, § 4912(span)(1), inserted before semicolon at end “and provide for making medical assistance for items and services described in subsection (a) of section 1396r–1a of this title available to children during a presumptive eligibility period in accordance with such section”.

Subsec. (a)(57). Puspan. L. 105–33, § 4701(span)(2)(A)(ii), substituted “medicaid managed care organization” for “health maintenance organization”.

Subsec. (a)(63). Puspan. L. 105–33, § 4724(g)(1)(A), struck out “and” at end.

Subsec. (a)(64). Puspan. L. 105–33, § 4724(g)(1)(B), which directed the amendment of par. (64) by substituting “; and” for the period at end, could not be executed because there was no period at end.

Puspan. L. 105–33, § 4724(f), added par. (64).

Subsec. (a)(65). Puspan. L. 105–33, § 4724(g)(1)(C), added par. (65).

Subsec. (e)(2)(A). Puspan. L. 105–33, § 4709(2), which directed the amendment of subsec. (e)(2) by inserting “or by or through the case manager” before period at end, was executed by making insertion before period at end of subpar. (A) to reflect the probable intent of Congress.

Puspan. L. 105–33, § 4709(1), substituted “who is enrolled with a medicaid managed care organization (as defined in section 1396span(m)(1)(A) of this title), with a primary care case manager (as defined in section 1396d(t) of this title),” for “who is enrolled with a qualified health maintenance organization (as defined in title XIII of the Public Health Service Act) or with an entity described in paragraph (2)(B)(iii), (2)(E), (2)(G), or (6) of section 1396span(m) of this title under a contract described in section 1396span(m)(2)(A) of this title”.

Subsec. (e)(12). Puspan. L. 105–33, § 4731(a), added par. (12).

Subsec. (i)(1)(B). Puspan. L. 105–33, § 4752(a), substituted “establish alternative remedies if the State demonstrates to the Secretary’s satisfaction that the alternative remedies are effective in deterring noncompliance and correcting deficiencies, and may provide” for “provide”.

Subsec. (j). Puspan. L. 105–33, § 4702(span)(2), substituted “a numbered paragraph of” for “paragraphs (1) through (25)”.

Subsec. (l)(1)(D). Puspan. L. 105–33, § 4731(span), inserted “(or, at the option of a State, after any earlier date)” after “children born after September 30, 1983”.

Subsec. (n). Puspan. L. 105–33, § 4714(a)(1), designated existing provisions as par. (1) and added pars. (2) and (3).

Subsec. (p)(2). Puspan. L. 105–33, § 4701(span)(2)(A)(iii), substituted “medicaid managed care organization” for “health maintenance organization” in introductory provisions.

Subsec. (r)(1). Puspan. L. 105–33, § 4715(a), designated existing provisions as subpar. (A), inserted “, the treatment described in subparagraph (B) shall apply,” after “under such a waiver”, substituted “, and” for “and,” after “Federal Republic of Germany”, and added subpar. (B).

Subsec. (w)(2)(E). Puspan. L. 105–33, § 4701(span)(2)(A)(iv), substituted “medicaid managed care organization” for “health maintenance organization”.

Subsec. (w)(5). Puspan. L. 105–12 added par. (5).

1996—Subsec. (a). Puspan. L. 104–193, § 913, which directed substitution of “The Commission for Accreditation of Christian Science Nursing Organizations/Facilities, Inc.” for “The First Church of Christ, Scientist, Boston, Massachusetts” in third sentence, was executed by making the substitution for “the First Church of Christ, Scientist, Boston, Massachusetts” in first undesignated closing par. to reflect the probable intent of Congress.

Subsec. (a)(25)(A)(i). Puspan. L. 104–226 struck out “including the use of information collected by the Medicare and Medicaid Coverage Data Bank under section 1320span–14 of this title and any additional measures” before “as specified by the Secretary in regulations)”.

Subsec. (a)(59). Puspan. L. 104–248 substituted “subsection (x)” for “subsection (v)”.

Subsec. (a)(63). Puspan. L. 104–193, § 114(span), added par. (63).

Subsec. (c). Puspan. L. 104–193, § 114(d)(1), substituted “if the State requires individuals described in subsection (l)(1) to apply for assistance under the State program funded under part A of subchapter IV as a condition of applying for or receiving medical assistance under this subchapter.” for “if—

“(1) the State has in effect, under its plan established under part A of subchapter IV, payment levels that are less than the payment levels in effect under such plan on May 1, 1988; or

“(2) the State requires individuals described in subsection (l)(1) of this section to apply for benefits under such part as a condition of applying for, or receiving, medical assistance under this subchapter.”

Subsec. (e)(1)(B). Puspan. L. 104–193, § 114(c), substituted “2001” for “1998”.

Subsec. (j). Puspan. L. 104–193, § 108(k), substituted “1308(f)” for “1308(c)”.

1994—Subsec. (a)(10)(A)(ii)(XI). Puspan. L. 103–296 substituted “Commissioner of Social Security” for “Secretary”.

Subsec. (a)(11)(C), (53)(A). Puspan. L. 103–448 substituted “special supplemental nutrition program” for “special supplemental food program”.

1993—Subsec. (a)(10). Puspan. L. 103–66, § 13603(c), in concluding provisions, substituted “services, or hospitals, (XI)” for “services, or hospitals; and (XI)” and “other individuals, (XII)” for “other individuals, and (XI)”, and inserted “, and” and subdiv. (XIII) before semicolon at end.

Subsec. (a)(10)(A)(ii)(XII). Puspan. L. 103–66, § 13603(a), added subcl. (XII).

Subsec. (a)(10)(C)(iv). Puspan. L. 103–66, § 13601(span)(1), substituted “paragraphs numbered (1) through (24)” for “paragraphs numbered (1) through (21)”.

Subsec. (a)(11). Puspan. L. 103–66, § 13631(f)(1)(A), (B), in subpar. (B), struck out “effective July 1, 1969,” after “(B)” and “and” before “(ii)” and substituted “to the individual under section 1396span of this title, and (iii) providing for coordination of information and education on pediatric vaccinations and delivery of immunization services” for “to him under section 1396span of this title”, and in subpar. (C), inserted “, including the provision of information and education on pediatric vaccinations and the delivery of immunization services,” after “operations under this subchapter”.

Subsec. (a)(18). Puspan. L. 103–66, § 13611(d)(1)(A), substituted “, transfers of assets, and treatment of certain trusts” for “and transfers of assets”.

Subsec. (a)(25)(A). Puspan. L. 103–66, § 13622(a), substituted “insurers, group health plans (as defined in section 607(1) of the Employee Retirement Income Security Act of 1974), service benefit plans, and health maintenance organizations)” for “insurers)” in introductory provisions.

Subsec. (a)(25)(A)(i). Puspan. L. 103–66, § 13581(span)(2), substituted “(including the use of information collected by the Medicare and Medicaid Coverage Data Bank under section 1320span–14 of this title and any additional measures as specified” for “(as specified”.

Subsec. (a)(25)(H). Puspan. L. 103–66, § 13622(span), added subpar. (H).

Subsec. (a)(25)(I). Puspan. L. 103–66, § 13622(c), added subpar. (I).

Subsec. (a)(32)(D). Puspan. L. 103–66, § 13631(e)(1), added subpar. (D).

Subsec. (a)(43)(A). Puspan. L. 103–66, § 13631(f)(1)(C), inserted before comma at end “and the need for age-appropriate immunizations against vaccine-preventable diseases”.

Subsec. (a)(51). Puspan. L. 103–66, § 13611(d)(1)(B), struck out “(A)” before “meet the requirements” and “, and (B) meet the requirement of section 1396p(c) of this title (relating to transfer of assets)” after “community spouses)”.

Subsec. (a)(54). Puspan. L. 103–66, § 13623(a)(1), which directed amendment of par. (54) by striking “and” at end, could not be executed because “and” did not appear at end subsequent to amendment by Puspan. L. 103–66, § 13602(c). See below.

Puspan. L. 103–66, § 13602(c), amended par. (54) generally. Prior to amendment, par. (54) read as follows:

“(A) provide that, any formulary or similar restriction (except as provided in section 1396r–8(d) of this title) on the coverage of covered outpatient drugs under the plan shall permit the coverage of covered outpatient drugs of any manufacturer which has entered into and complies with an agreement under section 1396r–8(a) of this title, which are prescribed for a medically accepted indication (as defined in suspansection 1396r–8(k)(6) of this title), and

“(B) comply with the reporting requirements of section 1396r–8(span)(2)(A) of this title and the requirements of subsections (d) and (g) of section 1396r–8 of this title; and”.

Subsec. (a)(55). Puspan. L. 103–66, § 13623(a)(3), redesignated par. (55) relating to providing for adjusted payments as (56).

Puspan. L. 103–66, § 13623(a)(2), amended par. (55) relating to providing for receipt and initial processing of applications by substituting semicolon for period at end of subpar. (B).

Subsec. (a)(56). Puspan. L. 103–66, § 13623(a)(3), redesignated par. (55) relating to providing for adjusted payments as (56), transferred such par. to appear after par. (55) relating to providing for receipt and initial processing of applications, and substituted semicolon for period at end.

Subsec. (a)(57). Puspan. L. 103–66, § 13623(a)(4), transferred par. (57) to appear after par. (56) as redesignated by Puspan. L. 103–66, § 13623(a)(3). See above.

Subsec. (a)(58). Puspan. L. 103–66, § 13623(a)(6), redesignated par. (58) relating to maintaining a list as (59).

Puspan. L. 103–66, § 13623(a)(5), amended par. (58) relating to providing that a State develop a written description of advance directive laws by substituting a semicolon for period at end.

Puspan. L. 103–66, § 13623(a)(4), transferred par. (58) relating to providing that a State develop a written description of advance directive laws to follow par. (57) which was transferred by Puspan. L. 103–66, § 13623(a)(4), to appear after par. (56), as redesignated by Puspan. L. 103–66, § 13623(a)(3). See above.

Subsec. (a)(59). Puspan. L. 103–66, § 13625(a)(1), struck out “and” at end.

Puspan. L. 103–66, § 13623(a)(6), redesignated par. (58), relating to maintaining a list, as (59), transferred such par. to appear after par. (58) relating to providing that a State develop a written description of advance directive laws, and substituted “; and” for period at end.

Subsec. (a)(60). Puspan. L. 103–66, § 13623(a)(7), added par. (60).

Subsec. (a)(61). Puspan. L. 103–66, § 13625(a), added par. (61).

Subsec. (a)(62). Puspan. L. 103–66, § 13631(a), added par. (62).

Subsec. (j). Puspan. L. 103–66, § 13601(span)(2), substituted “paragraphs (1) through (25)” for “paragraphs (1) through (22)”.

Subsec. (k). Puspan. L. 103–66, § 13611(d)(1)(C), struck out subsec. (k) which read as follows:

“(k)(1) In the case of a medicaid qualifying trust (described in paragraph (2)), the amounts from the trust deemed available to a grantor, for purposes of subsection (a)(17) of this section, is the maximum amount of payments that may be permitted under the terms of the trust to be distributed to the grantor, assuming the full exercise of discretion by the trustee or trustees for the distribution of the maximum amount to the grantor. For purposes of the previous sentence, the term ‘grantor’ means the individual referred to in paragraph (2).

“(2) For purposes of this subsection, a ‘medicaid qualifying trust’ is a trust, or similar legal device, established (other than by will) by an individual (or an individual’s spouse) under which the individual may be the beneficiary of all or part of the payments from the trust and the distribution of such payments is determined by one or more trustees who are permitted to exercise any discretion with respect to the distribution to the individual.

“(3) This subsection shall apply without regard to—

“(A) whether or not the medicaid qualifying trust is irrevocable or is established for purposes other than to enable a grantor to qualify for medical assistance under this subchapter; or

“(B) whether or not the discretion described in paragraph (2) is actually exercised.

“(4) The State may waive the application of this subsection with respect to an individual where the State determines that such application would work an undue hardship.”

Subsec. (z). Puspan. L. 103–66, § 13603(span), added subsec. (z).

1991—Subsec. (h). Puspan. L. 102–234, § 3(a), struck out “to limit the amount of payment adjustments that may be made under a plan under this subchapter with respect to hospitals that serve a disproportionate number of low-income patients with special needs or” after “Secretary”.

Subsec. (t). Puspan. L. 102–234, § 2(span)(1), substituted “Nothing” for “Except as provided in section 1396span(i) of this title, nothing” and “taxes of general applicability” for “taxes (whether or not of general applicability)”.

1990—Subsec. (a)(10). Puspan. L. 101–508, § 4713(a)(1)(D), which directed amendment of par. (10) by adding subdiv. (XI), relating to medical assistance available to an individual described in subsection (u)(1), in the matter following subparagraph (E), was executed in the matter following subpar. (F) to reflect the probable intent of Congress and the intervening amendment by Puspan. L. 101–508, § 4713(a)(1)(A)–(C), which added subpar. (F). See below. Direction by section 4713(a)(1)(D) to strike “and” before “(X)” could not be executed because “and” did not appear after amendment by Puspan. L. 101–508, § 4402(d)(1). See below.

Puspan. L. 101–508, § 4402(d)(1), in closing provisions, struck out “and” at end of subdiv. (IX), inserted “and” at end of subdiv. (X), and added subdiv. (XI) relating to medical assistance to cover costs of premiums, etc.

Subsec. (a)(10)(A)(i)(VII). Puspan. L. 101–508, § 4601(a)(1)(A), added subcl. (VII).

Subsec. (a)(10)(A)(ii)(IX). Puspan. L. 101–508, § 4601(a)(1)(B), substituted “, clause (i)(VI), or clause (i)(VII)” for “or clause (i)(VI)”.

Subsec. (a)(10)(C)(iv). Puspan. L. 101–508, §§ 4711(d)(2), 4755(c)(1)(A), amended cl. (iv) identically, substituting “through (21)” for “through (20)”.

Subsec. (a)(10)(E)(iii). Puspan. L. 101–508, § 4501(span), added cl. (iii).

Subsec. (a)(10)(F). Puspan. L. 101–508, § 4713(a)(1)(A)–(C), added subpar. (F).

Subsec. (a)(13)(A). Puspan. L. 101–508, § 4801(e)(1)(A), inserted “(including the costs of services required to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident eligible for benefits under this subchapter)” after “take into account the costs”.

Subsec. (a)(13)(E). Puspan. L. 101–508, § 4704(e)(1), repealed Puspan. L. 101–239, § 6402(c)(2). See 1989 Amendment note below.

Puspan. L. 101–508, § 4704(a), substituted “prescribes” for “may prescribe” and “on the same methodology used under section 1395l(a)(3) of this title” for “on such tests of reasonableness as the Secretary may prescribe in regulations under this subparagraph”.

Subsec. (a)(13)(F). Puspan. L. 101–508, § 4711(c)(1)(A), added subpar. (F).

Subsec. (a)(17). Puspan. L. 101–508, § 4723(span), inserted “, payments made to the State under section 1396span(f)(2)(B) of this title,” after “insurance premiums”.

Subsec. (a)(25)(G). Puspan. L. 101–508, § 4402(a)(1), added subpar. (G).

Subsec. (a)(32)(C). Puspan. L. 101–508, § 4708(a), added subpar. (C).

Subsec. (a)(41). Puspan. L. 101–508, § 4754(a), substituted “shall promptly notify the Secretary and, in the case of a physician and notwithstanding paragraph (7), the State medical licensing board” for “shall promptly notify the Secretary”.

Subsec. (a)(54). Puspan. L. 101–508, § 4401(a)(2), added par. (54).

Subsec. (a)(55). Puspan. L. 101–508, § 4604(span), added par. (55) relating to providing for adjusted payments.

Puspan. L. 101–508, § 4602(a), added par. (55) relating to providing for receipt and initial processing of applications.

Subsec. (a)(57). Puspan. L. 101–508, § 4751(a)(1), added par. (57).

Subsec. (a)(58). Puspan. L. 101–508, § 4752(c), added par. (58) relating to maintaining a list.

Puspan. L. 101–508, § 4751(a)(1), added par. (58) relating to providing that a State develop a written description of advance directive laws.

Subsec. (e)(2)(A). Puspan. L. 101–508, § 4732(span)(1), inserted “or with an eligible organization with a contract under section 1395mm of this title” after “section 1396span(m)(2)(A) of this title”.

Subsec. (e)(4). Puspan. L. 101–508, § 4603(a)(1), inserted “(or would remain if pregnant)” after “remains”.

Subsec. (e)(6). Puspan. L. 101–508, § 4603(a)(2), substituted “In” for “At the option of a State, in”, substituted “the woman shall be deemed to continue to be” for “the State plan may nonetheless treat the woman as being”, and inserted at end “The preceding sentence shall not apply in the case of a woman who has been provided ambulatory prenatal care pursuant to section 1396r–1 of this title during a presumptive eligibility period and is then, in accordance with such section, determined to be ineligible for medical assistance under the State plan.”

Subsec. (e)(11). Puspan. L. 101–508, § 4402(c), added par. (11).

Subsec. (h). Puspan. L. 101–508, § 4711(c)(1)(B), inserted before period at end “or to limit the amount of payment that may be made under a plan under this subchapter for home and community care”.

Subsec. (j). Puspan. L. 101–508, §§ 4711(d)(1), 4755(c)(1)(B), amended subsec. (j) identically substituting “through (22)” for “through (21)”.

Subsec. (l)(1)(C). Puspan. L. 101–508, § 4601(a)(1)(C)(i), inserted “children” after “(C)”.

Subsec. (l)(1)(D). Puspan. L. 101–508, § 4601(a)(1)(C)(ii), added subpar. (D) and struck out former subpar. (D) which read as follows: “at the option of the State, children born after September 30, 1983, who have attained 6 years of age but have not attained 7 or 8 years of age (as selected by the State),”.

Subsec. (l)(2)(C). Puspan. L. 101–508, § 4601(a)(1)(C)(iii), added subpar. (C) and struck out former subpar. (C) which read as follows: “If a State elects, under subsection (a)(10)(A)(ii)(IX) of this section, to cover individuals not described in subparagraph (A) or (B) of paragraph (1), for purposes of that paragraph and with respect to individuals not described in such subparagraphs the State shall establish an income level which is a percentage (not more than 100 percent) of the income official poverty line described in subparagraph (A).”

Subsec. (l)(3). Puspan. L. 101–508, § 4601(a)(1)(C)(iv), inserted “, (a)(10)(A)(i)(VII),” after “(a)(10)(A)(i)(VI)”.

Subsec. (l)(4)(A). Puspan. L. 101–508, § 4601(a)(1)(C)(v), inserted “or subsection (a)(10)(A)(i)(VII)” after “(a)(10)(A)(i)(VI)”.

Subsec. (l)(4)(B). Puspan. L. 101–508, § 4601(a)(1)(C)(vi), substituted “(a)(10)(A)(i)(VI), or (a)(10)(A)(i)(VII)” for “or (a)(10)(A)(i)(VI)”.

Subsec. (m)(1)(B). Puspan. L. 101–508, § 4501(e)(2)(A), inserted “, except as provided in paragraph (2)(C)” after “program”.

Subsec. (m)(2)(C). Puspan. L. 101–508, § 4501(e)(2)(B), added subpar. (C).

Subsec. (r)(1). Puspan. L. 101–508, § 4715(a), inserted “there shall be disregarded reparation payments made by the Federal Republic of Germany and” after “under such a waiver”.

Subsec. (r)(2)(A). Puspan. L. 101–508, § 4601(a)(1)(D), inserted “(a)(10)(A)(i)(VII),” after “(a)(10)(A)(i)(VI),”.

Subsec. (s). Puspan. L. 101–508, § 4604(a), added subsec. (s).

Subsec. (t). Puspan. L. 101–508, § 4701(span)(1), added subsec. (t).

Subsec. (u). Puspan. L. 101–508, § 4713(a)(2), added subsec. (u).

Subsec. (v). Puspan. L. 101–508, § 4724(a), added subsec. (v).

Subsec. (w). Puspan. L. 101–508, § 4751(a)(2), added subsec. (w).

Subsec. (x). Puspan. L. 101–508, § 4752(a)(1)(A), added subsec. (x).

Subsec. (y). Puspan. L. 101–508, § 4755(a)(2), added subsec. (y).

1989—Subsec. (a)(9)(C). Puspan. L. 101–239, § 6115(c), substituted “paragraphs (15) and (16)” for “paragraphs (14) and (15)”.

Puspan. L. 101–234 repealed Puspan. L. 100–360, § 204(d)(3), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.

Subsec.(a)(10)(A). Puspan. L. 101–239, § 6405(span), substituted “(1) through (5), (17) and (21)” for “(1) through (5) and (17)” in introductory provisions.

Subsec. (a)(10)(A)(i)(VI). Puspan. L. 101–239, § 6401(a)(1), added subcl. (VI).

Subsec. (a)(10)(A)(ii)(IX). Puspan. L. 101–239, § 6401(a)(2), inserted “or clause (i)(VI)” after “clause (i)(IV)”.

Subsec. (a)(10)(E). Puspan. L. 101–239, § 6408(d)(1), designated existing provisions as cl. (i) and added cl. (ii).

Subsec. (a)(11)(C). Puspan. L. 101–239, § 6406(a)(1), added subpar. (C).

Subsec. (a)(13)(D). Puspan. L. 101–239, § 6408(c)(1), substituted “in amounts no lower than the amounts, using the same methodology, used” for “in the same amounts, and using the same methodology, as used”, “in the case of” for “a separate rate may be paid for”, and “there shall be paid an additional amount, to take into account the room and board furnished by the facility, equal to at least 95 percent of the rate that would have been paid by the State under the plan for facility services in that facility for that individual” for “to take into account the room and board furnished by such facility”.

Subsec. (a)(13)(E). Puspan. L. 101–239, § 6404(c), substituted “clause (B) or (C) of section 1396d(a)(2) of this title” for “section 1396d(a)(2)(B) of this title provided by a rural health clinic”.

Puspan. L. 101–239, § 6402(c)(2), which directed insertion of “, and for payment for services described in section 1396d(a)(2)(C) of this title under the plan,” after “provided by a rural health clinic under the plan”, was repealed by Puspan. L. 101–508, § 4704(e)(1).

Subsec. (a)(30)(A). Puspan. L. 101–239, § 6402(a), inserted before semicolon at end “and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area”.

Subsec. (a)(43)(A). Puspan. L. 101–239, § 6403(d)(1), substituted “section 1396d(r)” for “section 1396d(a)(4)(B)”.

Subsec. (a)(43)(D). Puspan. L. 101–239, § 6403(span), added subpar. (D).

Subsec. (a)(53). Puspan. L. 101–239, § 6406(a)(2)–(4), added par. (53).

Subsec. (e)(7). Puspan. L. 101–239, § 6401(a)(8), substituted “, (C), or (D)” for “or (C)” in introductory provisions.

Subsec. (f). Puspan. L. 101–239, § 6411(e)(2), inserted “and section 1396r–5 of this title” after “section 1382h(span)(3) of this title”.

Puspan. L. 101–239, § 6411(a)(1), inserted “and except with respect to qualified medicare beneficiaries, qualified severely impaired individuals, and individuals described in subsection (m)(1)” before “, no State”.

Puspan. L. 101–239, § 6408(d)(4)(C), inserted “, except with respect to qualified disabled and working individuals (described in section 1396d(s) of this title),” after “section 1382h(span)(3) of this title”.

Subsec. (l)(1)(C), (D). Puspan. L. 101–239, § 6401(a)(3), added subpars. (C) and (D) and struck out former subpar. (C) which read as follows: “at the option of the State, children born after September 30, 1983, who have attained one year of age but have not attained 2, 3, 4, 5, 6, 7, or 8 years of age (as selected by the State),”.

Subsec. (l)(2)(A)(ii)(II). Puspan. L. 101–239, § 6401(a)(4)(A), amended subcl. (II) generally. Prior to amendment, subcl. (II) read as follows: “July 1, 1990, is 100 percent.”

Subsec. (l)(2)(A)(iv). Puspan. L. 101–239, § 6401(a)(4)(B), added cl. (iv).

Subsec. (l)(2)(B), (C). Puspan. L. 101–239, § 6401(a)(5), (6), added subpar. (B), struck out “, or, if less, the percentage established under subparagraph (A)” after “not more than 100 percent” in former subpar. (B), and redesignated former subpar. (B) as (C).

Subsec. (l)(3). Puspan. L. 101–239, § 6401(a)(6)(A), inserted “, (a)(10)(A)(i)(VI),” after “(a)(10)(A)(i)(IV)” in introductory provisions.

Subsec. (l)(3)(C). Puspan. L. 101–239, § 6401(a)(6)(B), substituted “(C), or (D)” for “or (C)”.

Subsec. (l)(4)(A). Puspan. L. 101–239, § 6401(a)(7)(A), inserted “and for children described in subsection (a)(10)(A)(i)(VI)” after “(a)(10)(A)(i)(IV)”.

Subsec. (l)(4)(B). Puspan. L. 101–239, § 6401(a)(7)(B), inserted “or (a)(10)(A)(i)(VI)” after “(a)(10)(A)(i)(IV)”.

Subsec. (p)(2)(C). Puspan. L. 101–239, § 6411(d)(3)(B), added subpar. (C).

Subsec. (r)(2)(A). Puspan. L. 101–239, § 6401(a)(9), inserted “(a)(10)(A)(i)(VI),” after “(a)(10)(A)(i)(IV),” in introductory provisions.

1988—Subsec. (a)(9)(C). Puspan. L. 100–360, § 204(d)(3), substituted “paragraphs (14) and (15)” for “paragraphs (13) and (14)”.

Subsec. (a)(10). Puspan. L. 100–647, § 8434(span)(1), inserted “who is only entitled to medical assistance because the individual is such a beneficiary” after “section 1396d(p)(1) of this title” in subdiv. (VIII) of closing provisions.

Puspan. L. 100–360, § 302(a)(1)(C), inserted “(A)(i)(IV) or” before “(A)(ii)(X)” in subdiv. (VII) of closing provisions.

Puspan. L. 100–360, § 302(span)(1), added subdiv. (X) in closing provisions.

Subsec. (a)(10)(A)(i)(I). Puspan. L. 100–485, § 202(c)(4), substituted “section 682(e)(6) of this title” for “section 614(g) of this title”.

Subsec. (a)(10)(A)(i)(IV). Puspan. L. 100–360, § 302(a)(1)(A), added subcl. (IV).

Subsec. (a)(10)(A)(i)(V). Puspan. L. 100–485, § 401(d)(1), added subcl. (V).

Subsec. (a)(10)(A)(ii)(VI). Puspan. L. 100–360, § 411(k)(17)(B), substituted “(c), (d), or (e)” for “(c) or (d)” in two places.

Subsec. (a)(10)(A)(ii)(IX). Puspan. L. 100–360, § 302(a)(1)(B), amended subcl. (IX) generally. Prior to amendment, subcl. (IX) read as follows: “subject to subsection (l)(4) of this section, who are described in subsection (l)(1) of this section;”.

Subsec. (a)(10)(A)(ii)(X). Puspan. L. 100–360, § 301(e)(2)(A), struck out “subject to subsection (m)(3) of this section,” before “who are described”.

Subsec. (a)(10)(A)(ii)(XI). Puspan. L. 100–360, § 411(k)(5)(B), substituted “may be more restrictive” for “are more restrictive” and a semicolon for the period at end.

Puspan. L. 100–360, § 411(k)(5)(A), amended Puspan. L. 100–203, § 4104, see 1987 Amendment note below.

Subsec. (a)(10)(C)(i)(III). Puspan. L. 100–360, § 303(e)(1), substituted “no more restrictive than the methodology” for “the same methodology” in two places.

Subsec. (a)(10)(E). Puspan. L. 100–360, § 301(e)(2)(B), struck out “subject to subsection (m)(3) of this section,” before “for making medical”.

Puspan. L. 100–360, § 301(a)(1), struck out “at the option of a State, but” after “(E)”.

Subsec. (a)(13)(A). Puspan. L. 100–360, § 411(l)(3)(J), as added by Puspan. L. 100–485, § 608(d)(27)(H), amended Puspan. L. 100–203, § 4211(h)(2)(B), see 1987 Amendment note below.

Subsec. (a)(13)(C). Puspan. L. 100–360, § 411(l)(3)(H)(i), as amended by Puspan. L. 100–485, § 608(d)(27)(F), amended Puspan. L. 100–203, § 4211(h)(2)(C), see 1987 Amendment note below.

Subsec. (a)(13)(D). Puspan. L. 100–360, § 411(l)(3)(H)(ii), (iii), as amended by Puspan. L. 100–485, § 608(d)(27)(G), amended Puspan. L. 100–203, § 4211(h)(2)(D), see 1987 Amendment note below.

Subsec. (a)(15). Puspan. L. 100–360, § 301(e)(2)(C), as added by Puspan. L. 100–485, § 608(d)(14)(I)(iii), struck out par. (15) which read as follows: “in the case of eligible individuals 65 years of age or older who are not qualified medicare beneficiaries (as defined in section 1396d(p)(1) of this title) but are covered by either or both of the insurance programs established by subchapter XVIII of this chapter, provide where, under the plan, all of any deductible, cost sharing, or similar charge imposed with respect to such individual under the insurance program established by such subchapter is not met, the portion thereof which is met shall be determined on a basis reasonably related (as determined in accordance with standards approved by the Secretary and included in the plan) to such individual’s income or his income and resources;”.

Subsec. (a)(17). Puspan. L. 100–360, § 411(k)(10)(G)(ii), amended directory language of Puspan. L. 100–203, § 4118(h)(1), see 1987 Amendment note below.

Puspan. L. 100–360, § 301(e)(2)(D), formerly § 301(e)(2)(C), as redesignated and amended by Puspan. L. 100–485, § 608(d)(14)(I)(i), substituted “(m)(3), and (m)(4)” for “(m)(4), and (m)(5)”.

Subsec. (a)(28)(D)(i). Puspan. L. 100–360, § 411(l)(3)(E), substituted “section 1396r(e) of this title” for “section 1396r(f) of this title (relating to implementation of nursing facility requirements, including paragraph (6)(B), relating to specification of resident assessment instrument)”.

Subsec. (a)(33)(B). Puspan. L. 100–360, § 411(l)(6)(C), substituted “section 1396r(g) of this title” for “section 1396r(d) of this title”.

Subsec. (a)(44)(A). Puspan. L. 100–360, § 411(l)(6)(D), amended Puspan. L. 100–203, § 4212(e)(1)(B), see 1987 Amendment note below.

Subsec. (a)(50). Puspan. L. 100–360, § 411(n)(4), formerly § 411(n)(3), as redesignated by Puspan. L. 100–485, § 608(d)(28), added Puspan. L. 100–203, § 9119(d)(1)(A), see 1987 Amendment note below.

Subsec. (a)(51). Puspan. L. 100–360, § 303(e)(2)–(4), added par. (51).

Subsec. (a)(52). Puspan. L. 100–485, § 303(a)(2), added par. (52).

Subsec. (c). Puspan. L. 100–360, § 302(c)(1), amended subsec. (c) generally. Prior to amendment, subsec. (c) read as follows: “Notwithstanding subsection (span) of this section, the Secretary shall not approve any State plan for medical assistance if he determines that the approval and operation of the plan will result in a reduction in aid or assistance in the form of money payments (other than so much, if any, of the aid or assistance in such form as was, immediately prior to the effective date of the State plan under this subchapter, attributable to medical needs) provided for eligible individuals under a plan of such State approved under subchapter I, X, XIV, or XVI of this chapter, or part A of subchapter IV of this chapter.”

Subsec. (d). Puspan. L. 100–360, § 411(k)(7)(C), amended Puspan. L. 100–203, § 4113(span)(2)(ii), see 1987 Amendment note below.

Subsec. (e)(1). Puspan. L. 100–485, § 303(span)(1), designated existing provisions as subpar. (A), inserted “subject to subparagraph (B)” after “January 1, 1974,”, and added subpar. (B).

Subsec. (e)(2)(A). Puspan. L. 100–360, § 411(k)(7)(D), repealed Puspan. L. 100–203, § 4113(d)(2), see 1987 Amendment note below.

Puspan. L. 100–360, § 411(k)(7)(B), amended Puspan. L. 100–203, § 4113(a)(2), see 1987 Amendment note below.

Subsec. (e)(6). Puspan. L. 100–360, § 302(e)(1), amended par. (6) generally. Prior to amendment, par. (6) read as follows: “At the option of a State, if a State plan provides medical assistance for individuals under subsection (a)(10)(A)(ii)(IX) of this section, the plan may provide that any woman described in such subsection and subsection (l)(1)(A) of this section shall continue to be treated as an individual described in subsection (a)(10)(A)(ii)(IX) of this section without regard to any change in income of the family of which she is a member until the end of the 60-day period beginning on the last day of her pregnancy.”

Subsec. (e)(7). Puspan. L. 100–360, § 302(e)(2), in introductory provisions, substituted “In the case” for “If a State plan provides medical assistance for individuals under subsection (a)(10)(A)(ii)(IX) of this section, in the case” and inserted “or paragraph (2) of section 1396d(n) of this title”, and, in concluding provisions, substituted “such respective provision” for “subsection (a)(10)(A)(ii)(IX) of this section and subsection (l)(1) of this section”.

Subsec. (e)(10). Puspan. L. 100–485, § 303(d), added par. (10).

Subsec. (f). Puspan. L. 100–360, § 411(k)(10)(G)(iv), added Puspan. L. 100–203, § 4118(h)(2), see 1987 Amendment note below.

Subsec. (i). Puspan. L. 100–360, § 411(l)(8)(C), amended Puspan. L. 100–203, § 4213(span)(1), see 1987 Amendment note below.

Subsec. (l)(1). Puspan. L. 100–360, § 302(e)(3)(A), inserted “any of subclauses (I) through (III) of” after “described in” in concluding provisions.

Subsec. (l)(1)(C). Puspan. L. 100–360, § 302(a)(2)(A), inserted “at the option of the State,” after “(C)” and struck out “and” after “1983,”.

Subsec. (l)(2)(A). Puspan. L. 100–360, § 302(a)(2)(B), as amended by Puspan. L. 100–485, § 608(d)(15)(A), designated existing provisions as cl. (i), substituted “(not less than the percentage provided under clause (ii) and not more than 185 percent)” for “(not more than 185 percent)”, and added cls. (ii) and (iii).

Subsec. (l)(2)(A)(ii). Puspan. L. 100–485, § 608(d)(15)(B)(i), in introductory provisions, substituted “The” for “Subject to clause (iii), the”, and in subcl. (I), inserted “or, if greater, the percentage provided under clause (iii),”.

Subsec. (l)(2)(A)(iii). Puspan. L. 100–485, § 608(d)(15)(B)(ii), substituted “clause (ii)(I)” for “clause (ii)” in introductory provisions and concluding provisions.

Subsec. (l)(3). Puspan. L. 100–360, § 302(e)(3)(B), inserted “(a)(10)(A)(i)(IV) or” after “of subsection” in introductory provisions.

Subsec. (l)(4). Puspan. L. 100–360, § 302(c)(2), (d), added par. (4) and struck out former par. (4) which read as follows:

“(A) A State plan may not elect the option of furnishing medical assistance to individuals described in subsection (a)(10)(A)(ii)(IX) of this section unless the State has in effect, under its plan established under part A of subchapter IV of this chapter, payment levels that are not less than the payment levels in effect under its plan on July 1, 1987.

“(B)(i) A State may not elect, under subsection (a)(10)(A)(ii)(IX) of this section, to cover only individuals described in paragraph (1)(A) or to cover only individuals described in paragraph (1)(B).

“(ii) A State may not elect, under subsection (a)(10)(A)(ii)(IX) of this section, to cover individuals described in subparagraph (C) of paragraph (1) unless the State has elected, under such subsection, to cover individuals described in the preceding subparagraphs of such paragraph.

“(C) A State plan may not provide, in its election of the option of furnishing medical assistance to individuals described in paragraph (1), that such individuals must apply for benefits under part A of subchapter IV of this chapter as a condition of applying for, or receiving, medical assistance under this subchapter.”

Subsec. (m)(3). Puspan. L. 100–360, § 301(e)(2)(E), formerly § 301(e)(2)(D), as redesignated and amended by Puspan. L. 100–485, § 608(d)(14)(I)(ii), redesignated par. (4) as (3) and struck out former par. (3) which read as follows: “A State plan may not provide coverage for individuals under subsection (a)(10)(A)(ii)(X) of this section or coverage under subsection (a)(10)(E) of this section, unless the plan provides coverage of some or all of the individuals described in subsection (l)(1) of this section.”

Subsec. (m)(4). Puspan. L. 100–360, § 301(e)(2)(E), formerly § 301(e)(2)(D), as redesignated and amended by Puspan. L. 100–485, § 608(d)(14)(I)(ii), redesignated par. (5) as (4). Former par. (4) redesignated (3).

Subsec. (m)(4)(A). Puspan. L. 100–647, § 8434(span)(2), substituted “section 1396d(p)(1)(B)” for “section 1396d(p)(1)(C)”.

Subsec. (m)(5). Puspan. L. 100–360, § 301(e)(2)(E), formerly § 301(e)(2)(D), as redesignated and amended by Puspan. L. 100–485, § 608(d)(14)(I)(ii), redesignated par. (5) as (4).

Subsec. (o). Puspan. L. 100–360, § 411(n)(2), made technical correction to directory language of Puspan. L. 100–203, § 9115(span), see 1987 Amendment note below.

Subsec. (q). Puspan. L. 100–360, § 411(n)(4), formerly § 411(n)(3), as redesignated by Puspan. L. 100–485, § 608(d)(28), added Puspan. L. 100–203, § 9119(d)(1)(B), see 1987 Amendment note below.

Subsec. (r). Puspan. L. 100–360, § 303(e)(5), designated existing provisions as par. (1), redesignated subpars. (A) and (B) as cls. (i) and (ii), respectively, and added par. (2).

Puspan. L. 100–360, § 303(d), added subsec. (r).

Subsec. (r)(2)(A). Puspan. L. 100–485, § 608(d)(16)(C), substituted “, or (f) or under section 1396d(p) of this title” for “, or under subsection (f)” in introductory provisions.

1987—Subsec. (a)(9)(C). Puspan. L. 100–203, § 4072(d), substituted “paragraphs (13) and (14)” for “paragraphs (12) and (13)”.

Subsec. (a)(10). Puspan. L. 100–203, § 4101(e)(1), substituted “postpartum, and family planning services” for “and postpartum services” in subdiv. (VII) of closing provisions.

Subsec. (a)(10)(A)(ii)(VI). Puspan. L. 100–203, § 4211(h)(1)(A), substituted “nursing facility or intermediate care facility for the mentally retarded” for “skilled nursing facility or intermediate care facility”.

Puspan. L. 100–203, § 4102(span)(1), substituted “subsection (c) or (d) of section 1396n of this title” for “section 1396n(c) of this title” in two places.

Subsec. (a)(10)(A)(ii)(IX), (X). Puspan. L. 100–203, § 4118(p)(1), (2), realigned margin of subcls. (IX) and (X).

Subsec. (a)(10)(A)(ii)(XI). Puspan. L. 100–203, § 4104, as amended by Puspan. L. 100–360, § 411(k)(5)(A), added subcl. (XI).

Subsec. (a)(10)(C)(iv). Puspan. L. 100–203, § 4211(h)(1)(B), substituted “in an intermediate care facility” for “intermediate care facility services”.

Subsec. (a)(10)(D). Puspan. L. 100–203, § 4211(h)(1)(C), struck out “skilled” before “nursing”.

Subsec. (a)(13)(A). Puspan. L. 100–203, § 4211(h)(2)(B), as amended by Puspan. L. 100–360, § 411(l)(3)(J), as added by Puspan. L. 100–485, § 608(d)(27)(H), substituted “, nursing facility, and intermediate care facility for the mentally retarded and” for “, skilled nursing facility, and intermediate care facility and”.

Puspan. L. 100–203, § 4211(h)(2)(A), substituted “services, nursing facility services, and services in an intermediate care facility for the mentally retarded” for “, skilled nursing facility, and intermediate care facility services”.

Puspan. L. 100–203, § 4211(span)(1)(A), inserted “which, in the case of nursing facilities, take into account the costs of complying with subsections (span) (other than paragraph (3)(F) thereof), (c), and (d) of section 1396r of this title and provide (in the case of a nursing facility with a waiver under section 1396r(span)(4)(C)(ii) of this title) for an appropriate reduction to take into account the lower costs (if any) of the facility for nursing care,” after second reference to “State”.

Subsec. (a)(13)(C). Puspan. L. 100–203, § 4211(h)(2)(C), as amended by Puspan. L. 100–360, § 411(l)(3)(H)(i), as amended by Puspan. L. 100–485, § 608(d)(27)(F), substituted “nursing facilities and for intermediate care facilities for the mentally retarded” for “skilled nursing facilities and intermediate care facilities” in introductory provisions.

Subsec. (a)(13)(D). Puspan. L. 100–203, § 4211(h)(2)(D), as amended by Puspan. L. 100–360, § 411(l)(3)(H)(ii), (iii), as amended by Puspan. L. 100–485, § 608(d)(27)(G), substituted “nursing facility or intermediate care facility for the mentally retarded” for “skilled nursing facility or intermediate care facility” and “nursing facility services or services in an intermediate care facility for the mentally retarded” for “skilled nursing facility services or intermediate care facility services”.

Subsec. (a)(17). Puspan. L. 100–203, § 4118(p)(3), substituted “subsections (l)(3), (m)(4), and (m)(5)” for “subsection (l)(3)”.

Puspan. L. 100–203, § 4118(h)(1), as amended by Puspan. L. 100–360, § 411(k)(10)(G)(ii), substituted “(whether in the form of insurance premiums or otherwise and regardless of whether such costs are reimbursed under another public program of the State or political subdivision thereof)” for “(whether in the form of insurance premiums or otherwise)”.

Subsec. (a)(23). Puspan. L. 100–203, § 4113(c)(1), designated provision relating to the obtaining of medical assistance by an eligible individual as cl. (A) and added cl. (B).

Puspan. L. 100–93, § 8(f)(1), inserted “subsection (g) and in” after “as provided in”.

Subsec. (a)(28). Puspan. L. 100–203, § 4211(span)(1)(B), amended par. (28) generally. Prior to amendment, par. (28) read as follows: “provide that any skilled nursing facility receiving payments under such plan must satisfy all of the requirements contained in section 1395x(j) of this title, except that the exclusion contained therein with respect to institutions which are primarily for the care and treatment of mental diseases shall not apply for purposes of this subchapter;”.

Subsec. (a)(30)(B)(i), (ii). Puspan. L. 100–203, § 4211(h)(3), substituted “intermediate care facility for the mentally retarded” for “skilled nursing facility, intermediate care facility”.

Subsec. (a)(30)(C). Puspan. L. 100–203, § 4118(p)(4), substituted “use” for “provide”.

Puspan. L. 100–203, § 4113(span)(1), inserted “, an entity which meets the requirements of section 1320c–1 of this title, as determined by the Secretary,” before “or a private accreditation body”.

Subsec. (a)(31). Puspan. L. 100–203, § 4212(d)(2), in introductory provision substituted “services in an intermediate care facility for the mentally retarded (where” for “skilled nursing facility services (and with respect to intermediate care facility services where” and in subpar. (B) substituted “intermediate care facility for the mentally retarded” for “skilled nursing or intermediate care facility”.

Subsec. (a)(33)(B). Puspan. L. 100–203, § 4212(d)(3), inserted “, except as provided in section 1396r(d) of this title,” after “(B) that”.

Subsec. (a)(38). Puspan. L. 100–93, § 8(f)(2), substituted “the information described in section 1320a–7(span)(9) of this title” for “respectively, (A) full and complete information as to the ownership of a subcontractor (as defined by the Secretary in regulations) with whom such entity has had, during the previous twelve months, business transactions in an aggregate amount in excess of $25,000, and (B) full and complete information as to any significant business transactions (as defined by the Secretary in regulations), occurring during the five-year period ending on the date of such request, between such entity and any wholly owned supplier or between such entity and any subcontractor”.

Subsec. (a)(39). Puspan. L. 100–93, § 8(f)(3), substituted “exclude” for “bar”, “individual or entity” for “person” in two places, and inserted reference to section 1320a–7a of this title.

Subsec. (a)(42). Puspan. L. 100–203, § 4118(m)(1)(B), struck out “(A)” after “provide”, the comma after “under the plan”, and cls. (B) and (C) which read as follows: “(B) that such audits, for such entities also providing services under subchapter XVIII of this chapter, will be coordinated and conducted jointly (to such extent and in such manner as the Secretary shall prescribe) with audits conducted for purposes of such subchapter, and (C) for payment of such proportion of costs of each such common audit as is determined under methods specified by the Secretary under section 1320a–8(a) of this title”.

Subsec. (a)(44). Puspan. L. 100–203, § 4212(e)(1)(A), substituted “services in an intermediate care facility for the mentally retarded” for “skilled nursing facility services, intermediate care facility services”.

Subsec. (a)(44)(A). Puspan. L. 100–203, § 4218(a)(1), substituted “physician (or, in the case of skilled nursing facility services or intermediate care facility services, a physician, or a nurse practitioner or clinical nurse specialist who is not an employee of the facility but is working in collaboration with a physician) certifies” for “physician certifies” and “a physician, a physician assistant under the supervision of a physician, or, in the case of skilled nursing facility services or intermediate care facility services, a physician, or a nurse practitioner or clinical nurse specialist who is not an employee of the facility but is working in collaboration with a physician,” for “the physician, or a physician assistant or nurse practitioner under the supervision of a physician,”.

Puspan. L. 100–203, § 4212(e)(1)(B), as amended by Puspan. L. 100–360, § 411(l)(6)(D), substituted “that are services provided in an intermediate care facility for the mentally retarded” for “that are intermediate care facility services provided in an institution for the mentally retarded”.

Subsec. (a)(44)(B). Puspan. L. 100–203, § 4218(a)(2), substituted “a physician, or, in the case of skilled nursing facility services or intermediate care facility services, a physician, or a nurse practitioner or clinical nurse specialist who is not an employee of the facility but is working in collaboration with a physician;” for “a physician;”.

Subsec. (a)(46). Puspan. L. 100–93, § 5(a)(1), struck out “and” after “title;”.

Subsec. (a)(47). Puspan. L. 100–93, § 5(a)(2), (3), substituted semicolon for period at end of par. (47), relating to ambulatory prenatal care and redesignated par. (47), relating to cards evidencing eligibility, as (48).

Subsec. (a)(48). Puspan. L. 100–93, § 5(a)(3), redesignated par. (47), relating to cards evidencing eligibility for medical assistance, as (48), and substituted “address; and” for “address.”

Subsec. (a)(49). Puspan. L. 100–93, § 5(a)(4), added par. (49).

Subsec. (a)(50). Puspan. L. 100–203, § 9119(d)(1)(A), as added by Puspan. L. 100–360, § 411(n)(4), formerly § 411(n)(3), as redesignated by Puspan. L. 100–485, § 608(d)(28), added par. (50).

Subsec. (d). Puspan. L. 100–203, § 4113(span)(2)(i), inserted “an entity which meets the requirements of section 1320c–1 of this title, as determined by the Secretary, for the performance of the quality review functions described in subsection (a)(30)(C) of this section, or” after “contracts with”.

Puspan. L. 100–203, § 4113(span)(2)(ii), as amended by Puspan. L. 100–360, § 411(k)(7)(C), substituted “an entity or organization” for “organization (or organizations)” in two places.

Subsec. (e)(2)(A). Puspan. L. 100–203, § 4113(d)(2), which directed substitution of “subparagraph (B)(iii), (E), or (G) of section 1396span(m)(2) of this title” for “section 1396a(m)(2)(G) of this title”, was repealed by Puspan. L. 100–360, § 411(k)(7)(D).

Puspan. L. 100–203, § 4113(a)(2), as amended by Puspan. L. 100–360, § 411(k)(7)(B), substituted “paragraph (2)(B)(iii), (2)(E), (2)(G), or (6) of section 1396span(m) of this title” for “section 1396span(m)(2)(G) of this title”.

Puspan. L. 100–203, § 4113(c)(2), substituted “but, except for benefits furnished under section 1396d(a)(4)(C) of this title, only” for “but only”.

Subsec. (e)(3)(B)(i). Puspan. L. 100–203, § 4211(h)(4), substituted “nursing facility, or intermediate care facility for the mentally retarded” for “skilled nursing facility, or intermediate care facility”.

Subsec. (e)(3)(C). Puspan. L. 100–203, § 4118(c)(1), substituted “for medical assistance under the State plan under this subchapter” for “to have a supplemental security income (or State supplemental) payment made with respect to him under subchapter XVI of this chapter”.

Subsec. (e)(4). Puspan. L. 100–203, § 4101(a)(2), inserted sentence at end relating to child’s medical assistance eligibility identification number and submission and payment of claims under such number during period in which a child is eligible for assistance.

Subsec. (e)(5). Puspan. L. 100–203, § 4101(e)(2), substituted “through the end of the month in which the 60-day period (beginning on the last day of her pregnancy) ends” for “until the end of the 60-day period beginning on the last day of her pregnancy”.

Subsec. (e)(7). Puspan. L. 100–203, § 4101(span)(2)(B), substituted “subparagraph (B) or (C)” for “subparagraph (B), (C), (D), (E), or (F)”.

Subsec. (e)(9). Puspan. L. 100–203, § 4118(p)(6), realigned margins of par. (9).

Subsec. (e)(9)(A)(iii). Puspan. L. 100–203, § 4211(h)(5)(A), substituted “nursing facility, or intermediate care facility for the mentally retarded” for “skilled nursing facility, or intermediate care facility,”.

Subsec. (e)(9)(B). Puspan. L. 100–203, § 4211(h)(5)(B), substituted “nursing facilities, or intermediate care facilities for the mentally retarded” for “skilled nursing facilities, or intermediate care facilities”.

Subsec. (f). Puspan. L. 100–203, § 4118(h)(2), as added by Puspan. L. 100–360, § 411(k)(10)(G)(iv), inserted “regardless of whether such expenses are reimbursed under another public program of the State or political subdivision thereof” after “State law” in first sentence.

Subsec. (i). Puspan. L. 100–203, § 4213(span)(1), as amended by Puspan. L. 100–360, § 411(l)(8)(C), in par. (1), substituted “intermediate care facility for the mentally retarded” for “skilled nursing facility or intermediate care facility” and “the requirements for such a facility under this subchapter” for “the provisions of section 1395x(j) of this title or section 1396d(c) of this title, respectively,”, and in pars. (2) and (3), substituted “the requirements for such a facility under this subchapter” for “the provisions of section 1395x(j) of this title or section 1396d(c) of this title (as the case may be)”.

Subsec. (j). Puspan. L. 100–203, § 4116, inserted reference to Northern Mariana Islands in two places.

Subsec. (l). Puspan. L. 100–93, § 7, redesignated subsec. (l), relating to disregarding certain benefits for purposes of determining post-eligibility contributions, as (o).

Subsec. (l)(1). Puspan. L. 100–203, § 4118(p)(7), made technical corrections in introductory provisions and substituted “and whose” for “, whose” in closing provisions.

Subsec. (l)(1)(C). Puspan. L. 100–203, § 4101(c)(2), substituted “5, 6, 7, or 8 years of age” for “or 5 years of age”.

Puspan. L. 100–203, § 4101(span)(1), added subpar. (C). Former subpar. (C), which related to children who have attained one year of age but have not attained two years of age, was struck out.

Subsec. (l)(1)(D) to (F). Puspan. L. 100–203, § 4101(span)(1)(B), struck out subpars. (D) to (F) which related to children who have attained two years of age but have not attained three years of age, children who have attained three years of age but have not attained four years of age, and children who have attained four years of age but have not attained five years of age, respectively.

Subsec. (l)(2). Puspan. L. 100–203, § 4118(p)(8), struck out “nonfarm” after second reference to “income” in subpar. (A).

Puspan. L. 100–203, § 4101(a)(1)(A), designated existing provisions as subpar. (A), inserted “with respect to individuals described in subparagraph (A) or (B) of that paragraph”, substituted “185 percent” for “100 percent”, and added subpar. (B).

Subsec. (l)(3)(C). Puspan. L. 100–203, § 4101(span)(2)(A)(i), substituted “subparagraph (B) or (C)” for “subparagraph (B), (C), (D), (E), or (F)”.

Subsec. (l)(3)(D). Puspan. L. 100–203, § 4101(a)(1)(B), inserted “appropriate” after “applied is the”.

Subsec. (l)(3)(E). Puspan. L. 100–203, § 4101(e)(3), inserted “(except to the extent such methodology is inconsistent with clause (D) of subsection (a)(17))” after “subchapter IV”.

Subsec. (l)(4)(A). Puspan. L. 100–203, § 4101(e)(4), substituted “July 1, 1987” for “April 17, 1986”.

Subsec. (l)(4)(B)(ii). Puspan. L. 100–203, § 4101(span)(2)(A)(ii), substituted “subparagraph (C)” for “subparagraph (C), (D), (E), or (F)”.

Subsec. (l)(4)(C). Puspan. L. 100–203, § 4101(e)(5), added subpar. (C).

Subsec. (m)(2)(A). Puspan. L. 100–203, § 4118(p)(8), struck out “nonfarm” before “official”.

Subsec. (o). Puspan. L. 100–203, § 9115(span), as amended by Puspan. L. 100–360, § 411(n)(2), substituted “subparagraph (E) or (G) of section 1382(e)(1) of this title” for “section 1382(e)(1)(E) of this title”.

Puspan. L. 100–93, § 7, redesignated subsec. (l), relating to disregarding certain benefits for purposes of determining post-eligibility contributions, as (o).

Subsec. (p). Puspan. L. 100–93, § 7, added subsec. (p).

Subsec. (q). Puspan. L. 100–203, § 9119(d)(1)(B), as added by Puspan. L. 100–360, § 411(n)(4), formerly § 411(n)(3), as redesignated by Puspan. L. 100–485, § 608(d)(28), added subsec. (q).

1986—Subsec. (a). Puspan. L. 99–509, § 9406(span), inserted at end “Notwithstanding paragraph (10)(B) or any other provision of this subsection, a State plan shall provide medical assistance with respect to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law only in accordance with section 1396span(v) of this title.”

Puspan. L. 99–272, § 9529(a)(1), inserted at end “For purposes of this subchapter, any child who meets the requirements of paragraph (1) or (2) of section 673(span) of this title shall be deemed to be a dependent child as defined in section 606 of this title and shall be deemed to be a recipient of aid to families with dependent children under part A of subchapter IV in the State where such child resides.”

Subsec. (a)(9)(C). Puspan. L. 99–509, § 9320(h)(3), substituted “paragraphs (12) and (13)” for “paragraphs (11) and (12)”.

Subsec. (a)(10). Puspan. L. 99–509, § 9408(span), added cl. (IX) at end.

Puspan. L. 99–509, § 9403(c), added cl. (VIII) at end.

Puspan. L. 99–509, § 9401(c), added cl. (VII) at end.

Puspan. L. 99–272, § 9505(span)(1), added cl. (VI) at end.

Puspan. L. 99–272, § 9501(span), added cl. (V) at end.

Subsec. (a)(10)(A)(i)(I). Puspan. L. 99–272, § 12305(span)(3), substituted “, 606(h), or 673(span) of this title” for “or 606(h) of this title”.

Subsec. (a)(10)(A)(i)(II). Puspan. L. 99–509, § 9404(a), inserted “or who are qualified severely impaired individuals (as defined in section 1396d(q) of this title)” after “subchapter XVI”.

Subsec. (a)(10)(A)(ii)(V). Puspan. L. 99–272, § 9510(a), inserted “for a period of not less than 30 consecutive days (with eligibility by reason of this subclause beginning on the first day of such period)” after “are in a medical institution”.

Subsec. (a)(10)(A)(ii)(VII). Puspan. L. 99–514, § 1895(c)(7)(A), realigned margin of subcl. (VII).

Puspan. L. 99–272, § 9505(span)(2), added subcl. (VII).

Subsec. (a)(10)(A)(ii)(VIII). Puspan. L. 99–514, § 1895(c)(7)(B), realigned margins of subcl. (VIII).

Puspan. L. 99–272, § 9529(span)(1), added subcl. (VIII).

Subsec. (a)(10)(A)(ii)(IX). Puspan. L. 99–509, § 9401(a), added subcl. (IX).

Subsec. (a)(10)(A)(ii)(X). Puspan. L. 99–509, § 9402(a)(1), added subcl. (X).

Subsec. (a)(10)(C). Puspan. L. 99–509, § 9403(g)(1), inserted “or (E)” after “subparagraph (A)” in introductory text.

Subsec. (a)(10)(C)(iv). Puspan. L. 99–509, § 9408(c)(3), substituted “through (20)” for “through (19)”.

Puspan. L. 99–514, § 1895(c)(3)(C), substituted “through (19)” for “through (18)”.

Puspan. L. 99–272, § 9505(d)(2), substituted “through (18)” for “through (17)”.

Subsec. (a)(10)(E). Puspan. L. 99–509, § 9403(a), added subpar. (E).

Subsec. (a)(13)(B). Puspan. L. 99–272, § 9509(a)(1), substituted “hospitals” for “hospitals, skilled nursing facilities, and intermediate care facilities”.

Subsec. (a)(13)(C). Puspan. L. 99–272, § 9509(a)(4), added subpar. (C). Former subpar. (C) redesignated (D).

Puspan. L. 99–272, § 9505(c)(1), added subpar. (C). Former subpar. (C) redesignated (D).

Subsec. (a)(13)(D). Puspan. L. 99–514, § 1895(c)(1), inserted “and” after “facility;”.

Puspan. L. 99–509, § 9435(span)(1), inserted “and for payment of amounts under section 1396d(o)(3) of this title” before first semicolon.

Puspan. L. 99–272, § 9509(a)(2), (3), redesignated former subpar. (C) as (D), and struck out “and” at the end thereof. Former subpar. (D) redesignated (E).

Puspan. L. 99–272, § 9505(c)(1)(B), redesignated former subpar. (C) as (D).

Subsec. (a)(13)(E). Puspan. L. 99–272, § 9509(a)(3), redesignated former subpar. (D) as (E).

Subsec. (a)(15). Puspan. L. 99–509, § 9403(g)(4)(A), inserted “are not qualified medicare beneficiaries (as defined in section 1396d(p)(1) of this title) but” after “older who”.

Subsec. (a)(17). Puspan. L. 99–509, § 9401(e)(1), inserted “except as provided in subsection (l)(3)” after “(17)”.

Subsec. (a)(25). Puspan. L. 99–272, § 9503(a)(1), amended par. (25) generally. Prior to amendment, par. (25) read as follows: “provide (A) that the State or local agency administering such plan will take all reasonable measures to ascertain the legal liability of third parties to pay for care and services (available under the plan) arising out of injury, disease, or disability, (B) that where the State or local agency knows that a third party has such a legal liability such agency will treat such legal liability as a resource of the individual on whose behalf the care and services are made available for purposes of paragraph (17)(B), and (C) that in any case where such a legal liability is found to exist after medical assistance has been made available on behalf of the individual and where the amount of reimbursement the State can reasonably expect to recover exceeds the costs of such recovery, the State or local agency will seek reimbursement for such assistance to the extent of such legal liability;”.

Subsec. (a)(30)(C). Puspan. L. 99–509, § 9431(a), added subpar. (C).

Subsec. (a)(47). Puspan. L. 99–570 added par. (47) relating to cards evidencing eligibility for medical assistance.

Puspan. L. 99–509, § 9407(a), added par. (47) relating to ambulatory prenatal care.

Subsec. (span)(2). Puspan. L. 99–509, § 9405, inserted before semicolon “, regardless of whether or not the residence is maintained permanently or at a fixed address”.

Subsec. (d). Puspan. L. 99–509, § 9431(span)(1), inserted “(including quality review functions described in subsection (a)(30)(C) of this section)” after “medical or utilization review functions”.

Subsec. (e)(2)(A). Puspan. L. 99–272, § 9517(span)(1), inserted reference to an entity described in section 1396span(m)(2)(G) of this title, and substituted “such organization or entity” for “such organization”.

Subsec. (e)(2)(B). Puspan. L. 99–272, § 9517(span)(2), substituted “an organization or entity” for “a health maintenance organization” and “the organization or entity” for “the organization”.

Subsec. (e)(5). Puspan. L. 99–272, § 9501(c), added par. (5).

Subsec. (e)(6), (7). Puspan. L. 99–509, § 9401(d), added pars. (6) and (7).

Subsec. (e)(8). Puspan. L. 99–509, § 9403(f)(2), added par. (8).

Subsec. (e)(9). Puspan. L. 99–509, § 9408(a), added par. (9).

Subsec. (f). Puspan. L. 99–643, § 7(span), substituted “subsection (e) and section 1382h(span)(3) of this title” for “subsection (e)”.

Subsec. (g). Puspan. L. 99–272, § 9503(a)(2), added subsec. (g).

Subsec. (h). Puspan. L. 99–509, § 9433(a), added subsec. (d) to section 2173 of Puspan. L. 97–35, which in turn added subsec. (h) of this section. See 1981 Amendment note below.

Subsec. (j). Puspan. L. 99–509, § 9408(c)(2), substituted “(21)” for “(20)”.

Puspan. L. 99–514, § 1895(c)(3)(B), substituted “(20)” for “(19)”.

Puspan. L. 99–272, § 9505(d)(1), substituted “(19)” for “(18)”.

Subsec. (k). Puspan. L. 99–272, § 9506(a), added subsec. (k).

Subsec. (l). Puspan. L. 99–643, § 3(span), added subsec. (l) relating to disregarding of certain benefits for purposes of determining post-eligibility contributions.

Puspan. L. 99–509, § 9401(span), added subsec. (l) relating to description of group.

Subsec. (m). Puspan. L. 99–509, § 9402(a)(2), (span), added subsec. (m).

Subsec. (m)(3). Puspan. L. 99–509, § 9403(f)(1)(A), which directed insertion of “or coverage under subsection (a)(10)(E) of this section” after “subsection (a)(10)(A)(ii)(IX) of this section”, was executed by making the insertion after “subsection (a)(10)(A)(ii)(X) of this section” as the probable intent of Congress.

Subsec. (m)(5). Puspan. L. 99–509, § 9403(f)(1)(B), added par. (5).

Subsec. (n). Puspan. L. 99–509, § 9403(e), added subsec. (n).

1984—Subsec. (a)(9)(C). Puspan. L. 98–369, § 2373(span)(1), realigned margin of subpar. (C).

Subsec. (a)(10)(A). Puspan. L. 98–369, § 2373(span)(2), realigned margins of subpar. (A).

Subsec. (a)(10)(A)(i). Puspan. L. 98–369, § 2361(a), amended cl. (i) generally. Prior to the amendment cl. (i) read as follows: “all individuals receiving aid or assistance under any plan of the State approved under subchapter I, X, XIV, or XVI of this chapter, or part A or part E of subchapter IV of this chapter (including pregnant women deemed by the State to be receiving such aid as authorized in section 606(g) of this title and individuals considered by the State to be receiving such aid as authorized under section 614(g) of this title), or with respect to whom supplemental security income benefits are being paid under subchapter XVI of this chapter; and”.

Subsec. (a)(10)(A)(i)(I). Puspan. L. 98–378, § 20(c), substituted “section 602(a)(37) or 606(h) of this title” for “section 602(a)(37) of this title”.

Subsec. (a)(13)(A). Puspan. L. 98–369, § 2373(span)(3), made clarifying amendment by striking out “(A)” and all that follows through “hospital” the first place it appears and inserting in lieu thereof “(A) for payment (except where the State agency is subject to an order under section 1396m of this title) of the hospital”, resulting in no change in text.

Subsec. (a)(13)(B), (C). Puspan. L. 98–369, § 2314(span), added subpar. (B) and redesignated former subpar. (B) as (C).

Subsec. (a)(20)(B). Puspan. L. 98–369, § 2373(span)(4), substituted “periodic” for “periodical”.

Subsec. (a)(20)(C). Puspan. L. 98–369, § 2373(span)(5), struck out reference to section 803(a)(1)(A)(i) and (ii) of this title.

Subsec. (a)(26). Puspan. L. 98–369, § 2368(span), in amending par. (26) generally, revised existing provisions to continue their application to review of inpatient mental hospital service programs, and to sever provisions relating to review of skilled nursing programs. See par. (31) of this section.

Subsec. (a)(26)(B)(ii). Puspan. L. 98–617, § 3(a)(7), repealed the amendment made by Puspan. L. 98–369, § 2373(span)(6). See below.

Puspan. L. 98–369, § 2373(span)(6), provided that cl. (ii) is amended by substituting “facilities” for “homes”.

Subsec. (a)(26)(C). Puspan. L. 98–617, § 3(span)(10), realigned margin of subpar. (C).

Subsec. (a)(28). Puspan. L. 98–369, § 2335(e), struck out “and tuberculosis” after “mental diseases”.

Subsec. (a)(30). Puspan. L. 98–369, § 2363(a)(1)(A), designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (a)(31). Puspan. L. 98–369, § 2368(a), in amending par. (31) generally, revised existing provisions to cover review of skilled nursing facilities.

Subsec. (a)(33)(A). Puspan. L. 98–369, § 2373(span)(7), substituted “second sentence” for “penultimate sentence”.

Subsec. (a)(42). Puspan. L. 98–369, § 2373(span)(8), substituted “subchapter” for “part” after “audits conducted for purposes of such”.

Subsec. (a)(43). Puspan. L. 98–369, § 2303(g)(1), redesignated par. (44) as (43), and struck out former par. (43) which provided that if the State plan makes provision for payment to a physician for laboratory services the performance of which such physician, or other physician with whom he shares his practice, did not personally perform or supervise, the plan include provision to insure that payment for such services not exceed the payment authorized by section 1395u(h) of this title.

Subsec. (a)(44). Puspan. L. 98–369, § 2363(a)(1)(B), added par. (44).

Puspan. L. 98–369, § 2303(g)(1)(C), redesignated former par. (44) as (43).

Subsec. (a)(45). Puspan. L. 98–369, § 2367(a), added par. (45).

Subsec. (a)(46). Puspan. L. 98–369, § 2651(c), added par. (46).

Subsec. (a), foll. par. (46). Puspan. L. 98–369, § 2373(span)(9), substituted “The provisions of paragraph (9)(A), (31), and (33) and of section 1396span(i)(4) of this title shall not apply to” for “For purposes of paragraph (9)(A), (26), (31), and (33), and of section 1396span(i)(4) of this title, the term ‘skilled nursing facility’ and ‘nursing home’ do not include”.

Subsec. (e)(4). Puspan. L. 98–369, § 2362(a), added par. (4).

Subsec. (f). Puspan. L. 98–369, § 2373(span)(10), substituted “paragraph (10)(A)” and “paragraph (10)(C)” for “clause (10)(A)” and “clause (10)(C)”, respectively, wherever appearing.

1982—Subsec. (a)(10). Puspan. L. 97–248, § 131(c), formerly § 131(span), as redesignated by Puspan. L. 97–448, § 309(a)(8), in provisions following subpar. (D) added cl. (IV).

Subsec. (a)(10)(A). Puspan. L. 97–248, § 137(span)(7), redesignated existing provisions as provisions preceding cl. (i) and cl. (i), and added cl. (ii).

Subsec. (a)(10)(C), (D). Puspan. L. 97–248, § 137(a)(3), amended directory language of Puspan. L. 97–35, § 2171(a)(3), to correct an error, and did not involve any change in text. See 1981 Amendment note below.

Subsec. (a)(10)(C)(i). Puspan. L. 97–248, § 137(span)(8), substituted “, (II)” for “and (II)”, and added subcl. (III).

Subsec. (a)(10)(C)(ii)(I). Puspan. L. 97–248, § 137(span)(9), substituted “under the age of 18 who (but for income and resources) would be eligible for medical assistance as an individual described in subparagraph (A)(i)” for “described in section 1396d(a)(i) of this title”.

Subsec. (a)(14). Puspan. L. 97–248, § 131(a), substituted provisions that a State plan for medical assistance must provide that enrollment fees, premiums, or similar charges, and deductions, cost sharing, or similar charges, may be imposed only as provided in section 1396o of this title for provisions that such plan must provide that, with respect to individuals receiving assistance, no enrollment fee, premium, or similar charge, and no deduction, cost sharing, or similar charge with respect to the care and services listed in pars. (1) through (5), (7), and (17) of section 1396d(a) of this title, would be imposed under the plan, and any deduction, cost sharing, or similar charge imposed under the plan with respect to other care and services would be nominal in amount (as determined in accordance with standards approved by the Secretary and included in the plan), and with respect to individuals not receiving assistance, there could be imposed an enrollment fee, premium, or similar charge (as determined in accordance with standards prescribed by the Secretary) related to the individual’s income, and any deductible, cost-sharing, or similar charge imposed under the plan would be nominal.

Subsec. (a)(18). Puspan. L. 97–248, § 132(a), substituted provisions that a State plan for medical assistance must comply with the provisions of section 1396p of this title with respect to liens, adjustments and recoveries of medical assistance correctly paid, and transfers of assets for provisions that such plan must provide that no lien could be imposed against the property of any individual prior to his death on account of medical assistance paid or to be paid on his behalf under the plan (except pursuant to the judgment of a court on account of benefits incorrectly paid on behalf of such individual), and that there would be no adjustment or recovery (except, in the case of an individual who was 65 years of age or older when he received such assistance, from his estate, and then only after the death of his surviving spouse, if any, and only at a time when he had no surviving child who was under age 21 or (with respect to States eligible to participate in the State program established under subchapter XVI of this chapter), was blind or permanently and totally disabled, or was blind or disabled as defined in section 1382c of this title with respect to States which were not eligible to participate in such program) of any medical assistance correctly paid on behalf of such individual under the plan.

Subsec. (a). Puspan. L. 97–248, § 137(e), inserted “, (26)” after “(9)(A)” in provisions following par. (44).

Subsec. (span)(2) to (4). Puspan. L. 97–248, § 137(span)(10), struck out par. (2) which provided that the Secretary would not approve any plan which imposed any age requirement which excluded any individual who had not attained the age of 19 and was a dependent child under part A of subchapter IV of this chapter, and redesignated pars. (3) and (4) as (2) and (3), respectively.

Subsec. (d). Puspan. L. 97–248, § 146(a), substituted references to utilization and quality control peer review organizations having a contract with the Secretary, for references to conditionally or otherwise designated Professional Standards Review Organizations, wherever appearing.

Subsec. (e)(3). Puspan. L. 97–248, § 134(a), added par. (3).

Subsec. (j). Puspan. L. 97–248, §§ 132(c), 136(d), struck out subsec. (j) which related to the denial of medical assistance under a State plan because of an individual’s disposal of resources for less than fair market value, the period of ineligibility, and the eligibility of certain individuals for medical assistance under a State plan who would otherwise be ineligible because of the provisions of section 1382span(c) of this title, and added a new subsec. (j) relating to waiver or modification of requirements with respect to American Samoa medical assistance program.

1981—Subsec. (a)(9)(C). Puspan. L. 97–35, § 2175(d)(1)(C), added subpar. (C).

Subsec. (a)(10)(A). Puspan. L. 97–35, § 2171(a)(1), substituted “including at least the care and services listed in paragraphs (1) through (5) and (17) of section 1396d(a) of this title, to all individuals receiving aid or assistance under any plan of the State approved under subchapter I, X, XIV, or XVI of this chapter, or part A or part E of subchapter IV of this chapter (including pregnant women deemed by the State to be receiving such aid as authorized by section 606(g) of this title and individuals considered by the State to be receiving such aid as authorized under section 614(g) of this title)” for “to all individuals receiving aid or assistance under any plan of the State approved under subchapters I, X, XIV, or XVI, or part A of subchapter IV of this chapter”.

Subsec. (a)(10)(B). Puspan. L. 97–35, § 2171(a)(2), substituted reference to subparagraph for reference to clause in two places.

Subsec. (a)(10)(C). Puspan. L. 97–35, § 2171(a)(3), as amended by Puspan. L. 97–248, § 137(a)(3), substituted provisions relating to plans for medical assistance included for any group of individuals described in section 1396d(a) of this title who are not described in subpar. (A) for provisions relating to medical assistance for any group of individuals not described in subpar. (A) and who do not meet the income and resources requirements of the appropriate State plan, or the supplementary security income program under subchapter XVI of this chapter, as the case may be, as determined in accordance with standards prescribed by the Secretary.

Subsec. (a)(10)(D). Puspan. L. 97–35, § 2171(a)(3), as amended by Puspan. L. 97–248, § 137(a)(3), added subpar. (D).

Subsec. (a)(11). Puspan. L. 97–35, § 2193(c)(9), substituted “under (or through an allotment under) subchapter V, (i) providing for utilizing such agency, institution, or organization in furnishing care and services which are available under such subchapter or allotment” for “for part or all of the cost of plans or projects under subchapter V, (i) providing for utilizing such agency, institution, or organization in furnishing care and services which are available under such plan or project under subchapter V”.

Subsec. (a)(13)(A). Puspan. L. 97–35, §§ 2171(span), 2173(a)(1)(B), (C), struck out subpar. (A) which provided that a State plan must provide for the inclusion of some institutional and some noninstitutional care and services and for the inclusion of home health services for any individual who is entitled to skilled nursing facility services, redesignated subpar. (E) as (A), and in subpar. (A), as so redesignated, made the subsection applicable to hospital facilities, inserted reference to rates which take into account the situation of hospitals which serve a disproportionate number of low income patients with special needs and provide, in the case of hospital patients receiving services at an inappropriate level of care under conditions similar to those described in section 1395x(v)(1)(G) of this title, for lower reimbursement rates reflecting the level of care actually received in a manner consistent with such section, and substituted “safety standards and to assure that individuals eligible for medical assistance have reasonable access (taking into account geographic location and reasonable travel time) to inpatient hospital services of adequate quality” for “safety standards”.

Subsec. (a)(13)(B). Puspan. L. 97–35, §§ 2171(span), 2173(a)(1)(C), struck out subpar. (B) which provided that a State plan must provide in the case of individuals receiving aid or assistance under any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter, or with respect to whom supplemental security income benefits are being paid under subchapter XVI of this chapter, for the inclusion of at least the care and services listed in paragraphs (1) through (5) and (17) of section 1396d(a) of this title, and redesignated subpar. (F) as (B).

Subsec. (a)(13)(C). Puspan. L. 97–35, § 2171(span), struck out subpar. (C) which provided for care and services of individuals not included in former subpar. (B).

Subsec. (a)(13)(D). Puspan. L. 97–35, § 2173(a)(1)(A), struck out subpar. (D) which provided for payment of reasonable cost of inpatient hospital services provided under the plan with provisions for determination of such costs with certain maximum limitations and for payment of reasonable cost of inappropriate inpatient services described in subsec. (h)(1) of this section.

Subsec. (a)(13)(E), (F). Puspan. L. 97–35, § 2173(a)(1)(C), redesignated subpars. (E) and (F) as (A) and (B), respectively.

Subsec. (a)(20)(D). Puspan. L. 97–35, § 2173(a)(2), struck out subpar. (D) which required provision for methods of determining reasonable cost of institutional care of such patients.

Subsec. (a)(23). Puspan. L. 97–35, § 2175(a), substituted “except as provided in section 1396n and except in the case of” for “except in the case of”, and struck out provision that a State plan shall not be deemed to be out of compliance with the requirements of this paragraph or pars. (1) and (10) of this subsection solely by reason of the fact that the State or any political subdivision thereof has entered into a contract with an organization which has agreed to provide care and services in addition to those offered under the State plan to individuals eligible for medical assistance who reside in the geographic area served by such organization and who elect to obtain such care and services from such organization, or by reason of the fact that the plan provides for payment for rural health clinic services only if those services are provided by a rural health clinic.

Subsec. (a)(25)(C). Puspan. L. 97–35, § 2182, substituted “of the individual and where the amount of reimbursement the State can reasonably expect to recover exceeds the costs of such recovery, the State” for “of the individual, the State”.

Subsec. (a)(30). Puspan. L. 97–35, § 2174(a), substituted “that payments are consistent” for “that payments (including payments for any drugs provided under the plan) are not in excess of reasonable charges consistent”.

Subsec. (a)(39). Puspan. L. 97–35, § 2105(c), substituted “person” for “individual” in two places.

Subsec. (a)(44). Puspan. L. 97–35, § 2181(a)(2)(C), added par. (44).

Subsec. (span)(2). Puspan. L. 97–35, § 2172(a), substituted “any age requirement which excludes any individual who has not attained the age of 19 and is a dependent child under part A of subchapter IV of this chapter;” for “effective July 1, 1967, any age requirement which excludes any individual who has not attained the age of 21 and is or would, except for the provisions of section 606(a)(2) of this title, be a dependent child under part A of subchapter IV of this chapter; or”.

Subsec. (d). Puspan. L. 97–35, § 2113(m), added subsec. (d).

Subsec. (e). Puspan. L. 97–35, § 2178(span), designated existing provisions as par. (1) and added par. (2).

Subsec. (h). Puspan. L. 97–35, § 2173(span)(1), (d), as amended by Puspan. L. 99–509, § 9433(a), added a new subsec. (h) and repealed former subsec. (h) which related to skilled nursing and intermediate care facility services.

1980—Subsec. (a)(13)(B). Puspan. L. 96–499, § 965(span)(1), substituted “paragraphs (1) through (5) and (17)” for “clauses (1) through (5)”.

Subsec. (a)(13)(C)(i). Puspan. L. 96–499, § 965(span)(2), substituted “paragraphs (1) through (5) and (17)” for “clauses (1) through (5)”.

Subsec. (a)(13)(C)(ii). Puspan. L. 96–499, § 965(span)(3), substituted “paragraphs numbered (1) through (17)” for “clauses numbered (1) through (16)”.

Subsec. (a)(13)(D). Puspan. L. 96–499, § 902(span)(1), designated existing provisions as cl. (i) and added cl. (ii).

Subsec. (a)(13)(D)(i). Puspan. L. 96–499, §§ 903(span), 905(a), inserted “(except where the State agency is subject to an order under section 1396m of this title)” after “payment” and “, except that in the case of hospitals reimbursed for services under part A of subchapter XVIII of this chapter in accordance with section 1395f(span)(3) of this title, the plan must provide for payment of inpatient hospital services provided in such hospitals under the plan in accordance with the reimbursement system used under such section” after “subchapter XVIII of this chapter”.

Subsec. (a)(13)(E). Puspan. L. 96–499, § 905(a), inserted “(except where the State agency is subject to an order under section 1396m of this title)”.

Puspan. L. 96–499, § 962(a), substituted provisions which required a State plan for medical assistance to provide for payment of skilled nursing facility and intermediate care facility services provided under such plan through the use of rates determined in accordance with methods and standards developed by the State rather than on a reasonable cost related basis, required the filing of uniform cost reports by each facility, and required periodic audits of such reports by the State.

Subsec. (a)(14)(A)(i). Puspan. L. 96–499, § 965(span)(4), substituted “paragraphs (1) through (5), (7), and (17)” for “clauses (1) through (5) and (7)”.

Subsec. (a)(33)(B). Puspan. L. 96–499, § 916(span)(1)(B), inserted exception authorizing the Secretary where there was cause to question the adequacy of participation determinations to make independent determinations concerning the extent to which individual institutions and agencies met the requirements for participation.

Subsec. (a)(35). Puspan. L. 96–499, § 912(span), substituted “disclosing entity (as defined in section 1320a–3(a)(2) of this title)” for “intermediate care facility”.

Subsec. (a)(39). Puspan. L. 96–499, § 913(c), substituted provisions requiring that State plans for medical assistance authorize the State agency to bar specified individuals from participation in the program under the State plan when required by the Secretary to do so pursuant to section 1320a–7 of this title for provisions requiring that State plans for medical assistance provide for the suspension of physicians or other individuals from participation in the State plan upon notification by the Secretary that such physician or other individual had been suspended from participation in the plan under subchapter XVIII of this chapter.

Subsec. (a)(41). Puspan. L. 96–272 added par. (41).

Subsec. (a)(42). Puspan. L. 96–499, § 914(span)(1), added par. (42).

Subsec. (a)(43). Puspan. L. 96–499, § 918(span)(1)(C), added par. (43).

Subsec. (g). Puspan. L. 96–499, § 913(d), struck out subsec. (g) which related to waiver of suspension of payments to physicians or practitioners suspended from participation in approved State plans.

Subsec. (h). Puspan. L. 96–499, § 902(span)(2), added subsec. (h).

Subsec. (i). Puspan. L. 96–499, § 916(span)(1)(A), added subsec. (i).

Subsec. (j). Puspan. L. 96–611 added subsec. (j).

1978—Subsec. (a)(4)(C). Puspan. L. 95–559 added cl. (C).

1977—Subsec. (a)(13)(F). Puspan. L. 95–210, § 2(c)(1), added subpar. (F).

Subsec. (a)(23). Puspan. L. 95–210, § 2(c)(2), inserted “, or by reason of the fact that the plan provides for payment for rural health clinic services only if those services are provided by a rural health clinic” after “who elect to obtain such care and services from such organization”.

Subsec. (a)(26). Puspan. L. 95–142, § 20(span), inserted provision relating to staff of skilled nursing facilities.

Subsec. (a)(27)(B). Puspan. L. 95–142, § 9, inserted “or the Secretary” after “State agency” wherever appearing.

Subsec. (a)(32). Puspan. L. 95–142, § 2(a)(3), substituted provisions relating to terms, conditions, etc., for payments under an assignment or power of attorney, for provisions relating to terms, conditions, etc., for payments to anyone other than the individual receiving any care or service provided by a physician, dentist, or other individual practitioner, or such physician, dentist, or practitioner.

Subsec. (a)(35). Puspan. L. 95–142, § 3(c)(1)(A), substituted provisions relating to requirements for intermediate care facilities to comply with section 1320a–3 of this title for provisions relating to disclosure requirements, effective Jan. 1, 1973, applicable to intermediate care facilities with respect to ownership, corporate, status, etc.

Subsec. (a)(37). Puspan. L. 95–142, §§ 2(span)(1)(C), 3(c)(1)(C), 7(span)(1), added subsec. (a)(37) and made and struck out minor changes in phraseology, necessitating no changes in text.

Subsec. (a)(38). Puspan. L. 95–142, §§ 3(c)(1)(D), 7(span)(2), 19(span)(2)(A), added par. (38) and made and struck out minor changes in phraseology necessitating no changes in text.

Subsec. (a)(39). Puspan. L. 95–142, §§ 7(span)(3), 19(span)(2)(B), added par. (39).

Subsec. (a)(40). Puspan. L. 95–142, § 19(span)(2)(C), added par. (40).

Subsec. (a), foll. par. (40). Puspan. L. 95–142, § 2(span)(1)(D), added paragraph relating to waiver of requirement of cl. (A) of par. (37).

Subsec. (g). Puspan. L. 95–142, § 7(c), added subsec. (g).

1976—Subsec. (g). Puspan. L. 94–552 struck out provisions for consent to suit and waiver of immunity by State.

1975—Subsec. (a). Puspan. L. 94–48, § 1, added undesignated paragraph at end of subsec. (a) relating to eligibility under this subchapter of any individual who was eligible for the month of August 1972, under a State plan approved under subchapters I, X, XIV, XVI, or part A of subchapter IV of this chapter if such individual would have been eligible for such month had the increase in monthly insurance benefits under subchapter II of this chapter resulting from enactment of Puspan. L. 92–336 not been applicable to such individual.

Subsec. (a)(23). Puspan. L. 94–48, § 2, inserted “except in the case of Puerto Rico, the Virgin Islands, and Guam,”.

Subsec. (g). Puspan. L. 94–182 added subsec. (g).

1974—Subsec. (a)(14)(B)(i). Puspan. L. 93–368 substituted “may” for “shall”.

1973—Subsec. (a)(5). Puspan. L. 93–233, § 13(a)(2)(A), (B), substituted “to administer or to supervise the administration of the plan” for “to administer the plan” and “to supervise the administration of the plan” in that order and inserted after the parenthetical phrase the conditional provision “if the State is eligible to participate in the State plan program established under subchapter XVI, or by the agency or agencies administering the supplemental security income program established under subchapter XVI or the State plan approved under part A of subchapter IV if the State is not eligible to participate in the State plan program established under subchapter XVI”.

Subsec. (a)(10). Puspan. L. 93–233, § 13(a)(3), incorporated existing text in provisions designated as cl. (A), providing therein for medical assistance to individuals with respect to whom supplemental security income benefits are paid; incorporated existing par. (A) in provisions designated as cl. (B); incorporated existing par. (B) in provisions designated as cl. (C), providing therein for individuals not meeting income and resources requirements of the supplemental security income program; substituted in cls. (B)(ii), (C), (C)(i)(ii) and “medical assistance” for “medical or remedial care and services” appearing in predecessor provisions and in cl. (C)(i) “except for income and resources” for “if needy” appearing in predecessor provision; and in the exception provisions included reference to par. (16) of section 1396(a) of this title in item (I), substituted “deductibles” for “the deductibles” in item (II), and added item (III).

Subsec. (a)(13)(B). Puspan. L. 93–233, § 13(a)(4), substituted “any plan of the State approved” for “the State’s plan approved” and inserted after “part A of subchapter IV of this chapter” text reading “, or with respect to whom supplemental security income benefits are being paid under subchapter XVI of this chapter”.

Subsec. (a)(13)(C)(ii)(I). Puspan. L. 93–233, § 18(x)(1), substituted reference to cl. “16” for “14”.

Subsec. (a)(14)(A). Puspan. L. 93–233, § 13(a)(5), substituted “any plan of the State approved” for “a State plan approved” and “with respect to whom supplemental security income benefits are being paid under subchapter XVI of this chapter, or who meet the income and resources requirements of the appropriate State plan, or the supplemental security income program under subchapter XVI of this chapter, as the case may be, and individuals with respect to whom there is being paid, or who are eligible, or would be eligible if they were not in a medical institution, to have paid with respect to them, a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in paragraph (10)(A)” for “who meet the income and resources requirements of the one of such State plans which is appropriate”.

Subsec. (a)(14)(B). Puspan. L. 93–233, § 13(a)(6)(A)–(D), inserted after “with respect to individuals” the parenthetical provision “(other than individuals with respect to whom there is being paid, or who are eligible or would be eligible if they were not in a medical institution, to have paid with respect to them, a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in paragraph (10)(A))”; inserted after “any such State plan” the clause “and with respect to whom supplemental security income benefits are not being paid under subchapter XVI of this chapter”; substituted “the appropriate State plan, or the supplemental security income program under subchapter XVI of this chapter, as the case may be,” for “the one of such State plans which is appropriate”; and struck out “or who, after December 31, 1973, are included under the State plan for medical assistance pursuant to subsection (a)(10)(B) of this section approved under this subchapter” preceding the hyphen and cl. (i), respectively.

Subsec. (a)(17). Puspan. L. 93–233, § 13(a)(7)(A)–(D), (8), substituted: “any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, and with respect to whom supplemental security income benefits are not being paid under subchapter XVI” for “the State’s plan approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV”; “except for income and resources” for “if he met the requirements as to need”; “any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, or to have paid with respect to him supplemental security income benefits under subchapter XVI” for “a State plan approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV”; “such aid, assistance, or benefits” for “and amount of such aid or assistance under such plan”; and “(with respect to States eligible to participate in the State program established under subchapter XVI), is blind or permanently and totally disabled, or is blind or disabled as defined in section 1382c of this title (with respect to States which are not eligible to participate in such program)” for “is blind or permanently and totally disabled”.

Subsec. (a)(18). Puspan. L. 93–233, § 13(a)(8), substituted “(with respect to States eligible to participate in the State program established under subchapter XVI of this chapter), is blind or permanently and totally disabled, or is blind or disabled as defined in section 1382c of this title (with respect to States which are not eligible to participate in such program)” for “is blind or permanently and totally disabled”.

Subsec. (a)(20)(C). Puspan. L. 93–233, § 13(a)(9), inserted reference to section 803(a)(1)(A)(i) and (ii) of this title.

Subsec. (a)(21), (24). Puspan. L. 93–233, § 18(x)(4), provided for substitution of “nursing facilities” for “nursing homes”.

Subsec. (a)(26)(B). Puspan. L. 93–233, § 18(x)(4), provided for substitution of “nursing facility” and “nursing facilities” for “nursing home” and “nursing homes”, changes already executed under 1972 Amendment by Puspan. L. 92–603, § 278(a)(19).

Subsec. (a)(33)(A). Puspan. L. 93–233, § 18(x)(2), substituted “penultimate sentence” for “last sentence”.

Subsec. (a)(34). Puspan. L. 93–233, § 18(o), inserted “(or application was made on his behalf in the case of a deceased individual)” after “he made application”.

Subsec. (a)(35)(A). Puspan. L. 93–233, § 18(p), required the intermediate care facility to supply full and complete information respecting the person who is the owner (in whole or in part) of any mortgage, deed of trust, note, or other obligation secured (in whole or in part) by the intermediate care facility or any of the property or assets of the intermediate care facility.

Subsec. (a)(35) to (37). Puspan. L. 93–233, § 18(x)(3)(A), (B), substituted “; and” for “.” at end of par. (35); and corrected numerical sequence of paragraphs, redesignating par. (37) as (36), the original subsec. (a) having been enacted without a par. (36).

Subsec. (e). Puspan. L. 93–233, § 18(q), substituted “each family which was receiving aid pursuant to a plan of the State approved under part A” for “each family which was eligible for assistance pursuant to part A”, “for such aid because of increased hours of, or increased income from, employment” for “for such assistance because of increased income from employment”, and “remain eligible for assistance under the plan approved under this subchapter (as though the family was receiving aid under the plan approved under part A of subchapter IV of this chapter) for 4 calendar months beginning with the month in which such family became ineligible for aid under the plan approved under part A of subchapter IV of this chapter because of income and resources or hours of work limitations” for “remain eligible for such assistance for 4 calendar months following the month in which such family would otherwise be determined to be ineligible for such assistance because of the income and resources limitations”.

Subsec. (f). Puspan. L. 93–233, § 13(a)(10)(A)–(D), substituted: “no State not eligible to participate in the State plan program established under subchapter XVI” for “no State” and “any supplemental security income payment and State supplementary payment made with respect to such individual” for “such individual’s payment under subchapter XVI” and “as recognized under State law” for “as defined in section 213 of Title 26” in parenthetical text; and inserted two end sentences for consideration of certain individuals as eligible for medical assistance under cl. (10)(A) or (C) of subsec. (a) of this section or as eligible for such assistance under cl. (10)(A) in States not providing such assistance under cl. (10)(C), respectively.

1972—Subsec. (a). Puspan. L. 92–603, §§ 268(a), 278(span)(14), inserted provisions exempting Christian Science sanatoriums from certain nursing facility and nursing home requirements.

Subsec. (a)(9). Puspan. L. 92–603, § 239(a), inserted provisions to utilize State health agency for establishing and maintaining health standards for private or public institutions in which recipients of medical assistance under the plan may receive care or services.

Subsec. (a)(13)(A)(ii), (C). Puspan. L. 92–603, § 278(a)(18), (span)(14), substituted “skilled nursing facility” for “skilled nursing home”.

Subsec. (a)(13)(D). Puspan. L. 92–603, §§ 221(c)(5), 232(a), inserted provisions that the reasonable cost of inpatient hospital services shall not exceed the amount determined under section 1395x(v) of this title and inserted reference to the consistency of methods and standards with section 1320a–1 of this title for determining the reasonable cost of inpatient hospital services.

Subsec. (a)(13)(E). Puspan. L. 92–603, § 249(a), added subpar. (E).

Subsec. (a)(14). Puspan. L. 92–603, § 208(a), substituted a nominal amount for an amount reasonably related to the recipient’s income as the amount of the deduction, cost sharing, or similar charge imposed under the plan and inserted provisions covering individuals who are not receiving aid or assistance under any state plan and who do not meet the income and resources requirements and covering individuals who are included under the state plan for medical assistance pursuant to subsec. (a)(10)(B) of this section approved under this subchapter.

Subsec. (a)(23). Puspan. L. 92–603, § 240, inserted provisions allowing States to adopt comprehensive health care programs while still complying with medicaid requirements.

Subsec. (a)(26). Puspan. L. 92–603, §§ 274(a), 278(a)(19), (span)(14), substituted “evaluation)” for “evaluation” and “care” for “care)” and substituted “skilled nursing facility” and “skilled nursing facilities” for “skilled nursing home” and “skilled nursing homes”.

Subsec. (a)(28). Puspan. L. 92–603, §§ 246(a), 278(a)(20), substituted “skilled nursing facility” for “skilled nursing home” and substituted a simple reference to the requirements contained in section 1395x(j) of this title with a specified exception for provisions spelling out in detail the requirements for skilled nursing homes receiving payments.

Subsec. (a)(30). Puspan. L. 92–603, § 237(a)(2), substituted “under the plan (including but not limited to utilization review plans as provided for in section 1396span(i)(4) of this title)” for “under the plan”.

Subsec. (a)(31)(A). Puspan. L. 92–603, § 298, struck out “which provides more than a minimum level of health care services” after “intermediate care facility”.

Subsec. (a)(32). Puspan. L. 92–603, § 236(span)(3), added par. (32).

Subsec. (a)(33). Puspan. L. 92–603, § 239(span)(3), added par. (33).

Subsec. (a)(34). Puspan. L. 92–603, § 255(a)(3), added par. (34).

Subsec. (a)(35). Puspan. L. 92–603, § 299A(3), added par. (35).

Subsec. (a)(37). Puspan. L. 92–603, § 299D(span)(3), added par. (37).

Subsec. (d). Puspan. L. 92–603, § 231, repealed subsec. (d) which related to modification of state plans for medical assistance under certain circumstances.

Subsec. (e). Puspan. L. 92–603, § 209(a), added subsec. (e).

Subsec. (f). Puspan. L. 92–603, § 209(span)(1), added subsec. (f).

1971—Subsec. (a)(31). Puspan. L. 92–223 added par. (31).

1969—Subsec. (c). Puspan. L. 91–56, § 2(c), substituted “aid or assistance in the form of money payments (other than so much, if any, of the aid or assistance in such form as was, immediately prior to the effective date of the State plan under this subchapter, attributable to medical needs)” for “aid or assistance (other than so much of the aid or assistance as is provided for under the plan of the State approved under this subchapter)”.

Subsec. (d). Puspan. L. 91–56, § 2(d), added subsec. (d).

1968—Subsec. (a)(2). Puspan. L. 90–248, § 231, changed the date on which State plans must meet certain financial participation requirements by substituting “July 1, 1969” for “July 1, 1970”.

Subsec. (a)(4). Puspan. L. 90–248, § 210(a)(6), designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (a)(10). Puspan. L. 90–248, §§ 223(a), 241(f)(1), struck out “IV,” after “I,” and inserted “, and part A of subchapter IV of this chapter” after “XVI of this chapter”, and designated existing provisions as item I and added item II.

Subsec. (a)(11). Puspan. L. 90–248, § 302(span), designated existing provisions as cl. (A) and added cl. (B).

Subsec. (a)(13). Puspan. L. 90–248, § 224(a), designated existing provisions as subpar. (A), incorporated existing cl. (A) in provisions designated as subpars. (B) and (C)(i), making subpar. (B) and (C) applicable to individuals receiving aid or assistance under an approved State plan and to individuals not covered under subpar. (B), respectively, added cl. (ii) of subpar. (C), redesignated former cl. (B) as subpar. (D), and deleted effective date of July 1, 1967, for former cls. (A) and (B).

Subsec. (a)(13)(A). Puspan. L. 90–248, § 224(c)(1), designated existing provisions as cl. (i) and added cl. (ii).

Subsec. (a)(14)(A). Puspan. L. 90–248, § 235(a)(1), inserted “in the case of individuals receiving aid or assistance under State plans approved under subchapters I, X, XIV, XVI, and part A of subchapter IV of this chapter,”.

Subsec. (a)(14)(B). Puspan. L. 90–248, § 235(a)(2), inserted “inpatient hospital services or” after “respect to” and substituted “to an individual” for “him”.

Subsec. (a)(15). Puspan. L. 90–248, § 235(a)(3), struck out subpar. (B) provision for meeting the full cost of any deductible imposed with respect to any such individual under the insurance program established by part A of such subchapter, deleted subpar. (B) designation preceding “where, under the plan”, and substituted therein “established by such subchapter” for “established by part B of such subchapter”.

Subsec. (a)(17). Puspan. L. 90–248, § 238, inserted in parenthetical expression “and may, in accordance with standards prescribed by the Secretary, differ with respect to income levels, but only in the case of applicants or recipients of assistance under the plan who are not receiving aid or assistance under the State’s plan approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, based on the variations between shelter costs in urban areas and in rural areas” after “all groups”.

Puspan. L. 90–248, § 241(f)(2), in cl. (B) struck out “IV,” after “I,” and inserted “, or part A of subchapter IV” after “XVI”.

Subsec. (a)(23) to (30). Puspan. L. 90–248, §§ 227(a), 228(a), 229(a), 234(a), 236(a), 237, added pars. (23), (24), (25), (26) to (28), (29), (30), respectively.

Subsec. (span)(2). Puspan. L. 90–248, § 241(f)(3), inserted “part A of” before “subchapter IV”.

Subsec. (c). Puspan. L. 90–248, § 241(f)(4), struck out “IV,” after “I,” and inserted “, or part A of subchapter IV of this chapter” after “XVI of this chapter”.

Puspan. L. 118–42, div. G, title I, § 203(span), Mar. 9, 2024, 138 Stat. 403, provided that: “The amendments made by subsection (a) [amending this section] shall take effect on the date that is 24 months after the date of enactment of this Act [Mar. 9, 2024].”

Puspan. L. 118–42, div. G, title I, § 205(a)(2), Mar. 9, 2024, 138 Stat. 406, provided that: “The amendments made by—

Puspan. L. 117–328, div. FF, title V, § 5112(c), Dec. 29, 2022, 136 Stat. 5940, provided that: “The amendments made by this section [amending this section and section 1397gg of this title] shall take effect on the first day of the first fiscal quarter that begins on or after the date that is 1 year after the date of enactment of this Act [Dec. 29, 2022].”

Puspan. L. 117–328, div. FF, title V, § 5121(d), Dec. 29, 2022, 136 Stat. 5943, provided that: “The amendments made by this section [amending this section and sections 1396d, 1397bspan, and 1397jj of this title] shall apply beginning on the first day of the first calendar quarter that begins on or after the date that is 24 months after the date of enactment of this Act [Dec. 29, 2022].”

Puspan. L. 117–328, div. FF, title V, § 5122(c), Dec. 29, 2022, 136 Stat. 5944, provided that: “The amendments made by this section [amending this section and sections 1396d and 1397jj of this title] shall take effect on the first day of the first calendar quarter that begins after the date that is 24 months after the date of enactment of this Act [Dec. 29, 2022] and shall apply to items and services furnished for periods beginning on or after such date.”

Puspan. L. 117–328, div. FF, title V, § 5123(d), Dec. 29, 2022, 136 Stat. 5946, provided that: “The amendments made by this section [amending this section and sections 1396u–2 and 1397gg of this title] shall take effect on July 1, 2025.”

Puspan. L. 117–328, div. FF, title V, § 5131(c), Dec. 29, 2022, 136 Stat. 5953, provided that: “The amendments made by this section [amending this section and provisions set out as a note under section 1396d of this title] take effect on April 1, 2023.”

Puspan. L. 117–169, title I, § 11405(c), Aug. 16, 2022, 136 Stat. 1901, provided that: “The amendments made by this section [amending this section and sections 1396d, 1396o, 1396o–1, and 1397cc of this title] take effect on the 1st day of the 1st fiscal quarter that begins on or after the date that is 1 year after the date of enactment of this Act [Aug. 16, 2022] and shall apply to expenditures made under a State plan or waiver of such plan under title XIX of the Social Security Act (42 U.S.C. 1396 through 1396w–6) or under a State child health plan or waiver of such plan under title XXI of such Act (42 U.S.C. 1397aa through 1397mm) on or after such effective date.”

Puspan. L. 117–103, div. P, title II, § 202(span), Mar. 15, 2022, 136 Stat. 804, provided that:

Puspan. L. 117–2, title IX, § 9812(span), Mar. 11, 2021, 135 Stat. 213, as amended by Puspan. L. 117–328, div. FF, title V, § 5113, Dec. 29, 2022, 136 Stat. 5940, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to State elections made under paragraph (16) of section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)), as added by subsection (a), beginning on the 1st day of the 1st fiscal year quarter that begins one year after the date of the enactment of this Act [Mar. 11, 2021].”

[Puspan. L. 117–328, div. FF, title V, § 5113, Dec. 29, 2022, 136 Stat. 5940, provided in part that the amendment made by section 5113 to section 9812(span) of Puspan. L. 117–2, set out above, is effective as if included in the enactment of Puspan. L. 117–2.]

Puspan. L. 116–260, div. CC, title II, § 209(a)(4), Dec. 27, 2020, 134 Stat. 2986, provided that: “The amendments made by this subsection [amending this section and sections 1396span and 1396u–7 of this title] shall take effect on the date of the enactment of this Act [Dec. 27, 2020] and shall apply to transportation furnished on or after such date.”

Puspan. L. 116–260, div. CC, title II, § 209(span)(4)(B), Dec. 27, 2020, 134 Stat. 2988, provided that:

Amendment by section 210(span) of Puspan. L. 116–260 applicable with respect to items and services furnished on or after Jan. 1, 2022, see section 210(e) of Puspan. L. 116–260, set out as a note under section 1308 of this title.

Puspan. L. 116–16, § 7(span), Apr. 18, 2019, 133 Stat. 864, provided that: “The amendment made by this section [amending section 202(a)(2) of Puspan. L. 113–67, which amended this section] shall take effect on the date of the enactment of this Act [Apr. 18, 2019].”

Puspan. L. 115–271, title I, § 1001(d), Oct. 24, 2018, 132 Stat. 3902, provided that:

Puspan. L. 115–271, title I, § 1002(a)(2), Oct. 24, 2018, 132 Stat. 3902, provided that: “The amendments made by this subsection [amending this section] shall take effect with respect to foster youth who attain 18 years of age on or after January 1, 2023.”

Puspan. L. 115–271, title I, § 1006(span)(4), Oct. 24, 2018, 132 Stat. 3915, as amended by Puspan. L. 118–42, div. G, title I, § 201(span), Mar. 9, 2024, 138 Stat. 399, provided that:

Puspan. L. 115–271, title I, § 1007(c), Oct. 24, 2018, 132 Stat. 3916, provided that: “The amendments made by this section [amending this section] take effect on the date of enactment of this Act [Oct. 24, 2018] and shall apply to medical assistance furnished on or after that date, without regard to final regulations to carry out such amendments being promulgated as of such date.”

Puspan. L. 115–123, div. E, title XII, § 53102(a)(2), Fespan. 9, 2018, 132 Stat. 298, provided that: “The amendment made by paragraph (1) [amending this section] shall take effect on the date of enactment of this Act [Fespan. 9, 2018].”

Puspan. L. 115–123, div. E, title XII, § 53102(span)(1), Fespan. 9, 2018, 132 Stat. 298, provided that, effective Sept. 30, 2017, section 202(span) of Puspan. L. 113–67 (amending this section and sections 1396k and 1396p of this title) is repealed and the provisions amended by such subsection shall be applied and administered as if such amendments had never been enacted.

Puspan. L. 115–123, div. E, title XII, § 53102(span)(3), Fespan. 9, 2018, 132 Stat. 299, provided that: “The repeal and amendment made by this subsection [amending this section, sections 1396k and 1396p of this title, and section 202(c) of Puspan. L. 113–67, set out as an Effective Date of 2013 Amendment note below] shall take effect as if enacted on September 30, 2017, and shall apply with respect to any open claims, including claims pending, generated, or filed, after such date. The amendments made by subsections (a) and (span) of section 202 of the Bipartisan Budget Act of 2013 (Public Law 113–67; 127 Stat. 1177; 42 U.S.C. 1396a note [sic]) [amending this section and sections 1396k and 1396p of this title] that took effect on October 1, 2017, are null and void and section 1902(a)(25) of the Social Security Act (42 U.S.C. 1396a(a)(25)) shall be applied and administered as if such amendments had not taken effect on such date.”

Puspan. L. 114–63, § 2, Oct. 7, 2015, 129 Stat. 549, provided that the repeal of section 3(e) of Puspan. L. 111–255 is effective as if included in the enactment of Puspan. L. 111–255.

Puspan. L. 113–67, div. A, title II, § 202(c), Dec. 26, 2013, 127 Stat. 1177, as amended by Puspan. L. 113–93, title II, § 211, Apr. 1, 2014, 128 Stat. 1047; Puspan. L. 114–10, title II, § 220, Apr. 16, 2015, 129 Stat. 154; Puspan. L. 115–123, div. E, title XII, § 53102(span)(2), Fespan. 9, 2018, 132 Stat. 299, provided that: “The amendments made by subsection (a) [amending this section] shall take effect on October 1, 2019.”

[Puspan. L. 113–93, title II, § 211, Apr. 1, 2014, 128 Stat. 1047, provided in part that the amendment made by that section to section 202(c) of Puspan. L. 113–67, set out above, is effective as if included in the enactment of Puspan. L. 113–67.]

Puspan. L. 111–296, title I, § 103(c)(2), Dec. 13, 2010, 124 Stat. 3192, provided that:

Amendment by Puspan. L. 111–255 effective on the earlier of the effective date of final regulations promulgated by the Commissioner of Social Security to carry out such amendment or 180 days after Oct. 5, 2010, see section 3(d) of Puspan. L. 111–255, set out as an Effective and Termination Dates of 2010 Amendment note under section 1382a of this title.

Puspan. L. 111–148, title II, § 2002(c), Mar. 23, 2010, 124 Stat. 282, provided that: “The amendments made by subsections (a) and (span) [amending this section] take effect on January 1, 2014.”

Puspan. L. 111–148, title II, § 2004(d), title X, § 10201(a)(3), Mar. 23, 2010, 124 Stat. 283, 918, provided that: “The amendments made by this section [amending this section and sections 1396span, 1396r–1, and 1396u–7 of this title] take effect on January 1, 2014.”

Puspan. L. 111–148, title II, § 2202(c), Mar. 23, 2010, 124 Stat. 292, provided that: “The amendments made by this section [amending this section and section 1396span of this title] take effect on January 1, 2014, and apply to services furnished on or after that date.”

Puspan. L. 111–148, title II, § 2301(c), Mar. 23, 2010, 124 Stat. 293, provided that:

Puspan. L. 111–148, title II, § 2303(d), Mar. 23, 2010, 124 Stat. 296, provided that: “The amendments made by this section [enacting section 1396r–1c of this title and amending this section and sections 1396span, 1396d, and 1396u–7 of this title] take effect on the date of the enactment of this Act [Mar. 23, 2010] and shall apply to items and services furnished on or after such date.”

Puspan. L. 111–148, title II, § 2402(g), Mar. 23, 2010, 124 Stat. 304, provided that: “The amendments made by subsections (span) through (f) [amending this section and sections 1396span, 1396d and 1396n of this title] take effect on the first day of the first fiscal year quarter that begins after the date of enactment of this Act [Mar. 23, 2010].”

Puspan. L. 111–148, title VI, § 6508, Mar. 23, 2010, 124 Stat. 778, provided that:

Amendment by section 8002(a)(2), (span) of Puspan. L. 111–148 effective Jan. 1, 2011, see section 8002(e) of Puspan. L. 111–148, formerly set out as an Effective Date note under section 300ll of this title.

Puspan. L. 111–5, div. B, title V, § 5004(a)(2), Fespan. 17, 2009, 123 Stat. 504, provided that: “The amendments made by this subsection [amending this section and section 1396r–6 of this title] shall take effect on July 1, 2009.”

Puspan. L. 111–5, div. B, title V, § 5006(f), Fespan. 17, 2009, 123 Stat. 511, provided that: “The amendments made by this section [amending this section and sections 1396o, 1396o–1, 1396p, 1396u–2, and 1397gg of this title] shall take effect on July 1, 2009.”

Amendment by section 113(span)(1) of Puspan. L. 111–3 effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see section 3 of Puspan. L. 111–3, set out as an Effective Date note under section 1396 of this title.

Puspan. L. 111–3, title II, § 203(f), Fespan. 4, 2009, 123 Stat. 49, provided that: “The amendments made by this section [enacting section 1396w–2 of this title and amending this section and section 1397gg of this title] are effective on the date of the enactment of this Act [Fespan. 4, 2009].”

Puspan. L. 111–3, title II, § 211(d), Fespan. 4, 2009, 123 Stat. 54, provided that:

[For definition of “Medicaid”, see section 1(c)(2) of Puspan. L. 111–3, set out as a Definitions note under section 1396 of this title.]

Puspan. L. 111–3, title V, § 501(d)(3), Fespan. 4, 2009, 123 Stat. 87, provided that: “The amendments made by this subsection [amending this section and section 1397gg of this title] shall take effect on January 1, 2009.”

Puspan. L. 111–3, title V, § 501(e)(3), Fespan. 4, 2009, 123 Stat. 88, provided that: “The amendments made by this subsection [amending this section and section 1397hh of this title] shall be effective for annual reports submitted for years beginning after date of enactment [Fespan. 4, 2009].”

Puspan. L. 110–90, § 3(c), Sept. 29, 2007, 121 Stat. 985, provided that: “The amendments made by this section [amending this section and section 1396u–3 of this title] shall be effective as of September 30, 2007.”

Puspan. L. 109–432, div. B, title IV, § 405(c)(2)(A), Dec. 20, 2006, 120 Stat. 2999, provided that the amendment made by section 405(c)(2)(A) is effective as if included in the enactment of the Deficit Reduction Act of 2005 (Public Law 109–171).

Puspan. L. 109–171, title VI, § 6032(span), Fespan. 8, 2006, 120 Stat. 74, as amended by Puspan. L. 109–432, div. B, title IV, § 405(c)(2)(A)(iii), Dec. 20, 2006, 120 Stat. 3000, provided that: “Except as provided in section 6034(e) [set out below], the amendments made by subsection (a) [amending this section] take effect on January 1, 2007.”

Puspan. L. 109–171, title VI, § 6034(e), Fespan. 8, 2006, 120 Stat. 78, provided that: “Except as otherwise provided in this chapter [chapter 3 (§§ 6031–6036) of subtitle A of title VI of Puspan. L. 109–171, enacting sections 1396h and 1396u–6 of this title, amending this section and sections 1395i, 1395ddd, 1396span, and 1396v of this title, and enacting provisions set out as notes under this section and sections 1396span and 1396h of this title], in the case of a State plan under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] which the Secretary determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by a provision of this chapter, the State plan shall not be regarded as failing to comply with the requirements of such Act [42 U.S.C. 301 et seq.] solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act [Fespan. 8, 2006]. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.”

Puspan. L. 109–171, title VI, § 6035(c), Fespan. 8, 2006, 120 Stat. 80, as amended by Puspan. L. 109–432, div. B, title IV, § 405(c)(2)(A)(iii), Dec. 20, 2006, 120 Stat. 3000, provided that: “Except as provided in section 6034(e) [set out above], the amendments made by this section [amending this section] take effect on January 1, 2006.”

Puspan. L. 109–171, title VI, § 6062(d), Fespan. 8, 2006, 120 Stat. 99, provided that: “The amendments made by this section [amending this section and sections 1396span, 1396d, and 1396o of this title] shall apply to medical assistance for items and services furnished on or after January 1, 2007.”

Puspan. L. 109–171, title VI, § 6065(span), Fespan. 8, 2006, 120 Stat. 102, provided that: “The amendments made by subsection (a) [amending this section] shall apply to medical assistance for items and services furnished on or after the date that is 1 year after the date of enactment of this Act [Fespan. 8, 2006].”

Puspan. L. 109–171, title VI, § 6083(span), Fespan. 8, 2006, 120 Stat. 121, provided that: “The amendments made by subsection (a) [amending this section] take effect on the date of the enactment of this Act [Fespan. 8, 2006].”

Puspan. L. 109–91, title I, § 101(c), Oct. 20, 2005, 119 Stat. 2091, provided that: “The amendments made by this section [amending this section and section 1396u–3 of this title] shall be effective as of September 30, 2005.”

Amendment by Puspan. L. 108–265 effective July 1, 2005, see section 502(span)(4) of Puspan. L. 108–265, as amended, set out as an Effective Date note under section 1754 of this title.

Puspan. L. 108–173, title I, § 103(f)(3), Dec. 8, 2003, 117 Stat. 2160, provided that: “The amendments made by this subsection [amending this section and section 1396u–3 of this title] shall apply to calendar quarters beginning on or after April 1, 2004.”

Amendment by section 236(span)(1) of Puspan. L. 108–173 applicable to services furnished on or after Jan. 1, 2004, see section 236(c) of Puspan. L. 108–173, set out as a note under section 1395cc of this title.

Amendment by Puspan. L. 108–40 effective July 1, 2003, see section 8 of Puspan. L. 108–40, set out as a note under section 603 of this title.

Puspan. L. 107–121, § 2(c), Jan. 15, 2002, 115 Stat. 2384, provided that:

Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(e)], Dec. 21, 2000, 114 Stat. 2763, 2763A–574, provided that: “The amendments made by this section [amending this section and sections 1396span and 1396n of this title and repealing provisions set out as a note under this section] take effect on January 1, 2001, and shall apply to services furnished on or after such date.”

Puspan. L. 106–354, § 2(d), Oct. 24, 2000, 114 Stat. 1384, provided that: “The amendments made by this section [enacting section 1396r–1span of this title and amending this section and sections 1396span and 1396d of this title] apply to medical assistance for items and services furnished on or after October 1, 2000, without regard to whether final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 106–170, title II, § 201(d), Dec. 17, 1999, 113 Stat. 1894, provided that: “The amendments made by this section [amending this section and sections 1396span, 1396d, and 1396o of this title and enacting provisions set out as a note below] apply to medical assistance for items and services furnished on or after October 1, 2000.”

Puspan. L. 106–169, title II, § 121(span), Dec. 14, 1999, 113 Stat. 1830, provided that: “The amendments made by subsection (a) [amending this section and section 1396d of this title] apply to medical assistance for items and services furnished on or after October 1, 1999.”

Amendment by section 205(c) of Puspan. L. 106–169 effective Jan. 1, 2000, and applicable to trusts established on or after such date, see section 205(d) of Puspan. L. 106–169, set out as a note under section 1382a of this title.

Amendment by section 206(span) of Puspan. L. 106–169 effective with respect to disposals made on or after Dec. 14, 1999, see section 206(c) of Puspan. L. 106–169, set out as a note under section 1382span of this title.

Puspan. L. 106–113, div. B, § 1000(a)(6) [title VI, § 603(a)(3)], Nov. 29, 1999, 113 Stat. 1536, 1501A–395, provided that: “The amendments made by this subsection [amending this section and provisions set out as a note under this section] shall take effect as if included in the enactment of section 4712 of BBA (111 Stat. 508) [the Balanced Budget Act of 1997, Puspan. L. 105–33].”

Puspan. L. 106–113, div. B, § 1000(a)(6) [title VI, § 604(c)], Nov. 29, 1999, 113 Stat. 1536, 1501A–395, provided that:

Puspan. L. 106–113, div. B, § 1000(a)(6) [title VI, § 608(aa)], Nov. 29, 1999, 113 Stat. 1536, 1501A–398 provided that the amendment made by section 1000(a)(6) [title VI, § 608(aa)(1)] is effective as if included in the enactment of BBA [the Balanced Budget Act of 1997, Puspan. L. 105–33].

Puspan. L. 106–113, div. B, § 1000(a)(6) [title VI, § 608(bspan)], Nov. 29, 1999, 113 Stat. 1536, 1501A–398, provided that: “Except as otherwise provided, the amendments made by this section [amending this section and sections 1396span, 1396d, 1396g–1, 1396i, 1396n, 1396r, 1396r–1, 1396r–1a, 1396r–4, 1396r–6, 1396r–8, 1396t, 1396u–2, and 1396u–3 of this title] shall take effect on the date of enactment of this Act [Nov. 29, 1999].”

Amendment by section 4106(c) of Puspan. L. 105–33 applicable to bone mass measurements performed on or after July 1, 1998, see section 4106(d) of Puspan. L. 105–33, set out as a note under section 1395x of this title.

Amendment by section 4454(span)(1) of Puspan. L. 105–33 effective Aug. 5, 1997, and applicable to items and services furnished on or after such date, with provision that Secretary of Health and Human Services issue regulations to carry out such amendment by not later than July 1, 1998, see section 4454(d) of Puspan. L. 105–33, set out as an Effective Date note under section 1395i–5 of this title.

Amendment by section 4701(span)(2)(A)(i)–(iv), (d)(1) of Puspan. L. 105–33 effective Aug. 5, 1997, and applicable to contracts entered into or renewed on Oct. 1, 1997, except as otherwise provided, see section 4710(a) of Puspan. L. 105–33, set out as a note under section 1396span of this title.

Amendment by section 4702(span)(2) of Puspan. L. 105–33 applicable to primary care case management services furnished on or after Oct. 1, 1997, subject to provisions relating to extension of effective date for State law amendments, and to nonapplication to waivers, see section 4710(span)(1) of Puspan. L. 105–33, set out as a note under section 1396span of this title.

Amendment by section 4709 of Puspan. L. 105–33 effective Oct. 1, 1997, subject to provisions relating to extension of effective date for State law amendments, and to nonapplication to waivers, see section 4710(span)(7) of Puspan. L. 105–33, set out as a note under section 1396span of this title.

Puspan. L. 105–33, title IV, § 4711(d), Aug. 5, 1997, 111 Stat. 508, provided that: “This section [amending this section and sections 1396d and 1396r–4 of this title] shall take effect on the date of the enactment of this Act [Aug. 5, 1997] and the amendments made by subsections (a) and (c) [amending this section and sections 1396d and 1396r–4 of this title] shall apply to payment for items and services furnished on or after October 1, 1997.”

Puspan. L. 105–33, title IV, § 4712(span)(3), Aug. 5, 1997, 111 Stat. 509, provided that: “The amendments made by this subsection [amending this section and section 1396span of this title] shall apply to services furnished on or after October 1, 1997.”

Puspan. L. 105–33, title IV, § 4712(c), Aug. 5, 1997, 111 Stat. 509, as amended by Puspan. L. 106–113, div. B, § 1000(a)(6) [title VI, § 603(a)(2)], Nov. 29, 1999, 113 Stat. 1536, 1501A–394, which provided that the amendment made by section 4712(c) was effective for services furnished on or after Oct. 1, 2004, was repealed by Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(c)(1), (e)], Dec. 21, 2000, 114 Stat. 2763, 2763A–574, effective Jan. 1, 2001, and applicable to services furnished on or after such date.

Puspan. L. 105–33, title IV, § 4714(c), Aug. 5, 1997, 111 Stat. 510, provided that: “The amendments made by this section [amending this section and sections 1395w–4, 1395cc, 1396d of this title] shall apply to payment for (and with respect to provider agreements with respect to) items and services furnished on or after the date of the enactment of this Act [Aug. 5, 1997]. The amendments made by subsection (a) [amending this section and section 1396d of this title] shall also apply to payment by a State for items and services furnished before such date if such payment is the subject of a law suit that is based on the provisions of sections 1902(n) and 1905(p) of the Social Security Act [42 U.S.C. 1396a(n), 1396d(p)] and that is pending as of, or is initiated after, the date of the enactment of this Act.”

Puspan. L. 105–33, title IV, § 4715(span), Aug. 5, 1997, 111 Stat. 511, provided that: “The amendments made by this section [amending this section] shall apply on and after October 1, 1997.”

Puspan. L. 105–33, title IV, § 4724(c)(2), Aug. 5, 1997, 111 Stat. 517, provided that: “The amendments made by paragraph (1) [amending this section] shall take effect on January 1, 1998.”

Puspan. L. 105–33, title IV, § 4724(g)(2), Aug. 5, 1997, 111 Stat. 518, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to suppliers of medical assistance consisting of durable medical equipment furnished on or after January 1, 1998.”

Puspan. L. 105–33, title IV, § 4731(c), Aug. 5, 1997, 111 Stat. 520, provided that: “The amendments made by this section [amending this section] shall apply to medical assistance for items and services furnished on or after October 1, 1997.”

Puspan. L. 105–33, title IV, § 4741(c), Aug. 5, 1997, 111 Stat. 523, provided that: “The amendments made by this section [amending this section and section 1396e of this title] shall take effect on the date of the enactment of this Act [Aug. 5, 1997].”

Puspan. L. 105–33, title IV, § 4751(c), Aug. 5, 1997, 111 Stat. 524, provided that: “The amendments made by this section [amending this section] take effect on the date of the enactment of this Act [Aug. 5, 1997].”

Puspan. L. 105–33, title IV, § 4752(span), Aug. 5, 1997, 111 Stat. 525, provided that: “The amendment made by subsection (a) [amending this section] takes effect on the date of the enactment of this Act [Aug. 5, 1997].”

Puspan. L. 105–33, title IV, § 4753(c), Aug. 5, 1997, 111 Stat. 526, provided that: “Except as otherwise specifically provided, the amendments made by this section [amending this section and section 1396span of this title] shall take effect on January 1, 1998.”

Puspan. L. 105–33, title IV, § 4911(c), Aug. 5, 1997, 111 Stat. 571, provided that: “The amendments made by this section [amending this section and section 1396d of this title] shall apply to medical assistance for items and services furnished on or after October 1, 1997.”

Puspan. L. 105–33, title IV, § 4912(c), Aug. 5, 1997, 111 Stat. 573, provided that: “The amendments made by this section [enacting section 1396r–1a and amending this section and section 1396span of this title] shall take effect on the date of the enactment of this Act [Aug. 5, 1997].”

Puspan. L. 105–33, title IV, § 4913(span), Aug. 5, 1997, 111 Stat. 573, provided that: “The amendment made by subsection (a) [amending this section] applies to medical assistance furnished on or after July 1, 1997.”

Amendment by Puspan. L. 105–12 effective Apr. 30, 1997, and applicable to Federal payments made pursuant to obligations incurred after Apr. 30, 1997, for items and services provided on or after such date, subject to also being applicable with respect to contracts entered into, renewed, or extended after Apr. 30, 1997, as well as contracts entered into before Apr. 30, 1997, to the extent permitted under such contracts, see section 11 of Puspan. L. 105–12, set out as an Effective Date note under section 14401 of this title.

Puspan. L. 104–248, § 1(a)(2), Oct. 9, 1996, 110 Stat. 3148, provided that: “The amendment made by paragraph (1) [amending this section] shall be effective as if included in the enactment of the amendments made by section 4752(c)(1) of the Omnibus Budget Reconciliation Act of 1990 [Puspan. L. 101–508].”

Amendment by sections 108(k) and 114(span)–(d)(1), of Puspan. L. 104–193 effective July 1, 1997, with transition rules relating to State options to accelerate such date, rules relating to claims, actions, and proceedings commenced before such date, rules relating to closing out of accounts for terminated or substantially modified programs and continuance in office of Assistant Secretary for Family Support, and provisions relating to termination of entitlement under AFDC program, see section 116 of Puspan. L. 104–193, as amended, set out as an Effective Date note under section 601 of this title.

Puspan. L. 104–193, title IX, § 913, Aug. 22, 1996, 110 Stat. 2354, provided that the amendment made by that section is effective Jan. 1, 1997.

Amendment by Puspan. L. 103–448 effective Oct. 1, 1994, see section 401 of Puspan. L. 103–448, set out as a note under section 1755 of this title.

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

Amendment by section 13581(span)(2) of Puspan. L. 103–66 effective Jan. 1, 1994, see section 13581(d) of Puspan. L. 103–66, set out as a note under section 1395y of this title.

Puspan. L. 103–66, title XIII, § 13601(c), Aug. 10, 1993, 107 Stat. 613, provided that: “The amendments made by subsections (a) and (span) [amending this section and section 1396d of this title] shall take effect as if included in the enactment of section 4721(a) of OBRA–1990 [Puspan. L. 101–508].”

Amendment by section 13602(c) of Puspan. L. 103–66 applicable to calendar quarters beginning on or after Oct. 1, 1993, without regard to whether or not regulations to carry out the amendments by section 13602(a)(1) and (c) of Puspan. L. 103–66 have been promulgated by such date, see section 13602(d)(2) of Puspan. L. 103–66, set out as a note under section 1396r–8 of this title.

Puspan. L. 103–66, title XIII, § 13603(f), Aug. 10, 1993, 107 Stat. 621, provided that: “The amendments made by this section [amending this section and sections 1396d and 1396n of this title] shall apply to medical assistance furnished on or after January 1, 1994, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Amendment by section 13611(d)(1) of Puspan. L. 103–66 applicable, except as otherwise provided, to payments under this subchapter for calendar quarters beginning on or after Oct. 1, 1993, without regard to whether or not final regulations to carry out the amendments by section 13611 of Puspan. L. 103–66 have been promulgated by such date, see section 13611(e) of Puspan. L. 103–66, set out as a note under section 1396p of this title.

Puspan. L. 103–66, title XIII, § 13622(d), Aug. 10, 1993, 107 Stat. 632, provided that:

Amendment by section 13623(a) of Puspan. L. 103–66 applicable, except as otherwise provided, to calendar quarters beginning on or after Apr. 1, 1994, without regard to whether or not final regulations to carry out the amendments by section 13623 of Puspan. L. 103–66 have been promulgated by such date, see section 13623(c) of Puspan. L. 103–66, set out as an Effective Date note under section 1396g–1 of this title.

Puspan. L. 103–66, title XIII, § 13625(span), Aug. 10, 1993, 107 Stat. 636, provided that: “Section 1902(a)(61) of the Social Security Act [42 U.S.C. 1396a(a)(61)] (as added by subsection (a)) shall take effect January 1, 1995, and the standards referred to in such section shall be established not later than March 31, 1994.”

Puspan. L. 103–66, title XIII, § 13631(e)(2), Aug. 10, 1993, 107 Stat. 644, provided that: “The amendments made by paragraph (1) [amending this section] shall take effect on the date of the enactment of this Act [Aug. 10, 1993].”

Puspan. L. 103–66, title XIII, § 13631(f)(3), Aug. 10, 1993, 107 Stat. 644, provided that:

Puspan. L. 103–66, title XIII, § 13631(i), Aug. 10, 1993, 107 Stat. 645, provided that: “Except as otherwise provided in this section, the amendments made by this section [enacting section 1396s of this title, transferring former section 1396s of this title to section 1396v of this title, and amending this section and sections 1396span and 1396d of this title] shall apply to payments under State plans approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for calendar quarters beginning on or after October 1, 1994.”

Puspan. L. 102–234, § 2(c)(1), Dec. 12, 1991, 105 Stat. 1799, provided that: “The amendments made by this section [amending this section and section 1396span of this title] shall take effect January 1, 1992, without regard to whether or not regulations have been promulgated to carry out such amendments by such date.”

Puspan. L. 102–234, § 3(e)(1), Dec. 12, 1991, 105 Stat. 1803, provided that: “The amendments made by this section [amending this section and sections 1396span and 1396r–4 of this title] shall take effect January 1, 1992.”

Puspan. L. 101–508, title IV, § 4402(e), Nov. 5, 1990, 104 Stat. 1388–164, provided that:

Puspan. L. 101–508, title IV, § 4501(f), Nov. 5, 1990, 104 Stat. 1388–166, provided that: “The amendments made by this section [amending this section and sections 1395v and 1396d of this title] shall apply to calendar quarters beginning on or after January 1, 1991, without regard to whether or not regulations to implement such amendments are promulgated by such date; except that the amendments made by subsection (e) [amending this section and section 1396d of this title] shall apply to determinations of income for months beginning with January 1991.”

Puspan. L. 101–508, title IV, § 4601(span), Nov. 5, 1990, 104 Stat. 1388–167, provided that:

Puspan. L. 101–508, title IV, § 4602(span), Nov. 5, 1990, 104 Stat. 1388–167, provided that: “The amendments made by subsection (a) [amending this section] apply to payments under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for calenar [sic] quarters beginning on or after July 1, 1991, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 101–508, title IV, § 4603(span), Nov. 5, 1990, 104 Stat. 1388–168, provided that:

Puspan. L. 101–508, title IV, § 4604(d), Nov. 5, 1990, 104 Stat. 1388–169, provided that:

Amendment by section 4701(span)(1) of Puspan. L. 101–508 effective Jan. 1, 1991, see section 4701(c) of Puspan. L. 101–508, set out as a note under section 1396span of this title.

Puspan. L. 101–508, title IV, § 4704(f), Nov. 5, 1990, 104 Stat. 1388–172, provided that: “The amendments made by this section [amending this section and sections 1396span, 1396d, and 1396n of this title] shall be effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1989 [Puspan. L. 101–239].”

Puspan. L. 101–508, title IV, § 4708(span), Nov. 5, 1990, 104 Stat. 1388–174, provided that: “The amendments made by this section [amending this section] shall apply to services furnished on or after the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–508, title IV, § 4711(e), Nov. 5, 1990, 104 Stat. 1388–187, provided that:

Puspan. L. 101–508, title IV, § 4713(c), Nov. 5, 1990, 104 Stat. 1388–191, provided that: “The amendments made by this section [amending this section and section 1396d of this title] shall apply to medical assistance furnished on or after January 1, 1991.”

Puspan. L. 101–508, title IV, § 4715(span), Nov. 5, 1990, 104 Stat. 1388–192, provided that: “The amendment made by subsection (a) [amending this section] shall apply to treatment of income for months beginning more than 30 days after the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–508, title IV, § 4732(e), Nov. 5, 1990, 104 Stat. 1388–196, provided that: “The amendments made by this section [amending this section and section 1396span of this title] shall take effect on the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–508, title IV, § 4751(c), Nov. 5, 1990, 104 Stat. 1388–205, provided that: “The amendments made by this section [amending this section and sections 1396span and 1396r of this title] shall apply with respect to services furnished on or after the first day of the first month beginning more than 1 year after the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–508, title IV, § 4752(c)(2), Nov. 5, 1990, 104 Stat. 1388–207, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to medical assistance for calendar quarters beginning more than 60 days after the date of establishment of the physician identifier system under section 1902(x) of the Social Security Act [42 U.S.C. 1396a(x)].”

Puspan. L. 101–508, title IV, § 4754(span), Nov. 5, 1990, 104 Stat. 1388–209, provided that: “The amendment made by subsection (a) [amending this section] shall apply to sanctions effected more than 60 days after the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–508, title IV, § 4755(c)(1), Nov. 5, 1990, 104 Stat. 1388–210, provided that the amendment made by that section is effective July 1, 1990.

Puspan. L. 101–508, title IV, § 4801(e)(11), Nov. 5, 1990, 104 Stat. 1388–217, provided that the amendment made by that section is effective on the date on which the Secretary promulgates standards regarding the qualifications of nursing facility administrators under section 1396r(f)(4) of this title.

Puspan. L. 101–508, title IV, § 4801(e)(19), Nov. 5, 1990, 104 Stat. 1388–219, provided that: “Except as provided in paragraphs (7), (11), and (16), the amendments made by this subsection [amending this section and sections 1396span and 1396r of this title, repealing section 1396g of this title, and amending provisions set out as a note under this section] shall take effect as if they were included in the enactment of the Omnibus Budget Reconciliation Act of 1987 [Puspan. L. 100–203].”

Amendment by section 6115(c) of Puspan. L. 101–239 applicable to screening pap smears performed on or after July 1, 1990, see section 6115(d) of Puspan. L. 101–239, set out as a note under section 1395x of this title.

Puspan. L. 101–239, title VI, § 6401(c), Dec. 19, 1989, 103 Stat. 2259, provided that:

Puspan. L. 101–239, title VI, § 6402(c), formerly § 6402(d), Dec. 19, 1989, 103 Stat. 2261, as renumbered and amended by Puspan. L. 101–508, title IV, § 4704(e)(2), Nov. 5, 1990, 104 Stat. 1388–172, provided that: “The amendments made by this section [enacting section 1396r–7 of this title and amending this section] (except as otherwise provided in such amendments) shall take effect on the date of the enactment of this Act [Dec. 19, 1989].”

Puspan. L. 101–239, title VI, § 6403(e), Dec. 19, 1989, 103 Stat. 2264, provided that: “The amendments made by this section [amending this section and section 1396d of this title] shall take effect on April 1, 1990, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 101–239, title VI, § 6404(d), Dec. 19, 1989, 103 Stat. 2264, provided that:

Puspan. L. 101–239, title VI, § 6405(c), Dec. 19, 1989, 103 Stat. 2265, provided that: “The amendments made by this section [amending this section and section 1396d of this title] shall become effective with respect to services furnished by a certified pediatric nurse practitioner or certified family nurse practitioner on or after July 1, 1990.”

Puspan. L. 101–239, title VI, § 6406(span), Dec. 19, 1989, 103 Stat. 2266, provided that: “The amendments made by subsection (a) [amending this section] shall take effect on July 1, 1990, without regard to whether regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 101–239, title VI, § 6408(c)(2), Dec. 19, 1989, 103 Stat. 2268, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to services furnished on or after April 1, 1990, without regard to whether or not final regulations have been promulgated by such date to implement such amendments.”

Puspan. L. 101–239, title VI, § 6408(d)(5), Dec. 19, 1989, 103 Stat. 2269, provided that:

Puspan. L. 101–239, title VI, § 6411(a)(2), Dec. 19, 1989, 103 Stat. 2270, provided that: “The amendment made by paragraph (1) [amending this section] shall apply as if it had been included in the enactment of the Medicare Catastrophic Coverage Act of 1988 [Puspan. L. 100–360].”

Amendment by section 6411(d)(3)(B) of Puspan. L. 101–239 applicable to employment and contracts as of 90 days after Dec. 19, 1989, see section 6411(d)(4)(B) of Puspan. L. 101–239, set out as a note under section 1395mm of this title.

Puspan. L. 101–239, title VI, § 6411(e)(4), Dec. 19, 1989, 103 Stat. 2272, provided that:

Amendment by Puspan. L. 101–234 effective Jan. 1, 1990, see section 201(c) of Puspan. L. 101–234, set out as a note under section 1320a–7a of this title.

Puspan. L. 100–647, title VIII, § 8434(c), Nov. 10, 1988, 102 Stat. 3805, provided that: “The amendment made by this section [amending this section and section 1396d of this title] shall be effective as if included in the enactment of section 301 of the Medicare Catastrophic Coverage Act of 1988 [Puspan. L. 100–360].”

Amendment by section 202(c)(4) of Puspan. L. 100–485 effective Oct. 1, 1990, with provision for earlier effective dates in case of States making certain changes in their State plans and formally notifying the Secretary of Health and Human Services of their desire to become subject to the amendments by title II of Puspan. L. 100–485 at such earlier effective dates, see section 204(a), (span)(1)(A) of Puspan. L. 100–485, set out as a note under section 671 of this title.

Puspan. L. 100–485, title III, § 303(f), Oct. 13, 1988, 102 Stat. 2393, as amended by Puspan. L. 101–239, title VI, § 6411(i)(2), Dec. 19, 1989, 103 Stat. 2273; Puspan. L. 104–193, title I, § 110(q), Aug. 22, 1996, 110 Stat. 2175, provided that:

Puspan. L. 100–485, title IV, § 401(g), Oct. 13, 1988, 102 Stat. 2396, as amended by Puspan. L. 103–432, title II, § 234(a), Oct. 31, 1994, 108 Stat. 4466, provided that:

[Puspan. L. 103–432, title II, § 234(span), Oct. 31, 1994, 108 Stat. 4466, provided that: “The amendment made by subsection (a) [amending section 401(g)(2) of Puspan. L. 100–485, set out above] shall take effect as if included in the provision of the Family Support Act of 1988 [Puspan. L. 100–485] to which the amendment relates at the time such provision became law.”]

Amendment by section 608(d)(14)(I), (15)(A), (B), (16)(C), (27)(F)–(H), (28) of Puspan. L. 100–485 effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, Puspan. L. 100–360, see section 608(g)(1) of Puspan. L. 100–485, set out as a note under section 704 of this title.

Amendment by section 204(d)(3) of Puspan. L. 100–360 applicable to screening mammography performed on or after Jan. 1, 1990, see section 204(e) of Puspan. L. 100–360, set out as a note under section 1395m of this title.

Amendment by section 301(e)(2) of Puspan. L. 100–360 effective July 1, 1989, see section 301(e)(3) of Puspan. L. 100–360, set out as a note under section 1395v of this title.

Puspan. L. 100–360, title III, § 301(h), July 1, 1988, 102 Stat. 750, as amended by Puspan. L. 100–485, title VI, § 608(d)(14)(K), Oct. 13, 1988, 102 Stat. 2416, provided that:

Puspan. L. 100–360, title III, § 302(f), July 1, 1988, 102 Stat. 753, provided that:

Amendment by section 303(d) of Puspan. L. 100–360 effective on and after Apr. 8, 1988, with additional provision for supersedure of certain administrative regulations, see section 303(g)(4) of Puspan. L. 100–360, set out as an Effective Date note under section 1396r–5 of this title.

Amendment by section 303(e)(1), (5) of Puspan. L. 100–360 applicable to medical assistance furnished on or after Oct. 1, 1982, see section 303(g)(6) of Puspan. L. 100–360, set out as an Effective Date note under section 1396r–5 of this title.

Subsec. (a)(51)(A), as enacted by section 303(e)(2)–(4) of Puspan. L. 100–360, applicable to payments under this subchapter for calendar quarters beginning on or after Sept. 30, 1989, without regard to whether or not final regulations to carry out that paragraph have been promulgated by that date, see section 303(g)(1)(A) of Puspan. L. 100–360, set out as an Effective Date note under section 1396r–5 of this title.

Subsec. (a)(51)(B), as enacted by section 303(e)(2)–(4) of Puspan. L. 100–360, applicable to payments under this subchapter for calendar quarters beginning on or after July 1, 1988 (except in certain situations requiring State legislative action), without regard to whether or not final regulations to carry out that paragraph have been promulgated by that date, with an exception for resources disposed of before July 1, 1988, see section 303(g)(2)(A), (C), (5) of Puspan. L. 100–360, set out as an Effective Date note under section 1396r–5 of this title.

Except as specifically provided in section 411 of Puspan. L. 100–360, amendment by section 411(k)(5), (7)(B)–(D), (10)(G)(ii), (iv), (17)(B), (l)(3)(E), (H), (J), (6)(C), (D), (8)(C), and (n)(2), (4) of Puspan. L. 100–360, as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, Puspan. L. 100–203, effective as if included in the enactment of that provision in Puspan. L. 100–203, see section 411(a) of Puspan. L. 100–360, set out as a Reference to OBRA; Effective Date note under section 106 of Title 1, General Provisions.

For effective date of amendment by section 4072(d) of Puspan. L. 100–203, see section 4072(e) of Puspan. L. 100–203, set out as a note under section 1395x of this title.

Puspan. L. 100–203, title IV, § 4101(a)(3), Dec. 22, 1987, 101 Stat. 1330–141, provided that: “The amendments made by this subsection [amending this section] shall apply to medical assistance furnished on or after July 1, 1988.”

Puspan. L. 100–203, title IV, § 4101(span)(3), Dec. 22, 1987, 101 Stat. 1330–141, provided that: “The amendments made by this subsection [amending this section and provisions set out below] shall apply with respect to medical assistance furnished on or after July 1, 1988.”

Amendment by section 4101(c)(2) of Puspan. L. 100–203 applicable to medical assistance furnished on or after Oct. 1, 1988, see section 4101(c)(3) of Puspan. L. 100–203, set out as a note under section 1396d of this title.

Puspan. L. 100–203, title IV, § 4101(e)(6), Dec. 22, 1987, 101 Stat. 1330–143, provided that:

Puspan. L. 100–203, title IV, § 4113(c)(3), Dec. 22, 1987, 101 Stat. 1330–152, provided that: “The amendments made by this subsection [amending this section] shall apply to services furnished on and after July 1, 1988.”

Puspan. L. 100–203, title IV, § 4118(c)(2), Dec. 22, 1987, 101 Stat. 1330–155, provided that: “The amendment made by paragraph (1) [amending this section] shall be effective as if it were included in section 134 of the Tax Equity and Fiscal Responsibility Act of 1982 [Puspan. L. 97–248].”

Puspan. L. 100–203, title IV, § 4118(h)(3), formerly § 4118(h)(2), Dec. 22, 1987, 101 Stat. 1330–156, as renumbered and amended by Puspan. L. 100–360, title IV, § 411(k)(10)(G)(iii), July 1, 1988, 102 Stat. 796, provided that: “The amendments made by this subsection [amending this section and section 1396span of this title] shall apply to costs incurred after the date of the enactment of this Act [Dec. 22, 1987].”

Puspan. L. 100–203, title IV, § 4118(m)(2), Dec. 22, 1987, 101 Stat. 1330–157, provided that: “The amendments made by paragraph (1) [amending this section and repealing section 1320a–8 of this title] shall apply to audits conducted after the date of the enactment of this Act [Dec. 22, 1987].”

Amendments by sections 4211(span)(1), (h)(1)–(5), 4212(d)(2), (3), (e)(1) of Puspan. L. 100–203 applicable to nursing facility services furnished on or after Oct. 1, 1990, without regard to whether regulations implementing such amendments are promulgated by such date, except as otherwise specifically provided in section 1396r of this title, and except that subsec. (a)(28)(B) of this section as amended by section 4211(span) of Puspan. L. 100–203 applicable to calendar quarters beginning more than 6 months after Dec. 22, 1987, with transitional rule, see section 4214(a), (span)(2) of Puspan. L. 100–203, as amended, set out as an Effective Date note under section 1396r of this title.

Puspan. L. 100–203, title IV, § 4212(d)(4), Dec. 22, 1987, 101 Stat. 1330–213, provided that: “The amendments made by this subsection [amending this section and section 1396span of this title] shall not apply to a State until such date (not earlier than October 1, 1990) as of which the Secretary determines that—

Amendment by section 4213(span)(1) of Puspan. L. 100–203 applicable to payments under this subchapter for calendar quarters beginning on or after Dec. 22, 1987, without regard to whether regulations implementing such amendments are promulgated by such date, except as otherwise specifically provided in section 1396r of this title, with transitional rule, see section 4214(span) of Puspan. L. 100–203, as amended, set out as an Effective Date note under section 1396r of this title.

Puspan. L. 100–203, title IV, § 4218(span), Dec. 22, 1987, 101 Stat. 1330–221, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to certifications or recertifications during the period beginning on July 1, 1988, and ending on October 1, 1990.”

Amendment by section 9115(span) of Puspan. L. 100–203 effective July 1, 1988, see section 9115(c) of Puspan. L. 100–203, set out as a note under section 1382 of this title.

Puspan. L. 100–203, title IX, § 9119(d)(2), as added by Puspan. L. 100–360, title IV, § 411(n)(4), formerly § 411(n)(3), July 1, 1988, 102 Stat. 807, and renumbered by Puspan. L. 100–485, title VI, § 608(d)(28), Oct. 13, 1988, 102 Stat. 2423, provided that: “The amendments made by paragraph (1) [amending this section] apply to payments under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for calendar quarters beginning on or after July 1, 1988, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Amendment by sections 5(a) and 8(f) of Puspan. L. 100–93, applicable, with certain exception, to payments under subchapter XIX of this chapter for calendar quarters beginning more than thirty days after Aug. 18, 1987, without regard to whether or not final regulations to carry out such amendments have been published by such date, see section 15(c) of Puspan. L. 100–93, set out as a note under section 1320a–7 of this title.

Amendment by section 7 of Puspan. L. 100–93 effective at end of fourteen-day period beginning Aug. 18, 1987, and inapplicable to administrative proceedings commenced before end of such period, see section 15(a) of Puspan. L. 100–93, set out as a note under section 1320a–7 of this title.

Puspan. L. 99–643, § 10(span), Nov. 10, 1986, 100 Stat. 3580, provided that:

Puspan. L. 99–570, title XI, § 11005(c)(2), Oct. 27, 1986, 100 Stat. 3207–169, provided that: “The amendments made by subsection (span) [amending this section] shall become effective on January 1, 1987, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Amendment by Puspan. L. 99–514 effective, except as otherwise provided, as if included in enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, Puspan. L. 99–272, see section 1895(e) of Puspan. L. 99–514, set out as a note under section 162 of Title 26, Internal Revenue Code.

Amendment by section 9320(h)(3) of Puspan. L. 99–509 applicable to services furnished on or after Jan. 1, 1989, with exceptions for hospitals located in rural areas which meet certain requirements related to certified registered nurse anesthetists, see section 9320(i), (k) of Puspan. L. 99–509, as amended, set out as notes under section 1395k of this title.

Puspan. L. 99–509, title IX, § 9401(f), Oct. 21, 1986, 100 Stat. 2052, as amended by Puspan. L. 100–203, title IV, § 4101(span)(2)(C), Dec. 22, 1987, 101 Stat. 1330–141, provided that:

Puspan. L. 99–509, title IX, § 9402(c), Oct. 21, 1986, 100 Stat. 2053, provided that: “The amendments made by this section [amending this section] shall apply to payments to States for calendar quarters beginning on or after July 1, 1987, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 99–509, title IX, § 9403(h), Oct. 21, 1986, 100 Stat. 2056, provided that: “The amendments made by this section [amending this section and sections 1396span, 1396d, and 1396o of this title] apply to payments under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for calendar quarters beginning on or after July 1, 1987, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 99–509, title IX, § 9404(c), Oct. 21, 1986, 100 Stat. 2057, provided that:

Puspan. L. 99–509, title IX, § 9406(c), Oct. 21, 1986, 100 Stat. 2058, provided that:

Puspan. L. 99–509, title IX, § 9407(d), Oct. 21, 1986, 100 Stat. 2060, provided that: “The amendments made by this section [enacting section 1396r–1 of this title and amending this section and sections 1396span and 1396s of this title] shall apply to ambulatory prenatal care furnished in calendar quarters beginning on or after April 1, 1987, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 99–509, title IX, § 9408(d), Oct. 21, 1986, 100 Stat. 2061, provided that: “The amendments made by this section [amending this section and section 1396d of this title] shall apply to services furnished on or after the date of the enactment of this Act [Oct. 21, 1986].”

Puspan. L. 99–509, title IX, § 9431(c), Oct. 21, 1986, 100 Stat. 2066, provided that: “The amendments made by this section [amending this section and section 1396span of this title] apply to payments under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for calendar quarters beginning on or after July 1, 1987, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.”

Puspan. L. 99–509, title IX, § 9433(span), Oct. 21, 1986, 100 Stat. 2068, provided that: “The amendment made by subsection (a) [amending section 2173 of Puspan. L. 97–35, which amended this section] shall apply as though it was included in the enactment of the Omnibus Budget Reconciliation Act of 1981 (Public Law 97–35).”

Puspan. L. 99–509, title IX, § 9435(f), Oct. 21, 1986, 100 Stat. 2071, provided that: “The amendments made by this section [amending this section and section 1396d of this title and provisions set out as notes under this section and sections 1396d and 1396n of this title] shall be effective as if included in the enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985 [Puspan. L. 99–272].”

Puspan. L. 99–272, title IX, § 9501(d)(2), (3), Apr. 7, 1986, 100 Stat. 202, provided that:

Puspan. L. 99–272, title IX, § 9503(g), Apr. 7, 1986, 100 Stat. 207, provided that:

Puspan. L. 99–272, title IX, § 9505(e), Apr. 7, 1986, 100 Stat. 209, as amended by Puspan. L. 99–509, title IX, § 9435(d)(1), Oct. 21, 1986, 100 Stat. 2070, provided that: “The amendments made by this section [amending this section and sections 1396d and 1396o of this title] shall apply to medical assistance provided for hospice care furnished on or after the date of the enactment of this Act [Apr. 7, 1986], without regard to whether or not regulations to carry out the amendments have been promulgated by that date.”

Puspan. L. 99–272, title IX, § 9506(span), (c), Apr. 7, 1986, 100 Stat. 210, as amended by Puspan. L. 99–509, title IX, § 9435(c), Oct. 21, 1986, 100 Stat. 2070, provided that:

Puspan. L. 99–272, title IX, § 9509(span), Apr. 7, 1986, 100 Stat. 211, provided that:

Puspan. L. 99–272, title IX, § 9510(span), Apr. 7, 1986, 100 Stat. 212, as amended by Puspan. L. 99–509, title IX, § 9435(d)(2), Oct. 21, 1986, 100 Stat. 2070, provided that: “The amendment made by this section [amending this section] shall apply with respect to payment for services furnished on or after October 1, 1985, without regard to whether or not regulations to carry out the amendment have been promulgated by that date.”

Puspan. L. 99–272, title IX, § 9529(a)(2), Apr. 7, 1986, 100 Stat. 220, provided that: “The amendment made by paragraph (1) [amending this section] shall apply to medical assistance furnished on or after the first calendar quarter that begins more than 90 days after the date of the enactment of this Act [Apr. 7, 1986].”

Puspan. L. 99–272, title IX, § 9529(span)(3), Apr. 7, 1986, 100 Stat. 221, provided that: “This subsection, and the amendments made by this subsection [amending this section and enacting provisions set out below], shall apply to adoption assistance agreements entered into before, on, or after the date of the enactment of this Act [Apr. 7, 1986].”

Amendment by section 12305(span)(3) of Puspan. L. 99–272 applicable to medical assistance furnished in or after first calendar quarter beginning more than 90 days after Apr. 7, 1986, see section 12305(c) of Puspan. L. 99–272, set out as a note under section 673 of this title.

Amendment by Puspan. L. 98–617 effective as if originally included in the Deficit Reduction Act of 1984, Puspan. L. 98–369, see section 3(c) of Puspan. L. 98–617, set out as a note under section 1395f of this title.

Amendment by section 2303(g)(1) of Puspan. L. 98–369 applicable to clinical diagnostic laboratory tests furnished on or after July 1, 1984, but not applicable to clinical diagnostic laboratory tests furnished to inpatients of a provider operating under a waiver granted pursuant to section 602(k) of Puspan. L. 98–21, set out as a note under section 1395y of this title, see section 2303(j)(1) and (3) of Puspan. L. 98–369, set out as a note under section 1395l of this title.

Puspan. L. 98–369, div. B, title III, § 2314(c)(3), July 18, 1984, 98 Stat. 1080, provided that:

Amendment by section 2335(e) of Puspan. L. 98–369 effective July 18, 1984, see section 2335(g) of Puspan. L. 98–369, set out as a note under section 1395f of this title.

Puspan. L. 98–369, div. B, title III, § 2361(d), July 18, 1984, 98 Stat. 1104, provided that:

Puspan. L. 98–369, div. B, title III, § 2362(span), July 18, 1984, 98 Stat. 1105, provided that: “The amendment made by subsection (a) [amending this section] shall apply to children born on or after October 1, 1984.”

Amendment by section 2363(a)(1) of Puspan. L. 98–369 applicable to calendar quarters beginning on or after July 18, 1984, except that, in the case of individuals admitted to skilled nursing facilities before that date, the amendment shall not require recertifications sooner or more frequently than were required under the law in effect before that date, see section 2363(c) of Puspan. L. 98–369, set out as a note under section 1396span of this title.

Puspan. L. 98–369, div. B, title III, § 2367(c), July 18, 1984, 98 Stat. 1109, provided that:

Puspan. L. 98–369, div. B, title III, § 2368(c), July 18, 1984, 98 Stat. 1110, provided that: “The amendments made by this section [amending this section] shall become effective on the date of the enactment of this Act [July 18, 1984].”

Amendment by section 2651(c) of Puspan. L. 98–369 effective Apr. 1, 1985, except as otherwise provided, see section 2651(l)(2) of Puspan. L. 98–369, set out as an Effective Date note under section 1320span–7 of this title.

Amendment by section 131(a), (c) of Puspan. L. 97–248 effective Oct. 1, 1982, see section 131(d) of Puspan. L. 97–248, formerly § 131(c), redesignated Puspan. L. 97–448, title III, § 309(a)(8), Jan. 12, 1983, 96 Stat. 2408, set out as an Effective Date note under section 1396o of this title.

Amendment by section 132(a), (c) of Puspan. L. 97–248 effective Sept. 3, 1982, see section 132(d) of Puspan. L. 97–248, set out as an Effective Date note under section 1396p of this title.

Puspan. L. 97–248, title I, § 134(span), Sept. 3, 1982, 96 Stat. 375, provided that: “The amendment made by subsection (a) [amending this section] shall become effective on October 1, 1982.”

Amendment by section 136(d) of Puspan. L. 97–248 effective Oct. 1, 1982, see section 136(e) of Puspan. L. 97–248, set out as a note under section 1301 of this title.

Puspan. L. 97–248, title I, § 137(d), Sept. 3, 1982, 96 Stat. 381, provided that:

Amendment by section 146(a) of Puspan. L. 97–248 effective with respect to contracts entered into or renewed on or after Sept. 3, 1982, see section 149 of Puspan. L. 97–248, set out as an Effective Date note under section 1320c of this title.

Puspan. L. 97–35, title XXI, § 2113(o), Aug. 13, 1981, 95 Stat. 796, provided that: “The amendments made by this section [amending this section and sections 1320c, 1320c–1, 1320c–3, 1320c–4, 1320c–7, 1320c–8, 1320c–9, 1320c–11, 1320c–17, 1320c–21, and 1396span of this title and repealing sections 1320c–13 and 1320c–20 of this title] apply to agreements with Professional Standards Review Organizations entered into on or after October 1, 1981.”

Puspan. L. 97–35, title XXI, § 2171(c), Aug. 13, 1981, 95 Stat. 808, provided that: “The amendments made by this section [amending this section] shall become effective on the date of the enactment of this Act [Aug. 13, 1981].”

Puspan. L. 97–35, title XXI, § 2172(c), Aug. 13, 1981, 95 Stat. 808, provided that: “The amendments made by this section [amending this section and section 1396d of this title] shall become effective on the date of the enactment of this Act [Aug. 13, 1981].”

Puspan. L. 97–35, title XXI, § 2173(span)(2), Aug. 13, 1981, 95 Stat. 809, provided that: “The amendment made by paragraph (1) [amending this section] shall not apply with respect to services furnished before the date the Secretary of Health and Human Services first promulgates and has in effect final regulations (on an interim or other basis) to carry out section 1902(a)(13)(A) of the Social Security Act [42 U.S.C. 1396a(a)(13)(A)] (as amended by this subtitle).”

Puspan. L. 97–35, title XXI, § 2174(c), Aug. 13, 1981, 95 Stat. 809, provided that: “The amendments made by this section [amending this section and section 1396span of this title] shall apply to services furnished on or after October 1, 1981.”

Puspan. L. 97–35, title XXI, § 2175(d)(2), Aug. 13, 1981, 95 Stat. 811, provided that:

Puspan. L. 97–35, title XXI, § 2178(c), Aug. 13, 1981, 95 Stat. 815, provided that: “The amendments made by this section [amending this section and section 1396span of this title] shall apply with respect to services furnished, under a State plan approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.], on or after October 1, 1981; except that such amendments shall not apply with respect to services furnished by a health maintenance organization under a contract with a State entered into under such title before October 1, 1981 unless the organization requests that such amendments apply and the Secretary of Health and Human Services and the single State agency (administering or supervising the administration of the State plan under such title) agree to such request.”

Puspan. L. 97–35, title XXI, § 2181(span), Aug. 13, 1981, 95 Stat. 815, as amended by Puspan. L. 97–248, title I, § 137(a)(4), Sept. 3, 1982, 96 Stat. 376, provided that: “The amendment made by subsection (a)(1) [amending section 603 of this title] shall apply to reductions for calendar quarters beginning on or after June 30, 1974, and the amendments made by subsection (a)(2) [amending this section] shall take effect on October 1, 1981, except that, in the case of a State plan under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] which the Secretary determines requires State legislation in order to incorporate the provisions required to be included by this section into such State plan, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to include the provisions required to be included in such State plan by subsection (a)(2) of this section before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act [Aug. 13, 1981], but the requirements previously set forth in paragraphs (1) through (3) of section 403(g) of the Social Security Act [42 U.S.C. 603(g)(1)–(3)] (prior to its repeal by this section) shall apply under title XIX of such Act to such State on and after October 1, 1981, whether or not the provisions required to be included by this section in the State plan under title XIX have been incorporated into such State plan.”

For effective date, savings, and transitional provisions relating to amendment by section 2193(c)(9) of Puspan. L. 97–35, see section 2194 of Puspan. L. 97–35, set out as a note under section 701 of this title.

Amendment by section 902(span) of Puspan. L. 96–499 effective on date on which final regulations to implement the amendment are first issued, see section 902(c) of Puspan. L. 96–499, set out as a note under section 1395x of this title.

Puspan. L. 96–499, title IX, § 914(span)(2), Dec. 5, 1980, 94 Stat. 2622, as amended by Puspan. L. 97–248, title I, § 137(c)(1), Sept. 3, 1982, 96 Stat. 381, provided that:

“(B) In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by paragraph (1), the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act.”

Puspan. L. 96–499, title IX, § 918(span)(2), Dec. 5, 1980, 94 Stat. 2626, provided that:

Puspan. L. 96–499, title IX, § 962(span), Dec. 5, 1980, 94 Stat. 2651, provided that: “The amendment made by subsection (a) [amending this section] shall become effective on October 1, 1980.”

Puspan. L. 96–499, title IX, § 965(c), Dec. 5, 1980, 94 Stat. 2652, provided that:

Puspan. L. 95–559, § 14(a)(2), Nov. 1, 1978, 92 Stat. 2140, provided that:

Amendment by Puspan. L. 95–210 applicable to medical assistance provided, under a State plan approved under subchapter XIX of this chapter, on and after the first day of the 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 Puspan. L. 95–210, set out as a note under section 1395cc of this title.

Amendment by section 2(a)(3) of Puspan. L. 95–142 applicable with respect to care and services furnished on or after Oct. 25, 1977, see section 2(a)(4) of Puspan. L. 95–142, set out as a note under section 1395g of this title.

Puspan. L. 95–142, § 2(span)(2), Oct. 25, 1977, 91 Stat. 1177, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to calendar quarters beginning on and after July 1, 1978, with respect to State plans approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.].”

Amendment by section 3(c)(1) of Puspan. L. 95–142 effective Jan. 1, 1978, see section 3(e) of Puspan. L. 95–142, set out as an Effective Date note under section 1320a–3 of this title.

Puspan. L. 95–142, § 7(e)(2), Oct. 25, 1977, 91 Stat. 1194, provided that: “The amendment made by subsection (span) [amending this section] shall become effective on January 1, 1978.”

Puspan. L. 95–142, § 19(c)(2), Oct. 25, 1977, 91 Stat. 1205, provided that:

Amendment by section 20(span) of Puspan. L. 95–142 effective Oct. 1, 1977, and the Secretary to adjust payments made to States under section 1396span of this title to reflect such amendment, see section 20(c) of Puspan. L. 95–142, set out as a note under section 1396span of this title.

Puspan. L. 94–552, § 2, Oct. 18, 1976, 90 Stat. 2540, provided that: “The amendments made by the first section [amending this section and section 1396span of this title] shall take effect as of January 1, 1976.”

Puspan. L. 94–182, title I, § 111(c), Dec. 31, 1975, 89 Stat. 1054, provided that: “The amendments made by this section [amending this section and section 1396span of this title] shall (except as otherwise provided for therein) become effective January 1, 1976.”

Puspan. L. 93–368, § 9(span), Aug. 7, 1974, 88 Stat. 422, provided that: “The amendment made by subsection (a) [amending this section] shall be effective January 1, 1973.”

Puspan. L. 93–233, § 13(d), Dec. 31, 1973, 87 Stat. 965, provided that: “The amendments made by subsection (a) [amending this section and sections 1396, 1396span, and 1396d of this title] shall be effective with respect to payments under section 1903 of the Social Security Act [42 U.S.C. 1396span] for calendar quarters commencing after December 31, 1973.”

Puspan. L. 93–233, § 18(z–3)(4), Dec. 31, 1973, 87 Stat. 974, provided that: “The amendments made by subsections (o) and (u) [amending this section and section 1396span of this title] shall be effective July 1, 1973”.

Puspan. L. 92–603, title II, § 208(span), Oct. 30, 1972, 86 Stat. 1381, provided that: “The amendment made by subsection (a) [amending this section] shall be effective January 1, 1973 (or earlier if the State plan so provided).”

Puspan. L. 92–603, title II, § 209(span)(2), Oct. 30, 1972, 86 Stat. 1382, provided that: “The amendment made by this subsection [amending this section] shall become effective on January 1, 1974.”

Puspan. L. 92–603, title II, § 232(c), Oct. 30, 1972, 86 Stat. 1411, provided that: “The amendments made by this section [amending this section and section 705 of this title] shall be effective July 1, 1972 (or earlier if the State plan so provides).”

Amendment by section 236(span) of Puspan. L. 92–603 effective Jan. 1, 1973, or earlier if the State plan so provides, see section 236(c) of Puspan. L. 92–603, set out as a note under section 1395u of this title.

Puspan. L. 92–603, title II, § 237(d)(2), Oct. 30, 1972, 86 Stat. 1416, provided that: “The amendment made by subsection (a)(2) [amending this section] shall be effective July 1, 1973.”

Puspan. L. 92–603, title II, § 239(d), Oct. 30, 1972, 86 Stat. 1418, provided that: “The amendments made by this section [amending this section and section 705 of this title] shall be effective January 1, 1973 (or earlier if the State plan so provides).”

Amendment by section 246(a) of Puspan. L. 92–603 to be effective July 1, 1973, see section 246(c) of Puspan. L. 92–603, set out as a note under section 1395x of this title.

Puspan. L. 92–603, title II, § 255(span), Oct. 30, 1972, 86 Stat. 1446, provided that: “The amendments made by subsection (a) [amending this section] shall be effective July 1, 1973.”

Puspan. L. 92–603, title II, § 268(c), Oct. 30, 1972, 86 Stat. 1451, provided that: “The amendments made by this section [amending this section and section 1396g of this title] shall be effective on the date of the enactment of this Act [Oct. 30, 1972].”

Amendment by section 299D(span) of Puspan. L. 92–603 effective beginning Jan. 1, 1973, or within 6 months following Oct. 30, 1972, whichever is later, see section 299D(c) of Puspan. L. 92–603, set out as a note under section 1395aa of this title.

Puspan. L. 92–223, § 4(d), Dec. 28, 1971, 85 Stat. 810, as amended by Puspan. L. 92–603, title II, § 292, Oct. 30, 1972, 86 Stat. 1458, provided that: “The amendments made by this section [amending this section and section 1396d of this title and repealing section 1320a of this title] shall become effective January 1, 1972; except that the repeal made by subsection (c) [repealing section 1320a of this title], shall not become effective in the case of any State, which on January 1, 1972 did not have in effect a State plan approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.], until the first day of the first month (occurring after such date) that such State does have in effect a State plan approved under such title [42 U.S.C. 1396 et seq.].”

Amendment by section 210(a)(6) of Puspan. L. 90–248 effective July 1, 1969, or, if earlier (with respect to a State’s plan approved under this subchapter) on the date as of which the modification of the State plan to comply with such amendment is approved, see section 210(span) of Puspan. L. 90–248, set out as a note under section 302 of this title.

Puspan. L. 90–248, title II, § 223(span), Jan. 2, 1968, 81 Stat. 902, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to calendar quarters beginning after June 30, 1967.”

Puspan. L. 90–248, title II, § 224(span), Jan. 2, 1968, 81 Stat. 902, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to calendar quarters beginning after December 31, 1967.”

Puspan. L. 90–248, title II, § 224(c)(2), Jan. 2, 1968, 81 Stat. 902, provided that: “The amendment made by paragraph (1) of this subsection [amending this section] shall apply with respect to calendar quarters beginning after June 30, 1970.”

Puspan. L. 90–248, title II, § 227(span), Jan. 2, 1968, 81 Stat. 904, as amended by Puspan. L. 92–603, title II, § 271A(a), Oct. 30, 1972, 86 Stat. 1451, provided that: “The amendments made by this section [amending this section] shall apply with respect to calendar quarters beginning after June 30, 1969; except that such amendments shall apply in the case of Puerto Rico, the Virgin Islands, and Guam only with respect to calendar quarters beginning after June 30, 1975.”

[Puspan. L. 92–603, title II, § 271A(span), Oct. 30, 1972, 86 Stat. 1451, provided that: “The amendment made by subsection (a) [amending section 227(span) of Puspan. L. 90–248, set out above] shall be effective from and after July 1, 1972.”]

Puspan. L. 90–248, title II, § 229(span), Jan. 2, 1968, 81 Stat. 904, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to legal liabilities of third parties arising after March 31, 1968.”

Puspan. L. 90–248, title II, § 234(span), Jan. 2, 1968, 81 Stat. 907, provided that: “The amendments made by subsection (a) of this section [amending this section] (unless otherwise specified in the body of such amendments) shall take effect on January 1, 1969.”

Puspan. L. 90–248, title II, § 235(span), Jan. 2, 1968, 81 Stat. 908, provided that: “The amendments made by subsection (a) [amending this section] shall be effective in the case of calendar quarters beginning after December 31, 1967.”

Enactment by section 236(a) of Puspan. L. 90–248 effective July 1, 1970, except as otherwise specified in the text thereof, see section 236(c) of Puspan. L. 90–248, set out as an Effective Date note under section 1396g of this title.

Puspan. L. 90–248, title II, § 237, Jan. 2, 1968, 81 Stat. 911, provided that the amendment made by that section is effective Apr. 1, 1968.

Puspan. L. 90–248, title II, § 238, Jan. 2, 1968, 81 Stat. 911, provided that the amendment made by that section is effective July 1, 1969.

Puspan. L. 99–272, title IX, § 9503(c), Apr. 7, 1986, 100 Stat. 206, provided that: “The Secretary of Health and Human Services shall promulgate final regulations necessary to carry out sections 1902(a)(25) and 1903(r)(6)(J) of the Social Security Act [42 U.S.C. 1396a(a)(25), 1396span(r)(6)(J)] within 6 months after the date of the enactment of this Act [Apr. 7, 1986].”

Puspan. L. 116–260, div. CC, title II, § 205(span), Dec. 27, 2020, 134 Stat. 2983, provided that: “Nothing in section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) or section 1902(a)(17) or 1924 of the Social Security Act (42 U.S.C. 1396a(a)(17), 1396r–5) shall be construed as prohibiting a State from—

Similar provisions were contained in the following prior acts:

Puspan. L. 116–215, div. B, title I, § 1105(span), Dec. 11, 2020, 134 Stat. 1043.

Puspan. L. 116–159, div. C, title III, § 2302(span), Oct. 1, 2020, 134 Stat. 731.

Puspan. L. 116–136, div. A, title III, § 3812(span), Mar. 27, 2020, 134 Stat. 429.

Puspan. L. 116–94, div. N, title I, § 204(span), Dec. 20, 2019, 133 Stat. 3111.

Puspan. L. 116–39, § 3(span), Aug. 6, 2019, 133 Stat. 1061, provided that: “Nothing in section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) or section 1902(a)(17) or 1924 of the Social Security Act (42 U.S.C. 1396a(a)(17), 1396r–5) shall be construed as prohibiting a State from applying an income or resource disregard under a methodology authorized under section 1902(r)(2) of such Act (42 U.S.C. 1396a(r)(2))—

Puspan. L. 115–271, title I, § 1001(span), Oct. 24, 2018, 132 Stat. 3901, provided that: “Nothing in this section [amending this section and enacting provisions set out as notes under this section] shall be construed as changing the exclusion from medical assistance under the subdivision (A) following paragraph (30) [now (32)] of section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)), as redesignated by section 1006(span)(2)(B) of this Act, including any applicable restrictions on a State submitting claims for Federal financial participation under title XIX of such Act [42 U.S.C. 1396 et seq.] for such assistance.”

Puspan. L. 115–271, title I, § 1001(c), Oct. 24, 2018, 132 Stat. 3902, provided that: “Nothing in this section [amending this section and enacting provisions set out as notes under this section] shall be construed to mandate, encourage, or suggest that a State suspend or terminate coverage for individuals before they have been adjudicated or sentenced.”

Puspan. L. 115–123, div. E, title XII, § 53103(span), Fespan. 9, 2018, 132 Stat. 301, provided that:

Puspan. L. 114–255, div. A, title V, § 5005(d), Dec. 13, 2016, 130 Stat. 1194, provided that: “Nothing in this section [amending this section and sections 1396span, 1396u–2, and 1397gg of this title and enacting provisions set out as a note under this section] shall be construed as changing or limiting the appeal rights of providers or the process for appeals of States under the Social Security Act [42 U.S.C. 301 et seq.].”

Puspan. L. 114–255, div. A, title V, § 5006(c), Dec. 13, 2016, 130 Stat. 1196, provided that:

Puspan. L. 111–5, div. B, title V, § 5006(e)(3), Fespan. 17, 2009, 123 Stat. 511, provided that: “Nothing in the amendments made by this subsection [amending this section and section 1397gg of this title] shall be construed as superseding existing advisory committees, working groups, guidance, or other advisory procedures established by the Secretary of Health and Human Services or by any State with respect to the provision of health care to Indians.”

Puspan. L. 106–169, title I, § 121(c), Dec. 14, 1999, 113 Stat. 1830, provided that: “If the Ticket to Work and Work Incentives Improvement Act of 1999 [Puspan. L. 106–170] is enacted (whether before, on, or after the date of the enactment of this Act)—

Functions, powers, and duties of Secretary of Health and Human Services under subsec. (a)(4)(A) of this section, insofar as relates to the prescription of personnel standards on a merit basis, transferred to Office of Personnel Management, see section 4728(a)(3)(D) of this title.

Puspan. L. 118–42, div. G, title I, § 206, Mar. 9, 2024, 138 Stat. 406, provided that:

Puspan. L. 118–42, div. G, title I, § 207, Mar. 9, 2024, 138 Stat. 410, provided that:

Puspan. L. 117–159, div. A, title I, § 11002, June 25, 2022, 136 Stat. 1316, provided that:

Puspan. L. 117–159, div. A, title I, § 11003, June 25, 2022, 136 Stat. 1317, provided that:

Puspan. L. 116–260, div. CC, title II, § 209(span)(3), Dec. 27, 2020, 134 Stat. 2988, provided that: “Not later than 24 months after the date of the enactment of this Act [Dec. 27, 2020], the Secretary of Health and Human Services, through the Centers for Medicare & Medicaid Services, shall assess guidance issued to States by the Centers for Medicare & Medicaid Services relating to Federal requirements for nonemergency transportation to medically necessary services under the Medicaid program under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] and update such guidance as necessary to ensure States have appropriate and current guidance in designing and administering coverage under the Medicaid program of nonemergency transportation to medically necessary services.”

Puspan. L. 116–260, div. CC, title II, § 209(c), Dec. 27, 2020, 134 Stat. 2989, provided that: “In the case of a State that exercises the option described in section 1902(a)(70) of the Social Security Act (42 U.S.C. 1396a(a)(7) [1396a(a)(70)]), in establishing a non-emergency medical transportation brokerage program under such section, a State Medicaid agency may consult relevant stakeholders, including stakeholders representing patients, medical providers, Medicaid managed care organizations, brokers for non-emergency medical transportation, and transportation providers (including public transportation providers).”

Puspan. L. 116–94, div. N, title I, § 202(e)(3), Dec. 20, 2019, 133 Stat. 3109, provided that:

Puspan. L. 115–271, title I, § 1002(span), Oct. 24, 2018, 132 Stat. 3902, provided that: “Not later than 1 year after the date of the enactment of this Act [Oct. 24, 2018], the Secretary of Health and Human Services shall issue guidance to States, with respect to the State Medicaid programs of such States—

Puspan. L. 115–271, title I, § 1005(a), Oct. 24, 2018, 132 Stat. 3912, provided that: “Not later than 1 year after the date of the enactment of this Act [Oct. 24, 2018], the Secretary of Health and Human Services shall issue guidance to improve care for infants with neonatal abstinence syndrome and their families. Such guidance shall include—

Puspan. L. 115–271, title I, § 1009(a), (span), Oct. 24, 2018, 132 Stat. 3917, provided that:

Puspan. L. 115–271, title I, § 1010, Oct. 24, 2018, 132 Stat. 3918, provided that: “Not later than January 1, 2019, the Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall issue 1 or more final guidance documents, or update existing guidance documents, to States regarding mandatory and optional items and services that may be provided under a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), or under a waiver of such a plan, for non-opioid treatment and management of pain, including, but not limited to, evidence-based, non-opioid pharmacological therapies and non-pharmacological therapies.”

Puspan. L. 115–271, title I, § 1018, Oct. 24, 2018, 132 Stat. 3924, provided that:

Puspan. L. 115–271, title V, subtitle D, Oct. 24, 2018, 132 Stat. 3965, provided that:

Puspan. L. 114–255, div. A, title V, § 5005(a)(5), Dec. 13, 2016, 130 Stat. 1193, provided that: “Not later than July 1, 2017, the Secretary of Health and Human Services shall, in consultation with the heads of State agencies administering State Medicaid plans (or waivers of such plans), issue regulations establishing uniform terminology to be used with respect to specifying reasons under subparagraph (A)(v) of paragraph (8) of section 1902(kk) of the Social Security Act (42 U.S.C. 1396a(kk)), as added by paragraph (1), for the termination (as described in such paragraph (8)) of the participation of certain providers in the Medicaid program under title XIX of such Act [42 U.S.C. 1396 et seq.] or the Children’s Health Insurance Program under title XXI of such Act [42 U.S.C. 1397aa et seq.].”

Puspan. L. 114–255, div. A, title V, § 5006(d), Dec. 13, 2016, 130 Stat. 1196, provided that: “In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet one or more additional requirements imposed by amendments made by this section [amending this section], the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act [Dec. 13, 2016]. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.”

Puspan. L. 114–255, div. B, title XII, § 12001, Dec. 13, 2016, 130 Stat. 1272, provided that: “Nothing in title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) shall be construed as prohibiting separate payment under the State plan under such title (or under a waiver of the plan) for the provision of a mental health service or primary care service under such plan, with respect to an individual, because such service is—

Puspan. L. 113–93, title II, § 223, Apr. 1, 2014, 128 Stat. 1077, as amended by Puspan. L. 116–16, § 4, Apr. 18, 2019, 133 Stat. 859; Puspan. L. 116–29, § 1, July 5, 2019, 133 Stat. 1031; Puspan. L. 116–39, § 2, Aug. 6, 2019, 133 Stat. 1061; Puspan. L. 116–59, div. B, title III, § 1301, Sept. 27, 2019, 133 Stat. 1105; Puspan. L. 116–69, div. B, title III, § 1301, Nov. 21, 2019, 133 Stat. 1137; Puspan. L. 116–94, div. N, title I, § 201, Dec. 20, 2019, 133 Stat. 3103; Puspan. L. 116–136, div. A, title III, § 3814(a), (span), Mar. 27, 2020, 134 Stat. 430, 431; Puspan. L. 116–159, div. C, title III, § 2304, Oct. 1, 2020, 134 Stat. 732; Puspan. L. 116–215, div. B, title I, § 1104, Dec. 11, 2020, 134 Stat. 1043; Puspan. L. 116–260, div. CC, title II, § 206, Dec. 27, 2020, 134 Stat. 2984; Puspan. L. 117–159, div. A, title I, § 11001, June 25, 2022, 136 Stat. 1314, provided that:

Puspan. L. 111–148, title II, § 2001(d)(2), Mar. 23, 2010, 124 Stat. 278, provided that: “Beginning April 2015, and annually thereafter, the Secretary of Health and Human Services shall submit a report to the appropriate committees of Congress on the total enrollment and new enrollment in Medicaid for the fiscal year ending on September 30 of the preceding calendar year on a national and State-by-State basis, and shall include in each such report such recommendations for administrative or legislative changes to improve enrollment in the Medicaid program as the Secretary determines appropriate.”

Puspan. L. 111–148, title II, § 2704, Mar. 23, 2010, 124 Stat. 323, provided that:

Puspan. L. 111–148, title II, § 2706, Mar. 23, 2010, 124 Stat. 325, provided that:

Puspan. L. 111–148, title II, § 2707, Mar. 23, 2010, 124 Stat. 326, as amended by Puspan. L. 114–97, § 2(a)–(d), Dec. 11, 2015, 129 Stat. 2194–2197, provided that:

[Puspan. L. 114–97, § 2(e), Dec. 11, 2015, 129 Stat. 2198, provided that: “The amendments made by this section [amending section 2707 of Puspan. L. 111–148, set out above] shall take effect on the date of the enactment of this Act [Dec. 11, 2015].”]

Puspan. L. 111–148, title IV, § 4108, Mar. 23, 2010, 124 Stat. 561, provided that:

Puspan. L. 111–148, title VI, § 6411(a)(2), Mar. 23, 2010, 124 Stat. 775, provided that:

Puspan. L. 111–148, title VI, § 6411(c), Mar. 23, 2010, 124 Stat. 775, provided that: “The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall submit an annual report to Congress concerning the effectiveness of the Recovery Audit Contractor program under Medicaid and Medicare and shall include [in] such reports recommendations for expanding or improving the program.”

Puspan. L. 111–5, div. B, title V, § 5000(a), Fespan. 17, 2009, 123 Stat. 496, provided that: “The purposes of this title [enacting section 1320span–24 of this title, amending this section and sections 1396o, 1396o–1, 1396p, 1396r–4, 1396r–6, 1396u–2, 1396u–3, and 1397gg of this title, and enacting provisions set out as notes under this section and sections 1396d and 1396r–6 of this title] are as follows:

Puspan. L. 111–3, title II, § 211(a)(2), Fespan. 4, 2009, 123 Stat. 52, provided that: “Notwithstanding any provision of section 1115 of the Social Security Act (42 U.S.C. 1315), or any other provision of law, the Secretary [of Health and Human Services] may not waive the requirements of section 1902(a)(46)(B) of such Act (42 U.S.C. 1396a(a)(46)(B)) with respect to a State.”

Puspan. L. 110–90, § 4, Sept. 29, 2007, 121 Stat. 985, which required that an automated, secure, wespan-based asset verification request and response process be applied to Medicaid’s asset eligibility determinations in certain States during a certain period, was repealed by Puspan. L. 110–252, title VII, § 7001(d)(4), June 30, 2008, 122 Stat. 2394.

Puspan. L. 109–171, title VI, § 6063, Fespan. 8, 2006, 120 Stat. 99, provided that:

Puspan. L. 116–260, div. CC, title II, § 204(g), Dec. 27, 2020, 134 Stat. 2983, provided that: “Not later than 1 year after the date of the enactment of this Act [Dec. 27, 2020], the Secretary shall update the terms and conditions of any approved MFP demonstration project under section 6071 of the Deficit Reduction Act of 2005 [Puspan. L. 109–171] (42 U.S.C. 1396a note) in effect on the date of the enactment of this Act to ensure that such terms and conditions are the same as are required for any new State applicant for such project under the amendments made by this section.”

Puspan. L. 109–171, title VI, § 6071, Fespan. 8, 2006, 120 Stat. 102, as amended by Puspan. L. 111–148, title II, § 2403(a), (span)(1), Mar. 23, 2010, 124 Stat. 304, 305; Puspan. L. 116–3, § 2, Jan. 24, 2019, 133 Stat. 6; Puspan. L. 116–16, § 5, Apr. 18, 2019, 133 Stat. 859; Puspan. L. 116–39, § 4, Aug. 6, 2019, 133 Stat. 1061; Puspan. L. 116–94, div. N, title I, § 205, Dec. 20, 2019, 133 Stat. 3112; Puspan. L. 116–136, div. A, title III, § 3811, Mar. 27, 2020, 134 Stat. 429; Puspan. L. 116–159, div. C, title III, § 2301, Oct. 1, 2020, 134 Stat. 731; Puspan. L. 116–215, div. B, title I, § 1107, Dec. 11, 2020, 134 Stat. 1043; Puspan. L. 116–260, div. CC, title II, § 204(a), (span)(1), (c)–(f), Dec. 27, 2020, 134 Stat. 2980–2983; Puspan. L. 117–328, div. FF, title V, § 5114, Dec. 29, 2022, 136 Stat. 5940, provided that:

[Puspan. L. 116–260, div. CC, title II, § 204(span)(2), Dec. 27, 2020, 134 Stat. 2980, provided that: “The amendments made by paragraph (1) [amending section 6071 of Puspan. L. 109–171, set out above] shall take effect on the date that is 30 days after the date of the enactment of this Act [Dec. 27, 2020].”]

[Puspan. L. 116–39, § 4, Aug. 6, 2019, 133 Stat. 1061, which directed amendment of section 6071(h)(1)(F) of Puspan. L. 109–171, set out above, by substituting “$254,500,000” for “$132,000,000”, was executed by making the substitution for “132,000,000” to reflect the probable intent of Congress and the amendment by section 5 of Puspan. L. 116–16, which struck out the dollar sign.]

[Puspan. L. 111–148, title II, § 2403(span)(2), Mar. 23, 2010, 124 Stat. 305, provided that: “The amendments made by this subsection [amending section 6071 of Puspan. L. 109–171, set out above] take effect 30 days after the date of enactment of this Act [Mar. 23, 2010].”]

Puspan. L. 107–251, title IV, § 404, Oct. 26, 2002, 116 Stat. 1662, as amended by Puspan. L. 108–163, § 2(n)(1), Dec. 6, 2003, 117 Stat. 2023, provided that:

Puspan. L. 106–554, § 1(a)(6) [title I, § 125], Dec. 21, 2000, 114 Stat. 2763, 2763A–479, provided that:

Puspan. L. 106–554, § 1(a)(6) [title VII, § 702(d)], Dec. 21, 2000, 114 Stat. 2763, 2763A–574, provided that: “The Comptroller General of the United States shall provide for a study on the need for, and how to, rebase or refine costs for making payment under the medicaid program for services provided by Federally-qualified health centers and rural health clinics (as provided under the amendments made by this section [amending this section and sections 1396span and 1396n of this title and repealing provisions set out as a note under this section]). The Comptroller General shall provide for submittal of a report on such study to Congress by not later than 4 years after the date of the enactment of this Act [Dec. 21, 2000].”

Puspan. L. 106–170, title II, § 201(c), Dec. 17, 1999, 113 Stat. 1893, provided that: “Not later than 3 years after the date of the enactment of this Act [Dec. 17, 1999], the Comptroller General of the United States shall submit a report to the Congress regarding the amendments made by this section [amending this section and sections 1396span, 1396d, and 1396o of this title] that examines—

Puspan. L. 106–113, div. B, § 1000(a)(6) [title VI, § 603(span)], Nov. 29, 1999, 113 Stat. 1536, 1501A–395, provided that: “Not later than 1 year after the date of the enactment of this Act [Nov. 29, 1999], the Comptroller General of the United States shall submit a report to Congress that evaluates the effect on Federally-qualified health centers and rural health clinics and on the populations served by such centers and clinics of the phase-out and elimination of the reasonable cost basis for payment for Federally-qualified health center services and rural health clinic services provided under section 1902(a)(13)(C)(i) of the Social Security Act (42 U.S.C. 1396a(a)(13)(C)(i)), as amended by section 4712 of BBA (111 Stat. 508) [the Balanced Budget Act of 1997, Puspan. L. 105–33] and subsection (a) of this section. Such report shall include an analysis of the amount, method, and impact of payments made by States that have provided for payment under title XIX of such Act [42 U.S.C. 1396 et seq.] for such services on a basis other than payment of costs which are reasonable and related to the cost of furnishing such services, together with any recommendations for legislation, including whether a new payment system is needed, that the Comptroller General determines to be appropriate as a result of the study.”

Puspan. L. 106–170, title II, § 204, Dec. 17, 1999, 113 Stat. 1897, provided that: