Notes on social security : US Code - Notes

Search Notes on social security : US Code - Notes

SUBCHAPTER I - GRANTS TO STATES FOR OLD-AGE ASSISTANCE
Sec.
301. Authorization of appropriations.
302. State old-age plans.
(a) Contents.
(b) Approval by Secretary.
(c) Limitation on number of plans.
303. Payments to States and certain territories;
computation of amount; eligibility of State to
receive payment.
(a) Computation of amounts.
(b) Method of computing and paying amounts.
304. Stopping payment on deviation from required
provisions of plan or failure to comply
therewith.
305. Omitted.
306. Definitions.

SUBCHAPTER II - FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY
INSURANCE BENEFITS
401. Trust Funds.
(a) Federal Old-Age and Survivors Insurance
Trust Fund.
(b) Federal Disability Insurance Trust Fund.
(c) Board of Trustees; duties; reports to
Congress.
(d) Investments.
(e) Sale of acquired obligations.
(f) Proceeds from sale or redemption of
obligations; interest.
(g) Payments into Treasury.
(h) Benefit payments.
(i) Gifts and bequests.
(j) Travel expenses.
(k) Experiment and demonstration project
expenditures.
(l) Interfund borrowing.
(m) Accounting for unnegotiated benefit checks.
(n) Payments to Funds in satisfaction of
obligations.
401a. Omitted.
402. Old-age and survivors insurance benefit payments.
(a) Old-age insurance benefits.
(b) Wife's insurance benefits.
(c) Husband's insurance benefits.
(d) Child's insurance benefits.
(e) Widow's insurance benefits.
(f) Widower's insurance benefits.
(g) Mother's and father's insurance benefits.
(h) Parent's insurance benefits.
(i) Lump-sum death payments.
(j) Application for monthly insurance benefits.
(k) Simultaneous entitlement to benefits.
(l) Entitlement to survivor benefits under
railroad retirement provisions.
(m) Repealed.
(n) Termination of benefits upon removal of
primary beneficiary.
(o) Application for benefits by survivors of
members and former members of uniformed
services.
(p) Extension of period for filing proof of
support and applications for lump-sum death
payment.
(q) Reduction of benefit amounts for certain
beneficiaries.
(r) Presumed filing of application by
individuals eligible for old-age insurance
benefits and for wife's or husband's
insurance benefits.
(s) Child over specified age to be disregarded
for certain benefit purposes unless
disabled.
(t) Suspension of benefits of aliens who are
outside United States; residency
requirements for dependents and survivors.
(u) Conviction of subversive activities, etc.
(v) Waiver of benefits.
(w) Increase in old-age insurance benefit
amounts on account of delayed retirement.
(x) Limitation on payments to prisoners, certain
other inmates of publicly funded
institutions, fugitives, probationers, and
parolees.
(y) Limitation on payments to aliens.
403. Reduction of insurance benefits.
(a) Maximum benefits.
(b) Deductions on account of work.
(c) Deductions on account of noncovered work
outside United States or failure to have
child in care.
(d) Deductions from dependents' benefits on
account of noncovered work outside United
States by old-age insurance beneficiary.
(e) Occurrence of more than one event.
(f) Months to which earnings are charged.
(g) Penalty for failure to report certain
events.
(h) Report of earnings to Commissioner.
(i) Repealed.
(j) Attainment of retirement age.
(k) Noncovered remunerative activity outside
United States.
(l) Good cause for failure to make reports
required.
404. Overpayments and underpayments.
(a) Procedure for adjustment or recovery.
(b) No recovery from persons without fault.
(c) Nonliability of certifying and disbursing
officers.
(d) Payment to survivors or heirs when eligible
person is deceased.
(e) Adjustments due to supplemental security
income payments.
(f) Collection of delinquent amounts.
(g) Cross-program recovery of overpayments.
405. Evidence, procedure, and certification for
payments.
(a) Rules and regulations; procedures.
(b) Administrative determination of entitlement
to benefits; findings of fact; hearings;
investigations; evidentiary hearings in
reconsiderations of disability benefit
terminations; subsequent applications.
(c) Wage records.
(d) Issuance of subpenas in administrative
proceedings.
(e) Judicial enforcement of subpenas; contempt.
(f) Repealed.
(g) Judicial review.
(h) Finality of Commissioner's decision.
(i) Certification for payment.
(j) Representative payees.
(k) Payments to incompetents.
(l) Delegation of powers and duties by
Commissioner.
(m) Repealed.
(n) Joint payments.
(o) Crediting of compensation under Railroad
Retirement Act.
(p) Special rules in case of Federal service.
(q) Expedited benefit payments.
(r) Use of death certificates to correct program
information.
(s) Notice requirements.
(t) Same-day personal interviews at field
offices in cases where time is of essence.
(u) Redetermination of entitlement.
405a. Regulations pertaining to frequency or due dates
of payments and reports under voluntary
agreements covering State and local employees;
effective date.
406. Representation of claimants before Commissioner.
(a) Recognition of representatives; fees for
representation before Commissioner.
(b) Fees for representation before court.
(c) Notification of options for obtaining
attorneys.
(d) Assessment on attorneys.
407. Assignment of benefits.
(a) In general.
(b) Amendment of section.
(c) Withholding of taxes.
408. Penalties.
(a) In general.
(b) Restitution.
(c) Violations by certified payees.
(d) Effect upon certification as payee;
definitions.
(e) Application of subsection (a)(6) and (7) to
certain aliens.
409. "Wages" defined.
(a) In general.
(b) Regulations providing exclusions from term.
(c) Individuals performing domestic services.
(d) Members of uniformed services.
(e) Peace Corps volunteers.
(f) Tips.
(g) Members of religious orders.
(h) Retired justices and judges.
(i) Employer contributions under sections 401(k)
and 414(h)(2) of Internal Revenue Code.
(j) Amounts deferred under nonqualified deferred
compensation plans.
(k) "National average wage index" and "deferred
compensation amount" defined.
410. Definitions relating to employment.
(a) Employment.
(b) Included and excluded service.
(c) American vessel.
(d) American aircraft.
(e) American employer.
(f) Agricultural labor.
(g) Farm.
(h) State.
(i) United States.
(j) Employee.
(k) Covered transportation service.
(l) Service in uniformed services.
(m) Member of a uniformed service.
(n) Crew leader.
(o) Peace Corps volunteer service.
(p) Medicare qualified government employment.
(q) Treatment of real estate agents and direct
sellers.
(r) Service in employ of international
organizations by certain transferred
Federal employees.
410a. Transferred.
411. Definitions relating to self-employment.
(a) Net earnings from self-employment.
(b) Self-employment income.
(c) Trade or business.
(d) Partnership and partner.
(e) Taxable year.
(f) Partner's taxable year ending as result of
death.
(g) Regular basis.
(h) Option dealers and commodity dealers.
(i) Church employee income.
(j) Codification of treatment of certain
termination payments received by former
insurance salesmen.
412. Self-employment income credited to calendar years.
413. Quarter and quarter of coverage.
(a) Definitions.
(b) Crediting of wages paid in 1937.
(c) Alternative method for determining quarters
of coverage with respect to wages in period
from 1937 to 1950.
(d) Amount required for a quarter of coverage.
414. Insured status for purposes of old-age and
survivors insurance benefits.
(a) "Fully insured individual" defined.
(b) "Currently insured individual" defined.
(c) Criterion described.
415. Computation of primary insurance amount.
(a) Primary insurance amount.
(b) Average indexed monthly earnings; average
monthly wage.
(c) Application of prior provisions in certain
cases.
(d) Primary insurance amount under 1939 Act.
(e) Certain wages and self-employment income not
to be counted.
(f) Recomputation of benefits.
(g) Rounding of benefits.
(h) Service of certain Public Health Service
Officers.
(i) Cost-of-living increases in benefits.
416. Additional definitions.
(a) Spouse; surviving spouse.
(b) Wife.
(c) Widow.
(d) Divorced spouses; divorce.
(e) Child.
(f) Husband.
(g) Widower.
(h) Determination of family status.
(i) Disability; period of disability.
(j) Periods of limitation ending on nonwork
days.
(k) Waiver of nine-month requirement for widow,
stepchild, or widower in case of accidental
death or in case of serviceman dying in
line of duty, or in case of remarriage to
same individual.
(l) Retirement age.
417. Benefits for veterans.
(a) Determination of benefits.
(b) Determination of insurance status.
(c) Filing proof of support.
(d) Definitions.
(e) Determination based on wages and
self-employment.
(f) Right to annuity; waiver.
(g) Appropriation to trust funds.
(h) Determination of veterans status.
418. Voluntary agreements for coverage of State and
local employees.
(a) Purpose of agreement.
(b) Definitions.
(c) Services covered.
(d) Positions covered by retirement systems.
(e) Effective date of agreement; retroactive
coverage.
(f) Duration of agreement.
(g) Instrumentalities of two or more States.
(h) Delegation of functions.
(i) Wisconsin Retirement Fund.
(j) Certain positions no longer covered by
retirement systems.
(k) Certain employees of State of Utah.
(l) Policemen and firemen in certain States.
(m) Positions compensated solely on a fee basis.
(n) Optional medicare coverage of current
employees.
419. Repealed.
420. Disability provisions inapplicable if benefit
rights impaired.
421. Disability determinations.
(a) State agencies.
(b) Determinations by Commissioner.
(c) Review of determination by Commissioner.
(d) Hearings and judicial review.
(e) State's right to cost from Trust Funds.
(f) Use of funds.
(g) Regulations governing determinations in
certain cases.
(h) Evaluation of mental impairments by
qualified medical professionals.
(i) Review of disability cases to determine
continuing eligibility; permanent
disability cases; appropriate number of
cases reviewed; reporting requirements.
(j) Rules and regulations; consultative
examinations.
(k) Establishment of uniform standards for
determination of disability.
(l) Special notice to blind individuals with
respect to hearings and other official
actions.
(m) Work activity as basis for review.
422. Rehabilitation services.
(a),
(b) Repealed.
(c) "Period of trial work" defined.
(d) Cost of rehabilitation services from trust
funds.
(e) Treatment referrals for individuals with
alcoholism or drug addiction condition.
423. Disability insurance benefit payments.
(a) Disability insurance benefits.
(b) Filing application.
(c) Definitions; insured status; waiting period.
(d) "Disability" defined.
(e) Engaging in substantial gainful activity.
(f) Standard of review for termination of
disability benefits.
(g) Continued payment of disability benefits
during appeal.
(h) Interim benefits in cases of delayed final
decisions.
(i) Reinstatement of entitlement.
(j) Limitation on payments to prisoners.
424. Repealed.
424a. Reduction of disability benefits.
(a) Conditions for reduction; computation.
(b) Reduction where benefits payable on other
than monthly basis.
(c) Reductions and deductions under other
provisions.
(d) Exception.
(e) Conditions for payment.
(f) Redetermination of reduction.
(g) Proportionate reduction; application of
excess.
(h) Furnishing of information.
425. Additional rules relating to benefits based on
disability.
(a) Suspension of benefits.
(b) Continued payments during rehabilitation
program.
426. Entitlement to hospital insurance benefits.
(a) Individuals over 65 years.
(b) Individuals under 65 years.
(c) Conditions.
(d) "Qualified railroad retirement beneficiary"
defined.
(e) Benefits for widows and widowers.
(f) Medicare waiting period for recipients of
disability benefits.
(g) Information regarding eligibility of Federal
employees.
(h) Waiver of waiting period for individuals
with ALS.
(i) Continuing eligibility of certain terminated
individuals.
(j) Certain uninsured individuals.
426-1. End stage renal disease program.
(a) Entitlement to benefits.
(b) Duration of period of entitlement.
(c) Individuals participating in self-care
dialysis training programs; kidney
transplant failures; resumption of
previously terminated regular course of
dialysis.
(c) Continuing eligibility of certain terminated
individuals.
426a. Transitional provision on eligibility of uninsured
individuals for hospital insurance benefits.
(a) Entitlement to benefits.
(b) Persons ineligible.
(c) Authorization of appropriations.
427. Transitional insured status for purposes of
old-age and survivors benefits.
(a) Determination of entitlement to benefits
under section 402(a) to (c) of this title.
(b) Determination of entitlement to surviving
spouse's benefits under section 402(e) or
(f) of this title.
(c) Deceased individual entitled to benefits by
reason of subsection (a) deemed to meet
requirements of subsection (b).
428. Benefits at age 72 for certain uninsured
individuals.
(a) Eligibility.
(b) Amount of benefits.
(c) Reduction for government pension system
benefits.
(d) Suspension for months in which cash payments
are made under public assistance or in
which supplemental security income benefits
are payable.
(e) Suspension where individual is residing
outside United States.
(f) Treatment as monthly insurance benefits.
(g) Annual reimbursement of Federal Old-Age and
Survivors Insurance Trust Fund.
(h) Definitions.
429. Benefits in case of members of uniformed services.
430. Adjustment of contribution and benefit base.
(a) Determination and publication by
Commissioner in Federal Register subsequent
to cost-of-living benefit increase;
effective date.
(b) Determination of amount.
(c) Amount of base for period prior to initial
cost-of-living benefit increase.
(d) Determinations for calendar years after 1976
for purposes of retirement benefit plans.
431. Benefits for certain individuals interned by
United States during World War II.
(a) "Internee" defined.
(b) Applicability in determining entitlement to
and amount of monthly benefits and lump-sum
death payments, and period of disability;
effect of payment of benefits by other
agency or instrumentality of United States.
(c) Authorization of appropriations.
432. Processing of tax data.
433. International agreements.
(a) Purpose of agreement.
(b) Definitions.
(c) Crediting periods of coverage; conditions of
payment of benefits.
(d) Regulations.
(e) Reports to Congress; effective date of
agreements.
434. Demonstration project authority.
(a) Authority.
(b) Requirements.
(c) Authority to waive compliance with benefits
requirements.
(d) Reports.

SUBCHAPTER III - GRANTS TO STATES FOR UNEMPLOYMENT COMPENSATION
ADMINISTRATION
501. Use of available funds.
502. Payments to States; computation of amounts.
(a) Certification of amounts.
(b) Payment of amounts.
(c) Mailing costs.
503. State laws.
(a) Provisions required.
(b) Failure to comply; payments stopped.
(c) Denial of certification; availability of
records to Railroad Retirement Board;
cooperation with Federal agencies.
(d) Disclosure of unemployment compensation
information; deduction and withholding of
amounts owed to State food stamp agencies;
reimbursement of administrative costs;
non-compliance of State agency.
(e) Disclosure of wage information;
non-compliance of State agency.
(f) Income and eligibility verification system.
(g) Recovery of unemployment benefit payments.
(h) Disclosure to Secretary of Health and Human
Services of wage and unemployment
compensation claims information; suspension
by Secretary of Labor of payments to State
for noncompliance.
(i) Access to State employment records.
(j) Worker profiling.
(k) Transfer of unemployment experience upon
transfer of business.
504. Judicial review.
(a) Finding by Secretary of Labor; petition for
review; filing of record.
(b) Findings of fact by Secretary of Labor; new
or modified findings.
(c) Affirmance or setting aside of Secretary's
action; review by Supreme Court.
(d) Stay of Secretary's action.

SUBCHAPTER IV - GRANTS TO STATES FOR AID AND SERVICES TO NEEDY
FAMILIES WITH CHILDREN AND FOR CHILD-WELFARE SERVICES

PART A - BLOCK GRANTS TO STATES FOR TEMPORARY ASSISTANCE FOR NEEDY
FAMILIES
601. Purpose.
(a) In general.
(b) No individual entitlement.
602. Eligible States; State plan.
(a) In general.
(b) Plan amendments.
(c) Public availability of State plan summary.
603. Grants to States.
(a) Grants.
(b) Contingency Fund.
603a. Transferred.
604. Use of grants.
(a) General rules.
(b) Limitation on use of grant for
administrative purposes.
(c) Authority to treat interstate immigrants
under rules of former State.
(d) Authority to use portion of grant for other
purposes.
(e) Authority to reserve certain amounts for
assistance.
(f) Authority to operate employment placement
program.
(g) Implementation of electronic benefit
transfer system.
(h) Use of funds for individual development
accounts.
(i) Sanction welfare recipients for failing to
ensure that minor dependent children attend
school.
(j) Requirement for high school diploma or
equivalent.
(k) Limitations on use of grant for matching
under certain Federal transportation
program.
604a. Services provided by charitable, religious, or
private organizations.
(a) In general.
(b) Religious organizations.
(c) Nondiscrimination against religious
organizations.
(d) Religious character and freedom.
(e) Rights of beneficiaries of assistance.
(f) Employment practices.
(g) Nondiscrimination against beneficiaries.
(h) Fiscal accountability.
(i) Compliance.
(j) Limitations on use of funds for certain
purposes.
(k) Preemption.
605. Administrative provisions.
(a) Quarterly.
(b) Notification.
(c) Computation and certification of payments to
States.
(d) Payment method.
606. Federal loans for State welfare programs.
(a) Loan authority.
(b) Rate of interest.
(c) Use of loan.
(d) Limitation on total amount of loans to
State.
(e) Limitation on total amount of outstanding
loans.
(f) Appropriation.
607. Mandatory work requirements.
(a) Participation rate requirements.
(b) Calculation of participation rates.
(c) Engaged in work.
(d) "Work activities" defined.
(e) Penalties against individuals.
(f) Nondisplacement in work activities.
(g) Sense of Congress.
(h) Sense of Congress that States should impose
certain requirements on noncustodial,
nonsupporting minor parents.
(i) Review of implementation of State work
programs.
608. Prohibitions; requirements.
(a) In general.
(b) Individual responsibility plans.
(c) Sanctions against recipients not considered
wage reductions.
(d) Nondiscrimination provisions.
(e) Special rules relating to treatment of
certain aliens.
(f) Special rules relating to treatment of
non-213A aliens.
(g) State required to provide certain
information.
608a. Fraud under means-tested welfare and public
assistance programs.
(a) In general.
(b) Welfare or public assistance programs for
which Federal funds are appropriated.
609. Penalties.
(a) In general.
(b) Reasonable cause exception.
(c) Corrective compliance plan.
(d) Limitation on amount of penalties.
610. Appeal of adverse decision.
(a) In general.
(b) Administrative review.
(c) Judicial review of adverse decision.
611. Data collection and reporting.
(a) Quarterly reports by States.
(b) Annual reports to Congress by Secretary.
611a. State required to provide certain information.
612. Direct funding and administration by Indian
tribes.
(a) Grants for Indian tribes.
(b) 3-year tribal family assistance plan.
(c) Minimum work participation requirements and
time limits.
(d) Emergency assistance.
(e) Accountability.
(f) Eligibility for Federal loans.
(g) Penalties.
(h) Data collection and reporting.
(i) Special rule for Indian tribes in Alaska.
613. Research, evaluations, and national studies.
(a) Research.
(b) Development and evaluation of innovative
approaches to reducing welfare dependency
and increasing child well-being.
(c) Dissemination of information.
(d) Annual ranking of States and review of most
and least successful work programs.
(e) Annual ranking of States and review of
issues relating to out-of-wedlock births.
(f) State-initiated evaluations.
(g) Report on circumstances of certain children
and families.
(h) Funding of studies and demonstrations.
(i) Child poverty rates.
(j) Evaluation of welfare-to-work programs.
614. Study by Census Bureau.
(a) In general.
(b) Appropriation.
615. Waivers.
(a) Continuation of waivers.
(b) State option to terminate waiver.
(c) Secretarial encouragement of current
waivers.
(d) Continuation of individual waivers.
616. Administration.
617. Limitation on Federal authority.
618. Funding for child care.
(a) General child care entitlement.
(b) Use of funds.
(c) Application of Child Care and Development
Block Grant Act of 1990.
(d) "State" defined.
619. Definitions.

PART B - CHILD AND FAMILY SERVICES

SUBPART 1 - CHILD WELFARE SERVICES
620. Authorization of appropriations.
621. Allotments to States.
(a) Allotment formula.
(b) Allotment percentage.
(c) Promulgation of allotment percentage.
(d) "United States" defined.
622. State plans for child welfare services.
(a) Joint development.
(b) Requisite features of State plans.
623. Payment to States.
(a) Payment schedule.
(b) Computation and method of payment.
(c) Prohibited payments; exceptions.
(d) Minimum State expenditures.
624. Reallotment.
(a) In general.
(b) Exception relating to foster child
protections.
625. Definitions.
626. Research, training, or demonstration projects.
(a) Authorization of appropriations.
(b) Appropriations for demonstration projects
for development of alternate care
arrangements for infants not requiring
hospitalization.
(c) Payments; advances or reimbursements;
installments; conditions.
627. Repealed.
628. Payments to Indian tribal organizations.
(a) Amounts.
(b) Inclusion in State allotment.
(c) "Indian tribe" and "tribal organization"
defined.
628a. Child welfare traineeships.
628b. National random sample study of child welfare.
(a) In general.
(b) Requirements.
(c) Preferred contents.
(d) Reports.
(e) Appropriation.

SUBPART 2 - PROMOTING SAFE AND STABLE FAMILIES
629. Findings and purpose.
(a) Findings.
(b) Purpose.
629a. Definitions.
(a) In general.
(b) Other terms.
629b. State plans.
(a) Plan requirements.
(b) Approval of plans.
629c. Allotments to States.
(a) Indian tribes.
(b) Territories.
(c) Other States.
(d) Reallotments.
629d. Payments to States.
(a) Entitlement.
(b) Prohibitions.
(c) Direct payments to tribal organizations of
Indian tribes.
629e. Evaluations; research; technical assistance.
(a) Evaluations.
(b) Coordination of evaluations.
(c) Research.
(d) Technical assistance.
629f. Authorization of appropriations; reservation of
certain amounts.
(a) Authorization.
(b) Reservation of certain amounts.
629g. Discretionary grants.
(a) Limitations on authorization of
appropriations.
(b) Reservation of certain amounts.
(c) Allotments.
(d) Grants.
(e) Applicability of certain rules.
629h. Entitlement funding for State courts to assess and
improve handling of proceedings relating to
foster care and adoption.
(a) In general.
(b) Applications.
(c) Allotments.
(d) Federal share.
629i. Grants for programs for mentoring children of
prisoners.
(a) Findings and purpose.
(b) Definitions.
(c) Program authorized.
(d) Application requirements.
(e) Federal share.
(f) Considerations in awarding grants.
(g) Evaluation.
(h) Authorization of appropriations; reservation
of certain amounts.

PART C - WORK INCENTIVE PROGRAM FOR RECIPIENTS OF AID UNDER STATE
PLAN APPROVED UNDER PART A
630 to 645. Repealed or Omitted.

PART D - CHILD SUPPORT AND ESTABLISHMENT OF PATERNITY
651. Authorization of appropriations.
652. Duties of Secretary.
(a) Establishment of separate organizational
unit; duties.
(b) Certification of child support obligations
to Secretary of the Treasury for
collection.
(c) Payment of child support collections to
States.
(d) Child support management information system.
(e) Technical assistance to States.
(f) Regulations.
(g) Performance standards for State paternity
establishment programs.
(h) Prompt State response to requests for child
support assistance.
(i) Prompt State distribution of amounts
collected as child support.
(j) Training of Federal and State staff,
research and demonstration programs, and
special projects of regional or national
significance.
(k) Denial of passports for nonpayment of child
support.
(l) Facilitation of agreements between State
agencies and financial institutions.
653. Federal Parent Locator Service.
(a) Establishment; purpose.
(b) Disclosure of information to authorized
persons.
(c) "Authorized person" defined.
(d) Form and manner of request for information.
(e) Compliance with request; search of files and
records by head of any department, etc., of
United States; transmittal of information
to Secretary; reimbursement for cost of
search; fees.
(f) Arrangements and cooperation with State
agencies.
(g) Reimbursement for reports by State agencies.
(h) Federal Case Registry of Child Support
Orders.
(i) National Directory of New Hires.
(j) Information comparisons and other
disclosures.
(k) Fees.
(l) Restriction on disclosure and use.
(m) Information integrity and security.
(n) Federal Government reporting.
(o) Use of set-aside funds.
(p) "Support order" defined.
653a. State Directory of New Hires.
(a) Establishment.
(b) Employer information.
(c) Reporting format and method.
(d) Civil money penalties on noncomplying
employers.
(e) Entry of employer information.
(f) Information comparisons.
(g) Transmission of information.
(h) Other uses of new hire information.
654. State plan for child and spousal support.
654a. Automated data processing.
(a) In general.
(b) Program management.
(c) Calculation of performance indicators.
(d) Information integrity and security.
(e) State case registry.
(f) Information comparisons and other
disclosures of information.
(g) Collection and distribution of support
payments.
(h) Expedited administrative procedures.
654b. Collection and disbursement of support payments.
(a) State disbursement unit.
(b) Required procedures.
(c) Timing of disbursements.
(d) "Business day" defined.
655. Payments to States.
(a) Amounts payable each quarter.
(b) Estimate of amounts payable; installment
payments.
(c) Repealed.
(d) State reports.
(e) Special project grants for interstate
enforcement; appropriations.
(f) Direct Federal funding to Indian tribes and
tribal organizations.
655a. Provision for reimbursement of expenses.
656. Support obligation as obligation to State; amount;
discharge in bankruptcy.
(a) Collection processes.
(b) Nondischargeability.
657. Distribution of collected support.
(a) In general.
(b) Continuation of assignments.
(c) Definitions.
(d) Gap payments not subject to distribution
under this section.
(e) Amounts collected for child for whom foster
care maintenance payments are made.
658. Repealed.
658a. Incentive payments to States.
(a) In general.
(b) Amount of incentive payment.
(c) Treatment of interstate collections.
(d) Administrative provisions.
(e) Regulations.
(f) Reinvestment.
659. Consent by United States to income withholding,
garnishment, and similar proceedings for
enforcement of child support and alimony
obligations.
(a) Consent to support enforcement.
(b) Consent to requirements applicable to
private person.
(c) Designation of agent; response to notice or
process.
(d) Priority of claims.
(e) No requirement to vary pay cycles.
(f) Relief from liability.
(g) Regulations.
(h) Moneys subject to process.
(i) Definitions.
659a. International support enforcement.
(a) Authority for declarations.
(b) Standards for foreign support enforcement
procedures.
(c) Designation of United States Central
Authority.
(d) Effect on other laws.
660. Civil action to enforce child support obligations;
jurisdiction of district courts.
661, 662. Repealed.
663. Use of Federal Parent Locator Service in
connection with enforcement or determination of
child custody in cases of parental kidnaping of
child.
(a) Agreements with States for use of Federal
Parent Locator Service.
(b) Requests from authorized persons for
information.
(c) Information which may be disclosed.
(d) "Custody or visitation determination" and
"authorized person" defined.
(e) Agreement on use of Federal Parent Locator
Service with United States Central
Authority under Convention on the Civil
Aspects of International Child Abduction.
(f) Agreement to assist in locating missing
children under Federal Parent Locator
Service.
664. Collection of past-due support from Federal tax
refunds.
(a) Procedures applicable; distribution.
(b) Regulations; contents, etc.
(c) "Past-due support" defined.
665. Allotments from pay for child and spousal support
owed by members of uniformed services on active
duty.
(a) Mandatory allotment; notice upon failure to
make; amount of allotment; adjustment or
discontinuance; consultation.
(b) "Authorized person" defined.
(c) Regulations.
666. Requirement of statutorily prescribed procedures
to improve effectiveness of child support
enforcement.
(a) Types of procedures required.
(b) Withholding from income of amounts payable
as support.
(c) Expedited procedures.
(d) Exemption of States.
(e) "Overdue support" defined.
(f) Uniform Interstate Family Support Act.
(g) Laws voiding fraudulent transfers.
667. State guidelines for child support awards.
(a) Establishment of guidelines; method.
(b) Availability of guidelines; rebuttable
presumption.
(c) Technical assistance to States; State to
furnish Secretary with copies.
668. Encouragement of States to adopt civil procedure
for establishing paternity in contested cases.
669. Collection and reporting of child support
enforcement data.
(a) In general.
(b) Types of services.
(c) Types of service recipients.
(d) Rule of interpretation.
669a. Nonliability for financial institutions providing
financial records to State child support
enforcement agencies in child support cases.
(a) In general.
(b) Prohibition of disclosure of financial
record obtained by State child support
enforcement agency.
(c) Civil damages for unauthorized disclosure.
(d) Definitions.
669b. Grants to States for access and visitation
programs.
(a) In general.
(b) Amount of grant.
(c) Allotments to States.
(d) No supplantation of State expenditures for
similar activities.
(e) State administration.

PART E - FEDERAL PAYMENTS FOR FOSTER CARE AND ADOPTION ASSISTANCE
670. Congressional declaration of purpose;
authorization of appropriations.
671. State plan for foster care and adoption
assistance.
(a) Requisite features of State plan.
(b) Approval of plan by Secretary.
672. Foster care maintenance payments program.
(a) Qualifying children.
(b) Additional qualifications.
(c) "Foster family home" and "child-care
institution" defined.
(d) Children removed from their homes pursuant
to voluntary placement agreements.
(e) Placements in best interest of child.
(f) "Voluntary placement" and "voluntary
placement agreement" defined.
(g) Revocation of voluntary placement agreement.
(h) Aid for dependent children; assistance for
minor children in needy families.
673. Adoption assistance program.
(a) Agreements with adoptive parents of children
with special needs; State payments;
qualifying children; amount of payments;
changes in circumstances; placement period
prior to adoption; nonrecurring adoption
expenses.
(b) Aid for dependent children; assistance for
minor children in needy families.
(c) Children with special needs.
673a. Interstate compacts.
673b. Adoption incentive payments.
(a) Grant authority.
(b) Incentive-eligible State.
(c) Data requirements.
(d) Adoption incentive payment.
(e) 2-year availability of incentive payments.
(f) Limitations on use of incentive payments.
(g) Definitions.
(h) Limitations on authorization of
appropriations.
(i) Technical assistance.
674. Payments to States.
(a) Amounts.
(b) Quarterly estimates of State's entitlement
for next quarter; payments; United States'
pro rata share of amounts recovered as
overpayment; allowance, disallowance, or
deferral of claim.
(c) Automated data collection expenditures.
(d) Reduction for violation of plan requirement.
(e) Discretionary grants for educational and
training vouchers for youths aging out of
foster care.
(f) Reduction for failure to submit required
data.
675. Definitions.
676. Administration.
(a) Technical assistance to States.
(b) Data collection and evaluation.
677. John H. Chafee Foster Care Independence Program.
(a) Purpose.
(b) Applications.
(c) Allotments to States.
(d) Use of funds.
(e) Penalties.
(f) Data collection and performance measurement.
(g) Evaluations.
(h) Limitations on authorization of
appropriations.
(i) Educational and training vouchers.
678. Rule of construction.
679. Collection of data relating to adoption and foster
care.
(a) Advisory Committee on Adoption and Foster
Care Information.
(b) Report to Congress; regulations.
(c) Data collection system.
679a. National Adoption Information Clearinghouse.
679b. Annual report.

PART F - JOB OPPORTUNITIES AND BASIC SKILLS TRAINING PROGRAM
681 to 687. Repealed.

SUBCHAPTER V - MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT
701. Authorization of appropriations; purposes;
definitions.
702. Allotment to States and Federal set-aside.
(a) Special projects.
(b) Excess funds; preference.
(c) Allotments to States.
(d) Re-allotment of unallotted funds.
703. Payments to States.
(a) Statutory provisions applicable.
(b) Unobligated allotments.
(c) Reduction of payments; fair market value of
supplies or equipment, value of salaries,
travel expenses, etc.
703a. Omitted.
704. Use of allotment funds.
(a) Covered services.
(b) Restrictions.
(c) Use of portion of funds.
(d) Limitation on use of funds for
administrative costs.
704a. Omitted.
704b. Nonavailability of allotments after close of
fiscal year.
705. Application for block grant funds.
706. Administrative and fiscal accountability.
(a) Annual reporting requirements; form, etc.
(b) Audits; implementation, standards, etc.
(c) Public inspection of reports and audits.
(d) Access to books, records, etc.; creation of
new records.
707. Criminal penalty for false statements.
708. Nondiscrimination provisions.
(a) Federally funded activities.
(b) Compliance.
(c) Authority of Attorney General; civil
actions.
709. Administration of Federal and State programs.
710. Separate program for abstinence education.
(a) In general.
(b) Purpose of allotment.
(c) Applicability of sections 703, 707, and 708.
(d) Appropriations.
711 to 731. Omitted or Repealed.

SUBCHAPTER VI - TEMPORARY STATE FISCAL RELIEF
801. Repealed.

SUBCHAPTER VII - ADMINISTRATION
901. Social Security Administration.
901a. Repealed.
902. Commissioner; Deputy Commissioner; other officers.
(a) Commissioner of Social Security.
(b) Deputy Commissioner of Social Security.
(c) Chief Actuary.
(d) Chief Financial Officer.
(e) Inspector General.
903. Social Security Advisory Board.
(a) Establishment of Board.
(b) Functions of Board.
(c) Structure and membership of Board.
(d) Terms of appointment.
(e) Chairman.
(f) Compensation, expenses, and per diem.
(g) Meetings.
(h) Federal Advisory Committee Act.
(i) Personnel.
(j) Authorization of appropriations.
904. Administrative duties of Commissioner.
(a) Personnel.
(b) Budgetary matters.
(c) Employment restriction.
(d) Seal of office.
(e) Data exchanges.
905, 905a. Transferred.
906. Training grants for public welfare personnel.
(a) Authorization of appropriations.
(b) Allocation for carrying out direct grant
programs.
(c) Payments to States for cost of grant
programs to certain agencies and
institutions.
(d) Advance payments to States.
(e) Reallotments.
(f) Direct grants to certain agencies and
institutions.
907. Repealed.
907a. National Commission on Social Security.
(a) Establishment; membership; Chairman and Vice
Chairman; quorum; terms of office;
vacancies; per diem and expense
reimbursement; meetings.
(b) Continuing study, investigation, and review
of social security program; scope of study,
etc., and public participation.
(c) Special, annual, and final reports to
President and Congress concerning
implementation, etc., of study,
investigation, and review responsibilities;
termination of Commission.
(d) Executive Director and additional personnel;
appointment and compensation.
(e) Administrative procedures.
(f) Data and information from other Federal
departments and agencies.
(g) Administrative support services from General
Services Administration; reimbursement.
(h) Authorization of appropriations.
908. Omitted.
909. Delivery of benefit checks.
(a) Saturdays, Sundays, and holidays.
(b) Recovery of overpayments.
(c) Early delivery.
910. Recommendations by Board of Trustees to remedy
inadequate balances in Social Security trust
funds.
(a) Terms and conditions of recommendations.
(b) "Balance ratio" defined.
911. Budgetary treatment of trust fund operations.
912. Office of Rural Health Policy.
913. Duties and authority of Secretary.

SUBCHAPTER VIII - SPECIAL BENEFITS FOR CERTAIN WORLD WAR II
VETERANS
1001. Basic entitlement to benefits.
1002. Qualified individuals.
1003. Residence outside the United States.
1004. Disqualifications.
(a) In general.
(b) Requirement for Attorney General.
1005. Benefit amount.
1006. Applications and furnishing of information.
(a) In general.
(b) Verification requirement.
1007. Representative payees.
(a) In general.
(b) Examination of fitness of prospective
representative payee.
(c) Requirement for maintaining lists of
undesirable payees.
(d) Persons ineligible to serve as
representative payees.
(e) Deferral of payment pending appointment of
representative payee.
(f) Hearing.
(g) Notice requirements.
(h) Accountability monitoring.
(i) Restitution.
(j) Misuse of benefits.
(k) Periodic onsite review.
(l) Liability for misused amounts.
1008. Overpayments and underpayments.
(a) In general.
(b) Waiver of recovery of overpayment.
(c) Limited immunity for disbursing officers.
(d) Authorized collection practices.
(e) Cross-program recovery of overpayments.
1009. Hearings and review.
(a) Hearings.
(b) Judicial review.
1010. Other administrative provisions.
(a) Regulations and administrative arrangements.
(b) Payment of benefits.
(c) Entitlement redeterminations.
(d) Suspension and termination of benefits.
1010a. Optional Federal administration of State
recognition payments.
(a) In general.
(b) Agreement terms.
(c) Special disposition of administration fees.
1011. Penalties for fraud.
(a) In general.
(b) Court order for restitution.
1012. Definitions.
1013. Appropriations.

SUBCHAPTER IX - EMPLOYMENT SECURITY ADMINISTRATIVE FINANCING
1101. Employment Security Administration Account.
(a) Establishment.
(b) Amount credited to Account; transfer of
funds; adjustments; repayment of internal
revenue refunds.
(c) Administrative expenditures; necessary
expenses; quarterly transfer of funds;
adjustments; limitation; estimate of net
receipts.
(d) Additional tax attributable to reduced
credits; transfer of funds.
(e) Revolving fund; appropriations; advances to
Account; repayment; interest.
(f) Determination of excess in Account;
limitation on amount to be retained; use of
balance in Account during certain fiscal
years; net balance.
1102. Transfers between Federal Unemployment Account and
Employment Security Administration Account.
(a) Determination of excess; amount transferred.
(b) Unemployment account excesses.
(c) Report to Congress.
1103. Amounts transferred to State accounts.
(a) Determination and certification by Secretary
of Labor.
(b) Transfer of funds where State is ineligible.
(c) Use of funds.
(d) Special transfer in fiscal year 2002.
(e) Special transfer in fiscal year 2006.
1104. Unemployment Trust Fund.
(a) Establishment.
(b) Investments.
(c) Sale or redemption of obligations.
(d) Treatment of interest and proceeds.
(e) Separate book accounts.
(f) Payment to State agencies and Railroad
Retirement Board.
(g) Federal unemployment account; establishment.
1105. Extended Unemployment Compensation Account.
(a) Establishment.
(b) Transfers to account.
(c) Transfers to State accounts.
(d) Advances to account; repayment.
1106. Unemployment compensation research program.
1107. Personnel training.
(a) Creation of program.
(b) Repayment of costs.
(c) Detail of Federal and State employees.
(d) Authorization of appropriations.
1108. Advisory Council on Unemployment Compensation.
(a) Establishment.
(b) Function.
(c) Members.
(d) Staff and other assistance.
(e) Compensation.
(f) Report.
1109. Federal Employees Compensation Account.
1110. Borrowing between Federal accounts.
(a) In general.
(b) Treatment of advance.
(c) Repayment.

SUBCHAPTER X - GRANTS TO STATES FOR AID TO BLIND
1201. Authorization of appropriations.
1202. State plans for aid to blind.
1202a. Repealed.
1203. Payment to States.
(a) Authorization of payments.
(b) Computation of amounts.
1204. Operation of State plans.
1205. Omitted.
1206. "Aid to the blind" defined.

SUBCHAPTER XI - GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE
SIMPLIFICATION

PART A - GENERAL PROVISIONS
1301. Definitions.
1301-1,
1301a. Omitted.
1302. Rules and regulations; impact analyses of Medicare
and Medicaid rules and regulations on small rural
hospitals.
1303. Separability.
1304. Reservation of right to amend or repeal.
1305. Short title of chapter.
1306. Disclosure of information in possession of Social
Security Administration or Department of Health
and Human Services.
(a) Disclosure prohibited; exceptions.
(b) Requests for information and services.
(c) Cost reimbursement.
(d) Compliance with requests.
(e) Public inspection.
(f) Opportunity for review.
1306a. Public access to State disbursement records.
1306b. State data exchanges.
1307. Penalty for fraud.
1308. Additional grants to Puerto Rico, Virgin Islands,
Guam, and American Samoa; limitation on total
payments.
(a) Limitation on total payments to each
territory.
(b) Entitlement to matching grant.
(c) Definitions.
(d) Authority to transfer funds to certain
programs.
(e) Repealed.
(f) Total amount certified under subchapter XIX.
(g) Medicaid payments to territories for fiscal
year 1998 and thereafter.
1309. Amounts disregarded not to be taken into account
in determining eligibility of other individuals.
1310. Cooperative research or demonstration projects.
(a) In general.
(b) Limitations and costs.
(c) Survey of use of payments.
1311. Public assistance payments to legal
representatives.
1312. Medical care guides and reports for public
assistance and medical assistance.
1313. Assistance for United States citizens returned
from foreign countries.
(a) Authorization; reimbursement; utilization of
facilities of public or private agencies
and organizations.
(b) Plans and arrangements for assistance;
consultations.
(c) "Temporary assistance" defined.
(d) Maximum total amount of temporary
assistance.
(e) Authority of Secretary to accept gifts.
1314. Public advisory groups.
(a) Advisory Council on Public Welfare;
appointment and functions of initial
Council.
(b) Membership and representation of interests
on initial Council.
(c) Technical and other assistance for initial
Council; availability of data.
(d) Termination of initial Council's existence
on submission of report.
(e) Succeeding Councils; appointment; functions;
membership; representation of interests;
assistance and data; termination.
(f) Advisory committees; functions; reports by
Secretary.
(g) Compensation and travel expenses.
(h) Exemption from conflict of interest laws of
members of Council or advisory committees;
exceptions.
1314a. Measurement and reporting of welfare receipt.
(a) Congressional policy.
(b) Development of welfare indicators and
predictors.
(c) Advisory Board on Welfare Indicators.
(d) Annual welfare indicators report.
(e) Short title.
1315. Demonstration projects.
(a) Waiver of State plan requirements; costs
regarded as State plan expenditures;
availability of appropriations.
(b) Child support enforcement programs.
(c) Demonstration projects to test alternative
definitions of unemployment.
(e) Extensions of State-wide comprehensive
demonstration projects for which waivers
granted.
(f) Application for extension of waiver project;
submission; approval.
1316. Administrative and judicial review of public
assistance determinations.
(a) Determination of conformity with
requirements for approval; petition for
reconsideration; hearing; time limitations;
review by court of appeals.
(b) Amendment of plans.
(c) Restitution when Secretary reverses his
determination.
(d) Items covered under other subchapters;
disallowance.
1317. Appointment of the Administrator and Chief Actuary
of the Centers for Medicare&Medicaid Services.
1318. Alternative Federal payment with respect to public
assistance expenditures.
1319. Federal participation in payments for repairs to
home owned by recipient of aid or assistance.
1320. Approval of certain projects.
1320a. Uniform reporting systems for health services
facilities and organizations.
(a) Establishment; criteria for regulations;
requirements for hospitals.
(b) Monitoring, etc., of systems by Secretary.
(c) Availability of information to appropriate
agencies and organizations.
1320a-1. Limitation on use of Federal funds for capital
expenditures.
(a) Use of reimbursement for planning activities
for health services and facilities.
(b) Agreement between Secretary and State for
submission of proposed capital expenditures
related to health care facilities and
procedures for appeal from recommendations.
(c) Manner of payment to States for carrying out
agreement.
(d) Determination of amount of exclusions from
Federal payments.
(e) Treatment of lease or comparable arrangement
of any facility or equipment for a facility
in determining amount of exclusions from
Federal payments.
(f) Reconsideration by Secretary of
determinations.
(g) "Capital expenditure" defined.
(h) Applicability to Christian Science
sanatoriums.
(i) National advisory council; establishment or
designation of existing council; functions;
consultations with other appropriate
national advisory councils; composition;
compensation and travel expenses.
(j) Capital expenditure review exception for
eligible organization health care
facilities.
1320a-1a. Transferred.
1320a-2. Effect of failure to carry out State plan.
1320a-2a. Reviews of child and family services programs, and
of foster care and adoption assistance programs,
for conformity with State plan requirements.
(a) In general.
(b) Elements of review system.
(c) Provisions for administrative and judicial
review.
1320a-3. Disclosure of ownership and related information;
procedure; definitions; scope of requirements.
1320a-3a. Disclosure requirements for other providers under
part B of Medicare.
(a) Disclosure required to receive payment.
(b) Updates to information supplied.
(c) Verification.
(d) Definitions.
1320a-4. Issuance of subpenas by Comptroller General.
(a) Authorization; scope; service and proof of
service.
(b) Contumacy or refusal to obey subpena;
contempt proceedings.
(c) Nondisclosure of personal medical records by
Government Accountability Office.
1320a-5. Disclosure by institutions, organizations, and
agencies of owners, officers, etc., convicted of
offenses related to programs; notification
requirements; "managing employee" defined.
1320a-6. Adjustments in SSI benefits on account of
retroactive benefits under subchapter II.
(a) Reduction in benefits.
(b) "Supplemental security income benefits"
defined.
(c) Reimbursement of the State.
1320a-7. Exclusion of certain individuals and entities from
participation in Medicare and State health care
programs.
(a) Mandatory exclusion.
(b) Permissive exclusion.
(c) Notice, effective date, and period of
exclusion.
(d) Notice to State agencies and exclusion under
State health care programs.
(e) Notice to State licensing agencies.
(f) Notice, hearing, and judicial review.
(g) Application for termination of exclusion.
(h) "State health care program" defined.
(i) "Convicted" defined.
(j) Definition of immediate family member and
member of household.
1320a-7a. Civil monetary penalties.
(a) Improperly filed claims.
(b) Payments to induce reduction or limitation
of services.
(c) Initiation of proceeding; authorization by
Attorney General, notice, etc., estoppel,
failure to comply with order or procedure.
(d) Amount or scope of penalty, assessment, or
exclusion.
(e) Review by courts of appeals.
(f) Compromise of penalties and assessments;
recovery; use of funds recovered.
(g) Finality of determination respecting
penalty, assessment or exclusion.
(h) Notification of appropriate entities of
finality of determination.
(i) Definitions.
(j) Subpoenas.
(k) Injunctions.
(l) Liability of principal for acts of agent.
(m) Claims within jurisdiction of other
departments or agencies.
(n) Safe harbor for payment of medigap premiums.
1320a-7b. Criminal penalties for acts involving Federal
health care programs.
(a) Making or causing to be made false
statements or representations.
(b) Illegal remunerations.
(c) False statements or representations with
respect to condition or operation of
institutions.
(d) Illegal patient admittance and retention
practices.
(e) Violation of assignment terms.
(f) "Federal health care program" defined.
1320a-7c. Fraud and abuse control program.
(a) Establishment of program.
(b) Additional use of funds by Inspector
General.
(c) "Health plan" defined.
1320a-7d. Guidance regarding application of health care
fraud and abuse sanctions.
(a) Solicitation and publication of
modifications to existing safe harbors and
new safe harbors.
(b) Advisory opinions.
(c) Special fraud alerts.
1320a-7e. Health care fraud and abuse data collection
program.
(a) General purpose.
(b) Reporting of information.
(c) Disclosure and correction of information.
(d) Access to reported information.
(e) Protection from liability for reporting.
(f) Coordination with National Practitioner Data
Bank.
(g) Definitions and special rules.
1320a-7f. Coordination of medicare and medicaid surety bond
provisions.
1320a-8. Civil monetary penalties and assessments for
subchapters II, VIII and XVI.
(a) False statements or representations of
material fact; proceedings to exclude;
wrongful conversions by representative
payees.
(b) Initiation of proceedings; hearing;
sanctions.
(c) Amount or scope of penalties, assessments,
or exclusions.
(d) Judicial review.
(e) Compromise of money penalties and
assessments; recovery; use of funds
recovered.
(f) Finality of determination respecting
penalty, assessment, or exclusion.
(g) Notification of appropriate entities of
finality of determination.
(h) Injunction.
(i) Delegation of authority.
(j) "State agency" defined.
(k) Liability of principal for acts of agents.
(l) Protection of ongoing criminal
investigations.
1320a-8a. Administrative procedure for imposing penalties
for false or misleading statements.
(a) In general.
(b) Penalty.
(c) Duration of penalty.
(d) Effect on other assistance.
(e) Definition.
(f) Consultations.
1320a-8b. Attempts to interfere with administration of this
chapter.
1320a-9. Demonstration projects.
(a) Authority to approve demonstration projects.
(b) Waiver authority.
(c) Treatment as program expenditures.
(d) Duration of demonstration.
(e) Application.
(f) Evaluations; report.
(g) Cost neutrality.
1320a-10. Effect of failure to carry out State plan.
1320b. Repealed.
1320b-1. Notification of Social Security claimant with
respect to deferred vested benefits.
1320b-2. Period within which certain claims must be filed.
(a) Claims.
(b) Waiver.
1320b-3. Applicants or recipients under public assistance
programs not to be required to make election
respecting certain veterans' benefits.
(a) Supplemental Security Income program.
(b) Period of effectiveness.
1320b-4. Nonprofit hospital or critical access hospital
philanthropy.
1320b-5. Authority to waive requirements during national
emergencies.
(a) Purpose.
(b) Secretarial authority.
(c) Authority for retroactive waiver.
(d) Certification to Congress.
(e) Duration of waiver.
(f) Report to Congress.
(g) Definitions.
1320b-6. Exclusion of representatives and health care
providers convicted of violations from
participation in social security programs.
(a) In general.
(b) Notice, effective date, and period of
exclusion.
(c) Notice to State agencies.
(d) Notice to State licensing agencies.
(e) Notice, hearing, and judicial review.
(f) Application for termination of exclusion.
(g) Availability of records of excluded
representatives and health care providers.
(h) Reporting requirement.
(i) Delegation of authority.
(j) Definitions.
1320b-7. Income and eligibility verification system.
(a) Requirements of State eligibility systems.
(b) Applicable programs.
(c) Protection of applicants from improper use
of information.
(d) Citizenship or immigration status
requirements; documentation; verification
by Immigration and Naturalization Service;
denial of benefits; hearing.
(e) Erroneous State citizenship or immigration
status determinations; penalties not
required.
(f) Medical assistance to aliens for treatment
of emergency conditions.
1320b-8. Hospital protocols for organ procurement and
standards for organ procurement agencies.
1320b-9. National Commission on Children.
(a) Establishment.
(b) Membership.
(c) Duties and functions of Commission; public
hearings in different geographical areas;
broad spectrum of witnesses and testimony.
(d) Interim and final report to President and
Congress; recommendations.
(e) Time of appointment of members; vacancies;
election of Chairman; quorum; calling of
meetings; number of meetings; voting;
compensation and expenses.
(f) Executive Director and additional personnel;
appointment and compensation; consultants.
(g) Time and place of hearings and nature of
testimony authorized.
(h) Data and information from other agencies and
departments.
(i) Support services by General Services
Administration.
(j) Authorization of appropriations.
(k) Donations accepted and deposited in Treasury
in separate fund; expenditures; gift or
bequest to or for use of United States.
(l) Public surveys.
1320b-10. Prohibitions relating to references to Social
Security or Medicare.
(a) Prohibited acts.
(b) Civil penalties.
(c) Application of other law; compromise,
recovery, and deposit into Treasury of
civil money penalties.
(d) Enforcement.
1320b-11. Blood Donor Locator Service.
(a) In general.
(b) Provision of address information.
(c) Manner and form of requests.
(d) Procedures and safeguards.
(e) Arrangements with State agencies and
authorized persons.
(f) Procedures for administrative review.
(g) Unauthorized disclosure of information.
(h) Definitions.
1320b-12. Research on outcomes of health care services and
procedures.
(a) Establishment of program.
(b) Priorities.
(c) Methodologies and criteria for evaluations.
(d) Standards for data bases.
(e) Dissemination of research findings and
guidelines.
(f) Evaluations.
(g) Research with respect to dissemination.
(h) Omitted.
(i) Authorization of appropriations.
1320b-13. Social security account statements.
(a) Provision upon request.
(b) Notice to eligible individuals.
(c) Mandatory provision of statements.
(d) Disclosure to governmental employees of
effect of noncovered employment.
1320b-14. Outreach efforts to increase awareness of the
availability of medicare cost-sharing and
subsidies for low-income individuals under
subchapter XVIII.
(a) Outreach.
(b) Coordination with States.
1320b-15. Protection of social security and medicare trust
funds.
(a) In general.
(b) "Public debt obligation" defined.
(c) "Federal fund" defined.
1320b-16. Public disclosure of certain information on
hospital financial interest and referral
patterns.
1320b-17. Cross-program recovery of overpayments from
benefits.
(a) In general.
(b) Limitation applicable to current benefits.
(c) No effect on eligibility or benefit amount
under subchapter VIII or XVI.
(d) Inapplicability of prohibition against
assessment and legal process.
(e) Programs described.
1320b-18. Repealed.
1320b-19. The Ticket to Work and Self-Sufficiency Program.
(a) In general.
(b) Ticket system.
(c) State participation.
(d) Responsibilities of the Commissioner.
(e) Program managers.
(f) Employment networks.
(g) Individual work plans.
(h) Employment network payment systems.
(i) Suspension of disability reviews.
(j) Authorizations.
(k) Definitions.
(l) Regulations.
1320b-20. Work incentives outreach program.
(a) Establishment.
(b) Conditions.
(c) Definitions.
(d) Authorization of appropriations.
1320b-21. State grants for work incentives assistance to
disabled beneficiaries.
(a) In general.
(b) Services provided.
(c) Application.
(d) Amount of payments.
(e) Annual report.
(f) Funding.
(g) Definitions.
(h) Authorization of appropriations.
1320b-22. Grants to develop and establish State
infrastructures to support working individuals
with disabilities.
(a) Establishment.
(b) Grants for infrastructure and outreach.
(c) Availability of funds.
(d) Annual report.
(e) Appropriation.
(f) Recommendation.
1320b-23. Repealed.

PART B - PEER REVIEW OF UTILIZATION AND QUALITY OF HEALTH CARE
SERVICES
1320c. Purpose.
1320c-1. "Utilization and quality control peer review
organization" defined.
1320c-2. Contracts with utilization and quality control
peer review organizations.
(a) Establishment and consolidation of
geographic areas.
(b) Organizations entitled to contract with
Secretary.
(c) Terms of contract.
(d) Review prior to termination of contract;
modification and termination; reviewing
panel.
(e) Authority of Secretary.
(f) Termination not subject to judicial review.
(g) Timely provision of hospital data to peer
review organizations.
(h) Publication of new policy or procedure and
general criteria and standards for
evaluation; performance comparison report.
(i) Preference in contracting with in-State
organizations.
1320c-3. Functions of peer review organizations.
(a) Review of professional activities;
determination of payment; determination of
review authority; consultation with
professional health care practitioners;
standards of health care; other duties.
(b) Review by physicians; physician's family
defined.
(c) Utilization of services of physicians to
make final determinations of denial
decisions with respect to professional
conduct of other physicians.
(d) Review of ambulatory surgical procedures.
(e) Review of hospital denial notices.
(f) Identification of methods for identifying
cases of substandard care.
1320c-4. Right to hearing and judicial review.
1320c-5. Obligations of health care practitioners and
providers of health care services; sanctions and
penalties; hearings and review.
(a) Assurances regarding services and items
ordered or provided by practitioner or
provider.
(b) Sanctions and penalties; hearings and
review.
(c) Enlistment of support of other organizations
to assure practitioner's or provider's
compliance with obligations.
1320c-6. Limitation on liability.
(a) Providers of information to organizations
having a contract with Secretary.
(b) Employees and fiduciaries of organizations
having contracts with Secretary.
(c) Physicians and providers.
(d) Reimbursement by Secretary for expenses
incurred in defense of legal proceedings.
1320c-7. Application of this part to certain State programs
receiving Federal financial assistance.
(a) State plan provision that functions of peer
review organizations may be performed by
contract with such organization.
(b) Federal share of expenditures.
1320c-8. Authorization for use of certain funds to
administer provisions of this part.
1320c-9. Prohibition against disclosure of information.
(a) Freedom of Information Act inapplicable;
exceptions to nondisclosure.
(b) Disclosure of information permitted.
(c) Penalties.
(d) Subpoena and discovery proceedings regarding
patient records.
(e) Organizations with contracts.
1320c-10. Annual reports.
1320c-11. Exemptions for religious nonmedical health care
institutions.
1320c-12. Medical officers in American Samoa, Northern
Mariana Islands, and Trust Territory of Pacific
Islands to be included in utilization and quality
control peer review program.
1320c-13 to
1320c-22. Repealed or Omitted.

PART C - ADMINISTRATIVE SIMPLIFICATION
1320d. Definitions.
1320d-1. General requirements for adoption of standards.
(a) Applicability.
(b) Reduction of costs.
(c) Role of standard setting organizations.
(d) Implementation specifications.
(e) Protection of trade secrets.
(f) Assistance to Secretary.
(g) Application to modifications of standards.
1320d-2. Standards for information transactions and data
elements.
(a) Standards to enable electronic exchange.
(b) Unique health identifiers.
(c) Code sets.
(d) Security standards for health information.
(e) Electronic signature.
(f) Transfer of information among health plans.
1320d-3. Timetables for adoption of standards.
(a) Initial standards.
(b) Additions and modifications to standards.
1320d-4. Requirements.
(a) Conduct of transactions by plans.
(b) Compliance with standards.
1320d-5. General penalty for failure to comply with
requirements and standards.
(a) General penalty.
(b) Limitations.
1320d-6. Wrongful disclosure of individually identifiable
health information.
(a) Offense.
(b) Penalties.
1320d-7. Effect on State law.
(a) General effect.
(b) Public health.
(c) State regulatory reporting.
1320d-8. Processing payment transactions by financial
institutions.

SUBCHAPTER XII - ADVANCES TO STATE UNEMPLOYMENT FUNDS
1321. Eligibility requirements for transfer of funds;
reimbursement by State; application;
certification; limitation.
1322. Repayment by State; certification; transfer;
interest on loan; credit of interest on loan.
(a) Repayment by State; certification; transfer.
(b) Interest on loan.
(c) Credit of interest on loan.
1323. Repayable advances to Federal Unemployment
Account.
1324. "Governor" defined.

SUBCHAPTER XIII - RECONVERSION UNEMPLOYMENT BENEFITS FOR SEAMEN
1331 to
1336. Repealed.

SUBCHAPTER XIV - GRANTS TO STATES FOR AID TO PERMANENTLY AND
TOTALLY DISABLED
1351. Authorization of appropriations.
1352. State plans for aid to permanently and totally
disabled.
1353. Payments to States.
1354. Operation of State plans.
1355. Definitions.

SUBCHAPTER XV - UNEMPLOYMENT COMPENSATION FOR FEDERAL EMPLOYEES
1361 to
1371. Repealed.

SUBCHAPTER XVI - SUPPLEMENTAL SECURITY INCOME FOR AGED, BLIND, AND
DISABLED
1381. Statement of purpose; authorization of
appropriations.
1381a. Basic entitlement to benefits.

PART A - DETERMINATION OF BENEFITS
1382. Eligibility for benefits.
(a) "Eligible individual" defined.
(b) Amount of benefits.
(c) Period for determination of benefits.
(d) Limitation on amount of gross income earned;
"gross income" defined.
(e) Limitation on eligibility of certain
individuals.
(f) Individuals outside United States;
determination of status.
(g) Individuals deemed to meet resources test.
(h) Individuals deemed to meet income test.
(i) Application and review requirements for
certain individuals.
1382a. Income; earned and unearned income defined;
exclusions from income.
1382b. Resources.
(a) Exclusions from resources.
(b) Disposition of resources; grounds for
exemption from disposition requirements.
(c) Disposal of resources for less than fair
market value.
(d) Funds set aside for burial expenses.
(e) Trusts.
1382c. Definitions.
1382d. Rehabilitation services for blind and disabled
individuals.
(a) Referral by Commissioner of eligible
individuals to appropriate State agency.
(b),
(c) Repealed.
(d) Reimbursement by Commissioner to State
agency of costs of providing services to
referred individuals.
(e) Reimbursement for vocational rehabilitation
services furnished during certain months of
nonpayment of insurance benefits.
1382e. Supplementary assistance by State or subdivision
to needy individuals.
(a) Exclusion of cash payments in determination
of income of individuals for purposes of
eligibility for benefits; agreement by
Commissioner and State for Commissioner to
make supplementary payments on behalf of
State or subdivision.
(b) Agreement between Commissioner and State;
contents.
(c) Residence requirement by State or
subdivision for supplementary payments;
disregarding amounts of certain income by
State or subdivision in determining
eligibility for supplementary payments.
(d) Payment to Commissioner by State of amount
equal to expenditures by Commissioner as
supplementary payments; time and manner of
payment by State; fees for Federal
administration of State supplementary
payments.
(e) State standards; establishment; annual
public review; annual certification;
payments to individuals.
1382f. Cost-of-living adjustments in benefits.
(a) Increase of dollar amounts.
(b) Publication in Federal Register of new
dollar amounts.
(c) Additional increases.
1382g. Payments to State for operation of supplementation
program.
(a) Eligibility; agreement with Commissioner.
(b) Levels of supplementary payments.
(c) Election to apply subsection (a)(4).
(d) Determinations respecting any portion of
period July 1, 1980, through June 30, 1981.
(e) Meeting subsection (a)(4) requirements for
any month after March 1983.
(f) Passthrough relating to optional State
supplementation.
(g) Mandatory pass-through of increased personal
needs allowance.
1382h. Benefits for individuals who perform substantial
gainful activity despite severe medical
impairment.
(a) Eligible individuals.
(b) Blind or disabled individuals receiving
supplemental security income benefits.
(c) Continuing disability or blindness reviews;
limitation.
(d) Information and training programs.
1382i. Medical and social services for certain
handicapped persons.
(a) Authorization of appropriations for pilot
program.
(b) State allotments.
(c) Requisite features of State plans.
(d) Payments to States; computation of payments.
(e) Rules and regulations.
(f) Reports.
1382j. Attribution of sponsor's income and resources to
aliens.
(a) Attribution as unearned income.
(b) Determination of amount and resources.
(c) Support and maintenance.
(d) Information and documentation; agreements
with Secretary of State and Attorney
General.
(e) Joint and several liability of alien and
sponsor for overpayments.
(f) Exemptions.
1382k. Repealed.

PART B - PROCEDURAL AND GENERAL PROVISIONS
1383. Procedure for payment of benefits.
(a) Time, manner, form, and duration of
payments; representative payees;
promulgation of regulations.
(b) Overpayments and underpayments; adjustment,
recovery, or payment of amounts by
Commissioner.
(c) Hearing to determine eligibility or amount
of benefits; subsequent application; time
within which to request hearing; time for
determinations of Commissioner pursuant to
hearing; judicial review.
(d) Procedures applicable; prohibition on
assignment of payments; representation of
claimants; maximum fees; penalties for
violations.
(e) Administrative requirements prescribed by
Commissioner; criteria; reduction of
benefits to individual for noncompliance
with requirements; payment to homeless.
(f) Furnishing of information by Federal
agencies.
(g) Reimbursement to States for interim
assistance payments.
(h) Payment of certain travel expenses.
(i) Unnegotiated checks; notice to Commissioner;
payment to States; notice to States;
investigation of payees.
(j) Application and review requirements for
certain individuals.
(k) Notifications to applicants and recipients.
(l) Special notice to blind individuals with
respect to hearings and other official
actions.
(m) Pre-release procedures for institutionalized
persons.
(n) Concurrent SSI and food stamp applications
by institutionalized individuals.
(o) Notice requirements.
(p) Reinstatement of eligibility on the basis of
blindness or disability.
1383a. Penalties for fraud.
(a) In general.
(b) Restitution.
(c) Prohibition on certification as
representative payee.
1383b. Administration.
(a) Authority of Commissioner.
(b) Examination to determine blindness.
(c) Notification of review.
(d) Regulations regarding completion of plans
for achieving self-support.
1383c. Eligibility for medical assistance of aged, blind,
or disabled individuals under State's medical
assistance plan.
(a) Determination by Commissioner pursuant to
agreement between Commissioner and State;
costs.
(b) Preservation of benefit status for certain
disabled widows and widowers.
(c) Loss of benefits upon entitlement to child's
insurance benefits based on disability.
(d) Retention of medicaid when SSI benefits are
lost upon entitlement to early widow's or
widower's insurance benefits.
1383d. Outreach program for children.
(a) Establishment.
(b) Requirements.
1383e. Treatment referrals for individuals with
alcoholism or drug addiction condition.
1383f. Annual report on program.
(a) In general.
(b) Views of individual members of Social
Security Advisory Board.
1384, 1385. Omitted.

SUBCHAPTER XVII - GRANTS FOR PLANNING COMPREHENSIVE ACTION TO
COMBAT MENTAL RETARDATION
1391. Authorization of appropriations.
1392. Availability of funds during certain fiscal years;
limitation on amount; utilization of grant.
1393. Applications; single State agency designation;
essential planning services; plans for
expenditure; final activities report and other
necessary reports; records; accounting.
1394. Payments to States; adjustments; advances or
reimbursement; installments; conditions.

SUBCHAPTER XVIII - HEALTH INSURANCE FOR AGED AND DISABLED
1395. Prohibition against any Federal interference.
1395a. Free choice by patient guaranteed.
(a) Basic freedom of choice.
(b) Use of private contracts by medicare
beneficiaries.
1395b. Option to individuals to obtain other health
insurance protection.
1395b-1. Incentives for economy while maintaining or
improving quality in provision of health
services.
(a) Grants and contracts to develop and engage
in experiments and demonstration projects.
(b) Waiver of certain payment or reimbursement
requirements; advice and recommendations of
specialists preceding experiments and
demonstration projects.
1395b-2. Notice of medicare benefits; medicare and medigap
information.
(a) Notice of medicare benefits.
(b) Medicare and medigap information.
(c) Contents of notice.
1395b-3. Health insurance advisory service for medicare
beneficiaries.
(a) In general.
(b) Outreach elements.
(c) Assistance provided.
(d) Educational material.
(e) Notice to beneficiaries.
(f) Report.
1395b-4. Health insurance information, counseling, and
assistance grants.
(a) Grants.
(b) Grant applications.
(c) Special grants.
(d) Criteria for issuing grants.
(e) Annual State report.
(f) Report to Congress.
(g) Authorization of appropriations for grants.
1395b-5. Beneficiary incentive programs.
(a) Repealed.
(b) Program to collect information on fraud and
abuse.
(c) Program to collect information on program
efficiency.
1395b-6. Medicare Payment Advisory Commission.
(a) Establishment.
(b) Duties.
(c) Membership.
(d) Director and staff; experts and consultants.
(e) Powers.
(f) Authorization of appropriations.
1395b-7. Explanation of medicare benefits.
(a) In general.
(b) Request for itemized statement for medicare
items and services.
1395b-8. Chronic care improvement.
(a) Implementation of chronic care improvement
programs.
(b) Developmental phase (Phase I).
(c) Expanded implementation phase (Phase II).
(d) Identification and enrollment of prospective
program participants.
(e) Chronic care improvement programs.
(f) Terms of agreements.
(g) Funding.
1395b-9. Provisions relating to administration.
(a) Coordinated administration of medicare
prescription drug and Medicare Advantage
programs.
(b) Employment of management staff.
(c) Medicare Beneficiary Ombudsman.

PART A - HOSPITAL INSURANCE BENEFITS FOR AGED AND DISABLED
1395c. Description of program.
1395d. Scope of benefits.
(a) Entitlement to payment for inpatient
hospital services, post-hospital extended
care services, home health services, and
hospice care.
(b) Services not covered.
(c) Inpatients of psychiatric hospitals.
(d) Hospice care; election; waiver of rights;
revocation; change of election.
(e) Services taken into account.
(f) Coverage of extended care services without
regard to three-day prior hospitalization
requirement.
(g) "Spell of illness" defined.
1395e. Deductibles and coinsurance.
(a) Inpatient hospital services; outpatient
hospital diagnostic services; blood;
post-hospital extended care services.
(b) Inpatient hospital deductible; application.
1395f. Conditions of and limitations on payment for
services.
(a) Requirement of requests and certifications.
(b) Amount paid to provider of services.
(c) No payments to Federal providers of
services.
(d) Payments for emergency hospital services.
(e) Payment for inpatient hospital services
prior to notification of noneligibility.
(f) Payment for certain inpatient hospital
services furnished outside United States.
(g) Payments to physicians for services rendered
in teaching hospitals.
(h) Payment for specified hospital services
provided in Department of Veterans Affairs
hospitals; amount of payment.
(i) Payment for hospice care.
(j) Elimination of lesser-of-cost-or-charges
provision.
(k) Payments to home health agencies for durable
medical equipment.
(l) Payment for inpatient critical access
hospital services.
1395g. Payments to providers of services.
(a) Determination of amount.
(b) Conditions.
(c) Payments under assignment or power of
attorney.
(d) Accrual of interest on balance of excess or
deficit not paid.
(e) Periodic interim payments.
1395h. Provisions relating to the administration of part
A.
(a) In general.
(b) Repealed.
(c) Prompt payment of claims.
(d) to
(i) Repealed.
(j) Denial of claim; notification and
reconsideration.
(k) Annual reporting requirement on erroneous
payment recovery.
1395i. Federal Hospital Insurance Trust Fund.
(a) Creation; deposits; transfers from Treasury.
(b) Board of Trustees; composition; meetings;
duties.
(c) Investment of Trust Fund by Managing
Trustee.
(d) Authority of Managing Trustee to sell
obligations.
(e) Interest on and proceeds from sale or
redemption of obligations.
(f) Payment of estimated taxes.
(g) Transfers from other Funds.
(h) Payments from Trust Fund amounts certified
by Secretary.
(i) Payment of travel expenses for travel within
United States; reconsideration interviews
and proceedings before administrative law
judges.
(j) Loans from other Funds; interest; repayment;
report to Congress.
(k) Health Care Fraud and Abuse Control Account.
1395i-1. Authorization of appropriations.
1395i-1a. Repealed.
1395i-2. Hospital insurance benefits for uninsured elderly
individuals not otherwise eligible.
(a) Individuals eligible to enroll.
(b) Time, manner, and form of enrollment.
(c) Period of enrollment; scope of coverage.
(d) Monthly premiums.
(e) Contract or other arrangement for payment of
monthly premiums.
(f) Deposit of amounts into Treasury.
(g) Buy-in under this part for qualified
medicare beneficiaries.
1395i-2a. Hospital insurance benefits for disabled
individuals who have exhausted other entitlement.
(a) Eligibility.
(b) Enrollment.
(c) Coverage period.
(d) Payment of premiums.
1395i-3. Requirements for, and assuring quality of care in,
skilled nursing facilities.
(a) "Skilled nursing facility" defined.
(b) Requirements relating to provision of
services.
(c) Requirements relating to residents' rights.
(d) Requirements relating to administration and
other matters.
(e) State requirements relating to skilled
nursing facility requirements.
(f) Responsibilities of Secretary relating to
skilled nursing facility requirements.
(g) Survey and certification process.
(h) Enforcement process.
(i) Construction.
1395i-4. Medicare rural hospital flexibility program.
(a) Establishment.
(b) Application.
(c) Medicare rural hospital flexibility program
described.
(d) "Rural health network" defined.
(e) Certification by Secretary.
(f) Permitting maintenance of swing beds.
(g) Grants.
(h) Grandfathering provisions.
(i) Waiver of conflicting part A provisions.
(j) Authorization of appropriations.
1395i-5. Conditions for coverage of religious nonmedical
health care institutional services.
(a) In general.
(b) Election.
(c) Monitoring and safeguard against excessive
expenditures.
(d) Sunset.
(e) Annual report.

PART B - SUPPLEMENTARY MEDICAL INSURANCE BENEFITS FOR AGED AND
DISABLED
1395j. Establishment of supplementary medical insurance
program for aged and disabled.
1395k. Scope of benefits; definitions.
(a) Scope of benefits.
(b) Definitions.
1395l. Payment of benefits.
(a) Amounts.
(b) Deductible provision.
(c) Mental disorders.
(d) Nonduplication of payments.
(e) Information for determination of amounts
due.
(f) Maximum rate of payment per visit for
independent rural health clinics.
(g) Physical therapy services.
(h) Fee schedules for clinical diagnostic
laboratory tests; percentage of prevailing
charge level; nominal fee for samples;
adjustments; recipients of payments;
negotiated payment rate.
(i) Outpatient surgery.
(j) Accrual of interest on balance of excess or
deficit not paid.
(k) Hepatitis B vaccine.
(l) Fee schedule for services of certified
registered nurse anesthetists.
(m) Incentive payments for physicians' services
furnished in underserved areas.
(n) Payments to hospital outpatient departments
for radiology; amount; definitions.
(o) Limitation on benefit for payment for
therapeutic shoes for individuals with
severe diabetic foot disease.
(p) Repealed.
(q) Requests for payment to include information
on referring physician.
(r) Cap on prevailing charge; billing on
assignment-related basis.
(s) Other prepaid organizations.
(t) Prospective payment system for hospital
outpatient department services.
(u) Incentive payments for physician scarcity
areas.
1395m. Special payment rules for particular items and
services.
(a) Payment for durable medical equipment.
(b) Fee schedules for radiologist services.
(c) Payment and standards for screening
mammography.
(d) Frequency limits and payment for colorectal
cancer screening tests.
(e) Repealed.
(f) Reduction in payments for physician
pathology services during 1991.
(g) Payment for outpatient critical access
hospital services.
(h) Payment for prosthetic devices and orthotics
and prosthetics.
(i) Payment for surgical dressings.
(j) Requirements for suppliers of medical
equipment and supplies.
(k) Payment for outpatient therapy services and
comprehensive outpatient rehabilitation
services.
(l) Establishment of fee schedule for ambulance
services.
(m) Payment for telehealth services.
1395n. Procedure for payment of claims of providers of
services.
(a) Conditions for payment for services
described in section 1395k(a)(2) of this
title.
(b) Conditions for payment for services
described in section 1395x(s) of this
title.
(c) Collection of charges from individuals for
services specified in section 1395x(s) of
this title.
(d) Payment to Federal provider of services or
other Federal agencies prohibited.
(e) Payment to fund designated by medical staff
or faculty of medical school.
1395o. Eligible individuals.
1395p. Enrollment periods.
(a) Generally; regulations.
(b) Repealed.
(c) Initial general enrollment period; eligible
individuals before March 1, 1966.
(d) Eligible individuals on or after March 1,
1966.
(e) General enrollment period.
(f) Individuals deemed enrolled in medical
insurance program.
(g) Commencement of enrollment period.
(h) Waiver of enrollment period requirements
where individual's rights were prejudiced
by administrative error or inaction.
(i) Special enrollment periods.
(j) Special rules for individuals with ALS.
1395q. Coverage period.
(a) Commencement.
(b) Continuation.
(c) Termination.
(d) Payment of expenses incurred during coverage
period.
(e) Commencement of coverage for special
enrollment periods.
1395r. Amount of premiums for individuals enrolled under
this part.
(a) Determination of monthly actuarial rates and
premiums.
(b) Increase in monthly premium.
(c) Premiums rounded to nearest multiple of ten
cents.
(d) "Continuous period of eligibility" defined.
(e) State payment of part B late enrollment
premium increases.
(f) Limitation on increase in monthly premium.
(g) Exclusions from estimate of benefits and
administrative costs.
(h) Potential application of comparative cost
adjustment in CCA areas.
(i) Reduction in premium subsidy based on
income.
1395s. Payment of premiums.
(a) Deductions from section 402 or 423 monthly
benefits.
(b) Deductions from railroad retirement
annuities or pensions.
(c) Portion of monthly premium in excess of
deducted amount.
(d) Deductions from civil service retirement
annuities.
(e) Manner and time of payment prescribed by
Secretary.
(f) Deposit of amounts in Treasury.
(g) Premium payability period.
(h) Exempted monthly benefits.
(i) Adjustments for individuals enrolled in
Medicare+Choice plans.
1395t. Federal Supplementary Medical Insurance Trust
Fund.
(a) Creation; deposits; fund transfers.
(b) Board of Trustees; composition; meetings;
duties.
(c) Investment of Trust Fund by Managing
Trustee.
(d) Authority of Managing Trustee to sell
obligations.
(e) Interest on or proceeds from sale or
redemption of obligations.
(f) Transfers to other Funds.
(g) Payments from Trust Fund of amounts provided
for by this part or with respect to
administrative expenses.
(h) Payments from Trust Fund of costs incurred
by Director of Office of Personnel
Management.
(i) Payments from Trust Fund of costs incurred
by Railroad Retirement Board.
1395t-1, 1395t-2. Repealed.
1395u. Provisions relating to the administration of part
B.
(a) In general.
(b) Determination of reasonable charges.
(c) Prompt payment of claims.
(d) to
(f) Repealed.
(g) Authority of Railroad Retirement Board to
enter into contracts with medicare
administrative contractors.
(h) Participating physician or supplier;
agreement with Secretary; publication of
directories; availability; inclusion of
program in explanation of benefits; payment
of claims on assignment-related basis.
(i) Definitions.
(j) Monitoring of charges of nonparticipating
physicians; sanctions; restitution.
(k) Sanctions for billing for services of
assistant at cataract operations.
(l) Prohibition of unassigned billing of
services determined to be medically
unnecessary by carrier.
(m) Disclosure of information of unassigned
claims for certain physicians' services.
(n) Elimination of markup for certain purchased
services.
(o) Reimbursement for drugs and biologicals.
(p) Requiring submission of diagnostic
information.
(q) Anesthesia services; counting actual time
units.
(r) Establishment of physician identification
system.
(s) Application of fee schedule.
(t) Facility provider number required on claims.
1395v. Agreements with States.
(a) Duty of Secretary; enrollment of eligible
individuals.
(b) Coverage of groups to which applicable.
(c) Eligible individuals.
(d) Monthly premiums; coverage periods.
(e) Subsection (d)(3) terminations deemed
resulting in section 1395p enrollment.
(f) "Carrier" as including State agency;
provisions facilitating deductions,
coinsurance, etc., and leading to economy
and efficiency of operation.
(g) Subsection (b) exclusions from coverage
groups.
(h) Modifications respecting subsection (b)
coverage groups.
(i) Enrollment of qualified medicare
beneficiaries.
1395w. Appropriations to cover Government contributions
and contingency reserve.
(a) In general.
(b) Contingency reserve.
(c) Election under section 1395w-24.
1395w-1. Repealed.
1395w-2. Intermediate sanctions for providers or suppliers
of clinical diagnostic laboratory tests.
1395w-3. Competitive acquisition of certain items and
services.
(a) Establishment of competitive acquisition
programs.
(b) Program requirements.
(c) Program Advisory and Oversight Committee.
(d) Report.
(e) Demonstration project for clinical
laboratory services.
1395w-3a. Use of average sales price payment methodology.
(a) Application.
(b) Payment amount.
(c) Manufacturer's average sales price.
(d) Monitoring of market prices.
(e) Authority to use alternative payment in
response to public health emergency.
(f) Quarterly report on average sales price.
(g) Judicial review.
1395w-3b. Competitive acquisition of outpatient drugs and
biologicals.
(a) Implementation of competitive acquisition.
(b) Program requirements.
(c) Bidding process.
(d) Computation of payment amounts.
(e) Cost-sharing.
(f) Special payment rules.
(g) Judicial review.
1395w-4. Payment for physicians' services.
(a) Payment based on fee schedule.
(b) Establishment of fee schedules.
(c) Determination of relative values for
physicians' services.
(d) Conversion factors.
(e) Geographic adjustment factors.
(f) Sustainable growth rate.
(g) Limitation on beneficiary liability.
(h) Sending information to physicians.
(i) Miscellaneous provisions.
(j) Definitions.

PART C - MEDICARE+CHOICE PROGRAM
1395w-21. Eligibility, election, and enrollment.
(a) Choice of medicare benefits through
Medicare+Choice plans.
(b) Special rules.
(c) Process for exercising choice.
(d) Providing information to promote informed
choice.
(e) Coverage election periods.
(f) Effectiveness of elections and changes of
elections.
(g) Guaranteed issue and renewal.
(h) Approval of marketing material and
application forms.
(i) Effect of election of Medicare+Choice plan
option.
1395w-22. Benefits and beneficiary protections.
(a) Basic benefits.
(b) Antidiscrimination.
(c) Disclosure requirements.
(d) Access to services.
(e) Quality assurance program.
(f) Grievance mechanism.
(g) Coverage determinations, reconsiderations,
and appeals.
(h) Confidentiality and accuracy of enrollee
records.
(i) Information on advance directives.
(j) Rules regarding provider participation.
(k) Treatment of services furnished by certain
providers.
(l) Return to home skilled nursing facilities
for covered post-hospital extended care
services.
1395w-23. Payments to Medicare+Choice organizations.
(a) Payments to organizations.
(b) Annual announcement of payment rates.
(c) Calculation of annual Medicare+Choice
capitation rates.
(d) MA payment area; MA local area; MA region
defined.
(e) Special rules for individuals electing MSA
plans.
(f) Payments from Trust Funds.
(g) Special rule for certain inpatient hospital
stays.
(h) Special rule for hospice care.
(i) New entry bonus.
(j) Computation of benchmark amounts.
1395w-24. Premiums and bid amounts.
(a) Submission of proposed premiums, bid
amounts, and related information.
(b) Monthly premium charged.
(c) Uniform premium and bid amounts.
(d) Terms and conditions of imposing premiums.
(e) Limitation on enrollee liability.
(f) Requirement for additional benefits before
2006.
(g) Prohibition of State imposition of premium
taxes.
(h) Permitting use of segments of service areas.
1395w-25. Organizational and financial requirements for
Medicare+Choice organizations; provider-sponsored
organizations.
(a) Organized and licensed under State law.
(b) Assumption of full financial risk.
(c) Certification of provision against risk of
insolvency for unlicensed PSOs.
(d) "Provider-sponsored organization" defined.
1395w-26. Establishment of standards.
(a) Establishment of solvency standards for
provider-sponsored organizations.
(b) Establishment of other standards.
1395w-27. Contracts with Medicare+Choice organizations.
(a) In general.
(b) Minimum enrollment requirements.
(c) Contract period and effectiveness.
(d) Protections against fraud and beneficiary
protections.
(e) Additional contract terms.
(f) Prompt payment by Medicare+Choice
organization.
(g) Intermediate sanctions.
(h) Procedures for termination.
(i) Medicare+Choice program compatibility with
employer or union group health plans.
1395w-27a. Special rules for MA regional plans.
(a) Regional service area; establishment of MA
regions.
(b) Application of single deductible and
catastrophic limit on out-of-pocket
expenses.
(c) Portion of total payments to an organization
subject to risk for 2006 and 2007.
(d) Organizational and financial requirements.
(e) Stabilization Fund.
(f) Computation of applicable MA region-specific
non-drug monthly benchmark amounts.
(g) Election of uniform coverage determination.
(h) Assuring network adequacy.
1395w-28. Definitions; miscellaneous provisions.
(a) Definitions relating to Medicare+Choice
organizations.
(b) Definitions relating to Medicare+Choice
plans.
(c) Other references to other terms.
(d) Coordinated acute and long-term care
benefits under Medicare+Choice plan.
(e) Restriction on enrollment for certain
Medicare+Choice plans.
(f) Restriction on enrollment for specialized MA
plans for special needs individuals.
1395w-29. Comparative cost adjustment (CCA) program.
(a) Establishment of program.
(b) Requirements for selection of CCA areas.
(c) Selection of CCA areas.
(d) Application of comparative cost adjustment.
(e) Computation of CCA benchmark amount.
(f) Premium adjustment.

PART D - VOLUNTARY PRESCRIPTION DRUG BENEFIT PROGRAM

SUBPART 1 - PART D ELIGIBLE INDIVIDUALS AND PRESCRIPTION DRUG
BENEFITS
1395w-101. Eligibility, enrollment, and information.
(a) Provision of qualified prescription drug
coverage through enrollment in plans.
(b) Enrollment process for prescription drug
plans.
(c) Providing information to beneficiaries.
1395w-102. Prescription drug benefits.
(a) Requirements.
(b) Standard prescription drug coverage.
(c) Alternative prescription drug coverage
requirements.
(d) Access to negotiated prices.
(e) Covered part D drug defined.
1395w-103. Access to a choice of qualified prescription drug
coverage.
(a) Assuring access to a choice of coverage.
(b) Flexibility in risk assumed and application
of fallback plan.
1395w-104. Beneficiary protections for qualified prescription
drug coverage.
(a) Dissemination of information.
(b) Access to covered part D drugs.
(c) Cost and utilization management; quality
assurance; medication therapy management
program.
(d) Consumer satisfaction surveys.
(e) Electronic prescription program.
(f) Grievance mechanism.
(g) Coverage determinations and
reconsiderations.
(h) Appeals.
(i) Privacy, confidentiality, and accuracy of
enrollee records.
(j) Treatment of accreditation.
(k) Public disclosure of pharmaceutical prices
for equivalent drugs.

SUBPART 2 - PRESCRIPTION DRUG PLANS; PDP SPONSORS; FINANCING
1395w-111. PDP regions; submission of bids; plan approval.
(a) Establishment of PDP regions; service areas.
(b) Submission of bids, premiums, and related
information.
(c) Actuarial valuation.
(d) Review of information and negotiation.
(e) Approval of proposed plans.
(f) Application of limited risk plans.
(g) Guaranteeing access to coverage.
(h) Annual report on use of limited risk plans
and fallback plans.
(i) Noninterference.
(j) Coordination of benefits.
1396w-112. Requirements for and contracts with prescription
drug plan (PDP) sponsors.
(a) General requirements.
(b) Contract requirements.
(c) Waiver of certain requirements to expand
choice.
(d) Solvency standards for non-licensed
entities.
(e) Licensure does not substitute for or
constitute certification.
(f) Periodic review and revision of standards.
(g) Prohibition of State imposition of premium
taxes; relation to State laws.
1395w-113. Premiums; late enrollment penalty.
(a) Monthly beneficiary premium.
(b) Late enrollment penalty.
(c) Collection of monthly beneficiary premiums.
1395w-114. Premium and cost-sharing subsidies for low-income
individuals.
(a) Income-related subsidies for individuals
with income up to 150 percent of poverty
line.
(b) Premium subsidy amount.
(c) Administration of subsidy program.
(d) Relation to medicaid program.
1395w-115. Subsidies for part D eligible individuals for
qualified prescription drug coverage.
(a) Subsidy payment.
(b) Reinsurance payment amount.
(c) Adjustments relating to bids.
(d) Payment methods.
(e) Portion of total payments to a sponsor or
organization subject to risk (application
of risk corridors).
(f) Disclosure of information.
(g) Payment for fallback prescription drug
plans.
1395w-116. Medicare Prescription Drug Account in the Federal
Supplementary Medical Insurance Trust Fund.
(a) Establishment and operation of Account.
(b) Payments from Account.
(c) Deposits into Account.

SUBPART 3 - APPLICATION TO MEDICARE ADVANTAGE PROGRAM AND TREATMENT
OF EMPLOYER-SPONSORED PROGRAMS AND OTHER PRESCRIPTION DRUG PLANS
1395w-131. Application to Medicare Advantage program and
related managed care programs.
(a) Special rules relating to offering of
qualified prescription drug coverage.
(b) Application of default enrollment rules.
(c) Application of part D rules for prescription
drug coverage.
(d) Special rules for private fee-for-service
plans that offer prescription drug
coverage.
(e) Application to reasonable cost reimbursement
contractors.
(f) Application to PACE.
1395w-132. Special rules for employer-sponsored programs.
(a) Subsidy payment.
(b) Application of MA waiver authority.
(c) Definitions.
1395w-133. State Pharmaceutical Assistance Programs.
(a) Requirements for benefit coordination.
(b) State Pharmaceutical Assistance Program.
(c) Relation to other provisions.
(d) Facilitation of transition and coordination
with State Pharmaceutical Assistance
Programs.
1395w-134. Coordination requirements for plans providing
prescription drug coverage.
(a) Application of benefit coordination
requirements to additional plans.
(b) Rx Plan.
(c) Relation to other provisions.

SUBPART 4 - MEDICARE PRESCRIPTION DRUG DISCOUNT CARD AND
TRANSITIONAL ASSISTANCE PROGRAM
1395w-141. Medicare prescription drug discount card and
transitional assistance program.
(a) Establishment of program.
(b) Eligibility for discount card and for
transitional assistance.
(c) Enrollment and enrollment fees.
(d) Provision of information on enrollment and
program features.
(e) Discount card features.
(f) Eligibility procedures for endorsed programs
and transitional assistance.
(g) Transitional assistance.
(h) Qualification of prescription drug card
sponsors and endorsement of discount card
programs; beneficiary protections.
(i) Disclosure and oversight.
(j) Treatment of territories.
(k) Funding.

SUBPART 5 - DEFINITIONS AND MISCELLANEOUS PROVISIONS
1395w-151. Definitions; treatment of references to provisions
in part C.
(a) Definitions.
(b) Application of part C provisions under this
part.
1395w-152. Miscellaneous provisions.
(a) Access to coverage in territories.
(b) Application of demonstration authority.

PART E - MISCELLANEOUS PROVISIONS
1395x. Definitions.
(a) Spell of illness.
(b) Inpatient hospital services.
(c) Inpatient psychiatric hospital services.
(d) Supplier.
(e) Hospital.
(f) Psychiatric hospital.
(g) Outpatient occupational therapy services.
(h) Extended care services.
(i) Post-hospital extended care services.
(j) Skilled nursing facility.
(k) Utilization review.
(l) Agreements for transfer between skilled
nursing facilities and hospitals.
(m) Home health services.
(n) Durable medical equipment.
(o) Home health agency.
(p) Outpatient physical therapy services.
(q) Physicians' services.
(r) Physician.
(s) Medical and other health services.
(t) Drugs and biologicals.
(u) Provider of services.
(v) Reasonable costs.
(w) Arrangements for certain services; payments
pursuant to arrangements for utilization
review activities.
(x) State and United States.
(y) Extended care in religious nonmedical health
care institutions.
(z) Institutional planning.
(aa) Rural health clinic services and Federally
qualified health center services.
(bb) Services of a certified registered nurse
anesthetist.
(cc) Comprehensive outpatient rehabilitation
facility services.
(dd) Hospice care; hospice program; definitions;
certification; waiver by Secretary.
(ee) Discharge planning process.
(ff) Partial hospitalization services.
(gg) Certified nurse-midwife services.
(hh) Clinical social worker; clinical social
worker services.
(ii) Qualified psychologist services.
(jj) Screening mammography.
(kk) Covered osteoporosis drug.
(ll) Speech-language pathology services;
audiology services.
(mm) Critical access hospital; critical access
hospital services.
(nn) Screening pap smear; screening pelvic exam.
(oo) Prostate cancer screening tests.
(pp) Colorectal cancer screening tests.
(qq) Diabetes outpatient self-management training
services.
(rr) Bone mass measurement.
(ss) Religious nonmedical health care
institution.
(tt) Post-institutional home health services;
home health spell of illness.
(uu) Screening for glaucoma.
(vv) Medical nutrition therapy services;
registered dietitian or nutrition
professional.
(ww) Initial preventive physical examination.
(xx) Cardiovascular screening blood test.
(yy) Diabetes screening tests.
(zz) Intravenous immune globulin.
(aaa) Extended care in religious nonmedical health
care institutions.
1395y. Exclusions from coverage and medicare as secondary
payer.
(a) Items or services specifically excluded.
(b) Medicare as secondary payer.
(c) Drug products.
(d) Items or services provided for emergency
medical conditions.
(e) Item or service by excluded individual or
entity or at direction of excluded
physician; limitation of liability of
beneficiaries with respect to services
furnished by excluded individuals and
entities.
(f) Utilization guidelines for provision of home
health services.
(g) Contracts with utilization and quality
control peer review organizations.
(h) Waiver of electronic form requirement.
(i) Awards and contracts for original research
and experimentation of new and existing
medical procedures; conditions.
(j) Nonvoting members and experts.
(k) Dental benefits under group health plans.
(l) National and local coverage determination
process.
(m) Coverage of routine costs associated with
certain clinical trials of category A
devices.
1395z. Consultation with State agencies and other
organizations to develop conditions of
participation for providers of services.
1395aa. Agreements with States.
(a) Use of State agencies to determine
compliance by providers of services with
conditions of participation.
(b) Payment in advance or by way of
reimbursement to State for performance of
functions of subsection (a).
(c) Use of State or local agencies to survey
hospitals.
(d) Fulfillment of requirements by States.
(e) Prohibition of user fees for survey and
certification.
1395bb. Effect of accreditation.
(a) In general.
(b) Accreditation by American Osteopathic
Association or other national accreditation
body.
(c) Disclosure of accreditation survey.
(d) Deficiencies.
(e) State or local accreditation.
1395cc. Agreements with providers of services; enrollment
processes.
(a) Filing of agreements; eligibility for
payment; charges with respect to items and
services.
(b) Termination or nonrenewal of agreements.
(c) Refiling after termination or nonrenewal;
agreements with skilled nursing facilities.
(d) Decision to withhold payment for failure to
review long-stay cases.
(e) "Provider of services" defined.
(f) Maintenance of written policies and
procedures.
(g) Penalties for improper billing.
(h) Dissatisfaction with determination of
Secretary; appeal by institutions or
agencies; single notice and hearing.
(i) Intermediate sanctions for psychiatric
hospitals.
(j) Enrollment process for providers of services
and suppliers.
1395cc-1. Demonstration of application of physician volume
increases to group practices.
(a) Demonstration program authorized.
(b) Eligibility criteria.
(c) Patients within scope of demonstration.
(d) Incentives.
1395cc-2. Provisions for administration of demonstration
program.
(a) General administrative authority.
(b) Contracts for program administration.
(c) Rules applicable to both program agreements
and program administration contracts.
(d) Limitations on judicial review.
(e) Application limited to parts A and B.
(f) Reports to Congress.
1395cc-3. Health care quality demonstration program.
(a) Definitions.
(b) Demonstration projects.
(c) Administration by contract.
(d) Eligibility criteria.
(e) Waiver authority.
(f) Budget neutrality.
(g) Notice requirements.
(h) Participation and support by Federal
agencies.
1395dd. Examination and treatment for emergency medical
conditions and women in labor.
(a) Medical screening requirement.
(b) Necessary stabilizing treatment for
emergency medical conditions and labor.
(c) Restricting transfers until individual
stabilized.
(d) Enforcement.
(e) Definitions.
(f) Preemption.
(g) Nondiscrimination.
(h) No delay in examination or treatment.
(i) Whistleblower protections.
1395ee. Practicing Physicians Advisory Council; Council
for Technology and Innovation.
(a) Practicing Physicians Advisory Council.
(b) Council for Technology and Innovation.
1395ff. Determinations; appeals.
(a) Initial determinations.
(b) Appeal rights.
(c) Conduct of reconsiderations by independent
contractors.
(d) Deadlines for hearings by the Secretary;
notice.
(e) Administrative provisions.
(f) Review of coverage determinations.
(g) Qualifications of reviewers.
(h) Prior determination process for certain
items and services.
(i) Mediation process for local coverage
determinations.
1395gg. Overpayment on behalf of individuals and
settlement of claims for benefits on behalf of
deceased individuals.
(a) Payments to providers of services or other
person regarded as payment to individuals.
(b) Incorrect payments on behalf of individuals;
payment adjustment.
(c) Exception to subsection (b) payment
adjustment.
(d) Liability of certifying or disbursing
officer for failure to recoup.
(e) Settlement of claims for benefits under this
subchapter on behalf of deceased
individuals.
(f) Settlement of claims for section 1395k
benefits on behalf of deceased individuals.
(g) Refund of premiums for deceased individuals.
(h) Appeals by providers of services or
suppliers.
1395hh. Regulations.
(a) Authority to prescribe regulations;
ineffectiveness of substantive rules not
promulgated by regulation.
(b) Notice of proposed regulations; public
comment.
(c) Publication of certain rules; public
inspection; changes in data collection and
retrieval.
(e) Retroactivity of substantive changes;
reliance upon written guidance.
(f) Report on areas of inconsistency or
conflict.
1395ii. Application of certain provisions of subchapter
II.
1395jj. Designation of organization or publication by
name.
1395kk. Administration of insurance programs.
(a) Functions of Secretary; performance directly
or by contract.
(b) Contracts to secure special data, actuarial
information, etc.
(c) Oaths and affirmations.
1395kk-1. Contracts with medicare administrative
contractors.
(a) Authority.
(b) Contracting requirements.
(c) Terms and conditions.
(d) Limitation on liability of medicare
administrative contractors and certain
officers.
(e) Requirements for information security.
(f) Incentives to improve contractor performance
in provider education and outreach.
(g) Communications with beneficiaries, providers
of services and suppliers.
(h) Conduct of prepayment review.
1395ll. Studies and recommendations.
(a) Health care of the aged and disabled.
(b) Operation and administration of insurance
programs.
1395mm. Payments to health maintenance organizations and
competitive medical plans.
(a) Rates and adjustments.
(b) Definitions; requirements.
(c) Enrollment in plan; duties of organization
to enrollees.
(d) Right to enroll with contracting
organization in geographic area.
(e) Limitation on charges; election of coverage;
"adjusted community rate" defined;
workmen's compensation and insurance
benefits.
(f) Membership requirements.
(g) Risk-sharing contract.
(h) Reasonable cost reimbursement contract;
requirements.
(i) Duration, termination, effective date, and
terms of contract; powers and duties of
Secretary.
(j) Payment in full and limitation on actual
charges; physicians, providers of services,
or renal dialysis facilities not under
contract with organization.
(k) Risk-sharing contracts.
1395nn. Limitation on certain physician referrals.
(a) Prohibition of certain referrals.
(b) General exceptions to both ownership and
compensation arrangement prohibitions.
(c) General exception related only to ownership
or investment prohibition for ownership in
publicly traded securities and mutual
funds.
(d) Additional exceptions related only to
ownership or investment prohibition.
(e) Exceptions relating to other compensation
arrangements.
(f) Reporting requirements.
(g) Sanctions.
(h) Definitions and special rules.
1395oo. Provider Reimbursement Review Board.
(a) Establishment.
(b) Appeals by groups.
(c) Right to counsel; rules of evidence.
(d) Decisions of Board.
(e) Rules and regulations.
(f) Finality of decision; judicial review;
determinations of Board authority;
jurisdiction; venue; interest on amount in
controversy.
(g) Certain findings not reviewable.
(h) Composition and compensation.
(i) Technical and clerical assistance.
(j) "Provider of services" defined.
1395pp. Limitation on liability where claims are
disallowed.
(a) Conditions prerequisite to payment for items
and services notwithstanding determination
of disallowance.
(b) Knowledge of person or provider that payment
could not be made; indemnification of
individual.
(c) Knowledge of both provider and individual to
whom items or services were furnished that
payment could not be made.
(d) Exercise of rights.
(e) Payment where beneficiary not at fault.
(f) Presumption with respect to coverage denial;
rebuttal; requirements; "fiscal
intermediary" defined.
(g) Coverage denial defined.
(h) Supplier responsibility for items furnished
on assignment basis.
1395qq. Indian health service facilities.
(a) Eligibility for payments; conditions and
requirements.
(b) Eligibility based on submission of plan to
achieve compliance with conditions and
requirements; twelve-month period.
(c) Payments into special fund for improvements
to achieve compliance with conditions and
requirements; certification of compliance
by Secretary.
(d) Report by Secretary; status of facilities in
complying with conditions and requirements.
(e) Services provided by Indian Health Service,
Indian tribe, or tribal organization.
(f) Cross reference.
1395rr. End stage renal disease program.
(a) Type, duration, and scope of benefits.
(b) Payments with respect to services; dialysis;
regulations; physicians' services; target
reimbursement rates; home dialysis supplies
and equipment; self-care home dialysis
support services; self-care dialysis units;
hepatitis B vaccine.
(c) Renal disease network areas; coordinating
councils, executive committees, and medical
review boards; national end stage renal
disease medical information system;
functions of network organizations.
(d) Donors of kidney for transplant surgery.
(e) Reimbursement of providers, facilities, and
nonprofit entities for costs of artificial
kidney and automated dialysis peritoneal
machines for home dialysis.
(f) Experiments, studies, and pilot projects.
(g) Conditional approval of dialysis facilities;
restriction-of-payments notice to public
and facility; notice and hearing; judicial
review.
1395ss. Certification of medicare supplemental health
insurance policies.
(a) Submission of policy by insurer.
(b) Standards and requirements; periodic review
by Secretary.
(c) Requisite findings.
(d) Criminal penalties; civil penalties for
certain violations.
(e) Dissemination of information.
(f) Study and evaluation of comparative
effectiveness of various State approaches
to regulating medicare supplemental
policies; report to Congress no later than
January 1, 1982; periodic evaluations.
(g) Definitions.
(h) Rules and regulations.
(i) Commencement of certification program.
(j) State regulation of policies issued in other
States.
(k) Amended NAIC Model Regulation or Federal
model standards applicable; effective date;
medicare supplemental policy and State
regulatory program meeting applicable
standards.
(l) Transitional compliance with NAIC Model
Transition Regulation; "qualifying medicare
supplemental policy" and "NAIC Model
Transition Regulation" defined.
(m) Revision of amended NAIC Model Regulation
and amended Federal model standards;
effective dates; medicare supplemental
policy and State regulatory program meeting
applicable standards.
(n) Transition compliance with revision of NAIC
Model Regulation and Federal model
standards.
(o) Requirements of group benefits; core group
benefits; uniform outline of coverage.
(p) Standards for group benefits.
(q) Guaranteed renewal of policies; termination;
suspension.
(r) Required ratio of aggregate benefits to
aggregate premiums.
(s) Coverage for pre-existing conditions.
(t) Medicare select policies.
(u) Additional rules relating to individuals
enrolled in MSA plans and in private
fee-for-service plans.
(v) Rules relating to medigap policies that
provide prescription drug coverage.
(w) Development of new standards for medicare
supplemental policies.
1395tt. Hospital providers of extended care services.
(a) Hospital facility agreements; reasonable
costs of services.
(b) Eligible facilities.
(c) Terms and conditions of facility agreements.
(d) Post-hospital extended care services.
(e) Reimbursement for routine hospital services.
(f) Conditions applicable to skilled nursing
facilities.
(g) Agreements on demonstration basis.
1395uu. Payments to promote closing or conversion of
underutilized hospital facilities.
(a) Transitional allowances; procedures
applicable.
(b) Allowable costs as transitional allowances;
findings and determinations.
(c) Factors determinative of transitional
allowance.
(d) Hearing to review determination.
1395vv. Withholding payments from certain medicaid
providers.
(a) Adjustments by Secretary.
(b) Implementing regulations; notice,
opportunity to be heard, etc.
(c) Payment to States of amounts recovered.
1395ww. Payments to hospitals for inpatient hospital
services.
(a) Determination of costs for inpatient
hospital services; limitations; exemptions;
"operating costs of inpatient hospital
services" defined.
(b) Computation of payment; definitions;
exemptions; adjustments.
(c) Payment in accordance with State hospital
reimbursement control system; amount of
payment; discontinuance of payments.
(d) Inpatient hospital service payments on basis
of prospective rates; Medicare Geographical
Classification Review Board.
(e) Proportional adjustments in applicable
percentage increases.
(f) Reporting of costs of hospitals receiving
payments on basis of prospective rates.
(g) Prospective payment for capital-related
costs; return on equity capital for
hospitals.
(h) Payments for direct graduate medical
education costs.
(i) Avoiding duplicative payments to hospitals
participating in rural demonstration
programs.
(j) Prospective payment for inpatient
rehabilitation services.
(k) Payment to nonhospital providers.
(l) Payment for nursing and allied health
education for managed care enrollees.
1395xx. Payment of provider-based physicians and payment
under certain percentage arrangements.
(a) Criteria; amount of payments.
(b) Prohibition of recognition of payments under
certain percentage agreements.
1395yy. Payment to skilled nursing facilities for routine
service costs.
(a) Per diem limitations.
(b) Excess overhead allocations for
hospital-based facilities.
(c) Adjustments in limitations; publication of
data.
(d) Access to skilled nursing facilities.
(e) Prospective payment.
1395zz. Provider education and technical assistance.
(a) Coordination of education funding.
(b) Enhanced education and training.
(c) Tailoring education and training activities
for small providers or suppliers.
(d) Internet websites; FAQs.
(e) Encouragement of participation in education
program activities.
(f) Construction.
(g) Definitions.
1395aaa. Transferred.
1395bbb. Conditions of participation for home health
agencies; home health quality.
(a) Conditions of participation; protection of
individual rights; notification of State
entities; use of home health aides; medical
equipment; individual's plan of care;
compliance with Federal, State, and local
laws and regulations.
(b) Duty of Secretary.
(c) Surveys of home health agencies.
(d) Assessment process; reports to Congress.
(e) Enforcement.
(f) Intermediate sanctions.
(g) Payment on basis of location of service.
1395ccc. Offset of payments to individuals to collect
past-due obligations arising from breach of
scholarship and loan contract.
(a) In general.
(b) Past-due obligation.
(c) Collection under this section shall not be
exclusive.
(d) Collection from providers and health
maintenance organizations.
(e) Transfer from trust funds.
1395ddd. Medicare Integrity Program.
(a) Establishment of Program.
(b) Activities described.
(c) Eligibility of entities.
(d) Process for entering into contracts.
(e) Limitation on contractor liability.
(f) Recovery of overpayments.
1395eee. Payments to, and coverage of benefits under,
programs of all-inclusive care for elderly
(PACE).
(a) Receipt of benefits through enrollment in
PACE program; definitions for PACE program
related terms.
(b) Scope of benefits; beneficiary safeguards.
(c) Eligibility determinations.
(d) Payments to PACE providers on capitated
basis.
(e) PACE program agreement.
(f) Regulations.
(g) Waivers of requirements.
(h) Demonstration project for for-profit
entities.
(i) Miscellaneous provisions.
1395fff. Prospective payment for home health services.
(a) In general.
(b) System of prospective payment for home
health services.
(c) Requirements for payment information.
(d) Limitation on review.
(e) Construction related to home health
services.
1395ggg. Medicare subvention demonstration project for
military retirees.
(a) Definitions.
(b) Demonstration project.
(c) Crediting of payments.
(d) Waiver of certain medicare requirements.
(e) Inspector General.
(f) Voluntary participation.
(g) TRICARE health care plans.
(h) Additional plans.
(i) Payments based on regular medicare payment
rates.
(j) Maintenance of effort.
(k) Evaluation and reports.
1395hhh. Health care infrastructure improvement program.
(a) Establishment.
(b) Application.
(c) Selection criteria.
(d) Projects.
(e) State and local permits.
(f) Forgiveness of indebtedness.
(g) Funding.
(h) Report to Congress.
(i) Limitation on review.

SUBCHAPTER XIX - GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
1396. Appropriations.
1396a. State plans for medical assistance.
(a) Contents.
(b) Approval by Secretary.
(c) Lower payment levels or applying for
benefits as condition of applying for, or
receiving, medical assistance.
(d) Performance of medical or utilization review
functions.
(e) Continued eligibility of families determined
ineligible because of income and resources
or hours of work limitations of plan;
individuals enrolled with health
maintenance organizations; persons deemed
recipients of supplemental security income
or State supplemental payments; entitlement
for certain newborns; postpartum
eligibility for pregnant women.
(f) Effective date of State plan as
determinative of duty of State to provide
medical assistance to aged, blind, or
disabled individuals.
(g) Reduction of aid or assistance to providers
of services attempting to collect from
beneficiary in violation of third-party
provisions.
(h) Payments for hospitals serving
disproportionate number of low-income
patients and for home and community care.
(i) Termination of certification for
participation of and suspension of State
payments to intermediate care facilities
for the mentally retarded.
(j) Waiver or modification of subchapter
requirements with respect to medical
assistance program in American Samoa.
(k) Repealed.
(l) Description of group.
(m) Description of individuals.
(n) Payment amounts.
(o) Certain benefits disregarded for purposes of
determining post-eligibility contributions.
(p) Exclusion power of State; exclusion as
prerequisite for medical assistance
payments; "exclude" defined.
(q) Minimum monthly personal needs allowance
deduction; "institutionalized individual or
couple" defined.
(r) Disregarding payments for certain medical
expenses by institutionalized individuals.
(s) Adjustment in payment for hospital services
furnished to low-income children under age
of 6 years.
(t) Limitation on payments to States for
expenditures attributable to taxes.
(u) Qualified COBRA continuation beneficiaries.
(v) State agency disability and blindness
determinations for medical assistance
eligibility.
(w) Maintenance of written policies and
procedures respecting advance directives.
(x) Physician identifier system; establishment.
(y) Intermediate sanctions for psychiatric
hospitals.
(z) Optional coverage of TB-related services.
(aa) Certain breast or cervical cancer patients.
(bb) Payment for services provided by
Federally-qualified health centers and
rural health clinics.
1396b. Payment to States.
(a) Computation of amount.
(b) Quarterly expenditures beginning after
December 31, 1969.
(c) Treatment of educationally-related services.
(d) Estimates of State entitlement;
installments; adjustments to reflect
overpayments or underpayments; time for
recovery or adjustment; uncollectable or
discharged debts; obligated appropriations;
disputed claims.
(e) Transition costs of closures or conversions
permitted.
(f) Limitation on Federal participation in
medical assistance.
(g) Decrease in Federal medical assistance
percentage of amounts paid for services
furnished under State plan after June 30,
1973.
(h) Repealed.
(i) Payment for organ transplants; item or
service furnished by excluded individual,
entity, or physician; other restrictions.
(j) Adjustment of amount.
(k) Technical assistance to States.
(l) Repealed.
(m) "Medicaid managed care organization"
defined; duties and functions of Secretary;
payments to States; reporting requirements;
remedies.
(n) Repealed.
(o) Restrictions on authorized payments to
States.
(p) Assignment of rights of payment; incentive
payments for enforcement and collection.
(q) "State medicaid fraud control unit" defined.
(r) Mechanized claims processing and information
retrieval systems; operational, etc.,
requirements.
(s) Limitations on certain physician referrals.
(t) Repealed.
(u) Limitation of Federal financial
participation in erroneous medical
assistance expenditures.
(v) Medical assistance to aliens not lawfully
admitted for permanent residence.
(w) Prohibition on use of voluntary
contributions, and limitation on use of
provider-specific taxes to obtain Federal
financial participation under medicaid.
1396c. Operation of State plans.
1396d. Definitions.
(a) Medical assistance.
(b) Federal medical assistance percentage; State
percentage; Indian health care percentage.
(c) Nursing facility.
(d) Intermediate care facility for mentally
retarded.
(e) Physicians' services.
(f) Nursing facility services.
(g) Chiropractors' services.
(h) Inpatient psychiatric hospital services for
individuals under age 21.
(i) Institution for mental diseases.
(j) State supplementary payment.
(k) Supplemental security income benefits.
(l) Rural health clinics.
(m) Qualified family member.
(n) "Qualified pregnant woman or child" defined.
(o) Optional hospice benefits.
(p) Qualified medicare beneficiary; medicare
cost-sharing.
(q) Qualified severely impaired individual.
(r) Early and periodic screening, diagnostic,
and treatment services.
(s) Qualified disabled and working individual.
(t) Primary care case management services;
primary care case manager; primary care
case management contract; and primary care.
(u) Conditions for State plans.
(v) Employed individual with a medically
improved disability.
(w) Independent foster care adolescent.
(x) Strategies, treatment, and services.
1396e. Enrollment of individuals under group health
plans.
(a) Requirements of each State plan; guidelines.
(b) Timing of enrollment; failure to enroll.
(c) Premiums considered payments for medical
assistance; eligibility.
(d) Repealed.
(e) Definitions.
1396f. Observance of religious beliefs.
1396g. State programs for licensing of administrators of
nursing homes.
(a) Nature of State program.
(b) Licensing by State agency or board
representative of concerned professions and
institutions.
(c) Functions and duties of State agency or
board.
(d) Waiver of standards other than good
character or suitability standards.
(e) "Nursing home" and "nursing home
administrator" defined.
1396g-1. Required laws relating to medical child support.
(a) In general.
(b) "Insurer" defined.
1396h. Transferred.
1396i. Certification and approval of rural health clinics
and intermediate care facilities for mentally
retarded.
1396j. Indian health service facilities.
(a) Eligibility for reimbursement for medical
assistance.
(b) Facilities deemed to meet requirements upon
submission of acceptable plan for achieving
compliance.
(c) Agreement to reimburse State agency for
providing care and services.
(d) Cross reference.
1396k. Assignment, enforcement, and collection of rights
of payments for medical care; establishment of
procedures pursuant to State plan; amounts
retained by State.
1396l. Hospital providers of nursing facility services.
1396m. Withholding of Federal share of payments for
certain medicare providers.
(a) Adjustment of Federal matching payments.
(b) Reductions in payments to and by States.
(c) Notice.
(d) Regulations.
(e) Restoration to trust funds of recovered
amounts.
(f) Liability of States for withheld payments.
1396n. Compliance with State plan and payment provisions.
(a) Activities deemed as compliance.
(b) Waivers to promote cost-effectiveness and
efficiency.
(c) Waiver respecting medical assistance
requirement in State plan; scope, etc.;
"habilitation services" defined; imposition
of certain regulatory limits prohibited;
computation of expenditures for certain
disabled patients; coordinated services;
substitution of participants.
(d) Home and community-based services for
elderly.
(e) Waiver for children infected with AIDS or
drug dependent at birth.
(f) Monitor of implementation of waivers;
termination of waiver for noncompliance;
time limitation for action on requests for
plan approval, amendments, or waivers.
(g) Optional targeted case management services.
(h) Period of waivers; continuations.
1396o. Use of enrollment fees, premiums, deductions, cost
sharing, and similar charges.
(a) Imposition of certain charges under plan in
case of individuals described in section
1396a(a)(10)(A) or (E).
(b) Imposition of certain charges under plan in
case of individuals other than those
described in section 1396a(a)(10)(A) or
(E).
(c) Imposition of monthly premium; persons
affected; amount; prepayment; failure to
pay; use of funds from other programs.
(d) Premiums for qualified disabled and working
individuals described in section 1396d(s).
(e) Prohibition of denial of services on basis
of individual's inability to pay certain
charges.
(f) Charges imposed under waiver authority of
Secretary.
(g) Individuals provided medical assistance
under section 1396a(a)(10)(A)(ii)(XV) or
(XVI).
1396p. Liens, adjustments and recoveries, and transfers
of assets.
(a) Imposition of lien against property of an
individual on account of medical assistance
rendered to him under a State plan.
(b) Adjustment or recovery of medical assistance
correctly paid under a State plan.
(c) Taking into account certain transfers of
assets.
(d) Treatment of trust amounts.
(e) Definitions.
1396q. Application of provisions of subchapter II
relating to subpoenas.
1396r. Requirements for nursing facilities.
(a) "Nursing facility" defined.
(b) Requirements relating to provision of
services.
(c) Requirements relating to residents' rights.
(d) Requirements relating to administration and
other matters.
(e) State requirements relating to nursing
facility requirements.
(f) Responsibilities of Secretary relating to
nursing facility requirements.
(g) Survey and certification process.
(h) Enforcement process.
(i) Construction.
1396r-1. Presumptive eligibility for pregnant women.
(a) Ambulatory prenatal care.
(b) Definitions.
(c) Duties of State agency, qualified providers,
and presumptively eligible pregnant women.
(d) Ambulatory prenatal care as medical
assistance.
1396r-1a. Presumptive eligibility for children.
(a) In general.
(b) Definitions; regulations.
(c) Application for medical assistance;
procedure upon determination of presumptive
eligibility.
(d) Treatment of medical assistance.
Sec.
1396r-1b. Presumptive eligibility for certain breast or
cervical cancer patients.
(a) State option.
(b) Definitions.
(c) Administration.
(d) Payment.
1396r-2. Information concerning sanctions taken by State
licensing authorities against health care
practitioners and providers.
(a) Information reporting requirement.
(b) Form of information.
(c) Confidentiality of information provided.
(d) Appropriate coordination.
1396r-3. Correction and reduction plans for intermediate
care facilities for mentally retarded.
(a) Written plans to remedy substantial
deficiencies; time for submission.
(b) Conditions for approval of reduction plans.
(c) Contents of reduction plan.
(d) Notice and comment; approval of more than 15
reduction plans in any fiscal year;
corrections costing $2,000,000 or more.
(e) Termination of provider agreements;
disallowance of percentage amounts for
purposes of Federal financial
participation.
(f) Applicability of section limited to plans
approved by January 1, 1990.
1396r-4. Adjustment in payment for inpatient hospital
services furnished by disproportionate share
hospitals.
(a) Implementation of requirement.
(b) Hospitals deemed disproportionate share.
(c) Payment adjustment.
(d) Requirements to qualify as disproportionate
share hospital.
(e) Special rule.
(f) Limitation on Federal financial
participation.
(g) Limit on amount of payment to hospital.
(h) Limitation on certain State DSH
expenditures.
(i) Requirement for direct payment.
(j) Annual reports and other requirements
regarding payment adjustments.
1396r-5. Treatment of income and resources for certain
institutionalized spouses.
(a) Special treatment for institutionalized
spouses.
(b) Rules for treatment of income.
(c) Rules for treatment of resources.
(d) Protecting income for community spouse.
(e) Notice and fair hearing.
(f) Permitting transfer of resources to
community spouse.
(g) Indexing dollar amounts.
(h) Definitions.
1396r-6. Extension of eligibility for medical assistance.
(a) Initial 6-month extension.
(b) Additional 6-month extension.
(c) Applicability in States and territories.
(d) General disqualification for fraud.
(e) "Caretaker relative" defined.
(f) Sunset.
1396r-7. Repealed.
1396r-8. Payment for covered outpatient drugs.
(a) Requirement for rebate agreement.
(b) Terms of rebate agreement.
(c) Determination of amount of rebate.
(d) Limitations on coverage of drugs.
(e) Treatment of pharmacy reimbursement limits.
(f) Repealed and redesignated.
(g) Drug use review.
(h) Electronic claims management.
(i) Omitted.
(j) Exemption of organized health care settings.
(k) Definitions.
1396s. Program for distribution of pediatric vaccines.
(a) Establishment of program.
(b) Vaccine-eligible children.
(c) Program-registered providers.
(d) Negotiation of contracts with manufacturers.
(e) Use of pediatric vaccines list.
(f) Requirement of State maintenance of
immunization laws.
(g) Termination.
(h) Definitions.
1396t. Home and community care for functionally disabled
elderly individuals.
(a) "Home and community care" defined.
(b) "Functionally disabled elderly individual"
defined.
(c) Determinations of functional disability.
(d) Individual community care plan (ICCP).
(e) Ceiling on payment amounts and maintenance
of effort.
(f) Minimum requirements for home and community
care.
(g) Minimum requirements for small community
care settings.
(h) Minimum requirements for large community
care settings.
(i) Survey and certification process.
(j) Enforcement process for providers of
community care.
(k) Secretarial responsibilities.
(l) Waiver of Statewideness.
(m) Limitation on amount of expenditures as
medical assistance.
1396u. Community supported living arrangements services.
(a) Community supported living arrangements
services.
(b) "Developmentally disabled individual"
defined.
(c) Criteria for selection of participating
States.
(d) Quality assurance.
(e) Maintenance of effort.
(f) Excluded services.
(g) Waiver of requirements.
(h) Minimum protections.
(i) Treatment of funds.
(j) Limitation on amounts of expenditures as
medical assistance.
1396u-1. Assuring coverage for certain low-income families.
(a) References to subchapter IV-A are references
to pre-welfare-reform provisions.
(b) Application of pre-welfare-reform
eligibility criteria.
(c) Treatment for purposes of transitional
coverage provisions.
(d) Waivers.
(e) State option to use 1 application form.
(f) Additional rules of construction.
(g) Relation to other provisions.
(h) Transitional increased Federal matching rate
for increased administrative costs.
(i) Welfare reform effective date.
1396u-2. Provisions relating to managed care.
(a) State option to use managed care.
(b) Beneficiary protections.
(c) Quality assurance standards.
(d) Protections against fraud and abuse.
(e) Sanctions for noncompliance.
(f) Timeliness of payment.
(g) Identification of patients for purposes of
making DSH payments.
1396u-3. State coverage of medicare cost-sharing for
additional low-income medicare beneficiaries.
(a) In general.
(b) Selection of qualifying individuals.
(c) Allocation.
(d) Applicable FMAP.
(e) Limitation on entitlement.
(f) Coverage of costs through part B of medicare
program.
(g) Special rules.
1396u-4. Program of all-inclusive care for elderly (PACE).
(a) State option.
(b) Scope of benefits; beneficiary safeguards.
(c) Eligibility determinations.
(d) Payments to PACE providers on a capitated
basis.
(e) PACE program agreement.
(f) Regulations.
(g) Waivers of requirements.
(h) Demonstration project for for-profit
entities.
(i) Post-eligibility treatment of income.
(j) Miscellaneous provisions.
1396u-5. Special provisions relating to medicare
prescription drug benefit.
(a) Requirements relating to medicare
prescription drug low-income subsidies and
medicare transitional prescription drug
assistance.
(b) Regular Federal subsidy of administrative
costs.
(c) Federal assumption of medicaid prescription
drug costs for dually eligible individuals.
(d) Coordination of prescription drug benefits.
(e) Treatment of territories.
1396v. References to laws directly affecting medicaid
program.
(a) Authority or requirements to cover
additional individuals.
(b) Additional State plan requirements.

SUBCHAPTER XX - BLOCK GRANTS TO STATES FOR SOCIAL SERVICES
1397. Purposes; authorization of appropriations.
1397a. Payments to States.
(a) Amount; covered services.
(b) Funding requirements.
(c) Expenditure of funds.
(d) Transfers of funds.
(e) Use of portion of funds.
(f) Authority to use vouchers.
1397b. Allotments.
(a) Computation of amounts for jurisdictions of
Puerto Rico, Guam, etc.
(b) Computation of amounts for each State other
than jurisdictions of Puerto Rico, Guam,
etc.
(c) Appropriations.
1397c. State reporting requirements.
1397d. Limitation on use of grants; waiver.
1397e. Administrative and fiscal accountability.
(a) Reporting requirements; form, contents, etc.
(b) Audits; implementation, etc.
(c) State reports on expenditure and use of
social services funds.
(d) Additional accounting requirements.
1397f. Additional grants.
(a) Entitlement.
(b) Program options.
(c) Use of grants.
(d) Remittance of certain amounts.
(e) Reallocation of remaining funds.
(f) Definitions.

SUBCHAPTER XXI - STATE CHILDREN'S HEALTH INSURANCE PROGRAM
1397aa. Purpose; State child health plans.
(a) Purpose.
(b) State child health plan required.
(c) State entitlement.
(d) Effective date.
1397bb. General contents of State child health plan;
eligibility; outreach.
(a) General background and description.
(b) General description of eligibility standards
and methodology.
(c) Outreach and coordination.
1397cc. Coverage requirements for children's health
insurance.
(a) Required scope of health insurance coverage.
(b) Benchmark benefit packages.
(c) Categories of services; determination of
actuarial value of coverage.
(d) Description of existing comprehensive
State-based coverage.
(e) Cost-sharing.
(f) Application of certain requirements.
1397dd. Allotments.
(a) Appropriation; total allotment.
(b) Allotments to 50 States and District of
Columbia.
(c) Allotments to territories.
(d) Repealed.
(e) 3-year availability of amounts allotted.
(f) Procedure for redistribution of unused
allotments.
(g) Rule for redistribution and extended
availability of fiscal years 1998, 1999,
2000, and 2001 allotments.
1397ee. Payments to States.
(a) In general.
(b) Enhanced FMAP.
(c) Limitation on certain payments for certain
expenditures.
(d) Maintenance of effort.
(e) Advance payment; retrospective adjustment.
(f) Flexibility in submittal of claims.
(g) Authority for qualifying States to use
certain funds for medicaid expenditures.
1397ff. Process for submission, approval, and amendment of
State child health plans.
(a) Initial plan.
(b) Plan amendments.
(c) Disapproval of plans and plan amendments.
(d) Program operation.
(e) Continued approval.
1397gg. Strategic objectives and performance goals; plan
administration.
(a) Strategic objectives and performance goals.
(b) Records, reports, audits, and evaluation.
(c) Program development process.
(d) Program budget.
(e) Application of certain general provisions.
1397hh. Annual reports; evaluations.
(a) Annual report.
(b) State evaluations.
(c) Federal evaluation.
(d) Inspector General audit and GAO report.
1397ii. Miscellaneous provisions.
(a) Relation to other laws.
(b) Adjustment to Current Population Survey to
include State-by-State data relating to
children without health insurance coverage.
1397jj. Definitions.
(a) Child health assistance.
(b) "Targeted low-income child" defined.
(c) Additional definitions.