§ 1316. Administrative and judicial review of public assistance determinations

Footnotes

1. 1 So in original. Probably should be followed by “or”.
2. 2 So in original. Probably should be capitalized.

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1935

   Social Security Amendments of 1965

   Pub. L. 89–97 title IV § 404(a) · 79 Stat. 288

   Enacted · 42 U.S.C. § 1316

   Aug. 14, 1935, ch. 531, title XI, § 1116, as added Pub. L. 89–97, title IV, § 404(a), July 30, 1965, 79 Stat. 419

   Source evidence

   Code source credit
   Aug. 14, 1935, ch. 531, title XI, § 1116, as added Pub. L. 89–97, title IV, § 404(a), July 30, 1965, 79 Stat. 419

   Enacted provision · exact public law section
   (a) Title XI of the Social Security Act is amended by 42 USC 1301. adding at the end thereof the following new section: “Sec. 1116. “administrative and judicial review of certain administrative determinations (a) (1) Whenever a State plan is submitted to the Secretary by a State for approval under title I, IV, X, XIV, XVI, or XIX, he shall, not later than 90 days after the date the plan is submitted 42 USC 301, 601, 1201, 1351, 1381. Ante, p. 343. to him, make a determination as to whether it conforms to the requirements for approval under such title. The 90-day period provided herein may be extended by written agreement of the Secretary and the affected State. “(2) Any State dissatisfied with a determination of the Secretary under paragraph (1) with respect to any plan may, within 60 days after it has been notified of such determination, file a petition with the Secretary for reconsideration of the issue of whether such plan conforms to the requirements for approval under such title. Within 30 days after receipt of such a petition, the Secretary shall notify the State of the time and place at which a hearing will be held for the purpose of reconsidering such issue. Such hearing shall be held not less than 20 days nor more than 60 days after the date notice of such hearing is furnished to such State, unless the Secretary and such State agree in writing to holding the hearing at another time. The Secretary shall affirm, modify, or reverse his original determination within 60 days of the conclusion of the hearing. “(3) Any State Which is dissatisfied with a final determination made by the Secretary on such a reconsideration or a final determination of the Secretary under section 4, 404, 1004, 1404, 1604j or 1904 may, within 60 days after it has been notified of such determination, file with the United States court of appeals for the circuit in which such State is located a petition for review of such determination. A copy of the petition shall be forthwith transmitted by the clerk of the court to the Secretary. The Secretary thereupon shall file in the court the record of the proceedings on which he based his determination as provided in section 2112 of title 28, United States Code. “(4) The findings of fact by the Secretary, if supported by substantial evidence, shall be conclusive; but the court, for good cause shown, may remand the case to the Secretary to take further evidence, and the Secretary may thereupon make new or modified findings of fact and may modify his previous action, and shall certify to the court the transcript and record of the further proceedings. Such new or modified findings of fact shall likewise be conclusive if supported by substantial evidence. “(5) The court shall have jurisdiction to affirm the action of the Secretary or to set it aside, in whole or in part. The judgment of the court shall be subject to review by the Supreme Court of the United States upon certiorari or certification as provided in section 1254 of 62 Stat. 928. title 28, United States Code. “(b) For the purposes of subsection (a), any amendment of a State plan approved under title I, IV, X, XIV, XVI, or XIX may, at the option of the State, be treated as the submission of a new State plan. “(c) Action pursuant to an initial determination of the Secretary described in subsection (a) shall not be stayed pending reconsideration, but in the event that the Secretary subsequently determines that his initial determination was incorrect he shall certify restitution forthwith in a lump sum of any funds incorrectly withheld or otherwise denied. “(d) Whenever the Secretary determines that any item or class of items on account of which Federal financial participation is claimed under title I, IV, X, XIV, XVI, or XIX shall be disallowed for such participation, the State shall be entitled to and upon request shall receive a reconsideration of the disallowance.”

2. 1968

   Social Security Amendments of 1967

   Pub. L. 90–248 § 241(c)(5)(A) · 81 Stat. 821

   Struck and inserted · 42 U.S.C. § 1316(a)(1)

   Pub. L. 90–248, § 241(c)(5)(A), struck out “IV,” after “I,” and inserted “or part A of subchapter IV,” after “XIX,”

   Source evidence

   Code amendment note
   Subsec. (a)(1). Pub. L. 90–248, § 241(c)(5)(A), struck out “IV,” after “I,” and inserted “or part A of subchapter IV,” after “XIX,”.

   Enacted provision · exact public law section
   (A) by striking out “IV,” in subsection (a)(1), and by inserting after “XIX,” in such subsection the following: “or part A of title IV,”; and

3. 1968

   Social Security Amendments of 1967

   Pub. L. 90–248 § 241(c)(5)(B) · 81 Stat. 821

   Struck and inserted · 42 U.S.C. § 1316(b); 42 U.S.C. § 1316(d)

   Pub. L. 90–248, § 241(c)(5)(B), struck out “IV,” after “I,” and inserted “, or part A of subchapter IV,” after “XIX”

   Source evidence

   Code amendment note
   Subsecs. (b), (d). Pub. L. 90–248, § 241(c)(5)(B), struck out “IV,” after “I,” and inserted “, or part A of subchapter IV,” after “XIX”.

   Enacted provision · exact public law section
   (B) by striking out “IV,” in subsections (b) and (d), and by inserting after “XIX” in such subsections the following: “, or part A of title IV,”.

4. 1973

   Pub. L. 93–233 § 18 · 87 Stat. 946

   Inserted · 42 U.S.C. § 1316(a)

   Pub. L. 93–233, § 18(z–2)(1)(C)(i), (ii), inserted references in par. (1) to subchapter VI of this chapter and in par. (3) to section 804 of this title

   Source evidence

   Code amendment note
   Subsec. (a). Pub. L. 93–233, § 18(z–2)(1)(C)(i), (ii), inserted references in par. (1) to subchapter VI of this chapter and in par. (3) to section 804 of this title.

   Enacted provision · exact public law section
   Sec. 18. Inclusion of All Wage Level Increases in Automatic Adjustment of Earnings Test (a) Section 203(f) (8) (B) (ii) of the Social Security Act 86 Stat. 1341. 42 USC 403. is amended by— (1) striking out “contribution and benefit base” and inserting “exempt amount” in lieu thereof; and (2) striking out “section 230(a)” and inserting “subparagraph (A) ” in lieu thereof. Inclusion in Old-Age Insurance Benefit in Certain Cases of Delayed Retirement (b) Section 202(w) of such Act is amended by inserting at the end 86 Stat. 1339. 42 USC 402. thereof the following new paragraph: “(5) If an individual’s primary insurance amount is determined under paragraph (3) of section 215(a) and, as a result of this subsection, 86 Stat. 1333. 42 USC 415. he would be entitled to a higher old-age insurance benefit if his primary insurance amount were determined under section 215(a) without regard to such paragraph, such individual’s old-age insurance benefit based upon his primary insurance amount determined under such paragraph shall be increased by an amount equal to the difference between such benefit and the benefit to which he would be entitled if his primary insurance amount were determined under such section without regard to such paragraph.” Elimination of Benefits at Age 72 for Uninsured Individuals Receiving Supplemental Security Income Benefits (c) Section 228(d) of such Act is amended by inserting “and such individual is not an individual with respect to whom supplemental 86 Stat. 1465. security income benefits are payable pursuant to title XVI or section Ante, p. 154. 42 USC 1381. 211 of Public Law 93–66 for the following month, nor shall such benefit be paid for such month if such individual is an individual with respect to whom supplemental security income benefits are payable pursuant to title XVI or section 211 of Public Law 93–66 for such month, unless the Secretary determines that such benefits are not payable with respect to such individual for the month following such month” immediately before the period at the end thereof. Limitations on Eligibility Determinations Under Resources Tests of State Plans (d) Section 1611 of such Act (as amended by Public Law 92–603) is amended by striking out subsection (g) and inserting in lieu thereof the following new subsection: “(g) In the case of any individual or any individual and his spouse (as the case may be) who— “(1) received aid or assistance for December 1973 under a plan 86 Stat. 1484, 1465. 42 USC 301, 1201, 1351, 1381. of a State approved under title I, X, XIV, or XVI, “(2) has, since December 31, 1973, continuously resided in the State under the plan of which he or they received such aid or assistance for December 1973, and “(3) has, since December 31, 1973, continuously been (except for periods not in excess of six consecutive months) an eligible individual or eligible spouse with respect to whom supplemental security income benefits are payable, the resources of such individual or such individual and his spouse (as the case may be) shall be deemed not to exceed the amount specified in sections 1611(a) (1) (B) and 1611(a) (2) (B) during any period that the resources of such individual or individuals and his spouse (as the case may be) does not exceed the maximum amount of resources specified in the State plan, as in effect for October 1972, under which he or they received such aid or assistance for December 1973.” Limitations on Eligibility and Benefit Determinations Under Income Tests of State Plans for Aid to the Blind (e) Section 1611 of such Act is amended by striking out subsection (h) and inserting in lieu thereof the following new subsection: “(h) In determining eligibility for, and the amount of, benefits payable under this section in the case of any individual or any individual and his spouse (as the case may be) who— “(1) received aid or assistance for December 1978 under a plan of a State approved under title X or XVI, “(2) is blind under the definition of that term in the plan, as in effect for October 1972, under which he or they received such aid or assistance for December 1978, “(3) has, since December 31, 1973, continuously resided in the State under the plan of which he or they received such aid or assistance for December 1973, and “(4) has, since December 31, 1973, continuously been (except for periods not in excess of six consecutive months) an eligible individual or an eligible spouse with respect to whom supplemental security income benefits are payable, there shall be disregarded an amount equal to the greater of (A) the maximum amount of any earned or unearned income which could have been disregarded under the State plan, as in effect for October 1972, under which he or they received such aid or assistance for December 1973, and (B) the amount which would be required to be disregarded under section 1612 without application of this subsection.” Correction of Erroneous Designations and Cross-References (f) (1) Section 226 of such Act is amended by— 86 Stat. 1371. 42 USC 426. (A) redesignating subsection (a)(1) as subsection (a); (B) redesignating clauses (A) and (B) of subsection (a), as redesignated by this subsection, as clauses (1) and (2), respectively; and (C) redesignating subsection (f) (as added by section 201 (b) (5) of the. Social Security Amendments of 1972 and redesignated by section 299L of that Act) and the subsection (f) (as enacted by section 101 of the Social Security Amendments of 1965 and redesignated by section 201(b) (5) of the Social Security Amendments of 1972) as subsections (n) and (i), respectively; and by inserting such subsections (h) and (i) (as so redesignated) immediately after subsection (g) of such section. (2) Section 226(h)(1)(A) of such Act, as redesignated by this subsection, is amended by striking out “and 202(e) (5), and the term ‘age 62’ in sections” and inserting “. 202(e) (5),” in lieu thereof. (3) Section 226(h)(1)(B) of such Act, as redesignated by this subsection, is amended by striking out “shall” and inserting “and the phrase ‘before he attained age 60’ in the matter following subparagraph (G) of section 202(f) (1) shall each” in lieu thereof. (4) Paragraphs (2) and (3) of section 226(h) of such Act, as redesignated by this subsection, are each amended by striking out “(a) (2)” and inserting “b” in lieu thereof. Initial Payments to Presumptively Disabled Individuals Unrecoverable Only if Individual Is Ineligible Because Not Disabled (g) Section 1631(a)(4)(B) of such Act is amended by inserting 86 Stat. 1475. 42 USC 1383. “solely because such individual is determined not to be disabled” immediately before the period at the end thereof. Technical Correction of Limitation on Fiscal Liability of States for Optional Supplementation (h) (1) Section 401(a) (1) of the Social Security Amendments of 1972 is amended by— 86 Stat. 1485. 42 USC 1382a note. (A) inserting “, other than fiscal year 1974,” immediately after “any fiscal year”; and (B) inserting “, and the amount payable for fiscal year 1974 pursuant to such agreement or agreements shall not exceed one-half of the non-Federal share of such expenditures” immediately before the period of the end thereof. (2) Section 401(c)(1) of such Act is amended by inserting “excluding” 86 Stat. 1487. immediately before “expenditures authorized under section 1119”. Modification of Transitional Administrative Provisions (i) Section 402 of the Social Security Amendments of 1972 is amended by— (1) striking out “XVI” the first time that it appears therein and inserting VI” in lieu thereof; (2) inserting “the third and fourth quarters in the fiscal year ending June 30, 1974, and” immediately after “with respect to expenditures for”; and (3) inserting “the third and fourth quarters of the fiscal year ending June 30, 1974, and any quarter of” immediately after “during such portion of”. Inclusion of Title VI in Limitation on Grants to States for Social Services (j) Section 1130(a) of such Act is amended by inserting “603(a) (I),” immediately after “403(a) (3),”. Clarification of Coverage of Hospitalization for Dental Services (k) (1) Section 1814(a) (2) (E) of such Act (as amended by Public Law 86 Stat. 1447. 42 USC 1395f. 92–603) is amended to read as follows: “(E) in the case of inpatient hospital services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth, the individual, because of his underlying medical condition and clinical status, requires hospitalization in connection with the provision of such dental services;”. (2) The last sentence of section 1814(a) is amended by striking out “or (D)” and inserting “(D), or (E)” in lieu thereof. (3) Section 1862(a) (12) of such Act is amended by striking out “a dental procedure” and all that follows thereafter, and inserting “the provision of such dental services if the individual, because of his underlying medical condition and clinical status, requires hospitalization in connection with the provision of such services; or” in lieu thereof. Continuation of State Agreements for Coverage of Certain Individuals (l) Section 1843(b) of such Act is amended by adding at the end thereof the following; “Effective January 1, 1974, and subject to 86 Stat. 1381. 42 USC 1396a. section 1902(f), the Secretary shall, at the request of any State not eligible to participate in the State plan program established under 42 USC 1381. title XVI, continue in effect the agreement entered into under this section with such State subject to such modifications as the Secretary may by regulations provide to take account of the termination of any 42 USC 301, 1201, 1351. plans of such State approved under titles I, X, XIV, and XVI and the establishment of the supplemental security income program under title XVI.”. Technical Improvement of Provisions Governing Disposition of HMO Savings (m) Section 1876 (a) (3) (A) (ii) of such Act is amended by striking out “, with the apportionment of savings being proportional to the losses absorbed and not yet offset”. Technical Improvement of Provisions Governing Allowable HMO Premium Charges (n) The last sentence of section 1876(g) (2) of such Act is amended 86 Stat. 1401. 42 USC 1395mm. by— (1) inserting “of its premium rate, or other charges” immediately after “portion”; (2) striking out “may” and inserting “shall”; (3) striking out “(i) ”; and (4) striking out “less (ii) the actuarial value of other charges made in lieu of such deductible and coinsurance”. Applications for Assistance on Behalf of Deceased Individuals (o) Section 1902(a) (34) of the Social Security Act (as amended by Public Law 92–603) is amended by inserting “(or application was made 86 Stat. 1446. 42 USC 1396a. on his behalf in the case of a deceased individual) ” immediately after “lie made application”. Expansion of Intermediate Care Facility Ownership Disclosure Requirements (p) Section 1902(a) (35) (A) of such Act is amended by inserting 86 Stat. 1460. 42 USC 1396a. “or who is the owner (in whole or in part) of any mortgage, deed of trust, note, or other obligation secured (in whole or in part) by such intermediate care facility or any of the property or assets of such inter-mediate care facility” immediately after “intermediate care facility”. Technical Modification of Extended Medicaid Eligibility for AFDC Recipients (q) Section 1902(e) of such Act is amended to read as follows: 86 Stat. 1381. 42 USC 1396a. “(e) Notwithstanding any other provision of this title, effective January 1, 1974, each State plan approved under this title must provide that each family which was receiving aid pursuant to a plan of the State approved under part A of title IV in at least 3 of the 6 months immediately preceding the month in which such family became ineligible for such aid because of increased hours of, or increased income from, employment, shall, while a member of such family is employed, remain eligible for assistance under the plan approved under this title (as though the family was receiving aid Linder the plan approved under part A of title IV) for 4 calendar months beginning with the month in which such family became ineligible for aid under the plan approved under part A or title IV because of income and resources or hours of work limitations contained in such plan.”. Limitation on Payments to States for Expenditures in Relation to Disabled Individuals Eligible for Medicare (r) (1) Section 1903(a) (1) of such Act is amended by inserting “and 42 USC 1396b. disabled individuals entitled to hospital insurance benefits under title XVIII” immediately after “individuals sixty-five years of age or older”. (2) Section 1903(b) (2) of such Act is amended by inserting “and disabled individuals entitled to hospital insurance benefits under title XVIII” immediately after “individuals aged 65 or over”. Federal Payment for Cost of Inspecting Institutions Limited to Expenses Incurred During Covered Period (s) Section 1903(a) (4) of such Act is amended by striking out “sums expended” and inserting “sums expended with respect to costs incurred” in lieu thereof. Federal Payment for Family Planning Expenditures Not Limited to Administrative Costs (t) Section 1903(a) (5) of such Act is amended by striking out “(as found necessary by the Secretary for the proper and efficient administration of the plan) ”. Exception to Limitation on Payments to States for Expenditures in Relation to Individuals Eligible for Medicare (u) Section 1903(b) (2) of such Act is amended by inserting “, other than amounts expended under provisions of the plan of such State required by section 1902(a) (34)” immediately before the period at the end thereof. Utilization Review by Medical Personnel Associated With an Institution (v) Section 1903(g) (1) (C) of such Act is amended by striking out “and who are not. employed by” and by inserting “or, except in the case of hospitals, employed by the institution” immediately after “any such institution”. Authority To Prescribe Standards Under Title XIX for Active Treatment of Mental Illness (w) Section 1905(h) (1) (B) of such Act is amended by— (1) striking out “, involves active treatment (i)” and inserting “(i) involve active treatment” in lieu thereof, (2) striking out “pursuant to title XVIII”, and (3) striking out “(ii) which” and inserting “(ii)” in lieu thereof. Correction of Erroneous Designations and Cross References (x) (1) Section 1902(a) (13) (C) of such Act is amended by striking out “(14)” and inserting “(16)” in lieu thereof. (2) Section 1902(a) (33) (A) of such Act is amended by striking out “last sentence” and inserting “penultimate sentence” in lieu thereof. (3) Section 1902(a) of such Act is amended by— (A) striking out the period at the end of paragraph (35) and inserting “; and” in lieu thereof; and (B) redesignating paragraph (37) as paragraph (36). (4) Sections 1902 (a) (21 ), (24), and (26) (B), and the last sentence of section 1902(d), of such Act are each amended by striking out “nursing home” and “nursing homes” each time that they appear therein and inserting “nursing facility” and “nursing facilities”, respectively, in lieu thereof. (5) Section 1903(a) of such Act is amended by striking out “and section 1117” in the first parenthetical phrase. (6) Section 1903(b) of such Act is amended by redesignating paragraphs (2) and (3) as paragraphs (1) and (2), respectively. (7) Section 1905(a) (16) of such Act is amended by striking out 96 Stat. 1460. 42 USC 1396d. “under 21, as defined in subsection (e);” and inserting “under age 21, as defined in subsection (h); and” in lieu thereof. (8) Section 1905(c) of such Act is amended by striking out “skilled 85 Stat. 809; 86 Stat. 1464. nursing home” each time that it appears therein and inserting “skilled nursing facility” in lieu thereof. (9) Section 1905 of such Act is amended by redesignating subsection (h) (which was enacted by section 299L(b) of the Social Security Amendments of 1972) as subsection (i). (10) Section 1905(h) (2) is amended by striking out “(e) (1)” and 86 Stat. 1461. inserting “(1) ” in lieu thereof. Deletion of Obsolete Provisions (y) (1) Section 1903 of such Act is amended by— 79 Stat. 349. 42 USC 1396b. (A) striking out subsection (c); (B) striking out “(a), (b), and (c)” in subsection (d) and inserting “(a) and (b)” in lieu thereof. (2) Section 1905(b) of such Act is amended by striking out everything 42 USC 1396d. after “section 1110(a)(8)” and inserting a period in lieu I hereof. (3) Section 1908 of such Act is amended by striking out the last 42 USC 1396g. sentence of subsection (d) and subsections (e) and (f), and redesignatingsubsection (g) as subsection (e). Determination of Amount of Exclusion for Disapproved Capital Expenditures by Institutions Reimbursed on Fixed Fee or Negotiated Rate Basis (z) The last sentence of section 1122(d) (1) of such Act is amended 85 Stat. 1386. 42 USC 1320a–1. by inserting “or a fixed fee or negotiated rate” immediately after “per capita” each tune that it appears therein. Technical Improvement of Authority To Include Expenses Related to Capital Expenditures in Certain Cases (z–1) Section 1122(d)(2) of such Act is amended by striking out “include” the last time that it appears therein and inserting “exclude” in lieu thereof. Conforming Amendments to Title XI of the Social Security Act (z–2) (1) Title XI of the Social Security Act is amended— (A) in section 1101 (a) (1), by— 42 USC 1301. (i) Striking out “I.”. “X”. “XIV,”, and “XVI.”, and (ii) by adding at the end of such section 1101(a) the following new sentence; “In the. case of Puerto Rico, the Virgin Islands, and Guam, titles I, X, and XIV, and title XVI (as in effect without regard to the amendment made by 42 USC 301, 1201, 1351, 1381. 86 Stat. 1465. section 301 of the Social Security Amendments of 1972) shall continue to apply, and the term ‘State’ when used in such titles (but not in title XVI as in effect pursuant to such amendment after December 31, 1973) includes Puerto Rico, the Virgin Islands, and Guam,”, (B) in section 1115, by— 42 USC 1315. (i) inserting (in the matter preceding subsection (a)) “VI,” immediately after “title I,”, (ii) inserting (in subsection (a)) “602,” immediately after “402”. and J (iii) inserting (in subsection (b)) “603,” immediately after “403,”, and (C) in section 1116, by— (i) inserting (in subsection (a)(1)) “VI,” immediately after “title I,”, (ii) inserting (in subsection (a)(3)) “604,” immediately after “404,”, (iii) inserting (in subsection (b)) “VI,” immediately after “title I”, and (iv) inserting (in subsection (d)) “VI,” immediately after “title I,”. (2) The amendments made by this subsection shall be effective on and after January 1, 1974. Effective Dates (z–3) (1) The amendments made by subsections (g), (h), (j), and (1) shall be effective January 1, 1974. (2) The amendment s made by subsection (k) shall be effective with respect to admissions subject to the provisions of section 1814(a) (2) 42 USC 1395f. of the Social Security Act which occur after December 31, 1972. (3) The amendments made by subsections (m) and (n) shall be effective with respect, co services provided after June 30, 1973. (4) The amendments made by subsections (o) and (u) shall be effective July 1, 1973.

5. 1973

   Pub. L. 93–233 § 18 · 87 Stat. 946

   Inserted · 42 U.S.C. § 1316(b); 42 U.S.C. § 1316(d)

   Pub. L. 93–233, § 18(z–2)(1)(C)(iii), (iv), inserted reference to subchapter VI of this chapter

   Source evidence

   Code amendment note
   Subsecs. (b), (d). Pub. L. 93–233, § 18(z–2)(1)(C)(iii), (iv), inserted reference to subchapter VI of this chapter.

   Enacted provision · exact public law section
   Sec. 18. Inclusion of All Wage Level Increases in Automatic Adjustment of Earnings Test (a) Section 203(f) (8) (B) (ii) of the Social Security Act 86 Stat. 1341. 42 USC 403. is amended by— (1) striking out “contribution and benefit base” and inserting “exempt amount” in lieu thereof; and (2) striking out “section 230(a)” and inserting “subparagraph (A) ” in lieu thereof. Inclusion in Old-Age Insurance Benefit in Certain Cases of Delayed Retirement (b) Section 202(w) of such Act is amended by inserting at the end 86 Stat. 1339. 42 USC 402. thereof the following new paragraph: “(5) If an individual’s primary insurance amount is determined under paragraph (3) of section 215(a) and, as a result of this subsection, 86 Stat. 1333. 42 USC 415. he would be entitled to a higher old-age insurance benefit if his primary insurance amount were determined under section 215(a) without regard to such paragraph, such individual’s old-age insurance benefit based upon his primary insurance amount determined under such paragraph shall be increased by an amount equal to the difference between such benefit and the benefit to which he would be entitled if his primary insurance amount were determined under such section without regard to such paragraph.” Elimination of Benefits at Age 72 for Uninsured Individuals Receiving Supplemental Security Income Benefits (c) Section 228(d) of such Act is amended by inserting “and such individual is not an individual with respect to whom supplemental 86 Stat. 1465. security income benefits are payable pursuant to title XVI or section Ante, p. 154. 42 USC 1381. 211 of Public Law 93–66 for the following month, nor shall such benefit be paid for such month if such individual is an individual with respect to whom supplemental security income benefits are payable pursuant to title XVI or section 211 of Public Law 93–66 for such month, unless the Secretary determines that such benefits are not payable with respect to such individual for the month following such month” immediately before the period at the end thereof. Limitations on Eligibility Determinations Under Resources Tests of State Plans (d) Section 1611 of such Act (as amended by Public Law 92–603) is amended by striking out subsection (g) and inserting in lieu thereof the following new subsection: “(g) In the case of any individual or any individual and his spouse (as the case may be) who— “(1) received aid or assistance for December 1973 under a plan 86 Stat. 1484, 1465. 42 USC 301, 1201, 1351, 1381. of a State approved under title I, X, XIV, or XVI, “(2) has, since December 31, 1973, continuously resided in the State under the plan of which he or they received such aid or assistance for December 1973, and “(3) has, since December 31, 1973, continuously been (except for periods not in excess of six consecutive months) an eligible individual or eligible spouse with respect to whom supplemental security income benefits are payable, the resources of such individual or such individual and his spouse (as the case may be) shall be deemed not to exceed the amount specified in sections 1611(a) (1) (B) and 1611(a) (2) (B) during any period that the resources of such individual or individuals and his spouse (as the case may be) does not exceed the maximum amount of resources specified in the State plan, as in effect for October 1972, under which he or they received such aid or assistance for December 1973.” Limitations on Eligibility and Benefit Determinations Under Income Tests of State Plans for Aid to the Blind (e) Section 1611 of such Act is amended by striking out subsection (h) and inserting in lieu thereof the following new subsection: “(h) In determining eligibility for, and the amount of, benefits payable under this section in the case of any individual or any individual and his spouse (as the case may be) who— “(1) received aid or assistance for December 1978 under a plan of a State approved under title X or XVI, “(2) is blind under the definition of that term in the plan, as in effect for October 1972, under which he or they received such aid or assistance for December 1978, “(3) has, since December 31, 1973, continuously resided in the State under the plan of which he or they received such aid or assistance for December 1973, and “(4) has, since December 31, 1973, continuously been (except for periods not in excess of six consecutive months) an eligible individual or an eligible spouse with respect to whom supplemental security income benefits are payable, there shall be disregarded an amount equal to the greater of (A) the maximum amount of any earned or unearned income which could have been disregarded under the State plan, as in effect for October 1972, under which he or they received such aid or assistance for December 1973, and (B) the amount which would be required to be disregarded under section 1612 without application of this subsection.” Correction of Erroneous Designations and Cross-References (f) (1) Section 226 of such Act is amended by— 86 Stat. 1371. 42 USC 426. (A) redesignating subsection (a)(1) as subsection (a); (B) redesignating clauses (A) and (B) of subsection (a), as redesignated by this subsection, as clauses (1) and (2), respectively; and (C) redesignating subsection (f) (as added by section 201 (b) (5) of the. Social Security Amendments of 1972 and redesignated by section 299L of that Act) and the subsection (f) (as enacted by section 101 of the Social Security Amendments of 1965 and redesignated by section 201(b) (5) of the Social Security Amendments of 1972) as subsections (n) and (i), respectively; and by inserting such subsections (h) and (i) (as so redesignated) immediately after subsection (g) of such section. (2) Section 226(h)(1)(A) of such Act, as redesignated by this subsection, is amended by striking out “and 202(e) (5), and the term ‘age 62’ in sections” and inserting “. 202(e) (5),” in lieu thereof. (3) Section 226(h)(1)(B) of such Act, as redesignated by this subsection, is amended by striking out “shall” and inserting “and the phrase ‘before he attained age 60’ in the matter following subparagraph (G) of section 202(f) (1) shall each” in lieu thereof. (4) Paragraphs (2) and (3) of section 226(h) of such Act, as redesignated by this subsection, are each amended by striking out “(a) (2)” and inserting “b” in lieu thereof. Initial Payments to Presumptively Disabled Individuals Unrecoverable Only if Individual Is Ineligible Because Not Disabled (g) Section 1631(a)(4)(B) of such Act is amended by inserting 86 Stat. 1475. 42 USC 1383. “solely because such individual is determined not to be disabled” immediately before the period at the end thereof. Technical Correction of Limitation on Fiscal Liability of States for Optional Supplementation (h) (1) Section 401(a) (1) of the Social Security Amendments of 1972 is amended by— 86 Stat. 1485. 42 USC 1382a note. (A) inserting “, other than fiscal year 1974,” immediately after “any fiscal year”; and (B) inserting “, and the amount payable for fiscal year 1974 pursuant to such agreement or agreements shall not exceed one-half of the non-Federal share of such expenditures” immediately before the period of the end thereof. (2) Section 401(c)(1) of such Act is amended by inserting “excluding” 86 Stat. 1487. immediately before “expenditures authorized under section 1119”. Modification of Transitional Administrative Provisions (i) Section 402 of the Social Security Amendments of 1972 is amended by— (1) striking out “XVI” the first time that it appears therein and inserting VI” in lieu thereof; (2) inserting “the third and fourth quarters in the fiscal year ending June 30, 1974, and” immediately after “with respect to expenditures for”; and (3) inserting “the third and fourth quarters of the fiscal year ending June 30, 1974, and any quarter of” immediately after “during such portion of”. Inclusion of Title VI in Limitation on Grants to States for Social Services (j) Section 1130(a) of such Act is amended by inserting “603(a) (I),” immediately after “403(a) (3),”. Clarification of Coverage of Hospitalization for Dental Services (k) (1) Section 1814(a) (2) (E) of such Act (as amended by Public Law 86 Stat. 1447. 42 USC 1395f. 92–603) is amended to read as follows: “(E) in the case of inpatient hospital services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth, the individual, because of his underlying medical condition and clinical status, requires hospitalization in connection with the provision of such dental services;”. (2) The last sentence of section 1814(a) is amended by striking out “or (D)” and inserting “(D), or (E)” in lieu thereof. (3) Section 1862(a) (12) of such Act is amended by striking out “a dental procedure” and all that follows thereafter, and inserting “the provision of such dental services if the individual, because of his underlying medical condition and clinical status, requires hospitalization in connection with the provision of such services; or” in lieu thereof. Continuation of State Agreements for Coverage of Certain Individuals (l) Section 1843(b) of such Act is amended by adding at the end thereof the following; “Effective January 1, 1974, and subject to 86 Stat. 1381. 42 USC 1396a. section 1902(f), the Secretary shall, at the request of any State not eligible to participate in the State plan program established under 42 USC 1381. title XVI, continue in effect the agreement entered into under this section with such State subject to such modifications as the Secretary may by regulations provide to take account of the termination of any 42 USC 301, 1201, 1351. plans of such State approved under titles I, X, XIV, and XVI and the establishment of the supplemental security income program under title XVI.”. Technical Improvement of Provisions Governing Disposition of HMO Savings (m) Section 1876 (a) (3) (A) (ii) of such Act is amended by striking out “, with the apportionment of savings being proportional to the losses absorbed and not yet offset”. Technical Improvement of Provisions Governing Allowable HMO Premium Charges (n) The last sentence of section 1876(g) (2) of such Act is amended 86 Stat. 1401. 42 USC 1395mm. by— (1) inserting “of its premium rate, or other charges” immediately after “portion”; (2) striking out “may” and inserting “shall”; (3) striking out “(i) ”; and (4) striking out “less (ii) the actuarial value of other charges made in lieu of such deductible and coinsurance”. Applications for Assistance on Behalf of Deceased Individuals (o) Section 1902(a) (34) of the Social Security Act (as amended by Public Law 92–603) is amended by inserting “(or application was made 86 Stat. 1446. 42 USC 1396a. on his behalf in the case of a deceased individual) ” immediately after “lie made application”. Expansion of Intermediate Care Facility Ownership Disclosure Requirements (p) Section 1902(a) (35) (A) of such Act is amended by inserting 86 Stat. 1460. 42 USC 1396a. “or who is the owner (in whole or in part) of any mortgage, deed of trust, note, or other obligation secured (in whole or in part) by such intermediate care facility or any of the property or assets of such inter-mediate care facility” immediately after “intermediate care facility”. Technical Modification of Extended Medicaid Eligibility for AFDC Recipients (q) Section 1902(e) of such Act is amended to read as follows: 86 Stat. 1381. 42 USC 1396a. “(e) Notwithstanding any other provision of this title, effective January 1, 1974, each State plan approved under this title must provide that each family which was receiving aid pursuant to a plan of the State approved under part A of title IV in at least 3 of the 6 months immediately preceding the month in which such family became ineligible for such aid because of increased hours of, or increased income from, employment, shall, while a member of such family is employed, remain eligible for assistance under the plan approved under this title (as though the family was receiving aid Linder the plan approved under part A of title IV) for 4 calendar months beginning with the month in which such family became ineligible for aid under the plan approved under part A or title IV because of income and resources or hours of work limitations contained in such plan.”. Limitation on Payments to States for Expenditures in Relation to Disabled Individuals Eligible for Medicare (r) (1) Section 1903(a) (1) of such Act is amended by inserting “and 42 USC 1396b. disabled individuals entitled to hospital insurance benefits under title XVIII” immediately after “individuals sixty-five years of age or older”. (2) Section 1903(b) (2) of such Act is amended by inserting “and disabled individuals entitled to hospital insurance benefits under title XVIII” immediately after “individuals aged 65 or over”. Federal Payment for Cost of Inspecting Institutions Limited to Expenses Incurred During Covered Period (s) Section 1903(a) (4) of such Act is amended by striking out “sums expended” and inserting “sums expended with respect to costs incurred” in lieu thereof. Federal Payment for Family Planning Expenditures Not Limited to Administrative Costs (t) Section 1903(a) (5) of such Act is amended by striking out “(as found necessary by the Secretary for the proper and efficient administration of the plan) ”. Exception to Limitation on Payments to States for Expenditures in Relation to Individuals Eligible for Medicare (u) Section 1903(b) (2) of such Act is amended by inserting “, other than amounts expended under provisions of the plan of such State required by section 1902(a) (34)” immediately before the period at the end thereof. Utilization Review by Medical Personnel Associated With an Institution (v) Section 1903(g) (1) (C) of such Act is amended by striking out “and who are not. employed by” and by inserting “or, except in the case of hospitals, employed by the institution” immediately after “any such institution”. Authority To Prescribe Standards Under Title XIX for Active Treatment of Mental Illness (w) Section 1905(h) (1) (B) of such Act is amended by— (1) striking out “, involves active treatment (i)” and inserting “(i) involve active treatment” in lieu thereof, (2) striking out “pursuant to title XVIII”, and (3) striking out “(ii) which” and inserting “(ii)” in lieu thereof. Correction of Erroneous Designations and Cross References (x) (1) Section 1902(a) (13) (C) of such Act is amended by striking out “(14)” and inserting “(16)” in lieu thereof. (2) Section 1902(a) (33) (A) of such Act is amended by striking out “last sentence” and inserting “penultimate sentence” in lieu thereof. (3) Section 1902(a) of such Act is amended by— (A) striking out the period at the end of paragraph (35) and inserting “; and” in lieu thereof; and (B) redesignating paragraph (37) as paragraph (36). (4) Sections 1902 (a) (21 ), (24), and (26) (B), and the last sentence of section 1902(d), of such Act are each amended by striking out “nursing home” and “nursing homes” each time that they appear therein and inserting “nursing facility” and “nursing facilities”, respectively, in lieu thereof. (5) Section 1903(a) of such Act is amended by striking out “and section 1117” in the first parenthetical phrase. (6) Section 1903(b) of such Act is amended by redesignating paragraphs (2) and (3) as paragraphs (1) and (2), respectively. (7) Section 1905(a) (16) of such Act is amended by striking out 96 Stat. 1460. 42 USC 1396d. “under 21, as defined in subsection (e);” and inserting “under age 21, as defined in subsection (h); and” in lieu thereof. (8) Section 1905(c) of such Act is amended by striking out “skilled 85 Stat. 809; 86 Stat. 1464. nursing home” each time that it appears therein and inserting “skilled nursing facility” in lieu thereof. (9) Section 1905 of such Act is amended by redesignating subsection (h) (which was enacted by section 299L(b) of the Social Security Amendments of 1972) as subsection (i). (10) Section 1905(h) (2) is amended by striking out “(e) (1)” and 86 Stat. 1461. inserting “(1) ” in lieu thereof. Deletion of Obsolete Provisions (y) (1) Section 1903 of such Act is amended by— 79 Stat. 349. 42 USC 1396b. (A) striking out subsection (c); (B) striking out “(a), (b), and (c)” in subsection (d) and inserting “(a) and (b)” in lieu thereof. (2) Section 1905(b) of such Act is amended by striking out everything 42 USC 1396d. after “section 1110(a)(8)” and inserting a period in lieu I hereof. (3) Section 1908 of such Act is amended by striking out the last 42 USC 1396g. sentence of subsection (d) and subsections (e) and (f), and redesignatingsubsection (g) as subsection (e). Determination of Amount of Exclusion for Disapproved Capital Expenditures by Institutions Reimbursed on Fixed Fee or Negotiated Rate Basis (z) The last sentence of section 1122(d) (1) of such Act is amended 85 Stat. 1386. 42 USC 1320a–1. by inserting “or a fixed fee or negotiated rate” immediately after “per capita” each tune that it appears therein. Technical Improvement of Authority To Include Expenses Related to Capital Expenditures in Certain Cases (z–1) Section 1122(d)(2) of such Act is amended by striking out “include” the last time that it appears therein and inserting “exclude” in lieu thereof. Conforming Amendments to Title XI of the Social Security Act (z–2) (1) Title XI of the Social Security Act is amended— (A) in section 1101 (a) (1), by— 42 USC 1301. (i) Striking out “I.”. “X”. “XIV,”, and “XVI.”, and (ii) by adding at the end of such section 1101(a) the following new sentence; “In the. case of Puerto Rico, the Virgin Islands, and Guam, titles I, X, and XIV, and title XVI (as in effect without regard to the amendment made by 42 USC 301, 1201, 1351, 1381. 86 Stat. 1465. section 301 of the Social Security Amendments of 1972) shall continue to apply, and the term ‘State’ when used in such titles (but not in title XVI as in effect pursuant to such amendment after December 31, 1973) includes Puerto Rico, the Virgin Islands, and Guam,”, (B) in section 1115, by— 42 USC 1315. (i) inserting (in the matter preceding subsection (a)) “VI,” immediately after “title I,”, (ii) inserting (in subsection (a)) “602,” immediately after “402”. and J (iii) inserting (in subsection (b)) “603,” immediately after “403,”, and (C) in section 1116, by— (i) inserting (in subsection (a)(1)) “VI,” immediately after “title I,”, (ii) inserting (in subsection (a)(3)) “604,” immediately after “404,”, (iii) inserting (in subsection (b)) “VI,” immediately after “title I”, and (iv) inserting (in subsection (d)) “VI,” immediately after “title I,”. (2) The amendments made by this subsection shall be effective on and after January 1, 1974. Effective Dates (z–3) (1) The amendments made by subsections (g), (h), (j), and (1) shall be effective January 1, 1974. (2) The amendment s made by subsection (k) shall be effective with respect to admissions subject to the provisions of section 1814(a) (2) 42 USC 1395f. of the Social Security Act which occur after December 31, 1972. (3) The amendments made by subsections (m) and (n) shall be effective with respect, co services provided after June 30, 1973. (4) The amendments made by subsections (o) and (u) shall be effective July 1, 1973.

6. 1975

   Social Services Amendments of 1974

   Pub. L. 93–647 § 3(d)(1) · 88 Stat. 2337

   Substituted · 42 U.S.C. § 1316(a)(1)

   Pub. L. 93–647, § 3(d)(1), substituted “XIX or XX” for “or XIX”

   Source evidence

   Code amendment note
   Subsec. (a)(1). Pub. L. 93–647, § 3(d)(1), substituted “XIX or XX” for “or XIX”.

   Enacted provision · exact public law section
   (1) striking out “or XIX” in subsections (a)(1) and (b) and inserting “XIX or XX” in lieu thereof,

7. 1975

   Social Services Amendments of 1974

   Pub. L. 93–647 § 3(d)(2) · 88 Stat. 2337

   Substituted · 42 U.S.C. § 1316(a)(3)

   Pub. L. 93–647, § 3(d)(2), substituted “1396c, or 1397b” for “or 1396c”

   Source evidence

   Code amendment note
   Subsec. (a)(3). Pub. L. 93–647, § 3(d)(2), substituted “1396c, or 1397b” for “or 1396c”.

   Enacted provision · exact public law section
   (2) striking out “or 1904” and inserting “1904, or 2003” in lieu thereof in subsection (a)(3), and

8. 1975

   Social Services Amendments of 1974

   Pub. L. 93–647 § 3(d)(1) · 88 Stat. 2337

   Substituted · 42 U.S.C. § 1316(b)

   Pub. L. 93–647, § 3(d)(1), substituted “XIX or XX” for “or XIX”

   Source evidence

   Code amendment note
   Subsec. (b). Pub. L. 93–647, § 3(d)(1), substituted “XIX or XX” for “or XIX”.

   Enacted provision · exact public law section
   (1) striking out “or XIX” in subsections (a)(1) and (b) and inserting “XIX or XX” in lieu thereof,

9. 1975

   Social Services Amendments of 1974

   Pub. L. 93–647 § 3(d)(3) · 88 Stat. 2337

   Inserted · 42 U.S.C. § 1316(d)

   Pub. L. 93–647, § 3(d)(3), inserted “XX,” after “XIX,”

   Source evidence

   Code amendment note
   Subsec. (d). Pub. L. 93–647, § 3(d)(3), inserted “XX,” after “XIX,”.

   Enacted provision · exact public law section
   (3) inserting “XX,” immediately after “XIX,” in subsection (d).

10. 1981

    Pub. L. 97–35 § 2353(h)(1) · 95 Stat. 357

    1. Amended · 42 U.S.C. § 1316(a)(1)

       Pub. L. 97–35, § 2353(h)(1), as amended by Pub. L. 98–369, § 2354(c)(2)

    2. Substituted · 42 U.S.C. § 1316(a)(1)

       Pub. L. 97–35, § 2353(h)(1), as substituted “or XIX” for “XIX or XX”

    Source evidence

    Code amendment note
    Subsec. (a)(1). Pub. L. 97–35, § 2353(h)(1), as amended by Pub. L. 98–369, § 2354(c)(2), substituted “or XIX” for “XIX or XX”.

    Enacted provision · exact public law section
    (1) in subsections (a)(1) and (b), by striking out “XIX, or XX” and inserting in lieu thereof “or XIX”;

11. 1981

    Pub. L. 97–35 § 2353(h)(2) · 95 Stat. 357

    Substituted · 42 U.S.C. § 1316(a)(3)

    Pub. L. 97–35, § 2353(h)(2), substituted “or 1396c of this title” for “1396c, or 1397b of this title”

    Source evidence

    Code amendment note
    Subsec. (a)(3). Pub. L. 97–35, § 2353(h)(2), substituted “or 1396c of this title” for “1396c, or 1397b of this title”.

    Enacted provision · exact public law section
    (2) in subsection (a)(3), by striking out “1904, or 2003” and inserting in lieu thereof “or 1904”; and

12. 1981

    Pub. L. 97–35 § 2353(h)(1) · 95 Stat. 357

    1. Amended · 42 U.S.C. § 1316(b)

       Pub. L. 97–35, § 2353(h)(1), as amended by Pub. L. 98–369, § 2354(c)(2)

    2. Substituted · 42 U.S.C. § 1316(b)

       Pub. L. 97–35, § 2353(h)(1), as substituted “or XIX” for “XIX or XX”

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 97–35, § 2353(h)(1), as amended by Pub. L. 98–369, § 2354(c)(2), substituted “or XIX” for “XIX or XX”.

    Enacted provision · exact public law section
    (1) in subsections (a)(1) and (b), by striking out “XIX, or XX” and inserting in lieu thereof “or XIX”;

13. 1981

    Pub. L. 97–35 § 2353(h)(3) · 95 Stat. 357

    Substituted · 42 U.S.C. § 1316(d)

    Pub. L. 97–35, § 2353(h)(3), substituted “or XIX” for “XIX, or XX”

    Source evidence

    Code amendment note
    Subsec. (d). Pub. L. 97–35, § 2353(h)(3), substituted “or XIX” for “XIX, or XX”.

    Enacted provision · exact public law section
    (3) in subsection (d), by striking out “XIX, XX” and inserting in lieu thereof “or XIX”.

14. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2663(e)(6)(A) · 98 Stat. 494

    Struck · 42 U.S.C. § 1316(a)(1)

    Pub. L. 98–369, § 2663(e)(6)(A), struck out “VI,” after “I,”

    Source evidence

    Code amendment note
    Subsec. (a)(1). Pub. L. 98–369, § 2663(e)(6)(A), struck out “VI,” after “I,”.

    Enacted provision · exact public law section
    (A) by striking out “VI,” in subsections (a)(1), (b), and (d);

15. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2354(c)(2) · 98 Stat. 494

    Changed · 42 U.S.C. § 1316(a)(1)

    Pub. L. 98–369, § 2354(c)(2), corrected typographical error in directory language of Pub. L. 97–35, § 2353(h)(1). See 1981 Amendment note below

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 98–369, § 2354(c)(2), corrected typographical error in directory language of Pub. L. 97–35, § 2353(h)(1). See 1981 Amendment note below.

    Enacted provision · exact public law section
    (2) Section 2353(h)(1) of Public Law 97–35 is amended by striking out the comma after “XIX”.

16. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2663(e)(6)(B) · 98 Stat. 494

    Struck · 42 U.S.C. § 1316(a)(3)

    Pub. L. 98–369, § 2663(e)(6)(B), struck out “804,” after “604,”

    Source evidence

    Code amendment note
    Subsec. (a)(3). Pub. L. 98–369, § 2663(e)(6)(B), struck out “804,” after “604,”.

    Enacted provision · exact public law section
    (B) by striking out “604,” in subsection (a)(3); and

17. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2663(e)(6)(A) · 98 Stat. 494

    Struck · 42 U.S.C. § 1316(b)

    Pub. L. 98–369, § 2663(e)(6)(A), struck out “VI,” after “I,”

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 98–369, § 2663(e)(6)(A), struck out “VI,” after “I,”.

    Enacted provision · exact public law section
    (A) by striking out “VI,” in subsections (a)(1), (b), and (d);

18. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2354(c)(2) · 98 Stat. 494

    Changed · 42 U.S.C. § 1316(b)

    Pub. L. 98–369, § 2354(c)(2), corrected typographical error in directory language of Pub. L. 97–35, § 2353(h)(1). See 1981 Amendment note below

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 98–369, § 2354(c)(2), corrected typographical error in directory language of Pub. L. 97–35, § 2353(h)(1). See 1981 Amendment note below.

    Enacted provision · exact public law section
    (2) Section 2353(h)(1) of Public Law 97–35 is amended by striking out the comma after “XIX”.

19. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2663(e)(6)(C) · 98 Stat. 494

    Substituted · 42 U.S.C. § 1316(d)

    Pub. L. 98–369, § 2663(e)(6)(C), substituted “XVI, or XIX, or part A” for “XVI, or or XIX, or part A”

    Source evidence

    Code amendment note
    Subsec. (d). Pub. L. 98–369, § 2663(e)(6)(C), substituted “XVI, or XIX, or part A” for “XVI, or or XIX, or part A”.

    Enacted provision · exact public law section
    (C) by striking out “XVI,” and all that follows through “part A” in subsection (d) and inserting in lieu thereof “XVI, or XIX, or part A”.

20. 1984

    Spending Reduction Act of 1984

    Pub. L. 98–369 § 2663(e)(6)(A) · 98 Stat. 494

    Struck · 42 U.S.C. § 1316(d)

    Pub. L. 98–369, § 2663(e)(6)(A), struck out “VI,” after “I,”

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 98–369, § 2663(e)(6)(A), struck out “VI,” after “I,”.

    Enacted provision · exact public law section
    (A) by striking out “VI,” in subsections (a)(1), (b), and (d);

21. 1996

    Personal Responsibility and Work Opportunity Reconciliation Act of 1996

    Pub. L. 104–193 § 108(g)(3)(A) · 110 Stat. 2105

    Struck · 42 U.S.C. § 1316(a)(1)

    Pub. L. 104–193, § 108(g)(3)(A), struck out “or part A of subchapter IV,” after “XIX,”

    Source evidence

    Code amendment note
    Subsec. (a)(1). Pub. L. 104–193, § 108(g)(3)(A), struck out “or part A of subchapter IV,” after “XIX,”.

    Enacted provision · exact public law section
    (A) in each of subsections (a)(1), (b), and (d), by striking “or part A of title IV,”; and

22. 1996

    Personal Responsibility and Work Opportunity Reconciliation Act of 1996

    Pub. L. 104–193 § 108(g)(3)(B) · 110 Stat. 2105

    Struck · 42 U.S.C. § 1316(a)(3)

    Pub. L. 104–193, § 108(g)(3)(B), struck out “604,” before “1204,”

    Source evidence

    Code amendment note
    Subsec. (a)(3). Pub. L. 104–193, § 108(g)(3)(B), struck out “604,” before “1204,”.

    Enacted provision · exact public law section
    (B) in subsection (a)(3), by striking “404,”.

23. 1996

    Personal Responsibility and Work Opportunity Reconciliation Act of 1996

    Pub. L. 104–193 § 108(g)(3)(A) · 110 Stat. 2105

    Struck · 42 U.S.C. § 1316(b); 42 U.S.C. § 1316(d)

    Pub. L. 104–193, § 108(g)(3)(A), struck out “or part A of subchapter IV,” after “XIX,”

    Source evidence

    Code amendment note
    Subsecs. (b), (d). Pub. L. 104–193, § 108(g)(3)(A), struck out “or part A of subchapter IV,” after “XIX,”.

    Enacted provision · exact public law section
    (A) in each of subsections (a)(1), (b), and (d), by striking “or part A of title IV,”; and

24. 2008

    Medicare Improvements for Patients and Providers Act of 2008

    Pub. L. 110–275 § 204(b) · 122 Stat. 2494

    Struck · 42 U.S.C. § 1316(d)

    Pub. L. 110–275, § 204(b), struck out “or XIX,” after “XVI,”

    Source evidence

    Code amendment note
    Subsec. (d). Pub. L. 110–275, § 204(b), struck out “or XIX,” after “XVI,”.

    Enacted provision · exact public law section
    (b) Conforming Amendment.— Section 1116(d) of such Act (42 U.S.C. 1316(d)) is amended by striking “or XIX,”.

    Effective date note
    Pub. L. 110–275, title II, § 204(c), July 15, 2008, 122 Stat. 2593, provided that: “The amendments made by this section [amending this section] take effect on the date of the enactment of this Act [July 15, 2008] and apply to any disallowance of a claim for Federal financial participation under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) made on or after such date or during the 60-day period prior to such date.”

25. 2008

    Medicare Improvements for Patients and Providers Act of 2008

    Pub. L. 110–275 § 204(a) · 122 Stat. 2494

    Added · 42 U.S.C. § 1316(e)

    Pub. L. 110–275, § 204(a), added subsec. (e)

    Source evidence

    Code amendment note
    Subsec. (e). Pub. L. 110–275, § 204(a), added subsec. (e).

    Enacted provision · exact public law section
    (a) In General.— Section 1116 of the Social Security Act (42 U.S.C. 1316) is amended by adding at the end the following new subsection: “(e) (1) Time periods. Whenever the Secretary determines that any item or class of items on account of which Federal financial participation is claimed under title XIX shall be disallowed for such participation, the State shall be entitled to and upon request shall receive a reconsideration of the disallowance, provided that such request is made during the 60-day period that begins on the date the State receives notice of the disallowance. “(2) (A) A State may appeal a disallowance of a claim for federal financial participation under title XIX by the Secretary, or an unfavorable reconsideration of a disallowance, during the 60-day period that begins on the date the State receives notice of the disallowance or of the unfavorable reconsideration, in whole or in part, to the Departmental Appeals Board, established in the Department of Health and Human Services (in this paragraph referred to as the ‘Board’), by filing a notice of appeal with the Board. “(B) The Board shall consider a State’s appeal of a disallowance of such a claim (or of an unfavorable reconsideration of a disallowance) on the basis of such documentation as the State may submit and as the Board may require to support the final decision of the Board. In deciding whether to uphold a disallowance of such a claim or any portion thereof, the Board shall be bound by all applicable laws and regulations and shall conduct a thorough review of the issues, taking into account all relevant evidence. The Board’s decision of an appeal under subparagraph (A) shall be the final decision of the Secretary and shall be subject to reconsideration by the Board only upon motion of either party filed during the 60-day period that begins on the date of the Board’s decision or to judicial review in accordance with subparagraph (C). “(C) A State may obtain judicial review of a decision of the Board by filing an action in any United States District Court located within the appealing State (or, if several States jointly appeal the disallowance of claims for Federal financial participation under section 1903, in any United States District Court that is located within any State that is a party to the appeal) or the United States District Court for the District of Columbia. Such an action may only be filed— “(i) if no motion for reconsideration was filed within the 60-day period specified in subparagraph (B), during such 60-day period; or “(ii) if such a motion was filed within such period, during the 60-day period that begins on the date of the Board’s decision on such motion.” .

    Effective date note
    Pub. L. 110–275, title II, § 204(c), July 15, 2008, 122 Stat. 2593, provided that: “The amendments made by this section [amending this section] take effect on the date of the enactment of this Act [July 15, 2008] and apply to any disallowance of a claim for Federal financial participation under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) made on or after such date or during the 60-day period prior to such date.”

27 of 27 references resolved to an enrolled provision