[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR457.65]



[Page 380-381]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 457_ALLOTMENTS AND GRANTS TO STATES--Table of Contents

 

Subpart A_Introduction; State Plans for Child Health Insurance Programs 

                         and Outreach Strategies

 

Sec.  457.65  Effective date and duration of State plans and plan 



amendments.



    (a) Effective date in general. Except as otherwise limited by this 

section--

    (1) A State plan or plan amendment takes effect on the day specified 

in the plan or plan amendment, but no earlier than October 1, 1997.

    (2) The effective date may be no earlier than the date on which the 

State begins to incur costs to implement its State plan or plan 

amendment.

    (3) A State plan amendment that takes effect prior to submission of 

the amendment to CMS may remain in effect only until the end of the 

State fiscal year in which the State makes it effective, or, if later, 

the end of the 90-day period following the date on which the State makes 

it effective, unless the State submits the amendment to CMS for approval 

before the end of that State fiscal year or that 90-day period.

    (b) Amendments relating to eligibility or benefits. A State plan 

amendment that eliminates or restricts eligibility or benefits may not 

be in effect for longer than a 60-day period, unless the amendment is 

submitted to CMS before the end of that 60-day period. The amendment may 

not take effect unless--

    (1) The State certifies that it has provided prior public notice of 

the proposed change in a form and manner provided under applicable State 

law; and

    (2) The public notice was published before the requested effective 

date of the change.

    (c) Amendments relating to cost sharing. A State plan amendment that 

implements cost-sharing charges, increases existing cost-sharing 

charges, or increases the cumulative cost-sharing maximum as set forth 

at Sec.  457.560 is considered an amendment that restricts benefits and 

must meet the requirements in paragraph (b) of this section.

    (d) Amendments relating to enrollment procedures. A State plan 

amendment that implements a required period of uninsurance, increases 

the length of existing required periods of uninsurance, or institutes or 

extends the use of waiting lists, enrollments caps or closed enrollment 

periods is considered an amendment that restricts eligibility and must 

meet the requirements in paragraph (b) of this section.

    (e) Amendments relating to the source of State funding. A State plan 

amendment that changes the source of the State share of funding can take 

effect



[[Page 381]]



no earlier than the date of submission of the amendment.

    (f) Continued approval. An approved State plan continues in effect 

unless--

    (1) The State adopts a new plan by obtaining approval under Sec.  

457.60 of an amendment to the State plan;

    (2) Withdraws its plan in accordance with Sec.  457.170(b); or

    (3) The Secretary finds substantial noncompliance of the plan with 

the requirements of the statute or regulations.