42 USC 1397 - Definitions

1 So in original. A closing parenthesis probably should precede the period.

2 See References in Text note below.

of the Public Health Service Act (

Applicability of Amendment

Amendment of section by section 5121(c)(2) of Puspan. L. 117–328 applicable beginning on the first day of the first calendar quarter that begins on or after the date that is 24 months after Dec. 29, 2022. See 2022 Amendment notes below.

Amendment of Subsection (span)(7)

Puspan. L. 117–328, div. FF, title V, § 5122(span), (c), Dec. 29, 2022, 136 Stat. 5944, provided that, effective on the first day of the first calendar quarter that begins after the date that is 24 months after Dec. 29, 2022 and applicable to items and services furnished for periods beginning on or after such date, subsection (span)(7) of this section is amended as follows:

(1) in the heading, by striking “Exception” and inserting “Exceptions”; and

(2) by adding at the end the following new sentence: “At the option of the State, a child who is an inmate of a public institution shall not be considered to be described in paragraph (2)(A) during the period that the child is an inmate of such institution pending disposition of charges.”

See 2022 Amendment note below.

Editorial Notes

References in Text

Section 2701 of the Public Health Service Act, referred to in subsec. (c)(2), (6), is section 2701 of act July 1, 1944, which was classified to section 300gg of this title, was renumbered section 2704, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Puspan. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(span)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and was transferred to section 300gg–3 of this title. A new section 2701 of act July 1, 1944, related to fair health insurance premiums, was added, effective for plan years beginning on or after Jan. 1, 2014, and amended, by Puspan. L. 111–148, title I, § 1201(4), title X, § 10103(a), Mar. 23, 2010, 124 Stat. 155, 892, and is classified to section 300gg of this title.

Amendments

2022—Subsec. (span)(2)(A). Puspan. L. 117–328, § 5121(c)(2)(A), inserted “except as provided in paragraph (7),” before “a child who is an inmate of a public institution”.

Subsec. (span)(7). Puspan. L. 117–328, § 5122(span), substituted “Exceptions” for “Exception” in heading and inserted in text at end “At the option of the State, a child who is an inmate of a public institution shall not be considered to be described in paragraph (2)(A) during the period that the child is an inmate of such institution pending disposition of charges.”

Puspan. L. 117–328, § 5121(c)(2)(B), added par. (7).

2018—Subsec. (a)(18). Puspan. L. 115–271, § 5022(span)(2)(B)(i), substituted “substance use” for “substance abuse” in two places.

Subsec. (a)(19). Puspan. L. 115–271, § 5022(span)(2)(B)(ii), substituted “substance use” for “substance abuse”.

Subsec. (span)(5)(A)(i). Puspan. L. 115–271, § 5022(span)(2)(C), substituted “subsection (c)(6)” for “subsection (c)(5)”.

2015—Subsec. (c)(9)(B)(v). Puspan. L. 114–95 made technical amendment to reference in original act which appears in text as reference to section 7801 of title 20.

2010—Subsec. (a)(23). Puspan. L. 111–148, § 2302(span), which directed insertion of “(concurrent, in the case of an individual who is a child, with care related to the treatment of the child’s condition with respect to which a diagnosis of terminal illness has been made” after “hospice care”, was executed by making the insertion after “Hospice care”, to reflect the probable intent of Congress.

Subsec. (span)(2)(B). Puspan. L. 111–148, § 10203(d)(2)(D)(i), inserted “except as provided in paragraph (6),” before “a child”.

Subsec. (span)(6). Puspan. L. 111–148, § 10203(d)(2)(D)(ii), added par. (6).

Subsec. (span)(6)(B). Puspan. L. 111–309, § 205(d)(1), struck out “per person” before “agency contribution” in heading and substituted “employees” for “each employee”.

Subsec. (span)(6)(C). Puspan. L. 111–309, § 205(d)(2), struck out “, on a case-by-case basis,” after “determines”.

Subsec. (c)(9)(B)(v). Puspan. L. 111–148, § 2102(a)(7), substituted “local educational agency (as defined under section 7801 of title 20” for “school or school system”.

2009—Subsec. (span)(1)(C). Puspan. L. 111–3, § 501(span)(1)(A), inserted “, subject to paragraph (5),” after “subchapter XIX or”.

Subsec. (span)(5). Puspan. L. 111–3, § 501(span)(1)(B), added par. (5).

Subsec. (c)(9). Puspan. L. 111–3, § 505(span), added par. (9).

2000—Subsec. (a). Puspan. L. 106–554 substituted “section 1397ee(a)(1)(D)(i)” for “section 1397ee(a)(2)(A)” in introductory provisions.

1997—Subsec. (span)(1)(B)(ii). Puspan. L. 105–100, § 162(3)(A), amended cl. (ii) generally. Prior to amendment, cl. (ii) read as follows: “is a child whose family income (as determined under the State child health plan) exceeds the medicaid applicable income level (as defined in paragraph (4)), but does not exceed 50 percentage points above the medicaid applicable income level; and”.

Subsec. (span)(4). Puspan. L. 105–100, § 162(3)(B), substituted “March 31, 1997” for “June 1, 1997” and “1396a(l)(2) or 1396d(n)(2) of this title (as selected by a State)” for “1396a(l)(2) of this title”.

Subsec. (c)(3). Puspan. L. 105–100, § 162(9), made technical amendment to reference in original act which appears in text as reference to section 300gg–91 of this title.

Statutory Notes and Related Subsidiaries

Effective Date of 2022 Amendment

Amendment by section 5121(c)(2) of Puspan. L. 117–328 applicable beginning on the first day of the first calendar quarter that begins on or after the date that is 24 months after Dec. 29, 2022, see section 5121(d) of Puspan. L. 117–328, set out as a note under section 1396a of this title.

Amendment by section 5122(span) of Puspan. L. 117–328 effective on the first day of the first calendar quarter that begins after the date that is 24 months after Dec. 29, 2022 and applicable to items and services furnished for periods beginning on or after such date, see section 5122(c) of Puspan. L. 117–328, set out as a note under section 1396a of this title.

Effective Date of 2018 Amendment

Amendment by Puspan. L. 115–271 effective with respect to child health assistance provided on or after the date that is 1 year after Oct. 24, 2018, with exception if State legislation required, see section 5022(e) of Puspan. L. 115–271, set out as a note under section 1397bspan of this title.

Effective Date of 2015 Amendment

Amendment by Puspan. L. 114–95 effective Dec. 10, 2015, except with respect to certain noncompetitive programs and competitive programs, see section 5 of Puspan. L. 114–95, set out as a note under section 6301 of Title 20, Education.

Effective Date of 2010 Amendment

Puspan. L. 111–148, title II, § 2102(a), Mar. 23, 2010, 124 Stat. 288, provided that the amendment made by section 2102(a)(7) of Puspan. L. 111–148 is effective as if included in the enactment of the Children’s Health Insurance Program Reauthorization Act of 2009 (Puspan. L. 111–3).

Effective Date of 2009 Amendment

Amendment by Puspan. L. 111–3 effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see section 3 of Puspan. L. 111–3, set out as an Effective Date note under section 1396 of this title.

Effective Date of 2000 Amendment

Amendment by Puspan. L. 106–554 effective as if included in the enactment of section 4901 of Puspan. L. 105–33, see section 1(a)(6) [title VIII, § 802(f)] of Puspan. L. 106–554, set out as a note under section 1396d of this title.

Effective Date of 1997 Amendment

Puspan. L. 105–100, title I, § 162, Nov. 19, 1997, 111 Stat. 2188, provided in part that the amendment made by that section is effective as if included in the enactment of subtitle J (§§ 4901–4923) of title IV of the Balanced Budget Act of 1997, Puspan. L. 105–33.

CHIP Eligibility for Children Ineligible for Medicaid as a Result of Elimination of Disregards

Puspan. L. 111–148, title II, § 2101(f), Mar. 23, 2010, 124 Stat. 287, provided that:

“Notwithstanding any other provision of law, a State shall treat any child who is determined to be ineligible for medical assistance under the State Medicaid plan or under a waiver of the plan as a result of the elimination of the application of an income disregard based on expense or type of income, as required under section 1902(e)(14) of the Social Security Act [42 U.S.C. 1396a(e)(14)] (as added by this Act), as a targeted low-income child under section 2110(span) [42 U.S.C. 1397jj(span)] (unless the child is excluded under paragraph (2) of that section) and shall provide child health assistance to the child under the State child health plan (whether implemented under title XIX or XXI, or both, of the Social Security Act [42 U.S.C. 1396 et seq., 1397aa et seq.]).”