Waiver of State plan requirements; costs regarded as State plan expenditures; availability of appropriations
Child support enforcement programs
Demonstration projects to test alternative definitions of unemployment
Regulations relating to applications for or renewals of demonstration projects
Extensions of State-wide comprehensive demonstration projects for which waivers granted
Application for extension of waiver project; submission; approval
Requirement of budget neutrality for Medicaid demonstration projects
In general
Beginning January 1 2027, the Secretary may not approve an application for (or renewal or amendment of) an experimental, pilot, or demonstration project undertaken under subsection (a) to promote the objectives of subchapter XIX in a State (in this subsection referred to as a “Medicaid demonstration project”) unless the Chief Actuary for the Centers for Medicare & Medicaid Services certifies that such project, or, in the case of a renewal, the duration of the preceding waiver, is not expected to result in an increase in the amount of Federal expenditures compared to the amount that such expenditures would otherwise be in the absence of such project. For purposes of this subsection, expenditures for the coverage of populations and services that the State could have otherwise provided through its Medicaid State plan or other authority under subchapter XIX, including expenditures that could be made under such authority but for the provision of such services at a different site of service than authorized under such State plan or other authority, shall be considered expenditures in the absence of such a project.
Treatment of savings
In the event that expenditures with respect to a State under a Medicaid demonstration project are, during an approval period for such project, less than the amount of such expenditures that would have otherwise been made in the absence of such project, the Secretary shall specify the methodology to be used with respect to the subsequent approval period for such project for purposes of taking the difference between such expenditures into account.
Aug. 14, 1935, ch. 531Pub. L. 87–543, title I, § 12276 Stat. 192Pub. L. 89–97, title I, § 121(c)(3)79 Stat. 352Pub. L. 90–36, § 281 Stat. 94Pub. L. 90–248, title II81 Stat. 917Pub. L. 93–233, § 1887 Stat. 973Pub. L. 93–647, § 3(c)88 Stat. 2349Pub. L. 95–216, title IV, § 40491 Stat. 1562Pub. L. 97–35, title XXIII, § 2353(g)95 Stat. 872Pub. L. 98–369, div. B, title VI, § 2663(e)(5)98 Stat. 1168Pub. L. 98–378, § 1098 Stat. 1317Pub. L. 99–272, title XIV, § 14001(b)(2)100 Stat. 328Pub. L. 100–485, title V, § 503102 Stat. 2402Pub. L. 104–193, title I, § 108(g)(2)110 Stat. 2168Pub. L. 105–33, title IV, § 4757(a)111 Stat. 527Pub. L. 106–554, § 1(a)(6) [title VII, § 703(a)]114 Stat. 2763Pub. L. 111–148, title II, § 2601(b)(2)124 Stat. 315Pub. L. 113–183, title III, § 302(b)128 Stat. 1945Pub. L. 119–21, title VII, § 71118(a)139 Stat. 306(, title XI, § 1115, as added , , ; amended , , ; , , ; , §§ 241(c)(4), 247, , , 918; (z–2)(1)(B), , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , , 2763A–574; , title X, § 10201(i), , , 922; , , ; , , .)
Editorial Notes
References in Text
Pub. L. 92–603, title III, § 30186 Stat. 1465Sections 1382 and 1383 of this title, referred to in subsec. (a)(1), (2), respectively, are references to sections 1382 and 1383 of this title as they existed prior to the general revision of this subchapter by , , , eff. . The prior sections (which are set out as notes under sections 1382 and 1383, respectively, of this title) continue in effect for Puerto Rico, Guam, and the Virgin Islands.
Amendments
Pub. L. 119–212025—Subsec. (g). added subsec. (g).
Pub. L. 113–1832014—Subsec. (b). designated existing provisions as par. (1), redesignated former pars. (1) to (3) as subpars. (A) to (C), respectively, of par. (1), realigned margins, and added par. (2).
Pub. L. 111–148, § 10201(i)2010—Subsec. (d). , added subsec. (d).
Pub. L. 111–148, § 2601(b)(2)(A)section 1396n(h)(2) of this titleSubsec. (e)(2). , inserted “(5 years, in the case of a waiver described in )” after “3 years”.
Pub. L. 111–148, § 2601(b)(2)(B)section 1396n(h)(2) of this titleSubsec. (f)(6). , inserted “(5 years, in the case of a waiver described in )” after “3 years”.
Pub. L. 106–5542000—Subsec. (f). added subsec. (f).
Pub. L. 105–331997—Subsec. (e). added subsec. (e).
Pub. L. 104–193, § 108(g)(2)(A)1996—Subsec. (a)(2). , designated existing provisions as subpar. (A), struck out “603,” before “655,”, substituted “, and” for period at end, and added subpar. (B).
Pub. L. 104–193, § 108(g)(2)(C)Subsec. (b). , redesignated subsec. (c) as (b) and struck out former subsec. (b) which related to purposes, criteria and procedures applicable to establishment, participatory effect, duration and termination of demonstration projects.
Pub. L. 104–193, § 108(g)(2)(C)Subsec. (c). , redesignated subsec. (d) as (c). Former subsec. (c) redesignated (b).
Pub. L. 104–193, § 108(g)(2)(B)Subsec. (c)(3). , substituted “part A of such subchapter” for “the program of aid to families with dependent children”.
Pub. L. 104–193, § 108(g)(2)(C)Subsec. (d). , redesignated subsec. (d) as (c).
Pub. L. 100–4851988—Subsec. (d). added subsec. (d).
Pub. L. 99–2721986—Subsec. (b)(2)(C). struck out subpar. (C) relating to use of funds as are appropriated for payments to States under chapter 67 of title 31 to cover costs of salaries for individuals in public service employment.
Pub. L. 98–378, § 10(a)(1)1984—Subsec. (a). , substituted “part A or D of subchapter IV” for “part A of subchapter IV” in provisions preceding par. (1).
Pub. L. 98–369, § 2663(e)(5), struck out “VI,” after “I,” in provisions preceding par. (1).
Pub. L. 98–378, § 10(a)(2)Subsec. (a)(1). , inserted “654,”.
Pub. L. 98–369, § 2663(e)(5), struck out “802,” after “602,”.
Pub. L. 98–378, § 10(a)(3)Subsec. (a)(2). , inserted “655,”.
Pub. L. 98–369, § 2663(e)(5), struck out “803,” after “603,”.
Pub. L. 98–378, § 10(b)Subsec. (c). , added subsec. (c).
Pub. L. 97–35section 1397a of this title1981—Subsec. (a). substituted in provision preceding par. (1) “or XIX” for “XIX, or XX”, in par. (1) “or 1396a of this title” for “1396a, 1397a, 1397b, or 1397c of this title”, and in par. (2) “or 1396b of this title” for “1396b, or 1397a of this title” and in par. (2) struck out “or expenditures with respect to which payment shall be made under ,” before “as may be appropriate”.
Pub. L. 95–2161977— designated existing provisions as subsec. (a) and existing pars. (a) and (b) thereof as pars. (1) and (2), respectively, and added subsec. (b).
Pub. L. 93–647, § 3(c)(1)1975—, substituted “XIX, or XX” for “or XIX”.
Pub. L. 93–647, § 3(c)(2)Subsec. (a). , inserted references to sections 1397a, 1397b, and 1397c.
Pub. L. 93–647, § 3(c)(3)section 1397a of this titleSubsec. (b). , (4), substituted “1396b, or 1397a” for “1396b”, and inserted “or expenditures with respect to which payment shall be made under ” after “administration of such State plan or plans,”.
Pub. L. 93–233section 802 of this titlesection 803 of this title1973— inserted references in text preceding subsec. (a) to subchapter VI of this chapter, in subsec. (a) to , and in subsec. (b) to .
Pub. L. 90–248, § 241(c)(4)1968—, in opening phrase struck out “IV,” after “I,” and inserted “, or part A of subchapter IV,” after “XIX”.
Pub. L. 90–248, § 247, substituted in second sentence “$4,000,000” for “$2,000,000” and “beginning after ” for “ending prior to ”.
Pub. L. 90–361967— substituted “” for “”.
Pub. L. 89–971965— included in enumeration in opening phrase, and cls. (a) and (b), subchapter XIX of this chapter, and sections 1396a and 1396b of this title, respectively.
Statutory Notes and Related Subsidiaries
Effective Date of 2000 Amendment
Pub. L. 106–554, § 1(a)(6) [title VII, § 703(b)]114 Stat. 2763
Effective Date of 1997 Amendment
Pub. L. 105–33, title IV, § 4757(b)111 Stat. 528
Effective Date of 1996 Amendment
Pub. L. 104–193section 116 of Pub. L. 104–193section 601 of this titleAmendment by effective , with transition rules relating to State options to accelerate such date, rules relating to claims, actions, and proceedings commenced before such date, rules relating to closing out of accounts for terminated or substantially modified programs and continuance in office of Assistant Secretary for Family Support, and provisions relating to termination of entitlement under AFDC program, see , as amended, set out as an Effective Date note under .
Effective Date of 1986 Amendment
Pub. L. 99–272Pub. L. 99–272, title XIV, § 14001(e)100 Stat. 329Amendment by effective , see , , .
Effective Date of 1984 Amendment
Pub. L. 98–369section 2664(b) of Pub. L. 98–369section 401 of this titleAmendment by effective , but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see , set out as a note under .
Effective Date of 1981 Amendment
Pub. L. 97–35section 2354 of Pub. L. 97–35section 1397 of this titleAmendment by effective , except as otherwise explicitly provided, see , set out as an Effective Date note under .
Effective Date of 1975 Amendment
Pub. L. 93–647section 7(b) of Pub. L. 93–647section 303 of this titleAmendment by effective with respect to payments under sections 603 and 803 of this title for quarters commencing after , see , set out as a note under .
Effective Date of 1973 Amendment
Pub. L. 93–233Pub. L. 93–233section 1301 of this titleAmendment by effective on and after , see section 18(z–2)(2) of , set out as a note under .
Effective Date of 1965 Amendment
Pub. L. 89–97, title I, § 121(c)(3)79 Stat. 352, , , provided that the amendment made by that section is effective .
Guidance on Opportunities for Innovation
Pub. L. 114–255, div. B, title XII, § 12003130 Stat. 1273
Family Support Demonstration Projects
Pub. L. 100–485, title V, § 501102 Stat. 2400Pub. L. 103–432, title II, § 262108 Stat. 4467
Demonstration Projects To Test the Effect of Early Childhood Development Programs .—
State Demonstration Projects To Encourage Innovative Education and Training Programs for Children .—
Demonstrations To Ensure Long Term Family Self-Sufficiency Through Community-Based Services .—
Authorization of Appropriations .—
Demonstration Projects To Encourage States To Employ Parents Receiving AFDC as Paid Child Care Providers
Pub. L. 100–485, title V, § 502102 Stat. 2401section 602(g)(1)(A) of this title, , , authorized Secretary of Health and Human Services to permit up to 5 States to undertake and carry out demonstration projects designed to test whether employment of parents of dependent children receiving AFDC as providers of child care for other children receiving AFDC would effectively facilitate the conduct of the job opportunities and basic skills training program under part F of title IV of this chapter by making additional child care services available to meet the requirements of while affording significant numbers of families receiving such aid a realistic opportunity to avoid welfare dependence through employment as a child care provider, and authorized to be appropriated not to exceed $1,000,000 for each of the fiscal years 1990, 1991, and 1992 for grants to States to carry out such demonstration projects.
Demonstration Projects To Address Child Access Problems
Pub. L. 100–485, title V, § 504102 Stat. 2403, , , provided that any State could establish and conduct one or more demonstration projects (in accordance with such terms, conditions, and requirements prescribed by the Secretary of Health and Human Services, except that no such project could include the withholding of aid to families with dependent children pending visitation) to develop, improve, or expand activities designed to increase compliance with child access provisions of court orders, specified activities that could be funded by a grant under this section, authorized to be appropriated not to exceed $4,000,000 for each of the fiscal years 1990 and 1991, and directed Secretary of Health and Human Services, not later than , to submit to Congress a report on the effectiveness of the demonstration projects established under this section.
Demonstration Projects To Provide Counseling and Services to High-Risk Teenagers
Pub. L. 100–485, title V, § 506102 Stat. 2405
Findings and Purpose .—
In General .—
Nature of Project .—
Applications; Selection Criteria .—
Evaluation and Report .—
Funding .—
Duration .—
Authorization of Appropriations .—
Continuation of Federal Financial Participation in Experimental, Pilot, or Demonstration Projects Approved Before , for Period On-And-After , Without Denial or Reduction on Account of Subchapter XVI Provisions for Supplemental Security Income for the Aged, Blind and Disabled; Waiver of Subchapter XVI Restrictions for Individuals; Federal Payments of Non-Federal Share as Supplementary Payments
Pub. L. 93–233, § 1187 Stat. 958