C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 430—GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS › Subpart B—State Plans

42 C.F.R. § 430.15

Basis and authority for action on State plan material

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(a) Basis for action. (1) Determinations as to whether State plans (including plan amendments and administrative practice under the plans) originally meet or continue to meet the requirements for approval are based on relevant Federal statutes and regulations.

(2) Guidelines are furnished to assist in the interpretation of the regulations.

(b) Approval authority. The Regional Administrator exercises delegated authority to approve the State plan and plan amendments on the basis of policy statements and precedents previously approved by the Administrator.

(c) Disapproval authority. (1) The Administrator retains authority for determining that proposed plan material is not approvable or that previously approved material no longer meets the requirements for approval.

(2) The Administrator does not make a final determination of disapproval without first consulting the Secretary.

Notes of Decisions
Cited in 36 cases (2 in the last 5 years), 1990–2023 · leading case: Christ the King Manor, Inc. v. Sec'y United States Dep't of Health & Human Servs., 730 F.3d 291 (3rd Cir. 2013).
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Christ the King Manor, Inc. v. Sec'y United States Dep't of Health & Human Servs., 730 F.3d 291 (3rd Cir. 2013). · cites it 2× “42 C.F.R. § 430.15 (b). Therefore, they argue, HHS could reasonably conclude that the proposed amendment, which “employed a substantially similar methodology” to the one taken the previous three years, “was likewise compliant with Section 30(A).”
Planned Parenthood of Indiana, Inc. v. Comm'r of Indiana State Dep't of Health, 699 F.3d 962 (7th Cir. 2012). “After consulting with the HHS Secretary, see 42 C.F.R. § 430.15 (c), the CMS Administrator rejected the proposed plan amendment citing § 1396a(a)(23), the free-choice-of-provider rule.”
Commonwealth of Pennsylvania D v. United States, 897 F.3d 497 (3rd Cir. 2018). · cites it 2× “§§ 1396 , 1396a ; 42 C.F.R. § 430.15 (a). Within HHS, CMS oversees state compliance with Medicaid requirements.”
The Arc of California v. Toby Douglas, 757 F.3d 975 (9th Cir. 2014). “§ 1396a(b), but has delegated to the regional administrator for the Centers for Medicare and Medicaid Services (“CMS”) the responsibility of reviewing in the first instance state plans for compliance with the provisions of the Act, see 42 C.F.R. § 430.15 (b). The Secretary also…”
Long Term Care Pharmacy All. v. Ferguson, 362 F.3d 50 (1st Cir. 2004). “Of course, the Secretary of HHS (“the Secretary”) can enforce compliance with the provision and implementing regulations already mentioned, in a number of ways — by disapproving a state plan, 42 C.F.R. § 430.15 (2002), and by cutting off funds, 42 U.”
Cmty. Pharmacies of Indiana, Inc. v. Indiana Fam. & Soc. Servs. Admin., 801 F. Supp. 2d 802 (S.D. Ind. 2011). · cites it 2× “3d at 134 ; 42 C.F.R. § 430.15 (a). The Secretary of HHS delegates power to review and approve plans to Regional Administrators of the Centers for Medicare and Medicaid Services.”
Managed Pharmacy Care v. Kathleen Sebelius, 716 F.3d 1235 (9th Cir. 2013). “42 C.F.R. § 430.15 (b); see also Alaska DHSS, 424 *1242 F.”
State of West Virginia v. Tommy G. Thompson, Sec'y of the United States Dep't of Health & Human Servs., 475 F.3d 204 (4th Cir. 2007). “42 C.F.R. § 430.15 (b) (2005). The Administrator consults with the Secretary before making a final determination of disapproval.”
Developmental Servs. Network v. Toby Douglas, 666 F.3d 540 (9th Cir. 2011). “42 C.F.R. §§ 430.15 , 430.18; see also San Lazaro Ass’n, Inc.”
Veneruso v. Mount Vernon Neighborhood Health Ctr., 933 F. Supp. 2d 613 (S.D.N.Y. 2013). “§§ 1396 , 1396a, 1396a(bb); 42 C.F.R. § 430.15 (a); see also Cmty. Health Ctr.”
The State of Louisiana, Petitioner, v. United States Dep't of Health & Human Servs., Respondent, 905 F.2d 877 (5th Cir. 1990). · cites it 2× “§§ 1316 (a)(1), 1396a, 1396c; 42 C.F.R. § 430.15 . As long as the plans meet federal requirements, the states have considerable discretion to design and operate their individual programs.”
RCJ Med. Servs., Inc. v. Bonta´, 2001 Cal. Daily Op. Serv. 7384 (Cal. Ct. App. 2001). “( 42 C.F.R. § 430.15 (b) (2000).) Pursuant to title 42 of the Code of Federal Regulations, part 430.”
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