42 C.F.R. § 430.16
Timing and notice of action on State plan material
(a) Timing. (1) A State plan or plan amendment will be considered approved unless CMS, within 90 days after receipt of the plan or plan amendment in the regional office, sends the State—
(i) Written notice of disapproval; or
(ii) Written notice of any additional information it needs in order to make a final determination.
(2) If CMS requests additional information, the 90-day period for CMS action on the plan or plan amendment begins on the day it receives that information.
(b) Notice of final determination. (1) The Regional Administrator or the Administrator notifies the Medicaid agency of the approval of a State plan or plan amendment.
(2) Only the Administrator gives notice of disapproval of a State plan or plan amendment.
Notes of Decisions
Cited in 12
cases, 1996–2013 · leading case: Exeter Mem'l Hosp. Ass'n v. Belshe, 943 F. Supp. 1239 (E.D. Cal. 1996).
Exeter Mem'l Hosp. Ass'n v. Belshe, 943 F. Supp. 1239 (E.D. Cal. 1996). “42 C.F.R. § 430.16 . If HCFA fails to act upon a submitted amendment within 90 days after its submission, the amendment is deemed approved.”
California Ass'n of Rural Health Clinics v. Douglas, 738 F.3d 1007 (9th Cir. 2013). “42 C.F.R. § 430.16 . This 90-day period will be too short for full litigation to take place.”
Evergreen Presbyterian Ministries Inc. v. Hood, 235 F.3d 908 (5th Cir. 2001). “Normally, HCFA has ninety days to approve or disapprove the proposed amendment, see 42 C.F.R. § 430.16 (a)(1); however, as authorized under the regulations, HCFA mailed to LDHH several "stop-the-clock” letters.”
DeSario v. Thomas, 139 F.3d 80 (2d Cir. 1998). “42 C.F.R. § 430.16 (1996). Further, Title XIX requires that the federal government suspend payments to a state if that state’s Medicaid plan ceases to comply with Title XIX.”
Visiting Nurse Ass'n of North Shore, Inc. v. Bullen, 93 F.3d 997 (1st Cir. 1996). “” Although a Plan amendment is deemed approved unless HCFA acts within ninety days of its filing, see 42 C.F.R. § 430.16 (a), HCFA tolled the ninety-day period by advising defendants that additional information was needed — i.”
California Ass'n of Rural Health Clinics v. Maxwell-Jolly, 748 F. Supp. 2d 1184 (E.D. Cal. 2010). “Defendants argue that 42 C.F.R. §§ 430.16 and 447.256 support the view that “by its own regulations, the federal Medicaid statute permits implementation of a rate change before a state submits a SPA” or seeks approval of any amendment.”
Rosen v. Tennessee Comm'r of Fin. & Admin., 280 F. Supp. 2d 743 (M.D. Tenn. 2002). “42 C.F.R. § 430.16 (1996). The Defendant’s original waiver was submitted on October 1, 2001, and supplemented in February, 2002.”
California Hosp. Ass'n v. Maxwell-Jolly, 776 F. Supp. 2d 1129 (E.D. Cal. 2011). “42 C.F.R. § 430.16 . A request for more information, however, stops the 90-day clock.”
Wal-Mart Stores, Inc. v. Knickrehm, 101 F. Supp. 2d 749 (E.D. Ark. 2000). “See 42 C.F.R. § 430.16 (a). The Medicaid Act requires the states to pay for certain services and it gives them the option to provide additional services.”
Rite Aid of Pennsylvania, Inc. v. Houstoun, 171 F.3d 842 (3rd Cir. 1999). “§ 1396n(f)(2); 42 C.F.R. § 430.16 . Federal statutes and regulations establish the criteria for the HCFA to make its decision.”
California Ass'n of Rura v. David Maxwell-Jolly, 721 F.3d 1097 (9th Cir. 2013). “42 C.F.R. § 430.16 . This 90-day period will be too short for full litigation to take place.”
California Ass'n of Rura v. David Maxwell-Jolly (9th Cir. 2013). “42 C.F.R. § 430.16 . This 90-day period will be too short for full litigation to take place.”
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