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. § 430.20

Effective dates of State plans and plan amendments

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For purposes of FFP, the following rules apply:

(a) New plans. The effective date of a new plan—

(1) May not be earlier than the first day of the quarter in which an approvable plan is submitted to the regional office; and

(2) With respect to expenditures for medical assistance, may not be earlier than the first day on which the plan is in operation on a statewide basis.

(b) Plan amendment. (1) For a plan amendment that provides additional services to individuals eligible under the approved plan, increases the payment amounts for services already included in the plan, or makes additional groups eligible for services provided under the approved plan, the effective date is determined in accordance with paragraph (a) of this section.

(2) For a plan amendment that changes the State's payment method and standards, the rules of § 447.256 of this chapter apply.

(3) For other plan amendments, the effective date may be a date requested by the State if CMS approves it.

[53 FR 36571, Sept. 21, 1988, as amended at 56 FR 8845, Mar. 1, 1991]
Notes of Decisions
Cited in 17 cases (1 in the last 5 years), 1989–2021 · 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). “See 42 C.F.R. §§ 430.20 (b)(2) & 447.256(c) (permitting a state plan amendment that changes the state's payment methods and standards to become effective as early as "the first day of the calendar quarter in which an approvable amendment is submitted”).”
Massachusetts Hosp. Ass'n v. Dep't of Pub. Welfare, 419 Mass. 644 (Mass. 1995). “42 C.F.R. § 430.20 (b) (2). Additionally, we have held that only where vested substantive rights of the parties have been adversely affected can a regulation be viewed as impermissibly retroactive.”
Tomarken v. State, 100 A.D.3d 1072 (N.Y. App. Div. 2012). “CMS, the federal agency responsible for administering the Medicaid program, informed respondents that September 1, 2009 was the appropriate effective date for the new SPA, consistent with federal regulations (see 42 CFR 430.20). 2 3****If SPA No. 09-61 was not given retroactive…”
Pinnacle Nursing Home v. Axelrod, 719 F. Supp. 1173 (W.D.N.Y. 1989). “In relevant part, 42 C.F.R. § 430.20 also concerns the effective date of a plan and provides at (b)(2), "the effective date may be a date requested by the state if HCFA approves it.”
In re Gorney Est., 314 Mich. App. 281 (Mich. Ct. App. 2016). “A State plan amendment that is approved will become effective not earlier than the first day of the calendar quarter in which an approvable amendment is submitted in accordance with [42 CFR 430.20 and 42 CFR 447.253].”). Respectfully, the partial dissent conflates defendants’…”
Cmty. Healthcare Assoc. v. New York State Dep't of Health, 921 F. Supp. 2d 130 (S.D.N.Y. 2013). “Federal law requires prior approval of significant changes to the State Plan, see 42 C.F.R. § 430.20 , and public notice and comment for changes to the payment methodology, 42 C.”
Youville Hosp. v. Commonwealth, 617 N.E.2d 605 (Mass. 1993). “42 C.F.R. §§ 430.20 (b), 447.256 (c) (1992).”
Visiting Nurse Ass'n of North Shore, Inc. v. Bullen, 93 F.3d 997 (1st Cir. 1996). “” 42 C.F.R. § 430.20 (b) (emphasis added); see also id.”
Christ the King Manor, Inc. v. Sec'y United States Dep't of Health & Human Servs., 673 F. App'x 164 (3rd Cir. 2016). “See 42 C.F.R. § 430.20 (noting the earliest effective date that a plan may be become effective after review).”
in Re Rasmer Est. (Mich. 2017). · cites it 2× “42 CFR 430.20(a)(1) and (b)(2). Second, “[f]or other plan amendments, the effective date may be a date requested by the State if CMS approves it.”
in Re Rasmer Est. (Mich. 2017). · cites it 2× “42 CFR 430.20(a)(1) and (b)(2). Second, “[f]or other plan amendments, the effective date may be a date requested by the State if CMS approves it.”
Jewish Mem'l Hosp. v. Commonwealth, 617 N.E.2d 598 (Mass. 1993). “See 42 C.F.R. §§ 430.20 (b) and 447.256 (c) (1992).”
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— 42 C.F.R. § 430.20(a)(1) — 2 cases
in Re Rasmer Est. (Mich. 2017). “42 CFR 430.20(a)(1) and (b)(2). Second, “[f]or other plan amendments, the effective date may be a date requested by the State if CMS approves it.”
in Re Rasmer Est. (Mich. 2017). “42 CFR 430.20(a)(1) and (b)(2). Second, “[f]or other plan amendments, the effective date may be a date requested by the State if CMS approves it.”
— 42 C.F.R. § 430.20(b)(3) — 2 cases
in Re Rasmer Est. (Mich. 2017). “42 CFR 430.20(a)(1) and (b)(2). Second, “[f]or other plan amendments, the effective date may be a date requested by the State if CMS approves it.”
in Re Rasmer Est. (Mich. 2017). “42 CFR 430.20(a)(1) and (b)(2). Second, “[f]or other plan amendments, the effective date may be a date requested by the State if CMS approves it.”
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