45 C.F.R. § 201.3

Approval of State plans and amendments

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The State plan consists of written documents furnished by the State to cover each of its programs under the Act: Old-age assistance (title I); aid and services to needy families with children (part A of title IV); aid to the blind (title X); aid to the permanently and totally disabled (title XIV); or aid to the aged, blind or disabled (title XVI). The State may submit the common material on more than one program as an integrated plan. However, it must identify the provisions pertinent to each title since a separate plan must be approved for each public assistance title. A plan submitted under title XVI encompasses, under a single plan, the programs otherwise covered by three separate plans under titles I, X, and XIV. After approval of the original plan by the Administration, all relevant changes, required by new statutes, rules, regulations, interpretations, and court decisions, are required to be submitted currently so that the Administration may determine whether the plan continues to meet Federal requirements and policies.

(a) Submittal. State plans and revisions of the plans are submitted first to the State governor or his designee for review in accordance with § 204.1 of this chapter, and then to the regional office. The States are encouraged to obtain consultation of the regional staff when a plan is in process of preparation or revision.

(b) Review. Staff in the regional offices are responsible for review of State plans and amendments. They also initiate discussion with the State agency on clarification of significant aspects of the plan which come to their attention in the course of this review. State plan material on which the regional staff has questions concerning the application of Federal policy is referred with recommendations as required to the central office for technical assistance. Comments and suggestions, including those of consultants in specified areas, may be prepared by the central office for use by the regional staff in negotiations with the State agency.

(c) Action. The Regional Administrator, exercised delegated authority to take affirmative action on State plans and amendments thereto on the basis of policy statements or precedents previously approved by the Administrator. The Administrator retains authority for determining that proposed plan material is not approvable, or that a previously approved plan no longer meets the requirements for approval, except that a final determination of disapproval may not be made without prior consultation and discussion by the Administrator with the Secretary. The Regional Administrator, or the Administrator formally notifies the State agency of the actions taken on State plans or revisions.

(d) Basis for approval. 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. Guidelines are furnished to assist in the interpretation of the regulations.

(e) Prompt approval of State plans. Pursuant to section 1116 of the Act, the determination as to whether a State plan submitted for approval conforms to the requirements for approval under the Act and regulations issued pursuant thereto shall be made promptly and not later than the 90th day following the date on which the plan submittal is received in the regional office, unless the Regional Administrator, has secured from the State agency a written agreement to extend that period.

(f) Prompt approval of plan amendments. Any amendment of an approved State plan may, at the option of the State, be considered as a submission of a new State plan. If the State requests that such amendment be so considered the determination as to its conformity with the requirements for approval shall be made promptly and not later than the 90th day following the date on which such a request is received in the regional office with respect to an amendment that has been received in such office, unless the Regional Administrator, has secured from the State agency a written agreement to extend that period. In absence of request by a State that an amendment of an approved State plan shall be considered as a submission of a new State plan, the procedures under § 201.6 (a) and (b) shall be applicable.

(g) Effective date. The effective date of a new plan may not be earlier than the first day of the calendar quarter in which an approvable plan is submitted, and with respect to expenditures for assistance under such plan, may not be earlier than the first day on which the plan is in operation on a statewide basis. The same applies with respect to plan amendments that provide additional assistance or services to persons eligible under the approved plan or that make new groups eligible for assistance or services provided under the approved plan. For other plan amendments the effective date shall be as specified in other sections of this chapter.

[35 FR 12180, July 29, 1970, as amended at 39 FR 34542, Sept. 26, 1974; 42 FR 43977, Sept. 1, 1977; 53 FR 36579, Sept. 21, 1988]
Notes of Decisions
Cited in 34 cases, 1970–1997 · leading case: Rosado v. Wyman
Rosado v. Wyman (1970) scotus · cites it 2× “45 CFR § 201.3 . If, after affording the State reasonable notice and an opportunity for a hearing, HEW determines that the state plan does not conform to the federal requirements, the federal agency then has a legal obligation to terminate federal aid to which the State would…”
State of New Jersey v. Department of Health and Human Services (1981) ca3 · cites it 3× “at § 1316(a)(1); see 45 C.F.R. § 201.3 . If the Secretary ascertains that it does not, the state may request administrative reconsideration by the Secretary, in the form of a plan-conformity hearing.”
Washington State Health Facilities, Ass'n v. Washington, Department of Social & Health Services (1989) ca9 · cites it 10× “(TN) 79-15, as a new state plan to HHS for review and approval pursuant to 45 C.F.R. § 201.3 (1987). 2 The amended plan incorporated the state regulation which changed the cost savings rule.”
County of Alameda v. Caspar W. Weinberger, Etc. (1975) ca9 · cites it 3× “Pursuant to 45 C.F.R. § 201.3 (e) & (f), HEW was required to approve or disapprove California’s plan within 90 days after the plan’s submission.”
Ward v. Thomas (1995) ctd · cites it 4× “Indeed, the language of 45 C.F.R. § 201.3 (g) appears to contemplate that an effective plan date may be earlier than the date the plan is submitted to the Secretary for approval.”
Michigan Hospital Ass'n v. Department of Social Services (1990) miwd · cites it 3× “§ 1316 and 1396a(a) 2 and a Federal regulation, 45 C.F.R. § 201.3 (d) 3 by approving 1987 and 1988 Michigan medicaid state plan amendments establishing Michigan’s method for reimbursing hospitals.”
Haley v. Commissioner of Public Welfare (1985) mass “” The transmittal is a guideline authorized by 45 C.F.R. § 201.3 (d) (1984), which advises State agencies of the HCFA views concerning current Federal policy and interpretation of applicable statutes and regulations.”
United States v. Aloi (1977) nyed “V 1975); 45 C.F.R. § 201.3 (1976). Finally, the Secretary is empowered to promulgate regulations which are necessary for the proper and efficient operation of state plans.”
Feld v. Berger (1976) nysd “45 C.F.R. § 201.3 (1975). 23 . Id. § 205.”
Department of Social Services v. Villa Capri Homes, Inc. (1985) mo “We do not believe the federal regulations invoked by the Commission vitiate the plan.”
Tinkham v. Department of Public Welfare (1981) massappct · cites it 2× “” 45 C.F.R. § 201.3 (d) (1980). 5 A State which adopts a Medicaid program must provide assistance to the group referred to in the regulations as the categorically needy 6 (42 U.”
Illinois Hospital Ass'n v. Illinois Department of Public Aid (1983) ilnd “Section 1396c; 45 C.F.R. §§ 201.3 , 205.5(a). 6. Before October 1, 1981 Section 1396a(a)(13)(D) required states to reimburse hospitals their “reasonable costs” of providing covered hospital services to.”
— 45 C.F.R. § 201.3(a) — 2 cases
— 45 C.F.R. § 201.3(f) — 2 cases
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