42 U.S.C. § 1396c

Operation of State plans

Read at: OLRCuscode.house.gov CornellLII GovInfogovinfo.gov JustiaTitle 42 CasesGoogle Scholar
If the Secretary, after reasonable notice and opportunity for hearing to the State agency administering or supervising the administration of the State plan approved under this subchapter, finds—(1) that the plan has been so changed that it no longer complies with the provisions of section 1396a of this title; or(2) that in the administration of the plan there is a failure to comply substantially with any such provision;the Secretary shall notify such State agency that further payments will not be made to the State (or, in his discretion, that payments will be limited to categories under or parts of the State plan not affected by such failure), until the Secretary is satisfied that there will no longer be any such failure to comply. Until he is so satisfied he shall make no further payments to such State (or shall limit payments to categories under or parts of the State plan not affected by such failure).(Aug. 14, 1935, ch. 531, title XIX, § 1904, as added Pub. L. 89–97, title I, § 121(a), July 30, 1965, 79 Stat. 351.)Editorial NotesConstitutionality

For information regarding the constitutionality of section 121(a) of Pub. L. 89–97, enacting this section, see the Table of Laws Held Unconstitutional in Whole or in Part by the Supreme Court on the Constitution Annotated website, constitution.congress.gov.

Notes of Decisions
Cited in 199 cases (23 in the last 5 years), 1969–2026 · leading case: National Federation of Independent Business v. Sebelius
National Federation of Independent Business v. Sebelius (2012) scotus · cites it 8× “The threatened loss of over 10 percent of a State’s overall budget is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion. The Government claims that the expansion is properly viewed as only a modification of the existing…”
Planned Parenthood of AR, etc. v. Cindy Gillespie (2017) ca8 · cites it 6× “Under that authority, the Secretary has required States to give providers the right to appeal an exclusion from the Medicaid program.”
Wilder v. Virginia Hospital Assn. (1990) scotus · cites it 4× “42 U. S. C. § 1396c (1982 ed.). The Secretary has expressed his intention to withhold funds if the state plan does not comply with the statute or if there is "noncompliance in practice.”
Planned Parenthood of Grt TX v. Courtney Ph (2020) ca5 · cites it 6× “91 42 U.S.C. § 1396c. 21 Case: 17-50282 Document: 00515648975 Page: 22 Date Filed: 11/23/2020 No.”
State of Tenn. v. United States Dep't of State (2019) ca6 · cites it 4× “42 U.S.C. § 1396c. The Medicaid Act provides for a system of administrative and judicial review for HHS's decisions concerning state plans and a determination to reduce or withhold a state's FMAP.”
Armstrong v. Exceptional Child Center, Inc. (2015) scotus · cites it 3× “42 U.S.C. § 1396c. As we have elsewhere explained, the "express provision of one method of enforcing a substantive rule suggests that Congress intended to preclude others.”
Suter v. Artist M. (1992) scotus · cites it 4× “, at 512 (citing 42 U. S. C. § 1396c). [2] In substantially identical language, the Adoption Act, too, requires States to live up to the commitments stated in their plans.”
Doe v. Kidd (2007) ca4 · cites it 4× “§ 1396a, sets forth several criteria that a "State plan for medical assistance" must satisfy in order to gain federal approval and enable the Secretary to disburse federal funds.”
Sabree Ex Rel. Sabree v. Richman (2004) ca3 · cites it 4× “42 U.S.C. § 1396c. individuals . . . . There is no dispute that plaintiffs 42 U.”
Florida Ex Rel. Attorney General v. United States Department of Health & Human Services (2011) ca11 · cites it 4× “Under 42 U.S.C. § 1396c, a state whose plan does not comply with the requirements under § 1396a will be notified by HHS of its noncompliance, and "further payments will not be made to the State (or, in [HHS's] discretion.”
Pharmaceutical Research and Manufacturers of America v. Walsh, Acting Commissioner, Maine Department of Human Services (2003) scotus · cites it 2× “1, 17 (1981), is set forth in the Act itself: termination of funding by the Secretary of the Department of Health and Human Services, see 42 U. S. C. § 1396c. Petitioner must seek enforcement of the Medicaid conditions by that authority — and may seek and obtain relief in the…”
Safe Streets Alliance v. Hickenlooper (2017) ca10 “See 42 U.S.C. § 1396c. Providers seeking more generous payments could try to persuade the Secretary to exercise that authority, but the Secretary’s decision not to take such a step could be successfully challenged in court under the Administrative Procedure Act (APA) “only when…”
— 42 U.S.C. § 1396c(2) — 6 cases
Planned Parenthood of AR, etc. v. Cindy Gillespie (2017) ca8 “Under that authority, the Secretary has required States to give providers the right to appeal an exclusion from the Medicaid program.”
Planned Parenthood of Grt TX v. Courtney Ph (2020) ca5 “91 42 U.S.C. § 1396c. 21 Case: 17-50282 Document: 00515648975 Page: 22 Date Filed: 11/23/2020 No.”
— 42 U.S.C. § 1396c(A)(2) — 1 case
Ramey v. Rizzuto (1999) cod
— 42 U.S.C. § 1396c(l) — 2 cases
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.