42 U.S.C. § 1396i

Certification and approval of rural health clinics and intermediate care facilities for mentally retarded

Read at: OLRCuscode.house.gov CornellLII GovInfogovinfo.gov JustiaTitle 42 CasesGoogle Scholar

(a)(1) Whenever the Secretary certifies a facility in a State to be qualified as a rural health clinic under subchapter XVIII, such facility shall be deemed to meet the standards for certification as a rural health clinic for purposes of providing rural health clinic services under this subchapter.(2) The Secretary shall notify the State agency administering the medical assistance plan of his approval or disapproval of any facility in that State which has applied for certification by him as a qualified rural health clinic.(b)(1) The Secretary may cancel approval of any intermediate care facility for the mentally retarded at any time if he finds on the basis of a determination made by him as provided in section 1396a(a)(33)(B) of this title that a facility fails to meet the requirements contained in section 1396a(a)(31) of this title or section 1396d(d) of this title, or if he finds grounds for termination of his agreement with the facility pursuant to section 1395cc(b) of this title. In that event the Secretary shall notify the State agency and the intermediate care facility for the mentally retarded that approval of eligibility of the facility to participate in the programs established by this subchapter and subchapter XVIII shall be terminated at a time specified by the Secretary. The approval of eligibility of any such facility to participate in such programs may not be reinstated unless the Secretary finds that the reason for termination has been removed and there is reasonable assurance that it will not recur.(2) Any intermediate care facility for the mentally retarded which is dissatisfied with a determination by the Secretary that it no longer qualifies as a 11 So in original. Probably should be “an”. intermediate care facility for the mentally retarded for purposes of this subchapter, shall be entitled to a hearing by the Secretary to the same extent as is provided in section 405(b) of this title and to judicial review of the Secretary’s final decision after such hearing as is provided in section 405(g) of this title, except that, in so applying such sections and in applying section 405(l) of this title thereto, any reference therein to the Commissioner of Social Security or the Social Security Administration shall be considered a reference to the Secretary or the Department of Health and Human Services, respectively. Any agreement between such facility and the State agency shall remain in effect until the period for filing a request for a hearing has expired or, if a request has been filed, until a decision has been made by the Secretary; except that the agreement shall not be extended if the Secretary makes a written determination, specifying the reasons therefor, that the continuation of provider status constitutes an immediate and serious threat to the health and safety of patients, and the Secretary certifies that the facility has been notified of its deficiencies and has failed to correct them.(Aug. 14, 1935, ch. 531, title XIX, § 1910, as added and amended Pub. L. 92–603, title II, §§ 249A(a), 278(b)(12), Oct. 30, 1972, 86 Stat. 1426, 1454; Pub. L. 95–210, § 2(d), Dec. 13, 1977, 91 Stat. 1489; Pub. L. 96–499, title IX, § 916(b)(2), Dec. 5, 1980, 94 Stat. 2624; Pub. L. 100–203, title IV, § 4212(e)(3), Dec. 22, 1987, 101 Stat. 1330–213; Pub. L. 100–360, title IV, § 411(l)(6)(F), July 1, 1988, as added Pub. L. 100–485, title VI, § 608(d)(27)(J), Oct. 13, 1988, 102 Stat. 2423; Pub. L. 101–239, title VI, § 6901(d)(5), Dec. 19, 1989, 103 Stat. 2301; Pub. L. 103–296, title I, § 108(d)(4), Aug. 15, 1994, 108 Stat. 1486; Pub. L. 106–113, div. B, § 1000(a)(6) [title VI, § 608(n)], Nov. 29, 1999, 113 Stat. 1536, 1501A–397.)Editorial NotesAmendments

1999—Pub. L. 106–113 struck out “of” after “approval of” in section catchline.

1994—Subsec. (b)(2). Pub. L. 103–296 inserted before period at end of first sentence “, except that, in so applying such sections and in applying section 405(l) of this title thereto, any reference therein to the Commissioner of Social Security or the Social Security Administration shall be considered a reference to the Secretary or the Department of Health and Human Services, respectively”.

1989—Pub. L. 101–239, § 6901(d)(5)(A), substituted “rural health clinics and intermediate care facilities for the mentally retarded” for “rural health clinics” in section catchline.

Subsec. (b)(1). Pub. L. 101–239, § 6901(d)(5)(B)–(D), substituted “any intermediate care facility for the mentally retarded” for “any skilled nursing or intermediate care facility”, “section 1396a(a)(31) of this title or section 1396d(d) of this title” for “section 1396a(a)(28) of this title or section 1396r of this title or section 1396d(c) of this title”, and “the intermediate care facility for the mentally retarded” for “the skilled nursing facility or intermediate care facility”.

Subsec. (b)(2). Pub. L. 101–239, § 6901(d)(5)(D), substituted “intermediate care facility for the mentally retarded” for “skilled nursing facility or intermediate care facility” in two places.

1988—Subsec. (b)(1). Pub. L. 100–360, § 411(l)(6)(F), as added by Pub. L. 100–485, § 608(d)(27)(J), inserted “or section 1396r of this title” after “1396a(a)(28) of this title”.

1987—Pub. L. 100–203 struck out “skilled nursing facilities and” before “of rural” in section catchline, redesignated subsecs. (b) and (c) as (a) and (b), respectively, and struck out former subsec. (a) which related to certification and approval of skilled nursing facilities.

1980—Subsec. (c). Pub. L. 96–499 added subsec. (c).

1977—Pub. L. 95–210 substituted “facilities and of rural health clinics” for “facilities” in section catchline, redesignated existing subsecs. (a) and (b) as (a)(1) and (2), respectively, and added subsec. (b).

Statutory Notes and Related SubsidiariesEffective Date of 1994 Amendment

Amendment by Pub. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Pub. L. 103–296, set out as a note under section 401 of this title.

Effective Date of 1989 Amendment

Amendment by Pub. L. 101–239 effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1987, Pub. L. 100–203, see section 6901(d)(6) of Pub. L. 101–239, set out as a note under section 1395i–3 of this title.

Effective Date of 1988 Amendments

Amendment by Pub. L. 100–485 effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, Pub. L. 100–360, see section 608(g)(1) of Pub. L. 100–485, set out as a note under section 704 of this title.

Except as specifically provided in section 411 of Pub. L. 100–360, amendment by Pub. L. 100–360, as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, Pub. L. 100–203, effective as if included in the enactment of that provision in Pub. L. 100–203, see section 411(a) of Pub. L. 100–360, set out as a Reference to OBRA; Effective Date note under section 106 of Title 1, General Provisions.

Effective Date of 1987 Amendment

Amendment by Pub. L. 100–203 applicable to nursing facility services furnished on or after Oct. 1, 1990, without regard to whether regulations implementing such amendment are promulgated by such date, except as otherwise specifically provided in section 1396r of this title, with transitional rule, see section 4214(a), (b)(2) of Pub. L. 100–203, as amended, set out as an Effective Date note under section 1396r of this title.

Effective Date of 1977 Amendment

Amendment by Pub. L. 95–210 applicable to medical assistance provided, under a State plan approved under subchapter XIX of this chapter, on and after first day of first calendar quarter that begins more than six months after Dec. 13, 1977, with exception for plans requiring State legislation, see section 2(f) of Pub. L. 95–210, set out as a note under section 1395cc of this title.

Effective Date

Section effective with respect to agreements filed with Secretary under section 1395cc of this title by skilled nursing facilities before, on, or after Oct. 30, 1972, but accepted by him on or after such date, see section 249A(e) of Pub. L. 92–603, set out as an Effective Date of 1972 Amendment note under section 1395cc of this title.

Notes of Decisions

Cited in 25 cases (1 in the last 5 years), 1978–2021 · leading case: Derek Waskul v. Washtenaw Cnty. Cmty. Mental Health, 979 F.3d 426 (6th Cir. 2020).

Sort: Relevance Newest Treatment

Derek Waskul v. Washtenaw Cnty. Cmty. Mental Health, 979 F.3d 426 (6th Cir. 2020). “at 499 (noting 42 U.S.C. § 1396i(b)(2) incorporates 42 U.”

Avon Nursing & Rehab. v. Becerra, 995 F.3d 305 (2d Cir. 2021). · cites it 2× “42 U.S.C. § 1396i(b)(2); see Mich. Ass’n, 127 F.”

Gruter Found., Inc. v. Bowen, 652 F. Supp. 245 (N.D. Ohio 1986). · cites it 6× “” 42 U.S.C. § 1396i. Considering the procedural history of this review since April, 1986, when the first survey occurred, plaintiffs’ reasons must be considered hypertechnical.”

Lexington Mgmt. Co. v. Missouri Dep't of Soc. Servs., 656 F. Supp. 36 (W.D. Mo. 1986). · cites it 4× “Nevertheless, pursuant to “look behind” authority under 42 U.S.C. § 1396i(c), 1 the federal govern *38 ment may intervene and cancel a Medicaid provider agreement for noncompliance with basic Medicaid standards.”

Health Equity Resources, Urbana, Inc. v. Sullivan, 927 F.2d 963 (7th Cir. 1991). · cites it 3× “42 U.S.C. § 1396i(c). (The statute has since been amended to narrow the scope of its application, but the amended version does not govern this case.”

Wayside Farms, Inc. v. United States Dep't of Health & Human Servs., 663 F. Supp. 945 (N.D. Ohio 1987). · cites it 3× “§ 1331 , 42 U.S.C. § 1396i(c)(2), 42 U.S.C. § 405 (g) and of the United States Constitution.”

Claridge House, Inc. v. United States Dep't of Health & Human Servs., 795 F. Supp. 1393 (S.D. Ohio 1991). · cites it 2× “Second, plaintiff relies upon the language of former 42 U.S.C. § 1396i(c), although plaintiff recognizes that the provision on which it relies is no longer in effect.”

Alta Bumpus v. Donald E. Clark, 681 F.2d 679 (9th Cir. 1982). “A state plan for medical assistance could not meet the demands of plaintiffs without imposing significant limitations on the rights of providers to withdraw.”

Town Court Nursing Ctr., Inc. v. Beal, 586 F.2d 266 (3rd Cir. 1978). · cites it 2× “42 U.S.C.A. § 1396i(a)(2) (Supp. 1978). Since only skilled nursing facilities certified by the Secretary under Medicare are eligible to participate in Medicaid, the state agency then must “take appropriate action to terminate the facility’s participation under the [state] plan.”

Illinois Council on Long Term Care Inc. v. Shalala, 143 F.3d 1072 (7th Cir. 1998). “§ 405 (g) via 42 U.S.C. § 1396i(b)(2) is independently sufficient to prevent anticipatory judicial review of regulations.”

Messier v. Southbury Training Sch., 916 F. Supp. 133 (D. Conn. 1996). “42 U.S.C. § 1396i(b). In Wilder , the Supreme Court found that an analogous remedial measure authorizing HHS to withdraw funds for non-compliance in no way indicated Congressional intent to foreclose suit under Section 1983.”

Mediplex of Massachusetts, Inc. v. Shalala, 39 F. Supp. 2d 88 (D. Mass. 1999). “42 U.S.C. § 1396i — 3(h)(2)(B). Sub-paragraph (B) specifically does not include termination of the facility’s provider agreement.”

Show all 25 citing cases →

— 42 U.S.C. § 1396i(a)(2) — 1 case

Town Court Nursing Ctr., Inc. v. Beal, 586 F.2d 266 (3rd Cir. 1978). “42 U.S.C.A. § 1396i(a)(2) (Supp. 1978). Since only skilled nursing facilities certified by the Secretary under Medicare are eligible to participate in Medicaid, the state agency then must “take appropriate action to terminate the facility’s participation under the [state] plan.”

— 42 U.S.C. § 1396i(a)(l) — 2 cases

Americana Healthcare Corp. v. Schweiker, 688 F.2d 1072 (7th Cir. 1982).

— 42 U.S.C. § 1396i(b) — 2 cases

Rayford v. Bowen, 715 F. Supp. 1347 (W.D. La. 1989).

— 42 U.S.C. § 1396i(b)(2) — 5 cases

Derek Waskul v. Washtenaw Cnty. Cmty. Mental Health, 979 F.3d 426 (6th Cir. 2020). “at 499 (noting 42 U.S.C. § 1396i(b)(2) incorporates 42 U.”

Avon Nursing & Rehab. v. Becerra, 995 F.3d 305 (2d Cir. 2021). “42 U.S.C. § 1396i(b)(2); see Mich. Ass’n, 127 F.”

Michigan Ass'n of Homes & Servs. for the Aging, Inc. v. Shalala, 127 F.3d 496 (6th Cir. 1997).

Rayford v. Bowen, 715 F. Supp. 1347 (W.D. La. 1989).

— 42 U.S.C. § 1396i(b)(l) — 2 cases

Oakwood Cmty. Ctr. icf/mr v. Sebelius, 723 F. Supp. 2d 937 (E.D. Ky. 2010).

Beverly California Corp. v. Shalala, 78 F.3d 403 (8th Cir. 1996).

— 42 U.S.C. § 1396i(c) — 6 cases

Gruter Found., Inc. v. Bowen, 652 F. Supp. 245 (N.D. Ohio 1986). “” 42 U.S.C. § 1396i. Considering the procedural history of this review since April, 1986, when the first survey occurred, plaintiffs’ reasons must be considered hypertechnical.”

Claridge House, Inc. v. United States Dep't of Health & Human Servs., 795 F. Supp. 1393 (S.D. Ohio 1991). “Second, plaintiff relies upon the language of former 42 U.S.C. § 1396i(c), although plaintiff recognizes that the provision on which it relies is no longer in effect.”

Lexington Mgmt. Co. v. Missouri Dep't of Soc. Servs., 656 F. Supp. 36 (W.D. Mo. 1986). “Nevertheless, pursuant to “look behind” authority under 42 U.S.C. § 1396i(c), 1 the federal govern *38 ment may intervene and cancel a Medicaid provider agreement for noncompliance with basic Medicaid standards.”

Health Equity Resources, Urbana, Inc. v. Sullivan, 927 F.2d 963 (7th Cir. 1991). “42 U.S.C. § 1396i(c). (The statute has since been amended to narrow the scope of its application, but the amended version does not govern this case.”

Wayside Farm, Inc. v. United States Dep't of Health & Human Servs., 863 F.2d 447 (6th Cir. 1988).

— 42 U.S.C. § 1396i(c)(2) — 8 cases

Wayside Farms, Inc. v. United States Dep't of Health & Human Servs., 663 F. Supp. 945 (N.D. Ohio 1987). “§ 1331 , 42 U.S.C. § 1396i(c)(2), 42 U.S.C. § 405 (g) and of the United States Constitution.”

Nw. Healthcare, L.P. v. Sullivan, 793 F. Supp. 724 (W.D. Tex. 1992).

Wayside Farm, Inc. v. United States Dep't of Health & Human Servs., 863 F.2d 447 (6th Cir. 1988).

— 42 U.S.C. § 1396i(c)(l) — 5 cases

Wayside Farm, Inc. v. United States Dep't of Health & Human Servs., 863 F.2d 447 (6th Cir. 1988).

Banks v. Sec'y of the Indiana Fam. & Soc. Servs. Admin., 997 F.2d 231 (7th Cir. 1993).

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.