assistance in the form of money payments under any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, or to have paid with respect to him supplemental security income benefits under subchapter XVI of this chapter as would not be disregarded (or set aside for future needs) in determining his eligibility for such aid, assistance or benefits, (C) provide for reasonable evaluation of any such income or resources, and (D) do not take into account the financial responsibility of any individual for any applicant or recipient of assistance under the plan unless such applicant or recipient is such individual's spouse or such individual's child who is under age 21 or (with respect to States eligible to participate in the State program established under subchapter XVI of this chapter), is blind or permanently and totally disabled, or is blind or disabled as defined in section 1382c of this title (with respect to States which are not eligible to participate in such program); and provide for flexibility in the application of such standards with respect to income by taking into account, except to the extent prescribed by the Secretary, the costs (whether in the form of insurance premiums or otherwise) incurred for medical care or for any other type of remedial care recognized under State law;

(18) provide that no lien may be imposed against the property of any individual prior to his death on account of medical assistance paid or to be paid on his behalf under the plan (except pursuant to the judgment of a court on account of benefits incorrectly paid on behalf of such individual), and that there shall be no adjustment or recovery (except, in the case of an individual who was 65 years of age or older when he received such assistance, from his estate, and then only after the death of his surviving spouse, if any, and only at a time when he has no surviving child who is under age 21 or (with respect to States eligible to participate in the State program established under subchapter XVI of this chapter), is blind or permanently and totally disabled, or is blind or disabled as defined in section 1382c of this title with respect to States which are not eligible to participate in such program) of any medical assistance correctly paid on behalf of such individual under the plan;

(20) If the State plan includes medical assistance in behalf of individuals 65 years of age or older who are patients in institutions for mental diseases

(C) provide for the development of alternate plans of care, making maximum utilization of available resources, for recipients 65 years of age or older who would otherwise need care in such institutions, including appropriate medical treatment and other aid or assistance; for services referred to in section 303 (a) (4) (A) (i) and (ii), section 803 (a) (1) (A) (i) and (ii), or section 1383 (a) (4) (A) (i) and (ii) of this

title which are appropriate for such recipients and for such patients; and for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and such patients will be effectively carried out; and

(D) provide methods of determining the reasonable cost of institutional care for such patients;

(21) if the State plan includes medical assistance in behalf of individuals 65 years of age or older who are patients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including provision for utilization of community mental health centers, nursing facilities, and other alternatives to care in public institutions for mental diseases;

(23) provide that any individual eligible for medical assistance (including drugs) may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required (including an organization which provides such services, or arranges for their availability, on a prepayment basis), who undertakes to provide him such services; and a State plan shall not be deemed to be out of compliance with the requirements of this paragraph or paragraph (1) or (10) solely by reason of the fact that the State (or any political subdivision thereof) has entered into a contract with an organization which has agreed to provide care and services in addition to those offered under the State plan to individuals eligible for medical assistance who reside in the geographic area served by such organization and who elect to obtain such care and services from such organization;

(24) effective July 1, 1969, provide for consultative services by health agencies and other appropriate agencies of the State to hospitals, nursing facilities, home health agencies, clinics, laboratories, and such other institutions as the Secretary may specify in order to assist them (A) to qualify for payments under this chapter, (B) to establish and maintain such fiscal records as may be necessary for the proper and efficient administration of this chapter, and (C) to provide information needed to determine payments due under this chapter on account of care and services furnished to individuals;

(26) effective July 1, 1969, provide (A) for a regular program of medical review (including medical evaluation) of each patient's need for skilled nursing facility care or (in the case of individuals who are eligible therefor under the State plan) need for care in a mental hospital, a written plan) need for care in a mental hospital, a written plan of care, and, where applicable, a plan of rehabilitation prior to admission to a skilled nursing facility; (B) for periodic inspections to be made in all skilled nursing facilities and mental institutions (if the State plan includes care in

such institutions) within the State by one or more medical review teams (composed of physicians and other appropriate health and social service personnel) of (i) the care being provided in such nursing facilities (and mental institutions, if care therein is provided under the State plan) to persons receiving assistance under the State plan, (ii) with respect to each of the patients receiving such care, the adequacy of the services available in particular nursing facilities (or institutions) to meet the current health needs and promote the maximum physical well-being of patients receiving care in such facilities (or institutions), (iii) the necessity and desirability of the continued placement of such patients in such nursing facilities (or institutions), and (iv) the feasibility of meeting their health care needs through alternative institutional or noninstitutional services; and (C) for the making by such team or teams of full and complete reports of the findings resulting from such inspections together with any recommendations to the State agency administering or supervising the administration of the State plan;

(28) provide that any skilled nursing facility receiving payments under such plan must satisfy all of the requirements contained in section 1395x (j) of this title, except that the exclusion contained therein with respect to institutions which are primarily for the care and treatment of mental diseases and tuberculosis shall not apply for purposes of this subchapter;

(29) include a State program which meets the requirements set forth in section 1396g of this title, for the licensing of administrators of nursing homes;

(30) provide such methods and procedures relating to the utilization of, and the payment for, care and services available under the plan (including but not limited to utilization review plans as provided for in section 1396b (i) (4) of this title) as may be necessary to safeguard against unnecessary utilization of such care and services and to assure that payments (including payments for any drugs provided under the plan) are not in excess of reasonable charges consistent with efficiency, economy, and quality of care;

(31) provide (A) for a regular program of independent professional review (including medical evaluation of each patient's need for intermediate care) and a written plan of service prior to admission or authorization of benefits in an intermediate care facility as determined under regulations of the Secretary; (B) for periodic on-site inspections to be made in all such intermediate care facilities (if the State plan includes care in such institutions) within the State by one or more independent professional review teams (composed of physicians or registered nurses and other appropriate health and social service personnel) of (i) the care being provided in such intermediate care facilities to persons receiving assistance under the State plan, (ii) with respect to each of the patients receiving such care, the adequacy of the services available in particular

intermediate care facilities to meet the current health needs and promote the maximum physical well-being of patients receiving care in such facilities, (iii) the necessity and desirability of the continued placement of such patients in such facilities, and (iv) the feasibility of meeting their health care needs through alternative institutional or non-institutional services; and (C) for the making by such team or teams of full and complete reports of the findings resulting from such inspections, together with any recommendations to the State agency administering or supervising the administration of the State plan;

(32) provide that no payment under the plan for any care or service to an individual by a physician, dentist, or other individual practitioner shall be made to anyone other than such individual or such physician, dentist, or practitioner, except that payment may be made (A) to the employer of such physician, dentist, or practitioner if such physician, dentist, or practitioner is required as a condition of his employment to turn over his fee for such care or service to his employer, or (B) (where the care or service was provided in a hospital, clinic, or other facility) to the facility in which the care or service was provided if there is a contractual arrangement between such physician, dentist, or practitioner and such facility under which such facility submits the bill for such care or service;

(33) provide

(A) that the State health agency, or other appropriate State medical agency, shall be responsible for establishing a plan, consistent with regulations prescribed by the Secretary, for the review by appropriate professional health personnel of the appropriateness and quality of care and services furnished to recipients of medical assistance under the plan in order to provide guidance with respect thereto in the administration of the plan to the State agency established or designated pursuant to paragraph (5) and, where applicable, to the State agency described in the penultimate sentence of this subsection; and

(B) that the State or local agency utilized by the Secretary for the purpose specified in the first sentence of section 1395aa (a) of this title, or, if such agency is not the State agency which is responsible for licensing health institutions, the State agency responsible for such licensing, will perform for the State agency administering or supervising the administration of the plan approved under this subchapter the function of determining whether institutions and agencies meet the requirements for participation in the program under such plan;

(34) provide that in the case of any individual who has been determined to be eligible for medical assistance under the plan, such assistance will be made available to him for care and services included under the plan and furnished in or after the third month before the month in which he made application (or application was made on his behalf in the case of deceased individual) for such

assistance if such individual was (or upon application would have been) eligible for such assistance at the time such care and services were furnished;

(35) effective January 1, 1973, provide that any intermediate care facility receiving payments under such plan must supply to the licensing agency of the State full and complete information as to the identity (A) of each person having (directly or indirectly) an ownership interest of 10 per centum or more in such intermediate care facility or who is the owner (in whole or in part) of any mortgage, deed or trust, note, or other obligation secured (in whole or in part) by such intermediate care facility or any of the property or assets of such intermediate care facility, (B) in case an intermediate care facility is organized as a corporation, of each officer and director of the corporation, and (C) in case an intermediate care facility is organized as a partnership, of each partner; and promptly report any changes which would affect the current accuracy of the information so required to be supplied; and

(36) provide that within 90 days following the completion of each survey of any health care facility, laboratory, agency, clinic, or organization, by the appropriate State agency described in paragraph (9), such agency shall (in accordance with regulations of the Secretary) make public in readily available form and place the pertinent findings of each such survey relating to the compliance of each such health care facility, laboratory, clinic, agency, or organization with (A) the statutory conditions of participation imposed under this subchapter, and (B) the major additional conditions which the Secretary finds necessary in the interest of health and safety of individuals who are furnished care or services by any such facility, laboratory, clinic, agency, or organization.

Notwithstanding paragraph (5), if on January 1, 1965, and on the date on which a State submits its plan for approval under this subchapter, the State agency which administered or supervised the administration of the plan of such State approved under subchapter X of this chapter (or subchapter XVI of this chapter, insofar as it relates to the blind) was different from the State agency which administered or supervised the administration of the State plan approved under subchapter I of this chapter (or subchapter XVI of this chapter, insofar as it relates to the aged), the State agency which administered or supervised the administration of such plan approved under subchapter X of this chapter (or subchapter XVI of this chapter, insofar as it relates to the blind) may be designated to administer or supervise the administration of the portion of the State plan for medical assistance which relates to blind individuals and a different State agency may be established or designated to administer or supervise the administration of the rest of the State plan for medical assistance; and in such case the part of the plan which each such agency administers, or the administration of which each such agency supervises, shall be regarded as a separate plan for purposes of this subchapter (except for purposes of paragraph (10)).

For purposes of paragraphs (9) (A), (29), (31), and (33), and of section 1396b (i) (4) of this title, the terms "skilled nursing facility" and "nursing home" do not include a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts.

(d) Repealed. Pub. L. 92-603, title II, § 231, Oct. 30, 1972, 36 Stat. 1410.

(e) Continued eligibility of families determined ineligible because of income and resources or hours of work limitations of plan.

Notwithstanding any other provision of this subchapter, effective January 1, 1974, each State plan approved under this subchapter must provide that each family which was receiving aid pursuant to a plan of the State approved under part A of subchapter IV of this chapter in at least 3 of the 6 months immediately preceding the month in which such family became ineligible for such aid because of increased hours of, or increased income from, employment, shall, while a member of such family is employed, remain eligible for assistance under the plan approved under this subchapter (as though the family was receiving aid under the plan approved under part A of subchapter IV of this chapter) for 4 calendar months beginning with the month in which such family became ineligible for aid under the plan approved under part A of subchapter IV of this chapter because of income and resources or hours of work limitations contained in such plan. (f) Effective date of State plan as determinative of duty of State to provide medical assistance to aged, blind, or disabled individuals.

Notwithstanding any other provision of this subchapter, except as provided in subsection (e) of this section, no State not eligible to participate in the State plan program established under subchapter XVI of this chapter shall be required to provide medical assistance to any aged, blind, or disabled individual (within the meaning of subchapter XVI of this chapter) for any month unless such State would be (or would have been) required to provide medical assistance to such individual for such month had its plan for medical assistance approved under this subchapter and in effect on January 1, 1972, been in effect in such month, except that for this purpose any such individual shall be deemed eligible for medical assistance under such State plan if (in addition to meeting such other requirements as are or may be imposed under the State plan) the income of any such individual as determined in accordance with section 1396b (f) of this title (after deducting any supplemental security income payment and State supplementary payment made with respect to such individual, and incurred expenses for medical care as recognized under State law) is not in excess of the standard for medical assistance established under the State plan as in effect on January 1, 1972. In States which provide medical assistance to individuals pursuant to clause (10) (C) of subsection (a) of this section, an individual who is eligible for medical assistance by reason of the requirements of this section concerning the deduction of incurred medical expenses from income shall be considered an individual eligible for medical assistance under clause (10)

(A) of that subsection if that individual is, or is eligible to be (1) an individual with respect to whom there is payable a State supplementary payment on the basis of which similarly situated individuals are eligible to receive medical assistance equal in amount, duration, and scope to that provided to individuals eligible under clause (10) (A), or (2) an eligible individual or eligible spouse, as defined in subchapter XVI of this chapter, with respect to whom supplemental security income benefits are payable; otherwise that individual shall be considered to be an individual eligible for medical assistance under clause (10(C) of that subsection. In States which do not provide medical assistance to individuals pursuant to clause (10) (C) of that subsection, an individual who is eligible for medical assistance by reason of the requirements of this section concerning the deduction of incurred medical expenses from income shall be considered an individual eligible for medical asistance under clause (10) (A) of that subsection. (As amended Dec. 28, 1971, Pub. L. 92-223, § 4(b), 85 Stat. 809; Oct. 30, 1972, Pub. L. 92-603, title II, §§ 208(a), 209 (a), (b) (1), 221 (c) (5), 231, 232(a), 236(b), 237(a) (2), 239 (a), (b), 240, 246(a), 249 (a), 255(a), 268 (a), 274(a), 278(a) (18), (19), (b)(14), 298, 299A, 299D(b), 86 Stat. 1381, 1389, 1410, 14151418, 1424, 1426, 1446, 1450, 1452-1454, 1460, 1462; Dec. 31, 1973, Pub. L. 93-233, §§ 13(a) (2)-(10), 18(o), (p), (q), (x) (1)−(4), 87 Stat. 960-962, 971, 972.)

AMENDMENTS

1973 Subsec. (a) (5). Pub. L. 93-233, § 13(a) (2) (A), (B), substituted "to administer or to supervise the administration of the plan" for "to administer the plan" and "to supervise the administration of the plan" in that order and added after the parenthetical phrase the conditional provision "if the State is eligible to participate in the State plan program established under subchapter XVI of this chapter, or by the agency or agencies administering the supplemental security income program established under subchapter XVI of this chapter or the State plan approved under part A of subchapter IV of this chapter if the State is not eligible to participate in the State plan program established under subchapter XVI of this chapter".

Subsec. (a) (10). Pub. L. 93-233, § 13(a) (3), incorporated existing text in provisions designated as cl. (A), providing therein for medical assistance to individuals with respect to whom supplemental security income benefits are paid; incorporated existing par. (A) in provisions designated as cl. (B); incorporated existing par. (B) in provisions designated as cl. (C), providing therein for individuals not meeting income and resources requirements of the supplemental security income program; substituted in cls. (B) (ii), (C), (C)(1) (ii) and "medical assistance" for "medical or remedial care and services" appearing in predecessor provisions and in cl. (C) (1) "except for income and resources" for "if needy" appearing in predecessor provision; and in the exception provisions included reference to par. (16) of section 1396 (a) of this title in item I, substituted "deductibles" for "the deductibles" in item (II), and added item (III).

Subsec. (a) (13) (B). Pub. L. 93-233, § 13(a) (4), substituted "any plan of the State approved" for "the State's plan approved" and inserted after "part A of subchapter IV of this chapter" text reading ", or with respect to whom supplemental security income benefits are being paid under subchapter XVI of this chapter".

Subsec. (a) (13) (C) (11) (I). Pub. L. 93-233, § 18(x) (1), substituted reference to clause "16" for "14".

Subsec. (a) (14) (A). Pub. L. 93-233, § 13(a) (5), substituted "any plan of the State approved" for "a State plan

approved" and "with respect to whom supplemental security income benefits are being paid under subchapter XVI of this chapter, or who meet the income and resources requirements of the appropriate State plan, or the supplemental security income program under subchapter XVI of this chapter, as the case may be, and individuals with respect to whom there is being paid, or who are eligible, or would be eligible if they were not in a medical institution, to have paid with respect to them, a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in paragraph (10)(A)" for "who meet the income and resources requirements of the one of such State plans which is appropriate".

Subsec. (a) (14) (B). Pub. L. 93-233, § 13(a) (6) (A)-(D), inserted after "with respect to individuals" the parenthetical provision "(other than individuals with respect to whom there is being paid, or who are eligible or would be eligible if they were not in a medical institution, to have paid with respect to them, a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in paragraph (10) (A))"; inserted after "any such State plan" the clause "and with respect to whom supplemental security income benefits are not being paid under subchapter XVI of this chapter"; substituted "the appropriate State plan, or the supplemental security income program under supchapter XVI of this chapter, as the case may be," for "the one of such State plans which is appropriate"; and struck out "or who, after December 31, 1973, are included under the State plan for medical assistance pursuant to subsection (a) (10) (B) of this section approved under this subchapter" preceding the hyphen and cl. (1), respectively.

Subsec. (a) (17). Pub. L. 93-233, § 13(a) (7) (A)−(D), 8, substituted: "any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter, and with respect to whom supplemental security income benefits are not being paid under subchapter XVI of this chapter" for "the State's plan approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter"; "except for income and resources" for "if he met the requirements as to need": "any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter, or to have paid with respect to him supplemental security income benefits under subchapter XVI of this chapter" for "a State plan approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter"; "such aid, assistance, or benefits" for "and amount of such aid or assistance under such plan"; and "(with respect to States eligible to participate in the State program established under subchapter XVI of this chapter), is blind or permanently and totally disabled, or is blind or disabled as defined in section 1382c of this title (with respect to States which are not eligible to participate in such program)" for "is blind or permanently and totally disabled".

Subsec. (a) (18). Pub. L. 93-233, § 13(a)(8), substituted "(with respect to States eligible to participate in the State program established under subchapter XVI of this chapter), is blind or permanently and totally disabled, or is blind or disabled as defined in section 1382c of this title (with respect to States which are not eligible to participate in such program)" for "is blind or permanently and totally disabled".

Subsec. (a) (20) (C). Pub. L. 93-233, § 13 (a) (9), inserted reference to section 803 (a) (1) (A) (i) and (ii) of this title. Subsec. (a) (21). Pub. L. 93–233, § 18(x) (4) provided for substitution of "nursing facilities" for "nursing homes". Subsec. (a) (24). Pub. L. 93–233, § 18(x) (4) provided for substitution of "nursing facilities" for "nursing homes".

Subsec. (a) (26) (B). Pub. L. 93-233. § 18(x) (4), provided for substitution of "nursing facility" and "nursing facilities" for "nursing home" and "nursing homes". changes already executed under 1972 Amendment by Pub. L. 92-603, § 278(a) (19).

Subsec. (a) (33) (A). Pub. L. 93-233, § 18(x) (2), substituted "penultimate sentence" for "last sentence".

Subsec. (a) (34). Pub. L. 93-233, § 18 (o), inserted "(or application was made on his behalf in the case of a deceased individual)" following "he made application".

Subsec. (a) (35) (A). Pub. L. 93-233, § 18(p), required the intermediate care facility to supply full and complete information respecting the person who is the owner (in whole or in part) of any mortgage, deed of trust, note, or other obligation secured (in whole or in part) by the intermediate care facility or any of the property or assets of the intermediate care facility..

Subsec. (a) (35)–(37). Pub. L. 93-233, § 18(x) (3) (A), (B), substituted "; and" for "." at end of par. (35); and corrected numerical sequence of paragraphs, redesignating par. (37) as (36), the original subsec. (a) having been enacted without a par. (36).

Subsec. (e). Pub. L. 93-233, § 18(q), substituted "each family which was receiving aid pursuant to a plan of the State approved under part A” for “each family which was eligible for assistance pursuant to part A", "for such aid because of increased hours of, or increased income from, employment" for "for such assistance because of increased income from employment", and "remain eligible for assistance under the plan approved under this subchapter (as though the family was receiving aid under the plan approved under part A of subchapter IV of this chapter) for 4 calendar months beginning with the month in which such family became ineligible for aid under the plan approved under part A of subchapter IV of this chapter because of income and resources or hours of work limitations" for "remain eligible for such assistance for 4 calendar months following the month in which such family would otherwise be determined to be ineligible for such assistance because of the income and resources

limitations".

Subsec. (f) Pub. L. 93-233, § 13 (a) (10) (A)-(D) substituted: "no State not eligible to participate in the State plan program established under subchapter XVI of this chapter" for "no State" and "any supplemental security income payment and State supplementary payment made with respect to such individual" for "such individual's payment under subchapter XVI of this chapter" and "as recognized under State law" for "as defined in section 213 of Title 26" in parenthetical text; and added two end sentences for consideration of certain individuals as eligible for medical assistance under cl. (10) (A) or (C) of subsec. (a) of this section or as eligible for such assistance under cl. (10)(A) in States not providing such assistance under cl. (10) (C), respectively.

1972 Subsec. (a). Pub. L. 92-603, §§ 268 (a), 278(b) (14), added provisions exempting Christian Science sanatoriums from certain nursing facility and nursing home requirements.

Subsec. (a) (9). Pub. L. 92–603, § 239 (a), added provisions to utilize state health agency for establishing and maintaining health standards for private or public institutions in which recipients of medical assistance under the plan may receive care or services.

Subsec. (a) (13) (A) (ii). Pub. L. 92-603, § 278 (a) (18), (b) (14), substituted "skilled nursing facility" for "skilled nursing home."

Subsec. (a) (13) (C). Pub. L. 92-603, § 278 (a) (18), (b) (14), substituted "skilled nursing facility" for "skilled nursing home".

Subsec. (a) (13) (D). Pub. L. 92-603, §§ 221 (c) (5), 232 (a), added provisions that the reasonable cost of inpatient hospital services shall not exceed the amount determined under section 1395x(v) of this title and inserted reference to the consistency of methods and standards with section 1320a-1 of this title for determining the reasonable cost of inpatient hospital services.

Subsec. (a) (13) (E). Pub. L. 92-603, § 249 (a), added subpar. (E).

Subsec. (a) (14). Pub. L. 92-603, § 208 (a), substituted a nominal amount for an amount reasonably related to the recipient's income as the amount of the deduction, cost sharing, or similar charge imposed under the plan and added provisions covering individuals who are not receiving aid or assistance under any state plan and who do not meet the income and resources requirements and covering individuals who are included under the state plan for medical assistance pursuant to subsec. (a) (10) (B) of this section approved under this subchapter.

Subsec. (a) (23). Pub. L. 92-603, § 240, added provisions allowing States to adopt comprehensive health care programs while still complying with medicaid requirements. Subsec. (a) (26). Pub. L. 92-603, §§ 274(a), 278(a) (19), (b) (14), substituted "evaluation)" for "evaluation" and "care" for "care)" and substituted "skilled nursing facility" and "skilled nursing facilities" for "skilled nursing home" and "skilled nursing homes".

Subsec, (a) (28). Pub, L. 92-603, § 246 (a), substituted "skilled nursing facility" for "skilled nursing home" and substituted a simple reference to the requirements contained in section 1395x(j) of this title with a specified exception for provisions spelling out in detail the requirements for skilled nursing homes receiving payments.

Subsec. (a) (30), Pub. L. 92-603, § 237(a)(2), substituted "under the plan (including but not limited to utilization review plans as provided for in section 1396b (1) (4) of this title)" for "under the plan".

Subsec. (a) (31) (A). Pub. L. 92-603, § 298, struck out "which provides more than a minimum level of health care services" following "intermediate care facility". Subsec. (a) (32), Pub. L. 92-603, § 236(b)(3), added par (32).

Subsec, (a) (33). Pub. L. 92-603, § 239 (b) (3), added par. (33).

Subsec. (a) (34). Pub. L. 92-603, § 255 (a) (3), added par (34).

Subsec. (a) (35). Pub. L. 92-603, § 299A(3), added par. (35).

Subsec. (a) (37). Pub. L. 92-603, § 299D (b)(3), added par. (37).

Subsc. (d). Pub. L. 92-603, § 231, repealed subsec. (d), which related to modification of state plans for medical assistance under certain circumstances.

Subsec. (e). Pub. L. 92–603, § 209(a), added subsec. (e). Subsec. (f). Pub. L. 92-603, § 209 (b) (1), added subsec. (f).

1971-Subsec. (a) (31). Pub. L. 92-223 added par. (31). EFFECTIVE DATE OF 1973 AMENDMENT

Section 13(d) of Pub. L. 93-233 provided that: "The amendments made by subsection (a) [to subsecs. (a) (5), (10), (13) (B), (14) (A), (B), (17), (18), (20) (C), and (f) of this section and sections 1396, 1396b(a) (1), (f) (4), and 1396(a), (a) (iv)-(vii), (j), and (k) of this title] shall be effective with respect to payments under section 1903 of the Social Security Act [section 1396b of this title] for calendar quarters commencing after December 31, 1973." Section 18(z-3) (4) of Pub. L. 93-233 provided that: "The amendments made by subsections (o) and (u) [of subsec. (a) (3) of this section and section 1396b(b)(2) of this title] shall be effective July 1, 1973".

EFFECTIVE DATE OF 1972 AMENDMENT

Section 268 (c) of Pub. L. 92-603 provided that: "The amendments made by this section [amending subsec. (a) of this section and section 1396g (g)(1) of this title] shall be effective on the date of the enactment of this Act [Oct. 30, 1972]."

Amendment of subsec. (a) (9) and (a) (33) by section 239 (a), (b) of Pub. L. 92-603 to be effective Jan. 1, 1973 (or earlier if the state plan so provides), see section 239 (d) of Pub. L. 92-603, set out as a note under section 705 of this title.

Amendment of subsec. (a) (13) by section 232 (a) of Pub. L. 92-603 effective July 1, 1972 or earlier if the State plan so provides, see section 232 (c) of Pub. L. 92-603, set out as a note under section 705 of this title.

Section 208(b) of Pub. L. 92-603 provided that: "The amendment made by subsection (a) [amending subsec. (a) (14) of this section] shall be effective January 1, 1973 (or earlier if the State plan so provided)."

Amendment of subsec. (a) (28) by section 246(a) of Pub. L. 92-603 to be effective July 1, 1973, see section 246 (c) of Pub. L. 92-603, set out as a note under section 1395x of this title.

Section 237 (d) (2) of Pub. L. 92-603 provided that: "The amendment made by subsection (a) (2) [amending subsec. (a) (30) of this section] shall be effective July 1, 1973."

Amendment of subsec. (a) (32) by section 236(b) of Pub. L. 92-603 effective Jan. 1, 1973 or earlier if the state plan so provides, see section 236 (c) of Pub. L. 92-603, set out as a note under section 1395u of this title.