42 U.S. Code Chapter 7 - SOCIAL SECURITY

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SUBCHAPTER I—GRANTS TO STATES FOR OLD-AGE ASSISTANCE Sec. 301. Authorization of appropriations. 302. State old-age plans. 303. Payments to States and certain territories; computation of amount; eligibility of State to receive payment. 304. Stopping payment on deviation from required provisions of plan or failure to comply therewith. 305. Omitted. 306. Definitions. SUBCHAPTER II—FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE BENEFITS 401. Trust Funds. 401a. Omitted. 402. Old-age and survivors insurance benefit payments. 403. Reduction of insurance benefits. 404. Overpayments and underpayments. 405. Evidence, procedure, and certification for payments. 405a. Regulations pertaining to frequency or due dates of payments and reports under voluntary agreements covering State and local employees; effective date. 406. Representation of claimants before Commissioner. 407. Assignment of benefits. 408. Penalties. 409. “Wages” defined. 410. Definitions relating to employment. 410a. Transferred. 411. Definitions relating to self-employment. 412. Self-employment income credited to calendar years. 413. Quarter and quarter of coverage. 414. Insured status for purposes of old-age and survivors insurance benefits. 415. Computation of primary insurance amount. 416. Additional definitions. 417. Benefits for veterans. 418. Voluntary agreements for coverage of State and local employees. 419. Repealed. 420. Disability provisions inapplicable if benefit rights impaired. 421. Disability determinations. 422. Rehabilitation services. 423. Disability insurance benefit payments. 424. Repealed. 424a. Reduction of disability benefits. 425. Additional rules relating to benefits based on disability. 426. Entitlement to hospital insurance benefits. 426–1. End stage renal disease program. 426a. Transitional provision on eligibility of uninsured individuals for hospital insurance benefits. 427. Transitional insured status for purposes of old-age and survivors benefits. 428. Benefits at age 72 for certain uninsured individuals. 429. Benefits in case of members of uniformed services. 430. Adjustment of contribution and benefit base. 431. Benefits for certain individuals interned by United States during World War II. 432. Processing of tax data. 433. International agreements. 434. Demonstration project authority. SUBCHAPTER III—GRANTS TO STATES FOR UNEMPLOYMENT COMPENSATION ADMINISTRATION 501. Use of available funds. 502. Payments to States; computation of amounts. 503. State laws. 504. Judicial review. 505. Demonstration projects. SUBCHAPTER IV—GRANTS TO STATES FOR AID AND SERVICES TO NEEDY FAMILIES WITH CHILDREN AND FOR CHILD-WELFARE SERVICES
Part A—Block Grants to States for Temporary Assistance for Needy Families

601. Purpose. 602. Eligible States; State plan. 603. Grants to States. 603a. Transferred. 604. Use of grants. 604a. Services provided by charitable, religious, or private organizations. 605. Administrative provisions. 606. Federal loans for State welfare programs. 607. Mandatory work requirements. 608. Prohibitions; requirements. 608a. Fraud under means-tested welfare and public assistance programs. 609. Penalties. 610. Appeal of adverse decision. 611. Data collection and reporting. 611a. State required to provide certain information. 612. Direct funding and administration by Indian tribes. 613. Research, evaluations, and national studies. 614. Study by Census Bureau. 615. Waivers. 616. Administration. 617. Limitation on Federal authority. 618. Funding for child care. 619. Definitions.
Part B—Child and Family Services

subpart 1—child welfare services

620. Repealed. 621. Purpose. 622. State plans for child welfare services. 623. Allotments to States. 624. Payment to States. 625. Limitations on authorization of appropriations. 626. Research, training, or demonstration projects. 627. Family connection grants. 628. Payments to Indian tribal organizations. 628a. Transferred. 628b. National random sample study of child welfare.
subpart 2—promoting safe and stable families

629. Purpose. 629a. Definitions. 629b. State plans. 629c. Allotments to States. 629d. Payments to States. 629e. Evaluations; research; technical assistance. 629f. Authorization of appropriations; reservation of certain amounts. 629g. Discretionary and targeted grants. 629h. Entitlement funding for State courts to assess and improve handling of proceedings relating to foster care and adoption. 629i. Grants for programs for mentoring children of prisoners.
subpart 3—common provisions

629m. Data standardization for improved data matching.
Part C—Work Incentive Program for Recipients of Aid Under State Plan Approved Under Part A

630 to 645. Repealed or Omitted.
Part D—Child Support and Establishment of Paternity

651. Authorization of appropriations. 652. Duties of Secretary. 653. Federal Parent Locator Service. 653a. State Directory of New Hires. 654. State plan for child and spousal support. 654a. Automated data processing. 654b. Collection and disbursement of support payments. 655. Payments to States. 655a. Provision for reimbursement of expenses. 656. Support obligation as obligation to State; amount; discharge in bankruptcy. 657. Distribution of collected support. 658. Repealed. 658a. Incentive payments to States. 659. Consent by United States to income withholding, garnishment, and similar proceedings for enforcement of child support and alimony obligations. 659a. International support enforcement. 660. Civil action to enforce child support obligations; jurisdiction of district courts. 661, 662. Repealed. 663. Use of Federal Parent Locator Service in connection with enforcement or determination of child custody in cases of parental kidnaping of child. 664. Collection of past-due support from Federal tax refunds. 665. Allotments from pay for child and spousal support owed by members of uniformed services on active duty. 666. Requirement of statutorily prescribed procedures to improve effectiveness of child support enforcement. 667. State guidelines for child support awards. 668. Encouragement of States to adopt civil procedure for establishing paternity in contested cases. 669. Collection and reporting of child support enforcement data. 669a. Nonliability for financial institutions providing financial records to State child support enforcement agencies in child support cases. 669b. Grants to States for access and visitation programs.
Part E—Federal Payments for Foster Care and Adoption Assistance

670. Congressional declaration of purpose; authorization of appropriations. 671. State plan for foster care and adoption assistance. 672. Foster care maintenance payments program. 673. Adoption and guardianship assistance program. 673a. Interstate compacts. 673b. Adoption incentive payments. 673c. Timely interstate home study incentive payments. 674. Payments to States. 675. Definitions. 676. Administration. 677. John H. Chafee Foster Care Independence Program. 678. Rule of construction. 679. Collection of data relating to adoption and foster care. 679a. National Adoption Information Clearinghouse. 679b. Annual report. 679c. Programs operated by Indian tribal organizations.
Part F—Job Opportunities and Basic Skills Training Program

681 to 687. Repealed. SUBCHAPTER V—MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT 701. Authorization of appropriations; purposes; definitions. 702. Allotment to States and Federal set-aside. 703. Payments to States. 703a. Omitted. 704. Use of allotment funds. 704a. Omitted. 704b. Nonavailability of allotments after close of fiscal year. 705. Application for block grant funds. 706. Administrative and fiscal accountability. 707. Criminal penalty for false statements. 708. Nondiscrimination provisions. 709. Administration of Federal and State programs. 710. Separate program for abstinence education. 711. Maternal, infant, and early childhood home visiting programs. 712. Services to individuals with a postpartum condition and their families. 713. Personal responsibility education. 714 to 731. Omitted or Repealed. SUBCHAPTER VI—TEMPORARY STATE FISCAL RELIEF 801. Repealed. SUBCHAPTER VII—ADMINISTRATION 901. Social Security Administration. 901a. Repealed. 902. Commissioner; Deputy Commissioner; other officers. 903. Social Security Advisory Board. 904. Administrative duties of Commissioner. 905, 905a. Transferred. 906. Training grants for public welfare personnel. 907. Repealed. 907a. National Commission on Social Security. 908. Omitted. 909. Delivery of benefit checks. 910. Recommendations by Board of Trustees to remedy inadequate balances in Social Security trust funds. 911. Budgetary treatment of trust fund operations. 912. Office of Rural Health Policy. 913. Duties and authority of Secretary. 914. Office of Women’s Health. SUBCHAPTER VIII—SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS 1001. Basic entitlement to benefits. 1002. Qualified individuals. 1003. Residence outside the United States. 1004. Disqualifications. 1005. Benefit amount. 1006. Applications and furnishing of information. 1007. Representative payees. 1008. Overpayments and underpayments. 1009. Hearings and review. 1010. Other administrative provisions. 1010a. Optional Federal administration of State recognition payments. 1011. Penalties for fraud. 1012. Definitions. 1013. Appropriations. SUBCHAPTER IX—EMPLOYMENT SECURITY ADMINISTRATIVE FINANCING 1101. Employment security administration account. 1102. Transfers between Federal unemployment account and employment security administration account. 1103. Amounts transferred to State accounts. 1104. Unemployment Trust Fund. 1105. Extended unemployment compensation account. 1106. Unemployment compensation research program. 1107. Personnel training. 1108. Advisory Council on Unemployment Compensation. 1109. Federal Employees Compensation Account. 1110. Borrowing between Federal accounts. 1111. Data exchange standardization for improved interoperability. SUBCHAPTER X—GRANTS TO STATES FOR AID TO BLIND 1201. Authorization of appropriations. 1202. State plans for aid to blind. 1202a. Repealed. 1203. Payment to States. 1204. Operation of State plans. 1205. Omitted. 1206. “Aid to the blind” defined. SUBCHAPTER XI—GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE SIMPLIFICATION
Part A—General Provisions

1301. Definitions. 1301–1, 1301a. Omitted. 1302. Rules and regulations; impact analyses of Medicare and Medicaid rules and regulations on small rural hospitals. 1303. Separability. 1304. Reservation of right to amend or repeal. 1305. Short title of chapter. 1306. Disclosure of information in possession of Social Security Administration or Department of Health and Human Services. 1306a. Public access to State disbursement records. 1306b. State data exchanges. 1307. Penalty for fraud. 1308. Additional grants to Puerto Rico, Virgin Islands, Guam, and American Samoa; limitation on total payments. 1309. Amounts disregarded not to be taken into account in determining eligibility of other individuals. 1310. Cooperative research or demonstration projects. 1311. Public assistance payments to legal representatives. 1312. Medical care guides and reports for public assistance and medical assistance. 1313. Assistance for United States citizens returned from foreign countries. 1314. Public advisory groups. 1314a. Measurement and reporting of welfare receipt. 1315. Demonstration projects. 1315a. Center for Medicare and Medicaid Innovation. 1315b. Providing Federal coverage and payment coordination for dual eligible beneficiaries. 1316. Administrative and judicial review of public assistance determinations. 1317. Appointment of the Administrator and Chief Actuary of the Centers for Medicare & Medicaid Services. 1318. Alternative Federal payment with respect to public assistance expenditures. 1319. Federal participation in payments for repairs to home owned by recipient of aid or assistance. 1320. Approval of certain projects. 1320a. Uniform reporting systems for health services facilities and organizations. 1320a–1. Limitation on use of Federal funds for capital expenditures. 1320a–1a. Transferred. 1320a–2. Effect of failure to carry out State plan. 1320a–2a. Reviews of child and family services programs, and of foster care and adoption assistance programs, for conformity with State plan requirements. 1320a–3. Disclosure of ownership and related information; procedure; definitions; scope of requirements. 1320a–3a. Disclosure requirements for other providers under part B of Medicare. 1320a–4. Issuance of subpenas by Comptroller General. 1320a–5. Disclosure by institutions, organizations, and agencies of owners, officers, etc., convicted of offenses related to programs; notification requirements; “managing employee” defined. 1320a–6. Adjustments in SSI benefits on account of retroactive benefits under subchapter II. 1320a–7. Exclusion of certain individuals and entities from participation in Medicare and State health care programs. 1320a–7a. Civil monetary penalties. 1320a–7b. Criminal penalties for acts involving Federal health care programs. 1320a–7c. Fraud and abuse control program. 1320a–7d. Guidance regarding application of health care fraud and abuse sanctions. 1320a–7e. Health care fraud and abuse data collection program. 1320a–7f. Coordination of medicare and medicaid surety bond provisions. 1320a–7g. Funds to reduce medicaid fraud and abuse. 1320a–7h. Transparency reports and reporting of physician ownership or investment interests. 1320a–7i. Reporting of information relating to drug samples. 1320a–7j. Accountability requirements for facilities. 1320a–7k. Medicare and Medicaid program integrity provisions. 1320a–7l. Nationwide program for national and State background checks on direct patient access employees of long-term care facilities and providers. 1320a–7m. Use of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse in the Medicare fee-for-service program. 1320a–8. Civil monetary penalties and assessments for subchapters II, VIII and XVI. 1320a–8a. Administrative procedure for imposing penalties for false or misleading statements. 1320a–8b. Attempts to interfere with administration of this chapter. 1320a–9. Demonstration projects. 1320a–10. Effect of failure to carry out State plan. 1320b. Repealed. 1320b–1. Notification of Social Security claimant with respect to deferred vested benefits. 1320b–2. Period within which certain claims must be filed. 1320b–3. Applicants or recipients under public assistance programs not to be required to make election respecting certain veterans’ benefits. 1320b–4. Nonprofit hospital or critical access hospital philanthropy. 1320b–5. Authority to waive requirements during national emergencies. 1320b–6. Exclusion of representatives and health care providers convicted of violations from participation in social security programs. 1320b–7. Income and eligibility verification system. 1320b–8. Hospital protocols for organ procurement and standards for organ procurement agencies. 1320b–9. Improved access to, and delivery of, health care for Indians under subchapters XIX and XXI. 1320b–9a. Child health quality measures. 1320b–9b. Adult health quality measures. 1320b–10. Prohibitions relating to references to Social Security or Medicare. 1320b–11. Blood Donor Locator Service. 1320b–12. Research on outcomes of health care services and procedures. 1320b–13. Social security account statements. 1320b–14. Outreach efforts to increase awareness of the availability of medicare cost-sharing and subsidies for low-income individuals under subchapter XVIII. 1320b–15. Protection of social security and medicare trust funds. 1320b–16. Public disclosure of certain information on hospital financial interest and referral patterns. 1320b–17. Cross-program recovery of overpayments from benefits. 1320b–18. Repealed. 1320b–19. The Ticket to Work and Self-Sufficiency Program. 1320b–20. Work incentives outreach program. 1320b–21. State grants for work incentives assistance to disabled beneficiaries. 1320b–22. Grants to develop and establish State infrastructures to support working individuals with disabilities. 1320b–23. Pharmacy benefit managers transparency requirements. 1320b–24. Consultation with Tribal Technical Advisory Group. 1320b–25. Reporting to law enforcement of crimes occurring in federally funded long-term care facilities.
Part B—Peer Review of Utilization and Quality of Health Care Services

1320c. Purpose. 1320c–1. Definition of quality improvement organization. 1320c–2. Contracts with quality improvement organizations. 1320c–3. Functions of quality improvement organizations. 1320c–4. Right to hearing and judicial review. 1320c–5. Obligations of health care practitioners and providers of health care services; sanctions and penalties; hearings and review. 1320c–6. Limitation on liability. 1320c–7. Application of this part to certain State programs receiving Federal financial assistance. 1320c–8. Authorization for use of certain funds to administer provisions of this part. 1320c–9. Prohibition against disclosure of information. 1320c–10. Annual reports. 1320c–11. Exemptions for religious nonmedical health care institutions. 1320c–12. Medical officers in American Samoa, the Northern Mariana Islands, and the Trust Territory of the Pacific Islands to be included in the quality improvement program. 1320c–13 to 1320c–22. Repealed or Omitted.
Part C—Administrative Simplification

1320d. Definitions. 1320d–1. General requirements for adoption of standards. 1320d–2. Standards for information transactions and data elements. 1320d–3. Timetables for adoption of standards. 1320d–4. Requirements. 1320d–5. General penalty for failure to comply with requirements and standards. 1320d–6. Wrongful disclosure of individually identifiable health information. 1320d–7. Effect on State law. 1320d–8. Processing payment transactions by financial institutions. 1320d–9. Application of HIPAA regulations to genetic information.
Part D—Comparative Clinical Effectiveness Research

1320e. Comparative clinical effectiveness research. 1320e–1. Limitations on certain uses of comparative clinical effectiveness research. 1320e–2. Trust Fund transfers to Patient-Centered Outcomes Research Trust Fund. SUBCHAPTER XII—ADVANCES TO STATE UNEMPLOYMENT FUNDS 1321. Eligibility requirements for transfer of funds; reimbursement by State; application; certification; limitation. 1322. Repayment by State; certification; transfer; interest on loan; credit of interest on loan. 1323. Repayable advances to Federal unemployment account. 1324. “Governor” defined. SUBCHAPTER XIII—RECONVERSION UNEMPLOYMENT BENEFITS FOR SEAMEN 1331 to 1336. Repealed. SUBCHAPTER XIV—GRANTS TO STATES FOR AID TO PERMANENTLY AND TOTALLY DISABLED 1351. Authorization of appropriations. 1352. State plans for aid to permanently and totally disabled. 1353. Payments to States. 1354. Operation of State plans. 1355. Definitions. SUBCHAPTER XV—UNEMPLOYMENT COMPENSATION FOR FEDERAL EMPLOYEES 1361 to 1371. Repealed. SUBCHAPTER XVI—SUPPLEMENTAL SECURITY INCOME FOR AGED, BLIND, AND DISABLED 1381. Statement of purpose; authorization of appropriations. 1381a. Basic entitlement to benefits.
Part A—Determination of Benefits

1382. Eligibility for benefits. 1382a. Income; earned and unearned income defined; exclusions from income. 1382b. Resources. 1382c. Definitions. 1382d. Rehabilitation services for blind and disabled individuals. 1382e. Supplementary assistance by State or subdivision to needy individuals. 1382f. Cost-of-living adjustments in benefits. 1382g. Payments to State for operation of supplementation program. 1382h. Benefits for individuals who perform substantial gainful activity despite severe medical impairment. 1382i. Medical and social services for certain handicapped persons. 1382j. Attribution of sponsor’s income and resources to aliens. 1382k. Repealed.
Part B—Procedural and General Provisions

1383. Procedure for payment of benefits. 1383a. Penalties for fraud. 1383b. Administration. 1383c. Eligibility for medical assistance of aged, blind, or disabled individuals under State’s medical assistance plan. 1383d. Outreach program for children. 1383e. Treatment referrals for individuals with alcoholism or drug addiction condition. 1383f. Annual report on program. 1384, 1385. Omitted. SUBCHAPTER XVII—GRANTS FOR PLANNING COMPREHENSIVE ACTION TO COMBAT MENTAL RETARDATION 1391. Authorization of appropriations. 1392. Availability of funds during certain fiscal years; limitation on amount; utilization of grant. 1393. Applications; single State agency designation; essential planning services; plans for expenditure; final activities report and other necessary reports; records; accounting. 1394. Payments to States; adjustments; advances or reimbursement; installments; conditions. SUBCHAPTER XVIII—HEALTH INSURANCE FOR AGED AND DISABLED 1395. Prohibition against any Federal interference. 1395a. Free choice by patient guaranteed. 1395b. Option to individuals to obtain other health insurance protection. 1395b–1. Incentives for economy while maintaining or improving quality in provision of health services. 1395b–2. Notice of medicare benefits; medicare and medigap information. 1395b–3. Health insurance advisory service for medicare beneficiaries. 1395b–4. Health insurance information, counseling, and assistance grants. 1395b–5. Beneficiary incentive programs. 1395b–6. Medicare Payment Advisory Commission. 1395b–7. Explanation of medicare benefits. 1395b–8. Chronic care improvement. 1395b–9. Provisions relating to administration. 1395b–10. Addressing health care disparities.
Part A—Hospital Insurance Benefits for Aged and Disabled

1395c. Description of program. 1395d. Scope of benefits. 1395e. Deductibles and coinsurance. 1395f. Conditions of and limitations on payment for services. 1395g. Payments to providers of services. 1395h. Provisions relating to the administration of part A. 1395i. Federal Hospital Insurance Trust Fund. 1395i–1. Authorization of appropriations. 1395i–1a. Repealed. 1395i–2. Hospital insurance benefits for uninsured elderly individuals not otherwise eligible. 1395i–2a. Hospital insurance benefits for disabled individuals who have exhausted other entitlement. 1395i–3. Requirements for, and assuring quality of care in, skilled nursing facilities. 1395i–3a. Protecting residents of long-term care facilities. 1395i–4. Medicare rural hospital flexibility program. 1395i–5. Conditions for coverage of religious nonmedical health care institutional services.
Part B—Supplementary Medical Insurance Benefits for Aged and Disabled

1395j. Establishment of supplementary medical insurance program for aged and disabled. 1395k. Scope of benefits; definitions. 1395l. Payment of benefits. 1395m. Special payment rules for particular items and services. 1395n. Procedure for payment of claims of providers of services. 1395o. Eligible individuals. 1395p. Enrollment periods. 1395q. Coverage period. 1395r. Amount of premiums for individuals enrolled under this part. 1395s. Payment of premiums. 1395t. Federal Supplementary Medical Insurance Trust Fund. 1395t–1, 1395t–2. Repealed. 1395u. Provisions relating to the administration of part B. 1395v. Agreements with States. 1395w. Appropriations to cover Government contributions and contingency reserve. 1395w–1. Repealed. 1395w–2. Intermediate sanctions for providers or suppliers of clinical diagnostic laboratory tests. 1395w–3. Competitive acquisition of certain items and services. 1395w–3a. Use of average sales price payment methodology. 1395w–3b. Competitive acquisition of outpatient drugs and biologicals. 1395w–4. Payment for physicians’ services. 1395w–5. Public reporting of performance information.
Part C—Medicare Choice Program

1395w–21. Eligibility, election, and enrollment. 1395w–22. Benefits and beneficiary protections. 1395w–23. Payments to Medicare Choice organizations. 1395w–24. Premiums and bid amounts. 1395w–25. Organizational and financial requirements for Medicare Choice organizations; provider-sponsored organizations. 1395w–26. Establishment of standards. 1395w–27. Contracts with Medicare Choice organizations. 1395w–27a. Special rules for MA regional plans. 1395w–28. Definitions; miscellaneous provisions. 1395w–29. Repealed.
Part D—Voluntary Prescription Drug Benefit Program

subpart 1—part d eligible individuals and prescription drug benefits

1395w–101. Eligibility, enrollment, and information. 1395w–102. Prescription drug benefits. 1395w–103. Access to a choice of qualified prescription drug coverage. 1395w–104. Beneficiary protections for qualified prescription drug coverage.
subpart 2—prescription drug plans; pdp sponsors; financing

1395w–111. PDP regions; submission of bids; plan approval. 1396w–112. Requirements for and contracts with prescription drug plan (PDP) sponsors. 1395w–113. Premiums; late enrollment penalty. 1395w–114. Premium and cost-sharing subsidies for low-income individuals. 1395w–114a. Medicare coverage gap discount program. 1395w–115. Subsidies for part D eligible individuals for qualified prescription drug coverage. 1395w–116. Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund.
subpart 3—application to medicare advantage program and treatment of employer-sponsored programs and other prescription drug plans

1395w–131. Application to Medicare Advantage program and related managed care programs. 1395w–132. Special rules for employer-sponsored programs. 1395w–133. State Pharmaceutical Assistance Programs. 1395w–134. Coordination requirements for plans providing prescription drug coverage.
subpart 4—medicare prescription drug discount card and transitional assistance program

1395w–141. Medicare prescription drug discount card and transitional assistance program.
subpart 5—definitions and miscellaneous provisions

1395w–151. Definitions; treatment of references to provisions in part C. 1395w–152. Miscellaneous provisions. 1395w–153. Condition for coverage of drugs under this part. 1395w–154. Improved Medicare prescription drug plan and MA–PD plan complaint system.
Part E—Miscellaneous Provisions

1395x. Definitions. 1395y. Exclusions from coverage and medicare as secondary payer. 1395z. Consultation with State agencies and other organizations to develop conditions of participation for providers of services. 1395aa. Agreements with States. 1395bb. Effect of accreditation. 1395cc. Agreements with providers of services; enrollment processes. 1395cc–1. Demonstration of application of physician volume increases to group practices. 1395cc–2. Provisions for administration of demonstration program. 1395cc–3. Health care quality demonstration program. 1395cc–4. National pilot program on payment bundling. 1395cc–5. Independence at home medical practice demonstration program. 1395dd. Examination and treatment for emergency medical conditions and women in labor. 1395ee. Practicing Physicians Advisory Council; Council for Technology and Innovation. 1395ff. Determinations; appeals. 1395gg. Overpayment on behalf of individuals and settlement of claims for benefits on behalf of deceased individuals. 1395hh. Regulations. 1395ii. Application of certain provisions of subchapter II. 1395jj. Designation of organization or publication by name. 1395kk. Administration of insurance programs. 1395kk–1. Contracts with medicare administrative contractors. 1395ll. Studies and recommendations. 1395mm. Payments to health maintenance organizations and competitive medical plans. 1395nn. Limitation on certain physician referrals. 1395oo. Provider Reimbursement Review Board. 1395pp. Limitation on liability where claims are disallowed. 1395qq. Indian Health Service facilities. 1395rr. End stage renal disease program. 1395rr–1. Medicare coverage for individuals exposed to environmental health hazards. 1395ss. Certification of medicare supplemental health insurance policies. 1395ss–1. Clarification. 1395tt. Hospital providers of extended care services. 1395uu. Payments to promote closing or conversion of underutilized hospital facilities. 1395vv. Withholding payments from certain medicaid providers. 1395ww. Payments to hospitals for inpatient hospital services. 1395xx. Payment of provider-based physicians and payment under certain percentage arrangements. 1395yy. Payment to skilled nursing facilities for routine service costs. 1395zz. Provider education and technical assistance. 1395aaa. Contract with a consensus-based entity regarding performance measurement. 1395aaa–1. Quality and efficiency measurement. 1395bbb. Conditions of participation for home health agencies; home health quality. 1395ccc. Offset of payments to individuals to collect past-due obligations arising from breach of scholarship and loan contract. 1395ddd. Medicare Integrity Program. 1395eee. Payments to, and coverage of benefits under, programs of all-inclusive care for elderly (PACE). 1395fff. Prospective payment for home health services. 1395ggg. Omitted. 1395hhh. Health care infrastructure improvement program. 1395iii. Medicare Improvement Fund. 1395jjj. Shared savings program. 1395kkk. Independent Payment Advisory Board. 1395kkk–1. GAO study and report on determination and implementation of payment and coverage policies under the Medicare program. SUBCHAPTER XIX—GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS 1396. Medicaid and CHIP Payment and Access Commission. 1396–1. Appropriations. 1396a. State plans for medical assistance. 1396b. Payment to States. 1396b–1. Payment adjustment for health care-acquired conditions. 1396c. Operation of State plans. 1396d. Definitions. 1396e. Enrollment of individuals under group health plans. 1396e–1. Premium assistance option for children. 1396f. Observance of religious beliefs. 1396g. State programs for licensing of administrators of nursing homes. 1396g–1. Required laws relating to medical child support. 1396h. State false claims act requirements for increased State share of recoveries. 1396i. Certification and approval of rural health clinics and intermediate care facilities for mentally retarded. 1396j. Indian Health Service facilities. 1396k. Assignment, enforcement, and collection of rights of payments for medical care; establishment of procedures pursuant to State plan; amounts retained by State. 1396l. Hospital providers of nursing facility services. 1396m. Withholding of Federal share of payments for certain medicare providers. 1396n. Compliance with State plan and payment provisions. 1396o. Use of enrollment fees, premiums, deductions, cost sharing, and similar charges. 1396o–1. State option for alternative premiums and cost sharing. 1396p. Liens, adjustments and recoveries, and transfers of assets. 1396q. Application of provisions of subchapter II relating to subpoenas. 1396r. Requirements for nursing facilities. 1396r–1. Presumptive eligibility for pregnant women. 1396r–1a. Presumptive eligibility for children. 1396r–1b. Presumptive eligibility for certain breast or cervical cancer patients. 1396r–1c. Presumptive eligibility for family planning services. 1396r–2. Information concerning sanctions taken by State licensing authorities against health care practitioners and providers. 1396r–3. Correction and reduction plans for intermediate care facilities for mentally retarded. 1396r–4. Adjustment in payment for inpatient hospital services furnished by disproportionate share hospitals. 1396r–5. Treatment of income and resources for certain institutionalized spouses. 1396r–6. Extension of eligibility for medical assistance. 1396r–7. Repealed. 1396r–8. Payment for covered outpatient drugs. 1396s. Program for distribution of pediatric vaccines. 1396t. Home and community care for functionally disabled elderly individuals. 1396u. Community supported living arrangements services. 1396u–1. Assuring coverage for certain low-income families. 1396u–2. Provisions relating to managed care. 1396u–3. State coverage of medicare cost-sharing for additional low-income medicare beneficiaries. 1396u–4. Program of all-inclusive care for elderly (PACE). 1396u–5. Special provisions relating to medicare prescription drug benefit. 1396u–6. Medicaid Integrity Program. 1396u–7. State flexibility in benefit packages. 1396u–8. Health opportunity accounts. 1396v. References to laws directly affecting medicaid program. 1396w. Asset verification through access to information held by financial institutions. 1396w–1. Medicaid Improvement Fund. 1396w–2. Authorization to receive relevant information. 1396w–3. Enrollment simplification and coordination with State health insurance exchanges. 1396w–4. State option to provide coordinated care through a health home for individuals with chronic conditions. 1396w–5. Addressing health care disparities. SUBCHAPTER XX—BLOCK GRANTS TO STATES FOR SOCIAL SERVICES AND ELDER JUSTICE
Division A—Block Grants to States for Social Services

1397. Purposes of division; authorization of appropriations. 1397a. Payments to States. 1397b. Allotments. 1397c. State reporting requirements. 1397d. Limitation on use of grants; waiver. 1397e. Administrative and fiscal accountability. 1397f. Additional grants. 1397g. Demonstration projects to address health professions workforce needs. 1397h. Program for early detection of certain medical conditions related to environmental health hazards.
Division B—Elder Justice

1397j. Definitions. 1397j–1. General provisions.
Part I—National Coordination of Elder Justice Activities and Research

subpart a—elder justice coordinating council and advisory board on elder abuse, neglect, and exploitation

1397k. Elder Justice Coordinating Council. 1397k–1. Advisory Board on Elder Abuse, Neglect, and Exploitation. 1397k–2. Research protections. 1397k–3. Authorization of appropriations.
subpart b—elder abuse, neglect, and exploitation forensic centers

1397l. Establishment and support of elder abuse, neglect, and exploitation forensic centers.
Part II—Programs To Promote Elder Justice

1397m. Enhancement of long-term care. 1397m–1. Adult protective services functions and grant programs. 1397m–2. Long-term care ombudsman program grants and training. 1397m–3. Provision of information regarding, and evaluations of, elder justice programs. 1397m–4. Report. 1397m–5. Rule of construction. SUBCHAPTER XXI—STATE CHILDREN’S HEALTH INSURANCE PROGRAM 1397aa. Purpose; State child health plans. 1397bb. General contents of State child health plan; eligibility; outreach. 1397cc. Coverage requirements for children’s health insurance. 1397dd. Allotments. 1397ee. Payments to States. 1397ff. Process for submission, approval, and amendment of State child health plans. 1397gg. Strategic objectives and performance goals; plan administration. 1397hh. Annual reports; evaluations. 1397ii. Miscellaneous provisions. 1397jj. Definitions. 1397kk. Phase-out of coverage for nonpregnant childless adults; conditions for coverage of parents. 1397ll. Optional coverage of targeted low-income pregnant women through a State plan amendment. 1397mm. Grants to improve outreach and enrollment.


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