Source: https://www.law.cornell.edu/uscode/text/42/1397jj
Timestamp: 2018-03-20 20:03:23
Document Index: 366789742

Matched Legal Cases: ['§ 1397', '§ 1397', '§ 1397', '§\u202f1397', '§\u202f2110', '§\u202f4901', '§\u202f162', '§\u202f1', '§\u202f802', '§\u202f501', '§\u202f2102', '§\u202f10203', '§\u202f205', '§\u202f9215', '§\u202f1201', '§\u202f1562', '§\u202f10107', '§\u202f1201', '§\u202f10103', '§\u202f2302', '§\u202f10203', '§\u202f10203', '§\u202f205', '§\u202f205', '§\u202f2102', '§\u202f501', '§\u202f501', '§\u202f505', '§\u202f162', '§\u202f162', '§\u202f162', '§\u202f2102', '§\u202f802', '§\u202f162', '§\u202f4901', '§\u202f2101']

42 U.S. Code § 1397jj - Definitions | US Law | LII / Legal Information Institute
U.S. Code › Title 42 › Chapter 7 › Subchapter XXI › § 1397jj
42 U.S. Code § 1397jj - Definitions
§ 1397jj.
(a) Child health assistanceFor purposes of this subchapter, the term “child health assistance” means payment for part or all of the cost of health benefits coverage for targeted low-income children that includes any of the following (and includes, in the case described in section 1397ee(a)(1)(D)(i) of this title, payment for part or all of the cost of providing any of the following), as specified under the State plan:
Inpatient substance abusetreatment services and residential substance abuse treatment services.
Outpatient substance abusetreatment services.
Hospice care (concurrent, in the case of an individual who is a child, with care related to the treatment of the child’s condition with respect to which a diagnosis of terminal illness has been made.[1]
(24) Any other medical, diagnostic, screening, preventive, restorative, remedial, therapeutic, or rehabilitative services (whether in a facility, home, school, or other setting) if recognized by State law and only if the service is—
(b) “Targeted low-income child” definedFor purposes of this subchapter—
(1) In generalSubject to paragraph (2), the term “targeted low-income child” means a child—
(ii) is a child—
who is not found to be eligible for medical assistance under subchapter XIX or, subject to paragraph (5), covered under a group health plan or under health insurance coverage (as such terms are defined in section 300gg–91 of this title).
(2) Children excludedSuch term does not include—
A child shall not be considered to be described in paragraph (1)(C) notwithstanding that the child is covered under a health insurance coverage program that has been in operation since before July 1, 1997, and that is offered by a State which receives no Federal funds for the program’s operation.
The term “medicaid applicable income level” means, with respect to a child, the effective income level (expressed as a percent of the poverty line) that has been specified under the State plan under subchapter XIX (including under a waiver authorized by the Secretary or under section 1396a(r)(2) of this title), as of March 31, 1997, for the child to be eligible for medical assistance under section 1396a(l)(2) or 1396d(n)(2) of this title (as selected by a State) for the age of such child.
(A) In generalSubject to subparagraphs (B) and (C), in the case of any child who is enrolled in a group health plan or health insurance coverage offered through an employer who would, but for the application of paragraph (1)(C), satisfy the requirements for being a targeted low-income child under a State child health plan that is implemented under this subchapter, a State may waive the application of such paragraph to the child in order to provide—
dental coverage consistent with the requirements of subsection (c)(5) of section 1397cc of this title; or
(C) ConditionsA State may not offer dental-only supplemental coverage under this paragraph unless the State satisfies the following conditions:
(i) Income eligibilityThe State child health plan under this subchapter—
(A) In generalA child shall not be considered to be described in paragraph (2)(B) if—
For purposes of subparagraph (A)(ii), this subparagraph applies to a child if the State determines that the annual aggregate amount of premiums and cost-sharing imposed for coverage of the family of the child would exceed 5 percent of such family’s income for the year involved.
(c) Additional definitionsFor purposes of this subchapter:
The term “creditable health coverage” has the meaning given the term “creditable coverage” under section 2701(c) [2] of the Public Health Service Act (42 U.S.C. 300gg(c)) and includes coverage that meets the requirements of section 1397cc of this title provided to a targeted low-income child under this subchapter or under a waiver approved under section 1397ee(c)(2)(B) of this title (relating to a direct service waiver).
The terms “group health plan”, “group health insurance coverage”, and “health insurance coverage” have the meanings given such terms in section 300gg–91 of this title.
The term “low-income child” means a child whose family income is at or below 200 percent of the poverty line for a family of the size involved.
The term “preexisting condition exclusion” has the meaning given such term in section 2701(b)(1)(A) 2 of the Public Health Service Act (42 U.S.C. 300gg(b)(1)(A)).
Unless the context otherwise requires, the terms “State child health plan” and “plan” mean a State child health plan approved under section 1397ff of this title.
The term “uncovered child” means a child that does not have creditable health coverage.
(A) In generalThe term “school-based health center” means a health clinic that—
(B) Sponsoring facilityFor purposes of subparagraph (A)(iii), the term “sponsoring facility” includes any of the following:
A local educational agency (as defined under section 7801 of title 20.1
(Aug. 14, 1935, ch. 531, title XXI, § 2110, as added Pub. L. 105–33, title IV, § 4901(a), Aug. 5, 1997, 111 Stat. 567; amended Pub. L. 105–100, title I, § 162(3), (9), Nov. 19, 1997, 111 Stat. 2189, 2190; Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(d)(5)], Dec. 21, 2000, 114 Stat. 2763, 2763A–582; Pub. L. 111–3, title V, §§ 501(b)(1), 505(b), Feb. 4, 2009, 123 Stat. 85, 90; Pub. L. 111–148, title II, §§ 2102(a)(7), 2302(b), title X, § 10203(d)(2)(D), Mar. 23, 2010, 124 Stat. 288, 293, 930; Pub. L. 111–309, title II, § 205(d), Dec. 15, 2010, 124 Stat. 3290; Pub. L. 114–95, title IX, § 9215(qqq)(2), Dec. 10, 2015, 129 Stat. 2189.)
[1]  So in original. A closing parenthesis probably should precede the period.
Section 2701 of the Public Health Service Act, referred to in subsec. (c)(2), (6), is section 2701 of act July 1, 1944, which was classified to section 300gg of this title, was renumbered section 2704, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Pub. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and was transferred to section 300gg–3 of this title. A new section 2701 of act July 1, 1944, related to fair health insurance premiums, was added, effective for plan years beginning on or after Jan. 1, 2014, and amended, by Pub. L. 111–148, title I, § 1201(4), title X, § 10103(a), Mar. 23, 2010, 124 Stat. 155, 892, and is classified to section 300gg of this title.
2015—Subsec. (c)(9)(B)(v). Pub. L. 114–95 made technical amendment to reference in original act which appears in text as reference to section 7801 of title 20.
2010—Subsec. (a)(23). Pub. L. 111–148, § 2302(b), which directed insertion of “(concurrent, in the case of an individual who is a child, with care related to the treatment of the child’s condition with respect to which a diagnosis of terminal illness has been made” after “hospice care”, was executed by making the insertion after “Hospice care”, to reflect the probable intent of Congress.
Subsec. (b)(2)(B). Pub. L. 111–148, § 10203(d)(2)(D)(i), inserted “except as provided in paragraph (6),” before “a child”.
Subsec. (b)(6). Pub. L. 111–148, § 10203(d)(2)(D)(ii), added par. (6).
Subsec. (b)(6)(B). Pub. L. 111–309, § 205(d)(1), struck out “per person” before “agency contribution” in heading and substituted “employees” for “each employee”.
Subsec. (b)(6)(C). Pub. L. 111–309, § 205(d)(2), struck out “, on a case-by-case basis,” after “determines”.
Subsec. (c)(9)(B)(v). Pub. L. 111–148, § 2102(a)(7), substituted “local educational agency (as defined under section 7801 of title 20” for “school or school system”.
2009—Subsec. (b)(1)(C). Pub. L. 111–3, § 501(b)(1)(A), inserted “, subject to paragraph (5),” after “subchapter XIX or”.
Subsec. (b)(5). Pub. L. 111–3, § 501(b)(1)(B), added par. (5).
Subsec. (c)(9). Pub. L. 111–3, § 505(b), added par. (9).
2000—Subsec. (a). Pub. L. 106–554 substituted “section 1397ee(a)(1)(D)(i)” for “section 1397ee(a)(2)(A)” in introductory provisions.
1997—Subsec. (b)(1)(B)(ii). Pub. L. 105–100, § 162(3)(A), amended cl. (ii) generally. Prior to amendment, cl. (ii) read as follows: “is a child whose family income (as determined under the State child health plan) exceeds the medicaid applicable income level (as defined in paragraph (4)), but does not exceed 50 percentage points above the medicaid applicable income level; and”.
Subsec. (b)(4). Pub. L. 105–100, § 162(3)(B), substituted “March 31, 1997” for “June 1, 1997” and “1396a(l)(2) or 1396d(n)(2) of this title (as selected by a State)” for “1396a(l)(2) of this title”.
Subsec. (c)(3). Pub. L. 105–100, § 162(9), made technical amendment to reference in original act which appears in text as reference to section 300gg–91 of this title.
Pub. L. 111–148, title II, § 2102(a), Mar. 23, 2010, 124 Stat. 288, provided that the amendment made by section 2102(a)(7) of Pub. L. 111–148 is effective as if included in the enactment of the Children’s Health Insurance Program Reauthorization Act of 2009 (Pub. L. 111–3).
Amendment by Pub. L. 106–554 effective as if included in the enactment of section 4901 of Pub. L. 105–33, see section 1(a)(6) [title VIII, § 802(f)] of Pub. L. 106–554, set out as a note under section 1396d of this title.
Pub. L. 105–100, title I, § 162, Nov. 19, 1997, 111 Stat. 2188, provided in part that the amendment made by that section is effective as if included in the enactment of subtitle J (§§ 4901–4923) of title IV of the Balanced Budget Act of 1997, Pub. L. 105–33.
Pub. L. 111–148, title II, § 2101(f), Mar. 23, 2010, 124 Stat. 287, provided that:
“Notwithstanding any other provision of law, a State shall treat any child who is determined to be ineligible for medical assistance under the State Medicaid plan or under a waiver of the plan as a result of the elimination of the application of an income disregard based on expense or type of income, as required under section 1902(e)(14) of the Social Security Act [42 U.S.C. 1396a(e)(14)] (as added by this Act), as a targeted low-income child under section 2110(b) [42 U.S.C. 1397jj(b)] (unless the child is excluded under paragraph (2) of that section) and shall provide child health assistance to the child under the State child health plan (whether implemented under title XIX or XXI, or both, of the Social Security Act [42 U.S.C. 1396 et seq., 1397aa et seq.]).”