{"identifier":"/us/usc/t42/s1396b\u20131","title":42,"num":"\u00a7\u202f1396b\u20131.","heading":"Payment adjustment for health care-acquired conditions","text":"\u00a7\u202f1396b\u20131.\nPayment adjustment for health care-acquired conditions\n(a)\nIn general\nThe Secretary of Health and Human Services (in this subsection referred to as the \u201cSecretary\u201d) shall identify current State practices that prohibit payment for health care-acquired conditions and shall incorporate the practices identified, or elements of such practices, which the Secretary determines appropriate for application to the Medicaid program in regulations. Such regulations shall be effective as of\nJuly 1, 2011\n42 U.S.C. 1396b\n(b)\nHealth care-acquired condition\nIn this section.\n1\n1 So in original. The period probably should be a comma.\n42 U.S.C. 1395ww(d)(4)(D)(iv)\n(c)\nMedicare provisions\nIn carrying out this section, the Secretary shall apply to State plans (or waivers) under title XIX of the Social Security Act [\n42 U.S.C. 1396\n42 U.S.C. 1395ww(d)(4)(D)\n42 U.S.C. 1395","url":"https://projectusc.org/usc/t42/s1396b\u20131.html","content":[{"t":"sec","id":"/us/usc/t42/s1396b\u20131","children":[{"t":"num","text":"\u00a7\u202f1396b\u20131."},{"t":"heading","text":"Payment adjustment for health care-acquired conditions"},{"t":"subsec","id":"/us/usc/t42/s1396b\u20131/a","children":[{"t":"num","text":"(a)"},{"t":"heading","text":"In general"},{"t":"content","children":[{"t":"p","text":"The Secretary of Health and Human Services (in this subsection referred to as the \u201cSecretary\u201d) shall identify current State practices that prohibit payment for health care-acquired conditions and shall incorporate the practices identified, or elements of such practices, which the Secretary determines appropriate for application to the Medicaid program in regulations. Such regulations shall be effective as of ","children":[{"t":"text","text":"July 1, 2011","tail":", and shall prohibit payments to States under section 1903 of the Social Security Act ["},{"t":"ref","text":"42 U.S.C. 1396b","href":"/us/usc/t42/s1396b","tail":"] for any amounts expended for providing medical assistance for health care-acquired conditions specified in the regulations. The regulations shall ensure that the prohibition on payment for health care-acquired conditions shall not result in a loss of access to care or services for Medicaid beneficiaries."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"subsec","id":"/us/usc/t42/s1396b\u20131/b","children":[{"t":"num","text":"(b)"},{"t":"heading","text":"Health care-acquired condition"},{"t":"content","children":[{"t":"p","text":"In this section.","children":[{"t":"ref","text":"1"},{"t":"num","text":"1","tail":"\u202fSo in original. The period probably should be a comma."},{"t":"text","text":"\u202fSo in original. The period probably should be a comma.","tail":" the term \u201chealth care-acquired condition\u201d means a medical condition for which an individual was diagnosed that could be identified by a secondary diagnostic code described in section 1886(d)(4)(D)(iv) of the Social Security Act ("},{"t":"ref","text":"42 U.S.C. 1395ww(d)(4)(D)(iv)","href":"/us/usc/t42/s1395ww/d/4/D/iv","tail":")."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"subsec","id":"/us/usc/t42/s1396b\u20131/c","children":[{"t":"num","text":"(c)"},{"t":"heading","text":"Medicare provisions"},{"t":"content","children":[{"t":"p","text":"In carrying out this section, the Secretary shall apply to State plans (or waivers) under title XIX of the Social Security Act [","children":[{"t":"ref","text":"42 U.S.C. 1396","href":"/us/usc/t42/s1396","tail":" et seq.] the regulations promulgated pursuant to section 1886(d)(4)(D) of such Act ("},{"t":"ref","text":"42 U.S.C. 1395ww(d)(4)(D)","href":"/us/usc/t42/s1395ww/d/4/D","tail":") relating to the prohibition of payments based on the presence of a secondary diagnosis code specified by the Secretary in such regulations, as appropriate for the Medicaid program. The Secretary may exclude certain conditions identified under title XVIII of the Social Security Act ["},{"t":"ref","text":"42 U.S.C. 1395","href":"/us/usc/t42/s1395","tail":" et seq.] for non-payment under title XIX of such Act when the Secretary finds the inclusion of such conditions to be inapplicable to beneficiaries under title XIX."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"text","text":"\n"},{"t":"text","text":"\n"}]}]}