us/statute/42/1396a/e/1

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Beginning April 1, 1990 , for provisions relating to the extension of eligibility for medical assistance for certain families who have received aid pursuant to a State plan approved under part A of subchapter IV and have earned income, see section 1396r–6 of this title .

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Rules

managed_care_minimum_enrollment_period_max_months

Parameter

source: 42 USC 1396a(e)(2)(B)

- name: managed_care_minimum_enrollment_period_max_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(2)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not more than six months
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

disabled_child_deeming_age_ceiling_years

Parameter

source: 42 USC 1396a(e)(3)(A)

- name: disabled_child_deeming_age_ceiling_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(3)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: is 18 years of age or younger
  versions:
    - effective_from: '1990-04-01'
      formula: '18'

newborn_deemed_eligibility_period_years

Parameter

source: 42 USC 1396a(e)(4)

- name: newborn_deemed_eligibility_period_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: remain eligible for such assistance for a period of one year
  versions:
    - effective_from: '1990-04-01'
      formula: '1'

qualified_medicare_beneficiary_determination_validity_months

Parameter

source: 42 USC 1396a(e)(8)

- name: qualified_medicare_beneficiary_determination_validity_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(8)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: valid for an individual for a period of 12 months
  versions:
    - effective_from: '1990-04-01'
      formula: '12'

qualified_medicare_beneficiary_redetermination_min_interval_months

Parameter

source: 42 USC 1396a(e)(8)

- name: qualified_medicare_beneficiary_redetermination_min_interval_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(8)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not more frequently than once every 6 months
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

ventilator_dependency_daily_hours_threshold

Parameter

source: 42 USC 1396a(e)(9)(A)(i)

- name: ventilator_dependency_daily_hours_threshold
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(9)(A)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: at least six hours per day
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

ventilator_dependency_consecutive_inpatient_days_threshold

Parameter

source: 42 USC 1396a(e)(9)(A)(ii)

- name: ventilator_dependency_consecutive_inpatient_days_threshold
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(9)(A)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: for at least 30 consecutive days
  versions:
    - effective_from: '1990-04-01'
      formula: '30'

group_health_plan_minimum_enrollment_period_max_months

Parameter

source: 42 USC 1396a(e)(11)(B)

- name: group_health_plan_minimum_enrollment_period_max_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(11)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not more than 6 months
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

child_continuous_eligibility_period_months

Parameter

source: 42 USC 1396a(e)(12)(A)

- name: child_continuous_eligibility_period_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(12)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: the end of the 12-month period
  versions:
    - effective_from: '2024-01-01'
      formula: '12'

child_continuous_eligibility_age_ceiling_years

Parameter

source: 42 USC 1396a(e)(12)

- name: child_continuous_eligibility_age_ceiling_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(12)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: under the age of 19
  versions:
    - effective_from: '2024-01-01'
      formula: '19'

express_lane_screening_threshold_minimum_percentage_point_excess

Parameter

source: 42 USC 1396a(e)(13)(C)(ii)(I)

- name: express_lane_screening_threshold_minimum_percentage_point_excess
  kind: parameter
  dtype: Rate
  source: 42 USC 1396a(e)(13)(C)(ii)(I)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: exceeds the highest income threshold ... by a minimum of 30 percentage points
  versions:
    - effective_from: '2009-01-01'
      formula: '0.30'

express_lane_error_rate_reduction_threshold

Parameter

source: 42 USC 1396a(e)(13)(E)(i)(IV), (V)

- name: express_lane_error_rate_reduction_threshold
  kind: parameter
  dtype: Rate
  source: 42 USC 1396a(e)(13)(E)(i)(IV), (V)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: error rate exceeds 3 percent
  versions:
    - effective_from: '2009-01-01'
      formula: '0.03'

express_lane_child_default_age_ceiling_years

Parameter

source: 42 USC 1396a(e)(13)(G)

- name: express_lane_child_default_age_ceiling_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(13)(G)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: child means an individual under 19 years of age
  versions:
    - effective_from: '2009-01-01'
      formula: '19'

express_lane_child_state_option_max_age_years

Parameter

source: 42 USC 1396a(e)(13)(G)

- name: express_lane_child_state_option_max_age_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(13)(G)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not to exceed 21 years of age
  versions:
    - effective_from: '2009-01-01'
      formula: '21'

clinical_trial_compensation_age_threshold_years

Parameter

source: 42 USC 1396a(e)(15)

- name: clinical_trial_compensation_age_threshold_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(15)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: who has attained 19 years of age
  versions:
    - effective_from: '2021-01-01'
      formula: '19'

clinical_trial_compensation_disregard_cap

Parameter

source: 42 USC 1396a(e)(15)

- name: clinical_trial_compensation_disregard_cap
  kind: parameter
  dtype: Money
  unit: USD
  source: 42 USC 1396a(e)(15)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: The first $2,000 received
  versions:
    - effective_from: '2021-01-01'
      formula: '2000'

clinical_trial_compensation_disregarded_for_income_eligibility

Derived

source: 42 USC 1396a(e)(15)

- name: clinical_trial_compensation_disregarded_for_income_eligibility
  kind: derived
  entity: Person
  dtype: Money
  period: Month
  unit: USD
  source: 42 USC 1396a(e)(15)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: >-
              The first $2,000 received by an individual (who has attained 19 years of age) as
              compensation for participation in a clinical trial ... shall be disregarded
  versions:
    - effective_from: '2021-01-01'
      formula: >-
        if individual_age_years >= clinical_trial_compensation_age_threshold_years and
        compensation_received_for_qualifying_rare_disease_clinical_trial:
        min(clinical_trial_compensation_amount, clinical_trial_compensation_disregard_cap) else: 0

extended_postpartum_coverage_period_months

Parameter

source: 42 USC 1396a(e)(16)(A), (B)

- name: extended_postpartum_coverage_period_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(16)(A), (B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: during the 12-month period that begins on the last day of the individual’s pregnancy
  versions:
    - effective_from: '2021-01-01'
      formula: '12'

▸citations (1)

References

This rule cites 1 other rule.

42 USC § 1396rinferredUS Federal › Statutes › Title 42 › § 1396r

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us/statute/42/1396a/e/1 · Axiom

Official source

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Rules

managed_care_minimum_enrollment_period_max_months

Parameter

source: 42 USC 1396a(e)(2)(B)

- name: managed_care_minimum_enrollment_period_max_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(2)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not more than six months
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

disabled_child_deeming_age_ceiling_years

Parameter

source: 42 USC 1396a(e)(3)(A)

- name: disabled_child_deeming_age_ceiling_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(3)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: is 18 years of age or younger
  versions:
    - effective_from: '1990-04-01'
      formula: '18'

newborn_deemed_eligibility_period_years

Parameter

source: 42 USC 1396a(e)(4)

- name: newborn_deemed_eligibility_period_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: remain eligible for such assistance for a period of one year
  versions:
    - effective_from: '1990-04-01'
      formula: '1'

qualified_medicare_beneficiary_determination_validity_months

Parameter

source: 42 USC 1396a(e)(8)

- name: qualified_medicare_beneficiary_determination_validity_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(8)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: valid for an individual for a period of 12 months
  versions:
    - effective_from: '1990-04-01'
      formula: '12'

qualified_medicare_beneficiary_redetermination_min_interval_months

Parameter

source: 42 USC 1396a(e)(8)

- name: qualified_medicare_beneficiary_redetermination_min_interval_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(8)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not more frequently than once every 6 months
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

ventilator_dependency_daily_hours_threshold

Parameter

source: 42 USC 1396a(e)(9)(A)(i)

- name: ventilator_dependency_daily_hours_threshold
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(9)(A)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: at least six hours per day
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

ventilator_dependency_consecutive_inpatient_days_threshold

Parameter

source: 42 USC 1396a(e)(9)(A)(ii)

- name: ventilator_dependency_consecutive_inpatient_days_threshold
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(9)(A)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: for at least 30 consecutive days
  versions:
    - effective_from: '1990-04-01'
      formula: '30'

group_health_plan_minimum_enrollment_period_max_months

Parameter

source: 42 USC 1396a(e)(11)(B)

- name: group_health_plan_minimum_enrollment_period_max_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(11)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not more than 6 months
  versions:
    - effective_from: '1990-04-01'
      formula: '6'

child_continuous_eligibility_period_months

Parameter

source: 42 USC 1396a(e)(12)(A)

- name: child_continuous_eligibility_period_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(12)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: the end of the 12-month period
  versions:
    - effective_from: '2024-01-01'
      formula: '12'

child_continuous_eligibility_age_ceiling_years

Parameter

source: 42 USC 1396a(e)(12)

- name: child_continuous_eligibility_age_ceiling_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(12)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: under the age of 19
  versions:
    - effective_from: '2024-01-01'
      formula: '19'

express_lane_screening_threshold_minimum_percentage_point_excess

Parameter

source: 42 USC 1396a(e)(13)(C)(ii)(I)

- name: express_lane_screening_threshold_minimum_percentage_point_excess
  kind: parameter
  dtype: Rate
  source: 42 USC 1396a(e)(13)(C)(ii)(I)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: exceeds the highest income threshold ... by a minimum of 30 percentage points
  versions:
    - effective_from: '2009-01-01'
      formula: '0.30'

express_lane_error_rate_reduction_threshold

Parameter

source: 42 USC 1396a(e)(13)(E)(i)(IV), (V)

- name: express_lane_error_rate_reduction_threshold
  kind: parameter
  dtype: Rate
  source: 42 USC 1396a(e)(13)(E)(i)(IV), (V)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: error rate exceeds 3 percent
  versions:
    - effective_from: '2009-01-01'
      formula: '0.03'

express_lane_child_default_age_ceiling_years

Parameter

source: 42 USC 1396a(e)(13)(G)

- name: express_lane_child_default_age_ceiling_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(13)(G)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: child means an individual under 19 years of age
  versions:
    - effective_from: '2009-01-01'
      formula: '19'

express_lane_child_state_option_max_age_years

Parameter

source: 42 USC 1396a(e)(13)(G)

- name: express_lane_child_state_option_max_age_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(13)(G)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: not to exceed 21 years of age
  versions:
    - effective_from: '2009-01-01'
      formula: '21'

clinical_trial_compensation_age_threshold_years

Parameter

source: 42 USC 1396a(e)(15)

- name: clinical_trial_compensation_age_threshold_years
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(15)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: who has attained 19 years of age
  versions:
    - effective_from: '2021-01-01'
      formula: '19'

clinical_trial_compensation_disregard_cap

Parameter

source: 42 USC 1396a(e)(15)

- name: clinical_trial_compensation_disregard_cap
  kind: parameter
  dtype: Money
  unit: USD
  source: 42 USC 1396a(e)(15)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: The first $2,000 received
  versions:
    - effective_from: '2021-01-01'
      formula: '2000'

clinical_trial_compensation_disregarded_for_income_eligibility

Derived

source: 42 USC 1396a(e)(15)

- name: clinical_trial_compensation_disregarded_for_income_eligibility
  kind: derived
  entity: Person
  dtype: Money
  period: Month
  unit: USD
  source: 42 USC 1396a(e)(15)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: >-
              The first $2,000 received by an individual (who has attained 19 years of age) as
              compensation for participation in a clinical trial ... shall be disregarded
  versions:
    - effective_from: '2021-01-01'
      formula: >-
        if individual_age_years >= clinical_trial_compensation_age_threshold_years and
        compensation_received_for_qualifying_rare_disease_clinical_trial:
        min(clinical_trial_compensation_amount, clinical_trial_compensation_disregard_cap) else: 0

extended_postpartum_coverage_period_months

Parameter

source: 42 USC 1396a(e)(16)(A), (B)

- name: extended_postpartum_coverage_period_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(e)(16)(A), (B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/e
            excerpt: during the 12-month period that begins on the last day of the individual’s pregnancy
  versions:
    - effective_from: '2021-01-01'
      formula: '12'

▸citations (1)

References

This rule cites 1 other rule.

42 USC § 1396rinferredUS Federal › Statutes › Title 42 › § 1396r