---
kind: "section"
citation: "42 C.F.R. § 447.256"
title: "42"
number: "447.256"
heading: "Procedures for CMS action on assurances and State plan amendments."
url: "https://uscodex.org/cfr/42/447.256"
---

# §447.256. Procedures for CMS action on assurances and State plan amendments.

- (a) **Criteria for approval.**
  - (1) CMS approval action on State plans and State plan amendments, is taken in accordance with [subpart B of part 430](/cfr/42/part430-subpartB.md) of this chapter and sections [1116](/cfr/42/1116.md), [1902(b)](/cfr/42/1902.md?p=b) and [1915(f)](/cfr/42/1915.md?p=f) of the Act.
  - (2) In the case of State plan and plan amendment changes in payment methods and standards, CMS bases its approval on the acceptability of the Medicaid agency's assurances that the requirements of [§ 447.253](/cfr/42/447.253.md) have been met, and the State's compliance with the other requirements of this subpart.
- (b) **Time limit.** CMS will send a notice to the agency of its determination as to whether the assurances regarding a State plan amendment are acceptable within 90 days of the date CMS receives the assurances described in [§ 447.253](/cfr/42/447.253.md), and the related information described in [§ 447.255](/cfr/42/447.255.md) of this subpart. If CMS does not send a notice to the agency of its determination within this time limit and the provisions in [paragraph (a)](#a) of this section are met, the assurances and/or the State plan amendment will be deemed accepted and approved.
- (c) **Effective date.** A State plan amendment that is approved will become effective not earlier than the first day of the calendar quarter in which an approvable amendment is submitted in accordance with [§§ 430.20](/cfr/42/430.20.md) of this chapter and 447.253.

## Notes

### Amendments

[48 FR 56058, Dec. 19, 1983, as amended at 52 FR 28147, July 28, 1987]

### Source

Source: 46 FR 47971, Sept. 30, 1981, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, and 1396r-8, and Pub. L. 111-148.

### Source

Source: 43 FR 45253, Sept. 29, 1978, unless otherwise noted.

### Amendments

[48 FR 56058, Dec. 19, 1983, as amended at 52 FR 28147, July 28, 1987]