45 C.F.R. § 150.217 Preliminary determination.
Title 45 - Public Welfare
If, at the end of the 30-day period (and any extension), the State has not established to CMS's satisfaction that it is substantially enforcing the HIPAA requirements described in the notice, CMS takes the following actions: (a) Consults with the appropriate State officials identified in §150.211 (or their designees). (b) Notifies the State of CMS's preliminary determination that the State has failed to substantially enforce the requirements and that the failure is continuing. (c) Permits the State a reasonable opportunity to show evidence of substantial enforcement.
Title 45: Public Welfare
PART 150—CMS ENFORCEMENT IN GROUP AND INDIVIDUAL INSURANCE MARKETS
Subpart B—CMS Enforcement Processes for Determining Whether States Are Failing To Substantially Enforce HIPAA Requirements
§ 150.217 Preliminary determination.

