If, after providing notice and a reasonable opportunity for the State to show that it has corrected any failure to substantially enforce, CMS finds that the failure to substantially enforce has not been corrected, it will send the State a written notice of its final determination. The notice includes the following:
(a) Identification of the PHS Act requirements that CMS is enforcing.
(b) The effective date of CMS's enforcement.
[64 FR 45795, Aug. 20, 1999, as amended at 78 FR 13440, Feb. 27, 2013]