[Federal Register: October 18, 2006 (Volume 71, Number 201)]
[Notices]
[Page 61482-61483]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr18oc06-65]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Notice of Hearing: Reconsideration of Disapproval of Minnesota
State Plan Amendment 05-015B
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice of Hearing.
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SUMMARY: This notice announces an administrative hearing to be held on
December 4, 2006, at 233 N. Michigan Avenue, Suite 600, the Illinois
Room, Chicago, IL 60601, to reconsider CMS' decision to disapprove
Minnesota State plan amendment 05-015B.
Closing Date: Requests to participate in the hearing as a party
must be received by the presiding officer by November 2, 2006.
FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding
[[Page 61483]]
Officer, CMS, Lord Baltimore Drive, Mail Stop LB-23-20, Baltimore,
Maryland 21244; Telephone: (410) 786-2055.
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider CMS' decision to disapprove Minnesota State plan
amendment (SPA) 05-015B which was submitted on September 28, 2005. This
SPA was disapproved on June 12, 2006.
Under this SPA, the State proposed to limit incurred medical and
remedial care expenses protected under the post eligibility process
only to those expenses incurred while an individual is eligible for
Medicaid.
Sections 1902(a)(17), and 1902(a)(51) in conjunction with section
1924 of the Social Security Act (the Act), as these sections are
refined by section 1902(r)(1), require States to take into account,
under the post eligibility process, amounts for incurred medical and
remedial care expenses that are not subject to payment by a third
party. Section 1902(r)(1)(A)(ii) of the Act and Federal regulations at
42 CFR 435.733(c)(4)(ii) permit States to place ``reasonable'' limits
on the amounts of necessary medical and remedial care expenses
recognized under State law but not covered under the State plan. The
amendment was disapproved because CMS found that the amendment violated
the statute for reasons set forth in the disapproval letter.
The issues to be decided in the hearing are:
Whether Minnesota's SPA 05-015B impermissibly limits the
amount of incurred expenses which may be deducted from an
institutionalized individual's income for purposes of the post
eligibility process by limiting these expenses to those incurred when
the individual was Medicaid eligible; and
Whether allowing this limitation undermines the protection
of expenses which can be incurred when an individual is not Medicaid
eligible, which must be considered for purposes of the medically needy
spend down.
Section 1116 of the Act and Federal regulations at 42 CFR Part 430,
establish Department procedures that provide an administrative hearing
for reconsideration of a disapproval of a State plan or plan amendment.
CMS is required to publish a copy of the notice to a State Medicaid
agency that informs the agency of the time and place of the hearing,
and the issues to be considered. If we subsequently notify the agency
of additional issues that will be considered at the hearing, we will
also publish that notice.
Any individual or group that wants to participate in the hearing as
a party must petition the presiding officer within 15 days after
publication of this notice, in accordance with the requirements
contained at 42 CFR 430.76(b)(2). Any interested person or organization
that wants to participate as amicus curiae must petition the presiding
officer before the hearing begins in accordance with the requirements
contained at 42 CFR 430.76(c). If the hearing is later rescheduled, the
presiding officer will notify all participants.
The notice to Minnesota announcing an administrative hearing to
reconsider the disapproval of its SPA reads as follows:
Ms. Christine Bronson,
Medicaid Director,
Minnesota Department of Human Services,
P.O. Box 64983,
St. Paul, MN 55164-0983.
Dear Ms. Bronson: I am responding to your request for
reconsideration of the decision to disapprove the Minnesota State
plan amendment (SPA) 05-015B, which was submitted on September 28,
2005, and disapproved on June 12, 2006.
Under this SPA, the State proposed to limit incurred medical and
remedial care expenses protected under the post eligibility process
only to those expenses incurred while an individual is eligible for
Medicaid.
Sections 1902(a)(17), and 1902(a)(51) in conjunction with
section 1924 of the Social Security Act (the Act), as these sections
are refined by section 1902(r)(1), require States to take into
account, under the post eligibility process, amounts for incurred
medical and remedial care expenses that are not subject to payment
by a third party. Section 1902(r)(1)(A)(ii) of the Act and Federal
regulations at 42 CFR 435.733(c)(4)(ii) permit States to place
``reasonable'' limits on the amounts of necessary medical and
remedial care expenses recognized under State law but not covered
under the State plan. The amendment was disapproved because CMS
found that the amendment violated the statute for reasons set forth
in the disapproval letter.
The issues to be decided at the hearing are:
Whether Minnesota's SPA 05-015B impermissibly limits
the amount of incurred expenses which may be deducted from an
institutionalized individual's income for purposes of the post
eligibility process by limiting these expenses to those incurred
when the individual was Medicaid eligible; and
Whether allowing this limitation undermines the
protection of expenses which can be incurred when an individual is
not Medicaid eligible, which must be considered for purposes of the
medically needy spend down.
I am scheduling a hearing on your request for reconsideration to
be held on December 4, 2006, at 233 N. Michigan Avenue, Suite 600,
the Illinois Room, Chicago, IL 60601, to reconsider the decision to
disapprove SPA 05-015B. If this date is not acceptable, we would be
glad to set another date that is mutually agreeable to the parties.
The hearing will be governed by the procedures prescribed by Federal
regulations at 42 CFR part 430.
I am designating Ms. Kathleen Scully-Hayes as the presiding
officer. If these arrangements present any problems, please contact
the presiding officer at (410) 786-2055. In order to facilitate any
communication which may be necessary between the parties to the
hearing, please notify the presiding officer to indicate
acceptability of the hearing date that has been scheduled and
provide names of the individuals who will represent the State at the
hearing.
Sincerely,
Mark B. McClellan, M.D., PhD
Section 1116 of the Social Security Act (42 U.S.C. section 1316);
(42 CFR section 430.18).
(Catalog of Federal Domestic Assistance program No. 13.714, Medicaid
Assistance Program.)
Dated: October 5, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E6-17368 Filed 10-17-06; 8:45 am]
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