[Federal Register: December 19, 2007 (Volume 72, Number 243)]
[Notices]
[Page 71915-71921]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr19de07-79]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-2273-N]
RIN 0938-AO99
State Children's Health Insurance Program (SCHIP); Additional
Allotments To Eliminate FY 2007 Funding Shortfalls
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice describes the methodology and process we are using
for determining the amounts of certain States' remaining SCHIP funding
shortfalls in Federal fiscal year (FY) 2007, in accordance with the
provisions of the U.S. Troop Readiness, Veteran's Care, Katrina
Recovery, and Iraq Accountability Appropriations Act, 2007. This notice
also contains the amounts of the additional allotments to be provided
to such States to eliminate such FY 2007 funding shortfalls, determined
in accordance with this methodology.
FOR FURTHER INFORMATION CONTACT: Richard Strauss, (410) 786-2019.
SUPPLEMENTARY INFORMATION:
I. Background
A. Availability and Redistribution of SCHIP Fiscal Year Allotments
Title XXI of the Social Security Act (the Act) sets forth the State
Children's Health Insurance Program (SCHIP) to enable States, the
District of Columbia, and specified Commonwealths and Territories to
initiate and expand health insurance coverage to uninsured, low-income
children. The 50 States, the District of Columbia, and the
Commonwealths and Territories may implement the SCHIP through a
separate child health program under title XXI of the Act, an expanded
program under title XIX of the Act, or a combination of both.
Section 2104(e) of the Act specifies that the SCHIP allotments for
a Federal fiscal year are available for payment to States for their
expenditures under an approved State child health plan for an initial
3-fiscal year period of availability, including the fiscal year for
which the allotment was provided. Section 2104(f) of the Act specifies
that the amounts of States' allotments which are not expended during
the initial 3-year period of availability are to be redistributed to
those States that have
[[Page 71916]]
fully spent these fiscal year allotments during this period of
availability in accordance with an appropriate procedure determined by
the Secretary. Furthermore, section 2104(e) of the Act specifies that
the amounts of the redistributed allotments continue to be available
for expenditure by the States receiving these redistributions to the
end of the fiscal year in which these funds are redistributed.
B. Enactment of NIHRA, UTRA, and Special Rules for Addressing FY 2007
SCHIP Funding Shortfalls
In general, under section 2104(e) and (f) of the Act, any
unexpended SCHIP allotments remaining following the end of the initial
3-year period of availability would otherwise be redistributed in
accordance with an appropriate procedure determined by the Secretary.
However, section 201(a) of the National Institutes of Health Reform Act
of 2006 (NIHRA) (Pub. L. 109-482, enacted on January 15, 2007) amended
the SCHIP statute to add a new section 2104(h) of the Act. This new
subsection provided for special rules to address States' FY 2007 SCHIP
funding shortfalls. Specifically, in order to address States' FY 2007
SCHIP funding shortfalls, section 2104(h)(1) of the Act provided for
the redistribution in FY 2007 of the unexpended FY 2004 allotments
remaining at the end of FY 2006. Furthermore, section 2104(h)(2) of the
Act provided for the redistribution of certain amounts of unexpended FY
2005 allotments which became available for redistribution in months
after March 31, 2007. On May 29, 2007, we published a notice in the
Federal Register (72 FR 29502) describing the implementation of section
201(a) of the NIHRA and containing the amounts of the States'
redistributed FY 2004 and FY 2005 allotments, determined in accordance
with the NIHRA.
In accordance with the methodology established under NIHRA, the
amounts of the States' projected FY 2007 shortfalls, and the associated
FY 2004 and FY 2005 redistributed allotments, were determined on a
monthly basis to address the FY 2007 shortfalls. In that regard, and
since the total amounts of the FY 2004 and FY 2005 allotments available
for redistribution were limited (to about $146.9 million and $137.4
million, respectively), the total FY 2007 shortfalls for the 6 States
receiving the redistributions were not addressed. That is, the total
amounts of the FY 2004 and FY 2005 redistributed allotments that were
provided to the 6 recipient States were only sufficient to address the
States' FY 2007 shortfalls experienced through May 2007; these amounts
were not sufficient to cover the 6 States' remaining FY 2007 shortfalls
occurring in months after May 2007, nor were these amounts sufficient
to address other States' FY 2007 projected shortfalls occurring after
May 2007.
On May 29, 2007, the U.S. Troop Readiness, Veteran's Care, Katrina
Recovery, and Iraq Accountability Appropriations Act, 2007 (UTRA, Pub
L. 110-28) was enacted; in particular, title VII of this law amended
section 2104(h) of the Act (as amended by NIHRA), to provide for
additional allotment amounts to fund States' remaining SCHIP funding
shortfalls in FY 2007.
Note, under paragraph 2104(h)(7) of the Act as amended by the
NIHRA, the special rules for the redistribution of the unexpended FY
2004 and FY 2005 allotments in FY 2007 to address FY 2007 SCHIP funding
shortfalls apply only to a State that receives an allotment for FY 2007
under subsection 2104(b) of the Act. In that regard, under subsection
2104(b) of the Act, a State refers only to the 50 States and the
District of Columbia. Therefore, subsection 2104(h) of the Act, as
amended by NIHRA and as further amended by UTRA, does not apply to the
Commonwealths and Territories, which received SCHIP allotments for FY
2007 under the authority of subsection 2104(c) of the Act. Accordingly,
unless otherwise indicated in this notice, in referring to the
redistribution of the FY 2004 and FY 2005 allotments or the additional
allotments for eliminating FY 2007 shortfalls, the term ``State'' means
only the 50 States and the District of Columbia, as applicable.
II. Provisions of This Notice
The purpose of this notice is to set forth the methodology and
process we are using to implement the UTRA provision for eliminating
States' SCHIP funding Shortfalls in FY 2007.
A. Methodology for Determining the Amounts of Additional Allotments To
Eliminate States' SCHIP Funding Shortfalls in FY 2007
Section 2104(h)(1) and (2) of the Act, as amended by NIHRA
contained the methodology for determining the amounts of States'
redistributions of the unexpended FY 2004 allotments remaining at the
end of FY 2006 and certain amounts of unexpended FY 2005 allotments,
respectively. The methodology for determining these redistributed
allotment amounts, and the actual amounts of the redistributed
allotments determined in accordance with such methodology, was
described in the Federal Register published on May 29, 2007.
Subsequent to the enactment of NIHRA, section 7001(a) of UTRA
amended section 2104(h)(4) of the Act (as amended by NIHRA) to provide
for additional allotment amounts to eliminate the FY 2007 SCHIP funding
shortfalls remaining after the redistributions of the unexpended FY
2004 and FY 2005 allotments in FY 2007, both for States that received
the FY 2004 and FY 2005 redistributions, as well as for other States
that did not receive such redistributions, but which also have
projected FY 2007 shortfalls. Under the amended section 2104(h)(4) of
the Act, a ``remaining shortfall State'' is defined as a State for
which the Secretary estimates on the basis of the most recent data
available to the Secretary as of the date of enactment (of UTRA) that
the projected FY 2007 Federal SCHIP expenditures will exceed the sum
of:
The amounts of the State's allotments for FY 2005 and FY
2006 that were not expended by the end of FY 2006.
The amount of the State's allotment for FY 2007.
The amounts, if any, of the FY 2004 and FY 2005 allotments
that were redistributed to the State in FY 2007, in accordance with
section 2104(h)(1) and (2) of the Act, respectively.
Section 2104(h)(7) of the Act as amended by the NIHRA indicates
that the provisions of subsection 2104(h) of the Act apply only to the
50 States and the District of Columbia; that is, these provisions do
not apply to the Commonwealths and Territories. Therefore, the FY 2004
and FY 2005 shortfall redistributions, and the FY 2007 shortfall
allotments, are only available for the 50 States and the District of
Columbia. Accordingly, unless otherwise indicated in this notice, the
term ``State'' means only the 50 States and the District of Columbia,
as applicable.
Before enactment of UTRA, section 2104(h)(4) of the Act (as amended
by NIHRA) required that the FY 2004 and FY 2005 redistributed
allotments could only be used to make payments by States with respect
to their expenditures for (1) providing child health assistance or
other health benefits coverage for populations eligible under the State
child health plan (including under a waiver of this plan) on October 1,
2006; and (2) providing child health assistance or other health
benefits coverage to an individual who is not a child or a pregnant
woman at the regular Federal medical assistance percentage (FMAP,
referenced in section
[[Page 71917]]
1905(b) of the Act) only (not the enhanced FMAP, referenced in section
2105(b) of the Act). Under the NIHRA, the FY 2004 and FY 2005
redistributed allotments were available for States' expenditures for a
child or a pregnant woman only, at the enhanced FMAP rate. However, the
UTRA amended section 2104(h)(4) of the Act to remove both of these
limitations. Under the revised section 2104(h)(4) of the Act, the
Federal matching rate for expenditures related to all the populations
indicated is the enhanced FMAP rate.
As indicated above, under section 2104(h)(4) of the Act, as amended
by UTRA, the amount of a State's remaining FY 2007 shortfall, if any,
is determined by comparing each State's allotment funds available in FY
2007 (including FY 2004 and FY 2005 redistributed allotments, if any)
to its projected FY 2007 expenditures, based on the State's most recent
estimates available as of May 25, 2007, the date of enactment of UTRA.
In this regard, we determined the amounts of States' projected FY 2007
expenditures, by using their estimated expenditures as reported and
certified by the State to CMS on their quarterly budget submissions of
Forms CMS-37 and CMS-21B. By May 25, 2007, most States had submitted
their certified estimates of their FY 2007 expenditures on their May
2007 Forms CMS-37 and CMS-21B. However, there were 3 States that had
not submitted and certified their May 2007 submissions of these reports
by May 25, 2007; for those 3 States, we are using the projected FY 2007
expenditures as provided in their February 2007 submissions of such
reports, as those represented the most recent certified estimates of
their FY 2007 expenditures available as of May 25, 2007.
As described in the notice published in the Federal Register on May
29, 2007, the amounts of the States' FY 2004 and FY 2005 redistributed
allotments were determined in accordance with the provisions of section
2104(h)(1) and (2) of the Act respectively, based on the States' other
available allotments in FY 2007 (that is, the unexpended FY 2005 and FY
2006 allotments carried into FY 2007 and the FY 2007 allotments) and
the States' projected FY 2007 allotments using the States' February FY
2007 estimates. This determination did not include any additional FY
2007 shortfall allotments as provided under the recently enacted UTRA,
since as provided in section 2104(h)(2) of the Act, we used the
information available as of March 31, 2007, and UTRA was not enacted
until May 25, 2007.
In accordance with section 2104(h)(4) of the Act, as amended by
UTRA, the amounts of the FY 2007 shortfall allotments were determined
based on the amounts of each State's other available allotments in FY
2007 (that is, the unexpended FY 2005 and FY 2006 allotments carried
into FY 2007 and the FY 2007 allotments), the previously determined FY
2004 and FY 2005 redistributed allotments, and the States' projected FY
2007 expenditures available as of the date of enactment of UTRA.
Because the UTRA provided for an additional $650 million to address the
shortfalls in FY 2007 remaining after the provision of such FY 2004 and
FY 2005 redistributed allotments, and furthermore, since such
redistributed allotments were required to be based on the FY 2007
shortfalls determined with the data available at the times indicated
above and in the May 29, 2007 Federal Register notice (that is, using
the February 2007 estimates), we are not recalculating the amounts of
the States' FY 2004 and FY 2005 redistributed allotments in order to
determine the amounts of the addition FY 2007 shortfall allotments.
Rather, since the $650 million is available and intended to cover the
States' full remaining FY 2007 shortfalls, we determined the amounts of
the FY 2007 shortfall allotments by subtracting each shortfall State's
allotments available in FY 2007 (including the FY 2004 and FY 2005
redistributed allotments, if any) from its projected FY 2007
expenditures; the difference (for the shortfall States with projected
FY 2007 expenditures greater than their available allotments)
represents the amount of the State's FY 2007 shortfall allotment.
B. Retrospective Adjustment
Section 2104(h)(5) of the Act provides that the Secretary may
adjust the estimates and determinations of the amounts of the FY 2004
redistributed allotments (section 2104(h)(1) of the Act), the FY 2005
redistributed allotments (section 2104(h)(2) of the Act), the amounts
available for the FY 2005 redistribution (section 2104(h)(3) of the
Act), and the additional FY 2007 shortfall allotments (section
2104(h)(4) of the Act) on the basis of the amounts reported by States
not later than November 30, 2007 on Forms CMS-64 and CMS-21. However,
in no case may the amounts of the FY 2005 allotments redistributed from
States (as determined under section 2104(h)(3) of the Act) exceed the
amounts that were determined based on the most recent data available as
of March 31, 2007. As described in the May 29, 2007 Federal Register,
these amounts were determined based on the States' submissions of the
February 2007 quarterly estimate reports of their FY 2007 expenditures,
and using those estimates would not exceed the lesser of 50 percent of
the States' available FY 2005 allotments as were determined available
as of March 31, 2007 or $20 million. Furthermore, under section
2104(h)(5)(B) of the Act, in providing for any additional FY 2005
redistributed allotments under any retrospective adjustment, only the
actual unexpended FY 2005 allotments remaining at the end of FY 2007
(as determined following the submission of States' fourth quarter FY
2007 expenditure reports submitted by November 30, 2007) may be used.
The additional funds made available under UTRA to eliminate FY 2007
shortfalls may be available for any retrospective adjustments. Finally,
under section 2104(h)(5)(C) of the Act, any retrospective adjustment
may not provide for the reduction of any States' FY 2006 or FY 2007
allotments.
C. Ordering of Expenditures
In applying State's expenditures against their available SCHIP
allotments, expenditures are ordered as provided under section
2105(a)(1)(A) through (D) and 2105(a)(2) of the Act as follows:
Title XIX SCHIP-related expenditures for which payment is
made at the enhanced FMAP (section 2105(a)(1)(A) of the Act);
Title XIX expenditures for medical assistance provided
during a presumptive eligibility period under section 1920A of the Act
(section 2105(a)(1)(B) of the Act);
Child health assistance for targeted low-income children
in the form of providing health benefits coverage that meets the
requirements of section 2103 (per section 2105(a)(1)(C) of the Act);
Expenditures listed in section 2105(a)(1)(D)(i) through
(iv) of the Act, respectively: Other child health assistance for
targeted low-income children; health services initiatives under the
plan for improving the health of children (including targeted low-
income children and other low-income children); expenditures for
outreach activities; and administration expenditures.
In accordance with the ordering of allotments and expenditures
provisions described above, the expenditures of States will be applied
against the FY 2004 and FY 2005 redistributed allotments, the
additional FY 2007 shortfall allotments, and any other allotments
available to the States in FY
[[Page 71918]]
2007 (that is, the FY 2005, FY 2006 and FY 2007 allotments).
D. No Ordering Election for Amounts of States' FY 2004 Redistributed
Allotments, FY 2005 Redistributed Allotments, and FY 2007 Shortfall
Allotments
In the past, for purposes of applying States' expenditures against
the redistributed allotments, States receiving redistributed allotment
amounts were given flexibility to decide the ordering of the
redistributed allotments with respect to the States' other available
allotments. This allowed the redistribution States to optimize the use
of these redistributed funds. However, because of the statutory
provisions made by the NIHRA and UTRA on the identification of
shortfall States and the determination of the amount of the funding
shortfalls on a monthly basis, and the requirement that these
redistributed allotments and additional allotments be available only
after the States' other SCHIP allotment funds have been exhausted, we
believe that the FY 2004 and FY 2005 redistributed allotments and the
FY 2007 shortfall allotments must be ordered after the States' other
available allotments are exhausted. Therefore, shortfall States must
spend their available FY 2005, FY 2006, and FY 2007 allotments first,
before any amounts of redistributed FY 2004 allotments, redistributed
FY 2005 allotments, and FY 2007 shortfall allotments. Furthermore,
since the unexpended FY 2004 allotments must be redistributed before
any redistribution of the FY 2005 allotments, and the FY 2007 shortfall
allotments are available for any remaining shortfalls, the amounts of
any FY 2004 redistributed allotment must be ordered prior to any FY
2005 redistributed allotments, and the FY 2005 redistributed allotments
must be ordered prior to any FY 2007 shortfall allotments.
As specified in section 2104(h)(6) of the Act, as added by section
201(a) of the NIHRA, and as amended by UTRA, the amounts of the
unexpended FY 2004 and FY 2005 allotments redistributed to a State in
FY 2007, and the amounts of the FY 2007 shortfall allotments, are only
available for expenditure by the State through September 30, 2007; and
any amounts of these redistributed allotments or additional allotments
remaining at the end of FY 2007, shall not be subject to redistribution
under section 2104(f) of the Act. This provision does not limit the
authority of the Secretary to make any retrospective adjustments under
section 2104(h)(5) of the Act, as discussed above.
The amounts of the FY 2004 and FY 2005 redistributed allotment
amounts, the reduction of the FY 2005 allotments, and the amounts of
the additional FY 2007 shortfall allotments, will be incorporated into
the Form CMS-21C (Allocation of Title XIX and Title XXI Expenditures to
the SCHIP Fiscal Year Allotment). Form CMS-21C is used for tracking
States' expenditures against their available SCHIP allotments. The
Medicaid and SCHIP expenditure system will then automatically apply
expenditures reported on the quarterly expenditure reports for FY 2007
against the revised FY 2005 allotments, the other SCHIP allotments
available in FY 2007, the FY 2004 and FY 2005 redistributed amounts,
and the additional FY 2007 shortfall allotments available in FY 2007.
E. Repeal of Special Rule for Coverage for Populations Eligible on
October 1, 2006
Section 2104(h)(4)(A) of the Act, was added by the NIHRA and under
which States could only use amounts of FY 2004 allotments or FY 2005
allotments, redistributed under section 2104(h) of the Act, only for
expenditures for providing child health assistance or other health
benefits coverage for populations eligible for assistance or benefits
under its approved State child health assistance plan (including a
waiver of this plan) as in effect on October 1, 2006, has been repealed
by UTRA.
F. Table for Determination of the Additional FY 2007 Shortfall
Allotments
In the table included in this notice we set forth the determination
of the additional FY 2007 shortfall allotments. In the Federal Register
notice published on May 29, 2007, we provided the amounts of the
States' FY 2004 and FY 2005 redistributed allotments; those amounts are
incorporated into the calculation of the additional FY 2007 shortfall
allotments to eliminate States remaining FY 2007 shortfalls.
The following describes the table for determining the FY 2007
shortfall allotments to eliminate the remaining FY 2007 shortfalls.
Based on the States' most recent estimates of their FY 2007
expenditures available as of May 25, 2007, the date of enactment for
UTRA, there are 12 States with projected shortfalls in SCHIP funds in
FY 2007.
Key to Table--Additional FY 2007 Allotments to Eliminate the Remaining
FY 2007 Shortfalls
This Table presents the determination of the amounts of the
additional FY 2007 shortfall allotments to eliminate the shortfalls
remaining in FY 2007 for the 50 States and DC based on the most recent
expenditure projections for FY 2007, after the provision of the FY 2004
and FY 2005 redistributed allotments.
Column/Description
Column A = State. Name of State, District of Columbia, the
Commonwealth or Territory.
Column B = FY 2007 Expends. MAY 2007 Estimates. Column B contains
the projected FY 2007 Federal expenditures based on the most recent
data available submitted as of May 25, 2007, the date of enactment for
UTRA. For most States this data was obtained from the certified May
2007 submissions of the Forms CMS-37 and CMS-21B. For 3 States, the
certified May 2007 submission was not available as of May 25, 2007; for
those States, the certified February 2007 submission of these forms was
used.
Column C = Tot. Allotments in FY 2007 NOT Including FY 04/05
Redists. Column C contains the total allotments available to each State
in FY 2007, not including any FY 2004 or FY 2005 redistributed
allotments. These allotments include: the unexpended FY 2005 allotments
remaining at the end of FY 2006 and carried into FY 2007 (and further
reduced, as applicable, by the provisions of section 2104(h)(3) of the
Act, as amended by NIHRA); the unexpended FY 2006 allotments remaining
at the end of FY 2006 and carried into FY 2007; and the FY 2007
allotments.
Column D = Tot. FY 07 SF Before Redist. or Addtl Allots. Column D
contains the amounts of the States' FY 2007 shortfalls, if any,
determined before the provision of any redistributed FY 2004 or FY 2005
allotments, and is equal to the difference between the amounts in
Column B and Column C. For States whose available allotments in FY 2007
in Column C is greater than or equal to the projected FY 2007
expenditures in Column B, the entry in Column D is $0.
Column E = For SF States FY 2004 Redistributions u/NIHRA. Column E
contains the total FY 2004 redistributed allotments as published in the
May 29, 2007 Federal Register in Table 3 (72 FR 29513). With respect to
States for which there is no redistribution of FY 2004 allotments, the
entry in Column E is $0.
Column F = For SF States FY 2005 Redistributions u/NIHRA. Column F
[[Page 71919]]
contains the total FY 2005 redistributed allotments as published in the
May 29, 2007 Federal Register in Table 3 (72 FR 29513). With respect to
States for which there is no redistribution of FY 2005 allotments, the
entry in Column F is $0.
Column G = Tot. FY 04/05 Redist. Amounts. Column G contains the
total FY 2004 and FY 2005 redistributed allotments, if any, determined
as the sum of the entries is Column E and Column F.
Column H = Tot. FY 07 SF AFTER FY 04/05 Redist. Column H contains
the amount of the States' FY 2007 shortfalls, if any, remaining after
the provision of any FY 2004 or FY 2005 redistributed allotments, and
is determined as the difference between the amounts in Column D and
Column G. The amount in Column H represents the amount of the States'
additional FY 2007 shortfall allotment, provided to eliminate the
States' remaining projected FY 2007 shortfall after the provision of
the FY 2004 and FY 2005 redistributed allotments. With respect to
States for which there is no additional FY 2007 shortfall allotment,
the entry in Column H is $0.
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III. Regulatory Impact Statement
We have examined the impact of this rule as required by Executive
Order 12866 (September 1993, Regulatory Planning and Review), the
Regulatory Flexibility Act (RFA) (September 19, 1980 Pub. L. 96-354),
section 1102(b) of the Social Security Act, the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104-4) and Executive Order 13132.
Executive Order 12866 directs agencies to assess all costs and
benefits of available regulatory alternatives and, if regulation is
necessary, to select regulatory approaches that maximize net benefits
(including potential economic, environmental, public health and safety
effects, distributive impacts, and equity). A regulatory impact
analysis (RIA) must be prepared for major rules with economically
significant effects ($100 million or more in any one year). We have
determined that with respect to the additional FY 2007 shortfall
allotments totaling about $606.9 million, this notice is economically
significant. However, because this notice only announces the provision
of additional allotment funds determined based on the formula specified
in statute and does not put forward any administrative policies, we
have not performed an analysis beyond that which is presented in
section II. above.
Because State participation in the SCHIP program is voluntary, any
payments and expenditures States make or incur on behalf of the program
that are not reimbursed by the Federal Government are made voluntarily.
The RFA requires agencies to analyze options for regulatory relief
of small businesses. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and small governmental
jurisdictions. Most hospitals and most other providers and suppliers
are small entities, either by nonprofit status or by having revenues of
$6 million to $29 million in any 1 year. Individuals and States are not
included in the definition of a small entity. We are not preparing an
analysis for the RFA because we have determined that this notice will
not have a significant economic impact on a substantial number of small
entities.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule may have a significant impact on
the operations of a substantial number of small rural hospitals. This
analysis must conform to the provisions of section 604 of the RFA. For
purposes of section 1102(b) of the Act, we define a small rural
hospital as a hospital that is located outside of a Core-Based
Statistical Area and has fewer than 100 beds. We are not preparing an
analysis for section 1102(b) of the Act because we have determined that
this notice will not have a significant impact on the operations of a
substantial number of small rural hospitals.
Section 202 of the Unfunded Mandates Reform Act of 1995 also
requires that agencies assess anticipated costs and benefits before
issuing any rule whose mandates require spending in any 1 year of $100
million in 1995 dollars, updated annually for inflation. That threshold
level is currently approximately $120 million. This notice will not
create an unfunded mandate on States, tribal, or local governments.
Therefore, we are not required to perform an assessment of the costs
and benefits of this notice.
Executive Order 13132 establishes certain requirements that an
agency must meet when it publishes a proposed rule (and subsequent
final rule) that imposes substantial direct requirement costs on State
and local governments, preempts State law, or otherwise has Federalism
implications. We have reviewed this notice and have determined that it
does not significantly affect States' rights, roles, and
responsibilities.
Low-income children will benefit from payments under this program
through increased opportunities for health insurance coverage. We
believe this notice will have an overall positive impact by informing
States, the District of Columbia, and Commonwealths and Territories of
the extent to which they are permitted to expend funds under their
child health plans using the additional FY 2007 shortfall allotment
amounts.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
IV. Waiver of Notice of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a proposed notice in the Federal Register to
provide a period of public comment before the provisions of a notice,
such as this, are effective in accordance with section 553(b) of the
Administrative Procedure Act (APA) (5 U.S.C. 553(b)). We also
ordinarily provide a 30-day delay in the effective date of the
provisions of a notice in accordance with section 553(d) of the APA (5
U.S.C. 553(d)). However, we can waive both the notice of proposed
rulemaking and the 30-day delay in effective date if the Secretary
finds, for good cause, that it is impracticable, unnecessary, or
contrary to the public interest, and incorporates a statement of the
finding and the reasons in the notice.
We find there is good cause to waive notice of proposed rulemaking
and the delay in the effective date of this issuance of the additional
FY 2007 allotments and the methodology for the additional allotments to
eliminate the FY 2007 funding shortfalls in SCHIP because the delay
required for a notice of proposed rulemaking and the delay in the
effective date would be contrary to the public interest in light of the
pressing financial needs faced by some States that could result in
disruption of program operations.
We determined the amounts of the additional FY 2007 allotments to
eliminate the FY 2007 SCHIP funding shortfall as expeditiously as
possible in order to make them available to the States as soon as
possible. In determining the amounts of the additional FY 2007
allotments we used State FY 2007 projected Federal expenditures as
contained in the most recent available States' quarterly budget report
submissions as certified by the States as of May 25, 2007, the date of
enactment of UTRA . The additional FY 2007 shortfall allotments make
available Federal funds to the recipient shortfall States, which is
especially important for those shortfall States that may need these
funds.
We are waiving notice of proposed rulemaking and the 30-day delay
in effective date, and are publishing this issuance of the Federal
Register as a notice.
In accordance with the provisions of this notice, we have
determined the amounts of the additional FY 2007 shortfall allotments
to eliminate the FY 2007 shortfalls in SCHIP funding available to
shortfall States are effective immediately upon publication of this
notice.
Authority: (Section 1102 of the Social Security Act (42 U.S.C.
1302) (Catalog of Federal Domestic Assistance Program No. 93.767,
State Children's Health Insurance Program))
Dated: July 6, 2007.
Leslie V. Norwalk,
Acting Administrator, Centers for Medicare & Medicaid Services.
Dated: July 12, 2007.
Michael O. Leavitt,
Secretary.
(Editorial Note:
This document was received at the Federal Register on December
14, 2007.)
[FR Doc. 07-6092 Filed 12-14-07; 12:13 pm]
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