[Federal Register: March 4, 2008 (Volume 73, Number 43)]
[Notices]
[Page 11647-11648]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr04mr08-70]
[[Page 11647]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
Centers for Medicare & Medicaid Services
Notice of Hearing: Reconsideration of Disapproval of Ohio State
Plan Amendment (SPA) 07-014
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
April 4, 2008, at the CMS Chicago Regional Office, 233 N. Michigan
Avenue, Suite 600, the Illinois Room, Chicago, IL 60601-5519, to
reconsider CMS' decision to disapprove Ohio SPA 07-014.
Closing Date: Requests to participate in the hearing as a party
must be received by the presiding officer by March 19, 2008.
FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding
Officer, CMS, 2520 Lord Baltimore Drive, Suite L, Baltimore, Maryland
21244, Telephone: (410) 786-2055.
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider CMS' decision to disapprove Ohio SPA 07-014,
which was submitted on September 28, 2007, and disapproved on December
20, 2007.
Under this SPA, the State proposed to expand Medicaid eligibility
by excluding all family income that is between 201 percent of the
Federal poverty level (FPL) and 300 percent of the FPL in calculating
income for purposes of determining eligibility. As a result, although
the plan nominally provides for eligibility of optional targeted low-
income children only for those with family income through 200 percent
of the FPL, in effect, the eligibility level would rise to 300 percent
of the FPL.
The amendment was disapproved because it indicated that the State
will claim Federal matching funds at a rate other than the rate set
forth in the Social Security Act (the Act), and thus, is not consistent
with methods of administration necessary for proper and efficient
operation of the plan, as required by section 1902(a)(4) of the Act.
At the hearing:
The disapproval of this SPA will be discussed. The SPA was
disapproved because the State declared its intent and was unwilling to
change its intent to claim Federal matching funds at the regular
matching rate, rather than the enhanced matching rate set forth in the
Act, for the expanded population optional targeted low-income children,
with income between 201 percent and 300 percent of the FPL.
Section 1903(a)(1) of the Act requires that the Secretary
pay the Federal medical assistance percentage (FMAP) of claimed State
expenditures under the approved plan. The FMAP is defined at section
1905(b) of the Act. This section provides that the Federal matching
rate for children described in section 1905(u)(2)(B) or (u)(3) of the
Act ``is equal to the enhanced FMAP described in section 2105(b)'' of
the Act, unless the State has exhausted its allotment under section
2104 of the Act, under the State Children's Health Insurance Program,
or failed to comply with maintenance of effort and proper reporting
requirements. Since none of those conditions appear to apply, and the
expansion group is comprised of individuals who are described in
section 1905(u)(2)(B) of the Act, the enhanced FMAP is the applicable
FMAP rate, and claims at any other rate would not be consistent with
proper and efficient administration of the State plan.
The State's proposal was not consistent with methods of
administration necessary for proper and efficient operation of the
plan, as required by section 1902(a)(4) of the Act, because the State
indicated in its overall submission that the State did not plan to
submit claims at the statutorily indicated FMAP rate.
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 Ohio announcing an administrative hearing to
reconsider the disapproval of its SPA reads as follows:
Ara Mekhjian, Esq.,
Assistant Attorney General,
State of Ohio,
Health and Human Services Section,
30 E. Broad Street, 26th Floor,
Columbus, OH 43215-3400.
Dear Mr. Mekhjian:
I am responding to your request for reconsideration of the
decision to disapprove the Ohio State plan amendment (SPA) 07-014,
which was submitted on September 28, 2007, and disapproved on
December 20, 2007.
Under this SPA, the State proposed to expand Medicaid
eligibility by excluding all family income that is between 201
percent of the Federal poverty level (FPL) and 300 percent of the
FPL in calculating income for purposes of determining eligibility.
As a result, although the plan nominally provides for eligibility of
optional targeted low-income children only for those with family
income through 200 percent of the FPL, in effect, the eligibility
level would rise to 300 percent of the FPL.
The amendment was disapproved because it indicated that the
State will claim Federal matching funds at a rate other than the
rate set forth in the Social Security Act (the Act), and thus, is
not consistent with methods of administration necessary for proper
and efficient operation of the plan, as required by section
1902(a)(4) of the Act.
At the hearing:
The disapproval of this SPA will be discussed. The SPA
was disapproved because the State declared its intent and was
unwilling to change its intent to claim Federal matching funds at
the regular matching rate, rather than the enhanced matching rate
set forth in the Act, for the expanded population optional targeted
low-income children, with income between 201 percent and 300 percent
of the FPL.
Section 1903(a)(1) of the Act requires that the
Secretary pay the Federal medical assistance percentage (FMAP) of
claimed State expenditures under the approved plan. The FMAP is
defined at section 1905(b) of the Act. This section provides that
the Federal matching rate for children described in section
1905(u)(2)(B) or (u)(3) of the Act ``is equal to the enhanced FMAP
described in section 2105(b)'' of the Act, unless the State has
exhausted its allotment under section 2104 of the Act, under the
State Children's Health Insurance Program, or failed to comply with
maintenance of effort and proper reporting requirements. Since none
of those conditions appear to apply, and the expansion group is
comprised of individuals who are described in section 1905(u)(2)(B)
of the Act, the enhanced FMAP is the applicable FMAP rate, and
claims at any other rate would not be consistent with proper and
efficient administration of the State plan.
The State's proposal was not consistent with methods of
administration necessary for proper and efficient operation of the
plan, as required by section 1902(a)(4) of the Act, because the
State indicated in its overall
[[Page 11648]]
submission that the State did not plan to submit claims at the
statutorily indicated FMAP rate.
I am scheduling a hearing at your request for reconsideration to
be held on April 4, 2008, at the Centers for Medicare & Medicaid
Services' Chicago Regional Office, 233 N. Michigan Avenue, Suite
600, the Illinois Room, Chicago, IL 60601-5519, to reconsider the
decision to disapprove SPA 07-014. 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,
Kerry Weems,
Acting Administrator.
(Section 1116 of the Social Security Act (42 U.S.C. 1316); 42 CFR
430.18).
(Catalog of Federal Domestic Assistance program No. 13.714, Medicaid
Assistance Program.)
Dated: February 25, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E8-4068 Filed 3-3-08; 8:45 am]
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