[Federal Register Volume 74, Number 234 (Tuesday, December 8, 2009)]
[Notices]
[Pages 64697-64700]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-29248]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Implementation of Section 5001 of the American Recovery and
Reinvestment Act of 2009 for Adjustments to the Third and Fourth
Quarters of Fiscal Year 2009 Federal Medical Assistance Percentage
Rates for Federal Matching Shares for Medicaid and Title IV-E Foster
Care, Adoption Assistance and Guardianship Assistance Programs
AGENCY: Office of the Secretary, DHHS.
ACTION: Notice
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SUMMARY: This notice finalizes the methodology for calculating the
higher Federal matching funding that is made available under Section
5001 of the American Recovery and Reinvestment Act of 2009 (ARRA), and
provides the final calculation of the adjusted Federal Medical
Assistance Percentage (FMAP) rates for the third and fourth quarters of
Fiscal Year 2009 (FY09). Section 5001 of the ARRA provides for
temporary increases in the FMAP rates to provide fiscal relief to
States and to protect and maintain State Medicaid and certain other
assistance programs in a period of economic downturn. The increased
FMAP rates apply during a recession adjustment period that is defined
as the period beginning October 1, 2008 and ending December 31, 2010.
DATES: Effective Date: The percentages listed are for the third quarter
of FY09 beginning April 1, 2009 and ending June 30, 2009 and for the
fourth quarter of FY09 beginning July 1, 2009 and ending September 30,
2009.
A. Background
The FMAP is used to determine the amount of Federal matching for
specified State expenditures for assistance payments under programs
under the Social Security Act. Sections 1905(b) and 1101(a)(8)(B) of
the Social Security Act (``the Act'') require the Secretary of Health
and Human Services
[[Page 64698]]
to publish the FMAP rates each year. The Secretary calculates the
percentages using formulas set forth in sections 1905(b) and
1101(a)(8)(B), and from the Department of Commerce's statistics of
average income per person in each State and for the nation as a whole.
The percentages must be within the upper and lower limits given in
section 1905(b) of the Act. The percentages to be applied to the
District of Columbia, Puerto Rico, the Virgin Islands, Guam, American
Samoa, and the Northern Mariana Islands are specified separately in the
Act, and thus are not based on the statutory formula that determines
the percentages for the 50 States.
Section 1905(b) of the Act specifies the formula for calculating
FMAP as follows:
The FMAP for any State shall be 100 per centum less the State
percentage; and the State percentage shall be that percentage which
bears the same ratio to 45 per centum as the square of the per
capita income of such State bears to the square of the per capita
income of the continental United States (including Alaska) and
Hawaii; except that (1) the FMAP shall in no case be less than 50
per centum or more than 83 per centum, and (2) the FMAP for Puerto
Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and
American Samoa shall be 50 per centum.
Section 4725 of the Balanced Budget Act of 1997 amended section
1905(b) to provide that the FMAP for the District of Columbia for
purposes of titles XIX (Medicaid) and XXI (CHIP) shall be 70 percent.
The Medicare Improvements for Patients and Providers Act of 2008 (Pub.
L. 110-275) amended the FMAP applied to the District of Columbia for
maintenance payments under title IV-E programs to make it consistent
with the 70 percent Medicaid match rate.
Section 5001 of Division B of the ARRA provides for a temporary
increase in FMAP rates for Medicaid and title IV-E Foster Care,
Adoption Assistance and Guardianship Assistance programs. The purposes
of the increases to the FMAP rates are to provide fiscal relief to
States and to protect and maintain State Medicaid and certain other
assistance programs in a period of economic downturn, referred to as
the ``recession adjustment period.'' The recession adjustment period is
defined as the period beginning October 1, 2008 and ending December 31,
2010.
On August 4, 2009, we published a notice with a comment period that
described the methodology for calculating the increased Federal
matching funding made available under ARRA. (74 FR 38630.) In this
issuance, we consider the single comment we received on that prior
notice, and set forth the final methodology and FMAP rates for the
third and fourth quarters of Federal fiscal year 2009.
B. Calculation of the Increased FMAP Rates Under ARRA
Section 5001 of the ARRA specifies that the FMAP rates shall be
temporarily increased for the following: (1) Maintenance of FMAP rates
for FY09, FY10, and first quarter of FY11, so that the FMAP rate will
not decrease from the prior year, determined by using as the FMAP rate
for the current year the greater of any prior fiscal year FMAP rates
between 2008-2010 or the rate calculated for the current fiscal year;
(2) in addition to any maintenance increase, the application of an
increase in each State's FMAP of 6.2 percentage points; and (3) an
additional percentage point increase based on the State's increase in
unemployment during the recession adjustment period. The resulting
increased FMAP cannot exceed 100 percent. Each State's FMAP will be
recalculated each fiscal quarter beginning October 2008. Availability
of certain components of the increased FMAP is conditioned on States
meeting statutory programmatic requirements, such as the maintenance of
effort requirement, which are not part of the calculation process.
Expenditures for which the increased FMAP is not available under
title XIX include expenditures for disproportionate share hospital
payments, certain eligibility expansions, services received through an
IHS or Tribal facility (which are already paid at a rate of 100 percent
and therefore not subject to increase), and expenditures that are paid
at an enhanced FMAP rate. The increased FMAP is available for
expenditures under part E of title IV (including Foster Care, Adoption
Assistance and Guardianship Assistance programs) only to the extent of
a maintenance increase (hold harmless), if any, and the 6.2 percentage
point increase. The increased FMAP does not apply to part D of title
IV-E (Child Support Enforcement Program).
For title XIX purposes only, for each qualifying State with an
unemployment rate that has increased at a rate above the statutory
threshold percentage, ARRA provides additional relief above the general
6.2 percentage point increase in FMAP through application of a separate
increase calculation. For those States, the FMAP for each qualifying
State is increased by the number of percentage points equal to the
product of the State matching percentage (as calculated under section
1905(b) and adjusted if necessary for the maintenance of FMAP without
reduction from the prior year, and after applying half of the 6.2
percentage point general increase in the Federal percentage) and the
applicable percent determined from the State unemployment increase
percentage for the quarter.
The unemployment increase percentage for a calendar quarter is
equal to the number of percentage points (if any) by which the average
monthly unemployment rate for the State in the most recent previous 3-
consecutive-month period for which data are available exceeds the
lowest average monthly unemployment rate for the State for any 3-
consecutive-month period beginning on or after January 1, 2006. A State
qualifies for additional relief based on an increase in unemployment if
that State's unemployment increase percentage is at least 1.5
percentage points.
The applicable percent is: (1) 5.5 percent if the State
unemployment increase percentage is at least 1.5 percentage points but
less than 2.5 percentage points; (2) 8.5 percent if the State
unemployment increase percentage is at least 2.5 percentage points but
less than 3.5 percentage points; and (3) 11.5 percent if the State
unemployment increase percentage is at least 3.5 percentage points.
If the State's applicable percent is less than the applicable
percent for the preceding quarter, then the higher applicable percent
shall continue in effect for any calendar quarter beginning on January
1, 2009 and ending before July 1, 2010.
Puerto Rico, the Virgin Islands, Guam, the Commonwealth of the
Northern Mariana Islands, and America Samoa can make a one-time
election between (1) a 30 percent increase in their cap on Medicaid
payments (as determined under subsections (f) and (g) of section 1108
of the Social Security Act), or (2) applying the increase of 6.2
percentage points in the FMAP plus a 15 percent increase in the cap on
Medicaid payments. There is no quarterly unemployment adjustment for
Territories. As a result, we are not addressing the Territories or
Commonwealth in this document, and will instead work with them
separately and individually.
C. Response to Public Comments on Methodology
Only one comment was received in response to the request for public
comments on the methodology set forth in the August 4, 2009 Notice. The
commenter supported the methodology set forth in the August 4, 2009
Notice for the calculation of the ARRA increased FMAP. In light of the
absence
[[Page 64699]]
of any issues raised through public comment, the methodology for
calculating the adjusted FMAPs will remain as it was set forth in the
August 4, 2009 Notice.
D. Adjusted FMAPs for the Third and Fourth Quarters of 2009
ARRA adjustments to FMAPs are shown by State in the accompanying
table. The hold harmless FY09 FMAP is the higher of the original FY08
or FY09 FMAP. The 6.2 percentage point increase is added to the hold
harmless FY09 FMAP. The unemployment tier is determined by comparing
the average unemployment rate for the three consecutive months
preceding the start of each fiscal quarter to the lowest consecutive 3-
month average unemployment rate beginning January 1, 2006. The
unemployment adjustment is calculated according to the unemployment
tier and added to the hold harmless FY09 FMAP with the 6.2 percentage
point increase.
FOR FURTHER INFORMATION CONTACT: Carrie Shelton or Thomas Musco, Office
of Health Policy, Office of the Assistant Secretary for Planning and
Evaluation, Room 447D--Hubert H. Humphrey Building, 200 Independence
Avenue, SW., Washington, DC 20201, (202) 690-6870.
(Catalog of Federal Domestic Assistance Program Nos. 93.558: TANF
Contingency Funds; 93.563: Child Support Enforcement; 93-596: Child
Care Mandatory and Matching Funds of the Child Care and Development
Fund; 93.658: Foster Care; 93.659: Adoption Assistance; 93.090:
Guardianship Assistance; 93.769: Ticket-to-Work and Work Incentives
Improvement Act)
Dated: November 20, 2009.
Kathleen Sebelius,
Secretary.
ARRA Adjustments to FMAP Q3 & Q4 FY09
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Hold
harmless 1st & 2nd 3rd Quarter 3-month 4th Quarter
FY08 FY09 Hold FY09 FMAP Quarter FY09 FY09 FMAP average Minimum Unemployment Unemployment Unemployment FY09 FMAP
State original original harmless with FMAP unemployment unemployment unemployment difference tier adjustment unemployment
FMAP FMAP FY09 6.2%pt unemployment adjustment ending June Q4 FY09 adjustment
increase adjustment 2009
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Alabama............................. 67.62 67.98 67.98 74.18 76.64 77.51 9.6 3.3 6.3 11.5 3.33 77.51
Alaska.............................. 52.48 50.53 52.48 58.68 58.68 61.12 8.2 6.0 2.2 5.5 2.44 61.12
Arizona............................. 66.20 65.77 66.20 72.40 75.01 75.93 8.2 3.6 4.6 11.5 3.53 75.93
Arkansas............................ 72.94 72.81 72.94 79.14 79.14 80.46 6.9 4.8 2.1 5.5 1.32 80.46
California.......................... 50.00 50.00 50.00 56.20 61.59 61.59 11.4 4.8 6.6 11.5 5.39 61.59
Colorado............................ 50.00 50.00 50.00 56.20 58.78 61.59 7.5 3.6 3.9 11.5 5.39 61.59
Connecticut......................... 50.00 50.00 50.00 56.20 60.19 60.19 7.8 4.3 3.5 11.5 5.39 61.59
Delaware............................ 50.00 50.00 50.00 56.20 60.19 61.59 8.0 3.3 4.7 11.5 5.39 61.59
District of Columbia................ 70.00 70.00 70.00 76.20 77.68 79.29 10.5 5.4 5.1 11.5 3.09 79.29
Florida............................. 56.83 55.40 56.83 63.03 67.64 67.64 10.2 3.3 6.9 11.5 4.61 67.64
Georgia............................. 63.10 64.49 64.49 70.69 73.44 74.42 9.6 4.3 5.3 11.5 3.73 74.42
Hawaii.............................. 56.50 55.11 56.50 62.70 66.13 67.35 7.2 2.2 5.0 11.5 4.65 67.35
Idaho............................... 69.87 69.77 69.87 76.07 78.37 79.18 7.7 2.8 4.9 11.5 3.11 79.18
Illinois............................ 50.00 50.32 50.32 56.52 60.48 61.88 9.9 4.4 5.5 11.5 5.36 61.88
Indiana............................. 62.69 64.26 64.26 70.46 73.23 74.21 10.4 4.4 6.0 11.5 3.75 74.21
Iowa................................ 61.73 62.62 62.62 68.82 68.82 68.82 5.6 3.7 1.9 5.5 1.89 70.71
Kansas.............................. 59.43 60.08 60.08 66.28 66.28 68.31 6.8 4.0 2.8 8.5 3.13 69.41
Kentucky............................ 69.78 70.13 70.13 76.33 77.80 79.41 10.5 5.4 5.1 11.5 3.08 79.41
Louisiana........................... 72.47 71.31 72.47 78.67 80.01 80.01 6.5 3.5 3.0 8.5 2.08 80.75
Maine............................... 63.31 64.41 64.41 70.61 72.40 74.35 8.3 4.4 3.9 11.5 3.74 74.35
Maryland............................ 50.00 50.00 50.00 56.20 58.78 60.19 7.1 3.4 3.7 11.5 5.39 61.59
Massachusetts....................... 50.00 50.00 50.00 56.20 58.78 60.19 8.3 4.4 3.9 11.5 5.39 61.59
Michigan............................ 58.10 60.27 60.27 66.47 69.58 70.68 14.1 6.7 7.4 11.5 4.21 70.68
Minnesota........................... 50.00 50.00 50.00 56.20 60.19 61.59 8.2 3.9 4.3 11.5 5.39 61.59
Mississippi......................... 76.29 75.84 76.29 82.49 83.62 84.24 9.3 6.0 3.3 8.5 1.75 84.24
Missouri............................ 62.42 63.19 63.19 69.39 71.24 73.27 8.8 4.7 4.1 11.5 3.88 73.27
Montana............................. 68.53 68.04 68.53 74.73 76.29 77.14 6.2 3.2 3.0 8.5 2.41 77.14
Nebraska............................ 58.02 59.54 59.54 65.74 65.74 67.79 4.8 2.8 2.0 5.5 2.05 67.79
Nevada.............................. 52.64 50.00 52.64 58.84 63.93 63.93 11.3 4.2 7.1 11.5 5.09 63.93
New Hampshire....................... 50.00 50.00 50.00 56.20 56.20 58.78 6.6 3.4 3.2 8.5 3.99 60.19
New Jersey.......................... 50.00 50.00 50.00 56.20 58.78 61.59 8.8 4.2 4.6 11.5 5.39 61.59
New Mexico.......................... 71.04 70.88 71.04 77.24 77.24 78.66 6.4 3.5 2.9 8.5 2.20 79.44
New York............................ 50.00 50.00 50.00 56.20 58.78 60.19 8.2 4.3 3.9 11.5 5.39 61.59
North Carolina...................... 64.05 64.60 64.60 70.80 73.55 74.51 10.9 4.5 6.4 11.5 3.71 74.51
North Dakota........................ 63.75 63.15 63.75 69.95 69.95 69.95 4.2 3.0 1.2 0 0.00 69.95
Ohio................................ 60.79 62.14 62.14 68.34 70.25 72.34 10.7 5.3 5.4 11.5 4.00 72.34
Oklahoma............................ 67.10 65.90 67.10 73.30 74.94 74.94 6.3 3.3 3.0 8.5 2.53 75.83
Oregon.............................. 60.86 62.45 62.45 68.65 71.58 72.61 12.0 5.0 7.0 11.5 3.96 72.61
Pennsylvania........................ 54.08 54.52 54.52 60.72 63.05 64.32 8.1 4.3 3.8 11.5 4.87 65.59
Rhode Island........................ 52.51 52.59 52.59 58.79 63.89 63.89 11.9 4.8 7.1 11.5 5.10 63.89
South Carolina...................... 69.79 70.07 70.07 76.27 78.55 79.36 11.8 5.5 6.3 11.5 3.09 79.36
South Dakota........................ 60.03 62.55 62.55 68.75 68.75 70.64 5.0 2.7 2.3 5.5 1.89 70.64
Tennessee........................... 63.71 64.28 64.28 70.48 73.25 74.23 10.5 4.5 6.0 11.5 3.75 74.23
Texas............................... 60.56 59.44 60.56 66.76 68.76 68.76 7.1 4.4 2.7 8.5 3.09 69.85
Utah................................ 71.63 70.71 71.63 77.83 77.83 79.98 5.4 2.5 2.9 8.5 2.15 79.98
Vermont............................. 59.03 59.45 59.45 65.65 67.71 69.96 7.3 3.5 3.8 11.5 4.31 69.96
Virginia............................ 50.00 50.00 50.00 56.20 58.78 61.59 7.0 2.8 4.2 11.5 5.39 61.59
Washington.......................... 51.52 50.94 51.52 57.72 60.22 62.94 9.1 4.4 4.7 11.5 5.22 62.94
West Virginia....................... 74.25 73.73 74.25 80.45 80.45 81.70 8.4 4.2 4.2 11.5 2.60 83.05
Wisconsin........................... 57.62 59.38 59.38 65.58 65.58 68.77 8.8 4.4 4.4 11.5 4.31 69.89
Wyoming............................. 50.00 50.00 50.00 56.20 56.20 56.20 5.2 2.8 2.4 5.5 2.58 58.78
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[[Page 64700]]
[FR Doc. E9-29248 Filed 12-7-09; 8:45 am]
BILLING CODE 4210-01-P