[Federal Register Volume 75, Number 128 (Tuesday, July 6, 2010)]
[Rules and Regulations]
[Pages 38748-38749]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-16272]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 447 and 457
[CMS-2244-CN]
RIN 0938-AP73
Medicaid Program; Premiums and Cost Sharing; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS
ACTION: Correction of final rule with comment period.
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SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the Federal Register on May
28, 2010 entitled ``Medicaid Program; Premiums and Cost Sharing.'' The
May 28, 2010, final rule revised a November 25, 2008, final rule
entitled, ``Medicaid Programs; Premiums and Cost Sharing'' which
addressed public comments received during reopened comment periods, and
reflected relevant statutory changes made in the American Recovery and
Reinvestment Act of 2009. The November 2008 document revised final rule
implemented and interpreted section 1916A of the Social Security Act.
DATES: Effective Date: This correction document is effective July 1,
2010.
FOR FURTHER INFORMATION CONTACT: Christine Gerhardt, (410) 786-0693.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2010-12954 of May 28, 2010 (75 FR 30244), there were two
technical errors that are identified and corrected in the ``Correction
of Errors'' section below. The provisions in this correction notice are
effective as if they had been included in the document published May
28, 2010. Accordingly, the corrections are effective July 1, 2010.
II. Summary of Errors
On page 30255, in the preamble under Section III, ``Provisions of
the Revised Final Rule,'' we set forth the definition of ``Indian
health care provider.'' On page 30256, we specify that the definition
is added to a new paragraph (b) under Sec. 447.50. However, on page
30261, we inadvertently omitted the definition of ``Indian health care
provider'' from Sec. 447.50 (b) of the regulations text.
On page 30264, we inadvertently omitted a statutory exception to
the policy specified in the amended paragraph (b) under Sec. 447.74 of
the regulations text. According to section 1916A(e)(2) of the Social
Security Act (the Act), the limitation to 20 percent of the State
Medicaid agency's payment for alternative cost sharing imposed on
individuals with family income more than 150 percent of the Federal
poverty level (FPL) does not apply to non-emergency services furnished
in a hospital emergency department.
III. Waiver of Proposed Rulemaking
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a rule take effect in accordance with section 553(b) of
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we
can waive this notice and comment procedure if the Secretary finds, for
good cause, that the notice and comment process is impracticable,
unnecessary, or contrary to the public interest, and incorporates a
statement of the finding and the reasons therefore in the notice.
Section 553(d) of the APA ordinarily requires a 30-day delay in
effective date of final rules after the date of their publication in
the Federal Register. This 30-day delay in effective date can be
waived, however, if an agency finds for good cause that the delay is
impracticable, unnecessary, or contrary to the public interest, and the
agency incorporates a statement of the findings and its reasons in the
rule issued.
With respect to our proposal to add a definition of ``Indian health
care provider'' as a new paragraph (b)(2) in Sec. 447.50 of the
regulations text, we inadvertently omitted this definition from the
revised final rule. In the preamble under Section III, Provisions of
the Revised Final Rule, we gave the new definition on page 30255. Also,
on page 30256, we mentioned that the definition of ``Indian health care
provider'' is added to a new paragraph (b) under Sec. 447.50. Because
the intended content of the regulation is clear when the document is
read as a whole, we believe further process is unnecessary. We further
believe that correction of the error is in the public interest because
it would avoid confusion. Therefore, we find good cause to waive a
notice of proposed rulemaking and delayed effective date.
With respect to our proposal to add an exception to the policy
specified in the amended paragraph (b) under Sec. 447.74, section
1916A(e)(2) of the Act makes clear that the limitation to 20 percent of
the State Medicaid agency's payment for alternative cost sharing
imposed on individuals with family income more than 150 percent of the
Federal poverty level (FPL) does not apply to non-emergency services
furnished in a hospital emergency department. Since this change is
necessary to accurately reflect the statutory requirements, we believe
that correction of this error is in the public interest because it will
prevent confusion as to those
[[Page 38749]]
requirements. Therefore, we find good cause to waive a notice of
proposed rulemaking and delayed effective date in order to comply with
the statutory exemption of this service from the requirements specified
in Sec. 447.74(b).
IV. Correction of Errors
Regulations Text
0
Accordingly, CMS amends 42 CFR part 447, as amended in FR Doc. 2010-
12954 of May 28, 2010 (75 FR 30244), effective July 1, 2010, by making
the following corrections:
PART 447--PAYMENTS FOR SERVICES
0
1. The authority citation for part 447 continues to read as follows:
Authority: Sec. 1102 of the Social Security Act (42 U.S.C.
1302).
0
2. In Sec. 447.50, a new paragraph (b)(2) is added to read as follows:
Sec. 447.50 Cost sharing: Basis and purpose.
* * * * *
(b) * * *
(2) Indian health care provider means a health care program
operated by the Indian Health Service (IHS) or by an Indian Tribe,
Tribal Organization, or Urban Indian Organization (otherwise known as
an I/T/U) as those terms are defined in section 4 of the Indian Health
Care Improvement Act (25 U.S.C. 1603).
* * * * *
0
3. In Sec. 447.74, revise paragraph (b) to read as follows:
Sec. 447.74 Alternative premium and cost sharing protections for
individuals with family incomes above 150 percent of the FPL.
* * * * *
(b) Cost sharing may be imposed under the State plan on individuals
whose family income exceeds 150 percent of the FPL if the cost sharing
does not exceed 20 percent of the payment the agency makes for the item
or service (including a non-preferred drug but not including non-
emergency services furnished in a hospital emergency department), with
the following exception: In the case of States that do not have fee-
for-service payment rates, any copayment that the State imposes for
services provided by an MCO to a Medicaid beneficiary, including a
child covered under a Medicaid expansion program for whom enhanced
match is claimed under title XXI of the Act, may not exceed $3.40 per
visit for Federal FY 2009. Thereafter, any copayment may not exceed
this amount as updated each October 1 by the percentage increase in the
medical care component of the CPI-U for the period of September to
September ending in the preceding calendar year and then rounded to the
next highest 5-cent increment.
* * * * *
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program)
Dated: June 29, 2010.
Dawn L. Smalls,
Executive Secretary to the Department.
[FR Doc. 2010-16272 Filed 6-30-10; 4:15 pm]
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