[Federal Register Volume 75, Number 245 (Wednesday, December 22, 2010)]
[Notices]
[Pages 80501-80503]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-32054]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Adjustments for Disaster-Recovery States to the Fourth Quarter of 
Fiscal Year 2011 and Fiscal Year 2012 Federal Medical Assistance 
Percentage (FMAP) 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 describes the methodology for calculating the 
higher federal matching funding that is made available under section 
1905(aa) of the Social Security Act, as amended by section 2006 of the 
Patient Protection and Affordable Care Act of 2010 (``Affordable Care 
Act'') and provides the adjusted Federal Medical Assistance Percentage 
(FMAP) rates for the fourth quarter of Fiscal Year 2011 and Fiscal Year 
2012 for disaster-recovery FMAP adjustment states. Section 1905(aa) of 
the Social Security Act provides for an increase in the FMAP rate for 
qualifying states that have experienced a major, statewide disaster.

DATES: Effective Date: The percentages listed are for the fourth 
quarter of Fiscal Year 2011 beginning July 1, 2011 and ending September 
30, 2011, and for Fiscal Year 2012.

A. Background

    The Federal Medical Assistance Percentage (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 to 
publish the FMAP rates each year. The Secretary calculates the 
percentages, using formulas set forth in

[[Page 80502]]

sections 1905(b) and 1101(a)(8)(B), 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 in 
statute, and thus are not based on the statutory formula that 
determines the percentages for the 50 States.
    Section 1905(b) of the Social Security 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.

    Section 2006 of the Patient Protection and Affordable Care Act of 
2010 (``Affordable Care Act'') amended section 1905 of the Social 
Security Act by adding section (aa) to provide for an increase in the 
FMAP rate for qualifying states for Medicaid and title IV-E Foster 
Care, Adoption Assistance and Guardianship Assistance programs. The 
purpose of the increase to the FMAP rate is to provide increased 
Federal financial participation for qualifying states that have 
experienced a major, statewide disaster.

B. Definition of a Disaster-Recovery FMAP Adjustment State

    Section 1905(aa) of the Social Security Act, as added by section 
2006 of the Affordable Care Act specifies that the annual FMAP rate 
shall be increased for a ``disaster-recovery FMAP adjustment state.'' 
The statute defines a ``disaster-recovery FMAP adjustment state'' as 
one of the 50 states or District of Columbia for which, at any time 
during the preceding 7 fiscal years, the President has declared a major 
disaster under section 401 of the Robert T. Stafford Disaster Relief 
and Emergency Assistance Act under which every county or parish in the 
state is eligible for individual and public or public assistance from 
the federal government, and for which the FMAP as determined for the 
fiscal year is less than the FMAP for the preceding fiscal year by at 
least three percentage points. For Fiscal Year 2011 (FY11), the first 
fiscal year in which a state can qualify for the disaster adjustment, 
the FMAP for FY11 must be less than the FMAP for the preceding fiscal 
year after the application of the ``hold harmless'' provision under 
subsection (a) of Section 5001 of the American Recovery and 
Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5), by at least three 
percentage points. For Fiscal Year 2012 (FY12) and beyond, the FMAP 
rate for the state for the fiscal year, as determined based on the 
annual FMAP calculation (without regard to section 1905(aa)), must be 
less than the preceding year FMAP rate, including the applicable 
disaster-recovery adjustment, by at least three percentage points.

C. Calculation of the Increased FMAP Rates for Disaster-Recovery FMAP 
Adjustment States

    For the first year in which a state qualifies for the disaster-
recovery FMAP adjustment, the FMAP shall be equal to the FMAP as 
determined for the fiscal year, plus 50% of the number of percentage 
points by which the FMAP is less than the preceding fiscal year FMAP. 
For FY11, the preceding fiscal year FMAP includes the application of 
the ``hold harmless'' provision under subsection (a) of Section 5001 of 
the ARRA. In year two or any succeeding fiscal year in the qualifying 
7-year period, the FMAP shall be equal to the FMAP as determined for 
the preceding fiscal year, including any disaster-recovery adjustment 
for that year, plus 25% of the number of percentage points by which the 
FMAP as determined for the fiscal year (without any disaster-recovery 
adjustment) is less than the FMAP for the previous year (including any 
applicable disaster-recovery adjustments).
    Expenditures for which the increased FMAP is not available under 
title XIX include expenditures for disproportionate share hospital 
payments and expenditures that are paid at an enhanced FMAP rate, as 
well as any payments made under Title XXI. The increased FMAP is 
available for expenditures under part E of title IV only.
    Disaster-recovery FMAP adjustments will be included in the annual 
publication of the FMAP rates for the succeeding fiscal year. Beginning 
in the fall of 2011, the annual Federal Register Notice will include 
the FMAP rates for the succeeding fiscal year, as well as disaster-
recovery adjustments to the FMAP rates.

D. Disaster-Recovery FMAP Adjustments for the Fourth Quarter of Fiscal 
Year 2011 and Fiscal Year 2012

    The application of the disaster-recovery FMAP adjustment is 
effective January 1, 2011. Due to the extension of the ARRA FMAP 
adjustments, which extended the recession adjustment period to June 30, 
2011 (the end of the third quarter of FY11), no state will qualify for 
the disaster-recovery adjustment until the fourth quarter of FY11. As 
such, any adjustments that are made to the FY11 FMAP rates are 
effective for the fourth fiscal quarter only. Disaster-recovery FMAP 
adjustments made in future fiscal years will be applicable for all four 
quarters of the year.
    Based on the criteria for a qualifying state, only three states 
meet the requirement that the FMAP as determined for FY11 is less than 
the previous year FMAP, after the application of subsection (a) of 
Section 5001 of the ARRA, by at least three percentage points. Of the 
three states, only one state, Louisiana, has had a presidential 
disaster declaration that applies to all counties and parishes within 
the state in the preceding 7 fiscal years. Therefore, this notice only 
provides a disaster-recovery FMAP adjustment for the state of Louisiana 
for fourth quarter of FY11. The disaster-recovery adjusted FMAP rate is 
shown in the accompanying table.
    Based on the criteria for a qualifying state, only two states meet 
the requirement that the FMAP as determined for FY12 is less than the 
previous year FMAP by at least three percentage points. Of the two 
states, only one state, Louisiana, has had a presidential disaster 
declaration that applies to all counties and parishes within the state 
in the preceding 7 fiscal years. Therefore, this notice only provides a 
disaster-recovery FMAP adjustment for the state of Louisiana for FY12. 
The disaster-recovery adjusted FMAP rate is shown in the accompanying 
table. This is the second fiscal year for which Louisiana has qualified 
for the disaster-recovery adjustment; the adjusted FMAP rate for FY12 
reflects the calculation as prescribed in statute for succeeding 
qualifying years.

FOR FURTHER INFORMATION CONTACT: Carrie Shelton, 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. 93.658: Foster 
Care; 93.659:

[[Page 80503]]

Adoption Assistance; 93.090: Guardianship Assistance; 93.778: 
Medical Assistance Program)

    Dated: November 12, 2010.
Kathleen Sebelius,
Secretary.

                           Fiscal Year 2011 (Q4) Disaster-Recovery Adjusted FMAP Rates
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                                                                                               Disaster-recovery
              State                    FY11 FMAP      ARRA Hold harmless   Decrease in FMAP   adjusted FMAP FY11
                                                         FY 08-10 FMAP                               (Q4)
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Louisiana.......................              63.61               72.47                8.86               68.04
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                             Fiscal Year 2012 Disaster-Recovery Adjusted FMAP Rates
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                                                      FY11 FMAP/Disaster
              State                    FY12 FMAP       recovery adjusted   Decrease in FMAP    Disaster-recovery
                                                             FMAP                             adjusted FMAP FY12
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Louisiana.......................              61.09               68.04                6.95               69.78
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[FR Doc. 2010-32054 Filed 12-21-10; 8:45 am]
BILLING CODE 4150-05-P