Implementation of Section 5001 of the American Recovery and Reinvestment Act of 2009 (Pub. L. 111-5) for Adjustments to the Fourth Quarter of Fiscal Year 2010 Federal Medical Assistance Percentage Rates for Federal Matching Shares for Medicaid and Title IV-E Foster Care, Adoption Assistance and Guardianship Assistance Programs, 66763-66766 [2010-27412]
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Federal Register / Vol. 75, No. 209 / Friday, October 29, 2010 / Notices
CFR 225.41) to acquire shares of a bank
or bank holding company. The factors
that are considered in acting on the
notices are set forth in paragraph 7 of
the Act (12 U.S.C. 1817(j)(7)).
The notices are available for
immediate inspection at the Federal
Reserve Bank indicated. The notices
also will be available for inspection at
the offices of the Board of Governors.
Interested persons may express their
views in writing to the Reserve Bank
indicated for that notice or to the offices
of the Board of Governors. Comments
must be received not later than
November 15, 2010.
A. Federal Reserve Bank of Chicago
(Colette A. Fried, Assistant Vice
President) 230 South LaSalle Street,
Chicago, Illinois 60690–1414:
1. Marcelo L. Sacomori, London,
England; to acquire additional voting
shares of Granville Bancshares, Inc., and
thereby indirectly acquire additional
voting shares of Granville National
Bank, both of Granville, Illinois and
Sheridan State Bank, Sheridan, Illinois.
B. Federal Reserve Bank of Kansas
City (Dennis Denney, Assistant Vice
President) 1 Memorial Drive, Kansas
City, Missouri 64198–0001:
1. Larry L. Bingham, Baxter Springs,
Kansas; Ross C. Hartley, Teton Village,
Wyoming; Fred Mitchelson, Pittsburg,
Kansas; and Bob L. Robinson, Baxter
Springs, Kansas; to acquire control of
American BancShares, Inc., and thereby
indirectly acquire control of American
Bank of Baxter Springs, both of Baxter
Springs, Kansas.
Board of Governors of the Federal Reserve
System, October 26, 2010.
Board, are available for immediate
inspection at the Federal Reserve Bank
indicated. The application also will be
available for inspection at the offices of
the Board of Governors. Interested
persons may express their views in
writing on the standards enumerated in
the BHC Act (12 U.S.C. 1842(c)). If the
proposal also involves the acquisition of
a nonbanking company, the review also
includes whether the acquisition of the
nonbanking company complies with the
standards in section 4 of the BHC Act
(12 U.S.C. 1843). Unless otherwise
noted, nonbanking activities will be
conducted throughout the United States.
Unless otherwise noted, comments
regarding each of these applications
must be received at the Reserve Bank
indicated or the offices of the Board of
Governors not later than November 26,
2010.
A. Federal Reserve Bank of Kansas
City (Dennis Denney, Assistant Vice
President) 1 Memorial Drive, Kansas
City, Missouri 64198–0001:
1. JRMB II, Inc., Lawton, Oklahoma; to
become a bank holding company by
acquiring 82.97 percent of the voting
shares of J.R. Montgomery
Bancorporation, Lawton, Oklahoma, and
thereby indirectly acquire voting shares
of City National Bank and Trust
Company, Lawton, Oklahoma, and Fort
Sill National Bank, Fort Sill, Oklahoma.
Board of Governors of the Federal Reserve
System, October 26, 2010.
Robert deV. Frierson,
Deputy Secretary of the Board.
[FR Doc. 2010–27377 Filed 10–28–10; 8:45 am]
BILLING CODE 6210–01–P
Robert deV. Frierson,
Deputy Secretary of the Board.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
[FR Doc. 2010–27375 Filed 10–28–10; 8:45 am]
BILLING CODE 6210–01–P
FEDERAL RESERVE SYSTEM
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
Formations of, Acquisitions by, and
Mergers of Bank Holding Companies
The companies listed in this notice
have applied to the Board for approval,
pursuant to the Bank Holding Company
Act of 1956 (12 U.S.C. 1841 et seq.)
(BHC Act), Regulation Y (12 CFR Part
225), and all other applicable statutes
and regulations to become a bank
holding company and/or to acquire the
assets or the ownership of, control of, or
the power to vote shares of a bank or
bank holding company and all of the
banks and nonbanking companies
owned by the bank holding company,
including the companies listed below.
The applications listed below, as well
as other related filings required by the
VerDate Mar<15>2010
15:23 Oct 28, 2010
Jkt 223001
Implementation of Section 5001 of the
American Recovery and Reinvestment
Act of 2009 (Pub. L. 111–5) for
Adjustments to the Fourth Quarter of
Fiscal Year 2010 Federal Medical
Assistance Percentage Rates for
Federal Matching Shares for Medicaid
and Title IV–E Foster Care, Adoption
Assistance and Guardianship
Assistance Programs
Office of the Secretary, DHHS.
Notice.
AGENCY:
ACTION:
This notice provides the
adjusted Federal Medical Assistance
Percentage (FMAP) rate for the fourth
quarter of Fiscal Year 2010 (FY10) as
required under Section 5001 of the
American Recovery and Reinvestment
Act of 2009 (ARRA). Section 5001 of the
ARRA provides for temporary increases
SUMMARY:
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66763
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 was originally
defined in ARRA as the period
beginning October 1, 2008 and ending
December 31, 2010. Public Law 111–226
amended ARRA to extend the recession
adjustment period to June 30, 2011 and
to extend the hold harmless provision
that prevents a State’s FMAP rate from
decreasing due to a lower
unemployment rate from the calendar
quarter ending before July 1, 2010 to the
calendar quarter ending before January
1, 2011. Public Law 111–226 also
provided for a phase-down of the
general FMAP increase in the last two
quarters of the extended recession
adjustment period, and changed the
methodology for calculating the
unemployment adjustment for those
quarters.
DATES: Effective Date: The percentages
listed are for the fourth quarter of FY10
beginning July 1, 2010 through
September 30, 2010.
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 (‘‘the
Act’’). Sections 1905(b) and
1101(a)(8)(B) of the Act require the
Secretary of Health and Human Services
to publish the FMAP rates each year.
The Secretary calculates the percentages
using formulas in sections 1905(b) and
1101(a)(8)(B), and statistics from the
Department of Commerce 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 the 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
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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.
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
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
(MIPPA) (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 purpose of the increases to the
FMAP rates is 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. Public Law
111–226 extends the recession
adjustment period to June 30, 2011.
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 the first three calendar
quarters 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
a general percentage point increase in
each State’s FMAP of 6.2 percentage
points (decreasing during the last two
quarters of the extended recession
adjustment period); 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.
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Jkt 223001
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 general percentage point
increase. The increased FMAP does not
apply to other parts of title IV, including
part D (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 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 general
percentage point increase in the Federal
percentage) and the applicable percent
determined from the State
unemployment increase percentage for
the quarter.
The unemployment increase
percentage for calendar quarters other
than the last two quarters of the
recession adjustment period 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-consecutivemonth 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. A different but related
methodology for an unemployment
adjustment applies for the last two
quarters of the recession adjustment
period.
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
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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 or after January 1, 2009 and ending
before January 1, 2011, as amended by
Public Law 111–226. This hold
harmless provision is not in effect from
January 1, 2011 to June 30, 2011.
Under section 5001(b)(2) of ARRA,
Puerto Rico, the Virgin Islands, Guam,
the Commonwealth of the Northern
Mariana Islands, and America Samoa
were given the option to make a special
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 Act), or (2) applying the
general 6.2 percentage point increase in
the FMAP plus a 15 percent increase in
the cap on Medicaid payments. There is
no quarterly unemployment adjustment
for territories. All territories and the
Commonwealth of the Northern Mariana
Islands elected the 30 percent increase
in their spending cap on Medicaid
payments; therefore there is no
recalculation of their FMAP rate.
D. Adjusted FMAPs for the Fourth
Quarter of FY2010
ARRA adjustments to FMAPs are
shown by State in the accompanying
table. The hold harmless FY10 FMAP is
the higher of the original FY08, FY09,
or FY10 FMAP. The 6.2 percentage
point increase is added to the hold
harmless FY10 FMAP. The
unemployment adjustment is calculated
according to the unemployment tier and
added to the hold harmless FY10 FMAP
with the 6.2 percentage point increase.
For the fourth quarter of FY10, the
unemployment tier is determined by
comparing the average unemployment
rate for the three consecutive months
preceding the start of the fiscal quarter
to the lowest consecutive 3-month
average unemployment rate beginning
January 1, 2006. If the State’s applicable
percent is less than the applicable
percent for the third quarter of FY10,
then the higher applicable percent shall
continue for the fourth quarter of FY10.
As indicated in the August 4, 2009
Federal Register Notice that proposed
the methodology for the FMAP
unemployment adjustment calculations
(74 FR 38630), we utilize annual
updates to the historical Bureau of
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Federal Register / Vol. 75, No. 209 / Friday, October 29, 2010 / Notices
Labor Statistics (BLS) data to make
changes to the States’ lowest
unemployment rate beginning with the
fourth quarter FMAP rate adjustment
calculation each year. As such, the rates
calculated and presented in the
accompanying table are based on
updates to the historical BLS data used
to determine the States’ average lowest
unemployment rate for any 3
(Catalog of Federal Domestic Assistance
Program Nos. 93.778: Medical Assistance
Program; 93.658: Foster Care; 93.659:
Adoption Assistance; 93.090: Guardianship
Assistance)
consecutive months beginning January
1, 2006.
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.
Dated: September 22, 2010.
Kathleen Sebelius,
Secretary.
ARRA ADJUSTMENTS TO FMAP Q4 FY10
Hold harmless
FY10
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
State
Hold harmless
FY10 FMAP
with 6.2% pt
increase
4th Quarter
FY10
unemployment
tier
4th Quarter
FY10
unemployment
adjustment
4th Quarter
FY10 FMAP
unemployment
adjustment
4th Quarter
FY10 FMAP
unemployment
hold harmless
68.01
52.48
66.20
72.94
50.00
50.00
50.00
50.21
70.00
56.83
65.10
56.50
69.87
50.32
65.93
63.51
60.38
70.96
72.47
64.99
50.00
50.00
63.19
50.00
76.29
64.51
68.53
60.56
52.64
50.00
50.00
71.35
50.00
65.13
63.75
63.42
67.10
62.74
54.81
52.63
70.32
62.72
65.57
60.56
71.68
59.45
50.00
51.52
74.25
60.21
50.00
74.21
58.68
72.40
79.14
56.20
56.20
56.20
56.41
76.20
63.03
71.30
62.70
76.07
56.52
72.13
69.71
66.58
77.16
78.67
71.19
56.20
56.20
69.39
56.20
82.49
70.71
74.73
66.76
58.84
56.20
56.20
77.55
56.20
71.33
69.95
69.62
73.30
68.94
61.01
58.83
76.52
68.92
71.77
66.76
77.88
65.65
56.20
57.72
80.45
66.41
56.20
11.5
5.5
11.5
8.5
11.5
11.5
11.5
11.5
11.5
11.5
11.5
11.5
11.5
11.5
11.5
8.5
8.5
11.5
8.5
11.5
11.5
11.5
11.5
8.5
11.5
11.5
11.5
5.5
11.5
8.5
11.5
11.5
11.5
11.5
0
11.5
11.5
11.5
11.5
11.5
11.5
5.5
11.5
11.5
11.5
8.5
11.5
11.5
11.5
11.5
11.5
3.32
2.44
3.53
2.04
5.39
5.39
5.39
5.37
3.09
4.61
3.66
4.65
3.11
5.36
3.56
2.84
3.10
2.98
2.08
3.67
5.39
5.39
3.88
3.99
2.37
3.72
3.26
2.00
5.09
3.99
5.39
2.94
5.39
3.65
0.00
3.85
3.43
3.93
4.84
5.09
3.06
1.88
3.60
4.18
2.90
3.18
5.39
5.22
2.60
4.22
5.39
77.53
61.12
75.93
81.18
61.59
61.59
61.59
61.78
79.29
67.64
74.96
67.35
79.18
61.88
75.69
72.55
69.68
80.14
80.75
74.86
61.59
61.59
73.27
60.19
84.86
74.43
77.99
68.76
63.93
60.19
61.59
80.49
61.59
74.98
69.95
73.47
76.73
72.87
65.85
63.92
79.58
70.80
75.37
70.94
80.78
68.83
61.59
62.94
83.05
70.63
61.59
77.53
62.46
75.93
81.18
61.59
61.59
61.59
61.78
79.29
67.64
74.96
67.35
79.18
61.88
75.69
72.55
69.68
80.14
81.48
74.86
61.59
61.59
73.27
61.59
84.86
74.43
77.99
68.76
63.93
61.59
61.59
80.49
61.59
74.98
69.95
73.47
76.73
72.87
65.85
63.92
79.58
70.80
75.37
70.94
80.78
69.96
61.59
62.94
83.05
70.63
61.59
Alabama ...................................................
Alaska ......................................................
Arizona .....................................................
Arkansas ..................................................
California ..................................................
Colorado ...................................................
Connecticut ..............................................
Delaware ..................................................
Dist. of Columbia .....................................
Florida ......................................................
Georgia ....................................................
Hawaii ......................................................
Idaho ........................................................
Illinois .......................................................
Indiana .....................................................
Iowa ..........................................................
Kansas .....................................................
Kentucky ..................................................
Louisiana ..................................................
Maine .......................................................
Maryland ..................................................
Massachusetts .........................................
Michigan ...................................................
Minnesota .................................................
Mississippi ................................................
Missouri ....................................................
Montana ...................................................
Nebraska ..................................................
Nevada .....................................................
New Hampshire .......................................
New Jersey ..............................................
New Mexico .............................................
New York .................................................
North Carolina ..........................................
North Dakota ............................................
Ohio ..........................................................
Oklahoma .................................................
Oregon .....................................................
Pennsylvania ............................................
Rhode Island ............................................
South Carolina .........................................
South Dakota ...........................................
Tennessee ...............................................
Texas .......................................................
Utah ..........................................................
Vermont ....................................................
Virginia .....................................................
Washington ..............................................
West Virginia ............................................
Wisconsin .................................................
Wyoming ..................................................
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Federal Register / Vol. 75, No. 209 / Friday, October 29, 2010 / Notices
BILLING CODE 4150–05–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
NIAID Blue Ribbon Panel Meeting on
Adjuvant Discovery and Development
Notice is hereby given that the
National Institute of Allergy and
Infectious Diseases (NIAID), a
component of the National Institutes of
Health (NIH) of the Department of
Health and Human Services (DHHS),
will convene a Blue Ribbon Panel to
provide expertise in developing a
strategic plan and research agenda for
the discovery, development and clinical
evaluation of adjuvants for use with
preventive vaccines. NIAID has
developed a draft Strategic Plan and
Research Agenda for Adjuvant
Discovery and Development, which
summarizes the current status of
research in the field of preventive
vaccine adjuvants, identifies gaps in
knowledge and capabilities, and defines
NIAID’s goals for the continued
discovery, development and application
of adjuvants for human vaccines that
protect against infectious disease. The
Panel will review the draft Strategic
Plan and Research Agenda and
recommend ways the NIAID can
enhance its adjuvant research programs.
DATES: November 17–18, 2010.
ADDRESSES: The meeting location is:
Rockville—Hilton Hotel (Roosevelt
Room), 1750 Rockville Pike, Rockville,
MD 20850.
FOR FURTHER INFORMATION CONTACT: Ms.
Grace Tollini-Farrell, 301–496–7551.
Dated: October 21, 2010.
Daniel Rotrosen,
Director, Division of Allergy, Immunology and
Transplantation, NIAID, National Institutes
of Health.
BILLING CODE 4140–01–P
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
National Institute of
Environmental Health Sciences
(NIEHS), National Institutes of Health,
HHS.
ACTION: Extension of public comment
period.
Jkt 223001
BILLING CODE 4140–01–P
[Document Identifier: CMS–10319]
National Toxicology Program (NTP);
Office of Liaison, Policy and Review;
Meeting of the NTP Board of Scientific
Counselors: Amended Notice
15:23 Oct 28, 2010
[FR Doc. 2010–27424 Filed 10–28–10; 8:45 am]
Centers for Medicare & Medicaid
Services
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
VerDate Mar<15>2010
Dated: October 21, 2010.
John R. Bucher,
Associate Director, National Toxicology
Program.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
[FR Doc. 2010–27317 Filed 10–28–10; 8:45 am]
AGENCY:
The NTP announces an
amended date for submission of written
public comments for the November 30–
December 1, 2010 meeting of the NTP
Board of Scientific Counselors (BSC).
Information regarding the BSC meeting
was published on October 19, 2010, in
the Federal Register (75 FR 201) and is
available on the BSC meeting page
(https://ntp.niehs.nih.gov/go/165). The
guidelines and deadlines published in
this Federal Register notice still apply,
except that the deadline for submission
of written comments is extended to
November 16, 2010.
DATES: The BSC meeting will be held on
November 30–December 1, 2010. The
deadline for submission of written
comments and for pre-registration to
attend the meeting, including registering
to present oral comments, is November
16, 2010.
ADDRESSES: The BSC meeting will be
held in the Rodbell Auditorium, Rall
Building at the NIEHS, 111 T.W.
Alexander Drive, Research Triangle
Park, NC 27709. Public comments on all
agenda topics and any other
correspondence should be submitted to
Dr. Lori White, Designated Federal
Officer for the BSC, NTP Office of
Liaison, Policy and Review, NIEHS, P.O.
Box 12233, K2–03, Research Triangle
Park, NC 27709; telephone: 919–541–
9834; fax: 919–541–0295;
whiteld@niehs.nih.gov. Courier address:
NIEHS, 530 Davis Drive, Room K2136,
Morrisville, NC 27560.
FOR FURTHER INFORMATION CONTACT: Dr.
Lori D. White (telephone: 919–541–9834
or whiteld@niehs.nih.gov).
SUMMARY:
[FR Doc. 2010–27412 Filed 10–28–10; 8:45 am]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS) is publishing the
following summary of proposed
AGENCY:
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Fmt 4703
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collections for public comment.
Interested persons are invited to send
comments regarding this burden
estimate or any other aspect of this
collection of information, including any
of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions;
(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Pre-Existing
Condition Insurance Plan Program
Solicitation and Contractor’s Proposal
Package; Use: The Department of Health
and Human Services (HHS) is
requesting a renewal of this package by
the Office of Management and Budget
(OMB); specifically, HHS is now seeking
a three-year approval for this collection.
On March 23, 2010, the President signed
into law H.R. 3590, the Patient
Protection and Affordable Care Act
(Affordable Care Act), Public Law 111–
148. Section 1101 of the law establishes
a ‘‘temporary high risk health insurance
pool program’’ (which has been named
the Pre-Existing Condition Insurance
Plan, or PCIP) to provide health
insurance coverage to currently
uninsured individuals with pre-existing
conditions. The law authorizes HHS to
carry out the program directly or
through contracts with States or private,
non-profit entities.
This package renewal is requested as
a result of a possible transition in
administration of the program from a
Federally-run to a State administered
program. A State who originally decided
to have HHS administer the program in
their State may in the future notify HHS
of their desire to administer the PreExisting Condition Plan (PCIP) program.
PCIP is also referred to as the temporary
qualified high risk insurance pool
program, as it is called in the Affordable
Care Act, but we have adopted the term
PCIP to better describe the program and
avoid confusion with the existing State
high risk pool programs. Form Number:
CMS–10319 (OMB#: 0938–1085);
Frequency: Occasionally; Affected
Public: State governments; Number of
Respondents: 2; Total Annual
Responses: 2; Total Annual Hours:
2,992. (For policy questions regarding
this collection contact Laura Dash at
301–492–4296. For all other issues call
410–786–1326.)
E:\FR\FM\29OCN1.SGM
29OCN1
]]>Agencies
[Federal Register Volume 75, Number 209 (Friday, October 29, 2010)]
[Notices]
[Pages 66763-66766]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-27412]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Implementation of Section 5001 of the American Recovery and
Reinvestment Act of 2009 (Pub. L. 111-5) for Adjustments to the Fourth
Quarter of Fiscal Year 2010 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 provides the adjusted Federal Medical Assistance
Percentage (FMAP) rate for the fourth quarter of Fiscal Year 2010
(FY10) as required under Section 5001 of the American Recovery and
Reinvestment Act of 2009 (ARRA). 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 was
originally defined in ARRA as the period beginning October 1, 2008 and
ending December 31, 2010. Public Law 111-226 amended ARRA to extend the
recession adjustment period to June 30, 2011 and to extend the hold
harmless provision that prevents a State's FMAP rate from decreasing
due to a lower unemployment rate from the calendar quarter ending
before July 1, 2010 to the calendar quarter ending before January 1,
2011. Public Law 111-226 also provided for a phase-down of the general
FMAP increase in the last two quarters of the extended recession
adjustment period, and changed the methodology for calculating the
unemployment adjustment for those quarters.
DATES: Effective Date: The percentages listed are for the fourth
quarter of FY10 beginning July 1, 2010 through September 30, 2010.
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 (``the Act''). Sections 1905(b) and
1101(a)(8)(B) of the Act require the Secretary of Health and Human
Services to publish the FMAP rates each year. The Secretary calculates
the percentages using formulas in sections 1905(b) and 1101(a)(8)(B),
and statistics from the Department of Commerce 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
the 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
[[Page 66764]]
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
(MIPPA) (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 purpose
of the increases to the FMAP rates is 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. Public Law 111-226 extends the recession adjustment period to
June 30, 2011.
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 the first three calendar quarters 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 a general percentage point increase in each State's FMAP
of 6.2 percentage points (decreasing during the last two quarters of
the extended recession adjustment period); 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 general
percentage point increase. The increased FMAP does not apply to other
parts of title IV, including part D (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
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 general
percentage point increase in the Federal percentage) and the applicable
percent determined from the State unemployment increase percentage for
the quarter.
The unemployment increase percentage for calendar quarters other
than the last two quarters of the recession adjustment period 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. A different but related methodology for an
unemployment adjustment applies for the last two quarters of the
recession adjustment period.
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 or after
January 1, 2009 and ending before January 1, 2011, as amended by Public
Law 111-226. This hold harmless provision is not in effect from January
1, 2011 to June 30, 2011.
Under section 5001(b)(2) of ARRA, Puerto Rico, the Virgin Islands,
Guam, the Commonwealth of the Northern Mariana Islands, and America
Samoa were given the option to make a special 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 Act),
or (2) applying the general 6.2 percentage point increase in the FMAP
plus a 15 percent increase in the cap on Medicaid payments. There is no
quarterly unemployment adjustment for territories. All territories and
the Commonwealth of the Northern Mariana Islands elected the 30 percent
increase in their spending cap on Medicaid payments; therefore there is
no recalculation of their FMAP rate.
D. Adjusted FMAPs for the Fourth Quarter of FY2010
ARRA adjustments to FMAPs are shown by State in the accompanying
table. The hold harmless FY10 FMAP is the higher of the original FY08,
FY09, or FY10 FMAP. The 6.2 percentage point increase is added to the
hold harmless FY10 FMAP. The unemployment adjustment is calculated
according to the unemployment tier and added to the hold harmless FY10
FMAP with the 6.2 percentage point increase.
For the fourth quarter of FY10, the unemployment tier is determined
by comparing the average unemployment rate for the three consecutive
months preceding the start of the fiscal quarter to the lowest
consecutive 3-month average unemployment rate beginning January 1,
2006. If the State's applicable percent is less than the applicable
percent for the third quarter of FY10, then the higher applicable
percent shall continue for the fourth quarter of FY10.
As indicated in the August 4, 2009 Federal Register Notice that
proposed the methodology for the FMAP unemployment adjustment
calculations (74 FR 38630), we utilize annual updates to the historical
Bureau of
[[Page 66765]]
Labor Statistics (BLS) data to make changes to the States' lowest
unemployment rate beginning with the fourth quarter FMAP rate
adjustment calculation each year. As such, the rates calculated and
presented in the accompanying table are based on updates to the
historical BLS data used to determine the States' average lowest
unemployment rate for any 3 consecutive months beginning January 1,
2006.
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. 93.778: Medical
Assistance Program; 93.658: Foster Care; 93.659: Adoption
Assistance; 93.090: Guardianship Assistance)
Dated: September 22, 2010.
Kathleen Sebelius,
Secretary.
ARRA Adjustments to FMAP Q4 FY10
--------------------------------------------------------------------------------------------------------------------------------------------------------
Hold harmless 4th Quarter 4th Quarter 4th Quarter 4th Quarter
Hold harmless FY10 FMAP with FY10 FY10 FY10 FMAP FY10 FMAP
State FY10 6.2% pt unemployment unemployment unemployment unemployment
increase tier adjustment adjustment hold harmless
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama................................................. 68.01 74.21 11.5 3.32 77.53 77.53
Alaska.................................................. 52.48 58.68 5.5 2.44 61.12 62.46
Arizona................................................. 66.20 72.40 11.5 3.53 75.93 75.93
Arkansas................................................ 72.94 79.14 8.5 2.04 81.18 81.18
California.............................................. 50.00 56.20 11.5 5.39 61.59 61.59
Colorado................................................ 50.00 56.20 11.5 5.39 61.59 61.59
Connecticut............................................. 50.00 56.20 11.5 5.39 61.59 61.59
Delaware................................................ 50.21 56.41 11.5 5.37 61.78 61.78
Dist. of Columbia....................................... 70.00 76.20 11.5 3.09 79.29 79.29
Florida................................................. 56.83 63.03 11.5 4.61 67.64 67.64
Georgia................................................. 65.10 71.30 11.5 3.66 74.96 74.96
Hawaii.................................................. 56.50 62.70 11.5 4.65 67.35 67.35
Idaho................................................... 69.87 76.07 11.5 3.11 79.18 79.18
Illinois................................................ 50.32 56.52 11.5 5.36 61.88 61.88
Indiana................................................. 65.93 72.13 11.5 3.56 75.69 75.69
Iowa.................................................... 63.51 69.71 8.5 2.84 72.55 72.55
Kansas.................................................. 60.38 66.58 8.5 3.10 69.68 69.68
Kentucky................................................ 70.96 77.16 11.5 2.98 80.14 80.14
Louisiana............................................... 72.47 78.67 8.5 2.08 80.75 81.48
Maine................................................... 64.99 71.19 11.5 3.67 74.86 74.86
Maryland................................................ 50.00 56.20 11.5 5.39 61.59 61.59
Massachusetts........................................... 50.00 56.20 11.5 5.39 61.59 61.59
Michigan................................................ 63.19 69.39 11.5 3.88 73.27 73.27
Minnesota............................................... 50.00 56.20 8.5 3.99 60.19 61.59
Mississippi............................................. 76.29 82.49 11.5 2.37 84.86 84.86
Missouri................................................ 64.51 70.71 11.5 3.72 74.43 74.43
Montana................................................. 68.53 74.73 11.5 3.26 77.99 77.99
Nebraska................................................ 60.56 66.76 5.5 2.00 68.76 68.76
Nevada.................................................. 52.64 58.84 11.5 5.09 63.93 63.93
New Hampshire........................................... 50.00 56.20 8.5 3.99 60.19 61.59
New Jersey.............................................. 50.00 56.20 11.5 5.39 61.59 61.59
New Mexico.............................................. 71.35 77.55 11.5 2.94 80.49 80.49
New York................................................ 50.00 56.20 11.5 5.39 61.59 61.59
North Carolina.......................................... 65.13 71.33 11.5 3.65 74.98 74.98
North Dakota............................................ 63.75 69.95 0 0.00 69.95 69.95
Ohio.................................................... 63.42 69.62 11.5 3.85 73.47 73.47
Oklahoma................................................ 67.10 73.30 11.5 3.43 76.73 76.73
Oregon.................................................. 62.74 68.94 11.5 3.93 72.87 72.87
Pennsylvania............................................ 54.81 61.01 11.5 4.84 65.85 65.85
Rhode Island............................................ 52.63 58.83 11.5 5.09 63.92 63.92
South Carolina.......................................... 70.32 76.52 11.5 3.06 79.58 79.58
South Dakota............................................ 62.72 68.92 5.5 1.88 70.80 70.80
Tennessee............................................... 65.57 71.77 11.5 3.60 75.37 75.37
Texas................................................... 60.56 66.76 11.5 4.18 70.94 70.94
Utah.................................................... 71.68 77.88 11.5 2.90 80.78 80.78
Vermont................................................. 59.45 65.65 8.5 3.18 68.83 69.96
Virginia................................................ 50.00 56.20 11.5 5.39 61.59 61.59
Washington.............................................. 51.52 57.72 11.5 5.22 62.94 62.94
West Virginia........................................... 74.25 80.45 11.5 2.60 83.05 83.05
Wisconsin............................................... 60.21 66.41 11.5 4.22 70.63 70.63
Wyoming................................................. 50.00 56.20 11.5 5.39 61.59 61.59
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[[Page 66766]]
[FR Doc. 2010-27412 Filed 10-28-10; 8:45 am]
BILLING CODE 4150-05-P
