Notice of Hearing: Reconsideration of Disapproval of Minnesota State Plan Amendment 05-015B, 61482-61483 [E6-17368]
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Federal Register / Vol. 71, No. 201 / Wednesday, October 18, 2006 / Notices
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costs furnished to eligible individuals
that are not within the statutory
definition of medical assistance. It will
result in State claims for FFP in
expenditures as medical assistance
which are not within the statutory
definition of medical assistance.
Furthermore, section 1902(a)(30)(A) of
the Act requires that State plan payment
rates must be consistent with efficiency,
economy, and quality of care. The
payments that would be made under
SPA 05–49 are for care or services that
are not within the scope of medical
assistance, and are not furnished to
Medicaid-eligible individuals. Instead,
the SPA would authorize a pool of
funding, to subsidize health insurance
that would be furnished to home health
and personal care workers. The
proposed payments would not be
payment for identifiable covered
Medicaid services, as defined under
section 1905(a)(30)(A) of the Act.
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 New York announcing
an administrative hearing to reconsider
the disapproval of its SPA reads as
follows:
Mr. Gregor N. Macmillan, Director, State of
New York, Department of Health, Corning
Tower, The Governor Nelson A. Rockefeller
Empire State Plaza, Albany, NY 12237.
Dear Mr. Macmillan:
I am responding to your request for
reconsideration of the decision to disapprove
New York State plan amendment (SPA) 05–
49, which was submitted on September 29,
2005, and disapproved on June 21, 2006.
Under SPA 05–49, New York was proposing
to provide supplemental funding to home
care agencies for the purpose of maintaining
VerDate Aug<31>2005
15:24 Oct 17, 2006
Jkt 211001
or subsidizing health insurance coverage for
employed home care workers.
The amendment was disapproved because
it did not comport with the requirements of
section 1902(a)(4), 1902(a)(10)(A),
1902(a)(30)(A), and 1905(a) of the Social
Security Act (the Act) and implementing
regulations.
The issues in this reconsideration are
whether:
(1) The proposed payments are for services
to eligible individuals within the scope of the
eligibility provisions of section 1902(a)(10) of
the Act, as applied consistent with the
limitations in the definition of medical
assistance at section 1905(a) of the Act;
(2) The proposed payments are for services
that are within the scope of covered medical
assistance, as set forth in section 1905(a) of
the Act and incorporated by section
1902(a)(10) of the Act;
(3) It is necessary for the proper and
efficient operation of the plan for the State
to include in the State plan a provision to
provider costs that are not within the
statutory definition of medical assistance;
and
(4) The proposed payments are consistent
with efficiency and economy as required by
section 1902(a)(30)(A) of the Act.
We discuss these issues in more detail
below, as set forth in the initial disapproval
decision.
The proposed payments under SPA 05–49
are not for a group or category of individuals
who are eligible under the statute under
either section 1902(a)(10) of the Act nor as
medical assistance for a covered benefit
under 1905(a) of the Act. The proposed
methodology would directly compensate
home health and personal care employers for
health insurance costs. Under the Medicaid
statute, Federal funding is only available for
medical assistance for individuals eligible
under the approved State plan. Section
1902(a)(10) of the Act lists mandatory and
optional groups of individuals who may be
eligible for medical assistance. Section
1902(a)(10) must be read in concert with
section 1905(a) of the Act, which defines
medical assistance benefits (including
additional specification of the categories of
eligible individuals). For the same reasons,
SPA 05–49 is not consistent with the
requirements of section 1902(a)(4) of the Act.
Section 1902(a)(4) of the Act requires that
State Medicaid plans provide for methods of
administration that are found by the
Secretary to be necessary for the proper and
efficient operation of the plan. It is not
considered necessary for the proper and
efficient operation of the plan for the State
to include in the State plan a provision
which would pay for provider costs
furnished to eligible individuals that are not
within the statutory definition of medical
assistance. It will result in State claims for
Federal financial participation in
expenditures as medical assistance which are
not within the statutory definition of medical
assistance.
Furthermore, section 1902(a)(30)(A) of the
Act requires that State plan payment rates
must be consistent with efficiency, economy,
and quality of care. The payments that would
be made under SPA 05–49 are for care or
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Frm 00026
Fmt 4703
Sfmt 4703
services that are not within the scope of
medical assistance, and are not furnished to
Medicaid-eligible individuals. Instead, the
SPA would authorize a pool of funding, to
subsidize health insurance that would be
furnished to home health and personal care
workers. The proposed payments would not
be payment for identifiable covered Medicaid
services, as defined under section
1905(a)(30)(A) of the Act.
I am scheduling a hearing on your request
for reconsideration to be held on November
22, 2006, at 26 Federal Plaza, Room 38–110a,
New York, NY, 10278, to reconsider the
decision to disapprove SPA 05–49. 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 at 42 CFR part 430.
I am designating Ms. Kathleen ScullyHayes 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,
Mark B. McClellan, M.D., PhD
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: September 29, 2006.
Mark B. McClellan,
Administrator.
[FR Doc. E6–17361 Filed 10–17–06; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
Notice of Hearing: Reconsideration of
Disapproval of Minnesota State Plan
Amendment 05–015B
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of Hearing.
AGENCY:
SUMMARY: This notice announces an
administrative hearing to be held on
December 4, 2006, at 233 N. Michigan
Avenue, Suite 600, the Illinois Room,
Chicago, IL 60601, to reconsider CMS’
decision to disapprove Minnesota State
plan amendment 05–015B.
Closing Date: Requests to participate
in the hearing as a party must be
received by the presiding officer by
November 2, 2006.
FOR FURTHER INFORMATION CONTACT:
Kathleen Scully-Hayes, Presiding
E:\FR\FM\18OCN1.SGM
18OCN1
rmajette on PROD1PC67 with NOTICES1
Federal Register / Vol. 71, No. 201 / Wednesday, October 18, 2006 / Notices
Officer, CMS, Lord Baltimore Drive,
Mail Stop LB–23–20, Baltimore,
Maryland 21244; Telephone: (410) 786–
2055.
SUPPLEMENTARY INFORMATION: This
notice announces an administrative
hearing to reconsider CMS’ decision to
disapprove Minnesota State plan
amendment (SPA) 05–015B which was
submitted on September 28, 2005. This
SPA was disapproved on June 12, 2006.
Under this SPA, the State proposed to
limit incurred medical and remedial
care expenses protected under the post
eligibility process only to those
expenses incurred while an individual
is eligible for Medicaid.
Sections 1902(a)(17), and 1902(a)(51)
in conjunction with section 1924 of the
Social Security Act (the Act), as these
sections are refined by section
1902(r)(1), require States to take into
account, under the post eligibility
process, amounts for incurred medical
and remedial care expenses that are not
subject to payment by a third party.
Section 1902(r)(1)(A)(ii) of the Act and
Federal regulations at 42 CFR
435.733(c)(4)(ii) permit States to place
‘‘reasonable’’ limits on the amounts of
necessary medical and remedial care
expenses recognized under State law
but not covered under the State plan.
The amendment was disapproved
because CMS found that the amendment
violated the statute for reasons set forth
in the disapproval letter.
The issues to be decided in the
hearing are:
• Whether Minnesota’s SPA 05–015B
impermissibly limits the amount of
incurred expenses which may be
deducted from an institutionalized
individual’s income for purposes of the
post eligibility process by limiting these
expenses to those incurred when the
individual was Medicaid eligible; and
• Whether allowing this limitation
undermines the protection of expenses
which can be incurred when an
individual is not Medicaid eligible,
which must be considered for purposes
of the medically needy spend down.
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
VerDate Aug<31>2005
15:24 Oct 17, 2006
Jkt 211001
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 Minnesota announcing
an administrative hearing to reconsider
the disapproval of its SPA reads as
follows:
Ms. Christine Bronson,
Medicaid Director,
Minnesota Department of Human Services,
P.O. Box 64983,
St. Paul, MN 55164–0983.
Dear Ms. Bronson: I am responding to your
request for reconsideration of the decision to
disapprove the Minnesota State plan
amendment (SPA) 05–015B, which was
submitted on September 28, 2005, and
disapproved on June 12, 2006.
Under this SPA, the State proposed to limit
incurred medical and remedial care expenses
protected under the post eligibility process
only to those expenses incurred while an
individual is eligible for Medicaid.
Sections 1902(a)(17), and 1902(a)(51) in
conjunction with section 1924 of the Social
Security Act (the Act), as these sections are
refined by section 1902(r)(1), require States to
take into account, under the post eligibility
process, amounts for incurred medical and
remedial care expenses that are not subject to
payment by a third party. Section
1902(r)(1)(A)(ii) of the Act and Federal
regulations at 42 CFR 435.733(c)(4)(ii) permit
States to place ‘‘reasonable’’ limits on the
amounts of necessary medical and remedial
care expenses recognized under State law but
not covered under the State plan. The
amendment was disapproved because CMS
found that the amendment violated the
statute for reasons set forth in the
disapproval letter.
The issues to be decided at the hearing are:
• Whether Minnesota’s SPA 05–015B
impermissibly limits the amount of incurred
expenses which may be deducted from an
institutionalized individual’s income for
purposes of the post eligibility process by
limiting these expenses to those incurred
when the individual was Medicaid eligible;
and
• Whether allowing this limitation
undermines the protection of expenses which
can be incurred when an individual is not
Medicaid eligible, which must be considered
for purposes of the medically needy spend
down.
I am scheduling a hearing on your request
for reconsideration to be held on December
4, 2006, at 233 N. Michigan Avenue, Suite
600, the Illinois Room, Chicago, IL 60601, to
reconsider the decision to disapprove SPA
05–015B. If this date is not acceptable, we
would be glad to set another date that is
mutually agreeable to the parties. The
PO 00000
Frm 00027
Fmt 4703
Sfmt 4703
61483
hearing will be governed by the procedures
prescribed by Federal regulations at 42 CFR
part 430.
I am designating Ms. Kathleen ScullyHayes 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,
Mark B. McClellan, M.D., PhD
Section 1116 of the Social Security
Act (42 U.S.C. section 1316); (42 CFR
section 430.18).
(Catalog of Federal Domestic Assistance
program No. 13.714, Medicaid Assistance
Program.)
Dated: October 5, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. E6–17368 Filed 10–17–06; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. 2004D–0228]
Guidance for Industry on Fixed Dose
Combinations, Co-Packaged Drug
Products, and Single-Entity Versions
of Previously Approved Antiretrovirals
for the Treatment of HIV; Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
SUMMARY: The Food and Drug
Administration (FDA) is announcing the
availability of a guidance for industry
entitled ‘‘Fixed Dose Combinations, CoPackaged Drug Products, and SingleEntity Versions of Previously Approved
Antiretrovirals for the Treatment of
HIV.’’ The guidance is intended to
encourage sponsors to submit to FDA
applications for fixed dose combination
(FDC), co-packaged, and single-entity
versions of antiretroviral drugs for the
treatment of human immunodeficiency
virus (HIV). The availability of a wide
range of safe and effective antiretroviral
products may help facilitate a wider
distribution of anti-HIV drugs to better
meet the demands of the global HIV/
AIDS pandemic.
DATES: Submit written or electronic
comments on agency guidances at any
time.
E:\FR\FM\18OCN1.SGM
18OCN1
Agencies
[Federal Register Volume 71, Number 201 (Wednesday, October 18, 2006)]
[Notices]
[Pages 61482-61483]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-17368]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Notice of Hearing: Reconsideration of Disapproval of Minnesota
State Plan Amendment 05-015B
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice of Hearing.
-----------------------------------------------------------------------
SUMMARY: This notice announces an administrative hearing to be held on
December 4, 2006, at 233 N. Michigan Avenue, Suite 600, the Illinois
Room, Chicago, IL 60601, to reconsider CMS' decision to disapprove
Minnesota State plan amendment 05-015B.
Closing Date: Requests to participate in the hearing as a party
must be received by the presiding officer by November 2, 2006.
FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding
[[Page 61483]]
Officer, CMS, Lord Baltimore Drive, Mail Stop LB-23-20, Baltimore,
Maryland 21244; Telephone: (410) 786-2055.
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider CMS' decision to disapprove Minnesota State plan
amendment (SPA) 05-015B which was submitted on September 28, 2005. This
SPA was disapproved on June 12, 2006.
Under this SPA, the State proposed to limit incurred medical and
remedial care expenses protected under the post eligibility process
only to those expenses incurred while an individual is eligible for
Medicaid.
Sections 1902(a)(17), and 1902(a)(51) in conjunction with section
1924 of the Social Security Act (the Act), as these sections are
refined by section 1902(r)(1), require States to take into account,
under the post eligibility process, amounts for incurred medical and
remedial care expenses that are not subject to payment by a third
party. Section 1902(r)(1)(A)(ii) of the Act and Federal regulations at
42 CFR 435.733(c)(4)(ii) permit States to place ``reasonable'' limits
on the amounts of necessary medical and remedial care expenses
recognized under State law but not covered under the State plan. The
amendment was disapproved because CMS found that the amendment violated
the statute for reasons set forth in the disapproval letter.
The issues to be decided in the hearing are:
Whether Minnesota's SPA 05-015B impermissibly limits the
amount of incurred expenses which may be deducted from an
institutionalized individual's income for purposes of the post
eligibility process by limiting these expenses to those incurred when
the individual was Medicaid eligible; and
Whether allowing this limitation undermines the protection
of expenses which can be incurred when an individual is not Medicaid
eligible, which must be considered for purposes of the medically needy
spend down.
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 Minnesota announcing an administrative hearing to
reconsider the disapproval of its SPA reads as follows:
Ms. Christine Bronson,
Medicaid Director,
Minnesota Department of Human Services,
P.O. Box 64983,
St. Paul, MN 55164-0983.
Dear Ms. Bronson: I am responding to your request for
reconsideration of the decision to disapprove the Minnesota State
plan amendment (SPA) 05-015B, which was submitted on September 28,
2005, and disapproved on June 12, 2006.
Under this SPA, the State proposed to limit incurred medical and
remedial care expenses protected under the post eligibility process
only to those expenses incurred while an individual is eligible for
Medicaid.
Sections 1902(a)(17), and 1902(a)(51) in conjunction with
section 1924 of the Social Security Act (the Act), as these sections
are refined by section 1902(r)(1), require States to take into
account, under the post eligibility process, amounts for incurred
medical and remedial care expenses that are not subject to payment
by a third party. Section 1902(r)(1)(A)(ii) of the Act and Federal
regulations at 42 CFR 435.733(c)(4)(ii) permit States to place
``reasonable'' limits on the amounts of necessary medical and
remedial care expenses recognized under State law but not covered
under the State plan. The amendment was disapproved because CMS
found that the amendment violated the statute for reasons set forth
in the disapproval letter.
The issues to be decided at the hearing are:
Whether Minnesota's SPA 05-015B impermissibly limits
the amount of incurred expenses which may be deducted from an
institutionalized individual's income for purposes of the post
eligibility process by limiting these expenses to those incurred
when the individual was Medicaid eligible; and
Whether allowing this limitation undermines the
protection of expenses which can be incurred when an individual is
not Medicaid eligible, which must be considered for purposes of the
medically needy spend down.
I am scheduling a hearing on your request for reconsideration to
be held on December 4, 2006, at 233 N. Michigan Avenue, Suite 600,
the Illinois Room, Chicago, IL 60601, to reconsider the decision to
disapprove SPA 05-015B. 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,
Mark B. McClellan, M.D., PhD
Section 1116 of the Social Security Act (42 U.S.C. section 1316);
(42 CFR section 430.18).
(Catalog of Federal Domestic Assistance program No. 13.714, Medicaid
Assistance Program.)
Dated: October 5, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E6-17368 Filed 10-17-06; 8:45 am]
BILLING CODE 4120-01-P