Notice of Hearing: Reconsideration of Disapproval of Ohio State Plan Amendment (SPA) 07-014, 11647-11648 [E8-4068]

Agencies

• Centers for Medicare & Medicaid Services
• Department of Health and Human Services (hhs)

[Federal Register Volume 73, Number 43 (Tuesday, March 4, 2008)]
[Notices]
[Pages 11647-11648]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-4068]



[[Page 11647]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval of Ohio State 
Plan Amendment (SPA) 07-014

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of Hearing.

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SUMMARY: This notice announces an administrative hearing to be held on 
April 4, 2008, at the CMS Chicago Regional Office, 233 N. Michigan 
Avenue, Suite 600, the Illinois Room, Chicago, IL 60601-5519, to 
reconsider CMS' decision to disapprove Ohio SPA 07-014.
    Closing Date: Requests to participate in the hearing as a party 
must be received by the presiding officer by March 19, 2008.

FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding 
Officer, CMS, 2520 Lord Baltimore Drive, Suite L, Baltimore, Maryland 
21244, Telephone: (410) 786-2055.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider CMS' decision to disapprove Ohio SPA 07-014, 
which was submitted on September 28, 2007, and disapproved on December 
20, 2007.
    Under this SPA, the State proposed to expand Medicaid eligibility 
by excluding all family income that is between 201 percent of the 
Federal poverty level (FPL) and 300 percent of the FPL in calculating 
income for purposes of determining eligibility. As a result, although 
the plan nominally provides for eligibility of optional targeted low-
income children only for those with family income through 200 percent 
of the FPL, in effect, the eligibility level would rise to 300 percent 
of the FPL.
    The amendment was disapproved because it indicated that the State 
will claim Federal matching funds at a rate other than the rate set 
forth in the Social Security Act (the Act), and thus, is not consistent 
with methods of administration necessary for proper and efficient 
operation of the plan, as required by section 1902(a)(4) of the Act.
    At the hearing:
     The disapproval of this SPA will be discussed. The SPA was 
disapproved because the State declared its intent and was unwilling to 
change its intent to claim Federal matching funds at the regular 
matching rate, rather than the enhanced matching rate set forth in the 
Act, for the expanded population optional targeted low-income children, 
with income between 201 percent and 300 percent of the FPL.
     Section 1903(a)(1) of the Act requires that the Secretary 
pay the Federal medical assistance percentage (FMAP) of claimed State 
expenditures under the approved plan. The FMAP is defined at section 
1905(b) of the Act. This section provides that the Federal matching 
rate for children described in section 1905(u)(2)(B) or (u)(3) of the 
Act ``is equal to the enhanced FMAP described in section 2105(b)'' of 
the Act, unless the State has exhausted its allotment under section 
2104 of the Act, under the State Children's Health Insurance Program, 
or failed to comply with maintenance of effort and proper reporting 
requirements. Since none of those conditions appear to apply, and the 
expansion group is comprised of individuals who are described in 
section 1905(u)(2)(B) of the Act, the enhanced FMAP is the applicable 
FMAP rate, and claims at any other rate would not be consistent with 
proper and efficient administration of the State plan.
     The State's proposal was not consistent with methods of 
administration necessary for proper and efficient operation of the 
plan, as required by section 1902(a)(4) of the Act, because the State 
indicated in its overall submission that the State did not plan to 
submit claims at the statutorily indicated FMAP rate.
    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 Ohio announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Ara Mekhjian, Esq.,
Assistant Attorney General,
State of Ohio,
Health and Human Services Section,
30 E. Broad Street, 26th Floor,
Columbus, OH 43215-3400.

Dear Mr. Mekhjian:

    I am responding to your request for reconsideration of the 
decision to disapprove the Ohio State plan amendment (SPA) 07-014, 
which was submitted on September 28, 2007, and disapproved on 
December 20, 2007.
    Under this SPA, the State proposed to expand Medicaid 
eligibility by excluding all family income that is between 201 
percent of the Federal poverty level (FPL) and 300 percent of the 
FPL in calculating income for purposes of determining eligibility. 
As a result, although the plan nominally provides for eligibility of 
optional targeted low-income children only for those with family 
income through 200 percent of the FPL, in effect, the eligibility 
level would rise to 300 percent of the FPL.
    The amendment was disapproved because it indicated that the 
State will claim Federal matching funds at a rate other than the 
rate set forth in the Social Security Act (the Act), and thus, is 
not consistent with methods of administration necessary for proper 
and efficient operation of the plan, as required by section 
1902(a)(4) of the Act.
    At the hearing:
     The disapproval of this SPA will be discussed. The SPA 
was disapproved because the State declared its intent and was 
unwilling to change its intent to claim Federal matching funds at 
the regular matching rate, rather than the enhanced matching rate 
set forth in the Act, for the expanded population optional targeted 
low-income children, with income between 201 percent and 300 percent 
of the FPL.
     Section 1903(a)(1) of the Act requires that the 
Secretary pay the Federal medical assistance percentage (FMAP) of 
claimed State expenditures under the approved plan. The FMAP is 
defined at section 1905(b) of the Act. This section provides that 
the Federal matching rate for children described in section 
1905(u)(2)(B) or (u)(3) of the Act ``is equal to the enhanced FMAP 
described in section 2105(b)'' of the Act, unless the State has 
exhausted its allotment under section 2104 of the Act, under the 
State Children's Health Insurance Program, or failed to comply with 
maintenance of effort and proper reporting requirements. Since none 
of those conditions appear to apply, and the expansion group is 
comprised of individuals who are described in section 1905(u)(2)(B) 
of the Act, the enhanced FMAP is the applicable FMAP rate, and 
claims at any other rate would not be consistent with proper and 
efficient administration of the State plan.
     The State's proposal was not consistent with methods of 
administration necessary for proper and efficient operation of the 
plan, as required by section 1902(a)(4) of the Act, because the 
State indicated in its overall

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submission that the State did not plan to submit claims at the 
statutorily indicated FMAP rate.
    I am scheduling a hearing at your request for reconsideration to 
be held on April 4, 2008, at the Centers for Medicare & Medicaid 
Services' Chicago Regional Office, 233 N. Michigan Avenue, Suite 
600, the Illinois Room, Chicago, IL 60601-5519, to reconsider the 
decision to disapprove SPA 07-014. 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,

Kerry Weems,
Acting Administrator.

(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: February 25, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
 [FR Doc. E8-4068 Filed 3-3-08; 8:45 am]
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