Medicaid Program; Premiums and Cost Sharing, 13346-13348 [E9-6907]
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13346
Federal Register / Vol. 74, No. 58 / Friday, March 27, 2009 / Rules and Regulations
SUMMARY: This correcting amendment
corrects a technical error in the
amendatory instructions of the
regulations text in the final rule entitled
‘‘Medicare Program; Surety Bond
Requirement for Suppliers of Durable
Medical Equipment, Prosthetics,
Orthotics, and Supplies (DMEPOS)’’
published in the January 2, 2009
Federal Register (74 FR 166). In that
final rule, we implemented section
1834(a)(16)(B) of the Social Security Act
(the Act) requiring certain Medicare
suppliers of durable medical equipment,
prosthetics, orthotics and supplies
(DMEPOS) to furnish CMS with a surety
bond. In addition, in the January 2, 2009
final rule, we responded to public
comments on the August 1, 2007
proposed rule (72 FR 42001). The
effective date for the January 2, 2009
final rule was March 3, 2009.
DATES: Effective Date: This correcting
amendment is effective March 27, 2009.
FOR FURTHER INFORMATION CONTACT:
Frank Whelan, (410) 786–1302.
SUPPLEMENTARY INFORMATION:
date of the provisions of a notice in
accordance with section 553(d) of the
APA (5 U.S.C. 553(d)). However, we can
waive both the notice and comment
procedure and the 30-day delay in
effective date if the Secretary finds, for
good cause, that it is impracticable,
unnecessary or contrary to the public
interest to follow the notice and
comment procedure or to comply with
the 30-day delay in the effective date,
and incorporates a statement of the
findings and the reasons in the notice.
This action merely corrects a
technical error in the January 2, 2009
final rule that was promulgated through
notice and comment rulemaking. We are
in no way changing the policy
contained in that rule. For this reason,
we find that both notice and comment
and the 30-day delay in effective date
for this action are unnecessary.
Therefore, we find there is good cause
to waive notice and comment
procedures and the 30-day delay in
effective date for this action.
I. Background and Summary of Error
List of Subjects in 42 CFR Part 424
In FR Doc. E8–30802 issued on
January 2, 2009 (74 FR 166), the final
rule entitled ‘‘Medicare Program; Surety
Bond Requirement for Suppliers of
Durable Medical Equipment,
Prosthetics, Orthotics, and Supplies
(DMEPOS), there was a technical error
that is identified and corrected in this
document. The error was the result of a
conflicting amendatory instruction in
the ‘‘Payment Policies Under the
Physician Fee Schedule and Other
Revisions to Part B for CY 2009’’ final
rule with comment period (73 FR
69726) that was effective January 1,
2009. The correction in this correcting
amendment is effective on March 27,
2009.
On page 198 of the January 2, 2009
final rule, we made a technical error in
the amendatory instruction for § 424.57.
In the first amendatory instruction 2.D.,
the phrase ‘‘Redesignating paragraphs
(d) and (e) as paragraphs (e) and (f)’’
should be corrected to read
‘‘Redesignating paragraphs (d) and (e) as
paragraphs (e) and (g).’’
Emergency medical services, Health
facilities, Health professions, Medicare.
sroberts on PROD1PC70 with RULES
II. Waiver of Proposed Rulemaking and
Delay in Effective Date
We ordinarily publish a notice of
proposed rulemaking in the Federal
Register to provide a period for public
comment before the provisions of a
notice such as this take effect, in
accordance with section 553(b) of the
Administrative Procedure Act (APA) (5
U.S.C. 553(b)). We also ordinarily
provide a 30-day delay in the effective
VerDate Nov<24>2008
15:28 Mar 26, 2009
Jkt 217001
For the reasons set forth in the
preamble, the Centers for Medicare &
Medicaid Services amends 42 CFR
chapter IV as set forth below:
■
PART 424—CONDITIONS FOR
MEDICARE PAYMENT
1. The authority citation for part 424
is revised to read as follows:
■
Authority: Secs. 1102 and 1871 of the
Social Security Act (42 U.S.C. 1302 and
1395hh).
Subpart D—To Whom Payment Is
Ordinarily Made
§ 424.57
[Amended]
2. Section 424.57 is amended by
redesignating paragraphs (d) and (e) as
paragraphs (e) and (g).
■
Authority: Catalog of Federal Domestic
Program No. 93.774, Medicare—
Supplementary Medical Insurance Program.
Dated: March 17, 2009.
Ashley Files Flory,
Acting Executive Secretary to the Department.
[FR Doc. E9–6778 Filed 3–26–09; 8:45 am]
BILLING CODE 4120–01–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 447 and 457
[CMS–2244–F3]
RIN 0938–A047
Medicaid Program; Premiums and Cost
Sharing
AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; delay of effective
date and reopening of comment period.
SUMMARY: This action temporarily
delays the effective date of the
November 25, 2008 final rule entitled,
‘‘Medicaid Program; Premiums and Cost
Sharing’’ (73 FR 71828) until December
31, 2009. In addition, this action
reopens the comment period on the
policies set out in the November 25,
2008 final rule, and specifically solicits
comments on the effect of certain
provisions of the American Recovery
and Reinvestment Act of 2009.
DATES: Effective Date. This action is
effective March 26, 2009. The effective
date of the rule amending 42 CFR parts
447 and 457 published in the November
25, 2008 Federal Register (73 FR 71828)
is delayed until December 31, 2009.
Comment Period. To be assured
consideration, comments must be
received at one of the addresses
provided below, no later than 5 p.m. on
April 27, 2009.
ADDRESSES: In commenting, please refer
to file code CMS–2244–F3. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
You may submit comments in one of
four ways (please choose only one of the
ways listed):
1. Electronically. You may submit
electronic comments on this regulation
to https://www.regulations.gov. Follow
the instructions for ‘‘Comment or
Submission’’ and enter the file code to
find the document accepting comments.
2. By regular mail. You may mail
written comments (one original and two
copies) to the following address ONLY:
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Attention: CMS–2244–
F3, P.O. Box 8010, Baltimore, MD
21244–8010.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments (one
E:\FR\FM\27MRR1.SGM
27MRR1
Federal Register / Vol. 74, No. 58 / Friday, March 27, 2009 / Rules and Regulations
original and two copies) to the following
address ONLY: Centers for Medicare &
Medicaid Services, Department of
Health and Human Services, Attention:
CMS–2244–F3, Mail Stop C4–26–05,
7500 Security Boulevard, Baltimore, MD
21244–8010.
4. By hand or courier. If you prefer,
you may deliver (by hand or courier)
your written comments (one original
and two copies) before the close of the
comment period to either of the
following addresses:
a. Room 445–G, Hubert H. Humphrey
Building, 200 Independence Avenue,
SW., Washington, DC 20201.
(Because access to the interior of the
HHH Building is not readily available to
persons without Federal Government
identification, commenters are
encouraged to leave their comments in
the CMS drop slots located in the main
lobby of the building. A stamp-in clock
is available for persons wishing to retain
a proof of filing by stamping in and
retaining an extra copy of the comments
being filed.)
b. 7500 Security Boulevard,
Baltimore, MD 21244–1850.
If you intend to deliver your
comments to the Baltimore address,
please call telephone number (410) 786–
9994 in advance to schedule your
arrival with one of our staff members.
Comments mailed to the addresses
indicated as appropriate for hand or
courier delivery may be delayed and
received after the comment period.
FOR FURTHER INFORMATION CONTACT:
Christine Gerhardt, (410) 786–0693.
SUPPLEMENTARY INFORMATION:
I. Background
sroberts on PROD1PC70 with RULES
A. Regulatory History
On November 25, 2008, we published
a final rule entitled ‘‘Medicaid Program;
Premiums and Cost Sharing’’ in the
Federal Register to implement and
interpret the provisions of sections
6041, 6042, and 6043 of the Deficit
Reduction Act of 2005 (DRA), and
section 405(a)(1) of the Tax Relief and
Health Care Act of 2006 (TRHCA) (73
FR 71828). The DRA was amended by
the TRHCA which revised sections
6041, 6042, and 6043 of the DRA
including limitations on cost sharing for
individuals with family incomes at or
below 100 percent of the Federal
poverty line. These sections amended
the Social Security Act (the Act) by
adding a new section 1916A to provide
State Medicaid agencies with increased
flexibility to impose premium and cost
sharing requirements on certain
Medicaid recipients. The final rule
allowed for flexibility to supplement the
VerDate Nov<24>2008
15:28 Mar 26, 2009
Jkt 217001
existing authority States have to impose
premiums and cost sharing under
section 1916 of the Act. The DRA
provisions also specifically address cost
sharing for non-preferred drugs and
non-emergency care furnished in a
hospital emergency department. In
addition, in the November 25, 2008 final
rule, we responded to public comments
on the February 22, 2008 proposed rule
(73 FR 9727).
Subsequent to the publication of the
November 25, 2008 final rule, in
accordance with the memorandum of
January 20, 2009 from the Assistant to
the President and the Chief of Staff,
entitled ‘‘Regulatory Review,’’ we
published a final rule in the Federal
Register to temporarily delay for 60
days the effective date of the November
25, 2008 final rule entitled, ‘‘Medicaid
Program; Premiums and Cost Sharing’’
(January 27, 2009, 74 FR 4888). The
final rule also reopened the comment
period on the policies set out in the
November 25, 2008 final rule. We
received 5 public comments in response
to the January 27, 2009 final rule.
B. New Legislation
The American Recovery and
Reinvestment Act of 2009 (ARRA), Pub.
L. 111–5, was enacted on February 17,
2009. Certain provisions of ARRA affect
current regulations regarding premiums
and cost sharing. Specifically, section
5006(a) of ARRA added section 1916(j)
to the Social Security Act (the Act) to
provide that effective December 31,
2009, the Medicaid program and the
Children’s Health Insurance Program
(CHIP) are prohibited from imposing an
enrollment fee, premium, or similar
charge, or deduction, copayment, costsharing or similar charge on American
Indians and Alaska Natives for services
provided directly by the Indian Health
Service, an Indian Tribe, Tribal
Organization, or Urban Indian
Organization or through referral under
contract health services for which
payment may be made.
II. Provisions of the Final Rule
This action delays the effective date of
the November 25, 2008 final rule. The
effective date of that rule, which would
have been March 27, 2009, is now
December 31, 2009. Upon review and
consideration of the new provisions of
ARRA and the public comments we
received during the reopened comment
period, we believe that it may be
necessary to revise a substantial portion
of the November 25, 2008 final rule.
Therefore, to inform future rulemaking
on this issue, we are delaying the
effective date a second time to give the
public an additional opportunity to
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13347
submit additional comments on the
policy set forth in the November 25,
2008 final rule as well as the provisions
of ARRA, discussed above. We
anticipate that this time period will
allow sufficient time for CMS to
consider such comments and develop
appropriate revisions to the delayed
rule.
IV. Waiver of Proposed Rulemaking
and Delay in Effective Date
We ordinarily publish a notice of
proposed rulemaking in the Federal
Register to provide a period for public
comment before the provisions of a
notice such as this take effect, in
accordance with section 553(b) of the
Administrative Procedure Act (APA) (5
U.S.C. 553(b)). We also ordinarily
provide a 30-day delay in the effective
date of the provisions of a notice in
accordance with section 553(d) of the
APA (5 U.S.C. 553(d)). However, we can
waive both the notice and comment
procedure and the 30-day delay in
effective date if the Secretary finds, for
good cause, that it is impracticable,
unnecessary or contrary to the public
interest to follow the notice and
comment procedure or to comply with
the 30-day delay in the effective date,
and incorporates a statement of the
finding and the reasons in the notice.
This final rule delays the effective
date of the final rule that was
promulgated through notice and
comment rulemaking, and does not
make substantive changes to the policies
that were finalized in the final rule.
Delay in the effective date and
reopening of the comment period is
necessary to ensure that the final rule
fully takes into account public
comments, and conforms to recently
enacted legislation, before the rule
becomes effective. We do not believe
that there will be any adverse impact or
effect on the public from this delay in
the effective date. Moreover, it would
not be in the public interest for the
underlying rule to go into effect, or to
have uncertainty about whether it is in
effect, when the underlying rule does
not conform to statutory requirements.
In addition, it is not in the public
interest to put into effect a rule that we
intend to revise in a reasonable time
frame after fully taking into account
public comment. For the reasons stated
above, we find that both notice and
comment procedures and the 30-day
delay in effective date for this final rule
are unnecessary and contrary to the
public interest. Therefore, we find there
is good cause to waive notice and
comment procedures and the 30-day
delay in effective date for this final rule.
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13348
Federal Register / Vol. 74, No. 58 / Friday, March 27, 2009 / Rules and Regulations
(Catalog of Federal Domestic Assistance
Program No. 93.778, Medical Assistance
Program)
(TAL) is listed as 4, 170 mt. In the third
column, the commercial quota is listed
at 3,123 mt, and the recreational harvest
limit is listed as 965 mt.
The corrected values for these scup
specification values are as follows: The
2009 proposed TAC is 5,307 mt, the
final rule TAC is 7,049 mt, the final rule
TAL is 5,071 mt, the commercial quota
is 3,798 mt, and the recreational harvest
limit is 1,173 mt.
The black sea bass commercial quota
in the first column of page 35 is listed
as 1,043 mt. The corrected value for the
commercial quota is 495 mt.
Dated: March 20, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Approved: March 24, 2009.
Charles E. Johnson,
Acting Secretary.
[FR Doc. E9–6907 Filed 3–24–09; 4:15 pm]
BILLING CODE 4120–01–P
DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric
Administration
50 CFR Part 648
[Docket No. 090311306–9309–01]
RIN 0648–XN88
Fisheries of the Northeastern United
States; Summer Flounder, Scup, and
Black Sea Bass Fisheries; 2009 Scup
and Black Sea Bass Specifications;
Correction
sroberts on PROD1PC70 with RULES
AGENCY: National Marine Fisheries
Service (NMFS), National Oceanic and
Atmospheric Administration (NOAA),
Commerce.
ACTION: Final rule; correction.
SUMMARY: On January 2, 2009, NMFS
published in the Federal Register a final
rule containing final specifications for
the 2009 scup and black sea bass
fisheries. On six occasions in the
preamble text of that rule, the English
system of measurement in pounds for
various iterations of the scup and black
sea bass specifications were incorrectly
converted into metric system of
measurement equivalents. This
document corrects those values to
insure that the metric values are
consistent with the 2009 specifications.
DATES: Effective March 27, 2009,
through December 31, 2009.
FOR FURTHER INFORMATION CONTACT:
Michael Ruccio, Fishery Policy Analyst,
(978) 281–9104.
SUPPLEMENTARY INFORMATION: The final
rule, including final quota specifications
(i.e., commercial quota and recreational
harvest limit) for the 2009 summer
flounder, scup, and black sea bass
fisheries was published in the Federal
Register on January 2, 2009 (74 FR 29).
On page 32, in the first column, the
proposed scup Total Allowable Catch
(TAC) is listed as 5,339 metric tons (mt),
the TAC implemented by the final rule
in the second column is listed as 5,796
mt, and the Total Allowable Landings
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15:28 Mar 26, 2009
Jkt 217001
Classification
Pursuant to 5 U.S.C. 553(b)(B), the
Assistant Administrator finds good
cause to waive prior notice and
opportunity for additional public
comment for this action because any
delay of this action would be contrary
to the public interest. As explained
above, this rule corrects various metric
values for the 2009 scup TAC, TAL,
commercial quota, and recreational
harvest limit and black sea bass
commercial quota that had already been
published in the Federal Register. In the
final specifications rule published
January 2, 2009 (74 FR 29), the various
quota iterations were correctly listed in
the English system of measurement.
These values were inadvertently
converted to the metric system utilizing
the incorrect conversion factor and thus,
the metric values listed in the final
specifications rule are not correct or
equal to the English system values. To
delay this correction notice would cause
confusion over the aforementioned
available 2009 scup and black sea bass
harvest levels because of the disparity
between the English system of
measurement, in pounds, and the metric
expression of those same values, in
metric tons that were incorrectly
converted in the original specifications
that published January 2, 2009 (74 FR
29). Moreover, pursuant to 5 U.S.C.
553(d), the Assistant Administrator
finds good cause to waive the 30-day
delay in effective date for the reasons
given above. Delaying the rule for 30
days may negatively impact fishermen
accustomed to referring to the metric
system of measurement because the
values for the aforementioned harvest
levels were incorrectly converted from
the English system of measurement in
the final specifications. The immediate
publication of the correct information
will rectify any confusion on the matter
of what the metric expression of the
2009 scup and black sea bass harvest
levels should be.
Because prior notice and opportunity
for public comment are not required for
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this rule by 5 U.S.C. 553, or any other
law, the analytical requirements of the
Regulatory Flexibility Act, 5 U.S.C. 601
et seq., are inapplicable.
This final rule is exempt from review
under Executive Order 12866.
Correction
Accordingly, the final rule FR Doc.
E8–31236, published on January 2, 2009
(74 FR 29), is corrected as follows:
1. On page 32:
a. In the first column, in the last
paragraph, in the seventh line, ‘‘(5, 339–
mt) scup Total Allowable Catch’’ is
corrected to read ‘‘(5,307- mt) , scup
Total Allowable Catch’’ and in the
second column, in the last paragraph, in
the second line, ‘‘(5,796–mt) scup TAC’’
is corrected to read ‘‘(7,049 -mt) scup
TAC’’, and in the third line, ‘‘(4,170–mt)
scup TAL.’’is corrected to read ‘‘(5,071mt) scup TAL’’.
b. In the third column, in the seventh
line, ‘‘commercial quota of 8,373,848 lb
(3,123 mt) is corrected to read
‘‘commercial quota of 8,373,848 lb
(3,798 mt) and in the eighth and ninth
lines, ‘‘recreational harvest limit of
2,585,952 lb (965 mt).’’ is corrected to
read ‘‘recreational harvest limit of
2,585,952 lb (1, 173 mt).’’
2. On page 35, in the first column, in
the fourth line, ‘‘(1,048–mt) black sea
bass TAL.’’ is corrected to read ‘‘(495–
mt) black sea bass TAL.’’
Dated: March 23, 2009
Samuel D. Rauch III,
Deputy Assistant Administrator For
Regulatory Programs, National Marine
Fisheries Service.
[FR Doc. E9–6898 Filed 3–26–09; 8:45 am]
BILLING CODE 3510–22–S
DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric
Administration
50 CFR Part 679
[Docket No. 080103016–9316–02]
RIN 0648–AW40
Fisheries of the Exclusive Economic
Zone Off Alaska; Revise Maximum
Retainable Amounts of Groundfish
Using Arrowtooth Flounder as a Basis
Species in the Gulf of Alaska
AGENCY: National Marine Fisheries
Service (NMFS), National Oceanic and
Atmospheric Administration (NOAA),
Commerce.
ACTION: Final rule.
SUMMARY: NMFS issues a regulation to
revise the maximum retainable amounts
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]]>Agencies
[Federal Register Volume 74, Number 58 (Friday, March 27, 2009)]
[Rules and Regulations]
[Pages 13346-13348]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-6907]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 447 and 457
[CMS-2244-F3]
RIN 0938-A047
Medicaid Program; Premiums and Cost Sharing
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; delay of effective date and reopening of comment
period.
-----------------------------------------------------------------------
SUMMARY: This action temporarily delays the effective date of the
November 25, 2008 final rule entitled, ``Medicaid Program; Premiums and
Cost Sharing'' (73 FR 71828) until December 31, 2009. In addition, this
action reopens the comment period on the policies set out in the
November 25, 2008 final rule, and specifically solicits comments on the
effect of certain provisions of the American Recovery and Reinvestment
Act of 2009.
DATES: Effective Date. This action is effective March 26, 2009. The
effective date of the rule amending 42 CFR parts 447 and 457 published
in the November 25, 2008 Federal Register (73 FR 71828) is delayed
until December 31, 2009.
Comment Period. To be assured consideration, comments must be
received at one of the addresses provided below, no later than 5 p.m.
on April 27, 2009.
ADDRESSES: In commenting, please refer to file code CMS-2244-F3.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit comments in one of four ways (please choose only one
of the ways listed):
1. Electronically. You may submit electronic comments on this
regulation to https://www.regulations.gov. Follow the instructions for
``Comment or Submission'' and enter the file code to find the document
accepting comments.
2. By regular mail. You may mail written comments (one original and
two copies) to the following address ONLY: Centers for Medicare &
Medicaid Services, Department of Health and Human Services, Attention:
CMS-2244-F3, P.O. Box 8010, Baltimore, MD 21244-8010.
Please allow sufficient time for mailed comments to be received
before the close of the comment period.
3. By express or overnight mail. You may send written comments (one
[[Page 13347]]
original and two copies) to the following address ONLY: Centers for
Medicare & Medicaid Services, Department of Health and Human Services,
Attention: CMS-2244-F3, Mail Stop C4-26-05, 7500 Security Boulevard,
Baltimore, MD 21244-8010.
4. By hand or courier. If you prefer, you may deliver (by hand or
courier) your written comments (one original and two copies) before the
close of the comment period to either of the following addresses:
a. Room 445-G, Hubert H. Humphrey Building, 200 Independence
Avenue, SW., Washington, DC 20201.
(Because access to the interior of the HHH Building is not readily
available to persons without Federal Government identification,
commenters are encouraged to leave their comments in the CMS drop slots
located in the main lobby of the building. A stamp-in clock is
available for persons wishing to retain a proof of filing by stamping
in and retaining an extra copy of the comments being filed.)
b. 7500 Security Boulevard, Baltimore, MD 21244-1850.
If you intend to deliver your comments to the Baltimore address,
please call telephone number (410) 786-9994 in advance to schedule your
arrival with one of our staff members.
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and received after the comment
period.
FOR FURTHER INFORMATION CONTACT: Christine Gerhardt, (410) 786-0693.
SUPPLEMENTARY INFORMATION:
I. Background
A. Regulatory History
On November 25, 2008, we published a final rule entitled ``Medicaid
Program; Premiums and Cost Sharing'' in the Federal Register to
implement and interpret the provisions of sections 6041, 6042, and 6043
of the Deficit Reduction Act of 2005 (DRA), and section 405(a)(1) of
the Tax Relief and Health Care Act of 2006 (TRHCA) (73 FR 71828). The
DRA was amended by the TRHCA which revised sections 6041, 6042, and
6043 of the DRA including limitations on cost sharing for individuals
with family incomes at or below 100 percent of the Federal poverty
line. These sections amended the Social Security Act (the Act) by
adding a new section 1916A to provide State Medicaid agencies with
increased flexibility to impose premium and cost sharing requirements
on certain Medicaid recipients. The final rule allowed for flexibility
to supplement the existing authority States have to impose premiums and
cost sharing under section 1916 of the Act. The DRA provisions also
specifically address cost sharing for non-preferred drugs and non-
emergency care furnished in a hospital emergency department. In
addition, in the November 25, 2008 final rule, we responded to public
comments on the February 22, 2008 proposed rule (73 FR 9727).
Subsequent to the publication of the November 25, 2008 final rule,
in accordance with the memorandum of January 20, 2009 from the
Assistant to the President and the Chief of Staff, entitled
``Regulatory Review,'' we published a final rule in the Federal
Register to temporarily delay for 60 days the effective date of the
November 25, 2008 final rule entitled, ``Medicaid Program; Premiums and
Cost Sharing'' (January 27, 2009, 74 FR 4888). The final rule also
reopened the comment period on the policies set out in the November 25,
2008 final rule. We received 5 public comments in response to the
January 27, 2009 final rule.
B. New Legislation
The American Recovery and Reinvestment Act of 2009 (ARRA), Pub. L.
111-5, was enacted on February 17, 2009. Certain provisions of ARRA
affect current regulations regarding premiums and cost sharing.
Specifically, section 5006(a) of ARRA added section 1916(j) to the
Social Security Act (the Act) to provide that effective December 31,
2009, the Medicaid program and the Children's Health Insurance Program
(CHIP) are prohibited from imposing an enrollment fee, premium, or
similar charge, or deduction, copayment, cost-sharing or similar charge
on American Indians and Alaska Natives for services provided directly
by the Indian Health Service, an Indian Tribe, Tribal Organization, or
Urban Indian Organization or through referral under contract health
services for which payment may be made.
II. Provisions of the Final Rule
This action delays the effective date of the November 25, 2008
final rule. The effective date of that rule, which would have been
March 27, 2009, is now December 31, 2009. Upon review and consideration
of the new provisions of ARRA and the public comments we received
during the reopened comment period, we believe that it may be necessary
to revise a substantial portion of the November 25, 2008 final rule.
Therefore, to inform future rulemaking on this issue, we are delaying
the effective date a second time to give the public an additional
opportunity to submit additional comments on the policy set forth in
the November 25, 2008 final rule as well as the provisions of ARRA,
discussed above. We anticipate that this time period will allow
sufficient time for CMS to consider such comments and develop
appropriate revisions to the delayed rule.
IV. Waiver of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a notice such as this take effect, in accordance with
section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C.
553(b)). We also ordinarily provide a 30-day delay in the effective
date of the provisions of a notice in accordance with section 553(d) of
the APA (5 U.S.C. 553(d)). However, we can waive both the notice and
comment procedure and the 30-day delay in effective date if the
Secretary finds, for good cause, that it is impracticable, unnecessary
or contrary to the public interest to follow the notice and comment
procedure or to comply with the 30-day delay in the effective date, and
incorporates a statement of the finding and the reasons in the notice.
This final rule delays the effective date of the final rule that
was promulgated through notice and comment rulemaking, and does not
make substantive changes to the policies that were finalized in the
final rule. Delay in the effective date and reopening of the comment
period is necessary to ensure that the final rule fully takes into
account public comments, and conforms to recently enacted legislation,
before the rule becomes effective. We do not believe that there will be
any adverse impact or effect on the public from this delay in the
effective date. Moreover, it would not be in the public interest for
the underlying rule to go into effect, or to have uncertainty about
whether it is in effect, when the underlying rule does not conform to
statutory requirements. In addition, it is not in the public interest
to put into effect a rule that we intend to revise in a reasonable time
frame after fully taking into account public comment. For the reasons
stated above, we find that both notice and comment procedures and the
30-day delay in effective date for this final rule are unnecessary and
contrary to the public interest. Therefore, we find there is good cause
to waive notice and comment procedures and the 30-day delay in
effective date for this final rule.
[[Page 13348]]
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program)
Dated: March 20, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare & Medicaid Services.
Approved: March 24, 2009.
Charles E. Johnson,
Acting Secretary.
[FR Doc. E9-6907 Filed 3-24-09; 4:15 pm]
BILLING CODE 4120-01-P
