Notice of Hearing: Reconsideration of Disapproval Texas Medicaid State Plan Amendment (SPA) 13-0045-MM2 and Texas Children's Health Insurance Program SPA 13-0035, 38034-38036 [2014-15615]
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38034
Federal Register / Vol. 79, No. 128 / Thursday, July 3, 2014 / Notices
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. The term ‘‘collection of
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
includes agency requests or
requirements that members of the public
submit reports, keep records, or provide
information to a third party. Section
3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-day notice in the
Federal Register concerning each
proposed collection of information,
including each proposed extension or
reinstatement of an existing collection
of information, before submitting the
collection to OMB for approval. To
comply with this requirement, CMS is
publishing this notice that summarizes
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Durable Medical
Equipment, Prosthetics, Orthotics and
Supplies (DMEPOS) Competitive
Bidding Program; Use: Section 302 of
the MMA amended section 1847 of the
Social Security Act (the Act) to require
the implementation of the DMEPOS
competitive bidding program. The Act
provided the program requirements for
the submission of bids in establishing
payment rates and the awarding of
contracts; provided the requirements for
mergers and acquisitions; and a
requirement for the Secretary to recompete contracts not less often than
once every 3 years. The MMA also
requires the Secretary to re-compete
contracts not less often than once every
3 years. The Round 1 Rebid contract
period for all product categories except
mail-order diabetic supplies expired on
December 31, 2013. (Round 1 Rebid
contracts for mail-order diabetic testing
supplies ended on December 31, 2012.)
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The competition for the Round 1 Recompete began in August of 2012. The
Round 1 Re-compete contracts and
prices became effective on January 1,
2014 and will expire on December 31,
2016. Round 2 and National Mail-Order
contracts and prices will expire on June
30, 2016.
The most recent approval for this
information collection request (ICR) was
issued by OMB on June 10, 2013. That
ICR included the estimated burden to
collect the information in bidding
Forms A and B for the Round 1 Recompete. We are now seeking approval
to collect the information in Forms A
and B for competitions that will occur
before 2017. For these upcoming
competitions CMS will publish a
slightly modified version of the RFB
instructions and accompanying Forms A
and B so that suppliers will be better
able to identify and understand the
requirements of the program. We
decided to modify the Request for Bids
(RFB) instructions and forms based on
our experience from the last round of
competition. The end result is expected
to produce more complete and accurate
information to evaluate suppliers. No
new collection requirements have been
added to the modified RFB instructions
or Form A or B. Finally, we are retaining
without change the Change of
Ownership (CHOW) Purchaser Form
and the CHOW Contract Supplier
Notification Form, the Subcontracting
Disclosure Form, and Forms C and D
and their associated burden under this
ICR. We intend to continue use of these
forms on an ongoing basis.
Form Number: CMS–10169 (OMB
control number: 0938–1016); Frequency:
Occasionally; Affected Public: Private
Sector—Business or other for-profits
and Individuals or Households; Number
of Respondents: 49,625; Total Annual
Responses: 39,380; Total Annual Hours:
235,024. (For policy questions regarding
this collection contact Michael Keane at
410–786–4495.)
Dated: June 27, 2014.
Martique Jones,
Deputy Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2014–15603 Filed 7–2–14; 8:45 am]
BILLING CODE 4120–01–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
Notice of Hearing: Reconsideration of
Disapproval Texas Medicaid State Plan
Amendment (SPA) 13–0045–MM2 and
Texas Children’s Health Insurance
Program SPA 13–0035
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of hearing:
reconsideration of disapproval.
AGENCY:
This notice announces an
administrative hearing to be held on
August 14, 2014, at the Department of
Health and Human Services, Centers for
Medicare and Medicaid Services,
Division of Medicaid & Children’s
Health, Dallas Regional Office, 1301
Young Street, Room #801, 8th Floor
Dallas, Texas 75202 to reconsider CMS’
decision to disapprove Texas’ Medicaid
SPA 13–0045–MM2 and the CHIP SPA
13–0035.
Closing Date: Requests to participate
in the hearing as a party must be
received by the presiding officer by (15
days after publication).
FOR FURTHER INFORMATION CONTACT:
Benjamin R. Cohen, Presiding Officer,
CMS, 2520 Lord Baltimore Drive, Suite
L, Baltimore, Maryland 21244,
Telephone: (410) 786–3169.
SUPPLEMENTARY INFORMATION: This
notice announces an administrative
hearing to reconsider CMS’ decision to
disapprove the Texas Medicaid SPA 13–
0045–MM2 and the Children’s Health
Insurance Program (CHIP) SPA 13–0035
which were submitted to the Centers for
Medicare and Medicaid Services (CMS)
on December 31, 2013 and disapproved
on March 31, 2014. In part, these SPAs
request CMS approval of the state’s
proposed alternative single, streamlined
application, both a paper version and
online version, for completing an
eligibility determination based on
modified adjusted gross income (MAGI).
Specifically, Texas’s proposals requiring
all applicants to submit information on
assets and provide detailed information
on absent parents make the application
longer and the information is not
necessary for completing an eligibility
determination based on MAGI.
The issues to be considered at the
hearing are:
• Whether Texas Medicaid SPA 13–
0045–MM2, complied with the statutory
requirement in section 1902(a)(19) of
the Social Security Act (the Act), under
which the state plan must assure that
eligibility for care and services under
SUMMARY:
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tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 128 / Thursday, July 3, 2014 / Notices
the plan will be determined and
provided in a manner consistent with
the simplicity of administration and the
best interests of the recipients.
Requiring applicants to provide
additional detailed information, which
is not necessary for determining their
eligibility for coverage, is inconsistent
with simplicity of administration of the
state plan and is not in the best interests
of Medicaid recipients or applicants.
• Whether Texas CHIP SPA 13–0035,
complied with section 2101(a) of the
Act which specifies that the state plan
must assure that eligibility for care and
services must be provided in an
effective and efficient manner.
Requiring applicants to provide
additional detailed information, which
is not necessary for determining their
eligibility for coverage, is inconsistent
with simplicity of administration of the
state plan and is not in the best interests
of CHIP recipients or applicants.
• Whether the state failed to comply
with section 1902(e)(14)(C) of the Act,
as added by section 2002 of the
Affordable Care Act, and section
2102(b)(1)(B)(v) of the Act, as added by
section 2101 of the Affordable Care Act,
which prohibit the use of asset or
resource tests as criteria for Medicaid
and CHIP eligibility among eligibility
groups subject to MAGI, including
children, pregnant women, parents, and,
if eligible in a state, other nondisabled,
nonelderly adults. Consistent with these
statutory provisions, questions about
assets and resources were not included
in the Secretary’s model single
streamlined application, which was
released on April 30, 2013.
• Whether the state complied with
the requirements of sections 1902(a)(4)
and 2101(a) of the Act, as implemented
in 42 CFR 435.907 and 42 CFR 457.330,
for approval of an alternative single,
streamlined application. While an
alternative application may be tailored
to accommodate state preferences and
policies, it must also reflect the general
principles of the model application and
must comply with the applicable
provisions of law and regulation. The
regulations at 42 CFR 435.907 and 42
CFR 457.330 note specifically that the
alternative application may be no more
burdensome on the applicant than the
model application. CMS guidance
released June 18, 2013 further clarified
that the application may only include
questions that ‘‘are necessary for
determining eligibility for coverage in a
Qualified Health Plan (QHP) and all
insurance affordability programs, or the
administration of these programs.’’
Section 1116 of the Act and federal
regulations at 42 CFR part 430, establish
Department procedures that provide an
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16:53 Jul 02, 2014
Jkt 232001
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 Texas announcing an
administrative hearing to reconsider the
disapproval of its SPAs reads as follows:
Ms. Kay Ghahremani, State Medicaid
Director, Texas Health and Human Services
Commission, P.O. Box 13247, Austin, TX
78711.
Dear Ms. Ghahremani:
I am responding to your request for
reconsideration of the decision to disapprove
Texas’s Medicaid state plan amendment
(SPA) 13–0045–MM2 and the Children’s
Health Insurance Program (CHIP) SPA 13–
0035, which were submitted to the Centers
for Medicare and Medicaid Services (CMS)
on December 31, 2013 and disapproved on
March 31, 2014. I am scheduling a hearing
on your request for reconsideration to be held
on August 14, 2014, at the Department of
Health and Human Services, Centers for
Medicare and Medicaid Services, Division of
Medicaid & Children’s Health, Dallas
Regional Office, 1301 Young Street, Room
#801, Dallas, Texas 75202.
In part, these SPAs request CMS approval
of the state’s proposed alternative single,
streamlined application, both a paper version
and online version, for completing an
eligibility determination based on modified
adjusted gross income (MAGI). Specifically,
Texas’s proposals requiring all applicants to
submit information on assets and provide
detailed information on absent parents make
the application longer and the information is
not necessary for completing an eligibility
determination based on MAGI.
In your request for reconsideration, you
described changes that the state is
considering with respect to these SPAs, and
we will continue to talk with you about these
changes. In the event that CMS and the state
come to agreement on resolution of the
issues, which formed the basis for
disapproval, these SPAs may be moved to
approval prior to the scheduled hearing.
The issues to be considered at the hearing
are:
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38035
• Whether Texas Medicaid SPA 13–0045–
MM2, complied with the statutory
requirement in section 1902(a)(19) of the
Social Security Act (the Act), under which
the state plan must assure that eligibility for
care and services under the plan will be
determined and provided in a manner
consistent with simplicity of administration
and the best interests of the recipients.
Requiring applicants to provide additional
detailed information, which is not necessary
for determining their eligibility for coverage,
is inconsistent with the simplicity of
administration of the state plan and is not in
the best interests of Medicaid recipients or
applicants.
• Whether Texas CHIP SPA 13–0035,
complied with section 2101(a) of the Act
which specifies that the state plan must
assure that eligibility for care and services
must be provided in an effective and efficient
manner. Requiring applicants to provide
additional detailed information, which is not
necessary for determining their eligibility for
coverage, is inconsistent with simplicity of
administration of the state plan and is not in
the best interests of CHIP recipients or
applicants.
• Whether the state failed to comply with
section 1902(e)(14)(C) of the Act, as added by
section 2002 of the Affordable Care Act, and
section 2102(b)(1)(B)(v) of the Act, as added
by section 2101 of the Affordable Care Act
which prohibit the use of asset or resource
tests as criteria for Medicaid and CHIP
eligibility among eligibility groups subject to
MAGI, including children, pregnant women,
parents, and, if eligible in a state, other
nondisabled, nonelderly adults. Consistent
with these statutory provisions, questions
about assets and resources were not included
in the Secretary’s model single streamlined
application, which was released on April 30,
2013.
• Whether the state complied with the
requirements of sections 1902(a)(4) and
2101(a) of the Act, as implemented in 42 CFR
435.907 and 42 CFR 457.330, for approval of
an alternative single, streamlined
application. While an alternative application
may be tailored to accommodate state
preferences and policies, it must also reflect
the general principles of the model
application and must comply with the
applicable provisions of law and regulation.
The regulations at 42 CFR 435.907 and 42
CFR 457.330 note specifically that the
alternative application may be no more
burdensome on the applicant than the model
application. CMS guidance released June 18,
2013 further clarified that the application
may only include questions ‘‘that are
necessary for determining eligibility for
coverage in a Qualified Health Plan (QHP)
and all insurance affordability programs, or
for the administration of these programs.’’
If the hearing date is not acceptable, I
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 Mr. Benjamin R. Cohen as
the presiding officer. If these arrangements
present any problems, please contact the Mr.
Cohen at (410) 786–3169. In order to
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Federal Register / Vol. 79, No. 128 / Thursday, July 3, 2014 / Notices
facilitate any communication that may be
necessary between the parties prior 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,
Marilyn Tavenner,
Administrator.
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: June 27, 2014.
Marilyn Tavenner,
Administrator, Center for Medicare &
Medicaid Services.
[FR Doc. 2014–15615 Filed 7–2–14; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2014–N–0801]
Agency Information Collection
Activities; Proposed Collection;
Comment Request; Exports:
Notification and Recordkeeping
Requirements
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA) is announcing an
opportunity for public comment on the
proposed collection of certain
information by the Agency. Under the
Paperwork Reduction Act of 1995
(PRA), Federal Agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information including each proposed
extension of an existing collection of
information, and to allow 60 days for
public comment in response to the
notice. This notice solicits comments on
export notification and recordkeeping
requirements for persons exporting
human drugs, biological products,
devices, animal drugs, food, cosmetics,
and tobacco that may not be marketed
or sold in the United States.
DATES: Submit either electronic or
written comments on the collection of
information by September 2, 2014.
tkelley on DSK3SPTVN1PROD with NOTICES
SUMMARY:
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Submit electronic
comments on the collection of
information to https://
www.regulations.gov. Submit written
comments on the collection of
information to the Division of Dockets
Management (HFA–305), Food and Drug
Administration, 5630 Fishers Lane, Rm.
1061, Rockville, MD 20852. All
comments should be identified with the
docket number found in brackets in the
heading of this document.
FOR FURTHER INFORMATION CONTACT: FDA
PRA Staff, Office of Operations, Food
and Drug Administration, 8455
Colesville Rd., COLE–14526, Silver
Spring, MD 20993–0002, PRAStaff@
fda.hhs.gov.
SUPPLEMENTARY INFORMATION: Under the
PRA (44 U.S.C. 3501–3520), Federal
Agencies must obtain approval from the
Office of Management and Budget
(OMB) for each collection of
information they conduct or sponsor.
‘‘Collection of information’’ is defined
in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes Agency requests
or requirements that members of the
public submit reports, keep records, or
provide information to a third party.
Section 3506(c)(2)(A) of the PRA (44
U.S.C. 3506(c)(2)(A)) requires Federal
Agencies to provide a 60-day notice in
the Federal Register concerning each
proposed collection of information,
including each proposed extension of an
existing collection of information,
before submitting the collection to OMB
for approval. To comply with this
requirement, FDA is publishing notice
of the proposed collection of
information set forth in this document.
With respect to the following
collection of information, FDA invites
comments on these topics: (1) Whether
the proposed collection of information
is necessary for the proper performance
of FDA’s functions, including whether
the information will have practical
utility; (2) the accuracy of FDA’s
estimate of the burden of the proposed
collection of information, including the
validity of the methodology and
assumptions used; (3) ways to enhance
the quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques,
when appropriate, and other forms of
information technology.
ADDRESSES:
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Exports: Notification and
Recordkeeping Requirements—21 CFR
1.101 (OMB Control Number 0910–
0482)—Extension
Section 801 of the Federal Food, Drug,
and Cosmetic Act (the FD&C Act) (21
U.S.C. 381) charges the Secretary of
Health and Human Services, through
FDA, with the responsibility of assuring
exports (Exports: Notification and
Recordkeeping Requirements—§ 1.101
(21 CFR 1.101)) which pertain to the
exportation of unapproved new drugs,
biologics, devices, animal drugs, food,
cosmetics, and tobacco products are not
be sold in the United States.
The respondents to this information
collection are exporters who have
notified FDA of their intent to export
unapproved products that may not be
sold or markets in the United States as
allowed under section 801(e) of the
FD&C Act. In general, the notification
identifies the product being exported
(e.g. name, description, and in some
cases, country of destination) and
specifies where the notifications were
sent. These notifications are sent only
for an initial export. Subsequent exports
of the same product to the same
destination or in the case of certain
countries identified in section 802(b) of
the FD&C Act (21 U.S.C. 382) would not
result in a notification to FDA.
The recordkeepers to this information
collection are exporters who export
human drugs, biologics, devices, animal
drugs, foods, cosmetics, and tobacco
products that may not be sold in the
United States and maintain records
demonstrating their compliance with
the requirements in section 801(e)(1) of
the FD&C Act.
On March 30, 2012, OMB approved
‘‘Further Amendments to General
Regulations of the Food and Drug
Administration to Incorporate Tobacco
Products,’’ OMB control number 0910–
0690, which amended, among other
sections, § 1.101 to incorporate tobacco
products. This amendment reflects the
Agency’s authority over tobacco
products under the Family Smoking
Prevention and Tobacco Control Act
(Pub. L. 111–31) and added tobacco
products to the list of products covered
under § 1.101(a) and (b).
FDA estimates the burden of this
collection of information as follows:
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]]>Agencies
[Federal Register Volume 79, Number 128 (Thursday, July 3, 2014)]
[Notices]
[Pages 38034-38036]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-15615]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Notice of Hearing: Reconsideration of Disapproval Texas Medicaid
State Plan Amendment (SPA) 13-0045-MM2 and Texas Children's Health
Insurance Program SPA 13-0035
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice of hearing: reconsideration of disapproval.
-----------------------------------------------------------------------
SUMMARY: This notice announces an administrative hearing to be held on
August 14, 2014, at the Department of Health and Human Services,
Centers for Medicare and Medicaid Services, Division of Medicaid &
Children's Health, Dallas Regional Office, 1301 Young Street, Room
801, 8th Floor Dallas, Texas 75202 to reconsider CMS' decision
to disapprove Texas' Medicaid SPA 13-0045-MM2 and the CHIP SPA 13-0035.
Closing Date: Requests to participate in the hearing as a party
must be received by the presiding officer by (15 days after
publication).
FOR FURTHER INFORMATION CONTACT: Benjamin R. Cohen, Presiding Officer,
CMS, 2520 Lord Baltimore Drive, Suite L, Baltimore, Maryland 21244,
Telephone: (410) 786-3169.
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider CMS' decision to disapprove the Texas Medicaid
SPA 13-0045-MM2 and the Children's Health Insurance Program (CHIP) SPA
13-0035 which were submitted to the Centers for Medicare and Medicaid
Services (CMS) on December 31, 2013 and disapproved on March 31, 2014.
In part, these SPAs request CMS approval of the state's proposed
alternative single, streamlined application, both a paper version and
online version, for completing an eligibility determination based on
modified adjusted gross income (MAGI). Specifically, Texas's proposals
requiring all applicants to submit information on assets and provide
detailed information on absent parents make the application longer and
the information is not necessary for completing an eligibility
determination based on MAGI.
The issues to be considered at the hearing are:
Whether Texas Medicaid SPA 13-0045-MM2, complied with the
statutory requirement in section 1902(a)(19) of the Social Security Act
(the Act), under which the state plan must assure that eligibility for
care and services under
[[Page 38035]]
the plan will be determined and provided in a manner consistent with
the simplicity of administration and the best interests of the
recipients. Requiring applicants to provide additional detailed
information, which is not necessary for determining their eligibility
for coverage, is inconsistent with simplicity of administration of the
state plan and is not in the best interests of Medicaid recipients or
applicants.
Whether Texas CHIP SPA 13-0035, complied with section
2101(a) of the Act which specifies that the state plan must assure that
eligibility for care and services must be provided in an effective and
efficient manner. Requiring applicants to provide additional detailed
information, which is not necessary for determining their eligibility
for coverage, is inconsistent with simplicity of administration of the
state plan and is not in the best interests of CHIP recipients or
applicants.
Whether the state failed to comply with section
1902(e)(14)(C) of the Act, as added by section 2002 of the Affordable
Care Act, and section 2102(b)(1)(B)(v) of the Act, as added by section
2101 of the Affordable Care Act, which prohibit the use of asset or
resource tests as criteria for Medicaid and CHIP eligibility among
eligibility groups subject to MAGI, including children, pregnant women,
parents, and, if eligible in a state, other nondisabled, nonelderly
adults. Consistent with these statutory provisions, questions about
assets and resources were not included in the Secretary's model single
streamlined application, which was released on April 30, 2013.
Whether the state complied with the requirements of
sections 1902(a)(4) and 2101(a) of the Act, as implemented in 42 CFR
435.907 and 42 CFR 457.330, for approval of an alternative single,
streamlined application. While an alternative application may be
tailored to accommodate state preferences and policies, it must also
reflect the general principles of the model application and must comply
with the applicable provisions of law and regulation. The regulations
at 42 CFR 435.907 and 42 CFR 457.330 note specifically that the
alternative application may be no more burdensome on the applicant than
the model application. CMS guidance released June 18, 2013 further
clarified that the application may only include questions that ``are
necessary for determining eligibility for coverage in a Qualified
Health Plan (QHP) and all insurance affordability programs, or the
administration of these programs.''
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 Texas announcing an administrative hearing to
reconsider the disapproval of its SPAs reads as follows:
Ms. Kay Ghahremani, State Medicaid Director, Texas Health and Human
Services Commission, P.O. Box 13247, Austin, TX 78711.
Dear Ms. Ghahremani:
I am responding to your request for reconsideration of the
decision to disapprove Texas's Medicaid state plan amendment (SPA)
13-0045-MM2 and the Children's Health Insurance Program (CHIP) SPA
13-0035, which were submitted to the Centers for Medicare and
Medicaid Services (CMS) on December 31, 2013 and disapproved on
March 31, 2014. I am scheduling a hearing on your request for
reconsideration to be held on August 14, 2014, at the Department of
Health and Human Services, Centers for Medicare and Medicaid
Services, Division of Medicaid & Children's Health, Dallas Regional
Office, 1301 Young Street, Room 801, Dallas, Texas 75202.
In part, these SPAs request CMS approval of the state's proposed
alternative single, streamlined application, both a paper version
and online version, for completing an eligibility determination
based on modified adjusted gross income (MAGI). Specifically,
Texas's proposals requiring all applicants to submit information on
assets and provide detailed information on absent parents make the
application longer and the information is not necessary for
completing an eligibility determination based on MAGI.
In your request for reconsideration, you described changes that
the state is considering with respect to these SPAs, and we will
continue to talk with you about these changes. In the event that CMS
and the state come to agreement on resolution of the issues, which
formed the basis for disapproval, these SPAs may be moved to
approval prior to the scheduled hearing.
The issues to be considered at the hearing are:
Whether Texas Medicaid SPA 13-0045-MM2, complied with
the statutory requirement in section 1902(a)(19) of the Social
Security Act (the Act), under which the state plan must assure that
eligibility for care and services under the plan will be determined
and provided in a manner consistent with simplicity of
administration and the best interests of the recipients. Requiring
applicants to provide additional detailed information, which is not
necessary for determining their eligibility for coverage, is
inconsistent with the simplicity of administration of the state plan
and is not in the best interests of Medicaid recipients or
applicants.
Whether Texas CHIP SPA 13-0035, complied with section
2101(a) of the Act which specifies that the state plan must assure
that eligibility for care and services must be provided in an
effective and efficient manner. Requiring applicants to provide
additional detailed information, which is not necessary for
determining their eligibility for coverage, is inconsistent with
simplicity of administration of the state plan and is not in the
best interests of CHIP recipients or applicants.
Whether the state failed to comply with section
1902(e)(14)(C) of the Act, as added by section 2002 of the
Affordable Care Act, and section 2102(b)(1)(B)(v) of the Act, as
added by section 2101 of the Affordable Care Act which prohibit the
use of asset or resource tests as criteria for Medicaid and CHIP
eligibility among eligibility groups subject to MAGI, including
children, pregnant women, parents, and, if eligible in a state,
other nondisabled, nonelderly adults. Consistent with these
statutory provisions, questions about assets and resources were not
included in the Secretary's model single streamlined application,
which was released on April 30, 2013.
Whether the state complied with the requirements of
sections 1902(a)(4) and 2101(a) of the Act, as implemented in 42 CFR
435.907 and 42 CFR 457.330, for approval of an alternative single,
streamlined application. While an alternative application may be
tailored to accommodate state preferences and policies, it must also
reflect the general principles of the model application and must
comply with the applicable provisions of law and regulation. The
regulations at 42 CFR 435.907 and 42 CFR 457.330 note specifically
that the alternative application may be no more burdensome on the
applicant than the model application. CMS guidance released June 18,
2013 further clarified that the application may only include
questions ``that are necessary for determining eligibility for
coverage in a Qualified Health Plan (QHP) and all insurance
affordability programs, or for the administration of these
programs.''
If the hearing date is not acceptable, I 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 Mr. Benjamin R. Cohen as the presiding officer.
If these arrangements present any problems, please contact the Mr.
Cohen at (410) 786-3169. In order to
[[Page 38036]]
facilitate any communication that may be necessary between the
parties prior 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,
Marilyn Tavenner,
Administrator.
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: June 27, 2014.
Marilyn Tavenner,
Administrator, Center for Medicare & Medicaid Services.
[FR Doc. 2014-15615 Filed 7-2-14; 8:45 am]
BILLING CODE 4120-01-P
