Notice of Hearing: Reconsideration of Disapproval Ohio Medicaid State Plan Amendment (SPA) 14-002, 71786-71787 [2014-28427]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 79, Number 232 (Wednesday, December 3, 2014)]
[Notices]
[Pages 71786-71787]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-28427]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval Ohio Medicaid 
State Plan Amendment (SPA) 14-002

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

ACTION: Notice of Hearing: Reconsideration of Disapproval.

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SUMMARY: This notice announces an administrative hearing to be held on 
January 7, 2015, at the Department of Health and Human Services, 
Centers for Medicare and Medicaid Services, Division of Medicaid & 
Children's Health, Chicago Regional Office, 233 N. Michigan, Avenue 
Suite 600 Chicago, Illinois 60601-5519, to reconsider CMS' decision to 
disapprove Ohio's Medicaid SPA 14-002.

CLOSING DATE: Requests to participate in the hearing as a party must be 
received by the presiding officer by December 18, 2014.

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 Ohio's Medicaid SPA 
14-002 which was submitted to the Centers for Medicare and Medicaid 
Services (CMS) on February 28, 2014 and disapproved on August 29, 2014. 
In part, this SPA requested CMS approval of the state's proposal to 
exclude from the definition of an inmate any individual under age 19 
who is residing in a juvenile detention facility and has not yet been 
adjudicated.
    The issues to be considered at the hearing are:
     Whether Ohio Medicaid SPA 14-002 complied with the 
statutory requirement in section 1902(a)(10)(A) of the Social Security 
Act (the Act), which provides that the state plan must provide for 
making ``medical assistance'' available to eligible individuals. This 
section incorporates by reference the definition of medical assistance 
in section 1905(a) of the Act, which specifically provides, in the text 
following paragraph (29), that ``. . . such term does not include--(A) 
any such payments with respect to care and services for any individual 
who is an inmate of a public institution (except as a patient in a 
medical institution). . . .'' This exclusion is not limited based on 
the age of the inmate.
     Whether the individuals specified in Ohio 14-002 are not 
inmates because they are individuals ``in a public institution for a 
temporary period, pending other living arrangements appropriate to his 
needs,'' as specified in 42 CFR 435.1010 when they are involuntarily 
incarcerated in a public institution who have not yet been adjudicated.
    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:

Mr. John McCarthy
Director
Ohio Department of Medicaid
50 West Town Street, Suite 400
Columbus, OH 43215

Dear Mr. McCarthy:
    I am responding to your request for reconsideration of the decision 
to disapprove Ohio's Medicaid state plan amendment (SPA) 14-002, which 
was submitted to the Centers for Medicare and Medicaid Services (CMS) 
on February 28, 2014 and disapproved on August 29, 2014. I am 
scheduling a hearing on your request for reconsideration to be held on 
January 07, 2015, at the Department of Health and Human Services, 
Centers for Medicare and Medicaid Services, Division of Medicaid & 
Children's Health, Chicago Regional Office, 233 N. Michigan, Avenue 
Suite 600 Chicago, Illinois 60601-5519.
    In part, this SPA requested CMS approval of the state's proposal to 
exclude from the definition of an inmate any individual under age 19 
who is residing in a juvenile detention facility and has not yet been 
adjudicated. In its submission the state included the proposed change 
in the eligibility section of the state plan. However, this is not an 
eligibility issue, but is related to availability of federal financial 
participation (FFP) for services.
    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. During the 
reconsideration process, no federal financial participation (FFP) is 
available for services provided to individuals under age 19 residing in 
juvenile detention centers or other correctional institutions; except 
for inpatient care in a medical institution.
    The issues to be considered at the hearing are:
     Whether Ohio Medicaid SPA 14-002 complied with the 
statutory requirement in section 1902(a)(10)(A) of the Social Security 
Act (the Act), which provides that the state plan must provide for 
making ``medical assistance'' available to eligible individuals. This 
section incorporates by reference the definition of medical assistance 
in section 1905(a) of the Act, which specifically provides, in the text 
following paragraph (29), that ``. . . such term does not include--(A) 
any such payments with respect to care and services for any individual 
who is an inmate of a public institution (except as a patient in a 
medical institution) . . .'' This exclusion is not limited based on the 
age of the inmate.
     Whether the individuals specified in Ohio 14-002 are not 
inmates because they are individuals ``in a public institution for a 
temporary period, pending other living arrangements appropriate to his 
needs,'' as specified in 42 CFR 435.1010 when they are involuntarily 
incarcerated in a public institution who have not yet been adjudicated.

[[Page 71787]]

    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 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
    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: November 26, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2014-28427 Filed 12-2-14; 8:45 am]
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