Federal Financial Participation in State Assistance Expenditures; Federal Matching Shares for Medicaid, the Children's Health Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 1, 2016 Through September 30, 2017, 73779-73782 [2015-30050]
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73779
Federal Register / Vol. 80, No. 227 / Wednesday, November 25, 2015 / Notices
ACTION:
Notice.
In compliance with the
requirement for opportunity for public
comment on proposed data collection
projects (Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995), the
Health Resources and Services
Administration (HRSA) announces
plans to submit an Information
Collection Request (ICR), described
below, to the Office of Management and
Budget (OMB). Prior to submitting the
ICR to OMB, HRSA seeks comments
from the public regarding the burden
estimate, below, or any other aspect of
the ICR.
DATES: Comments on this ICR should be
received no later than January 25, 2016.
ADDRESSES: Submit your comments to
paperwork@hrsa.gov or mail the HRSA
Information Collection Clearance
Officer, Room 10C–24, Parklawn
Building, 5600 Fishers Lane, Rockville,
MD 20857.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the data collection plans and draft
instruments, email paperwork@hrsa.gov
or call the HRSA Information Collection
Clearance Officer at (301) 443–1984.
SUPPLEMENTARY INFORMATION: When
submitting comments or requesting
information, please include the
SUMMARY:
information request collection title for
reference. Information Collection
Request Title: Rural Network Allied
Health Training Program Performance
Improvement Measurement System
(PIMS). OMB No. 0915–xxxx—New.
Abstract: The Allied Health Training
Program will support the development
of formal, mature rural health networks
that focus on activities that achieve
efficiencies, expand access to,
coordinate, and improve the quality of
essential health care services, and
strengthen the rural health care system
as a whole. This purpose will be
achieved through the recruitment,
clinical training, and retention of allied
health professionals. This program will
further support integrated rural health
networks that can partner with local
community colleges and other
accredited educational institutions
(such as vocational and technical
colleges) to develop formal clinical
training programs.
Need and Proposed Use of the
Information: For this program,
performance measures were drafted to
provide data to the program and to
enable HRSA to provide aggregate
program data required by Congress
under the Government Performance and
Results Act of 1993. These measures
cover the principal topic areas of
interest to the Federal Office of Rural
Health Policy including: (a) Access to
Number of
respondents
Form name
Number of
responses per
respondent
care; (b) population demographics; (c)
staffing; (d) consortium/network; (e)
sustainability; and (f) project specific
domains. Several measures will be used
for this program. All measures will
speak to the Federal Office of Rural
Health Policy’s progress toward meeting
the goals set.
Likely Respondents: The respondents
are recipients of the Rural Network
Allied Health Training Program grant
funding.
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose or provide the information
requested. This includes the time
needed to review instructions; to
develop, acquire, install and utilize
technology and systems for the purpose
of collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information; to train
personnel and to be able to respond to
a collection of information; to search
data sources; to complete and review
the collection of information; and to
transmit or otherwise disclose the
information. The total annual burden
hours estimated for this Information
Collection Request are summarized in
the table below.
Total Estimated Annualized burden
hours:
Total
responses
Average
burden per
response
(in hours)
Total burden
hours
Rural Network Allied Health Training Program Performance Improvement Measurement System (PIMS) ...........
10
1
10
3.33
30.33
Total ..............................................................................
10
1
10
3.33
30.33
tkelley on DSK3SPTVN1PROD with NOTICES
HRSA specifically requests comments
on: (1) The necessity and utility of the
proposed information collection for the
proper performance of the agency’s
functions; (2) the accuracy of the
estimated burden; (3) ways to enhance
the quality, utility, and clarity of the
information to be collected; and (4) the
use of automated collection techniques
or other forms of information
technology to minimize the information
collection burden.
Jackie Painter,
Director, Division of the Executive Secretariat.
[FR Doc. 2015–29967 Filed 11–24–15; 8:45 am]
BILLING CODE 4165–15–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Federal Financial Participation in State
Assistance Expenditures; Federal
Matching Shares for Medicaid, the
Children’s Health Insurance Program,
and Aid to Needy Aged, Blind, or
Disabled Persons for October 1, 2016
Through September 30, 2017
Office of the Secretary, DHHS.
Notice.
AGENCY:
ACTION:
The Federal Medical
Assistance Percentages (FMAP),
Enhanced Federal Medical Assistance
Percentages (eFMAP), and disasterrecovery FMAP adjustments for Fiscal
Year 2017 have been calculated
pursuant to the Social Security Act (the
Act). These percentages will be effective
SUMMARY:
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from October 1, 2016 through
September 30, 2017. This notice
announces the calculated FMAP rates,
in accordance with sections 1101(a)(8)
and 1905(b) of the Act, that the U.S.
Department of Health and Human
Services (HHS) will use in determining
the amount of federal matching for state
medical assistance (Medicaid),
Temporary Assistance for Needy
Families (TANF) Contingency Funds,
Child Support Enforcement collections,
Child Care Mandatory and Matching
Funds of the Child Care and
Development Fund, Foster Care Title
IV–E Maintenance payments, and
Adoption Assistance payments, and the
eFMAP rates for the Children’s Health
Insurance Program (CHIP) expenditures.
Table 1 gives figures for each of the 50
states, the District of Columbia, Puerto
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Federal Register / Vol. 80, No. 227 / Wednesday, November 25, 2015 / Notices
Rico, the Virgin Islands, Guam,
American Samoa, and the
Commonwealth of the Northern Mariana
Islands. This notice reminds states of
available disaster-recovery FMAP
adjustments for qualifying states, and
adjustments available for states meeting
requirements for negative growth in
total state personal income. At this time,
no states qualify for such adjustments.
This notice also contains the
increased eFMAPs for CHIP as
authorized under the Patient Protection
and Affordable Care Act (Affordable
Care Act) for fiscal years 2016 through
2019 (October 1, 2015 through
September 30, 2019).
Programs under title XIX of the Act
exist in each jurisdiction. Programs
under titles I, X, and XIV operate only
in Guam and the Virgin Islands. The
percentages in this notice apply to state
expenditures for most medical
assistance and child health assistance,
and assistance payments for certain
social services. The Act provides
separately for federal matching of
administrative costs.
Sections 1905(b) and 1101(a)(8)(B) of
the Social Security Act (the Act) require
the Secretary of HHS to publish the
FMAP rates each year. The Secretary
calculates the percentages, using
formulas in sections 1905(b) and
1101(a)(8), and calculations by the
Department of Commerce of average
income per person in each state and for
the Nation as a whole. The percentages
must fall within the upper and lower
limits specified in section 1905(b) of the
Act. The percentages for the District of
Columbia, Puerto Rico, the Virgin
Islands, Guam, American Samoa, and
the Northern Mariana Islands are
specified in statute, and thus are not
based on the statutory formula that
determines the percentages for the 50
states.
tkelley on DSK3SPTVN1PROD with NOTICES
Federal Medical Assistance Percentage
(FMAP)
Section 1905(b) of the Act specifies
the formula for calculating FMAPs as
follows:
‘‘Federal medical assistance percentage for
any state shall be 100 per centum less the
state percentage; and the state percentage
shall be that percentage which bears the same
ratio to 45 per centum as the square of the
per capita income of such state bears to the
square of the per capita income of the
continental United States (including Alaska)
and Hawaii; except that (1) the Federal
medical assistance percentage shall in no
case be less than 50 per centum or more than
83 per centum, (2) the Federal medical
assistance percentage for Puerto Rico, the
Virgin Islands, Guam, the Northern Mariana
Islands, and American Samoa shall be 55
percent . . .’’.
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Section 4725(b) of the Balanced
Budget Act of 1997 amended section
1905(b) to provide that the FMAP for
the District of Columbia for purposes of
titles XIX and XXI shall be 70 percent.
For the District of Columbia, we note
under Table 1 that other rates may apply
in certain other programs. In addition,
we note the rate that applies for Puerto
Rico, the Virgin Islands, Guam,
American Samoa, and the
Commonwealth of the Northern Mariana
Islands in certain other programs
pursuant to section 1118 of the Act. The
rates for the States, District of Columbia
and the territories are displayed in
Table 1, Column 1.
Section 1905(y) of the Act, as added
by section 2001 of the Patient Protection
and Affordable Care Act of 2010
(‘‘Affordable Care Act’’), provides for a
significant increase in the FMAP for
medical assistance expenditures for
individuals determined eligible under
the new adult group in the state and
who will be considered to be ‘‘newly
eligible’’ in 2014, as defined in section
1905(y)(2)(A) of the Act. This newly
eligible FMAP is 100 percent for
Calendar Years 2014, 2015, and 2016,
gradually declining to 90 percent in
2020 where it remains indefinitely. In
addition, section 1905(z) of the Act, as
added by section 10201 of the
Affordable Care Act, provides that states
that had expanded substantial coverage
to low-income parents and nonpregnant
adults without children prior to the
enactment of the Affordable Care Act,
referred to as ‘‘expansion states,’’ shall
receive an enhanced FMAP that begins
in 2014 for medical assistance
expenditures for nonpregnant childless
adults who may be required to enroll in
benchmark coverage. . These provisions
are discussed in more detail in the
Medicaid Eligibility proposed rule
published on August 17, 2011 (76 FR
51172) and the final rule published on
March 23, 2012 (77 FR 17143). This
notice is not intended to set forth the
newly eligible or expansion state FMAP
rates.
Other Adjustments to the FMAP
For purposes of Title XIX (Medicaid)
of the Social Security Act, the Federal
Medical Assistance Percentage (FMAP),
defined in section 1905(b) of the Social
Security Act, for each state beginning
with fiscal year 2006 is subject to an
adjustment pursuant to section 614 of
the Children’s Health Insurance
Program Reauthorization Act of 2009
(CHIPRA), Public Law 111–3. Section
614 of CHIPRA stipulates that a state’s
FMAP under Title XIX (Medicaid) must
be adjusted in two situations.
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In the first situation, if a state
experiences positive growth in total
personal income and an employer in
that state has made a significantly
disproportionate contribution to a
pension or insurance fund, the state’s
FMAP must be adjusted. Employer
pension and insurance fund
contributions are significantly
disproportionate if the increase in
contributions exceeds 25 percent of the
increase in total personal income in that
state. A Federal Register Notice with
comment period was issued on June 7,
2010 (75 FR 32182) announcing the
methodology for calculating this
adjustment; a final notice was issued on
October 15, 2010 (75 FR 63480).
A second situation arises if a state
experiences negative growth in total
personal income. Beginning with Fiscal
Year 2006, section 614(b)(3) of CHIPRA
specifies that certain employer pension
or insurance fund contributions shall be
disregarded when computing the per
capita income used to calculate the
FMAP for states with negative growth in
total personal income. In that instance,
for the purposes of calculating the
FMAP, for a calendar year in which a
state’s total personal income has
declined, the portion of an employer
pension and insurance fund
contribution that exceeds 125 percent of
the amount of the employer
contribution in the previous calendar
year shall be disregarded.
We request that states follow the same
methodology to determine potential
FMAP adjustments for negative growth
in total personal income that HHS
employs to make adjustments to the
FMAP for states experiencing
significantly disproportionate pension
or insurance contributions. See also the
information described in the January 21,
2014 Federal Register notice (79 FR
3385).
This notice does not contain an FY
2017 adjustment for a major statewide
disaster for any state because no state’s
FMAP decreased by at least three
percentage points from FY 2016 to FY
2017.
Enhanced Federal Medical Assistance
Percentage (eFMAP) for CHIP
Section 2105(b) of the Act specifies
the formula for calculating the eFMAP
rates as follows:
The ‘‘enhanced FMAP’’, for a state for a
fiscal year, is equal to the Federal medical
assistance percentage (as defined in the first
sentence of section 1905(b)) for the state
increased by a number of percentage points
equal to 30 percent of the number of
percentage points by which (1) such Federal
medical assistance percentage for the state, is
less than (2) 100 percent; but in no case shall
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Federal Register / Vol. 80, No. 227 / Wednesday, November 25, 2015 / Notices
the enhanced FMAP for a state exceed 85
percent.
In addition, Section 2105(b) of the
Social Security Act, as amended by
Section 2101 of the Affordable Care Act,
increases the eFMAP for states by 23
percentage points:
. . . during the period that begins on October
1, 2015, and ends on September 30, 2019, the
enhanced FMAP determined for a state for a
fiscal year (or for any portion of a fiscal year
occurring during such period) shall be
increased by 23 percentage points, but in no
case shall exceed 100 percent.
The eFMAP rates are used in the
Children’s Health Insurance Program
under Title XXI, and in the Medicaid
program for certain children for
expenditures for medical assistance
described in sections 1905(u)(2) and
1905(u)(3) of the Act. There is no
specific requirement to publish the
eFMAP rates. We include them in this
notice for the convenience of the states,
and display both the normal eFMAP
rates (Table 1, Column 2) and the
Affordable Care Act’s increased eFMAP
rates (Table 1, Column 3) for
comparison.
DATES: Effective Dates: The percentages
listed in Table 1 will be effective for
each of the four quarter-year periods
beginning October 1, 2016 and ending
September 30, 2017.
FOR FURTHER INFORMATION CONTACT:
Thomas Musco or Rose Chu, Office of
Health Policy, Office of the Assistant
Secretary for Planning and Evaluation,
73781
Room 447D, Hubert H. Humphrey
Building, 200 Independence Avenue
SW., Washington, DC 20201, (202) 690–
6870.
(Catalog of Federal Domestic Assistance
Program Nos. 93.558: TANF Contingency
Funds; 93.563: Child Support Enforcement;
93.596: Child Care Mandatory and Matching
Funds of the Child Care and Development
Fund; 93.658: Foster Care Title IV–E; 93.659:
Adoption Assistance; 93.769: Ticket-to-Work
and Work Incentives Improvement Act
(TWWIIA) Demonstrations to Maintain
Independence and Employment; 93.778:
Medical Assistance Program; 93.767:
Children’s Health Insurance Program)
Dated: November 18, 2015.
Sylvia M. Burwell,
Secretary.
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2016–SEPTEMBER 30, 2017 (FISCAL YEAR 2017)
Federal Medical Assistance
percentages
tkelley on DSK3SPTVN1PROD with NOTICES
State
Enhanced
Federal Medical Assistance
percentages
Enhanced
Federal Medical Assistance
percentages
with ACA 23
PT increase ***
70.16
50.00
55.00
69.24
69.69
50.00
50.02
50.00
54.20
70.00
61.10
67.89
55.00
54.93
71.51
51.30
66.74
56.74
56.21
70.46
62.28
64.38
50.00
50.00
65.15
50.00
74.63
63.21
65.56
51.85
64.67
50.00
50.00
71.13
50.00
66.88
50.00
55.00
62.32
59.94
64.47
51.78
55.00
51.02
79.11
65.00
68.50
78.47
78.78
65.00
65.01
65.00
67.94
79.00
72.77
77.52
68.50
68.45
80.06
65.91
76.72
69.72
69.35
79.32
73.60
75.07
65.00
65.00
75.61
65.00
82.24
74.25
75.89
66.30
75.27
65.00
65.00
79.79
65.00
76.82
65.00
68.50
73.62
71.96
75.13
66.25
68.50
65.71
100.00
88.00
91.50
100.00
100.00
88.00
88.01
88.00
90.94
100.00
95.77
100.00
91.50
91.45
100.00
88.91
99.72
92.72
92.35
100.00
96.60
98.07
88.00
88.00
98.61
88.00
100.00
97.25
98.89
89.30
98.27
88.00
88.00
100.00
88.00
99.82
88.00
91.50
96.62
94.96
98.13
89.25
91.50
88.71
Alabama .......................................................................................................................................
Alaska ..........................................................................................................................................
American Samoa * .......................................................................................................................
Arizona .........................................................................................................................................
Arkansas ......................................................................................................................................
California ......................................................................................................................................
Colorado ......................................................................................................................................
Connecticut ..................................................................................................................................
Delaware ......................................................................................................................................
District of Columbia ** ..................................................................................................................
Florida ..........................................................................................................................................
Georgia ........................................................................................................................................
Guam * .........................................................................................................................................
Hawaii ..........................................................................................................................................
Idaho ............................................................................................................................................
Illinois ...........................................................................................................................................
Indiana .........................................................................................................................................
Iowa .............................................................................................................................................
Kansas .........................................................................................................................................
Kentucky ......................................................................................................................................
Louisiana ......................................................................................................................................
Maine ...........................................................................................................................................
Maryland ......................................................................................................................................
Massachusetts .............................................................................................................................
Michigan .......................................................................................................................................
Minnesota ....................................................................................................................................
Mississippi ....................................................................................................................................
Missouri ........................................................................................................................................
Montana .......................................................................................................................................
Nebraska ......................................................................................................................................
Nevada .........................................................................................................................................
New Hampshire ...........................................................................................................................
New Jersey ..................................................................................................................................
New Mexico .................................................................................................................................
New York .....................................................................................................................................
North Carolina ..............................................................................................................................
North Dakota ................................................................................................................................
Northern Mariana Islands * ..........................................................................................................
Ohio .............................................................................................................................................
Oklahoma .....................................................................................................................................
Oregon .........................................................................................................................................
Pennsylvania ................................................................................................................................
Puerto Rico * ................................................................................................................................
Rhode Island ................................................................................................................................
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73782
Federal Register / Vol. 80, No. 227 / Wednesday, November 25, 2015 / Notices
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2016–SEPTEMBER 30, 2017 (FISCAL YEAR 2017)—Continued
Federal Medical Assistance
percentages
State
Enhanced
Federal Medical Assistance
percentages
Enhanced
Federal Medical Assistance
percentages
with ACA 23
PT increase ***
71.30
54.94
64.96
56.18
69.90
54.46
55.00
50.00
50.00
71.80
58.51
50.00
79.91
68.46
75.47
69.33
78.93
68.12
68.50
65.00
65.00
80.26
70.96
65.00
100.00
91.46
98.47
92.33
100.00
91.12
91.50
88.00
88.00
100.00
93.96
88.00
South Carolina .............................................................................................................................
South Dakota ...............................................................................................................................
Tennessee ...................................................................................................................................
Texas ...........................................................................................................................................
Utah .............................................................................................................................................
Vermont .......................................................................................................................................
Virgin Islands * .............................................................................................................................
Virginia .........................................................................................................................................
Washington ..................................................................................................................................
West Virginia ................................................................................................................................
Wisconsin .....................................................................................................................................
Wyoming ......................................................................................................................................
* For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI will be 75 per centum.
** The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and for capitation payments and DSH
allotments under those titles. For other purposes, the percentage for DC is 50.00, unless otherwise specified by law.
*** Section 2101(a) of the Affordable Care Act amended Section 2105(b) of the Social Security Act to increase the enhanced FMAP for states
by 23 percentage points, but not to exceed 100 percent, for the period that begins on October 1, 2015 and ends on September 30, 2019 (fiscal
years 2016 through 2019).
[FR Doc. 2015–30050 Filed 11–24–15; 8:45 am]
BILLING CODE 4150–05–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
[OMHA–1502–N]
Medicare Program; Administrative Law
Judge Hearing Program for Medicare
Claim and Entitlement Appeals;
Quarterly Listing of Program
Issuances—July Through September
2015
Office of Medicare Hearings
and Appeals (OMHA), HHS.
ACTION: Notice.
AGENCY:
This quarterly notice lists the
OMHA Case Processing Manual (OCPM)
manual instructions that were published
from July through September 2015. This
manual standardizes the day-to-day
procedures for carrying out adjudicative
functions, in accordance with
applicable statutes, regulations and
OMHA directives, and gives OMHA
staff direction for processing appeals at
the OMHA level of adjudication.
FOR FURTHER INFORMATION CONTACT:
Amanda Axeen, by telephone at (571)
777–2705, or by email at
amanda.axeen@hhs.gov.
SUPPLEMENTARY INFORMATION:
tkelley on DSK3SPTVN1PROD with NOTICES
SUMMARY:
I. Background
The Office of Medicare Hearings and
Appeals (OMHA), a staff division within
the Office of the Secretary of the U.S.
Department of Health and Human
Services (HHS), administers the
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nationwide Administrative Law Judge
(ALJ) hearing program for Medicare
claim, organization and coverage
determination, and entitlement appeals
under sections 1869, 1155,
1876(c)(5)(B), 1852(g)(5), and 1860D–
4(h) of the Social Security Act (the Act).
OMHA ensures that Medicare
beneficiaries and the providers and
suppliers that furnish items or services
to Medicare beneficiaries, as well as
Medicare Advantage Organizations
(MAOs) and Medicaid State Agencies,
have a fair and impartial forum to
address disagreements with Medicare
coverage and payment determinations
made by Medicare contractors, MAOs,
or Part D Plan Sponsors (PDPSs), and
determinations related to Medicare
eligibility and entitlement, Part B late
enrollment penalties, and incomerelated monthly adjustment amounts
(IRMAA) made by the Social Security
Administration (SSA).
The Medicare claim, organization and
coverage determination appeals
processes consist of four levels of
administrative review, and a fifth level
of review with the Federal district
courts after administrative remedies
under HHS regulations have been
exhausted. The first two levels of review
are administered by the Centers for
Medicare & Medicaid Services (CMS)
and conducted by Medicare contractors
for claim appeals, by MAOs and an
independent review entity for Part C
organization determination appeals, or
by PDPSs and an independent review
entity for Part D coverage determination
appeals. The third level of review is
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administered by OMHA and conducted
by Administrative Law Judges. The
fourth level of review is administered by
the HHS Departmental Appeals Board
(DAB) and conducted by the Medicare
Appeals Council. In addition, OMHA
and the DAB administer the second and
third levels of appeal, respectively, for
Medicare eligibility, entitlement, Part B
late enrollment penalty, and IRMAA
reconsiderations made by SSA; a fourth
level of review with the Federal district
courts is available after administrative
remedies within SSA and HHS have
been exhausted.
Sections 1869, 1155, 1876(c)(5)(B),
1852(g)(5), and 1860D–4(h) of the Act
are implemented through the
regulations at 42 CFR part 405, subparts
I and J; part 417, subpart Q; part 422,
subpart M; part 423, subparts M and U;
and part 478, subpart B. As noted above,
OMHA administers the nationwide
Administrative Law Judge hearing
program in accordance with these
statutes and applicable regulations. As
part of that effort, OMHA has
established the OMHA Case Processing
Manual (OCPM). Through the OCPM,
the OMHA Chief Administrative Law
Judge establishes the day-to-day
procedures for carrying out adjudicative
functions, in accordance with
applicable statutes, regulations and
OMHA directives. The OCPM provides
direction for processing appeals at the
OMHA level of adjudication for
Medicare Part A and B claims; Part C
organization determinations; Part D
coverage determinations; and SSA
eligibility and entitlement, Part B late
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]]>Agencies
[Federal Register Volume 80, Number 227 (Wednesday, November 25, 2015)]
[Notices]
[Pages 73779-73782]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-30050]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Federal Financial Participation in State Assistance Expenditures;
Federal Matching Shares for Medicaid, the Children's Health Insurance
Program, and Aid to Needy Aged, Blind, or Disabled Persons for October
1, 2016 Through September 30, 2017
AGENCY: Office of the Secretary, DHHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Federal Medical Assistance Percentages (FMAP), Enhanced
Federal Medical Assistance Percentages (eFMAP), and disaster-recovery
FMAP adjustments for Fiscal Year 2017 have been calculated pursuant to
the Social Security Act (the Act). These percentages will be effective
from October 1, 2016 through September 30, 2017. This notice announces
the calculated FMAP rates, in accordance with sections 1101(a)(8) and
1905(b) of the Act, that the U.S. Department of Health and Human
Services (HHS) will use in determining the amount of federal matching
for state medical assistance (Medicaid), Temporary Assistance for Needy
Families (TANF) Contingency Funds, Child Support Enforcement
collections, Child Care Mandatory and Matching Funds of the Child Care
and Development Fund, Foster Care Title IV-E Maintenance payments, and
Adoption Assistance payments, and the eFMAP rates for the Children's
Health Insurance Program (CHIP) expenditures. Table 1 gives figures for
each of the 50 states, the District of Columbia, Puerto
[[Page 73780]]
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands. This notice reminds states of available
disaster-recovery FMAP adjustments for qualifying states, and
adjustments available for states meeting requirements for negative
growth in total state personal income. At this time, no states qualify
for such adjustments.
This notice also contains the increased eFMAPs for CHIP as
authorized under the Patient Protection and Affordable Care Act
(Affordable Care Act) for fiscal years 2016 through 2019 (October 1,
2015 through September 30, 2019).
Programs under title XIX of the Act exist in each jurisdiction.
Programs under titles I, X, and XIV operate only in Guam and the Virgin
Islands. The percentages in this notice apply to state expenditures for
most medical assistance and child health assistance, and assistance
payments for certain social services. The Act provides separately for
federal matching of administrative costs.
Sections 1905(b) and 1101(a)(8)(B) of the Social Security Act (the
Act) require the Secretary of HHS to publish the FMAP rates each year.
The Secretary calculates the percentages, using formulas in sections
1905(b) and 1101(a)(8), and calculations by the Department of Commerce
of average income per person in each state and for the Nation as a
whole. The percentages must fall within the upper and lower limits
specified in section 1905(b) of the Act. The percentages for the
District of Columbia, Puerto Rico, the Virgin Islands, Guam, American
Samoa, and the Northern Mariana Islands are specified in statute, and
thus are not based on the statutory formula that determines the
percentages for the 50 states.
Federal Medical Assistance Percentage (FMAP)
Section 1905(b) of the Act specifies the formula for calculating
FMAPs as follows:
``Federal medical assistance percentage for any state shall be
100 per centum less the state percentage; and the state percentage
shall be that percentage which bears the same ratio to 45 per centum
as the square of the per capita income of such state bears to the
square of the per capita income of the continental United States
(including Alaska) and Hawaii; except that (1) the Federal medical
assistance percentage shall in no case be less than 50 per centum or
more than 83 per centum, (2) the Federal medical assistance
percentage for Puerto Rico, the Virgin Islands, Guam, the Northern
Mariana Islands, and American Samoa shall be 55 percent . . .''.
Section 4725(b) of the Balanced Budget Act of 1997 amended section
1905(b) to provide that the FMAP for the District of Columbia for
purposes of titles XIX and XXI shall be 70 percent. For the District of
Columbia, we note under Table 1 that other rates may apply in certain
other programs. In addition, we note the rate that applies for Puerto
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands in certain other programs pursuant to
section 1118 of the Act. The rates for the States, District of Columbia
and the territories are displayed in Table 1, Column 1.
Section 1905(y) of the Act, as added by section 2001 of the Patient
Protection and Affordable Care Act of 2010 (``Affordable Care Act''),
provides for a significant increase in the FMAP for medical assistance
expenditures for individuals determined eligible under the new adult
group in the state and who will be considered to be ``newly eligible''
in 2014, as defined in section 1905(y)(2)(A) of the Act. This newly
eligible FMAP is 100 percent for Calendar Years 2014, 2015, and 2016,
gradually declining to 90 percent in 2020 where it remains
indefinitely. In addition, section 1905(z) of the Act, as added by
section 10201 of the Affordable Care Act, provides that states that had
expanded substantial coverage to low-income parents and nonpregnant
adults without children prior to the enactment of the Affordable Care
Act, referred to as ``expansion states,'' shall receive an enhanced
FMAP that begins in 2014 for medical assistance expenditures for
nonpregnant childless adults who may be required to enroll in benchmark
coverage. . These provisions are discussed in more detail in the
Medicaid Eligibility proposed rule published on August 17, 2011 (76 FR
51172) and the final rule published on March 23, 2012 (77 FR 17143).
This notice is not intended to set forth the newly eligible or
expansion state FMAP rates.
Other Adjustments to the FMAP
For purposes of Title XIX (Medicaid) of the Social Security Act,
the Federal Medical Assistance Percentage (FMAP), defined in section
1905(b) of the Social Security Act, for each state beginning with
fiscal year 2006 is subject to an adjustment pursuant to section 614 of
the Children's Health Insurance Program Reauthorization Act of 2009
(CHIPRA), Public Law 111-3. Section 614 of CHIPRA stipulates that a
state's FMAP under Title XIX (Medicaid) must be adjusted in two
situations.
In the first situation, if a state experiences positive growth in
total personal income and an employer in that state has made a
significantly disproportionate contribution to a pension or insurance
fund, the state's FMAP must be adjusted. Employer pension and insurance
fund contributions are significantly disproportionate if the increase
in contributions exceeds 25 percent of the increase in total personal
income in that state. A Federal Register Notice with comment period was
issued on June 7, 2010 (75 FR 32182) announcing the methodology for
calculating this adjustment; a final notice was issued on October 15,
2010 (75 FR 63480).
A second situation arises if a state experiences negative growth in
total personal income. Beginning with Fiscal Year 2006, section
614(b)(3) of CHIPRA specifies that certain employer pension or
insurance fund contributions shall be disregarded when computing the
per capita income used to calculate the FMAP for states with negative
growth in total personal income. In that instance, for the purposes of
calculating the FMAP, for a calendar year in which a state's total
personal income has declined, the portion of an employer pension and
insurance fund contribution that exceeds 125 percent of the amount of
the employer contribution in the previous calendar year shall be
disregarded.
We request that states follow the same methodology to determine
potential FMAP adjustments for negative growth in total personal income
that HHS employs to make adjustments to the FMAP for states
experiencing significantly disproportionate pension or insurance
contributions. See also the information described in the January 21,
2014 Federal Register notice (79 FR 3385).
This notice does not contain an FY 2017 adjustment for a major
statewide disaster for any state because no state's FMAP decreased by
at least three percentage points from FY 2016 to FY 2017.
Enhanced Federal Medical Assistance Percentage (eFMAP) for CHIP
Section 2105(b) of the Act specifies the formula for calculating
the eFMAP rates as follows:
The ``enhanced FMAP'', for a state for a fiscal year, is equal
to the Federal medical assistance percentage (as defined in the
first sentence of section 1905(b)) for the state increased by a
number of percentage points equal to 30 percent of the number of
percentage points by which (1) such Federal medical assistance
percentage for the state, is less than (2) 100 percent; but in no
case shall
[[Page 73781]]
the enhanced FMAP for a state exceed 85 percent.
In addition, Section 2105(b) of the Social Security Act, as amended
by Section 2101 of the Affordable Care Act, increases the eFMAP for
states by 23 percentage points:
. . . during the period that begins on October 1, 2015, and ends on
September 30, 2019, the enhanced FMAP determined for a state for a
fiscal year (or for any portion of a fiscal year occurring during
such period) shall be increased by 23 percentage points, but in no
case shall exceed 100 percent.
The eFMAP rates are used in the Children's Health Insurance Program
under Title XXI, and in the Medicaid program for certain children for
expenditures for medical assistance described in sections 1905(u)(2)
and 1905(u)(3) of the Act. There is no specific requirement to publish
the eFMAP rates. We include them in this notice for the convenience of
the states, and display both the normal eFMAP rates (Table 1, Column 2)
and the Affordable Care Act's increased eFMAP rates (Table 1, Column 3)
for comparison.
DATES: Effective Dates: The percentages listed in Table 1 will be
effective for each of the four quarter-year periods beginning October
1, 2016 and ending September 30, 2017.
FOR FURTHER INFORMATION CONTACT: Thomas Musco or Rose Chu, Office of
Health Policy, Office of the Assistant Secretary for Planning and
Evaluation, Room 447D, Hubert H. Humphrey Building, 200 Independence
Avenue SW., Washington, DC 20201, (202) 690-6870.
(Catalog of Federal Domestic Assistance Program Nos. 93.558: TANF
Contingency Funds; 93.563: Child Support Enforcement; 93.596: Child
Care Mandatory and Matching Funds of the Child Care and Development
Fund; 93.658: Foster Care Title IV-E; 93.659: Adoption Assistance;
93.769: Ticket-to-Work and Work Incentives Improvement Act (TWWIIA)
Demonstrations to Maintain Independence and Employment; 93.778:
Medical Assistance Program; 93.767: Children's Health Insurance
Program)
Dated: November 18, 2015.
Sylvia M. Burwell,
Secretary.
Table 1--Federal Medical Assistance Percentages and Enhanced Federal Medical Assistance Percentages, Effective
October 1, 2016-September 30, 2017 (Fiscal Year 2017)
----------------------------------------------------------------------------------------------------------------
Enhanced
Enhanced Federal
Federal Federal Medical
State Medical Medical Assistance
Assistance Assistance percentages
percentages percentages with ACA 23 PT
increase ***
----------------------------------------------------------------------------------------------------------------
Alabama......................................................... 70.16 79.11 100.00
Alaska.......................................................... 50.00 65.00 88.00
American Samoa *................................................ 55.00 68.50 91.50
Arizona......................................................... 69.24 78.47 100.00
Arkansas........................................................ 69.69 78.78 100.00
California...................................................... 50.00 65.00 88.00
Colorado........................................................ 50.02 65.01 88.01
Connecticut..................................................... 50.00 65.00 88.00
Delaware........................................................ 54.20 67.94 90.94
District of Columbia **......................................... 70.00 79.00 100.00
Florida......................................................... 61.10 72.77 95.77
Georgia......................................................... 67.89 77.52 100.00
Guam *.......................................................... 55.00 68.50 91.50
Hawaii.......................................................... 54.93 68.45 91.45
Idaho........................................................... 71.51 80.06 100.00
Illinois........................................................ 51.30 65.91 88.91
Indiana......................................................... 66.74 76.72 99.72
Iowa............................................................ 56.74 69.72 92.72
Kansas.......................................................... 56.21 69.35 92.35
Kentucky........................................................ 70.46 79.32 100.00
Louisiana....................................................... 62.28 73.60 96.60
Maine........................................................... 64.38 75.07 98.07
Maryland........................................................ 50.00 65.00 88.00
Massachusetts................................................... 50.00 65.00 88.00
Michigan........................................................ 65.15 75.61 98.61
Minnesota....................................................... 50.00 65.00 88.00
Mississippi..................................................... 74.63 82.24 100.00
Missouri........................................................ 63.21 74.25 97.25
Montana......................................................... 65.56 75.89 98.89
Nebraska........................................................ 51.85 66.30 89.30
Nevada.......................................................... 64.67 75.27 98.27
New Hampshire................................................... 50.00 65.00 88.00
New Jersey...................................................... 50.00 65.00 88.00
New Mexico...................................................... 71.13 79.79 100.00
New York........................................................ 50.00 65.00 88.00
North Carolina.................................................. 66.88 76.82 99.82
North Dakota.................................................... 50.00 65.00 88.00
Northern Mariana Islands *...................................... 55.00 68.50 91.50
Ohio............................................................ 62.32 73.62 96.62
Oklahoma........................................................ 59.94 71.96 94.96
Oregon.......................................................... 64.47 75.13 98.13
Pennsylvania.................................................... 51.78 66.25 89.25
Puerto Rico *................................................... 55.00 68.50 91.50
Rhode Island.................................................... 51.02 65.71 88.71
[[Page 73782]]
South Carolina.................................................. 71.30 79.91 100.00
South Dakota.................................................... 54.94 68.46 91.46
Tennessee....................................................... 64.96 75.47 98.47
Texas........................................................... 56.18 69.33 92.33
Utah............................................................ 69.90 78.93 100.00
Vermont......................................................... 54.46 68.12 91.12
Virgin Islands *................................................ 55.00 68.50 91.50
Virginia........................................................ 50.00 65.00 88.00
Washington...................................................... 50.00 65.00 88.00
West Virginia................................................... 71.80 80.26 100.00
Wisconsin....................................................... 58.51 70.96 93.96
Wyoming......................................................... 50.00 65.00 88.00
----------------------------------------------------------------------------------------------------------------
* For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI
will be 75 per centum.
** The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and
for capitation payments and DSH allotments under those titles. For other purposes, the percentage for DC is
50.00, unless otherwise specified by law.
*** Section 2101(a) of the Affordable Care Act amended Section 2105(b) of the Social Security Act to increase
the enhanced FMAP for states by 23 percentage points, but not to exceed 100 percent, for the period that
begins on October 1, 2015 and ends on September 30, 2019 (fiscal years 2016 through 2019).
[FR Doc. 2015-30050 Filed 11-24-15; 8:45 am]
BILLING CODE 4150-05-P
