Medicaid Program; Final FY 2014 and Preliminary FY 2016 Disproportionate Share Hospital Allotments, and Final FY 2014 and Preliminary FY 2016 Institutions for Mental Diseases Disproportionate Share Hospital Limits, 74432-74447 [2016-25813]

Download as PDF 74432 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices includes whether the acquisition of the nonbanking company complies with the standards in section 4 of the BHC Act (12 U.S.C. 1843). Unless otherwise noted, nonbanking activities will be conducted throughout the United States. Unless otherwise noted, comments regarding each of these applications must be received at the Reserve Bank indicated or the offices of the Board of Governors not later than November 21, 2016. A. Federal Reserve Bank of Philadelphia (William Spaniel, Senior Vice President) 100 North 6th Street, Philadelphia, Pennsylvania 19105– 1521. Comments can also be sent electronically to Comments.applications@phil.frb.org: 1. Hamilton Bancorp, Inc., Ephrata, Pennsylvania; to become a bank holding company by acquiring Stonebridge Bank, West Chester, Pennsylvania. B. Federal Reserve Bank of Chicago (Colette A. Fried, Assistant Vice President) 230 South LaSalle Street, Chicago, Illinois 60690–1414: 1. BankFinancial Corporation, Burr Ridge, Illinois; to become a bank holding company through the conversion of its federal savings bank subsidiary, BankFinancial, F.S.B., Olympia Fields, Illinois, into a national bank to be known as BankFinancial, National Association. Board of Governors of the Federal Reserve System, October 21, 2016. Margaret McCloskey Shanks, Deputy Secretary of the Board. [FR Doc. 2016–25891 Filed 10–25–16; 8:45 am] BILLING CODE 6210–01–P FEDERAL RESERVE SYSTEM asabaliauskas on DSK3SPTVN1PROD with NOTICES Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and § 225.41 of the Board’s Regulation Y (12 CFR 225.41) to acquire shares of a bank or bank holding company. The factors that are considered in acting on the notices are set forth in paragraph 7 of the Act (12 U.S.C. 1817(j)(7)). The notices are available for immediate inspection at the Federal Reserve Bank indicated. The notices also will be available for inspection at the offices of the Board of Governors. Interested persons may express their views in writing to the Reserve Bank indicated for that notice or to the offices of the Board of Governors. Comments must be received not later than November 4, 2016. VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 A. Federal Reserve Bank of Dallas (Robert L. Triplett III, Senior Vice President) 2200 North Pearl Street, Dallas, Texas 75201–2272: 1. Edward B. Tomlinson, II, Rowlett, Texas, individually and as a Voting Person under a Voting Agreement dated November 1, 2013 (the ‘‘Voting Agreement’’), Charles S. Leis, Eagle, Idaho, individually and as a Voting Person under the Voting Agreement, and the following parties to the Voting Agreement, which constitutes a group of persons acting in concert: Sherry Wortham, Wills Point, Texas, Linda Tomlinson Mitchell, Gun Barrel City, Texas, Jeffrey S. Moore, Lisle, Illinois, Jeffrey Soulier, Kihei, Hawaii, Edward B. Tomlinson, II, Rowlett, Texas, Brad Wagenaar, Honolulu, Hawaii, Charles S. Leis, Eagle, Idaho, Stanley B. Leis, Eagle, Idaho, Stephen T. Leis, Kihei, Hawaii, James F. Bowen, Rowlett, Texas, H. Grady Chandler, Garland, Texas, Daniel R. Goodfellow, Wenatchee, Washington, J. Stephen Goodfellow, Wenatchee, Washington, The Revocable Trust of Dorvin D. Leis, Kahului, Hawaii (Edward B. Tomlinson, II, Charles S. Leis, and Stephen T. Leis as co-trustees), Samuel S. Aguirre Revocable Living Trust, Alen, Hawaii (Samuel S. Aguirre as trustee), Paul R. Botts Revocable Living Trust, Kailua, Hawaii (Paul R. Botts and Cheryl A. Botts as co-trustees), the Goodfellow Main Trust fbo Chad S. Goodfellow, Wenatchee, Washington (Chad S. Goodfellow as trustee), the Goodfellow Main Trust fbo Chelsea D. Goodfellow, Wenatchee, Washington (Chad S. Goodfellow as trustee), the Harvey C. King 1992 Revocable Living Trust, Kailua, Hawaii (Harvey C. King as trustee), the Roger MacArthur Revocable Living Trust, Wailuku, Hawaii (Roger MacArthur and Helen MacArthur as cotrustees), the William W. Wilmore Revocable Living Trust, Kahului, Hawaii (William W. Wilmore and Barbara K. Wilmore as co-trustees); to collectively control and retain 25 percent or more of the shares of Texas Brand Bancshares, Inc., and therefore indirectly, Texas Brand Bank, both of Garland, Texas. Board of Governors of the Federal Reserve System, October 21, 2016. Margaret McCloskey Shanks, Deputy Secretary of the Board. [FR Doc. 2016–25892 Filed 10–25–16; 8:45 am] BILLING CODE 6210–01–P PO 00000 Frm 00042 Fmt 4703 Sfmt 4703 FEDERAL RETIREMENT THRIFT INVESTMENT BOARD Sunshine Act; Notice of ETAC Member Meeting November 14, 2016, 1 p.m.–3 p.m. PLACE: 77 K Street NE., Washington, DC 20002. STATUS: Open. MATTERS TO BE CONSIDERED: TIME AND DATE: Agenda Employee Thrift Advisory Council November 14, 2016, 1:00 p.m.–3:00 p.m. (In-Person), 77 K Street, NE., Washington, DC 20002. 1. Approval of the minutes of the May 23, 2016 Joint Board/ETAC meeting 2. Thrift Savings Plan Statistics 3. Target Architecture Plan 4. Blended Retirement System 5. 2017–2021 Strategic Plan 6. Post Separation Retention Rate 7. New Business CONTACT PERSON FOR MORE INFORMATION: Kimberly Weaver, Director, Office of External Affairs, (202) 942–1640. Dated: October 24, 2016. Megan Grumbine, General Counsel, Federal Retirement Thrift Investment Board. [FR Doc. 2016–25979 Filed 10–24–16; 4:15 pm] BILLING CODE 6760–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS–2401–N] RIN 0938–ZB30 Medicaid Program; Final FY 2014 and Preliminary FY 2016 Disproportionate Share Hospital Allotments, and Final FY 2014 and Preliminary FY 2016 Institutions for Mental Diseases Disproportionate Share Hospital Limits Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. AGENCY: This notice announces the final federal share disproportionate share hospital (DSH) allotments for federal fiscal year (FY) 2014 and the preliminary federal share DSH allotments for FY 2016, and corresponding limitations on aggregate state DSH payments to institutions for mental disease and other mental health facilities. In addition, this notice includes background information SUMMARY: E:\FR\FM\26OCN1.SGM 26OCN1 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices describing the methodology for determining the amounts of states’ FY DSH allotments. DATES: Effective November 25, 2016. The final allotments and limitations set forth in this notice are effective for the fiscal years specified. FOR FURTHER INFORMATION CONTACT: Stuart Goldstein, (410) 786–0694 and Richard Cuno, (410) 786–1111. SUPPLEMENTARY INFORMATION: asabaliauskas on DSK3SPTVN1PROD with NOTICES I. Background A. Fiscal Year DSH Allotments A state’s federal fiscal year (FY) disproportionate share hospital (DSH) allotment represents the aggregate limit on the federal share amount of the state’s payments to DSH hospitals in the state for the FY. The amount of such allotment is determined in accordance with the provisions of section 1923(f)(3) of the Social Security Act (the Act). Under such provisions, in general a state’s FY DSH allotment is calculated by increasing the amount of its DSH allotment for the preceding FY by the percentage change in the Consumer Price Index for all Urban Consumers (CPI–U) for the previous FY. The Affordable Care Act amended Medicaid DSH provisions, adding section 1923(f)(7) of the Act which would have required reductions to states’ FY DSH allotments beginning with FY 2014, the calculation of which was described in the Disproportionate Share Hospital Payment Reduction final rule published in the September 18, 2013 Federal Register (78 FR 57293). Under the DSH reduction methodology, first, each state’s unreduced FY DSH allotment would have been calculated in accordance with the provisions of section 1923(f) of the Act, excluding section 1923(f)(7) of the Act; then, the reduction amount for each state would have been determined under the provisions of section 1923(f)(7) of the Act and implementing regulations at 42 CFR 447.294; and, finally, the net FY DSH allotment for each state would have been determined by subtracting the DSH reduction amount for the state from its unreduced FY 2014 DSH allotment. The reductions under section 1923(f)(7) of the Act were delayed and modified by section 1204 of Division B (Medicare and Other Health Provisions) of the Pathway for SGR Reform Act of 2013 (Pub. L. 113–67 enacted on December 26, 2013). The reductions of states’ fiscal year DSH allotments under section 1923(f)(7) of the Act that were applicable to FY 2014 and 2015 were repealed, and the FY 2016 reductions were increased. Subsequently, the VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 reductions were delayed and modified by the Medicare Access and CHIP Reauthorization Act of 2015 (Pub. L. 114–10 enacted on April 16, 2015) (MACRA). The reductions of states’ fiscal year DSH allotments under section 1923(f)(7) of the Act that were applicable to FY 2017 were repealed and are instead scheduled to begin in FY 2018. Because there are no reductions to DSH allotments for FY 2014 and FY 2016 under section 1923(f)(7) of the Act, this notice contains only the statespecific final FY 2014 DSH allotments and preliminary FY 2016 DSH allotments, as calculated under the statute without application of the reductions that would have been imposed under the Affordable Care Act provisions beginning with FY 2014. This notice also provides information on the calculation of such FY DSH allotments, the calculation of the states’ institutions for mental disease (IMD) DSH limits, and the amounts of states’ final FY 2014 IMD DSH limits and preliminary FY 2016 IMD DSH limits. B. Determination of Fiscal Year DSH Allotments Generally, in accordance with the methodology specified under section 1923(f)(3) of the Act, a state’s FY DSH allotment is calculated by increasing the amount of its DSH allotment for the preceding FY by the percentage change in the CPI–U for the previous FY. Also in accordance with section 1923(f)(3) of the Act, a state’s DSH allotment for a FY is subject to the limitation that an increase to a state’s DSH allotment for a FY cannot result in the DSH allotment exceeding the greater of the state’s DSH allotment for the previous FY or 12 percent of the state’s total medical assistance expenditures for the allotment year (this is referred to as the 12 percent limit). Furthermore, under section 1923(h) of the Act, federal financial participation (FFP) for DSH payments to IMDs and other mental health facilities is limited to state-specific aggregate amounts. Under this provision, the aggregate limit for DSH payments to IMDs and other mental health facilities is the lesser of a state’s FY 1995 total computable (state and federal share) IMD and other mental health facility DSH expenditures applicable to the state’s FY 1995 DSH allotment (as reported on the Form CMS–64 as of January 1, 1997), or the amount equal to the product of the state’s current year total computable DSH allotment and the applicable percentage specified in section 1902(h) of the Act (the applicable percentage is PO 00000 Frm 00043 Fmt 4703 Sfmt 4703 74433 the IMD share of DSH total computable expenditures as of FY 1995). In general, we determine states’ DSH allotments for a FY and the IMD DSH limits for the same FY using the most recent available estimates of or actual medical assistance expenditures, including DSH expenditures in their Medicaid programs and the most recent available change in the CPI–U used for the FY in accordance with the methodology prescribed in the statute. The indicated estimated or actual expenditures are obtained from states for each relevant FY from the most recent available quarterly Medicaid budget reports (Form CMS–37) or quarterly Medicaid expenditure reports (Form CMS–64), respectively, submitted by the states. For example, as part of the initial determination of a state’s FY DSH allotment (referred to as the preliminary DSH allotments) that is determined before the beginning of the FY for which the DSH allotments and IMD DSH limits are being determined, we use estimated expenditures for the FY obtained from the August submission of the CMS–37 submitted by states prior to the beginning of the FY; such estimated expenditures are subject to update and revision during the FY before such actual expenditure data become available. We also use the most recent available estimated CPI–U percentage change that is available before the beginning of the FY for determining the states’ preliminary FY DSH allotments; such estimated CPI–U percentage change is subject to update and revision during the FY before the actual CPI–U percentage change becomes available. In determining the final DSH allotments and IMD DSH limits for a FY we use the actual expenditures for the FY and actual CPI–U percentage change for the previous FY. II. Provisions of the Notice A. Calculation of the Final FY 2014 Federal Share State DSH Allotments, and the Preliminary FY 2016 Federal Share State DSH Allotments 1. Final FY 2014 Federal Share State DSH Allotments Addendum 1 to this notice provides the states’ final FY 2014 DSH allotments determined in accordance with section 1923(f)(3) of the Act. As described in the background section, in general, the DSH allotment for a FY is calculated by increasing the FY DSH allotment for the preceding FY by the CPI–U increase for the previous fiscal year. For purposes of calculating the states’ final FY 2014 DSH allotments, the preceding final fiscal year DSH allotments (for FY 2013) were published in the February 2, 2016 E:\FR\FM\26OCN1.SGM 26OCN1 74434 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices Federal Register (81 FR 5448). For purposes of calculating the states’ final FY 2014 DSH allotments we are using the actual Medicaid expenditures for FY 2014. Finally, for purposes of calculating the states’ final FY 2014 DSH allotments, the applicable historical percentage change in the CPI– U for the previous FY (FY 2013) was 1.6 percent; we note that this is an increase from the estimated 1.5 percentage change in the CPI–U for FY 2013 that was available and used in the calculation of the preliminary FY 2014 DSH allotments which were published in the February 28, 2014 Federal Register (79 FR 11436). III. Collection of Information Requirements 2. Calculation of the Preliminary FY 2016 Federal Share State DSH Allotments IV. Regulatory Impact Analysis Addendum 2 to this notice provides the preliminary FY 2016 DSH allotments determined in accordance with section 1923(f)(3) of the Act. The preliminary FY 2016 DSH allotments contained in this notice were determined based on the most recent available estimates from states of their FY 2016 total computable Medicaid expenditures. Also, the preliminary FY 2016 allotments contained in this notice were determined by increasing the preliminary FY 2015 DSH allotments as contained in the notice published in the February 2, 2016 Federal Register (81 FR 5448) by 0.3 percent, representing the most recent available estimate of the percentage increase in the CPI–U for FY 2015 (the previous FY to FY 2016). We will publish states’ final FY 2016 DSH allotments in future notices based on the states’ four quarterly Medicaid expenditure reports (Form CMS–64) for FY 2016 available following the end of FY 2016 and the actual change in the CPI–U for FY 2015. asabaliauskas on DSK3SPTVN1PROD with NOTICES B. Calculation of the Final FY 2014 and Preliminary FY 2016 IMD DSH Limits Section 1923(h) of the Act specifies the methodology to be used to establish the limits on the amount of DSH payments that a state can make to IMDs and other mental health facilities. FFP is not available for IMD or DSH payments that exceed the IMD limits. In this notice, we are publishing the final FY 2014 and the preliminary FY 2016 IMD DSH limits determined in accordance with the provisions discussed above. Addendums 3 and 4 to this notice detail each state’s final FY 2014 and preliminary FY 2016 IMD DSH limit, respectively, determined in accordance with section 1923(h) of the Act. VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 This notice does not impose any new or revised information collection or recordkeeping requirements or burden. While discussed in section I.B. of this preamble and in Addendums 3 and 4, the requirements and burden associated with Form CMS–37 (OMB control number 0938–0101) and Form CMS–64 (OMB control number 0938–0067) are unaffected by this notice. Consequently, this notice, CMS–37, and CMS–64 are not subject to Office of Management and Budget review under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.). We have examined the impact of this notice as required by Executive Order 12866 on Regulatory Planning and Review (September 1993), the Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96–354), section 1102(b) of the Act, section 202 of the Unfunded Mandates Reform Act of 1995 (March 22, 1995; Pub. L. 104– 4), Executive Order 13132 on Federalism (August 4, 1999) and the Congressional Review Act (5 U.S.C. 804(2)). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). This notice reaches the $100 million economic threshold and thus is considered a major rule under the Congressional Review Act. The final FY 2014 DSH allotments being published in this notice are approximately $11 million more than the preliminary FY 2014 DSH allotments published in the February 28, 2014 Federal Register (79 FR 11436). The increase in the final FY 2014 DSH allotments is due to the difference between the actual percentage change in the CPI–U for FY 2013 used in the calculation of the final FY 2014 allotments (1.6 percent) as compared to the estimated percentage change in the CPI–U for FY 2013 used in the calculation of the preliminary FY 2014 allotments (1.5 percent). The final FY 2014 IMD DSH limits being published in this notice are approximately $563 thousand more than the preliminary FY 2014 IMD DSH PO 00000 Frm 00044 Fmt 4703 Sfmt 4703 limits published in the February 28, 2014 Federal Register (79 FR 11436). The increases in the IMD DSH limits are because the DSH allotment for a FY is a factor in the determination of the IMD DSH limit for the FY. Since the final FY 2014 DSH allotments were increased as compared to the preliminary FY 2014 DSH allotments, the associated FY 2014 IMD DSH limits for some states were also increased. The preliminary FY 2016 DSH allotments being published in this notice are about $36 million more than the preliminary FY 2015 DSH allotments published in the February 2, 2016 Federal Register (81 FR 5448). The increase in the DSH allotments is due to the application of the statutory formula for calculating DSH allotments under which the prior fiscal year allotments are increased by the percentage increase in the CPI–U for the prior fiscal year. The preliminary FY 2016 IMD DSH limits being published in this notice are about $260 thousand less than the final FY 2014 IMD DSH limits published in the February 28, 2014 Federal Register (79 FR 11436). Although the DSH allotment for a FY is a factor in the determination of the IMD DSH limit for the FY and the preliminary FY 2016 DSH allotments are greater than the preliminary FY 2015 DSH allotments, the associated preliminary FY 2016 IMD DSH limits for some states decreased. This is attributable to a decrease in the FMAP rates for certain states. The RFA requires agencies to analyze options for regulatory relief of small businesses, if a rule has a significant impact on a substantial number of small entities. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and small governmental jurisdictions. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of less than $7.0 million to $34.5 million in any one year. Individuals and states are not included in the definition of a small entity. We are not preparing an analysis for the RFA because the Secretary has determined that this notice will not have significant economic impact on a substantial number of small entities. Specifically, any impact on providers is due to the effect of the various controlling statutes; providers are not impacted as a result of the independent regulatory action in publishing this notice. The purpose of the notice is to announce the latest distributions as required by the statute. In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of E:\FR\FM\26OCN1.SGM 26OCN1 74435 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Core-Based Statistical Area for Medicaid payment regulations and has fewer than 100 beds. We are not preparing analysis for section 1102(b) of the Act because the Secretary has determined that this notice will not have a significant impact on the operations of a substantial number of small rural hospitals. The Medicaid statute specifies the methodology for determining the amounts of states’ DSH allotments and IMD DSH limits; and as described previously, the application of the methodology specified in statute results in the decreases or increases in states’ DSH allotments and IMD DSH limits for the applicable FYs. The statute applicable to these allotments and limits does not apply to the determination of the amounts of DSH payments made to specific DSH hospitals; rather, these allotments and limits represent an overall limit on the total of such DSH payments. In this regard, we do not believe that this notice will have a significant economic impact on a substantial number of small entities. Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule whose mandates require spending in any 1 year of $100 million in 1995 dollars, updated annually for inflation. In 2016, that threshold is approximately $146 million. This notice will have no consequential effect on state, local, or tribal governments, in the aggregate, or on the private sector. Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on state and local governments, preempts state law, or otherwise has Federalism implications. Since this notice does not impose any costs on state or local governments, the requirements of E.O. 13132 are not applicable. A. Alternatives Considered The methodologies for determining the states’ fiscal year DSH allotments and IMD DSH Limits, as reflected in this notice, were established in accordance with the methodologies and formula for determining states’ allotments as specified in statute. This notice does not put forward any further discretionary administrative policies for determining such allotments. B. Accounting Statement As required by OMB Circular A–4 (available at http:// www.whitehouse.gov/omb/circulars/ a004/a-4.pdf), in the Table 1, we have prepared an accounting statement showing the classification of the estimated expenditures associated with the provisions of this notice. Table 1 provides our best estimate of the change (decrease) in the federal share of states’ Medicaid DSH payments resulting from the application of the provisions of the Medicaid statute relating to the calculation of states’ FY DSH allotments and the increase in the FY DSH allotments from FY 2015 to FY 2016. TABLE 1—ACCOUNTING STATEMENT: CLASSIFICATION OF ESTIMATED EXPENDITURES, FROM THE FY 2015 TO FY 2016 [In millions] Category Transfers Annualized Monetized Transfers ............................................................................................................................. From Whom To Whom? .......................................................................................................................................... C. Congressional Review Act This proposed regulation is subject to the Congressional Review Act provisions of the Small Business Regulatory Enforcement Fairness Act of 1996 (5 U.S.C. 801 et seq.) and has been transmitted to the Congress and the Comptroller General for review. In accordance with the provisions of Executive Order 12866, this notice was reviewed by the Office of Management and Budget. $36. Federal Government to States. Dated: September 8, 2016. Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services. Dated: October 13, 2016. Sylvia Burwell, Secretary, Department of Health and Human Services. KEY TO ADDENDUM 1—FINAL DSH ALLOTMENTS FOR FY 2014 [The Final FY 2014 DSH Allotments for the NON-Low DSH States are presented in the top section of this addendum, and the Final FY 2014 DSH Allotments for the Low-DSH States are presented in the bottom section of this addendum] Column Column Column Column Column A B C D Description .............. .............. .............. .............. asabaliauskas on DSK3SPTVN1PROD with NOTICES Column E .............. Column F .............. Column G .............. Column H .............. Column I ................ Column J ............... VerDate Sep<11>2014 State. FY 2014 FMAPs. This column contains the States’ FY 2014 Federal Medical Assistance Percentages. Prior FY (2013) DSH Allotments. This column contains the States’ prior FY 2013 DSH Allotments. Prior FY (2013) DSH Allotments (Col C) x (100 percent + Percentage Increase in CPIU): 101.6 percent. This column contains the amount in Column C increased by 1 plus the percentage increase in the CPI–U for the prior FY (101.6 percent). FY 2014 TC MAP Exp. Including DSH. This column contains the amount of the States’ FY 2014 total computable (TC) medical assistance expenditures including DSH expenditures. FY 2014 TC DSH Expenditures. This column contains the amount of the States’ FY 2014 total computable DSH expenditures. FY 2014 TC MAP Exp. Net of DSH. This column contains the amount of the States’ FY 2014 total computable medical assistance expenditures net of DSH expenditures, calculated as the amount in Column E minus the amount in Column F. 12 percent Amount. This column contains the amount of the ‘‘12 percent limit’’ in Federal share, determined in accordance with the provisions of section 1923(f)(3) of the Act. Greater of FY 2013 Allotment or 12 percent Limit. This column contains the greater of the State’s prior FY (FY 2013) DSH allotment or the amount of the 12 percent Limit, determined as the maximum of the amount in Column C or Column H. FY 2014 DSH Allotment. This column contains the States’ final FY 2014 DSH allotments, determined as the minimum of the amount in Column I or Column D. For states with ‘‘na’’ in Columns I or D, refer to the footnotes in the addendum. 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00045 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00046 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 50.00 70.10 55.31 51.85 71.64 57.93 50.00 66.33 54.74 69.20 50.00 64.02 63.14 53.54 70.34 59.06 0.00 TOTAL ....................................................... ALASKA ............................................................ ARKANSAS ...................................................... DELAWARE ...................................................... HAWAII ............................................................. IDAHO ............................................................... IOWA ................................................................ MINNESOTA ..................................................... MONTANA ........................................................ NEBRASKA ...................................................... NEW MEXICO .................................................. NORTH DAKOTA ............................................. OKLAHOMA ...................................................... OREGON .......................................................... SOUTH DAKOTA ............................................. UTAH ................................................................ WISCONSIN ..................................................... 68.12 67.23 50.00 50.00 50.00 70.00 58.79 65.93 50.00 66.92 56.91 69.83 na 61.55 50.00 50.00 66.32 73.05 62.03 63.10 50.00 50.00 50.00 65.78 63.02 53.52 50.11 70.57 na 58.69 56.76 50.00 50.00 71.09 B FY 2014 FMAPs (%) ALABAMA ......................................................... ARIZONA .......................................................... CALIFORNIA .................................................... COLORADO ..................................................... CONNECTICUT ................................................ DISTRICT OF COLUMBIA ............................... FLORIDA .......................................................... GEORGIA ......................................................... ILLINOIS ........................................................... INDIANA ........................................................... KANSAS ........................................................... KENTUCKY ...................................................... LOUISIANA 1 ..................................................... MAINE ............................................................... MARYLAND ...................................................... MASSACHUSETTS .......................................... MICHIGAN ........................................................ MISSISSIPPI ..................................................... MISSOURI ........................................................ NEVADA ........................................................... NEW HAMPSHIRE ........................................... NEW JERSEY .................................................. NEW YORK ...................................................... NORTH CAROLINA .......................................... OHIO ................................................................. PENNSYLVANIA .............................................. RHODE ISLAND ............................................... SOUTH CAROLINA .......................................... TENNESSEE 2 .................................................. TEXAS .............................................................. VERMONT 3 ...................................................... VIRGINIA .......................................................... WASHINGTON ................................................. WEST VIRGINIA ............................................... A State asabaliauskas on DSK3SPTVN1PROD with NOTICES 21,402,636 45,325,292 9,512,282 10,240,000 17,271,044 41,378,149 78,476,334 11,926,371 29,733,219 21,402,636 10,036,360 38,049,129 47,561,414 11,604,719 20,612,808 99,326,563 10,244,637,203 $323,093,267 106,384,369 1,151,840,630 97,190,657 210,141,962 64,355,975 210,141,962 282,378,262 225,902,609 224,589,223 43,341,780 152,352,923 na 110,324,530 80,116,623 320,466,492 278,438,100 160,233,246 497,773,773 48,595,328 168,217,088 676,394,441 1,687,702,633 309,959,394 426,850,861 589,710,881 68,296,138 344,107,463 na 1,004,741,257 23,640,971 92,050,138 194,381,315 70,922,912 C Prior FY (2013) DSH Allotments 21,745,078 46,050,497 9,664,479 10,403,840 17,547,381 42,040,199 79,731,955 12,117,193 30,208,951 21,745,078 10,196,942 38,657,915 48,322,397 11,790,395 20,942,613 100,915,788 10,408,551,398 $328,262,759 108,086,519 1,170,270,080 98,745,708 213,504,233 65,385,671 213,504,233 286,896,314 229,517,051 228,182,651 44,035,248 154,790,570 na 112,089,722 81,398,489 325,593,956 282,893,110 162,796,978 505,738,153 49,372,853 170,908,561 687,216,752 1,714,705,875 314,918,744 433,680,475 599,146,255 69,388,876 349,613,182 na 1,020,817,117 24,019,227 93,522,940 197,491,416 72,057,679 D Prior FY (2013) DSH allotment (Col C) × 100% + pct increase in CPIU: 101.6% 1,412,407,094 4,840,075,746 1,691,771,386 1,949,895,249 1,585,631,105 3,921,556,276 9,917,891,767 1,072,160,721 1,771,909,070 4,168,980,357 911,750,976 4,666,284,967 6,784,093,341 778,125,953 2,064,362,848 7,396,295,700 LOW DSH STATES 396,484,377,590 $5,211,164,487 9,184,808,597 63,473,249,870 5,919,783,385 6,820,658,024 2,367,792,161 20,303,199,078 9,396,958,654 16,616,392,364 9,094,042,848 2,727,710,336 7,792,776,771 na 2,365,417,230 9,210,329,395 14,250,839,665 13,502,617,518 4,865,309,235 8,828,757,766 2,281,105,301 1,322,700,772 12,470,313,962 51,806,022,238 11,992,545,816 19,439,277,855 23,461,728,946 2,434,239,452 5,321,038,897 na 31,385,332,042 1,526,126,311 7,547,405,238 10,233,713,069 3,331,020,307 E FY 2014 TC MAP Exp. including DSH 23,114,859 37,579,991 14,203,340 0 24,108,102 43,692,924 43,384,841 18,113,453 41,226,990 2,385,192 2,102,554 43,523,823 32,160,564 1,642,404 31,747,312 50,838,381 16,559,997,057 $481,382,790 143,402,254 2,483,466,487 197,297,029 149,024,544 54,250,889 336,086,757 435,057,563 457,503,046 260,455,931 77,294,578 211,149,028 na 39,328,950 100,897,485 0 562,486,296 222,637,569 728,957,576 78,243,748 109,314,773 1,213,920,187 3,366,485,105 406,901,519 672,625,070 956,292,192 138,322,435 495,387,414 na 1,526,236,093 37,448,781 178,694,576 365,034,687 74,411,705 F FY 2014 TC DSH expenditures 1,389,292,235 4,802,495,755 1,677,568,046 1,949,895,249 1,561,523,003 3,877,863,352 9,874,506,926 1,054,047,268 1,730,682,080 4,166,595,165 909,648,422 4,622,761,144 6,751,932,777 776,483,549 2,032,615,536 7,345,457,319 379,924,380,533 $4,729,781,697 9,041,406,343 60,989,783,383 5,722,486,356 6,671,633,480 2,313,541,272 19,967,112,321 8,961,901,091 16,158,889,318 8,833,586,917 2,650,415,758 7,581,627,743 na 2,326,088,280 9,109,431,910 14,250,839,665 12,940,131,222 4,642,671,666 8,099,800,190 2,202,861,553 1,213,385,999 11,256,393,775 48,439,537,133 11,585,644,297 18,766,652,785 22,505,436,754 2,295,917,017 4,825,651,483 na 29,859,095,949 1,488,677,530 7,368,710,662 9,868,678,382 3,256,608,602 G FY 2014 TC MAP EXP. net of DSH Col E–F ADDENDUM 1—FINAL DSH ALLOTMENTS FOR FISCAL YEAR: 2014 219,361,931.84 695,328,645 257,085,076 304,447,885.55 225,085,529.04 586,922,597 1,559,132,673 154,422,872 265,992,149 604,884,725 143,628,698 682,697,044 1,000,352,841 120,095,125 294,084,697 1,106,220,253 58,293,764,783 $688,936,698 1,320,703,419 9,629,965,797 903,550,477 1,053,415,813 335,064,598 3,010,557,470 1,314,722,356 2,551,403,577 1,291,646,693 403,033,162 1,098,582,186 na 346,730,334 1,438,331,354 2,250,132,579 1,895,853,099 666,628,335 1,205,110,388 326,420,111 191,587,263 1,777,325,333 7,648,347,968 1,700,491,666 2,781,672,580 3,481,187,789 362,262,089 697,721,479 na 4,503,997,450 226,534,414 1,163,480,631 1,558,212,376 470,155,300 H ‘‘12% Amount’’ = Col G × .12/ (1¥.12/Col B)* (in FS) 219,361,932 695,328,645 257,085,076 304,447,886 225,085,529 586,922,597 1,559,132,673 154,422,872 265,992,149 604,884,725 143,628,698 682,697,044 1,000,352,841 120,095,125 294,084,697 1,106,220,253 58,293,764,783 $688,936,698 1,320,703,419 9,629,965,797 903,550,477 1,053,415,813 335,064,598 3,010,557,470 1,314,722,356 2,551,403,577 1,291,646,693 403,033,162 1,098,582,186 na 346,730,334 1,438,331,354 2,250,132,579 1,895,853,099 666,628,335 1,205,110,388 326,420,111 191,587,263 1,777,325,333 7,648,347,968 1,700,491,666 2,781,672,580 3,481,187,789 362,262,089 697,721,479 na 4,503,997,450 226,534,414 1,163,480,631 1,558,212,376 470,155,300 I Greater of Col H. Or Col C (12% Limit, FY 2012 allotment) 21,745,078 46,050,497 9,664,479 10,403,840 17,547,381 42,040,199 79,731,955 12,117,193 30,208,951 21,745,078 10,196,942 38,657,915 48,322,397 11,790,395 20,942,613 100,915,788 11,140,511,397 $328,262,759 108,086,519 1,170,270,080 98,745,708 213,504,233 65,385,671 213,504,233 286,896,314 229,517,051 228,182,651 44,035,248 154,790,570 731,960,000 112,089,722 81,398,489 325,593,956 282,893,110 162,796,978 505,738,153 49,372,853 170,908,561 687,216,752 1,714,705,875 314,918,744 433,680,475 599,146,255 69,388,876 349,613,182 0 1,020,817,117 24,019,227 93,522,940 197,491,416 72,057,679 J FY 2014 DSH allotment MIN Col I, Col D 74436 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 26OCN1 50.00 VerDate Sep<11>2014 TOTAL ................................................ 2 Tennessee’s 3 Per 237,807 10,758,733,966 514,096,763 241,612 10,930,873,709 522,322,311 539,403,281 451,956,973,427 55,472,595,837 466,255 16,970,288,042 410,290,985 2014 DSH allotment for Louisiana determined under the provisions of section 1903(f)(3)(C) and (D) of the Act. DSH allotment for FY 2014, determined under section 1923(f)(6)(A) of the Social Security Act, is 0. 1905(z)(1)(A) of Act, Vermont’s regular FMAP is increased by 2.2 percentage points for the period 1/1/2014—12/31/2015. 0.00 TOTAL LOW DSH STATES ...................... 1 FY 0.00 WYOMING ........................................................ asabaliauskas on DSK3SPTVN1PROD with NOTICES 538,937,026 434,986,685,385 55,062,304,852 85,095,320 66,598,602,843 8,304,838,060 85,095,320 66,598,602,843 8,304,838,060 241,612 11,662,833,710 522,322,313 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00047 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 74437 74438 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices KEY TO ADDENDUM 2—PRELIMINARY DSH ALLOTMENTS FOR FY 2016 [The Preliminary FY 2016 DSH Allotments for the NON-Low DSH States are presented in the top section of this addendum, and the Preliminary FY 2016 DSH Allotments for the Low-DSH States are presented in the bottom section of this addendum] Column Column Column Column Column A B C D Description .......... .......... ......... ......... Column E .......... Column F .......... Column G ......... Column H ......... Column I ........... asabaliauskas on DSK3SPTVN1PROD with NOTICES Column J .......... VerDate Sep<11>2014 State. FY 2016 FMAPs. This column contains the States’ FY 2016 Federal Medical Assistance Percentages. Prior FY (2015) DSH Allotments. This column contains the States’ prior FY 2015 DSH Allotments. Prior FY (2015) DSH Allotments (Col C) x (100percent + Percentage Increase in CPIU): 100.3percent. This column contains the amount in Column C increased by 1 plus the estimated percentage increase in the CPI–U for the prior FY (100.3 percent). FY 2016 TC MAP Exp. Including DSH. This column contains the amount of the States’ projected FY 2016 total computable (TC) medical assistance expenditures including DSH expenditures. FY 2016 TC DSH Expenditures. This column contains the amount of the States’ projected FY 2016 total computable DSH expenditures. FY 2016 TC MAP Exp. Net of DSH. This column contains the amount of the States’ projected FY 2016 total computable medical assistance expenditures net of DSH expenditures, calculated as the amount in Column E minus the amount in Column F. 12 percent Amount. This column contains the amount of the ‘‘12 percent limit’’ in Federal share, determined in accordance with the provisions of section 1923(f)(3) of the Act. Greater of FY 2015 Allotment or 12 percent Limit. This column contains the greater of the State’s prior FY (FY 2015) DSH allotment or the amount of the 12 percent Limit, determined as the maximum of the amount in Column C or Column H. FY 2016 DSH Allotment. This column contains the States’ preliminary FY 2016 DSH allotments, determined as the minimum of the amount in Column I or Column D. For states with ‘‘na’’ in Columns I or D, refer to the footnotes in the addendum. 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00048 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00049 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 50.00 70.00 54.83 53.98 71.24 54.91 50.00 65.24 51.16 70.37 50.00 60.99 64.38 51.61 70.24 58.23 .................. TOTAL ....................................................... ALASKA ............................................................ ARKANSAS ...................................................... DELAWARE ...................................................... HAWAII 3 ........................................................... IDAHO ............................................................... IOWA ................................................................ MINNESOTA ..................................................... MONTANA ........................................................ NEBRASKA ...................................................... NEW MEXICO .................................................. NORTH DAKOTA ............................................. OKLAHOMA ...................................................... OREGON .......................................................... SOUTH DAKOTA ............................................. UTAH ................................................................ WISCONSIN ..................................................... 69.87 68.92 50.00 50.72 50.00 70.00 60.67 67.55 50.89 66.60 55.96 70.32 62.21 62.67 50.00 50.00 65.60 74.17 63.28 64.93 50.00 50.00 50.00 66.24 62.47 52.01 50.42 71.08 65.05 57.13 54.45 50.00 50.00 71.42 B FY 2016 FMAPs (%) 22,071,255 46,741,254 9,809,445 10,559,898 17,810,592 42,670,802 80,927,935 12,298,951 30,662,084 22,071,255 10,349,895 39,237,784 49,047,232 11,967,251 21,256,752 102,429,524 11,308,351,030 $333,186,701 109,707,817 1,187,824,131 100,226,893 216,706,796 66,366,456 216,706,796 291,199,759 232,959,806 231,605,390 44,695,778 157,112,428 743,671,360 113,771,068 82,619,466 330,477,865 287,136,507 165,238,933 513,324,226 50,113,446 173,472,190 697,525,004 1,740,426,463 319,642,526 440,185,682 608,133,449 70,429,709 354,857,380 na 1,036,129,374 24,379,515 94,925,784 200,453,788 73,138,544 C Prior FY (2015) DSH Allotments 22,137,469 46,881,478 9,838,873 10,591,578 17,864,024 42,798,814 81,170,719 12,335,848 30,754,070 22,137,469 10,380,945 39,355,497 49,194,374 12,003,153 21,320,522 102,736,813 11,342,276,083 $334,186,261 110,036,940 1,191,387,603 100,527,574 217,356,916 66,565,555 217,356,916 292,073,358 233,658,685 232,300,206 44,829,865 157,583,765 745,902,374 114,112,381 82,867,324 331,469,299 287,997,917 165,734,650 514,864,199 50,263,786 173,992,607 699,617,579 1,745,647,742 320,601,454 441,506,239 609,957,849 70,640,998 355,921,952 na 1,039,237,762 24,452,654 95,210,561 201,055,149 73,357,960 D Prior FY (2015) DSH allotment (Col C) × 100% + pct increase in CPIU: 100.3% 1,845,425,000 6,474,078,000 2,024,107,000 2,280,099,000 1,954,296,000 4,977,980,000 12,331,901,000 1,114,619,000 2,123,413,000 6,102,795,000 1,291,738,000 5,461,374,000 9,507,193,000 901,031,000 2,546,400,000 8,533,715,000 LOW DSH STATES 522,847,769,000 $5,930,834,000 12,053,707,000 111,044,623,000 8,094,087,000 7,523,550,000 2,768,440,000 21,269,943,000 9,111,625,000 16,127,216,000 12,434,804,000 3,237,360,000 10,502,654,000 8,188,536,000 2,595,932,000 10,300,033,000 17,688,569,000 18,245,307,000 5,593,780,000 9,977,517,000 3,487,301,000 1,982,620,000 15,818,782,000 67,708,685,000 14,344,107,000 23,409,769,000 25,118,027,000 2,798,911,000 6,627,245,000 na 40,938,942,000 1,950,326,000 8,682,506,000 13,268,547,000 4,023,484,000 E FY 2016 TC MAP Exp. including DSH 28,763,000 50,820,000 23,869,000 0 25,668,000 46,668,000 154,640,000 1,656,000 45,557,000 32,020,000 1,765,000 52,314,000 82,564,000 1,617,000 30,842,000 170,702,000 18,345,503,000 $479,878,000 170,695,000 615,463,000 221,186,000 121,554,000 36,674,000 360,904,000 435,016,000 394,376,000 128,475,000 78,926,000 498,275,000 881,390,000 42,279,000 102,916,000 0 399,957,000 225,000,000 741,320,000 79,052,000 215,300,000 1,055,083,000 5,212,860,000 584,963,000 0 970,040,000 140,859,000 514,209,000 na 2,913,588,000 37,449,000 202,125,000 412,552,000 73,139,000 F FY 2016 TC DSH expenditures 1,816,662,000 6,423,258,000 2,000,238,000 2,280,099,000 1,928,628,000 4,931,312,000 12,177,261,000 1,112,963,000 2,077,856,000 6,070,775,000 1,289,973,000 5,409,060,000 9,424,629,000 899,414,000 2,515,558,000 8,363,013,000 504,502,266,000 $5,450,956,000 11,883,012,000 110,429,160,000 7,872,901,000 7,401,996,000 2,731,766,000 20,909,039,000 8,676,609,000 15,732,840,000 12,306,329,000 3,158,434,000 10,004,379,000 7,307,146,000 2,553,653,000 10,197,117,000 17,688,569,000 17,845,350,000 5,368,780,000 9,236,197,000 3,408,249,000 1,767,320,000 14,763,699,000 62,495,825,000 13,759,144,000 23,409,769,000 24,147,987,000 2,658,052,000 6,113,036,000 na 38,025,354,000 1,912,877,000 8,480,381,000 12,855,995,000 3,950,345,000 G FY 2016 TC MAP EXP. net of DSH Col E–F ADDENDUM 2—PRELIMINARY DSH ALLOTMENTS FOR FISCAL YEAR: 2016 ALABAMA ......................................................... ARIZONA .......................................................... CALIFORNIA .................................................... COLORADO ..................................................... CONNECTICUT ................................................ DISTRICT OF COLUMBIA ............................... FLORIDA .......................................................... GEORGIA ......................................................... ILLINOIS ........................................................... INDIANA ........................................................... KANSAS ........................................................... KENTUCKY ...................................................... LOUISIANA ....................................................... MAINE ............................................................... MARYLAND ...................................................... MASSACHUSETTS .......................................... MICHIGAN ........................................................ MISSISSIPPI ..................................................... MISSOURI ........................................................ NEVADA ........................................................... NEW HAMPSHIRE ........................................... NEW JERSEY .................................................. NEW YORK ...................................................... NORTH CAROLINA .......................................... OHIO ................................................................. PENNSYLVANIA .............................................. RHODE ISLAND ............................................... SOUTH CAROLINA .......................................... TENNESSEE 1 .................................................. TEXAS .............................................................. VERMONT 2 ...................................................... VIRGINIA .......................................................... WASHINGTON ................................................. WEST VIRGINIA ............................................... A State asabaliauskas on DSK3SPTVN1PROD with NOTICES 286,841,368.42 930,264,952 307,279,149 351,823,946.70 278,316,256.69 757,245,421 1,922,725,421 163,658,241 325,750,091 878,260,278 203,679,947 808,079,778 1,390,051,810 140,627,387 364,064,823 1,264,057,747 77,526,317,353 $789,752,816 1,726,585,777 17,436,183,158 1,237,541,959 1,168,736,211 395,635,076 3,127,720,722 1,266,113,277 2,470,488,745 1,801,322,003 482,473,066 1,447,547,184 1,086,423,149 379,011,092 1,610,071,105 2,792,931,947 2,620,869,313 768,606,876 1,367,706,426 501,713,828 279,050,526 2,331,110,368 9,867,761,842 2,016,384,289 3,477,095,152 3,766,868,694 418,591,302 882,561,812 na 5,776,348,701 294,434,354 1,339,007,526 2,029,893,947 569,775,106 H ‘‘12% Amount’’ = Col G × .12/(1-.12/ Col B) * (in FS) 286,841,368 930,264,952 307,279,149 351,823,947 278,316,257 757,245,421 1,922,725,421 163,658,241 325,750,091 878,260,278 203,679,947 808,079,778 1,390,051,810 140,627,387 364,064,823 1,264,057,747 77,526,317,353 $789,752,816 1,726,585,777 17,436,183,158 1,237,541,959 1,168,736,211 395,635,076 3,127,720,722 1,266,113,277 2,470,488,745 1,801,322,003 482,473,066 1,447,547,184 1,086,423,149 379,011,092 1,610,071,105 2,792,931,947 2,620,869,313 768,606,876 1,367,706,426 501,713,828 279,050,526 2,331,110,368 9,867,761,842 2,016,384,289 3,477,095,152 3,766,868,694 418,591,302 882,561,812 na 5,776,348,701 294,434,354 1,339,007,526 2,029,893,947 569,775,106 I Greater of Col H or Col C (12% Limit, FY 2015 Allotment) 22,137,469 46,881,478 9,838,873 10,591,578 17,864,024 42,798,814 81,170,719 12,335,848 30,754,070 22,137,469 10,380,945 39,355,497 49,194,374 12,003,153 21,320,522 102,736,813 11,395,376,080 $334,186,261 110,036,940 1,191,387,603 100,527,574 217,356,916 66,565,555 217,356,916 292,073,358 233,658,685 232,300,206 44,829,865 157,583,765 745,902,374 114,112,381 82,867,324 331,469,299 287,997,917 165,734,650 514,864,199 50,263,786 173,992,607 699,617,579 1,745,647,742 320,601,454 441,506,239 609,957,849 70,640,998 355,921,952 53,100,000 1,039,237,762 24,452,654 95,210,561 201,055,149 73,357,960 J FY 2016 DSH Allotment MIN Col I, Col D Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 26OCN1 74439 VerDate Sep<11>2014 18:25 Oct 25, 2016 2 FMAP 11,838,508,175 530,157,145 245,236 C Prior FY (2015) DSH Allotments 11,874,023,700 531,747,616 245,972 D Prior FY (2015) DSH allotment (Col C) × 100% + pct increase in CPIU: 100.3% DSH allotment for FY 2016 determined under section 1923(f)(6)(A) of the Act for Vermont for FY 2016 determined in accordance with section 1905(z)(1)(A) of the Act. 1 Tennessee’s .................. .................. TOTAL LOW DSH STATES ...................... TOTAL ................................................ 50.00 B FY 2016 FMAPs (%) 592,926,113,000 70,078,344,000 608,180,000 E FY 2016 TC MAP Exp. including DSH 19,095,450,000 749,947,000 482,000 F FY 2016 TC DSH expenditures 573,830,663,000 69,328,397,000 607,698,000 G FY 2016 TC MAP EXP. net of DSH Col E–F 87,994,996,285 10,468,678,931 95,952,316 H ‘‘12% Amount’’ = Col G × .12/(1-.12/ Col B) * (in FS) ADDENDUM 2—PRELIMINARY DSH ALLOTMENTS FOR FISCAL YEAR: 2016—Continued WYOMING ........................................................ A State asabaliauskas on DSK3SPTVN1PROD with NOTICES 87,994,996,285 10,468,678,931 95,952,316 I Greater of Col H or Col C (12% Limit, FY 2015 Allotment) 11,927,123,698 531,747,618 245,972 J FY 2016 DSH Allotment MIN Col I, Col D 74440 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices Jkt 241001 PO 00000 Frm 00050 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 74441 KEY TO ADDENDUM 3—FINAL IMD DSH LIMITS FOR FY 2014 [The final FY 2014 IMD DSH Limits for the Non-Low DSH States are presented in the top section of this addendum and the preliminary FY 2014 IMD DSH Limits for the Low-DSH States are presented in the bottom section of the addendum] Column Description Column A .......... Column B .......... State. Inpatient Hospital Services FY 95 DSH Total Computable. This column contains the States’ total computable FY 1995 inpatient hospital DSH expenditures as reported on the Form CMS–64. IMD and Mental Health Services FY 95 DSH Total Computable. This column contains the total computable FY 1995 mental health facility DSH expenditures as reported on the Form CMS–64 as of January 1, 1997. Total Inpatient Hospital & IMD & Mental Health FY 95 DSH Total Computable, Col. B + C. This column contains the total computation of all inpatient hospital DSH expenditures and mental health facility DSH expenditures for FY 1995 as reported on the Form CMS–64 as of January 1, 1997 (representing the sum of Column B and Column C). Applicable Percentage, Col. C/D. This column contains the ‘‘applicable percentage’’ representing the total Computable FY 1995 mental health facility DSH expenditures divided by total computable all inpatient hospital and mental health facility DSH expenditures for FY 1995 (the amount in Column C divided by the amount in Column D) Per section 1923(h)(2)(A)(ii)(III) of the Act, for FYs after FY 2002, the applicable percentage can be no greater than 33 percent. FY 2014 Federal Share DSH Allotment. This column contains the states’ FY 2014 DSH allotments from Column J Addendum 1. FY 2014 FMAP. FY 2014 DSH Allotments in Total Computable, Col. F/G. This column contains states’ FY 2013 total computable DSH allotment (determined as Column F/Column G). Applicable Percentage Applied to FY 2014 Allotments in TC, Col E x Col H. This column contains the applicable percentage of FY 2013 total computable DSH allotment (calculated as the percentage in Column E multiplied by the amount in Column H). FY 2014 TC IMD DSH Limit. Lesser of Col. I or C. This column contains the total computable FY 2014 TC IMD DSH Limit equal to the lesser of the amount in Column I or Column C. FY 2014 IMD DSH Limit in Federal Share, Col. G x J. This column contains the FY 2014 Federal Share IMD DSH limit determined by converting the total computable FY 2014 IMD DSH Limit from Column J into a federal share amount by multiplying it by the FY 2014 FMAP in Column G. Column C ......... Column D ......... Column E .......... Column F .......... Column G ......... Column H ......... Column I ........... Column J .......... asabaliauskas on DSK3SPTVN1PROD with NOTICES Column K .......... VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00051 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 VerDate Sep<11>2014 $4,451,770 28,474,900 1,555,919 594,776 105,573,725 6,545,136 149,714,986 0 89,408,276 153,566,302 76,663,508 37,443,073 132,917,149 60,958,342 120,873,531 105,635,054 304,765,552 0 207,234,618 0 94,753,948 357,370,461 605,000,000 236,072,627 93,432,758 579,199,682 2,397,833 72,076,341 0 292,513,592 9,071,297 7,770,268 163,836,435 18,887,045 $413,006,229 93,916,100 2,189,879,543 173,900,441 303,359,275 39,532,234 184,468,014 407,343,557 315,868,508 79,960,783 11,587,208 158,804,908 1,078,512,169 99,957,958 22,226,467 469,653,946 133,258,800 182,608,033 521,946,524 73,560,000 92,675,916 736,742,539 2,418,869,368 193,201,966 535,731,956 388,207,319 108,503,167 366,681,364 0 1,220,515,401 19,979,252 129,313,480 171,725,815 66,962,606 13,402,460,846 2,506,827 2,422,649 0 0 2,081,429 12,011,250 24,240,000 237,048 6,449,102 6,490,015 214,523 20,019,969 11,437,908 321,120 3,621,116 A ALABAMA ................... ARIZONA .................... CALIFORNIA .............. COLORADO ............... CONNECTICUT .......... DISTRICT OF COLUMBIA ................... FLORIDA .................... GEORGIA ................... ILLINOIS ..................... INDIANA ..................... KANSAS ..................... KENTUCKY ................ LOUISIANA ................. MAINE ......................... MARYLAND ................ MASSACHUSETTS .... MICHIGAN .................. MISSISSIPPI ............... MISSOURI .................. NEVADA ..................... NEW HAMPSHIRE ..... NEW JERSEY ............ NEW YORK ................ NORTH CAROLINA .... OHIO ........................... PENNSYLVANIA ........ RHODE ISLAND ......... SOUTH CAROLINA .... TENNESSEE .............. TEXAS ........................ VERMONT .................. VIRGINIA .................... WASHINGTON ........... WEST VIRGINIA ......... TOTAL ................. 19:10 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00052 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM ALASKA ...................... ARKANSAS ................ DELAWARE ................ HAWAII ....................... IDAHO ......................... IOWA .......................... MINNESOTA ............... MONTANA .................. NEBRASKA ................ NEW MEXICO ............ NORTH DAKOTA ....... OKLAHOMA ................ OREGON .................... SOUTH DAKOTA ....... UTAH .......................... 26OCN1 17,611,765 819,351 7,069,000 0 0 0 5,257,214 0 1,811,337 254,786 988,478 3,273,248 19,975,092 751,299 934,586 4,118,758,904 C B STATE IMD and mental health services FY 95 DSH total computable Inpatient hospital services FY 95 DSH total computable asabaliauskas on DSK3SPTVN1PROD with NOTICES 20,118,592 3,242,000 7,069,000 0 2,081,429 12,011,250 29,497,214 237,048 8,260,439 6,744,801 1,203,001 23,293,217 31,413,000 1,072,419 4,555,702 17,521,219,750 46,077,370 334,183,000 407,343,557 405,276,784 233,527,085 88,250,716 196,247,981 1,211,429,318 160,916,300 143,099,998 575,289,000 438,024,352 182,608,033 729,181,142 73,560,000 187,429,864 1,094,113,000 3,023,869,368 429,274,593 629,164,714 967,407,001 110,901,000 438,757,705 0 1,513,028,993 29,050,549 137,083,748 335,562,250 85,849,651 $417,457,999 122,391,000 2,191,435,462 174,495,217 408,933,000 D Total inpatient & IMD & mental health FY 95 DSH total computable Col B + C 14.20 33.00 0.00 22.06 33.00 33.00 19.08 10.97 33.00 33.00 18.36 33.00 0.00 28.42 0.00 33.00 32.66 20.01 33.00 14.85 33.00 2.16 16.43 0.00 19.33 31.23 5.67 33.00 22.00 1.07 23.27 0.07 0.34 25.82 33.00 25.27 33.00 0.00 0.00 0.00 17.82 0.00 21.93 3.78 33.00 14.05 33.00 33.00 20.51 ........................ E Applicable percent Col C/D 21,745,078 46,050,497 9,664,479 10,403,840 17,547,381 42,040,199 79,731,955 12,117,193 30,208,951 21,745,078 10,196,942 38,657,915 48,322,397 11,790,395 20,942,613 70.00 58.79 65.93 50.00 66.92 56.91 69.83 62.11 61.55 50.00 50.00 66.32 73.05 62.03 63.10 50.00 50.00 50.00 65.78 63.02 53.52 50.11 70.57 65.29 58.69 56.76 50.00 50.00 71.09 68.12 67.23 50.00 50.00 50.00 G FY 2014 FMA Ps (%) 50.00 70.10 55.31 51.85 71.64 57.93 50.00 66.33 54.74 69.20 50.00 64.02 63.14 53.54 70.34 .................. LOW DSH STATES 11,140,511,397 65,385,671 213,504,233 286,896,314 229,517,051 228,182,651 44,035,248 154,790,570 731,960,000 112,089,722 81,398,489 325,593,956 282,893,110 162,796,978 505,738,153 49,372,853 170,908,561 687,216,752 1,714,705,875 314,918,744 433,680,475 599,146,255 69,388,876 349,613,182 0 1,020,817,117 24,019,227 93,522,940 197,491,416 72,057,679 $328,262,759 108,086,519 1,170,270,080 98,745,708 213,504,233 F FY 2014 allotment in FS 43,490,156 65,692,578 17,473,294 20,065,265 24,493,832 72,570,687 159,463,910 18,268,043 55,186,246 31,423,523 20,393,884 60,384,122 76,532,146 22,021,657 29,773,405 19,847,024,163 93,408,101 363,164,200 435,152,911 459,034,102 340,978,259 77,376,995 221,667,722 1,178,489,776 182,111,652 162,796,978 651,187,912 426,557,765 222,856,917 815,312,192 78,245,409 341,817,122 1,374,433,504 3,429,411,750 478,745,430 688,163,242 1,119,481,044 138,473,111 495,413,323 0 1,739,337,395 42,317,172 187,045,880 394,982,832 101,361,203 $481,888,959 160,771,261 2,340,540,160 197,491,416 427,008,466 H FY 2014 allotments in TC col F/G ADDENDUM 3—FINAL IMD DSH LIMIT FOR FY: 2014 14,351,751 16,602,492 5,766,187 0 0 0 28,420,850 0 12,101,159 1,187,029 6,729,982 8,485,398 25,255,608 7,267,147 6,107,908 3,779,602,867 13,268,308 119,844,186 0 101,267,700 112,522,826 25,534,408 42,293,025 129,303,046 60,096,845 53,723,003 119,571,677 140,764,063 0 231,713,221 0 112,799,650 448,931,632 686,138,803 157,985,992 102,194,208 369,428,745 2,993,980 81,383,368 0 336,265,750 13,213,920 10,602,253 130,344,335 22,299,608 $5,138,861 37,404,267 1,661,783 673,160 110,240,246 I Applicable percentage applied to FY 2013 allotments in TC Col E × Col H 14,351,751 819,351 5,766,187 0 0 0 5,257,214 0 1,811,337 254,786 988,478 3,273,248 19,975,092 751,299 934,586 3,439,738,238 6,545,136 119,844,186 0 89,408,276 112,522,826 25,534,408 37,443,073 129,303,046 60,096,845 53,723,003 105,635,054 140,764,063 0 207,234,618 0 94,753,948 357,370,461 605,000,000 157,985,992 93,432,758 369,428,745 2,397,833 72,076,341 0 292,513,592 9,071,297 7,770,268 130,344,335 18,887,045 $4,451,770 28,474,900 1,555,919 594,776 105,573,725 J FY 2014 TC IMD limit (lesser of Col I or Col C) 7,175,876 574,365 3,189,278 0 0 0 2,628,607 0 991,526 176,312 494,239 2,095,533 12,612,273 402,245 657,388 1,931,100,088 4,581,595 70,456,397 0 44,704,138 75,300,275 14,531,632 26,146,498 80,310,122 36,989,608 26,861,501 52,817,527 93,354,726 0 128,547,634 0 47,376,974 178,685,231 302,500,000 103,923,186 58,881,324 197,718,264 1,201,554 50,864,274 0 171,676,227 5,148,868 3,885,134 65,172,167 13,426,800 $3,032,546 19,143,675 777,960 297,388 52,786,863 K FY 2014 IMD limit in FS Col G × J N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH .................. L MMA low DSH Status 74442 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 6,609,524 0 98,662,480 13,501,123,326 WISCONSIN ............... WYOMING .................. asabaliauskas on DSK3SPTVN1PROD with NOTICES TOTAL LOW DSH STATES ........... TOTAL .......... VerDate Sep<11>2014 4,181,997,071 63,238,167 4,492,011 0 17,683,120,397 161,900,647 11,101,535 0 ........................ ........................ 33.00 0.00 11,662,833,710 522,322,313 100,915,788 241,612 .................. .................. 59.06 50.00 20,735,610,077 888,585,914 170,869,942 483,224 3,968,265,459 188,662,592 56,387,081 0 3,498,413,578 58,675,341 4,492,011 0 1,964,750,712 33,650,624 2,652,982 0 .................. .................. LOW DSH LOW DSH Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00053 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 74443 74444 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices KEY TO ADDENDUM 4—PRELIMINARY IMD DSH LIMITS FOR FY 2016 [The preliminary FY 2016 IMD DSH Limits for the Non-Low DSH States are presented in the top section of this addendum and the preliminary FY 2016 IMD DSH Limits for the Low-DSH States are presented in the bottom section of the addendum] Column Description Column A .......... Column B .......... State. Inpatient Hospital Services FY 95 DSH Total Computable. This column contains the States’ total computable FY 1995 inpatient hospital DSH expenditures as reported on the Form CMS–64. IMD and Mental Health Services FY 95 DSH Total. Computable. This column contains the total computable FY 1995 mental health facility DSH expenditures as reported on the Form CMS–64 as of January 1, 1997. Total Inpatient Hospital & IMD & Mental Health FY 95 DSH Total. Computable, Col. B + C. This column contains the total computation of all inpatient hospital DSH expenditures and mental health facility DSH expenditures for FY 1995 as reported on the Form CMS–64 as of January 1, 1997 (representing the sum of Column B and Column C). Applicable Percentage, Col. C/D. This column contains the ‘‘applicable percentage’’ representing the total Computable FY 1995 mental health facility DSH expenditures divided by total computable all inpatient hospital and mental health facility DSH expenditures for FY 1995 (the amount in Column C divided by the amount in Column D) Per section 1923(h)(2)(A)(ii)(III) of the Act, for FYs after FY 2002, the applicable percentage can be no greater than 33 percent. FY 2016 Federal Share DSH Allotment. This column contains the states’ preliminary FY 2016 DSH allotments from Column J Addendum 1. FY 2016 FMAP. FY 2016 DSH Allotments in Total Computable, Col. F/G. This column contains states’ FY 2016 total computable DSH allotment (determined as Column F/Column G). Applicable Percentage Applied to FY 2016 Allotments in TC, Col E × Col H. This column contains the applicable percentage of FY 2015 total computable DSH allotment (calculated as the percentage in Column E multiplied by the amount in Column H). FY 2016 TC IMD DSH Limit. Lesser of Col. I or C. This column contains the total computable FY 2016 TC IMD DSH Limit equal to the lesser of the amount in Column I or Column C. FY 2016 IMD DSH Limit in Federal Share, Col. G × J. This column contains the FY 2016 Federal Share IMD DSH limit determined by converting the total computable FY 2016 IMD DSH Limit from Column J into a federal share amount by multiplying it by the FY 2016 FMAP in Column G. Column C ......... Column D ......... Column E .......... Column F .......... Column G ......... Column H ......... Column I ........... Column J .......... asabaliauskas on DSK3SPTVN1PROD with NOTICES Column K .......... VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00054 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 VerDate Sep<11>2014 $4,451,770 28,474,900 1,555,919 594,776 105,573,725 6,545,136 149,714,986 0 89,408,276 153,566,302 76,663,508 37,443,073 132,917,149 60,958,342 120,873,531 105,635,054 304,765,552 0 207,234,618 0 94,753,948 357,370,461 605,000,000 236,072,627 93,432,758 579,199,682 2,397,833 72,076,341 0 292,513,592 9,071,297 7,770,268 163,836,435 18,887,045 $413,006,229 93,916,100 2,189,879,543 173,900,441 303,359,275 39,532,234 184,468,014 407,343,557 315,868,508 79,960,783 11,587,208 158,804,908 1,078,512,169 99,957,958 22,226,467 469,653,946 133,258,800 182,608,033 521,946,524 73,560,000 92,675,916 736,742,539 2,418,869,368 193,201,966 535,731,956 388,207,319 108,503,167 366,681,364 0 1,220,515,401 19,979,252 129,313,480 171,725,815 66,962,606 13,402,460,846 2,506,827 2,422,649 0 0 2,081,429 12,011,250 24,240,000 237,048 6,449,102 6,490,015 214,523 20,019,969 11,437,908 321,120 3,621,116 A ALABAMA ................... ARIZONA .................... CALIFORNIA .............. COLORADO ............... CONNECTICUT .......... DISTRICT OF COLUMBIA ................... FLORIDA .................... GEORGIA ................... ILLINOIS ..................... INDIANA ..................... KANSAS ..................... KENTUCKY ................ LOUISIANA ................. MAINE ......................... MARYLAND ................ MASSACHUSETTS .... MICHIGAN .................. MISSISSIPPI ............... MISSOURI .................. NEVADA ..................... NEW HAMPSHIRE ..... NEW JERSEY ............ NEW YORK ................ NORTH CAROLINA .... OHIO ........................... PENNSYLVANIA ........ RHODE ISLAND ......... SOUTH CAROLINA .... TENNESSEE .............. TEXAS ........................ VERMONT .................. VIRGINIA .................... WASHINGTON ........... WEST VIRGINIA ......... TOTAL ................. 19:10 Oct 25, 2016 Jkt 241001 PO 00000 Frm 00055 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM ALASKA ...................... ARKANSAS ................ DELAWARE ................ HAWAII ....................... IDAHO ......................... IOWA .......................... MINNESOTA ............... MONTANA .................. NEBRASKA ................ NEW MEXICO ............ NORTH DAKOTA ....... OKLAHOMA ................ OREGON .................... SOUTH DAKOTA ....... UTAH .......................... 26OCN1 17,611,765 819,351 7,069,000 0 0 0 5,257,214 0 1,811,337 254,786 988,478 3,273,248 19,975,092 751,299 934,586 4,118,758,904 C B State IMD and mental health services FY 95 DSH total computable 20,118,592 3,242,000 7,069,000 0 2,081,429 12,011,250 29,497,214 237,048 8,260,439 6,744,801 1,203,001 23,293,217 31,413,000 1,072,419 4,555,702 17,521,219,750 46,077,370 334,183,000 407,343,557 405,276,784 233,527,085 88,250,716 196,247,981 1,211,429,318 160,916,300 143,099,998 575,289,000 438,024,352 182,608,033 729,181,142 73,560,000 187,429,864 1,094,113,000 3,023,869,368 429,274,593 629,164,714 967,407,001 110,901,000 438,757,705 0 1,513,028,993 29,050,549 137,083,748 335,562,250 85,849,651 $417,457,999 122,391,000 2,191,435,462 174,495,217 408,933,000 D Total inpatient & IMD & mental health FY 95 DSH total computable Col B + C 14.20 33.00 0.00 22.06 33.00 33.00 19.08 10.97 33.00 33.00 18.36 33.00 0.00 28.42 0.00 33.00 32.66 20.01 33.00 14.85 33.00 2.16 16.43 0.00 19.33 31.23 5.67 33.00 22.00 1.07 23.27 0.07 0.34 25.82 33.00 25.27 33.00 0.00 0.00 0.00 17.82 0.00 21.93 3.78 33.00 14.05 33.00 33.00 20.51 ........................ E Applicable percent Col C/D 22,137,469 46,881,478 9,838,873 10,591,578 17,864,024 42,798,814 81,170,719 12,335,848 30,754,070 22,137,469 10,380,945 39,355,497 49,194,374 12,003,153 21,320,522 70.00 60.67 67.55 50.89 66.60 55.96 70.32 62.21 62.67 50.00 50.00 65.60 74.17 63.28 64.93 50.00 50.00 50.00 66.24 62.47 52.01 50.42 71.08 65.05 57.13 54.45 50.00 50.00 71.42 69.87 68.92 50.00 50.72 50.00 G FY 2016 FMAPs (%) 50.00 70.00 54.83 53.98 71.24 54.91 50.00 65.24 51.16 70.37 50.00 60.99 64.38 51.61 70.24 .................. LOW DSH STATES 11,395,376,080 66,565,555 217,356,916 292,073,358 233,658,685 232,300,206 44,829,865 157,583,765 745,902,374 114,112,381 82,867,324 331,469,299 287,997,917 165,734,650 514,864,199 50,263,786 173,992,607 699,617,579 1,745,647,742 320,601,454 441,506,239 609,957,849 70,640,998 355,921,952 53,100,000 1,039,237,762 24,452,654 95,210,561 201,055,149 73,357,960 $334,186,261 110,036,940 1,191,387,603 100,527,574 217,356,916 F FY 2016 allotment in FS 44,274,938 66,973,540 17,944,324 19,621,300 25,075,834 77,943,569 162,341,438 18,908,412 60,113,507 31,458,674 20,761,890 64,527,787 76,412,510 23,257,417 30,353,818 20,298,543,664 95,093,650 358,260,946 432,380,989 459,144,596 348,799,108 80,110,552 224,095,229 1,199,007,192 182,084,540 165,734,648 662,938,598 439,021,215 223,452,407 813,628,633 77,412,269 347,985,214 1,399,235,158 3,491,295,484 483,999,780 706,749,222 1,172,770,331 140,105,113 500,734,316 81,629,516 1,819,075,375 44,908,455 190,421,122 402,110,298 102,713,470 $478,297,211 159,658,938 2,382,775,206 198,201,053 434,713,832 H FY 2016 allotments in TC Col F/G 14,610,730 16,926,230 5,921,627 0 0 0 28,933,705 0 13,181,602 1,188,357 6,851,424 9,067,680 25,216,128 7,674,948 6,226,977 3,857,495,519 13,507,734 118,226,112 0 101,292,076 115,103,706 26,436,482 42,756,180 131,554,202 60,087,898 54,692,434 121,729,348 144,877,001 0 231,234,750 0 114,835,121 457,032,604 698,520,178 159,719,927 104,954,279 387,014,209 3,029,266 82,257,467 0 351,681,478 14,023,072 10,793,571 132,696,398 22,597,109 $5,100,559 37,145,479 1,691,770 675,579 112,229,530 I Applicable percentage applied to FY 2016 allotments in TC Col E × Col H ADDENDUM 4—PRELIMINARY IMD DSH LIMIT FOR FISCAL YEAR: 2016 Inpatient hospital services FY 95 DSH total computable asabaliauskas on DSK3SPTVN1PROD with NOTICES 14,610,730 819,351 5,921,627 0 0 0 5,257,214 0 1,811,337 254,786 988,478 3,273,248 19,975,092 751,299 934,586 3,470,599,160 6,545,136 118,226,112 0 89,408,276 115,103,706 26,436,482 37,443,073 131,554,202 60,087,898 54,692,434 105,635,054 144,877,001 0 207,234,618 0 94,753,948 357,370,461 605,000,000 159,719,927 93,432,758 387,014,209 2,397,833 72,076,341 0 292,513,592 9,071,297 7,770,268 132,696,398 18,887,045 $4,451,770 28,474,900 1,555,919 594,776 105,573,725 J FY 2016 TC IMD limit (lesser of Col I or Col C) 7,305,365 573,546 3,246,828 0 0 0 2,628,607 0 926,680 179,293 494,239 1,996,354 12,859,964 387,745 656,453 1,944,261,931 4,581,595 71,727,782 0 45,499,872 76,659,068 14,793,855 26,329,969 81,839,869 37,657,086 27,346,217 52,817,527 95,039,313 0 131,138,066 0 47,376,974 178,685,231 302,500,000 105,798,480 58,367,444 201,286,090 1,208,987 51,231,863 0 167,113,015 4,939,321 3,885,134 66,348,199 13,489,128 $3,110,452 19,624,901 777,960 301,670 52,786,863 K FY 2016 IMD limit in FS Col G × J N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW LOW DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH DSH .................. L MMA low DSH status Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices 74445 Inpatient hospital services FY 95 DSH total computable VerDate Sep<11>2014 18:25 Oct 25, 2016 98,662,480 13,501,123,326 TOTAL LOW DSH STATES ........... 6,609,524 0 A WISCONSIN ............... WYOMING .................. B State asabaliauskas on DSK3SPTVN1PROD with NOTICES TOTAL .......... 4,181,997,071 63,238,167 4,492,011 0 C IMD and mental health services FY 95 DSH total computable 17,683,120,397 161,900,647 11,101,535 0 D Total inpatient & IMD & mental health FY 95 DSH total computable Col B + C 33.00 0.00 ........................ ........................ E Applicable percent Col C/D 11,927,123,698 531,747,618 102,736,813 245,972 F FY 2016 allotment in FS .................. .................. 58.23 50.00 G FY 2016 FMAPs (%) 21,215,437,356 916,893,692 176,432,789 491,944 H FY 2016 allotments in TC Col F/G 4,051,517,746 194,022,228 58,222,820 0 I Applicable percentage applied to FY 2016 allotments in TC Col E × Col H ADDENDUM 4—PRELIMINARY IMD DSH LIMIT FOR FISCAL YEAR: 2016—Continued 3,529,688,919 59,089,759 4,492,011 0 J FY 2016 TC IMD limit (lesser of Col I or Col C) 1,978,132,703 33,870,772 2,615,698 0 K FY 2016 IMD limit in FS Col G × J .................. .................. LOW DSH LOW DSH L MMA low DSH status 74446 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices Jkt 241001 PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 E:\FR\FM\26OCN1.SGM 26OCN1 Federal Register / Vol. 81, No. 207 / Wednesday, October 26, 2016 / Notices [FR Doc. 2016–25813 Filed 10–25–16; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families asabaliauskas on DSK3SPTVN1PROD with NOTICES Submission for OMB Review; Comment Request Title: National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants. OMB No.: 0970–0462. Description: The Administration for Children and Families (ACF), U.S. Department of Health and Human Services (HHS) is proposing data collection activities as part of the Health Profession Opportunity Grants (HPOG) Program. ACF has developed a multipronged research and evaluation approach for the HPOG program to better understand and assess the activities conducted and their results. Two rounds of HPOG grants have been awarded—the first in 2010 (HPOG 1.0) and the second in 2015 (HPOG 2.0). There are federal evaluations associated with each round of grants. HPOG grants provide funding to government agencies, community-based organizations, post-secondary educational institutions, and tribalaffiliated organizations to provide education and training services to Temporary Assistance for Needy Families (TANF) recipients and other low-income individuals. Under HPOG 2.0, ACF awarded grants to five tribalaffiliated organizations and 27 nontribal entities. The proposed data collection activities described in this notice will provide data for the implementation studies of the National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants (i.e., the HPOG 2.0 National Evaluation and the HPOG 2.0 Tribal Evaluation) as well as the impact study for the HPOG 2.0 National Evaluation. OMB previously approved baseline data collection and informed consent forms for the HPOG 2.0 Evaluations under OMB Control Number 0970–0462. The design for the HPOG 2.0 National Evaluation features an implementation study, cost benefit study, and impact study. This information collection clearance request pertains to the implementation study and impact study. VerDate Sep<11>2014 18:25 Oct 25, 2016 Jkt 241001 The goal of the HPOG 2.0 National Evaluation Implementation Study is to describe and assess the implementation, systems change, outcomes and other important information about the operations of the 27 non-tribal HPOG grantees, which are operating 38 distinct programs. To achieve these goals, it is necessary to collect data about the nontribal HPOG program designs and implementation, HPOG partner and program networks, the composition and intensity of HPOG services received, participant characteristics and HPOG experiences, and participant outputs and outcomes. The goal of the HPOG 2.0 National Evaluation Impact Study is to measure and analyze key participant outcomes and impacts including completion of education and training, receipt of certificates and/or degrees, earnings, and employment in a healthcare career. The goal of the HPOG 2.0 Tribal Evaluation is to conduct a comprehensive implementation and outcome evaluation of the five Tribal HPOG 2.0 grantee programs. The evaluation will identify and assess how programmatic health profession training operations are working; determine differences in approaches being used when programs are serving different sub-populations, including participants with different characteristics and skill levels; and identify programs and practices that are successful in supporting the target population to achieve portable industry-recognized certificates or degrees as well as employment-related outcomes. The information collection activities to be submitted in the request package include: (1) Screening Interview to identify respondents for the HPOG 2.0 National Evaluation first-round telephone interviews. (2) HPOG 2.0 National Evaluation first-round telephone interviews with management and staff. These interviews will collect information about the HPOG program context and about program administration, activities and services, partner and stakeholder roles and networks, and respondent perceptions of the program’s strengths. (3) HPOG 2.0 National Evaluation in-person implementation interviews with HPOG personnel will collect information from six HPOG 2.0 programs with promising approaches to the topic areas of specific interest to ACF. (4) HPOG 2.0 National Evaluation participant contact update forms will collect updated participant contact information for impact study PO 00000 Frm 00057 Fmt 4703 Sfmt 4703 74447 participants (treatment and control) every 3 months, during the three year follow-up period. (5) HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews will collect information on high-level program strategies, partnerships in place to implement the Tribal HPOG 2.0 program, program development and lessons learned. (6) HPOG 2.0 Tribal Evaluation program implementation staff interviews will collect information from instructors, trainers, recruitment and orientation staff, and providers of program or supportive services on Tribal HPOG 2.0 program processes including recruitment, screening, orientation, provision of supportive services, and program implementation. (7) HPOG 2.0 Tribal Evaluation employer interviews will collect information from local or regional employers that are partnering with Tribal HPOG 2.0 programs or have employed participants, and collect information on employers’ impressions of the Tribal HPOG 2.0 program and program graduates. (8) HPOG 2.0 Tribal Evaluation program participant focus groups will collect information on participants’ perceptions, experience, outcomes and satisfaction with the Tribal HPOG 2.0 program. (9) HPOG 2.0 Tribal Evaluation program participant completer interviews will collect information on the current employment status of the participants who completed a training program and their perceptions of and satisfaction with the Tribal HPOG 2.0 program. (10) HPOG 2.0 Tribal Evaluation program participant non-completer interviews will collect information on reasons participants left the program, short-term outcomes, how they feel the program could be improved, and any plans for future academic training. Respondents: For the HPOG 2.0 National Evaluation: HPOG program managers; HPOG program staff; and representatives of partner agencies and stakeholders, including support service providers, education and vocational training providers, Workforce Investment Boards, TANF agencies, and participants at the 27 non-tribal HPOG 2.0 grantees. For the HPOG 2.0 Tribal Evaluation: Tribal HPOG 2.0 program staff; administrative staff at grantee institutions; representatives from partner agencies and stakeholders, including local employers; and Tribal HPOG program participants at the five Tribal HPOG 2.0 grantees. E:\FR\FM\26OCN1.SGM 26OCN1

Agencies

[Federal Register Volume 81, Number 207 (Wednesday, October 26, 2016)]
[Notices]
[Pages 74432-74447]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-25813]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-2401-N]
RIN 0938-ZB30


Medicaid Program; Final FY 2014 and Preliminary FY 2016 
Disproportionate Share Hospital Allotments, and Final FY 2014 and 
Preliminary FY 2016 Institutions for Mental Diseases Disproportionate 
Share Hospital Limits

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

ACTION: Notice.

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SUMMARY: This notice announces the final federal share disproportionate 
share hospital (DSH) allotments for federal fiscal year (FY) 2014 and 
the preliminary federal share DSH allotments for FY 2016, and 
corresponding limitations on aggregate state DSH payments to 
institutions for mental disease and other mental health facilities. In 
addition, this notice includes background information

[[Page 74433]]

describing the methodology for determining the amounts of states' FY 
DSH allotments.

DATES: Effective November 25, 2016. The final allotments and 
limitations set forth in this notice are effective for the fiscal years 
specified.

FOR FURTHER INFORMATION CONTACT: Stuart Goldstein, (410) 786-0694 and 
Richard Cuno, (410) 786-1111.

SUPPLEMENTARY INFORMATION: 

I. Background

A. Fiscal Year DSH Allotments

    A state's federal fiscal year (FY) disproportionate share hospital 
(DSH) allotment represents the aggregate limit on the federal share 
amount of the state's payments to DSH hospitals in the state for the 
FY. The amount of such allotment is determined in accordance with the 
provisions of section 1923(f)(3) of the Social Security Act (the Act). 
Under such provisions, in general a state's FY DSH allotment is 
calculated by increasing the amount of its DSH allotment for the 
preceding FY by the percentage change in the Consumer Price Index for 
all Urban Consumers (CPI-U) for the previous FY.
    The Affordable Care Act amended Medicaid DSH provisions, adding 
section 1923(f)(7) of the Act which would have required reductions to 
states' FY DSH allotments beginning with FY 2014, the calculation of 
which was described in the Disproportionate Share Hospital Payment 
Reduction final rule published in the September 18, 2013 Federal 
Register (78 FR 57293). Under the DSH reduction methodology, first, 
each state's unreduced FY DSH allotment would have been calculated in 
accordance with the provisions of section 1923(f) of the Act, excluding 
section 1923(f)(7) of the Act; then, the reduction amount for each 
state would have been determined under the provisions of section 
1923(f)(7) of the Act and implementing regulations at 42 CFR 447.294; 
and, finally, the net FY DSH allotment for each state would have been 
determined by subtracting the DSH reduction amount for the state from 
its unreduced FY 2014 DSH allotment.
    The reductions under section 1923(f)(7) of the Act were delayed and 
modified by section 1204 of Division B (Medicare and Other Health 
Provisions) of the Pathway for SGR Reform Act of 2013 (Pub. L. 113-67 
enacted on December 26, 2013). The reductions of states' fiscal year 
DSH allotments under section 1923(f)(7) of the Act that were applicable 
to FY 2014 and 2015 were repealed, and the FY 2016 reductions were 
increased. Subsequently, the reductions were delayed and modified by 
the Medicare Access and CHIP Reauthorization Act of 2015 (Pub. L. 114-
10 enacted on April 16, 2015) (MACRA). The reductions of states' fiscal 
year DSH allotments under section 1923(f)(7) of the Act that were 
applicable to FY 2017 were repealed and are instead scheduled to begin 
in FY 2018.
    Because there are no reductions to DSH allotments for FY 2014 and 
FY 2016 under section 1923(f)(7) of the Act, this notice contains only 
the state-specific final FY 2014 DSH allotments and preliminary FY 2016 
DSH allotments, as calculated under the statute without application of 
the reductions that would have been imposed under the Affordable Care 
Act provisions beginning with FY 2014. This notice also provides 
information on the calculation of such FY DSH allotments, the 
calculation of the states' institutions for mental disease (IMD) DSH 
limits, and the amounts of states' final FY 2014 IMD DSH limits and 
preliminary FY 2016 IMD DSH limits.

B. Determination of Fiscal Year DSH Allotments

    Generally, in accordance with the methodology specified under 
section 1923(f)(3) of the Act, a state's FY DSH allotment is calculated 
by increasing the amount of its DSH allotment for the preceding FY by 
the percentage change in the CPI-U for the previous FY. Also in 
accordance with section 1923(f)(3) of the Act, a state's DSH allotment 
for a FY is subject to the limitation that an increase to a state's DSH 
allotment for a FY cannot result in the DSH allotment exceeding the 
greater of the state's DSH allotment for the previous FY or 12 percent 
of the state's total medical assistance expenditures for the allotment 
year (this is referred to as the 12 percent limit).
    Furthermore, under section 1923(h) of the Act, federal financial 
participation (FFP) for DSH payments to IMDs and other mental health 
facilities is limited to state-specific aggregate amounts. Under this 
provision, the aggregate limit for DSH payments to IMDs and other 
mental health facilities is the lesser of a state's FY 1995 total 
computable (state and federal share) IMD and other mental health 
facility DSH expenditures applicable to the state's FY 1995 DSH 
allotment (as reported on the Form CMS-64 as of January 1, 1997), or 
the amount equal to the product of the state's current year total 
computable DSH allotment and the applicable percentage specified in 
section 1902(h) of the Act (the applicable percentage is the IMD share 
of DSH total computable expenditures as of FY 1995).
    In general, we determine states' DSH allotments for a FY and the 
IMD DSH limits for the same FY using the most recent available 
estimates of or actual medical assistance expenditures, including DSH 
expenditures in their Medicaid programs and the most recent available 
change in the CPI-U used for the FY in accordance with the methodology 
prescribed in the statute. The indicated estimated or actual 
expenditures are obtained from states for each relevant FY from the 
most recent available quarterly Medicaid budget reports (Form CMS-37) 
or quarterly Medicaid expenditure reports (Form CMS-64), respectively, 
submitted by the states. For example, as part of the initial 
determination of a state's FY DSH allotment (referred to as the 
preliminary DSH allotments) that is determined before the beginning of 
the FY for which the DSH allotments and IMD DSH limits are being 
determined, we use estimated expenditures for the FY obtained from the 
August submission of the CMS-37 submitted by states prior to the 
beginning of the FY; such estimated expenditures are subject to update 
and revision during the FY before such actual expenditure data become 
available. We also use the most recent available estimated CPI-U 
percentage change that is available before the beginning of the FY for 
determining the states' preliminary FY DSH allotments; such estimated 
CPI-U percentage change is subject to update and revision during the FY 
before the actual CPI-U percentage change becomes available. In 
determining the final DSH allotments and IMD DSH limits for a FY we use 
the actual expenditures for the FY and actual CPI-U percentage change 
for the previous FY.

II. Provisions of the Notice

A. Calculation of the Final FY 2014 Federal Share State DSH Allotments, 
and the Preliminary FY 2016 Federal Share State DSH Allotments

1. Final FY 2014 Federal Share State DSH Allotments
    Addendum 1 to this notice provides the states' final FY 2014 DSH 
allotments determined in accordance with section 1923(f)(3) of the Act. 
As described in the background section, in general, the DSH allotment 
for a FY is calculated by increasing the FY DSH allotment for the 
preceding FY by the CPI-U increase for the previous fiscal year. For 
purposes of calculating the states' final FY 2014 DSH allotments, the 
preceding final fiscal year DSH allotments (for FY 2013) were published 
in the February 2, 2016

[[Page 74434]]

Federal Register (81 FR 5448). For purposes of calculating the states' 
final FY 2014 DSH allotments we are using the actual Medicaid 
expenditures for FY 2014. Finally, for purposes of calculating the 
states' final FY 2014 DSH allotments, the applicable historical 
percentage change in the CPI-U for the previous FY (FY 2013) was 1.6 
percent; we note that this is an increase from the estimated 1.5 
percentage change in the CPI-U for FY 2013 that was available and used 
in the calculation of the preliminary FY 2014 DSH allotments which were 
published in the February 28, 2014 Federal Register (79 FR 11436).
2. Calculation of the Preliminary FY 2016 Federal Share State DSH 
Allotments
    Addendum 2 to this notice provides the preliminary FY 2016 DSH 
allotments determined in accordance with section 1923(f)(3) of the Act. 
The preliminary FY 2016 DSH allotments contained in this notice were 
determined based on the most recent available estimates from states of 
their FY 2016 total computable Medicaid expenditures. Also, the 
preliminary FY 2016 allotments contained in this notice were determined 
by increasing the preliminary FY 2015 DSH allotments as contained in 
the notice published in the February 2, 2016 Federal Register (81 FR 
5448) by 0.3 percent, representing the most recent available estimate 
of the percentage increase in the CPI-U for FY 2015 (the previous FY to 
FY 2016).
    We will publish states' final FY 2016 DSH allotments in future 
notices based on the states' four quarterly Medicaid expenditure 
reports (Form CMS-64) for FY 2016 available following the end of FY 
2016 and the actual change in the CPI-U for FY 2015.

B. Calculation of the Final FY 2014 and Preliminary FY 2016 IMD DSH 
Limits

    Section 1923(h) of the Act specifies the methodology to be used to 
establish the limits on the amount of DSH payments that a state can 
make to IMDs and other mental health facilities. FFP is not available 
for IMD or DSH payments that exceed the IMD limits. In this notice, we 
are publishing the final FY 2014 and the preliminary FY 2016 IMD DSH 
limits determined in accordance with the provisions discussed above.
    Addendums 3 and 4 to this notice detail each state's final FY 2014 
and preliminary FY 2016 IMD DSH limit, respectively, determined in 
accordance with section 1923(h) of the Act.

III. Collection of Information Requirements

    This notice does not impose any new or revised information 
collection or recordkeeping requirements or burden. While discussed in 
section I.B. of this preamble and in Addendums 3 and 4, the 
requirements and burden associated with Form CMS-37 (OMB control number 
0938-0101) and Form CMS-64 (OMB control number 0938-0067) are 
unaffected by this notice. Consequently, this notice, CMS-37, and CMS-
64 are not subject to Office of Management and Budget review under the 
authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et 
seq.).

IV. Regulatory Impact Analysis

    We have examined the impact of this notice as required by Executive 
Order 12866 on Regulatory Planning and Review (September 1993), the 
Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-354), 
section 1102(b) of the Act, section 202 of the Unfunded Mandates Reform 
Act of 1995 (March 22, 1995; Pub. L. 104-4), Executive Order 13132 on 
Federalism (August 4, 1999) and the Congressional Review Act (5 U.S.C. 
804(2)).
    Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, if regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety 
effects, distributive impacts, and equity). A regulatory impact 
analysis (RIA) must be prepared for major rules with economically 
significant effects ($100 million or more in any 1 year). This notice 
reaches the $100 million economic threshold and thus is considered a 
major rule under the Congressional Review Act.
    The final FY 2014 DSH allotments being published in this notice are 
approximately $11 million more than the preliminary FY 2014 DSH 
allotments published in the February 28, 2014 Federal Register (79 FR 
11436). The increase in the final FY 2014 DSH allotments is due to the 
difference between the actual percentage change in the CPI-U for FY 
2013 used in the calculation of the final FY 2014 allotments (1.6 
percent) as compared to the estimated percentage change in the CPI-U 
for FY 2013 used in the calculation of the preliminary FY 2014 
allotments (1.5 percent). The final FY 2014 IMD DSH limits being 
published in this notice are approximately $563 thousand more than the 
preliminary FY 2014 IMD DSH limits published in the February 28, 2014 
Federal Register (79 FR 11436). The increases in the IMD DSH limits are 
because the DSH allotment for a FY is a factor in the determination of 
the IMD DSH limit for the FY. Since the final FY 2014 DSH allotments 
were increased as compared to the preliminary FY 2014 DSH allotments, 
the associated FY 2014 IMD DSH limits for some states were also 
increased.
    The preliminary FY 2016 DSH allotments being published in this 
notice are about $36 million more than the preliminary FY 2015 DSH 
allotments published in the February 2, 2016 Federal Register (81 FR 
5448). The increase in the DSH allotments is due to the application of 
the statutory formula for calculating DSH allotments under which the 
prior fiscal year allotments are increased by the percentage increase 
in the CPI-U for the prior fiscal year. The preliminary FY 2016 IMD DSH 
limits being published in this notice are about $260 thousand less than 
the final FY 2014 IMD DSH limits published in the February 28, 2014 
Federal Register (79 FR 11436). Although the DSH allotment for a FY is 
a factor in the determination of the IMD DSH limit for the FY and the 
preliminary FY 2016 DSH allotments are greater than the preliminary FY 
2015 DSH allotments, the associated preliminary FY 2016 IMD DSH limits 
for some states decreased. This is attributable to a decrease in the 
FMAP rates for certain states.
    The RFA requires agencies to analyze options for regulatory relief 
of small businesses, if a rule has a significant impact on a 
substantial number of small entities. For purposes of the RFA, small 
entities include small businesses, nonprofit organizations, and small 
governmental jurisdictions. Most hospitals and most other providers and 
suppliers are small entities, either by nonprofit status or by having 
revenues of less than $7.0 million to $34.5 million in any one year. 
Individuals and states are not included in the definition of a small 
entity. We are not preparing an analysis for the RFA because the 
Secretary has determined that this notice will not have significant 
economic impact on a substantial number of small entities. 
Specifically, any impact on providers is due to the effect of the 
various controlling statutes; providers are not impacted as a result of 
the independent regulatory action in publishing this notice. The 
purpose of the notice is to announce the latest distributions as 
required by the statute.
    In addition, section 1102(b) of the Act requires us to prepare a 
regulatory impact analysis if a rule may have a significant impact on 
the operations of

[[Page 74435]]

a substantial number of small rural hospitals. This analysis must 
conform to the provisions of section 604 of the RFA. For purposes of 
section 1102(b) of the Act, we define a small rural hospital as a 
hospital that is located outside of a Core-Based Statistical Area for 
Medicaid payment regulations and has fewer than 100 beds. We are not 
preparing analysis for section 1102(b) of the Act because the Secretary 
has determined that this notice will not have a significant impact on 
the operations of a substantial number of small rural hospitals.
    The Medicaid statute specifies the methodology for determining the 
amounts of states' DSH allotments and IMD DSH limits; and as described 
previously, the application of the methodology specified in statute 
results in the decreases or increases in states' DSH allotments and IMD 
DSH limits for the applicable FYs. The statute applicable to these 
allotments and limits does not apply to the determination of the 
amounts of DSH payments made to specific DSH hospitals; rather, these 
allotments and limits represent an overall limit on the total of such 
DSH payments. In this regard, we do not believe that this notice will 
have a significant economic impact on a substantial number of small 
entities.
    Section 202 of the Unfunded Mandates Reform Act of 1995 also 
requires that agencies assess anticipated costs and benefits before 
issuing any rule whose mandates require spending in any 1 year of $100 
million in 1995 dollars, updated annually for inflation. In 2016, that 
threshold is approximately $146 million. This notice will have no 
consequential effect on state, local, or tribal governments, in the 
aggregate, or on the private sector.
    Executive Order 13132 establishes certain requirements that an 
agency must meet when it promulgates a proposed rule (and subsequent 
final rule) that imposes substantial direct requirement costs on state 
and local governments, preempts state law, or otherwise has Federalism 
implications. Since this notice does not impose any costs on state or 
local governments, the requirements of E.O. 13132 are not applicable.

A. Alternatives Considered

    The methodologies for determining the states' fiscal year DSH 
allotments and IMD DSH Limits, as reflected in this notice, were 
established in accordance with the methodologies and formula for 
determining states' allotments as specified in statute. This notice 
does not put forward any further discretionary administrative policies 
for determining such allotments.

B. Accounting Statement

    As required by OMB Circular A-4 (available at http://www.whitehouse.gov/omb/circulars/a004/a-4.pdf), in the Table 1, we have 
prepared an accounting statement showing the classification of the 
estimated expenditures associated with the provisions of this notice. 
Table 1 provides our best estimate of the change (decrease) in the 
federal share of states' Medicaid DSH payments resulting from the 
application of the provisions of the Medicaid statute relating to the 
calculation of states' FY DSH allotments and the increase in the FY DSH 
allotments from FY 2015 to FY 2016.

Table 1--Accounting Statement: Classification of Estimated Expenditures,
                       From the FY 2015 to FY 2016
                              [In millions]
------------------------------------------------------------------------
           Category                             Transfers
------------------------------------------------------------------------
Annualized Monetized Transfers  $36.
From Whom To Whom?............  Federal Government to States.
------------------------------------------------------------------------

C. Congressional Review Act

    This proposed regulation is subject to the Congressional Review Act 
provisions of the Small Business Regulatory Enforcement Fairness Act of 
1996 (5 U.S.C. 801 et seq.) and has been transmitted to the Congress 
and the Comptroller General for review.
    In accordance with the provisions of Executive Order 12866, this 
notice was reviewed by the Office of Management and Budget.

    Dated: September 8, 2016.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
    Dated: October 13, 2016.
Sylvia Burwell,
Secretary, Department of Health and Human Services.

           Key to Addendum 1--Final DSH Allotments for FY 2014
    [The Final FY 2014 DSH Allotments for the NON-Low DSH States are
presented in the top section of this addendum, and the Final FY 2014 DSH
Allotments for the Low-DSH States are presented in the bottom section of
                             this addendum]
------------------------------------------------------------------------
          Column                            Description
------------------------------------------------------------------------
Column A.................  State.
Column B.................  FY 2014 FMAPs. This column contains the
                            States' FY 2014 Federal Medical Assistance
                            Percentages.
Column C.................  Prior FY (2013) DSH Allotments. This column
                            contains the States' prior FY 2013 DSH
                            Allotments.
Column D.................  Prior FY (2013) DSH Allotments (Col C) x (100
                            percent + Percentage Increase in CPIU):
                            101.6 percent. This column contains the
                            amount in Column C increased by 1 plus the
                            percentage increase in the CPI-U for the
                            prior FY (101.6 percent).
Column E.................  FY 2014 TC MAP Exp. Including DSH. This
                            column contains the amount of the States' FY
                            2014 total computable (TC) medical
                            assistance expenditures including DSH
                            expenditures.
Column F.................  FY 2014 TC DSH Expenditures. This column
                            contains the amount of the States' FY 2014
                            total computable DSH expenditures.
Column G.................  FY 2014 TC MAP Exp. Net of DSH. This column
                            contains the amount of the States' FY 2014
                            total computable medical assistance
                            expenditures net of DSH expenditures,
                            calculated as the amount in Column E minus
                            the amount in Column F.
Column H.................  12 percent Amount. This column contains the
                            amount of the ``12 percent limit'' in
                            Federal share, determined in accordance with
                            the provisions of section 1923(f)(3) of the
                            Act.
Column I.................  Greater of FY 2013 Allotment or 12 percent
                            Limit. This column contains the greater of
                            the State's prior FY (FY 2013) DSH allotment
                            or the amount of the 12 percent Limit,
                            determined as the maximum of the amount in
                            Column C or Column H.
Column J.................  FY 2014 DSH Allotment. This column contains
                            the States' final FY 2014 DSH allotments,
                            determined as the minimum of the amount in
                            Column I or Column D. For states with ``na''
                            in Columns I or D, refer to the footnotes in
                            the addendum.
------------------------------------------------------------------------


[[Page 74436]]


                                                                     Addendum 1--Final DSH Allotments for Fiscal Year: 2014
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                     Prior FY (2013)
                                                                      DSH allotment     FY 2014 TC MAP                      FY 2014 TC MAP    ``12% Amount'' =   Greater of Col    FY 2014 DSH
                 State                    FY 2014   Prior FY (2013)   (Col C) x 100%    Exp. including    FY 2014 TC DSH   EXP. net of DSH    Col G x .12/(1-     H. Or Col C     allotment MIN
                                         FMAPs (%)   DSH Allotments   + pct increase         DSH           expenditures        Col E-F        .12/Col B)* (in    (12% Limit, FY    Col I, Col D
                                                                     in CPIU: 101.6%                                                                FS)         2012 allotment)
A                                                B                C                D                  E                F                  G                  H                I                J
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALABAMA...............................       68.12     $323,093,267     $328,262,759     $5,211,164,487     $481,382,790     $4,729,781,697       $688,936,698     $688,936,698     $328,262,759
ARIZONA...............................       67.23      106,384,369      108,086,519      9,184,808,597      143,402,254      9,041,406,343      1,320,703,419    1,320,703,419      108,086,519
CALIFORNIA............................       50.00    1,151,840,630    1,170,270,080     63,473,249,870    2,483,466,487     60,989,783,383      9,629,965,797    9,629,965,797    1,170,270,080
COLORADO..............................       50.00       97,190,657       98,745,708      5,919,783,385      197,297,029      5,722,486,356        903,550,477      903,550,477       98,745,708
CONNECTICUT...........................       50.00      210,141,962      213,504,233      6,820,658,024      149,024,544      6,671,633,480      1,053,415,813    1,053,415,813      213,504,233
DISTRICT OF COLUMBIA..................       70.00       64,355,975       65,385,671      2,367,792,161       54,250,889      2,313,541,272        335,064,598      335,064,598       65,385,671
FLORIDA...............................       58.79      210,141,962      213,504,233     20,303,199,078      336,086,757     19,967,112,321      3,010,557,470    3,010,557,470      213,504,233
GEORGIA...............................       65.93      282,378,262      286,896,314      9,396,958,654      435,057,563      8,961,901,091      1,314,722,356    1,314,722,356      286,896,314
ILLINOIS..............................       50.00      225,902,609      229,517,051     16,616,392,364      457,503,046     16,158,889,318      2,551,403,577    2,551,403,577      229,517,051
INDIANA...............................       66.92      224,589,223      228,182,651      9,094,042,848      260,455,931      8,833,586,917      1,291,646,693    1,291,646,693      228,182,651
KANSAS................................       56.91       43,341,780       44,035,248      2,727,710,336       77,294,578      2,650,415,758        403,033,162      403,033,162       44,035,248
KENTUCKY..............................       69.83      152,352,923      154,790,570      7,792,776,771      211,149,028      7,581,627,743      1,098,582,186    1,098,582,186      154,790,570
LOUISIANA \1\.........................          na               na               na                 na               na                 na                 na               na      731,960,000
MAINE.................................       61.55      110,324,530      112,089,722      2,365,417,230       39,328,950      2,326,088,280        346,730,334      346,730,334      112,089,722
MARYLAND..............................       50.00       80,116,623       81,398,489      9,210,329,395      100,897,485      9,109,431,910      1,438,331,354    1,438,331,354       81,398,489
MASSACHUSETTS.........................       50.00      320,466,492      325,593,956     14,250,839,665                0     14,250,839,665      2,250,132,579    2,250,132,579      325,593,956
MICHIGAN..............................       66.32      278,438,100      282,893,110     13,502,617,518      562,486,296     12,940,131,222      1,895,853,099    1,895,853,099      282,893,110
MISSISSIPPI...........................       73.05      160,233,246      162,796,978      4,865,309,235      222,637,569      4,642,671,666        666,628,335      666,628,335      162,796,978
MISSOURI..............................       62.03      497,773,773      505,738,153      8,828,757,766      728,957,576      8,099,800,190      1,205,110,388    1,205,110,388      505,738,153
NEVADA................................       63.10       48,595,328       49,372,853      2,281,105,301       78,243,748      2,202,861,553        326,420,111      326,420,111       49,372,853
NEW HAMPSHIRE.........................       50.00      168,217,088      170,908,561      1,322,700,772      109,314,773      1,213,385,999        191,587,263      191,587,263      170,908,561
NEW JERSEY............................       50.00      676,394,441      687,216,752     12,470,313,962    1,213,920,187     11,256,393,775      1,777,325,333    1,777,325,333      687,216,752
NEW YORK..............................       50.00    1,687,702,633    1,714,705,875     51,806,022,238    3,366,485,105     48,439,537,133      7,648,347,968    7,648,347,968    1,714,705,875
NORTH CAROLINA........................       65.78      309,959,394      314,918,744     11,992,545,816      406,901,519     11,585,644,297      1,700,491,666    1,700,491,666      314,918,744
OHIO..................................       63.02      426,850,861      433,680,475     19,439,277,855      672,625,070     18,766,652,785      2,781,672,580    2,781,672,580      433,680,475
PENNSYLVANIA..........................       53.52      589,710,881      599,146,255     23,461,728,946      956,292,192     22,505,436,754      3,481,187,789    3,481,187,789      599,146,255
RHODE ISLAND..........................       50.11       68,296,138       69,388,876      2,434,239,452      138,322,435      2,295,917,017        362,262,089      362,262,089       69,388,876
SOUTH CAROLINA........................       70.57      344,107,463      349,613,182      5,321,038,897      495,387,414      4,825,651,483        697,721,479      697,721,479      349,613,182
TENNESSEE \2\.........................          na               na               na                 na               na                 na                 na               na                0
TEXAS.................................       58.69    1,004,741,257    1,020,817,117     31,385,332,042    1,526,236,093     29,859,095,949      4,503,997,450    4,503,997,450    1,020,817,117
VERMONT \3\...........................       56.76       23,640,971       24,019,227      1,526,126,311       37,448,781      1,488,677,530        226,534,414      226,534,414       24,019,227
VIRGINIA..............................       50.00       92,050,138       93,522,940      7,547,405,238      178,694,576      7,368,710,662      1,163,480,631    1,163,480,631       93,522,940
WASHINGTON............................       50.00      194,381,315      197,491,416     10,233,713,069      365,034,687      9,868,678,382      1,558,212,376    1,558,212,376      197,491,416
WEST VIRGINIA.........................       71.09       70,922,912       72,057,679      3,331,020,307       74,411,705      3,256,608,602        470,155,300      470,155,300       72,057,679
                                       ---------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL.............................        0.00   10,244,637,203   10,408,551,398    396,484,377,590   16,559,997,057    379,924,380,533     58,293,764,783   58,293,764,783   11,140,511,397
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                         LOW DSH STATES
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALASKA................................       50.00       21,402,636       21,745,078      1,412,407,094       23,114,859      1,389,292,235     219,361,931.84      219,361,932       21,745,078
ARKANSAS..............................       70.10       45,325,292       46,050,497      4,840,075,746       37,579,991      4,802,495,755        695,328,645      695,328,645       46,050,497
DELAWARE..............................       55.31        9,512,282        9,664,479      1,691,771,386       14,203,340      1,677,568,046        257,085,076      257,085,076        9,664,479
HAWAII................................       51.85       10,240,000       10,403,840      1,949,895,249                0      1,949,895,249     304,447,885.55      304,447,886       10,403,840
IDAHO.................................       71.64       17,271,044       17,547,381      1,585,631,105       24,108,102      1,561,523,003     225,085,529.04      225,085,529       17,547,381
IOWA..................................       57.93       41,378,149       42,040,199      3,921,556,276       43,692,924      3,877,863,352        586,922,597      586,922,597       42,040,199
MINNESOTA.............................       50.00       78,476,334       79,731,955      9,917,891,767       43,384,841      9,874,506,926      1,559,132,673    1,559,132,673       79,731,955
MONTANA...............................       66.33       11,926,371       12,117,193      1,072,160,721       18,113,453      1,054,047,268        154,422,872      154,422,872       12,117,193
NEBRASKA..............................       54.74       29,733,219       30,208,951      1,771,909,070       41,226,990      1,730,682,080        265,992,149      265,992,149       30,208,951
NEW MEXICO............................       69.20       21,402,636       21,745,078      4,168,980,357        2,385,192      4,166,595,165        604,884,725      604,884,725       21,745,078
NORTH DAKOTA..........................       50.00       10,036,360       10,196,942        911,750,976        2,102,554        909,648,422        143,628,698      143,628,698       10,196,942
OKLAHOMA..............................       64.02       38,049,129       38,657,915      4,666,284,967       43,523,823      4,622,761,144        682,697,044      682,697,044       38,657,915
OREGON................................       63.14       47,561,414       48,322,397      6,784,093,341       32,160,564      6,751,932,777      1,000,352,841    1,000,352,841       48,322,397
SOUTH DAKOTA..........................       53.54       11,604,719       11,790,395        778,125,953        1,642,404        776,483,549        120,095,125      120,095,125       11,790,395
UTAH..................................       70.34       20,612,808       20,942,613      2,064,362,848       31,747,312      2,032,615,536        294,084,697      294,084,697       20,942,613
WISCONSIN.............................       59.06       99,326,563      100,915,788      7,396,295,700       50,838,381      7,345,457,319      1,106,220,253    1,106,220,253      100,915,788

[[Page 74437]]

 
WYOMING...............................       50.00          237,807          241,612        539,403,281          466,255        538,937,026         85,095,320       85,095,320          241,612
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL LOW DSH STATES..............        0.00      514,096,763      522,322,311     55,472,595,837      410,290,985     55,062,304,852      8,304,838,060    8,304,838,060      522,322,313
                                       ---------------------------------------------------------------------------------------------------------------------------------------------------------
        TOTAL.........................        0.00   10,758,733,966   10,930,873,709    451,956,973,427   16,970,288,042    434,986,685,385     66,598,602,843   66,598,602,843   11,662,833,710
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ FY 2014 DSH allotment for Louisiana determined under the provisions of section 1903(f)(3)(C) and (D) of the Act.
\2\ Tennessee's DSH allotment for FY 2014, determined under section 1923(f)(6)(A) of the Social Security Act, is 0.
\3\ Per 1905(z)(1)(A) of Act, Vermont's regular FMAP is increased by 2.2 percentage points for the period 1/1/2014--12/31/2015.


[[Page 74438]]


        Key to Addendum 2--Preliminary DSH Allotments for FY 2016
 [The Preliminary FY 2016 DSH Allotments for the NON-Low DSH States are
  presented in the top section of this addendum, and the Preliminary FY
 2016 DSH Allotments for the Low-DSH States are presented in the bottom
                        section of this addendum]
------------------------------------------------------------------------
          Column                            Description
------------------------------------------------------------------------
Column A.................  State.
Column B.................  FY 2016 FMAPs. This column contains the
                            States' FY 2016 Federal Medical Assistance
                            Percentages.
Column C.................  Prior FY (2015) DSH Allotments. This column
                            contains the States' prior FY 2015 DSH
                            Allotments.
Column D.................  Prior FY (2015) DSH Allotments (Col C) x
                            (100percent + Percentage Increase in CPIU):
                            100.3percent. This column contains the
                            amount in Column C increased by 1 plus the
                            estimated percentage increase in the CPI-U
                            for the prior FY (100.3 percent).
Column E.................  FY 2016 TC MAP Exp. Including DSH. This
                            column contains the amount of the States'
                            projected FY 2016 total computable (TC)
                            medical assistance expenditures including
                            DSH expenditures.
Column F.................  FY 2016 TC DSH Expenditures. This column
                            contains the amount of the States' projected
                            FY 2016 total computable DSH expenditures.
Column G.................  FY 2016 TC MAP Exp. Net of DSH. This column
                            contains the amount of the States' projected
                            FY 2016 total computable medical assistance
                            expenditures net of DSH expenditures,
                            calculated as the amount in Column E minus
                            the amount in Column F.
Column H.................  12 percent Amount. This column contains the
                            amount of the ``12 percent limit'' in
                            Federal share, determined in accordance with
                            the provisions of section 1923(f)(3) of the
                            Act.
Column I.................  Greater of FY 2015 Allotment or 12 percent
                            Limit. This column contains the greater of
                            the State's prior FY (FY 2015) DSH allotment
                            or the amount of the 12 percent Limit,
                            determined as the maximum of the amount in
                            Column C or Column H.
Column J.................  FY 2016 DSH Allotment. This column contains
                            the States' preliminary FY 2016 DSH
                            allotments, determined as the minimum of the
                            amount in Column I or Column D. For states
                            with ``na'' in Columns I or D, refer to the
                            footnotes in the addendum.
------------------------------------------------------------------------


[[Page 74439]]


                                                                  Addendum 2--Preliminary DSH Allotments for Fiscal Year: 2016
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                     Prior FY (2015)
                                                                      DSH allotment                                                           ``12% Amount'' =   Greater of Col
                                          FY 2016   Prior FY (2015)   (Col C) x 100%    FY 2016 TC MAP    FY 2016 TC DSH    FY 2016 TC MAP    Col G x .12/(1-   H or Col C (12%    FY 2016 DSH
                 State                   FMAPs (%)   DSH Allotments   + pct increase    Exp. including     expenditures    EXP. net of DSH    .12/Col B) * (in   Limit, FY 2015   Allotment MIN
                                                                         in CPIU:            DSH                               Col E-F              FS)            Allotment)      Col I, Col D
                                                                          100.3%
A                                                B                C                D                  E                F                  G                  H                I                J
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALABAMA...............................       69.87     $333,186,701     $334,186,261     $5,930,834,000     $479,878,000     $5,450,956,000       $789,752,816     $789,752,816     $334,186,261
ARIZONA...............................       68.92      109,707,817      110,036,940     12,053,707,000      170,695,000     11,883,012,000      1,726,585,777    1,726,585,777      110,036,940
CALIFORNIA............................       50.00    1,187,824,131    1,191,387,603    111,044,623,000      615,463,000    110,429,160,000     17,436,183,158   17,436,183,158    1,191,387,603
COLORADO..............................       50.72      100,226,893      100,527,574      8,094,087,000      221,186,000      7,872,901,000      1,237,541,959    1,237,541,959      100,527,574
CONNECTICUT...........................       50.00      216,706,796      217,356,916      7,523,550,000      121,554,000      7,401,996,000      1,168,736,211    1,168,736,211      217,356,916
DISTRICT OF COLUMBIA..................       70.00       66,366,456       66,565,555      2,768,440,000       36,674,000      2,731,766,000        395,635,076      395,635,076       66,565,555
FLORIDA...............................       60.67      216,706,796      217,356,916     21,269,943,000      360,904,000     20,909,039,000      3,127,720,722    3,127,720,722      217,356,916
GEORGIA...............................       67.55      291,199,759      292,073,358      9,111,625,000      435,016,000      8,676,609,000      1,266,113,277    1,266,113,277      292,073,358
ILLINOIS..............................       50.89      232,959,806      233,658,685     16,127,216,000      394,376,000     15,732,840,000      2,470,488,745    2,470,488,745      233,658,685
INDIANA...............................       66.60      231,605,390      232,300,206     12,434,804,000      128,475,000     12,306,329,000      1,801,322,003    1,801,322,003      232,300,206
KANSAS................................       55.96       44,695,778       44,829,865      3,237,360,000       78,926,000      3,158,434,000        482,473,066      482,473,066       44,829,865
KENTUCKY..............................       70.32      157,112,428      157,583,765     10,502,654,000      498,275,000     10,004,379,000      1,447,547,184    1,447,547,184      157,583,765
LOUISIANA.............................       62.21      743,671,360      745,902,374      8,188,536,000      881,390,000      7,307,146,000      1,086,423,149    1,086,423,149      745,902,374
MAINE.................................       62.67      113,771,068      114,112,381      2,595,932,000       42,279,000      2,553,653,000        379,011,092      379,011,092      114,112,381
MARYLAND..............................       50.00       82,619,466       82,867,324     10,300,033,000      102,916,000     10,197,117,000      1,610,071,105    1,610,071,105       82,867,324
MASSACHUSETTS.........................       50.00      330,477,865      331,469,299     17,688,569,000                0     17,688,569,000      2,792,931,947    2,792,931,947      331,469,299
MICHIGAN..............................       65.60      287,136,507      287,997,917     18,245,307,000      399,957,000     17,845,350,000      2,620,869,313    2,620,869,313      287,997,917
MISSISSIPPI...........................       74.17      165,238,933      165,734,650      5,593,780,000      225,000,000      5,368,780,000        768,606,876      768,606,876      165,734,650
MISSOURI..............................       63.28      513,324,226      514,864,199      9,977,517,000      741,320,000      9,236,197,000      1,367,706,426    1,367,706,426      514,864,199
NEVADA................................       64.93       50,113,446       50,263,786      3,487,301,000       79,052,000      3,408,249,000        501,713,828      501,713,828       50,263,786
NEW HAMPSHIRE.........................       50.00      173,472,190      173,992,607      1,982,620,000      215,300,000      1,767,320,000        279,050,526      279,050,526      173,992,607
NEW JERSEY............................       50.00      697,525,004      699,617,579     15,818,782,000    1,055,083,000     14,763,699,000      2,331,110,368    2,331,110,368      699,617,579
NEW YORK..............................       50.00    1,740,426,463    1,745,647,742     67,708,685,000    5,212,860,000     62,495,825,000      9,867,761,842    9,867,761,842    1,745,647,742
NORTH CAROLINA........................       66.24      319,642,526      320,601,454     14,344,107,000      584,963,000     13,759,144,000      2,016,384,289    2,016,384,289      320,601,454
OHIO..................................       62.47      440,185,682      441,506,239     23,409,769,000                0     23,409,769,000      3,477,095,152    3,477,095,152      441,506,239
PENNSYLVANIA..........................       52.01      608,133,449      609,957,849     25,118,027,000      970,040,000     24,147,987,000      3,766,868,694    3,766,868,694      609,957,849
RHODE ISLAND..........................       50.42       70,429,709       70,640,998      2,798,911,000      140,859,000      2,658,052,000        418,591,302      418,591,302       70,640,998
SOUTH CAROLINA........................       71.08      354,857,380      355,921,952      6,627,245,000      514,209,000      6,113,036,000        882,561,812      882,561,812      355,921,952
TENNESSEE \1\.........................       65.05               na               na                 na               na                 na                 na               na       53,100,000
TEXAS.................................       57.13    1,036,129,374    1,039,237,762     40,938,942,000    2,913,588,000     38,025,354,000      5,776,348,701    5,776,348,701    1,039,237,762
VERMONT \2\...........................       54.45       24,379,515       24,452,654      1,950,326,000       37,449,000      1,912,877,000        294,434,354      294,434,354       24,452,654
VIRGINIA..............................       50.00       94,925,784       95,210,561      8,682,506,000      202,125,000      8,480,381,000      1,339,007,526    1,339,007,526       95,210,561
WASHINGTON............................       50.00      200,453,788      201,055,149     13,268,547,000      412,552,000     12,855,995,000      2,029,893,947    2,029,893,947      201,055,149
WEST VIRGINIA.........................       71.42       73,138,544       73,357,960      4,023,484,000       73,139,000      3,950,345,000        569,775,106      569,775,106       73,357,960
                                       ---------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL.............................  ..........   11,308,351,030   11,342,276,083    522,847,769,000   18,345,503,000    504,502,266,000     77,526,317,353   77,526,317,353   11,395,376,080
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                         LOW DSH STATES
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALASKA................................       50.00       22,071,255       22,137,469      1,845,425,000       28,763,000      1,816,662,000     286,841,368.42      286,841,368       22,137,469
ARKANSAS..............................       70.00       46,741,254       46,881,478      6,474,078,000       50,820,000      6,423,258,000        930,264,952      930,264,952       46,881,478
DELAWARE..............................       54.83        9,809,445        9,838,873      2,024,107,000       23,869,000      2,000,238,000        307,279,149      307,279,149        9,838,873
HAWAII \3\............................       53.98       10,559,898       10,591,578      2,280,099,000                0      2,280,099,000     351,823,946.70      351,823,947       10,591,578
IDAHO.................................       71.24       17,810,592       17,864,024      1,954,296,000       25,668,000      1,928,628,000     278,316,256.69      278,316,257       17,864,024
IOWA..................................       54.91       42,670,802       42,798,814      4,977,980,000       46,668,000      4,931,312,000        757,245,421      757,245,421       42,798,814
MINNESOTA.............................       50.00       80,927,935       81,170,719     12,331,901,000      154,640,000     12,177,261,000      1,922,725,421    1,922,725,421       81,170,719
MONTANA...............................       65.24       12,298,951       12,335,848      1,114,619,000        1,656,000      1,112,963,000        163,658,241      163,658,241       12,335,848
NEBRASKA..............................       51.16       30,662,084       30,754,070      2,123,413,000       45,557,000      2,077,856,000        325,750,091      325,750,091       30,754,070
NEW MEXICO............................       70.37       22,071,255       22,137,469      6,102,795,000       32,020,000      6,070,775,000        878,260,278      878,260,278       22,137,469
NORTH DAKOTA..........................       50.00       10,349,895       10,380,945      1,291,738,000        1,765,000      1,289,973,000        203,679,947      203,679,947       10,380,945
OKLAHOMA..............................       60.99       39,237,784       39,355,497      5,461,374,000       52,314,000      5,409,060,000        808,079,778      808,079,778       39,355,497
OREGON................................       64.38       49,047,232       49,194,374      9,507,193,000       82,564,000      9,424,629,000      1,390,051,810    1,390,051,810       49,194,374
SOUTH DAKOTA..........................       51.61       11,967,251       12,003,153        901,031,000        1,617,000        899,414,000        140,627,387      140,627,387       12,003,153
UTAH..................................       70.24       21,256,752       21,320,522      2,546,400,000       30,842,000      2,515,558,000        364,064,823      364,064,823       21,320,522
WISCONSIN.............................       58.23      102,429,524      102,736,813      8,533,715,000      170,702,000      8,363,013,000      1,264,057,747    1,264,057,747      102,736,813

[[Page 74440]]

 
WYOMING...............................       50.00          245,236          245,972        608,180,000          482,000        607,698,000         95,952,316       95,952,316          245,972
                                       ---------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL LOW DSH STATES..............  ..........      530,157,145      531,747,616     70,078,344,000      749,947,000     69,328,397,000     10,468,678,931   10,468,678,931      531,747,618
                                       ---------------------------------------------------------------------------------------------------------------------------------------------------------
        TOTAL.........................  ..........   11,838,508,175   11,874,023,700    592,926,113,000   19,095,450,000    573,830,663,000     87,994,996,285   87,994,996,285   11,927,123,698
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Tennessee's DSH allotment for FY 2016 determined under section 1923(f)(6)(A) of the Act
\2\ FMAP for Vermont for FY 2016 determined in accordance with section 1905(z)(1)(A) of the Act.


[[Page 74441]]


           Key to Addendum 3--Final IMD DSH Limits for FY 2014
    [The final FY 2014 IMD DSH Limits for the Non-Low DSH States are
  presented in the top section of this addendum and the preliminary FY
 2014 IMD DSH Limits for the Low-DSH States are presented in the bottom
                        section of the addendum]
------------------------------------------------------------------------
          Column                            Description
------------------------------------------------------------------------
Column A.................  State.
Column B.................  Inpatient Hospital Services FY 95 DSH Total
                            Computable. This column contains the States'
                            total computable FY 1995 inpatient hospital
                            DSH expenditures as reported on the Form CMS-
                            64.
Column C.................  IMD and Mental Health Services FY 95 DSH
                            Total Computable. This column contains the
                            total computable FY 1995 mental health
                            facility DSH expenditures as reported on the
                            Form CMS-64 as of January 1, 1997.
Column D.................  Total Inpatient Hospital & IMD & Mental
                            Health FY 95 DSH Total Computable, Col. B +
                            C. This column contains the total
                            computation of all inpatient hospital DSH
                            expenditures and mental health facility DSH
                            expenditures for FY 1995 as reported on the
                            Form CMS-64 as of January 1, 1997
                            (representing the sum of Column B and Column
                            C).
Column E.................  Applicable Percentage, Col. C/D. This column
                            contains the ``applicable percentage''
                            representing the total Computable FY 1995
                            mental health facility DSH expenditures
                            divided by total computable all inpatient
                            hospital and mental health facility DSH
                            expenditures for FY 1995 (the amount in
                            Column C divided by the amount in Column D)
                            Per section 1923(h)(2)(A)(ii)(III) of the
                            Act, for FYs after FY 2002, the applicable
                            percentage can be no greater than 33
                            percent.
Column F.................  FY 2014 Federal Share DSH Allotment. This
                            column contains the states' FY 2014 DSH
                            allotments from Column J Addendum 1.
Column G.................  FY 2014 FMAP.
Column H.................  FY 2014 DSH Allotments in Total Computable,
                            Col. F/G. This column contains states' FY
                            2013 total computable DSH allotment
                            (determined as Column F/Column G).
Column I.................  Applicable Percentage Applied to FY 2014
                            Allotments in TC, Col E x Col H. This column
                            contains the applicable percentage of FY
                            2013 total computable DSH allotment
                            (calculated as the percentage in Column E
                            multiplied by the amount in Column H).
Column J.................  FY 2014 TC IMD DSH Limit. Lesser of Col. I or
                            C. This column contains the total computable
                            FY 2014 TC IMD DSH Limit equal to the lesser
                            of the amount in Column I or Column C.
Column K.................  FY 2014 IMD DSH Limit in Federal Share, Col.
                            G x J. This column contains the FY 2014
                            Federal Share IMD DSH limit determined by
                            converting the total computable FY 2014 IMD
                            DSH Limit from Column J into a federal share
                            amount by multiplying it by the FY 2014 FMAP
                            in Column G.
------------------------------------------------------------------------


[[Page 74442]]


                                                                                              Addendum 3--Final IMD DSH Limit for FY: 2014
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                                              Applicable
                                                             Inpatient                      Total inpatient                                                                   percentage
                                                              hospital      IMD and mental   & IMD & mental    Applicable                       FY 2014       FY 2014       applied to  FY   FY 2014 TC IMD    FY 2014 IMD      MMA low
                          STATE                            services FY 95  health services    health FY 95   percent  Col C/     FY 2014        FMA Ps     allotments in         2013        limit (lesser     limit in FS        DSH
                                                             DSH total     FY 95 DSH total     DSH total            D        allotment in FS      (%)       TC  col F/G     allotments in   of Col I or Col     Col G x J       Status
                                                             computable       computable    computable  Col                                                                TC  Col E x Col         C)
                                                                                                 B + C                                                                            H
A                                                                       B                C                D               E                F           G                H                I                J                K           L
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALABAMA.................................................     $413,006,229       $4,451,770     $417,457,999            1.07     $328,262,759       68.12     $481,888,959       $5,138,861       $4,451,770       $3,032,546         N/A
ARIZONA.................................................       93,916,100       28,474,900      122,391,000           23.27      108,086,519       67.23      160,771,261       37,404,267       28,474,900       19,143,675         N/A
CALIFORNIA..............................................    2,189,879,543        1,555,919    2,191,435,462            0.07    1,170,270,080       50.00    2,340,540,160        1,661,783        1,555,919          777,960         N/A
COLORADO................................................      173,900,441          594,776      174,495,217            0.34       98,745,708       50.00      197,491,416          673,160          594,776          297,388         N/A
CONNECTICUT.............................................      303,359,275      105,573,725      408,933,000           25.82      213,504,233       50.00      427,008,466      110,240,246      105,573,725       52,786,863         N/A
DISTRICT OF COLUMBIA....................................       39,532,234        6,545,136       46,077,370           14.20       65,385,671       70.00       93,408,101       13,268,308        6,545,136        4,581,595         N/A
FLORIDA.................................................      184,468,014      149,714,986      334,183,000           33.00      213,504,233       58.79      363,164,200      119,844,186      119,844,186       70,456,397         N/A
GEORGIA.................................................      407,343,557                0      407,343,557            0.00      286,896,314       65.93      435,152,911                0                0                0         N/A
ILLINOIS................................................      315,868,508       89,408,276      405,276,784           22.06      229,517,051       50.00      459,034,102      101,267,700       89,408,276       44,704,138         N/A
INDIANA.................................................       79,960,783      153,566,302      233,527,085           33.00      228,182,651       66.92      340,978,259      112,522,826      112,522,826       75,300,275         N/A
KANSAS..................................................       11,587,208       76,663,508       88,250,716           33.00       44,035,248       56.91       77,376,995       25,534,408       25,534,408       14,531,632         N/A
KENTUCKY................................................      158,804,908       37,443,073      196,247,981           19.08      154,790,570       69.83      221,667,722       42,293,025       37,443,073       26,146,498         N/A
LOUISIANA...............................................    1,078,512,169      132,917,149    1,211,429,318           10.97      731,960,000       62.11    1,178,489,776      129,303,046      129,303,046       80,310,122         N/A
MAINE...................................................       99,957,958       60,958,342      160,916,300           33.00      112,089,722       61.55      182,111,652       60,096,845       60,096,845       36,989,608         N/A
MARYLAND................................................       22,226,467      120,873,531      143,099,998           33.00       81,398,489       50.00      162,796,978       53,723,003       53,723,003       26,861,501         N/A
MASSACHUSETTS...........................................      469,653,946      105,635,054      575,289,000           18.36      325,593,956       50.00      651,187,912      119,571,677      105,635,054       52,817,527         N/A
MICHIGAN................................................      133,258,800      304,765,552      438,024,352           33.00      282,893,110       66.32      426,557,765      140,764,063      140,764,063       93,354,726         N/A
MISSISSIPPI.............................................      182,608,033                0      182,608,033            0.00      162,796,978       73.05      222,856,917                0                0                0         N/A
MISSOURI................................................      521,946,524      207,234,618      729,181,142           28.42      505,738,153       62.03      815,312,192      231,713,221      207,234,618      128,547,634         N/A
NEVADA..................................................       73,560,000                0       73,560,000            0.00       49,372,853       63.10       78,245,409                0                0                0         N/A
NEW HAMPSHIRE...........................................       92,675,916       94,753,948      187,429,864           33.00      170,908,561       50.00      341,817,122      112,799,650       94,753,948       47,376,974         N/A
NEW JERSEY..............................................      736,742,539      357,370,461    1,094,113,000           32.66      687,216,752       50.00    1,374,433,504      448,931,632      357,370,461      178,685,231         N/A
NEW YORK................................................    2,418,869,368      605,000,000    3,023,869,368           20.01    1,714,705,875       50.00    3,429,411,750      686,138,803      605,000,000      302,500,000         N/A
NORTH CAROLINA..........................................      193,201,966      236,072,627      429,274,593           33.00      314,918,744       65.78      478,745,430      157,985,992      157,985,992      103,923,186         N/A
OHIO....................................................      535,731,956       93,432,758      629,164,714           14.85      433,680,475       63.02      688,163,242      102,194,208       93,432,758       58,881,324         N/A
PENNSYLVANIA............................................      388,207,319      579,199,682      967,407,001           33.00      599,146,255       53.52    1,119,481,044      369,428,745      369,428,745      197,718,264         N/A
RHODE ISLAND............................................      108,503,167        2,397,833      110,901,000            2.16       69,388,876       50.11      138,473,111        2,993,980        2,397,833        1,201,554         N/A
SOUTH CAROLINA..........................................      366,681,364       72,076,341      438,757,705           16.43      349,613,182       70.57      495,413,323       81,383,368       72,076,341       50,864,274         N/A
TENNESSEE...............................................                0                0                0            0.00                0       65.29                0                0                0                0         N/A
TEXAS...................................................    1,220,515,401      292,513,592    1,513,028,993           19.33    1,020,817,117       58.69    1,739,337,395      336,265,750      292,513,592      171,676,227         N/A
VERMONT.................................................       19,979,252        9,071,297       29,050,549           31.23       24,019,227       56.76       42,317,172       13,213,920        9,071,297        5,148,868         N/A
VIRGINIA................................................      129,313,480        7,770,268      137,083,748            5.67       93,522,940       50.00      187,045,880       10,602,253        7,770,268        3,885,134         N/A
WASHINGTON..............................................      171,725,815      163,836,435      335,562,250           33.00      197,491,416       50.00      394,982,832      130,344,335      130,344,335       65,172,167         N/A
WEST VIRGINIA...........................................       66,962,606       18,887,045       85,849,651           22.00       72,057,679       71.09      101,361,203       22,299,608       18,887,045       13,426,800         N/A
                                                         -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL...............................................   13,402,460,846    4,118,758,904   17,521,219,750  ..............   11,140,511,397  ..........   19,847,024,163    3,779,602,867    3,439,738,238    1,931,100,088  ..........
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                             LOW DSH STATES
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALASKA..................................................        2,506,827       17,611,765       20,118,592           33.00       21,745,078       50.00       43,490,156       14,351,751       14,351,751        7,175,876     LOW DSH
ARKANSAS................................................        2,422,649          819,351        3,242,000           25.27       46,050,497       70.10       65,692,578       16,602,492          819,351          574,365     LOW DSH
DELAWARE................................................                0        7,069,000        7,069,000           33.00        9,664,479       55.31       17,473,294        5,766,187        5,766,187        3,189,278     LOW DSH
HAWAII..................................................                0                0                0            0.00       10,403,840       51.85       20,065,265                0                0                0     LOW DSH
IDAHO...................................................        2,081,429                0        2,081,429            0.00       17,547,381       71.64       24,493,832                0                0                0     LOW DSH
IOWA....................................................       12,011,250                0       12,011,250            0.00       42,040,199       57.93       72,570,687                0                0                0     LOW DSH
MINNESOTA...............................................       24,240,000        5,257,214       29,497,214           17.82       79,731,955       50.00      159,463,910       28,420,850        5,257,214        2,628,607     LOW DSH
MONTANA.................................................          237,048                0          237,048            0.00       12,117,193       66.33       18,268,043                0                0                0     LOW DSH
NEBRASKA................................................        6,449,102        1,811,337        8,260,439           21.93       30,208,951       54.74       55,186,246       12,101,159        1,811,337          991,526     LOW DSH
NEW MEXICO..............................................        6,490,015          254,786        6,744,801            3.78       21,745,078       69.20       31,423,523        1,187,029          254,786          176,312     LOW DSH
NORTH DAKOTA............................................          214,523          988,478        1,203,001           33.00       10,196,942       50.00       20,393,884        6,729,982          988,478          494,239     LOW DSH
OKLAHOMA................................................       20,019,969        3,273,248       23,293,217           14.05       38,657,915       64.02       60,384,122        8,485,398        3,273,248        2,095,533     LOW DSH
OREGON..................................................       11,437,908       19,975,092       31,413,000           33.00       48,322,397       63.14       76,532,146       25,255,608       19,975,092       12,612,273     LOW DSH
SOUTH DAKOTA............................................          321,120          751,299        1,072,419           33.00       11,790,395       53.54       22,021,657        7,267,147          751,299          402,245     LOW DSH
UTAH....................................................        3,621,116          934,586        4,555,702           20.51       20,942,613       70.34       29,773,405        6,107,908          934,586          657,388     LOW DSH

[[Page 74443]]

 
WISCONSIN...............................................        6,609,524        4,492,011       11,101,535           33.00      100,915,788       59.06      170,869,942       56,387,081        4,492,011        2,652,982     LOW DSH
WYOMING.................................................                0                0                0            0.00          241,612       50.00          483,224                0                0                0     LOW DSH
                                                         -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL LOW DSH STATES................................       98,662,480       63,238,167      161,900,647  ..............      522,322,313  ..........      888,585,914      188,662,592       58,675,341       33,650,624  ..........
                                                         -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
        TOTAL...........................................   13,501,123,326    4,181,997,071   17,683,120,397  ..............   11,662,833,710  ..........   20,735,610,077    3,968,265,459    3,498,413,578    1,964,750,712  ..........
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------


[[Page 74444]]


        Key to Addendum 4--Preliminary IMD DSH Limits for FY 2016
 [The preliminary FY 2016 IMD DSH Limits for the Non-Low DSH States are
  presented in the top section of this addendum and the preliminary FY
 2016 IMD DSH Limits for the Low-DSH States are presented in the bottom
                        section of the addendum]
------------------------------------------------------------------------
          Column                            Description
------------------------------------------------------------------------
Column A.................  State.
Column B.................  Inpatient Hospital Services FY 95 DSH Total
                            Computable. This column contains the States'
                            total computable FY 1995 inpatient hospital
                            DSH expenditures as reported on the Form CMS-
                            64.
Column C.................  IMD and Mental Health Services FY 95 DSH
                            Total. Computable. This column contains the
                            total computable FY 1995 mental health
                            facility DSH expenditures as reported on the
                            Form CMS-64 as of January 1, 1997.
Column D.................  Total Inpatient Hospital & IMD & Mental
                            Health FY 95 DSH Total. Computable, Col. B +
                            C. This column contains the total
                            computation of all inpatient hospital DSH
                            expenditures and mental health facility DSH
                            expenditures for FY 1995 as reported on the
                            Form CMS-64 as of January 1, 1997
                            (representing the sum of Column B and Column
                            C).
Column E.................  Applicable Percentage, Col. C/D. This column
                            contains the ``applicable percentage''
                            representing the total Computable FY 1995
                            mental health facility DSH expenditures
                            divided by total computable all inpatient
                            hospital and mental health facility DSH
                            expenditures for FY 1995 (the amount in
                            Column C divided by the amount in Column D)
                            Per section 1923(h)(2)(A)(ii)(III) of the
                            Act, for FYs after FY 2002, the applicable
                            percentage can be no greater than 33
                            percent.
Column F.................  FY 2016 Federal Share DSH Allotment. This
                            column contains the states' preliminary FY
                            2016 DSH allotments from Column J Addendum
                            1.
Column G.................  FY 2016 FMAP.
Column H.................  FY 2016 DSH Allotments in Total Computable,
                            Col. F/G. This column contains states' FY
                            2016 total computable DSH allotment
                            (determined as Column F/Column G).
Column I.................  Applicable Percentage Applied to FY 2016
                            Allotments in TC, Col E x Col H. This column
                            contains the applicable percentage of FY
                            2015 total computable DSH allotment
                            (calculated as the percentage in Column E
                            multiplied by the amount in Column H).
Column J.................  FY 2016 TC IMD DSH Limit. Lesser of Col. I or
                            C. This column contains the total computable
                            FY 2016 TC IMD DSH Limit equal to the lesser
                            of the amount in Column I or Column C.
Column K.................  FY 2016 IMD DSH Limit in Federal Share, Col.
                            G x J. This column contains the FY 2016
                            Federal Share IMD DSH limit determined by
                            converting the total computable FY 2016 IMD
                            DSH Limit from Column J into a federal share
                            amount by multiplying it by the FY 2016 FMAP
                            in Column G.
------------------------------------------------------------------------


[[Page 74445]]


                                                                                       Addendum 4--Preliminary IMD DSH Limit for Fiscal Year: 2016
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                                              Applicable
                                                             Inpatient                      Total inpatient                                                                   percentage
                                                              hospital      IMD and mental   & IMD & mental    Applicable                                     FY 2016       applied to  FY   FY 2016 TC IMD    FY 2016 IMD      MMA low
                          State                            services FY 95  health services    health FY 95   percent Col C/      FY 2016        FY 2016    allotments in         2016        limit  (lesser  limit in FS Col      DSH
                                                             DSH total     FY 95 DSH total     DSH total            D        allotment in FS   FMAPs (%)     TC Col F/G     allotments in   of Col I or Col       G x J         status
                                                             computable       computable     computable Col                                                                 TC Col E x Col         C)
                                                                                                 B + C                                                                            H
A                                                                       B                C                D               E                F           G                H                I                J                K           L
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ALABAMA.................................................     $413,006,229       $4,451,770     $417,457,999            1.07     $334,186,261       69.87     $478,297,211       $5,100,559       $4,451,770       $3,110,452         N/A
ARIZONA.................................................       93,916,100       28,474,900      122,391,000           23.27      110,036,940       68.92      159,658,938       37,145,479       28,474,900       19,624,901         N/A
CALIFORNIA..............................................    2,189,879,543        1,555,919    2,191,435,462            0.07    1,191,387,603       50.00    2,382,775,206        1,691,770        1,555,919          777,960         N/A
COLORADO................................................      173,900,441          594,776      174,495,217            0.34      100,527,574       50.72      198,201,053          675,579          594,776          301,670         N/A
CONNECTICUT.............................................      303,359,275      105,573,725      408,933,000           25.82      217,356,916       50.00      434,713,832      112,229,530      105,573,725       52,786,863         N/A
DISTRICT OF COLUMBIA....................................       39,532,234        6,545,136       46,077,370           14.20       66,565,555       70.00       95,093,650       13,507,734        6,545,136        4,581,595         N/A
FLORIDA.................................................      184,468,014      149,714,986      334,183,000           33.00      217,356,916       60.67      358,260,946      118,226,112      118,226,112       71,727,782         N/A
GEORGIA.................................................      407,343,557                0      407,343,557            0.00      292,073,358       67.55      432,380,989                0                0                0         N/A
ILLINOIS................................................      315,868,508       89,408,276      405,276,784           22.06      233,658,685       50.89      459,144,596      101,292,076       89,408,276       45,499,872         N/A
INDIANA.................................................       79,960,783      153,566,302      233,527,085           33.00      232,300,206       66.60      348,799,108      115,103,706      115,103,706       76,659,068         N/A
KANSAS..................................................       11,587,208       76,663,508       88,250,716           33.00       44,829,865       55.96       80,110,552       26,436,482       26,436,482       14,793,855         N/A
KENTUCKY................................................      158,804,908       37,443,073      196,247,981           19.08      157,583,765       70.32      224,095,229       42,756,180       37,443,073       26,329,969         N/A
LOUISIANA...............................................    1,078,512,169      132,917,149    1,211,429,318           10.97      745,902,374       62.21    1,199,007,192      131,554,202      131,554,202       81,839,869         N/A
MAINE...................................................       99,957,958       60,958,342      160,916,300           33.00      114,112,381       62.67      182,084,540       60,087,898       60,087,898       37,657,086         N/A
MARYLAND................................................       22,226,467      120,873,531      143,099,998           33.00       82,867,324       50.00      165,734,648       54,692,434       54,692,434       27,346,217         N/A
MASSACHUSETTS...........................................      469,653,946      105,635,054      575,289,000           18.36      331,469,299       50.00      662,938,598      121,729,348      105,635,054       52,817,527         N/A
MICHIGAN................................................      133,258,800      304,765,552      438,024,352           33.00      287,997,917       65.60      439,021,215      144,877,001      144,877,001       95,039,313         N/A
MISSISSIPPI.............................................      182,608,033                0      182,608,033            0.00      165,734,650       74.17      223,452,407                0                0                0         N/A
MISSOURI................................................      521,946,524      207,234,618      729,181,142           28.42      514,864,199       63.28      813,628,633      231,234,750      207,234,618      131,138,066         N/A
NEVADA..................................................       73,560,000                0       73,560,000            0.00       50,263,786       64.93       77,412,269                0                0                0         N/A
NEW HAMPSHIRE...........................................       92,675,916       94,753,948      187,429,864           33.00      173,992,607       50.00      347,985,214      114,835,121       94,753,948       47,376,974         N/A
NEW JERSEY..............................................      736,742,539      357,370,461    1,094,113,000           32.66      699,617,579       50.00    1,399,235,158      457,032,604      357,370,461      178,685,231         N/A
NEW YORK................................................    2,418,869,368      605,000,000    3,023,869,368           20.01    1,745,647,742       50.00    3,491,295,484      698,520,178      605,000,000      302,500,000         N/A
NORTH CAROLINA..........................................      193,201,966      236,072,627      429,274,593           33.00      320,601,454       66.24      483,999,780      159,719,927      159,719,927      105,798,480         N/A
OHIO....................................................      535,731,956       93,432,758      629,164,714           14.85      441,506,239       62.47      706,749,222      104,954,279       93,432,758       58,367,444         N/A
PENNSYLVANIA............................................      388,207,319      579,199,682      967,407,001           33.00      609,957,849       52.01    1,172,770,331      387,014,209      387,014,209      201,286,090         N/A
RHODE ISLAND............................................      108,503,167        2,397,833      110,901,000            2.16       70,640,998       50.42      140,105,113        3,029,266        2,397,833        1,208,987         N/A
SOUTH CAROLINA..........................................      366,681,364       72,076,341      438,757,705           16.43      355,921,952       71.08      500,734,316       82,257,467       72,076,341       51,231,863         N/A
TENNESSEE...............................................                0                0                0            0.00       53,100,000       65.05       81,629,516                0                0                0         N/A
TEXAS...................................................    1,220,515,401      292,513,592    1,513,028,993           19.33    1,039,237,762       57.13    1,819,075,375      351,681,478      292,513,592      167,113,015         N/A
VERMONT.................................................       19,979,252        9,071,297       29,050,549           31.23       24,452,654       54.45       44,908,455       14,023,072        9,071,297        4,939,321         N/A
VIRGINIA................................................      129,313,480        7,770,268      137,083,748            5.67       95,210,561       50.00      190,421,122       10,793,571        7,770,268        3,885,134         N/A
WASHINGTON..............................................      171,725,815      163,836,435      335,562,250           33.00      201,055,149       50.00      402,110,298      132,696,398      132,696,398       66,348,199         N/A
WEST VIRGINIA...........................................       66,962,606       18,887,045       85,849,651           22.00       73,357,960       71.42      102,713,470       22,597,109       18,887,045       13,489,128         N/A
                                                         -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL...............................................   13,402,460,846    4,118,758,904   17,521,219,750  ..............   11,395,376,080  ..........   20,298,543,664    3,857,495,519    3,470,599,160    1,944,261,931  ..........
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                                                                                                             LOW DSH STATES
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ALASKA..................................................        2,506,827       17,611,765       20,118,592           33.00       22,137,469       50.00       44,274,938       14,610,730       14,610,730        7,305,365     LOW DSH
ARKANSAS................................................        2,422,649          819,351        3,242,000           25.27       46,881,478       70.00       66,973,540       16,926,230          819,351          573,546     LOW DSH
DELAWARE................................................                0        7,069,000        7,069,000           33.00        9,838,873       54.83       17,944,324        5,921,627        5,921,627        3,246,828     LOW DSH
HAWAII..................................................                0                0                0            0.00       10,591,578       53.98       19,621,300                0                0                0     LOW DSH
IDAHO...................................................        2,081,429                0        2,081,429            0.00       17,864,024       71.24       25,075,834                0                0                0     LOW DSH
IOWA....................................................       12,011,250                0       12,011,250            0.00       42,798,814       54.91       77,943,569                0                0                0     LOW DSH
MINNESOTA...............................................       24,240,000        5,257,214       29,497,214           17.82       81,170,719       50.00      162,341,438       28,933,705        5,257,214        2,628,607     LOW DSH
MONTANA.................................................          237,048                0          237,048            0.00       12,335,848       65.24       18,908,412                0                0                0     LOW DSH
NEBRASKA................................................        6,449,102        1,811,337        8,260,439           21.93       30,754,070       51.16       60,113,507       13,181,602        1,811,337          926,680     LOW DSH
NEW MEXICO..............................................        6,490,015          254,786        6,744,801            3.78       22,137,469       70.37       31,458,674        1,188,357          254,786          179,293     LOW DSH
NORTH DAKOTA............................................          214,523          988,478        1,203,001           33.00       10,380,945       50.00       20,761,890        6,851,424          988,478          494,239     LOW DSH
OKLAHOMA................................................       20,019,969        3,273,248       23,293,217           14.05       39,355,497       60.99       64,527,787        9,067,680        3,273,248        1,996,354     LOW DSH
OREGON..................................................       11,437,908       19,975,092       31,413,000           33.00       49,194,374       64.38       76,412,510       25,216,128       19,975,092       12,859,964     LOW DSH
SOUTH DAKOTA............................................          321,120          751,299        1,072,419           33.00       12,003,153       51.61       23,257,417        7,674,948          751,299          387,745     LOW DSH
UTAH....................................................        3,621,116          934,586        4,555,702           20.51       21,320,522       70.24       30,353,818        6,226,977          934,586          656,453     LOW DSH

[[Page 74446]]

 
WISCONSIN...............................................        6,609,524        4,492,011       11,101,535           33.00      102,736,813       58.23      176,432,789       58,222,820        4,492,011        2,615,698     LOW DSH
WYOMING.................................................                0                0                0            0.00          245,972       50.00          491,944                0                0                0     LOW DSH
                                                         -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    TOTAL LOW DSH STATES................................       98,662,480       63,238,167      161,900,647  ..............      531,747,618  ..........      916,893,692      194,022,228       59,089,759       33,870,772  ..........
                                                         -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
        TOTAL...........................................   13,501,123,326    4,181,997,071   17,683,120,397  ..............   11,927,123,698  ..........   21,215,437,356    4,051,517,746    3,529,688,919    1,978,132,703  ..........
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[[Page 74447]]

[FR Doc. 2016-25813 Filed 10-25-16; 8:45 am]
 BILLING CODE 4120-01-P