Federal Matching Shares for Medicaid, the Children's Health Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 1, 2018 Through September 30, 2019, 55383-55386 [2017-24953]
Download as PDF
<![CDATA[
Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices
health care, increase awareness of the
connection between oral health and
overall health, prevent disease and
promote oral health, and improve health
literacy to health providers and patients
alike. HRSA developed a core set of oral
health clinical competencies for nondental providers as part of its
Integration of Oral Health and Primary
Care Practice (IOHPCP) initiative in
response to recommendations from two
Institute of Medicine (IOM) reports:
Advancing Oral Health in America and
Improving Access to Oral Health Care
for Vulnerable and Underserved
Populations. NNOHA participated in
the IOHPCP initiative and in fiscal year
(FY) 2012 received supplemental
funding (U30CS09745–05–02) to
implement a pilot project in safety net
settings to inform the impact and
effectiveness of oral health core clinical
competencies and inter-professional
collaboration in primary care settings.
The goal of the project was to increase
integration of oral health and primary
health care. NNOHA published the pilot
project results in a user guide entitled,
User’s Guide for Implementation of
inter-professional oral health core
clinical competencies and continues to
provide technical assistance to health
centers and training on oral health
integration and primary care practice.
The Joint Explanatory Statement to
the Consolidated Appropriations Act of
FY 2017 encouraged HRSA to allocate
$250,000 for demonstration projects to
support the implementation of
integrating oral health and primary care
projects. The projects are to model the
core clinical oral health competencies
for non-dental providers that HRSA
published and initially tested in its 2014
report, Integration of Oral Health and
Primary Care Practice. In order to
achieve this goal, HRSA will provide
supplemental funding to the NNOHA to
advance and expand the
implementation of oral health core
clinical competencies in health centers,
focusing on services for pregnant
women and children. Additionally,
these demonstration projects will
directly align with four HRSA
recommendations for effectively
incorporating the competencies into
clinical practice as described in the
2014 Integrating Oral Health and
Primary Care Practice report. This
activity is consistent with the current
work plan of NNOHA and includes
providing training and technical
assistance on IOHPCP. NNOHA’s
primary roles are to coordinate all
activities at the planning,
implementation, evaluation, and
dissemination stages, as well as provide
technical assistance and training to
participating HCs. NNOHA shall select
no fewer than six HCs, which it
supports as part of the current HRSAfunded National Training and Technical
Assistance Cooperative Agreement
Program (U30CS29051). NNOHA will
assure that each HC will propose,
implement, and track data for an
innovative inter-professional oral health
project that measurably increases the
adoption of the core clinical oral health
competencies among non-dental
providers in the delivery of care to
pregnant women and children.
FOR FURTHER INFORMATION CONTACT:
Chinyere Amaefule, Office of Quality
Improvement, Division of Strategic
Partnerships, Bureau of Primary Health
Care, Health Resources and Services
Administration, 5600 Fishers Lane,
Rockville, Maryland 20857, Phone:
(301) 594–4417, Email: Camaefule@
hrsa.gov.
Grantee/organization name
Grant No.
National Network of Oral Health Access ......................................................................
U30CS29051
Dated: November 14, 2017.
George Sigounas,
Administrator.
[FR Doc. 2017–25191 Filed 11–20–17; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Federal Matching Shares for Medicaid,
the Children’s Health Insurance
Program, and Aid to Needy Aged,
Blind, or Disabled Persons for October
1, 2018 Through September 30, 2019
Office of the Secretary, DHHS.
Notice.
AGENCY:
ACTION:
The percentages listed in Table
1 will be effective for each of the four
quarter-year periods beginning October
1, 2018 and ending September 30, 2019.
FOR FURTHER INFORMATION CONTACT:
Caryn Marks or Rose Chu, Office of
Health Policy, Office of the Assistant
Secretary for Planning and Evaluation,
Room 447D—Hubert H. Humphrey
Building, 200 Independence Avenue
asabaliauskas on DSKBBXCHB2PROD with NOTICES
DATES:
VerDate Sep<11>2014
18:56 Nov 20, 2017
Jkt 244001
SW., Washington, DC 20201, (202) 690–
6870.
SUPPLEMENTARY INFORMATION: The
Federal Medical Assistance Percentages
(FMAP), Enhanced Federal Medical
Assistance Percentages (eFMAP), and
disaster-recovery FMAP adjustments for
Fiscal Year 2019 have been calculated
pursuant to the Social Security Act (the
Act). These percentages will be effective
from October 1, 2018 through
September 30, 2019. This notice
announces the calculated FMAP rates,
in accordance with sections 1101(a)(8)
and 1905(b) of the Act, that the U.S.
Department of Health and Human
Services (HHS) will use in determining
the amount of federal matching for state
medical assistance (Medicaid),
Temporary Assistance for Needy
Families (TANF) Contingency Funds,
Child Support Enforcement collections,
Child Care Mandatory and Matching
Funds of the Child Care and
Development Fund, Title IV–E Foster
Care Maintenance payments, Adoption
Assistance payments and Kinship
Guardianship Assistance payments, and
the eFMAP rates for the Children’s
PO 00000
Frm 00040
Fmt 4703
Sfmt 4703
55383
State
CO
FY 2017
authorized
funding level
FY 2017–2018
estimated
supplemental
amount
$500,000
$250,000
Health Insurance Program (CHIP)
expenditures. Table 1 gives figures for
each of the 50 states, the District of
Columbia, Puerto Rico, the Virgin
Islands, Guam, American Samoa, and
the Commonwealth of the Northern
Mariana Islands. This notice reminds
states of available disaster-recovery
FMAP adjustments for qualifying states,
and adjustments available for states
meeting requirements for negative
growth in total state personal income.
At this time, no states qualify for such
adjustments.
This notice also contains the
increased eFMAPs for CHIP as
authorized under the Patient Protection
and Affordable Care Act (PPACA) for
fiscal years 2016 through 2019 (October
1, 2015 through September 30, 2019).
Programs under title XIX of the Act
exist in each jurisdiction. Programs
under titles I, X, and XIV operate only
in Guam and the Virgin Islands. The
percentages in this notice apply to state
expenditures for most medical
assistance and child health assistance,
and assistance payments for certain
social services. The Act provides
E:\FR\FM\21NON1.SGM
21NON1
55384
Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices
separately for federal matching of
administrative costs. Sections 1905(b)
and 1101(a)(8)(B) of the Social Security
Act (the Act) require the Secretary of
HHS to publish the FMAP rates each
year. The Secretary calculates the
percentages, using formulas in sections
1905(b) and 1101(a)(8), and calculations
by the Department of Commerce of
average income per person in each state
and for the Nation as a whole. The
percentages must fall within the upper
and lower limits specified in section
1905(b) of the Act. The percentages for
the District of Columbia, Puerto Rico,
the Virgin Islands, Guam, American
Samoa, and the Northern Mariana
Islands are specified in statute, and thus
are not based on the statutory formula
that determines the percentages for the
50 states.
Federal Medical Assistance Percentage
(FMAP)
Section 1905(b) of the Act specifies
the formula for calculating FMAPs as
follows:
asabaliauskas on DSKBBXCHB2PROD with NOTICES
‘‘Federal medical assistance percentage’’
for any state shall be 100 per centum less the
state percentage; and the state percentage
shall be that percentage which bears the same
ratio to 45 per centum as the square of the
per capita income of such state bears to the
square of the per capita income of the
continental United States (including Alaska)
and Hawaii; except that (1) the Federal
medical assistance percentage shall in no
case be less than 50 per centum or more than
83 per centum, (2) the Federal medical
assistance percentage for Puerto Rico, the
Virgin Islands, Guam, the Northern Mariana
Islands, and American Samoa shall be 55
percent . . . .
Section 4725(b) of the Balanced Budget
Act of 1997 amended section 1905(b) to
provide that the FMAP for the District
of Columbia for purposes of titles XIX
and XXI shall be 70 percent. For the
District of Columbia, we note under
Table 1 that other rates may apply in
certain other programs. In addition, we
note the rate that applies for Puerto
Rico, the Virgin Islands, Guam,
American Samoa, and the
Commonwealth of the Northern Mariana
Islands in certain other programs
pursuant to section 1118 of the Act. The
rates for the States, District of Columbia
and the territories are displayed in
Table 1, Column 1.
Section 1905(y) of the Act, as added
by section 2001 of the Patient Protection
and Affordable Care Act of 2010
(‘‘Affordable Care Act’’), provides for a
significant increase in the FMAP for
medical assistance expenditures for
individuals determined eligible under
the new adult group in the state and
who will be considered to be ‘‘newly
eligible’’ in 2014, as defined in section
VerDate Sep<11>2014
18:56 Nov 20, 2017
Jkt 244001
1905(y)(2)(A) of the Act. This newly
eligible FMAP is 100 percent for
Calendar Years 2014, 2015, and 2016,
gradually declining to 90 percent in
2020 where it remains indefinitely. In
addition, section 1905(z) of the Act, as
added by section 10201 of the
Affordable Care Act, provides that states
that had expanded substantial coverage
to low-income parents and nonpregnant
adults without children prior to the
enactment of the Affordable Care Act,
referred to as ‘‘expansion states,’’ shall
receive an enhanced FMAP beginning in
2014 for medical assistance
expenditures for nonpregnant childless
adults who may be required to enroll in
benchmark coverage. These provisions
are discussed in more detail in the
Medicaid Eligibility proposed rule
published on August 17, 2011 (76 FR
51172) and the final rule published on
March 23, 2012 (77 FR 17143). This
notice is not intended to set forth the
newly eligible or expansion state FMAP
rates.
for the purposes of calculating the
FMAP, for a calendar year in which a
state’s total personal income has
declined, the portion of an employer
pension and insurance fund
contribution that exceeds 125 percent of
the amount of the employer
contribution in the previous calendar
year shall be disregarded.
We request that states follow the same
methodology to determine potential
FMAP adjustments for negative growth
in total personal income that HHS
employs to make adjustments to the
FMAP for states experiencing
significantly disproportionate pension
or insurance contributions. See also the
information described in the January 21,
2014 Federal Register notice (79 FR
3385). This notice does not contain an
FY 2019 adjustment for a major
statewide disaster for any state
(territories are not eligible for FMAP
adjustments) because no state’s FMAP
decreased by at least three percentage
points from FY 2018 to FY 2019.
Other Adjustments to the FMAP
For purposes of Title XIX (Medicaid)
of the Social Security Act, the Federal
Medical Assistance Percentage (FMAP),
defined in section 1905(b) of the Social
Security Act, for each state beginning
with fiscal year 2006 is subject to an
adjustment pursuant to section 614 of
the Children’s Health Insurance
Program Reauthorization Act of 2009
(CHIPRA), Public Law 111–3. Section
614 of CHIPRA stipulates that a state’s
FMAP under Title XIX (Medicaid) must
be adjusted in two situations.
In the first situation, if a state
experiences positive growth in total
personal income and an employer in
that state has made a significantly
disproportionate contribution to a
pension or insurance fund, the state’s
FMAP must be adjusted. Employer
pension and insurance fund
contributions are significantly
disproportionate if the increase in
contributions exceeds 25 percent of the
increase in total personal income in that
state. A Federal Register Notice with
comment period was issued on June 7,
2010 (75 FR 32182) announcing the
methodology for calculating this
adjustment; a final notice was issued on
October 15, 2010 (75 FR 63480). A
second situation arises if a state
experiences negative growth in total
personal income. Beginning with Fiscal
Year 2006, section 614(b)(3) of CHIPRA
specifies that certain employer pension
or insurance fund contributions shall be
disregarded when computing the per
capita income used to calculate the
FMAP for states with negative growth in
total personal income. In that instance,
Enhanced Federal Medical Assistance
Percentage (eFMAP) for CHIP
PO 00000
Frm 00041
Fmt 4703
Sfmt 4703
Section 2105(b) of the Act specifies
the formula for calculating the eFMAP
rates as follows:
The ‘‘enhanced FMAP’’, for a state for a
fiscal year, is equal to the Federal medical
assistance percentage (as defined in the first
sentence of section 1905(b)) for the state
increased by a number of percentage points
equal to 30 percent of the number of
percentage points by which (1) such Federal
medical assistance percentage for the state, is
less than (2) 100 percent; but in no case shall
the enhanced FMAP for a state exceed 85
percent.
In addition, Section 2105(b) of the
Social Security Act, as amended by
Section 2101 of the Affordable Care Act,
increases the eFMAP for states by 23
percentage points:
. . . during the period that begins on
October 1, 2015, and ends on September 30,
2019, the enhanced FMAP determined for a
state for a fiscal year (or for any portion of
a fiscal year occurring during such period)
shall be increased by 23 percentage points,
but in no case shall exceed 100 percent.
The eFMAP rates are used in the
Children’s Health Insurance Program
under Title XXI, and in the Medicaid
program for certain children for
expenditures for medical assistance
described in sections 1905(u)(2) and
1905(u)(3) of the Act. There is no
specific requirement to publish the
eFMAP rates. We include them in this
notice for the convenience of the states,
and display both the normal eFMAP
rates (Table 1, Column 2) and the
Affordable Care Act’s increased eFMAP
E:\FR\FM\21NON1.SGM
21NON1
55385
Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices
rates (Table 1, Column 3) for
comparison.
(Catalog of Federal Domestic Assistance
Program Nos. 93.558: TANF Contingency
Funds; 93.563: Child Support Enforcement;
93.596: Child Care Mandatory and Matching
Funds of the Child Care and Development
Fund; 93.658: Foster Care Title IV–E; 93.659:
Adoption Assistance; 93.769: Ticket-to-Work
and Work Incentives Improvement Act
(TWWIIA) Demonstrations to Maintain
Independence and Employment; 93.778:
Medical Assistance Program; 93.767:
Children’s Health Insurance Program)
Dated: November 13, 2017.
Eric D. Hargan,
Acting Secretary.
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2018–SEPTEMBER 30, 2019
[Fiscal year 2019]
asabaliauskas on DSKBBXCHB2PROD with NOTICES
Federal medical
assistance
percentages
Alabama .....................................................................................................................
Alaska ........................................................................................................................
American Samoa * .....................................................................................................
Arizona .......................................................................................................................
Arkansas ....................................................................................................................
California ....................................................................................................................
Colorado ....................................................................................................................
Connecticut ................................................................................................................
Delaware ....................................................................................................................
District of Columbia ** ................................................................................................
Florida ........................................................................................................................
Georgia ......................................................................................................................
Guam * .......................................................................................................................
Hawaii ........................................................................................................................
Idaho ..........................................................................................................................
Illinois .........................................................................................................................
Indiana .......................................................................................................................
Iowa ...........................................................................................................................
Kansas .......................................................................................................................
Kentucky ....................................................................................................................
Louisiana ....................................................................................................................
Maine .........................................................................................................................
Maryland ....................................................................................................................
Massachusetts ...........................................................................................................
Michigan .....................................................................................................................
Minnesota ..................................................................................................................
Mississippi ..................................................................................................................
Missouri ......................................................................................................................
Montana .....................................................................................................................
Nebraska ....................................................................................................................
Nevada .......................................................................................................................
New Hampshire .........................................................................................................
New Jersey ................................................................................................................
New Mexico ...............................................................................................................
New York ...................................................................................................................
North Carolina ............................................................................................................
North Dakota ..............................................................................................................
Northern Mariana Islands * ........................................................................................
Ohio ...........................................................................................................................
Oklahoma ...................................................................................................................
Oregon .......................................................................................................................
Pennsylvania ..............................................................................................................
Puerto Rico * ..............................................................................................................
Rhode Island ..............................................................................................................
South Carolina ...........................................................................................................
South Dakota .............................................................................................................
Tennessee .................................................................................................................
Texas .........................................................................................................................
Utah ...........................................................................................................................
Vermont .....................................................................................................................
Virgin Islands * ...........................................................................................................
Virginia .......................................................................................................................
Washington ................................................................................................................
West Virginia ..............................................................................................................
Wisconsin ...................................................................................................................
Wyoming ....................................................................................................................
Enhanced federal
medical
assistance
percentages
Enhanced federal
medical
assistance
percentages with
ACA 23 Pt Inc ***
80.32
65.00
68.50
78.87
79.36
65.00
65.00
65.00
70.29
79.00
72.61
77.33
68.50
67.74
79.79
65.22
76.17
71.95
69.97
80.17
75.50
75.16
65.00
65.00
75.12
65.00
83.47
75.78
75.88
66.81
75.41
65.00
65.00
80.58
65.00
77.01
65.00
68.50
74.16
73.67
73.79
66.58
68.50
66.80
79.85
69.70
76.11
70.73
78.80
67.72
68.50
65.00
65.00
82.04
71.56
65.00
100.00
88.00
91.50
100.00
100.00
88.00
88.00
88.00
93.29
100.00
95.61
100.00
91.50
90.74
100.00
88.22
99.17
94.95
92.97
100.00
98.50
98.16
88.00
88.00
98.12
88.00
100.00
98.78
98.88
89.81
98.41
88.00
88.00
100.00
88.00
100.00
88.00
91.50
97.16
96.67
96.79
89.58
91.50
89.80
100.00
92.70
99.11
93.73
100.00
90.72
91.50
88.00
88.00
100.00
94.56
88.00
71.88
50.00
55.00
69.81
70.51
50.00
50.00
50.00
57.55
70.00
60.87
67.62
55.00
53.92
71.13
50.31
65.96
59.93
57.10
71.67
65.00
64.52
50.00
50.00
64.45
50.00
76.39
65.40
65.54
52.58
64.87
50.00
50.00
72.26
50.00
67.16
50.00
55.00
63.09
62.38
62.56
52.25
55.00
52.57
71.22
56.71
65.87
58.19
69.71
53.89
55.00
50.00
50.00
74.34
59.37
50.00
* For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI will be 75 per centum.
VerDate Sep<11>2014
18:56 Nov 20, 2017
Jkt 244001
PO 00000
Frm 00042
Fmt 4703
Sfmt 4703
E:\FR\FM\21NON1.SGM
21NON1
55386
Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices
** The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and for capitation payments and DSH
allotments under those titles. For other purposes, the percentage for DC is 50.00, unless otherwise specified by law.
*** Section 2101(a) of the Affordable Care Act amended Section 2105(b) of the Social Security Act to increase the enhanced FMAP for states
by 23 percentage points, but not to exceed 100 percent, for the period that begins on October 1, 2015 and ends on September 30, 2019 (fiscal
years 2016 through 2019).
[FR Doc. 2017–24953 Filed 11–20–17; 8:45 am]
BILLING CODE 4150–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Announcement of Meeting of the
Secretary’s Advisory Committee on
National Health Promotion and Disease
Prevention Objectives for 2030
Office of Disease Prevention
and Health Promotion, Office of the
Assistant Secretary for Health, Office of
the Secretary, Department of Health and
Human Services.
ACTION: Notice.
AGENCY:
The U.S. Department of
Health and Human Services (HHS)
announces the next federal advisory
committee meeting regarding the
development of national health
promotion and disease prevention
objectives for 2030. This meeting will be
held online via webinar and is open to
the public. The Committee will discuss
the nation’s health promotion and
disease prevention objectives and will
provide recommendations to improve
health status and reduce health risks for
the nation by the year 2030. The
Committee will advise the Secretary on
the Healthy People 2030 mission,
vision, framework, and organizational
structure. The Committee will provide
advice regarding criteria for identifying
a more focused set of measurable,
nationally representative objectives.
Pursuant to the Committee’s charter, the
Committee’s advice must assist the
Secretary in reducing the number of
objectives while ensuring that the
selection criteria identifies the most
critical public health issues that are
high-impact priorities supported by
current national data.
DATES: The Committee will meet on
December 11, 2017, from 3:00 p.m. to
5:00 p.m. Eastern Time (ET).
ADDRESSES: The meeting will be held
online via webinar. To register to attend
the meeting, please visit the Healthy
People Web site at https://
www.healthypeople.gov.
FOR FURTHER INFORMATION CONTACT:
Emmeline Ochiai, Designated Federal
Official, Secretary’s Advisory
Committee on National Health
Promotion and Disease Prevention
Objectives for 2030, U.S. Department of
Health and Human Services, Office of
asabaliauskas on DSKBBXCHB2PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
18:56 Nov 20, 2017
Jkt 244001
the Assistant Secretary for Health,
Office of Disease Prevention and Health
Promotion, 1101 Wootton Parkway,
Room LL–100, Rockville, MD 20852,
(240) 453–8280 (telephone), (240) 453–
8281 (fax). Additional information is
available on the Healthy People Web
site at https://www.healthypeople.gov.
SUPPLEMENTARY INFORMATION: The
names and biographies of the
Committee members are available at
https://www.healthypeople.gov/2020/
about/history-development/healthypeople-2030-advisory-committee.
Purpose of Meeting: Through the
Healthy People initiative, HHS leverages
scientific insights and lessons from the
past decade, along with new knowledge
of current data, trends, and innovations,
to develop the next iteration of national
health promotion and disease
prevention objectives. Healthy People
provides science-based, 10-year national
objectives for promoting health and
preventing disease. Since 1979, Healthy
People has set and monitored national
health objectives that meet a broad
range of health needs, encourage
collaboration across sectors, guide
individuals toward making informed
health decisions, and measure the
impact of our prevention and health
promotion activities. Healthy People
2030 health objectives will reflect
assessments of major risks to health and
wellness, changing public health
priorities, and emerging technologies
related to our nation’s health
preparedness and prevention.
Public Participation at Meeting:
Members of the public are invited to
join the online Committee meeting.
There will be no opportunity for oral
public comments during this online
Committee meeting. However, written
comments are welcome throughout the
entire development process of the
national health promotion and disease
prevention objectives for 2030 and may
be emailed to HP2030@hhs.gov.
To join the Committee meeting,
individuals must pre-register at the
Healthy People Web site at https://
www.healthypeople.gov. Participation in
the meeting is limited. Registrations will
be accepted until maximum webinar
capacity is reached, and must be
completed by 9:00 a.m. ET on December
11, 2017. A waiting list will be
maintained should registrations exceed
capacity, and those individuals will be
contacted as additional space for the
meeting becomes available. Registration
PO 00000
Frm 00043
Fmt 4703
Sfmt 4703
questions may be directed to
HealthyPeople@norc.org.
Authority: 42 U.S.C. 300u and 42
U.S.C. 217a. The Secretary’s Advisory
Committee on National Health
Promotion and Disease Prevention
Objectives for 2030 is governed by
provisions of the Federal Advisory
Committee Act (FACA), Public Law 92–
463, as amended (5 U.S.C., App.) which
sets forth standards for the formation
and use of federal advisory committees.
Dated: November 14, 2017.
Don Wright,
Deputy Assistant Secretary for Health,
(Disease Prevention and Health Promotion).
[FR Doc. 2017–25192 Filed 11–20–17; 8:45 am]
BILLING CODE 4150–32–P
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
[Docket No. USCG–2017–0125]
Information Collection Request to
Office of Management and Budget;
OMB Control Number: 1625–0121
Coast Guard, DHS.
Sixty-day notice requesting
comments.
AGENCY:
ACTION:
In compliance with the
Paperwork Reduction Act of 1995, the
U.S. Coast Guard intends to submit an
Information Collection Request (ICR) to
the Office of Management and Budget
(OMB), Office of Information and
Regulatory Affairs (OIRA), requesting an
extension of its approval for the
following collection of information:
1625–0121, United States Coast Guard
Academy Introduction Mission Program
Application and Supplemental Forms;
without change. Our ICR describes the
information we seek to collect from the
public. Before submitting this ICR to
OIRA, the Coast Guard is inviting
comments as described below.
DATES: Comments must reach the Coast
Guard on or before January 22, 2018.
ADDRESSES: You may submit comments
identified by Coast Guard docket
number [USCG–2017–0125] to the Coast
Guard using the Federal eRulemaking
Portal at https://www.regulations.gov.
See the ‘‘Public participation and
request for comments’’ portion of the
SUPPLEMENTARY INFORMATION section for
SUMMARY:
E:\FR\FM\21NON1.SGM
21NON1
]]>Agencies
[Federal Register Volume 82, Number 223 (Tuesday, November 21, 2017)]
[Notices]
[Pages 55383-55386]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-24953]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Federal Matching Shares for Medicaid, the Children's Health
Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons
for October 1, 2018 Through September 30, 2019
AGENCY: Office of the Secretary, DHHS.
ACTION: Notice.
-----------------------------------------------------------------------
DATES: The percentages listed in Table 1 will be effective for each of
the four quarter-year periods beginning October 1, 2018 and ending
September 30, 2019.
FOR FURTHER INFORMATION CONTACT: Caryn Marks or Rose Chu, Office of
Health Policy, Office of the Assistant Secretary for Planning and
Evaluation, Room 447D--Hubert H. Humphrey Building, 200 Independence
Avenue SW., Washington, DC 20201, (202) 690-6870.
SUPPLEMENTARY INFORMATION: The Federal Medical Assistance Percentages
(FMAP), Enhanced Federal Medical Assistance Percentages (eFMAP), and
disaster-recovery FMAP adjustments for Fiscal Year 2019 have been
calculated pursuant to the Social Security Act (the Act). These
percentages will be effective from October 1, 2018 through September
30, 2019. This notice announces the calculated FMAP rates, in
accordance with sections 1101(a)(8) and 1905(b) of the Act, that the
U.S. Department of Health and Human Services (HHS) will use in
determining the amount of federal matching for state medical assistance
(Medicaid), Temporary Assistance for Needy Families (TANF) Contingency
Funds, Child Support Enforcement collections, Child Care Mandatory and
Matching Funds of the Child Care and Development Fund, Title IV-E
Foster Care Maintenance payments, Adoption Assistance payments and
Kinship Guardianship Assistance payments, and the eFMAP rates for the
Children's Health Insurance Program (CHIP) expenditures. Table 1 gives
figures for each of the 50 states, the District of Columbia, Puerto
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands. This notice reminds states of available
disaster-recovery FMAP adjustments for qualifying states, and
adjustments available for states meeting requirements for negative
growth in total state personal income. At this time, no states qualify
for such adjustments.
This notice also contains the increased eFMAPs for CHIP as
authorized under the Patient Protection and Affordable Care Act (PPACA)
for fiscal years 2016 through 2019 (October 1, 2015 through September
30, 2019).
Programs under title XIX of the Act exist in each jurisdiction.
Programs under titles I, X, and XIV operate only in Guam and the Virgin
Islands. The percentages in this notice apply to state expenditures for
most medical assistance and child health assistance, and assistance
payments for certain social services. The Act provides
[[Page 55384]]
separately for federal matching of administrative costs. Sections
1905(b) and 1101(a)(8)(B) of the Social Security Act (the Act) require
the Secretary of HHS to publish the FMAP rates each year. The Secretary
calculates the percentages, using formulas in sections 1905(b) and
1101(a)(8), and calculations by the Department of Commerce of average
income per person in each state and for the Nation as a whole. The
percentages must fall within the upper and lower limits specified in
section 1905(b) of the Act. The percentages for the District of
Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and
the Northern Mariana Islands are specified in statute, and thus are not
based on the statutory formula that determines the percentages for the
50 states.
Federal Medical Assistance Percentage (FMAP)
Section 1905(b) of the Act specifies the formula for calculating
FMAPs as follows:
``Federal medical assistance percentage'' for any state shall be
100 per centum less the state percentage; and the state percentage
shall be that percentage which bears the same ratio to 45 per centum
as the square of the per capita income of such state bears to the
square of the per capita income of the continental United States
(including Alaska) and Hawaii; except that (1) the Federal medical
assistance percentage shall in no case be less than 50 per centum or
more than 83 per centum, (2) the Federal medical assistance
percentage for Puerto Rico, the Virgin Islands, Guam, the Northern
Mariana Islands, and American Samoa shall be 55 percent . . . .
Section 4725(b) of the Balanced Budget Act of 1997 amended section
1905(b) to provide that the FMAP for the District of Columbia for
purposes of titles XIX and XXI shall be 70 percent. For the District of
Columbia, we note under Table 1 that other rates may apply in certain
other programs. In addition, we note the rate that applies for Puerto
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands in certain other programs pursuant to
section 1118 of the Act. The rates for the States, District of Columbia
and the territories are displayed in Table 1, Column 1.
Section 1905(y) of the Act, as added by section 2001 of the Patient
Protection and Affordable Care Act of 2010 (``Affordable Care Act''),
provides for a significant increase in the FMAP for medical assistance
expenditures for individuals determined eligible under the new adult
group in the state and who will be considered to be ``newly eligible''
in 2014, as defined in section 1905(y)(2)(A) of the Act. This newly
eligible FMAP is 100 percent for Calendar Years 2014, 2015, and 2016,
gradually declining to 90 percent in 2020 where it remains
indefinitely. In addition, section 1905(z) of the Act, as added by
section 10201 of the Affordable Care Act, provides that states that had
expanded substantial coverage to low-income parents and nonpregnant
adults without children prior to the enactment of the Affordable Care
Act, referred to as ``expansion states,'' shall receive an enhanced
FMAP beginning in 2014 for medical assistance expenditures for
nonpregnant childless adults who may be required to enroll in benchmark
coverage. These provisions are discussed in more detail in the Medicaid
Eligibility proposed rule published on August 17, 2011 (76 FR 51172)
and the final rule published on March 23, 2012 (77 FR 17143). This
notice is not intended to set forth the newly eligible or expansion
state FMAP rates.
Other Adjustments to the FMAP
For purposes of Title XIX (Medicaid) of the Social Security Act,
the Federal Medical Assistance Percentage (FMAP), defined in section
1905(b) of the Social Security Act, for each state beginning with
fiscal year 2006 is subject to an adjustment pursuant to section 614 of
the Children's Health Insurance Program Reauthorization Act of 2009
(CHIPRA), Public Law 111-3. Section 614 of CHIPRA stipulates that a
state's FMAP under Title XIX (Medicaid) must be adjusted in two
situations.
In the first situation, if a state experiences positive growth in
total personal income and an employer in that state has made a
significantly disproportionate contribution to a pension or insurance
fund, the state's FMAP must be adjusted. Employer pension and insurance
fund contributions are significantly disproportionate if the increase
in contributions exceeds 25 percent of the increase in total personal
income in that state. A Federal Register Notice with comment period was
issued on June 7, 2010 (75 FR 32182) announcing the methodology for
calculating this adjustment; a final notice was issued on October 15,
2010 (75 FR 63480). A second situation arises if a state experiences
negative growth in total personal income. Beginning with Fiscal Year
2006, section 614(b)(3) of CHIPRA specifies that certain employer
pension or insurance fund contributions shall be disregarded when
computing the per capita income used to calculate the FMAP for states
with negative growth in total personal income. In that instance, for
the purposes of calculating the FMAP, for a calendar year in which a
state's total personal income has declined, the portion of an employer
pension and insurance fund contribution that exceeds 125 percent of the
amount of the employer contribution in the previous calendar year shall
be disregarded.
We request that states follow the same methodology to determine
potential FMAP adjustments for negative growth in total personal income
that HHS employs to make adjustments to the FMAP for states
experiencing significantly disproportionate pension or insurance
contributions. See also the information described in the January 21,
2014 Federal Register notice (79 FR 3385). This notice does not contain
an FY 2019 adjustment for a major statewide disaster for any state
(territories are not eligible for FMAP adjustments) because no state's
FMAP decreased by at least three percentage points from FY 2018 to FY
2019.
Enhanced Federal Medical Assistance Percentage (eFMAP) for CHIP
Section 2105(b) of the Act specifies the formula for calculating
the eFMAP rates as follows:
The ``enhanced FMAP'', for a state for a fiscal year, is equal
to the Federal medical assistance percentage (as defined in the
first sentence of section 1905(b)) for the state increased by a
number of percentage points equal to 30 percent of the number of
percentage points by which (1) such Federal medical assistance
percentage for the state, is less than (2) 100 percent; but in no
case shall the enhanced FMAP for a state exceed 85 percent.
In addition, Section 2105(b) of the Social Security Act, as amended
by Section 2101 of the Affordable Care Act, increases the eFMAP for
states by 23 percentage points:
. . . during the period that begins on October 1, 2015, and ends on
September 30, 2019, the enhanced FMAP determined for a state for a
fiscal year (or for any portion of a fiscal year occurring during
such period) shall be increased by 23 percentage points, but in no
case shall exceed 100 percent.
The eFMAP rates are used in the Children's Health Insurance Program
under Title XXI, and in the Medicaid program for certain children for
expenditures for medical assistance described in sections 1905(u)(2)
and 1905(u)(3) of the Act. There is no specific requirement to publish
the eFMAP rates. We include them in this notice for the convenience of
the states, and display both the normal eFMAP rates (Table 1, Column 2)
and the Affordable Care Act's increased eFMAP
[[Page 55385]]
rates (Table 1, Column 3) for comparison.
(Catalog of Federal Domestic Assistance Program Nos. 93.558: TANF
Contingency Funds; 93.563: Child Support Enforcement; 93.596: Child
Care Mandatory and Matching Funds of the Child Care and Development
Fund; 93.658: Foster Care Title IV-E; 93.659: Adoption Assistance;
93.769: Ticket-to-Work and Work Incentives Improvement Act (TWWIIA)
Demonstrations to Maintain Independence and Employment; 93.778:
Medical Assistance Program; 93.767: Children's Health Insurance
Program)
Dated: November 13, 2017.
Eric D. Hargan,
Acting Secretary.
Table 1--Federal Medical Assistance Percentages and Enhanced Federal Medical Assistance Percentages, Effective
October 1, 2018-September 30, 2019
[Fiscal year 2019]
----------------------------------------------------------------------------------------------------------------
Enhanced federal
Federal medical Enhanced federal medical
assistance medical assistance
percentages assistance percentages with
percentages ACA 23 Pt Inc ***
----------------------------------------------------------------------------------------------------------------
Alabama................................................ 71.88 80.32 100.00
Alaska................................................. 50.00 65.00 88.00
American Samoa *....................................... 55.00 68.50 91.50
Arizona................................................ 69.81 78.87 100.00
Arkansas............................................... 70.51 79.36 100.00
California............................................. 50.00 65.00 88.00
Colorado............................................... 50.00 65.00 88.00
Connecticut............................................ 50.00 65.00 88.00
Delaware............................................... 57.55 70.29 93.29
District of Columbia **................................ 70.00 79.00 100.00
Florida................................................ 60.87 72.61 95.61
Georgia................................................ 67.62 77.33 100.00
Guam *................................................. 55.00 68.50 91.50
Hawaii................................................. 53.92 67.74 90.74
Idaho.................................................. 71.13 79.79 100.00
Illinois............................................... 50.31 65.22 88.22
Indiana................................................ 65.96 76.17 99.17
Iowa................................................... 59.93 71.95 94.95
Kansas................................................. 57.10 69.97 92.97
Kentucky............................................... 71.67 80.17 100.00
Louisiana.............................................. 65.00 75.50 98.50
Maine.................................................. 64.52 75.16 98.16
Maryland............................................... 50.00 65.00 88.00
Massachusetts.......................................... 50.00 65.00 88.00
Michigan............................................... 64.45 75.12 98.12
Minnesota.............................................. 50.00 65.00 88.00
Mississippi............................................ 76.39 83.47 100.00
Missouri............................................... 65.40 75.78 98.78
Montana................................................ 65.54 75.88 98.88
Nebraska............................................... 52.58 66.81 89.81
Nevada................................................. 64.87 75.41 98.41
New Hampshire.......................................... 50.00 65.00 88.00
New Jersey............................................. 50.00 65.00 88.00
New Mexico............................................. 72.26 80.58 100.00
New York............................................... 50.00 65.00 88.00
North Carolina......................................... 67.16 77.01 100.00
North Dakota........................................... 50.00 65.00 88.00
Northern Mariana Islands *............................. 55.00 68.50 91.50
Ohio................................................... 63.09 74.16 97.16
Oklahoma............................................... 62.38 73.67 96.67
Oregon................................................. 62.56 73.79 96.79
Pennsylvania........................................... 52.25 66.58 89.58
Puerto Rico *.......................................... 55.00 68.50 91.50
Rhode Island........................................... 52.57 66.80 89.80
South Carolina......................................... 71.22 79.85 100.00
South Dakota........................................... 56.71 69.70 92.70
Tennessee.............................................. 65.87 76.11 99.11
Texas.................................................. 58.19 70.73 93.73
Utah................................................... 69.71 78.80 100.00
Vermont................................................ 53.89 67.72 90.72
Virgin Islands *....................................... 55.00 68.50 91.50
Virginia............................................... 50.00 65.00 88.00
Washington............................................. 50.00 65.00 88.00
West Virginia.......................................... 74.34 82.04 100.00
Wisconsin.............................................. 59.37 71.56 94.56
Wyoming................................................ 50.00 65.00 88.00
----------------------------------------------------------------------------------------------------------------
* For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI
will be 75 per centum.
[[Page 55386]]
** The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and
for capitation payments and DSH allotments under those titles. For other purposes, the percentage for DC is
50.00, unless otherwise specified by law.
*** Section 2101(a) of the Affordable Care Act amended Section 2105(b) of the Social Security Act to increase
the enhanced FMAP for states by 23 percentage points, but not to exceed 100 percent, for the period that
begins on October 1, 2015 and ends on September 30, 2019 (fiscal years 2016 through 2019).
[FR Doc. 2017-24953 Filed 11-20-17; 8:45 am]
BILLING CODE 4150-15-P
