Federal Financial Participation in State Assistance Expenditures; Federal Matching Shares for Medicaid, the Children's Health Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 1, 2021 Through September 30, 2022, 76586-76589 [2020-26387]
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Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices
community, county, regional, and state
levels.
With the continuing shift in the
healthcare environment towards
provision of value-based care and
utilization of reimbursement strategies
through Centers for Medicare and
Medicaid Services quality reporting
programs, the latest competitive Rural
Health Care Coordination Program
cohort also aligned with this shift. An
increased number of sophisticated
applicants leveraging increasingly
intricate reporting methodologies for
quality data collection, utilization and
analysis has resulted in an estimate of
burden hours more in line with the
realities of the health care landscape. In
addition, the total number of responses
has increased to 10 since the previous
Notice of Award. This is due to a new
Rural Health Care Coordination Program
grant cycle with an increased number of
awardees and therefore an increased
number of respondents.
Need and Proposed Use of the
Information: For this program,
performance measures were drafted to
provide data to the program and to
enable HRSA to provide aggregate
program data required by Congress
under the Government Performance and
Results Act of 1993. These measures
cover the principal topic areas of
interest to the Federal Office of Rural
Health Policy, including: (a) Access to
care; (b) population demographics; (c)
staffing; (d) consortium/network; (e)
sustainability; and (f) project specific
domains. All measures will speak to
HRSA’s progress toward meeting the
goals set.
Likely Respondents: Recipients of the
Rural Health Care Coordination Program
funding.
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose or provide the information
requested. This includes the time
needed to review instructions; to
develop, acquire, install, and utilize
technology and systems for the purpose
of collecting, validating, and verifying
information, processing and
maintaining information, and disclosing
and providing information; to train
personnel and to be able to respond to
a collection of information; to search
data sources; to complete and review
the collection of information; and to
transmit or otherwise disclose the
information. The total annual burden
hours estimated for this ICR are
summarized in the table below.
TOTAL ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents
Form name
Rural Health Care Coordination Grant Program Measures
Total ..............................................................................
HRSA specifically requests comments
on: (1) The necessity and utility of the
proposed information collection for the
proper performance of the agency’s
functions, (2) the accuracy of the
estimated burden, (3) ways to enhance
the quality, utility, and clarity of the
information to be collected, and (4) the
use of automated collection techniques
or other forms of information
technology to minimize the information
collection burden.
Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2020–26254 Filed 11–27–20; 8:45 am]
BILLING CODE 4165–15–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Federal Financial Participation in State
Assistance Expenditures; Federal
Matching Shares for Medicaid, the
Children’s Health Insurance Program,
and Aid to Needy Aged, Blind, or
Disabled Persons for October 1, 2021
Through September 30, 2022
Office of the Secretary, HHS.
Notice.
AGENCY:
ACTION:
The percentages listed in Table
1 will be effective for each of the four
DATES:
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Number of
responses per
respondent
Frm 00073
Fmt 4703
Total
burden
hours
10
1
10
3.5
35
10
........................
10
........................
35
quarter-year periods beginning October
1, 2021 and ending September 30, 2022.
FOR FURTHER INFORMATION CONTACT: Ann
Conmy, 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 2022 have been calculated
pursuant to the Social Security Act (the
Act). These percentages will be effective
from October 1, 2021 through
September 30, 2022. 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
PO 00000
Average
burden per
response
(in hours)
Total
responses
Sfmt 4703
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 adjustments available for states
meeting requirements for
disproportionate employer pension or
insurance fund contributions and
adjustments for disaster recovery. At
this time, no state qualifies for such
adjustments, and territories are not
eligible.
The FY 2022 FMAP rates do not
include the 6.2 percentage point
increase in the FMAP provided under
Section 6008 of the Families First
Coronavirus Response Act (FFCRA)
(Pub. L. 116–127) because the increase
depends upon states meeting statutory
requirements in FFCRA that cannot be
assumed. If applied, the temporary 6.2
percentage increase in the FMAP is
effective beginning January 1, 2020 and
can extend through the last day of the
calendar quarter in which the public
health emergency declared by the
Secretary of Health and Human Services
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Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices
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for COVID–19, including any
extensions, terminates.
Programs under title XIX of the Act
exist in each jurisdiction. Programs
under titles I, X, and XIV operate only
in Guam and the Virgin Islands. The
percentages in this notice apply to state
expenditures for most medical
assistance and child health assistance,
and assistance payments for certain
social services. The Act provides
separately for federal matching of
administrative costs.
Sections 1905(b) and 1101(a)(8)(B) of
the Social Security Act (the Act) require
the Secretary of HHS to publish the
FMAP rates each year. The Secretary
calculates the percentages, using
formulas in sections 1905(b) and
1101(a)(8), and calculations by the
Department of Commerce of average
income per person in each state and for
the United States (meaning, for this
purpose, the fifty states and the District
of Columbia). 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
the 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 the
Federal medical assistance percentage
shall in no case be less than 50 per
centum or more than 83 per centum.
Section 1905(b) further specifies that
the FMAP 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
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20:03 Nov 27, 2020
Jkt 253001
Islands in certain other programs
pursuant to section 1118 of the Act.
Section 202(c) of the Further
Consolidated Appropriations Act, 2020
(Pub. L. 116–94) amends section 1905(b)
to increase the FMAP to 76 percent for
Puerto Rico and increase the FMAP to
83 percent for the Virgin Islands, Guam,
the Northern Mariana Islands, and
American Samoa to 83 percent, for the
period beginning December 21, 2020,
and ending September 30, 2021. 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’’) (Pub. L. 111–
148), provides for a significant increase
in the FMAP for medical assistance
expenditures for newly eligible
individuals described in section
1902(a)(10)(A)(i)(VIII) of the Act, as
added by the Affordable Care Act (the
new adult group); ‘‘newly eligible’’ is
defined in section 1905(y)(2)(A) of the
Act. The FMAP for the new adult group
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 offered substantial health
coverage to certain low-income parents
and nonpregnant, childless adults on
the date of 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 under
section 1937 of the Act. These
provisions are discussed in more detail
in the Medicaid Program: Eligibility
Changes Under the Affordable Care Act
of 2010 proposed rule published on
August 17, 2011 (76 FR 51148, 51172)
and the final rule published on March
23, 2012 (77 FR 17144, 17194). This
notice is not intended to set forth the
matching rates for the new adult group
as specified in section 1905(y) of the Act
or the matching rates for nonpregnant,
childless adults in expansion states as
specified in section 1905(z) of the Act.
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, can be subject to
an adjustment pursuant to section 614
of the Children’s Health Insurance
Program Reauthorization Act of 2009
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Sfmt 4703
76587
(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 no growth or positive
growth in total personal income and an
employer in that state has made a
significantly disproportionate
contribution to an employer pension or
insurance fund, the state’s FMAP must
be adjusted. The adjustment involves
disregarding the significantly
disproportionate employer pension or
insurance fund contribution in
computing the per capita income for the
state (but not in computing the per
capita income for the United States).
Employer pension and insurance fund
contributions are significantly
disproportionate if the increase in
contributions exceeds 25 percent of the
total increase in personal income in that
state. A Federal Register Notice with
comment period was published on June
7, 2010 (75 FR 32182) announcing the
methodology for calculating this
adjustment; a final notice was published
on October 15, 2010 (75 FR 63480).
The 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, 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 or insurance fund
contribution that exceeds 125 percent of
the amount of such contribution in the
previous calendar year shall be
disregarded in computing the per capita
income for the state (but not in
computing the per capita income for the
United States).
No Federal source of reliable and
timely data on pension and insurance
contributions by individual employers
and states is currently available. We
request that states report employer
pension or insurance fund contributions
to help determine potential FMAP
adjustments for states experiencing
significantly disproportionate pension
or insurance contributions and states
experiencing a negative growth in total
personal income. See also the
information described in the January 21,
2014 Federal Register notice (79 FR
3385).
Section 2006 of the Affordable Care
Act provides a special adjustment to the
FMAP for certain states recovering from
a major disaster. This notice does not
contain an FY 2022 adjustment for a
major statewide disaster for any state
(territories are not eligible for FMAP
adjustments) because no state had a
recent major statewide disaster and had
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Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices
its FMAP decreased by at least three
percentage points from FY 2020 to FY
2021. See information described in the
December 22, 2010 Federal Register
notice (75 FR 80501).
Enhanced Federal Medical Assistance
Percentage (eFMAP) for CHIP
Section 2105(b) of the Act specifies
the formula for calculating the eFMAP
rates as 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.
The eFMAP rates are used in the
Children’s Health Insurance Program
under Title XXI, and in the Medicaid
program for expenditures for medical
assistance provided to certain children
as 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
(Table 1, Column 2).
Section 2705(b) of the Act, as
amended by the HEALTHY KIDS Act of
2017, increased the eFMAP by 11.5
percentage points for FY 2021 and is no
longer applicable.
(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 24, 2020.
Alex M. Azar II,
Secretary.
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2021–SEPTEMBER 30, 2022
[Fiscal year 2022]
Federal Medical
Assistance
Percentages
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State
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 ...............................................................................................................................
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E:\FR\FM\30NON1.SGM
72.37
50.00
55.00
70.01
71.62
50.00
50.00
50.00
57.72
70.00
61.03
66.85
55.00
53.64
70.21
51.09
66.30
62.14
60.16
72.75
68.02
64.00
50.00
50.00
65.48
50.51
78.31
66.36
64.90
57.80
62.59
50.00
50.00
73.71
50.00
67.65
53.59
55.00
64.10
68.31
60.22
52.68
55.00
54.88
70.75
58.69
66.36
30NON1
Enhanced Federal
Medical Assistance
Percentages
80.66
65.00
68.50
79.01
80.13
65.00
65.00
65.00
70.40
79.00
72.72
76.80
68.50
67.55
79.15
65.76
76.41
73.50
72.11
80.93
77.61
74.80
65.00
65.00
75.84
65.36
84.82
76.45
75.43
70.46
73.81
65.00
65.00
81.60
65.00
77.36
67.51
68.50
74.87
77.82
72.15
66.88
68.50
68.42
79.53
71.08
76.45
76589
Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2021–SEPTEMBER 30, 2022—Continued
[Fiscal year 2022]
Federal Medical
Assistance
Percentages
State
Texas .......................................................................................................................................
Utah .........................................................................................................................................
Vermont ...................................................................................................................................
Virgin Islands * .........................................................................................................................
Virginia .....................................................................................................................................
Washington ..............................................................................................................................
West Virginia ............................................................................................................................
Wisconsin .................................................................................................................................
Wyoming ..................................................................................................................................
Enhanced Federal
Medical Assistance
Percentages
60.80
66.83
56.47
55.00
50.00
50.00
74.68
59.88
50.00
72.56
76.78
69.53
68.50
65.00
65.00
82.28
71.92
65.00
* 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 for the territories.
** For purposes of section 1905(b) of the Social Security Act, the FMAP for the District of Columbia, for purposes of titles XIX and XXI, shall be
70 percent. 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 disproportionate share hospital (DSH) allotments under those titles. For other purposes, the percentage for DC is 50.00, unless otherwise
specified by law.
[FR Doc. 2020–26387 Filed 11–27–20; 8:45 am]
BILLING CODE P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Center for Scientific Review; Amended
Notice of Meeting
Notice is hereby given of a change in
the meeting of the Center for Scientific
Review Special Emphasis Panel,
December 10, 2020, 09:30 a.m. to
December 10, 2020, 05:00 p.m., National
Institutes of Health, Eunice Kennedy
Shriver National Institute of, 6701B
Rockledge Drive, Bethesda, MD 20892,
which was published in the Federal
Register on November 16, 2020, 85 FR
73063.
This notice is being amended to
change the meeting start time from
10:00 a.m. to 9:30 a.m. The meeting is
closed to the public.
Dated: November 24, 2020.
Miguelina Perez,
Program Analyst, Office of Federal Advisory
Committee Policy.
[FR Doc. 2020–26370 Filed 11–27–20; 8:45 am]
BILLING CODE 4140–01–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
National Institute on Drug Abuse;
Notice of Closed Meeting
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of the
following meeting.
VerDate Sep<11>2014
20:03 Nov 27, 2020
Jkt 253001
The meeting will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable material,
and personal information concerning
individuals associated with the grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
Name of Committee: National Institute on
Drug Abuse Special Emphasis Panel;
Mechanism for Time-Sensitive Drug Abuse
Research (R21 Clinical Trial Optional).
Date: December 9, 2020.
Time: 12:00 p.m. to 5:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: National Institutes of Health,
National Institute on Drug Abuse, 301 North
Stonestreet Avenue, Bethesda, MD 20892
(Telephone Conference Call).
Contact Person: Sheila Pirooznia, Ph.D.,
Scientific Review Officer, Division of
Extramural Review, Scientific Review
Branch, National Institute on Drug Abuse,
NIH, 301 North Stonestreet Avenue, MSC
6021, Bethesda, MD 20892, (301) 496–9350,
sheila.pirooznia@nih.gov.
This notice is being published less than 15
days prior to the meeting due to the timing
limitations imposed by the review and
funding cycle.
(Catalogue of Federal Domestic Assistance
Program Nos. 93.277, Drug Abuse Scientist
Development Award for Clinicians, Scientist
Development Awards, and Research Scientist
Awards; 93.278, Drug Abuse National
Research Service Awards for Research
Training; 93.279, Drug Abuse and Addiction
Research Programs, National Institutes of
Health, HHS)
PO 00000
Frm 00076
Fmt 4703
Sfmt 4703
Dated: November 24, 2020.
Tyeshia M. Roberson,
Program Analyst, Office of Federal Advisory
Committee Policy.
[FR Doc. 2020–26367 Filed 11–27–20; 8:45 am]
BILLING CODE 4140–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Center for Scientific Review; Notice of
Closed Meeting
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of the
following meeting.
The meeting will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable material,
and personal information concerning
individuals associated with the grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
Name of Committee: Center for Scientific
Review Special Emphasis Panel; Small
Business: Spine and Vertebral Disc.
Date: December 17, 2020.
Time: 11:00 a.m. to 12:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: National Institutes of Health,
Rockledge II, 6701 Rockledge Drive,
Bethesda, MD 20892 (Telephone Conference
Call).
Contact Person: Aftab A. Ansari, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
E:\FR\FM\30NON1.SGM
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]]>Agencies
[Federal Register Volume 85, Number 230 (Monday, November 30, 2020)]
[Notices]
[Pages 76586-76589]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-26387]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Federal Financial Participation in State Assistance Expenditures;
Federal Matching Shares for Medicaid, the Children's Health Insurance
Program, and Aid to Needy Aged, Blind, or Disabled Persons for October
1, 2021 Through September 30, 2022
AGENCY: Office of the Secretary, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
DATES: The percentages listed in Table 1 will be effective for each of
the four quarter-year periods beginning October 1, 2021 and ending
September 30, 2022.
FOR FURTHER INFORMATION CONTACT: Ann Conmy, 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 2022 have been
calculated pursuant to the Social Security Act (the Act). These
percentages will be effective from October 1, 2021 through September
30, 2022. 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 adjustments
available for states meeting requirements for disproportionate employer
pension or insurance fund contributions and adjustments for disaster
recovery. At this time, no state qualifies for such adjustments, and
territories are not eligible.
The FY 2022 FMAP rates do not include the 6.2 percentage point
increase in the FMAP provided under Section 6008 of the Families First
Coronavirus Response Act (FFCRA) (Pub. L. 116-127) because the increase
depends upon states meeting statutory requirements in FFCRA that cannot
be assumed. If applied, the temporary 6.2 percentage increase in the
FMAP is effective beginning January 1, 2020 and can extend through the
last day of the calendar quarter in which the public health emergency
declared by the Secretary of Health and Human Services
[[Page 76587]]
for COVID-19, including any extensions, terminates.
Programs under title XIX of the Act exist in each jurisdiction.
Programs under titles I, X, and XIV operate only in Guam and the Virgin
Islands. The percentages in this notice apply to state expenditures for
most medical assistance and child health assistance, and assistance
payments for certain social services. The Act provides separately for
federal matching of administrative costs.
Sections 1905(b) and 1101(a)(8)(B) of the Social Security Act (the
Act) require the Secretary of HHS to publish the FMAP rates each year.
The Secretary calculates the percentages, using formulas in sections
1905(b) and 1101(a)(8), and calculations by the Department of Commerce
of average income per person in each state and for the United States
(meaning, for this purpose, the fifty states and the District of
Columbia). 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 the 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 the Federal medical
assistance percentage shall in no case be less than 50 per centum or
more than 83 per centum.
Section 1905(b) further specifies that the FMAP 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. Section 202(c) of
the Further Consolidated Appropriations Act, 2020 (Pub. L. 116-94)
amends section 1905(b) to increase the FMAP to 76 percent for Puerto
Rico and increase the FMAP to 83 percent for the Virgin Islands, Guam,
the Northern Mariana Islands, and American Samoa to 83 percent, for the
period beginning December 21, 2020, and ending September 30, 2021. 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'')
(Pub. L. 111-148), provides for a significant increase in the FMAP for
medical assistance expenditures for newly eligible individuals
described in section 1902(a)(10)(A)(i)(VIII) of the Act, as added by
the Affordable Care Act (the new adult group); ``newly eligible'' is
defined in section 1905(y)(2)(A) of the Act. The FMAP for the new adult
group 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 offered substantial
health coverage to certain low-income parents and nonpregnant,
childless adults on the date of 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
under section 1937 of the Act. These provisions are discussed in more
detail in the Medicaid Program: Eligibility Changes Under the
Affordable Care Act of 2010 proposed rule published on August 17, 2011
(76 FR 51148, 51172) and the final rule published on March 23, 2012 (77
FR 17144, 17194). This notice is not intended to set forth the matching
rates for the new adult group as specified in section 1905(y) of the
Act or the matching rates for nonpregnant, childless adults in
expansion states as specified in section 1905(z) of the Act.
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, can be 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 no growth or
positive growth in total personal income and an employer in that state
has made a significantly disproportionate contribution to an employer
pension or insurance fund, the state's FMAP must be adjusted. The
adjustment involves disregarding the significantly disproportionate
employer pension or insurance fund contribution in computing the per
capita income for the state (but not in computing the per capita income
for the United States). Employer pension and insurance fund
contributions are significantly disproportionate if the increase in
contributions exceeds 25 percent of the total increase in personal
income in that state. A Federal Register Notice with comment period was
published on June 7, 2010 (75 FR 32182) announcing the methodology for
calculating this adjustment; a final notice was published on October
15, 2010 (75 FR 63480).
The 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, 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 or insurance fund
contribution that exceeds 125 percent of the amount of such
contribution in the previous calendar year shall be disregarded in
computing the per capita income for the state (but not in computing the
per capita income for the United States).
No Federal source of reliable and timely data on pension and
insurance contributions by individual employers and states is currently
available. We request that states report employer pension or insurance
fund contributions to help determine potential FMAP adjustments for
states experiencing significantly disproportionate pension or insurance
contributions and states experiencing a negative growth in total
personal income. See also the information described in the January 21,
2014 Federal Register notice (79 FR 3385).
Section 2006 of the Affordable Care Act provides a special
adjustment to the FMAP for certain states recovering from a major
disaster. This notice does not contain an FY 2022 adjustment for a
major statewide disaster for any state (territories are not eligible
for FMAP adjustments) because no state had a recent major statewide
disaster and had
[[Page 76588]]
its FMAP decreased by at least three percentage points from FY 2020 to
FY 2021. See information described in the December 22, 2010 Federal
Register notice (75 FR 80501).
Enhanced Federal Medical Assistance Percentage (eFMAP) for CHIP
Section 2105(b) of the Act specifies the formula for calculating
the eFMAP rates as 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.
The eFMAP rates are used in the Children's Health Insurance Program
under Title XXI, and in the Medicaid program for expenditures for
medical assistance provided to certain children as 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 (Table 1, Column 2).
Section 2705(b) of the Act, as amended by the HEALTHY KIDS Act of
2017, increased the eFMAP by 11.5 percentage points for FY 2021 and is
no longer applicable.
(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 24, 2020.
Alex M. Azar II,
Secretary.
Table 1--Federal Medical Assistance Percentages and Enhanced Federal Medical Assistance Percentages, Effective
October 1, 2021-September 30, 2022
[Fiscal year 2022]
----------------------------------------------------------------------------------------------------------------
Enhanced Federal
State Federal Medical Medical Assistance
Assistance Percentages Percentages
----------------------------------------------------------------------------------------------------------------
Alabama....................................................... 72.37 80.66
Alaska........................................................ 50.00 65.00
American Samoa *.............................................. 55.00 68.50
Arizona....................................................... 70.01 79.01
Arkansas...................................................... 71.62 80.13
California.................................................... 50.00 65.00
Colorado...................................................... 50.00 65.00
Connecticut................................................... 50.00 65.00
Delaware...................................................... 57.72 70.40
District of Columbia **....................................... 70.00 79.00
Florida....................................................... 61.03 72.72
Georgia....................................................... 66.85 76.80
Guam *........................................................ 55.00 68.50
Hawaii........................................................ 53.64 67.55
Idaho......................................................... 70.21 79.15
Illinois...................................................... 51.09 65.76
Indiana....................................................... 66.30 76.41
Iowa.......................................................... 62.14 73.50
Kansas........................................................ 60.16 72.11
Kentucky...................................................... 72.75 80.93
Louisiana..................................................... 68.02 77.61
Maine......................................................... 64.00 74.80
Maryland...................................................... 50.00 65.00
Massachusetts................................................. 50.00 65.00
Michigan...................................................... 65.48 75.84
Minnesota..................................................... 50.51 65.36
Mississippi................................................... 78.31 84.82
Missouri...................................................... 66.36 76.45
Montana....................................................... 64.90 75.43
Nebraska...................................................... 57.80 70.46
Nevada........................................................ 62.59 73.81
New Hampshire................................................. 50.00 65.00
New Jersey.................................................... 50.00 65.00
New Mexico.................................................... 73.71 81.60
New York...................................................... 50.00 65.00
North Carolina................................................ 67.65 77.36
North Dakota.................................................. 53.59 67.51
Northern Mariana Islands *.................................... 55.00 68.50
Ohio.......................................................... 64.10 74.87
Oklahoma...................................................... 68.31 77.82
Oregon........................................................ 60.22 72.15
Pennsylvania.................................................. 52.68 66.88
Puerto Rico*.................................................. 55.00 68.50
Rhode Island.................................................. 54.88 68.42
South Carolina................................................ 70.75 79.53
South Dakota.................................................. 58.69 71.08
Tennessee..................................................... 66.36 76.45
[[Page 76589]]
Texas......................................................... 60.80 72.56
Utah.......................................................... 66.83 76.78
Vermont....................................................... 56.47 69.53
Virgin Islands *.............................................. 55.00 68.50
Virginia...................................................... 50.00 65.00
Washington.................................................... 50.00 65.00
West Virginia................................................. 74.68 82.28
Wisconsin..................................................... 59.88 71.92
Wyoming....................................................... 50.00 65.00
----------------------------------------------------------------------------------------------------------------
* 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 for the territories.
** For purposes of section 1905(b) of the Social Security Act, the FMAP for the District of Columbia, for
purposes of titles XIX and XXI, shall be 70 percent. 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 disproportionate share
hospital (DSH) allotments under those titles. For other purposes, the percentage for DC is 50.00, unless
otherwise specified by law.
[FR Doc. 2020-26387 Filed 11-27-20; 8:45 am]
BILLING CODE P
