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, 2022 Through September 30, 2023, 67479-67482 [2021-25798]
Download as PDF
<![CDATA[
67479
Federal Register / Vol. 86, No. 225 / Friday, November 26, 2021 / Notices
timing in blood stem cell recipients,
characterize emerging vaccination
strategies (which may include boosters),
describe possible short and long-term
side effects of vaccines, and analyze the
incidence of COVID–19 infection based
on different vaccination approaches.
This information may guide future
vaccination strategies or COVID
treatments. Vaccination status of
recipients may also be useful for risk
adjustment in the annual transplant
center specific analysis. For example,
Centers for Disease Control and
Prevention advisors could potentially
use COVID–19 vaccination data on
blood stem cell transplant recipients to
make informed decisions regarding
whether to issue any recommendations
for this medically vulnerable
population. The data collected under
this extension request could help
answer these and other questions.
The additional COVID–19 vaccine
questions capture basic information on
vaccination status, vaccine
manufacturer/type, dose(s) given, and
date(s) received. Patients who need a
blood stem cell transplant are typically
aware of their COVID–19 risk and
vaccination status, and the information
is also found on the vaccine cards
carried by most recipients. Questions
about vaccination status will likely
become universal during the intake
process at transplant centers for the next
12 months or more. For these reasons,
HRSA believes the data will be readily
available to data professionals working
at transplant centers via the medical
record. To reduce burden, an
‘‘unknown’’ option has been included
for scenarios where the data cannot be
located, and a ‘‘date estimated’’
checkbox has been included when the
exact date of vaccination is not known.
Although these questions are
anticipated to be asked over the next 12
months and then removed, it is possible
that other COVID–19 related questions
may be requested for inclusion on these
forms in the future given the rapid
evolution of COVID–19 and its impact
on immunocompromised patients,
availability of new vaccines, and
continual changes in vaccination
recommendations.
Likely Respondents: Transplant
Centers.
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 1
Form name
Number of
responses per
respondent
Average
burden per
response
(in hours)
Total
responses
Total burden
hours
Baseline Pre-Transplant Essential Data (TED) ...................
Disease Classification ..........................................................
Product Form (includes Infusion, HLA, and Infectious Disease Marker inserts) ........................................................
100-day Post-TED ...............................................................
6 month Post-TED ...............................................................
1 year Post-TED ..................................................................
2 year Post-TED ..................................................................
3+ years Post-TED ..............................................................
200
200
48
48
9,600
9,600
2 0.70
3 0.43
6,720
4,160
200
200
200
200
200
200
45
48
43
40
34
172
9,000
9,600
8,600
8,000
6,800
34,400
1.00
0.88
0.85
0.65
0.65
4 0.52
9,000
8,448
7,310
5,200
4,420
17,773
Total ..............................................................................
200
........................
95,600
........................
63,031
1, The
jspears on DSK121TN23PROD with NOTICES1
total of 200 is the number of centers completing the form; the same group will complete all of the forms.
2 The decimal is rounded down, and the actual number is .683333333.
3 The decimal is rounded down, and the actual number is .433333333.
4 The decimal is rounded up, and the actual number is .516667.
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.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Maria G. Button,
Director, Executive Secretariat.
The Federal Medical Assistance
Percentages (FMAP), Enhanced Federal
Medical Assistance Percentages
(eFMAP), and disaster-recovery FMAP
adjustments for Fiscal Year 2023 have
been calculated pursuant to the Social
[FR Doc. 2021–25786 Filed 11–24–21; 8:45 am]
BILLING CODE 4165–15–P
VerDate Sep<11>2014
20:16 Nov 24, 2021
Jkt 256001
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, 2022
Through September 30, 2023
Office of the Secretary, DHHS.
Notice.
AGENCY:
ACTION:
PO 00000
Frm 00050
Fmt 4703
Sfmt 4703
Security Act (the Act). These
percentages will be effective from
October 1, 2022 through September 30,
2023. 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
E:\FR\FM\26NON1.SGM
26NON1
67480
Federal Register / Vol. 86, No. 225 / Friday, November 26, 2021 / Notices
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.
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.
jspears on DSK121TN23PROD with NOTICES1
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. . . .’’
Section 1905(b) further specifies that
the FMAP for Puerto Rico, the Virgin
VerDate Sep<11>2014
20:16 Nov 24, 2021
Jkt 256001
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’’) (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.
Section 6008 of the Families First
Coronavirus Response Act (FFCRA)
(Pub. L. 116–127) as amended by
section 3720 of the CARES Act (Pub. L.
116–136), provides a temporary 6.2
percentage point FMAP increase to each
qualifying state and territory’s FMAP
PO 00000
Frm 00051
Fmt 4703
Sfmt 4703
under section 1905(b) of the Act,
effective January 1, 2020 and extending
through the last day of the calendar
quarter in which the public health
emergency declared by the Secretary of
HHS for COVID–19, including any
extensions, terminates. The FY 2023
FMAP rates listed in Table 1 do not
include the 6.2 percentage point
increase in the FMAP that qualifying
states may receive under Section 6008
of the FFCRA (Pub. L. 116–127).
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).
E:\FR\FM\26NON1.SGM
26NON1
67481
Federal Register / Vol. 86, No. 225 / Friday, November 26, 2021 / Notices
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 2023 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
its FMAP decreased by at least three
percentage points from FY 2021 to FY
2022. 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 follows:
[T]he ‘‘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).
DATES: The percentages listed in Table
1 will be applicable for each of the four
quarter-year periods beginning October
1, 2022 and ending September 30, 2023.
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.
(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)
Xavier Becerra,
Secretary.
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2022–SEPTEMBER 30, 2023
[Fiscal Year 2023]
Federal
medical
assistance
percentages
jspears on DSK121TN23PROD with NOTICES1
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 .................................................................................................................................................................
VerDate Sep<11>2014
20:16 Nov 24, 2021
Jkt 256001
PO 00000
Frm 00052
Fmt 4703
Sfmt 4703
E:\FR\FM\26NON1.SGM
26NON1
72.43
50.00
55.00
69.56
71.31
50.00
50.00
50.00
58.49
70.00
60.05
66.02
55.00
56.06
70.11
50.00
65.66
63.13
59.76
72.17
67.28
63.29
50.00
50.00
64.71
50.79
77.86
65.81
64.12
57.87
62.65
50.00
50.00
73.26
50.00
Enhanced
federal
medical
assistance
percentages
80.70
65.00
68.50
78.69
79.92
65.00
65.00
65.00
70.94
79.00
72.04
76.21
68.50
69.24
79.08
65.00
75.96
74.19
71.83
80.52
77.10
74.30
65.00
65.00
75.30
65.55
84.50
76.07
74.88
70.51
73.86
65.00
65.00
81.28
65.00
67482
Federal Register / Vol. 86, No. 225 / Friday, November 26, 2021 / Notices
TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
EFFECTIVE OCTOBER 1, 2022–SEPTEMBER 30, 2023—Continued
[Fiscal Year 2023]
Federal
medical
assistance
percentages
State
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 ..................................................................................................................................................................
67.71
51.55
55.00
63.58
67.36
60.32
52.00
55.00
53.96
70.58
56.74
66.10
59.87
65.90
55.82
55.00
50.65
50.00
74.02
60.10
50.00
Enhanced
federal
medical
assistance
percentages
77.40
66.09
68.50
74.51
77.15
72.22
66.40
68.50
67.77
79.41
69.72
76.27
71.91
76.13
69.07
68.50
65.46
65.00
81.81
72.07
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.
** 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 D.C. is 50.00, unless otherwise specified
by law.
[FR Doc. 2021–25798 Filed 11–24–21; 8:45 am]
BILLING CODE P
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
[Docket No. USCG–2021–0824]
National Maritime Security Advisory
Committee
U.S. Coast Guard, Department
of Homeland Security.
ACTION: Notice of Federal Advisory
Committee teleconference meeting.
AGENCY:
The National Maritime
Security Advisory Committee
(Committee) will meet via
teleconference, to review and discuss
matters relating to national maritime
security. Specifically, the Coast Guard
intends to present and issue a task
focused on improving and enhancing
the sharing of information related to
cybersecurity risks that may cause a
transportation security incident. This
teleconference will be open to the
public.
jspears on DSK121TN23PROD with NOTICES1
SUMMARY:
DATES:
Meeting: The Committee will meet by
teleconference on Wednesday,
VerDate Sep<11>2014
20:16 Nov 24, 2021
Jkt 256001
December 15, 2021 from 1 p.m. until 3
p.m. Eastern Standard Time (EST). This
teleconference may close early if all
business is finished.
Comments and supporting
documentation: To ensure your
comments are received by Committee
members before the teleconference,
submit your written comments no later
than December 7, 2021.
ADDRESSES: To join the teleconference
or to request special accommodations,
contact the individual listed in the FOR
FURTHER INFORMATION CONTACT section
no later than 1 p.m. EST on December
7, 2021, to obtain the needed
information. The number of
teleconference lines are limited and will
be available on a first-come, first-served
basis.
For information on services for
individuals with disabilities, or to
request special assistance, contact the
individual listed in FOR FURTHER
INFORMATION CONTACT below as soon as
possible.
Instructions: You are free to submit
comments at any time, including orally
at the teleconference as time permits,
but if you want Committee members to
review your comment before the
teleconference, please submit your
comments no later than December 7,
2021. We are particularly interested in
PO 00000
Frm 00053
Fmt 4703
Sfmt 4703
comments on the issues in the
‘‘Agenda’’ section below. We encourage
you to submit comments through
Federal eRulemaking Portal at https://
regulations.gov. If your material cannot
be submitted using https://
regulations.gov, call or email the
individual in the FOR FURTHER
INFORMATION CONTACT section of this
document for alternate instructions. You
must include the docket number
[USCG–2021–0824]. Comments received
will be posted without alteration at
https://www.regulations.gov including
any personal information provided. You
may wish to view the Privacy and
Security Notice available on the
homepage of https://
www.regulations.gov and DHS’s
eRulemaking System of Records notice
(85 FR 14226, March 11, 2020). If you
encounter technical difficulties with
comment submission, contact the
individual listed in the FOR FURTHER
INFORMATION CONTACT section of this
notice.
Docket Search: Documents mentioned
in this notice as being available in the
docket, and all public comments, will
be in our online docket at https://
www.regulations.gov, and can be viewed
by following that website’s instructions.
Additionally, if you go to the online
docket and sign-up for email alerts, you
E:\FR\FM\26NON1.SGM
26NON1
]]>Agencies
[Federal Register Volume 86, Number 225 (Friday, November 26, 2021)]
[Notices]
[Pages 67479-67482]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-25798]
-----------------------------------------------------------------------
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, 2022 Through September 30, 2023
AGENCY: Office of the Secretary, DHHS.
ACTION: Notice.
-----------------------------------------------------------------------
The Federal Medical Assistance Percentages (FMAP), Enhanced Federal
Medical Assistance Percentages (eFMAP), and disaster-recovery FMAP
adjustments for Fiscal Year 2023 have been calculated pursuant to the
Social Security Act (the Act). These percentages will be effective from
October 1, 2022 through September 30, 2023. 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
[[Page 67480]]
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.
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 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. . . .''
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. 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.
Section 6008 of the Families First Coronavirus Response Act (FFCRA)
(Pub. L. 116-127) as amended by section 3720 of the CARES Act (Pub. L.
116-136), provides a temporary 6.2 percentage point FMAP increase to
each qualifying state and territory's FMAP under section 1905(b) of the
Act, effective January 1, 2020 and extending through the last day of
the calendar quarter in which the public health emergency declared by
the Secretary of HHS for COVID-19, including any extensions,
terminates. The FY 2023 FMAP rates listed in Table 1 do not include the
6.2 percentage point increase in the FMAP that qualifying states may
receive under Section 6008 of the FFCRA (Pub. L. 116-127).
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).
[[Page 67481]]
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 2023 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 its FMAP decreased by at least three percentage points
from FY 2021 to FY 2022. 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 follows:
[T]he ``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).
DATES: The percentages listed in Table 1 will be applicable for each of
the four quarter-year periods beginning October 1, 2022 and ending
September 30, 2023.
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.
(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)
Xavier Becerra,
Secretary.
Table 1--Federal Medical Assistance Percentages and Enhanced Federal
Medical Assistance Percentages, Effective October 1, 2022-September 30,
2023
[Fiscal Year 2023]
------------------------------------------------------------------------
Enhanced
Federal federal
State medical medical
assistance assistance
percentages percentages
------------------------------------------------------------------------
Alabama................................. 72.43 80.70
Alaska.................................. 50.00 65.00
American Samoa *........................ 55.00 68.50
Arizona................................. 69.56 78.69
Arkansas................................ 71.31 79.92
California.............................. 50.00 65.00
Colorado................................ 50.00 65.00
Connecticut............................. 50.00 65.00
Delaware................................ 58.49 70.94
District of Columbia **................. 70.00 79.00
Florida................................. 60.05 72.04
Georgia................................. 66.02 76.21
Guam *.................................. 55.00 68.50
Hawaii.................................. 56.06 69.24
Idaho................................... 70.11 79.08
Illinois................................ 50.00 65.00
Indiana................................. 65.66 75.96
Iowa.................................... 63.13 74.19
Kansas.................................. 59.76 71.83
Kentucky................................ 72.17 80.52
Louisiana............................... 67.28 77.10
Maine................................... 63.29 74.30
Maryland................................ 50.00 65.00
Massachusetts........................... 50.00 65.00
Michigan................................ 64.71 75.30
Minnesota............................... 50.79 65.55
Mississippi............................. 77.86 84.50
Missouri................................ 65.81 76.07
Montana................................. 64.12 74.88
Nebraska................................ 57.87 70.51
Nevada.................................. 62.65 73.86
New Hampshire........................... 50.00 65.00
New Jersey.............................. 50.00 65.00
New Mexico.............................. 73.26 81.28
New York................................ 50.00 65.00
[[Page 67482]]
North Carolina.......................... 67.71 77.40
North Dakota............................ 51.55 66.09
Northern Mariana Islands *.............. 55.00 68.50
Ohio.................................... 63.58 74.51
Oklahoma................................ 67.36 77.15
Oregon.................................. 60.32 72.22
Pennsylvania............................ 52.00 66.40
Puerto Rico *........................... 55.00 68.50
Rhode Island............................ 53.96 67.77
South Carolina.......................... 70.58 79.41
South Dakota............................ 56.74 69.72
Tennessee............................... 66.10 76.27
Texas................................... 59.87 71.91
Utah.................................... 65.90 76.13
Vermont................................. 55.82 69.07
Virgin Islands *........................ 55.00 68.50
Virginia................................ 50.65 65.46
Washington.............................. 50.00 65.00
West Virginia........................... 74.02 81.81
Wisconsin............................... 60.10 72.07
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.
** 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 D.C. is 50.00, unless otherwise
specified by law.
[FR Doc. 2021-25798 Filed 11-24-21; 8:45 am]
BILLING CODE P
