[Federal Register Volume 60, Number 57 (Friday, March 24, 1995)]
[Notices]
[Pages 15572-15573]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-7307]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Medicaid Program: Notice of Compliance Hearing: State of Kansas
Failure To Comply Substantially With Sections 1902(a)(14) and
1902(a)(19) of the Social Security Act by Not Fully Complying With the
Cost-Sharing Provisions of the Medicaid Statute
AGENCY: Health Care Financing Administration, HHS.
ACTION: Notice of compliance hearing.
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SUMMARY: This notice announces a compliance hearing on April 26, 1995,
in Room 111, New Federal Office Building, 601 East 12th Street, Kansas
City, Missouri, 64106-2808, to determine whether the State of Kansas,
in the administration of its Medicaid State plan, has failed to comply
with sections 1902(a)(14) and 1902(a)(19) of the Social Security Act
and 42 CFR 447.54(c).
CLOSING DATE: Requests to participate in the compliance hearing as a
party must be received by April 10, 1995.
FOR FURTHER INFORMATION CONTACT: Mr. Stanley Katz, Presiding Officer,
HCFA Hearing Staff, Ground Floor, Meadowwood East Building, 1849 Gwynn
Oak Avenue, Baltimore, MD 21207, Telephone: (410) 597-3013.
SUPPLEMENTARY INFORMATION: This notice announces a compliance hearing
to determine whether the State of Kansas, in the administration of its
Medicaid State plan, has failed to comply with sections 1902(a)(14) and
1902(a)(19) of the Social Security Act (the Act) and 42 Code of Federal
Regulations (CFR) 447.54(c). Section 1902(a)(14) of the Act requires a
Medicaid State plan to provide that premiums, deductibles, cost
sharing, or similar charges be imposed only as provided in section 1916
of the Act. Section 1902(a)(19) of the Act requires that the State plan
provide such safeguards as may be necessary to assure that care and
services are provided in the best interests of Medicaid recipients.
Preliminary findings are that (1) the copayment currently imposed by
Kansas does not conform to its approved State plan, and (2) in imposing
an institutional copayment level in an amount which deters recipients
from seeking needed care, Kansas has acted in a manner not in the best
interests of Medicaid recipients.
Section 1904 of the Act and 42 CFR 430, subpart D, establish
departmental procedures that provide a compliance hearing to determine
whether a State is not in compliance with a requirement of Federal law.
HCFA is required to publish a copy of the notice to the State Medicaid
agency which informs the agency of the time and place of the hearing
and the issues to be considered. (If we subsequently notify the agency
of additional issues which will be considered at the hearing, we will
also publish notice.) Any individual or group that wishes to
participate in the hearing as a party must petition the Hearing Officer
within 15 days after publication of this notice, in accordance with the
requirements at 42 CFR 430.76(b). Any interested person or organization
that wishes to participate as amicus curiae must petition the Hearing
Officer before the hearing begins, in accordance with the requirements
at 42 CFR 430.76(c). If the hearing is later rescheduled, the Hearing
Officer will notify all participants.
There is one issue to be considered at this hearing: whether Kansas
has failed to comply in practice with sections 1902(a)(14) and
1902(a)(19) of the Act and 42 CFR 447.54(c) in the administration of
its Medicaid State plan by imposing a copayment amount that does not
conform to its current State plan and is not in the best interests of
Medicaid recipients. The State of Kansas submitted a State plan
amendment (SPA) to increase its copayment for general hospital
inpatient services and inpatient free standing psychiatric facility
services from $25 to $325 per admission for Medicaid patients. The SPA
did not conform to the requirements of Federal law and regulations. A
letter disapproving the SPA was sent to the State on July 28, 1994.
However, at this time, Kansas continues to apply the higher copayment
amount.
The notice to Kansas announcing a compliance hearing to consider
our decision to find the State out of compliance with sections
1902(a)(14) and 1902(a)(19) of the Act and 42 CFR 447.54(c), reads as
follows:
Ms. Janet Schalansky,
Acting Secretary,
Kansas Department of Social and Rehabilitation Services, 915 S.W.
Harrison Street, Topeka, Kansas 66612.
Dear Ms. Schalansky: I am writing to advise you that the Health
Care Financing Administration has preliminarily determined that
Kansas has failed to comply in practice with sections 1902(a)(14)
and 1902(a)(19) of the Social Security Act (the Act) and 42 Code of
Federal Regulations (CFR) 447.54(c). By failing to comply
substantially in the administration of sections 1902(a)(14) and
1902(a)(19) of the Act and 42 CFR 447.54(c), as properly reflected
in its approved State plan, Kansas is substantially out of
compliance with the requirements for continued Federal financial
participation as explained in the letter to you dated October 6,
1994, from Joe L. Tilghman, Regional Administrator.
In accordance with the requirements of section 1904 of the Act
and the implementing regulations at 42 CFR 430.60 and 430.72, I am
scheduling a hearing on this determination to be held on April 26,
1995, in Room 111, New Federal Office Building, 601 East 12th
Street, Kansas City, Missouri, 64106-2808.
I am designating Mr. Stanley Katz as the presiding officer. If
these arrangements present any problems, please contact the
presiding officer. In order to facilitate any communication
necessary between the parties to the hearing, please notify the
presiding officer of the names of the individuals who will represent
the State at the hearing. The presiding officer may be reached at
(410) 597-3013. [[Page 15573]]
Sincerely,
Bruce C. Vladeck,
Administrator.
[Section 1904 of the Social Security Act]
[Catalog of Federal Domestic Assistance Program No. ________,
Medical Assistance Program]
Dated: March 16, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 95-7307 Filed 3-23-95; 8:45 am]
BILLING CODE 4120-01-P
