[Federal Register Volume 64, Number 81 (Wednesday, April 28, 1999)]
[Notices]
[Pages 22871-22872]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-10610]
[[Page 22871]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Notice of Hearing: Reconsideration of Disapproval of Minnesota
State Plan Amendment (SPA) 98-10
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice of hearing.
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SUMMARY: This notice announces an administrative hearing on June 9,
1999; 10:00 a.m.; Twenty-First floor; 105 W. Adams Street; Chicago,
Illinois 60603 to reconsider our decision to disapprove Minnesota State
Plan Amendment (SPA) 98-10.
CLOSING DATE: Requests to participate in the hearing as a party must be
received by the presiding officer by May 13, 1999.
FOR FURTHER INFORMATION CONTACT: Stanley Katz, Hearings Officer, HCFA,
C1-09-13, 7500 Security Boulevard, Baltimore, Maryland 21244,
Telephone: (410)-786-2661
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider HCFA's decision to disapprove Minnesota State
Plan Amendment 98-10 submitted March 30, 1998.
Section 1116 of the Social Security Act (the Act) and 42 CFR Part
430 establish Department procedures that provide an administrative
hearing for reconsideration of a disapproval of a State plan or plan
amendment. These requirements are made applicable under Title XIX. The
Health Care Financing Administration (HCFA) is required to publish a
copy of the notice to the State that informs the State of the time and
place of the hearing and the issues to be considered. If we
subsequently notify the State of additional issues that will be
considered at the hearing, we will also publish that notice.
Any individual or group that wants to participate in the hearing as
a party must petition the presiding officer within 15 days after
publication of this notice, in accordance with the requirements
contained at 42 CFR 430.76(b)(2). Any interested person or organization
that wants to participate as amicus curiae must petition the presiding
officer before the hearing begins in accordance with the requirements
contained at 42 CFR 430.76(c). If the hearing is later rescheduled, the
presiding officer will notify all participants.
Minnesota submitted this State Plan Amendment (SPA) on March 30,
1998. The issue is whether the State's proposal to adopt several less
restrictive Medicaid financial eligibility methodologies for the group
of low income families with children under section 1931 of the Social
Security Act comports with the requirements of section 1902(a)(17)of
the Act that a state use reasonable standards which are comparable for
all groups in determining eligibility for and the amount of medical
assistance.
Specifically, the State proposed to disregard earned income and
resources used to determine a grant under the Temporary Assistance for
Needy Families (TANF) program. If these proposals mean that the types
of income and resources which TANF would count will be disregarded in
determining the eligibility of all individuals under Section 1931, HCFA
would have no objections. However, HCFA understands that the intent of
these provisions was to disregard the earned income and resources only
in situations in which the family receives a TANF grant. Given this
understanding, these proposed disregards are not in accordance with
Federal law. HCFA concluded that these provisions violate the
requirement in Section 1902 (a)(17).
Section 1931(b)(2)(C)of the Act permits a State to use less
restrictive income and resource methodologies in determining
eligibility than it used under its Aid to Families with Dependent
Children (AFDC) State plan in effect on July 16, 1996. Nevertheless,
HCFA believes this language must be read in context of other title XIX
requirements rather than in a vacuum. Therefore, the requirements of
section 1902 (a)(17) apply.This section requires States to have
reasonable standards for determining eligibility for Medicaid
assistance which are ``comparable for all groups.'' A disregard which
treats the same types of income or the same amounts of resources
differently whether or not an individual participates in the TANF
program, does not result in comparable treatment of income and
resources for all individuals under the 1931 group. If two individuals
have identical amounts of income from the same source, that income
would be counted in determining the eligibility of an individual who
applied only for Medicaid but would be disregarded if the individual
received a TANF grant in addition to applying for Medicaid. This does
not comport with the comparability requirements of Section 1902(a)(17).
Therefore, the proposal to disregard earned income used in determining
a TANF grant and to disregard resources used in determining a TANF
grant was disapproved by HCFA. The deficiencies described above left
HCFA no choice but to recommend disapproval of Minnesota SPA 98-10.
The notice to Minnesota announcing an administrative hearing to
reconsider the disapproval of its SPA reads as follows:
Mary B. Kennedy, State Medicaid Director, Assistant Commissioner
Health Care Administration, Minnesota Department of Health Services,
444 Lafayette Road North, Saint Paul, Minnesota 55155.
Dear Ms. Kennedy: I am responding to your request for
reconsideration of the decision to disapprove Minnesota State Plan
Amendment (SPA) 98-10. The issue is the State's proposal to adopt
several less restrictive methodologies for the group of low income
families with children eligible under Section 1931 of the Social
Security Act.
Specifically, the State proposed to disregard earned income and
resources used in determining a grant under the Temporary Assistance
for Needy Families (TANF) program. If these proposals mean that the
types of income and resources which TANF would count will be
disregarded in determining the eligibility of all individuals under
section 1931, HCFA would have no objections. However, HCFA
understands that the intent of these provisions is to disregard the
earned income and the resources only in situations in which the
family receives a TANF grant. Given this understanding, these
proposed disregards are not in accordance with Federal law. These
provisions violate the requirement in section 1902(a)(17) that all
individuals in a group be subject to comparable standards for
determining eligibility.
Section 1931(b)(2)(C) of the Act permits a State to use less
restrictive income and resource methodologies in determining
eligibility than it used under its Aid to Families with Dependent
Children (AFDC) State plan in effect on July 16,1996. Nevertheless,
this language must be read in context of other title XIX
requirements rather than in a vacuum. The comparability requirements
of Section 1902(a)(17) must apply. This section requires States to
have reasonable standards for determining eligibility for Medicaid
assistance which are ``comparable for all groups.'' A disregard
which treats the same types of income or the same amounts of
resources differently whether or not an individual participates in
the TANF program, does not result in comparable treatment of income
and resources for all individuals under the 1931 group. If two
individuals have identical amounts of income from the same source,
that income would be counted in determining the eligibility of an
individual who applied only for Medicaid but would be disregarded if
the individual received a TANF grant in addition to applying for
Medicaid. This does not comport with the comparability requirements
of section 1902(a)(17). Therefore, the proposal to disregard earned
income used in determining a TANF grant and to disregard resources
used in determining a TANF grant was disapproved by HCFA. The
deficiencies described above left HCFA no choice but to
[[Page 22872]]
recommend disapproval of Minnesota SPA 98-10.
I am scheduling a hearing on your request for reconsideration to
be held on June 9, 1999 on the Twenty-First Floor; 105 W. Adams
Street; Chicago, Illinois 60603. If this date is not acceptable, we
would be glad to set another date that is mutually agreeable to the
parties. The hearing will be governed by the procedures prescribed
at 42 CFR, part 430.
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 which
may be necessary between the parties to the hearing, please notify
the presiding officer to indicate acceptability of the hearing date
that has been scheduled and provide names of the individuals who
will represent the State at the hearing. The presiding officer may
be reached at (410)-786-2661.
Sincerely,
Nancy-Ann Min DeParle,
Administrator.
(Section 1116 of the Social Security Act (42 U.S.C. section 1316);
42 CFR section 430.18)
(Catalog of Federal Domestic Assistance Program No. 13.714, Medicaid
Assistance Program)
Dated: April 22, 1999.
Nancy Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 99-10610 Filed 4-27-99; 8:45 am]
BILLING CODE 4120-01-P
