[Federal Register Volume 60, Number 86 (Thursday, May 4, 1995)]
[Notices]
[Pages 22067-22068]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-11019]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Hearing: Reconsideration of Disapproval of Illinois State Plan
Amendment (SPA)
AGENCY: Health Care Financing Administration (HCFA), HHS.
[[Page 22068]] ACTION: Notice of hearing.
-----------------------------------------------------------------------
SUMMARY: This notice announces an administrative hearing on June 14,
1995, at 10 a.m. in the 15th Floor Conference Room, 105 West Adams,
Chicago, Illinois to reconsider our decision to disapprove Illinois SPA
93-14.
CLOSING DATE: Requests to participate in the hearing as a party must be
received by the presiding officer by May 19, 1995.
FOR FURTHER INFORMATION CONTACT: Stan Katz, Presiding Officer, Ground
floor, Meadowwood East Building, 1849 Gwynn Oak Avenue, Baltimore,
Maryland 21207, Telephone: (410) 597-3013.
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider our decision to disapprove Illinois State plan
amendment (SPA) number 93-14.
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. The Health Care Financing Administration (HCFA) is required
to publish a copy of the notice to a State Medicaid agency that 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
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.
The State of Illinois submitted SPA 93-14 on October 18, 1994, to
establish a new payment adjustment for uncompensated care services, and
requested an effective date of July 1, 1993.
The issue in this matter is whether Illinois SPA 93-14, meets
Federal regulations which require the State to comply with the public
notice requirements in Section 447.205.
Illinois published public notice on August 6, 1993, with the plan
amendment's proposed effective date of July 1, 1993.
HCFA believes the proposed effective date of the plan amendment was
not approvable because the State failed to comply with the Federal
regulation at 42 CFR 447.253(h) which requires that the Medicaid agency
must comply with public notice requirements in Sec. 447.205 when it is
proposing significant changes to its methods and standards for setting
payment rates for inpatient hospital and long-term care facility
services. Section 447.225(d)(1) requires that the notice be published
before the proposed effective date of the change. The State's requested
effective date is prior to the date of the public notice announcement.
However, because public notice was published on August 5, 1993,
HCFA believes the plan amendment was approvable with an effective date
of August 6, 1993.
The State of Illinois contends that the change was not significant.
Additionally, Illinois challenges HCFA's disapproval because public
notice was published prior to the State's implementation of the
amendment, and because the eventual disallowances of Federal financial
participation funds based on public notice requirements are the subject
of current regulatory reform proposals.
Under HCFA's policy, the sole factor in determining a significant
change is the degree to which the State is proposing to modify its
payment methods and standards. HCFA believes since this amendment
established a new payment adjustment for uncompensated care services,
the amendment represents a significant change in the methods and
standards used to determine payment rates.
The notice to Illinois announcing an administrative hearing to
reconsider the disapproval of its SPA reads as follows:
Mr. Robert W. Wright,
Director, Illinois Department of Public Aid, Jesse B. Harris
Building II, 3rd Floor, 100 South Grand Avenue, East, Springfield,
Illinois 62762-0001
Dear Mr. Wright: I am responding to your request for
reconsideration of the decision to disapprove Illinois State Plan
Amendment (SPA) 93-14. The State of Illinois submitted SPA 93-14 on
October 18, 1994, to establish a new payment adjustment for
uncompensated care services, and requested an effective date of July
1, 1993.
The issue in this matter is whether Illinois SPA 93-14, meets
Federal regulations at 42 CFR 447.253(h) which require the State to
comply with the public notice requirements in section 447.205.
I am scheduling a hearing on your request for reconsideration to
be held on June 14, 1995, at 10 a.m. in the 15th floor conference
room, 105 West Adams, Chicago, Illinois. 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 the names of the individuals who
will represent the State at the hearing. The presiding officer may
be reached at (410) 597-3013.
Sincerely,
Bruce C. Vladeck,
Administrator.
(Sec. 1116 of the Social Security Act (42 U.S.C. section 1316); 42
CFR 430.18)
(Catalog of Federal Domestic Assistance Program No. 13.714, Medicaid
Assistance Program)
Dated: April 28, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 95-11019 Filed 5-3-95; 8:45 am]
BILLING CODE 4120-01-P
