thefederalregister.com

Daily Rules, Proposed Rules, and Notices of the Federal Government

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice of Availability of Federal Matching Shares for Medicaid and Foster Care and Adoption Assistance

AGENCY: Office of the Secretary, Department of Heath and Human Services.
ACTION: Notice.
SUMMARY: Title V of the ARRA provides for temporary increases in the FMAPs for fiscal relief to States and to protect and maintain State Medicaid programs in a period of economic downturn. The recession adjustment period is defined as the period beginning on October 1, 2008 and ending on December 31, 2010.

Section 5001 of the ARRA specifies that the FMAP shall be temporarily increased for the following: (1) A maintenance of FMAP for fiscal year 2009, fiscal year 2010, and first quarter of fiscal year 2011, determined by substituting the greater of such percentage for the State compared to the FMAP calculated for the prior fiscal year; (2) the application of an increase in each state's FMAP of 6.2 percentage points; and (3) an additional percent increase based on the state's increase in unemployment. Each state's FMAP will be recalculated each fiscal quarter beginning October 2008.

Payments eligible for FMAP under title XIX, except disproportionate share hospital and enhanced FMAP payments, shall receive the 6.2 percentage point increase and any unemployment adjustment. Payments under part E of title IV shall only receive the 6.2 percentage point increase.

The unemployment increase percentage for a calendar quarter is equal to the number of percentage points (if any) by which the average monthly unemployment rate for the State in the most recent previous 3-consecutive-month period for which data are available exceeds the lowest average monthly unemployment rate for the State for any 3-consecutive-month period beginning on or after January 1, 2006. A State qualifies for additional relief based on an increase in unemployment if that State's unemployment increase percentage is at least 1.5 percentage points.

In addition to the general 6.2 percentage point increase in FMAP, the FMAP for each qualifying State is increased by the number of percentage points equal to the product of the State percentage calculated from half the 6.2 percentage point increase in FMAP and the applicable percent determined from the State unemployment increase percentage for the quarter. The applicable percent is (1) 5.5 percent if the State unemployment increase percentage is at least 1.5 percentage points but less than 2.5 percentage points, (2) 8.5 percent if the State unemployment increase percentage is at least 2.5 percentage points but less than 3.5 percentage points, and (3) 11.5 percent if the State unemployment increase percentage is at least 3.5 percentage points.

If the applicable percent applied to a State is less than the applicable percent applied for the preceding quarter, then the higher applicable percent shall continue in effect for any calendar quarter beginning on January 1, 2009 and ending before July 1, 2010.

Territories (Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and America Samoa) can make a one-time election between (1) a 30 percent increase in their cap on Medicaid payments (as determined under subsections (f) and (g) of section 1108 of the Social Security Act), or (2) apply the increase of 6.2 percentage points in the FMAP plus a 15 percent increase in cap on Medicaid payments.

In no case shall an increase in FMAP under this section result in an FMAP that exceeds 100 percent.

DATES: Effective Dates:The percentages listed will be effective for each of the 2 quarter-year periods in the period beginning October 1, 2008 and ending March 15, 2009.
FOR FURTHER INFORMATION CONTACT: Thomas Musco or Rose Chu, 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: 93.659: Adoption Assistance; 93.769: Ticket-to-Work and Work Incentives Improvement Act (TWWIIA) Demonstrations to Maintain Independence and Employment) Dated: March 26, 2009. Charles E. Johnson, Acting Secretary. ARRA Adjustments to FMAP State FY08
  • original
  • FMAP
  • FY09
  • original
  • FMAP
  • Hold
  • harmless
  • FY 09
  • Hold
  • harmless
  • FY09
  • FMAP with
  • 6.2% pt
  • increase
  • 3-Month
  • average
  • unemployment
  • rate
  • ending
  • Dec 2008
  • Minimum
  • unemployment
  • Unemployment
  • difference
  • Unemployment
  • tier
  • Unemployment
  • adjustment
  • 1st Quarter FY09 FMAP
  • adjust (incl HH-6.2-
  • unemployment)
  • 2nd Quarter FY09 FMAP
  • adjust (incl HH-6.2-
  • unemployment)
  • Alabama 67.62 67.98 67.98 74.18 6.1 3.4 2.7 8.5 2.46 76.64 76.64 Alaska 52.48 50.53 52.48 58.68 7.3 6.0 1.3 0 0.00 58.68 58.68 Arizona 66.20 65.77 66.20 72.40 6.5 3.7 2.8 8.5 2.61 75.01 75.01 Arkansas 72.94 72.81 72.94 79.14 5.7 4.7 1.0 0 0.00 79.14 79.14 California 50.00 50.00 50.00 56.20 8.7 4.8 3.9 11.5 5.39 61.59 61.59 Colorado 50.00 50.00 50.00 56.20 5.9 3.6 2.3 5.5 2.58 58.78 58.78 Connecticut 50.00 50.00 50.00 56.20 6.8 4.2 2.6 8.5 3.99 60.19 60.19 Delaware 50.00 50.00 50.00 56.20 5.7 3.2 2.5 8.5 3.99 60.19 60.19 District of Columbia 70.00 70.00 70.00 76.20 8.0 5.7 2.3 5.5 1.48 77.68 77.68 Florida 56.83 55.40 56.83 63.03 7.5 3.3 4.2 11.5 4.61 67.64 67.64 Georgia 63.10 64.49 64.49 70.69 7.5 4.3 3.2 8.5 2.75 73.44 73.44 Hawaii 56.50 55.11 56.50 62.70 5.0 2.3 2.7 8.5 3.43 66.13 66.13 Idaho 69.87 69.77 69.87 76.07 5.8 2.7 3.1 8.5 2.30 78.37 78.37 Illinois 50.00 50.32 50.32 56.52 7.4 4.3 3.1 8.5 3.96 60.48 60.48 Indiana 62.69 64.26 64.26 70.46 7.3 4.4 2.9 8.5 2.77 73.23 73.23 Iowa 61.73 62.62 62.62 68.82 4.4 3.5 0.9 0 0.00 68.82 68.82 Kansas 59.43 60.08 60.08 66.28 5.0 3.9 1.1 0 0.00 66.28 66.28 Kentucky 69.78 70.13 70.13 76.33 7.2 5.2 2.0 5.5 1.47 77.80 77.80 Louisiana 72.47 71.31 72.47 78.67 5.6 3.5 2.1 5.5 1.34 80.01 80.01 Maine 63.31 64.41 64.41 70.61 6.3 4.4 1.9 5.5 1.79 72.40 72.40 Maryland 50.00 50.00 50.00 56.20 5.3 3.5 1.8 5.5 2.58 58.78 58.78 Massachusetts 50.00 50.00 50.00 56.20 6.1 4.3 1.8 5.5 2.58 58.78 58.78 Michigan 58.10 60.27 60.27 66.47 9.8 6.7 3.1 8.5 3.11 69.58 69.58 Minnesota 50.00 50.00 50.00 56.20 6.4 3.8 2.6 8.5 3.99 60.19 60.19
    Mississippi 76.29 75.84 76.29 82.49 7.4 5.9 1.5 5.5 1.13 83.62 83.62 Missouri 62.42 63.19 63.19 69.39 6.8 4.6 2.2 5.5 1.85 71.24 71.24 Montana 68.53 68.04 68.53 74.73 5.0 3.1 1.9 5.5 1.56 76.29 76.29 Nebraska 58.02 59.54 59.54 65.74 3.8 2.8 1.0 0 0.00 65.74 65.74 Nevada 52.64 50.00 52.64 58.84 8.3 4.1 4.2 11.5 5.09 63.93 63.93 New Hampshire 50.00 50.00 50.00 56.20 4.3 3.4 0.9 0 0.00 56.20 56.20 New Jersey 50.00 50.00 50.00 56.20 6.4 4.2 2.2 5.5 2.58 58.78 58.78 New Mexico 71.04 70.88 71.04 77.24 4.5 3.2 1.3 0 0.00 77.24 77.24 New York 50.00 50.00 50.00 56.20 6.2 4.3 1.9 5.5 2.58 58.78 58.78 North Carolina 64.05 64.60 64.60 70.80 7.9 4.5 3.4 8.5 2.75 73.55 73.55 North Dakota 63.75 63.15 63.75 69.95 3.4 3.1 0.3 0 0.00 69.95 69.95 Ohio 60.79 62.14 62.14 68.34 7.4 5.3 2.1 5.5 1.91 70.25 70.25 Oklahoma 67.10 65.90 67.10 73.30 4.6 3.1 1.5 5.5 1.64 74.94 74.94 Oregon 60.86 62.45 62.45 68.65 8.1 5 3.1 8.5 2.93 71.58 71.58 Pennsylvania 54.08 54.52 54.52 60.72 6.2 4.3 1.9 5.5 2.33 63.05 63.05 Rhode Island 52.51 52.59 52.59 58.79 9.5 4.9 4.6 11.5 5.10 63.89 63.89 South Carolina 69.79 70.07 70.07 76.27 8.6 5.7 2.9 8.5 2.28 78.55 78.55 South Dakota 60.03 62.55 62.55 68.75 3.5 2.6 0.9 0 0.00 68.75 68.75 Tennessee 63.71 64.28 64.28 70.48 7.3 4.5 2.8 8.5 2.77 73.25 73.25 Texas 60.56 59.44 60.56 66.76 5.8 4.2 1.6 5.5 2.00 68.76 68.76 Utah 71.63 70.71 71.63 77.83 3.9 2.5 1.4 0 0.00 77.83 77.83 Vermont 59.03 59.45 59.45 65.65 5.7 3.5 2.2 5.5 2.06 67.71 67.71 Virginia 50.00 50.00 50.00 56.20 4.8 2.9 1.9 5.5 2.58 58.78 58.78 Washington 51.52 50.94 51.52 57.72 6.6 4.4 2.2 5.5 2.50 60.22 60.22 West Virginia 74.25 73.73 74.25 80.45 4.7 4.4 0.3 0 0.00 80.45 80.45 Wisconsin 57.62 59.38 59.38 65.58 5.7 4.5 1.2 0 0.00 65.58 65.58 Wyoming 50.00 50.00 50.00 56.20 3.3 2.8 0.5 0 0.00 56.20 56.20 Territories: American Samoa 50.00 50.00 Guam 50.00 50.00 Northern Mariana Islands 50.00 50.00 Puerto Rico 50.00 50.00 Virgin Islands 50.00 50.00