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SUBJECT CATEGORY: Notice of Hearing: Reconsideration of Disapproval of Montana State Plan Amendment (SPA) 07-004
DOCUMENT SUMMARY: This notice announces an administrative hearing to be held on
May 20, 2008, at the CMS Denver Regional Office, 1600 Broadway, Suite
Closing Date: Requests to participate in the hearing as a party must be received by the presiding officer by April 18, 2008.
SUMMARY: Reconsideration of Disapproval of Montana State Plan Amendment (07-004),
Under this SPA, the State proposed to eliminate cost sharing with respect to Medicaid services for enrolled members of federally recognized American Indian Tribes. CMS requested additional information from Montana that would describe how the State's proposal was consistent with the Equal Protection Clause of the Fourteenth Amendment of the Constitution and Title VI of the Civil Rights Act of 1964 (prohibiting discrimination on the basis of race, color, and national origin in federally assisted programs). The State submitted a response, but that response did not establish such consistency.
The proposed amendment was disapproved because it is inconsistent with section 1902(a)(10)(B) of the Social Security Act (Act). That provision requires that all categorically eligible individuals receive the same benefit package, and that all individuals within a covered eligibility group receive the same benefit package. CMS concluded that the proposed exemption from cost sharing by enrolled members of Tribes would not be consistent with section 1902(a)(10)(B) because it would result in a greater amount, duration, and scope of medical assistance available to Indians than to other similarly situated nonIndians. Moreover, CMS concluded that the State had not demonstrated that the proposed amendment was consistent with sections 1902(a)(4) and 1902(a)(19) of the Act, because the State had not demonstrated that it was consistent with the Equal Protection Clause and Title VI of the Civil Rights Act. Sections 1902(a)(4) and 1902(a)(19) of the Act require methods of administration necessary for the ``proper and efficient'' operation of the plan and provision of care and services in a manner ``consistent with the best interests of beneficiaries.''
The hearing will involve the following issues:
Section 1116 of the Act and Federal regulations at 42 CFR Part 430, establish Department procedures that provide an administrative hearing for reconsideration of a disapproval of a State plan or plan amendment. CMS 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 notice to Montana announcing an administrative hearing to reconsider the disapproval of its SPA reads as follows:
Mr. John Chappuis, State Medicaid Director, Montana Department of
Public Health and Human Services, P.O. Box 4210, Helena, MT 596044210. Dear Mr. Chappuis:
I am responding to your request for reconsideration of the decision to disapprove the Montana State plan amendment (SPA) 07004, which was submitted on May 24, 2007, and disapproved on January 4, 2008.
Under this SPA, the State proposed to eliminate cost sharing with respect to Medicaid services for enrolled members of federally recognized American Indian Tribes. CMS requested additional information from Montana that would describe how the State's proposal was consistent with the Equal Protection Clause of the Fourteenth Amendment of the Constitution and Title VI of the Civil Rights Act of 1964 (prohibiting discrimination on the basis of race, color, and national origin in federally assisted programs). The State submitted a response, but that response did not establish such consistency.
The proposed amendment was disapproved because it is inconsistent with section 1902(a)(10)(B) of the Social Security Act (the Act). That provision requires that all categorically eligible individuals receive the same benefit package, and that all individuals within a covered eligibility group receive the same benefit package. CMS concluded that the proposed exemption from cost sharing by enrolled members of Tribes would not be consistent with section 1902(a)(10)(B) because it would result in a greater amount, duration, and scope of medical assistance available to Indians than to other similarly situated nonIndians. Moreover, CMS concluded that the State had not demonstrated that the proposed amendment was consistent with sections 1902(a)(4) and 1902(a)(19) of the Act, because the State had not demonstrated that it was consistent with the Equal Protection Clause and Title VI of the Civil Rights Act. Sections 1902(a)(4) and 1902(a)(19) of the Act require methods of administration necessary for the ``proper and efficient'' operation of the plan and provision of care and services in a manner ``consistent with the best interests of beneficiaries.''
The hearing will involve the following issues:
I am scheduling a hearing on your request for reconsideration to be
held on May 20, 2008, at the CMS Denver Regional Office, 1600 Broadway,
Suite
I am designating Ms. Kathleen ScullyHayes as the presiding
officer. If these arrangements present any problems, please contact the
presiding officer at (410) 7862055. 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.
Sincerely,
Section 1116 of the Social Security Act (42 U.S.C. 1316; 42 CFR 430.18)
(Catalog of Federal Domestic Assistance program No. 13.714, Medicaid Assistance Program)
Dated: March 26, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services. [FR Doc. E86867 Filed 4208; 8:45 am]
BILLING CODE 412001P
FOR FURTHER INFORMATION CONTACT Kathleen Scully-Hayes, Presiding Officer, CMS, 2520 Lord Baltimore Drive, Suite L, Baltimore, Maryland 21244, Telephone: (410) 7862055.
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