[Federal Register Volume 77, Number 231 (Friday, November 30, 2012)]
[Notices]
[Pages 71420-71423]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-29035]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Federal Financial Participation in State Assistance Expenditures;
Federal Matching Shares for Medicaid, the Children's Health Insurance
Program, and Aid to Needy Aged, Blind, or Disabled Persons for October
1, 2013 Through September 30, 2014
AGENCY: Office of the Secretary, DHHS.
ACTION: Notice.
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SUMMARY: The Federal Medical Assistance Percentages (FMAP), Enhanced
Federal Medical Assistance Percentages (eFMAP), and disaster-recovery
FMAP adjustments for Fiscal Year 2014 have been calculated pursuant to
the Social Security Act (the Act). These percentages will be effective
from October 1, 2013 through September 30, 2014. This notice announces
the calculated FMAP and eFMAP rates that the U.S. Department of Health
and Human Services (HHS) will use in determining the amount of federal
matching for state medical assistance (Medicaid) and Children's Health
Insurance Program (CHIP) expenditures, Temporary Assistance for Needy
Families (TANF) Contingency Funds, Child Support Enforcement
collections, Child Care Mandatory and Matching Funds of the Child Care
and Development Fund, Foster Care Title IV-E Maintenance payments, and
Adoption Assistance payments. Table 1 gives figures for each of the 50
States, the District of Columbia, Puerto Rico, the Virgin Islands,
Guam, American Samoa, and the Commonwealth of the Northern Mariana
Islands. This notice also announces the disaster-recovery FMAP
adjustments for qualifying states for FY 2014 that the U.S. Department
of Health and Human Services (HHS) will use in determining the amount
of federal matching for state medical assistance (Medicaid) and title
IV-E Foster Care, Adoption Assistance and Guardianship Assistance
programs.
Programs under title XIX of the Act exist in each jurisdiction.
Programs under titles I, X, and XIV operate only in Guam and the Virgin
Islands, while a program under title XVI (Aid to the Aged, Blind, or
Disabled) operates only in Puerto Rico. The percentages in this notice
apply to state expenditures for most medical assistance and child
health assistance, and assistance payments for certain social services.
The Act provides separately for federal matching of administrative
costs.
Sections 1905(b) and 1101(a)(8)(B) of the Social Security Act (the
Act) require the Secretary of HHS to publish the FMAP rates each year.
The Secretary calculates the percentages, using formulas in sections
1905(b) and 1101(a)(8), and calculations by the Department of Commerce
of average income per person in each state and for the Nation as a
whole. The percentages must fall within the upper and lower limits
given in section 1905(b) of the Act. The percentages for the District
of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and
the Northern Mariana Islands are specified in statute, and thus are not
based on the statutory formula that determines the percentages for the
50 States.
Section 1905(b) of the Act specifies the formula for calculating
FMAPs as follows:
`` ``Federal medical assistance percentage'' for any State shall
be 100 per centum less the State percentage; and the State
percentage shall be that percentage which bears the same ratio to 45
per centum as the square of the per capita income of such State
bears to the square of the per capita income of the continental
United States (including Alaska) and Hawaii; except that (1) the
Federal medical assistance percentage shall in no case be less than
50 per centum or more than 83 per centum, (2) the Federal medical
assistance percentage for Puerto Rico, the Virgin Islands, Guam, the
Northern Mariana Islands, and American Samoa shall be 55 percent * *
*''.
Section 4725(b) of the Balanced Budget Act of 1997 amended section
1905(b) to provide that the FMAP for the District of Columbia for
purposes of titles XIX and XXI shall be 70 percent. For the District of
Columbia, we note under Table 1 that other rates may apply in certain
other programs. In addition, we note the rate that applies for Puerto
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands in certain other programs pursuant to
section 1118 of the Act.
Section 1905(y) of the Act, as added by section 2001 of the Patient
Protection and Affordable Care Act of 2010
[[Page 71421]]
(''Affordable Care Act''), provides for a significant increase in the
Federal Medical Assistance Percentage (FMAP) for medical expenditures
for individuals determined eligible under the new adult group in the
State and who will be considered to be ``newly eligible'' in 2014, as
defined in section 1905(y)(2)(A) of the Act. The FMAP for these newly
eligible individuals will be 100 percent for Calendar Year (CY) 2014-
2016, gradually declining to 90 percent in 2020 where it remains
indefinitely. In addition, section 1905(z) of the Act, as added by
section 10201 of the Affordable Care Act, provides that States that had
expanded substantial coverage to low-income parents and nonpregnant
adults without children prior to the enactment of the Affordable Care
Act, referred to as ``expansion States,'' shall receive an enhanced
FMAP that begins in 2014 for nonpregnant childless adults who may be
required to enroll in benchmark coverage. These provisions are
discussed in more detail in the Medicaid Eligibility proposed rule
published on August 17, 2011 (76 FR 51172) and the final rule published
on March 23, 2012 (77 FR 17143).
Section 2006 of the Affordable Care Act amended section 1905 of the
Social Security Act by adding section (aa) to provide for an increase
in the FMAP rate for qualifying States for Medicaid and title IV-E
Foster Care, Adoption Assistance and Guardianship Assistance programs.
The purpose of the increase to the FMAP rate is to provide increased
federal financial participation for qualifying States that have
experienced a major, statewide disaster.
The methodology for calculating and publishing disaster-recovery
adjustments to fiscal year FMAP rates was published on December 22,
2010 (75 FR 80501).
Section 1905(aa) of the Act defines a ``disaster-recovery FMAP
adjustment state'' as one of the 50 states or District of Columbia for
which, at any time during the preceding 7 fiscal years, the President
has declared a major disaster under section 401 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act under which every
county or parish in the state is eligible for individual and public
assistance or public assistance from the federal government, and for
which the FMAP as determined for the fiscal year is less than the FMAP
(for the first year of assistance) or the disaster-adjusted recovery
FMAP (for each subsequent year of assistance) for the preceding fiscal
year by at least three percentage points.
Qualifying states receive an adjustment to their annual FMAP rate
based on a formula specified in statute. In the first year a State
qualifies, this increase is applied to the FMAP as determined for the
fiscal year. Section 2006 of the Affordable Care Act specified that the
disaster-recovery adjustment in the second or any succeeding fiscal
year a State qualifies be applied to the prior year's disaster-recovery
adjusted FMAP. This resulted in increased, rather than phased down,
financial assistance to qualifying states each year, and allowed states
to continue to qualify for assistance after their underlying FMAP has
stabilized. Section 3204 of the Middle Class Tax Relief and Job
Creation Act of 2012 (Pub. L. 112-96) revised the formula in section
1905(aa) to apply the adjustment for the second or any succeeding
fiscal year that a state qualifies to the FMAP as determined for the
fiscal year, effective October 1, 2013. Further, section 100123 of the
Moving Ahead for Progress in the 21st Century Act (Pub. L. 112-141)
revised the formula again, this time for FY13 only, and changed the
effective date in Public Law 112-96 to October 1, 2012. As a result,
HHS has revised the FY13 disaster-recovery FMAP adjustment published on
November 30, 2011. Thus, the revised disaster-recovery FMAP rate for
Louisiana for FY13 (the only qualifying state, as published in 76 FR
74061) is included in Table 2 taking into account the revised formula
set forth in section 3204 of the Middle Class Tax Relief and Job
Creation Act of 2012.
Based on the criteria for a qualifying state, only one State,
Louisiana, meets the requirement for a disaster-recovery FMAP
adjustment in FY14. Hurricane Gustav caused Louisiana to be declared a
state-wide disaster area on September 2, 2008. In addition, Louisiana's
FMAP as determined for FY 2014 is less than the previous year disaster-
recovery adjusted FMAP by at least three percentage points. Therefore,
Louisiana is the only state that qualifies for a disaster-recovery
adjustment to their FY2014 FMAP rate. The disaster-recovery adjusted
FMAP rate for Louisiana for FY2014 is included in Table 2.
Section 2105(b) of the Act specifies the formula for calculating
the eFMAP rates as follows:
The ``enhanced FMAP'', for a State for a fiscal year, is equal
to the Federal medical assistance percentage (as defined in the
first sentence of section 1905(b)) for the State increased by a
number of percentage points equal to 30 percent of the number of
percentage points by which (1) such Federal medical assistance
percentage for the State, is less than (2) 100 percent; but in no
case shall the enhanced FMAP for a state exceed 85 percent.
The eFMAP rates are used in the Children's Health Insurance Program
under Title XXI, and in the Medicaid program for certain children for
expenditures for medical assistance described in sections 1905(u)(2)
and 1905(u)(3) of the Act. There is no specific requirement to publish
the eFMAP rates. We include them in this notice for the convenience of
the States.
DATES: Effective Dates: The percentages listed in Table 1 will be
effective for each of the four quarter-year periods beginning October
1, 2013 and ending September 30, 2014. The FY14 disaster-recovery
adjusted FMAP rate in Table 2 will also be effective for each of the
four quarter-year periods beginning October 1, 2013 and ending
September 30, 2014. The FY13 revised disaster-recovery adjusted FMAP
rate in Table 2 will be effective for each of the four quarter-year
periods beginning October 1, 2012 and ending September 30, 2013.
FOR FURTHER INFORMATION CONTACT: Carrie Shelton or Tom Musco, 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: Foster Care Title IV-E; 93.659: Adoption Assistance;
93.769: Ticket-to-Work and Work Incentives Improvement Act (TWWIIA)
Demonstrations to Maintain Independence and Employment; 93.778:
Medical Assistance Program; 93.767: Children's Health Insurance
Program)
Dated: November 23, 2012.
Kathleen Sebelius,
Secretary.
[[Page 71422]]
Table 1--Federal Medical Assistance Percentages and Enhanced Federal
Medical Assistance Percentages, Effective October 1, 2013-September 30,
2014
[Fiscal year 2014]
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Enhanced
Federal federal
State medical medical
assistance assistance
percentages percentages
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Alabama................................. 68.12 77.68
Alaska.................................. 50.00 65.00
American Samoa*......................... 55.00 68.50
Arizona................................. 67.23 77.06
Arkansas................................ 70.10 79.07
California.............................. 50.00 65.00
Colorado................................ 50.00 65.00
Connecticut............................. 50.00 65.00
Delaware................................ 55.31 68.72
District of Columbia**.................. 70.00 79.00
Florida................................. 58.79 71.15
Georgia................................. 65.93 76.15
Guam*................................... 55.00 68.50
Hawaii.................................. 51.85 66.30
Idaho................................... 71.64 80.15
Illinois................................ 50.00 65.00
Indiana................................. 66.92 76.84
Iowa.................................... 57.93 70.55
Kansas.................................. 56.91 69.84
Kentucky................................ 69.83 78.88
Louisiana............................... 60.98 72.69
Maine................................... 61.55 73.09
Maryland................................ 50.00 65.00
Massachusetts........................... 50.00 65.00
Michigan................................ 66.32 76.42
Minnesota............................... 50.00 65.00
Mississippi............................. 73.05 81.14
Missouri................................ 62.03 73.42
Montana................................. 66.33 76.43
Nebraska................................ 54.74 68.32
Nevada.................................. 63.10 74.17
New Hampshire........................... 50.00 65.00
New Jersey.............................. 50.00 65.00
New Mexico.............................. 69.20 78.44
New York................................ 50.00 65.00
North Carolina.......................... 65.78 76.05
North Dakota............................ 50.00 65.00
Northern Mariana Islands*............... 55.00 68.50
Ohio.................................... 63.02 74.11
Oklahoma................................ 64.02 74.81
Oregon.................................. 63.14 74.20
Pennsylvania............................ 53.52 67.46
Puerto Rico*............................ 55.00 68.50
Rhode Island............................ 50.11 65.08
South Carolina.......................... 70.57 79.40
South Dakota............................ 53.54 67.48
Tennessee............................... 65.29 75.70
Texas................................... 58.69 71.08
Utah.................................... 70.34 79.24
Vermont................................. 55.11 68.58
Virgin Islands*......................... 55.00 68.50
Virginia................................ 50.00 65.00
Washington.............................. 50.00 65.00
West Virginia........................... 71.09 79.76
Wisconsin............................... 59.06 71.34
Wyoming................................. 50.00 65.00
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* For purposes of section 1118 of the Social Security Act, the
percentage used under titles I, X, XIV, and XVI will be 75 per centum.
** The values for the District of Columbia in the table were set for the
state plan under titles XIX and XXI and for capitation payments and
DSH allotments under those titles. For other purposes, the percentage
for DC is 50.00, unless otherwise specified by law.
[[Page 71423]]
Table 2--Disaster-Recovery Adjusted FMAP Rates
Fiscal Year 2013 Revised Disaster-Recovery Adjusted FMAP Rates
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A B C D E F
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State FY13 FMAP FY12 disaster Decrease in Disaster Disaster
recovery FMAP recovery recovery
adjusted FMAP adjustment adjusted FMAP
increase FY13
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Col C-B 50% x Col D\*\ Col B + E
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Louisiana.......................................................... 61.24 69.78 8.54 4.27 65.51
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\*\ Percentage determined in accordance with section 1905(aa)(1)(A) of the Social Security Act.
Fiscal Year 2014 Disaster-Recovery Adjusted FMAP Rates
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A B C D E F
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State FY14 FMAP FY13 disaster Decrease in Disaster Disaster
recovery FMAP recovery recovery
adjusted FMAP adjustment adjusted FMAP
increase FY14
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Col C-B 25% x Col D\*\ Col B + E
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Louisiana.......................................................... 60.98 65.51 4.53 1.13 62.11
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\*\ Percentage determined in accordance with section 1905(aa)(1)(B) of the Social Security Act.
[FR Doc. 2012-29035 Filed 11-29-12; 8:45 am]
BILLING CODE 4150-05-P