[Federal Register Volume 59, Number 20 (Monday, January 31, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-1977]


[[Page Unknown]]

[Federal Register: January 31, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration

 

Hearing: Reconsideration of Disapproval of California State Plan 
Amendment (SPA)

AGENCY: Health Care Financing Administration, HHS.

ACTION: Notice of hearing.

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SUMMARY: This notice announces an administrative hearing on February 
24, 1994, in the 7th floor HCFA conference room, 75 Hawthorne Street, 
San Francisco, California, to reconsider our decision to disapprove 
California SPA 92-04.

CLOSING DATE: Requests to participate in the hearing as a party must be 
received by the Docket Clerk by February 15, 1994.

FOR FURTHER INFORMATION CONTACT: Docket Clerk, HCFA Hearing Staff, 1849 
Gwynn Oak Avenue, Meadowwood East Building, Groundfloor, Baltimore, 
Maryland 21207, Telephone: (410) 597-3013.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider our decision to disapprove California State plan 
amendment (SPA) number 92-04.
    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 Hearing 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 Hearing 
Officer before the hearing begins in accordance with the requirements 
contained at 42 CFR 430.76(c).
    California submitted SPA 92-04 on July 20, 1993, to provide 
prenatal care for pregnant illegal aliens under the State Medicaid 
plan. California believes that SPA 92-04 is approvable based on the 
decision of the United States Court of Appeals for the Second Circuit 
in the case of Lewis, et al. v. Grinker, et al., 965 F.2d 1206 (2d Cir. 
1992) and can be supported as good public policy. The Lewis decision 
allows for the coverage of prenatal services for illegal aliens under 
Medicaid. HCFA believes that such coverage is prohibited under the 
statutory provisions of sections 1902 and 1903(v).
    The last sentence of section 1902(a) of the Act provides that 
``[n]otwithstanding paragraph (10)(B) or any other provision of this 
subsection, a State plan shall provide medical assistance with respect 
to an alien who is not lawfully admitted for permanent residence or 
otherwise permanently residing in the United States under color of law 
only in accordance with section 1903(v).'' Section 1903(v) provides 
that ``except as provided in paragraph (2), no payment may be made to a 
State under this section for medical assistance furnished to an alien 
who is not lawfully admitted for permanent residence or otherwise 
permanently residing in the United States under color of law.'' Section 
1903(v)(2) of the Act authorizes payment for care and services that are 
furnished to an alien only if ``such care and services are necessary 
for the treatment of an emergency medical condition of the alien,'' and 
such alien otherwise meets the eligibility requirements for medical 
assistance under the State plan. An ``emergency medical condition'' is 
defined at section 1903(v), and this definition does not include 
routine prenatal care. HCFA believes the language of these statutory 
provisions in sections 1902 and 1903(v) is clear, and that Congress has 
not authorized expenditures for prenatal care for aliens who are not 
permanently residing in the United States under color of law (PRUCOL). 
Therefore, based on the above, and after consultation with the 
Secretary as required by 42 CFR 430.15(c)(2), California 92-04 was 
disapproved.
    The notice to California announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Mr. John Rodriguez,
Chief Deputy Director of Programs, Medical Care Services, Department 
of Health Services, 714 P Street, Room 1253, Sacramento, California 
95814
    Dear Mr. Rodriguez: I am responding to your request for 
reconsideration of the decision to disapprove California State Plan 
Amendment (SPA) 92-04.
    California submitted SPA 92-04 on July 20, 1993, to provide 
prenatal care for pregnant illegal aliens under the State Medicaid 
plan.
    The issue in this matter is whether California SPA 92-04 is 
consistent with the statutory provisions of the Medicaid Act and 
whether the plan amendment is approvable based on the decision of 
the United States Court of Appeals for the Second Circuit in the 
case of Lewis, et al. v. Grinker, et al., 965 F.2d 1206 (2d Cir. 
1992).
    I am scheduling a hearing on your request for reconsideration to 
be held on February 24, 1994, in the 7th floor HCFA conference room, 
75 Hawthorne Street, San Francisco, California. 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 Docket 
Clerk. In order to facilitate any communication which may be 
necessary between the parties to the hearing, please notify the 
Docket Clerk of the names of the individuals who will represent the 
State at the hearing. The Docket Clerk can be reached at (410) 597-
3013.
      Sincerely,
Bruce C. Vladeck,
Administrator.

    Authority: 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: January 21, 1994.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 94-1977 Filed 1-28-94; 8:45 am]
BILLING CODE 4120-01-P