[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