[Federal Register Volume 59, Number 95 (Wednesday, May 18, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-12103]


[[Page Unknown]]

[Federal Register: May 18, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)

Health Care Financing Administration

 

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

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Notice of Hearing.

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SUMMARY: This notice announces an administrative hearing on June 30, 
1994, in Room 202, 2201 6th Avenue, Seattle, Washington, to reconsider 
our decision to disapprove Washington SPA 93-18.

CLOSING DATES: Requests to participate in the hearing as a party must 
be received by the Docket Clerk by June 2, 1994.

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

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider our decision to disapprove Washington State plan 
amendment (SPA) number 93-18.
    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).
    If the hearing is later rescheduled, the Hearing Officer will 
notify all participants.
    The State of Washington submitted SPA 93-18 to extend coverage of 
``family preservation services'' under the Medicaid rehabilitation 
benefit option.
    The Medicaid program provides financial assistance for medical 
services authorized by Federal statute. Section 1905(a)(13) of the Act 
permits States to elect rehabilitation services as an optional Medicaid 
benefit. Federal regulations at 42 CFR 440.130(d) define rehabilitation 
services as ``any medical or remedial services recommended by a 
physician or other licensed practitioner of the healing arts, within 
the scope of his practice under State law, for maximum reduction of 
physical or mental disability and restoration of a recipient to his 
best possible functional level.''
    The issue in this matter is whether Washington SPA 93-18 complies 
with Federal regulations at 42 CFR 440.130(d).
    Washington SPA 93-18 describes family preservation services as 
``brief, intensive home based therapeutic interventions to reduce 
behavioral impairment, prevent the unnecessary imminent placement of 
children in a more restrictive setting for care, and facilitate the 
reunification of children with their families.'' The State's Division 
of Children and Family Services (DCFS) will assess a child's 
eligibility for family preservation services after determining that 
``the child is in imminent danger of out of home placement, or that a 
high likelihood exists that the child already placed out of home could 
return home within seven days if the family were provided family 
preservation services.''
    The State of Washington believes that, under SPA 93-18, family 
preservation services: Are ``medical or remedial services'' within the 
scope of medical assistance and 42 CFR 440.130(d); are ``rehabilitative 
services'' as defined in 42 CFR 440.130(d); and will be recommended by 
a ``physician or other licensed practitioner of the healing arts'' as 
required by 42 CFR 440.130(d).
    HCFA believes that the proposed services (including parenting 
education, child development training, advocacy, and communication and 
negotiation skills) are not medical or remedial services within the 
scope of medical assistance. Furthermore, the proposed services would 
be provided based on social factors (likelihood of out-of-home 
placement or ability to return home) rather than ``reduction of 
physical or mental disability and restoration of a recipient to his 
best possible functional level'' as required by the standards for 
rehabilitative services set forth in 42 CFR 440.130(d). In addition, 
HCFA believes SPA 93-18 is not clear whether the services will be 
``recommended by a physician or other licensed practitioner of the 
healing arts, within the scope of his practice under State law.'' 
Therefore, HCFA disapproved Washington SPA 93-18 on February 9, 1994, 
because HCFA believes SPA 93-18 does not meet the requirements in 
Federal law and regulations.
    The notice to Washington announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Ms. Jean Soliz
Secretary, Department of Social and Health Services, P.O. Box 45010, 
Olympia, Washington 98504-5080.

    Dear Ms. Soliz: I am responding to your request for 
reconsideration of the decision to disapprove Washington State Plan 
Amendment (SPA) 93-18.
    The State of Washington submitted SPA 93-18 to extend coverage 
of ``family preservation services'' under the Medicaid 
rehabilitation benefit option.
    The Medicaid program provides financial assistance for medical 
services authorized by Federal statute. Section 1905(a)(13) of the 
Social Security Act permits States to elect rehabilitation services 
as an optional Medicaid benefit. Federal regulations at 42 CFR 
440.130(d) define rehabilitation services as ``any medical or 
remedial services recommended by a physician or other licensed 
practitioner of the healing arts, within the scope of his practice 
under State law, for maximum reduction of physical or mental 
disability and restoration of a recipient to his best possible 
functional level.''
    The issue in this matter is whether Washington SPA 93-18 
complies with Federal regulations at 42 CFR 440.130(d).
    I am scheduling a hearing on your request for reconsideration to 
be held on June 30, 1994, in Room 202, 2201 6th Avenue, Seattle, 
Washington. 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.
(Section 1116 of the Social Security Act (42 U.S.C. section 1316); 
42 CFR section 430.18)

(Catalog of Federal Domestic Assistance Program No. 13.714, Medicaid 
Assistance Program)

    Dated: May 6, 1994
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 94-12103 Filed 5-17-94; 8:45 am]
BILLING CODE 4120-01-P