[Federal Register Volume 61, Number 251 (Monday, December 30, 1996)]
[Notices]
[Pages 68758-68763]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-33094]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Medicaid Bureau; Statement of Organization, Functions, and 
Delegations of Authority

    Part F of the Statement of Organization, Functions, and Delegations 
of Authority for the Department of Health and Human Services, Health 
Care Financing Administration (HCFA), (Federal Register, Vol. 59, No. 
60, pp. 14628-14662, dated Tuesday, March 29, 1994, and Federal 
Register, Vol. 59, No. 132, pg. 35528, dated Tuesday, July 12, 1994) is 
amended to reflect changes to the subordinate structure within HCFA's 
Medicaid Bureau.
    The Medicaid Bureau is streamlining their organization by 
abolishing its current substructure and creating a new organization 
comprised of six offices with no subordinate levels. The offices are 
functionally grouped to support services provided to specific Medicaid 
Bureau customers. Within the new structure operational and policy 
functions are no longer separated but are combined in each office.
    The specific amendments to Part F are described below:
     Section F.10.A.5. (Organization) is amended to read as 
follows:
    5. Medicaid Bureau (FAB)
    a. Office of Long Term Care Services (FAB4)
    b. Office of Medical Services (FAB5)
    c. Office of Beneficiary Services (FAB6)
    d. Office of Financial Services (FAB7)
    e. Office of Information Systems and Data Analysis (FAB8)
    f. Office of Program and Organizational Services (FAB9)
     Section F.20.A.5. (Functions) is amended to read as 
follows:

a. Office of Long Term Care Services (FAB4)

     Formulates, evaluates, and prepares policies, 
specifications for regulations, instructions, preprints, and procedures 
related to Medicaid payment and coverage policy for continuing and 
long-term care.
     Provides oversight of planning, development, 
implementation, and monitoring of Medicaid program operations in 
regional offices and State Medicaid agencies related to the provision 
and payment for continuing and long-term care, both institutional and 
non-institutional.
     Reviews State Plan Amendments related to continuing and 
long-term care, provides consultation to regional offices, and makes 
recommendations for approval and disapproval.
     Oversees and coordinates the assessment process for the 
operational implementation of the Medicaid program for continuing and 
long-term care under State plans and home and community-based services 
waivers.
     Provides ongoing policy and operational support, in 
concert with the Office of Research and Demonstrations, for Section 
1115 demonstrations in continuing and long-term care.
     Provides authoritative interpretation of Medicaid coverage 
and payment policy for continuing and long-term care for providers, 
Regional Offices, State governments, Congressional Staffs, other 
agencies of the Federal government, interest groups and the general 
public.
     Develops, evaluates, and reviews policies and operational 
implementation of the entire range of continuing and long-term care 
services under Medicaid including all institutional and non-
institutional sources of care, including: home and community-based 
services including waivers and State plan issues, nursing facilities, 
intermediate care facilities for persons with mental retardation/
developmental disabilities, psychiatric services for persons under age 
21, hospice, home health, personal care, private duty nursing, 
habilitation, rehabilitation, physical therapy, occupational therapy, 
respiratory therapy, speech therapy, language and hearing services, 
residential treatment

[[Page 68759]]

facilities, private non-medical institutions, medical day care, 
subacute care, community supported living arrangements, behavioral/
mental health, substance abuse treatment, pre-admission screening and 
annual resident review (PASARR) and case management.
     Develops and interprets policy and oversees operational 
implementation of a wide range of areas as they impact continuing and 
long-term care services, including: comparability, sufficiency, amount, 
duration and scope of services, the Boren Amendment, provider appeals, 
essential community providers of LTC, provider qualifications including 
conditions of participation for Medicaid providers, distinct part 
issues, and inmates of public institutions.
     Serves as focal point for enforcing State agency 
compliance with statute, regulations and instructions as they affect 
continuing and long-term care.
     Develops and puts in place strategies to assure new and 
existing legislation, regulations and policy for Medicaid continuing 
and long-term care is implemented effectively, including: development 
of written guidance, best practices information, training materials, 
technical assistance to States through telecommunications and on-site 
visits, data bases etc.
     Assumes principal responsibility for Bureau implementation 
of continuing and long-term care objectives in the MB and HCFA 
strategic plans.
     Supports cross-cutting activities in relation to 
functional areas of responsibilities involving: (1) Section 1115 
waivers, (2) quality of care initiatives, (3) health care reform, (4) 
fraud and abuse strategies, (5) legislative development, (6) 
communication strategy and implementation, and (7) internal budget and 
contracting.

b. Office of Medical Services (FAB5)

     Develops, interprets, and reviews Medicaid coverage and 
payment policies and procedures pertaining to maternal and child health 
services, family planning services, sterilization, hysterectomy, 
abortion, teenage pregnancy services, vaccines for children, school-
based health services, nutrition services, early intervention services, 
pregnancy related services, lab and X-ray services, dental services, 
nurse-midwife services, pediatric nurse practitioner services/
certification family services, transportation services, TB related 
services, medical day care, prescribed drugs, dentures and prosthetic 
devices and eyeglasses, other diagnostic, screening and preventive 
services, physician services and all other non-LTC services, provider 
appeals, and Indian health services; comparability and sufficiency of 
services and uniform availability of services statewide (hereafter 
designated as medical and remedial care services).
     Formulates, evaluates, and prepares policies, 
specifications for regulations, instructions, preprints, procedures and 
general instructions related to Medicaid medical and remedial care 
coverage and payment activities.
     Makes recommendations for legislative changes to improve 
program policy and ease of administration.
     Reviews State plan amendments and makes recommendations on 
approvals/disapprovals.
     Provides interpretations of Medicaid medical and remedial 
care coverage payment policies to regional offices, congressional 
staffs, other Departments of the Federal government, interest groups, 
and State agencies.
     Provides medical advice and consultation pertaining to the 
Medicaid program.
     Reviews, with the Office of Research and Demonstrations, 
research and demonstration agendas in the area of Medicaid medical and 
remedial care coverage and payment.
     Identifies, studies, and makes recommendations for 
modifying Medicaid medical and remedial care payment and coverage 
policies to reflect changes in recipient health care needs, program 
objectives, and the health care delivery system.
     Develops, evaluates, and reviews Medicaid coverage and 
payment hospital policies (including hospital Boren Amendment issues 
and Disproportionate Share Hospitals), regulations, and procedures 
pertaining to services provided by hospitals and Christian Science 
Sanitoriums under Medicaid; and Early and Periodic Screening, Diagnosis 
and Treatment (EPSDT) under Medicaid.
     Reviews requests for waivers under Section 1915 (c) and 
(d) of the Social Security Act.
     Monitors State medical and remedial care compliance to 
State plan and oversees the compliance process.
     Provides interpretations of policies to regional offices, 
congressional staffs, other Departments of the Federal government, 
interest groups and State agencies.
     Coordinates with other HCFA bureaus, divisions, and 
offices, the Social Security Administration, and other departmental 
components in the development of medical and remedial care policies.
     Provides policy, operational and systems support for 
implementation of the Medicaid drug rebate program.
     Coordinates with the Bureau of Data Management and 
Strategy and the States in the development of systems specifications 
for the format, transmission methods, data entry, maintenance, and 
modification of drug product data submitted by manufacturers.
     Develops and disseminates drug rebate technical notes, 
letters to Medicaid State Agencies, and acceptance letters to drug 
manufacturers. Processes signed drug rebate agreements.
     Maintains liaison with, and provides technical assistance 
to drug manufacturers, Medicaid State agencies, pharmaceutical 
associations, private sector vendors, and other parties regarding the 
drug rebate program.
     Establishes and maintains telephone ``hotline'' in 
answering queries regarding the monthly Consumer Price Index Urban and 
current Manufacturer and State address information.
     Prepares an annual report to Congress on drug product and 
expenditure data.
     Supports cross-cutting activities in relation to 
functional areas of responsibilities involving: (1) Section 1115 
waivers, (2) quality of care initiatives, (3) health care reform, (4) 
fraud and abuse strategies, (5) legislative development, (6) 
communication strategy and implementation, and (7) internal budgeting 
and contracting.

c. Office of Beneficiary Services (FAB6)

     Provides beneficiary casework services by responding to 
written and person inquiries and inquires made by other interested 
parties on behalf of beneficiaries which are directed to the bureau.
     Uses HCFA hotline to improve beneficiary access to the 
bureau.
     Develops with partners and stakeholders a network of 
contacts to facilitate casework and outreach to beneficiaries.
     Working with States and Regional Offices, develops and 
implements strategies to inform individuals of benefits available and 
how to gain access to the program.
     Develops consumer information directed at informing 
beneficiaries on a variety of programmatic issues.
     Identifies and develops reports on significant trends 
identified through casework activities.
     Serves as ombudsperson for beneficiaries through 
representation on

[[Page 68760]]

workgroups and at meetings within and outside HCFA.
     In conjunction with partners and stakeholders, develops 
strategies for addressing and overseeing eligibility and service access 
issues for beneficiaries.
     Develops strategies for addressing and overseeing quality 
issues for beneficiaries.
     Serves as the focal point in the bureau for special 
populations such as Native Americans, HIV/AIDS, individuals in rural 
areas, the homeless and migrants.
     Develops multi-faceted initiatives focused on priority 
program areas and special need of special populations.
     Collaborates with Federal and State agencies and private 
organizations to identify and eliminate barriers and improve health 
status of Medicaid beneficiaries.
     Works with Regional Offices to identify States' needs and 
coordinates initiatives for technical assistance, information exchange 
and capacity for addressing beneficiary issues.
     Develops, interprets and issues Medicaid policies and 
procedures for implementing mandatory and optional eligibility groups, 
financial eligibility requirements and non-financial eligibility 
requirements such as age, disability, residence and citizenship and 
beneficiary appeals.
     Develops, interprets and issues Medicaid policies and 
procedures for eligibility administration and beneficiary rights and 
responsibilities, confidentiality, outstationing of eligibility workers 
and other technical policies such as advance directives and state 
wideness.
     Develops, implements and coordinates a system for 
reviewing the States' performance of Income Eligibility Verification 
System (IEVS) requirements. Develops and interprets regulations and 
policies for States to establish IEVS.
     Evaluates and contributes to development of policies for 
Aid to Families with Dependent Children and Supplemental Security 
Income which have impact on Medicaid eligibility (including welfare 
reform proposals).
     Develops, directs and operates a national quality control 
program to determine the effectiveness of Medicaid State agencies' 
performance in the area of Medicaid eligibility determinations and 
negative case actions. As part of this function, the team establishes, 
maintains and disseminates MEQC schedules, develops Regional office 
reporting requirements, reviews State corrective action plans, 
participates in development of fiscal disallowances and preparing 
recommendations for waivers of disallowances.
     Encourages State to develop alternatives to the 
traditional Medicaid Quality Control (MEQC) program through MEQC pilots 
and participates in the development, review and approval tracking and 
development of reports relative to such pilots.
     Develops with partners strategies and guideline outside 
MEQC for monitoring State's eligibility policies and operations and 
evaluates finding resulting from these monitoring activities.
     Provides consultation on State plan amendments and 
prepares disapproval actions.
     Recommends specific action for new or proposed legislation 
on eligibility and beneficiary related issues.
     Provides consultation on eligibility aspects of Home and 
Community-based waivers.
     Prepares specifications for regulation, State plan 
preprints and manual instructions in program areas within the scope of 
this team's responsibilities.
     Maintains liaison with the Social Security Administration, 
Administration for Families and Children, Public Health Services, USDA 
and other Federal and State agencies that provide assistance and 
services to Medicaid beneficiaries.
     Supports cross-cutting activities in relation to 
functional areas of responsibilities involving: (1) Section 1115 
waivers, (2) quality of care initiatives, (3) health care reform, (4) 
fraud and abuse strategies, (5) legislative development, (6) 
communication strategy and implementation, and (7) internal budgeting 
and contracting.
     Serves as the focal point for Medicaid third party 
liability (TPL) operating instructions and policy guidance to Medicaid 
State agencies and regional offices.
     Develops and implements the regulations and operating 
instructions for regional offices and States to implement TPL programs.
     Reviews proposed legislation and regulations for potential 
impact on TPL operations and makes recommendations for changing 
regulations to improve TPL program administration.
     Investigates and corrects problems in TPL operational 
implementation by Medicaid State agencies.
     Assists regional offices in resolving operating issues 
involving various operational policies affecting TPL.
     Develops, interprets, and issues policies under Medicaid 
to ensure the appropriate allocation of health care/administrative 
costs under the Medicaid Bureau Strategic Plan.
     Develops, interprets and issues policies for third-party 
liability provisions; the liability of recipients and applicants for 
payment of coinsurance, deductible, and other cost sharing amounts; 
payment of premiums; cost avoidance; coordination of benefits; free 
care; cross-over claims; and estate recoveries.

d. Office of Financial Services (FAB7)

     Participates in the development and evaluation of proposed 
legislation or other remedies to improve financial programs and 
services.
     Reviews proposed legislation, regulations, and operating 
initiatives for their impact and to respond to congressional inquiries.
     Prepares regulations, manuals, program guidelines, general 
instructions, reporting instructions, and other written products 
related to financial policies, operations, and services.
     Serves as Medicaid Bureau liaison with the Office of 
Inspector General and the Department of Justice regarding audit 
services.
     Provides oversight and coordinates the national Medicaid 
medical assistance and administrative costs budgets and justifications. 
Develops and maintains budget preparation and execution policies and 
procedures used by States and regional offices.
     Formulates the national Medicaid operating and President's 
budget for medical assistance payments and administrative costs.
     Develops information necessary to support the budget 
submissions and congressional budget justifications. Develops, 
implements, and maintains the Medicaid budget preparation and execution 
policies and procedures for use by the States and Regional Offices 
(ROs) in administering the Medicaid program.
     Prepares the Congressional Quarterly Status of Funds 
report using State agency, RO, and Central Office data. Performs 
statistical and analytical reviews of State agency and RO submissions 
to establish historical trends and projections of the Medicaid program 
expenditures.
     Conducts onsite reviews of State agencies and ROs to 
determine methodologies used for budget preparation and execution and 
to evaluate capability and accuracy of the various systems.
     Establishes policies and procedures by which Medicaid 
State agencies and regional offices submit quarterly budget estimates 
and reports and administers

[[Page 68761]]

the State grants process for administrative and program payments.
     Maintains financial control over grants to States for 
Public Assistance (Medical Assistance Program) under Section 1903(d) of 
the Social Security Act.
     Reviews State expenditure reports together with 
recommendations regarding the allocability of expenditures provided by 
the RO, determines whether the recommended action is consistent with 
Federal law and regulations, prepares recommendations as to appropriate 
action attempts to resolve all issues with the ROs, documents 
unresolved issues to be referred to the appropriate HCFA authority for 
decisions, and incorporates the results of decisions in grants.
     Prepares grant award documents.
     Provides technical assistance and training to regional 
financial management staff in the monitoring of expenditures to assure 
full accountability for expenditures and develops appropriate financial 
management instructions.
     Reviews all State claims for Federal payment under Title 
XIX of the Social Security Act including regional office disallowances 
of State claims.
     Serves as the focal point for the defense of disallowance 
decisions before the Department Appeals Board.
     Ensures consistency with Federal laws, regulations, and 
policy in all actions that may result in disallowances of State claims 
for FFP. Reviews, secures necessary clearances, and provides technical 
assistance to regional offices in deferrals and disallowance 
notifications.
     Ensures the timely recovery of Federal funds and related 
interest; tracks disallowances from initiation through issuance, appeal 
and recovery of the Federal share of expenditures, preparing periodic 
reports on the status of disallowance actions; assists in the defense 
of disallowances, providing technical assistance to the Department 
Appeals Board (DAB) and legal staffs of the Departments of Health and 
Human Services and Justice in administrative or judicial appeals of 
Medicaid disallowances; and disseminates and implements all DAB and 
Court decisions.
     Provides oversight, administration, maintenance, and 
amendments and revisions of the Medicaid Budget and Expenditure System.
     Develops, coordinates, and maintains an automated system 
for budgets, grants, and expenditure reports and produces periodic 
reports from this system.
     Directs regional office financial reviews and audits of 
State agencies and oversees the Medicaid claims processing review 
activity.
     Directs the national financial management review process 
to monitor State Medicaid expenditures, develops financial management 
review guides, establishes the national schedule of reviews and 
provides instructions and technical assistance to ensure that reviews 
and policies are consistently implemented.
     Monitors regional office Medicaid financial management 
participating in onsite reviews and preparing periodic reports of 
activities and results and national performance.
     Collects, evaluates, and develops related information and 
calculates the Federal fiscal year National DSH payment target and 
State DSH allotments.
     Develops the Federal Register notice to publish the 
Federal fiscal year National DSH target and State DSH allotments.
     Establishes policies and procedures by which Medicaid 
State agencies and regional offices submit quarterly budget and 
expenditure information on State receipts under donation and taxes 
programs in accordance with the provisions of the Medicaid statute and 
regulations.
     Collects, evaluates, and develops information and 
reporting on State receipts of donations and taxes.
     In coordination with the regional offices, calculates 
States' limits on receipts of donations and taxes and any applicable 
reduction in Federal financial participation.
     Prepares regulations, manuals program guidelines, and 
other instructions related to donations and taxes provisions.
     Provides interpretations of established Medicaid policies 
to regional offices, congressional staffs, and other departmental 
offices on donations and taxes provisions.
     Establishes HCFA payment policy for Medicaid 
administrative costs. Responsible for operational policies regarding 
availability of Federal Financial Participation (FFP), designation of 
appropriate FFP rates, and for issuing interpretations to regional 
offices regarding operational FFP issues.
     Develops and coordinates the fiscal aspects of the 
Medicaid program, and sets and interprets Federal funding policies and 
regional office and State operational procedures.
     Provides the definitive interpretation of Federal funding 
of State Medicaid administrative costs, operational policies on the 
allocability and availability of Federal financial participation (FFP), 
and the appropriate FFP rates.
     Participates with HCFA components in development, review, 
and evaluation of State health system reforms under State Section 1115 
waiver programs.
     Participates in development, implementation, oversight and 
negotiation activities related to the financial and budget neutrality 
provisions of the States' Section 1115 programs, managed care and other 
health care reform initiatives, including reporting, rate setting, and 
conditions of Federal financial participation.
     Performs statistical and analytical reviews of State 
agency and RO submissions to establish historical trends and 
projections of the Medicaid budget estimates and program expenditures 
related to States' Section 1115 programs, managed care and other health 
care reform initiatives.
     Participates in onsite reviews of State agencies and ROs 
for oversight, technical assistance and negotiation of issues related 
to the provisions of States' Section 1115 programs and health care 
reform initiatives.
     Develops evaluates, interprets and reviews policies, 
regulations, standards and procedures, and provides operational 
oversight, pertaining to physician referral provisions.
     Provides oversight for the implementation and continuing 
operational support related to physician referral.
     Develops, plans and executes analytical studies to 
identify programmatic, operational or management areas of fiscal 
vulnerability or which impact the fiscal integrity of the Medicaid 
program.
     Performs financial analyses of and makes recommendations 
for addressing areas of fiscal vulnerability.
     In partnership with States, develops approaches to improve 
the fiscal integrity of the Medicaid program and reduce areas of fiscal 
vulnerability.
     Supports cross-cutting activities in relation to 
functional areas of responsibilities involving: (1) Section 1115 
waivers, (2) quality of care initiatives, (3) health care reform, (4) 
fraud and abuse strategies, (5) legislative development, (6) 
communication strategy and implementation, and (7) internal budgeting 
and contracting.

e. Office of Information Systems and Data Analysis (FAB8)

     Serves as the Bureau's focal point to improve State/
Federal decision making through the effective use of information.

[[Page 68762]]

     Develops information requirements for decision making in 
State/Federal health care programs through its leadership role in 
defining information requirements via customer input, and reconciles 
information needs.
     Develops staff capability for information analysis by 
incorporating data and statistical analysis techniques into program/
policy training, providing tools and materials necessary to facilitate 
data and information analysis, and ensures teams needing these skills 
are staffed with such members experienced in their use.
     Serves as clearinghouse for information on Medicaid 
programs and data availability to support comparative analyses.
     Monitors and tracks Medicaid population through 2082 and 
the Medicaid Statistical Information System data.
     Develops and maintains an automated system providing 
State-by-State inventories of Medicaid program characteristics.
     Develops, implements, and directs mathematical and 
statistical procedures, including sampling, precision, universe 
identification, etc., in support of the Medicaid quality control and 
assessment programs, as well as other Medicaid program activities.
     Provides statistical support and performs analyses related 
to Federal and State Medicaid program design quality and operations.
     Assists BDMS in setting standards to assure data accuracy 
and consistency through the development of data definitions, system 
edits, etc.
     Develops and maintains a centralized State data profile to 
support State and regional efforts to foster improvements to State 
program design via the assistance of technological advances made by 
other States and the private sector, including state-of-the-art 
technology in electronic data processing.
     Coordinates with all State Medicaid agencies, in 
conjunction with HCFA regional offices and BDMS, implementation of 
system coding and other changes related to the Medicare program's 
Physician Payment Reform initiative and other data initiatives such as 
common coding, uniform billing, and electronic data interchange.
     Develops, plans and executes analytical studies at the 
request of the Bureau Director; analyzes current Medicaid policies to 
identify weaknesses, define options for change, and assess their 
impact; and effectively communicates and disseminates findings 
associated with the program analyses and policy studies described 
above.
     Analyzes large-scale databases and designs population-
based surveys and other analyses to enhance program operations and 
policy coherency.
     Provides the bureau with internal systems expertise to 
produce and interpret operational performance indicators from the  
manipulation of computer-stored financial and program data and to 
review the integrity of systems operating within the Bureau.
     Serves as a focal point for Medicaid funding requests and 
coordinates with the appropriate components within HCFA and the 
Department and prepares the recommendations for final decisions 
regarding approval or disapproval.
     Directs the development and issuance of regulations, 
specifications, requirements, procedures, and instructional material to 
implement and maintain operational systems for processing Medicaid 
claims/encounter data and defines their application to the States and 
program recipients.
     Monitors Medicaid automated systems requirements, 
standards and procedures pertaining to the review and evaluation of 
State agency automated data processing, claims/encounter data 
processing, information retrieval systems, and integrated eligibility 
systems, in terms of their development, operations and funding to 
determine State compliance with published Federal requirements.
     Performs periodic reviews of State systems to identify 
deficiencies with regard to failing to meet performance standards 
developed by these and other HCFA staff.
     Reviews and approves State agency requests for Federal 
Financial Participation (FFP) associated with the cost of developing 
and operating Medicaid claims/encounter data processing, information 
retrieval systems, as well as integrated eligibility systems.
     Provides policy guidance for the application of conceptual 
equivalency in the determination of whether uncertified automated 
systems meet the Federal Medicaid Management Information System (MMIS) 
requirements, as well as provides technical guidance to HCFA components 
involved in the development of MMIS re-certification standards.
     Central coordination/liaison office for working with other 
HCFA components (e.g. BDMS, BPO, HSQB, ORD, etc.) on data and system-
related issues. Similarly relates to other governmental agencies and 
the private sector on Medicaid issues, in concert with BDMS' overall 
strategy/guidance.
     Promotes standardized electronic data interchange (EDI) 
and its adoption by States; works with Regional Offices, the National 
Uniform Billing Committee, and other health care claims/encounter work 
groups toward this end together with the State Medicaid Director's 
Association, the Medicare program and other interested parties for 
purposes of developing national standards.
     Participates on the American National Standards Institute 
(ANSI) committees (and other similar groups) regarding data elements 
for eligibility, health care services, coverage, payment, etc. 
information.
     Monitors State electronic verification/claims submission/
processing/payment systems, as well as HCPCS issues, and the conversion 
of the HCFA 1450 and 1500 to electronic formats.
     Coordinates with all State Medicaid Agencies the adoption 
of national standards for paper and electronic data interchange-based 
administrative transactions such as claims, encounters, remittance 
advice and eligibility inquiries.

f. Office of Program and Organizational Services (FAB9)

     Promote and support States' development of Medicaid 
program transitions to health system reform.
     Provide leadership to the Medicaid Bureau's coordinating 
activities related to State-initiated health system reforms 
accomplished through Statewide Section 1115 projects.
     Serve as the Medicaid Bureau's clearinghouse for 
information on State reform initiatives; identify needs and coordinate 
initiatives for technical assistance, information exchange and capacity 
building to further States' progress toward program reforms.
     Implement collaborative initiatives among Federal and 
State agencies and private organizations, for complementary efforts to 
improve health service delivery and/or financing in priority areas.
     Support management of Medicaid strategic planning, through 
analyses of data, trends and external forces, assessment of program 
activities in light of planned objectives, and coordination of Medicaid 
planning activities with other agencies and organizations.
     Serves as liaison with and ombudsman for the Medicaid 
regional components. Ensure that meaningful dialogue, instead of just 
one-way information flow, occurs during teleconferences and 
conferences.

[[Page 68763]]

Ensures involvement and participation by ORD and OMC when necessary to 
resolve operational conflicts impacting the Medicaid program. 
Represents the regions at leadership meetings of the Bureau, and 
provides leadership on Bureau priorities for regional office work.
     Compile and analyze other bureaus' plans to the extent 
they affect Medicaid resource use in the regions or in the bureau.
     Provide leadership in the development and revisions of the 
HCFA workplan related to the bureau's responsibilities or of the 
Medicaid Bureau work plan. Prepare Medicaid Bureau strategies.
     Represent the Bureau with AAORM staff. Participate in 
AAORM conference calls with the Regional Administrators and provide 
alerts to the leadership of the Medicaid Bureau when issues arise that 
will affect the Bureau's planning.
     Provide leadership within the Medicaid in the development 
of legislative implementation plans.
     Provides leadership on the evaluation of the Medicaid 
Bureau's structure and on the development and implementation of the 
means for dealing with the results of evaluations.
     Evaluates Medicaid operations and leadership, and HCFA-
wide policies and programs to develop, coordinate, and implement 
bureau-wide management, budget, personnel and administrative policies 
and programs. Leads the design, implementation, and operation of Bureau 
processes, methods and policy to be followed by all subdivisions of the 
Bureau in the areas of budget and financial operations, procurement, 
work planning, personnel, management analysis and evaluation, 
administrative and general services, and equal employment opportunity.
     Executes the budget for the bureau through the issuance of 
staff and dollar controls, budget allowances for administrative 
expenditures, and employment ceilings to the Bureau Director and team 
managers.
     Provides advice and assistance with regard to the 
development, coordination and control of manual issuances. Interprets 
and produces various program information reports.
     Serves as focal point for public information (e.g., 
newsletter articles, FOIA and Privacy Act requests, etc.). Plans, 
directs and coordinates the Bureau's paperwork burden reduction and 
information collection budget programs.
     Provides leadership of a program to ensure that the Bureau 
is responsive to States, regional offices, other central office 
components and the public. Directs a Bureau-wide tracking and control 
system on correspondence, policies, regulations, action documents, 
etc., and provides training and technical assistance on standards for 
content of written documents.
     Represents the Medicaid Bureau and participates on teams 
charged with redesigning HCFA-wide administrative and management 
programs, policies and procedures.
     Serves as focal point for the General Accounting Office 
and the Office of the Inspector General reports relating to MB and 
coordinates other operational reviews of and within MB (e.g., internal 
control reviews).
     Develops and conducts a curriculum and courses to develop 
or increase the knowledge of the Medicaid program of staff from the MB, 
regional offices, States, and other partners and stakeholders.
     Coordinates, tracks, and produces reports on State plan 
amendments, home and community-based waivers, State plan preprints, 
legislative proposals (A19s), regulations, correspondence, and Section 
1115 health care reform waivers.
     Develops and maintains general program compliance policies 
and tracks status of compliance issues.
     Serves as the liaison and coordinator between the public 
and other Federal agencies and the MB to address the needs of such 
individuals and organizations. These activities include securing 
appropriate attendees at meetings, participants on workgroup and teams, 
and tracking the MB resources committed to such activities.
     Develops and maintains a bureau administrative protocol 
and develops instructions for MB, regional offices, and States on 
submission and processing State plan amendments.
     Directs the Bureau's ADP activities relating to 
development, implementation, and administration of mainframe and PC-
based ADP systems.
     Ensures adherence to all HCFA Automated Data Processing 
(ADP) security measures, policies, and procedures and assists with the 
development, modification, and review of ADP policies.
     Provides bureau support on issues related to microcomputer 
systems. Serves as the primary bureau contact point in coordinating 
with the Bureau of Data Management and Strategy on issues associated 
with system applications.

    Dated: September 20, 1996.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 96-33094 Filed 12-27-96; 8:45 am]
BILLING CODE 4120-01-P