[Federal Register Volume 64, Number 81 (Wednesday, April 28, 1999)]
[Notices]
[Pages 22871-22872]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-10610]



[[Page 22871]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration


Notice of Hearing: Reconsideration of Disapproval of Minnesota 
State Plan Amendment (SPA) 98-10

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

ACTION: Notice of hearing.

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SUMMARY: This notice announces an administrative hearing on June 9, 
1999; 10:00 a.m.; Twenty-First floor; 105 W. Adams Street; Chicago, 
Illinois 60603 to reconsider our decision to disapprove Minnesota State 
Plan Amendment (SPA) 98-10.

CLOSING DATE: Requests to participate in the hearing as a party must be 
received by the presiding officer by May 13, 1999.

FOR FURTHER INFORMATION CONTACT: Stanley Katz, Hearings Officer, HCFA, 
C1-09-13, 7500 Security Boulevard, Baltimore, Maryland 21244, 
Telephone: (410)-786-2661

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider HCFA's decision to disapprove Minnesota State 
Plan Amendment 98-10 submitted March 30, 1998.
    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. These requirements are made applicable under Title XIX. The 
Health Care Financing Administration (HCFA) is required to publish a 
copy of the notice to the State that informs the State of the time and 
place of the hearing and the issues to be considered. If we 
subsequently notify the State 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 presiding 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 presiding 
officer before the hearing begins in accordance with the requirements 
contained at 42 CFR 430.76(c). If the hearing is later rescheduled, the 
presiding officer will notify all participants.
    Minnesota submitted this State Plan Amendment (SPA) on March 30, 
1998. The issue is whether the State's proposal to adopt several less 
restrictive Medicaid financial eligibility methodologies for the group 
of low income families with children under section 1931 of the Social 
Security Act comports with the requirements of section 1902(a)(17)of 
the Act that a state use reasonable standards which are comparable for 
all groups in determining eligibility for and the amount of medical 
assistance.
    Specifically, the State proposed to disregard earned income and 
resources used to determine a grant under the Temporary Assistance for 
Needy Families (TANF) program. If these proposals mean that the types 
of income and resources which TANF would count will be disregarded in 
determining the eligibility of all individuals under Section 1931, HCFA 
would have no objections. However, HCFA understands that the intent of 
these provisions was to disregard the earned income and resources only 
in situations in which the family receives a TANF grant. Given this 
understanding, these proposed disregards are not in accordance with 
Federal law. HCFA concluded that these provisions violate the 
requirement in Section 1902 (a)(17).
    Section 1931(b)(2)(C)of the Act permits a State to use less 
restrictive income and resource methodologies in determining 
eligibility than it used under its Aid to Families with Dependent 
Children (AFDC) State plan in effect on July 16, 1996. Nevertheless, 
HCFA believes this language must be read in context of other title XIX 
requirements rather than in a vacuum. Therefore, the requirements of 
section 1902 (a)(17) apply.This section requires States to have 
reasonable standards for determining eligibility for Medicaid 
assistance which are ``comparable for all groups.'' A disregard which 
treats the same types of income or the same amounts of resources 
differently whether or not an individual participates in the TANF 
program, does not result in comparable treatment of income and 
resources for all individuals under the 1931 group. If two individuals 
have identical amounts of income from the same source, that income 
would be counted in determining the eligibility of an individual who 
applied only for Medicaid but would be disregarded if the individual 
received a TANF grant in addition to applying for Medicaid. This does 
not comport with the comparability requirements of Section 1902(a)(17). 
Therefore, the proposal to disregard earned income used in determining 
a TANF grant and to disregard resources used in determining a TANF 
grant was disapproved by HCFA. The deficiencies described above left 
HCFA no choice but to recommend disapproval of Minnesota SPA 98-10.
    The notice to Minnesota announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Mary B. Kennedy, State Medicaid Director, Assistant Commissioner 
Health Care Administration, Minnesota Department of Health Services, 
444 Lafayette Road North, Saint Paul, Minnesota 55155.
    Dear Ms. Kennedy: I am responding to your request for 
reconsideration of the decision to disapprove Minnesota State Plan 
Amendment (SPA) 98-10. The issue is the State's proposal to adopt 
several less restrictive methodologies for the group of low income 
families with children eligible under Section 1931 of the Social 
Security Act.
    Specifically, the State proposed to disregard earned income and 
resources used in determining a grant under the Temporary Assistance 
for Needy Families (TANF) program. If these proposals mean that the 
types of income and resources which TANF would count will be 
disregarded in determining the eligibility of all individuals under 
section 1931, HCFA would have no objections. However, HCFA 
understands that the intent of these provisions is to disregard the 
earned income and the resources only in situations in which the 
family receives a TANF grant. Given this understanding, these 
proposed disregards are not in accordance with Federal law. These 
provisions violate the requirement in section 1902(a)(17) that all 
individuals in a group be subject to comparable standards for 
determining eligibility.
    Section 1931(b)(2)(C) of the Act permits a State to use less 
restrictive income and resource methodologies in determining 
eligibility than it used under its Aid to Families with Dependent 
Children (AFDC) State plan in effect on July 16,1996. Nevertheless, 
this language must be read in context of other title XIX 
requirements rather than in a vacuum. The comparability requirements 
of Section 1902(a)(17) must apply. This section requires States to 
have reasonable standards for determining eligibility for Medicaid 
assistance which are ``comparable for all groups.'' A disregard 
which treats the same types of income or the same amounts of 
resources differently whether or not an individual participates in 
the TANF program, does not result in comparable treatment of income 
and resources for all individuals under the 1931 group. If two 
individuals have identical amounts of income from the same source, 
that income would be counted in determining the eligibility of an 
individual who applied only for Medicaid but would be disregarded if 
the individual received a TANF grant in addition to applying for 
Medicaid. This does not comport with the comparability requirements 
of section 1902(a)(17). Therefore, the proposal to disregard earned 
income used in determining a TANF grant and to disregard resources 
used in determining a TANF grant was disapproved by HCFA. The 
deficiencies described above left HCFA no choice but to

[[Page 22872]]

recommend disapproval of Minnesota SPA 98-10.
    I am scheduling a hearing on your request for reconsideration to 
be held on June 9, 1999 on the Twenty-First Floor; 105 W. Adams 
Street; Chicago, Illinois 60603. 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 
presiding officer. In order to facilitate any communication which 
may be necessary between the parties to the hearing, please notify 
the presiding officer to indicate acceptability of the hearing date 
that has been scheduled and provide names of the individuals who 
will represent the State at the hearing. The presiding officer may 
be reached at (410)-786-2661.
    Sincerely,
Nancy-Ann Min DeParle,
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: April 22, 1999.
Nancy Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 99-10610 Filed 4-27-99; 8:45 am]
BILLING CODE 4120-01-P