[Federal Register Volume 67, Number 68 (Tuesday, April 9, 2002)]
[Notices]
[Pages 17072-17073]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-8471]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval of Arizona 
State Plan Amendment 01-013.

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of hearing.

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SUMMARY: This notice announces an administrative hearing on May 17, 
2002, at 10 a.m., Conference Rooms 615A & 615B; 75 Hawthorne Street; 
San Francisco, California 94105-3901 to reconsider our decision to 
disapprove Arizona State Plan Amendment (SPA) 01-013.

CLOSING DATE: Requests to participate in the hearing as a party must be 
received by the presiding officer by (April 24, 2002).

FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding 
Officer, CMS, C1-09-13, 7500 Security Boulevard, Baltimore, Maryland 
21244, Telephone: (410) 786-2055.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider our decision to disapprove Arizona's State Plan 
Amendment (SPA) 01-013.
    Arizona submitted SPA 01-013, on October 21, 2001. The issue is 
whether the state can provide retroactive payments to June 4, 1997, for 
school-based providers for services to children eligible under the 
Individuals with Disabilities Education Act. For the reasons stated 
below, the Center for Medicare & Medicaid Services (CMS) was unable to 
approve this amendment.
    Standard appropriations language authorizes the Secretary to make 
payments only ``for any quarter with respect to a state plan amendment 
in effect during such quarter, if submitted in or prior to such quarter 
and approved in that or any subsequent quarter.'' Under this language, 
the Secretary is not authorized to make payments for a quarter based on 
a SPA submitted in a later quarter.
    This statutory provision is implented by regulations at 42 CFR 
430.20 (b)(1) and (2). The regulation precludes CMS from approving an 
effective date prior to

[[Page 17073]]

the first day of the quarter in which a plan amendment is submitted, if 
the plan amendment provides for expanded Medicaid coverage or increased 
Medicaid payment for covered services. This plan amendment would expand 
coverage because the plan did not otherwise provide payment for 
services provided by school-based providers prior to July 1, 2000. 
Since this SPA would expand coverage, it could not be approved with an 
effective date of June 4, 1997, since that is prior to the first day of 
the quarter in which the SPA was submitted.
    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 CMS 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 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.
    The notice to Arizona announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:
    Ms. Phyllis Biedess, Director, Arizona Health Care Cost Containment 
System, 801 E. Jefferson, Phoenix, Arizona 85034.
    Dear Ms. Biedess: I am responding to your request for 
reconsideration of the decision to disapprove Arizona State Plan 
Amendment (SPA) 01-013.
    Arizona submitted SPA 01-013 on October 21, 2001. The issue is 
whether the state can provide retroactive payments to June 4, 1997, for 
school-based providers of services to children eligible under the 
Individuals with Disabilities Education Act. For the reasons stated 
below, the Center for Medicare & Medicaid Services (CMS) was unable to 
approve this amendment.
    Standard appropriations language authorizes the Secretary to make 
payments only ``for any quarter with respect to a state plan amendment 
in effect during such quarter, if submitted in or prior to such quarter 
and approved in that or any subsequent quarter.'' Under this language, 
the Secretary is not authorized to make payments for a quarter based on 
a SPA submitted in a later quarter.
    This statutory provision is implemented by regulations at 42 CFR 
430.20 (b)(1) and (2). The regulation precludes CMS from approving an 
effective date prior to the first day of the quarter in which a plan 
amendment is submitted, if the plan amendment provides for expanded 
Medicaid coverage or increased Medicaid payment for covered services. 
This plan amendment would expand coverage because the plan did not 
otherwise provide payment for services provided by school-based 
providers prior to July 1, 2000. Since this SPA would expand coverage, 
it could not be approved with an effective date of June 4, 1997, since 
that is prior to the first day of the quarter in which the SPA was 
submitted.
    Therefore, based on the reasoning set forth above, and after 
consultation with the Secretary as required under 42 CFR 430.15(c)(2), 
CMS disapproved Arizona SPA 01-013. I am scheduling a hearing on your 
request for reconsideration to be held May 17, 2002, at 10:00 a.m., 
Conference Rooms 615A & 615B; 75 Hawthorne Street; San Francisco, 
California 94105-3901. 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 Ms. Kathleen Scully-Hayes 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) 786-2055.

Sincerely,
Thomas A. Scully

    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)
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 02-8471 Filed 4-8-02; 8:45 am]
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