[Federal Register Volume 67, Number 205 (Wednesday, October 23, 2002)]
[Notices]
[Pages 65129-65130]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-26906]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval of South 
Carolina State Plan Amendment 01-14(A)

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

ACTION: Notice of hearing.

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SUMMARY: This notice announces an administrative hearing to be held on 
December 2, 2002, at 10 a.m., Atlanta Federal Center, 61 Forsyth 
Street, SW., Suite 4T20, Executive Conference Room, Atlanta, Georgia 
30303-8909, to reconsider our decision to disapprove South Carolina 
State Plan Amendment 01-14 (A).

CLOSING DATE: Requests to participate in the hearing as a party must be 
received by the presiding officer by November 7, 2002.

FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding 
Officer, CMS, 2520 Lord Baltimore Drive, Suite L, Baltimore, Maryland 
21244-2670, Telephone: (410) 786-2055.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider our decision to disapprove South Carolina State 
Plan Amendment (SPA) 01-14(A). South Carolina submitted SPA 01-014(A) 
on December 21, 2001. In this amendment, South Carolina proposed to 
revise the methodology for calculating supplemental payments for 
inpatient and outpatient services furnished by non-state government 
owned or operated facilities.
    The issue is whether the State's proposed revised methodology for 
calculating supplemental payments for inpatient and outpatient services 
furnished by non-state government owned or operated facilities was 
consistent with the requirements of

[[Page 65130]]

section 1902(a)(30)(A) of the Social Security Act (the Act), as 
implemented by the Centers for Medicare & Medicaid Services' (CMS) 
regulations at 42 CFR 447.272 and 447.321. The proposed methodology 
would increase supplemental payments to non-state government owned or 
operated facilities to result in aggregate payments based on 150 
percent of the estimated amount that would be paid for the same 
services under Medicare payment principles. In accordance with the 
regulations at 42 CFR 447.272 and 447.321, as amended on January 18, 
2002, effective May 14, 2002, aggregate payments to non-state 
government owned or operated hospitals may not exceed 100 percent of 
the reasonable estimate of the amount that would be paid for the same 
services under Medicare payment principles. Because the proposed 
payment methodology would provide for payments above the permissible 
level after that date, CMS concluded that the proposed methodologies 
are not in compliance with applicable regulations and the SPA could not 
be approved. 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 South Carolina SPA 01-14(A).
    Section 1116 of 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 South Carolina announcing an administrative hearing 
to reconsider the disapproval of its SPA reads as follows:

Mr. William Prince, Medicaid Director, South Carolina Department of 
Health and Human Services, P.O. Box 8206, Columbia, SC 29202-8206.

    Dear Mr. Prince: I am responding to your request for 
reconsideration of the decision to disapprove South Carolina State 
Plan Amendment (SPA) 01-14(A). South Carolina submitted SPA 01-14(A) 
on December 21, 2001. In this amendment, South Carolina proposed to 
revise the methodology for calculating supplemental payments for 
inpatient and outpatient services furnished by non-state government 
owned or operated facilities.
    The issue is whether the State's proposed revised methodology 
for calculating supplemental payments for inpatient and outpatient 
services furnished by non-state government owned or operated 
facilities was consistent with the requirements of section 
1902(a)(30)(A) of the Social Security Act (the Act), as implemented 
by the Centers for Medicare & Medicaid Services (CMS) regulations at 
42 CFR 447.272 and 447.321. The proposed methodology would increase 
supplemental payments to non-state government owned or operated 
facilities to result in aggregate payments based on 150 percent of 
the estimated amount that would be paid for the same services under 
Medicare payment principles. In accordance with the regulations at 
42 CFR 447.272 and 447.321, as amended on January 18, 2002, 
effective May 14, 2002, aggregate payments to non-state government 
owned or operated hospitals may not exceed 100 percent of the 
reasonable estimate of the amount that would be paid for the same 
services under Medicare payment principles. Because the proposed 
payment methodology would provide for payments above the permissible 
level after that date, CMS concluded that the proposed methodologies 
are not in compliance with applicable regulations and the SPA could 
not be approved. Based on the reasoning set forth above, and after 
consultation with the Secretary as required under 42 CFR 
430.15(c)(2), CMS disapproved South Carolina SPA 01-14(A).
    I am scheduling a hearing on your request for reconsideration to 
be held on December 2, 2002, at 10 a.m., Atlanta Federal Center, 61 
Forsyth Street, SW., Suite 4T20, Executive Conference Room, Atlanta, 
Georgia 30303-8909, to reconsider our decision to disapprove South 
Carolina SPA 01-14(A).
    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.

    Authority: Section 1116 of the Social Security Act (42 U.S.C. 
section 1316); (42 CFR 430.18)

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

    Dated: October 11, 2002.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 02-26906 Filed 10-22-02; 8:45 am]
BILLING CODE 4120-03-P