[Federal Register Volume 72, Number 144 (Friday, July 27, 2007)]
[Notices]
[Pages 41330-41331]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-14607]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval of Virginia 
Title XXI State Plan Amendment (SPA) No. 6

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 
September 4, 2007, at 150 S. Independence Mall West, Suite 216, 
Conference Room 241, Pennsylvania Room, The Public Ledger 
Building, Philadelphia, PA 19106-3499, to reconsider CMS' decision to 
disapprove Virginia's title XXI SPA No. 6.
    Closing Date: Requests to participate in the hearing as a party 
must be received by the presiding officer by (15 days after 
publication).

FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding 
Officer, CMS, Lord Baltimore Drive, Mail Stop LB-23-20, Baltimore, 
Maryland 21244, Telephone: (410) 786-2055.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider CMS' decision to disapprove Virginia's title XXI 
SPA No. 6, which was submitted on June 29, 2004. This SPA was 
disapproved on April 20, 2007.
    Under this SPA, the State requested the addition of new school-
based health services to the State Children's Health Insurance Program 
(SCHIP) Family Access to Medical Insurance Security (FAMIS) benefit 
package.
    The amendment was disapproved because CMS found that the amendment 
violated the statute for reasons set forth in the disapproval letter.
    The following issues are to be decided at the hearing:
    (1) Whether Virginia provided all information necessary to 
establish that the proposed SPA, in the context of its State child 
health plan, conformed to all requirements of the SCHIP statute and 
implementing regulations, including:
    (a) Information on the exact nature of the services to be covered; 
whether those services are within the definition of child health 
assistance at section 2110(a) of the Social Security Act (Act);
    (b) Information on proposed provider qualifications necessary to 
ensure the quality and appropriateness of care pursuant to section 
2102(a)(7) of the Act and ensure that services are provided in an 
effective manner pursuant to section 2101(a) of the Act, and;
    (c) Information on the budgetary impact necessary to ensure that 
services are provided in an effective and efficient manner.
    (2) In the absence of such information, whether a disapproval was 
warranted when 950 days had passed after CMS had requested that 
information.
    The Commonwealth of Virginia's title XXI SPA No. 6 was submitted to 
the CMS on June 29, 2004, with a requested retroactive effective date 
of August 3, 2003. This amendment requested the addition of new school-
based health services to the State's SCHIP FAMIS benefit package.
    A request for additional information (RAI) was submitted to the 
State on August 18, 2004, which stopped the 90-day review period. The 
RAI included questions concerning the nature of the proposed services, 
the qualifications of the providers, and the budgetary impact of the 
amendment.
    To date, the State has not responded to the request for additional 
information.
    Section 1116 of the Act and Federal regulations at 42 CFR part 430, 
Subpart D, and section 457.203 establish Department procedures that 
provide an administrative hearing for reconsideration of a disapproval 
of a State plan or plan amendment. 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 pursuant to 
42 CFR 430.74(a).
    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). A hearing may be rescheduled by written 
agreement between CMS and a State pursuant to 42 CFR 430.72(a).
    The notice to Virginia announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Mr. Brian McCormick,
Department of Medical Assistance Services, Commonwealth of Virginia, 
600 East Broad Street, Suite 1300, Richmond, VA 23219.
    Dear Mr. McCormick: I am responding to your request for 
reconsideration of the decision to disapprove Virginia's title XXI 
State plan amendment (SPA) No. 6, which was submitted on June 29, 
2004, and was disapproved on April 20, 2007.
    Under this SPA, the State requested the addition of new school-
based health services to the State Children's Health Insurance 
Program (SCHIP) Family Access to Medical Insurance Security (FAMIS) 
benefit package. The amendment was disapproved because the Centers 
for Medicare & Medicaid Services (CMS) was not certain if the 
amendment was in compliance with section 2106(c) of the Social 
Security Act (the Act) because the State did not respond to a 
request for additional information dated August 18, 2004. In the 
absence of a response, the SPA was disapproved because there was 
insufficient information to make the necessary determination.
    The following issues are to be decided at the hearing:
    (1) Whether Virginia provided all information necessary to 
establish that the proposed SPA, in the context of its State child 
health plan, conformed to all requirements of the SCHIP statute and 
implementing regulations, including:
    (a) Information on the exact nature of the services to be 
covered; whether those services are within the definition of child 
health assistance at section 2110(a) of the Act;
    (b) Information on proposed provider qualifications necessary to 
ensure the quality and appropriateness of care pursuant to section 
2102(a)(7) of the Act and ensure that services are provided in an 
effective manner pursuant to section 2101(a) of the Act, and;
    (c) Information on the budgetary impact necessary to ensure that 
services are provided in an effective and efficient manner.

[[Page 41331]]

    (2) In the absence of such information, whether a disapproval 
was warranted when 950 days had passed after CMS had requested that 
information.
    The Commonwealth of Virginia's title XXI SPA No. 6 was submitted 
to CMS on June 29, 2004, with a requested retroactive effective date 
of August 3, 2003. This amendment requested the addition of new 
school-based health services to the State's SCHIP FAMIS benefit 
package.
    A request for additional information was submitted to the State 
on August 18, 2004, which stopped the 90-day review period. The 
request for information included questions concerning the nature of 
the proposed services, the qualifications of the providers, and the 
budgetary impact of the amendment.
    To date, the State has not responded to this request for 
information.
    I am scheduling a hearing on your request for reconsideration to 
be held on September 4, 2007, at 150 S. Independence Mall West, 
Suite 216, Conference Room 241 (Pennsylvania Room), The 
Public Ledger Building, Philadelphia, PA 19106-3499, to reconsider 
the decision to disapprove SPA No. 6. 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 by Federal regulations at 42 CFR Part 430, 
Subpart D, and section 457.203.
    I am designating Ms. Kathleen Scully-Hayes as the presiding 
officer. If these arrangements present any problems, please contact 
the presiding officer at (410) 786-2055. 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.
    Sincerely,
Leslie V. Norwalk, Esq.,
Acting Administrator.

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: July 20, 2007.
Leslie V. Norwalk,
Acting Administrator, Centers for Medicare & Medicaid Services.
 [FR Doc. E7-14607 Filed 7-26-07; 8:45 am]
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