[Federal Register Volume 73, Number 104 (Thursday, May 29, 2008)]
[Notices]
[Pages 30942-30943]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-12022]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval of Texas State 
Plan Amendment (SPA) 07-020

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 
July 8, 2008, at the CMS Dallas Regional Office, 1301 Young Street, 
Suite 833, Room 1196, Dallas, Texas 75202, to reconsider CMS' decision 
to disapprove Texas SPA 07-020.
    Closing Date: Requests to participate in the hearing as a party 
must be received by the presiding officer by June 13, 2008.

FOR FURTHER INFORMATION CONTACT: Benjamin Cohen, Presiding Officer, 
CMS, 2520 Lord Baltimore Drive, Suite L, Baltimore, Maryland 21244, 
Telephone: (410) 786-3169.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider CMS' decision to disapprove Texas SPA 07-020 
which was submitted on July 20, 2007, and disapproved on February 22, 
2008.
    Under this SPA, the State would guarantee that, at the request of a 
hospital impacted as a result of a federally declared natural disaster, 
disproportionate share hospital (DSH) payments to that hospital would 
remain level from the prior year. In addition, the SPA would amend the 
conversion factors that expire August 31, 2007, and would update cost 
reporting citations that have changed due to a format change in the CMS 
Hospital and Hospital Health Care Complex Cost Report.
    The amendment was disapproved because it does not comply with the 
requirements of section 1902(a)(13)(A) of the Social Security Act (the 
Act) together with the hospital specific limits under 1923(g)(1) of the 
Act.
    The hearing will involve the following issues:
     Compliance with section 1923(g) of the Act. Whether the 
proposed State plan language concerning DSH payments assures compliance 
with hospital specific payment limits for current year DSH payments, 
and sufficient documentation of such compliance;
     Applicability of section 1923(e)(2) of the Act providing 
an exception to the section 1923(g) limits. Whether section

[[Page 30943]]

1923(e)(2) provides an exception to section 1923(g), and, if so, 
whether the State meets the criteria for such an exception; and
     Clarification of the status of State plan amendment 
components that address changes to conversion factors and updates to 
cost reporting citations based on changes to the CMS Hospital Cost 
Report. If the State does not prevail on the first two issues, whether 
the State is asking the hearing officer to withdraw affected components 
of the State plan amendment and remand remaining components for a 
determination of whether approval is warranted.
    Section 1116 of the Act and Federal regulations at 42 CFR Part 430, 
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.
    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 Texas announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Mr. Chris Traylor, State Medicaid Director, Texas Health and Human 
Services Commission, P.O. Box 13247, Austin, TX 78711.

    Dear Mr. Traylor: I am responding to your request for 
reconsideration of the decision to disapprove the Texas State plan 
amendment (SPA) 07-020, which was submitted on July 20, 2007, and 
disapproved on February 22, 2008.
    Under this SPA, the State would guarantee that, at the request 
of a hospital impacted as a result of a federally declared natural 
disaster, disproportionate share hospital (DSH) payments to that 
hospital would remain level from the prior year. In addition, the 
SPA would amend the conversion factors that expire August 31, 2007, 
and would update cost reporting citations that have changed due to a 
format change in the Centers for Medicare & Medicaid Services' (CMS) 
Hospital and Hospital Health Care Complex Cost Report.
    The amendment was disapproved because it does not comply with 
the requirements of section 1902(a)(13)(A) of the Social Security 
Act (the Act) together with the hospital specific limits under 
1923(g)(1) of the Act.
    The hearing will involve the following issues:
     Compliance with section 1923(g) of the Act. Whether the 
proposed State plan language concerning DSH payments assures 
compliance with hospital specific payment limits for current year 
DSH payments, and sufficient documentation of such compliance;
     Applicability of section 1923(e)(2) of the Act 
providing an exception to the section 1923(g) limits. Whether 
section 1923(e)(2) provides an exception to section 1923(g) and, if 
so, whether the State meets the criteria for such an exception; and
     Clarification of the status of SPA components that 
address changes to conversion factors and updates to cost reporting 
citations based on changes to the CMS Hospital and Hospital Health 
Care Complex Cost Report. If the State does not prevail on the first 
two issues, whether the State is asking the hearing officer to 
withdraw affected components of the SPA and remand remaining 
components for a determination of whether approval is warranted.
    I am scheduling a hearing on your request for reconsideration to 
be held on July 8, 2008, at the CMS Dallas Regional Office, 1301 
Young Street, Suite 833, Room 1196, Dallas, Texas 75202, in order to 
reconsider the decision to disapprove SPA 07-020. 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.
    I am designating Mr. Benjamin Cohen as the presiding officer. If 
these arrangements present any problems, please contact the 
presiding officer at (410) 786-3169. 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,
Kerry Weems,
Acting Administrator.

    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.)

    Dated: May 20, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E8-12022 Filed 5-28-08; 8:45 am]
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