[Federal Register Volume 77, Number 231 (Friday, November 30, 2012)]
[Notices]
[Pages 71420-71423]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-29035]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Federal Financial Participation in State Assistance Expenditures; 
Federal Matching Shares for Medicaid, the Children's Health Insurance 
Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 
1, 2013 Through September 30, 2014

AGENCY: Office of the Secretary, DHHS.

ACTION: Notice.

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SUMMARY: The Federal Medical Assistance Percentages (FMAP), Enhanced 
Federal Medical Assistance Percentages (eFMAP), and disaster-recovery 
FMAP adjustments for Fiscal Year 2014 have been calculated pursuant to 
the Social Security Act (the Act). These percentages will be effective 
from October 1, 2013 through September 30, 2014. This notice announces 
the calculated FMAP and eFMAP rates that the U.S. Department of Health 
and Human Services (HHS) will use in determining the amount of federal 
matching for state medical assistance (Medicaid) and Children's Health 
Insurance Program (CHIP) expenditures, Temporary Assistance for Needy 
Families (TANF) Contingency Funds, Child Support Enforcement 
collections, Child Care Mandatory and Matching Funds of the Child Care 
and Development Fund, Foster Care Title IV-E Maintenance payments, and 
Adoption Assistance payments. Table 1 gives figures for each of the 50 
States, the District of Columbia, Puerto Rico, the Virgin Islands, 
Guam, American Samoa, and the Commonwealth of the Northern Mariana 
Islands. This notice also announces the disaster-recovery FMAP 
adjustments for qualifying states for FY 2014 that the U.S. Department 
of Health and Human Services (HHS) will use in determining the amount 
of federal matching for state medical assistance (Medicaid) and title 
IV-E Foster Care, Adoption Assistance and Guardianship Assistance 
programs.
    Programs under title XIX of the Act exist in each jurisdiction. 
Programs under titles I, X, and XIV operate only in Guam and the Virgin 
Islands, while a program under title XVI (Aid to the Aged, Blind, or 
Disabled) operates only in Puerto Rico. The percentages in this notice 
apply to state expenditures for most medical assistance and child 
health assistance, and assistance payments for certain social services. 
The Act provides separately for federal matching of administrative 
costs.
    Sections 1905(b) and 1101(a)(8)(B) of the Social Security Act (the 
Act) require the Secretary of HHS to publish the FMAP rates each year. 
The Secretary calculates the percentages, using formulas in sections 
1905(b) and 1101(a)(8), and calculations by the Department of Commerce 
of average income per person in each state and for the Nation as a 
whole. The percentages must fall within the upper and lower limits 
given in section 1905(b) of the Act. The percentages for the District 
of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and 
the Northern Mariana Islands are specified in statute, and thus are not 
based on the statutory formula that determines the percentages for the 
50 States.
    Section 1905(b) of the Act specifies the formula for calculating 
FMAPs as follows:

    `` ``Federal medical assistance percentage'' for any State shall 
be 100 per centum less the State percentage; and the State 
percentage shall be that percentage which bears the same ratio to 45 
per centum as the square of the per capita income of such State 
bears to the square of the per capita income of the continental 
United States (including Alaska) and Hawaii; except that (1) the 
Federal medical assistance percentage shall in no case be less than 
50 per centum or more than 83 per centum, (2) the Federal medical 
assistance percentage for Puerto Rico, the Virgin Islands, Guam, the 
Northern Mariana Islands, and American Samoa shall be 55 percent * * 
*''.

    Section 4725(b) of the Balanced Budget Act of 1997 amended section 
1905(b) to provide that the FMAP for the District of Columbia for 
purposes of titles XIX and XXI shall be 70 percent. For the District of 
Columbia, we note under Table 1 that other rates may apply in certain 
other programs. In addition, we note the rate that applies for Puerto 
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of 
the Northern Mariana Islands in certain other programs pursuant to 
section 1118 of the Act.
    Section 1905(y) of the Act, as added by section 2001 of the Patient 
Protection and Affordable Care Act of 2010

[[Page 71421]]

(''Affordable Care Act''), provides for a significant increase in the 
Federal Medical Assistance Percentage (FMAP) for medical expenditures 
for individuals determined eligible under the new adult group in the 
State and who will be considered to be ``newly eligible'' in 2014, as 
defined in section 1905(y)(2)(A) of the Act. The FMAP for these newly 
eligible individuals will be 100 percent for Calendar Year (CY) 2014-
2016, gradually declining to 90 percent in 2020 where it remains 
indefinitely. In addition, section 1905(z) of the Act, as added by 
section 10201 of the Affordable Care Act, provides that States that had 
expanded substantial coverage to low-income parents and nonpregnant 
adults without children prior to the enactment of the Affordable Care 
Act, referred to as ``expansion States,'' shall receive an enhanced 
FMAP that begins in 2014 for nonpregnant childless adults who may be 
required to enroll in benchmark coverage. These provisions are 
discussed in more detail in the Medicaid Eligibility proposed rule 
published on August 17, 2011 (76 FR 51172) and the final rule published 
on March 23, 2012 (77 FR 17143).
    Section 2006 of the Affordable Care Act amended section 1905 of the 
Social Security Act by adding section (aa) to provide for an increase 
in the FMAP rate for qualifying States for Medicaid and title IV-E 
Foster Care, Adoption Assistance and Guardianship Assistance programs. 
The purpose of the increase to the FMAP rate is to provide increased 
federal financial participation for qualifying States that have 
experienced a major, statewide disaster.
    The methodology for calculating and publishing disaster-recovery 
adjustments to fiscal year FMAP rates was published on December 22, 
2010 (75 FR 80501).
    Section 1905(aa) of the Act defines a ``disaster-recovery FMAP 
adjustment state'' as one of the 50 states or District of Columbia for 
which, at any time during the preceding 7 fiscal years, the President 
has declared a major disaster under section 401 of the Robert T. 
Stafford Disaster Relief and Emergency Assistance Act under which every 
county or parish in the state is eligible for individual and public 
assistance or public assistance from the federal government, and for 
which the FMAP as determined for the fiscal year is less than the FMAP 
(for the first year of assistance) or the disaster-adjusted recovery 
FMAP (for each subsequent year of assistance) for the preceding fiscal 
year by at least three percentage points.
    Qualifying states receive an adjustment to their annual FMAP rate 
based on a formula specified in statute. In the first year a State 
qualifies, this increase is applied to the FMAP as determined for the 
fiscal year. Section 2006 of the Affordable Care Act specified that the 
disaster-recovery adjustment in the second or any succeeding fiscal 
year a State qualifies be applied to the prior year's disaster-recovery 
adjusted FMAP. This resulted in increased, rather than phased down, 
financial assistance to qualifying states each year, and allowed states 
to continue to qualify for assistance after their underlying FMAP has 
stabilized. Section 3204 of the Middle Class Tax Relief and Job 
Creation Act of 2012 (Pub. L. 112-96) revised the formula in section 
1905(aa) to apply the adjustment for the second or any succeeding 
fiscal year that a state qualifies to the FMAP as determined for the 
fiscal year, effective October 1, 2013. Further, section 100123 of the 
Moving Ahead for Progress in the 21st Century Act (Pub. L. 112-141) 
revised the formula again, this time for FY13 only, and changed the 
effective date in Public Law 112-96 to October 1, 2012. As a result, 
HHS has revised the FY13 disaster-recovery FMAP adjustment published on 
November 30, 2011. Thus, the revised disaster-recovery FMAP rate for 
Louisiana for FY13 (the only qualifying state, as published in 76 FR 
74061) is included in Table 2 taking into account the revised formula 
set forth in section 3204 of the Middle Class Tax Relief and Job 
Creation Act of 2012.
    Based on the criteria for a qualifying state, only one State, 
Louisiana, meets the requirement for a disaster-recovery FMAP 
adjustment in FY14. Hurricane Gustav caused Louisiana to be declared a 
state-wide disaster area on September 2, 2008. In addition, Louisiana's 
FMAP as determined for FY 2014 is less than the previous year disaster-
recovery adjusted FMAP by at least three percentage points. Therefore, 
Louisiana is the only state that qualifies for a disaster-recovery 
adjustment to their FY2014 FMAP rate. The disaster-recovery adjusted 
FMAP rate for Louisiana for FY2014 is included in Table 2.
    Section 2105(b) of the Act specifies the formula for calculating 
the eFMAP rates as follows:

    The ``enhanced FMAP'', for a State for a fiscal year, is equal 
to the Federal medical assistance percentage (as defined in the 
first sentence of section 1905(b)) for the State increased by a 
number of percentage points equal to 30 percent of the number of 
percentage points by which (1) such Federal medical assistance 
percentage for the State, is less than (2) 100 percent; but in no 
case shall the enhanced FMAP for a state exceed 85 percent.

    The eFMAP rates are used in the Children's Health Insurance Program 
under Title XXI, and in the Medicaid program for certain children for 
expenditures for medical assistance described in sections 1905(u)(2) 
and 1905(u)(3) of the Act. There is no specific requirement to publish 
the eFMAP rates. We include them in this notice for the convenience of 
the States.

DATES: Effective Dates: The percentages listed in Table 1 will be 
effective for each of the four quarter-year periods beginning October 
1, 2013 and ending September 30, 2014. The FY14 disaster-recovery 
adjusted FMAP rate in Table 2 will also be effective for each of the 
four quarter-year periods beginning October 1, 2013 and ending 
September 30, 2014. The FY13 revised disaster-recovery adjusted FMAP 
rate in Table 2 will be effective for each of the four quarter-year 
periods beginning October 1, 2012 and ending September 30, 2013.

FOR FURTHER INFORMATION CONTACT: Carrie Shelton or Tom Musco, Office of 
Health Policy, Office of the Assistant Secretary for Planning and 
Evaluation, Room 447D--Hubert H. Humphrey Building, 200 Independence 
Avenue SW., Washington, DC 20201, (202) 690-6870.

(Catalog of Federal Domestic Assistance Program Nos. 93.558: TANF 
Contingency Funds; 93.563: Child Support Enforcement; 93.596: Child 
Care Mandatory and Matching Funds of the Child Care and Development 
Fund; 93.658: Foster Care Title IV-E; 93.659: Adoption Assistance; 
93.769: Ticket-to-Work and Work Incentives Improvement Act (TWWIIA) 
Demonstrations to Maintain Independence and Employment; 93.778: 
Medical Assistance Program; 93.767: Children's Health Insurance 
Program)

    Dated: November 23, 2012.
Kathleen Sebelius,
Secretary.

[[Page 71422]]



  Table 1--Federal Medical Assistance Percentages and Enhanced Federal
 Medical Assistance Percentages, Effective October 1, 2013-September 30,
                                  2014
                           [Fiscal year 2014]
------------------------------------------------------------------------
                                                             Enhanced
                                              Federal         federal
                  State                       medical         medical
                                            assistance      assistance
                                            percentages     percentages
------------------------------------------------------------------------
Alabama.................................           68.12           77.68
Alaska..................................           50.00           65.00
American Samoa*.........................           55.00           68.50
Arizona.................................           67.23           77.06
Arkansas................................           70.10           79.07
California..............................           50.00           65.00
Colorado................................           50.00           65.00
Connecticut.............................           50.00           65.00
Delaware................................           55.31           68.72
District of Columbia**..................           70.00           79.00
Florida.................................           58.79           71.15
Georgia.................................           65.93           76.15
Guam*...................................           55.00           68.50
Hawaii..................................           51.85           66.30
Idaho...................................           71.64           80.15
Illinois................................           50.00           65.00
Indiana.................................           66.92           76.84
Iowa....................................           57.93           70.55
Kansas..................................           56.91           69.84
Kentucky................................           69.83           78.88
Louisiana...............................           60.98           72.69
Maine...................................           61.55           73.09
Maryland................................           50.00           65.00
Massachusetts...........................           50.00           65.00
Michigan................................           66.32           76.42
Minnesota...............................           50.00           65.00
Mississippi.............................           73.05           81.14
Missouri................................           62.03           73.42
Montana.................................           66.33           76.43
Nebraska................................           54.74           68.32
Nevada..................................           63.10           74.17
New Hampshire...........................           50.00           65.00
New Jersey..............................           50.00           65.00
New Mexico..............................           69.20           78.44
New York................................           50.00           65.00
North Carolina..........................           65.78           76.05
North Dakota............................           50.00           65.00
Northern Mariana Islands*...............           55.00           68.50
Ohio....................................           63.02           74.11
Oklahoma................................           64.02           74.81
Oregon..................................           63.14           74.20
Pennsylvania............................           53.52           67.46
Puerto Rico*............................           55.00           68.50
Rhode Island............................           50.11           65.08
South Carolina..........................           70.57           79.40
South Dakota............................           53.54           67.48
Tennessee...............................           65.29           75.70
Texas...................................           58.69           71.08
Utah....................................           70.34           79.24
Vermont.................................           55.11           68.58
Virgin Islands*.........................           55.00           68.50
Virginia................................           50.00           65.00
Washington..............................           50.00           65.00
West Virginia...........................           71.09           79.76
Wisconsin...............................           59.06           71.34
Wyoming.................................           50.00           65.00
------------------------------------------------------------------------
* For purposes of section 1118 of the Social Security Act, the
  percentage used under titles I, X, XIV, and XVI will be 75 per centum.
** The values for the District of Columbia in the table were set for the
  state plan under titles XIX and XXI and for capitation payments and
  DSH allotments under those titles. For other purposes, the percentage
  for DC is 50.00, unless otherwise specified by law.


[[Page 71423]]


                                                     Table 2--Disaster-Recovery Adjusted FMAP Rates
                                             Fiscal Year 2013 Revised Disaster-Recovery Adjusted FMAP Rates
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                                 A                                          B                C                D                E                F
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                               State                                      FY13 FMAP    FY12 disaster      Decrease in         Disaster         Disaster
                                                                                            recovery             FMAP         recovery         recovery
                                                                                       adjusted FMAP                        adjustment    adjusted FMAP
                                                                                                                              increase             FY13
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                                                                                                                     Col C-B    50% x Col D\*\         Col B + E
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Louisiana..........................................................           61.24            69.78             8.54             4.27            65.51
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\*\ Percentage determined in accordance with section 1905(aa)(1)(A) of the Social Security Act.


                                                 Fiscal Year 2014 Disaster-Recovery Adjusted FMAP Rates
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                                 A                                          B                C                D                E                F
--------------------------------------------------------------------------------------------------------------------------------------------------------
                               State                                      FY14 FMAP    FY13 disaster      Decrease in         Disaster         Disaster
                                                                                            recovery             FMAP         recovery         recovery
                                                                                       adjusted FMAP                        adjustment    adjusted FMAP
                                                                                                                              increase             FY14
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                     Col C-B    25% x Col D\*\         Col B + E
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Louisiana..........................................................           60.98            65.51             4.53             1.13            62.11
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\*\ Percentage determined in accordance with section 1905(aa)(1)(B) of the Social Security Act.

[FR Doc. 2012-29035 Filed 11-29-12; 8:45 am]
BILLING CODE 4150-05-P