[Federal Register Volume 84, Number 198 (Friday, October 11, 2019)]
[Notices]
[Pages 54905-54906]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-22319]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services


Notice of Hearing: Reconsideration of Disapproval South Carolina 
Medicaid State Plan Amendments (SPAs) 16-0012-A, 17-0006-A, and 18-
0011-A

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (HHS).

ACTION: Notice of hearing: Reconsideration of disapproval.

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SUMMARY: This notice announces an administrative hearing to be held on 
November 20, 2019, at the Department of Health and Human Services, 
Division of Medicaid Field Operations, South, Centers for Medicare & 
Medicaid Services, Division of Medicaid and Children's Health 
Operations, 61 Forsyth St., Suite 4T20, Atlanta, Georgia 30303-8909 to 
reconsider CMS's decision to disapprove South Carolina's Medicaid SPAs 
16-0012-A, 17-0006-A, and 18-0011-A.

DATES: Requests to participate in the hearing as a party must be 
received by the presiding officer by October 28, 2019.

FOR FURTHER INFORMATION CONTACT: Benjamin R. Cohen, Presiding Officer, 
CMS, 1508 Woodlawn Drive, Suite 100, Baltimore, Maryland 21207, 
Telephone: (410) 786-3169.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider CMS' decision to disapprove South Carolina's 
Medicaid state plan amendments (SPAs) 16-0012-A, 17-0006-A, and 18-
0011-A, which were submitted to the Centers for Medicare & Medicaid 
Services (CMS) on December 21, 2016, June 28, 2017, and June 29, 2018, 
respectively, and disapproved on July 9, 2019. These SPAs requested CMS 
approval to add new eligible physicians associated with Greenville 
Memorial Hospital and Palmetto Health Richland to the current physician 
teaching supplemental payment methodology. Specifically, SPAs 16-0012-
A, 17-0006-A, and 18-0011-A proposed to use amounts transferred from 
the Greenville Health Authority to the state Medicaid Agency for use as 
the non-federal share of the proposed payments. The source of the 
transfers would be from the ``Setoff Debt Collection Program,'' which 
garnishes state individual income tax refunds to satisfy medical debt 
liabilities for services furnished by certain providers, rather than 
state or local tax revenue as required by Section 1903(w)(6)(A) of the 
Social Security Act. The revenue collected from the Setoff Debt 
Collection Program is derived from previously uncollected patient 
revenue.
    The issues to be considered at the hearing are whether South 
Carolina SPAs 16-0012-A, 17-0006-A, and 18-0011-A are inconsistent with 
the requirements of:
     Section 1902(a)(2) of the Act, which provides that the 
state plan must assure adequate funding for the non-federal share of 
expenditures from state or local sources, such that the lack of 
adequate funds from local sources will not result in lowering the 
amount, duration, scope, or quality of care and services available 
under the plan.
     Sections 1903(a) and 1905(b) of the Act, which provide 
that states receive a statutorily determined Federal Medicaid 
Assistance Percentage (FMAP) for

[[Page 54906]]

allowable state expenditures on medical assistance.
     Section 1903(w)(6)(A) of the Act, which allows states to 
use funds derived from state or local taxes, which are then transferred 
from units of government to the Medicaid Agency, as the non-federal 
share of Medicaid payments unless the transferred funds are derived by 
the unit of government from donations or taxes that would not otherwise 
be recognized as the non-federal share under section 1903 of the Act.
    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 in the Federal Register 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 state Medicaid agency of additional issues that 
will be considered at the hearing, we will also publish that notice in 
the Federal Register.
    Any interested 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 or 
moved, the presiding officer will notify all participants.
    The notice to South Carolina announcing an administrative hearing 
to reconsider the disapproval of its SPAs reads as follows:

Joshua D. Baker,

Director, South Carolina Department of Health and Human Services, 
Post Office Box 8206, Columbia, SC 29202-8206.

Dear Mr. Baker:

    I am responding to the request for reconsideration (dated 
September 5, 2019) of the decision to disapprove South Carolina's 
state plan amendments (SPAs) 16-0012-A, 17-0006-A, and 18-0011-A, 
which we received on September 6, 2019. South Carolina SPAs 16-0012-
A, 17-0006-A, and 18-0011-A were submitted to the Centers for 
Medicare & Medicaid Services (CMS) on December 21, 2016, June 28, 
2017, and June 29, 2018, respectively, and disapproved on July 9, 
2019. I am scheduling a hearing on the request for reconsideration 
to be held on November 20, 2019 at the Department of Health and 
Human Services, Division of Medicaid Field Operations, South, 
Centers for Medicare & Medicaid Services, Division of Medicaid and 
Children's Health Operations, 61 Forsyth St., Suite 4T20, Atlanta, 
Georgia 30303-8909.
    I am designating Mr. Benjamin R. Cohen as the presiding officer. 
If these arrangements present any problems, please contact Mr. Cohen 
at (410) 786-3169. In order to facilitate any communication that may 
be necessary between the parties prior to the hearing, please notify 
the presiding officer to indicate acceptability of the hearing date 
and location that has been established and provide names of the 
individuals who will represent the State at the hearing. If the 
hearing date or location is not acceptable, Mr. Cohen can set 
another date mutually agreeable to the parties and may designate 
another location, with due regard for the convenience and necessity 
of the parties and their representatives. The hearing will be 
governed by the procedures prescribed by federal regulations at 42 
CFR part 430.
    These SPAs requested CMS approval to add new eligible physicians 
associated with Greenville Memorial Hospital and Palmetto Health 
Richland (since merged into a single entity, Prisma Health) to the 
current physician teaching supplemental payment methodology. 
Specifically, SPAs 16-0012-A, 17-0006-A, and 18-0011-A proposed to 
use intergovernmental transfers from the Greenville Health Authority 
to the state Medicaid Agency as the non-federal share of the 
proposed payments.\1\ The source of the transfers would be from the 
``Setoff Debt Collection Program,'' which garnishes state individual 
income tax refunds to satisfy medical debt liabilities for services 
furnished by certain providers, rather than state or local tax 
revenue as required by Section 1903(w)(6)(A) of the Social Security 
Act (the Act). The revenue collected from the Setoff Debt Collection 
Program is derived from previously uncollected patient revenue.
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    \1\ As reflected in the July 9, 2019 disapproval letter, CMS did 
not examine, or reach a conclusion with respect to, whether the 
Greenville Health Authority is a unit of government eligible to make 
an intergovernmental transfer.
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    The issues to be considered at the hearing are whether South 
Carolina SPAs 16-0012-A, 17-0006-A, and 18-0011-A are inconsistent 
with the requirements of:
     Section 1902(a)(2) of the Act, which provides that the 
state plan must assure adequate funding for the non-federal share of 
expenditures from state or local sources, such that the lack of 
adequate funds from local sources will not result in lowering the 
amount, duration, scope, or quality of care and services available 
under the plan.
     Sections 1903(a) and 1905(b) of the Act, which provide 
that states receive a statutorily determined Federal Medicaid 
Assistance Percentage (FMAP) for allowable state expenditures on 
medical assistance.
     Section 1903(w)(6)(A) of the Act, which allows States 
to use funds derived from State or local taxes, which are then 
transferred from units of government to the Medicaid Agency, as the 
non-federal share of Medicaid payments unless the transferred funds 
are derived by the unit of government from donations or taxes that 
would not otherwise be recognized as the non-federal share under 
section 1903 of the Act.
    In the event that CMS and the State come to agreement on 
resolution of the issues that formed the basis for disapproval, 
these SPAs may be moved to approval prior to the scheduled hearing.

Sincerely,

Seema Verma,

Administrator.

cc: Benjamin R. Cohen.

    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: October 4, 2019.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2019-22319 Filed 10-8-19; 4:15 pm]
BILLING CODE 4120-01-P