[Federal Register Volume 89, Number 121 (Monday, June 24, 2024)]
[Rules and Regulations]
[Pages 52389-52391]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-13712]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 430, 438, and 457

[CMS-2439-CN]
RIN 0938-AU99


Medicaid Program; Medicaid and Children's Health Insurance 
Program (CHIP) Managed Care Access, Finance, and Quality; Correction

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

ACTION: Final rule; correction.

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SUMMARY: This document corrects typographical errors in the final rule 
that appeared in the May 10, 2024 Federal Register, entitled ``Medicaid 
Program; Medicaid and Children's Health Insurance Program (CHIP) 
Managed Care Access, Finance, and Quality (referred to hereafter as the 
``Managed Care final rule''). The effective date of the Managed Care 
final rule is July 9, 2024.

DATES: This document is effective July 9, 2024.

FOR FURTHER INFORMATION CONTACT: 
    Rebecca Burch Mack, (303) 844-7355, Medicaid Managed Care.
    Laura Snyder, (410) 786-3198, Medicaid Managed Care State Directed 
Payments.
    Alex Loizias, (410) 786-2435, Medicaid Managed Care State Directed 
Payments and In Lieu of Services and Settings.
    Elizabeth Jones, (410) 786-7111, Medicaid Medical Loss Ratio.
    Jamie Rollin, (410) 786-0978, Medicaid Managed Care Program 
Integrity.
    Rachel Chappell, (410) 786-3100, and Emily Shockley, (410) 786-
3100, Contract Requirements for Overpayments.
    Carlye Burd, (720) 853-2780, Medicaid Managed Care Quality.
    Amanda Paige Burns, (410) 786-8030, Medicaid Quality Rating System.
    Joshua Bougie, (410) 786-8117, and Chanelle Parkar, (667) 290-8798, 
CHIP.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2024-08085 of May 10, 2024 (89 FR 41002), there were 
typographical errors that are identified and corrected in this 
correcting document. These corrections are effective as if they had 
been included in the Managed Care final rule. Accordingly, the 
corrections are effective July 9, 2024.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 41003, Table 1: Applicability Dates,
    a. We made a typographical error in the applicability date for 
Sec. Sec.  438.6(c)(2)(vi)(C)(3) and (4); 438.6(c)(2)(viii); 
438.6(c)(5)(i) through (iv); 438.10(c)(3); 438.68(d)(1)(iii); 
438.68(d)(2); 438.207(b)(3) and (d)(2); 438.602(g)(5)-(13); 457.1207 
(transparency provisions); 457.1218 (network adequacy standards); 
457.1230(b); 457.1285 (transparency) by omitting a space between the 
words ``after'' and ``July.''
    b. We used wording in the applicability date for Sec.  438.6(c)(4) 
that did not match the applicability date in regulation text.
    On page 41004, Table 1, Applicability Dates, we made a 
typographical error in the applicability date for Sec. Sec.  
438.505(a)(1); 457.1240(d) by not deleting the placeholder for the 
effective date and inserting the actual date.
    On page 41119, we made a punctuation error in ``State directed 
payment-'' by not deleting the unnecessary hyphen.
    On page 41123,
    a. We made a typographical error in the phrase ``has standardized 
process'' by omitting an ``a''.
    b. We made a typographical error in the phrase ``specific MLR 
report'' by omitting an ``s''.
    On page 41130, we made a typographical error and omitted ``of the 
final rule.''.
    On page 41139, we made a typographical error by omitting ``of'' 
before ``an overpayment''.
    On page 41168, we inadvertently used semicolons instead of periods 
in the sentence referencing Sec.  438.16(e)(2)(iii)(A), (B), and (C); 
used a colon after ``approval;'' included ``or'' before ``(C);'' and 
omitted a space between ``paragraph'' and ``(e)''.
    On page 41245, we made a typographical error by inadvertently 
including ``private sector'' and omitting ``State'' when referencing 
the last annual burden in Estimate 13 for Medicaid and quality rating 
system measure collection. We also inadvertently omitted the CHIP 
burden estimates at the end of the paragraph.
    On page 41254, in Table 6, Summary of CHIP Requirements and Burden, 
we made a typographical error by inadvertently excluding a CHIP-
specific entry for ``457.1240(d) QRS optional methodology 
implementation extension''.

[[Page 52390]]

    On page 41255, in Table 6, Summary of CHIP Requirements and Burden, 
the figures in the ``Total'' entry are incorrect.
    On page 41256, in Table 7, Summary of Medicaid and CHIP 
Requirements and Burden, the figures in the ``CHIP'' and the ``Total'' 
entries are incorrect.

B. Summary of Errors in the Regulation Text

    On page 41274, in the regulation text for Sec.  
438.16(e)(2)(iii)(A), we inadvertently included a semicolon at the end 
of this paragraph.
    On page 41281, in the regulation text for Sec.  438.515(b)(1), we 
inadvertently included a close parenthesis at the end of this 
paragraph.

III. Waiver of Proposed Rulemaking

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (the 
APA), the agency is required to publish a notice of the proposed rule 
in the Federal Register before the provisions of a rule take effect. In 
addition, section 553(d) of the APA mandates a 30-day delay in 
effective date after issuance or publication of a substantive rule. 
Sections 553(b)(B) and 553(d)(3) of the APA provide for exceptions from 
the APA notice and comment, and delay in effective date requirements. 
Section 553(b)(B) of the APA authorizes an agency to dispense with 
normal notice and comment rulemaking procedures for good cause if the 
agency makes a finding that the notice and comment process is 
impracticable, unnecessary, or contrary to the public interest, and 
includes a statement of the finding and the reasons for it in the rule. 
Similarly, section 553(d)(3) of the APA allows the agency to avoid the 
30-day delay in effective date where good cause is found and the agency 
includes in the rule a statement of the finding and the reasons for it. 
In our view, this correcting document does not constitute a rulemaking 
that would be subject to these requirements.
    This document merely corrects technical errors in the Managed Care 
final rule. The corrections contained in this document are consistent 
with, and do not make substantive changes to, the policies that were 
proposed, subject to notice and comment procedures, and adopted in the 
Managed Care final rule. As a result, the corrections made through this 
correcting document are intended to resolve inadvertent errors so that 
the rule accurately reflects the policies adopted in the final rule. 
Even if this were a rulemaking to which the notice and comment and 
delayed effective date requirements applied, we find that there is good 
cause to waive such requirements. Undertaking further notice and 
comment procedures to incorporate the corrections in this document into 
the Managed Care final rule or delaying the effective date of the 
corrections would be contrary to the public interest because it is in 
the public interest to ensure that the rule accurately reflects our 
policies as of the date they take effect. Further, such procedures 
would be unnecessary because we are not making any substantive 
revisions to the final rule, but rather, we are simply correcting the 
Federal Register document to reflect the policies that we previously 
proposed, received public comment on, and subsequently finalized in the 
final rule. For these reasons, we believe there is good cause to waive 
the requirements for notice and comment and delay in effective date.

Corrections

    In FR Doc. 2024-08085 appearing on page 41002 in the Federal 
Register of Friday, May 10, 2024, make the following corrections:
Correction of Errors in the Preamble
    1. On page 41003, in Table 1: Applicability Dates,
    a. Row 7, second column, the sentence that reads ``Applicable for 
the first rating period beginning on or afterJuly 9, 2026.'' is 
corrected to read ``Applicable for the first rating period beginning on 
or after July 9, 2026.''.
    b. Row 13, second column, the sentence that reads ``Applicable by 
the first rating period beginning on or after the release of reporting 
instructions.'' is corrected to read ``Applicable by the first rating 
period beginning on or after the date specified in the T-MSIS reporting 
instructions released by CMS.''.
    2. On page 41004, Table 1: Applicability Dates, row 2, second 
column, the sentence that reads ``Applicable by the end of the fourth 
calendar year following [inset the effective date of the final rule].'' 
is corrected to read ``Applicable by the end of the fourth calendar 
year following July 9, 2024.''.
    3. On page 41119, second column, last full paragraph, line 12, the 
phrase that reads ``State directed payment-'' is corrected to read 
``State directed payment''.
    4. On page 41123,
    a. Beginning in the first column, last full paragraph, line 12 and 
continuing to the second column, lines 1 through 5, the sentence that 
reads ``Currently CMS has standardized process that reviews T-MSIS data 
needs, proposes revisions to the T-MSIS submission file format(s), and 
provides opportunity for States' review and comment.'' is corrected to 
read ``Currently CMS has a standardized process that reviews T-MSIS 
data needs, proposes revisions to the T-MSIS submission file format(s), 
and provides opportunity for States' review and comment.''
    b. Second column, first partial paragraph, lines 36 through 41, the 
sentence that reads ``We are not finalizing proposed Sec. Sec.  
438.8(k)(1)(xiv) through (xvi) or Sec.  438.74(a)(3) through (4) to 
require SDP line-level reporting in the State summary and managed care 
plan specific MLR report.'' is corrected to read ``We are not 
finalizing proposed Sec. Sec.  438.8(k)(1)(xiv) through (xvi) or Sec.  
438.74(a)(3) through (4) to require SDP line-level reporting in the 
State summary and managed care plan specific MLR reports.''
    5. On page 41130, second column, first partial paragraph, lines 17 
through 24, the sentence that reads ``We are finalizing the effective 
date for this provision as the first rating period beginning on or 
after 1 year after the effective date for the provider incentive 
changes in Sec. Sec.  438.3(i), 438.608(e), and the existing cross-
references at Sec.  457.1200(d) for separate CHIP.'' is corrected to 
read ``We are finalizing the effective date for this provision as the 
first rating period beginning on or after 1 year after the effective 
date of the final rule for the provider incentive changes in Sec. Sec.  
438.3(i), 438.608(e), and the existing cross-references at Sec.  
457.1200(d) for separate CHIP.''
    6. On page 41139, second column, second paragraph, lines 9 through 
13, the sentence that reads ``We are instead finalizing in revised 
Sec.  438.608(a)(2) that States require managed care plans to define 
``prompt'' as within 30 calendar days of identifying or recovery an 
overpayment.'' is corrected to read ``We are instead finalizing in 
revised Sec.  438.608(a)(2) that States require managed care plans to 
define ``prompt'' as within 30 calendar days of identifying or recovery 
of an overpayment.''.
    7. On page 41168, first column, first partial paragraph, lines 16 
through 29, the sentence that reads `` ``Within 30 calendar days of 
receipt of a notice described in paragraph(e)(2)(iii)(A), (B) or (C) of 
this section, the State must submit an ILOS transition plan to CMS for 
review and approval: (A) The notice the State provides to an MCO, PIHP, 
or PAHP of its decision to terminate an ILOS; (B) The notice an MCO, 
PIHP, or PAHP provides to the State of its decision to cease offering 
an ILOS to its enrollees; or (C) The notice CMS provides to the State 
of its decision to

[[Page 52391]]

require the State to terminate an ILOS.'' '' is corrected to read `` 
``Within 30 calendar days of receipt of a notice described in paragraph 
(e)(2)(iii)(A), (B) or (C) of this section, the State must submit an 
ILOS transition plan to CMS for review and approval. (A) The notice the 
State provides to an MCO, PIHP, or PAHP of its decision to terminate an 
ILOS. (B) The notice an MCO, PIHP, or PAHP provides to the State of its 
decision to cease offering an ILOS to its enrollees. (C) The notice CMS 
provides to the State of its decision to require the State to terminate 
an ILOS.'' ''
    8. On page 41245, third column, first partial paragraph, lines 10 
through 14, the sentence that reads ``In aggregate for Medicaid, we 
estimate an annual private sector burden of 168 hours (7 States x 24 
hr) at a cost of $19,848 (168 hr x $118.14/hr).'' is corrected to read 
``In aggregate for Medicaid, we estimate an annual State burden of 168 
hours (7 States x 24 hr) at a cost of $19,848 (168 hr x $118.14/hr). In 
aggregate for CHIP, we estimate an annual State burden of 168 hours (7 
States x 24 hr) at a cost of $19,848 (168 hr x $118.14/hr).''.
    9. On page 41254, Table 6, Summary of CHIP Requirements and Burden, 
is corrected by adding the following entry directly above the entry for 
``457.1240(d) QRS website display yearly maintenance'':

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                                                                                         Total No.   Time per                                                             Annualized
  Regulatory section in Title 42 of   OMB control number (CMS   Number of respondents       of       response   Total time  Labor rate  Total cost        Frequency          time     Annualized
               the CFR                        ID No.)                                    responses    (hours)     (hours)     ($/hr)        ($)                             (hours)    cost ($)
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457.1240(d) QRS optional methodology  0938-1282 (CMS-10554)..  7 States...............          24           1         168      118.14      19,848  Annual..............         n/a         n/a
 implementation extension.
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    10. On page 41255, in Table 6, Summary of CHIP Requirements and 
Burden, row 3, the ``Total'' entry is corrected to read as follows:

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                                                                              Total No.                                                                                   Annualized
 Regulatory section in Title 42    OMB control number        Number of           of      Time per response  Total time  Labor rate ($/hr)  Total cost      Frequency         time     Annualized
           of the CFR                 (CMS ID No.)          respondents       responses       (hours)         (hours)                          ($)                          (hours)    cost ($)
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Total...........................  ...................  Varies..............       3,583  Varies...........     350,569  Varies...........  32,620,743  Varies...........      37,329   3,759,381
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    11. On page 41256, in Table 7, Summary of Medicaid and CHIP 
Requirements and Burden, rows 3 and 4, the ``CHIP'' and the ``Total'' 
entries are corrected to read as follows:

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                                                                              Total No.                                                                                   Annualized
                                   OMB control number        Number of           of      Time per response  Total time  Labor rate ($/hr)   Total cost      Frequency        time     Annualized
                                      (CMS ID No.)          respondents       responses       (hours)         (hours)                          ($)                          (hours)    cost ($)
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CHIP............................  0938-1282 (CMS-      Varies..............       3,583  Varies...........     350,569  Varies...........   32,620,743  Varies..........      37,329   3,759,381
                                   10554).
    Total.......................  ...................  Varies..............      22,539  Varies...........   1,880,524  Varies...........  168,966,977  Varies..........     112,542  10,889,606
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B. Correction of Errors in the Regulation Text


Sec.  438.16   [Corrected]

0
1. On page 41274, third column, last paragraph, the regulation text for 
Sec.  438.16(e)(2)(iii)(A), lines 1 through 3, the sentence that reads 
``(A) The notice the State provides to an MCO, PIHP, or PAHP of its 
decision to terminate an ILOS;'' is corrected to read ``(A) The notice 
the State provides to an MCO, PIHP, or PAHP of its decision to 
terminate an ILOS.''.


Sec.  438.515   [Corrected]

0
2. On page 41281, third column, second full paragraph, the regulation 
text for Sec.  438.515(b)(1), lines 1 through 12, the sentence that 
reads ``(1) Include data for all enrollees who receive coverage through 
the managed care plan for a service or action for which data are 
necessary to calculate the quality rating for the managed care plan 
including Medicaid FFS and Medicare data for enrollees who receive 
Medicaid benefits for the State through FFS and managed care, are 
dually eligible for both Medicare and Medicaid and receive full 
benefits from Medicaid, or both).'' is corrected to read ``(1) Include 
data for all enrollees who receive coverage through the managed care 
plan for a service or action for which data are necessary to calculate 
the quality rating for the managed care plan including Medicaid FFS and 
Medicare data for enrollees who receive Medicaid benefits for the State 
through FFS and managed care, are dually eligible for both Medicare and 
Medicaid and receive full benefits from Medicaid, or both.''.

Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2024-13712 Filed 6-21-24; 8:45 am]
BILLING CODE 4120-01-P