81_FR_5940 81 FR 5917 - State Health Insurance Assistance Program (SHIP)

81 FR 5917 - State Health Insurance Assistance Program (SHIP)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Register Volume 81, Issue 23 (February 4, 2016)

Page Range5917-5920
FR Document2016-02055

This rule implements a provision enacted by the Consolidated Appropriations Act of 2014 and reflects the transfer of the State Health Insurance Assistance Program (SHIP) from the Centers for Medicare & Medicaid Services (CMS), in the Department of Health and Human Services (HHS) to the Administration for Community Living (ACL) in HHS. The previous regulations were issued by CMS under the authority granted by the Omnibus Budget Reconciliation Act of 1990 (OBRA `90), Section 4360.

Federal Register, Volume 81 Issue 23 (Thursday, February 4, 2016)
[Federal Register Volume 81, Number 23 (Thursday, February 4, 2016)]
[Rules and Regulations]
[Pages 5917-5920]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-02055]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 403

DEPARTMENT OF HEALTH AND HUMAN SERVICES

45 CFR Part 1331

RIN 0985-AA11


State Health Insurance Assistance Program (SHIP)

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

ACTION: Interim final rule.

-----------------------------------------------------------------------

SUMMARY: This rule implements a provision enacted by the Consolidated 
Appropriations Act of 2014 and reflects the transfer of the State 
Health Insurance Assistance Program (SHIP) from the Centers for 
Medicare & Medicaid Services (CMS), in the Department of Health and 
Human Services (HHS) to the Administration for Community Living (ACL) 
in HHS. The previous regulations were issued by CMS under the authority 
granted by the Omnibus Budget Reconciliation Act of 1990 (OBRA `90), 
Section 4360.

DATES: Effective date: This interim final rule is effective on February 
4, 2016.
    Comment date: To be assured of consideration, comments must be 
received by ACL electronically through www.regulations.gov no later 
than midnight Eastern Standard Time (E.S.T.) on April 4, 2016.

ADDRESSES: You may submit comments in one of following ways (no 
duplicates, please): Written comments may be submitted through any of 
the methods specified below. Please do not submit duplicate comments.
     Federal eRulemaking Portal: You may (and we encourage you 
to) submit electronic comments on this regulation at http://www.regulations.gov. Follow the instructions under the ``submit a 
comment'' tab. Attachments should be in Microsoft Word, WordPerfect, or 
Excel; however, we prefer Microsoft Word.
     Regular, Express, or Overnight Mail: You may mail written 
comments to the following address ONLY: Administration for Community 
Living, Attention: SHIP Interim Rule, U.S. Department of Health and 
Human Services, Washington, DC 20201. Please allow sufficient time for 
mailed comments to be received before the close of the comment period.
     Individuals with a Disability: We will provide an 
appropriate accommodation, including alternative formats, upon request. 
To make such a request, please contact Marlina Moses-Gaither, (202) 
357-3552 (Voice) or at [email protected].

FOR FURTHER INFORMATION CONTACT: Josh Hodges, Administration for 
Community Living, telephone (202) 795-7364 (Voice). This is not a toll-
free number. This document will be made available in alternative 
formats upon request. Written correspondence can be sent to 
Administration for Community Living, U.S. Department of Health and 
Human Services, 330 C St. SW., Washington, DC 20201.

SUPPLEMENTARY INFORMATION:

I. Background

    The State Health Insurance Assistance Program (SHIP) was created 
under Section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 
1990 (Pub. L. 101-508). This section of the law authorized the Centers 
for Medicare & Medicaid Services (CMS) to make grants to States to 
establish and maintain health insurance advisory service programs for 
Medicare beneficiaries. Grant funds were made available to support 
information, counseling, and assistance activities relating to 
Medicare, Medicaid, and other related health insurance options such as: 
Medicare supplement insurance, long-term care insurance, managed care 
options, and other health insurance benefit information. In January 
2014, authorized in the Consolidated Appropriations Act of 2014, the 
SHIP program was transferred from CMS to the Administration for 
Community Living (ACL). This transfer reflects the existing formal and 
informal collaborations between the SHIP programs and the networks that 
ACL serves.

II. Transfer of Language and Technical Amendments

    In this interim final rule, ACL transfers all provisions of the 
existing SHIP regulations at 42 CFR part 403 subpart E, Sec. Sec.  
403.500-403.512, to a new part at 45 CFR 1331.1-1331.7, and 42 CFR part 
403 subpart E is reserved. This transfer positions the regulations 
governing the SHIP program alongside the other ACL regulations, 
reflecting the transfer of the program to ACL's administration.
    In addition, as Congress has transferred the entirety of the SHIP 
program to ACL, all references to CMS' administration of the program 
are changed in this rule to ACL.
    Finally, as HHS has promulgated new Uniform Administrative 
Requirements, Cost Principles, and Audit Requirements for HHS Awards, 
codified at 45 CFR part 75 since the previous rule's implementation, 
this rule changes a reference to previous guidance in Sec.  1331.7 
Administration.

III. Regulatory Analysis

A. Executive Order 12866

    This rule is not being treated as a ``significant regulatory 
action'' under section 3(f) of Executive Order 12866. Accordingly, the 
rule has not been reviewed by the Office of Management and Budget.

B. Regulatory Flexibility Analysis

    The Secretary certifies under 5 U.S.C. 605(b), the Regulatory 
Flexibility Act (Pub. L. 96-354), that this regulation will not have a 
significant economic impact on a substantial number of small

[[Page 5918]]

entities. The primary impact of this regulation is on entities applying 
for SHIP funding opportunities, specifically researchers, States, 
public or private agencies and organizations, institutions of higher 
education, and Indian tribes and Tribal organizations. The regulation 
does not have a significant economic impact on these entities.

C. Paperwork Reduction Act of 1995

    In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 
Ch. 3506; 5 CFR 1320 Appendix A.1) (PRA), ACL and CMS have determined 
that there are no new collections of information contained in this 
interim final rule.

D. Waiver of Proposed Rulemaking

    Under the Administrative Procedure Act (APA), ACL and CMS are 
required to publish a notice of proposed rulemaking and provide the 
public with an opportunity to comment on proposed regulations prior to 
establishing a final rule unless it is determined for good cause that 
the notice and comment procedure is impracticable, unnecessary or 
contrary to public interest. 5 U.S.C. 553(b). As noted previously, 
Congress has already transferred the SHIP program to ACL under the 
Consolidated Appropriations Act of 2014. This interim final rule makes 
no changes other than aligning the location of the regulations within 
the Federal Register with other ACL programs; amending the name of the 
administering agency to ACL; and updating a reference to new Uniform 
Administrative Requirements, Cost Principles, and Audit Requirements 
for HHS Awards, which have already undergone notice and comment 
rulemaking, therefore, there is good cause under 5 U.S.C. 553(b)(B) for 
waiving proposed rulemaking as unnecessary.

E. Waiver of Delayed Effective Date

    Agencies are required to delay the effective date of their final 
regulations by 30 days after publication, as required under 5 U.S.C. 
553(d), unless an exception under subsection (d) applies. Under 5 
U.S.C. 553(d), ACL and CMS may waive the delayed effective date 
requirement if they find good cause and explain the basis for the 
waiver in the final rulemaking document or if the regulations grant or 
recognize an exemption or relieve a restriction.
    In the present case, there is good cause to waive the delayed 
effective date for this interim final rule, because the substance of 
the regulation, other than the name of the administering agency, is 
identical to the current regulation.

F. Unfunded Mandates Reform Act

    Section 202 of the Unfunded Mandates Reform Act of 1995 requires 
that a covered agency prepare a budgetary impact statement before 
promulgating a rule that includes any Federal mandate that may result 
in expenditures by State, local, or Tribal governments, in the 
aggregate, or by the private sector, of $100 million, adjusted for 
inflation, or more in any one year. ACL and CMS have determined that 
this rule does not result in the expenditure by State, local, and 
Tribal government in the aggregate or by the private sector of more 
than $100 million in any one year.

G. Congressional Review

    This rule is not a major rule as defined in 5 U.S.C. Section 
804(2).

H. Assessment of Federal Regulations and Policies on Families

    Section 654 of the Treasury and General Government Appropriations 
Act of 1999 requires Federal agencies to determine whether a policy or 
regulation may affect family well-being. If the agency's conclusion is 
affirmative, then the agency must prepare an impact assessment 
addressing seven criteria specified in the law. These regulations do 
not have an impact on family well-being as defined in the legislation.

I. Executive Order 13132

    Executive Order 13132 on ``federalism'' was signed August 4, 1999. 
The purposes of the Order are: ``. . . to guarantee the division of 
governmental responsibilities between the national government and the 
States that was intended by the Framers of the Constitution, to ensure 
that the principles of federalism established by the Framers guide the 
executive departments and agencies in the formulation and 
implementation of policies, and to further the policies of the Unfunded 
Mandates Reform Act . . .'' Executive Order 13132 applies to actions 
with federalism implications, which are actions that have substantial 
direct effect on States, on the relationship between the Federal 
government and the States, or on the distribution of power and 
responsibilities among the various levels of government. For actions 
that have federalism implications and preempt state law or have 
federalism implications and impose substantial compliance costs on 
states and local governments, the agency must consult with state and 
local officials before publishing the rule and include a federalism 
statement in the preamble.
    The Department certifies that this rule does not have a substantial 
direct effect on States, on the relationship between the Federal 
government and the States, or on the distribution of power and 
responsibilities among the various levels of government.
    ACL and CMS are not aware of any specific state laws that would be 
preempted by the adoption of the regulation.

List of Subjects

42 CFR Part 403

    Grant programs, Health insurance, Medicare, Reporting and 
recordkeeping requirements.

45 CFR Part 1331

    Grant programs, Health insurance, Medicare, Reporting and 
recordkeeping requirements.

    Dated: December 17, 2015.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
    Dated: December 17, 2015.
Kathy Greenlee,
Administrator, Administration for Community Living.
    Approved: January 25, 2016.
Sylvia M. Burwell,
Secretary, U.S. Department of Health and Human Services.

Regulatory Text

    For the reasons discussed in the preamble, the Centers for Medicare 
& Medicaid Services, HHS, and Department of Health and Human Services 
amend title 42, chapter IV and title 45, chapter XIII, subchapter C, of 
the Code of Federal Regulations, respectively, as follows:

42 CFR CHAPTER IV

PART 403--SPECIAL PROGRAMS AND PROJECTS

0
1. The authority citation for part 403 continues to read as follows:

    Authority: 42 U.S.C. 1395b-3 and Secs. 1102 and 1871 of the 
Social Security Act (42 U.S.C. 1302 and 1395hh).

Subpart E [Removed and Reserved]

0
2. Subpart E, consisting of Sec. Sec.  403.500 through 403.512, is 
removed and reserved.

45 CFR CHAPTER XIII

0
3. Part 1331 is added to subchapter C read as follows:

PART 1331--STATE HEALTH INSURANCE ASSISTANCE PROGRAM

Sec.

[[Page 5919]]

 1331.1 Basis, scope, and definition.
 1331.2 Eligibility for grants.
 1331.3 Availability of grants.
 1331.4 Number and size of grants.
 1331.5 Limitations.
 1331.6 Reporting requirements.
 1331.7 Administration.

    Authority:  42 U.S.C. 1395b-4.


Sec.  1331.1  Basis, scope, and definition.

    (a) Basis. This part implements, in part, the provisions of section 
4360 of Public Law 101-508 by establishing a minimum level of funding 
for grants made to States for the purpose of providing information, 
counseling, and assistance relating to obtaining adequate and 
appropriate health insurance coverage to individuals eligible to 
receive benefits under the Medicare program.
    (b) Scope of part. This part sets forth the following:
    (1) Conditions of eligibility for the grant.
    (2) Minimum levels of funding for those States qualifying for the 
grants.
    (3) Reporting requirements.
    (c) Definition. For purposes of this subpart, the term ``State'' 
includes (except where otherwise indicated by the context) the 50 
States, the District of Columbia, the Commonwealth of Puerto Rico, the 
Virgin Islands, Guam, and American Samoa.


Sec.  1331.2  Eligibility for grants.

    To be eligible for a grant under this subpart, the State must have 
an approved Medicare supplemental regulatory program under section 1882 
of the Act and submit a timely application to ACL that meets the 
requirements of--
    (a) Section 4360 of Public Law 101-508 (42 U.S.C. 1395b-4);
    (b) This subpart; and
    (c) The applicable solicitation for grant applications issued by 
ACL.


Sec.  1331.3  Availability of grants.

    ACL awards grants to States subject to availability of funds, and 
if applicable, subject to the satisfactory progress in the State's 
project during the preceding grant period. The criteria by which 
progress is evaluated and the performance standards for determining 
whether satisfactory progress has been made are specified in the terms 
and conditions included in the notice of grant award sent to each 
State. ACL advises each State as to when to make application, what to 
include in the application, and provides information as to the timing 
of the grant award and the duration of the grant award. ACL also 
provides an estimate of the amount of funds that may be available to 
the State.


Sec.  1331.4  Number and size of grants.

    (a) General. For available grant funds, up to and including 
$10,000,000, grants will be made to States according to the terms and 
formula in paragraphs (b) and (c) of this section. For any available 
grant funds in excess of $10,000,000, distribution of grants will be at 
the discretion of ACL, and will be made according to criteria that ACL 
will communicate to the States via grant solicitation. ACL will provide 
information to each State as to what must be included in the 
application for grant funds. ACL awards the following type of grants:
    (1) New program grants.
    (2) Existing program enhancement grants.
    (b) Grant award. Subject to the availability of funds, each 
eligible State that submits an acceptable application receives a grant 
that includes a fixed amount (minimum funding level) and a variable 
amount.
    (1) A fixed portion is awarded to States in the following amounts:
    (i) Each of the 50 States, $75,000.
    (ii) The District of Columbia, $75,000.
    (iii) Puerto Rico, $75,000.
    (iv) American Samoa, $25,000.
    (v) Guam, $25,000.
    (vi) The Virgin Islands, $25,000.
    (2) A variable portion which is based on the number and location of 
Medicare beneficiaries residing in the State is awarded to each State. 
The variable amount a particular State receives is determined as set 
forth in paragraph (c) of this section.
    (c) Calculation of variable portion of the grant. (1) ACL bases the 
variable portion of the grant on--
    (i) The amount of available funds, and
    (ii) A comparison of each State with the average of all of the 
States (except the State being compared) with respect to three factors 
that relate to the size of the State's Medicare population and where 
that population resides.
    (2) The factors ACL uses to compare States' Medicare populations 
comprise separate components of the variable amount. These factors, and 
the extent to which they each contribute to the variable amount, are as 
follows:
    (i) Approximately 75 percent of the variable amount is based on the 
number of Medicare beneficiaries living in the State as a percentage of 
all Medicare beneficiaries nationwide.
    (ii) Approximately 10 percent of the variable amount is based on 
the percentage of the State's total population who are Medicare 
beneficiaries.
    (iii) Approximately 15 percent of the variable amount is based on 
the percentage of the State's Medicare beneficiaries that reside in 
rural areas (``rural areas'' are defined as all areas not included 
within a metropolitan Statistical Area).
    (3) Based on the foregoing four factors (that is, the amount of 
available funds and the three comparative factors), ACL determines a 
variable rate for each participating State for each grant period.
    (d) Submission of revised budget. A State that receives an amount 
of grant funds under this subpart that differs from the amount 
requested in the budget submitted with its application must submit a 
revised budget to ACL, along with its acceptance of the grant award, 
which reflects the amount awarded.


Sec.  1331.5  Limitations.

    (a) Use of grants. Except as specified in paragraph (b) of this 
section, and in the terms and conditions in the notice of grant award, 
a State that receives a grant under this subpart may use the grant for 
any reasonable expenses for planning, developing, implementing and/or 
operating the program for which the grant is made as described in the 
solicitation for application for the grant.
    (b) Maintenance of effort. A State that receives a grant to 
supplement an existing program (that is, an existing program 
enhancement grant)--
    (1) Must not use the grant to supplant funds for activities that 
were conducted immediately preceding the date of the initial award of a 
grant made under this subpart and funded through other sources 
(including in-kind contributions).
    (2) Must maintain the activities of the program at least at the 
level that those activities were conducted immediately preceding the 
initial award of a grant made under this subpart.


Sec.  1331.6  Reporting requirements.

    A State that receives a grant under this subpart must submit at 
least one annual report to ACL and any additional reports as ACL may 
prescribe in the notice of grant award. ACL advises the State of the 
requirements concerning the frequency, timing, and contents of reports 
in the notice of grant award that it sends to the State.


Sec.  1331.7  Administration.

    (a) General. Administration of grants will be in accordance with 
the provisions of this subpart, 45 CFR part 75 (``Uniform 
Administrative Requirements for Grants and Cooperative Agreements to 
State and Local Governments''), the terms of the solicitation, and the 
terms of the notice of grant award. Except for the minimum funding 
levels established by

[[Page 5920]]

Sec.  1331.4(b)(1), in the event of conflict between a provision of the 
notice of grant award, any provision of the solicitation, or of any 
regulation enumerated in 45 CFR part 75, the terms of the notice of 
grant award control.
    (b) Notice. ACL provides notice to each applicant regarding ACL's 
decision on an application for grant funding under Sec.  1331.4.
    (c) Appeal. Any applicant for a grant under this subpart has the 
right to appeal ACL's determination regarding its application. Appeal 
procedures are governed by the regulations at 45 CFR part 16 
(Procedures of the Departmental Grant Appeals Board).

[FR Doc. 2016-02055 Filed 2-3-16; 8:45 am]
BILLING CODE P



                                                                   Federal Register / Vol. 81, No. 23 / Thursday, February 4, 2016 / Rules and Regulations                                           5917

                                                  navigation position from 5 a.m. to 7                    the transfer of the State Health                      Reconciliation Act (OBRA) of 1990
                                                  p.m. from February 7, 2016 through                      Insurance Assistance Program (SHIP)                   (Pub. L. 101–508). This section of the
                                                  February 14, 2016. During this                          from the Centers for Medicare &                       law authorized the Centers for Medicare
                                                  temporary deviation, the bridge will                    Medicaid Services (CMS), in the                       & Medicaid Services (CMS) to make
                                                  operate per 33 CFR 117.5 from 7 p.m.                    Department of Health and Human                        grants to States to establish and
                                                  to 5 a.m.                                               Services (HHS) to the Administration                  maintain health insurance advisory
                                                     The James River is used by a variety                 for Community Living (ACL) in HHS.                    service programs for Medicare
                                                  of vessels including deep draft ocean-                  The previous regulations were issued by               beneficiaries. Grant funds were made
                                                  going vessels, U.S. government vessels,                 CMS under the authority granted by the                available to support information,
                                                  small commercial vessels, recreational                  Omnibus Budget Reconciliation Act of                  counseling, and assistance activities
                                                  vessels and tug and barge traffic. The                  1990 (OBRA ‘90), Section 4360.                        relating to Medicare, Medicaid, and
                                                  Coast Guard has carefully coordinated                   DATES: Effective date: This interim final             other related health insurance options
                                                  the restrictions with waterway users.                   rule is effective on February 4, 2016.                such as: Medicare supplement
                                                     Vessels able to pass through the                        Comment date: To be assured of                     insurance, long-term care insurance,
                                                  bridge in the closed position may do so                 consideration, comments must be                       managed care options, and other health
                                                  at any time. The bridge will not be able                received by ACL electronically through                insurance benefit information. In
                                                  to open for emergencies and there is no                 www.regulations.gov no later than                     January 2014, authorized in the
                                                  immediate alternate route for vessels to                midnight Eastern Standard Time (E.S.T.)               Consolidated Appropriations Act of
                                                  pass. The Coast Guard will also inform                  on April 4, 2016.                                     2014, the SHIP program was transferred
                                                  the users of the waterways through our                  ADDRESSES: You may submit comments                    from CMS to the Administration for
                                                  Local and Broadcast Notices to Mariners                 in one of following ways (no duplicates,              Community Living (ACL). This transfer
                                                  of the change in operating schedule for                 please): Written comments may be                      reflects the existing formal and informal
                                                  the bridge so that vessel operators can                 submitted through any of the methods                  collaborations between the SHIP
                                                  arrange their transit to minimize any                   specified below. Please do not submit                 programs and the networks that ACL
                                                  impact caused by the temporary                          duplicate comments.                                   serves.
                                                  deviation.                                                 • Federal eRulemaking Portal: You                  II. Transfer of Language and Technical
                                                     In accordance with 33 CFR 117.35(e),                 may (and we encourage you to) submit                  Amendments
                                                  the drawbridge must return to its regular               electronic comments on this regulation
                                                  operating schedule immediately at the                   at http://www.regulations.gov. Follow                    In this interim final rule, ACL
                                                  end of the effective period of this                     the instructions under the ‘‘submit a                 transfers all provisions of the existing
                                                  temporary deviation. This deviation                     comment’’ tab. Attachments should be                  SHIP regulations at 42 CFR part 403
                                                  from the operating regulations is                       in Microsoft Word, WordPerfect, or                    subpart E, §§ 403.500–403.512, to a new
                                                  authorized under 33 CFR 117.35.                         Excel; however, we prefer Microsoft                   part at 45 CFR 1331.1–1331.7, and 42
                                                    Dated: January 28, 2016.                              Word.                                                 CFR part 403 subpart E is reserved. This
                                                  Hal R. Pitts,                                              • Regular, Express, or Overnight Mail:             transfer positions the regulations
                                                                                                          You may mail written comments to the                  governing the SHIP program alongside
                                                  Bridge Program Manager, Fifth Coast Guard
                                                                                                          following address ONLY:                               the other ACL regulations, reflecting the
                                                  District.
                                                                                                          Administration for Community Living,                  transfer of the program to ACL’s
                                                  [FR Doc. 2016–02099 Filed 2–3–16; 8:45 am]
                                                                                                          Attention: SHIP Interim Rule, U.S.                    administration.
                                                  BILLING CODE 9110–04–P
                                                                                                          Department of Health and Human                           In addition, as Congress has
                                                                                                          Services, Washington, DC 20201. Please                transferred the entirety of the SHIP
                                                                                                          allow sufficient time for mailed                      program to ACL, all references to CMS’
                                                  DEPARTMENT OF HEALTH AND                                comments to be received before the                    administration of the program are
                                                  HUMAN SERVICES                                          close of the comment period.                          changed in this rule to ACL.
                                                  Centers for Medicare & Medicaid                            • Individuals with a Disability: We                   Finally, as HHS has promulgated new
                                                                                                          will provide an appropriate                           Uniform Administrative Requirements,
                                                  Services                                                                                                      Cost Principles, and Audit
                                                                                                          accommodation, including alternative
                                                                                                          formats, upon request. To make such a                 Requirements for HHS Awards, codified
                                                  42 CFR Part 403                                                                                               at 45 CFR part 75 since the previous
                                                                                                          request, please contact Marlina Moses-
                                                                                                          Gaither, (202) 357–3552 (Voice) or at                 rule’s implementation, this rule changes
                                                  DEPARTMENT OF HEALTH AND                                                                                      a reference to previous guidance in
                                                  HUMAN SERVICES                                          marlina.moses-gaither@acl.hhs.gov.
                                                                                                          FOR FURTHER INFORMATION CONTACT: Josh                 § 1331.7 Administration.
                                                  45 CFR Part 1331                                        Hodges, Administration for Community                  III. Regulatory Analysis
                                                                                                          Living, telephone (202) 795–7364
                                                  RIN 0985–AA11                                           (Voice). This is not a toll-free number.              A. Executive Order 12866
                                                                                                          This document will be made available                     This rule is not being treated as a
                                                  State Health Insurance Assistance
                                                                                                          in alternative formats upon request.                  ‘‘significant regulatory action’’ under
                                                  Program (SHIP)
                                                                                                          Written correspondence can be sent to                 section 3(f) of Executive Order 12866.
                                                  AGENCY:  Administration for Community                   Administration for Community Living,                  Accordingly, the rule has not been
                                                  Living (ACL), Department of Health and                  U.S. Department of Health and Human                   reviewed by the Office of Management
asabaliauskas on DSK5VPTVN1PROD with RULES




                                                  Human Services (HHS) and Centers for                    Services, 330 C St. SW., Washington, DC               and Budget.
                                                  Medicare & Medicaid Services (CMS),                     20201.
                                                                                                                                                                B. Regulatory Flexibility Analysis
                                                  HHS.                                                    SUPPLEMENTARY INFORMATION:
                                                  ACTION: Interim final rule.                                                                                     The Secretary certifies under 5 U.S.C.
                                                                                                          I. Background                                         605(b), the Regulatory Flexibility Act
                                                  SUMMARY:  This rule implements a                           The State Health Insurance Assistance              (Pub. L. 96–354), that this regulation
                                                  provision enacted by the Consolidated                   Program (SHIP) was created under                      will not have a significant economic
                                                  Appropriations Act of 2014 and reflects                 Section 4360 of the Omnibus Budget                    impact on a substantial number of small


                                             VerDate Sep<11>2014   16:15 Feb 03, 2016   Jkt 238001   PO 00000   Frm 00037   Fmt 4700   Sfmt 4700   E:\FR\FM\04FER1.SGM   04FER1


                                                  5918             Federal Register / Vol. 81, No. 23 / Thursday, February 4, 2016 / Rules and Regulations

                                                  entities. The primary impact of this                    F. Unfunded Mandates Reform Act                         The Department certifies that this rule
                                                  regulation is on entities applying for                    Section 202 of the Unfunded                         does not have a substantial direct effect
                                                  SHIP funding opportunities, specifically                Mandates Reform Act of 1995 requires                  on States, on the relationship between
                                                  researchers, States, public or private                                                                        the Federal government and the States,
                                                                                                          that a covered agency prepare a
                                                  agencies and organizations, institutions                                                                      or on the distribution of power and
                                                                                                          budgetary impact statement before
                                                  of higher education, and Indian tribes                                                                        responsibilities among the various
                                                                                                          promulgating a rule that includes any
                                                  and Tribal organizations. The regulation                                                                      levels of government.
                                                                                                          Federal mandate that may result in
                                                  does not have a significant economic                                                                            ACL and CMS are not aware of any
                                                                                                          expenditures by State, local, or Tribal
                                                  impact on these entities.                                                                                     specific state laws that would be
                                                                                                          governments, in the aggregate, or by the
                                                                                                                                                                preempted by the adoption of the
                                                  C. Paperwork Reduction Act of 1995                      private sector, of $100 million, adjusted
                                                                                                                                                                regulation.
                                                     In accordance with the Paperwork                     for inflation, or more in any one year.
                                                  Reduction Act of 1995 (44 U.S.C. Ch.                    ACL and CMS have determined that this                 List of Subjects
                                                  3506; 5 CFR 1320 Appendix A.1) (PRA),                   rule does not result in the expenditure
                                                                                                                                                                42 CFR Part 403
                                                  ACL and CMS have determined that                        by State, local, and Tribal government
                                                                                                          in the aggregate or by the private sector               Grant programs, Health insurance,
                                                  there are no new collections of
                                                                                                          of more than $100 million in any one                  Medicare, Reporting and recordkeeping
                                                  information contained in this interim
                                                                                                          year.                                                 requirements.
                                                  final rule.
                                                                                                          G. Congressional Review                               45 CFR Part 1331
                                                  D. Waiver of Proposed Rulemaking
                                                                                                            This rule is not a major rule as                      Grant programs, Health insurance,
                                                    Under the Administrative Procedure
                                                                                                          defined in 5 U.S.C. Section 804(2).                   Medicare, Reporting and recordkeeping
                                                  Act (APA), ACL and CMS are required
                                                                                                                                                                requirements.
                                                  to publish a notice of proposed                         H. Assessment of Federal Regulations
                                                  rulemaking and provide the public with                                                                          Dated: December 17, 2015.
                                                                                                          and Policies on Families
                                                  an opportunity to comment on proposed                                                                         Andrew M. Slavitt,
                                                  regulations prior to establishing a final                  Section 654 of the Treasury and                    Acting Administrator, Centers for Medicare
                                                  rule unless it is determined for good                   General Government Appropriations                     & Medicaid Services.
                                                  cause that the notice and comment                       Act of 1999 requires Federal agencies to                Dated: December 17, 2015.
                                                  procedure is impracticable, unnecessary                 determine whether a policy or                         Kathy Greenlee,
                                                  or contrary to public interest. 5 U.S.C.                regulation may affect family well-being.              Administrator, Administration for
                                                  553(b). As noted previously, Congress                   If the agency’s conclusion is affirmative,            Community Living.
                                                  has already transferred the SHIP                        then the agency must prepare an impact                  Approved: January 25, 2016.
                                                  program to ACL under the Consolidated                   assessment addressing seven criteria
                                                                                                                                                                Sylvia M. Burwell,
                                                  Appropriations Act of 2014. This                        specified in the law. These regulations
                                                                                                                                                                Secretary, U.S. Department of Health and
                                                  interim final rule makes no changes                     do not have an impact on family well-
                                                                                                                                                                Human Services.
                                                  other than aligning the location of the                 being as defined in the legislation.
                                                  regulations within the Federal Register                                                                       Regulatory Text
                                                                                                          I. Executive Order 13132
                                                  with other ACL programs; amending the                                                                            For the reasons discussed in the
                                                  name of the administering agency to                        Executive Order 13132 on                           preamble, the Centers for Medicare &
                                                  ACL; and updating a reference to new                    ‘‘federalism’’ was signed August 4,                   Medicaid Services, HHS, and
                                                  Uniform Administrative Requirements,                    1999. The purposes of the Order are:                  Department of Health and Human
                                                  Cost Principles, and Audit                              ‘‘. . . to guarantee the division of                  Services amend title 42, chapter IV and
                                                  Requirements for HHS Awards, which                      governmental responsibilities between                 title 45, chapter XIII, subchapter C, of
                                                  have already undergone notice and                       the national government and the States                the Code of Federal Regulations,
                                                  comment rulemaking, therefore, there is                 that was intended by the Framers of the               respectively, as follows:
                                                  good cause under 5 U.S.C. 553(b)(B) for                 Constitution, to ensure that the
                                                                                                          principles of federalism established by               42 CFR CHAPTER IV
                                                  waiving proposed rulemaking as
                                                  unnecessary.                                            the Framers guide the executive
                                                                                                                                                                PART 403—SPECIAL PROGRAMS AND
                                                                                                          departments and agencies in the
                                                  E. Waiver of Delayed Effective Date                                                                           PROJECTS
                                                                                                          formulation and implementation of
                                                     Agencies are required to delay the                   policies, and to further the policies of              ■ 1. The authority citation for part 403
                                                  effective date of their final regulations               the Unfunded Mandates Reform Act                      continues to read as follows:
                                                  by 30 days after publication, as required               . . .’’ Executive Order 13132 applies to
                                                                                                                                                                  Authority: 42 U.S.C. 1395b–3 and Secs.
                                                  under 5 U.S.C. 553(d), unless an                        actions with federalism implications,
                                                                                                                                                                1102 and 1871 of the Social Security Act (42
                                                  exception under subsection (d) applies.                 which are actions that have substantial               U.S.C. 1302 and 1395hh).
                                                  Under 5 U.S.C. 553(d), ACL and CMS                      direct effect on States, on the
                                                  may waive the delayed effective date                    relationship between the Federal                      Subpart E [Removed and Reserved]
                                                  requirement if they find good cause and                 government and the States, or on the
                                                  explain the basis for the waiver in the                 distribution of power and                             ■ 2. Subpart E, consisting of §§ 403.500
                                                  final rulemaking document or if the                     responsibilities among the various                    through 403.512, is removed and
                                                  regulations grant or recognize an                       levels of government. For actions that                reserved.
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                                                  exemption or relieve a restriction.                     have federalism implications and                      45 CFR CHAPTER XIII
                                                     In the present case, there is good                   preempt state law or have federalism
                                                  cause to waive the delayed effective                    implications and impose substantial                   ■ 3. Part 1331 is added to subchapter C
                                                  date for this interim final rule, because               compliance costs on states and local                  read as follows:
                                                  the substance of the regulation, other                  governments, the agency must consult                  PART 1331—STATE HEALTH
                                                  than the name of the administering                      with state and local officials before                 INSURANCE ASSISTANCE PROGRAM
                                                  agency, is identical to the current                     publishing the rule and include a
                                                  regulation.                                             federalism statement in the preamble.                 Sec.



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                                                                   Federal Register / Vol. 81, No. 23 / Thursday, February 4, 2016 / Rules and Regulations                                           5919

                                                   1331.1    Basis, scope, and definition.                § 1331.4    Number and size of grants.                beneficiaries that reside in rural areas
                                                   1331.2    Eligibility for grants.                        (a) General. For available grant funds,             (‘‘rural areas’’ are defined as all areas
                                                   1331.3    Availability of grants.                      up to and including $10,000,000, grants               not included within a metropolitan
                                                   1331.4    Number and size of grants.
                                                                                                          will be made to States according to the               Statistical Area).
                                                   1331.5    Limitations.
                                                   1331.6    Reporting requirements.                      terms and formula in paragraphs (b) and                  (3) Based on the foregoing four factors
                                                   1331.7    Administration.                              (c) of this section. For any available                (that is, the amount of available funds
                                                                                                          grant funds in excess of $10,000,000,                 and the three comparative factors), ACL
                                                     Authority: 42 U.S.C. 1395b–4.                                                                              determines a variable rate for each
                                                                                                          distribution of grants will be at the
                                                  § 1331.1    Basis, scope, and definition.               discretion of ACL, and will be made                   participating State for each grant period.
                                                    (a) Basis. This part implements, in                   according to criteria that ACL will                      (d) Submission of revised budget. A
                                                  part, the provisions of section 4360 of                 communicate to the States via grant                   State that receives an amount of grant
                                                  Public Law 101–508 by establishing a                    solicitation. ACL will provide                        funds under this subpart that differs
                                                  minimum level of funding for grants                     information to each State as to what                  from the amount requested in the
                                                  made to States for the purpose of                       must be included in the application for               budget submitted with its application
                                                  providing information, counseling, and                  grant funds. ACL awards the following                 must submit a revised budget to ACL,
                                                  assistance relating to obtaining adequate               type of grants:                                       along with its acceptance of the grant
                                                  and appropriate health insurance                           (1) New program grants.                            award, which reflects the amount
                                                  coverage to individuals eligible to                        (2) Existing program enhancement                   awarded.
                                                  receive benefits under the Medicare                     grants.
                                                                                                             (b) Grant award. Subject to the                    § 1331.5   Limitations.
                                                  program.                                                                                                        (a) Use of grants. Except as specified
                                                    (b) Scope of part. This part sets forth               availability of funds, each eligible State
                                                                                                          that submits an acceptable application                in paragraph (b) of this section, and in
                                                  the following:
                                                    (1) Conditions of eligibility for the                 receives a grant that includes a fixed                the terms and conditions in the notice
                                                  grant.                                                  amount (minimum funding level) and a                  of grant award, a State that receives a
                                                    (2) Minimum levels of funding for                     variable amount.                                      grant under this subpart may use the
                                                  those States qualifying for the grants.                    (1) A fixed portion is awarded to                  grant for any reasonable expenses for
                                                    (3) Reporting requirements.                           States in the following amounts:                      planning, developing, implementing
                                                    (c) Definition. For purposes of this                     (i) Each of the 50 States, $75,000.                and/or operating the program for which
                                                  subpart, the term ‘‘State’’ includes                       (ii) The District of Columbia, $75,000.            the grant is made as described in the
                                                  (except where otherwise indicated by                       (iii) Puerto Rico, $75,000.                        solicitation for application for the grant.
                                                  the context) the 50 States, the District of                (iv) American Samoa, $25,000.                        (b) Maintenance of effort. A State that
                                                  Columbia, the Commonwealth of Puerto                       (v) Guam, $25,000.                                 receives a grant to supplement an
                                                  Rico, the Virgin Islands, Guam, and                        (vi) The Virgin Islands, $25,000.                  existing program (that is, an existing
                                                  American Samoa.                                            (2) A variable portion which is based              program enhancement grant)—
                                                                                                          on the number and location of Medicare                  (1) Must not use the grant to supplant
                                                  § 1331.2    Eligibility for grants.                     beneficiaries residing in the State is                funds for activities that were conducted
                                                    To be eligible for a grant under this                 awarded to each State. The variable                   immediately preceding the date of the
                                                  subpart, the State must have an                         amount a particular State receives is                 initial award of a grant made under this
                                                  approved Medicare supplemental                          determined as set forth in paragraph (c)              subpart and funded through other
                                                  regulatory program under section 1882                   of this section.                                      sources (including in-kind
                                                  of the Act and submit a timely                             (c) Calculation of variable portion of             contributions).
                                                  application to ACL that meets the                       the grant. (1) ACL bases the variable                   (2) Must maintain the activities of the
                                                  requirements of—                                        portion of the grant on—                              program at least at the level that those
                                                    (a) Section 4360 of Public Law 101–                      (i) The amount of available funds, and             activities were conducted immediately
                                                  508 (42 U.S.C. 1395b–4);                                   (ii) A comparison of each State with               preceding the initial award of a grant
                                                    (b) This subpart; and                                 the average of all of the States (except              made under this subpart.
                                                    (c) The applicable solicitation for                   the State being compared) with respect
                                                  grant applications issued by ACL.                       to three factors that relate to the size of           § 1331.6   Reporting requirements.
                                                                                                          the State’s Medicare population and                      A State that receives a grant under
                                                  § 1331.3    Availability of grants.                     where that population resides.                        this subpart must submit at least one
                                                    ACL awards grants to States subject to                   (2) The factors ACL uses to compare                annual report to ACL and any additional
                                                  availability of funds, and if applicable,               States’ Medicare populations comprise                 reports as ACL may prescribe in the
                                                  subject to the satisfactory progress in the             separate components of the variable                   notice of grant award. ACL advises the
                                                  State’s project during the preceding                    amount. These factors, and the extent to              State of the requirements concerning the
                                                  grant period. The criteria by which                     which they each contribute to the                     frequency, timing, and contents of
                                                  progress is evaluated and the                           variable amount, are as follows:                      reports in the notice of grant award that
                                                  performance standards for determining                      (i) Approximately 75 percent of the                it sends to the State.
                                                  whether satisfactory progress has been                  variable amount is based on the number
                                                  made are specified in the terms and                     of Medicare beneficiaries living in the               § 1331.7   Administration.
                                                  conditions included in the notice of                    State as a percentage of all Medicare                   (a) General. Administration of grants
                                                  grant award sent to each State. ACL                     beneficiaries nationwide.                             will be in accordance with the
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                                                  advises each State as to when to make                      (ii) Approximately 10 percent of the               provisions of this subpart, 45 CFR part
                                                  application, what to include in the                     variable amount is based on the                       75 (‘‘Uniform Administrative
                                                  application, and provides information                   percentage of the State’s total                       Requirements for Grants and
                                                  as to the timing of the grant award and                 population who are Medicare                           Cooperative Agreements to State and
                                                  the duration of the grant award. ACL                    beneficiaries.                                        Local Governments’’), the terms of the
                                                  also provides an estimate of the amount                    (iii) Approximately 15 percent of the              solicitation, and the terms of the notice
                                                  of funds that may be available to the                   variable amount is based on the                       of grant award. Except for the minimum
                                                  State.                                                  percentage of the State’s Medicare                    funding levels established by


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                                                  5920             Federal Register / Vol. 81, No. 23 / Thursday, February 4, 2016 / Rules and Regulations

                                                  § 1331.4(b)(1), in the event of conflict                2016, OMB approved the information                       Estimated Time per Response: 120
                                                  between a provision of the notice of                    collection requirements contained in the              hours.
                                                  grant award, any provision of the                       Commission’s Report and Order, FCC                       Frequency of Response: One-time,
                                                  solicitation, or of any regulation                      15–70, published at 80 FR 66454,                      biennial and on-going reporting
                                                  enumerated in 45 CFR part 75, the terms                 October 29, 2015. The OMB Control                     requirements.
                                                  of the notice of grant award control.                   Number is 3060–1214. The Commission
                                                     (b) Notice. ACL provides notice to                   publishes this notice as an                              Obligation to Respond: Voluntary.
                                                  each applicant regarding ACL’s decision                 announcement of the effective date of                 The statutory authority for this
                                                  on an application for grant funding                     the rules. If you have any comments on                information collection is contained in
                                                  under § 1331.4.                                         the burden estimates listed below, or                 47 U.S.C. 251(e)(1).
                                                     (c) Appeal. Any applicant for a grant                how the Commission can improve the                       Total Annual Burden: 1,560 hours.
                                                  under this subpart has the right to                     collections and reduce any burdens
                                                  appeal ACL’s determination regarding                                                                             Total Annual Cost: No cost.
                                                                                                          caused thereby, please contact Cathy
                                                  its application. Appeal procedures are                  Williams, Federal Communications                         Nature and Extent of Confidentiality:
                                                  governed by the regulations at 45 CFR                   Commission, Room 1–C823, 445 12th                     If respondents submit information
                                                  part 16 (Procedures of the Departmental                 Street SW., Washington, DC 20554.                     which respondents believe is
                                                  Grant Appeals Board).                                   Please include the OMB Control                        confidential, respondents may request
                                                  [FR Doc. 2016–02055 Filed 2–3–16; 8:45 am]              Number, 3060–1214, in your                            confidential treatment of such
                                                  BILLING CODE P                                          correspondence. The Commission will                   information pursuant to section 0.459 of
                                                                                                          also accept your comments via email at                the Communication’s rules, 47 CFR
                                                                                                          PRA@fcc.gov.                                          0.459.
                                                  FEDERAL COMMUNICATIONS                                    To request materials in accessible
                                                                                                                                                                   Privacy Act: No impact(s).
                                                  COMMISSION                                              formats for people with disabilities
                                                                                                          (Braille, large print, electronic files,                 Needs and Uses: June 18, 2015, the
                                                  47 CFR Part 52                                          audio format), send an email to fcc504@               Commission adopted a Report and
                                                                                                          fcc.gov or call the Consumer and                      Order establishing the Numbering
                                                  [WC Docket Nos. 13–97, 04–36, 07–243, 10–               Governmental Affairs Bureau at (202)                  Authorization Application process,
                                                  90 and CC Docket No. 95–116, 01–92, and
                                                                                                          418–0530 (voice), (202) 418–0432                      which allows interconnected VoIP
                                                  99–200; FCC 15–70]
                                                                                                          (TTY).                                                providers to apply for a blanket
                                                  Numbering Policies for Modern                           Synopsis                                              authorization from the FCC that, once
                                                  Communications, IP-Enabled Services,                                                                          granted, will allow them to demonstrate
                                                  Telephone Number Requirements for                          As required by the Paperwork                       that they have the authority to provide
                                                  IP-Enabled, Services Providers,                         Reduction Act of 1995 (44 U.S.C. 3507),               service in specific areas, thus enabling
                                                  Telephone Number Portability et al.                     the FCC is notifying the public that it               them to request numbers directly from
                                                                                                          received final OMB approval on January                the Numbering Administrators. This
                                                  AGENCY:   Federal Communications                        5, 2016, for the information collection
                                                                                                                                                                collection covers the information and
                                                  Commission.                                             requirements contained in the
                                                                                                                                                                certifications that applicants must
                                                  ACTION: Final rule; announcement of                     modifications to the Commission’s rules
                                                                                                                                                                submit in order to comply with the
                                                  effective date.                                         in 47 CFR 52.15(g)(2)–(g)(3).
                                                                                                             Under 5 CFR part 1320, an agency                   Numbering Authorization Application
                                                  SUMMARY:   In this document, the                        may not conduct or sponsor a collection               process. The data, information, and
                                                  Commission announces that the Office                    of information unless it displays a                   documents acquired through this
                                                  of Management and Budget (OMB) has                      current, valid OMB Control Number.                    collection will allow interconnected
                                                  approved, for a period of three years, the                 No person shall be subject to any                  VoIP providers to obtain numbers with
                                                  information collection associated with                  penalty for failing to comply with a                  minimal burden or delay while also
                                                  the Commission’s Report and Order                       collection of information subject to the              preventing providers from obtaining
                                                  establishing rules for an authorization                 Paperwork Reduction Act that does not                 numbers without first demonstrating
                                                  process to enable interconnected VoIP                   display a current, valid OMB Control                  that they can deploy and properly
                                                  providers that choose direct access to                  Number. The OMB Control Number is                     utilize such resources. This information
                                                  request numbers directly from the                       3060–1214.                                            will also help the Federal
                                                  Numbering Administrators. This                             The foregoing notice is required by                Communications Commission (FCC)
                                                  document is consistent with the Report                  the Paperwork Reduction Act of 1995,                  protect against number exhaust while
                                                  and Order, which stated that the                        Public Law 104–13, October 1, 1995,                   promoting competitive neutrality among
                                                  Commission would publish a document                     and 44 U.S.C. 3507.                                   traditional telecommunications carriers
                                                  in the Federal Register announcing                         The total annual reporting burdens                 and interconnected VoIP providers by
                                                  OMB approval and the effective date of                  and costs for the respondents are as
                                                                                                                                                                allowing both entities to obtain numbers
                                                  those rules.                                            follows:
                                                                                                                                                                directly from the Numbering
                                                  DATES: The amendments to 47 CFR                            OMB Control Number: 3060–1214.
                                                                                                             OMB Approval Date: January 5, 2016.                Administrators. It will further help the
                                                  52.15(g)(2) and (g)(3) published at 80 FR                                                                     FCC to maintain efficient utilization of
                                                  66454, October 29, 2015, are effective                     OMB Expiration Date: January 31,
                                                                                                          2019.                                                 numbering resources and ensure that
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                                                  February 4, 2016.                                                                                             telephone numbers are not being
                                                                                                             Title: Direct Access to Numbers
                                                  FOR FURTHER INFORMATION CONTACT:                        Orders, FCC 15–70 Conditions.                         stranded.
                                                  Marilyn Jones, Competition Policy                          Form Number: N/A.                                  Federal Communications Commission.
                                                  Division, Wireline Competition Bureau,                     Respondents: Business or other for-
                                                  at (202) 418–1580, or email:                                                                                  Marlene H. Dortch,
                                                                                                          profit entities.
                                                  marilyn.jones@fcc.gov.                                     Number of Respondents and                          Secretary.
                                                  SUPPLEMENTARY INFORMATION: This                         Responses: 13 respondents; 13                         [FR Doc. 2016–02013 Filed 2–3–16; 8:45 am]
                                                  document announces that, on January 5,                  responses.                                            BILLING CODE 6712–01–P




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Document Created: 2016-02-04 00:31:01
Document Modified: 2016-02-04 00:31:01
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionInterim final rule.
ContactJosh Hodges, Administration for Community Living, telephone (202) 795-7364 (Voice). This is not a toll- free number. This document will be made available in alternative formats upon request. Written correspondence can be sent to Administration for Community Living, U.S. Department of Health and Human Services, 330 C St. SW., Washington, DC 20201.
FR Citation81 FR 5917 
RIN Number0985-AA11
CFR Citation42 CFR 403
45 CFR 1331
CFR AssociatedGrant Programs; Health Insurance; Medicare and Reporting and Recordkeeping Requirements

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