82_FR_55606 82 FR 55383 - Federal Matching Shares for Medicaid, the Children's Health Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 1, 2018 Through September 30, 2019

82 FR 55383 - Federal Matching Shares for Medicaid, the Children's Health Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 1, 2018 Through September 30, 2019

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Register Volume 82, Issue 223 (November 21, 2017)

Page Range55383-55386
FR Document2017-24953

Federal Register, Volume 82 Issue 223 (Tuesday, November 21, 2017)
[Federal Register Volume 82, Number 223 (Tuesday, November 21, 2017)]
[Notices]
[Pages 55383-55386]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-24953]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Federal Matching Shares for Medicaid, the Children's Health 
Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons 
for October 1, 2018 Through September 30, 2019

AGENCY: Office of the Secretary, DHHS.

ACTION: Notice.

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

DATES: The percentages listed in Table 1 will be effective for each of 
the four quarter-year periods beginning October 1, 2018 and ending 
September 30, 2019.

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

SUPPLEMENTARY INFORMATION: The Federal Medical Assistance Percentages 
(FMAP), Enhanced Federal Medical Assistance Percentages (eFMAP), and 
disaster-recovery FMAP adjustments for Fiscal Year 2019 have been 
calculated pursuant to the Social Security Act (the Act). These 
percentages will be effective from October 1, 2018 through September 
30, 2019. This notice announces the calculated FMAP rates, in 
accordance with sections 1101(a)(8) and 1905(b) of the Act, that the 
U.S. Department of Health and Human Services (HHS) will use in 
determining the amount of federal matching for state medical assistance 
(Medicaid), Temporary Assistance for Needy Families (TANF) Contingency 
Funds, Child Support Enforcement collections, Child Care Mandatory and 
Matching Funds of the Child Care and Development Fund, Title IV-E 
Foster Care Maintenance payments, Adoption Assistance payments and 
Kinship Guardianship Assistance payments, and the eFMAP rates for the 
Children's Health Insurance Program (CHIP) expenditures. Table 1 gives 
figures for each of the 50 states, the District of Columbia, Puerto 
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of 
the Northern Mariana Islands. This notice reminds states of available 
disaster-recovery FMAP adjustments for qualifying states, and 
adjustments available for states meeting requirements for negative 
growth in total state personal income. At this time, no states qualify 
for such adjustments.
    This notice also contains the increased eFMAPs for CHIP as 
authorized under the Patient Protection and Affordable Care Act (PPACA) 
for fiscal years 2016 through 2019 (October 1, 2015 through September 
30, 2019).
    Programs under title XIX of the Act exist in each jurisdiction. 
Programs under titles I, X, and XIV operate only in Guam and the Virgin 
Islands. The percentages in this notice apply to state expenditures for 
most medical assistance and child health assistance, and assistance 
payments for certain social services. The Act provides

[[Page 55384]]

separately for federal matching of administrative costs. Sections 
1905(b) and 1101(a)(8)(B) of the Social Security Act (the Act) require 
the Secretary of HHS to publish the FMAP rates each year. The Secretary 
calculates the percentages, using formulas in sections 1905(b) and 
1101(a)(8), and calculations by the Department of Commerce of average 
income per person in each state and for the Nation as a whole. The 
percentages must fall within the upper and lower limits specified in 
section 1905(b) of the Act. The percentages for the District of 
Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and 
the Northern Mariana Islands are specified in statute, and thus are not 
based on the statutory formula that determines the percentages for the 
50 states.

Federal Medical Assistance Percentage (FMAP)

    Section 1905(b) of the Act specifies the formula for calculating 
FMAPs as follows:

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

Section 4725(b) of the Balanced Budget Act of 1997 amended section 
1905(b) to provide that the FMAP for the District of Columbia for 
purposes of titles XIX and XXI shall be 70 percent. For the District of 
Columbia, we note under Table 1 that other rates may apply in certain 
other programs. In addition, we note the rate that applies for Puerto 
Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of 
the Northern Mariana Islands in certain other programs pursuant to 
section 1118 of the Act. The rates for the States, District of Columbia 
and the territories are displayed in Table 1, Column 1.
    Section 1905(y) of the Act, as added by section 2001 of the Patient 
Protection and Affordable Care Act of 2010 (``Affordable Care Act''), 
provides for a significant increase in the FMAP for medical assistance 
expenditures for individuals determined eligible under the new adult 
group in the state and who will be considered to be ``newly eligible'' 
in 2014, as defined in section 1905(y)(2)(A) of the Act. This newly 
eligible FMAP is 100 percent for Calendar Years 2014, 2015, and 2016, 
gradually declining to 90 percent in 2020 where it remains 
indefinitely. In addition, section 1905(z) of the Act, as added by 
section 10201 of the Affordable Care Act, provides that states that had 
expanded substantial coverage to low-income parents and nonpregnant 
adults without children prior to the enactment of the Affordable Care 
Act, referred to as ``expansion states,'' shall receive an enhanced 
FMAP beginning in 2014 for medical assistance expenditures for 
nonpregnant childless adults who may be required to enroll in benchmark 
coverage. These provisions are discussed in more detail in the Medicaid 
Eligibility proposed rule published on August 17, 2011 (76 FR 51172) 
and the final rule published on March 23, 2012 (77 FR 17143). This 
notice is not intended to set forth the newly eligible or expansion 
state FMAP rates.

Other Adjustments to the FMAP

    For purposes of Title XIX (Medicaid) of the Social Security Act, 
the Federal Medical Assistance Percentage (FMAP), defined in section 
1905(b) of the Social Security Act, for each state beginning with 
fiscal year 2006 is subject to an adjustment pursuant to section 614 of 
the Children's Health Insurance Program Reauthorization Act of 2009 
(CHIPRA), Public Law 111-3. Section 614 of CHIPRA stipulates that a 
state's FMAP under Title XIX (Medicaid) must be adjusted in two 
situations.
    In the first situation, if a state experiences positive growth in 
total personal income and an employer in that state has made a 
significantly disproportionate contribution to a pension or insurance 
fund, the state's FMAP must be adjusted. Employer pension and insurance 
fund contributions are significantly disproportionate if the increase 
in contributions exceeds 25 percent of the increase in total personal 
income in that state. A Federal Register Notice with comment period was 
issued on June 7, 2010 (75 FR 32182) announcing the methodology for 
calculating this adjustment; a final notice was issued on October 15, 
2010 (75 FR 63480). A second situation arises if a state experiences 
negative growth in total personal income. Beginning with Fiscal Year 
2006, section 614(b)(3) of CHIPRA specifies that certain employer 
pension or insurance fund contributions shall be disregarded when 
computing the per capita income used to calculate the FMAP for states 
with negative growth in total personal income. In that instance, for 
the purposes of calculating the FMAP, for a calendar year in which a 
state's total personal income has declined, the portion of an employer 
pension and insurance fund contribution that exceeds 125 percent of the 
amount of the employer contribution in the previous calendar year shall 
be disregarded.
    We request that states follow the same methodology to determine 
potential FMAP adjustments for negative growth in total personal income 
that HHS employs to make adjustments to the FMAP for states 
experiencing significantly disproportionate pension or insurance 
contributions. See also the information described in the January 21, 
2014 Federal Register notice (79 FR 3385). This notice does not contain 
an FY 2019 adjustment for a major statewide disaster for any state 
(territories are not eligible for FMAP adjustments) because no state's 
FMAP decreased by at least three percentage points from FY 2018 to FY 
2019.

Enhanced Federal Medical Assistance Percentage (eFMAP) for CHIP

    Section 2105(b) of the Act specifies the formula for calculating 
the eFMAP rates as follows:

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

    In addition, Section 2105(b) of the Social Security Act, as amended 
by Section 2101 of the Affordable Care Act, increases the eFMAP for 
states by 23 percentage points:

. . . during the period that begins on October 1, 2015, and ends on 
September 30, 2019, the enhanced FMAP determined for a state for a 
fiscal year (or for any portion of a fiscal year occurring during 
such period) shall be increased by 23 percentage points, but in no 
case shall exceed 100 percent.

The eFMAP rates are used in the Children's Health Insurance Program 
under Title XXI, and in the Medicaid program for certain children for 
expenditures for medical assistance described in sections 1905(u)(2) 
and 1905(u)(3) of the Act. There is no specific requirement to publish 
the eFMAP rates. We include them in this notice for the convenience of 
the states, and display both the normal eFMAP rates (Table 1, Column 2) 
and the Affordable Care Act's increased eFMAP

[[Page 55385]]

rates (Table 1, Column 3) for comparison.

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

    Dated: November 13, 2017.
Eric D. Hargan,
Acting Secretary.

 Table 1--Federal Medical Assistance Percentages and Enhanced Federal Medical Assistance Percentages, Effective
                                       October 1, 2018-September 30, 2019
                                               [Fiscal year 2019]
----------------------------------------------------------------------------------------------------------------
                                                                                                Enhanced federal
                                                          Federal medical    Enhanced federal       medical
                                                             assistance          medical           assistance
                                                            percentages         assistance      percentages with
                                                                               percentages     ACA 23 Pt Inc ***
----------------------------------------------------------------------------------------------------------------
Alabama................................................              71.88              80.32             100.00
Alaska.................................................              50.00              65.00              88.00
American Samoa *.......................................              55.00              68.50              91.50
Arizona................................................              69.81              78.87             100.00
Arkansas...............................................              70.51              79.36             100.00
California.............................................              50.00              65.00              88.00
Colorado...............................................              50.00              65.00              88.00
Connecticut............................................              50.00              65.00              88.00
Delaware...............................................              57.55              70.29              93.29
District of Columbia **................................              70.00              79.00             100.00
Florida................................................              60.87              72.61              95.61
Georgia................................................              67.62              77.33             100.00
Guam *.................................................              55.00              68.50              91.50
Hawaii.................................................              53.92              67.74              90.74
Idaho..................................................              71.13              79.79             100.00
Illinois...............................................              50.31              65.22              88.22
Indiana................................................              65.96              76.17              99.17
Iowa...................................................              59.93              71.95              94.95
Kansas.................................................              57.10              69.97              92.97
Kentucky...............................................              71.67              80.17             100.00
Louisiana..............................................              65.00              75.50              98.50
Maine..................................................              64.52              75.16              98.16
Maryland...............................................              50.00              65.00              88.00
Massachusetts..........................................              50.00              65.00              88.00
Michigan...............................................              64.45              75.12              98.12
Minnesota..............................................              50.00              65.00              88.00
Mississippi............................................              76.39              83.47             100.00
Missouri...............................................              65.40              75.78              98.78
Montana................................................              65.54              75.88              98.88
Nebraska...............................................              52.58              66.81              89.81
Nevada.................................................              64.87              75.41              98.41
New Hampshire..........................................              50.00              65.00              88.00
New Jersey.............................................              50.00              65.00              88.00
New Mexico.............................................              72.26              80.58             100.00
New York...............................................              50.00              65.00              88.00
North Carolina.........................................              67.16              77.01             100.00
North Dakota...........................................              50.00              65.00              88.00
Northern Mariana Islands *.............................              55.00              68.50              91.50
Ohio...................................................              63.09              74.16              97.16
Oklahoma...............................................              62.38              73.67              96.67
Oregon.................................................              62.56              73.79              96.79
Pennsylvania...........................................              52.25              66.58              89.58
Puerto Rico *..........................................              55.00              68.50              91.50
Rhode Island...........................................              52.57              66.80              89.80
South Carolina.........................................              71.22              79.85             100.00
South Dakota...........................................              56.71              69.70              92.70
Tennessee..............................................              65.87              76.11              99.11
Texas..................................................              58.19              70.73              93.73
Utah...................................................              69.71              78.80             100.00
Vermont................................................              53.89              67.72              90.72
Virgin Islands *.......................................              55.00              68.50              91.50
Virginia...............................................              50.00              65.00              88.00
Washington.............................................              50.00              65.00              88.00
West Virginia..........................................              74.34              82.04             100.00
Wisconsin..............................................              59.37              71.56              94.56
Wyoming................................................              50.00              65.00              88.00
----------------------------------------------------------------------------------------------------------------
* For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI
  will be 75 per centum.

[[Page 55386]]

 
** The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and
  for capitation payments and DSH allotments under those titles. For other purposes, the percentage for DC is
  50.00, unless otherwise specified by law.
*** Section 2101(a) of the Affordable Care Act amended Section 2105(b) of the Social Security Act to increase
  the enhanced FMAP for states by 23 percentage points, but not to exceed 100 percent, for the period that
  begins on October 1, 2015 and ends on September 30, 2019 (fiscal years 2016 through 2019).

[FR Doc. 2017-24953 Filed 11-20-17; 8:45 am]
 BILLING CODE 4150-15-P



                                                                                   Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices                                                            55383

                                                    health care, increase awareness of the                         provide technical assistance to health                        providing training and technical
                                                    connection between oral health and                             centers and training on oral health                           assistance on IOHPCP. NNOHA’s
                                                    overall health, prevent disease and                            integration and primary care practice.                        primary roles are to coordinate all
                                                    promote oral health, and improve health                           The Joint Explanatory Statement to                         activities at the planning,
                                                    literacy to health providers and patients                      the Consolidated Appropriations Act of                        implementation, evaluation, and
                                                    alike. HRSA developed a core set of oral                       FY 2017 encouraged HRSA to allocate                           dissemination stages, as well as provide
                                                    health clinical competencies for non-                          $250,000 for demonstration projects to                        technical assistance and training to
                                                    dental providers as part of its                                support the implementation of                                 participating HCs. NNOHA shall select
                                                    Integration of Oral Health and Primary                         integrating oral health and primary care                      no fewer than six HCs, which it
                                                    Care Practice (IOHPCP) initiative in                           projects. The projects are to model the                       supports as part of the current HRSA-
                                                    response to recommendations from two                           core clinical oral health competencies                        funded National Training and Technical
                                                    Institute of Medicine (IOM) reports:                           for non-dental providers that HRSA                            Assistance Cooperative Agreement
                                                    Advancing Oral Health in America and                           published and initially tested in its 2014                    Program (U30CS29051). NNOHA will
                                                    Improving Access to Oral Health Care                           report, Integration of Oral Health and                        assure that each HC will propose,
                                                    for Vulnerable and Underserved                                 Primary Care Practice. In order to                            implement, and track data for an
                                                    Populations. NNOHA participated in                             achieve this goal, HRSA will provide                          innovative inter-professional oral health
                                                    the IOHPCP initiative and in fiscal year                       supplemental funding to the NNOHA to                          project that measurably increases the
                                                    (FY) 2012 received supplemental                                advance and expand the                                        adoption of the core clinical oral health
                                                    funding (U30CS09745–05–02) to                                  implementation of oral health core                            competencies among non-dental
                                                    implement a pilot project in safety net                        clinical competencies in health centers,                      providers in the delivery of care to
                                                    settings to inform the impact and                              focusing on services for pregnant                             pregnant women and children.
                                                    effectiveness of oral health core clinical                     women and children. Additionally,
                                                    competencies and inter-professional                            these demonstration projects will                             FOR FURTHER INFORMATION CONTACT:
                                                    collaboration in primary care settings.                        directly align with four HRSA                                 Chinyere Amaefule, Office of Quality
                                                    The goal of the project was to increase                        recommendations for effectively                               Improvement, Division of Strategic
                                                    integration of oral health and primary                         incorporating the competencies into                           Partnerships, Bureau of Primary Health
                                                    health care. NNOHA published the pilot                         clinical practice as described in the                         Care, Health Resources and Services
                                                    project results in a user guide entitled,                      2014 Integrating Oral Health and                              Administration, 5600 Fishers Lane,
                                                    User’s Guide for Implementation of                             Primary Care Practice report. This                            Rockville, Maryland 20857, Phone:
                                                    inter-professional oral health core                            activity is consistent with the current                       (301) 594–4417, Email: Camaefule@
                                                    clinical competencies and continues to                         work plan of NNOHA and includes                               hrsa.gov.

                                                                                                                                                                                                                    FY 2017–2018
                                                                                                                                                                                                      FY 2017          estimated
                                                                                        Grantee/organization name                                                       Grant No.         State      authorized      supplemental
                                                                                                                                                                                                    funding level       amount

                                                    National Network of Oral Health Access ......................................................................     U30CS29051      CO             $500,000         $250,000



                                                     Dated: November 14, 2017.                                     SW., Washington, DC 20201, (202) 690–                         Health Insurance Program (CHIP)
                                                    George Sigounas,                                               6870.                                                         expenditures. Table 1 gives figures for
                                                    Administrator.                                                 SUPPLEMENTARY INFORMATION: The                                each of the 50 states, the District of
                                                    [FR Doc. 2017–25191 Filed 11–20–17; 8:45 am]                   Federal Medical Assistance Percentages                        Columbia, Puerto Rico, the Virgin
                                                    BILLING CODE 4165–15–P                                         (FMAP), Enhanced Federal Medical                              Islands, Guam, American Samoa, and
                                                                                                                   Assistance Percentages (eFMAP), and                           the Commonwealth of the Northern
                                                                                                                   disaster-recovery FMAP adjustments for                        Mariana Islands. This notice reminds
                                                    DEPARTMENT OF HEALTH AND                                       Fiscal Year 2019 have been calculated                         states of available disaster-recovery
                                                    HUMAN SERVICES                                                 pursuant to the Social Security Act (the                      FMAP adjustments for qualifying states,
                                                                                                                   Act). These percentages will be effective                     and adjustments available for states
                                                    Federal Matching Shares for Medicaid,                          from October 1, 2018 through                                  meeting requirements for negative
                                                    the Children’s Health Insurance                                September 30, 2019. This notice                               growth in total state personal income.
                                                    Program, and Aid to Needy Aged,                                announces the calculated FMAP rates,                          At this time, no states qualify for such
                                                    Blind, or Disabled Persons for October                         in accordance with sections 1101(a)(8)                        adjustments.
                                                    1, 2018 Through September 30, 2019                             and 1905(b) of the Act, that the U.S.                            This notice also contains the
                                                                                                                   Department of Health and Human                                increased eFMAPs for CHIP as
                                                    AGENCY:    Office of the Secretary, DHHS.
                                                                                                                   Services (HHS) will use in determining                        authorized under the Patient Protection
                                                    ACTION:    Notice.                                             the amount of federal matching for state                      and Affordable Care Act (PPACA) for
                                                                                                                   medical assistance (Medicaid),                                fiscal years 2016 through 2019 (October
                                                    DATES:  The percentages listed in Table                        Temporary Assistance for Needy                                1, 2015 through September 30, 2019).
                                                    1 will be effective for each of the four
asabaliauskas on DSKBBXCHB2PROD with NOTICES




                                                                                                                   Families (TANF) Contingency Funds,                               Programs under title XIX of the Act
                                                    quarter-year periods beginning October                         Child Support Enforcement collections,                        exist in each jurisdiction. Programs
                                                    1, 2018 and ending September 30, 2019.                         Child Care Mandatory and Matching                             under titles I, X, and XIV operate only
                                                    FOR FURTHER INFORMATION CONTACT:                               Funds of the Child Care and                                   in Guam and the Virgin Islands. The
                                                    Caryn Marks or Rose Chu, Office of                             Development Fund, Title IV–E Foster                           percentages in this notice apply to state
                                                    Health Policy, Office of the Assistant                         Care Maintenance payments, Adoption                           expenditures for most medical
                                                    Secretary for Planning and Evaluation,                         Assistance payments and Kinship                               assistance and child health assistance,
                                                    Room 447D—Hubert H. Humphrey                                   Guardianship Assistance payments, and                         and assistance payments for certain
                                                    Building, 200 Independence Avenue                              the eFMAP rates for the Children’s                            social services. The Act provides


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                                                    55384                      Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices

                                                    separately for federal matching of                      1905(y)(2)(A) of the Act. This newly                  for the purposes of calculating the
                                                    administrative costs. Sections 1905(b)                  eligible FMAP is 100 percent for                      FMAP, for a calendar year in which a
                                                    and 1101(a)(8)(B) of the Social Security                Calendar Years 2014, 2015, and 2016,                  state’s total personal income has
                                                    Act (the Act) require the Secretary of                  gradually declining to 90 percent in                  declined, the portion of an employer
                                                    HHS to publish the FMAP rates each                      2020 where it remains indefinitely. In                pension and insurance fund
                                                    year. The Secretary calculates the                      addition, section 1905(z) of the Act, as              contribution that exceeds 125 percent of
                                                    percentages, using formulas in sections                 added by section 10201 of the                         the amount of the employer
                                                    1905(b) and 1101(a)(8), and calculations                Affordable Care Act, provides that states             contribution in the previous calendar
                                                    by the Department of Commerce of                        that had expanded substantial coverage                year shall be disregarded.
                                                    average income per person in each state                 to low-income parents and nonpregnant                    We request that states follow the same
                                                    and for the Nation as a whole. The                      adults without children prior to the                  methodology to determine potential
                                                    percentages must fall within the upper                  enactment of the Affordable Care Act,                 FMAP adjustments for negative growth
                                                    and lower limits specified in section                   referred to as ‘‘expansion states,’’ shall            in total personal income that HHS
                                                    1905(b) of the Act. The percentages for                 receive an enhanced FMAP beginning in                 employs to make adjustments to the
                                                    the District of Columbia, Puerto Rico,                  2014 for medical assistance                           FMAP for states experiencing
                                                    the Virgin Islands, Guam, American                      expenditures for nonpregnant childless                significantly disproportionate pension
                                                    Samoa, and the Northern Mariana                         adults who may be required to enroll in               or insurance contributions. See also the
                                                    Islands are specified in statute, and thus              benchmark coverage. These provisions                  information described in the January 21,
                                                    are not based on the statutory formula                  are discussed in more detail in the                   2014 Federal Register notice (79 FR
                                                    that determines the percentages for the                 Medicaid Eligibility proposed rule                    3385). This notice does not contain an
                                                    50 states.                                              published on August 17, 2011 (76 FR                   FY 2019 adjustment for a major
                                                                                                            51172) and the final rule published on                statewide disaster for any state
                                                    Federal Medical Assistance Percentage
                                                                                                            March 23, 2012 (77 FR 17143). This                    (territories are not eligible for FMAP
                                                    (FMAP)
                                                                                                            notice is not intended to set forth the               adjustments) because no state’s FMAP
                                                      Section 1905(b) of the Act specifies                  newly eligible or expansion state FMAP                decreased by at least three percentage
                                                    the formula for calculating FMAPs as                    rates.
                                                    follows:                                                                                                      points from FY 2018 to FY 2019.
                                                                                                            Other Adjustments to the FMAP                         Enhanced Federal Medical Assistance
                                                       ‘‘Federal medical assistance percentage’’
                                                    for any state shall be 100 per centum less the            For purposes of Title XIX (Medicaid)                Percentage (eFMAP) for CHIP
                                                    state percentage; and the state percentage              of the Social Security Act, the Federal
                                                    shall be that percentage which bears the same           Medical Assistance Percentage (FMAP),                   Section 2105(b) of the Act specifies
                                                    ratio to 45 per centum as the square of the             defined in section 1905(b) of the Social              the formula for calculating the eFMAP
                                                    per capita income of such state bears to the            Security Act, for each state beginning                rates as follows:
                                                    square of the per capita income of the                  with fiscal year 2006 is subject to an                   The ‘‘enhanced FMAP’’, for a state for a
                                                    continental United States (including Alaska)                                                                  fiscal year, is equal to the Federal medical
                                                    and Hawaii; except that (1) the Federal
                                                                                                            adjustment pursuant to section 614 of
                                                                                                            the Children’s Health Insurance                       assistance percentage (as defined in the first
                                                    medical assistance percentage shall in no                                                                     sentence of section 1905(b)) for the state
                                                    case be less than 50 per centum or more than            Program Reauthorization Act of 2009
                                                                                                            (CHIPRA), Public Law 111–3. Section                   increased by a number of percentage points
                                                    83 per centum, (2) the Federal medical
                                                                                                                                                                  equal to 30 percent of the number of
                                                    assistance percentage for Puerto Rico, the              614 of CHIPRA stipulates that a state’s               percentage points by which (1) such Federal
                                                    Virgin Islands, Guam, the Northern Mariana              FMAP under Title XIX (Medicaid) must                  medical assistance percentage for the state, is
                                                    Islands, and American Samoa shall be 55                 be adjusted in two situations.
                                                    percent . . . .                                                                                               less than (2) 100 percent; but in no case shall
                                                                                                              In the first situation, if a state                  the enhanced FMAP for a state exceed 85
                                                    Section 4725(b) of the Balanced Budget                  experiences positive growth in total                  percent.
                                                    Act of 1997 amended section 1905(b) to                  personal income and an employer in
                                                    provide that the FMAP for the District                  that state has made a significantly                     In addition, Section 2105(b) of the
                                                    of Columbia for purposes of titles XIX                  disproportionate contribution to a                    Social Security Act, as amended by
                                                    and XXI shall be 70 percent. For the                    pension or insurance fund, the state’s                Section 2101 of the Affordable Care Act,
                                                    District of Columbia, we note under                     FMAP must be adjusted. Employer                       increases the eFMAP for states by 23
                                                    Table 1 that other rates may apply in                   pension and insurance fund                            percentage points:
                                                    certain other programs. In addition, we                 contributions are significantly                       . . . during the period that begins on
                                                    note the rate that applies for Puerto                   disproportionate if the increase in                   October 1, 2015, and ends on September 30,
                                                    Rico, the Virgin Islands, Guam,                         contributions exceeds 25 percent of the               2019, the enhanced FMAP determined for a
                                                    American Samoa, and the                                 increase in total personal income in that             state for a fiscal year (or for any portion of
                                                    Commonwealth of the Northern Mariana                    state. A Federal Register Notice with                 a fiscal year occurring during such period)
                                                                                                                                                                  shall be increased by 23 percentage points,
                                                    Islands in certain other programs                       comment period was issued on June 7,
                                                                                                                                                                  but in no case shall exceed 100 percent.
                                                    pursuant to section 1118 of the Act. The                2010 (75 FR 32182) announcing the
                                                    rates for the States, District of Columbia              methodology for calculating this                      The eFMAP rates are used in the
                                                    and the territories are displayed in                    adjustment; a final notice was issued on              Children’s Health Insurance Program
                                                    Table 1, Column 1.                                      October 15, 2010 (75 FR 63480). A                     under Title XXI, and in the Medicaid
                                                       Section 1905(y) of the Act, as added                 second situation arises if a state                    program for certain children for
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                                                    by section 2001 of the Patient Protection               experiences negative growth in total                  expenditures for medical assistance
                                                    and Affordable Care Act of 2010                         personal income. Beginning with Fiscal                described in sections 1905(u)(2) and
                                                    (‘‘Affordable Care Act’’), provides for a               Year 2006, section 614(b)(3) of CHIPRA                1905(u)(3) of the Act. There is no
                                                    significant increase in the FMAP for                    specifies that certain employer pension               specific requirement to publish the
                                                    medical assistance expenditures for                     or insurance fund contributions shall be              eFMAP rates. We include them in this
                                                    individuals determined eligible under                   disregarded when computing the per                    notice for the convenience of the states,
                                                    the new adult group in the state and                    capita income used to calculate the                   and display both the normal eFMAP
                                                    who will be considered to be ‘‘newly                    FMAP for states with negative growth in               rates (Table 1, Column 2) and the
                                                    eligible’’ in 2014, as defined in section               total personal income. In that instance,              Affordable Care Act’s increased eFMAP


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                                                                                          Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices                                                                       55385

                                                    rates (Table 1, Column 3) for                                                Funds of the Child Care and Development                              Medical Assistance Program; 93.767:
                                                    comparison.                                                                  Fund; 93.658: Foster Care Title IV–E; 93.659:                        Children’s Health Insurance Program)
                                                                                                                                 Adoption Assistance; 93.769: Ticket-to-Work
                                                    (Catalog of Federal Domestic Assistance                                                                                                             Dated: November 13, 2017.
                                                    Program Nos. 93.558: TANF Contingency                                        and Work Incentives Improvement Act
                                                                                                                                 (TWWIIA) Demonstrations to Maintain                                  Eric D. Hargan,
                                                    Funds; 93.563: Child Support Enforcement;
                                                    93.596: Child Care Mandatory and Matching                                    Independence and Employment; 93.778:                                 Acting Secretary.

                                                     TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES,
                                                                                 EFFECTIVE OCTOBER 1, 2018–SEPTEMBER 30, 2019
                                                                                                                                                        [Fiscal year 2019]

                                                                                                                                                                                                                                  Enhanced federal
                                                                                                                                                                                                               Enhanced federal
                                                                                                                                                                                          Federal medical                             medical
                                                                                                                                                                                                                   medical
                                                                                                                                                                                            assistance                               assistance
                                                                                                                                                                                                                  assistance
                                                                                                                                                                                           percentages                            percentages with
                                                                                                                                                                                                                 percentages      ACA 23 Pt Inc ***

                                                    Alabama .....................................................................................................................                    71.88                80.32              100.00
                                                    Alaska ........................................................................................................................                  50.00                65.00               88.00
                                                    American Samoa * .....................................................................................................                           55.00                68.50               91.50
                                                    Arizona .......................................................................................................................                  69.81                78.87              100.00
                                                    Arkansas ....................................................................................................................                    70.51                79.36              100.00
                                                    California ....................................................................................................................                  50.00                65.00               88.00
                                                    Colorado ....................................................................................................................                    50.00                65.00               88.00
                                                    Connecticut ................................................................................................................                     50.00                65.00               88.00
                                                    Delaware ....................................................................................................................                    57.55                70.29               93.29
                                                    District of Columbia ** ................................................................................................                         70.00                79.00              100.00
                                                    Florida ........................................................................................................................                 60.87                72.61               95.61
                                                    Georgia ......................................................................................................................                   67.62                77.33              100.00
                                                    Guam * .......................................................................................................................                   55.00                68.50               91.50
                                                    Hawaii ........................................................................................................................                  53.92                67.74               90.74
                                                    Idaho ..........................................................................................................................                 71.13                79.79              100.00
                                                    Illinois .........................................................................................................................               50.31                65.22               88.22
                                                    Indiana .......................................................................................................................                  65.96                76.17               99.17
                                                    Iowa ...........................................................................................................................                 59.93                71.95               94.95
                                                    Kansas .......................................................................................................................                   57.10                69.97               92.97
                                                    Kentucky ....................................................................................................................                    71.67                80.17              100.00
                                                    Louisiana ....................................................................................................................                   65.00                75.50               98.50
                                                    Maine .........................................................................................................................                  64.52                75.16               98.16
                                                    Maryland ....................................................................................................................                    50.00                65.00               88.00
                                                    Massachusetts ...........................................................................................................                        50.00                65.00               88.00
                                                    Michigan .....................................................................................................................                   64.45                75.12               98.12
                                                    Minnesota ..................................................................................................................                     50.00                65.00               88.00
                                                    Mississippi ..................................................................................................................                   76.39                83.47              100.00
                                                    Missouri ......................................................................................................................                  65.40                75.78               98.78
                                                    Montana .....................................................................................................................                    65.54                75.88               98.88
                                                    Nebraska ....................................................................................................................                    52.58                66.81               89.81
                                                    Nevada .......................................................................................................................                   64.87                75.41               98.41
                                                    New Hampshire .........................................................................................................                          50.00                65.00               88.00
                                                    New Jersey ................................................................................................................                      50.00                65.00               88.00
                                                    New Mexico ...............................................................................................................                       72.26                80.58              100.00
                                                    New York ...................................................................................................................                     50.00                65.00               88.00
                                                    North Carolina ............................................................................................................                      67.16                77.01              100.00
                                                    North Dakota ..............................................................................................................                      50.00                65.00               88.00
                                                    Northern Mariana Islands * ........................................................................................                              55.00                68.50               91.50
                                                    Ohio ...........................................................................................................................                 63.09                74.16               97.16
                                                    Oklahoma ...................................................................................................................                     62.38                73.67               96.67
                                                    Oregon .......................................................................................................................                   62.56                73.79               96.79
                                                    Pennsylvania ..............................................................................................................                      52.25                66.58               89.58
                                                    Puerto Rico * ..............................................................................................................                     55.00                68.50               91.50
                                                    Rhode Island ..............................................................................................................                      52.57                66.80               89.80
                                                    South Carolina ...........................................................................................................                       71.22                79.85              100.00
                                                    South Dakota .............................................................................................................                       56.71                69.70               92.70
                                                    Tennessee .................................................................................................................                      65.87                76.11               99.11
                                                    Texas .........................................................................................................................                  58.19                70.73               93.73
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                                                    Utah ...........................................................................................................................                 69.71                78.80              100.00
                                                    Vermont .....................................................................................................................                    53.89                67.72               90.72
                                                    Virgin Islands * ...........................................................................................................                     55.00                68.50               91.50
                                                    Virginia .......................................................................................................................                 50.00                65.00               88.00
                                                    Washington ................................................................................................................                      50.00                65.00               88.00
                                                    West Virginia ..............................................................................................................                     74.34                82.04              100.00
                                                    Wisconsin ...................................................................................................................                    59.37                71.56               94.56
                                                    Wyoming ....................................................................................................................                     50.00                65.00               88.00
                                                       * For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI will be 75 per centum.



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                                                    55386                      Federal Register / Vol. 82, No. 223 / Tuesday, November 21, 2017 / Notices

                                                       ** The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and for capitation payments and DSH
                                                    allotments under those titles. For other purposes, the percentage for DC is 50.00, unless otherwise specified by law.
                                                       *** Section 2101(a) of the Affordable Care Act amended Section 2105(b) of the Social Security Act to increase the enhanced FMAP for states
                                                    by 23 percentage points, but not to exceed 100 percent, for the period that begins on October 1, 2015 and ends on September 30, 2019 (fiscal
                                                    years 2016 through 2019).


                                                    [FR Doc. 2017–24953 Filed 11–20–17; 8:45 am]            the Assistant Secretary for Health,                   questions may be directed to
                                                    BILLING CODE 4150–15–P                                  Office of Disease Prevention and Health               HealthyPeople@norc.org.
                                                                                                            Promotion, 1101 Wootton Parkway,                        Authority: 42 U.S.C. 300u and 42
                                                                                                            Room LL–100, Rockville, MD 20852,                     U.S.C. 217a. The Secretary’s Advisory
                                                    DEPARTMENT OF HEALTH AND                                (240) 453–8280 (telephone), (240) 453–                Committee on National Health
                                                    HUMAN SERVICES                                          8281 (fax). Additional information is                 Promotion and Disease Prevention
                                                                                                            available on the Healthy People Web                   Objectives for 2030 is governed by
                                                    Announcement of Meeting of the                          site at http://www.healthypeople.gov.                 provisions of the Federal Advisory
                                                    Secretary’s Advisory Committee on                       SUPPLEMENTARY INFORMATION: The                        Committee Act (FACA), Public Law 92–
                                                    National Health Promotion and Disease                   names and biographies of the                          463, as amended (5 U.S.C., App.) which
                                                    Prevention Objectives for 2030                          Committee members are available at                    sets forth standards for the formation
                                                    AGENCY:  Office of Disease Prevention                   https://www.healthypeople.gov/2020/                   and use of federal advisory committees.
                                                    and Health Promotion, Office of the                     about/history-development/healthy-                      Dated: November 14, 2017.
                                                    Assistant Secretary for Health, Office of               people-2030-advisory-committee.                       Don Wright,
                                                    the Secretary, Department of Health and                    Purpose of Meeting: Through the
                                                                                                                                                                  Deputy Assistant Secretary for Health,
                                                    Human Services.                                         Healthy People initiative, HHS leverages
                                                                                                                                                                  (Disease Prevention and Health Promotion).
                                                    ACTION: Notice.                                         scientific insights and lessons from the
                                                                                                                                                                  [FR Doc. 2017–25192 Filed 11–20–17; 8:45 am]
                                                                                                            past decade, along with new knowledge
                                                    SUMMARY:   The U.S. Department of                       of current data, trends, and innovations,             BILLING CODE 4150–32–P

                                                    Health and Human Services (HHS)                         to develop the next iteration of national
                                                    announces the next federal advisory                     health promotion and disease
                                                    committee meeting regarding the                         prevention objectives. Healthy People                 DEPARTMENT OF HOMELAND
                                                    development of national health                          provides science-based, 10-year national              SECURITY
                                                    promotion and disease prevention                        objectives for promoting health and
                                                    objectives for 2030. This meeting will be               preventing disease. Since 1979, Healthy               Coast Guard
                                                    held online via webinar and is open to                  People has set and monitored national
                                                    the public. The Committee will discuss                  health objectives that meet a broad                   [Docket No. USCG–2017–0125]
                                                    the nation’s health promotion and                       range of health needs, encourage
                                                    disease prevention objectives and will                  collaboration across sectors, guide                   Information Collection Request to
                                                    provide recommendations to improve                      individuals toward making informed                    Office of Management and Budget;
                                                    health status and reduce health risks for               health decisions, and measure the                     OMB Control Number: 1625–0121
                                                    the nation by the year 2030. The                        impact of our prevention and health                   AGENCY:Coast Guard, DHS.
                                                    Committee will advise the Secretary on                  promotion activities. Healthy People
                                                                                                                                                                        Sixty-day notice requesting
                                                                                                                                                                  ACTION:
                                                    the Healthy People 2030 mission,                        2030 health objectives will reflect
                                                                                                            assessments of major risks to health and              comments.
                                                    vision, framework, and organizational
                                                    structure. The Committee will provide                   wellness, changing public health                      SUMMARY:   In compliance with the
                                                    advice regarding criteria for identifying               priorities, and emerging technologies                 Paperwork Reduction Act of 1995, the
                                                    a more focused set of measurable,                       related to our nation’s health                        U.S. Coast Guard intends to submit an
                                                    nationally representative objectives.                   preparedness and prevention.                          Information Collection Request (ICR) to
                                                    Pursuant to the Committee’s charter, the                   Public Participation at Meeting:                   the Office of Management and Budget
                                                    Committee’s advice must assist the                      Members of the public are invited to                  (OMB), Office of Information and
                                                    Secretary in reducing the number of                     join the online Committee meeting.                    Regulatory Affairs (OIRA), requesting an
                                                    objectives while ensuring that the                      There will be no opportunity for oral                 extension of its approval for the
                                                    selection criteria identifies the most                  public comments during this online                    following collection of information:
                                                    critical public health issues that are                  Committee meeting. However, written                   1625–0121, United States Coast Guard
                                                    high-impact priorities supported by                     comments are welcome throughout the
                                                                                                                                                                  Academy Introduction Mission Program
                                                    current national data.                                  entire development process of the
                                                                                                                                                                  Application and Supplemental Forms;
                                                    DATES: The Committee will meet on
                                                                                                            national health promotion and disease
                                                                                                                                                                  without change. Our ICR describes the
                                                                                                            prevention objectives for 2030 and may
                                                    December 11, 2017, from 3:00 p.m. to                                                                          information we seek to collect from the
                                                                                                            be emailed to HP2030@hhs.gov.
                                                    5:00 p.m. Eastern Time (ET).                                                                                  public. Before submitting this ICR to
                                                                                                               To join the Committee meeting,
                                                    ADDRESSES: The meeting will be held                     individuals must pre-register at the                  OIRA, the Coast Guard is inviting
                                                    online via webinar. To register to attend               Healthy People Web site at http://                    comments as described below.
                                                    the meeting, please visit the Healthy                   www.healthypeople.gov. Participation in               DATES: Comments must reach the Coast
                                                    People Web site at http://                                                                                    Guard on or before January 22, 2018.
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                                                                                                            the meeting is limited. Registrations will
                                                    www.healthypeople.gov.                                  be accepted until maximum webinar                     ADDRESSES: You may submit comments
                                                    FOR FURTHER INFORMATION CONTACT:                        capacity is reached, and must be                      identified by Coast Guard docket
                                                    Emmeline Ochiai, Designated Federal                     completed by 9:00 a.m. ET on December                 number [USCG–2017–0125] to the Coast
                                                    Official, Secretary’s Advisory                          11, 2017. A waiting list will be                      Guard using the Federal eRulemaking
                                                    Committee on National Health                            maintained should registrations exceed                Portal at http://www.regulations.gov.
                                                    Promotion and Disease Prevention                        capacity, and those individuals will be               See the ‘‘Public participation and
                                                    Objectives for 2030, U.S. Department of                 contacted as additional space for the                 request for comments’’ portion of the
                                                    Health and Human Services, Office of                    meeting becomes available. Registration               SUPPLEMENTARY INFORMATION section for



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Document Created: 2017-11-21 00:43:06
Document Modified: 2017-11-21 00:43:06
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesThe percentages listed in Table 1 will be effective for each of the four quarter-year periods beginning October 1, 2018 and ending September 30, 2019.
ContactCaryn Marks or Rose Chu, Office of Health Policy, Office of the Assistant Secretary for Planning and Evaluation, Room 447D--Hubert H. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201, (202) 690-6870.
FR Citation82 FR 55383 

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