[Federal Register: October 23, 2002 (Volume 67, Number 205)]
[Notices]               
[Page 65127-65128]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23oc02-93]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

 
Notice of Hearing: Reconsideration of Disapproval of Alaska State 
Plan Amendment 01-009

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of hearing.

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SUMMARY: This notice announces an administrative hearing on October 24, 
2002, at 10 a.m., Seattle Regional Office; 2201 Sixth Avenue; Room 
1206; Seattle, Washington 98121, to reconsider our decision to 
disapprove Alaska State Plan Amendment (SPA) 01-009.

CLOSING DATE: Requests to participate in the hearing as a party must be 
received by the presiding officer by November 7, 2002.

FOR FURTHER INFORMATION CONTACT: Kathleen Scully-Hayes, Presiding 
Officer, Centers for Medicare & Medicaid Services, 2520 Lord Baltimore 
Drive, Suite L, Baltimore, Maryland 21244-2670, Telephone: (410) 786-
2055.

SUPPLEMENTARY INFORMATION: This notice announces an administrative 
hearing to reconsider our decision to disapprove Alaska State Plan 
Amendment (SPA) 01-009. Alaska submitted SPA 01-009 on December 27, 
2001.
    The issue is whether the State's proposed rates are in compliance 
with the provisions of section 1902(a)(30)(A) of the Social Security 
Act (the Act),

[[Page 65128]]

which requires that payments under the plan be ``consistent with 
efficiency, economy and quality of care.''
    The proposed SPA would increase the Medicaid payment rate for 
inpatient and outpatient services at facilities paid as Indian Health 
Service (IHS) facilities (including tribal facilities operated under 
contracts or compacts pursuant to Public Law 93-638). The IHS sets 
Medicaid billing rates for inpatient and outpatient services furnished 
by Alaska IHS facilities, which are announced in the Federal Register. 
Alaska's proposed rates would substantially exceed the IHS published 
rates, and Alaska provided no analysis of why it would be consistent 
with efficiency, economy, and quality of care to pay rates higher than 
the rate authorized by IHS. Absent any such analysis, the CMS found 
that the proposed rates were not consistent with efficiency, economy, 
and quality of care as required under section 1902(a)(30)(A) of the 
Act. Therefore, based on the reasoning set forth above, and after 
consultation with the Secretary as required under 42 CFR 430.15(c)(2), 
CMS disapproved Alaska SPA 01-009.
    Section 1116 of the Act and 42 CFR, part 430, establish Department 
procedures that provide an administrative hearing for reconsideration 
of a disapproval of a state plan or plan amendment. The CMS is required 
to publish a copy of the notice to a state Medicaid agency that informs 
the agency of the time and place of the hearing and the issues to be 
considered. If we subsequently notify the agency of additional issues 
that will be considered at the hearing, we will also publish that 
notice.
    Any individual or group that wants to participate in the hearing as 
a party must petition the presiding officer within 15 days after 
publication of this notice, in accordance with the requirements 
contained at 42 CFR 430.76(b)(2). Any interested person or organization 
that wants to participate as amicus curiae must petition the presiding 
officer before the hearing begins in accordance with the requirements 
contained at 42 CFR 430.76(c). If the hearing is later rescheduled, the 
presiding officer will notify all participants.
    The notice to Alaska announcing an administrative hearing to 
reconsider the disapproval of its SPA reads as follows:

Mr. Robert Labbe,
Director, Division of Medical Assistance, Department of Health and 
Social Services, P.O. Box 110601, Juneau, AK 99811-0601.
    Dear Mr. Labbe: I am responding to your request for 
reconsideration of the decision to disapprove Alaska State Plan 
Amendment (SPA) 01-009. Alaska submitted SPA 01-009 on December 27, 
2001. This SPA would increase the Medicaid payment rate for 
inpatient and outpatient services at facilities paid as Indian 
Health Service (IHS) facilities (including tribal facilities 
operated under contracts or compacts pursuant to Public Law 93-638). 
The IHS sets Medicaid billing rates for inpatient and outpatient 
services furnished by Alaska IHS facilities, which are announced in 
the Federal Register. Alaska's proposed rates would substantially 
exceed the IHS published rates, and Alaska provided no analysis of 
why it would be consistent with efficiency, economy, and quality of 
care to pay rates higher than the rate authorized by IHS. Absent any 
such analysis, CMS found that the proposed rates were not consistent 
with efficiency, economy, and quality of care as required under 
section 1902(a)(30)(A) of the Act. Therefore, based on the reasoning 
set forth above, and after consultation with the Secretary as 
required under 42 CFR 430.15(c)(2), CMS disapproved Alaska SPA 01-
009.
    I am scheduling a hearing on your request for reconsideration to 
be held at 10:00 a.m., October 24, 2002, Seattle Regional Office; 
2201 Sixth Avenue; Room 1206; Seattle, Washington 98121, to 
reconsider our decision to disapprove Alaska SPA 01-009.
    If this date is not acceptable, we would be glad to set another 
date that is mutually agreeable to the parties. The hearing will be 
governed by the procedures prescribed at 42 CFR, part 430.
    I am designating Ms. Kathleen Scully-Hayes as the presiding 
officer. If these arrangements present any problems, please contact 
the presiding officer. In order to facilitate any communication 
which may be necessary between the parties to the hearing, please 
notify the presiding officer to indicate acceptability of the 
hearing date that has been scheduled and provide names of the 
individuals who will represent the State at the hearing. The 
presiding officer may be reached at (410) 786-2055.

 Sincerely,

Thomas A. Scully.

    Authority: Section 1116 of the Social Security Act (42 U.S.C. 
1316); 42 CFR 430.18)

(Catalog of Federal Domestic Assistance Program No. 13.714, Medicaid 
Assistance Program)

    Dated: October 11, 2002.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 02-26904 Filed 10-22-02; 8:45 am]
BILLING CODE 4120-03-P