Federal Register, Volume 76, Number 149, August 3, 2011, Pages 46595-47054 Page: 46,684

                                
Federal Register/Vol. 76, No. 149/Wednesday, August 3, 2011 /Proposed Rules

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 430, 433, 447, and 457
[CMS-2292-P]
RIN 0938-AQ32
Medicaid and Children's Health
Insurance Programs; Disallowance of
Claims for FFP and Technical
Corrections
AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Proposed rule.
SUMMARY: This proposed rule reflects
the Centers for Medicare and Medicaid
Services' commitment to the general
principles of the President's Executive
Order 13563 released January 18, 2011,
entitled "Improving Regulation and
Regulatory Review," as this rule would:
implement a new reconsideration
process for administrative
determinations to disallow claims for
Federal financial participation (FFP)
under title XIX of the Act (Medicaid);
lengthen the time States have to credit
the Federal Government for identified
but uncollected Medicaid provider
overpayments and provide that interest
will be due on amounts not credited
within that time period; make
conforming changes to the Medicaid
and Children's Health Insurance
Program (CHIP) disallowance process to
allow States the option to retain
disputed Federal funds through the new
administrative reconsideration process;
revise installment repayment standards
and schedules for States that owe
significant amounts; provide that
interest charges may accrue during the
new administrative reconsideration
process if a State chooses to retain the
funds during that period. This proposed
rule would also make a technical
correction to reporting requirements for
disproportionate share hospital
payments, revise internal delegations of
authority to reflect current CMS
structure, remove obsolete language,
and correct other technical errors.
DATES: To be assured consideration,
comments must be received at one of
the addresses provided below, no later
than 5 p.m. on September 2, 2011.
ADDRESSES: In commenting, please refer
to file code CMS-2292-P. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)

You may submit comments in one of
four ways (please choose only one of the
ways listed):
1. Electronically. You may submit
electronic comments on this regulation
to http://www.regulations.gov. Follow
the instructions under the "More Search
Options" tab.
2. By regular mail. You may mail
written comments to the following
address ONLY: Centers for Medicare &
Medicaid Services, Department of
Health and Human Services, Attention:
CMS-2292-P, P.O. Box 8016, Baltimore,
MD 21244-8016.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments to the
following address ONLY: Centers for
Medicare & Medicaid Services,
Department of Health and Human
Services, Attention: CMS-2292-P, Mail
Stop C4-26-05, 7500 Security
Boulevard, Baltimore, MD 21244-1850.
4. By hand or courier. If you prefer,
you may deliver (by hand or courier)
your written comments before the close
of the comment period to either of the
following addresses:
a. For delivery in Washington, DC-
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Room 445-G, Hubert
H. Humphrey Building, 200
Independence Avenue, SW.,
Washington, DC 20201.
(Because access to the interior of the
Hubert H. Humphrey Building is not
readily available to persons without
Federal Government identification,
commenters are encouraged to leave
their comments in the CMS drop slots
located in the main lobby of the
building. A stamp-in clock is available
for persons wishing to retain a proof of
filing by stamping in and retaining an
extra copy of the comments being filed.)
b. For delivery in Baltimore, MD-
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, 7500 Security
Boulevard, Baltimore, MD 21244-1850.
If you intend to deliver your
comments to the Baltimore address,
please call telephone number (410) 786-
7195 in advance to schedule your
arrival with one of our staff members.
Comments mailed to the addresses
indicated as appropriate for hand or
courier delivery may be delayed and
received after the comment period.
Submission of comments on
paperwork requirements. You may
submit comments on this document's
paperwork requirements by following
the instructions at the end of the

transmission.

Requirements" section in this
document.
For information on viewing public
comments, see the beginning of the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Robert Lane, (410) 786-2015, or Lisa
Carroll, (410) 786-2696, for general
information.
Edgar Davies, (410) 786-3280, for
Overpayments.
Claudia Simonson, (312) 353-2115, for
Overpayments resulting from Fraud.
Rory Howe, (410) 786-4878, for Upper
Payment Limit and Disproportionate
Share Hospital.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All
comments received before the close of
the comment period are available for
viewing by the public, including any
personally identifiable or confidential
business information that is included in
a comment. We post all comments
received before the close of the
comment period on the following Web
site as soon as possible after they have
been received: http://regulations.gov.
Follow the search instructions on that
Web site to view public comments.
Comments received timely will also
be available for public inspection as
they are received, generally beginning
approximately 3 weeks after publication
of a document, at the headquarters of
the Centers for Medicare & Medicaid
Services, 7500 Security Boulevard,
Baltimore, Maryland 21244, Monday
through Friday of each week from
8:30 a.m. to 4 p.m. To schedule an
appointment to view public comments,
phone 1-800-743-3951.
I. Background
Title XIX of the Social Security Act
(the Act) authorizes Federal grants to
States to jointly fund programs that
provide medical assistance to low-
income families, the elderly, and
persons with disabilities. This Federal-
State partnership is administered by
each State in accordance with an
approved State plan. States have
considerable flexibility in designing
their programs, but must comply with
Federal requirements specified in the
Medicaid statute, regulations, and
interpretive agency guidance. Federal
financial participation (FFP) is available
for State medical assistance
expenditures, and administrative
expenditures related to operating the
State Medicaid program, that are
authorized under Federal law and the
approved State plan.
Section 4901 of the Balanced Budget
Act of 1997 (Pub. L. 105-33, enacted on

August 5, 1997) (BBA), added title XXI

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"Collection of Information