Federal Register / Vol. 76, No. 33 / Thursday, February 17, 2011 / Rules and Regulations 9233 

ZIP code 

Two-letter 

state abbreviation City Territory, possession, or freely associated 

state 

96942 ................................. FM Chuuk ............................................................................ Federated States of Micronesia. 

96943 ................................. FM Yap ................................................................................ Federated States of Micronesia. 

96944 ................................. FM Kosrae ........................................................................... Federated States of Micronesia. 

96950 ................................. MP Saipan ........................................................................... Commonwealth of the Northern Mariana 

Islands. 

96951 ................................. MP Rota ............................................................................... Commonwealth of the Northern Mariana 

Islands. 

96952 ................................. MP Tinian ............................................................................. Commonwealth of the Northern Mariana 

Islands. 

96960 ................................. MH Majuro ............................................................................ Republic of the Marshall Islands. 

96970 ................................. MH Ebeye ............................................................................ Republic of the Marshall Islands. 

[Renumber current items 2.4.2 through 

2.4.4 as 2.4.5 through 2.4.7 and insert 

new 2.4.2 through 2.4.4 as follows:] 

2.4.2 Items Containing Goods 

Regardless of mail class or weight, 

items containing goods (i.e., contents 

other than documents; see IMM 123.63 

for ‘‘document’’ eligibility) must bear a 

properly completed PS Form 2976, 

Customs Declaration CN 22, or, if the 

customer prefers, a PS Form 2976–A, 

Customs Declaration and Dispatch 

Note—CP 72, when the items are sent to 

the United States or Puerto Rico from 

the ZIP Code destinations listed in the 

table in 2.4.1, or from the U.S. Virgin 

Islands.. 

2.4.3 Improperly Prepared Items 

Mailpieces deposited without a 

properly completed customs form under 

2.4.1 and 2.4.2 will be returned to the 

sender. 

2.4.4 Overseas Military Mail 

For determining customs declarations’ 

required usage when mailing to or from 

APO, FPO, or DPO addresses, see 

703.2.3.6 through 703.2.3.8. 

* * * * * 

We will publish an appropriate 

amendment to 39 CFR part 111 to reflect 

these changes. 

Neva R. Watson, 

Attorney, Legislative. 

[FR Doc. 2011–3446 Filed 2–16–11; 8:45 am] 

BILLING CODE 7710–12–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 457 

[CMS–2291–F] 

RIN 0938–AP53 

Children’s Health Insurance Program 

(CHIP); Allotment Methodology and 

States’ Fiscal Years 2009 Through 

2015 CHIP Allotments 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule. 

SUMMARY: This final rule describes the 

implementation of funding provisions 

under Title XXI of the Social Security 

Act (the Act), for the Children’s Health 

Insurance Program (CHIP), as amended 

by the Children’s Health Insurance 

Program Reauthorization Act of 2009 

(CHIPRA), by the Medicare, Medicaid, 

and SCHIP Extension Act of 2007 

(MMSEA), by other related CHIP 

legislation, and most recently by the 

Patient Protection and Affordable Care 

Act of 2010 (the Affordable Care Act). 

Specifically, this final rule addresses 

methodologies and procedures for 

determining States’ fiscal years 2009 

through 2015 allotments and payments 

in accordance with sections 2104 and 

2105 of the Act, as amended by CHIPRA 

and the Affordable Care Act. 

DATES: Effective Date: These regulations 

are effective on April 18, 2011. 

FOR FURTHER INFORMATION CONTACT: 

Richard Strauss, (410) 786–2019. 

SUPPLEMENTARY INFORMATION: 

I. Background 

A. The Children’s Health Insurance 

Program 

Title XXI of the Social Security Act 

(the Act) sets forth CHIP to enable 

States, the District of Columbia, and 

specified Commonwealths and 

Territories to initiate and expand health 

insurance coverage to uninsured, lowincome children. The 50 States, the 

District of Columbia, and the 

Commonwealths and Territories may 

implement the CHIP through a separate 

child health program under title XXI of 

the Act, an expanded Medicaid program 

under title XIX of the Act, or a 

combination of both. 

Federal funds appropriated for title 

XXI are limited, and the law specifies a 

formula and methodology to divide the 

total annual appropriation into 

individual allotments available for each 

State, the District of Columbia, and each 

U.S. Territory and Commonwealth with 

an approved child health plan. 

B. Funding of CHIP Allotments Before 

the Enactment of CHIPRA 

Section 4901 of the Balanced Budget 

Act of 1997 (Pub. L. 105–33, enacted on 

August 5, 1997) (BBA), which added 

Title XXI to the Social Security Act, 

appropriated funding for States’ CHIPs 

for each fiscal year over a 10 fiscal year 

(FY) period from 1998 through 2007. 

The funding for each FY varied from 

$4.295 billion for FY 1998 up to $5.0 

billion for FY 2007. Under section 

2104(c)(4) of the Act, additional 

appropriations were provided for each 

of FYs 1999 through 2007 to provide 

additional allotment amounts 

particularly for the Commonwealths and 

Territories. 

Public Law 110–92 (enacted on 

September 29, 2007), contained 

provisions to extend funding under the 

CHIP through November 16, 2007. In 

particular, section 136(a) of Public Law 

110–92 appropriated $5 billion for the 

purposes of providing FY 2008 

allotments to the 50 States, the District 

of Columbia, and the Commonwealths 

and Territories. In addition, $40 million 

was appropriated by this section to 

provide additional allotments to the 

Commonwealths and Territories in FY 

2008. 


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9234 Federal Register / Vol. 76, No. 33 / Thursday, February 17, 2011 / Rules and Regulations 

Section 136(b) of Public Law 110–92 

also provided that the FY 2008 

allotments will be determined in 

accordance with the same methodology 

as previous CHIP fiscal year allotments 

were determined. In addition, section 

136(c) of Public Law 110–92 amended 

the CHIP statute to add a new section 

2104(i) of the Act to provide for the 

redistribution in FY 2008 of the 

unexpended FY 2005 allotments 

remaining at the end of FY 2007 to those 

50 States or the District of Columbia that 

had estimated shortfalls in FY 2008. 

Finally, section 106 of Public Law 110– 

92 made the FY 2008 allotment funds 

available only for States’ CHIP 

expenditures for assistance provided 

through November 16, 2007. 

Subsequent to the enactment of Public 

Law 110–92; further continuing 

appropriation legislation was enacted 

which extended the dates which the FY 

2008 allotment funds were available as 

provided in section 106 of Public Law 

110–92; in particular, Public Law 110– 

116 (enacted on November 13, 2007), 

Public Law 110–137 (enacted on 

December 14, 2007), and Public Law 

110–149 (enacted on December 21, 

2007) extended the dates to December 

14, 2007, December 21, 2007, and 

December 31, 2007, respectively. 

Section 201 of the Medicare, 

Medicaid, and SCHIP Extension Act of 

2007 (Pub. L. 110–173, enacted on 

December 29, 2007) (MMSEA) amended 

section 2104(a) of the CHIP statute to 

explicitly provide funding for CHIP 

allotments in the amount of $5 billion 

for each of FYs 2008 and 2009 for the 

50 States and the District of Columbia 

and the Commonwealths and 

Territories, and for $40 million for the 

Commonwealths and Territories for 

each of FYs 2008 and 2009. These 

allotments will be determined in 

accordance with the existing 

methodology in CHIP statute for fiscal 

years before FY 2008. The funding 

provided for FY 2008 under the 

Continuing Appropriation legislation 

discussed above and enacted before 

MMSEA will no longer be available (and 

thus expenditures for FY 2008 will be 

paid from the allotments as provided 

under MMSEA). MMSEA provided that 

the FYs 2008 and 2009 allotment funds 

were only available for States’ 

expenditures through March 31, 2009. 

Section 201 of MMSEA amended the 

CHIP statute to add section 2104(j) of 

the Act which appropriated $1.6 billion 

for the purpose of providing additional 

allotments to eliminate States’ CHIP 

shortfalls in FY 2008. 

The provisions of MMSEA were 

implemented and described in a Federal 

Register notice dated May 23, 2008 (73 

FR 30112). 

C. Enactment of CHIPRA 

Section 101 of the CHIPRA amended 

section 2104(a) of the Act to appropriate 

funding for each of FYs 2009 through 

2012, and for two semi-annual periods 

in FY 2013, October 1, 2012 through 

March 31, 2013 and April 1, 2013 

through September 30, 2013 

respectively, for the purpose of 

providing allotments to States for each 

of those fiscal years or fiscal year 

periods. Furthermore, section 108 of 

CHIPRA provided additional funding 

for State allotments for the period 

October 1, 2012 through March 31, 2013 

(the first half of FY 2013). Finally, 

section 3(c) of CHIPRA provides for the 

coordination of funding for CHIP in FY 

2009 as previously provided under 

section 201 of MMSEA. 

In particular, section 3(c) of CHIPRA 

requires the Federal government to 

rescind any previously appropriated 

amounts that were not allotted or 

obligated before April 1, 2009 for the 

following: 

• Section 2104(a)(11) of the Act for 

purposes of providing State CHIP 

allotments for FY 2009 for States’ 

expenditures through March 31, 2009. 

• Section 2104(k) of the Act for 

purposes of the redistribution of 

unexpended FY 2006 allotments in FY 

2009 to address States’ funding 

shortfalls in FY 2009. 

• Section 2104(l) of the Act for 

purposes of providing additional 

allotments for States’ expenditures in 

FY 2009 to fund States’ shortfalls for 

their expenditures through March 31, 

2009. 

Furthermore, any amounts provided 

for FY 2009 CHIP allotments in section 

2104(a)(12) as appropriated through the 

amendments made by CHIPRA must be 

reduced by the amounts that were 

obligated before April 1, 2009 under 

sections 2104(a)(11), 2104(k), or 2104(l) 

of the Act, as amended by section 201 

of MMSEA (which refer to States’ FY 

2009 CHIP allotments, amounts of 

unexpended FY 2006 allotments 

redistributed in FY 2009, and the 

amounts of additional FY 2009 

allotments to address States’ CHIP 

funding shortfalls through March 31, 

2009, respectively). Funding for 

Territories and Commonwealths under 

Section 2104(c)(4) of the Act was not 

subject to coordination of funding under 

section 3(c) of CHIPRA. 

The rescission of these unobligated 

amounts as well as the reduction in the 

FY 2009 allotment for the amounts that 

were obligated before April 1, 2009 

ensure that States do not receive FY 

2009 allotments as determined under 

CHIPRA in excess of the total amount 

provided under section 2104(a)(12) of 

the Act for FY 2009, as amended by 

CHIPRA, and 2104(c)(4). 

D. The Patient Protection and 

Affordable Care Act 

Section 10203(d)(1) of the Patient 

Protection and Affordable Care Act of 

2010 (‘‘Affordable Care Act’’), Public 

Law 111–148, amended section 2104 of 

the CHIP statute to extend funding for 

CHIP to the end of FY 2015 and made 

other technical changes to the funding 

provisions under CHIP that do not affect 

the overall funding mechanism. 

E. Authority for Qualifying States to Use 

Available CHIP Allotments for Medicaid 

Expenditures 

Under section 2105(a)(1)(A) through 

(D) and (a)(2) of the Act, and before 

enactment of Extension of Availability 

of CHIP Allotment Act (Pub. L. 108–74, 

enacted on August 15, 2003), only 

Federal payments for the following 

Medicaid and CHIP expenditures were 

applied against States’ available CHIP 

allotments to include: 

• Medical assistance provided under 

title XIX (Medicaid) of the Act, to 

targeted low-income children in a CHIPrelated Medicaid expansion, for which 

the CHIP enhanced Federal medical 

assistance percentage (CHIP EFMAP) 

rate is available. 

• Medical assistance provided on 

behalf of a child during a period of 

presumptive eligibility under section 

1920A of the Act (these funds are 

matched at the regular Medicaid Federal 

medical assistance percentage (FMAP) 

rate). 

• Child health assistance to targeted 

low income children that meets 

minimum benefit requirements under 

CHIP. 

• Other types of expenditures in CHIP 

that are subject to the 10-percent limit 

on non-primary expenditures (including 

other child health assistance for targeted 

low-income children, health services 

initiatives, outreach, and administrative 

costs). 

Section 1(b) of the Extension of 

Availability of CHIP Allotment Act as 

amended by the Social Security Act, 

Technical corrections (Pub. L. 108–127, 

enacted November 17, 2003), added new 

section 2105(g) to the Act that certain 

‘‘qualifying States’’ that met prescribed 

criteria could elect to use up to 20 

percent of any of the States’ available 

CHIP allotments for FYs 1998, 1999, 

2000, or 2001 to increase the FMAP rate 

for certain regular Medicaid 

expenditures to the EFMAP rate 

available under CHIP. These 


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expenditures were for children under 19 

years of age whose family income 

exceeds 150 percent of the Federal 

poverty line and who are eligible under 

the States’ Medicaid program. As 

described in the Federal Register notice 

published on July 23, 2004 (69 FR 

44013), if a qualified State submitted 

both 20 percent allowance expenditures 

and other ‘‘regular’’ CHIP expenditures 

at the same time in a quarter, the 20 

percent allowance expenditures would 

be applied first against the available 

fiscal year reallotments. However, the 

20 percent allowance expenditures 

could be applied only against the 

specified fiscal year allotment funds 

(upon which the 20 percent allowances 

were based) and which would remain 

available. Under section 

2104(g)(1)(B)(iii) of the Act, the amounts 

of States’ FY 2001 reallotments would 

only be available through the end of FY 

2005; therefore, the FY 2001 20 percent 

allowances for the qualifying States are 

only available through the end of FY 

2005. 

Section 6103 of the Deficit Reduction 

Act of 2005 (Pub. L. 109–171, enacted 

on February 8, 2006) amended section 

2105(g) of the Act to provide for 

continued authority for qualifying States 

to use a portion of their available FYs 

2004 and 2005 CHIP allotments for 

payments to supplement the Medicaid 

FMAP that result in total Federal 

participation at the EFMAP rate (as 

determined in section 2105(b) of the 

Act) for certain expenditures made in 

the Medicaid program. 

Section 201(b) of the National 

Institutes of Health Reform Act of 2006 

(Pub. L. 109–482, enacted on January 

15, 2007) and section 201(b) of MMSEA, 

amended section 2105(g) of the Act to 

provide for continued authority of 

payments to qualifying States for FYs 

2006 through 2009. 

Finally, section 107 of CHIPRA 

amended title XXI of the Act to add a 

new paragraph (4) of section 2105(g) of 

the Act; under this new provision, 

qualifying states at their option may use 

up to their entire fiscal year allotments 

for each of FYs 2009 through 2015, to 

the extent such allotments remain 

available to the State under the Act, in 

an amount equal to the additional 

amount that would have been paid to 

the State if the EFMAP as determined by 

section 2104(b) of the Act was 

substituted for the FMAP defined in 

section 1905(b) of the Act. Section 

10203(d)(2)(C) of the Affordable Care 

Act further amended section 2105(g)(4) 

of the Act to provide that qualifying 

states at their option may use up to their 

entire fiscal year allotments for each of 

FYs 2009 through 2015. 

The CHIPRA amendments to the 

qualifying State provision provide that 

the indicated amounts of such 

allotments are available for certain 

expenditures of the qualifying States as 

described in section 2105(g)(4)(B) of the 

Act, as amended by CHIPRA. In 

particular, these are expenditures made 

by such States on or after February 5, 

2009 for children whose family income 

equals or exceeds 133 percent of the 

Federal poverty line but does not exceed 

the Medicaid applicable income level. 

As indicated above in this preamble, 

this is a change from what was in effect 

previously; that is, before CHIPRA, the 

income level was 150 percent of the 

Federal poverty line. 

II. Provisions of the Proposed Rule 

We published on September 16, 2009 

a proposed rule in the Federal Register 

(74 FR 47517), that set forth the 

methodologies and procedures to 

determine allotments of federal funds 

under title XXI of the Social Security 

Act (the Act), reflecting the statutory 

changes described above. We proposed 

new regulatory provisions that would be 

set forth in 42 CFR part 457 subpart F. 

III. Analysis of and Responses to Public 

Comments 

We received a total of 2 timely 

comments on the September 16, 2009 

(74 FR 47517) proposed rule. Both 

comments either indicated agreement 

with the content of the proposed rule or 

were outside of the scope of the rule; 

neither of these comments suggested 

any changes to the content of the 

proposed rule. 

IV. Provisions of the Final Regulations 

After consideration of the comments 

reviewed and further analysis of specific 

issues, we are adopting the September 

16, 2009 proposed rule as final with 

minor revisions discussed and 

identified below. 

The provisions of this final rule that 

differ from those of the proposed rule 

relate to the amendments made by the 

Affordable Care Act, which extended 

funding for CHIP to the end of FY 2015; 

previously funding for CHIP extended 

only through the end of FY 2013. 

Therefore, we are implementing the new 

provisions of the Affordable Care Act 

discussed in this final regulation as final 

without the need for public comments. 

In this final rule, we are retaining the 

provisions as published in the proposed 

rule, as follows: 

• Set forth the methodology and 

procedures for determining the CHIP 

allotments for FYs 2009 through 2015 

for the 50 States and the District of 

Columbia, and the U.S. Commonwealths 

and Territories as provided under 

section 2104(m) of the Act. 

• Describe the methodology and 

process used to coordinate the funding 

provided previously to States under 

MMSEA, as described in the May 23, 

2008 Federal Register notice (73 FR 

30112), under the provisions of section 

2104(a)(11) of the Act related to States’ 

FY 2009 allotments provided to States 

before CHIPRA, section 2104(k) of the 

Act related to the redistribution of 

States’ unexpended FY 2006 allotments 

to address States’ shortfalls in FY 2009, 

and section 2104(l) of the Act related to 

funding States’ shortfalls in FY 2009 for 

their expenditures through March 31, 

2009. 

• Set forth the FY 2009 allotments as 

determined in accordance with such 

methodologies and procedures. 

• Set forth the FY 2010 allotments as 

determined in accordance with such 

methodologies and procedures. 

• Describe the implementation of the 

continued authority under section 

2105(g)(4) of the Act as amended by 

CHIPRA for ‘‘qualifying States’’ to elect 

to receive their available CHIP 

allotments for FYs 2009 through 2015 

CHIP as increased Federal matching 

funds for certain expenditures in their 

Medicaid programs. 

• Describe the retrospective 

adjustment for the FY 2008 shortfall 

funding as provided under section 

2104(j) of the Act. 

To incorporate the policies and 

implement the statutory provisions as 

described above, we applied the 

following revisions: 

• In § 457.600(a), we removed the 

date ‘‘2007’’ and added in its place 

‘‘2015’’. 

• In § 457.608, we revised the 

heading ‘‘Process and calculation of 

State allotments for a fiscal year’’ to read 

‘‘Process and calculation of State 

allotments prior to FY 2009’’. 

• In part 457 subpart F, we added 

§ 457.609, ‘‘Process and calculation of 

State allotments for a fiscal year after FY 

2008’’, which implements the funding 

amounts available for States’ CHIP 

allotments for FYs 2009 through 2015 of 

this regulation. 

• In § 457.610, we revised the 

heading ‘‘Period of availability for State 

allotments for a fiscal year’’ to read 

‘‘Period of availability for State 

allotments prior to FY 2009’’. In the first 

line of the paragraph for this section, we 

removed the words ‘‘for a fiscal year’’ 

and add in its place ‘‘prior to FY 2009’’. 

• In part 457 subpart F, we add 

§ 457.611, ‘‘Period of availability for 

State allotments for a fiscal year after FY 

2008’’, which reflects the 3 fiscal year 

and 2 fiscal year periods of availability, 


jlentini on DSKJ8SOYB1PROD with RULES
9236 Federal Register / Vol. 76, No. 33 / Thursday, February 17, 2011 / Rules and Regulations 

as applicable to fiscal years before 2009 

and effective for FY 2009 and 

subsequent fiscal years, respectively. 

A. Methodology and Procedures for 

Determining the CHIP Allotments for FY 

2009 Through FY 2015 for the 50 States 

and the District of Columbia, and the 

U.S. Commonwealths and Territories 

1. Reauthorization Funding for the CHIP 

Section 2104(a)(1) through (18) of the 

Act, as amended by section 101 of 

CHIPRA, and as further amended by 

section 10203(d) of the Affordable Care 

Act, provides funding for providing 

States’ allotments for FYs 2009 through 

2015. In particular, section 101 of 

CHIPRA amended section 2104(a) of the 

Act to revise paragraph (11) for FY 2008, 

and adds new paragraphs (12) through 

(16) to provide appropriations for FY 

2009 through FY 2013, respectively. The 

Affordable Care Act further amended 

section 2104(a) of the Act to add new 

paragraphs (17) and (18), which provide 

appropriations for CHIP in FYs 2014 

and 2015. In particular, under the 

amendments made by CHIPRA and the 

Affordable Care Act, the appropriated 

amounts available for allotments for FYs 

2009 through 2015, respectively are: 

$10,562,000,000 for FY 2009 (before 

CHIPRA the amount for FY 2009 was 

$5,000,000,000); 12,520,000,000 for FY 

2010; $13,459,000,000 for FY 2011; 

$14,982,000,000 for FY 2012; 

$17,406,000,000 for FY 2013, 

$19,147,000,000 for FY 2014, and 

$2,850,000,000 for each of the first and 

second half of FY 2015. Also, section 

108 of CHIPRA, as amended by 10203(d) 

of the Affordable Care Act, provides for 

a one-time appropriation of 

$15,361,000,000 for allotments for the 

first half of FY 2015. Therefore, the total 

appropriation for providing allotments 

during FY 2015 is $21,061,000,000 

(determined as the sum of 

$2,850,000,000, $15,361,000,000, and 

$2,850,000,000). 

2. Methodology for Determining State’s 

Fiscal Year Allotments 

a. CHIPRA and Affordable Care Act 

Provisions 

Section 2104(m) of the Act, as 

amended by section 102 of CHIPRA and 

section 10203(d) of the Affordable Care 

Act sets forth the methodology for 

determining States’ CHIP allotments for 

each of FYs 2009 through 2015. In 

general, the States’ fiscal year allotments 

are provided from the appropriation for 

the respective fiscal year allotment, 

subject to a proration adjustment, 

described in section II.A.2.i. of this final 

rule. 

b. FY 2009 Allotments 

The FY 2009 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

provided from the FY 2009 

appropriation of $10,562,000,000, and 

the $40,000,000 available at section 

2104(c)(4) and are subject to a proration 

adjustment described in II.A.2.i. of this 

final rule, if necessary. The FY 2009 

CHIP allotments for the 50 States and 

the District of Columbia are determined 

under a different methodology than is 

used for the determining the FY 2009 

allotments for the Commonwealths and 

Territories. 

The FY 2009 allotment for the 50 

States and the District of Columbia is 

determined as 110 percent of the highest 

of the following 3 amounts: 

• The total Federal payments to the 

State from the States’ available CHIP 

allotments in FY 2008 as reported by the 

State and certified to the Secretary 

through the November 2008 submission 

of the quarterly expenditure reports, 

Forms CMS–21 (OMB# 0938–0731 with 

an expiration date of August 31, 2011) 

and CMS–64 (OMB# 0938–0067 with an 

expiration date of August 31, 2011), 

multiplied by the allotment increase 

factor described in section II.A.2.j. of 

this final rule. 

• The amount allotted to the State for 

FY 2008, multiplied by the allotment 

increase factor described in section 

II.A.2.j. of this final rule. 

• The projected total Federal 

payments to the State under title XXI of 

the Act for FY 2009, determined based 

on the February submission of 

projections of expenditures as certified 

by the State to CMS no later than March 

31, 2009. These projections may include 

certain amounts of Medicaid 

expenditures for certain ‘‘qualifying 

States’’ described in section 2105(g) of 

the Act. 

With respect to the last item related 

to projected total Federal payments for 

FY 2009 under title XXI, section 107 of 

CHIPRA added a new paragraph section 

2105(g)(4) of the Act to allow States to 

use up to 100 percent of their FY 2009 

allotments for these expenditures. This 

provision is further described in section 

II.E. of this final rule. 

The FY 2009 allotment for the 

Commonwealths and Territories is 

determined as the highest amount of the 

Federal payments made to the 

Commonwealth or Territory under title 

XXI of the Act in any of the fiscal years 

for the period of FYs 1999 through 2008, 

multiplied by the allotment increase 

factor described in section II.A.2.j. of 

this final rule, plus an additional 

amount. The additional amount is equal 

to $40,000,000, as appropriated under 

section 2104(c)(4)(B) of the Act, 

multiplied by the following percentage 

provided under section 2104(c)(2) of the 

Act for the indicated jurisdiction: 91.6 

percent for Puerto Rico; 3.5 percent for 

Guam; 2.6 percent for the Virgin Islands; 

1.2 percent for American Samoa; and 

1.1 percent for the Northern Mariana 

Islands. 

c. FY 2010 Allotments 

The FY 2010 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

provided from the FY 2010 

appropriation of $12,520,000,000, and 

are subject to a proration adjustment if 

necessary, described in section II.A.2.i. 

of this final rule. Under the CHIPRA, the 

FY 2010 allotment for each State is 

determined by multiplying the 

allotment increase factor for FY 2010 for 

the State, by the sum of: The State’s FY 

2009 allotment; the amount of the final 

FY 2006 redistributed allotments paid to 

the State as determined under section 

2104(k) of the Act, and subject to any 

final retrospective adjustment to such 

amount determined by section 

2104(k)(5) of the Act; the amount of the 

final additional FY 2009 allotments paid 

to the State as determined by section 

2104(l) of the Act, and subject to any 

final retrospective adjustment to such 

amount determined by section 

2104(l)(5) of the Act; and the amount of 

any contingency fund payment made to 

the State for FY 2010, as determined by 

section 2104(n) of the Act. 

For the 50 States and the District of 

Columbia, section 2104(m)(6) of the Act, 

the FY 2010 allotment may include 

additional amounts in situations where 

such States have submitted an 

expansion allotment adjustment request 

before August 31, 2009. 

For the Commonwealths and 

Territories, in accounting for the 

amounts of the FY 2009 allotments for 

purposes of determining the FY 2010 

allotments, the component of the FY 

2009 allotment for such jurisdictions 

relating to the additional $40 million 

referenced in section 2104(c)(4) of the 

Act, is not included. Section 

2104(m)(2)(A)(i)(I) of the Act, as 

amended by CHIPRA, references the FY 

2009 allotment as determined in section 

2104(m)(1) of the Act; that section, in 

turn, provides for determining the FY 

2009 allotments from the amounts 

appropriated in section 2104(a)(12) of 

the Act. That is, such section 2104(m)(1) 

of the Act does not include the 

additional $40 million which is 

separately appropriated and available 

only for the jurisdictions in determining 

their FY 2009 allotments. Therefore, the 


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Federal Register / Vol. 76, No. 33 / Thursday, February 17, 2011 / Rules and Regulations 9237 

component of the jurisdictions’ FY 2009 

allotment related to the additional $40 

million would not be included in 

determining the amount of the 

jurisdictions’ FY 2010 allotments. 

d. FY 2011 Allotments 

The FY 2011 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

provided from the FY 2011 

appropriation ($13,459,000,000). The 

amounts of these allotments are subject 

to a proration adjustment described in 

section II.A.2.i of this final rule, if 

necessary. Section 2104(m)(2)(A)(ii) of 

the Act, as amended by CHIPRA 

requires a ‘‘rebasing’’ process be used for 

determining the FY 2011 allotments; 

under the rebasing methodology, States’ 

payments rather than their allotments 

for FY 2010 must be considered in 

calculating the FY 2011 allotments. In 

particular, the FY 2011 allotments are 

determined by multiplying the 

allotment increase factor for FY 2011 for 

the State by the sum of: Any Federal 

payments made from the States’ 

available allotments in FY 2010; any 

amounts provided as redistributed 

allotments in FY 2010 to the State; and 

any Federal payments attributable to 

any contingency fund payments made to 

the State for FY 2010 determined under 

Section 2104(n) of the Act. 

e. FY 2012 Allotments 

The FY 2012 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

provided from the FY 2012 

appropriation ($14,982,000,000), and 

are subject to a proration adjustment 

described in section II.A.2.i. of this final 

rule, if necessary. Under the CHIPRA, 

the FY 2012 allotment for each State 

will be determined by multiplying the 

allotment increase factor for FY 2012 for 

the State, by the sum of: The State’s FY 

2011 allotment and any contingency 

fund payment made to the State for FY 

2011, as determined under section 

2104(n) of the Act. 

For the 50 States and the District of 

Columbia, in section 2104(m)(6) of the 

Act, the FY 2012 allotment may include 

additional amounts in situations where 

such States have submitted an 

expansion allotment adjustment request 

before August 31, 2011. 

f. FY 2013 Allotments 

The FY 2013 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

provided from the FY 2013 

appropriation ($17,406,000,000). The 

amounts of these allotments are subject 

to a proration adjustment described in 

section II.A.i. of this final rule, if 

necessary. Section 2104(m)(2)(B)(i) of 

the of the Act, as amended by the 

Affordable Care Act requires a 

‘‘rebasing’’ process be used for 

determining the FY 2013 allotments; the 

rebasing methodology means the States’ 

payments rather than their allotments 

for FY 2012 must be considered in 

calculating the FY 2013 allotments. In 

particular, the FY 2013 allotments are 

determined by multiplying the 

allotment increase factor for FY 2013 for 

the State by the sum of: Any Federal 

payments made from the States’ 

available allotments in FY 2012; any 

amounts provided as redistributed 

allotments in FY 2012 to the State; and 

any Federal payments attributable to 

any contingency fund payments made to 

the State for FY 2012 determined under 

Section 2104(n) of the Act. 

g. FY 2014 Allotments 

The FY 2014 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

provided from the FY 2014 

appropriation of $19,147,000,000, and 

are subject to a proration adjustment 

described in II.A.2.i. of this final rule, if 

necessary. Under section 2104(m), as 

amended by the Affordable Care Act, 

the FY 2014 allotment for each State is 

determined by multiplying the 

allotment increase factor for FY 2014 for 

the State, by the sum of: The State’s FY 

2013 allotment and any contingency 

fund payment made to the State for FY 

2013, as determined in section 2104(n) 

of the Act. 

For the 50 States and the District of 

Columbia, under section 2104(m)(6) of 

the Act, the FY 2014 allotment may 

include additional amounts in 

situations where such States have 

submitted an expansion allotment 

adjustment request before August 31, 

2013. 

h. FY 2015 Allotments 

The FY 2015 allotments for the 50 

States and the District of Columbia, and 

the Commonwealths and Territories, are 

comprised of two components related to 

the first half of FY 2015 (that is, the 

period of October 1, 2014 through 

March 31, 2015) and second half of FY 

2015 (that is, April 1, 2015 through 

September 30, 2015). The FY 2015 

allotments for the first and second half 

of FY 2015 are subject to a proration 

adjustment described in section II.A.2.i. 

of this final rule, as necessary. 

The allotments for the first half of FY 

2015 are provided from a total available 

appropriation of $18,211,000,000, 

comprised of $2,850,000,000 

appropriated under section 

2104(a)(18)(A) of the Act, and 

$15,361,000,000 appropriated by section 

108 of CHIPRA, as amended by the 

Affordable Care Act. The allotments for 

the first half of FY 2015 are equal to the 

‘‘first half ratio’’ multiplied by the 

allotment increase factor for FY 2015 

multiplied by the sum of any Federal 

payments made from the States’ 

available allotments in FY 2014; any 

amounts provided as redistributed 

allotments in FY 2014 to the State; and 

any Federal payments attributable to 

any contingency fund payments made to 

the State for FY 2014 as determined 

under Section 2104(n) of the Act. 

Therefore, the first half ratio is the 

percentage determined by dividing 

$18,211,000,000 (calculated as the sum 

of $2,850,000,000 (the appropriation for 

the first half of FY 2015) and 

15,361,000,000 (the one-time 

appropriation for the first half of the FY 

2015)) by $21,061,000,000 (calculated as 

$2,850,000,000, the appropriation for 

the second half of FY 2015) plus the 

$18,211,000,000 amount). 

The States’ CHIP allotments for the 

second half of FY 2015 are provided 

from a total available appropriation of 

$2,850,000,000, appropriated under 

section 2104(a)(18)(B) of the Act. The 

allotments for the second half of FY 

2015 are equal to $2,850,000,000 

multiplied by a percentage equal to the 

amount of the allotment for the State for 

the first half of FY 2015 divided by the 

sum of all such first half of FY 2015 

allotments for all States. 

i. Proration Rule 

Under section 2104(m)(4) of the Act, 

as amended by CHIPRA, if the amount 

of States’ allotments for a fiscal year (in 

accordance with the provisions 

described in this final rule, or in the 

case of FY 2015, the amount of an 

allotment for each half of the fiscal year) 

exceeds the total appropriations 

available for such periods, the total 

allotments for each of these periods will 

be reduced on a proportional basis. The 

total amount available nationally for the 

period is multiplied by a proration 

percentage determined by dividing the 

amount determined for the period by 

the sum of such amounts. 

j. The Allotment Increase Factor for a 

Fiscal Year 

Under Section 2104(m)(5) of the Act, 

the allotment increase factor for a fiscal 

year is equal to the product of two 

amounts for the fiscal year: The per 

capita health care growth factor and the 

child population growth factor. 

The per capita health care growth 

factor for a fiscal year is equal to 1 plus 

the percentage increase in the projected 


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per capita amount of the National 

Health Expenditures from the calendar 

year in which the previous fiscal year 

ends to the calendar year in which the 

fiscal year involved ends, as most 

recently published by CMS before the 

beginning of the fiscal year involved. 

In general, for the 50 States and the 

District of Columbia, the Child 

Population Growth Factor (CPGF) for a 

fiscal year is equal to 1 plus the 

percentage increase (if any) in the 

population of children in the State from 

July 1 in the previous fiscal year to July 

1 in the fiscal year involved, as 

determined by CMS based on the most 

recent published estimates of the 

Census Bureau available before the 

beginning of the fiscal year involved 

plus 1 percentage point. In the 

determination of the CPGF, section 

2104(m)(5)(B) refers to ‘‘the percentage 

increase (if any)’’ of the population of 

children in the State. In this regard, 

CPGF refers only to increases in the 

population of children. Thus, if there 

was a decrease in the population of 

children over the indicated period, the 

CPGF for such State would be 0.0 

percent plus one percentage point; that 

is, negative growth in the children 

population would not result in the 

growth factor being less than 101 

percent. 

Because of concerns about availability 

of data to determine the CGPF for the 

Commonwealths and the Territories, 

section 2104(m)(1)(B) of the Act 

explicitly required that the term ‘‘United 

States’’ be substituted for the term ‘‘the 

State’’. For fiscal years after FY 2009, 

that exception does not apply, and CMS 

will determine the CPGF for the 

Commonwealths and the Territories, 

based on the most recent published 

estimates of the Census Bureau. In 

accordance with section 602(b) of the 

CHIPRA, which added a new section 

2109(b)(2)(B) of the Act, we will be 

working with the Secretary of the 

Commerce Department on appropriate 

adjustments to improve the Current 

Population Survey (CPS), or develop 

other data, to determine the CPGF. 

k. CHIP Fiscal Year Allotment Process 

As described above, the determination 

of the allotments for each fiscal year 

potentially involves the collection of 

relevant data, such as related to the 

allotment increase factor, or the 

consideration of additional information 

later or after the end of the fiscal year; 

for example, the determination of the 

FYs 2010, 2012, and 2014 allotments 

allows States to receive increases in 

their CHIP allotments to reflect the 

submission of certain expansions to 

their CHIP programs. In that regard, we 

are incorporating into the CHIP 

regulation a process, which the 

Secretary may elect to publish 

preliminary fiscal year allotments. 

Consequently, this process at the time 

the updated allotment amounts became 

available the Secretary would publish a 

final notice. For example, the CHIPRA 

legislation as amended by the 

Affordable Care Act, in the 

determination of the FYs 2010, 2012, 

and 2014 allotments, States can amend 

their CHIP programs to provide for 

certain expansions; the increase in 

expenditures for such expansions will 

serve to increase the amount of the State 

fiscal year allotments associated with 

the year of such expansions. As 

determined by the Secretary, the CHIP 

allotments for a fiscal year may need to 

be published first as ‘‘Preliminary 

Allotments’’ and then later as ‘‘Final 

Allotments’’ in the Federal Register. The 

proposed rule provided for the potential 

for a preliminary and final allotment to 

be determined. 

B. Coordination of CHIP Funding for FY 

2009 

Before the enactment of CHIPRA, 

section 2104(a)(11) of the Act, as 

amended by MMSEA, appropriated $5 

billion for purposes of providing FY 

2009 allotments for States. The CHIP 

statute as amended by MMSEA and 

before the enactment of CHIPRA, funds 

were potentially available for allotment 

and obligation to States for their CHIP 

related expenditures in FY 2009 through 

March 31, 2009. Furthermore, section 

2104(k) of the Act and section 2104(l) of 

the Act, as amended by MMSEA, 

provided for redistribution of the 

unexpended FY 2006 allotments in FY 

2009, and for additional FY 2009 

shortfall allotments in FY 2009, 

respectively. However, section 3(c)(1) of 

CHIPRA provides for a rescission of 

amounts of these funds that were not 

obligated before April 1, 2009. Also, 

section 3(c)(2) of CHIPRA requires that 

the FY 2009 allotments, as determined 

under section 2104(m)(1) of the Act as 

amended by CHIPRA, be reduced by the 

following amounts that were 

appropriated and obligated before April 

1, 2009. Amounts appropriated and 

obligated before April 1, 2009 include 

the amounts of the FY 2009 allotments 

appropriated by section 2104(a)(11) of 

the Act, as amended by MMSEA and 

before the enactment of CHIPRA; 

amounts of FY 2006 redistributed 

allotments, provided in section 2104(k) 

of the Act; and, the amounts of the FY 

2009 shortfall allotments, provided in 

section 2104(l) of the Act. Funding for 

Territories and Commonwealths under 

section 2104(c)(4) is not part of this 

coordination of funding. This 

coordination ensures that States’ FY 

2009 CHIP funding does not exceed the 

final FY 2009 CHIP allotments as 

determined under the CHIPRA. 

C. FY 2009 Allotments Determined in 

Accordance With Such Methodologies 

and Procedures 

We calculated the FY 2009 allotments 

for the States in accordance with the 

methodology described in section II.A. 

of the September 16, 2009 (74 FR 47517) 

proposed rule relating to the calculation 

of the fiscal year CHIP allotments, and 

in section II.B. of the same proposed 

rule. That calculation was contained in 

three tables described as Table 1 

provided the calculation of the 

allotment increase factor for FY 2009, 

Table 2 provided the calculation of the 

FY 2009 allotment, and Table 3 

provided the coordination of funds in 

FY 2009. 

D. FY 2010 Allotments Determined in 

Accordance With Such Methodologies 

and Procedures 

In accordance with the methodology 

described in section II.A.2.c. of this final 

rule, relating to the calculation of the FY 

2010 CHIP allotments, and the 

availability of additional allotments, we 

calculated the FY 2010 allotments for 

the States. That calculation is contained 

in two tables described in section III of 

this final rule; Table 1 provides the 

calculation of the allotment increase 

factor for FY 2010, and Table 2 provides 

the calculation of the FY 2010 

allotment. 

E. FY 2011 Allotments Determined in 

Accordance With Such Methodologies 

and Procedures 

In accordance with the methodology 

described in section II.A.2.d. of this 

final rule relating to the calculation of 

the fiscal year CHIP allotments, we 

calculated the FY 2011 allotments for 

the States. That calculation is contained 

in two tables described in section III of 

this final rule; Table 3 provides the 

calculation of the allotment increase 

factor for FY 2011, and Table 4 provides 

the calculation of the FY 2011 

allotment, determined under the 

‘‘rebasing’’ methodology. 

F. Period of Availability for CHIP 

Allotments 

Section 105 of CHIPRA amended 

section 2104(e) of the Act to revise the 

period of availability for expenditure by 

States of their CHIP fiscal year 

allotments. Before the enactment of 

CHIPRA, States’ CHIP fiscal year 

allotments were available for 

expenditure by the State for three fiscal 


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years, the fiscal year in which they were 

initially allotted and the subsequent two 

fiscal years. Section 2104(e) of the Act, 

as amended by CHIPRA, now provides 

that each of the States’ fiscal year 

allotments for FYs 1998 through 2008 

are available for expenditure by the 

State for three fiscal years and 

allotments for FY 2009 and each 

succeeding fiscal year are available for 

expenditure by the States for two fiscal 

years; the fiscal year in which they were 

initially allotted and the immediately 

subsequent fiscal year. In this final rule, 

we have amended the CHIP regulations 

at § 457.610 and added § 457.611 to 

reflect the three fiscal year and two 

fiscal year periods of availability, as 

applicable to fiscal years before FY 2009 

and effective for FY 2009 and 

subsequent fiscal years, respectively. 

G. Continuing Authority for Qualifying 

States to Use FY 2009 Through FY 2015 

Allotments for Certain Medicaid 

Expenditures 

Section 107 of CHIPRA amended the 

CHIP statute to add a new section 

2105(g)(4) of the Act to allow certain 

‘‘qualifying States’’ described in section 

2105(g) of the Act to elect to use up to 

100 percent of their available CHIP 

fiscal year allotments for FY 2009 and 

following fiscal years (through FY 2015, 

as amended by section 10203(d)(2) of 

the Affordable Care Act) for certain 

expenditures in Medicaid. Before the 

enactment of CHIPRA, States were only 

able to use up to 20 percent of their 

available fiscal year CHIP allotments for 

the applicable Medicaid expenditures. 

With the enactment of CHIPRA, 

beginning with the FY 2009 allotment, 

States can use up to 100 percent of their 

FY 2009 and following fiscal year 

allotments for the States’ qualifying 

expenditures. In that case, only the 

Federal share portion of the 

expenditures which is above the amount 

that the State would have received 

under Medicaid will be applied against 

the CHIP allotment. 

Under section 5001 of the American 

Recovery and Reinvestment Act of 2009 

(ARRA, Pub. L. 111–5, enacted on 

February 17, 2009), and as further 

amended by the Public Law 111–226 

(enacted on August 10, 2010), the FMAP 

has been increased during the 11- 

quarter period, October 1, 2009 through 

June 30, 2011 under the Medicaid 

program. Therefore, the amount of the 

Federal share funds that will be applied 

against the CHIP qualifying States’ FY 

2009 (and following) allotments will be 

reduced. For example, a qualifying 

State’s regular Medicaid FMAP rate in 

FY 2009 is 50 percent, its increased 

FMAP under ARRA in Medicaid is 

60.00 percent, and its CHIP EFMAP is 

65.00 percent. The qualifying State will 

be able to claim the ‘‘qualifying’’ 

expenditures in FY 2009 at the 65.00 

percent EFMAP rate in CHIP, and only 

5 percent of such expenditures will 

apply against the State’s FY 2009 

allotment, calculated as 65.00 percent 

(CHIP EFMAP) minus 60.00 percent 

(increased FMAP under ARRA) 

claimable under the Medicaid program. 

In the same example (and assuming the 

same FMAP for Medicaid and EFMAP 

in CHIP), after June 30, 2011, 15.00 

percent of the qualifying expenditure in 

FY 2011 will apply against the State’s 

FY 2011 CHIP allotment, calculated as 

65.00 percent (CHIP EFMAP) minus 

50.00 percent (regular FMAP) claimable 

under the Medicaid program. We have 

amended the CHIP regulations to reflect 

this provision in this final rule. 

H. Retrospective Adjustment of FY 2008 

Shortfall Allotments 

Section 2104(j)(5) of the Act, as 

amended by MMSEA provides for a 

potential retrospective adjustment with 

respect to the amounts of States’ FY 

2008 shortfall allotments provided to 

them in FY 2008 and based on 

expenditure reports for FY 2008 

submitted and certified by States to 

CMS no later than November 30, 2008. 

Under section 2104(j)(2) and (3)(A) of 

the Act, additional FY 2008 shortfall 

allotments were made available only to 

those 50 States and the District of 

Columbia that were initially determined 

to have a shortfall in CHIP funding in 

FY 2008 based on their FY 2008 

expenditure projections as submitted 

and certified by the States by November 

30, 2007. For those States, section 

2104(j)(5) of the Act, the retrospective 

adjustment to the amounts of their 

additional FY 2008 shortfall allotments 

is based on the FY 2008 expenditure 

projections submitted and certified by 

such States by November 30, 2008. 

Through the end of FY 2008 and 

based on States’ estimated FY 2008 

CHIP expenditures, we had provided 

approximately $1,201 million in total 

additional FY 2008 shortfall allotments 

to States to address their projected 

shortfalls in FY 2008. However, based 

on the States’ actual FY 2008 

expenditures, as submitted through 

November 30, 2008, the final States’ 

shortfalls in FY 2008 were only 

approximately $995 million. That is, of 

those States who overestimated their 

projected shortfalls, final shortfalls for 

FY 2008 were about $232 million less 

than were previously estimated, and for 

States that underestimated their 

shortfalls, their actual shortfalls were 

about $26 million higher. Thus, the final 

net shortfall for States was about $995 

million ($1,201 million minus $232 

million plus $26 million). Table 4 of the 

proposed rule published in the Federal 

Register on September 16, 2009 (74 FR 

47517) contained the final FY 2008 

shortfall allotments after applying the 

retrospective adjustment under section 

2104(j)(5) of the Act. 

I. Retrospective Adjustment of FY 2009 

Shortfall Allotments 

Section 2104(l)(5) of the Act, as 

amended by MMSEA provides for a 

potential retrospective adjustment with 

respect to the amounts of States’ FY 

2009 shortfall allotments provided to 

them in FY 2009 prior to April 1, 2009 

based on expenditure reports for the 

first two quarters of FY 2009 as 

submitted and certified by States to 

CMS no later than May 31, 2009. 

Under section 2104(l)(2) and (3)(A) of 

the Act, additional FY 2009 shortfall 

allotments were made available to those 

States that were initially determined to 

have a shortfall in CHIP funding in FY 

2009 based on their expenditure 

projections for the first two quarters of 

FY 2009 as submitted and certified by 

the States by November 30, 2008. For 

those States, section 2104(l)(5) of the 

Act, provided the retrospective 

adjustment to the amounts of their 

additional FY 2009 shortfall allotments 

is based on the FY 2009 expenditures 

for the first two quarters of FY 2009 as 

submitted and certified by such States 

by May 31, 2009. 

Before April 1, 2009, and based on 

States’ estimated FY 2009 CHIP 

expenditures through the end of the 

second quarter of FY 2009, we had 

provided approximately $267 million in 

total additional FY 2009 shortfall 

allotments to States to address their 

projected shortfalls in FY 2009 through 

the end of the second quarter FY 2009 

in that amount. However, based on the 

States’ actual FY 2009 expenditures for 

the first two quarters of FY 2009, as 

submitted through May 31, 2009, the 

final States’ shortfalls in FY 2009 

through the second quarter of FY 2009 

for the shortfall States were only 

approximately $210 million. That is, for 

the shortfall States initially receiving 

the additional FY 2009 shortfall 

allotments, based on their actual FY 

2009 reported expenditures for the first 

two quarters of FY 2009, their final 

shortfalls for the first two quarters of FY 

2009 were about $58 million less than 

was previously estimated. Table 5 of the 

proposed rule published in the 

September 16, 2009 Federal Register (74 

FR 47517) contained the final FY 2009 

shortfall allotments after applying the 


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retrospective adjustment under section 

2104(l)(5) of the Act. 

III. Tables 

Following are the keys and associated 

tables for the CHIP funding provisions 

as discussed in previous sections: 

Table 1—Allotment Increase Factor 

for 2010 

Table 2—FY 2010 Children’s Health 

Insurance Program Allotments Under 

the Children’s Health Insurance 

Program Reauthorization Act Of 2010 

Table 3—Allotment Increase Factor 

for 2011 

Table 4—FY 2011 Children’s Health 

Insurance Program Allotments Under 

the Children’s Health Insurance 

Program Reauthorization Act Of 2011. 

A. Table 1—Allotment Increase Factor 

for 2010 

Key to Table 1 Column/Description 

Column A = State. Column A contains 

the name of the State, District of 

Columbia, U.S. Commonwealth or 

Territory. 

Column B = PCNHE 2009, PCNHE 

2010, PCHCG Factor. Column B 

contains the calculation of the Per 

Capita Health Care Growth (PCHCG) 

Factor for FY 2010, determined as 1 

plus the percentage increase in the Per 

Capital National Health Expenditures 

(PCNHE) from calendar year 2009 to 

calendar year 2010. 

Columns C through F = Calculation of 

the Child Population Growth Factor 

(CPGF) for FY 2010: 

Column C = July 1, 2009 Child 

Population. Column C contains the 

population of children in each State or 

the United States as of July 1, 2009, as 

provided by the most recent published 

data of the Census Bureau before the 

beginning of FY 2010. 

Column D = July 1, 2010 Child 

Population. Column D contains the 

population of children in each State or 

the United States as of July 1, 2010, as 

provided by the most recent published 

data of the Census Bureau before the 

beginning of FY 2010. 

Column E = Percent Increase 2009– 

2010. Column E contains the percentage 

increase, if any, of the population of 

children in each State, or the United 

States, from July 1, 2009 to July 1, 2010, 

calculated as the difference between the 

number in Column D minus the number 

in Column C divided by the number in 

Column C. 

Column F = FY 2010 Child Population 

Growth Factor. Column F contains the 

Child Population Growth Factor (CPGF) 

for each State, determined as 1.01 plus 

the percent in Column E for the State. 

Column G = FY 2010 Allotment 

Increase Factor. Column G contains the 

FY 2010 Allotment Increase Factor, 

calculated as the PCHCG factor in 

Column B multiplied by the CPGF 

percent in Column F. 

B. Table 2—FY 2010 Children’s Health 

Insurance Program Allotments Under 

the Children’s Health Insurance 

Program Reauthorization Act of 2009 

Key to Table 2 Column/Description 

Column A = State. Column A contains 

the name of the State, District of 

Columbia, U.S. Commonwealth or 

Territory. 

Column B = FY 2009 CHIP 

Allotments. Column B contains, for the 

50 States and the District of Columbia 

only, the States’ FY 2009 CHIP 

allotments, as were published in the 

September 16, 2009 Federal Register (74 

FR 47617). 

Column C = FY 2006 Redistributed 

Allotment Payments. Column C contains 

for the 50 States and the District of 

Columbia only, the amounts of 

redistributed FY 2006 allotments 

provided in FY 2009 as determined 

under section 2104(k) of the Act. 

Column D = FY 2009 Additional 

Allotment Payments. Column D 

contains the any additional allotment 

payments provided to the State in FY 

2009 under the provisions of section 

2104(l) of the Act, including the 

retrospective adjustments made under 

section 2104(l)(5) of the Act. 

Column E = FY 2009 Contingency 

Fund Payments. Column E contains any 

contingency fund payments made to a 

State for FY 2009, if any, under the 

provisions of section 2104(n) of the Act. 

Column F = Total. Column F contains 

the total of the amounts in Columns B, 

C, D, E, and F. 

Column G = FY 2010 Allotment 

Increase Factor. Column G contains the 

Allotment Increase Factor for each State 

as contained in Column G of Table 1. 

Column H = FY 2010 Total × Increase 

Factor. Column H contains the product 

of the total amount in Column F and the 

amount of the FY 2010 Allotment 

Increase Factor in Column G. This 

amount represents the FY 2010 CHIP 

allotment without the inclusion of any 

additional amounts available for the FY 

2010 allotment indicated in Column I. 

Column I = Additional Amount 

Available for FY 2010 Allotment. 

Column I contains, for the 50 States and 

the District of Columbia only, the 

amount of additional amounts available 

to increase the FY 2010 allotment, if 

any, as determined under the provisions 

of section 2014(m)(6) or (7) of the Act. 

Column J = Total FY 2010 Allotment. 

Column J contains the total FY 2010 

CHIP allotment, determined as the sum 

of the amounts in Column H and 

Column I, if any. 

C. Table 3—Allotment Increase Factor 

for 2011 

Key to Table 1 Column/Description 

Column A = State. Column A contains 

the name of the State, District of 

Columbia, U.S. Commonwealth or 

Territory. 

Column B = PCNHE 2010, PCNHE 

2011, PCHCG Factor. Column B 

contains the calculation of the Per 

Capita Health Care Growth (PCHCG) 

Factor for FY 2011, determined as 1 

plus the percentage increase in the Per 

Capital National Health Expenditures 

(PCNHE) from calendar year 2010 to 

calendar year 2011. 

Columns C through F = Calculation of 

the Child Population Growth Factor 

(CPGF) for FY 2011: 

Column C = July 1, 2010 Child 

Population. Column C contains the 

population of children in each State or 

the United States as of July 1, 2010, as 

provided by the most recent published 

data of the Census Bureau before the 

beginning of FY 2011. 

Column D = July 1, 2011 Child 

Population. Column D contains the 

population of children in each State or 

the United States as of July 1, 2010, as 

provided by the most recent published 

data of the Census Bureau before the 

beginning of FY 2011. 

Column E = Percent Increase 2010– 

2011. Column E contains the percentage 

increase, if any, of the population of 

children in each State, or the United 

States, from July 1, 2010 to July 1, 2011, 

calculated as the difference between the 

numbers in Column D minus the 

number in Column C divided by the 

number in Column C. 

Column F = FY 2011 Child Population 

Growth Factor. Column F contains the 

Child Population Growth Factor (CPGF) 

determined as 1.01 plus the percent in 

Column E for the State. 

Column G = FY 2011 Allotment 

Increase Factor. Column G contains the 

FY 2011 Allotment Increase Factor, 

calculated as the PCHCG factor in 

Column B multiplied by the CPGF 

percent in Column F. 

D. Table 4—FY 2011 Children’s Health 

Insurance Program Allotments Under 

the Children’s Health Insurance 

Program Reauthorization Act of 2009 

Key to Table 4 

Column/Description 

Column A = State. Column A contains 

the name of the State, District of 

Columbia, U.S. Commonwealth or 

Territory. 


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Column B = FY 2010 FS Exp. Applied 

Against Allotments. Column B contains 

the amounts of the Federal share 

expenditures that were applied against 

the State’s available allotments in FY 

2010. 

Column C = Contingency Fund 

Payments in FY 2010. Column C 

contains the amounts of contingency 

fund payments made to the State in FY 

2010, if any. 

Column D = Redistributed Allotments 

in FY 2010. Column D contains the 

amounts of redistributed allotments 

provided to the State in FY 2010, if any. 

Column E = Total FY 2010 FS 

Expenditures. Column E contains the 

sum of the total amounts of Federal 

Share expenditures applied against the 

States available allotments in FY 2010, 

Contingency Fund payments made in 

FY 2010, if any, and amounts of 

Redistributed Allotments in FY 2010, if 

any, calculated as the sum of the 

amounts in Columns B, C, and D. 

Column F = FY 2011 Allotment 

Increase Factor. Column F contains the 

Allotment Increase Factor for each State 

as contained in Column G of Table 3. 

Column G = FY 2011 CHIP Allotment. 

Column G contains the FY 2011 CHIP 

Allotment, calculated as the product of 

the total amount in Column E and the 

amount of the FY 2011 Allotment 

Increase Factor in Column F. 

BILLING CODE 4120–01–P 


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BILLING CODE 4120–01–C 


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V. Waiver of Proposed Rulemaking 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register and invite public comment on 

the proposed rule. This procedure can 

be waived, however, if an agency finds 

good cause that a notice-and-comment 

procedure is impracticable, 

unnecessary, or contrary to the public 

interest and incorporates a statement of 

the finding and its reasons in the rule 

issued. 

As discussed above, on September 16, 

2009, we issued a proposed rule that set 

forth the methodologies and procedures 

to determine CHIP allotments in 

accordance with applicable federal laws 

on that date. Since that date, the 

Affordable Care Act was enacted into 

law. The Affordable Care Act made 

technical changes to the CHIP funding 

provisions and extended CHIP funding 

through the end of federal fiscal year 

2015. The Affordable Care Act did not 

make any fundamental changes to the 

overall funding mechanism. Because 

there was no fundamental change to the 

funding mechanism, we believe it is 

unnecessary to reopen for public 

comment the methodologies and 

procedures to determine CHIP 

allotments set out in the proposed rule 

and made final in this rule. The changes 

made in the Affordable Care Act to 

extend the period of funding do not 

open up any new issues or concerns as 

to the calculation methodology or 

procedures. 

Therefore, we find good cause to 

waive the notice of proposed 

rulemaking and to issue this final rule. 

VI. Collection of Information 

Requirements 

This document does not impose any 

information collection and 

recordkeeping requirements. 

Consequently, it need not be reviewed 

by the Office of Management and 

Budget under the authority of the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 35). 

VII. Regulatory Impact Analysis 

A. Overall 

We have examined the impacts of this 

final rule as required by Executive 

Order 12866 on Regulatory Planning 

and Review (September 30, 1993), the 

Regulatory Flexibility Act (RFA) 

(September 19, 1980, Public Law 96– 

354), section 1102(b) of the Social 

Security Act, section 202 of the 

Unfunded Mandates Reform Act of 1995 

(Pub. L. 104–4), Executive Order 13132 

on Federalism (August 4, 1999), and the 

Congressional Review Act (5 U.S.C. 

804(2)). 

Executive Order 12866 directs 

agencies to assess all costs and benefits 

of available regulatory alternatives and, 

if regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety effects, distributive impacts, 

and equity). A regulatory impact 

analysis (RIA) must be prepared for 

major rules with economically 

significant effects ($100 million or more 

in any 1 year). We have determined that 

this final rule is economically 

significant, since it provides the 

methodologies under which State 

allotments for FYs 2009 through 2015 

are calculated. In particular, this final 

rule implements the CHIP statute as 

amended by CHIPRA and the Affordable 

Care Act, under which approximately 

up to $74 billion in additional Federal 

funds may be made available for FYs 

2009 through 2016 in addition to the 

amount of funds previously 

appropriated for States’ CHIPs in 

accordance with the methodology 

established in the CHIP statute. This 

final rule also includes the actual State 

fiscal year CHIP allotments for FYs 2010 

and 2011 determined in accordance 

with the methodology set out in this 

final rule. The methodologies for 

determining the States’ CHIP allotments 

was established in accordance with the 

methodologies specified in statute and 

does not put forward any discretionary 

administrative policies for determining 

such allotments. Therefore, we have 

determined that there are no policy 

options that require an analysis beyond 

that which is presented in section II of 

this final rule. 

The RFA requires agencies to analyze 

options for regulatory relief of small 

entities, if a rule has a significant impact 

on a substantial number of small 

entities. For purposes of the RFA, we 

estimate that most hospitals and most 

other providers and suppliers are small 

entities as that term is used in the RFA 

nonprofit organizations. The great 

majority of hospitals and most other 

health care providers and suppliers are 

small entities, either by being nonprofit 

organizations or by meeting the SBA 

definition of a small business having 

revenues of less than $7.0 million to 

$34.5 million in any 1 year. Individuals 

and States are not included in the 

definition of a small entity. We are not 

preparing an analysis for the RFA 

because we have determined that this 

final rule will not have a significant 

economic impact on a substantial 

number of small entities. 

In addition, section 1102(b) of the Act 

requires us to prepare a regulatory 

impact analysis if a rule may have a 

significant impact on the operations of 

a substantial number of small rural 

hospitals. This analysis must conform to 

the provisions of section 604 of the 

RFA. We are not preparing an analysis 

for section 1102(b) of the Act because 

we have determined that this final rule 

will not have a significant impact on the 

operations of a substantial number of 

small rural hospitals. 

Section 202 of the Unfunded 

Mandates Reform Act of 1995 (UMRA) 

also requires that agencies assess 

anticipated costs and benefits before 

issuing any rule whose mandates 

require spending in any 1 year of $100 

million in 1995 dollars, updated 

annually for inflation. In 2011, that 

threshold is approximately $136 

million. This final rule will not create 

an unfunded mandate on States, tribal, 

or local governments in the aggregate, or 

by the private sector in the amount of 

$136 million in any one year. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates a 

proposed rule (and subsequent final 

rule) that imposes substantial direct 

requirement costs on State and local 

governments, preempts State law, or 

otherwise has Federalism implications. 

We have determined that this final rule 

will not significantly affect States’ 

rights, roles, and responsibilities. 

Low-income children will benefit 

from payments under this program 

through increased opportunities for 

health insurance coverage. We believe 

this final rule will have an overall 

positive impact by informing States, the 

District of Columbia, and 

Commonwealths and Territories of the 

extent to which they are permitted to 

expend funds under their child health 

plans using the additional funds 

provided by the FY 2009 allotment 

amounts. 

B. Anticipated Effects 

1. Effects on the CHIP program. This 

final rule provides the methodologies 

established in accordance with the CHIP 

statute, for determining the amounts of 

States’ CHIP FY allotments through FY 

2015. In accordance with such 

methodologies, CMS will determine and 

issue CHIP allotments to States each FY. 

States will be able to administer their 

CHIP programs with the appropriate 

levels of funding made available 

determined in accordance with the 

methodologies provided in this rule. 

2. Effects on other entities. This final 

rule will have no effects on other 

entities; it is only promulgating the 

methodologies for determining the 

amounts of States’ CHIP allotments. 


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C. Anticipated Effects 

1. Effects on the CHIP program. This 

final rule provides the methodologies 

established in accordance with the CHIP 

statute, for determining the amounts of 

States’ CHIP FY 2009 allotments 

through FY 2015. In accordance with 

such methodologies, CMS will 

determine and issue CHIP allotments to 

States each FY. States will be able to 

administer their CHIP programs with 

the appropriate levels of funding made 

available determined in accordance 

with the methodologies provided in this 

rule. 

2. Effects on other entities. This final 

rule will have no effects on other 

entities; it is only promulgating the 

methodologies for determining the 

amounts of States’ CHIP allotments. 

D. Alternatives Considered 

The methodologies for determining 

the States’ fiscal year CHIP allotments, 

as reflected in the previously published 

proposed rule, and in final rule, were 

established in accordance with the 

methodologies and formula for 

determining States’ allotments as 

specified in statute. As indicated above, 

the only comments we received with 

respect to proposed rule either agreed 

with the substance of the proposed rule 

or were outside the scope of the rule. 

This final rule does not put forward any 

further discretionary administrative 

policies for determining such 

allotments. The main difference from 

the notice of proposed rule published in 

the Federal Register on September 16, 

2009, is that this final rule reflects the 

extension of funding for the CHIP and 

associated conforming changes in the 

CHIP statute for determining States’ FY 

allotments, as amended by the 

Affordable Care Act. 

E. Accounting Statement 

As required by OMB Circular A–4 

(available at http:// 

www.whitehouse.gov/omb/circulars/ 

a004/a-4.pdf), in Table 6, we have 

prepared an accounting statement 

showing the classification of the 

expenditures associated with the 

provisions of this rule. This table 

provides our best impact estimate of the 

rule, as it implements the CHIP statute 

as amended by CHIPRA, under which 

approximately up to $74 billion in 

additional Federal funds may be made 

available for fiscal years 2009 through 

2015, in addition to the amount of funds 

previously appropriated for States’ 

CHIPs. All expenditures are classified as 

transfers from the Federal Government 

to States. 

TABLE 6—ACCOUNTING STATEMENT: CLASSIFICATION OF ESTIMATED EXPENDITURES, FROM FY 2009 TO FY 2015 

[In $millions] 

Category Transfers 

Year dollar Units discount rate Period covered 

7% 3% 

Annualized Monetized Transfers ............................................................... 2009 $13,348.90 $13,381.15 FYs 2009–2015. 

From Whom To Whom? ............................................................................ Federal Government to States 

In accordance with the provisions of 

Executive Order 12866, this final rule 

was reviewed by the Office of 

Management and Budget. 

List of Subjects in 42 CFR Part 457 

Administrative practice and 

procedure, Grant programs—health, 

Health insurance, Reporting and 

recordkeeping requirements. 

For the reasons set forth in the 

preamble, the Centers for Medicare & 

Medicaid Services amends 42 CFR 

chapter IV as set forth below: 

PART 457—ALLOTMENTS AND 

GRANTS TO STATES 

■ 1. The authority citation for part 457 

continues to read as follows: 

Authority: Section 1102 of the Social 

Security Act (42 U.S.C. 1302). 

Subpart F—Payments to States 

§ 457.600 [Amended] 

■ 2. Amend § 457.600(a) by removing 

the date ‘‘2007’’ and adding in its place 

‘‘2015’’. 

§ 457.608 [Amended] 

■ 3. Amend the section heading in 

§ 457.608 by removing the phrase ‘‘for a 

fiscal year’’ and adding in its place 

‘‘prior to FY 2009’’. 

■ 4. Section 457.609 is added to subpart 

F to read as follows: 

§ 457.609 Process and calculation of State 

allotments for a fiscal year after FY 2008. 

(a) General. For each of the 50 States 

and the District of Columbia and for 

each Commonwealth and Territory with 

an approved State child health plan, the 

State allotments for FY 2009 through FY 

2015 are determined by CMS as 

described in paragraphs (b) through (g) 

of this section. Unless otherwise 

indicated in this section, the reference 

to ‘‘State’’ refers to the 50 States and the 

District of Columbia and the 

Commonwealths and Territories 

(American Samoa, Guam, the Northern 

Mariana Islands, Puerto Rico, and the 

Virgin Islands). 

(b) Amounts available for allotment. 

The total amounts available for 

allotment for each fiscal year are as 

follows: 

(1) FY 2009: $10,562,000,000. 

(2) FY 2010: $12,520,000,000. 

(3) FY 2011: $13,459,000,000. 

(4) FY 2012: $14,982,000,000. 

(5) FY 2013: $17,406,000,000. 

(6) FY 2014: $19,147,000,000. 

(7) FY 2015, for the period beginning 

October 1, 2014 and ending March 31, 

2015, the following amounts are 

available for allotment: 

(i) $2,850,000,000. 

(ii) 15,361,000,000. 

(8) FY 2015, for the period beginning 

April 1, 2013 and ending on September 

30, 2013, $2,850,000,000. 

(c) Determination of a State allotment 

for FY 2009. 

(1) For the 50 States and the District 

of Columbia. From the amount in 

paragraph (b)(1) of this section as 

appropriated for the fiscal year under 

section 2104(a) of the Act, subject to 

paragraph (e) related to proration, and 

paragraph (c)(3) of this section relating 

to coordination of funding, the 

allotment for FY 2009 is equal to 110 

percent of the highest of the following 

amounts for each State and the District 

of Columbia: 

(i) The total Federal payments to the 

State under title XXI of the Act for FY 

2008 as reported by the State and 


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certified to the Secretary through the 

November 2008 submission of the 

quarterly expenditure reports, Forms 

CMS–21 (OMB # 0938–0731) and CMS– 

64 (OMB # 0938–0067), multiplied by 

the allotment increase factor determined 

under paragraph (f) of this section. 

(ii) The amount allotted to the State 

for FY 2008, multiplied by the allotment 

increase factor determined under 

paragraph (f) of this section; 

(iii) The projected total Federal 

payments to the State under title XXI of 

the Act for FY 2009, subject to 

paragraph (c)(1)(iv) of this section, as 

determined based on the February 2009 

projections certified by the State to CMS 

by no later than March 31, 2009. 

(iv) In the case of a State described in 

section 2105(g) of the Act and electing 

the option under paragraph (4) of such 

section, for purposes of the projections 

described in paragraph (c)(1)(iii) of this 

section, such projections would include 

an amount equal to the difference 

between the following amounts: 

(A) the amount of Federal payments 

for the expenditures described in 

section 2105(g)(4)(B) of the Act made 

after February 4, 2009 that would have 

been paid to the State if claimed at the 

enhanced Federal medical assistance 

percentage determined under section 

2105(b) of the Act. 

(B) the amount of Federal payments 

for the expenditures described in 

section 2105(g)(4)(B) of the Act made 

after February 4, 2009 that would have 

been paid to the State if claimed at the 

Federal medical assistance percentage 

defined in section 1905(b) of the Act; 

during the recession adjustment period 

described in section 5001(h) of the 

American Recovery and Reinvestment 

Act of 2009 (ARRA), as amended the 

Federal medical assistance percentage is 

as determined for the State under 

section 5001 of ARRA. 

(2) For the Commonwealths or 

Territories. 

(i) From the amount in paragraph 

(b)(1) of this section, as appropriated for 

the FY 2009 under section 2104(a) of the 

Act, subject to paragraph (e) of this 

section related to proration, and 

paragraph (c)(3) of this section relating 

to coordination of funding, an amount 

equal to the highest amount of Federal 

payments made to the Commonwealth 

or Territory under title XXI of the Social 

Security Act for any fiscal year 

occurring during the period for FY 1999 

through FY 2008, multiplied by the 

allotment increase factor determined 

under paragraph (f) of this section, plus 

the additional amount for the fiscal year 

specified in paragraph (c)(2)(ii) of this 

section. 

(ii) Additional Amounts for FY 2009. 

From the amount appropriated for the 

fiscal year under section 2104(c)(4)(B) of 

the Act, the additional amount for each 

Commonwealth or Territory is equal to 

$40,000,000 multiplied by the following 

percentage as specified in section 

2104(c)(2) of the Act: 

(A) For Puerto Rico, 91.6 percent. 

(B) For Guam, 3.5 percent. 

(C) For the Virgin Islands, 2.6 percent. 

(D) For American Samoa, 1.2 percent. 

(E) For the Northern Mariana Islands, 

1.1 percent. 

(3) Coordination of CHIP Funding for 

FY 2009. The amount of the CHIP 

allotment for FY 2009 available for 

payment for a States’ expenditures may 

be reduced by the amounts appropriated 

and obligated before April 1, 2009 for 

States’ FY 2009 allotments, FY 2006 

allotments redistributed to the State in 

FY 2009 determined under section 

2104(k) of the Act, and the amounts of 

additional FY 2009 shortfall allotments 

determined under section 2104(l) of the 

Act. 

(d) Determination of a State allotment 

for FY 2010 through FY 2015. 

(1) General. Subject to the provisions 

of paragraph (e) of this section relating 

to proration and paragraph (g) of the 

section relating to increases in a fiscal 

year allotment for approved program 

expansions, the State allotments for FY 

2010 through FY 2015 are determined as 

follows. 

(2) Determination of a State Allotment 

for FY 2010. (i) For the 50 States and the 

District of Columbia, and for the 

Commonwealths and Territories subject 

to paragraph (d)(2)(ii) of this section, the 

State allotment for FY 2010 is equal to 

the product of the following: 

(A) The sum of: 

(1) The State Allotment for FY 2009, 

as determined under paragraph (c) of 

the section. 

(2) The amount of any Federal 

payments made as redistributions of 

unexpended FY 2006 allotments under 

section 2104(k) of the Act. 

(3) The amount of any Federal 

payments made as additional FY 2009 

allotments under section 2104(l) of the 

Act. 

(4) The amount of any Federal 

payments made as contingency fund 

payments for FY 2009 under section 

2104(n) of the Act. 

(B) The State allotment increase factor 

for FY 2010 as determined under 

paragraph (f) of the section. 

(ii) In determining the amount of the 

FY 2010 allotment for each 

Commonwealth and Territory, for 

purposes of determining the amount of 

the FY 2009 allotment under paragraph 

(d)(2)(i)(A)(1) of this section, the amount 

of such FY 2009 allotment will not 

include the additional amount 

determined under paragraph (c)(2)(ii). 

(3) Determination of a State Allotment 

for FY 2011. For the 50 States and the 

District of Columbia, and the 

Commonwealths and Territories, the 

State allotment for FY 2011 is equal to 

the product of: 

(i) The amount of Federal payments 

attributable and countable toward the 

available State allotments in FY 2010, 

including: 

(A) Any amount redistributed to the 

State in FY 2010, and 

(B) Any Federal payments made as 

contingency fund payments for FY 2010 

under section 2104(n) of the Act. 

(ii) The State allotment increase factor 

for FY 2011 as determined under 

paragraph (f) of the section. 

(4) Determination of a State Allotment 

for FY 2012. For the 50 States and the 

District of Columbia, and the 

Commonwealths and Territories, the 

State allotment for FY 2012 is equal to 

the product of: 

(i) The sum of: 

(A) The State Allotment for FY 2011, 

as determined under paragraph (d)(3) of 

this section. 

(B) The amount of any Federal 

payments made as contingency fund 

payments for FY 2011 under section 

2104(n) of the Act. 

(ii) The State allotment increase factor 

for FY 2012 as determined under 

paragraph (f) of this section. 

(5) Determination of a State Allotment 

for FY 2013. For the 50 States and the 

District of Columbia, and the 

Commonwealths and Territories, the 

State allotment for FY 2013 is equal to 

the product of: 

(i) The amount of Federal payments 

attributable and countable toward the 

available State allotments in FY 2012, 

including: 

(A) Any amount redistributed to the 

State in FY 2012, and 

(B) Any Federal payments made as 

contingency fund payments for FY 2012 

under section 2104(n) of the Act. 

(ii) The State allotment increase factor 

for FY 2013 as determined under 

paragraph (f) of the section. 

(6) Determination of a State Allotment 

for FY 2014. For the 50 States and the 

District of Columbia, and the 

Commonwealths and Territories, the 

State allotment for FY 2014 is equal to 

the product of: 

(i) The sum of: 

(A) The State Allotment for FY 2013, 

as determined under paragraph (d)(5) of 

this section. 

(B) The amount of any Federal 

payments made as contingency fund 

payments for FY 2013 under section 

2104(n) of the Act. 


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(ii) The State allotment increase factor 

for FY 2014 as determined under 

paragraph (f) of this section. 

(7) Determination of a State Allotment 

for FY 2015. 

(i) General. There are two State 

allotments for FY 2015; one for the 

period beginning October 1, 2014 and 

ending March 31, 2015 and the second 

beginning April 1, 2015 and ending 

September 30, 2015. These State 

allotments are determined for each of 

the 50 States and the District of 

Columbia, and the Commonwealths and 

Territories. 

(ii) The State allotment for FY 2015 

for the period October 1, 2014 and 

ending March 31, 2015 is determined as 

the product of the following: 

(A) The first half ratio determined as 

the amount in paragraph (d)(7)(ii)(A)(1) 

of this section divided by the amount in 

paragraph (d)(7)(ii)(A)(2) of this section 

as follows: 

(1) $18,211,000,000 (calculated as the 

sum of the amount in paragraph (b)(7)(i) 

of this section, $2,850,000,000 

(appropriated in section 2104(a)(18)(A) 

of the Act) and the amount in paragraph 

(b)(7)(ii) of this section, $15,361,000,000 

(appropriated in section 108 of Pub. L. 

111–3, as amended by section 10203 of 

Pub. L. 111–148)). 

(2) $21,061,000,000, determined as 

the sum of the amount determined in 

paragraph (1) of this section, 

$18,211,000,000, and $2,850,000,000, 

the amount in paragraph (b)(8) of this 

section, as appropriated in section 

2104(a)(18)(B) of the Act, as amended by 

section 10203 Of Public Law 111–148. 

(B) The product of: 

(1) The amount of Federal payments 

attributable and countable toward the 

total amount of available State 

allotments in FY 2014, to include: 

(i) Any amount redistributed to the 

State in FY 2014; and 

(ii) Any Federal payments made as 

contingency fund payments for FY 2014 

under section 2104(n) of the Act. 

(2) The State allotment increase factor 

for FY 2015 as determined under 

paragraph (f) of this section. 

(iii) The State allotment for FY 2015 

for the period April 1, 2015 and ending 

September 30, 2015 is determined as the 

product of the following: 

(A) $2,850,000,000 the amount in 

paragraph (b)(8) of this section, as 

appropriated in section 2104(a)(18)(B) of 

the Act; and 

(B) The ratio determined as the 

amount in paragraph (d)(7)(iii)(B)(1) of 

this section divided by the amount in 

paragraph (d)(7)(iii)(B)(2) of this section: 

(1) The amount of the State allotment 

determined in paragraph (d)(7)(ii) of this 

section. 

(2) The total of all the State allotments 

determined in paragraph (d)(7)(ii) of this 

section. 

(e) Proration. 

(1) If for a fiscal year the sum of the 

State allotments for the 50 States and 

the District of Columbia, and the State 

allotments for the Commonwealths and 

Territories (not including the additional 

amount for FY 2009 determined under 

paragraph (c)(2)(ii) of this section), 

exceeds the total amount available for 

allotment for the fiscal year in 

paragraph (b) of this section, the amount 

of the allotment for each of the 50 States 

and the District of Columbia, and for 

each of the Commonwealths and 

Territories (not including the additional 

amount for FY 2009 determined under 

paragraph (c)(2)(ii) of this section) will 

be reduced on a proportional basis as 

indicated in paragraph (e)(2) of this 

section. 

(2) The amount of the allotment for 

each of the 50 States and the District of 

Columbia, and for each of the 

Commonwealths and Territories (not 

including the additional amount for FY 

2009 determined in paragraph (c)(2)(ii) 

of this section) is equal to the product 

of: 

(i) The percentage determined by 

dividing the amount in paragraph 

(e)(2)(i)(A) by the amount in paragraph 

(e)(2)(i)(B) of this section. 

(A) The amount of the State allotment 

for each of the 50 States and the District 

of Columbia, and for each of the 

Commonwealths and Territories (not 

including the additional amount for FY 

2009 determined under paragraph 

(c)(2)(ii) of this section). 

(B) The sum of the amounts for each 

of the 50 States and the District of 

Columbia, and the Commonwealths and 

Territories in paragraph (e)(2)(i) of this 

section. 

(ii) The total amount available for 

allotment for the fiscal year under 

paragraph (b) of this section. 

(f) Allotment increase factor. The 

allotment increase factor for a fiscal year 

is equal to the product of the following: 

(1) Per capita health care growth 

factor. The per capita health care growth 

factor for a fiscal year is equal to 1 plus 

the percentage increase in the projected 

per capita amount of the National 

Health Expenditures from the calendar 

year in which the previous fiscal year 

ends to the calendar year in which the 

fiscal year involved ends, as most 

recently published by CMS before the 

beginning of the fiscal year involved. 

(2) Child Population Growth Factor 

(CPGF). The CPGF for a fiscal year is 

equal to 1 plus the percentage increase 

(if any) in the population of children in 

the State from July 1 in the previous 

fiscal year to July 1 in the fiscal year 

involved, as determined by CMS based 

on the most recent published estimates 

of the Census Bureau available before 

the beginning of the fiscal year involved 

plus 1 percentage point. For purposes of 

determining the CPGF for FY 2009 for 

the Commonwealths and Territories 

only, in applying the previous sentence, 

‘‘United States’’ is substituted for ‘‘the 

State’’. 

(g) Increase in State allotment for the 

50 States and the District of Columbia 

for FY 2010 through FY 2015 to account 

for approved program expansions. In 

the case of the 50 States and the District 

of Columbia, the State allotment for FY 

2010 through FY 2015, as determined in 

accordance with the provisions of this 

section, may be increased under the 

following conditions and amounts: 

(1) The State has submitted to the 

Secretary, and has approved by the 

Secretary a State plan amendment or 

waiver request relating to an expansion 

of eligibility for children or benefits 

under title XXI of the Act that becomes 

effective for a fiscal year (beginning 

with FY 2010 and ending with FY 

2015). 

(2) The State has submitted to the 

Secretary, before the August 31 

preceding the beginning of the fiscal 

year, a request for an expansion 

allotment adjustment under this 

paragraph for such fiscal year that 

specifies. 

(i) The additional expenditures that 

are attributable to the eligibility or 

benefit expansion provided under the 

amendment or waiver described in 

paragraph (g)(1) of this section, as 

certified by the State and submitted to 

the Secretary by not later than August 

31 preceding the beginning of the fiscal 

year. 

(ii) The extent to which such 

additional expenditures are projected to 

exceed the allotment of the State or 

District for the year. 

(3) Subject to paragraph (e) of this 

section relating to proration, the amount 

of the allotment of the State or District 

under this section for such fiscal year 

shall be increased by the excess amount 

described in paragraph (g)(2)(i)of this 

section. A State or District may only 

obtain an increase under paragraph 

(g)(2)(ii) of this section for an allotment 

for FY 2010, FY 2012, or FY 2014. 

(h) CHIP Fiscal Year Allotment 

Process. As determined by the 

Secretary, the CHIP allotments for a 

fiscal year may be published as 

Preliminary Allotments or Final 

Allotments in the Federal Register. 


jlentini on DSKJ8SOYB1PROD with RULES
Federal Register / Vol. 76, No. 33 / Thursday, February 17, 2011 / Rules and Regulations 9249 

§ 457.610 [Amended] 

■ 5. Amend the section heading for 

§ 457.610 by— 

■ A. Amending the section heading by 

removing the phrase ‘‘for a fiscal year’’ 

and adding in its place ‘‘prior to FY 

2009’’. 

■ B. Removing the phrase ‘‘for a fiscal 

year’’ and add in its place ‘‘prior to FY 

2009’’in the first line of the paragraph. 

■ 6. Section 457.611 is added to subpart 

F to read as follows: 

§ 457.611 Period of availability for State 

allotments for a fiscal year after FY 2008. 

The amount of a final allotment for a 

fiscal year after FY 2008, as determined 

under § 457.609 and reduced to reflect 

certain Medicaid expenditures in 

accordance with § 457.616, remains 

available until expended for Federal 

payments based on expenditures 

claimed during a 2-year period of 

availability, beginning with the fiscal 

year of the final allotment and ending 

with the end of the succeeding fiscal 

year following the fiscal year. 

Authority: (Section 1102 of the Social 

Security Act (42 U.S.C. 1302). 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program) 

(Catalog of Federal Domestic Assistance 

Program No. 93.767, State Children’s Health 

Insurance Program) 

Dated: November 3, 2010. 

Donald M. Berwick, 

Administrator, Centers for Medicare & 

Medicaid Services. 

Approved: November 30, 2010. 

Kathleen Sebelius, 

Secretary, Department of Health and Human 

Services. 

[FR Doc. 2011–3639 Filed 2–14–11; 4:15 pm] 

BILLING CODE 4120–01–P 

FEDERAL COMMUNICATIONS 

COMMISSION 

47 CFR Part 73 

[FCC 11–8; MB Docket No. 05–162; RM– 

11227, RM–11284] 

Radio Broadcasting Services; Enfield, 

NH; Hartford, VT; Keeseville and 

Morrisonville, NY; White River 

Junction, VT 

AGENCY: Federal Communications 

Commission. 

ACTION: Final rule; application for 

review. 

SUMMARY: This document grants the 

Application for Review filed by Hall 

Communications, Inc. of the Report and 

Order in this proceeding to the extent of 

rescinding the staff action reallotting 

FM Channel 231A to Morrisonville, 

New York, and reinstating the allotment 

of Channel 231A at Keeseville, New 

York, because an interest had been 

expressed in retaining the allotment at 

Keeseville. The document also affirms 

the Report and Order in all other 

respects. Finally, the document 

modifies the FM allotment processing 

policies so that, on a going forward 

basis, the Commission will no longer 

accept proposals involving the 

reallotment, class down-grade, or 

deletion of a vacant FM allotment. See 

SUPPLEMENTARY INFORMATION, supra. 

DATES: Effective March 30, 2011. 

FOR FURTHER INFORMATION CONTACT: 

Andrew J. Rhodes, Media Bureau, (202) 

418–2180. 

SUPPLEMENTARY INFORMATION: This is a 

synopsis of the Commission’s 

Memorandum Opinion and Order, MB 

Docket No. 05–162, adopted January 25, 

2011, and released January 26, 2011. 

The full text of this Commission 

decision is available for inspection and 

copying during normal business hours 

in the FCC’s Reference Information 

Center at Portals II, 445 12th Street, 

SW., Room CY–A257, Washington, DC 

20554. The document may also be 

purchased from the Commission’s 

duplicating contractor, Best Copy and 

Printing, Inc., Portals II, 445 12th Street, 

SW., Room CY–B402, Washington, DC 

20554, telephone 1–800–378–3160 or 

http://www.BCPIWEB.com. 

The Memorandum Opinion and Order 

agreed that the Report and Order’s 

deletion of Channel 231A at Keeseville 

was inconsistent with existing 

Commission case law, which states that 

the Commission will not remove a 

vacant FM allotment form a community 

if a potential applicant has expressed an 

interest in applying to build a station on 

that channel, absent a compelling 

reason to do so. See 71 FR 30827, May 

31, 2006. Because an interest had been 

expressed in retaining the channel at 

Keeseville, the channel should not have 

been deleted and reallotted to 

Morrisonville, New York. The reference 

coordinates for Channel 231A at 

Keeseville are 44–31–45 NL and 73–32– 

00 WL. 

The Memorandum Opinion and Order 

also affirmed the Report and Order 

insofar as it (1) Allotted Channel 282A 

to Enfield, New Hampshire as its first 

local aural transmission service; (2) 

reallotted Channel 282C3, Station 

WWOD(FM), from Hartford, Vermont, to 

Keeseville, New York, and modified the 

license of FM Station WWOD(FM) 

accordingly; and (3) reallotted Channel 

237A, Station WXLF(FM), from White 

River Junction, Vermont, to Hartford, 

Vermont and modified the license of FM 

Station WXLF(FM) accordingly. 

Next, prompted by the circumstances 

that gave rise to Hall’s Application for 

Review, the Commission concluded to 

discontinue the practice of considering 

rulemaking requests for the reallotment, 

class down-grade or deletion of a vacant 

FM allotment. The Commission 

determined that this practice is 

disruptive to the orderly auctioning of 

vacant FM spectrum, wastes limited 

staff resources, and undermines the 

finality of the actions adopting the 

initial allotment. However, the 

Commission will permit parties to 

propose same-class channel 

substitutions for vacant FM allotments 

in order to accommodate proposals in 

technically related FM allotment and/or 

application filings because same-class 

channel substitutions do not disturb 

final section 307(b) determinations on 

which the allotments were based. 

Finally, we note that, although the 

Report and Order in this proceeding 

removed Channel 231A at Keeseville, 

New York, § 73.202(b), the Table of FM 

Allotments, inadvertently did not reflect 

this change, and the channel continues 

to appear in the Table. Accordingly, 

there is no need for a further revision to 

the Table of FM Allotments with respect 

to Keeseville, New York. 

The Commission will send a copy of 

this Memorandum Opinion and Order 

in a report to be sent to Congress and 

the Government Accountability Office 

pursuant to the Congressional Review 

Act, see 5 U.S.C. 801(a)(1)(A). 

List of Subjects in 47 CFR Part 73 

Radio, Radio broadcasting. 

For the reasons discussed in the 

preamble, the Federal Communications 

Commission amends 47 CFR part 73 as 

follows: 

PART 73—RADIO BROADCAST 

SERVICES 

■ 1. The authority citation for part 73 

continues to read as follows: 

Authority: 47 U.S.C. 154, 303, 334, 336, 

and 339. 

§ 73.202 [Amended] 

■ 2. Section 73.202(b), the Table of FM 

Allotments under New York, is 

amended by removing Morrisonville, 

Channel 231A. 

Federal Communications Commission. 

Marlene H. Dortch, 

Secretary. 

[FR Doc. 2011–3640 Filed 2–16–11; 8:45 am] 

BILLING CODE 6712–01–P 


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