61386 Federal Register / Vol. 69, No. 200 / Monday, October 18, 2004 / Notices 

Dated: October 12, 2004. 

Alvin Hall, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention.

[FR Doc. 04–23220 Filed 10–15–04; 8:45 am] 

BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Disease, Disability, and Injury 

Prevention and Control Special 

Emphasis Panel: Occupational Health 

and Safety Research, Program 

Announcement (PA) 04038 

In accordance with section 10(a)(2) of 

the Federal Advisory Committee Act 

(Pub. L. 92–463), the Centers for Disease 

Control and Prevention (CDC) 

announces the following meeting: 

Name: Disease, Disability, and Injury 

Prevention and Control Special 

Emphasis Panel (SEP): Occupational 

Health and Safety Research, Program 

Announcement (PA) 04038. 

Times and Dates: 7 p.m.–7:30 p.m., 

November 4, 2004 (Open); 7:30 p.m.–9 

p.m., November 4, 2004 (Closed); 8 

a.m.–5 p.m., November 5, 2004 (Closed). 

Place: Courtyard by Marriott 

Louisville Downtown, 100 South 

Second Street, Louisville, KY 40202, 

phone (502) 562–0200. 

Status: Portions of the meeting will be 

closed to the public in accordance with 

provisions set forth in section 552b(c) 

(4) and (6), Title 5 U.S.C., and the 

Determination of the Director, 

Management Analysis and Services 

Office, CDC, pursuant to Public Law 92–

463. 

Matters To Be Discussed: The meeting 

will include a site visit and the review, 

discussion, and evaluation of an 

application received in response to 

Program Announcement Number 04038. 

Contact Person for More Information:

Chuck Rafferty, Ph.D., Research Grants 

Program Officer, Office of Extramural 

Programs, National Institute for 

Occupational Safety and Health, CDC, 

1600 Clifton Road, NE., MS–E74, 

Atlanta, GA 30333, Telephone (404) 

498–2530. 

The Director, Management Analysis 

and Services Office, has been delegated 

the authority to sign Federal Register

notices pertaining to announcements of 

meetings and other committee 

management activities, for both CDC 

and the Agency for Toxic Substances 

and Disease Registry.

Dated: October 12, 2004. 

Alvin Hall, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention (CDC).

[FR Doc. 04–23221 Filed 10–15–04; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Notice of Hearing: Reconsideration of 

Disapproval of California’s Medicaid 

State Plan Amendment 03–028B

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS.

ACTION: Notice of hearing.

SUMMARY: This notice announces an 

administrative hearing on California’s 

Medicaid State Plan Amendment (SPA) 

03–28B to be held on December 2, 2004, 

10 a.m., 75 Hawthorne Street; 4th Floor 

Conference Room, San Francisco, 

California 94105–3901 to reconsider our 

decision to disapprove SPA 03–028B. 

Closing Date: Requests to participate 

in the hearing as a party must be 

received by the presiding officer by 

November 2, 2004.

FOR FURTHER INFORMATION CONTACT:

Kathleen Scully-Hayes, Presiding 

Officer, CMS, LB–23–20, Lord Baltimore 

Drive, Baltimore, Maryland 21244, 

Telephone: (410) 786–2055.

SUPPLEMENTARY INFORMATION: This 

notice announces an administrative 

hearing to reconsider our decision to 

disapprove California’s Medicaid State 

Plan Amendment (SPA) 03–28B. 

California submitted SPA 03–28B on 

September 18, 2003. In this SPA, 

California proposed to provide targeted 

case management (TCM) services in 

several counties for two populations: 

persons on probation, and individuals 

with a public guardian. By letter dated 

July 6, 2004, the Centers for Medicare & 

Medicaid Services (CMS) disapproved 

the SPA. 

At issue in this reconsideration is 

whether SPA 03–28B is consistent with 

the requirements contained in sections 

1902(a)(10) and 1902(a)(23), of the 

Social Security Act (the Act), as 

described in more detail below. In 

general, CMS found that the SPA had 

three fundamental problems: (1) The 

proposed TCM services duplicate 

services that are integral components of 

the State’s adult probation program and 

the State’s public guardian program; (2) 

the amendment would result in charges 

to Medicaid for services available 

without charge to individuals on 

probation; and (3) the provider 

qualifications limit providers of services 

for these groups to the probation officers 

employed by the county probation 

departments and to court-appointed 

guardians under county public guardian 

agencies. 

More specifically, at issue is whether 

the SPA complies with the requirement 

in section 1902(a)(10) of the Act which 

authorizes State Medicaid plans to 

provide for ‘‘medical assistance.’’ In the 

definition of that term, at section 

1905(a)(19) of the Act, case management 

services are authorized ‘‘as defined in 

section 1915 (g)(2).’’ That section 

defines case management as services 

that assist beneficiaries in gaining 

access to needed services. The 

Congressional Conference committee 

report accompanying Pub. L. 99–272, 

which added section 1915(g) to the Act, 

emphasized that payment for case 

management services must not 

duplicate payments made to public 

agencies or private entities under other 

program authorities for the same 

purpose. CMS uses the term 

‘‘duplication of required coverage to 

refer to this situation. In this instance, 

Medicaid payment for services provided 

by the adult probation program and the 

public guardian program would 

duplicate payments under other 

programs that are the responsibility of 

the State government. Because the 

congressional definition of Medicaid 

TCM excluded duplicate coverage, CMS 

determined that the proposed case 

management services are not within the 

scope of the definition of ‘‘medical 

assistance’’ that is authorized to be 

included in a State Medicaid plan by 

section 1902(a)(10). 

The CMS’ reading of the term 

‘‘medical assistance’’ to exclude 

‘‘duplication of required coverage’’ is 

also consistent with the language of 

section 8435 of Pub. L. 100–647, which 

states that the Medicaid case 

management benefit is not to be 

construed as to require the Secretary of 

Health and Human Services to make 

payment for case management services 

that are provided without charge to the 

users of such services. Approval of SPA 

03–028B would be contrary to this 

provision, because the proposed adult 

population services are available 

without charge.

In addition, at issue is whether the 

proposed SPA is consistent with the 

requirements at section 1902(a)(23) of 

the Act that a state plan must provide 

that beneficiaries may obtain services 

from any qualified entity or person who 

undertakes to provide such services. 

The proposed SPA restricts providers of