76586 Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices 

community, county, regional, and state 

levels. 

With the continuing shift in the 

healthcare environment towards 

provision of value-based care and 

utilization of reimbursement strategies 

through Centers for Medicare and 

Medicaid Services quality reporting 

programs, the latest competitive Rural 

Health Care Coordination Program 

cohort also aligned with this shift. An 

increased number of sophisticated 

applicants leveraging increasingly 

intricate reporting methodologies for 

quality data collection, utilization and 

analysis has resulted in an estimate of 

burden hours more in line with the 

realities of the health care landscape. In 

addition, the total number of responses 

has increased to 10 since the previous 

Notice of Award. This is due to a new 

Rural Health Care Coordination Program 

grant cycle with an increased number of 

awardees and therefore an increased 

number of respondents. 

Need and Proposed Use of the 

Information: For this program, 

performance measures were drafted to 

provide data to the program and to 

enable HRSA to provide aggregate 

program data required by Congress 

under the Government Performance and 

Results Act of 1993. These measures 

cover the principal topic areas of 

interest to the Federal Office of Rural 

Health Policy, including: (a) Access to 

care; (b) population demographics; (c) 

staffing; (d) consortium/network; (e) 

sustainability; and (f) project specific 

domains. All measures will speak to 

HRSA’s progress toward meeting the 

goals set. 

Likely Respondents: Recipients of the 

Rural Health Care Coordination Program 

funding. 

Burden Statement: Burden in this 

context means the time expended by 

persons to generate, maintain, retain, 

disclose or provide the information 

requested. This includes the time 

needed to review instructions; to 

develop, acquire, install, and utilize 

technology and systems for the purpose 

of collecting, validating, and verifying 

information, processing and 

maintaining information, and disclosing 

and providing information; to train 

personnel and to be able to respond to 

a collection of information; to search 

data sources; to complete and review 

the collection of information; and to 

transmit or otherwise disclose the 

information. The total annual burden 

hours estimated for this ICR are 

summarized in the table below. 

TOTAL ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Total 

responses 

Average 

burden per 

response 

(in hours) 

Total 

burden 

hours 

Rural Health Care Coordination Grant Program Measures 10 1 10 3.5 35 

Total .............................................................................. 10 ........................ 10 ........................ 35 

HRSA specifically requests comments 

on: (1) The necessity and utility of the 

proposed information collection for the 

proper performance of the agency’s 

functions, (2) the accuracy of the 

estimated burden, (3) ways to enhance 

the quality, utility, and clarity of the 

information to be collected, and (4) the 

use of automated collection techniques 

or other forms of information 

technology to minimize the information 

collection burden. 

Maria G. Button, 

Director, Executive Secretariat. 

[FR Doc. 2020–26254 Filed 11–27–20; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Federal Financial Participation in State 

Assistance Expenditures; Federal 

Matching Shares for Medicaid, the 

Children’s Health Insurance Program, 

and Aid to Needy Aged, Blind, or 

Disabled Persons for October 1, 2021 

Through September 30, 2022 

AGENCY: Office of the Secretary, HHS. 

ACTION: Notice. 

DATES: The percentages listed in Table 

1 will be effective for each of the four 

quarter-year periods beginning October 

1, 2021 and ending September 30, 2022. 

FOR FURTHER INFORMATION CONTACT: Ann 

Conmy, Office of Health Policy, Office 

of the Assistant Secretary for Planning 

and Evaluation, Room 447D—Hubert H. 

Humphrey Building, 200 Independence 

Avenue SW, Washington, DC 20201, 

(202) 690–6870. 

SUPPLEMENTARY INFORMATION: The 

Federal Medical Assistance Percentages 

(FMAP), Enhanced Federal Medical 

Assistance Percentages (eFMAP), and 

disaster-recovery FMAP adjustments for 

Fiscal Year 2022 have been calculated 

pursuant to the Social Security Act (the 

Act). These percentages will be effective 

from October 1, 2021 through 

September 30, 2022. This notice 

announces the calculated FMAP rates, 

in accordance with sections 1101(a)(8) 

and 1905(b) of the Act, that the U.S. 

Department of Health and Human 

Services (HHS) will use in determining 

the amount of federal matching for state 

medical assistance (Medicaid), 

Temporary Assistance for Needy 

Families (TANF) Contingency Funds, 

Child Support Enforcement collections, 

Child Care Mandatory and Matching 

Funds of the Child Care and 

Development Fund, Title IV–E Foster 

Care Maintenance payments, Adoption 

Assistance payments and Kinship 

Guardianship Assistance payments, and 

the eFMAP rates for the Children’s 

Health Insurance Program (CHIP) 

expenditures. Table 1 gives figures for 

each of the 50 states, the District of 

Columbia, Puerto Rico, the Virgin 

Islands, Guam, American Samoa, and 

the Commonwealth of the Northern 

Mariana Islands. This notice reminds 

states of adjustments available for states 

meeting requirements for 

disproportionate employer pension or 

insurance fund contributions and 

adjustments for disaster recovery. At 

this time, no state qualifies for such 

adjustments, and territories are not 

eligible. 

The FY 2022 FMAP rates do not 

include the 6.2 percentage point 

increase in the FMAP provided under 

Section 6008 of the Families First 

Coronavirus Response Act (FFCRA) 

(Pub. L. 116–127) because the increase 

depends upon states meeting statutory 

requirements in FFCRA that cannot be 

assumed. If applied, the temporary 6.2 

percentage increase in the FMAP is 

effective beginning January 1, 2020 and 

can extend through the last day of the 

calendar quarter in which the public 

health emergency declared by the 

Secretary of Health and Human Services 


TKELLEY on DSKBCP9HB2PROD with NOTICES
Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices 76587 

for COVID–19, including any 

extensions, terminates. 

Programs under title XIX of the Act 

exist in each jurisdiction. Programs 

under titles I, X, and XIV operate only 

in Guam and the Virgin Islands. The 

percentages in this notice apply to state 

expenditures for most medical 

assistance and child health assistance, 

and assistance payments for certain 

social services. The Act provides 

separately for federal matching of 

administrative costs. 

Sections 1905(b) and 1101(a)(8)(B) of 

the Social Security Act (the Act) require 

the Secretary of HHS to publish the 

FMAP rates each year. The Secretary 

calculates the percentages, using 

formulas in sections 1905(b) and 

1101(a)(8), and calculations by the 

Department of Commerce of average 

income per person in each state and for 

the United States (meaning, for this 

purpose, the fifty states and the District 

of Columbia). The percentages must fall 

within the upper and lower limits 

specified in section 1905(b) of the Act. 

The percentages for the District of 

Columbia, Puerto Rico, the Virgin 

Islands, Guam, American Samoa, and 

the Northern Mariana Islands are 

specified in statute, and thus are not 

based on the statutory formula that 

determines the percentages for the 50 

states. 

Federal Medical Assistance Percentage 

(FMAP) 

Section 1905(b) of the Act specifies 

the formula for calculating FMAPs as 

the Federal medical assistance 

percentage’’ for any state shall be 100 

per centum less the state percentage; 

and the state percentage shall be that 

percentage which bears the same ratio to 

45 per centum as the square of the per 

capita income of such state bears to the 

square of the per capita income of the 

continental United States (including 

Alaska) and Hawaii; except that the 

Federal medical assistance percentage 

shall in no case be less than 50 per 

centum or more than 83 per centum. 

Section 1905(b) further specifies that 

the FMAP for Puerto Rico, the Virgin 

Islands, Guam, the Northern Mariana 

Islands, and American Samoa shall be 

55 percent. Section 4725(b) of the 

Balanced Budget Act of 1997 amended 

section 1905(b) to provide that the 

FMAP for the District of Columbia, for 

purposes of titles XIX and XXI, shall be 

70 percent. For the District of Columbia, 

we note under Table 1 that other rates 

may apply in certain other programs. In 

addition, we note the rate that applies 

for Puerto Rico, the Virgin Islands, 

Guam, American Samoa, and the 

Commonwealth of the Northern Mariana 

Islands in certain other programs 

pursuant to section 1118 of the Act. 

Section 202(c) of the Further 

Consolidated Appropriations Act, 2020 

(Pub. L. 116–94) amends section 1905(b) 

to increase the FMAP to 76 percent for 

Puerto Rico and increase the FMAP to 

83 percent for the Virgin Islands, Guam, 

the Northern Mariana Islands, and 

American Samoa to 83 percent, for the 

period beginning December 21, 2020, 

and ending September 30, 2021. The 

rates for the States, District of Columbia 

and the territories are displayed in 

Table 1, Column 1. 

Section 1905(y) of the Act, as added 

by section 2001 of the Patient Protection 

and Affordable Care Act of 2010 

(‘‘Affordable Care Act’’) (Pub. L. 111– 

148), provides for a significant increase 

in the FMAP for medical assistance 

expenditures for newly eligible 

individuals described in section 

1902(a)(10)(A)(i)(VIII) of the Act, as 

added by the Affordable Care Act (the 

new adult group); ‘‘newly eligible’’ is 

defined in section 1905(y)(2)(A) of the 

Act. The FMAP for the new adult group 

is 100 percent for Calendar Years 2014, 

2015, and 2016, gradually declining to 

90 percent in 2020, where it remains 

indefinitely. In addition, section 1905(z) 

of the Act, as added by section 10201 of 

the Affordable Care Act, provides that 

states that offered substantial health 

coverage to certain low-income parents 

and nonpregnant, childless adults on 

the date of enactment of the Affordable 

Care Act, referred to as ‘‘expansion 

states,’’ shall receive an enhanced 

FMAP beginning in 2014 for medical 

assistance expenditures for nonpregnant 

childless adults who may be required to 

enroll in benchmark coverage under 

section 1937 of the Act. These 

provisions are discussed in more detail 

in the Medicaid Program: Eligibility 

Changes Under the Affordable Care Act 

of 2010 proposed rule published on 

August 17, 2011 (76 FR 51148, 51172) 

and the final rule published on March 

23, 2012 (77 FR 17144, 17194). This 

notice is not intended to set forth the 

matching rates for the new adult group 

as specified in section 1905(y) of the Act 

or the matching rates for nonpregnant, 

childless adults in expansion states as 

specified in section 1905(z) of the Act. 

Other Adjustments to the FMAP 

For purposes of Title XIX (Medicaid) 

of the Social Security Act, the Federal 

Medical Assistance Percentage (FMAP), 

defined in section 1905(b) of the Social 

Security Act, for each state beginning 

with fiscal year 2006, can be subject to 

an adjustment pursuant to section 614 

of the Children’s Health Insurance 

Program Reauthorization Act of 2009 

(CHIPRA), Public Law 111–3. Section 

614 of CHIPRA stipulates that a state’s 

FMAP under Title XIX (Medicaid) must 

be adjusted in two situations. 

In the first situation, if a state 

experiences no growth or positive 

growth in total personal income and an 

employer in that state has made a 

significantly disproportionate 

contribution to an employer pension or 

insurance fund, the state’s FMAP must 

be adjusted. The adjustment involves 

disregarding the significantly 

disproportionate employer pension or 

insurance fund contribution in 

computing the per capita income for the 

state (but not in computing the per 

capita income for the United States). 

Employer pension and insurance fund 

contributions are significantly 

disproportionate if the increase in 

contributions exceeds 25 percent of the 

total increase in personal income in that 

state. A Federal Register Notice with 

comment period was published on June 

7, 2010 (75 FR 32182) announcing the 

methodology for calculating this 

adjustment; a final notice was published 

on October 15, 2010 (75 FR 63480). 

The second situation arises if a state 

experiences negative growth in total 

personal income. Beginning with Fiscal 

Year 2006, section 614(b)(3) of CHIPRA 

specifies that, for the purposes of 

calculating the FMAP for a calendar 

year in which a state’s total personal 

income has declined, the portion of an 

employer pension or insurance fund 

contribution that exceeds 125 percent of 

the amount of such contribution in the 

previous calendar year shall be 

disregarded in computing the per capita 

income for the state (but not in 

computing the per capita income for the 

United States). 

No Federal source of reliable and 

timely data on pension and insurance 

contributions by individual employers 

and states is currently available. We 

request that states report employer 

pension or insurance fund contributions 

to help determine potential FMAP 

adjustments for states experiencing 

significantly disproportionate pension 

or insurance contributions and states 

experiencing a negative growth in total 

personal income. See also the 

information described in the January 21, 

2014 Federal Register notice (79 FR 

3385). 

Section 2006 of the Affordable Care 

Act provides a special adjustment to the 

FMAP for certain states recovering from 

a major disaster. This notice does not 

contain an FY 2022 adjustment for a 

major statewide disaster for any state 

(territories are not eligible for FMAP 

adjustments) because no state had a 

recent major statewide disaster and had 


TKELLEY on DSKBCP9HB2PROD with NOTICES
76588 Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices 

its FMAP decreased by at least three 

percentage points from FY 2020 to FY 

2021. See information described in the 

December 22, 2010 Federal Register 

notice (75 FR 80501). 

Enhanced Federal Medical Assistance 

Percentage (eFMAP) for CHIP 

Section 2105(b) of the Act specifies 

the formula for calculating the eFMAP 

rates as the ‘‘enhanced FMAP’’, for a 

state for a fiscal year, is equal to the 

Federal medical assistance percentage 

(as defined in the first sentence of 

section 1905(b)) for the state increased 

by a number of percentage points equal 

to 30 percent of the number of 

percentage points by which (1) such 

Federal medical assistance percentage 

for the state, is less than (2) 100 percent; 

but in no case shall the enhanced FMAP 

for a state exceed 85 percent. 

The eFMAP rates are used in the 

Children’s Health Insurance Program 

under Title XXI, and in the Medicaid 

program for expenditures for medical 

assistance provided to certain children 

as described in sections 1905(u)(2) and 

1905(u)(3) of the Act. There is no 

specific requirement to publish the 

eFMAP rates. We include them in this 

notice for the convenience of the states 

(Table 1, Column 2). 

Section 2705(b) of the Act, as 

amended by the HEALTHY KIDS Act of 

2017, increased the eFMAP by 11.5 

percentage points for FY 2021 and is no 

longer applicable. 

(Catalog of Federal Domestic Assistance 

Program Nos. 93.558: TANF Contingency 

Funds; 93.563: Child Support Enforcement; 

93.596: Child Care Mandatory and Matching 

Funds of the Child Care and Development 

Fund; 93.658: Foster Care Title IV–E; 93.659: 

Adoption Assistance; 93.769: Ticket-to-Work 

and Work Incentives Improvement Act 

(TWWIIA) Demonstrations to Maintain 

Independence and Employment; 93.778: 

Medical Assistance Program; 93.767: 

Children’s Health Insurance Program) 

Dated: November 24, 2020. 

Alex M. Azar II, 

Secretary. 

TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES, 

EFFECTIVE OCTOBER 1, 2021–SEPTEMBER 30, 2022 

[Fiscal year 2022] 

State 

Federal Medical 

Assistance 

Percentages 

Enhanced Federal 

Medical Assistance 

Percentages 

Alabama ................................................................................................................................... 72.37 80.66 

Alaska ...................................................................................................................................... 50.00 65.00 

American Samoa * ................................................................................................................... 55.00 68.50 

Arizona ..................................................................................................................................... 70.01 79.01 

Arkansas .................................................................................................................................. 71.62 80.13 

California .................................................................................................................................. 50.00 65.00 

Colorado .................................................................................................................................. 50.00 65.00 

Connecticut .............................................................................................................................. 50.00 65.00 

Delaware .................................................................................................................................. 57.72 70.40 

District of Columbia ** .............................................................................................................. 70.00 79.00 

Florida ...................................................................................................................................... 61.03 72.72 

Georgia .................................................................................................................................... 66.85 76.80 

Guam * ..................................................................................................................................... 55.00 68.50 

Hawaii ...................................................................................................................................... 53.64 67.55 

Idaho ........................................................................................................................................ 70.21 79.15 

Illinois ....................................................................................................................................... 51.09 65.76 

Indiana ..................................................................................................................................... 66.30 76.41 

Iowa ......................................................................................................................................... 62.14 73.50 

Kansas ..................................................................................................................................... 60.16 72.11 

Kentucky .................................................................................................................................. 72.75 80.93 

Louisiana .................................................................................................................................. 68.02 77.61 

Maine ....................................................................................................................................... 64.00 74.80 

Maryland .................................................................................................................................. 50.00 65.00 

Massachusetts ......................................................................................................................... 50.00 65.00 

Michigan ................................................................................................................................... 65.48 75.84 

Minnesota ................................................................................................................................ 50.51 65.36 

Mississippi ................................................................................................................................ 78.31 84.82 

Missouri .................................................................................................................................... 66.36 76.45 

Montana ................................................................................................................................... 64.90 75.43 

Nebraska .................................................................................................................................. 57.80 70.46 

Nevada ..................................................................................................................................... 62.59 73.81 

New Hampshire ....................................................................................................................... 50.00 65.00 

New Jersey .............................................................................................................................. 50.00 65.00 

New Mexico ............................................................................................................................. 73.71 81.60 

New York ................................................................................................................................. 50.00 65.00 

North Carolina .......................................................................................................................... 67.65 77.36 

North Dakota ............................................................................................................................ 53.59 67.51 

Northern Mariana Islands * ...................................................................................................... 55.00 68.50 

Ohio ......................................................................................................................................... 64.10 74.87 

Oklahoma ................................................................................................................................. 68.31 77.82 

Oregon ..................................................................................................................................... 60.22 72.15 

Pennsylvania ............................................................................................................................ 52.68 66.88 

Puerto Rico* ............................................................................................................................. 55.00 68.50 

Rhode Island ............................................................................................................................ 54.88 68.42 

South Carolina ......................................................................................................................... 70.75 79.53 

South Dakota ........................................................................................................................... 58.69 71.08 

Tennessee ............................................................................................................................... 66.36 76.45 


TKELLEY on DSKBCP9HB2PROD with NOTICES
Federal Register / Vol. 85, No. 230 / Monday, November 30, 2020 / Notices 76589 

TABLE 1—FEDERAL MEDICAL ASSISTANCE PERCENTAGES AND ENHANCED FEDERAL MEDICAL ASSISTANCE PERCENTAGES, 

EFFECTIVE OCTOBER 1, 2021–SEPTEMBER 30, 2022—Continued 

[Fiscal year 2022] 

State 

Federal Medical 

Assistance 

Percentages 

Enhanced Federal 

Medical Assistance 

Percentages 

Texas ....................................................................................................................................... 60.80 72.56 

Utah ......................................................................................................................................... 66.83 76.78 

Vermont ................................................................................................................................... 56.47 69.53 

Virgin Islands * ......................................................................................................................... 55.00 68.50 

Virginia ..................................................................................................................................... 50.00 65.00 

Washington .............................................................................................................................. 50.00 65.00 

West Virginia ............................................................................................................................ 74.68 82.28 

Wisconsin ................................................................................................................................. 59.88 71.92 

Wyoming .................................................................................................................................. 50.00 65.00 

* For purposes of section 1118 of the Social Security Act, the percentage used under titles I, X, XIV, and XVI will be 75 per centum for the territories. 

** For purposes of section 1905(b) of the Social Security Act, the FMAP for the District of Columbia, for purposes of titles XIX and XXI, shall be 

70 percent. The values for the District of Columbia in the table were set for the state plan under titles XIX and XXI and for capitation payments 

and disproportionate share hospital (DSH) allotments under those titles. For other purposes, the percentage for DC is 50.00, unless otherwise 

specified by law. 

[FR Doc. 2020–26387 Filed 11–27–20; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

Center for Scientific Review; Amended 

Notice of Meeting 

Notice is hereby given of a change in 

the meeting of the Center for Scientific 

Review Special Emphasis Panel, 

December 10, 2020, 09:30 a.m. to 

December 10, 2020, 05:00 p.m., National 

Institutes of Health, Eunice Kennedy 

Shriver National Institute of, 6701B 

Rockledge Drive, Bethesda, MD 20892, 

which was published in the Federal 

Register on November 16, 2020, 85 FR 

73063. 

This notice is being amended to 

change the meeting start time from 

10:00 a.m. to 9:30 a.m. The meeting is 

closed to the public. 

Dated: November 24, 2020. 

Miguelina Perez, 

Program Analyst, Office of Federal Advisory 

Committee Policy. 

[FR Doc. 2020–26370 Filed 11–27–20; 8:45 am] 

BILLING CODE 4140–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Institute on Drug Abuse; 

Notice of Closed Meeting 

Pursuant to section 10(d) of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of the 

following meeting. 

The meeting will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), Title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with the grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: National Institute on 

Drug Abuse Special Emphasis Panel; 

Mechanism for Time-Sensitive Drug Abuse 

Research (R21 Clinical Trial Optional). 

Date: December 9, 2020. 

Time: 12:00 p.m. to 5:00 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institutes of Health, 

National Institute on Drug Abuse, 301 North 

Stonestreet Avenue, Bethesda, MD 20892 

(Telephone Conference Call). 

Contact Person: Sheila Pirooznia, Ph.D., 

Scientific Review Officer, Division of 

Extramural Review, Scientific Review 

Branch, National Institute on Drug Abuse, 

NIH, 301 North Stonestreet Avenue, MSC 

6021, Bethesda, MD 20892, (301) 496–9350, 

sheila.pirooznia@nih.gov. 

This notice is being published less than 15 

days prior to the meeting due to the timing 

limitations imposed by the review and 

funding cycle. 

(Catalogue of Federal Domestic Assistance 

Program Nos. 93.277, Drug Abuse Scientist 

Development Award for Clinicians, Scientist 

Development Awards, and Research Scientist 

Awards; 93.278, Drug Abuse National 

Research Service Awards for Research 

Training; 93.279, Drug Abuse and Addiction 

Research Programs, National Institutes of 

Health, HHS) 

Dated: November 24, 2020. 

Tyeshia M. Roberson, 

Program Analyst, Office of Federal Advisory 

Committee Policy. 

[FR Doc. 2020–26367 Filed 11–27–20; 8:45 am] 

BILLING CODE 4140–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

Center for Scientific Review; Notice of 

Closed Meeting 

Pursuant to section 10(d) of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of the 

following meeting. 

The meeting will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), Title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with the grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: Center for Scientific 

Review Special Emphasis Panel; Small 

Business: Spine and Vertebral Disc. 

Date: December 17, 2020. 

Time: 11:00 a.m. to 12:00 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institutes of Health, 

Rockledge II, 6701 Rockledge Drive, 

Bethesda, MD 20892 (Telephone Conference 

Call). 

Contact Person: Aftab A. Ansari, Ph.D., 

Scientific Review Officer, Center for 

Scientific Review, National Institutes of 


TKELLEY on DSKBCP9HB2PROD with NOTICES