63480 Federal Register / Vol. 75, No. 199 / Friday, October 15, 2010 / Notices 

ESTIMATED ANNUALIZED BURDEN TABLE—Continued 

Forms (if necessary) Type of respondent Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hrs.) 

Total burden 

hours 

Subsequent updates to the State 

Plan.

State Government or Qualified State 

Designated Entity.

56 1 500 28,000 

Total ........................................... ........................................................... ........................ ........................ ........................ 589,244 

Terry Nicolosi, 

Director, Office of Resources Management; 

Office of the Chief Information Officer. 

[FR Doc. 2010–25918 Filed 10–14–10; 8:45 am] 

BILLING CODE 4150–45–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Office of the Secretary 

Centers for Medicare & Medicaid 

Services 

Delegation of Authorities 

Notice is hereby given that I have 

delegated to the Administrator, Centers 

for Medicare & Medicaid Services 

(CMS), or his or her successor, 

authorities vested in the Secretary under 

Section 6409(a) and (b) of the Patient 

Protection and Affordable Care Act 

(ACA), Public Law 111–148, as 

amended hereafter, relating to the 

development of a Medicare self-referral 

disclosure protocol and the reduction of 

amounts due and owing under Section 

1877(g) [42 U.S.C. 1395nn(g)] of the 

Social Security Act. 

This delegation of authorities 

excludes the authority under Section 

6409(c) of ACA to submit a report to 

Congress on the implementation of 

Section 6409. 

This delegation of authorities granted 

herein may be re-delegated. 

These authorities shall be exercised 

under the Department’s policy on 

regulations and the existing delegation 

of authority to approve and issue 

regulations. 

I hereby affirm and ratify any actions 

taken by the Administrator, CMS, or his 

or her subordinates, which involved the 

exercise of the authorities delegated 

herein prior to the effective date of this 

delegation. 

This delegation of authorities granted 

herein is effective immediately. 

Authority: 44 U.S.C. 3101. 

Dated: September 29, 2010. 

Kathleen Sebelius, 

Secretary. 

[FR Doc. 2010–25976 Filed 10–14–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Medicaid Program: Implementation of 

Section 614 of the Children’s Health 

Insurance Program Reauthorization 

Act of 2009 for Adjustments to the 

Federal Medical Assistance 

Percentage for Medicaid Federal 

Matching Funds 

AGENCY: Office of the Secretary, 

Department of Health and Human 

Services. 

ACTION: Final notice. 

SUMMARY: 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 is subject to adjustment pursuant 

to section 614 of the Children’s Health 

Insurance Program Reauthorization Act 

of 2009 (CHIPRA), Public Law 111–3. 

Section 614 provides for a recalculation 

of the FMAP disregarding identifiable 

significantly disproportionate employer 

pension or insurance fund contributions 

for a State. These contributions, when 

counted, increase State personal income 

and, by operation of the statutory 

formula to calculate the FMAP, would 

decrease the FMAP for the State. This 

final notice announces the methodology 

that the U.S. Department of Health and 

Human Services will use to determine 

the need for, and amount of, any such 

recalculation of the FMAP for a State. 

A. Background 

Section 1905(b) of the Social Security 

Act defines the Federal Medical 

Assistance Percentage (FMAP), which is 

used to determine the share of Federal 

matching funds paid to each State for 

medical assistance payments under an 

approved Medicaid State plan under 

Title XIX of the Social Security Act. 

These FMAP rates are also used to 

determine Federal matching fund rates 

for State expenditures for assistance 

payments under certain social service 

programs under Title IV of the Social 

Security Act and for child health 

assistance expenditures under the 

Children’s Health Insurance Program 

under title XXI of the Social Security 

Act. In other Federal Register issuances, 

we have addressed changes to these 

FMAP rates required under the 

American Recovery and Reinvestment 

Act of 2009 (Pub. L. 111–5). 

This notice addresses adjustments to 

the FMAP rates that are applicable only 

to the Medicaid program and required 

by Section 614 of the Children’s Health 

Insurance Program Reauthorization Act 

of 2009 (CHIPRA). Section 614 specifies 

that certain significantly 

disproportionate employer pension or 

insurance fund contributions shall be 

disregarded when computing the per 

capita income used to calculate the 

FMAP. The statutory formula for 

calculating the FMAP is based on the 

ratio of the State’s per capita income to 

the per capita income of the entire 

United States. Under this formula, 

States with higher per capita income 

levels could have lower FMAP rates 

than States with lower per capita 

income levels. Significantly 

disproportionate employer pension or 

insurance fund contributions increase 

State personal income and, by operation 

of the statutory formula, could result in 

lower FMAPs than if those 

contributions were disregarded. 

CHIPRA requires adjustments to the 

Fiscal Year 2006 (FY06) through Fiscal 

Year 2010 (FY10) Medicaid FMAP rates 

and to any future FMAP calculation. 

A notice with comment on the 

proposed implementation of Section 

614 was published in the Federal 

Register on June 7, 2010. Only one 

person sent in comments during the 30- 

day period. 

B. Calculation of the FMAP Adjustment 

Under CHIPRA 

Section 614 of CHIPRA requires that 

the Title XIX Medicaid FMAP shall be 

adjusted for any States that had 

significantly disproportionate employer 

pension and insurance fund 

contributions. A significantly 

disproportionate employer contribution 

is defined as any identifiable employer 

contribution towards pension or other 

employee insurance funds that is 

estimated to accrue to residents of such 

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