73972 Federal Register / Vol. 75, No. 229 / Tuesday, November 30, 2010 / Rules and Regulations 

* * * * * 

[FR Doc. 2010–30104 Filed 11–29–10; 8:45 am] 

BILLING CODE 6560–50–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 261 

[EPA–R06–RCRA–2009–0312; SW FRL– 

9231–3] 

Hazardous Waste Management 

System; Identification and Listing of 

Hazardous Waste; Removal of Direct 

Final Exclusion 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Removal of Direct Final 

Exclusion. 

SUMMARY: Because EPA received 

adverse comment, we are removing the 

direct final exclusion for Eastman 

Chemical Company—Texas Operations, 

published on September 24, 2010. 

DATES: Effective November 30, 2010. 

FOR FURTHER INFORMATION CONTACT: 

Michelle Peace, Environmental 

Protection Agency, Multimedia 

Planning and Permitting Division, 

RCRA Branch, Mail Code: 6PD–C, 1445 

Ross Avenue, Dallas, TX 75202, by 

calling (214) 665–7430 or by e-mail at 

peace.michelle@epa.gov. 

SUPPLEMENTARY INFORMATION: Because 

EPA received adverse comment, we are 

removing the direct final exclusion for 

Eastman Chemical Company—Texas 

Operations, published on September 24, 

2010, 75 FR 58315. We stated in that 

direct final rule that if we received 

adverse comment by October 25, 2010, 

the direct final rule would not take 

effect and we would publish a timely 

removal in the Federal Register. We 

subsequently received adverse comment 

on that direct final rule. We will address 

the comments submitted in a 

subsequent final action which will be 

based on the parallel proposed rule also 

published on September 24, 2010, 75 FR 

58346. As stated in the direct final rule 

and the parallel proposed rule, we will 

not institute a second comment period 

on this action. 

Lists of Subjects in 40 CFR Part 261 

Environmental Protection, Hazardous 

waste, Recycling, Reporting and 

recordkeeping requirements. 

Authority: Sec. 3001(f) RCRA, 42 U.S.C. 

6921(f). 

Dated: November 16, 2010. 

Bill Luthans, 

Acting Director, Multimedia Planning and 

Permitting Division. 

■ 40 CFR part 261 is amended as 

follows: 

PART 261—IDENTIFICATION AND 

LISTING OF HAZARDOUS WASTE 

■ 1. The authority citation for part 261 

continues to read as follows: 

Authority: 42 U.S.C. 6905, 6912(a), 6921, 

6922, and 6938. 

■ 2. In Tables 1, 2 and 3 of Appendix 

IX of part 261 remove the following 

facility’s waste streams: for Facility: 

Eastman Chemical Company—Texas 

Operations, Address: Longview, TX; 

Waste Description: RKI bottom ash, RKI 

fly ash and RKI scrubber water 

blowdown. 

[FR Doc. 2010–30109 Filed 11–29–10; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 433, 447, and 457 

[CMS–2361–F] 

RIN 0938–AQ40 

Medicaid Program; Cost Limit for 

Providers Operated by Units of 

Government and Provisions To Ensure 

the Integrity of Federal-State Financial 

Partnership 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule; implementation of 

court orders. 

SUMMARY: This final rule amends 

Medicaid regulations to conform with 

the decision by the United States 

District Court for the District of 

Columbia on May 23, 2008 in Alameda 

County Medical Center, et al. v. Michael 

O. Leavitt, Secretary, U.S. Department of 

Health and Human Services, et al., 559 

F. Supp. 2d (2008) that vacated a final 

rule with comment period published in 

the Federal Register in May 29, 2007. 

This regulatory action takes ministerial 

steps to remove the vacated provisions 

from the Code of Federal Regulations 

and reinstate the prior regulatory 

language impacted by the May 29, 2007 

final rule with comment period. 

DATES: Effective Date: This regulation is 

effective immediately on date of 

publication November 30, 2010. 

FOR FURTHER INFORMATION CONTACT: Rob 

Weaver, (410) 786–5914. 

SUPPLEMENTARY INFORMATION: 

I. Background 

A. Introduction 

Title XIX of the Social Security Act 

(the Act) authorizes Federal grants to 

States for Medicaid programs that 

provide medical assistance to lowincome families, the elderly and persons 

with disabilities. Each State administers 

the Medicaid program in accordance 

with an approved Medicaid State plan. 

States have considerable flexibility in 

designing their programs, but must 

comply with Federal requirements 

specified in the Medicaid statute, 

regulations, and program guidance. 

Sections 1902(a)(2), 1903(a), and 

1905(b) of the Act set forth requirements 

that describe how the responsibility to 

fund the Medicaid program will be 

shared between the Federal and State 

governments. Section 1905(b) of the Act 

delineates a percentage referred to as the 

Federal medical assistance percentage 

(FMAP) that determines on a State-byState basis the Federal and non-Federal 

share of program expenditures. Section 

1903(a) of the Act requires Federal 

reimbursement to the State of the 

Federal share. Section 1902(a)(2) of the 

Act and implementing regulations at 42 

CFR 433.50(a)(1) permit a State to 

delegate some responsibility for the 

non-Federal share of medical assistance 

expenditures to local units of 

government sources under some 

circumstances. 

The U.S. Troop Readiness, Veterans 

Care, Katrina Recovery and Iraq 

Accountability Appropriations Act of 

2007 prohibited the Secretary of Health 

and Human Services from finalizing or 

otherwise implement the provisions 

contained in a proposed rule published 

on January 18, 2007, titled ‘‘Medicaid 

Program; Cost Limit for Providers 

Operated by Units of Government and 

Provisions To Ensure the Integrity of 

Federal-State Financial Partnership’’ (72 

FR 2236 through 2248). 

B. Final Rule With Comment Period 

Published May 29, 2007 

On May 29, 2007, the Department of 

Human and Human Services (DHHS) 

published a final rule with comment 

period titled, ‘‘Medicaid Program; Cost 

Limit for Providers Operated by Units of 

Government and Provisions To Ensure 

the Integrity of Federal-State Financial 

Partnership’’ in the Federal Register (72 

FR 29747 through 29836). 

That final rule eliminated, modified, 

or implemented regulatory requirements 

pertaining to the financial relationship 


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Federal Register / Vol. 75, No. 229 / Tuesday, November 30, 2010 / Rules and Regulations 73973 

between the Federal and State 

governments. Specifically, this rule 

consisted of the following: 

• Clarified that entities involved in 

the financing of the non-Federal share of 

Medicaid payments must be a unit of 

government. 

• Clarified the documentation 

necessary to support a Medicaid 

certified public expenditure. 

• Limited Medicaid reimbursement 

for health care providers that are 

operated by units of government to an 

amount that does not exceed the health 

care provider’s cost of providing 

services to Medicaid individuals. 

• Required all health care providers 

to receive and retain the full amount of 

total computable payments for services 

furnished under the approved Medicaid 

State plan. 

• Made conforming changes to 

provisions governing the Child Health 

Insurance Program (CHIP) to make the 

same requirements applicable, with the 

exception of the cost limit on 

reimbursement. 

On May 23, 2008, the United States 

District Court for the District of 

Columbia, in Alameda County Medical 

Center, et al. v. Michael O. Leavitt, 

Secretary, U.S. Department of Health 

and Human Services, et al., 559 F. 

Supp. 2d, found that DHHS had 

improperly promulgated these 

regulations. The court stated that DHHS 

violated the Congressional moratorium 

on finalization of this regulation in the 

Troop Readiness, Veteran’s Care, 

Katrina Recovery and Iraq 

Accountability Appropriation Act of 

2007 (UTRA), (Pub. L. 110–28) and 

vacated the rule and remanded the 

matter to DHHS. Accordingly, DHHS is 

removing the vacated rule from the 

Code of Federal Regulations. 

Section 7001 of the Supplemental 

Appropriations Act of 2008 Public Law 

110–252 extended the moratorium on 

finalizing the Cost rule to April 1, 2009. 

The Congress considered this matter 

again in the passage of the American 

Recovery and Reinvestment Act (ARRA) 

of 2009. Section 5003(d) of ARRA 

expressed the sense of Congress that the 

Cost rule should not be adopted as a 

final rule. 

II. Provisions of the Final Regulations 

In this final rule, DHHS is removing 

all of the provisions that were issued in 

the May 29, 2007 final rule with 

comment period. Concurrently, DHHS is 

restoring regulation text so that the 

regulatory language impacted by the 

May 2007 final rule will appear in the 

Code of Federal Regulations as it did 

prior to issuance of that rule. 

Part 433—State Fiscal Administration 

(Sec. 433.50) Basis, Scope, and 

Applicability 

In § 433.50(a)(1), DHHS is removing 

the language that states ‘‘and section 

1903(w)(7)(G).’’ DHHS is also removing 

‘‘units of.’’ DHHS is also adding ‘‘s’’ to 

the word ‘‘government’’ and adding the 

word ‘‘both’’ before the words ‘‘State and 

local governments.’’ In addition, DHHS 

is removing paragraphs (a)(1)(i) and 

(a)(1)(ii) of this regulation. 

(Sec. 433.51) Funds From Units of 

Government as the State Share of 

Financial Participation 

In § 433.51, DHHS is revising the 

section heading to read ‘‘§ 433.51 Public 

funds as the State share of financial 

participation.’’ 

In § 433.51(a), DHHS is adding the 

word ‘‘Public’’ before the word ‘‘funds.’’ 

DHHS is also removing the words ‘‘from 

units of government’’ of this regulation. 

In § 433.51(b), DHHS is revising the 

paragraph to read ‘‘The public funds are 

appropriated directly to the State or 

local Medicaid agency, or are 

transferred from other public agencies 

(including Indian tribes) to the State or 

local agency and under its 

administrative control, or certified by 

the contributing public agency as 

representing expenditures eligible for 

FFP under this section.’’ 

In § 433.51(c), DHHS is adding the 

word ‘‘Public’’ before the word ‘‘funds.’’ 

DHHS is also removing the words ‘‘from 

units of government’’ of this regulation. 

Part 447—Payments For Services 

(Sec. 447.206) Cost Limit for Providers 

Operated by Units of Government 

In part 447, DHHS is removing the 

entire provisions of § 447.206 of this 

regulation. (§ 447.207) Retention of 

payments. 

In part 447, DHHS is removing the 

entire provisions of § 447.207 of this 

regulation. 

(Sec. 447.271) Upper Limits Based on 

Customary Charges 

In § 447.271(a), DHHS is adding an 

introductory phrase to read ‘‘Except as 

provided in paragraph (b) of this 

section,’’. 

In § 447.271(b), DHHS is removing the 

word ‘‘Reserved’’ and replacing it with 

‘‘The agency may pay a public provider 

that provides services free or at a 

nominal charge at the same rate that 

would be used if the provider charges 

were equal to or greater than its costs.’’ 

(Sec. 447.272) Inpatient Services: 

Application of Upper Payment Limits 

In § 447.272(a), DHHS is removing the 

word ‘‘nursing facilities’’ replacing it 

with ‘‘NFs.’’ 

In § 447.272(a)(1), DHHS is revising 

the paragraph to read ‘‘State 

government-owned or operated facilities 

(that is, all facilities that are either 

owned or operated by the State).’’ 

In § 447.272(a)(2), DHHS is revising 

the paragraph to read ‘‘Non-State 

government-owned or operated facilities 

(that is, all government facilities that are 

neither owned nor operated by the 

State).’’ 

In § 447.272(a)(3), DHHS is revising 

the paragraph to read ‘‘Privately-owned 

and operated facilities.’’ 

In § 447.272(b)(1), DHHS is removing 

the words ‘‘For privately operated 

facilities.’’ 

In § 447.272(b)(2), DHHS is revising 

the paragraph to read ‘‘Except as 

provided for in paragraph (c) of this 

section, aggregate Medicaid payments to 

a group of facilities within one of the 

categories described in paragraph (a) of 

this section may not exceed the upper 

payment limit described in paragraph 

(b)(1) of this section.’’ 

In § 447.272(b)(3), DHHS is removing 

entire provision of this regulation. 

In § 447.272(b)(4), DHHS is removing 

entire provision of this regulation. 

In § 447.272(c), DHHS is removing 

symbol ‘‘—’’ and replacing it with ‘‘.’’. 

In § 447.272, DHHS is removing 

paragraph (c)(3) of this regulation. 

In § 447.272(d)(1), DHHS is revising 

the paragraph to read ‘‘For non-State 

government owned or operated 

hospitals—March 19, 2002.’’ 

(Sec. 447.321) Outpatient Hospital and 

Clinic Services: Application of Upper 

Payment Limits 

In § 447.321(a)(1), DHHS is revising 

the paragraph to read ‘‘State 

government-owned or operated facilities 

(that is, all facilities that are owned or 

operated by the State).’’ 

In § 447.321(a)(2), DHHS is revising 

the paragraph to read ‘‘Non-State 

government owned or operated facilities 

(that is, all government operated 

facilities that are neither owned nor 

operated by the State).’’ 

In § 447.321(a)(3), DHHS is revising 

the paragraph to read ‘‘Privately-owned 

and operated facilities.’’ 

In § 447.321(b)(1), DHHS is removing 

the words ‘‘For privately operated 

facilities,’’. 

In § 447.321(b)(2), DHHS is revising 

the provision to read ‘‘Except as 

provided for in paragraph (c) of this 

section, aggregate Medicaid payments to 


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73974 Federal Register / Vol. 75, No. 229 / Tuesday, November 30, 2010 / Rules and Regulations 

a group of facilities within one of the 

categories described in paragraph (a) of 

this section may not exceed the upper 

payment limit described in paragraph 

(b)(1) of this section.’’ 

In § 447.321, DHHS is removing 

paragraph (b)(3) of this regulation. 

In § 447.321, DHHS is removing 

pargraph (b)(4) of this regulation. 

In § 447.321(c)(1), DHHS is removing 

the designated number ‘‘(1)’’ of this 

regulation. 

In § 447.321, DHHS is removing 

paragraph (c)(2) of this regulation. 

In § 447.321, DHHS is removing 

paragraph (c)(3) of this regulation. 

In § 447.321(d), DHHS is removing 

reference to paragraph ‘‘(b)’’ and 

replacing it with a reference to 

paragraph ‘‘(b)(1).’’ 

In § 447.321(d)(1), DHHS is revising 

the paragraph to read ‘‘For non-State 

government-owned or operated 

hospitals—March 19, 2002.’’ 

In § 447.321, DHHS is removing 

paragraph (d)(2) and redesignating 

paragraph (d)(3) as paragraph (d)(2) of 

this regulation. 

Sec. 457.220 Funds From Units of 

Government as the State Share of 

Financial Participation 

In § 457.220(a), DHHS is adding the 

word ‘‘Public’’ before the word ‘‘Funds.’’ 

DHHS is also removing the words ‘‘from 

units of government.’’ 

In § 457.220(b), DHHS is revising the 

paragraph to read ‘‘The public funds are 

appropriated directly to the State or 

local SCHIP agency, or are transferred 

from other public agencies (including 

Indian tribes) to the State or local 

agency and are under its administrative 

control, or are certified by the 

contributing public agency as 

representing expenditures eligible for 

FFP under this section.’’ 

In § 457.220(c), DHHS is adding the 

word ‘‘public’’ after the word ‘‘The’’ 

before the word ‘‘funds.’’ DHHS is also 

removing the words ‘‘from units of 

government.’’ 

Sec. 457.628 Other Applicable Federal 

Regulations 

In § 457.628(a), DHHS is removing the 

parenthesis ‘‘(’’ before the word 

‘‘sources’’ and removing the parenthesis 

‘‘)’’ after the word ‘‘Donations’’ and 

adding a semicolon and the word 

‘‘Donations.’’ In addition, DHHS is 

removing the words ‘‘and § 447.207 of 

this chapter (Retention of payments).’’ 

III. Collection of Information 

This document does not impose 

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. 

IV. Waiver of Proposed Rulemaking 

and Delayed Effective Date 

DHHS ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register and invite public comment on 

the proposed rule. The notice of 

proposed rulemaking includes a 

reference to the legal authority under 

which the rule is proposed, and the 

terms and substances of the proposed 

rule or a description of the subjects and 

issues involved. This procedure can be 

waived, however, if an agency finds 

good cause that a notice-and-comment 

procedure is impractical, unnecessary, 

or contrary to the public interest and 

incorporates a statement of the finding 

and its reasons in the rule issued. DHHS 

has determined that providing prior 

notice and opportunity for comment on 

the amending regulations is 

unnecessary. This final rule merely 

removes regulatory language relating to 

CMS–2258–FC, which was vacated by 

the United States District Court for the 

District of Columbia. As a result of this 

decision, the regulatory language related 

to CMS–2258–FC has no force or effect, 

and public comment would not affect 

that status. The presence of that 

language in the Code of Federal 

Regulations can be confusing, and thus 

the public interest would be served by 

removal of that language. Furthermore, 

removing this language from the Code of 

Federal Regulations and reinstating the 

prior regulatory language has no legal 

impact but simply reflects this final 

judicial determination. 

For the same reasons, DHHS believes 

there is good cause for waiving any 

delay in the effective date, making the 

reinstated regulatory provisions 

immediately effective. See 5 U.S.C. 

553(d). 

V. Regulatory Impact Statement 

DHHS has examined the impact of 

this rule as required by Executive Order 

12866 on Regulatory Planning and 

Review (September 30, 1993), the 

Regulatory Flexibility Act (RFA) 

(September 19, 1980, Pub. L. 96–354), 

section 1102(b) of the Social Security 

Act, section 202 of the Unfunded 

Mandates Reform Act of 1995 (March 

22, 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). This regulatory action 

only removes those regulations vacated 

by the United States District Court for 

the District of Columbia. Therefore, this 

action is not a ‘‘significant’’ regulatory 

action as defined by E.O. 12866. This 

rule also does not reach the economic 

threshold and thus is not considered a 

major rule. 

The RFA requires agencies to analyze 

options for regulatory relief of small 

businesses. For purposes of the RFA, 

small entities include small businesses, 

nonprofit organizations, and small 

governmental jurisdictions. Most 

hospitals and most other providers and 

suppliers are small entities, either by 

nonprofit status or by having revenues 

of $7 million to $34.5 million in any one 

year. Individuals and States are not 

included in the definition of a small 

entity. DHHS is not preparing an 

analysis for the RFA because DHHS has 

determined, and the Secretary certifies, 

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. For purposes of section 1102(b) of 

the Act, we define a small rural hospital 

as a hospital that is located outside of 

a Core-Based Statistical Area (for 

Medicaid) and outside a Metropolitan 

Statistical Area for Medicare) and has 

fewer than 100 beds. DHHS is not 

preparing an analysis for section 1102(b) 

of the Act because we have determined, 

and the Secretary certifies, 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 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 2010, that threshold is approximately 

$135 million. This rule will have no 

consequential effect on State, local, or 

tribal governments or on the private 

sector. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates 


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Federal Register / Vol. 75, No. 229 / Tuesday, November 30, 2010 / Rules and Regulations 73975 

regulations that imposes substantial 

direct requirement costs on State and 

local governments, preempts State law, 

or otherwise has Federalism 

implications. Since this regulation does 

not impose any costs on State or local 

governments, the requirements of 

Executive Order 13132 are not 

applicable. 

In accordance with the provisions of 

Executive Order 12866, this regulation 

was reviewed by the Office of 

Management and Budget. 

List of Subjects 

42 CFR Part 433 

Administrative practice and 

procedure, Child support, Claims, Grant 

programs—health, Medicaid, Reporting 

and recordkeeping requirements. 

42 CFR Part 447 

Accounting, Administrative practice 

and procedure, Drugs, Grant programs— 

health, Health facilities, Health 

professions, Medicaid, Reporting and 

recordkeeping requirements, Rural 

areas. 

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 433—STATE FISCAL 

ADMINISTRATION 

■ 1. The authority citation for part 433 

continues to read as follows: 

Authority: Sec. 1102 of the Social Security 

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

Subpart B—General Administrative 

Requirements State Financial 

Participation 

■ 2. Section § 433.50 is amended by 

revising paragraph (a)(1) to read as 

follows: 

§ 433.50 Basis, scope, and applicability. 

(a) * * * 

(1) Section 1902(a)(2) of the Act 

which requires States to share in the 

cost of medical assistance expenditures 

and permit both State and local 

governments to participate in the 

financing of the non-Federal portion of 

medical assistance expenditures. 

* * * * * 

■ 3. Section 433.51 is revised to read as 

follows: 

§ 433.51 Public Funds as the State share 

of financial participation. 

(a) Public Funds may be considered as 

the State’s share in claiming FFP if they 

meet the conditions specified in 

paragraphs (b) and (c) of this section. 

(b) The public funds are appropriated 

directly to the State or local Medicaid 

agency, or are transferred from other 

public agencies (including Indian tribes) 

to the State or local agency and under 

its administrative control, or certified by 

the contributing public agency as 

representing expenditures eligible for 

FFP under this section. 

(c) The public funds are not Federal 

funds, or are Federal funds authorized 

by Federal law to be used to match other 

Federal funds. 

PART 447—PAYMENTS FOR 

SERVICES 

■ 4. The authority citation for part 447 

continues to read as follows: 

Authority: Sec. 1102 of the Social Security 

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

Subpart B—Payment Methods: General 

Provisions 

§ 447.206 [Removed] 

■ 5. Section 447.206 is removed. 

§ 447.207 [Removed] 

■ 6. Section 447.207 is removed. 

Subpart C—Payment for Inpatient 

Hospital and Long-Term Care Facility 

Services 

Upper Limits 

■ 7. Section § 447.271 is revised to read 

as follows: 

§ 447.271 Upper limits based on 

customary charges. 

(a) Except as provided in paragraph 

(b) of this section, the agency may not 

pay a provider more for inpatient 

hospital services under Medicaid than 

the provider’s customary charges to the 

general public for the services. 

(b) The agency may pay a public 

provider that provides services free or at 

a nominal charge at the same rate that 

would be used if the provider charges 

were equal to or greater than its costs. 

■ 8. Section 447.272 is amended by— 

■ A. Revising paragraphs (a), (b), and 

(d)(1). 

■ B. Revising the heading for paragraph 

(c). 

■ C. Removing paragraph (c)(3). 

The revisions read as follows: 

§ 447.272 Inpatient services: Application 

of upper payment limits. 

(a) Scope. This section applies to rates 

set by the agency to pay for inpatient 

services furnished by hospitals, NFs, 

and ICFs/MR within one of the 

following categories: 

(1) State government-owned or 

operated facilities (that is, all facilities 

that are either owned or operated by the 

State). 

(2) Non-State government-owned or 

operated facilities (that is, all 

government facilities that are neither 

owned nor operated by the State). 

(3) Privately-owned and operated 

facilities. 

(b) General rules. 

(1) Upper payment limit refers to a 

reasonable estimate of the amount that 

would be paid for the services furnished 

by the group of facilities under 

Medicare payment principles in 

subchapter B of this chapter. 

(2) Except as provided for in 

paragraph (c) of this section, aggregate 

Medicaid payments to a group of 

facilities within one of the categories 

described in paragraph (a) of this 

section may not exceed the upper 

payment limit described in paragraph 

(b)(1) of this section. 

(c) Exceptions. 

* * * * * 

(d) * * * 

(1) For non-State government owned 

or operated hospitals,—March 19, 2002. 

* * * * * 

Subpart F—Payment Methods for 

Other Institutional and Noninstitutional 

Services 

Outpatient Hospital and Clinic Services 

■ 9. Section 447.321 is amended by— 

■ A. Revising paragraphs (a), (b), (c) and 

(d)(1). 

■ B. Revising introductory text of 

paragraph (d) by removing the phrase 

‘‘paragraph (b)’’ and adding in its place 

the phrase ‘‘paragraph (b)(1).’’ 

■ C. Removing paragraphs (d)(2). 

■ D. Redesignating paragraph (d)(3)as 

paragraph (d)(2). 

The revisions read as follows: 

§ 447.321 Outpatient hospital and clinic 

services: Application of upper payment 

limits. 

(a) Scope. This section applies to rates 

set by the agency to pay for outpatient 

services furnished by hospitals and 

clinics within one of the following 

categories: 

(1) State government-owned or 

operated facilities (that is, all facilities 

that are owned or operated by the State.) 

(2) Non-State government owned or 

operated facilities (that is, all 

government operated facilities that are 

neither owned nor operated by the 

State). 

(3) Privately-owned and operated 

facilities. 


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73976 Federal Register / Vol. 75, No. 229 / Tuesday, November 30, 2010 / Rules and Regulations 

(b) General rules. (1) Upper payment 

limit refers to a reasonable estimate of 

the amount that would be paid for the 

services furnished by the group of 

facilities under Medicare payment 

principles in subchapter B of this 

chapter. 

(2) Except as provided in paragraph 

(c) of this section, aggregate Medicaid 

payments to a group of facilities within 

one of the categories described in 

paragraph (a) of this section may not 

exceed the upper payment limit 

described in paragraph (b)(1) of this 

section. 

(c) Exceptions. Indian Health Services 

and tribal facilities. The limitation in 

paragraph (b) of this section does not 

apply to Indian Health Services 

facilities and tribal facilities that are 

funded through the Indian SelfDetermination and Education 

Assistance Act (Pub. L. 93–638). 

(d) * * * 

(1) For non-State government-owned 

or operated hospitals—March 19, 2002. 

* * * * * 

PART 457—ALLOTMENTS AND 

GRANTS TO STATES 

■ 10. The authority for part 457 

continues to read as follows: 

Authority: Sec. 1102 of the Social Security 

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

Subpart B—General Administration— 

Reviews and Audits; Withholding for 

Failure To Comply; Deferral and 

Disallowance of Claims; Reduction of 

Federal Medical Payments 

■ 11. Section 457.220 is revised to read 

as follows: 

§ 457.220 Funds from units of government 

as the State share of financial participation. 

(a) Public funds may be considered as 

the State’s share in claiming FFP if they 

meet the conditions specified in 

paragraphs (b) and (c) of this section. 

(b) The public funds are appropriated 

directly to the State or local SCHIP 

agency, or are transferred from other 

public agencies (including Indian tribes) 

to the State or local agency and are 

under its administrative control, or are 

certified by the contributing public 

agency as representing expenditures 

eligible for FFP under this section. 

(c) The public funds are not Federal 

funds, or are Federal funds authorized 

by Federal law to be used to match other 

Federal funds. 

Subpart F—Payments to States 

■ 12. Section 457.628 is amended by 

revising the introductory text and 

paragraph (a) to read as follows: 

§ 457.628 Other applicable Federal 

regulations. 

Other regulations applicable to SCHIP 

programs include the following: 

(a) HHS regulations in 42 Subpart B— 

433.51–433.74 sources of non-Federal 

share and Health Care-Related Taxes 

and Provider-Related Donations; apply 

to States’ SCHIP programs in the same 

manner as they apply to States’ 

Medicaid programs. 

* * * * * 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program) 

Dated: July 28, 2010. 

Donald M. Berwick, 

Administrator, Centers for Medicare & 

Medicaid Services. 

Approved: August 20, 2010. 

Kathleen Sebelius 

Secretary. 

[FR Doc. 2010–30066 Filed 11–29–10; 8:45 am] 

BILLING CODE 4120–01–P 

FEDERAL COMMUNICATIONS 

COMMISSION 

47 CFR Part 73 

[MB Docket No. 09–52; FCC 10–24] 

Policies To Promote Rural Radio 

Service and To Streamline Allotment 

and Assignment Procedures 

AGENCY: Federal Communications 

Commission. 

ACTION: Final rule; announcement of 

compliance date. 

SUMMARY: In this document, the 

Commission announces that the Office 

of Management and Budget (OMB) has 

approved, for a period of three years, the 

information collection requirements 

associated with the Commission’s rules 

and FCC Forms 301, 314, 315, 316 and 

340. These rules and form changes were 

approved on May 27, 2010 and June 4, 

2010 and the compliance date will be 

November 30, 2010. 

DATES: The compliance date for 

§§ 73.3571(k), 73.7000, 73.7002(b), and 

73.7002(c) and FCC Forms 301, 314, 

315, 316 and 340 published at 75 FR 

9797, March 4, 2010 is November 30, 

2010. 

FOR FURTHER INFORMATION CONTACT: 

Cathy Williams on (202) 418–2918 or 

send an e-mail to: 

Cathy.Williams@fcc.gov. 

SUPPLEMENTARY INFORMATION: As 

required by the Paperwork Reduction 

Act of 1995 (44 U.S.C. 3507), the 

Commission is notifying the public that 

it received OMB approval on May 27, 

2010, and June 4, 2010, for a period of 

three years, for the information 

collection requirements contained in 

Sections 73.3571(k), 73.7000, 

73.7002(b), and 73.7002(c) of the 

Commission’s rules and FCC Forms 301, 

314, 315, 316 and 340 and that the 

compliance date for these rules and 

forms published at 75 FR 9797, March 

4, 2010, is November 30, 2010. If you 

have any comments on the burden 

estimates, or how the Commission can 

improve the collections and reduce any 

burdens caused thereby, please contact 

Cathy Williams, Federal 

Communications Commission, Room 1– 

C823, 445 12th Street, SW., Washington, 

DC 20554. Please include OMB Control 

Numbers 3060–0029, 3060–0027, 3060– 

0996, 3060–0031 and/or 3060–0009 in 

your correspondence. The Commission 

also will accept your comments via the 

Internet if you send them to 

PRA@fcc.gov. To request materials in 

accessible formats for people with 

disabilities (Braille, large print, 

electronic files, audio format), send an 

e-mail to fcc504@fcc.gov or call the 

Consumer & Governmental Affairs 

Bureau at (202)418–0530 (voice), (202) 

418–0432 (TTY). 

Under 5 CFR 1320, an agency may not 

conduct or sponsor a collection of 

information unless it displays a current, 

valid OMB Control Number. 

No person shall be subject to any 

penalty for failing to comply with a 

collection of information subject to the 

Paperwork Reduction Act that does not 

display a valid OMB Control Number. 

The OMB Control Numbers are 3060– 

0027, 3060–0029, 3060–0996, 3060– 

0031 and 3060–0009 and the total 

annual reporting burdens and costs for 

respondents are as follows: 

OMB Control Number: 3060–0029. 

OMB Approval Date: June 4, 2010. 

Expiration Date: June 30, 2013. 

Title: Application for Construction 

Permit for Reserved Channel 

Noncommercial Educational Broadcast 

Station. 

Form Number: FCC Form 340. 

Respondents: Business or other forprofit entities; Not-for-profit 

institutions; State, local or tribal 

government. 

Number of Respondents and 

Responses: 2,710 respondents and 2,710 

responses. 

Estimated Time per Response: 2 to 5 

hours. 

Frequency of Response: On occasion 

reporting requirement; Third party 

disclosure requirement. 

Obligation to Respond: Required to 

obtain or retain benefits. Statutory 

authority for this collection of 

information is contained in Sections 


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