Federal Register / Vol. 74, No. 178 / Wednesday, September 16, 2009 / Proposed Rules 47517 

measuring only those thiram residues 

convertible to and expressed in terms of 

the degradate carbon disulfide. 

Commodity Parts per 

million 

Expiration/ 

Revocation 

Date 

Apple ................. 6.0 9/11/10 

Peach ................ 7.0 None 

Strawberry ........ 6.0 None 

* * * * * 

5. Section 180.176 is amended by 

revising paragraph (a) and adding 

paragraph (c) to read as follows: 

§180.176 Mancozeb; tolerances for 

residues. 

(a) General. Tolerances are 

established for residues of mancozeb (a 

coordination product of zinc ion and 

maneb (manganese 

ethylenebisdithiocarbamate)), including 

its metabolites and degradates, in or on 

the commodities in the table in this 

paragraph. Compliance with the 

tolerance levels specified in this 

paragraph is to be determined by 

measuring only those mancozeb 

residues convertible to and expressed in 

terms of the degradate carbon disulfide. 

Commodity Parts per 

million 

Apple ......................................... 0.6 

Asparagus ................................. 0.1 

Banana ..................................... 2 

Barley, bran .............................. 20 

Barley, flour .............................. 20 

Barley, grain ............................. 5 

Barley, pearled barley .............. 20 

Barley, straw ............................. 25 

Beet, sugar, dried pulp ............. 3.0 

Beet, sugar, roots ..................... 1.2 

Beet, sugar, tops ...................... 60 

Cattle, kidney ............................ 0.5 

Cattle, liver ................................ 0.5 

Corn, field, forage ..................... 40 

Corn, field, grain ....................... 0.1 

Corn, field, stover ..................... 15 

Corn, pop, grain ........................ 0.06 

Corn, pop, stover ...................... 40 

Corn, sweet, forage .................. 70 

Corn, sweet, kernel plus cob 

with husks removed .............. 0.1 

Corn, sweet, stover .................. 40 

Cotton, undelinted seed ........... 0.5 

Crabapple ................................. 0.6 

Cranberry .................................. 5 

Fennel ....................................... 2.5 

Flax, seed ................................. 0.15 

Goat, kidney ............................. 0.5 

Goat, liver ................................. 0.5 

Grape ........................................ 1.5 

Hog, kidney ............................... 0.5 

Hog, liver .................................. 0.5 

Horse, kidney ............................ 0.5 

Horse, liver ............................... 0.5 

Oat, flour ................................... 20 

Oat, grain .................................. 5 

Oat, groats/rolled oats .............. 20 

Oat, straw ................................. 25 

Commodity Parts per 

million 

Onion, bulb ............................... 1.5 

Papaya ...................................... 10 

Peanut ...................................... 0.1 

Peanut, hay .............................. 65 

Pear .......................................... 0.6 

Potato ....................................... 0.2 

Poultry, kidney .......................... 0.5 

Poultry, liver .............................. 0.5 

Quince ...................................... 0.6 

Rice, grain ................................ 0.06 

Rice, straw ................................ 0.15 

Rye, bran .................................. 20 

Rye, grain ................................. 5 

Rye, straw ................................. 25 

Sheep, kidney ........................... 0.5 

Sheep, liver ............................... 0.5 

Sorghum, grain, forage ............. 0.15 

Sorghum, grain, grain ............... 0.25 

Sorghum, grain, stover ............. 0.15 

Tomato ...................................... 2.5 

Vegetable, cucurbit, group 9 .... 2 

Wheat, bran .............................. 20 

Wheat, flour .............................. 20 

Wheat, germ ............................. 20 

Wheat, grain ............................. 5 

Wheat, middlings ...................... 20 

Wheat, shorts ........................... 20 

Wheat, straw ............................. 25 

* * * * * 

(c) Tolerances with regional 

registrations. A tolerance with regional 

registrations is established for residues 

of the fungicide mancozeb, (a 

coordination product of zinc ion and 

maneb (manganese 

ethylenebisdithiocarbamate)), including 

its metabolites and degradates, in or on 

the commodity in the table in this 

paragraph. Compliance with the 

tolerance levels specified in this 

paragraph is to be determined by 

measuring only those mancozeb 

residues convertible to and expressed in 

terms of the degradate carbon disulfide. 

Commodity Parts per 

million 

Carrot, roots .............................. 1 

* * * * * 

6. Section 180.217 is amended by 

revising the section heading and 

paragraph (a) to read as follows: 

§180.217 Metiram; tolerances for residues. 

(a) General. Tolerances are 

established for residues of metiram (a 

mixture of 5.2 parts by weight of 

ammoniates of (ethylenebis 

(dithiocarbamato)) zinc with 1 part by 

weight ethylenebis (dithiocarbamic 

acid) bimolecular and trimolecular 

cyclic anhydrosulfides and disulfides], 

including its metabolites and 

degradates, in or on the commodities in 

the table in this paragraph. Compliance 

with the tolerance levels specified in 

this paragraph is to be determined by 

measuring only those metiram residues 

convertible to and expressed in terms of 

the degradate carbon disulfide. 

Commodity Parts per 

million 

Apple ......................................... 0.5 

Apple, wet pomace ................... 2 

Potato ....................................... 0.2 

* * * * * 

§ 180.319 [Amended] 

7. Section 180.319 is amended by 

removing the entry for the substance 

‘‘Coordination product of zinc ion and 

maneb’’ from the table. 

[FR Doc. E9–22302 Filed 9–15–09; 8:45 am] 

BILLING CODE 6560–50–S 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 457 

[CMS–2291–P] 

RIN 0938–AP53 

Children’s Health Insurance Program 

(CHIP); Allotment Methodology and 

States’ Fiscal Year 2009 CHIP 

Allotments 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Proposed rule. 

SUMMARY: This proposed rule describes 

the implementation of certain funding 

provisions under title XXI of the Social 

Security Act (the Act), 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), and by other related 

CHIP legislation. Specifically, this 

proposed rule addresses methodologies 

and procedures for determining States’ 

FY 2009 through FY 2013 allotments 

and payments in accordance with 

sections 2104 and 2105 of the Act, as 

amended by CHIPRA. 

DATES: To be assured consideration, 

comments must be received at one of 

the addresses provided below, no later 

than 5 p.m. eastern standard time (e.s.t.) 

on November 16, 2009. 

ADDRESSES: In commenting, please refer 

to file code CMS–2291–P. Because of 

staff and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 


srobinson on DSKHWCL6B1PROD with PROPOSALS
47518 Federal Register / Vol. 74, No. 178 / Wednesday, September 16, 2009 / Proposed Rules 

You may submit comments in one of 

four ways (please choose only one of the 

ways listed): 

1. Electronically. You may submit 

electronic comments on this regulation 

to http://www.regulations.gov. Follow 

the instructions under the ‘‘More Search 

Options’’ tab. 

2. By regular mail. You may mail 

written comments to the following 

address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS– 

2291–P, P.O. Box 8010, Baltimore, 

MD 21244–8010. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By express or overnight mail. You 

may send written comments to the 

following address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS– 

2291–P, Mail Stop C4–26–05, 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

4. By hand or courier. If you prefer, 

you may deliver (by hand or courier) 

your written comments before the close 

of the comment period to either of the 

following addresses: 

a. For delivery in Washington, DC— 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Room 445–G, Hubert 

H. Humphrey Building, 200 

Independence Avenue, SW., 

Washington, DC 20201. 

(Because access to the interior of the 

Hubert H. Humphrey Building is not 

readily available to persons without 

Federal government identification, 

commenters are encouraged to leave 

their comments in the CMS drop slots 

located in the main lobby of the 

building. A stamp-in clock is available 

for persons wishing to retain a proof of 

filing by stamping in and retaining an 

extra copy of the comments being filed.) 

b. For delivery in Baltimore, MD— 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, 7500 Security 

Boulevard, Baltimore, MD 21244– 

1850. 

If you intend to deliver your 

comments to the Baltimore address, 

please call telephone number (410) 786– 

7195 in advance to schedule your 

arrival with one of our staff members. 

Comments mailed to the addresses 

indicated as appropriate for hand or 

courier delivery may be delayed and 

received after the comment period. 

Submission of comments on 

paperwork requirements. You may 

submit comments on this document’s 

paperwork requirements by following 

the instructions at the end of the 

‘‘Collection of Information 

Requirements’’ section in this 

document. 

For information on viewing public 

comments, see the beginning of the 

SUPPLEMENTARY INFORMATION section. 

FOR FURTHER INFORMATION CONTACT: 

Richard Strauss, (410) 786–2019. 

SUPPLEMENTARY INFORMATION: 

Inspection of Public Comments: All 

comments received before the close of 

the comment period are available for 

viewing by the public, including any 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following Web 

site as soon as possible after they have 

been received: http:// 

www.regulations.gov. Follow the search 

instructions on that Web site to view 

public comments. 

Comments received timely will also 

be available for public inspection as 

they are received, generally beginning 

approximately 3 weeks after publication 

of a document, at the headquarters of 

the Centers for Medicare & Medicaid 

Services, 7500 Security Boulevard, 

Baltimore, Maryland 21244, Monday 

through Friday of each week from 8:30 

a.m. to 4 p.m. To schedule an 

appointment to view public comments, 

phone 1–800–743–3951. 

I. Background 

A. Availability and Redistribution of 

Children’s Health Insurance Program 

(CHIP) Fiscal Year Allotments Prior to 

CHIPRA 

Title XXI of the Social Security Act 

(the Act) sets forth the Children’s Health 

Insurance Program (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. 

Section 2104(b) of the Act requires 

States, the District of Columbia, and 

U.S. Territories and Commonwealths to 

have an approved child health plan for 

the fiscal year in order for the Secretary 

to provide an allotment for that fiscal 

year. 

Before the enactment of the Children’s 

Health Insurance Program 

Reauthorization Act of 2009 (CHIPRA, 

Pub. L. 111–3, enacted on February 4, 

2009), section 2104(e) of the Act 

specified that in general the CHIP 

allotments for a Federal fiscal year were 

available for payment to States for their 

expenditures under an approved State 

child health plan for an initial 3-fiscal 

year period of availability, including the 

fiscal year for which the allotment was 

provided. 

In general, before the enactment of 

CHIPRA, section 2104(f) of the Act 

specified that the amounts of States’ 

allotments which were not expended 

during the initial 3-year period of 

availability were to be redistributed to 

those States that had fully spent these 

fiscal year allotments during this period 

of availability in accordance with an 

appropriate procedure determined by 

the Secretary. Furthermore, section 

2104(e) of the Act specified that the 

amounts of the redistributed allotments 

continued to be available for 

expenditure by the States receiving 

these redistributions to the end of the 

fiscal year in which these funds were 

redistributed. 

B. Funding of CHIP Allotments Before 

the Enactment of CHIPRA 

Section 4901 of the Balanced Budget 

Act of 1997 (BBA, Pub. L. 105–33, 

enacted on August 5, 1997) established 

title XXI of the Social Security Act (the 

Act). In conjunction with further 

amendments of title XXI of the Act 

described later, appropriations for CHIP 

were made available to provide 

allotments to States for their CHIPs and 

related Medicaid program expenditures 

through March 31, 2009. With the 

enactment of the CHIPRA, title XXI was 

amended to provide funding for the 

CHIP through FY 2013. 

Under the initial BBA, sections 

2104(a)(1) through (10) of the Act 

appropriated funding for States’ CHIPs 

for each fiscal year over a ten fiscal year 

period from 1998 through 2007. The 

funding for each fiscal year varied from 

$4.295 billion for FY 1998 up to $5.0 

billion for FY 2007. Furthermore, under 

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

appropriations were provided for each 

of fiscal years 1999 through 2007 to 

provide additional allotment amounts 


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Federal Register / Vol. 74, No. 178 / Wednesday, September 16, 2009 / Proposed Rules 47519 

particularly for the Commonwealths and 

Territories. 

C. Enactment of Continuing 

Appropriations and Medicare, 

Medicaid, and SCHIP Extension Act of 

2007 

Continuing appropriation legislation 

(Pub. L. 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. 

Additionally, $40 million was 

appropriated by this section to provide 

additional allotments to the 

Commonwealths and Territories in FY 

2008. 

Section 136(b) of Public Law 110–92 

provided that the FY 2008 allotments be 

determined in accordance with the same 

methodology as previous CHIP fiscal 

year allotments were determined. 

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 provided that the FY 2008 allotment 

funds were only available 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 through 

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 (MMSEA, Pub. L. 110–173, 

enacted on December 29, 2007) 

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 FY 2008 and FY 2009. These 

allotments would 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 would no longer be available 

(and thus expenditures for FY 2008 

would be paid from the allotments as 

provided under MMSEA). MMSEA 

provided that the FY 2008 and FY 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 the 

Federal Register dated May 23, 2008 

(30112, Vol. 73, No. 101). 

D. Enactment of CHIPRA 

Section 101 of the CHIPRA amended 

section 2104(a) of the Act to appropriate 

funding for each fiscal year FY 2009 

through FY 2012, and for two semiannual periods in FY 2013, October 1, 

2012 through March 31, 2013 and April 

1, 2013 through September 30, 2013, 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 the 

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 of the following previously 

appropriated amounts that were not 

allotted or obligated before April 1, 

2009: 

• 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 under 

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). 

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 

the CHIPRA in excess of the total 

amount provided under section 

2104(a)(12) of the Act for FY 2009, as 

amended by CHIPRA. 

E. Expenditures, 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 Public Law 108–74 

(Extension of Availability of CHIP 

Allotment Act, enacted on August 15, 

2003), only Federal payments for the 

following Medicaid and CHIP 

expenditures were applied against 

States’ available CHIP allotments: (1) 

Medical assistance provided under title 

XIX (Medicaid) to targeted low-income 

children in a CHIP-related Medicaid 

expansion, for which the CHIP 

enhanced Federal medical assistance 

percentage (CHIP EFMAP) rate is 

available; (2) 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); (3) child health assistance 

to targeted low-income children that 

meets minimum benefit requirements 

under CHIP; and (4) certain 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 lowincome children, health services 

initiatives, outreach, and administrative 

costs). 

Section 1(b) of Public Law 108–74, as 

amended by Public Law 108–127 (Social 

Security Act, Technical corrections, 

enacted November 17, 2003), added new 

section 2105(g) to the Act under which 

certain ‘‘qualifying States’’ that met 

prescribed criteria could elect to use up 

to 20 percent of any of the States’ 

available CHIP allotments for FY 1998, 


srobinson on DSKHWCL6B1PROD with PROPOSALS
47520 Federal Register / Vol. 74, No. 178 / Wednesday, September 16, 2009 / Proposed Rules 

1999, 2000, or 2001 to increase the 

FMAP rate for certain regular Medicaid 

expenditures to the EFMAP rate 

available under CHIP. These 

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 

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 FY 

2004 and FY 2005 CHIP allotments for 

payments to supplement the Medicaid 

FMAP that result in total Federal 

participation at the EFMAP rate (as 

determined under section 2105(b) of the 

Act) for certain expenditures made 

under the Medicaid program. 

Section 201(b) of the National 

Institutes of Health Reform Act of 2006 

and section 201(b) of MMSEA amended 

section 2105(g) of the Act to provide for 

continued authority for such 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 fiscal years 2009 through 

2013, 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 under section 2104(b) of the 

Act was substituted for the FMAP 

defined in section 1905(b) of the Act. 

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, 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 This Proposed Rule 

For the reasons described in section I 

of this preamble, the purpose of this 

proposed rule would: 

• Set forth the methodology and 

procedures for determining the CHIP 

allotments for FY 2009 through FY 2013 

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 (page 30112, Vol. 

73, No. 101), 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. 

• Describe the implementation of the 

continued authority under section 

2104(g)(4) of the Act as amended by 

CHIPRA for ‘‘qualifying States’’ to elect 

to receive their available CHIP 

allotments for FY 2009 through FY 2013 

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 are proposing the 

following revisions: 

• In 42 CFR § 457.600(a), we are 

proposing to remove the date ‘‘2007’’ 

and add in its place ‘‘2013’’ of this 

regulation. 

• In § 457.608, we are proposing to 

revise the heading ‘‘Process and 

calculation of State allotments for a 

fiscal year’’ to read ‘‘Process and 

calculation of State allotments prior to 

FY 2009’’ of this regulation. 

• In part 457 subpart F, we are 

proposing to add § 457.609, ‘‘Process 

and calculation of State allotments for a 

fiscal year after FY 2008’’, which would 

implement the new funding amounts 

available for States’ CHIP allotments for 

FY 2009 through FY 2013. 

• In § 457.610, we are proposing to 

revise the heading ‘‘Period of 

availability for State allotments for a 

fiscal year’’ to read ‘‘Period of 

availability for State allotments prior to 

FY 2009’’ of this regulation. In the first 

line of the paragraph for this section, we 

are also proposing to remove the words 

‘‘for a fiscal year’’ and add in its place 

‘‘prior to FY 2009’’ of this regulation. 

• In part 457 subpart F, we are 

proposing to add § 457.611, ‘‘Period of 

availability for State allotments for a 

fiscal year after FY 2008’’, which would 

reflect the 3 fiscal year and 2 fiscal year 

periods of availability, as applicable to 

fiscal years before FY 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 2013 for the 50 States 

and the District of Columbia, and the 

U.S. Commonwealths and Territories 

1. Reauthorization Funding for the CHIP 

Section 101 of CHIPRA provides the 

reauthorization funding for providing 

States’ allotments for FY 2009 through 

FY 2013. 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. In 

particular, under the amendments made 

by CHIPRA the appropriated amounts 

available for allotments for these fiscal 

years, 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, and 

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

second half of FY 2013. Also, section 

108 of CHIPRA provided for a one-time 

appropriation of $11,706,000,000 for 

allotments for the first half of FY 2013. 

Therefore, the total appropriation for 

providing allotments during FY 2013 is 

$17,406,000,000. 

2. Methodology for Determining State’s 

Fiscal Year Allotments 

a. CHIPRA provision of 2009. Section 

102 of CHIPRA adds a new section 

2104(m) of the Act which sets forth the 


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methodology for determining States’ 

CHIP allotments for each of FY 2009 

through FY 2013. 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.g. of this proposed 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 

are subject to a proration adjustment 

described in II.A.2.g. of this proposed 

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 three 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 and CMS–64, multiplied 

by the allotment increase factor 

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

proposed rule; 

• The amount allotted to the State for 

FY 2008, multiplied by the allotment 

increase factor described in section 

II.A.2.h. of this proposed 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 proposed 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 FY 1999 through FY 

2008, multiplied by the allotment 

increase factor described in section 

II.A.2.h. of this proposed 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.g. 

of this proposed rule. Under the 

CHIPRA, the FY 2010 allotment for each 

State will be 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 under section 

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

final additional FY 2009 allotments paid 

to the State as determined under section 

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

final retrospective adjustment to such 

amount determined under section 

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

any contingency fund payment made to 

the State for FY 2010, as determined 

under 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 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. This is because 

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 

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.g of this proposed rule, if 

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

the CHIPRA amendments refers to a 

‘‘rebasing’’ process for determining the 

FY 2011 allotments; this requirement 

means that the 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 increase factor for FY 

2011 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 of $14,982,000,000, and 

are subject to a proration adjustment 

described in II.A.2.g.of this proposed 

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, under 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 

comprised of two components related to 

the first half of FY 2013 (that is, the 


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period of October 1, 2012 through 

March 31, 2013) and second half of FY 

2013 (that is, April 1, 2012 through 

September 30, 2013). The FY 2013 

allotments for the first and second half 

of FY 2013 are subject to a proration 

adjustment described in section II.A.2.g 

of this proposed rule, as applicable. 

The allotments for the first half of FY 

2013 are provided from a total available 

appropriation of $14,556,000,000, 

comprised of $2,850,000,000 

appropriated under section 

2104(a)(16)(A) of the Act, and 

$11,706,000,000 appropriated under 

section 108 of CHIPRA. The allotments 

for the first half of FY 2013 is equal to 

the ‘‘first half ratio’’ multiplied by: the 

allotment increase factor for FY 2013 

multiplied 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 as determined 

under Section 2104(n) of the Act. For 

this purpose, the first half ratio is the 

percentage determined by dividing 

$14,556,000,000 (calculated as the sum 

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

the first half of FY 2013) and 

$11,706,000,000 (the one-time 

appropriation for the first half of the FY 

2013)) by $17,406,000,000 (calculated as 

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

the second half of FY 2013) plus the 

$14,556,000,000 amount). 

The allotments for the second half of 

FY 2013 are provided from a total 

available appropriation of 

$2,850,000,000, appropriated under 

section 2104(a)(16)(B) of the Act. The 

allotments for the second half of FY 

2013 is 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 2013 divided by the 

sum of all such first half of FY 2013 

allotments for all States. 

(g) Proration Rule. Under section 

2104(m)(4) of the Act, as amended by 

CHIPRA, if the amount of States’ 

allotments for a fiscal year (as 

determined in accordance with the 

provisions described of this proposed 

rule, or in the case of FY 2013, 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. 

h. 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. 

For this purpose, in general, 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. 

In general, for the 50 States and the 

District of Columbia, the child 

population growth factor 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 child population growth factor, 

the CHIP legislation refers to ‘‘the 

percentage increase (if any)’’ of the 

population of children in the State. In 

this regard, child population growth 

factor 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 

child population growth factor 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 child 

population growth factor 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 we will determine the child 

population growth factor 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 child 

population growth factor. 

i. 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 

FY 2010 and FY 2012 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, under which the Secretary may 

elect to publish preliminary fiscal year 

allotments. Consequently, under this 

process at the time the updated 

allotment amounts became available the 

Secretary would publish a final notice. 

For example, under the CHIPRA 

legislation, in the determination of the 

FY 2010 and FY 2012 allotments, States 

can amend their CHIP programs to 

provide for expansions; the increase in 

expenditures for such expansions would 

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 provides 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. Under the 

CHIP statute as amended by MMSEA 

and before the enactment of CHIPRA, 

such 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. Furthermore, 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 


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appropriated and obligated before April 

1, 2009 include the amounts of the FY 

2009 allotments appropriated under 

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

amended by MMSEA and before the 

enactment of CHIPRA; amounts of FY 

2006 redistributed allotments, provided 

under section 2104(k) of the Act; and, 

the amounts of the FY 2009 shortfall 

allotments, provided under section 

2104(l) of the Act. 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 

In accordance with the methodology 

described in section II.A. of this 

proposed rule relating to the calculation 

of the fiscal year CHIP allotments, and 

in section II.B. of this proposed rule 

relating to the coordination of CHIP 

funding, we have calculated the FY 

2009 allotments for the States. That 

calculation is contained in three tables 

described in section III. of this proposed 

rule; Table 1 provides the calculation of 

the allotment increase factor for FY 

2009, Table 2 provides the calculation 

of the FY 2009 allotment, and Table 3 

provides the coordination of funds in 

FY 2009. 

D. Period of Availability for CHIP 

Allotments 

Section 105 of CHIPRA amended 

section 2105(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 3 fiscal 

years, the fiscal year and the subsequent 

2 fiscal years. With the enactment of 

CHIPRA, section 2105(e) of the Act now 

provides that each of the States’ fiscal 

year allotments for FY 1998 through FY 

2008, are available for the expenditure 

by the State for 3 fiscal years. Finally, 

section 2104(e) of the Act as amended 

by CHIPRA now indicates that States’ 

fiscal year allotments for FY 2009 and 

each succeeding fiscal year are available 

for expenditure by the States for 2 fiscal 

years, the current fiscal year and the 

immediately subsequent fiscal year. In 

this proposed rule, we have amended 

the CHIP regulations at § 457.611 to 

reflect the 3 fiscal year and 2 fiscal year 

periods of availability, as applicable to 

fiscal years before FY 2009 and effective 

for FY 2009 and subsequent fiscal years, 

respectively. 

E. Continuing Authority for Qualifying 

States To Use FY 2009 Through FY 2013 

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 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 would be applied 

against the CHIP allotment. 

Note, under section 5001 of the 

American Recovery and Reinvestment 

Act of 2009 (ARRA, Pub. L. 111–5, 

enacted on February 17, 2009) the 

FMAP under the Medicaid program has 

been increased during the 9-quarter 

period October 1, 2009 through 

December 31, 2010. Because of this 

increase, 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. This qualifying State 

would 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 would 

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 enhanced 

FMAP in CHIP), after December 31, 

2010 15.00 percent of the qualifying 

expenditure in FY 2011 would 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. 

F. 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, under 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 in 

this notice presents the final FY 2008 

shortfall allotments after applying the 

retrospective adjustment under section 

2104(j)(5) of the Act. 

G. 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 


srobinson on DSKHWCL6B1PROD with PROPOSALS
47524 Federal Register / Vol. 74, No. 178 / Wednesday, September 16, 2009 / Proposed Rules 

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, under section 2104(l)(5) of 

the Act, 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. 

Prior to 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 in 

this notice presents the final FY 2009 

shortfall allotments after applying the 

retrospective adjustment under section 

2104(l)(5) of the Act. Also, Column D in 

Table 3 reflects these final retrospective 

adjustment FY 2009 shortfall 

allotments. 

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 

2009 

Table 2—FY 2009 Children’s Health 

Insurance Program Allotments under 

the Children’s Health Insurance 

Program Reauthorization Act Of 2009 

Table 3—Coordination of CHIP Funding 

for Fiscal Year 2009 

Table 4—Retrospective Adjustment for 

the FY 2008 Shortfall Funding 

A. TABLE 1—ALLOTMENT INCREASE 

FACTOR FOR 2009 

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 2008, PCNHE 

2009, PCHCG Factor. Column B 

contains the calculation of the Per 

Capita Health Care Growth (PCHCG) 

Factor for FY 2009, determined as 1 

plus the percentage increase in the Per 

Capita National Health Expenditures 

(PCNHE) from calendar year 2008 to 

calendar year 2009. 

Columns C through F = Calculation of 

the Child Population Growth Factor 

(CPGF) for FY 2009: 

Column C = July 1, 2008 Child 

Population. Column C contains the 

population of children in each State or 

the United States as of July 1, 2008, as 

provided by the most recent published 

data of the Census Bureau before the 

beginning of FY 2009. 

Column D = July 1, 2009 Child 

Population. Column D 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 2009. 

Column E = Percent Increase 2008– 

2009. Column E contains the percentage 

increase, if any, of the population of 

children in each State, or the United 

States, from July 1, 2008 to July 1, 2009, 

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 = Child Population Growth 

Factor. Column F contains the CPGF for 

the 50 States and the District of 

Columbia, determined as the 1.01 plus 

the percent in Column E for the State. 

For the Commonwealths and Territories 

the CPGF is determined as 1.01 plus the 

percentage in Column E for the United 

States. 

Column G = FY 2009 Allotment 

Increase Factor. Column G contains the 

FY 2009 Allotment Increase Factor, 

calculated as the PCHCG factor in 

Column B multiplied by the CPGF 

percent in Column F. 


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B. Table 2—FY 2009 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 2008 Total Federal 

CHIP Payments. Column B contains, for 

the 50 States and the District of 

Columbia only, the total Federal 

payments applied to the States’ 

available CHIP allotment funds in FY 

2008, based on the States’ expenditure 

reports submitted through November 30, 

2008. For the Commonwealths and 

Territories, the entry in this Column is 

‘‘na.’’ 

Column C = FY 2008 CHIP 

Allotments. Column C contains for the 

50 States and the District of Columbia 

only, the States’ final FY 2008 CHIP 

Allotments, as published in the May 23, 

2008 Federal Register (30112, Vol. 73, 

No. 101). For the Commonwealths and 

Territories, Column C contains the 

maximum amount of the Federal 

payments for each of the jurisdictions as 

was applied against the jurisdiction’s 

available CHIP funds in each of the 

fiscal years FY 1999 through 2008. 

Column D = FY 2009 Allotment 

Increase Factor. Column D contains the 

Allotment Increase Factor for each State 

as contained in Column G of Table 1. 

Column E = FY 2008 Tot. Fed Pmts 

× Incr. Factor. Column E contains, for 

the 50 States and the District of 

Columbia only, the product of the FY 

2008 total Federal CHIP payments in 

Column B multiplied by the amount of 

the FY 2009 Allotment Increase Factor 

in Column D. Column E contains, for 

the Territories and Commonwealths, the 

product of the amount in Column C 

(containing the maximum amount of 


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Federal Payments in the FY 1999 

through FY 2008) multiplied by the 

amount in Column D (the allotment 

increase period). 

Column F = FY 2008 Allotments × 

Incr. Factor. Column F contains, for the 

50 States and the District of Columbia 

only, the product of the FY 2008 CHIP 

allotments in Column C multiplied by 

the amount of the FY 2009 Allotment 

Increase Factor in Column D. Column F 

contains, for each of the 

Commonwealths and Territories, the 

percentage for each jurisdiction, 

respectively, from section 2104(a)(3) the 

percent allocation. 

Column G = FY 2009 Projected 

Expenditures. Column G contains, for 

the 50 States and the District of 

Columbia only; the amounts of each 

State’s projected CHIP Federal payments 

as submitted by the States on their 

February 2009 quarterly expenditure 

reports no later than March 31, 2009. 

Column G contains, for each of the 

Commonwealths and Territories, the 

portion of the additional $40 million in 

allotment funds available to such 

jurisdiction for FY 2009, determined as 

the product of the percentage in Column 

F for the Jurisdiction multiplied by $40 

million. 

Column H = Maximum of Col. E, F, 

G. Column H contains, for the 50 States 

and the District of Columbia only, the 

maximum of the amounts in Columns E, 

F, and G. 

Column I = FY 2009 Allotments. 

Column I contains, for the 50 States and 

the District of Columbia, the FY 2009 

CHIP allotment, determined as 110 

percent multiplied by the amount in 

Column H. Column I contains for the 

Commonwealths and Territories, the FY 

2009 CHIP allotment, determined as the 

sum of the amount in Column E and the 

amount in Column G, for each 

jurisdiction. 


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C. Table 3—Coordination of CHIP 

Funding for Fiscal Year 2009 

Table 3 contains the amounts of each 

States’ FY 2009 CHIP allotment, as 

contained in Column I on Table 2, 

reduced by certain amounts of CHIP 

allotment funds already available to the 

State in FY 2009, as required under 

section 3(c) of CHIPRA. 

Key to Table 3 

Column/Description 

Column A = State. Column A contains 

the name of the State. 

Column B = FY 2009 Pre-CHIPRA 

Allotment Grants Issued Before April 1, 

2009. Column B contains the amount if 

any of the State’s FY 2009 allotment that 

was actually provided to the State in a 

grant award from such allotment before 

April 1, 2009, as determined under 

section 2104(a) of the Act before the 

enactment of CHIPRA, as published in 

the Federal Register on May 23, 2008 

(30112, Vol. 73, No. 101). 

Column C = FY 2006 Unexpended 

Allotments Redistributed in FY 2009 

Before April 1, 2009. Column C contains 

the total amount, if any, that the State 

received from the amounts of States’ 

unexpended FY 2006 allotments 

remaining at the end of FY 2008, and 

redistributed in FY 2009 before April 1, 

2009, determined in accordance with 

the provisions of section 2104(k) of the 

Act. 

Column D = FY 2009 Shortfall 

Allotments After Retrospective 

Adjustment. Column D contains the 

final amount if any, that the State 

received as an additional shortfall 

allotment for the first two quarters of FY 

2009, as determined under the 

retrospective adjustment provision of 


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

Table 5 for further information 

regarding the determination of the 

amounts of the FY 2009 shortfall 

allotments under the retrospective 

adjustment. 

Column E = Total FY 2009 PreCHIPRA Allotment Funds. Column E 

contains the total amount if any, that the 

State received as CHIP allotment funds 

in FY 2009 before April 1, 2009, 

determined as the sum of the amounts, 

if any, in Columns B, C, and D, for each 

State. 

Column F = FY 2009 Total Allotments 

Determined Under CHIPRA. Column F 

contains the total FY 2009 CHIP 

allotment determined under CHIPRA, as 

contained in Column I in Table 2. 

Column G = FY 2009 Allotments 

Under CHIPRA Balance Effective April 

1, 2009. Column G contains the balance 

of the FY 2009 CHIP allotment after the 

reduction by the amounts of the FY 

2009 allotment funds provided in FY 

2009, determined as the amount in 

Column F minus the amount in Column 

E. 


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D. Table 4—Retrospective Adjustment 

for the FY 2008 Shortfall Allotments 

Table 4 contains the final 

retrospective adjustment determination 

with respect to the amounts of the 

additional shortfall allotments provided 

to States to eliminate their CHIP funding 

shortfalls in FY 2008, in accordance 

with the provisions of section 2104(j)(5) 

of the Act. 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 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, under 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. 

Key to Table 4 

Column/Description 

Column A = State. Column A contains 

the name of the State. 

Column B = FY 2008 Actual 

Expenditures 11/30/08. Column B 

contains the total Federal share amount 

of the CHIP expenditures reported by 

the States for FY 2008, as contained on 

the States’ expenditure reports 

submitted and certified by the States by 

November 30, 2008. 

Column C = FY 2006 Carryover 

Allotments into FY 08. Column C 

contains the amounts of the States’ 

unused FY 2006 allotments remaining at 

the end of FY 2007, if any, and carried 

over into FY 2008. 

Column D = FY 2007 Carryover 

Allotments into FY 08. Column D 

contains the amounts of the States’ 

unused FY 2007 allotments remaining at 

the end of FY 2007, if any, and carried 

over into FY 2008. 

Column E = FY 2008 Allotments. 

Column E contains the amounts of the 

States’ FY 2008 allotments, as published 

in the May 23, 2008 Federal Register 

(30112, Vol. 73, No. 101). 

Column F = FY 2005 Redistribution 

Based on November 30, 2007 Estimates. 

Column F contains the amounts of the 

FY 2005 redistributed allotments issued 

to the State in FY 2008, if any, as based 

on the States’ estimates of CHIP funding 

needed for FY 2008 submitted and 

certified by the State by November 30, 

2007. 

Column G = Total Avail. Allotments 

in FY 2008. Column G contains the total 

amount of CHIP funds available to the 

State in FY 2008 without consideration 

of the issuance of any additional FY 

2008 shortfall allotments, determined as 

the sum of the amounts, if any, in 

Columns C, D, E, and F. 

Column H = Retro. Adjusted Shortfall 

in FY 2008. Column H contains the 

retrospective adjustment amount of 

States’ shortfall in CHIP funding for FY 

2008. This amount is based on the 

States’ actual FY 2008 CHIP 

expenditures as submitted and certified 

by the State by November 30, 2008 and 

the actually available CHIP funds 

without any additional FY 2008 

shortfall allotments. The retrospective 

adjustment is applicable only for States 

that were determined to have a shortfall 

in CHIP funding in FY 2008 based on 

their FY 2008 expenditure projections 

submitted and certified by November 

30, 2007; such States are those with an 

FY 2008 shortfall amount shown in 

Column I. For such States, the amount 

of the retrospective adjustment shortfall 

amount in Column H is calculated as 

the difference between the amounts of 

the States’ projected Federal share CHIP 

expenditures for FY 2008 in Column B 

and the amounts of the States’ available 

allotments funds in FY 2008 Column G. 

Column I = Total FY 2008 SF 

Allotment Grants Issued in FY 2008. 

Column I contains the total amounts of 

the additional FY 2008 shortfall 

allotments actually issued to the State in 

FY 2008 to address States’ CHIP funding 

shortfalls in FY 2008. 

Column J = FY 2008 Excess SF 

Allotments Provided In FY 2008. 

Column J contains the amounts of the 

States’ excess additional FY 2008 

shortfall allotments provided in FY 

2008, as determined under the 

retrospective adjustment provision. For 

States that received additional FY 2008 

shortfall allotments, the amounts in 

Column J represent the amount of the 

FY 2008 shortfall allotments provided 

in FY 2008 that were greater than were 

needed to address such States’ CHIP 

funding shortfalls in FY 2008. The 

amounts in Column J are calculated as 

the difference between the actual 

additional FY 2008 shortfall allotments 

in Column I and the amounts of the 

States’ retrospectively adjusted FY 2008 

shortfall in Column H. 

Column K = Additional FY 2008 SF 

Allotments Needed for FY 2008. 

Column K contains the amounts of the 

additional FY 2008 shortfall allotments 

needed by FY 2008 shortfall States as 

determined under the retrospective 

adjustment provision. For States that 

received such shortfall allotments in FY 

2008, the amounts in Column K 

represent the amount of the additional 

FY 2008 shortfall allotments needed in 

FY 2008 that were greater than were 

provided to address such States’ CHIP 

funding shortfalls in FY 2008. The 

amounts in Column K are calculated as 

the difference between the amounts of 

the States’ retrospectively adjusted FY 

2008 shortfall in Column H and the 

actual FY 2008 shortfall allotments 

provided to the States in Column I. 


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E. Table 5—Retrospective Adjustment 

for the FY 2009 Shortfall Funding 

Table 5 contains the final 

retrospective adjustment determination 

with respect to the amounts of the 

additional shortfall allotments provided 

to States to eliminate their CHIP funding 

shortfalls for the first two quarters of FY 

2009, in accordance with the provisions 

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

section 2104(l)(2) and (3)(A) of the Act, 

additional FY 2009 shortfall allotments 

were initially made available only to 

those States that were projected to have 

a shortfall in CHIP funding for the first 

two quarters of FY 2009 based on their 

FY 2009 expenditure projections as 

submitted and certified by the States by 

November 30, 2008. For those States, 

under section 2104(l)(5) of the Act, the 

retrospective adjustment to the amounts 

of their additional FY 2009 shortfall 

allotments are 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. 

Key to Table 5 

Column/Description 

Column A = State. Column A contains 

the name of the State. 

Column B = FY 09 Actual Expends. 

Thru 3/31/09 Reported By 5/31/09. 

Column B contains the total Federal 

share amount of the CHIP expenditures 

reported by the States for the first two 

quarters of FY 2009 (the period ending 

March 31, 2009), as contained on the 

States’ expenditure reports submitted 

and certified by the States by May 31, 

2009. 

Column C = FY 07 Carryover 

Allotments into FY 09. Column C 

contains the amounts of the States’ 

unused FY 2007 allotments remaining at 

the end of FY 2008, if any, and carried 

over into FY 2009. 

Column D = FY 08 Carryover 

Allotments into FY 09. Column D 

contains the amounts of the States’ 

unused FY 2008 allotments remaining at 

the end of FY 2008, if any, and carried 

over into FY 2009. 

Column E = FY 09 Pre-CHIPRA Allot. 

Grants. Column E contains the amounts 

of the States’ FY 2009 allotment grants 

as issued to States prior to April 1, 2009 

from the FY 2009 allotments as 

determined under the CHIP statute in 

effect prior to the enactment of CHIPRA, 

as published in the May 23, 2008 

Federal Register (30112, Vol. 73, No. 

101). 

Column F = FY 2006 Redistribution 

Based on 11/30/08 Estimates. Column F 

contains the amounts of the FY 2006 

redistributed allotments issued to the 

State in FY 2009, if any, as based on the 

States’ estimates of CHIP funding 

needed for FY 2009 submitted and 

certified by the State by November 30, 

2008. 

Column G = Total Avail. Allotments 

in FY 2009. Column G contains the total 

amount of CHIP funds available to the 

State in FY 2009 without consideration 

of the issuance of any additional FY 

2009 shortfall allotments, determined as 

the sum of the amounts, if any, in 

Columns C, D, E, and F. 

Column H = Retro. Adjusted Shortfall 

FY 2009 Thru 3/31/09. Column H 

contains the retrospective adjustment 

amount of States’ shortfalls in CHIP 

funding through the end of March 31, 

2009, based on the States’ actual FY 

2009 CHIP expenditures for the first two 

quarters of FY 2009 as submitted and 

certified by the State by May 31, 2009 

and the actually available CHIP funds 

not including any additional FY 2009 

shortfall allotments. The amount of the 

retrospective adjustment shortfall 

amount in Column H is calculated as 

the difference between the amounts of 

the States’ projected Federal share CHIP 

expenditures for the first two quarters of 

FY 2009 in Column B and the amounts 

of the States’ available allotments funds 

in FY 2009 Column G. 

Column I = Total FY 2009 SF 

Allotments Issued in FY 2009. Column 

I contains the total amounts of the 

additional FY 2009 shortfall allotments 

actually issued to the State in the first 

two quarters of FY 2009 prior to April 

1, 2009 to address States’ CHIP funding 

shortfalls for the first two quarters of FY 

2009. 

Column J = FY 2009 Excess SF 

Allotments Provided In FY 2009. 

Column J contains the amounts of the 

States’ excess additional FY 2009 

shortfall allotments provided in FY 

2009, as determined under the 

retrospective adjustment provision. For 

States that received additional FY 2009 

shortfall allotments, the amounts in 

Column J represent the amount of the 

FY 2009 shortfall allotments provided 

in FY 2009 that were greater than were 

needed to address such States’ CHIP 

funding shortfalls in FY 2009. The 

amounts in Column J are calculated as 

the difference between the actual 

additional FY 2009 shortfall allotments 

in Column I and the amounts of the 

States’ retrospectively adjusted FY 2009 

shortfall in Column H. 


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IV. Response to Comments 

Because of the large number of public 

comments we normally receive on 

Federal Register documents, we are not 

able to acknowledge or respond to them 

individually. We will consider all 

comments we receive by the date and 

time specified in the DATES section of 

this preamble, and, when we proceed 

with a subsequent document, we will 

respond to the comments in the 

preamble to that document. 

V. 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). 

VI. Regulatory Impact Analysis 

We have examined the impacts 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 (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 proposed rule is economically 

significant, since it provides the 

methodologies under which State 

allotments for FY 2009 through FY 2013 

were calculated and will be in the 

future. In particular, this rule 

implements the CHIP statute as 

amended by CHIPRA, under which 

approximately up to $44 billion in 

additional Federal funds may be made 

available for fiscal years FY 2009 

through FY 2013 in addition to the 

amount of funds previously 

appropriated for States’ CHIPs in 

accordance with the methodology 

established in the CHIP statute. This 

proposed rule also includes the actual 

State fiscal year CHIP allotments for FY 

2009 determined in accordance with the 

methodology set out in this proposed 

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 proposed rule. 

The RFA requires agencies to analyze 

options for regulatory relief of small 

businesses, if a rule has a significant 

economic impact on a substantial 

number of small entities. 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 less than $7 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 proposed rule 

would 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 603 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 and has 

fewer than 100 beds. We are not 

preparing an analysis for section 1102(b) 

of the Act because we have determined 

that this proposed rule would not have 

a significant impact on the operations of 

a substantial number of small rural 

hospitals. 

Section 202 of the 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. 

That threshold level is currently 

approximately $133 million. This 

proposed rule would not create an 

unfunded mandate on States, tribal, or 

local governments in the aggregate, or 

by the private sector in the amount of 

$133 million in any one year. Therefore, 

we are not required to perform an 

assessment of the costs and benefits of 

this rule. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it publishes 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 proposed rule 

would not significantly affect States’ 

rights, roles, and responsibilities. 

Low-income children would benefit 

from payments under this program 

through increased opportunities for 

health insurance coverage. We believe 

this proposed rule would 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. 

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 $44 billion in 

additional Federal funds may be made 

available for fiscal years FY 2009 

through FY 2013, in addition to the 

amount of funds previously 

appropriated for States’ CHIPs. All 

expenditures are classified as transfers 

from the Federal Government to States. 


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In accordance with the provisions of 

Executive Order 12866, this proposed 

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 proposes to amend 

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 

‘‘2013’’. 

§ 457.608 [Amended] 

3. Amend the section heading in 

§ 457.608 by removing the words ‘‘for a 

fiscal year’’ and adding in its place 

‘‘prior to FY 2009’’. 

4. Add a new § 457.609 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 

2013 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, for the period beginning 

October 1, 2012 and ending March 31, 

2013, the following amounts are as 

follows: 

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

(ii) $11,706,000,000. 

(6) FY 2013, 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) of this section 

related to proration, and paragraph 

(b)(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 

certified to the Secretary through the 

November 2008 submission of the 

quarterly expenditure reports, Forms 

CMS–21 and CMS–64, 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 2104(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 2104(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), 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 


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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 2013. (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 2013 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. 

(i) General. There are two State 

allotments for FY 2013; one for the 

period beginning October 1, 2012 and 

ending March 31, 2013 and the second 

beginning April 1, 2013 and ending 

September 30, 2013. 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 2013 

for the period October 1, 2012 and 

ending March 31, 2013 is determined as 

the product of the following: 

(A) The first half ratio determined as 

the amount in paragraph (d)(5)(A)(1) of 

this section divided by the amount in 

paragraph (d)(5)(A)(2) of this section. 

(1) $14,556,000,000 (calculated as the 

sum of the two amounts in paragraph 

(b)(5) of this section, $2,850,000,000 

(appropriated in section 2104(a)(16)(A) 

of the Act) and $11,706,000,000 

(appropriated in section 108 of Public 

Law 111–3)). 

(2) $17,406,000,000, determined as 

the sum of the amount determined 

under paragraph (d)(5)(A)(1) of this 

section, $14,556,000,000, and 

$2,850,000,000, the amount in 

paragraph (b)(6) of this section, as 

appropriated in section 2104(a)(16)(B) of 

the Act. 

(B) The product of: 

(1) The amount of Federal payments 

attributable and countable toward the 

total amount of available State 

allotments in FY 2012, including— 

(i) Any amount redistributed to the 

State in FY 2012; and 

(ii) Any Federal payments made as 

contingency fund payments for FY 2012 

under section 2104(n) of the Act. 

(2) The State allotment increase factor 

for FY 2013 as determined under 

paragraph (f) of this section. 

(iii) The State allotment for FY 2013 

for the period April 1, 2013 and ending 

September 31, 2013 is determined as the 

product of the following: 

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

paragraph (b)(6) of this section, as 

appropriated in section 2104(a)(16)(B) of 

the Act; and 

(B) The ratio determined as the 

amount in paragraph (d)(5)(iii)(B)(1) of 

this section divided by the amount in 

paragraph (d)(5)(iii)(B)(2) of this section. 

(1) The amount of the State allotment 

determined under paragraph (d)(5)(ii) of 

this section. 

(2) The total of all the State allotments 

determined under paragraph (d)(5)(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 under 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. 


srobinson on DSKHWCL6B1PROD with PROPOSALS
47536 Federal Register / Vol. 74, No. 178 / Wednesday, September 16, 2009 / Proposed Rules 

(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 under 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. 

The child population growth factor 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 Child Population 

Growth Factor 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 2013 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 2013, 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 

2013); and 

(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; and 

(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 subsection for such fiscal 

year shall be increased by the excess 

amount described in paragraph (g)(2)(i). 

A State or District may only obtain an 

increase under paragraph (g)(2)(ii) of 

this section for an allotment for FY 2010 

or FY 2012. 

(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. 

§ 457.610 [Amended] 

5. Amend the section heading for 

§ 457.610 by— 

A. Amending the section heading by 

removing the words ‘‘for a fiscal year’’ 

and adding in its place ‘‘prior to FY 

2009’’. 

B. Removing the words ‘‘for a fiscal 

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

FY 2009’’in the first line of the 

paragraph. 

6. Add a new § 457.611 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: June 19, 2009. 

Charlene Frizzera, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

Approved: July 29, 2009. 

Kathleen Sebelius, 

Secretary. 

[FR Doc. E9–22162 Filed 9–15–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF THE INTERIOR 

Fish and Wildlife Service 

50 CFR Part 17 

[Docket No. FWS–R1–ES–2008–0073; 

14420–1113–0000–C6] 

Endangered and Threatened Wildlife 

and Plants; 12-Month Finding on a 

Petition to Remove the Bliss Rapids 

Snail (Taylorconcha serpenticola) 

From the List of Endangered and 

Threatened Wildlife 

AGENCY: Fish and Wildlife Service, 

Interior. 

ACTION: Notice of 12-month petition 

finding. 

SUMMARY: We, the U.S. Fish and 

Wildlife Service (Service), announce a 

12-month finding on a petition to 

remove the Bliss Rapids snail 

(Taylorconcha serpenticola) from the 

Federal List of Endangered and 

Threatened Wildlife (List) pursuant to 

the Endangered Species Act of 1973, as 

amended (Act) (16 U.S.C. 1531 et seq.). 

Based on a thorough review of the best 

scientific and commercial data 

available, the species continues to be 

restricted to a small geographic area in 

the middle-Snake River, Idaho, where it 

is dependent upon cool-water spring 

outflows. Although some threats 

identified at the time of listing in 1992 

no longer exist or have been moderated, 

ground water depletion and impaired 

water quality still threaten the Bliss 

Rapids snail. In addition, there are 

significant uncertainties about the 

effects of hydropower operations and 

New Zealand mudsnails on the 


srobinson on DSKHWCL6B1PROD with PROPOSALS