44036 Federal Register / Vol. 79, No. 145 / Tuesday, July 29, 2014 / Notices 

Agenda items are subject to change as 

priorities dictate. 

Contact Person for More Information: 

Robin Moseley, M.A.T., Designated 

Federal Officer, OID, CDC, 1600 Clifton 

Road NE., Mailstop D10, Atlanta, 

Georgia 30333, Telephone: (404) 639– 

4461. 

The Director, Management Analysis 

and Services Office has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2014–17739 Filed 7–28–14; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Request for Nominations of 

Candidates To Serve on the Advisory 

Committee to the Director, Centers for 

Disease Control and Prevention 

The Centers for Disease Control and 

Prevention (CDC) is soliciting 

nominations for possible membership 

on the Advisory Committee to the 

Director, Centers for Disease Control 

and Prevention (ACD, CDC). This 

committee consists of 15 experts in 

fields related to health policy, public 

health, global health, preparedness, 

preventive medicine, the faith-based 

and community-based sector, and allied 

fields who are selected by the Secretary 

of the U.S. Department of Health and 

Human Services (HHS). The committee 

advises the HHS Secretary and the CDC 

Director concerning policy and broad 

strategies that will enable CDC to fulfill 

its mission of protecting health through 

health promotion, prevention, and 

preparedness. The committee 

recommends ways to prioritize CDC’s 

activities, improve results, and address 

health disparities. It also provides 

guidance to help CDC work more 

effectively with its various private and 

public sector constituents to make 

health protection a practical reality. 

Nominations are being sought for 

individuals who have expertise and 

qualifications necessary to contribute to 

the accomplishment of the committee’s 

mission. Nominees will be selected by 

the HHS Secretary or designee from 

authorities knowledgeable in the fields 

of public health as well as from the 

general public. Members may be invited 

to serve for terms of up to four years. 

The U.S. Department of Health and 

Human Services policy stipulates that 

committee membership shall be 

balanced in terms of professional 

training and background, points of view 

represented, and the committee’s 

function. In addition to a broad range of 

expertise, consideration is given to a 

broad representation of geographic areas 

within the U.S., with diverse 

representation of both genders, ethnic 

and racial minorities, lesbian, gay, 

bisexual, and transgender and persons 

with disabilities. Nominees must be 

U.S. citizens, and cannot be full-time 

employees of the U.S. Government. 

Candidates should submit the 

following items: 

• Current curriculum vitae, including 

complete contact information (name, 

affiliation, mailing address, telephone 

number, email address); 

• A letter of recommendation stating 

the qualifications of the candidate. 

Nomination materials must be 

postmarked by August 31, 2014, and 

sent to: Gayle Hickman, Office of the 

Chief of Staff, Centers for Disease 

Control and Prevention, 1600 Clifton 

Road, NE., Mailstop D14, Atlanta, 

Georgia 30333, telephone (404) 639– 

7158. 

The Director, Management Analysis 

and Services Office, has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities for both the 

Centers for Disease Control and 

Prevention, and the Agency for Toxic 

Substances and Disease Registry. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2014–17736 Filed 7–28–14; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Notice of Hearing: Reconsideration of 

Disapproval; Louisiana Medicaid State 

Plan Amendments (SPAs) 13–23, 13–25 

and 13–28 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice of Hearing: 

Reconsideration of Disapproval. 

SUMMARY: This notice announces an 

administrative hearing to be held on 

September 9, 2014, at the Department of 

Health and Human Services, Centers for 

Medicare & Medicaid Services, Division 

of Medicaid & Children’s Health, Dallas 

Regional Office, 1301 Young Street, 

Room #801, 8th Floor Dallas, Texas 

75202 to reconsider CMS’ decision to 

disapprove Louisiana’s Medicaid SPAs 

13–23, 13–25 and 13–28. 

Closing Date: Requests to participate 

in the hearing as a party must be 

received by the presiding officer by 

August 13, 2014. 

FOR FURTHER INFORMATION CONTACT: 

Benjamin R. Cohen, Presiding Officer, 

CMS, 2520 Lord Baltimore Drive, Suite 

L, Baltimore, Maryland 21244, 

Telephone: (410) 786–3169. 

SUPPLEMENTARY INFORMATION: This 

notice announces an administrative 

hearing to reconsider CMS’ decision to 

disapprove the Louisiana Medicaid 

SPAs 13–23, 13–25 and 13–28. CMS 

received Louisiana SPAs 13–23 and 13– 

25 on June 27, 2013, and 13–28 on July 

12, 2013 with proposed effective dates 

of June 24, 2013 and October 1, 2013, 

respectively. The amendments propose 

to provide for supplemental Medicaid 

inpatient hospital payments and 

disproportionate share hospital (DSH) 

payments to private hospitals 

participating in public-private 

partnerships. These SPAs were 

disapproved on May 2, 2014. 

The issues to be considered at the 

hearing are: 

• Whether the state established that 

Louisiana SPAs 13–23, 13–25 and 13–28 

comply with section 1903(w) of the 

Social Security Act (the Act) which 

generally provides that state 

expenditures are not allowable to the 

extent that the state receives certain 

provider-related donations and taxes As 

set forth in implementing regulations at 

42 Code of the Federal Register (CFR) 

433.54, expenditures are not allowable, 

and federal financial participation (FFP) 

is not available, to the extent that the 

state receives provider-related donations 

and there is a ‘‘hold harmless 

arrangement’’ under which providers (or 

the provider class) could be effectively 

repaid for a provider-related tax or 

donation through any direct or indirect 

payment, offset, or waiver. 

Æ Specifically, at issue is whether (1) 

the state established that certain 

payments from providers to the state 

(characterized by the state as advance 

lease payments) were not provider 

donations, when the state did not 

document such payments to be 

consistent with ordinary market 

business practices for leasing property; 


rmajette on DSK2TPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 145 / Tuesday, July 29, 2014 / Notices 44037 

(2) whether the state established that the 

supplemental and DSH payments made 

under the SPAs were not linked to 

Cooperative Endeavor Agreements that 

provide, among other things, for of the 

advance lease payments from privately 

owned hospitals that are at issue when 

such agreements were entered into with 

entities qualifying for increased 

Medicaid payments under the SPA; and 

(3) whether the state established that 

there was no hold harmless arrangement 

despite the apparent return of donated 

funds back to the private hospitals in 

the form of increased Medicaid 

payments. 

As noted in this statement of the 

issues set forth above, the burden is on 

the state to demonstrate that the 

‘‘advance lease payments’’ were not a 

donation, were not linked to Medicaid 

payments, and that there is no hold 

harmless arrangement. CMS is 

authorized under section 1902(b) of the 

Act, as implemented by 42 CFR Part 

430, Subpart B, to approve state plan 

amendments only based on a 

determination that the amendments 

comply with the requirements of 

relevant federal statutes and regulations 

and can serve as a basis for FFP. 

• Whether Louisiana SPAs 13–23, 

13–25 and 13–28 comply with the 

requirements of 1902(a)(2) and 

1902(a)(4) of the Act which requires that 

the state plan provide for the nonfederal share of expenditures under the 

state plan, from either state or local 

funding. Because the SPAs at issue 

propose to claim for FFP without 

adjustment to reflect unallowable 

expenditures resulting from the 

provider related donation and hold 

harmless arrangement discussed above, 

they would result in a non-federal share 

that would be insufficient to meet the 

requirements of section 1902(a)(2). 

Moreover, section 1902(a)(4) of the Act 

requires that the state plan comply with 

methods of administration as are found 

necessary by the Secretary for the 

proper and efficient operation of the 

plan. Among the implementing 

regulations for section 1902(a)(4) of the 

Act is the requirement at 42 CFR 430.10 

that a state plan contain all information 

necessary for CMS to determine that the 

plan can be approved to serve as a basis 

for FFP in the state program. Because 

the state has not established that the 

supplemental payments are not part of 

a hold harmless arrangement that would 

result in a reduction in FFP, the state 

has not established that the SPAs are 

consistent with section 1902(a)(4) and 

the implementing regulations at 42 CFR 

430.10. 

• Whether the state has established 

that the supplemental payments set 

forth in Louisiana SPA 13–23, 13–25, 

and 13.28 are consistent with the 

statutory requirement at section 

1902(a)(30)(A) of the Act that payments 

must be ‘‘consistent with efficiency, 

economy, and quality of care’’. 

• Whether Louisiana SPAs 13–23, 

13–25 and 13–28 comport with the 

broad principles of the federal-state 

partnership embodied in section 1903(a) 

of the Act, because they indicate 

circumstances in which the federal 

government would pay more than its 

share of the net expenditures, after 

accounting for claimed expenditures 

that are effectively repaid by the 

provider-related donations. 

Section 1116 of the Act and federal 

regulations at 42 CFR Part 430, establish 

Department procedures that provide an 

administrative hearing for 

reconsideration of a disapproval of a 

state plan or plan amendment. CMS is 

required to publish a copy of the notice 

to a state Medicaid agency that informs 

the agency of the time and place of the 

hearing, and the issues to be considered. 

If we subsequently notify the agency of 

additional issues that will be considered 

at the hearing, we will also publish that 

notice. 

Any individual or group that wants to 

participate in the hearing as a party 

must petition the presiding officer 

within 15 days after publication of this 

notice, in accordance with the 

requirements contained at 42 CFR 

430.76(b)(2). Any interested person or 

organization that wants to participate as 

amicus curiae must petition the 

presiding officer before the hearing 

begins in accordance with the 

requirements contained at 42 CFR 

430.76(c). If the hearing is later 

rescheduled, the presiding officer will 

notify all participants. 

The notice to Louisiana announcing 

an administrative hearing to reconsider 

the disapproval of its SPAs reads as 

follows: 

Ms. J. Ruth Kennedy, Medicaid Director, 

Department of Health and 

Hospitals, 628 North 4th Street, 

P.O. Box 91030, Baton Rouge, LA 

70821–9030. 

Dear Ms. Kennedy: I am responding to 

your request for reconsideration of the 

decision to disapprove Louisiana State 

Plan Amendments (SPAs) 13–23, 13–25 

and 13–28. The Centers for Medicare & 

Medicaid Services (CMS) received SPAs 

13–23 and 13–25 on June 27, 2013, and 

13–28 on July 12, 2013 with proposed 

effective dates of June 24, 2013 and 

October 1, 2013, respectively. The 

amendments propose to provide for 

supplemental Medicaid inpatient 

hospital payments and disproportionate 

share hospital (DSH) payments to 

private hospitals participating in publicprivate partnerships. These SPAs were 

disapproved on May 2, 2014. 

I am scheduling a hearing on your 

request for reconsideration to be held on 

September 9, 2014, at the Department of 

Health and Human Services, Centers for 

Medicare & Medicaid Services, Division 

of Medicaid & Children’s Health, Dallas 

Regional Office, 1301 Young Street, 

Room #801, Dallas, Texas 75202. The 

issues to be considered at the hearing 

are: 

• Whether the state established that 

Louisiana SPAs 13–23, 13–25 and 13–28 

comply with section 1903(w) of the 

Social Security Act (the Act) which 

generally provides that state 

expenditures are not allowable to the 

extent that the state receives providerrelated donations and taxes. As set forth 

in implementing regulations at 42 Code 

of the Federal Register (CFR) 433.54, 

expenditures are not allowable, and 

federal financial participation (FFP) is 

not available, to the extent that the state 

receives provider-related donations and 

there is a ‘‘hold harmless arrangement’’ 

under which providers (or the provider 

class) could be effectively repaid for a 

provider-related tax or donation through 

any direct or indirect payment, offset, or 

waiver. 

Æ Specifically, at issue is whether (1) 

the state established that certain 

payments from providers to the state 

(characterized by the state as advance 

lease payments) were not provider 

donations, when the state did not 

document such payments to be 

consistent with ordinary market 

business practices for leasing property; 

(2) whether the state established that the 

supplemental and DSH payments made 

under the SPAs were not linked to 

Cooperative Endeavor Agreements that 

provide, among other things, for the 

advance lease payments from privately 

owned hospitals that are at issue when 

such agreements were entered into with 

entities qualifying for increased 

Medicaid payments under the SPAs; 

and (3) whether the state established 

that there was no hold harmless 

arrangement despite the apparent return 

of donated funds back to the private 

hospitals in the form of increased 

Medicaid payments. 

Æ As noted in this statement of the 

issues set forth above, the burden is on 

the state to demonstrate that the 

‘‘advance lease payments’’ were not a 

donation, were not linked to Medicaid 

payments, and that there is no hold 

harmless arrangement. CMS is 

authorized under section 1902(b) of the 

Act, as implemented by 42 CFR Part 

430, Subpart B, to approve state plan 


rmajette on DSK2TPTVN1PROD with NOTICES
44038 Federal Register / Vol. 79, No. 145 / Tuesday, July 29, 2014 / Notices 

amendments only based on a 

determination that the amendments 

comply the requirements of relevant 

federal statutes and regulations and can 

serve as a basis for FFP. 

• Whether Louisiana SPAs 13–23, 

13–25 and 13–28 comply with the 

requirements of 1902(a)(2) and 

1902(a)(4) of the Act which requires that 

the state plan provide for the nonfederal share of expenditures under the 

state plan, from either state or local 

funding. Because the SPAs at issue 

propose to claim for FFP without 

adjustment to reflect unallowable 

expenditures resulting from the 

provider related donation and hold 

harmless arrangement discussed above, 

they would result in a non-federal share 

that would be insufficient to meet the 

requirements of section 1902(a)(2). 

Moreover, section 1902(a)(4) of the Act 

requires that the state plan comply with 

methods of administration as are found 

necessary by the Secretary for the 

proper and efficient operation of the 

plan. Among the implementing 

regulations for section 1902(a)(4) of the 

Act is the requirement at 42 CFR 430.10 

that a state plan contain all information 

necessary for CMS to determine that the 

plan can be approved to serve as a basis 

for FFP in the state program. Because 

the state has not established that the 

supplemental payments are not part of 

a hold harmless arrangement that would 

result in a reduction in FFP, t the state 

has not established that the SPAs are 

consistent with section 1902(a)(4) and 

the implementing regulations at 42 CFR 

430.10. 

• Whether the state has established 

that the supplemental payments set 

forth in Louisiana SPAs 13–23, 13–25, 

and 13–28 are consistent with the 

statutory requirement at section 

1902(a)(30)(A) of the Act that payments 

must be ‘‘consistent with efficiency, 

economy, and quality of care’’. 

• Whether Louisiana SPAs 13–23, 

13–25 and 13–28 comport with the 

broad principles of the federal-state 

partnership embodied in section 1903(a) 

of the Act, because they indicate 

circumstances in which the federal 

government would pay more than its 

share of the net expenditures, after 

accounting for claimed expenditures 

that are effectively repaid by the 

provider-related donations. 

If the hearing date is not acceptable, 

I would be glad to set another date that 

is mutually agreeable to the parties. The 

hearing will be governed by the 

procedures prescribed by federal 

regulations at 42 CFR Part 430. 

I am designating Mr. Benjamin R. 

Cohen as the presiding officer. If these 

arrangements present any problems, 

please contact Mr. Cohen at (410) 786 

3169. In order to facilitate any 

communication that may be necessary 

between the parties prior to the hearing, 

please notify the presiding officer to 

indicate acceptability of the hearing 

date that has been scheduled and 

provide names of the individuals who 

will represent the state at the hearing. 

Sincerely, 

Marilyn Tavenner 

cc: Benjamin R. Cohen 

Section 1116 of the Social Security 

Act (42 U.S.C. section 1316; 42 CFR 

section 430.18) 

(Catalog of Federal Domestic Assistance 

program No. 13.714, Medicaid 

Assistance Program.) 

Dated: July 23, 2014. 

Marilyn Tavenner, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2014–17871 Filed 7–28–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–6057–N] 

Medicare Program; Expanded 

Medicare Prior Authorization for Power 

Mobility Devices (PMDs) 

Demonstration 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

expansion of the Medicare Prior 

Authorization for Power Mobility 

Devices (PMDs) Demonstration to 12 

additional states. 

DATES: This expanded demonstration 

begins on October 1, 2014. 

FOR FURTHER INFORMATION CONTACT: 

Doris M. Jackson, (410) 786–4459. 

Questions regarding the Medicare 

Prior Authorization for Power Mobility 

Device Demonstration should be sent to 

pademo@cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 402(a)(1)(J) of the Social 

Security Amendments of 1967 (42 

U.S.C. 1395b–1(a)(1)(J)), authorizes the 

Secretary to conduct demonstrations 

designed to develop or demonstrate 

improved methods for the investigation 

and prosecution of fraud in the 

provision of care or services provided 

under the Medicare program. On 

September 1, 2012, we implemented the 

Medicare Prior Authorization for Power 

Mobility Devices (PMDs) Demonstration 

that would operate for a period of 3 

years (September 1, 2012 through 

August 31, 2015). The demonstration 

was initially implemented in California, 

Florida, Illinois, Michigan, New York, 

North Carolina, and Texas. These states 

were selected for the demonstrations 

based upon their history of having high 

levels of improper payments and 

incidents of fraud related to PMDs. The 

objective of the demonstration is to 

develop improved methods for the 

investigation and prosecution of fraud 

in order to protect the Medicare Trust 

Fund from fraudulent actions and any 

resulting improper payments. This 

demonstration is providing the agency 

with valuable data through which the 

agency, working with its partners, can 

develop new avenues for combating the 

submission of fraudulent claims to the 

Medicare program for PMDs and 

improving methods for the investigation 

and prosecution of PMD fraud. We will 

share demonstration data within the 

agency, with our contractors, and with 

law enforcement partners for further 

analysis and investigation. We believe 

that data evidencing changes in 

physician ordering and supplier billing 

practices that coincide with this 

demonstration could provide 

investigators and law enforcement with 

important information for determining 

how and where to focus their 

investigations concerning fraud in the 

provision of PMDs. For instance, results 

from this demonstration could 

potentially indicate collaboration 

between ordering physicians and 

suppliers in submitting fraudulent 

claims for PMDs. This data could assist 

investigators and law enforcement in 

targeting their investigations in this 

area. Additionally, changes in billing 

practices that result from this 

demonstration could provide specific 

leads for investigators and law 

enforcement personnel. For instance, 

where a supplier that frequently 

submitted claims prior to the 

demonstration stops submitting claims 

during the demonstration, law 

enforcement may determine it prudent 

to investigate that supplier. 

Data we will analyze will include the 

following: 

• Suppliers who no longer bill or 

have a significant decrease in billing. 

• Physicians/treating practitioners 

with a high volume of submissions. 

• Codes that show a dramatic 

increase in use. 

Based on preliminary data collected, 

spending per month on PMDs in the 


rmajette on DSK2TPTVN1PROD with NOTICES