38748 Federal Register / Vol. 75, No. 128 / Tuesday, July 6, 2010 / Rules and Regulations 

EPA—APPROVED IOWA REGULATIONS—Continued 

Iowa citation Title State effective 

date EPA approval date Explanation 

*******

Polk County 

CHAPTER V ........................... Polk County Board of Health 

Rules and Regulations Air 

Pollution Chapter V.

08/06/09 07/06/10 [insert FR page 

number where the document begins].

Article I, Section 5–2, definition of ‘‘variance’’; Article 

VI, Sections 5–16(n), (o) 

and (p); Article VIII; Article 

IX, Sections 5–27(3) and 

(4); Article X, Section 5–28, 

subsections (a) through (c); 

Article XIII and Article XVI, 

Section 5–75 are not a part 

of the SIP. 

* * * * * 

[FR Doc. 2010–16235 Filed 7–2–10; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 447 and 457 

[CMS–2244–CN] 

RIN 0938–AP73 

Medicaid Program; Premiums and Cost 

Sharing; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS 

ACTION: Correction of final rule with 

comment period. 

SUMMARY: This document corrects 

technical errors that appeared in the 

final rule with comment period 

published in the Federal Register on 

May 28, 2010 entitled ‘‘Medicaid 

Program; Premiums and Cost Sharing.’’ 

The May 28, 2010, final rule revised a 

November 25, 2008, final rule entitled, 

‘‘Medicaid Programs; Premiums and 

Cost Sharing’’ which addressed public 

comments received during reopened 

comment periods, and reflected relevant 

statutory changes made in the American 

Recovery and Reinvestment Act of 2009. 

The November 2008 document revised 

final rule implemented and interpreted 

section 1916A of the Social Security 

Act. 

DATES: Effective Date: This correction 

document is effective July 1, 2010. 

FOR FURTHER INFORMATION CONTACT: 

Christine Gerhardt, (410) 786–0693. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2010–12954 of May 28, 

2010 (75 FR 30244), there were two 

technical errors that are identified and 

corrected in the ‘‘Correction of Errors’’ 

section below. The provisions in this 

correction notice are effective as if they 

had been included in the document 

published May 28, 2010. Accordingly, 

the corrections are effective July 1, 2010. 

II. Summary of Errors 

On page 30255, in the preamble under 

Section III, ‘‘Provisions of the Revised 

Final Rule,’’ we set forth the definition 

of ‘‘Indian health care provider.’’ On 

page 30256, we specify that the 

definition is added to a new paragraph 

(b) under § 447.50. However, on page 

30261, we inadvertently omitted the 

definition of ‘‘Indian health care 

provider’’ from § 447.50 (b) of the 

regulations text. 

On page 30264, we inadvertently 

omitted a statutory exception to the 

policy specified in the amended 

paragraph (b) under § 447.74 of the 

regulations text. According to section 

1916A(e)(2) of the Social Security Act 

(the Act), the limitation to 20 percent of 

the State Medicaid agency’s payment for 

alternative cost sharing imposed on 

individuals with family income more 

than 150 percent of the Federal poverty 

level (FPL) does not apply to nonemergency services furnished in a 

hospital emergency department. 

III. Waiver of Proposed Rulemaking 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register to provide a period for public 

comment before the provisions of a rule 

take effect in accordance with section 

553(b) of the Administrative Procedure 

Act (APA) (5 U.S.C. 553(b)). However, 

we can waive this notice and comment 

procedure if the Secretary finds, for 

good cause, that the notice and 

comment process is impracticable, 

unnecessary, or contrary to the public 

interest, and incorporates a statement of 

the finding and the reasons therefore in 

the notice. 

Section 553(d) of the APA ordinarily 

requires a 30-day delay in effective date 

of final rules after the date of their 

publication in the Federal Register. 

This 30-day delay in effective date can 

be waived, however, if an agency finds 

for good cause that the delay is 

impracticable, unnecessary, or contrary 

to the public interest, and the agency 

incorporates a statement of the findings 

and its reasons in the rule issued. 

With respect to our proposal to add a 

definition of ‘‘Indian health care 

provider’’ as a new paragraph (b)(2) in 

§ 447.50 of the regulations text, we 

inadvertently omitted this definition 

from the revised final rule. In the 

preamble under Section III, Provisions 

of the Revised Final Rule, we gave the 

new definition on page 30255. Also, on 

page 30256, we mentioned that the 

definition of ‘‘Indian health care 

provider’’ is added to a new paragraph 

(b) under § 447.50. Because the intended 

content of the regulation is clear when 

the document is read as a whole, we 

believe further process is unnecessary. 

We further believe that correction of the 

error is in the public interest because it 

would avoid confusion. Therefore, we 

find good cause to waive a notice of 

proposed rulemaking and delayed 

effective date. 

With respect to our proposal to add an 

exception to the policy specified in the 

amended paragraph (b) under § 447.74, 

section 1916A(e)(2) of the Act makes 

clear that the limitation to 20 percent of 

the State Medicaid agency’s payment for 

alternative cost sharing imposed on 

individuals with family income more 

than 150 percent of the Federal poverty 

level (FPL) does not apply to nonemergency services furnished in a 

hospital emergency department. Since 

this change is necessary to accurately 

reflect the statutory requirements, we 

believe that correction of this error is in 

the public interest because it will 

prevent confusion as to those 


wwoods2 on DSK1DXX6B1PROD with RULES_PART 1
Federal Register / Vol. 75, No. 128 / Tuesday, July 6, 2010 / Rules and Regulations 38749 

requirements. Therefore, we find good 

cause to waive a notice of proposed 

rulemaking and delayed effective date 

in order to comply with the statutory 

exemption of this service from the 

requirements specified in § 447.74(b). 

IV. Correction of Errors 

Regulations Text 

■ Accordingly, CMS amends 42 CFR 

part 447, as amended in FR Doc. 2010– 

12954 of May 28, 2010 (75 FR 30244), 

effective July 1, 2010, by making the 

following corrections: 

PART 447—PAYMENTS FOR 

SERVICES 

■ 1. The authority citation for part 447 

continues to read as follows: 

Authority: Sec. 1102 of the Social Security 

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

■ 2. In § 447.50, a new paragraph (b)(2) 

is added to read as follows: 

§ 447.50 Cost sharing: Basis and purpose. 

* * * * * 

(b) * * * 

(2) Indian health care provider means 

a health care program operated by the 

Indian Health Service (IHS) or by an 

Indian Tribe, Tribal Organization, or 

Urban Indian Organization (otherwise 

known as an I/T/U) as those terms are 

defined in section 4 of the Indian Health 

Care Improvement Act (25 U.S.C. 1603). 

* * * * * 

■ 3. In § 447.74, revise paragraph (b) to 

read as follows: 

§ 447.74 Alternative premium and cost 

sharing protections for individuals with 

family incomes above 150 percent of the 

FPL. 

* * * * * 

(b) Cost sharing may be imposed 

under the State plan on individuals 

whose family income exceeds 150 

percent of the FPL if the cost sharing 

does not exceed 20 percent of the 

payment the agency makes for the item 

or service (including a non-preferred 

drug but not including non-emergency 

services furnished in a hospital 

emergency department), with the 

following exception: In the case of 

States that do not have fee-for-service 

payment rates, any copayment that the 

State imposes for services provided by 

an MCO to a Medicaid beneficiary, 

including a child covered under a 

Medicaid expansion program for whom 

enhanced match is claimed under title 

XXI of the Act, may not exceed $3.40 

per visit for Federal FY 2009. 

Thereafter, any copayment may not 

exceed this amount as updated each 

October 1 by the percentage increase in 

the medical care component of the CPI– 

U for the period of September to 

September ending in the preceding 

calendar year and then rounded to the 

next highest 5-cent increment. 

* * * * * 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program) 

Dated: June 29, 2010. 

Dawn L. Smalls, 

Executive Secretary to the Department. 

[FR Doc. 2010–16272 Filed 6–30–10; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Federal Emergency Management 

Agency 

44 CFR Part 64 

[Docket ID FEMA–2010–0003; Internal 

Agency Docket No. FEMA–8137] 

Suspension of Community Eligibility 

AGENCY: Federal Emergency 

Management Agency, DHS. 

ACTION: Final rule. 

SUMMARY: This rule identifies 

communities, where the sale of flood 

insurance has been authorized under 

the National Flood Insurance Program 

(NFIP), that are scheduled for 

suspension on the effective dates listed 

within this rule because of 

noncompliance with the floodplain 

management requirements of the 

program. If the Federal Emergency 

Management Agency (FEMA) receives 

documentation that the community has 

adopted the required floodplain 

management measures prior to the 

effective suspension date given in this 

rule, the suspension will not occur and 

a notice of this will be provided by 

publication in the Federal Register on a 

subsequent date. 

DATES: Effective Dates: The effective 

date of each community’s scheduled 

suspension is the third date (‘‘Susp.’’) 

listed in the third column of the 

following tables. 

FOR FURTHER INFORMATION CONTACT: If 

you want to determine whether a 

particular community was suspended 

on the suspension date or for further 

information, contact David Stearrett, 

Mitigation Directorate, Federal 

Emergency Management Agency, 500 C 

Street, SW., Washington, DC 20472, 

(202) 646–2953. 

SUPPLEMENTARY INFORMATION: The NFIP 

enables property owners to purchase 

flood insurance which is generally not 

otherwise available. In return, 

communities agree to adopt and 

administer local floodplain management 

aimed at protecting lives and new 

construction from future flooding. 

Section 1315 of the National Flood 

Insurance Act of 1968, as amended, 42 

U.S.C. 4022, prohibits flood insurance 

coverage as authorized under the NFIP, 

42 U.S.C. 4001 et seq.; unless an 

appropriate public body adopts 

adequate floodplain management 

measures with effective enforcement 

measures. The communities listed in 

this document no longer meet that 

statutory requirement for compliance 

with program regulations, 44 CFR part 

59. Accordingly, the communities will 

be suspended on the effective date in 

the third column. As of that date, flood 

insurance will no longer be available in 

the community. However, some of these 

communities may adopt and submit the 

required documentation of legally 

enforceable floodplain management 

measures after this rule is published but 

prior to the actual suspension date. 

These communities will not be 

suspended and will continue their 

eligibility for the sale of insurance. A 

notice withdrawing the suspension of 

the communities will be published in 

the Federal Register. 

In addition, FEMA has identified the 

Special Flood Hazard Areas (SFHAs) in 

these communities by publishing a 

Flood Insurance Rate Map (FIRM). The 

date of the FIRM, if one has been 

published, is indicated in the fourth 

column of the table. No direct Federal 

financial assistance (except assistance 

pursuant to the Robert T. Stafford 

Disaster Relief and Emergency 

Assistance Act not in connection with a 

flood) may legally be provided for 

construction or acquisition of buildings 

in identified SFHAs for communities 

not participating in the NFIP and 

identified for more than a year, on 

FEMA’s initial flood insurance map of 

the community as having flood-prone 

areas (section 202(a) of the Flood 

Disaster Protection Act of 1973, 42 

U.S.C. 4106(a), as amended). This 

prohibition against certain types of 

Federal assistance becomes effective for 

the communities listed on the date 

shown in the last column. The 

Administrator finds that notice and 

public comment under 5 U.S.C. 553(b) 

are impracticable and unnecessary 

because communities listed in this final 

rule have been adequately notified. 

Each community receives 6-month, 

90-day, and 30-day notification letters 

addressed to the Chief Executive Officer 

stating that the community will be 

suspended unless the required 

floodplain management measures are 

met prior to the effective suspension 


wwoods2 on DSK1DXX6B1PROD with RULES_PART 1