21608 Federal Register / Vol. 78, No. 70 / Thursday, April 11, 2013 / Notices 

to improve users’ understanding of 

levels of protection to be provided. 

Product testing results will be 

provided to the ASTM Committee on 

Personal Protective Clothing and 

Equipment—Biological Subcommittee 

(a.k.a. ASTM Task Force), which will 

utilize the data as the scientific basis to 

develop a standard establishing 

minimum performance criteria for 

single-use and reusable isolation gowns. 

The research objective is to evaluate 

performance properties, such as strength 

and barrier properties, of isolation 

gowns to be provided to the ASTM Task 

Force as scientific input for establishing 

minimum performances for 

conformance to this standard. 

In this study, all testing will be 

conducted blind. Results will be shared 

with the ASTM Task Force only in a 

blinded format. Results will be shared 

with the individual manufacturers for 

their gowns only. The final summary of 

the testing will be shared in a blinded 

format only with all manufacturers that 

participated. 

Randomized samples will be tested by 

both NIOSH and Nelson Labs. The 

ASTM Task Force will review and 

analyze all test results. Establishment of 

the minimum requirement for each 

property will be the responsibility of the 

ASTM Task Force. NIOSH plans to 

conduct testing to measure the 

following properties: Fabric weight, 

breaking strength, tear strength, seam 

strength, water resistance (impact 

penetration and hydrostatic pressure), 

microbial/viral penetration resistance, 

air permeability, evaporative resistance, 

and thermal insulation. 

Neither this announcement, nor 

product submittals in response to this 

announcement, obligates NIOSH to 

enter into a contractual agreement with 

any respondent. Inquiries should be 

sent to Selcen Kilinc at jcq8@cdc.gov. 

NIOSH reserves the right to establish a 

partnership based on scientific analysis 

and capabilities found by way of this 

announcement or other searches, if 

determined to be in the best interest of 

the government. 

Dated: April 5, 2013. 

John Howard, 

Director, National Institute for Occupational 

Safety and Health, Centers for Disease Control 

and Prevention. 

[FR Doc. 2013–08461 Filed 4–10–13; 8:45 am] 

BILLING CODE 4163–19–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Notice of Hearing: Reconsideration of 

Disapproval of Maine State Plan 

Amendments (SPA) 12–010 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice of hearing. 

SUMMARY: This notice announces an 

administrative hearing to be held on 

May 23, 2013, at the CMS Boston 

Regional Office, JFK Federal Building, 

15 N. Sudbury Street, Room 2050, 

Boston, Massachusetts 02203–0003 to 

reconsider CMS’ decision to disapprove 

Maine SPA 12–010. 

DATES: Closing Date: Requests to 

participate in the hearing as a party 

must be received by the presiding 

officer by (15 days after publication). 

FOR FURTHER INFORMATION CONTACT: 

Benjamin 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 Maine SPA 12–010 which 

was submitted on August 1, 2012, and 

disapproved on January 7, 2013. The 

SPA proposed changes to eligibility for 

parents, caretaker relatives, and 

children whose income is at or below 

133 percent of the federal poverty level 

(FPL). The proposal would make 

eligibility standards, methods, and 

procedures more restrictive than those 

in effect on March 23, 2010. 

CMS disapproved this SPA after 

consulting with the Secretary as 

required by 42 CFR 430.15(c)(2) because 

it appeared the proposal would have 

eliminated Medicaid eligibility for 

parents and caretaker relatives eligible 

under sections 1902(a)(10)(A)(i)(I) and 

1931 whose incomes are between 100 

percent and 133 percent of the FPL, and 

Medicaid eligibility of certain 

individuals considered ‘‘children’’ 

under Maine’s state Medicaid plan. Both 

proposals constituted more restrictive 

eligibility standards than those in effect 

in Maine as of March 23, 2010, that 

could not be excepted from the 

maintenance-of-effort (MOE) mandate 

that Maine is subject to under section 

1902(a)(74) and (gg) of the Social 

Security Act (hereafter ‘‘the Act’’). At 

issue in this appeal are the following 

issues. 

While states generally have authority 

to modify Medicaid eligibility rules, 

sections 1902(a)(74) and (gg) of the Act 

require that states maintain eligibility 

standards, methodologies, and 

procedures that are no more restrictive 

than those in effect under a state’s plan 

as of the date of enactment of the Patient 

Protection and Affordable Care Act 

(March 23, 2010). This MOE 

requirement applies to adults until a 

state’s health insurance exchange is 

operational (January 1, 2014) and to 

children until October 1, 2019. 

Section 1902(gg)(3) of the Act offers a 

partial non-application of the MOE 

requirement during the period between 

January 1, 2011, and December 31, 2013, 

when a state certifies to the Secretary 

that it has a budget deficit during the 

fiscal year for which it is seeking a nonapplication, or projects a budget deficit 

during the succeeding fiscal year. This 

provision limits the non-application to 

‘‘nonpregnant, nondisabled adults who 

are eligible for medical assistance under 

the state plan or under a waiver of the 

plan at the option of the state and whose 

income exceeds 133 percent of the 

poverty line.’’ 

Maine certified a projected budget 

deficit for state fiscal year 2013 in 

December 2011 and requested a nonapplication of the MOE requirement for 

the period of July 1, 2012, through June 

30, 2013. On February 10, 2012, CMS 

notified Maine that it qualified for the 

non-application for the requested 

period. 

Maine submitted SPA #12–010 on 

August 1, 2012, which proposed 

changes to its Medicaid eligibility rules 

for parents, caretaker relatives, children, 

and to Medicare savings programs 

(MSPs). Specifically, Maine proposed: 

Reducing the income eligibility limit 

from 150 percent of the FPL to 100 

percent for parents and caretaker 

relatives who may qualify under section 

1902(a)(10)(A)(i)(I) and 1931 of the Act; 

lowering the age limit of eligibility from 

20 to 18 for children who meet the 

eligibility requirements for the aid to 

families with dependent children 

(AFDC) state plan but who would not 

have received AFDC based on age; and 

reducing income eligibility for the MSPs 

through the elimination of certain 

income disregards. Maine eventually 

split the SPA into two, with the 

proposal relating to families, caretaker 

relatives, and children identified as SPA 

#12–010, and the proposal relating to 

MSPs identified as SPA #12–010A. 

On January 7, 2013, CMS approved 

SPA #12–010A, but disapproved SPA 

#12–010. CMS determined that Maine’s 

SPAs proposed eligibility rules more 

restrictive than Maine’s rules in effect 

on March 23, 2010. However, due to 

Maine’s FY 2013 budget deficit 


TKELLEY on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 70 / Thursday, April 11, 2013 / Notices 21609 

certification, CMS determined that nonapplication of the MOE requirement 

could apply to the changes to the MSP 

eligibility rules in SPA #12–010A. (The 

SPA will be effective only through June 

30, 2013, unless the state certifies that 

in the fiscal year beginning July 1, 2013, 

it again projects a budget deficit.) CMS 

concluded that SPA #12–010A did not 

reduce eligibility for any group of 

individuals eligible for Medicaid on the 

basis of a disability, pregnancy, or status 

as a child. (On February 20, 2013, Louis 

Bourgoin and others filed suit in the 

United States District Court for the 

District of Maine against the U.S. 

Department of Health & Human Services 

seeking to set aside the agency’s 

approval of Maine SPA #12–010A.) 

However, CMS determined that Maine 

was not permitted an exception from the 

MOE for the eligibility rule changes 

proposed by SPA #12–010. The changes 

proposed by SPA #12–010 applied to 

individuals who are exempted from the 

non-application provisions of the MOE 

requirement, specifically, adults whose 

incomes are below 133 percent of the 

FPL and children. 

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 Maine announcing an 

administrative hearing to reconsider the 

disapproval of its SPA reads as follows: 

Mary C. Mayhew, Commissioner 

Department of Health and Human 

Services 

Commissioner’s Office 

221 State Street 

11 State House Station 

Augusta, ME 04333–0011 

Dear Ms. Mayhew: 

I am responding to your request for 

reconsideration of the decision to 

disapprove the Maine State Plan 

Amendment (SPA) 12–010 which was 

submitted on August 1, 2012, and 

disapproved on January 7, 2013. The 

SPA proposed changes to eligibility for 

parents, caretaker relatives, and 

children whose income is at or below 

133 percent of the federal poverty level 

(FPL). The proposal would make 

eligibility standards, methods, and 

procedures more restrictive than those 

that were in effect on March 23, 2010. 

I disapproved Maine SPA 12–010 

because the proposal would have 

eliminated Medicaid eligibility for 

parents and caretaker relatives eligible 

under sections 1902(a)(10)(A)(i)(I) and 

1931 whose incomes are between 100 

percent and 133 percent of the FPL, and 

Medicaid eligibility of certain 

individuals considered ‘‘children’’ 

under Maine’s state Medicaid plan. Both 

proposals constituted more restrictive 

eligibility standards than those in effect 

in Maine as of March 23, 2010, that 

could not be excepted from the 

maintenance-of-effort (MOE) mandate 

that Maine is subject to under section 

1902(a)(74) and (gg) of the Social 

Security Act (hereafter ‘‘the Act’’). At 

issue in this appeal are the following 

issues, which are more detailed than set 

out in the disapproval letter: 

While states generally have authority 

to modify Medicaid eligibility rules, 

sections 1902(a)(74) and (gg) of the Act 

require that states maintain eligibility 

standards, methodologies, and 

procedures that are no more restrictive 

than those in effect under a state’s plan 

as of the date of enactment of the Patient 

Protection and Affordable Care Act 

(March 23, 2010). This MOE 

requirement applies to adults until a 

state’s health insurance exchange is 

operational (January 1, 2014) and to 

children until October 1, 2019. 

Section 1902(gg)(3) of the Act offers a 

partial non-application of the MOE 

requirement during the period between 

January 1, 2011, and December 31, 2013, 

when a state certifies to the Secretary 

that it has a budget deficit during the 

fiscal year for which it is seeking a nonapplication, or projects a budget deficit 

during the succeeding fiscal year. This 

provision limits the non-application to 

‘‘nonpregnant, nondisabled adults who 

are eligible for medical assistance under 

the state plan or under a waiver of the 

plan at the option of the state and whose 

income exceeds 133 percent of the 

poverty line.’’ 

Maine certified a projected budget 

deficit for state fiscal year 2013 in 

December 2011 and requested a nonapplication of the MOE requirement for 

the period of July 1, 2012, through June 

30, 2013. On February 10, 2012, the 

Centers for Medicare & Medicaid 

Services (CMS) notified Maine that it 

qualified for the non-application for the 

requested period. 

Maine submitted SPA #12–010 on 

August 1, 2012, which proposed 

changes to its Medicaid eligibility rules 

for parents, caretaker relatives, children, 

and to Medicare savings programs 

(MSPs). Specifically, Maine proposed: 

reducing the income eligibility limit 

from 150 percent of the FPL to 100 

percent for parents and caretaker 

relatives who may qualify under section 

1902(a)(10)(A)(i)(I) and 1931 of the Act; 

lowering the age limit of eligibility from 

20 to 18 for children who meet the 

eligibility requirements for the aid to 

families with dependent children 

(AFDC) state plan but who would not 

have received AFDC based on age; and 

reducing income eligibility for the MSPs 

through the elimination of certain 

income disregards. Maine eventually 

split the SPA into two, with the 

proposal relating to families, caretaker 

relatives and children identified as SPA 

#12–010, and the proposal relating to 

MSPs identified as SPA #12–010A. 

On January 7, 2013, CMS approved 

SPA #12–010A, but disapproved SPA 

#12–010. CMS determined that Maine’s 

SPAs proposed eligibility rules more 

restrictive than Maine’s rules in effect 

on March 23, 2010. However, due to 

Maine’s FY 2013 budget deficit 

certification, CMS determined that nonapplication of the MOE requirement 

could apply to the changes to the MSP 

eligibility rules in SPA #12–010A. (The 

SPA will be effective only through June 

30, 2013, unless the state certifies that 

in the fiscal year beginning July 1, 2013, 

it again projects a budget deficit.) CMS 

concluded that SPA #12–010A did not 

reduce eligibility for any group of 

individuals eligible for Medicaid on the 

basis of a disability, pregnancy, or status 

as a child. (On February 20, 2013, Louis 

Bourgoin and others filed suit in the 

United States District Court for the 

District of Maine against the U.S. 

Department of Health & Human Services 

seeking to set aside the agency’s 

approval of Maine SPA#12–010A.) 

However, CMS determined that Maine 

was not permitted an exception from the 

MOE for the eligibility rule changes 

proposed by SPA #12–010. The changes 

proposed by SPA #12–010 applied to 

individuals who are exempted from the 

non-application provisions of the MOE 

requirement, specifically, adults whose 

incomes are below 133 percent of the 

FPL and children. 


TKELLEY on DSK3SPTVN1PROD with NOTICES
21610 Federal Register / Vol. 78, No. 70 / Thursday, April 11, 2013 / Notices 

In its letter of disapproval, CMS 

responded to Maine’s claim that 

National Federation of Independent 

Business v. Sebelius, 567 U.S. ll, 132 

S. Ct. 2566 (2012), directed approval of 

the SPA. CMS pointed out that the 

Supreme Court did not strike down any 

provision of the Patient Protection and 

Affordable Care Act, including the MOE 

requirement, and that the MOE 

requirement is unrelated to the 

Medicaid eligibility expansion. 

I am scheduling a hearing on your 

request for reconsideration to be held on 

May 23, 2013, at the CMS Boston 

Regional Office, JFK Federal Building, 

15 N. Sudbury Street, Room 2050, 

Boston, Massachusetts 02203–0003 to 

reconsider CMS’ decision to disapprove 

Maine SPA #12–010. 

If this 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 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 

Acting Administrator 

Section 1116 of the Social Security 

Act (42 U.S.C. 1316; 42 CFR 430.18) 

(Catalog of Federal Domestic Assistance 

program No. 13.714, Medicaid Assistance 

Program.) 

Dated: April 4, 2013. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2013–08524 Filed 4–10–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Community Living 

Expansion Funds for the Support of 

the Senior Medicare Patrol (SMP) 

Program 

ACTION: Notice of intent to provide 

expansion and capacity building 

funding to the incumbent Senior 

Medicare Patrol (SMP) grantees under 

limited competition. 

SUMMARY: The Administration for 

Community Living is announcing the 

availability of expansion funds for the 

support of the Senior Medicare Patrol 

(SMP) Program. This additional funding 

opportunity will be used to expand the 

reach of the SMP program with the 

explicit purpose of expanding current 

program capacity to recruit, train, and 

support the SMP volunteer network. In 

addition, this funding opportunity will 

increase targeted collaborative efforts 

with the Centers for Medicare and 

Medicaid Services, Office of Inspector 

General and other law enforcement 

entities in identified high fraud states. 

Funding Opportunity Title/Program 

Name: Health Care Fraud Prevention 

Program Expansion and SMP Capacity 

Building Grants. 

Announcement Type: Health Care 

Fraud Prevention Program Expansion 

Capacity. 

Funding Opportunity Number: 

Program Announcement No. HHS– 

2013–ACL–AoA–SP–0049 

Statutory Authority: HIPAA of 1996 (Pub. 

L. 104–191). 

Catalog of Federal Domestic 

Assistance (CFDA) Number: 93.048 

Discretionary Projects 

DATES: The deadline date for comments 

on this program announcement is May 

13, 2013. Other important dates: 

• The application due date May 27, 

2013. 

• The anticipated start date is 

September 30, 2013. 

I. Funding Opportunity Description 

During the past several years, the 

Department of Health and Human 

Services has increased efforts to fight 

Medicare and Medicaid fraud. The 

Administration for Community Living 

(ACL), Administration on Aging (AoA), 

through the SMP program, has worked 

in partnership with the Centers for 

Medicare and Medicaid Services (CMS), 

the Office of Inspector General (OIG), 

and the Department of Justice to expand 

strategies to eliminate waste, fraud, and 

abuse in these Federal programs. This 

additional funding opportunity will be 

used to expand the reach of the SMP 

program with the explicit purpose of 

expanding efforts to target collaborative 

efforts with CMS, OIG and other law 

enforcement entities in high fraud states 

and to expand current capacity to 

recruit, train, and support the SMP 

volunteer network. 

Justification for the Exception to 

Competition 

It is necessary to limit competition for 

this program to the current SMP 

grantees to expand their implementation 

efforts. In order for the outcomes 

expected to be produced within the 

allotted timeframe of the program, the 

infrastructure for achieving these results 

must already be in place. This 

infrastructure includes: 

• A proven SMP volunteer 

management, training, and recruiting 

program; 

• Expertise in capturing data in the 

SMP management, tracking, and 

reporting system (SMART FACTS); 

• Established partnership 

relationships between the SMP program 

and state and local fraud control 

partners, including CMS, OIG, Attorney 

General, and State Insurance 

Commissioners offices; 

• Developed and tested SMP program 

public awareness materials, brochures, 

PSAs, and other resources to use in 

outreach and educational efforts; 

• Expertise and experience in 

reaching targeted populations with the 

SMP message, among others. 

The current SMP projects are 

uniquely qualified to address the 

requirements contained in this funding 

opportunity. Their established 

infrastructure and expertise will enable 

them to successfully meet the 

challenging and time-sensitive 

requirements of this program. It is 

essential that the infrastructure, 

foundation of expertise, and proven 

experience is in place to assure the grant 

objectives are achieved. 

II. Award Information 

A. Purpose of the Program: Health 

Care Fraud Prevention Program 

Expansion. 

B. Amount of the Awards: $20,000 to 

$372,000 per budget period. 

C. Project Period: September 30, 

2013–September 29, 2015. 

III. Eligible Applicants 

Incumbent Senior Medicare Patrol 

(SMP) grantees. 

IV. Evaluation Criteria 

A. Project Relevance & Current Need— 

Weight: 5 points 

B. Approach—Weight: 35 points 

C. Budget—Weight: 10 points 

D. Project Impact—Weight: 25 points 

E. Organizational Capacity—Weight: 25 

points 

V. Application and Submission 

Requirements 

A. SF 424—Application for Federal 

Assistance. 

B. SF 424A—Budget Information. 

C. Separate Budget Narrative/ 

Justification. 

D. SF 424B—Assurances. Note: Be 

sure to complete this form according to 


TKELLEY on DSK3SPTVN1PROD with NOTICES