Federal Register / Vol. 78, No. 87 / Monday, May 6, 2013 / Notices 26371 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786– 

1326. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on June 3, 2013. 

OMB, Office of Information and 

Regulatory Affairs Attention: CMS Desk 

Officer Fax Number: (202) 395–6974 

Email: OIRA_submission@omb.eop.gov. 

Dated: May 1, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–10681 Filed 5–3–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Notice of Hearing: Reconsideration of 

Disapproval of Kentucky State Plan 

Amendments (SPA) 10–007 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice of Hearing. 

SUMMARY: This notice announces an 

administrative hearing to be held on 

June 27, 2013, at the CMS Atlanta 

Regional Office, Atlanta Federal Center, 

61 Forsyth Street, South West, Atlanta, 

Georgia 30303–8909, to reconsider CMS’ 

decision to disapprove Kentucky SPA 

10–007. 

Closing Date: Requests to participate 

in the hearing as a party must be 

received by the presiding officer by May 

21, 2013. 

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’s decision to 

disapprove Kentucky SPA 10–007 

which was submitted on September 30, 

2010, and disapproved on April 2, 2013. 

The SPA proposed a payment 

methodology based on actual, incurred, 

costs for services provided by 

Community Mental Health Clinics 

(CMHCs). 

At issue in the hearing is whether the 

proposed cost-based Medicaid payment 

methodology is consistent with the 

requirements of section 1902(a)(30)(A) 

of the Social Security Act (Act) when 

Kentucky did not specifically document 

that, under the proposed methodology, 

non-Medicaid costs would be excluded 

from the Medicaid payment calculation. 

Specifically, it appears that the 

methodology would rely on a cost 

reporting mechanism which results in 

over-allocation of both indirect and 

direct cost to Medicaid services. 

Specifically, for CMHCs that function 

within a larger parent organization, the 

state proposed an inappropriate transfer 

of cost from the parent organization to 

the CMHCs. Additionally, the state did 

not demonstrate that it had an 

acceptable method of allocating 

practitioner cost between reimbursable 

and non-reimbursable activities. 

Section 1902(a)(30)(A) of the Act 

requires that states have methods and 

procedures in place to ensure payments 

are consistent with economy, efficiency, 

and quality of care. Because the 

proposed payment methodology is 

based on each provider’s reconciled 

cost, CMS requested that Kentucky 

document the cost-finding and provider 

reporting mechanisms used to 

determine payment. This information 

would allow CMS to ensure that the 

proposed payment would be limited to 

amounts economic and efficient for 

covered Medicaid services, and were 

sufficient to ensure quality of care. 

Upon review of Kentucky’s response, 

CMS determined that Kentucky was not 

able to document that its cost reporting 

mechanism properly allocated cost to 

Medicaid covered services. Specifically, 

CMS was concerned that Kentucky’s 

methodology did not demonstrate the 

exclusion of costs incurred outside of 

these clinics for non-Medicaid activities 

and services. CMS worked with 

Kentucky on its cost reporting 

methodology over an extended period of 

time; however, CMS was not able to 

resolve questions surrounding the issue 

of including non-Medicaid costs. As a 

result, CMS could not conclude that 

Kentucky’s proposed plan for payment 

was economic and efficient, or 

consistent with quality of care. In the 

absence of this specific information, 

CMS could not conclude that the 

requirements of section 1902(a)(30)(A) 

were satisfied. 

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 Kentucky announcing 

an administrative hearing to reconsider 

the disapproval of its SPA reads as 

follows: 

Mr. Lawrence J. Kissner, 

Commissioner, 

Cabinet for Health and Family Services, 

Department for Medicaid Services, 

275 East Main Street, 6W–A, 

Frankfort, KY 40621. 

Dear Mr. Kissner: 

I am responding to your request for 

reconsideration of the decision to disapprove 

the Kentucky State Plan Amendment (SPA) 

10–007 which was submitted on September 

30, 2010, and disapproved on April 2, 2013. 

The SPA proposed a payment methodology 

based on actual, incurred, costs for services 

provided by Community Mental Health 

Clinics (CMHCs). 

I disapproved Kentucky SPA 10–007 

because I could not conclude that it complied 

with section 1902(a)(30)(A) of the Social 

Security Act (the Act), which requires 

payments to be consistent with economy 

efficiency and quality of care. In order to 

meet this requirement, the Centers for 

Medicare & Medicaid Services (CMS) 

requested that Kentucky document the costfinding and provider reporting mechanisms 

used to determine payment. Upon review of 

the commonwealth’s response to CMS’s 

formal Request for Additional Information 

(RAI), CMS determined that Kentucky had 

not sufficiently documented that its cost 

reporting mechanism properly allocated cost 

to Medicaid covered services by excluding 

non-Medicaid costs from the Medicaid 

payment calculation. 

The CMS worked with Kentucky on its cost 

reporting methodology over an extended 

period of time; however, CMS was not able 

to resolve questions surrounding the issue of 

including non-Medicaid costs. As a result, 

CMS could not conclude that Kentucky’s 

proposed plan for payment was economic 

and efficient, or consistent with quality of 

care. In the absence of this specific 

information, CMS could not conclude that 

the requirements of section 1902(a)(30)(A) of 

the Act were satisfied. 

At issue in this appeal is whether the 

proposed cost-based Medicaid payment 

methodology is consistent with the 

requirements of section 1902(a)(30)(A) of the 

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26372 Federal Register / Vol. 78, No. 87 / Monday, May 6, 2013 / Notices 

Act when Kentucky did not specifically 

document that, under the proposed 

methodology, non-Medicaid costs would be 

excluded from the Medicaid payment 

calculation. Specifically, it appears that the 

methodology would rely on a cost reporting 

mechanism which results in over-allocation 

of both indirect and direct cost to Medicaid 

services. Specifically, for CHMCs that 

function within a larger central office unit, 

the state proposed an inappropriate transfer 

of cost from the larger central office unit to 

the CHMCs. Additionally, the state did not 

demonstrate that it had an acceptable method 

of allocating practitioner cost between 

reimbursable and non-reimbursable 

activities. 

I am scheduling a hearing on your request 

for reconsideration to be held on June 27, 

2013, at the CMS Atlanta Regional Office, 

Atlanta Federal Center, 61 Forsyth Street, 

South West, Atlanta, Georgia 30303–8909. 

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 29, 2013. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2013–10695 Filed 5–3–13; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Title: Health Profession Opportunity 

Grants (HPOG) program. 

Omb No.: 0970–0394. 

Description: The Administration for 

Children and Families (ACF), U.S. 

Department of Health and Human 

Services (HHS) is proposing data 

collection activities as part of the Health 

Profession Opportunity Grants (HPOG) 

program. ACF has developed a multipronged research and evaluation 

approach for the HPOG program to 

better understand and assess the 

activities conducted and their results. 

The proposed data collection activities 

described in this notice will provide 

data for two evaluation components, the 

National Implementation Evaluation of 

the Health Profession Opportunity 

Grants to Serve TANF Recipients and 

Other Low-Income Individuals (HPOG– 

NIE) and the Impact Studies of the 

Health Profession Opportunity Grants 

(HPOG-Impact). 

Two data collection efforts related to 

HPOG research were approved by OMB, 

including approval of a Performance 

Reporting System (PRS) (approved 

September 2011) and for collection of 

additional baseline data for the HPOGImpact study (approved October 2012). 

These collection activities will continue 

under this new request. 

This 30-day notice describes the 

remaining data collection efforts for 

both HPOG–NIE and HPOG-Impact. 

Information collection described under 

1 through 13 are included in the current 

OMB submission for review. 

Information collections 14 through 18 

will be submitted in a future 

information collection clearance 

request. 

The goal of HPOG–NIE is to describe 

and assess the implementation, systems 

change, and outcomes and other 

important information about the 

operations of the 27 HPOG grantees 

focused on TANF recipients and other 

low-income individuals. To achieve 

these goals, it is necessary to collect 

data about the HPOG program designs 

and implementation, HPOG partner and 

program networks and indicators of 

systems change, employers’ perceptions 

of HPOG programs, the composition and 

intensity of HPOG services received, 

participant characteristics and HPOG 

experiences, and participant outputs 

and outcomes. 

The goal of HPOG-Impact is to 

evaluate the effectiveness of approaches 

used by 20 of the HPOG grantees to 

provide TANF recipients and other lowincome individuals with opportunities 

for education, training and advancement 

within the health care field. HPOGImpact also is intended to evaluate 

variation in participant impact that may 

be attributable to different HPOG 

program components and models. The 

impact study design is a classic 

experiment in which eligible applicants 

will be randomly assigned to a 

treatment group that is offered 

participation in HPOG and a control 

group that is not permitted to enroll in 

HPOG. In approximately 13 sites, 

eligible applicants will be randomized 

into two treatment arms (a basic and an 

enhanced version of the intervention) 

and a control group. Data collected from 

the HPOG participants served by these 

20 grantees will also be used for the 

HPOG–NIE study. 

The new information collection 

activities proposed for HPOG–NIE and 

HPOG-Impact include: (1) The HPOG– 

NIE sampling questionnaire; (2) The 

HPOG–NIE follow-up phone protocol 

for the stakeholder/network survey; (3) 

The HPOG–NIE grantee survey; (4) The 

HPOG-Impact implementation interview 

guide for partnering employers; (5) The 

HPOG-Impact implementation interview 

guide for instructors; (6) The HPOGImpact implementation interview guide 

for HPOG program management; (7) The 

HPOG-Impact implementation interview 

guide for HPOG program staff; (8) The 

HPOG–NIE management and staff 

survey; (9) The HPOG–NIE stakeholder/ 

network survey; (10) The HPOG–NIE 

employer survey; (11) The HPOGImpact 15-month participant follow-up 

survey; (12) The HPOG-Impact 15- 

month control group member follow-up 

survey; and (13) The HPOG–NIE 15- 

month participant follow-up survey. 

Data collection activities to submit in 

a future information collection request 

include: (14) the HPOG–NIE follow-up 

stakeholder/network survey; (15) the 

HPOG-Impact second follow-up survey 

of both treatment and control group 

members; (16) the HPOG–NIE second 

supplemental participant follow-up 

survey; (17) HPOG-Impact follow-up 

data collection on children of HPOGImpact study participants; and (18) the 

HPOG–NIE in-person interviews with 

HPOG managers and staff. 

Respondents: Individuals enrolled in 

HPOG interventions; control group 

members; HPOG program managers; 

HPOG program staff, including 

instructors and case managers; 

representatives of partner agencies and 

stakeholders, including support service 

providers, education and vocational 

training providers, Workforce 

Investment Boards, TANF agencies, and 

local health care employers. 

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