[Federal Register Volume 74, Number 75 (Tuesday, April 21, 2009)]
[Notices]
[Pages 18235-18237]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-9095]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Notice of Availability of Federal Matching Shares for Medicaid 
and Foster Care and Adoption Assistance

AGENCY: Office of the Secretary, Department of Heath and Human 
Services.

ACTION: Notice.

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SUMMARY: The Federal Medical Assistance Percentages (FMAPs) for the 
first two quarters of Fiscal Year 2009 have been recalculated pursuant 
to the American Recovery and Reinvestment Act (ARRA). These percentages 
will be effective from October 1, 2008 through March 31, 2009. This 
notice announces the calculated FMAPs that the U.S. Department of 
Health and Human Services (HHS) will use in determining the amount of 
Federal matching for State medical assistance under Title XIX and Title 
IV-E. The table gives figures for each of the 50 States and the 
District of Columbia. Adjusted figures are not shown for Puerto Rico, 
the Virgin Islands, Guam, American Samoa, and the Commonwealth of the 
Northern Mariana Islands since territories have a choice between two 
methodologies to determine their recalculated figures. Programs under 
title XIX of the Act exist in each jurisdiction. The percentages in 
this notice only apply to State expenditures for most medical services

[[Page 18236]]

and medical insurance services. The statute provides separately for 
Federal matching of administrative costs.
    Title V of the ARRA provides for temporary increases in the FMAPs 
for fiscal relief to States and to protect and maintain State Medicaid 
programs in a period of economic downturn. The recession adjustment 
period is defined as the period beginning on October 1, 2008 and ending 
on December 31, 2010.
    Section 5001 of the ARRA specifies that the FMAP shall be 
temporarily increased for the following: (1) A maintenance of FMAP for 
fiscal year 2009, fiscal year 2010, and first quarter of fiscal year 
2011, determined by substituting the greater of such percentage for the 
State compared to the FMAP calculated for the prior fiscal year; (2) 
the application of an increase in each state's FMAP of 6.2 percentage 
points; and (3) an additional percent increase based on the state's 
increase in unemployment. Each state's FMAP will be recalculated each 
fiscal quarter beginning October 2008.
    Payments eligible for FMAP under title XIX, except disproportionate 
share hospital and enhanced FMAP payments, shall receive the 6.2 
percentage point increase and any unemployment adjustment. Payments 
under part E of title IV shall only receive the 6.2 percentage point 
increase.
    The unemployment increase percentage for a calendar quarter is 
equal to the number of percentage points (if any) by which the average 
monthly unemployment rate for the State in the most recent previous 3-
consecutive-month period for which data are available exceeds the 
lowest average monthly unemployment rate for the State for any 3-
consecutive-month period beginning on or after January 1, 2006. A State 
qualifies for additional relief based on an increase in unemployment if 
that State's unemployment increase percentage is at least 1.5 
percentage points.
    In addition to the general 6.2 percentage point increase in FMAP, 
the FMAP for each qualifying State is increased by the number of 
percentage points equal to the product of the State percentage 
calculated from half the 6.2 percentage point increase in FMAP and the 
applicable percent determined from the State unemployment increase 
percentage for the quarter. The applicable percent is (1) 5.5 percent 
if the State unemployment increase percentage is at least 1.5 
percentage points but less than 2.5 percentage points, (2) 8.5 percent 
if the State unemployment increase percentage is at least 2.5 
percentage points but less than 3.5 percentage points, and (3) 11.5 
percent if the State unemployment increase percentage is at least 3.5 
percentage points.
    If the applicable percent applied to a State is less than the 
applicable percent applied for the preceding quarter, then the higher 
applicable percent shall continue in effect for any calendar quarter 
beginning on January 1, 2009 and ending before July 1, 2010.
    Territories (Puerto Rico, the Virgin Islands, Guam, the Northern 
Mariana Islands, and America Samoa) can make a one-time election 
between (1) a 30 percent increase in their cap on Medicaid payments (as 
determined under subsections (f) and (g) of section 1108 of the Social 
Security Act), or (2) apply the increase of 6.2 percentage points in 
the FMAP plus a 15 percent increase in cap on Medicaid payments.
    In no case shall an increase in FMAP under this section result in 
an FMAP that exceeds 100 percent.

DATES: Effective Dates: The percentages listed will be effective for 
each of the 2 quarter-year periods in the period beginning October 1, 
2008 and ending March 15, 2009.

FOR FURTHER INFORMATION CONTACT: Thomas Musco or Rose Chu, Office of 
Health Policy, Office of the Assistant Secretary for Planning and 
Evaluation, Room 447D--Hubert H. Humphrey Building, 200 Independence 
Avenue, SW., Washington, DC 20201, (202) 690-6870.

(Catalog of Federal Domestic Assistance Program Nos. 93.558: TANF 
Contingency Funds; 93.563: Child Support Enforcement; 93-596: Child 
Care Mandatory and Matching Funds of the Child Care and Development 
Fund; 93.658: 93.659: Adoption Assistance; 93.769: Ticket-to-Work 
and Work Incentives Improvement Act (TWWIIA) Demonstrations to 
Maintain Independence and Employment)

    Dated: March 26, 2009.
Charles E. Johnson,
Acting Secretary.

                                                                                    ARRA Adjustments to FMAP
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                                                                                      Hold
                                                                                    harmless     3-Month                                                             1st Quarter    2nd Quarter
                                                     FY08       FY09       Hold       FY09       average       Minimum    Unemployment  Unemployment  Unemployment    FY09 FMAP      FY09 FMAP
                      State                        original   original   harmless  FMAP with  unemployment  unemployment   difference       tier       adjustment    adjust (incl   adjust (incl
                                                     FMAP       FMAP      FY 09      6.2% pt   rate ending                                                             HH-6.2-        HH-6.2-
                                                                                    increase    Dec 2008                                                            unemployment)  unemployment)
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Alabama.........................................      67.62      67.98      67.98      74.18          6.1           3.4           2.7           8.5          2.46         76.64          76.64
Alaska..........................................      52.48      50.53      52.48      58.68          7.3           6.0           1.3             0          0.00         58.68          58.68
Arizona.........................................      66.20      65.77      66.20      72.40          6.5           3.7           2.8           8.5          2.61         75.01          75.01
Arkansas........................................      72.94      72.81      72.94      79.14          5.7           4.7           1.0             0          0.00         79.14          79.14
California......................................      50.00      50.00      50.00      56.20          8.7           4.8           3.9          11.5          5.39         61.59          61.59
Colorado........................................      50.00      50.00      50.00      56.20          5.9           3.6           2.3           5.5          2.58         58.78          58.78
Connecticut.....................................      50.00      50.00      50.00      56.20          6.8           4.2           2.6           8.5          3.99         60.19          60.19
Delaware........................................      50.00      50.00      50.00      56.20          5.7           3.2           2.5           8.5          3.99         60.19          60.19
District of Columbia............................      70.00      70.00      70.00      76.20          8.0           5.7           2.3           5.5          1.48         77.68          77.68
Florida.........................................      56.83      55.40      56.83      63.03          7.5           3.3           4.2          11.5          4.61         67.64          67.64
Georgia.........................................      63.10      64.49      64.49      70.69          7.5           4.3           3.2           8.5          2.75         73.44          73.44
Hawaii..........................................      56.50      55.11      56.50      62.70          5.0           2.3           2.7           8.5          3.43         66.13          66.13
Idaho...........................................      69.87      69.77      69.87      76.07          5.8           2.7           3.1           8.5          2.30         78.37          78.37
Illinois........................................      50.00      50.32      50.32      56.52          7.4           4.3           3.1           8.5          3.96         60.48          60.48
Indiana.........................................      62.69      64.26      64.26      70.46          7.3           4.4           2.9           8.5          2.77         73.23          73.23
Iowa............................................      61.73      62.62      62.62      68.82          4.4           3.5           0.9             0          0.00         68.82          68.82
Kansas..........................................      59.43      60.08      60.08      66.28          5.0           3.9           1.1             0          0.00         66.28          66.28
Kentucky........................................      69.78      70.13      70.13      76.33          7.2           5.2           2.0           5.5          1.47         77.80          77.80
Louisiana.......................................      72.47      71.31      72.47      78.67          5.6           3.5           2.1           5.5          1.34         80.01          80.01
Maine...........................................      63.31      64.41      64.41      70.61          6.3           4.4           1.9           5.5          1.79         72.40          72.40
Maryland........................................      50.00      50.00      50.00      56.20          5.3           3.5           1.8           5.5          2.58         58.78          58.78
Massachusetts...................................      50.00      50.00      50.00      56.20          6.1           4.3           1.8           5.5          2.58         58.78          58.78
Michigan........................................      58.10      60.27      60.27      66.47          9.8           6.7           3.1           8.5          3.11         69.58          69.58
Minnesota.......................................      50.00      50.00      50.00      56.20          6.4           3.8           2.6           8.5          3.99         60.19          60.19

[[Page 18237]]

 
Mississippi.....................................      76.29      75.84      76.29      82.49          7.4           5.9           1.5           5.5          1.13         83.62          83.62
Missouri........................................      62.42      63.19      63.19      69.39          6.8           4.6           2.2           5.5          1.85         71.24          71.24
Montana.........................................      68.53      68.04      68.53      74.73          5.0           3.1           1.9           5.5          1.56         76.29          76.29
Nebraska........................................      58.02      59.54      59.54      65.74          3.8           2.8           1.0             0          0.00         65.74          65.74
Nevada..........................................      52.64      50.00      52.64      58.84          8.3           4.1           4.2          11.5          5.09         63.93          63.93
New Hampshire...................................      50.00      50.00      50.00      56.20          4.3           3.4           0.9             0          0.00         56.20          56.20
New Jersey......................................      50.00      50.00      50.00      56.20          6.4           4.2           2.2           5.5          2.58         58.78          58.78
New Mexico......................................      71.04      70.88      71.04      77.24          4.5           3.2           1.3             0          0.00         77.24          77.24
New York........................................      50.00      50.00      50.00      56.20          6.2           4.3           1.9           5.5          2.58         58.78          58.78
North Carolina..................................      64.05      64.60      64.60      70.80          7.9           4.5           3.4           8.5          2.75         73.55          73.55
North Dakota....................................      63.75      63.15      63.75      69.95          3.4           3.1           0.3             0          0.00         69.95          69.95
Ohio............................................      60.79      62.14      62.14      68.34          7.4           5.3           2.1           5.5          1.91         70.25          70.25
Oklahoma........................................      67.10      65.90      67.10      73.30          4.6           3.1           1.5           5.5          1.64         74.94          74.94
Oregon..........................................      60.86      62.45      62.45      68.65          8.1             5           3.1           8.5          2.93         71.58          71.58
Pennsylvania....................................      54.08      54.52      54.52      60.72          6.2           4.3           1.9           5.5          2.33         63.05          63.05
Rhode Island....................................      52.51      52.59      52.59      58.79          9.5           4.9           4.6          11.5          5.10         63.89          63.89
South Carolina..................................      69.79      70.07      70.07      76.27          8.6           5.7           2.9           8.5          2.28         78.55          78.55
South Dakota....................................      60.03      62.55      62.55      68.75          3.5           2.6           0.9             0          0.00         68.75          68.75
Tennessee.......................................      63.71      64.28      64.28      70.48          7.3           4.5           2.8           8.5          2.77         73.25          73.25
Texas...........................................      60.56      59.44      60.56      66.76          5.8           4.2           1.6           5.5          2.00         68.76          68.76
Utah............................................      71.63      70.71      71.63      77.83          3.9           2.5           1.4             0          0.00         77.83          77.83
Vermont.........................................      59.03      59.45      59.45      65.65          5.7           3.5           2.2           5.5          2.06         67.71          67.71
Virginia........................................      50.00      50.00      50.00      56.20          4.8           2.9           1.9           5.5          2.58         58.78          58.78
Washington......................................      51.52      50.94      51.52      57.72          6.6           4.4           2.2           5.5          2.50         60.22          60.22
West Virginia...................................      74.25      73.73      74.25      80.45          4.7           4.4           0.3             0          0.00         80.45          80.45
Wisconsin.......................................      57.62      59.38      59.38      65.58          5.7           4.5           1.2             0          0.00         65.58          65.58
Wyoming.........................................      50.00      50.00      50.00      56.20          3.3           2.8           0.5             0          0.00         56.20          56.20
Territories:
    American Samoa..............................      50.00      50.00  .........  .........  ............  ............  ............  ............  ............  .............  .............
    Guam........................................      50.00      50.00  .........  .........  ............  ............  ............  ............  ............  .............  .............
    Northern Mariana Islands....................      50.00      50.00  .........  .........  ............  ............  ............  ............  ............  .............  .............
    Puerto Rico.................................      50.00      50.00  .........  .........  ............  ............  ............  ............  ............  .............  .............
    Virgin Islands..............................      50.00      50.00  .........  .........  ............  ............  ............  ............  ............  .............  .............
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[FR Doc. E9-9095 Filed 4-20-09; 8:45 am]
BILLING CODE 4210-01-P