Federal Register / Vol. 60, No. 67 / Friday, April 7, 1995 / Notices 17791

likely to reveal personal information

concerning individuals associated with the

grant applications. This information is

exempt from mandatory disclosure.

Anyone wishing to obtain a roster of

members or other relevant information

should contact Linda Blankenbaker, Agency

for Health Care Policy and Research, Suite

602, 2101 East Jefferson Street, Rockville,

Maryland 20852, telephone (301) 594–1438.

Agenda items for this meeting are subject

to change as priorities dictate.

Dated: March 31, 1995.

Clifton R. Gaus,

Administrator.

[FR Doc. 95–8577 Filed 4–6–95; 8:45 am]

BILLING CODE 4160–90–M

Health Care Financing Administration

Notice of Hearing: Reconsideration of

Disapproval of Utah State Plan

Amendment (SPA)

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Notice of hearing.

SUMMARY: This notice announces an

administrative hearing on May 17, 1995

in Room 578, 1961 Stout Street, Denver,

Colorado to reconsider our decision to

disapprove Utah SPA 93–033.

CLOSING DATE: Requests to participate in

the hearing as a party must be received

by the presiding officer by April 24,

1995.

FOR FURTHER INFORMATION CONTACT: Stan

Katz, Presiding Officer, Groundfloor,

Meadowwood East Building, 1849

Gwynn Oak Avenue, Baltimore,

Maryland 21207, telephone: (410) 597–

3013.

SUPPLEMENTARY INFORMATION: This

notice announces an administrative

hearing to reconsider our decision to

disapprove Utah State plan amendment

(SPA) number 93–033.

Section 1116 of the Social Security

Act (the Act) and 42 CFR part 430

establish Department procedures that

provide an administrative hearing for

reconsideration of a disapproval of a

State plan or plan amendment. The

Health Care Financing Administration

(HCFA) 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 State of Utah submitted SPA 93–

033 which proposed changes in an asset

test for poverty level pregnant women.

Specifically, Utah’s amendment

required certain poverty level pregnant

women who did not meet the resource

test to make a one-time payment equal

to 4 percent of the individual’s total

non-exempt resources. In addition,

Utah’s amendment would waive this

requirement for high risk pregnant

women.

The issues in this matter are whether

Utah SPA 93–033 adheres to the Federal

law at section 1902(a)(14) of the Act

(referencing section 1916 of the Act)

section 1902(l) and section 1902(a)(17).

Section 1902(a)(14) of the Act

specifies that enrollment fees,

premiums, deductions, cost sharing, or

similar charges may be imposed only as

provided in section 1916. Section

1916(a)(1) prohibits the application of

any enrollment fee with respect to the

categorically needy. It restricts States

from charging a premium for Medicaid

for the categorically needy. An

exception is made regarding poverty

level pregnant women with income at or

above 150 percent of the Federal

Poverty Level. For these women, the

amount of that premium is restricted to

10 percent of the amount by which the

family income (less expense for care of

a dependent child) exceeds 150 percent

of the poverty level. In addition, section

1916(a)(2)(B) prohibits States from

imposing any deduction, cost sharing or

similar charge with respect to services

furnished to pregnant women, provided

the services relate to the pregnancy or

a complicating condition. HCFA

disapproved Utah’s amendment finding

contrary to the statute’s prohibition on

imposing premiums (other than those

authorized in section 1916(c) of the Act)

enrollment fees, or similar charges on

categorically needy individuals.

Utah believes its proposed policy to

waive the resource spenddown for

pregnant women determined to be in

the high risk category is supported by

section 1902(1)(3) of the Act. Utah

believes this is the only statutory

authority over resource standards and

methodologies for poverty level

pregnant women. Utah also claims that

section 1902(a)(17) explicitly exempts

pregnant women from all requirements

in that section. HCFA did not agree with

Utah’s interpretation of the statute that

section 1902(l) exempts this group from

the comparability requirements in

section 1902(a)(17).

While HCFA acknowledges that

subsection (l)(3) exempts the States from

using a resource test for high-risk

pregnant women, this exemption does

not override the remainder of section

1902 (a)(17) which requires

comparability of services to all such

women. Utah cites the phrase, ‘‘except

as provided in subsections (l)(3), (m)(3),

and (m)(4) include reasonable standards

(which shall be comparable for all

groups * * *)’’ as a rationale for this

assertion. However, section 1902(1)(3)

applies only in cases in which its

application would be inconsistent with

the requirements of subsection (a)(17).

HCFA believed that subsection (l)(3)

authorizes States to establish a more

liberal resource standard or to drop the

resource test for all section 1902(l)(A)

pregnant women, but not to adopt either

of these approaches for a specific

segment of that group. While the goal of

removing barriers to ensure positive

birth outcomes is a shared one, HCFA

did not approve foregoing a resource

test exclusively for high-risk pregnant

women because they are not a separate

group described in section 1902(l).

Utah points out that subsection (l)(3)

prescribes that a resource standard or

methodology may not be more

restrictive than applied under Title XVI.

Utah also believes that exclusion of all

resources based upon the level of

medical risk factors is less restrictive

than Title XVI, and is also reasonable.

However, HCFA believed that section

1902(a)(17) is explicitly meant to be

inclusive of whole eligibility groups and

not portions of groups. HCFA contended

it cannot authorize a State to single out

any part of an eligibility group for

preferential treatment. HCFA’s position

was, in order to drop the resource test

for high risk pregnant women, the State

must do so for the entire poverty level

group of pregnant women.

The notice to Utah announcing an

administrative hearing to reconsider the

disapproval of its SPA reads as follows:

Mr. Rod L. Betit,

Executive Director, Utah Department of

Health, 288 North 1460 West, P.O. Box

16700, Salt Lake City, Utah 84116–0700.

Dear Mr. Betit: I am responding to your

request for reconsideration of the decision to

disapprove Utah State Plan Amendment

(SPA) 93–033.

The State of Utah submitted SPA 93–33

which proposed changes in an asset test for

poverty level pregnant women. Specifically,

Utah proposed policy regarding a one-time

payment equal to 4 percent of the

individual’s total non-exempt resources if
17792 Federal Register / Vol. 60, No. 67 / Friday, April 7, 1995 / Notices

they are equal to or exceed $5,000. In

addition, Utah proposed to waive this

payment requirement for high risk pregnant

women.

The issues in this matter are whether Utah

SPA 93–033 adheres to the Federal law at

section 1902(a)(14) of the Act (referencing

section 1916 of the Act), section 1902(l) and

section 1902(a)(17).

I am scheduling a hearing on your request

for reconsideration to be held on May 17,

1995, in Room 578, 1961 Stout Street,

Denver, Colorado. If this date is not

acceptable, we would be glad to set another

date that is mutually agreeable to the parties.

The hearing will be governed by the

procedures prescribed at 42 CFR, Part 430.

I am designating Mr. Stanley Katz as the

presiding officer. If these arrangements

present any problems, please contact the

residing officer. In order to facilitate any

communication which may be necessary

between the parties 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. The presiding officer may be

reached at (410) 597–3013.

Sincerely,

Bruce C. Vladeck,

Administrator.

(Section 1116 of the Social Security Act (42

U.S.C. 1316); 42 CFR section 430.18)

(Catalog of Federal Domestic Assistance

Program No. 13.714, Medicaid Assistance

Program)

Dated: March 30, 1995.

Bruce C. Vladeck,

Administrator, Health Care Financing

Administration.

[FR Doc. 95–8524 Filed 4–6–95; 8:45 am]

BILLING CODE 4120–01–P

Public Health Service

Centers for Disease Control and

Prevention; Statement of Organization,

Functions, and Delegations of

Authority

Part H, Chapter HC (Centers for

Disease Control and Prevention) of the

Statement of Organization, Functions,

and Delegations of Authority of the

Department of Health and Human

Services (45 FR 67772–76, dated

October 14, 1980, and corrected at 45 FR

69696, October 20, 1980, as amended

most recently at 59 FR 63406–62407,

dated December 5, 1994) is amended to

reflect the transfer of the Division of

HIV/AIDS, excluding the Hematologic

Diseases Branch, Immunology Branch,

and Laboratory Investigations Branch,

from the National Center for Infectious

Diseases to the National Center for

Prevention Services.

Section HC–B, Organization and

Functions, is hereby amended as

follows:

Delete in its entirety the title and

functional statement for the Division of

HIV/AIDS (HCRK).

Following the functional statement for

the Division of Oral Health (HCM6),

Office of the Director (HCM61), insert

the following:

Division of HIV/AID (HCM7). (1)

Conducts national surveillance of

infectious diseases and other illnesses

associated with human

immunodeficiency virus/acquired

immunodeficiency syndrome (HIV/

AIDS), and sentinel surveillance of HIV

infection; (2) conducts national and

international surveillance,

epidemiologic investigations, and

studies to determine risk factors and

transmission patterns of HIV/AIDS; (3)

develops recommendations and

guidelines on the prevention and

control of HIV/AIDS; (4) evaluates

prevention and control activities in

collaboration with other CDC

components; (5) provides epidemic aid,

epidemiologic and surveillance

consultation, and financial assistance

for HIV/AIDS surveillance activities to

State and local health departments; (6)

provides consultation to other PHS

agencies, medical institutions, and

private physicians; (7) provides

information to the scientific community

through publications and presentations;

(8) works closely with NCID on HIV/

AIDS surveillance activities and

epidemiologic studies that require

laboratory support and collaboration.

Office of the Director (HCM71). (1)

Plans, directs, and coordinates the

activities of the Division; (2) develops

goals and objectives and provides

leadership, policy formulation, and

guidance in program planning and

development; (3) provides program

management and administrative support

services for HIV/AIDS activities, both

domestic and international.

International Activity (HCM712). (1)

Designs and executes epidemiologic

studies of HIV infection in developing

nations of Africa and other continents;

(2) develops and conducts

epidemiologic studies of risk factors for

AIDS and HIV transmission; (3)

provides technical assistance to

developing nations to develop AIDS

case surveillance systems; (4) assists

foreign governments in carrying out

seroprevalence studies and surveys; (5)

implements strategies to protect the

blood supply in developing countries;

(6) assists in the design,

implementation, and evaluation of AIDS

prevention and control activities; (7)

performs epidemiologic studies of HIV/

AIDS interventions in foreign countries;

(8) coordinates with other CIOs in CDC

that have similar international

responsibilities; (9) provides

consultation to WHO, USAID, and

AIDSTECH, and other organizations

whose mission is to prevent and control

HIV infection and related outcomes.

Technical Information Activity

(HCM713). (1) Provides scientific

information, in cooperation with other

CDC organizations, to health-care

professionals, public health officials,

and the general public; handles

controlled and general correspondence

and prepares responses to Freedom of

Information Act requests; (2)

coordinates preparation of responses

and provision of material requested by

Congress; (3) coordinates preparation of

documents for annual program review

with the Directors of NCPS and CDC; (4)

prepares HIV/AIDS briefing reports for

Director, CDC, and the Assistant

Secretary for Health; (5) prepares

printed and audiovisual materials on

HIV/AIDS in cooperation with other

CDC organizations; (6) assists in

preparing guidelines for prevention of

HIV infection; (7) maintains library of

HIV/AIDS reprints and MMWR articles

and distributes on request; (8)

coordinates requests for presentations at

scientific, medical, and public health

meetings; (9) assists in preparing,

editing, and clearing manuscripts; (10)

plans and arranges for HIV/AIDS

conferences and scientific meetings

sponsored by CDC.

Epidemiology Branch (HCM72). (1)

Designs and conducts epidemiologic

studies to determine risk factors, cofactors, and modes of transmission for

AIDS and HIV infection; (2) conducts

epidemic aid investigations of HIV

infection, infectious disease, and other

illnesses associated with HIV/AIDS; (3)

conducts technical reviews of proposals

submitted for epidemiologic studies,

arranges for ad hoc panel reviews, and

recommends funding levels; (4)

provides epidemiologic consultation to

State and local health departments,

other PHS agencies, and other groups

and individuals investigating the

syndrome; (5) responds to inquiries

from physicians and other health

providers for information on the

medical and epidemiologic aspects of

HIV/AIDS.

Pediatric and Family Studies Section

(HCM722). (1) Designs and conducts

epidemiologic studies of AIDS and HIV

infection that examine risk factors,

modes of transmission, and the natural

history of disease in children,

adolescents, mothers, and other family

members; (2) develops guidelines and

recommendations to reduce

transmission in these populations,

particularly aspects related to

transmission from mother to child and