Source: https://www.federalregister.gov/documents/2011/03/14/2011-5583/application-review-and-reporting-process-for-waivers-for-state-innovation
Timestamp: 2018-09-19 03:54:36
Document Index: 742538594

Matched Legal Cases: ['§\u200933', '§\u200933', '§\u200933', '§\u2009155', '§\u2009155', '§\u2009155', '§\u2009155']

A Proposed Rule by the Treasury Department and the Health and Human Services Department on 03/14/2011
13553-13567 (15 pages)
https://www.federalregister.gov/d/2011-5583 https://www.federalregister.gov/d/2011-5583
Comments received timely will be also available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Start Printed Page 13554Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone 1-800-743-3951.
These proposed regulations at 31 CFR 33.102 and 45 CFR 155.1302 permit, but do not require, States to submit a single application for a section 1332 waiver and a waiver under one or more of the existing waiver processes applicable under titles XVIII, XIX, and XXI of the Social Security Act, or under any other Federal law relating to the provision of health care items or services, provided that the application is consistent with the procedures described in these proposed regulations, the procedures for section 1115 demonstrations, if applicable, and the procedures under any other applicable Federal law under which the State seeks a waiver.[1]
The proposed regulations require a State seeking a section 1332 waiver to submit a waiver application to the Secretary of HHS. Upon receipt, the Secretary of HHS will transmit any Start Printed Page 13555application that includes a request for a waiver of provisions under the jurisdiction of the Secretary of the Treasury (sections 36B, 4980H and 5000A of the Internal Revenue Code) to be reviewed in accordance with the provisions of these proposed regulations. The Secretaries will coordinate the review of any application that includes a request for a waiver of provisions falling under the jurisdiction of each of the Departments of Health and Human Services and the Treasury (the Departments).
(3) The data and assumptions used to demonstrate that the State's proposal is in compliance with the comprehensive coverage requirement, the affordability requirement, the scope of coverage Start Printed Page 13556requirement and the Federal deficit requirement, including:
Consistent with section 1332 of the Affordable Care Act and the Secretaries' desire to implement a State waiver application process that promotes transparency, facilitates public involvement and input, and encourages sound decision-making at all levels of government, 31 CFR 33.116 and 45 CFR 155.1316 of the proposed regulations provide for a Federal public notice and comment period following a preliminary determination by the Secretaries that a State's application for a section 1332 waiver is complete. As required by section 1332 of the Affordable Care Act, the Federal notice and comment period is designed to ensure a meaningful level of public Start Printed Page 13557input, while avoiding the imposition of requirements that are in addition to, or duplicative of, those imposed under the APA or that are unreasonable or unnecessarily burdensome for State compliance.
Section 1332 of the Affordable Care Act requires that the Secretaries provide for a procedure for the periodic evaluation of section 1332 waivers by the Secretary or Secretaries with jurisdiction over the provisions for which the waiver was granted. These Start Printed Page 13558proposed regulations require that each periodic evaluation shall include a review of all annual reports submitted by the State in accordance with 45 CFR 155.1324 and 31 CFR 33.124 that relate to the period of time covered by the evaluation.
Paragraph (c) of 31 CFR 33.120 and 45 CFR 155.1320 of the proposed Start Printed Page 13559regulations further specifies that at least 6 months after the implementation date of the waiver and annually thereafter, the State must hold a public forum to solicit comments on the progress of a section 1332 waiver. As proposed in paragraph (c)(1) of 31 CFR 33.120 and 45 CFR 155.1320, the State must publish the date, time, and location of the public forum in a prominent location on the State's public Web site, at least 30 days prior to the date of the planned public forum.
31 CFR 33.108 and 45 CFR 155.1308 0938-New X 1 200 n/a 20.67 n/a 0 n/a
Paragraph (a)(1) of 31 CFR 33.112 and 45 CFR 155.1312 0938-New X 1 40 n/a 20.67 n/a 0 n/a
Paragraph (a)(2) of 31 CFR 33.112 and 45 CFR 155.1312 0938-New X 1 40 n/a 20.67 n/a 0 n/a
Paragraph (b)(1) of 31 CFR 33.120 and 45 CFR 155.1320 0938-New X 1 40 n/a 20.67 n/a 0 n/a
Paragraph (a) of 31 CFR 33.124 and 45 CFR 155.1324 0938-New X 4 10 n/a 20.67 n/a 0 n/a
Paragraph (b) of 31 CFR 33.124 and 45 CFR 155.1324 0938-New X 1 24 n/a 20.67 n/a 0 n/a
Paragraph (c)(2) of 31 CFR 33.124 and 45 CFR 155.1324 0938-New X 1 2 n/a 20.67 n/a 0 n/a
31 CFR 33.128 and 45 CFR 155.1328 0938-New X 1 196 n/a 20.67 n/a 0 n/a
Total X 10 n/a n/a 0 n/a
Authority: Sec. 1332, Pub. L. 111-148, 124 Stat. 119
(4) A process for the submission of reports to the Secretary by a State Start Printed Page 13561relating to the implementation of a waiver.
Complete application means an application that has been submitted and for which the Secretary and the Secretary of Health and Human Services have made a preliminary determination that it includes all required information and satisfies all requirements that are described in § 33.108(a)(2)(iv).
(B) Provides written evidence of the State's compliance with the public notice requirements set forth in § 33.112.
(1) Actuarial analyses and actuarial certifications. Actuarial analyses and actuarial certifications to support the State's estimates that the proposed waiver will comply with the Start Printed Page 13562comprehensive coverage requirement, the affordability requirement, and the scope of coverage requirement.
(i) The complete application for a section 1332 waiver, updates for the status of the State's application, and any supplemental materials received from the State prior to and during the Federal public notice and comment period.Start Printed Page 13563
(2) Each periodic evaluation must include a review of the annual report or reports submitted by the State in accordance with § 33.124 that relate to the period of time covered by the evaluation.
End Part Start Part Start Printed Page 13564
Complete application means an application that has been submitted and for which the Secretary and the Secretary of the Treasury have made a preliminary determination that it includes all required information and satisfies all requirements that are described in § 155.1308(a)(2)(iv).
(B) Provides written evidence of the State's compliance with the public notice requirements set forth in § 155.1312.
(4) The analyses, actuarial certifications, data, assumptions, analysis, targets and other information Start Printed Page 13565set forth in paragraph (a)(2)(iv)(D) of this section sufficient to provide the Secretary and the Secretary of the Treasury with the necessary data to determine that the State's proposed waiver:
(2) Such public hearings shall provide an interested party the opportunity to learn about and comment on the contents of the application for a section 1332 waiver.Start Printed Page 13566
(c) Approval of a section 1332 waiver application. The final decision of the Secretary and the Secretary of the Treasury on a State application for a section 1332 waiver will be issued by the Secretary no later than 180 days after the determination by the Secretary and the Secretary of the Treasury that a complete application was received in accordance with § 155.1308.
(2) The draft and final annual reports are to be published on a State's public Web site within 30 days of submission Start Printed Page 13567and approval to the Secretary, respectively.
(2) Each periodic evaluation must include a review of the annual report or reports submitted by the State in accordance with § 155.1324 that relate to the period of time covered by the evaluation.