Notice2025-02938
Notice of Hearing: Reconsideration of Disapproval Idaho Medicaid State Plan Amendment (SPA) 24-0015
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
February 24, 2025
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This notice announces an administrative hearing to be held on April 2, 2025, by way of video, or at the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, 701 Fifth Avenue, Suite 1600, Seattle, WA 98104 to reconsider CMS' decision to disapprove Idaho's Medicaid SPA 24-0015.
Full Text
<html>
<head>
<title>Federal Register, Volume 90 Issue 35 (Monday, February 24, 2025)</title>
</head>
<body><pre>
[Federal Register Volume 90, Number 35 (Monday, February 24, 2025)]
[Notices]
[Pages 10501-10502]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-02938]
[[Page 10501]]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Notice of Hearing: Reconsideration of Disapproval Idaho Medicaid
State Plan Amendment (SPA) 24-0015
AGENCY: Centers for Medicare & Medicaid Services (CMS), U.S. Department
of Health and Human Services (HHS).
ACTION: Notice of hearing: reconsideration of disapproval.
-----------------------------------------------------------------------
SUMMARY: This notice announces an administrative hearing to be held on
April 2, 2025, by way of video, or at the U.S. Department of Health and
Human Services, Centers for Medicare & Medicaid Services, 701 Fifth
Avenue, Suite 1600, Seattle, WA 98104 to reconsider CMS' decision to
disapprove Idaho's Medicaid SPA 24-0015.
DATES: Requests to participate in the hearing as a party must be
received by the presiding officer by March 11, 2025.
FOR FURTHER INFORMATION CONTACT: Benjamin R. Cohen, Presiding Officer,
<a href="/cdn-cgi/l/email-protection#f0b8959182999e97bf969699939582b0939d83de989883de979f86"><span class="__cf_email__" data-cfemail="d49cb1b5a6bdbab39bb2b2bdb7b1a694b7b9a7fabcbca7fab3bba2">[email protected]</span></a>, CMS Office of Hearings, 7500 Security
Blvd., Mail Stop B1-01-31, Baltimore, MD 21244-1850.
SUPPLEMENTARY INFORMATION: This notice announces an administrative
hearing to reconsider CMS' decision to disapprove Idaho's Medicaid
State Plan Amendment (SPA) 24-0015, which was submitted to the Centers
for Medicare & Medicaid Services (CMS) on October 11, 2024, and
disapproved on January 6, 2025. This SPA proposed to elect the option
authorized under section 1902(e)(16) of the Social Security Act (the
Act) to provide continuous Medicaid coverage to pregnant Medicaid
beneficiaries for the duration of their pregnancies and through the
last day of the month in which the 12-month period (beginning on the
last day of their pregnancies) ends. Idaho additionally proposed in the
SPA to exclude from its scope individuals whose pregnancies end due to
abortions ``that are not in accordance with Idaho Code 18-622.''
The issues to be considered at the hearing are whether Idaho's SPA
24-0015 is inconsistent with the requirements of section 1902(e)(16) of
the Social Security Act (the Act), which provides that, in states that
elect the extended postpartum coverage option, the state plan must
provide continuous Medicaid coverage to all individuals who are
enrolled in Medicaid while pregnant, from the beginning of their
pregnancy (or initial enrollment, if already pregnant at that time)
through the end of the 12th month following the date their pregnancy
ends.
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 in the Federal Register 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 state Medicaid agency of additional issues that
will be considered at the hearing, we will also publish that notice in
the Federal Register.
Any individual or group seeking 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
seeking 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. Please file any
petitions to participate as a party or any amicus curiae petitions by
electronic mail at <a href="/cdn-cgi/l/email-protection#246c4145564d4a436b42424d474156644749570a4c4c570a434b52"><span class="__cf_email__" data-cfemail="d79fb2b6a5beb9b098b1b1beb4b2a597b4baa4f9bfbfa4f9b0b8a1">[email protected]</span></a>.
The notice to Idaho announcing an administrative hearing to
reconsider the disapproval of its SPA 24-0015 reads as follows:
Alex J. Adams
Director
Idaho Department of Health and Welfare
450 West State Street, 10th Floor, P.O. Box 83720
Boise, Idaho 83720-0036
Dear Alex J. Adams:
I am responding to the January 20, 2025, request for
reconsideration of the decision to disapprove Idaho's State Plan
amendment (SPA) 24-0015. Idaho SPA 24-0015 was submitted to the
Centers for Medicare & Medicaid Services (CMS) on October 11, 2024,
and disapproved on January 6, 2025. I am scheduling a hearing on the
request for reconsideration to be held on April 2, 2025, by way of a
video hearing or at the Department of Health and Human Services,
Centers for Medicare & Medicaid Services, 701 Fifth Avenue, Suite
1600, Seattle, WA 98104.
I am designating Mr. Benjamin R. Cohen as the presiding officer.
If these arrangements present any problems, please contact Mr. Cohen
at <a href="/cdn-cgi/l/email-protection#1b537e7a6972757c547d7d72787e695b78766835737368357c746d"><span class="__cf_email__" data-cfemail="79311c180b10171e361f1f101a1c0b391a140a5711110a571e160f">[email protected]</span></a>. In order to facilitate any
communication that may be necessary between the parties prior to the
hearing, please notify the presiding officer at
<a href="/cdn-cgi/l/email-protection#f7bf9296859e9990b891919e949285b7949a84d99f9f84d9909881"><span class="__cf_email__" data-cfemail="460e2327342f28210920202f25233406252b35682e2e3568212930">[email protected]</span></a> to indicate acceptability of the hearing
date that has been scheduled, whether you will participate in person
or by way of video and provide names of the individuals who will
represent the State at the hearing. If the hearing date is not
acceptable, Mr. Cohen can set another date mutually agreeable to the
parties. The hearing will be governed by the procedures prescribed
by federal regulations at 42 CFR part 430.
Idaho SPA 24-0015 proposed to elect the option authorized under
section 1902(e)(16) of the Social Security Act (the Act) to provide
continuous Medicaid coverage to pregnant Medicaid beneficiaries for
the duration of their pregnancies and through the last day of the
month in which the 12-month period (beginning on the last day of
their pregnancies) ends. Idaho additionally proposed in the SPA to
exclude from its scope individuals 4-4-5 whose pregnancies end due
to abortions ``that are not in accordance with Idaho Code 18-622.''
CMS disapproved Idaho SPA 24-0015 because this exclusion is not
authorized under section 1902(e)(16) of the Act. As CMS explained in
our disapproval letter dated January 6, 2025, under the extended
postpartum coverage option at section 1902(e)(16) of the Act, in any
state that has elected the option, individuals are entitled to the
extended postpartum coverage regardless of the reason their
pregnancy ends. CMS referenced in the disapproval letter the CMS
state health official (SHO) letter, which explains that ``under the
extended postpartum option, individuals are entitled to the extended
postpartum option regardless of the reason a pregnancy ends.'' \1\
---------------------------------------------------------------------------
\1\ CMS SHO 21-007, ``Improving Maternal Health and Extending
Postpartum Coverage in Medicaid and the Children's Health Insurance
Program (CHIP),'' SHO 21-007 (December 7, 2021), page 3, available
at <a href="https://www.medicaid.gov/federal-policy-guidance/downloads/sho21007.pdf">https://www.medicaid.gov/federal-policy-guidance/downloads/sho21007.pdf</a>.
---------------------------------------------------------------------------
The issue to be considered at the hearing is whether Idaho SPA
24-0015 is inconsistent with the requirements of section 1902(e)(16)
of the Act, which provides that, in states that elect the extended
postpartum coverage option, the state plan must provide continuous
Medicaid coverage to all individuals who are enrolled in Medicaid
while pregnant, from the beginning of their pregnancy (or initial
enrollment, if already pregnant at that time) through the end of the
12th month following the date their pregnancy ends.
Subsequent to the completion of the hearing, all parties will be
served with a copy of recommended findings and a proposed decision.
The parties will then have 20 days to file exceptions to the
recommended findings and proposed decision. I am required to issue a
final decision within 60 days of the date the proposed decision was
served.
Sincerely,
Stephanie Carlton, Acting Administrator.
cc: Benjamin R. Cohen
Section 1116 of the Social Security Act (42 U.S.C. 1316); 42 CFR
430.18 (Assistance Listing Number 93.778, Grants to States for
Medicaid.)
[[Page 10502]]
The Acting Administrator of the Centers for Medicare & Medicaid
Services (CMS), Stephanie Carlton, having reviewed and approved this
document, authorizes Vanessa Garcia, who is the Federal Register
Liaison, to electronically sign this document for purposes of
publication in the Federal Register.
Vanessa Garcia,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2025-02938 Filed 2-21-25; 8:45 am]
BILLING CODE 4120-01-P
</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>Indexed from Federal Register on February 24, 2025.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.