oversight

Health Care Financing Administration: Medicaid Program--State Allotments for Payment of Medicare Part B Premiums for Qualifying Individuals for Federal Fiscal Year 1999

Published by the Government Accountability Office on 1999-05-12.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

      United States

GAO   General Accounting Office
      Washington, D.C. 20548

      Office of the General Counsel



      B-282635


      May 12, 1999

      The Honorable William V. Roth
      Chairman
      The Honorable Daniel Patrick Moynihan
      Ranking Minority Member
      Committee on Finance
      United States Senate

      The Honorable Thomas J. Bliley, Jr.
      Chairman
      The Honorable John D. Dingell
      Ranking Minority Member
      Committee on Commerce
      House of Representatives

      Subject: Department of Health and Human Services, Health Care Financing
               Administration: Medicaid Program; State Allotments for Payment of
               Medicare Part B Premiums for Qualifying Individuals: Federal Fiscal Year
               1999

      Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a
      major rule promulgated by Department of Health and Human Services, Health Care
      Financing Administration (HCFA), entitled “Medicaid Program; State Allotments for
      Payment of Medicare Part B Premiums for Qualifying Individuals: Federal Fiscal Year
      1999” (RIN: 0938-AJ28). We received the rule on April 27, 1999. It was published in
      the Federal Register as a notice on March 29, 1999. 64 Fed. Reg. 14931.

      The Social Security Act provides for the Medicaid program to pay all or part of the
      Medicare Part B premiums for beneficiaries belonging to two specific eligibility
      groups of low-income Medicare beneficiaries, referred to as Qualifying Individuals.
      This notice announces the federal fiscal year 1999 allotments that are available for
      state agencies to pay Medicare Part B premiums for these two eligibility groups.

      Enclosed is our assessment of HCFA’s compliance with the procedural steps required
      by section 801(a)(1)(B)(i) through (iv) of title 5 with respect to the rule. Our review
      indicates that HCFA complied with the applicable requirements.




                                                                                 GAO/OGC-99-46
If you have any questions about this report, please contact James W. Vickers,
Assistant General Counsel, at (202) 512-8210. The official responsible for GAO
evaluation work relating to the subject matter of the rule is William Scanlon,
Director, Health Financing and Public Health Issues. Mr. Scanlon can be reached at
(202) 512-7114.

Sincerely yours,




Robert P. Murphy
General Counsel

Enclosure

cc: Mr. Thomas A. Lavelle
    Health Insurance Specialist
    Health Care Financing
      Administration
    Department of Health and Human
      Services




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                                                                           ENCLOSURE

           ANALYSIS UNDER 5 U.S.C. § 801(a)(1)(B)(i)-(iv) OF A MAJOR RULE
                                    ISSUED BY
                 DEPARTMENT OF HEALTH AND HUMAN SERVICES,
                   HEALTH CARE FINANCING ADMINISTRATION
                                    ENTITLED
            "MEDICAID PROGRAM; STATE ALLOTMENTS FOR PAYMENT OF
            MEDICARE PART B PREMIUMS FOR QUALIFYING INDIVIDUALS:
                          FEDERAL FISCAL YEAR 1999"
                                (RIN: 0938-AJ28)

(i) Cost-benefit analysis

For states that execute a state plan amendment conforming to the requirements of the
Social Security Act, as amended by the Balanced Budget Act of 1997, a total of $1.5
billion is allocated over 5 years. The breakdown is as follows:

--   $200 million in fiscal year 1998,
--   $250 million in fiscal year 1999,
--   $300 million in fiscal year 2000,
--   $350 million in fiscal year 2001, and
--   $400 million in fiscal year 2002.

The benefits, according to HCFA, will include a positive effect on states and
individuals. Federal funding at the 100-percent matching rate is available for
Medicare cost sharing for Medicare Part B premium payments for qualifying
individuals and a greater number of low-income Medicare beneficiaries will be
eligible to have their Medicare Part B premiums paid under Medicaid.

(ii) Agency actions relevant to the Regulatory Flexibility Act, 5 U.S.C. §§ 603-605, 607,
and 609

The Secretary of Health and Human Services has determined that the notice will not
have a significant economic impact on a substantial number of small entities under
the standards of the Regulatory Flexibility Act.

(iii) Agency actions relevant to sections 202-205 of the Unfunded Mandates Reform
Act of 1995, 2 U.S.C. §§ 1532-1535

The notice does not impose a federal intergovernmental or private sector mandate as
defined in the Unfunded Mandates Reform Act of 1995.




                                                                            GAO/OGC-99-46
(iv) Other relevant information or requirements under acts and executive orders

Administrative Procedure Act, 5 U.S.C. §§ 551 et seq.

HCFA notes in the preamble to the notice that normally it would publish a proposed
notice with a public comment period and would delay the effective date for 30 days.
However, because the law sets out in detail the specific amounts available for each
federal fiscal year and the formula that is used to determine individual state
allotments, the Secretary has found good cause to waive these two requirements.
Also, no comments were received in response to the notice announcing fiscal year
1998 allotments. Because no prior notice was used and comments were not solicited,
HCFA has also properly invoked the exception to the 60-day delay in the effective
date of a major rule required by 5 U.S.C. 801.

Paperwork Reduction Act, 44 U.S.C. §§ 3501-3520

The notice does not contain any information collections which are subject to review
by the Office of Management and Budget under the Paperwork Reduction Act.

Statutory authorization for the rule

The notice was issued under the authority of sections 1902(a)(10) of the Social
Security Act (42 U.S.C. 1396a) and section 4732 of the Balanced Budget Act of 1997
(Pub. L. 105-33).

Executive Order No. 12866

The notice was found to be an “economically significant” regulatory action under
Executive Order No. 12866 and was reviewed and approved by the Office of
Management and Budget.




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