Revised federal allotments to states for social services expenditure pursuant to Title XX--Social Services Block Grant Act; promulgation for fiscal year 1985--HHS

The FY 1985 Federal allotments of $2.6 billion to States for social services under Section 2003 of the Social Security Act (Act) which were published in the Federal Register on October 27, 1983 (48 FR 49697) were based upon the authorization set forth in Section 2003 of the Act at the time they were prepared. Pub. L. 98-135, enacted October 24, 1983, amended Section 2003 of the Act by increasing the authorization to $2.7 billion for Fiscal Year 1984 and each succeeding fiscal year. Accordingly, the initial promulgation is rescinded and the promulgation as revised is set forth in the table below. These allotments are contingent upon Congressional appropriations actions for the year. If the Congress enacts, and the President approves, an amount different from the authorization, the allotments will be adjusted proportionately.     

Revised federal allotments to states for social services expenditures pursuant to Title XX--Social Services Block Grant Act; promulgation for fiscal year 1984--HHS. Notification

The Federal allotments of +2.5 billion to States for social services under Section 2003 of the Social Security Act (Act) which were published in the Federal Register November 26, 1982 (47 FR 53502) were based upon the authorization set forth in Section 2003 of the Act at that time and were contingent upon Congressional appropriations actions for the fiscal year. Public Law 98-135, enacted October 24, 1983, amended Section 2003 of the Act, by increasing the authorization to +2.7 billion for Fiscal Year 1984 and each succeeding fiscal year. The allocation of this authorized amount for Fiscal Year 1984 is shown in Column 1 of the table below, and it too is contingent upon Congressional appropriations actions. Public Law 98-139, enacted October 13, 1983 appropriates +2.675 billion for allocation to the States under Section 2003 of the Act for Fiscal Year 1984. The allocation of this appropriated amount is shown in Column 2 of the table below. Accordingly, the promulgation made in 47 FR 53502, November 26, 1982, is rescinded and the promulgation, as revised, is set forth in Column 2 of the table below.     

Federal allotments to states for social services expenditures pursuant to the Title XX-Social Services Block Grant Act; promulgation for fiscal year 1984-HHS. Notification of allocation of Title XX

This issuance sets forth the individual allotments to States for Fiscal Year 1984 pursuant to Title XX of the Social Security Act, as amended. The allotments to the States published herein are based upon the authorization set forth in Section 2003 of the Act and are contingent upon congressional appropriations actions for the fiscal year. If the Congress enacts and the President approves an amount different from the authorization, the allotments would be adjusted proportionately.     

Revised federal allotments to states for social services expenditures pursuant to the Title XX--Social Services Block Grant Act; promulgation for fiscal year 1983-HHS. Revised notification

Public Law 97-248, enacted September 3, 1982, among other things, amended Sec. 1101(a) of the Social Security Act, as amended, (Act) to define the term State when used in Title XX to no longer include American Samoa and the Trust Territory of the Pacific Islands. The Federal allotments to States for social services under Section 2003 of the Act which were promulgated in Vol. 46, No. 229 of the Federal Register page 58186 on November 30, 1981, included American Samoa and the Trust Territory of the Pacific Islands. Accordingly, the promulgation contained in such document is rescinded and the promulgation, as revised, is set forth in this issuance.     

Additional federal allotments to states for social services expenditures pursuant to the Title XX-Block Grants to States for Social Services--Office of Human Development Services, HHS

Section 2003 of the Social Security Act, as amended, authorizes $2.45 billion for allocation to the States for Social Services Block Grants--Fiscal Year 1983. Public Law 98-8, enacted March 245, 1983, appropriates an additional $225 million for Fiscal Year 1983. This notice contains State allotments and explanations of how the allotments were determined; conditions for receipt of these funds and other information.     

TRICARE; changes included in the National Defense Authorization Act for fiscal year 2005; TRICARE Dental Program. Interim final rule

The Department is publishing this interim final rule to implement sections 711 and 715 of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA-05), Public Law 108-375. Specifically, that legislation makes young dependents of deceased Service members eligible for enrollment in the TRICARE Dental Program when the child was not previously enrolled because of age, and authorizes post-graduate dental residents in a dental treatment facility of the uniformed services under a graduate dental education program accredited by the American Dental Association to provide dental treatment to dependents who are 12 years of age or younger and who are covered by a dental plan established under 10 U.S.C. 1076a. This rule also corrects certain references in 32 CFR 199.13. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates. Public comments are invited and will be considered for possible revisions to the final rule.     

Civilian Health and Medical Program of the Uniform Services (CHAMPUS); annual fiscal year deductible for outpatient services or supplies--DoD. Final rule

This amendment incorporates the applicable provisions of recent statutes relevant to the deductible amounts for outpatient care. Public laws 101-510 and 101-511 provide that effective April 1, 1991, the deductible amounts for medical care or services will increase from fifty dollars ($50.00) to one hundred and fifty dollars ($150.00) for an individual and from one hundred dollars ($100.00) to three hundred dollars ($300.00) for a family to include all CHAMPUS beneficiaries except dependents of active duty sponsors in pay grades E-4 or below. However, the Persian Gulf Conflict Supplemental Authorization and Personnel Benefit Act of 1991, Public Law 102-25, stipulates that, in the case of dependents of a member of the Uniformed Services who served or serves on active duty in the Persian Gulf theater of operations in connection with Operation Desert Storm, the provisions of Public Laws 101-510 and 101-511, shall not become effective until October 1, 1991. This latter category is defined in the rule as those dependents whose sponsors, are, or were, entitled to Special pay for Hostile Fire/Imminent Danger authorized by section 310 of title 37, United States Code, for service in the Persian Gulf Area.     

Office of the Secretary; TRICARE; changes included in the National Defense Authorization Act for fiscal year 2005; TRICARE dental program. Final rule

The Department is publishing this final rule to implement sections 711 and 715 of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA for FY05), Public Law 108-375. Specifically, that legislation makes young dependents of deceased Service members eligible for enrollment in the TRICARE Dental program when the child was not previously enrolled because of age, and authorizes post-graduate dental residents in a dental treatment facility of the uniformed services under a graduate dental education program accredited by the American Dental Association to provide dental treatment to dependents who are 12 years of age or younger and who are covered by a dental plan established under 10 U.S.C. 1076a. This adopts the interim rule published on September 21, 2005 (70 FR 55251).     

Title I--improving the academic achievement of the disadvantaged; Individuals with Disabilities Education Act (IDEA)--assistance to states for the education of children with disabilities. Final regulations

The Secretary amends the regulations governing programs administered under Title I of the Elementary and Secondary Education Act of 1965 (ESEA), as amended by the No Child Left Behind Act of 2001 (NCLB) (referred to in these regulations as the Title I program) and the regulations governing programs under Part B of the Individuals with Disabilities Education Act (IDEA) (referred to in these regulations as the IDEA program). These regulations provide States with additional flexibility regarding State, local educational agency (LEA), and school accountability for the achievement of a small group of students with disabilities whose progress is such that, even after receiving appropriate instruction, including special education and related services designed to address the students' individual needs, the students' individualized education program (IEP) teams (IEP Teams) are reasonably certain that the students will not achieve grade-level proficiency within the year covered by the students' IEPs.     

Federal financial participation in state assistance expenditures; federal matching shares for Aid to Families with Dependent Children, Medicaid, and aid to needy aged, blind, or disabled persons for October 1, 1991 through September 30, 1992--HHS. Notice

The Federal Percentages and Federal Medical Assistance Percentages for Fiscal Year 1992 have been calculated pursuant to the Social Security Act (the Act). These percentages will be effective from October 1, 1991 through September 30, 1992. This notice announces the calculated "Federal percentages" and "Federal medical assistance percentages" that we will use in determining the amount of Federal matching in State welfare and medical expenditures. The table gives figures for each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Programs under title XIX of the Act exist in each jurisdiction; title IV-A programs in all jurisdictions except American Samoa and the Northern Mariana Islands; programs under titles I, X, and XIV operate only in Guam and the Virgin Islands; while a program under title XVI (AABD) operates only in Puerto Rico. The percentages in this notice apply to State expenditures for assistance payments and medical services (except family planning which is subject to a higher matching rate). The statute provides separately for Federal matching of administrative costs. Sections 1101(a)(8) and 1905(b) of the Act, as revised by section 9528 of Pub. L. 99-272, require the Secretary of Health and Human Services to publish these percentages each year. The Secretary is to figure the percentages, by formulas in sections 1101(a)(8), and 1905(b) of the Act, from the Department of Commerce's statistics of average income per person in each State and in the Nation as a whole. The percentages are within upper and lower limits given in those two sections of the Act.(ABSTRACT TRUNCATED AT 250 WORDS)     

Federal financial participation in state assistance expenditures; federal matching shares for Aid to Families With Dependent Children, Medicaid, and aid to needy aged, blind, or disabled persons for October 1, 1994 through September 30, 1995--HHS. Notice

The Federal Percentages and Federal Medical Assistance Percentages for Fiscal Year 1995 have been calculated pursuant to the Social Security Act (the Act). These percentages will be effective from October 1, 1994 through September 30, 1995. This notice announces the calculated "Federal percentages" and "Federal medical assistance percentages" that we will use in determining the amount of Federal matching in State welfare and medical expenditures. The table gives figures for each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Programs under title XIX of the Act exist in each jurisdiction; title IV-A programs in all jurisdictions except American Samoa and the Northern Mariana Islands; programs under titles I, X, and XIV operate only in Guam and the Virgin Islands; while a program under title XVI (AABD) operates only in Puerto Rico. The percentages in this notice apply to State expenditures for assistance payments and medical services (except family planning which is subject to a higher matching rate). The statute provides separately for Federal matching of administrative costs. Sections 1101(a)(8) and 1905(b) of the Act, as revised by section 9528 of Public Law 99-272, require the Secretary of Health and Human Services to publish these percentages each year. The Secretary is to figure the percentages, by formulas in sections 1101(a)(8) and 1905(b) of the Act, from the Department of Commerce's statistics of average income per person in each State and in the Nation as a whole.(ABSTRACT TRUNCATED AT 250 WORDS)     

Standards for determining coal miner's total disability or death due to pneumoconiosis; claims for benefits under Part C of Title IV of the Federal Mine Safety and Health Act, as amended--Employment Standards Administration, Labor. Notice of proposed rulemaking; request for comment

On January 1, 1982, the Black Lung Benefits Revenue Act of 1981 and the Black Lung Benefits Amendments of 1981 became effective. This legislation made numerous substantive changes in the Black Lung Benefits Act, Title IV of the Federal Mine Safety and Health Act. Those changes affect both the criteria for establishing eligibility for benefits on claims filed on and after January 1, 1982, under the Black lung Benefits Act and the procedures for the payment of such benefits. These proposed rules are intended to implement those changes in the law and to make certain technical corrections in the implementing regulations previously promulgated in 1978 and 1980.     

Federal financial participation in state assistance expenditures; federal matching shares for Aid to Families with Dependent Children, foster care and adoption assistance, job opportunities and basic skills training, Medicaid, and aid to needy aged, blind, or disabled persons for October 1, 1993, through September 30, 1994--HHS. Notice

The Federal percentages and Federal medical assistance percentages for Fiscal Year 1994 have been calculated pursuant to the Social Security Act. These percentages will be effective from October 1, 1993, through September 30, 1994. This notice announces the calculated "Federal percentages" and "Federal medical assistance percentages" that we will use in determining the amount of Federal matching in State welfare and medical expenditures for programs under titles I, IV-A, IV-E, IV-F, X, XIV, XVI (Aid to the Aged, Blind, or Disabled), and XIX. The table gives figures for each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. The percentages in this notice apply to State expenditures for assistance payments, IV-A child care, JOBS services, and medical services (except family planning and certain JOBS expenditures which are subject to a higher matching rate). The statute provides separately for Federal matching of administrative costs. Sections 1101(a)(8) and 1905(b) of the Act requires the Secretary of Health and Human Services to publish these percentages each year. The Secretary is to figure the percentages, by formulas described in sections 1101(a)(8) and 1905(b) of the Act, using the Department of Commerce's statistics of average income per person in each State and in the Nation as a whole. The percentages are within upper and lower limits given in those two sections of the Act. The statute specifies the percentages to be applied to Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.(ABSTRACT TRUNCATED AT 250 WORDS)     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2000 rates. Department of Health and Human Services (HHS), Health Care Financing Administration (HCFA). Final rule

We are revising the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement changes arising from our continuing experience with the systems. In addition, in the addendum to this final rule, we describe changes in the amounts and factors necessary to determine rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 1999. We also set forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the prospective payment systems. Finally, we are revising certain policies governing payment to hospitals for the direct costs of graduate medical education.     

Assistance to states for the education of children with disabilities. Office of Special Education and Rehabilitative Services, Department of Education. Final regulations; preamble amendment

The Department of Education published in the Federal Register on March 12, 1999 (64 FR 12406), the final regulations for Assistance to States for the Education of Children with Disabilities and Early Intervention Program for Infants and Toddlers with Disabilities. The preamble to the final regulations did not include information concerning the biennial performance report. This document supplements the preamble of that document by adding the necessary information.     

Medicare program; revisions to payment policies under the physician fee schedule for calendar year 2003 and inclusion of registered nurses in the personnel provision of the critical access hospital emergency services requirement for frontier areas and remote locations. Final rule with comment period

This final rule with comment period refines the resource-based practice expense relative value units (RVUs) and makes other changes to Medicare Part B payment policy. In addition, as required by statute, we are announcing the physician fee schedule update for CY 2003. The update to the physician fee schedule occurs as a result of a calculation methodology specified by law. That law required the Department to set annual updates based in part on estimates of several factors. Although subsequent after-the-fact data indicate that actual increases were different to some degree from earlier estimates, the law does not permit those estimates to be revised. A subsequent law required estimates to be revised for FY 2000 and beyond. Although we have exhaustively examined opportunities for a different interpretation of law that would allow us to correct the flaw in the formula administratively, current law does not permit such an interpretation. Accordingly, without Congressional action to address the current legal framework, the Department is compelled to announce herein a physician fee schedule update for CY 2003 of -4.4 percent. Because the Department would adopt a change in the formula that determines the physician update if the law permitted it, we have examined how proper adjustments to past data could result in a positive update. The Department believes that revisions of estimates used to establish the sustainable growth rates (SGR) for fiscal years (FY) 1998 and 1999 and Medicare volume performance standards (MVPS) for 1990-1996 would, under present calculations, result in a positive update. The Department intends to work closely with Congress to develop legislation that could permit a positive update, and hopes that such legislation can be passed before the negative update takes effect. Because the Department wishes to change the update promptly in the event that Congress provides the Department legal authority to do so, we are requesting comments regarding how physician fee schedule rates could and should be recalculated prospectively in the event that Congress provides the Department with legal authority to revise estimates used to establish the sustainable growth rates (SGR) and for 1998 and 1999 and the NVPS for 1990-1996. The other policy changes concern: the pricing of the technical component for positron emission tomography (PET) scans, Medicare qualifications for clinical nurse specialists, a process to add or delete services to the definition of telehealth, the definition for ZZZ global periods, global period for surface radiation, and an endoscopic base for urology codes. In addition, this rule updates the codes subject to physician self-referral prohibitions. We are expanding the definition of a screening fecal-occult blood test and are modifying our regulations to expand coverage for additional colorectal cancer screening tests through our national coverage determination process. We also make revisions to the sustainable growth rate, the anesthesia conversion factor, and the work values for some gastroenterologic services. We are making these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule also clarifies the enrollment of physical and occupational therapists as therapists in private practice and clarifies the policy regarding services and supplies incident to a physician's professional services. In addition, this final rule discusses physical and occupational therapy payment caps and makes technical changes to the definition of outpatient rehabilitation services. In addition, we are finalizing the calendar year (CY) 2002 interim RVUs and are issuing interim RVUs for new and revised procedure codes for calendar year (CY) 2003. As required by the statute, we are announcing that the physician fee schedule update for CY 2003 is -4.4 percent, the initial estimate of the sustainable growth rate for CY 2003 is 7.6 percent, and the conversion factor for CY 2003 is $34.5920. This final rule will also allow registered nurses (RNs) to provide emergency care in certain critical access hospitals (CAHs) in frontier areas (an area with fewer than six residents per square mile) or remote locations (locations designated in a State's rural health plan that we have approved.) This policy applies if the State, following consultation with the State Boards of Medicine and Nursing, and in accordance with State law, requests that RNs be included, along with a doctor of medicine or osteopathy, a physician's assistant, or a nurse practitioner with training or experience in emergency care, as personnel authorized to provide emergency services in CAHs in frontier areas or remote locations.