New and Pending Demonstration Project Proposals Submitted Pursuant to Section 1115(a) of the Social Security Act: November and December 1994

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[ORD-070-N]

New and Pending Demonstration Project Proposals Submitted

Pursuant to Section 1115(a) of the Social Security Act: November and

December 1994

AGENCY: Health Care Financing Administration (HCFA).

ACTION: Notice.

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SUMMARY: This notice lists new proposals for demonstration projects

submitted to the Department of Health and Human Services during the

months of November and December 1994 under the authority of section

1115 of the Social Security Act. This notice also lists proposals that

have been submitted, approved, or disapproved since January 1993.

Comments: We will accept written comments on these proposals. We

will, if feasible, acknowledge receipt of all comments, but we will not

provide written responses to comments. We will, however, neither

approve nor disapprove a proposal received after the publication of the

Department of Health and Human Services' public notice guidelines in

the Federal Register on September 27, 1994, for at least 30 days after

publication of the notice of that proposal in the Federal Register, in

order to allow time to receive and consider comments. Direct comments

as indicated below.

ADDRESSES: Mail correspondence to: Susan Anderson, Office of Research

and Demonstrations, Health Care Financing Administration, 2230 Oak

Meadows, 6325 Security Boulevard, Baltimore, MD 21207.

FOR FURTHER INFORMATION CONTACT: Susan Anderson, (410) 966-5181.

SUPPLEMENTARY INFORMATION:

I. Background

Under Section 1115 of the Social Security Act (the Act), the

Department of Health and Human Services (HHS) may consider and approve

research and demonstration proposals with a broad range of policy

objectives. These demonstrations can lead to improvements in achieving

the purposes of the Act.

In exercising her discretionary authority, the Secretary has

developed a number of policies and procedures for reviewing proposals.

On September 27, 1994, we published a notice in the Federal Register

(59 FR 49249) that specified (1) the principles that we ordinarily will

consider when approving or disapproving demonstration projects under

the authority in section 1115(a) of the Act; (2) the procedures we

expect States to use in involving the public in the development of

proposed demonstration projects under section 1115; and (3) the

procedures we ordinarily will follow in reviewing demonstration

proposals. We are committed to a thorough and expeditious review of

State requests to conduct such demonstrations.

II. Listing of New and Pending Proposals for the Months of November and

December 1994

As part of our procedures, we are publishing a monthly notice in

the Federal Register of all new and pending proposals. This notice

contains proposals for the months of November and December 1994. This

initial publication of information on section 1115 demonstration

proposals lists all proposals submitted, approved or disapproved since

January 1, 1993. Future notices will only list actions occurring in a

single month, including new submissions, pending proposals, approvals,

and disapprovals. Proposals submitted in response to a grant

solicitation or other competitive process will be reported as received

during the month that such grant or bid is awarded, so as to prevent

interference with the awards process.

A. Comprehensive Health Reform Programs

1. New Proposals

No new proposals were submitted during the months of November and

December 1994.

2. Pending Proposals

Demonstration Title/State: The Diamond State Health Plan--Delaware.

Description: Delaware proposes to expand eligibility for Medicaid

to persons with incomes up to 100 percent of the Federal poverty level

and require that the Medicaid population enroll in managed care

delivery systems. The State's current section 1115 demonstration

project, the Delaware Health Care Partnership for Children, would be

incorporated into the statewide program as an optional provider for

eligible children.

Date Received: July 29, 1994.

State Contact: Kay Holmes, DSHP Coordinator, DHSS Medicaid Unit,

Biggs Building, P.O. Box 906, New Castle, Delaware 19720, (302) 577-

4900.

Federal Project Officer: Rosana Hernandez, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

[[Page 4419]]

Demonstration Title/State: MediPlan Plus--Illinois.

Description: Illinois seeks to develop a managed care delivery

system using a series of networks, either local or statewide, to tailor

its Medicaid delivery system to the needs of local urban neighborhoods

or large rural areas.

Date Received: September 15, 1994.

State Contact: Tom Toberman, Manager, Federal/State Monitoring, 201

South Grand Avenue East, Springfield, Illinois 62763, (217) 782-2570.

Federal Project Officer: Gina Clemons, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: MassHealth--Massachusetts.

Description: Massachusetts proposes to implement a range of

strategies to extend Medicaid coverage of its uninsured citizens,

including the employed, the short-term unemployed, and the long-term

unemployed. The proposed program would employ direct provision of

health services as well as indirect strategies to promote market forces

to address the needs of the uninsured, including providing subsidies to

employees with incomes up to 200 percent of the Federal poverty level.

Date Received: April 15, 1994.

State Contact: Laurie Burgess, Director, Managed Care Program

Development, Division of Medical Assistance, 600 Washington Street,

Boston, Massachusetts 02111, (617) 348-5695.

Federal Project Officer: Ed Hutton, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: MinnesotaCare--Minnesota.

Description: Minnesota proposes to expand its use of managed care

service delivery and to extend Medicaid eligibility to families and

children with incomes up to 275 percent of the Federal poverty level.

The State would also integrate Medicaid with other public entities that

deliver health services.

Date Received: July 28, 1994.

State Contact: Maria Gomez, Commissioner, Health Care Services

Delivery, Minnesota Department of Human Services, 444 Lafayette Road N,

St. Paul, Minnesota 55155, (612) 297-4113.

Federal Project Officer: Penny Pine, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Missouri.

Description: Missouri proposes to require that beneficiaries enroll

in managed care delivery systems, and extend Medicaid eligibility to

persons with incomes below 200 percent of the Federal poverty level. As

part of the program, Missouri would create a fully capitated managed

care pilot program to serve non-institutionalized persons with

permanent disabilities on a voluntary basis.

Date Received: June 30, 1994.

State Contact: Donna Checkett, Director, Division of Medical

Services, Missouri Department of Social Services, P.O. Box 6500,

Jefferson City, Missouri 65102-6500, (314) 751-6922.

Federal Project Officer: Suzanne Rotwein, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: The Granite State Partnership for Access

and Affordability in Health Care--New Hampshire.

Description: New Hampshire proposes to extend Medicaid eligibility

to adults with incomes below the AFDC cash standard and to create a

public insurance product for low income workers. The State also seeks

to implement a number of pilot initiatives to help redesign its health

care delivery system.

Date Received: June 14, 1994.

State Contact: Barry Bodell, New Hampshire Department of Health and

Human Services, Office of the Commissioner, 6 Hazen Drive, Concord, New

Hampshire 03301-6505, (603) 271-4332.

Federal Project Officer: Maria Boulmetis, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: OhioCare--Ohio.

Description: Ohio proposes to expand Medicaid eligibility to

include uninsured persons with incomes up to 100 percent of the Federal

poverty level. New and current eligibles in this statewide program

would receive services through managed care. Certain special health

related services, such as mental health and drug and alcohol addiction

services, would also be provided through managed care.

Date Received: March 2, 1994.

State Contact: Kathi Glynn, Director, Ohio Medicaid, 30 East Broad

Street, Columbus, Ohio 43266, (614) 644-0140.

Federal Project Officer: David Walsh, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

3. Approved Conceptual Proposals (Award of Waivers Pending)

Demonstration Title/State: Palmetto Health Initiative--South

Carolina.

Description: South Carolina proposes to expand Medicaid eligibility

to include uninsured persons with incomes of up to 100 percent of the

Federal poverty level. New and current eligibles in this statewide

program would receive services through either a fully capitated managed

health plan or a partially capitated primary care provider. South

Carolina also proposes to implement a managed care program, with a

focus on home and community-based services, for persons requiring, or

at risk of requiring, placement in a nursing facility.

The Health Care Financing Administration (HCFA) will be working

with South Carolina over the next year to develop the infrastructure

necessary for the proposed demonstration. HCFA will consider the

State's request for waivers once the State has successfully completed a

set of agreed upon milestones.

Date Received: March 1, 1994.

Date Concept Approved: November 18, 1994.

State Contact: Eugene A. Laurent, Ph.D., Executive Director, State

Health and Human Services Finance Commission, P.O. Box 8206, Columbia,

South Carolina 29202, (803) 253-6100.

Federal Project Officer: Sherrie Fried, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

4. Approved Proposals

Demonstration Title/State: Florida Health Security Program--

Florida.

Description: The Florida Health Security Program is a voluntary,

employer-based, discounted premium program designed to provide access

to private health insurance for employed but uninsured Floridians. The

program will use a managed competition model and will provide health

insurance for 1.1 million uninsured Floridians with incomes at or below

250 percent of the Federal poverty level. Health plans (indemnity and

HMO) will be offered by Accountable Health Partnerships and

administered by Community Health Purchasing Alliances.

Date Received: February 10, 1994.

Date Awarded: September 15, 1994.

Implementation Date: The implementation date has not yet been set,

pending approval by the State legislature. [[Page 4420]]

State Contact: Tom Wallace, Agency for Health Care Administration,

325 John Knox Road, Tallahassee, Florida 32303-4131, (904) 922-5760.

Federal Project Officer: Alisa Adamo, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: QUEST--Hawaii.

Description: The Hawaii QUEST program provides seamless coverage to

those persons previously covered through Federal and State programs and

those who are uninsured. This is accomplished through expansion of the

Medicaid income eligibility level to 300 percent of the Federal poverty

level and an elimination of categorical requirements and the assets

test. The State is providing Medicaid services through a managed care

delivery system.

Date Received: April 20, 1993.

Date Awarded: July 16, 1993.

Implementation Date: August 1, 1994.

State Contact: Winifred N. Odo, Administrator, Med-QUEST Division,

Department of Human Services, P.O. Box 339, Honolulu, Hawaii 96809-

0339, (808) 586-5391.

Federal Project Officer: Ron Lambert, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Kentucky Medicaid Access and Cost

Containment Demonstration Project--Kentucky.

Description: The Kentucky program will expand Medicaid eligibility

to 100 percent of the Federal poverty level.

Date Received: March 30, 1993.

Date Awarded: December 9, 1993.

Implementation Date: An implementation date has not yet been set,

pending approval by the State legislature.

State Contact: Masten Childers, II, Commissioner, Department for

Medicaid Services, Cabinet for Human Resources, Commonwealth of

Kentucky, Frankfort, Kentucky 40621-0001, (502) 564-4321.

Federal Project Officer: Penny Pine, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Oregon.

Description: Oregon's demonstration program expands Medicaid

eligibility and shifts delivery of Medicaid services into fully and

partially capitated plans and primary care case management programs.

The State utilized a public prioritization process to establish the

service package provided under Medicaid.

Date Received: August 19, 1991.

Date Awarded: March 19, 1993.

Implementation Date: February 1, 1994.

State Contact: Lynn Read, Office of Medical Assistance Programs,

500 Summer Street NE., Salem, Oregon 97310-1014, (513) 945-6587.

Federal Project Officer: Ron Deacon, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: RIte Care--Rhode Island.

Description: The RIte Care program provides coverage to pregnant

women and children up to 6 years of age with family incomes at or below

250 percent of the Federal poverty level. Individuals eligible for the

program are required to enroll in prepaid health plans which contract

with the State to provide comprehensive health services for a fixed

cost per enrollee per month. Eligible individuals are offered a choice

of health plans in which they will enroll.

Date Received: July 2, 1993.

Date Awarded: November 1, 1993.

Implementation Date: August 1, 1994.

State Contact: Robert J. Fallon, Director, Department of Human

Services, 600 New London Avenue, Cranston, Rhode Island 02920. (401)

464-2121.

Federal Project Officer: Debbie Van Hoven, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: TennCare--State of Tennessee.

Description: TennCare is a statewide program to provide health care

benefits to Medicaid beneficiaries, uninsured State residents, and

those whose medical conditions make them uninsurable. All TennCare

enrollees receive services through capitated managed care plans that

are either health maintenance organizations (HMOs) or preferred

provider organizations (PPOs).

Date Received: June 17, 1993.

Date Awarded: November 18, 1993.

Implementation Date: January 1, 1994.

State Contact: Manny Martins, Tennessee Department of Health,

Bureau of Medicaid, 729 Church Street, Nashville, Tennessee 37247-6501,

(615) 741-0213.

Federal Project Officer: Rose Hatten, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

5. Disapproved Proposals

No comprehensive health reform proposals have been disapproved

since January 1, 1993.

B. Other Section 1115 Demonstration Proposals

1. New Proposals

Demonstration Title/State: Family Planning Proposal--New Mexico.

Description: New Mexico proposes to extend Medicaid eligibility for

family planning services to all women of childbearing age with income

at or below 185 percent of the federal poverty level.

Date Received: November 1, 1994.

State Contact: Bruce Weydemeyer, Director, Division of Medical

Assistance, P.O. Box 2348, Santa Fe, New Mexico 87504-2348, (505) 827-

3106.

Federal Project Officers: Alisa Adamo, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Georgia's Children's Benefit Plan.

Description: The State of Georgia submitted a Section 1115 proposal

entitled ``Georgia Children's Benefit Plan'' that provides preventive

and primary care services for children 1 through 5 years of age who are

between 133 and 185 percent of Federal poverty level. The duration of

the waiver is 5 years with proposed project dates of July 1, 1995 to

June 30, 2000.

Date Received: December 12, 1994.

State Contact: Jacquelyn Foster-Rice, Georgia Department of Medical

Assistance, Maternal and Child Health, 2 Peachtree Street NW., 27th

Floor, Atlanta, Georgia 30303, phone: (404) 651-5785, FAX: (404) 656-

4913.

Federal Project Officer: Maria Boulmetis, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak Meadows

Building, 6325 Security Boulevard, Baltimore, Maryland 21207.

2. Pending Proposals

Demonstration Title/State: Demonstration Project for Family

Planning and Reproductive Services--Maryland.

Description: Maryland proposes to extend Medicaid eligibility for

family planning and preventive reproductive services for a 5-year

period to women who are Medicaid eligible due to their pregnancy and

remain Medicaid eligible 60 days postpartum.

Date Received: June 11, 1994.

State Contact: Jane Forman, Department of Health and Mental

[[Page 4421]] Hygiene, room 137, 201 West Preston Street, Baltimore,

Maryland 21201, (410) 225-6538.

Federal Project Officer: Alisa Adamo, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: High Cost User Initiative--Maryland.

Description: Maryland proposes to implement an integrated case

management system for high-cost, high-risk Medicaid beneficiaries.

Date Received: July 8, 1994.

State Contact: John Folkemer, Maryland Department of Health and

Mental Hygiene, Office of Medical Assistance Policy, 201 West Preston

Street, Baltimore, Maryland 21201, (410) 225-5206.

Federal Project Officer: Rosana Hernandez, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Minnesota Long Term Care Options

Project/Minnesota.

Description: The State proposes to integrate long-term care and

acute care services under combined Medicare and Medicaid capitation

payments for elderly dual eligibles.

Date Received: April 18, 1994.

State Contact: Pamela Parker, Minnesota Department of Human

Services, Human Services Building, 444 Lafayette Road North, St. Paul,

Minnesota 55155, (612) 296-2140.

Federal Project Officer: Melissa McNiff, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Pay-in Spenddown Pilot--Ohio.

Description: Ohio proposes to implement a one-county pilot program

to allow the medically needy to pay in spenddown amounts in order to

qualify for Medicaid to simplify eligibility administration.

Date Received: April 28, 1994.

State Contact: Jeanne Carroll, Ohio Department of Human Services,

30 East Broad Street, Columbus, Ohio 43266, (614) 466-6024.

Federal Project Officer: David Walsh, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: CHOICES--Citizenship, Health,

Opportunities, Interdependence, Choices and Supports--Rhode Island.

Description: Rhode Island proposes to consolidate all current State

and Federal funding streams for adults with developmental disabilities

under one program using managed care/managed competition.

Date Received: April 5, 1994.

State Contact: Susan Babin, Department of Mental Health,

Retardation, and Hospitals, Division of Developmental Disabilities, 600

New London Avenue, Cranston, Rhode Island 02920, (401) 464-3234.

Federal Project Officer: Melissa McNiff, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Virginia.

Description: Virginia proposes to expand Medicaid eligibility to

children in the State funded KIDS CARE program, and provide them with a

limited Medicaid benefit restricted to ambulatory services.

Date Received: May 18, 1994.

State Contact: Janet Kennedy, Suite 1300, 600 East Broad Street,

Richmond, Virginia 23219, (804) 371-8855.

Federal Project Officer: Maria Boulmetis, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Family Planning Demonstration--

Washington.

Description: The State proposes to provide family planning services

to low-income women for an additional 10 months postpartum, extending

total coverage for such services to one year.

Date Received: April 21, 1994.

State Contact: Claudia Lewis, Medical Assistance Administration,

Division of Client Services, P.O. Box 45530, Olympia, Washington 98504-

5530, (206) 586-2751.

Federal Project Officer: Maria Boulmetis, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Wisconsin.

Description: The State proposes to limit the amount of exempt funds

that may be set aside as burial and related expenses for SSI-related

Medicaid recipients.

Date Received: March 9, 1994.

State Contact: Jean Sheil, Division of Economic Support, Wisconsin

Department of Health and Social Services, 1 West Wilson Street, room

650, P.O. Box 7850, Madison, Wisconsin 53707, (608) 266-0613.

Federal Project Officer: J. Donald Sherwood, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

3. Approved Conceptual Proposals (Award of Waivers Pending)

Demonstration Title/State: Health Services for Children with

Special Needs--District of Columbia.

Description: The District of Columbia proposes to implement a

specialized managed care program, targeted to the needs of Medicaid-

eligible disabled children. Enrollment would be mandatory. The District

has been given a 1-year grant to help further develop the model

proposed in its application.

Date Received: March 25, 1994.

Date Awarded: August 5, 1994.

State Contact: Deborah Jones, Project Officer, Commission on Health

Care Finance, 2100 Martin Luther King Jr. Avenue, SE., suite 302,

Washington, DC 20020, (202) 727-2240.

Federal Project Officer: Phyllis Nagy, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

4. Approved Proposals

Demonstration Title/State: The Program for All-Inclusive Care for

the Elderly (PACE)--California (Sutter SeniorCare, Sacramento).

Description: The PACE program is a managed care service delivery

system for the frail elderly who live in the community but are

certified for institutionalization in a nursing home. Most of the 300

participants are dually eligible for Medicare and Medicaid, and all are

being assessed for eligibility for nursing home placement according to

State standards.

Date Received: July 14, 1993.

Date Awarded: May 1, 1994.

Implementation Date: May 1, 1994.

State Contact: John Rodriguez, Deputy Director, Medical Care

Services, California Department of Health Services, 7140 P Street, room

600, Sacramento, California 95814, (916) 654-2254.

Federal Project Officer: Stefan Miller, Health Care Financing

Administration, Office of Research and Demonstrations, room 2-F-4 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Nemours Children's Program--Delaware.

Description: The State has developed a public/private managed care

system which enrolls, on a capitated basis, Medicaid-eligible children

in pediatric clinics. The Nemours Foundation developed the clinics and

is subsidizing a portion of the service cost. [[Page 4422]]

Date Received: October 13, 1992.

Date Awarded: July 27, 1993.

Implementation Date: December 1993.

State Contact: Phillip P. Soule, Deputy Director, Delaware

Department of Social Services, 1901 North Dupont Highway, New Castle,

Delaware 19720, (301) 577-4900.

Federal Project Officer: David Walsh, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Preconception Project--Florida.

Description: This project is a demonstration and evaluation of a

preconceptional intervention program. Resource mothers will guide high-

risk clients, during home visits, through various risk reduction

activities over a 2-year period. The objective is to significantly

reduce the incidence of low birth weight infants in the target

population.

Date Received: July 31, 1991.

Date Awarded: June 28, 1994.

Implementation Date: June 1, 1994.

State Contact: Marshall E. Kelley, Director of Medicaid, P.O. Box

12800, Tallahassee, Florida 32317-2800, (904) 488-3560.

Federal Project Officer: Rosana Hernandez, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Drug Utilization Review Program--Iowa.

Description: Under this program, the State conducts on-line

prospective drug utilization review. There are 250 pharmacies that

participate in the project either as randomized control or experimental

entities.

Date Received: June 1992.

Date Awarded: September 30, 1992.

Implementation Date: June 13, 1994.

State Contact: Don Herman, State Medicaid Director, East 13th and

Walnut, Hoover Building, 5th Floor, Des Moines, Iowa 50319, (515) 281-

8794.

Federal Project Officer: Kathleen Gondek, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Primary and Preventive Care for. Kids--

Maryland.

Description: Maryland has developed a primary and preventive care

program that expands Medicaid eligibility for those services provided

to children born after September 30, 1983, with family incomes below

185 percent of the Federal poverty level.

Date Received: February 8, 1993.

Date Awarded: August 9, 1993.

Implementation Date: October 1993.

State Contact: Joseph M. Millstone, Director, Medical Care Policy

Administration, Maryland Department of Health and Mental Hygiene, 201

West Preston Street, Baltimore, Maryland 21201, (410) 235-1432.

Federal Project Officer: Sherrie Fried, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore. Maryland 21207.

Demonstration Title/State: Family Planning Project--South Carolina.

Description: South Carolina's project extends Medicaid eligibility

for family planning services to all women with incomes below 185

percent of the Federal poverty level who have had one or more Medicaid

reimbursed pregnancies.

Date Received: June 23, 1993.

Date Awarded: December 7, 1993.

Implementation Date: October 1994.

State Contact: Rob Erlich, Health and Human Services Finance

Commission. P.O. Box 8206, Columbia, South Carolina 29202-8206, (803)

253-4129.

Federal Project Officer: Alisa Adamo, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Medicaid Direct Purchase Vaccine Program

(MDPVP)--Virginia.

Description: The MDPVP streamlines the reimbursement process for

vaccine, by allowing States to directly reimburse manufacturers for

vaccines. Vaccine manufacturers send to each private physician who

treats children on Medicaid a shipment of vaccines on consignment at no

cost to the physician. Physicians then bill Medicaid for the office

visit when they inoculate children, but not for the cost of the

vaccine. The Medicaid program reimburses the manufacturer at a

discounted rate, according to the number of vaccines administered. The

manufacturer then sends quantities of the vaccines to the private

physicians to replace the amounts used.

Date Received: August 25, 1992.

Date Awarded: November 4, 1992.

Implementation Date: March 1, 1993.

State Contact: Dee Holmes, Department of Medical Assistance

Services, 600 East Broad Street, Richmond, Virginia 23219, (804) 371-

8850.

Federal Project Officer: Alisa Adamo, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Drug Utilization Program--Washington.

Description: Under this program, the State allows for pharmacy

reimbursement to cognitive services, including pharmacist intervention

with patient's drug-related problems. The project encompasses 200

pharmacies, half of which are experimental and the rest are the control

group.

Date Received: June 1992.

Date Awarded: September 30, 1992.

Implementation Date: February 1, 1994.

State Contact: Garth Holmes, Medical Assistance Administrator, 623

8th Avenue SE., P.O. Box 45510, Olympia, Washington 98504, (206) 586-

7034.

Federal Project Officer: Kathleen Gondek, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

5. Disapproved Proposals

Demonstration Title/State: Iowa.

Description: Iowa sought to waive the transfer of assets

requirements, to extend the look-back and penalty periods from 30 to 60

months, and make other changes related to the penalty periods.

Date Received: April 5, 1993.

Date of Disapproval: December 23, 1993.

Federal Project Officer: J. Donald Sherwood, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Long Term Care--Maine.

Description: Maine sought to continue Medicaid eligibility of

persons residing in nursing homes to coincide with the State's efforts

to eliminate State plan coverage of certain optional eligibility

groups. A waiver would have protected current beneficiaries from the

proposed change in the State plan.

Date Received: May 11, 1993.

Date of Disapproval: July 13, 1993.

Federal Project Officer: J. Donald Sherwood, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Minnesota.

Description: The State sought to: (1) increase the look-back period

for asset transfers in determining Medicaid nursing facility

eligibility from 36 to 60 months; (2) to treat the uncompensated

transfers of excluded assets in the same manner as non-excluded assets;

and (3) to apply any resulting penalty period to [[Page 4423]] the loss

of coverage of all Medicaid services, not just long term care services.

Date Received: October 14, 1993.

Date of Disapproval: April 7, 1994.

Federal Project Officer: J. Donald Sherwood, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

Demonstration Title/State: Project TOOTH--The Project Toward

Occupational Opportunity Through Health--New Hampshire.

Description: The State proposed to provide comprehensive dental

treatment for approximately 200 AFDC/JOBS program participants whose

disfiguring dental status presented the major impediment to their

employment following job training.

Date Received: December 6, 1993.

Date of Disapproval: April 19, 1994.

Federal Project Officer: Debbie Van Hoven, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

III. Requests for Copies of a Proposal

Requests for copies of a specific Medicaid proposal should be made

to the State contact listed for the specific proposal. If further help

or information is needed, inquiries should be directed to the HCFA at

the address above.

(Catalog of Federal Domestic Assistance Program, No. 93.779; Health

Financing Research, Demonstrations, and Experiments.)

Dated: January 13, 1995.

Bruce C. Vladeck,

Administrator, Health Care Financing Administration.

[FR Doc. 95-1550 Filed 1-20-95; 8:45 am]

BILLING CODE 4120-01-P