[Billing Code: 4120-01-P]

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 430, 438, and 457
[CMS-2439-CN]
RIN 0938-AU99
Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed
Care Access, Finance, and Quality; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and
Human Services (HHS).
ACTION: Final rule; correction.
SUMMARY: This document corrects typographical errors in the final rule that appeared in the
May 10, 2024 Federal Register, entitled “Medicaid Program; Medicaid and Children’s Health
Insurance Program (CHIP) Managed Care Access, Finance, and Quality (referred to hereafter as
the “Managed Care final rule”). The effective date of the Managed Care final rule is July 9,
2024.
DATES: This document is effective July 9, 2024.
FOR FURTHER INFORMATION CONTACT:
Rebecca Burch Mack, (303) 844-7355, Medicaid Managed Care.
Laura Snyder, (410) 786-3198, Medicaid Managed Care State Directed Payments.
Alex Loizias, (410) 786-2435, Medicaid Managed Care State Directed Payments and In Lieu of
Services and Settings.
Elizabeth Jones, (410) 786-7111, Medicaid Medical Loss Ratio.
Jamie Rollin, (410) 786-0978, Medicaid Managed Care Program Integrity.
Rachel Chappell, (410) 786-3100, and Emily Shockley, (410) 786-3100, Contract Requirements
for Overpayments.

Carlye Burd, (720) 853-2780, Medicaid Managed Care Quality.
Amanda Paige Burns, (410) 786-8030, Medicaid Quality Rating System.
Joshua Bougie, (410) 786-8117, and Chanelle Parkar, (667) 290-8798, CHIP.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2024-08085 of May 10, 2024 (89 FR 41002), there were typographical errors
that are identified and corrected in this correcting document. These corrections are effective as if
they had been included in the Managed Care final rule. Accordingly, the corrections are
effective July 9, 2024.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 41003, Table 1: Applicability Dates,
a. We made a typographical error in the applicability date for §§ 438.6(c)(2)(vi)(C)(3)
and (4); 438.6(c)(2)(viii); 438.6(c)(5)(i) through (iv); 438.10(c)(3); 438.68(d)(1)(iii);
438.68(d)(2); 438.207(b)(3) and (d)(2); 438.602(g)(5)-(13); 457.1207 (transparency provisions);
457.1218 (network adequacy standards); 457.1230(b); 457.1285 (transparency) by omitting a
space between the words “after” and “July.”
b. We used wording in the applicability date for § 438.6(c)(4) that did not match the
applicability date in regulation text.
On page 41004, Table 1, Applicability Dates, we made a typographical error in the
applicability date for §§ 438.505(a)(1); 457.1240(d) by not deleting the placeholder for the
effective date and inserting the actual date.
On page 41119, we made a punctuation error in “State directed payment-“ by not deleting
the unnecessary hyphen.
On page 41123,
a. We made a typographical error in the phrase “has standardized process” by omitting

an “a”.
b. We made a typographical error in the phrase “specific MLR report” by omitting an
“s”.
On page 41130, we made a typographical error and omitted “of the final rule.”.
On page 41139, we made a typographical error by omitting “of” before “an
overpayment”.
On page 41168, we inadvertently used semicolons instead of periods in the sentence
referencing § 438.16(e)(2)(iii)(A), (B), and (C); used a colon after “approval;” included “or”
before “(C);” and omitted a space between “paragraph” and “(e)”.
On page 41245, we made a typographical error by inadvertently including “private
sector” and omitting “State” when referencing the last annual burden in Estimate 13 for
Medicaid and quality rating system measure collection. We also inadvertently omitted the CHIP
burden estimates at the end of the paragraph.
On page 41254, in Table 6, Summary of CHIP Requirements and Burden, we made a
typographical error by inadvertently excluding a CHIP-specific entry for “457.1240(d) QRS
optional methodology implementation extension”.
On page 41255, in Table 6, Summary of CHIP Requirements and Burden, the figures in
the “Total” entry are incorrect.
On page 41256, in Table 7, Summary of Medicaid and CHIP Requirements and Burden,
the figures in the “CHIP” and the “Total” entries are incorrect.
B. Summary of Errors in the Regulation Text
On page 41274, in the regulation text for § 438.16(e)(2)(iii)(A), we inadvertently
included a semicolon at the end of this paragraph.
On page 41281, in the regulation text for § 438.515(b)(1), we inadvertently included a
close parenthesis at the end of this paragraph.
III. Waiver of Proposed Rulemaking

Under 5 U.S.C. 553(b) of the Administrative Procedure Act (the APA), the agency is
required to publish a notice of the proposed rule in the Federal Register before the provisions of
a rule take effect. In addition, section 553(d) of the APA mandates a 30-day delay in effective
date after issuance or publication of a substantive rule. Sections 553(b)(B) and 553(d)(3) of the
APA provide for exceptions from the APA notice and comment, and delay in effective date
requirements. Section 553(b)(B) of the APA authorizes an agency to dispense with normal
notice and comment rulemaking procedures for good cause if the agency makes a finding that the
notice and comment process is impracticable, unnecessary, or contrary to the public interest, and
includes a statement of the finding and the reasons for it in the rule. Similarly, section 553(d)(3)
of the APA allows the agency to avoid the 30-day delay in effective date where good cause is
found and the agency includes in the rule a statement of the finding and the reasons for it. In our
view, this correcting document does not constitute a rulemaking that would be subject to these
requirements.
This document merely corrects technical errors in the Managed Care final rule. The
corrections contained in this document are consistent with, and do not make substantive changes
to, the policies that were proposed, subject to notice and comment procedures, and adopted in the
Managed Care final rule. As a result, the corrections made through this correcting document are
intended to resolve inadvertent errors so that the rule accurately reflects the policies adopted in
the final rule. Even if this were a rulemaking to which the notice and comment and delayed
effective date requirements applied, we find that there is good cause to waive such requirements.
Undertaking further notice and comment procedures to incorporate the corrections in this
document into the Managed Care final rule or delaying the effective date of the corrections
would be contrary to the public interest because it is in the public interest to ensure that the rule
accurately reflects our policies as of the date they take effect. Further, such procedures would be
unnecessary because we are not making any substantive revisions to the final rule, but rather, we
are simply correcting the Federal Register document to reflect the policies that we previously

proposed, received public comment on, and subsequently finalized in the final rule. For these
reasons, we believe there is good cause to waive the requirements for notice and comment and
delay in effective date.
Corrections
In FR Doc. 2024-08085 appearing on page 41002 in the Federal Register of Friday, May
10, 2024, make the following corrections:
Correction of Errors in the Preamble
1. On page 41003, in Table 1: Applicability Dates,
a. Row 7, second column, the sentence that reads “Applicable for the first rating period
beginning on or afterJuly 9, 2026.” is corrected to read “Applicable for the first rating period
beginning on or after July 9, 2026.”.
b. Row 13, second column, the sentence that reads “Applicable by the first rating period
beginning on or after the release of reporting instructions.” is corrected to read “Applicable by
the first rating period beginning on or after the date specified in the T-MSIS reporting
instructions released by CMS.”.
2. On page 41004, Table 1: Applicability Dates, row 2, second column, the sentence that
reads “Applicable by the end of the fourth calendar year following [inset the effective date of the
final rule].” is corrected to read “Applicable by the end of the fourth calendar year following July
9, 2024.”.
3. On page 41119, second column, last full paragraph, line 12, the phrase that reads
“State directed payment-“ is corrected to read “State directed payment”.
4. On page 41123,
a. Beginning in the first column, last full paragraph, line 12 and continuing to the second
column, lines 1 through 5, the sentence that reads “Currently CMS has standardized process that
reviews T–MSIS data needs, proposes revisions to the T–MSIS submission file format(s), and
provides opportunity for States’ review and comment.” is corrected to read “Currently CMS has

a standardized process that reviews T–MSIS data needs, proposes revisions to the T–MSIS
submission file format(s), and provides opportunity for States’ review and comment.”
b. Second column, first partial paragraph, lines 36 through 41, the sentence that reads
“We are not finalizing proposed §§ 438.8(k)(1)(xiv) through (xvi) or § 438.74(a)(3) through (4)
to require SDP line-level reporting in the State summary and managed care plan specific MLR
report.” is corrected to read “We are not finalizing proposed §§ 438.8(k)(1)(xiv) through (xvi) or
§ 438.74(a)(3) through (4) to require SDP line-level reporting in the State summary and managed
care plan specific MLR reports.”
5. On page 41130, second column, first partial paragraph, lines 17 through 24, the
sentence that reads “We are finalizing the effective date for this provision as the first rating
period beginning on or after 1 year after the effective date for the provider incentive changes in
§§ 438.3(i), 438.608(e), and the existing cross-references at § 457.1200(d) for separate CHIP.” is
corrected to read “We are finalizing the effective date for this provision as the first rating period
beginning on or after 1 year after the effective date of the final rule for the provider incentive
changes in §§ 438.3(i), 438.608(e), and the existing cross-references at § 457.1200(d) for
separate CHIP.”
6. On page 41139, second column, second paragraph, lines 9 through 13, the sentence
that reads “We are instead finalizing in revised § 438.608(a)(2) that States require managed care
plans to define “prompt” as within 30 calendar days of identifying or recovery an overpayment.”
is corrected to read “We are instead finalizing in revised § 438.608(a)(2) that States require
managed care plans to define “prompt” as within 30 calendar days of identifying or recovery of
an overpayment.”.
7. On page 41168, first column, first partial paragraph, lines 16 through 29, the sentence
that reads ““Within 30 calendar days of receipt of a notice described in paragraph(e)(2)(iii)(A),
(B) or (C) of this section, the State must submit an ILOS transition plan to CMS for review and
approval: (A) The notice the State provides to an MCO, PIHP, or PAHP of its decision to

terminate an ILOS; (B) The notice an MCO, PIHP, or PAHP provides to the State of its decision
to cease offering an ILOS to its enrollees; or (C) The notice CMS provides to the State of its
decision to require the State to terminate an ILOS.”” is corrected to read ““Within 30 calendar
days of receipt of a notice described in paragraph (e)(2)(iii)(A), (B) or (C) of this section, the
State must submit an ILOS transition plan to CMS for review and approval. (A) The notice the
State provides to an MCO, PIHP, or PAHP of its decision to terminate an ILOS. (B) The notice
an MCO, PIHP, or PAHP provides to the State of its decision to cease offering an ILOS to its
enrollees. (C) The notice CMS provides to the State of its decision to require the State to
terminate an ILOS.””
8. On page 41245, third column, first partial paragraph, lines 10 through 14, the sentence
that reads “In aggregate for Medicaid, we estimate an annual private sector burden of 168 hours
(7 States × 24 hr) at a cost of $19,848 (168 hr × $118.14/hr).” is corrected to read “In aggregate
for Medicaid, we estimate an annual State burden of 168 hours (7 States × 24 hr) at a cost of
$19,848 (168 hr × $118.14/hr). In aggregate for CHIP, we estimate an annual State burden of
168 hours (7 States x 24 hr) at a cost of $19,848 (168 hr × $118.14/hr).”.
9. On page 41254, Table 6, Summary of CHIP Requirements and Burden, is corrected by
adding the following entry directly above the entry for “457.1240(d) QRS website display yearly
maintenance”:
Regulator
y Section
in Title 42
of the
CFR

OMB
Control
Number
(CMS ID
No.)

# of
Responde
nts

Total #
of
Respons
es

457.1240(d
) QRS
optional
methodolo
gy
implement
ation
extension

09381282
(CMS10554)

7 States

Time
per
Respo
nse
(hours
)
Tota
l
Time
(hou
rs)
Lab
or
Rat
e
($/h
r)
118.
Total
cost ($)

Freque
ncy

Annualize
d Time
(hours)

Annualized
Cost ($)

19,848

Annual

n/a

n/a

10. On page 41255, in Table 6, Summary of CHIP Requirements and Burden, row 3, the
“Total” entry is corrected to read as follows:

Regulator
y Section
in Title 42
of the
CFR

OMB
Control
Number
(CMS ID
No.)

TOTAL

# of
Responde
nts

Total #
of
Respons
es

Varies

3,583

Time
per
Respo
nse
(hours
)
Varies

Tota
l
Time
(hou
rs)
350,
Lab
or
Rat
e
($/h
r)
Vari
es

Total
cost ($)

Freque
ncy

Annualize
d Time
(hours)

Annualized
Cost ($)

32,620,7
Varies

37,329

3,759,381

11. On page 41256, in Table 7, Summary of Medicaid and CHIP Requirements and
Burden, rows 3 and 4, the “CHIP” and the “Total” entries are corrected to read as follows:
OMB
Control
Number
(CMS ID
No.)

# of
Responde
nts

Total #
of
Respons
es

09381282
(CMS10554)

Varies

Varies

CHIP

TOTAL

Tota
l
Time
(hou
rs)

3,583

Time
per
Respo
nse
(hours
)
Varies

22,539

Varies

1,88
0,52
350,
Lab
or
Rat
e
($/h
r)
Vari
es

Total
cost ($)

Freque
ncy

Annualize
d Time
(hours)

Annualized
Cost ($)

32,620,7
Varies

37,329

3,759,381

Vari
es

168,966,
Varies

112,542

10,889,606

B. Correction of Errors in the Regulation Text
§ 438.16 [Corrected]
1. On page 41274, third column, last paragraph, the regulation text for
§ 438.16(e)(2)(iii)(A), lines 1 through 3, the sentence that reads “(A) The notice the State
provides to an MCO, PIHP, or PAHP of its decision to terminate an ILOS;” is corrected to read
“(A) The notice the State provides to an MCO, PIHP, or PAHP of its decision to terminate an
ILOS.”.
§ 438.515 [Corrected]
2. On page 41281, third column, second full paragraph, the regulation text for
§ 438.515(b)(1), lines 1 through 12, the sentence that reads “(1) Include data for all enrollees
who receive coverage through the managed care plan for a service or action for which data are
necessary to calculate the quality rating for the managed care plan including Medicaid FFS and
Medicare data for enrollees who receive Medicaid benefits for the State through FFS and

managed care, are dually eligible for both Medicare and Medicaid and receive full benefits from
Medicaid, or both).” is corrected to read “(1) Include data for all enrollees who receive coverage
through the managed care plan for a service or action for which data are necessary to calculate
the quality rating for the managed care plan including Medicaid FFS and Medicare data for
enrollees who receive Medicaid benefits for the State through FFS and managed care, are dually
eligible for both Medicare and Medicaid and receive full benefits from Medicaid, or both.”.
Elizabeth J. Gramling,
Executive Secretary to the Department,
Department of Health and Human Services.

[FR Doc. 2024-13712 Filed: 6/21/2024 8:45 am; Publication Date: 6/24/2024]