Program Descriptions
Program Number
93.790
Title
Alternate Non-Emergency Service Providers Or Networks
Federal Agency
CENTERS FOR MEDICARE AND MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
Authorization
Section 6043, Emergency Room Co-payments for Non-Emergency Care, Deficit Reduction Act of 2005, Public Law 109-171, enacted February 8, 2006.
Status
Active
Objectives
To provide Federal payments to States for the establishment of alternate non-emergency service providers, or networks of such providers to provide non-emergency care.
Types of Assistance
Project Grants.
Uses and Use Restrictions
Funds from this program may be used for the establishment of alternate non-emergency service providers, or networks of such providers to provide non-emergency care. States may not use funds as the State's share of the Medicaid program costs or as supplemental Disproportionate Share Hospital (DSH) payments.
Eligibility Requirements
Applicant Eligibility
Grant applicants are limited to the 51 State Medicaid Agencies and the Medicaid Agencies in the Federal Territories.
Beneficiary Eligibility
Grant applicants are limited to the 51 State Medicaid Agencies and the Medicaid Agencies in the Federal Territories.
Credentials/Documentation
Federal funds will be directed to the State Medicaid Agency with the grant award amount identified in the award approval letter. Permissible administrative costs will be determined in accordance with the Office of Management and Budget (OMB) circular No. 87 "Cost Principals for States and Local Governments".
Application and Award Process
Preapplication Coordination
The Centers for Medicare and Medicaid Services (CMS) will issue guidance to States via a State Medicaid Director (SMD) letter regarding the application requirements. This program is excluded from coverage under E.O. 12372.
Application Procedure
A State may submit only one application. Applications must be submitted electronically to CMS via E-mail: Matransgrant@cms.hhs.gov
Award Procedure
CMS will make a decision for each application received. Each applicant will receive written notification of CMS' decision. Applicants approved for a grant award must submit a letter of acceptance to CMS within 30 days of the date of the award, agreeing to the terms and conditions of the award letter.
Deadlines
Please contact CMS for application deadline.
Range of Approval/Disapproval Time
60 to 90 days.
Appeals
Not applicable.
Renewals
Assistance Considerations
Formula and Matching Requirements
In providing for payments to States under subsection 1903(y) of the Act, the Secretary shall provide preference to States that establish, or provide for, alternate non-emergency services providers or networks of providers that: (1) serve rural or underserved areas where Medicaid beneficiaries may not have regular access to providers of primary care services; or (2) providers are in partnership with local community hospitals and/or (3) States who submit a State plan amendment for section 1916 A(e) for hospitals to impose cost sharing for non-emergency services provided in a hospital emergency department. No matching funds are required for this program.
Length and Time Phasing of Assistance
Project Period: Under this legislation, a total of $50,000,000 over 4 years (FY 2006-2009) has been made available for the establishment of alternate non-emergency service providers or networks of such providers to provide non-emergency care. CMS will have two separate competitive grant solicitations as follows: 1st FFY 2006 and 2007; 2nd FFY 2008 and 2009. Budget Period: FY 2006, 2007, 2008, and 2009.
Post Assistance Requirements
Reports
States will be required to submit quarterly reports to CMS related to program status and financial reports as identified in the terms and conditions post award.
Audits
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 24, 1997).
Records
Financial records, supporting documents and progress/annual reports and all other records pertinent to this program shall be retained three years.
Financial Information
Account Identification
75-0516-0-1-551.
Obligations
FY 07 $12,500,000; FY 08 est not available; and FY 09 est not reported.
Range and Average of Financial Assistance
Grant funds will be allocated based on the number of States that apply and meet the grant criteria.
Program Accomplishments
None. New Program.
Regulations, Guidelines and Literature
CMS will provide application guidance in the form of a State Medicaid Director letter. The letter may be located at http://www.cms.hhs.gov/GrantsAlternaNonEmergServ/
Information Contacts
Regional or Local Office
Not applicable.
Headquarters Office
Lyn Killman, Health Insurance Specialist, Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Mail Stop S2-01-16, Baltimore, MD 21244. Telephone: (410) 786-5951 E-mail: Lyn.Killman@cms.hhs.gov and Wanda Pigatt-Canty, Health Insurance Specialist, Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Mail Stop S2-01-16, Baltimore, MD 21244. Telephone: (410) 786-6177. E-mail: wanda.pigatt-canty@cms.hhs.gov.
Web Site Address
http://www.cms.hhs.gov/GrantsAlternaNonEmergServ/
Related Programs
None.
Examples of Funded Projects
Not applicable.
Criteria for Selecting Proposals
Each application will be reviewed by a team of CMS staff. The applicant selection criteria will consist of the following but will not be limited to only these factors: the project abstract, project narrative and budget.
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