H. Federalism

E.O. 13132 establishes certain requirements that an agency must meet when it promulgates a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on State and local governments, preempts State law, or otherwise has Federalism implications.

The provisions in this IFC impose substantial direct requirement costs on States. As mentioned in previous sections of this rule, the additional costs to States are attributable to necessary administrative and technical activities that will ensure high levels of program integrity in eligibility operations and data verification systems, in keeping with the cooperative Federalism that is central to the Medicaid program.