Medicare Program; Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model; Delay of Effective Date, 10961-10962 [2017-03347]
Download as PDF
Federal Register / Vol. 82, No. 32 / Friday, February 17, 2017 / Rules and Regulations
Dated: February 13, 2017.
Eric A. Washburn,
Bridge Administrator, Eighth Coast Guard
District.
[FR Doc. 2017–03186 Filed 2–16–17; 8:45 am]
BILLING CODE 9110–04–P
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
33 CFR Part 117
[Docket No. USCG–2017–0056]
Drawbridge Operation Regulation; Isle
of Wight (Sinepuxent) Bay, Ocean City,
MD
Coast Guard, DHS.
Notice of deviation from
drawbridge regulation.
AGENCY:
ACTION:
The Coast Guard has issued a
temporary deviation from the operating
schedule that governs the U.S. 50 (Harry
Kelly) Bridge across the Isle of Wight
(Sinepuxent) Bay, mile 0.5, at Ocean
City, MD. The deviation is necessary to
accommodate the free movement of
pedestrians and vehicles during the
2017 Island 2 Island Half Marathon
Bridge Run. This deviation allows the
bridge to remain in the closed-tonavigation position.
DATES: This deviation is effective from
8 a.m. to 10:30 a.m. on April 29, 2017.
ADDRESSES: The docket for this
deviation, [USCG–2017–0056], is
available at https://www.regulations.gov.
Type the docket number in the
‘‘SEARCH’’ box and click ‘‘SEARCH’’.
Click on Open Docket Folder on the line
associated with this deviation.
FOR FURTHER INFORMATION CONTACT: If
you have questions on this temporary
deviation, call or email Mr. Mickey
Sanders, Bridge Administration Branch
Fifth District, Coast Guard; telephone
(757) 398–6587, email
Mickey.D.Sanders2@uscg.mil.
SUPPLEMENTARY INFORMATION: The event
director, OC Tri Running Sports, with
approval from the Maryland State
Highway Administration, who owns
and operates the U.S. 50 (Harry Kelly)
Bridge, has requested a temporary
deviation from the current operating
regulations to accommodate the free
movement of pedestrians and vehicles
during the 2017 Island 2 Island Half
Marathon Bridge Run. The bridge is a
double bascule bridge and has a vertical
clearance in the closed position of 13
feet above mean high water.
The current operating schedule is set
out in 33 CFR 117.559. Under this
mstockstill on DSK3G9T082PROD with RULES
SUMMARY:
VerDate Sep<11>2014
16:06 Feb 16, 2017
Jkt 241001
temporary deviation, the bridge will be
maintained in the closed-to-navigation
position from 8 a.m. to 10:30 a.m. on
April 29, 2017. The Isle of Wight
(Sinepuxent) Bay is used by a variety of
vessels including small commercial
vessels and recreational vessels. The
Coast Guard has carefully considered
the nature and volume of vessel traffic
on the waterway in publishing this
temporary deviation.
Vessels able to pass through the
bridge in the closed position may do so
at any time. The bridge will be able to
open for emergencies and there is no
immediate alternate route for vessels
unable to pass through the bridge in the
closed position. The Coast Guard will
also inform the users of the waterways
through our Local and Broadcast Notice
to Mariners of the change in operating
schedule for the bridge so that vessel
operators can arrange their transits to
minimize any impacts caused by this
temporary deviation.
In accordance with 33 CFR 117.35(e),
the drawbridge must return to its regular
operating schedule immediately at the
end of the effective period of this
temporary deviation. This deviation
from the operating regulations is
authorized under 33 CFR 117.35.
Dated: February 13, 2016.
Hal R. Pitts,
Bridge Program Manager, Fifth Coast Guard
District.
[FR Doc. 2017–03193 Filed 2–16–17; 8:45 am]
BILLING CODE 9110–04–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 510 and 512
[CMS–5519–F2]
RIN 0938–AS90
Medicare Program; Advancing Care
Coordination Through Episode
Payment Models (EPMs); Cardiac
Rehabilitation Incentive Payment
Model; and Changes to the
Comprehensive Care for Joint
Replacement Model; Delay of Effective
Date
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; delay of effective
date.
AGENCY:
In accordance with the
memorandum of January 20, 2017, from
the Assistant to the President and Chief
of Staff, entitled ‘‘Regulatory Freeze
SUMMARY:
PO 00000
Frm 00003
Fmt 4700
Sfmt 4700
10961
Pending Review’’, this action delays for
60 days from the date of the
memorandum the effective date of the
rule entitled ‘‘Advancing Care
Coordination Through Episode Payment
Models (EPMs); Cardiac Rehabilitation
Incentive Payment Model; and Changes
to the Comprehensive Care for Joint
Replacement Model’’ published in the
January 3, 2017 Federal Register (82 FR
180). That rule implements three new
Medicare Parts A and B episode
payment models and a Cardiac
Rehabilitation (CR) Incentive Payment
model, and implements changes to the
existing Comprehensive Care for Joint
Replacement model under section
1115A of the Social Security Act (the
Act). Under the three new episode
payment models, acute care hospitals in
certain selected geographic areas will
participate in retrospective episode
payment models targeting care for
Medicare fee-for-service beneficiaries
receiving services during acute
myocardial infarction, coronary artery
bypass graft, and surgical hip/femur
fracture treatment episodes. All related
care within 90 days of hospital
discharge will be included in the
episode of care. Under the CR Incentive
Payment model, acute care hospitals in
certain selected geographic areas will
receive retrospective incentive
payments for beneficiary utilization of
cardiac rehabilitation/intensive cardiac
rehabilitation services during the 90
days following discharge from a
hospitalization treatment of an acute
myocardial infarction or coronary artery
bypass graft surgery. We believe these
models will further our goals of
improving the efficiency and quality of
care for Medicare beneficiaries receiving
care for these common clinical
conditions and procedures.
DATES:
Effective date: The effective date of
the final rule published in the January
3, 2017 Federal Register (82 FR 180) for
provisions that were to become effective
on February 18, 2017, is delayed to a
new effective date of March 21, 2017.
The provisions contained in the
following amendatory instructions
remain effective July 1, 2017: Number 3
amending 42 CFR 510.2; number 4
adding 42 CFR 510.110; number 6
amending 42 CFR 510.120; number 14
amending 42 CFR 510.405; number 15
amending 42 CFR 510.410; number 16
revising 42 CFR 510.500; number 17
revising 42 CFR 510.505; number 18
adding 42 CFR 510.506; and number 19
amending 42 CFR 510.515.
Applicability date: The regulations at
42 CFR part 512 are applicable on July
1, 2017.
E:\FR\FM\17FER1.SGM
17FER1
10962
Federal Register / Vol. 82, No. 32 / Friday, February 17, 2017 / Rules and Regulations
FOR FURTHER INFORMATION CONTACT:
Nora Fleming, (410) 786–6908.
For questions related to the EPMs:
EPMRULE@cms.hhs.gov. For questions
related to the CJR model: CJR@
cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
To the
mstockstill on DSK3G9T082PROD with RULES
extent that section 553 of the
Administrative Procedure Act (APA)
applies to this action to temporarily
delay the rule’s effective date, it is
exempt from notice and comment
because it constitutes a rule of
procedure under 5 U.S.C. 553(b)(A).
Furthermore, 5 U.S.C. 553(b)(B) permits
a waiver of prior notice and comment if
an agency finds good cause that a
notice-and-comment procedure is
impracticable, unnecessary, or contrary
to the public interest. Similarly, section
1871 of the Act, which normally
requires prior notice and a 60-day
public comment period for rules that
establish or change a substantive legal
standard, permits waiver of the
comment period when there is good
cause for an exception under 5 U.S.C.
553(b)(B). In addition, the requirement
under section 553(d) of the APA for a
30-day delay in the effective date of a
rule can be waived for good cause.
Consistent with the Assistant to the
President and Chief of Staff’s
memorandum of January 20, 2017, we
are postponing for 60 days from the date
of the memorandum, the effective date
of the final rule to allow Department
officials the opportunity for further
review and consideration of new
regulations. Moreover, we are exercising
no discretion in implementing this
specific provision of the memorandum.
As a result, undertaking notice and
comment procedure for this delay is
unnecessary and contrary to the public
interest, and we find good cause to
waive the notice and comment
requirements. For these same reasons,
we find good cause to waive the 30-day
delay in effective date provided for in 5
U.S.C. 553(d). Based on these findings,
this rule is effective immediately upon
publication in the Federal Register.
Dated: February 10, 2017.
Patrick H. Conway,
Acting Administrator, Centers for Medicare
& Medicaid Services.
Approved: February 15, 2017.
Thomas E. Price,
Secretary, Department of Health and Human
Services.
[FR Doc. 2017–03347 Filed 2–15–17; 4:15 pm]
BILLING CODE 4120–01–P
VerDate Sep<11>2014
16:06 Feb 16, 2017
Jkt 241001
DEPARTMENT OF HOMELAND
SECURITY
Federal Emergency Management
Agency
44 CFR Part 64
[Docket ID FEMA–2016–0002; Internal
Agency Docket No. FEMA–8467]
Suspension of Community Eligibility
Federal Emergency
Management Agency, DHS.
ACTION: Final rule.
AGENCY:
This rule identifies
communities where the sale of flood
insurance has been authorized under
the National Flood Insurance Program
(NFIP) that are scheduled for
suspension on the effective dates listed
within this rule because of
noncompliance with the floodplain
management requirements of the
program. If the Federal Emergency
Management Agency (FEMA) receives
documentation that the community has
adopted the required floodplain
management measures prior to the
effective suspension date given in this
rule, the suspension will not occur and
a notice of this will be provided by
publication in the Federal Register on a
subsequent date. Also, information
identifying the current participation
status of a community can be obtained
from FEMA’s Community Status Book
(CSB). The CSB is available at https://
www.fema.gov/national-floodinsurance-program-community-statusbook.
SUMMARY:
The effective date of each
community’s scheduled suspension is
the third date (‘‘Susp.’’) listed in the
third column of the following tables.
FOR FURTHER INFORMATION CONTACT: If
you want to determine whether a
particular community was suspended
on the suspension date or for further
information, contact Patricia Suber,
Federal Insurance and Mitigation
Administration, Federal Emergency
Management Agency, 400 C Street SW.,
Washington, DC 20472, (202) 646–4149.
SUPPLEMENTARY INFORMATION: The NFIP
enables property owners to purchase
Federal flood insurance that is not
otherwise generally available from
private insurers. In return, communities
agree to adopt and administer local
floodplain management measures aimed
at protecting lives and new construction
from future flooding. Section 1315 of
the National Flood Insurance Act of
1968, as amended, 42 U.S.C. 4022,
prohibits the sale of NFIP flood
insurance unless an appropriate public
DATES:
PO 00000
Frm 00004
Fmt 4700
Sfmt 4700
body adopts adequate floodplain
management measures with effective
enforcement measures. The
communities listed in this document no
longer meet that statutory requirement
for compliance with program
regulations, 44 CFR part 59.
Accordingly, the communities will be
suspended on the effective date in the
third column. As of that date, flood
insurance will no longer be available in
the community. We recognize that some
of these communities may adopt and
submit the required documentation of
legally enforceable floodplain
management measures after this rule is
published but prior to the actual
suspension date. These communities
will not be suspended and will continue
to be eligible for the sale of NFIP flood
insurance. A notice withdrawing the
suspension of such communities will be
published in the Federal Register.
In addition, FEMA publishes a Flood
Insurance Rate Map (FIRM) that
identifies the Special Flood Hazard
Areas (SFHAs) in these communities.
The date of the FIRM, if one has been
published, is indicated in the fourth
column of the table. No direct Federal
financial assistance (except assistance
pursuant to the Robert T. Stafford
Disaster Relief and Emergency
Assistance Act not in connection with a
flood) may be provided for construction
or acquisition of buildings in identified
SFHAs for communities not
participating in the NFIP and identified
for more than a year on FEMA’s initial
FIRM for the community as having
flood-prone areas (section 202(a) of the
Flood Disaster Protection Act of 1973,
42 U.S.C. 4106(a), as amended). This
prohibition against certain types of
Federal assistance becomes effective for
the communities listed on the date
shown in the last column. The
Administrator finds that notice and
public comment procedures under 5
U.S.C. 553(b), are impracticable and
unnecessary because communities listed
in this final rule have been adequately
notified.
Each community receives 6-month,
90-day, and 30-day notification letters
addressed to the Chief Executive Officer
stating that the community will be
suspended unless the required
floodplain management measures are
met prior to the effective suspension
date. Since these notifications were
made, this final rule may take effect
within less than 30 days.
National Environmental Policy Act.
FEMA has determined that the
community suspension(s) included in
this rule is a non-discretionary action
and therefore the National
E:\FR\FM\17FER1.SGM
17FER1
Agencies
[Federal Register Volume 82, Number 32 (Friday, February 17, 2017)]
[Rules and Regulations]
[Pages 10961-10962]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-03347]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 510 and 512
[CMS-5519-F2]
RIN 0938-AS90
Medicare Program; Advancing Care Coordination Through Episode
Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model;
and Changes to the Comprehensive Care for Joint Replacement Model;
Delay of Effective Date
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; delay of effective date.
-----------------------------------------------------------------------
SUMMARY: In accordance with the memorandum of January 20, 2017, from
the Assistant to the President and Chief of Staff, entitled
``Regulatory Freeze Pending Review'', this action delays for 60 days
from the date of the memorandum the effective date of the rule entitled
``Advancing Care Coordination Through Episode Payment Models (EPMs);
Cardiac Rehabilitation Incentive Payment Model; and Changes to the
Comprehensive Care for Joint Replacement Model'' published in the
January 3, 2017 Federal Register (82 FR 180). That rule implements
three new Medicare Parts A and B episode payment models and a Cardiac
Rehabilitation (CR) Incentive Payment model, and implements changes to
the existing Comprehensive Care for Joint Replacement model under
section 1115A of the Social Security Act (the Act). Under the three new
episode payment models, acute care hospitals in certain selected
geographic areas will participate in retrospective episode payment
models targeting care for Medicare fee-for-service beneficiaries
receiving services during acute myocardial infarction, coronary artery
bypass graft, and surgical hip/femur fracture treatment episodes. All
related care within 90 days of hospital discharge will be included in
the episode of care. Under the CR Incentive Payment model, acute care
hospitals in certain selected geographic areas will receive
retrospective incentive payments for beneficiary utilization of cardiac
rehabilitation/intensive cardiac rehabilitation services during the 90
days following discharge from a hospitalization treatment of an acute
myocardial infarction or coronary artery bypass graft surgery. We
believe these models will further our goals of improving the efficiency
and quality of care for Medicare beneficiaries receiving care for these
common clinical conditions and procedures.
DATES:
Effective date: The effective date of the final rule published in
the January 3, 2017 Federal Register (82 FR 180) for provisions that
were to become effective on February 18, 2017, is delayed to a new
effective date of March 21, 2017. The provisions contained in the
following amendatory instructions remain effective July 1, 2017: Number
3 amending 42 CFR 510.2; number 4 adding 42 CFR 510.110; number 6
amending 42 CFR 510.120; number 14 amending 42 CFR 510.405; number 15
amending 42 CFR 510.410; number 16 revising 42 CFR 510.500; number 17
revising 42 CFR 510.505; number 18 adding 42 CFR 510.506; and number 19
amending 42 CFR 510.515.
Applicability date: The regulations at 42 CFR part 512 are
applicable on July 1, 2017.
[[Page 10962]]
FOR FURTHER INFORMATION CONTACT: Nora Fleming, (410) 786-6908.
For questions related to the EPMs: EPMRULE@cms.hhs.gov. For
questions related to the CJR model: CJR@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: To the extent that section 553 of the
Administrative Procedure Act (APA) applies to this action to
temporarily delay the rule's effective date, it is exempt from notice
and comment because it constitutes a rule of procedure under 5 U.S.C.
553(b)(A). Furthermore, 5 U.S.C. 553(b)(B) permits a waiver of prior
notice and comment if an agency finds good cause that a notice-and-
comment procedure is impracticable, unnecessary, or contrary to the
public interest. Similarly, section 1871 of the Act, which normally
requires prior notice and a 60-day public comment period for rules that
establish or change a substantive legal standard, permits waiver of the
comment period when there is good cause for an exception under 5 U.S.C.
553(b)(B). In addition, the requirement under section 553(d) of the APA
for a 30-day delay in the effective date of a rule can be waived for
good cause. Consistent with the Assistant to the President and Chief of
Staff's memorandum of January 20, 2017, we are postponing for 60 days
from the date of the memorandum, the effective date of the final rule
to allow Department officials the opportunity for further review and
consideration of new regulations. Moreover, we are exercising no
discretion in implementing this specific provision of the memorandum.
As a result, undertaking notice and comment procedure for this delay is
unnecessary and contrary to the public interest, and we find good cause
to waive the notice and comment requirements. For these same reasons,
we find good cause to waive the 30-day delay in effective date provided
for in 5 U.S.C. 553(d). Based on these findings, this rule is effective
immediately upon publication in the Federal Register.
Dated: February 10, 2017.
Patrick H. Conway,
Acting Administrator, Centers for Medicare & Medicaid Services.
Approved: February 15, 2017.
Thomas E. Price,
Secretary, Department of Health and Human Services.
[FR Doc. 2017-03347 Filed 2-15-17; 4:15 pm]
BILLING CODE 4120-01-P