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 http://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]


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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