Medicare Program; Second Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment Classification Groups-September 5, 6, and 7, 2007, 29328-29330 [E7-9521]
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29328
Federal Register / Vol. 72, No. 101 / Friday, May 25, 2007 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
meetings may last longer than listed in
this notice—but will not begin before
the posted times.
2 If the business of the Panel
concludes on Thursday, September 6,
there will be no Friday meeting.
Deadlines: Deadline for Hardcopy
Comments/Suggested Agenda
Topics—
5 p.m. (e.s.t.), Thursday, August 9,
2007
Deadline for Hardcopy Presentations—
5 p.m. (e.s.t.), Thursday, August 9,
2007
Deadline for Attendance Registration—
5 p.m. (e.s.t.), Wednesday, August 29,
2007
Deadline for Special Accommodations—
5 p.m. (e.s.t.), Wednesday, August 29,
2007
Centers for Medicare & Medicaid
Services
Submission of Materials to the
Designated Federal Officer (DFO)
Orthotics, Prosthetics, and Pedorthics,
Inc.).
• The Compliance Team, Inc.
Authority: Section 1834(a)(20) of the Social
Security Act (42 U.S.C. 1395m(a)(20)).
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance Program; and No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: May 17, 2007.
Leslie V. Norwalk,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. E7–10156 Filed 5–24–07; 8:45 am]
BILLING CODE 4120–01–P
[CMS–1322–N]
Medicare Program; Second SemiAnnual Meeting of the Advisory Panel
on Ambulatory Payment Classification
Groups—September 5, 6, and 7, 2007
Centers for Medicare &
Medicaid Services, Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
In accordance with section
10(a) of the Federal Advisory Committee
Act (FACA) (5 U.S.C. Appendix 2), this
notice announces the second semiannual meeting of the Advisory Panel
on Ambulatory Payment Classification
(APC) Groups (the Panel) for 2007. The
purpose of the Panel is to review the
APC groups and their associated
weights and to advise the Secretary of
the Department of Health and Human
Services (DHHS) (the Secretary) and the
Administrator of the Centers for
Medicare & Medicaid Services (CMS)
(the Administrator) concerning the
clinical integrity of the APC groups and
their associated weights. We will
consider the Panel’s advice as we
prepare the final rule that updates the
hospital Outpatient Prospective
Payment System (OPPS) for CY 2008.
DATES: Meeting Dates: We are
scheduling the second semi-annual
meeting in 2007 for the following dates
and times:
• Wednesday, September 5, 2007, 1
p.m. to 5 p.m. (e.s.t.) 1
• Thursday, September 6, 2007, 8 a.m.
to 5 p.m. (e.s.t.) 1
• Friday, September 7, 2007, 8 a.m. to
12 noon (e.s.t.) 2
1 The times listed in this notice are
approximate times; consequently, the
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SUMMARY:
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17:34 May 24, 2007
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Because of staffing and resource
limitations, we cannot accept written
comments and presentations by FAX,
nor can we print written comments and
presentations received electronically for
dissemination at the meeting.
Only hardcopy comments and
presentations can be reproduced for
public dissemination. All hardcopy
presentations must be accompanied by
Form CMS–20017 (revised 01/07). The
form is now available through the CMS
Forms Web site. The Uniform Resource
Locator (URL) for linking to this form is
as follows: https://www.cms.hhs.gov/
cmsforms/downloads/cms20017.pdf.
Presenters must use the most recent
copy of CMS–20017 (updated 01/07) at
the above URL. Additionally, presenters
must clearly explain the action(s) that
they are requesting CMS to take in the
appropriate section of the form. They
must also clarify their relationship to
the organization that they represent in
the presentation.
(Note: Issues that are vague, or that are
outside the scope of the APC Panel’s
purpose, will not be considered for
presentations and comments. There will be
no exceptions to this rule. We appreciate
your cooperation on this matter.)
We are also requiring electronic
versions of the written comments and
presentations, in addition to the
hardcopies, to send electronically to the
Panel members for their review prior to
the meeting.
In summary, presenters and/or
commenters must do the following:
• Send BOTH electronic and
hardcopy versions of their presentations
and written comments by the prescribed
deadlines.
• Send electronic transmissions to the
e-mail address below.
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Fmt 4703
Sfmt 4703
• Mail (or send by courier) to the DFO
all hardcopies, accompanied by Form
CMS–20017 (revised 01/07), if they are
presenting, as specified in the ‘‘FURTHER
INFORMATION CONTACT’’ section of this
notice.
• Commenters are not required to
send Form CMS–20017 with their
written comments.
ADDRESSES: The meeting will be held in
the Auditorium, CMS Central Office,
7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
FOR FURTHER INFORMATION CONTACT:
• For further information, contact: Shirl
Ackerman-Ross, DFO, CMS, CMM,
HAPG, DOC, 7500 Security Boulevard,
Mail Stop C4–05–17, Baltimore, MD
21244–1850. Phone: (410) 786–4474.
(Note: Please advise couriers of the
following: When delivering hardcopies of
presentations to CMS, if no one answers at
the above phone number, please call (410)
786–4532.)
• E-mail address for comments,
presentations, and registration requests
is CMS APCPanel@cms.hhs.gov.
(Note: There is NO underscore in this email address; there is a SPACE between CMS
and APCPanel.)
• News media representatives must
contact our Public Affairs Office at (202)
690–6145.
Advisory Committees’ Information
Lines
The phone numbers for the CMS
Federal Advisory Committee Hotline are
1–877–449–5659 (toll free) and (410)
786–9379 (local).
Web Sites
Please search the CMS Web site at
https://www.cms.hhs.gov/FACA/05_
AdvisoryPanelonAmbulatoryPayment
ClassificationGroups.asp#TopOfPage in
order to obtain the following
information:
(Note: There is an UNDERSCORE after
FACA/05(like this_); there is no space.)
• Additional information on the APC
meeting agenda topics,
• Updates to the Panel’s activities,
• Copies of the current Charter, and
• Membership requirements.
You may also search information
about the APC Panel and its
membership in the FACA database at
the following URL: https://
www.fido.gov/facadatabase/public.asp.
SUPPLEMENTARY INFORMATION:
I. Background
The Secretary is required by section
1833(t)(9)(A) of the Social Security Act
(the Act), [as amended by section 201(h)
of the Medicare, Medicaid, and SCHIP
E:\FR\FM\25MYN1.SGM
25MYN1
Federal Register / Vol. 72, No. 101 / Friday, May 25, 2007 / Notices
Balanced Budget Refinement Act of
1999 (BBRA) (Pub. L. 106–113), and redesignated by section 202(a)(2) of the
BBRA] to establish and consult with an
expert outside advisory panel regarding
the clinical integrity of the APC groups
and weights that are components of the
hospital OPPS.
The APC Panel meets up to three
times annually. The Charter requires
that the Panel must be fairly balanced in
its membership in terms of the points of
view represented and the functions to
be performed. The Panel consists of up
to 15 members who are representatives
of providers and a Chair.
Each Panel member must be
employed full-time by a hospital,
hospital system, or other Medicare
provider subject to payment under the
OPPS. All Panel members must have
technical expertise that enables them to
participate fully in the work of the
Panel. The expertise encompasses
hospital payment systems, hospital
medical-care delivery systems, provider
billing systems, outpatient payment
requirements, APC groups, Current
Procedural Terminology codes, and the
use and payment of drugs and medical
devices in the outpatient setting, as well
as other forms of relevant expertise.
Details regarding membership
requirements for the APC Panel are
found on the CMS and FACA Web sites
as listed above.
The Panel presently consists of the
following members:
• E.L. Hambrick, M.D., J.D., Chair
• Marilyn Bedell, M.S., R.N., O.C.N.
• Gloryanne Bryant, B.S., R.H.I.A.,
R.H.I.T., C.C.S.
• Hazel Kimmel, R.N., C.C.S.
• Sandra J. Metzler, M.B.A., R.H.I.A.,
C.P.H.Q.
• Thomas M. Munger, M.D., F.A.C.C.
• James V. Rawson, M.D.
• Lou Ann Schraffenberger, M.B.A.,
R.H.I.A., C.C.S.-P.
• Judie S. Snipes, R.N., M.B.A.,
F.A.C.H.E.
• Timothy Gene Tyler, Pharm.D.
• Kim Allan Williams, M.D., F.A.C.C.,
F.A.B.C.
• Robert Matthew Zwolak, M.D.,
Ph.D., F.A.C.S.
• Patricia Spencer-Cisek, M.S.,
A.P.R.N.-B.C., A.O.C.N.
• Russ Ranallo, M.S.
• Michael A. Ross, M.D.
• Beverly Khnie Philip, M.D.
jlentini on PROD1PC65 with NOTICES
II. Agenda
The agenda for the September 2007
meeting will provide for discussion and
comment on the following topics as
designated in the Panel’s Charter:
• Reconfiguring APCs (for example,
splitting of APCs, moving Healthcare
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17:34 May 24, 2007
Jkt 211001
Common Procedure Coding System
[HCPCS] codes from one APC to another
and moving HCPCS codes from new
technology APCs to clinical APCs).
• Evaluating APC weights.
• Packaging device and drug costs
into APCs: methodology, effect on
APCs, and need for reconfiguring APCs
based upon device and drug packaging.
• Removing procedures from the
inpatient list for payment under the
OPPS.
• Using single and multiple
procedure claims data.
• Addressing other APC structure
technical issues.
(Note: The subject matter before the Panel
will be limited to these and related topics.
Issues related to calculation of the OPPS
conversion factor, charge compression, passthrough payments, or wage adjustments are
not within the scope of the Panel’s purpose.
Therefore, these issues will not be considered
for presentations and/or comments. There
will be no exceptions to this rule. We
appreciate your cooperation on this matter.)
The Panel may use data collected or
developed by entities and organizations,
other than DHHS and CMS, in
conducting its review. We urge
organizations to submit data for the
Panel’s and CMS staff’s review.
III. Written Comments and Suggested
Agenda Topics
Send hardcopy and electronic written
comments and suggested agenda topics
to the DFO at the address indicated
above. The DFO must receive these
items by 5 p.m. (e.s.t.), Thursday,
August 9, 2007. There will be no
exceptions. We appreciate your
cooperation on this matter.
The written comments and suggested
agenda topics submitted for the
September 2007 APC Panel meeting
must fall within the subject categories
outlined in the Panel’s Charter and as
listed in the Agenda section of this
notice.
IV. Oral Presentations
Individuals or organizations wishing
to make 5-minute oral presentations
must submit hardcopy and electronic
versions of their presentations to the
DFO by 5 p.m. (e.s.t.), Thursday, August
9, 2007, for consideration.
The number of oral presentations may
be limited by the time available. Oral
presentations should not exceed 5
minutes in length for an individual or
an organization.
The Chair may further limit time
allowed for presentations due to the
number of oral presentations, if
necessary.
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V. Presenter and Presentation
Information
All presenters must submit Form
CMS–20017 (revised 01/07). Hardcopies
are required for oral presentations;
however, electronic submissions of
Form CMS–20017 are optional. The
DFO must receive the following
information from those wishing to make
oral presentations:
• Form CMS–20017 completed with
all pertinent information identified on
the first page of the presentation.
• One hardcopy of presentation.
• Electronic copy of presentation.
• Personal registration information as
described in the Meeting Attendance
section below.
• Those persons wishing to submit
comments only must send hardcopy and
electronic versions of their comments,
but they are not required to submit
Form CMS–20017.
VI. Oral Comments
In addition to formal oral
presentations, there will be opportunity
during the meeting for public oral
comments, which will be limited to 1
minute for each individual and a total
of 3 minutes per organization.
VII. Meeting Attendance
The meeting is open to the public;
however, attendance is limited to space
available. Attendance will be
determined on a first-come, first-served
basis.
Persons wishing to attend this
meeting, which is located on Federal
property, must e-mail the Panel DFO to
register in advance no later than 5 p.m.
(e.s.t.), Wednesday, August 29, 2007. A
confirmation will be sent to the
requester(s) via return e-mail.
The following personal information
must be e-mailed to the DFO by the date
and time above:
• Name(s) of attendee(s),
• Title(s),
• Organization,
• E-mail address(es), and
• Telephone number(s).
VIII. Security, Building, and Parking
Guidelines
The following are the security,
building, and parking guidelines:
• Persons attending the meeting—
including presenters—must be
registered and on the attendance list by
the prescribed date.
• Individuals who are not registered
in advance will not be permitted to enter
the building and will be unable to
attend the meeting.
• Attendees must present
photographic identification to the
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Federal Register / Vol. 72, No. 101 / Friday, May 25, 2007 / Notices
Federal Protective Service or Guard
Service personnel before entering the
building.
• Security measures include
inspection of vehicles, inside and out, at
the entrance to the grounds.
• In addition, all persons entering the
building must pass through a metal
detector.
• All items brought into CMS—
including personal items such as
desktops, cell phones, palm pilots,
etc.—are subject to physical inspection.
• The public may enter the building
30–45 minutes before the meeting
convenes each day.
• All visitors must be escorted in
areas other than the lower and first-floor
levels in the Central Building.
• The main-entrance guards will
issue parking permits and instructions
upon arrival at the building.
IX. Special Accommodations
Individuals requiring sign-language
interpretation or other special
accommodations must send a request
for these services to the DFO by 5 p.m.
(e.s.t.), Wednesday, August 29, 2007.
Authority: Section 1833(t)(9) of the Act (42
U.S.C. 13951(t)). The Panel is governed by
the provisions of Pub. L. 92–463, as amended
(5 U.S.C. Appendix 2).
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare-Hospital
Insurance; and Program No. 93.774,
Medicare-Supplementary Medical Insurance
Program)
Dated: May 1, 2007.
Leslie V. Norwalk,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. E7–9521 Filed 5–24–07; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1546–N]
Medicare Program; Public Meeting in
Calendar Year 2007 for New Clinical
Laboratory Tests Payment
Determinations
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
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AGENCY:
SUMMARY: This notice announces a
public meeting to discuss payment
determinations for specific new
Physicians’ Current Procedural
Terminology (CPT) codes for clinical
laboratory tests. The meeting provides a
forum for interested parties to make oral
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17:34 May 24, 2007
Jkt 211001
presentations and submit written
comments on the new codes that will be
included in Medicare’s Clinical
Laboratory Fee Schedule for calendar
year 2008, which will be effective on
January 1, 2008. The meeting will
address technical issues relating to
payment determinations for a specified
list of new clinical laboratory codes.
The development of the codes for
clinical laboratory tests is performed by
the CPT Editorial Panel and will not be
discussed at the CMS meeting.
DATES: The public meeting is scheduled
for Monday, July 16, 2007 from 10 a.m.
to 2 p.m.
ADDRESSES: The public meeting will be
held in the main auditorium of the
central building of the Centers for
Medicare & Medicaid Services (CMS)
located at 7500 Security Boulevard,
Baltimore, Maryland 21244.
FOR FURTHER INFORMATION CONTACT:
Anita Greenberg, (410) 786–4601.
SUPPLEMENTARY INFORMATION:
I. Background
Section 531(b) of the Medicare,
Medicaid, and SCHIP Benefits
Improvement and Protection Act of
2000 (BIPA), Pub. L. 106–554, mandated
procedures that permit public
consultation for payment
determinations for new clinical
laboratory tests under Part B of title
XVIII of the Social Security Act (the
Act) in a manner consistent with the
procedures established for
implementing coding modifications for
International Classification of Diseases
(ICD–9–CM). The procedures and public
meeting announced in this notice for
new clinical laboratory tests are in
accordance with the procedures
published on November 23, 2001 in the
Federal Register (66 FR 58743) to
implement section 531(b) of BIPA. Also,
section 942(b) of the Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA), Pub.
L. 108–173, added section
1833(h)(8)(B)(iii) of the Act, which
required that we establish by regulation
procedures for determining the basis for,
and amount of, payment for new
clinical laboratory tests. In the calendar
year (CY) 2007 physician fee schedule
final rule (71 FR 69701 through 69704),
we adopted new 42 CFR subpart G
regarding payment for new clinical
diagnostic laboratory tests. Under 42
CFR 414.506, we annually convene a
meeting that includes representatives of
CMS officials involved in determining
payment amounts to receive individual
comments and recommendations (and
data on which the recommendations are
based).
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A newly created CPT code can either
represent a refinement or modification
of existing test methods, or a
substantially new test method. The
newly created CPT codes for the
calendar year 2007 will be listed at the
web site https://www.cms.hhs.gov/
ClinicalLabFeeSched on or after June 18,
2007.
The first method, called crosswalking, is used when a new test is
determined to be similar to an existing
test, multiple existing test codes, or a
portion of an existing test code. The
new test code is then assigned the
related existing local fee schedule
amounts and resulting national
limitation amount. The second method,
called gap-filling, is used when no
comparable, existing test is available.
When using this method, instructions
are provided to each Medicare carrier to
determine a payment amount for its
geographic area(s) for use in the first
year, and the carrier-specific amounts
are used to establish a national
limitation amount for following years.
For each new clinical laboratory test
code, a determination must be made to
either cross-walk or to gap-fill, and, if
cross-walking is appropriate, to know
which tests to cross-walk.
II. Meeting Format
This meeting is open to the public.
The on-site check-in for visitors will be
held from 9:30 to 10 a.m., followed by
opening remarks. Registered individuals
may discuss and recommend payment
determinations for specific new CPT
codes for the 2008 Clinical Laboratory
Fee Schedule.
Oral presentations must be brief, and
must be accompanied by three written
copies. Presenters may also make copies
available for approximately 50 meeting
participants. Presenters should address
the new test code(s) and descriptor, the
test purpose and method, costs, charges,
and make a recommendation with
rationale for using one of two methods
(cross-walking or gap-fill) for
determining payment for new clinical
laboratory codes. Presentations that do
not address the six items may be
considered incomplete and not
considered by CMS when making a
payment determination. We will request
missing information following the
meeting in order to prevent a
recommendation from being considered
incomplete.
A summary of the new codes and the
payment recommendations that are
presented during the public meeting
will be posted on our Web site by
September 7, 2007 and can be accessed
at https://www.cms.hhs.gov/
ClinicalLabFeeSched. In addition, the
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Agencies
[Federal Register Volume 72, Number 101 (Friday, May 25, 2007)]
[Notices]
[Pages 29328-29330]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-9521]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1322-N]
Medicare Program; Second Semi-Annual Meeting of the Advisory
Panel on Ambulatory Payment Classification Groups--September 5, 6, and
7, 2007
AGENCY: Centers for Medicare & Medicaid Services, Department of Health
and Human Services.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In accordance with section 10(a) of the Federal Advisory
Committee Act (FACA) (5 U.S.C. Appendix 2), this notice announces the
second semi-annual meeting of the Advisory Panel on Ambulatory Payment
Classification (APC) Groups (the Panel) for 2007. The purpose of the
Panel is to review the APC groups and their associated weights and to
advise the Secretary of the Department of Health and Human Services
(DHHS) (the Secretary) and the Administrator of the Centers for
Medicare & Medicaid Services (CMS) (the Administrator) concerning the
clinical integrity of the APC groups and their associated weights. We
will consider the Panel's advice as we prepare the final rule that
updates the hospital Outpatient Prospective Payment System (OPPS) for
CY 2008.
DATES: Meeting Dates: We are scheduling the second semi-annual meeting
in 2007 for the following dates and times:
Wednesday, September 5, 2007, 1 p.m. to 5 p.m. (e.s.t.) \1\
Thursday, September 6, 2007, 8 a.m. to 5 p.m. (e.s.t.) \1\
Friday, September 7, 2007, 8 a.m. to 12 noon (e.s.t.) \2\
\1\ The times listed in this notice are approximate times;
consequently, the meetings may last longer than listed in this notice--
but will not begin before the posted times.
\2\ If the business of the Panel concludes on Thursday, September
6, there will be no Friday meeting.
Deadlines: Deadline for Hardcopy Comments/Suggested Agenda Topics--
5 p.m. (e.s.t.), Thursday, August 9, 2007
Deadline for Hardcopy Presentations--
5 p.m. (e.s.t.), Thursday, August 9, 2007
Deadline for Attendance Registration--
5 p.m. (e.s.t.), Wednesday, August 29, 2007
Deadline for Special Accommodations--
5 p.m. (e.s.t.), Wednesday, August 29, 2007
Submission of Materials to the Designated Federal Officer (DFO)
Because of staffing and resource limitations, we cannot accept
written comments and presentations by FAX, nor can we print written
comments and presentations received electronically for dissemination at
the meeting.
Only hardcopy comments and presentations can be reproduced for
public dissemination. All hardcopy presentations must be accompanied by
Form CMS-20017 (revised 01/07). The form is now available through the
CMS Forms Web site. The Uniform Resource Locator (URL) for linking to
this form is as follows: https://www.cms.hhs.gov/cmsforms/downloads/
cms20017.pdf.
Presenters must use the most recent copy of CMS-20017 (updated 01/
07) at the above URL. Additionally, presenters must clearly explain the
action(s) that they are requesting CMS to take in the appropriate
section of the form. They must also clarify their relationship to the
organization that they represent in the presentation.
(Note: Issues that are vague, or that are outside the scope of
the APC Panel's purpose, will not be considered for presentations
and comments. There will be no exceptions to this rule. We
appreciate your cooperation on this matter.)
We are also requiring electronic versions of the written comments
and presentations, in addition to the hardcopies, to send
electronically to the Panel members for their review prior to the
meeting.
In summary, presenters and/or commenters must do the following:
Send BOTH electronic and hardcopy versions of their
presentations and written comments by the prescribed deadlines.
Send electronic transmissions to the e-mail address below.
Mail (or send by courier) to the DFO all hardcopies,
accompanied by Form CMS-20017 (revised 01/07), if they are presenting,
as specified in the ``FURTHER INFORMATION CONTACT'' section of this
notice.
Commenters are not required to send Form CMS-20017 with
their written comments.
ADDRESSES: The meeting will be held in the Auditorium, CMS Central
Office, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
FOR FURTHER INFORMATION CONTACT: For further information,
contact: Shirl Ackerman-Ross, DFO, CMS, CMM, HAPG, DOC, 7500 Security
Boulevard, Mail Stop C4-05-17, Baltimore, MD 21244-1850. Phone: (410)
786-4474.
(Note: Please advise couriers of the following: When delivering
hardcopies of presentations to CMS, if no one answers at the above
phone number, please call (410) 786-4532.)
E-mail address for comments, presentations, and
registration requests is CMS APCPanel@cms.hhs.gov.
(Note: There is NO underscore in this e-mail address; there is a
SPACE between CMS and APCPanel.)
News media representatives must contact our Public Affairs
Office at (202) 690-6145.
Advisory Committees' Information Lines
The phone numbers for the CMS Federal Advisory Committee Hotline
are 1-877-449-5659 (toll free) and (410) 786-9379 (local).
Web Sites
Please search the CMS Web site at https://www.cms.hhs.gov/FACA/05_
AdvisoryPanelonAmbulatoryPaymentClassificationGroups.asp#TopOfPage in
order to obtain the following information:
(Note: There is an UNDERSCORE after FACA/05(like this--); there
is no space.)
Additional information on the APC meeting agenda topics,
Updates to the Panel's activities,
Copies of the current Charter, and
Membership requirements.
You may also search information about the APC Panel and its
membership in the FACA database at the following URL: https://
www.fido.gov/facadatabase/public.asp.
SUPPLEMENTARY INFORMATION:
I. Background
The Secretary is required by section 1833(t)(9)(A) of the Social
Security Act (the Act), [as amended by section 201(h) of the Medicare,
Medicaid, and SCHIP
[[Page 29329]]
Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 106-113), and
re-designated by section 202(a)(2) of the BBRA] to establish and
consult with an expert outside advisory panel regarding the clinical
integrity of the APC groups and weights that are components of the
hospital OPPS.
The APC Panel meets up to three times annually. The Charter
requires that the Panel must be fairly balanced in its membership in
terms of the points of view represented and the functions to be
performed. The Panel consists of up to 15 members who are
representatives of providers and a Chair.
Each Panel member must be employed full-time by a hospital,
hospital system, or other Medicare provider subject to payment under
the OPPS. All Panel members must have technical expertise that enables
them to participate fully in the work of the Panel. The expertise
encompasses hospital payment systems, hospital medical-care delivery
systems, provider billing systems, outpatient payment requirements, APC
groups, Current Procedural Terminology codes, and the use and payment
of drugs and medical devices in the outpatient setting, as well as
other forms of relevant expertise. Details regarding membership
requirements for the APC Panel are found on the CMS and FACA Web sites
as listed above.
The Panel presently consists of the following members:
E.L. Hambrick, M.D., J.D., Chair
Marilyn Bedell, M.S., R.N., O.C.N.
Gloryanne Bryant, B.S., R.H.I.A., R.H.I.T., C.C.S.
Hazel Kimmel, R.N., C.C.S.
Sandra J. Metzler, M.B.A., R.H.I.A., C.P.H.Q.
Thomas M. Munger, M.D., F.A.C.C.
James V. Rawson, M.D.
Lou Ann Schraffenberger, M.B.A., R.H.I.A., C.C.S.-P.
Judie S. Snipes, R.N., M.B.A., F.A.C.H.E.
Timothy Gene Tyler, Pharm.D.
Kim Allan Williams, M.D., F.A.C.C., F.A.B.C.
Robert Matthew Zwolak, M.D., Ph.D., F.A.C.S.
Patricia Spencer-Cisek, M.S., A.P.R.N.-B.C., A.O.C.N.
Russ Ranallo, M.S.
Michael A. Ross, M.D.
Beverly Khnie Philip, M.D.
II. Agenda
The agenda for the September 2007 meeting will provide for
discussion and comment on the following topics as designated in the
Panel's Charter:
Reconfiguring APCs (for example, splitting of APCs, moving
Healthcare Common Procedure Coding System [HCPCS] codes from one APC to
another and moving HCPCS codes from new technology APCs to clinical
APCs).
Evaluating APC weights.
Packaging device and drug costs into APCs: methodology,
effect on APCs, and need for reconfiguring APCs based upon device and
drug packaging.
Removing procedures from the inpatient list for payment
under the OPPS.
Using single and multiple procedure claims data.
Addressing other APC structure technical issues.
(Note: The subject matter before the Panel will be limited to
these and related topics. Issues related to calculation of the OPPS
conversion factor, charge compression, pass-through payments, or
wage adjustments are not within the scope of the Panel's purpose.
Therefore, these issues will not be considered for presentations
and/or comments. There will be no exceptions to this rule. We
appreciate your cooperation on this matter.)
The Panel may use data collected or developed by entities and
organizations, other than DHHS and CMS, in conducting its review. We
urge organizations to submit data for the Panel's and CMS staff's
review.
III. Written Comments and Suggested Agenda Topics
Send hardcopy and electronic written comments and suggested agenda
topics to the DFO at the address indicated above. The DFO must receive
these items by 5 p.m. (e.s.t.), Thursday, August 9, 2007. There will be
no exceptions. We appreciate your cooperation on this matter.
The written comments and suggested agenda topics submitted for the
September 2007 APC Panel meeting must fall within the subject
categories outlined in the Panel's Charter and as listed in the Agenda
section of this notice.
IV. Oral Presentations
Individuals or organizations wishing to make 5-minute oral
presentations must submit hardcopy and electronic versions of their
presentations to the DFO by 5 p.m. (e.s.t.), Thursday, August 9, 2007,
for consideration.
The number of oral presentations may be limited by the time
available. Oral presentations should not exceed 5 minutes in length for
an individual or an organization.
The Chair may further limit time allowed for presentations due to
the number of oral presentations, if necessary.
V. Presenter and Presentation Information
All presenters must submit Form CMS-20017 (revised 01/07).
Hardcopies are required for oral presentations; however, electronic
submissions of Form CMS-20017 are optional. The DFO must receive the
following information from those wishing to make oral presentations:
Form CMS-20017 completed with all pertinent information
identified on the first page of the presentation.
One hardcopy of presentation.
Electronic copy of presentation.
Personal registration information as described in the
Meeting Attendance section below.
Those persons wishing to submit comments only must send
hardcopy and electronic versions of their comments, but they are not
required to submit Form CMS-20017.
VI. Oral Comments
In addition to formal oral presentations, there will be opportunity
during the meeting for public oral comments, which will be limited to 1
minute for each individual and a total of 3 minutes per organization.
VII. Meeting Attendance
The meeting is open to the public; however, attendance is limited
to space available. Attendance will be determined on a first-come,
first-served basis.
Persons wishing to attend this meeting, which is located on Federal
property, must e-mail the Panel DFO to register in advance no later
than 5 p.m. (e.s.t.), Wednesday, August 29, 2007. A confirmation will
be sent to the requester(s) via return e-mail.
The following personal information must be e-mailed to the DFO by
the date and time above:
Name(s) of attendee(s),
Title(s),
Organization,
E-mail address(es), and
Telephone number(s).
VIII. Security, Building, and Parking Guidelines
The following are the security, building, and parking guidelines:
Persons attending the meeting--including presenters--must
be registered and on the attendance list by the prescribed date.
Individuals who are not registered in advance will not be
permitted to enter the building and will be unable to attend the
meeting.
Attendees must present photographic identification to the
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Federal Protective Service or Guard Service personnel before entering
the building.
Security measures include inspection of vehicles, inside
and out, at the entrance to the grounds.
In addition, all persons entering the building must pass
through a metal detector.
All items brought into CMS--including personal items such
as desktops, cell phones, palm pilots, etc.--are subject to physical
inspection.
The public may enter the building 30-45 minutes before the
meeting convenes each day.
All visitors must be escorted in areas other than the
lower and first-floor levels in the Central Building.
The main-entrance guards will issue parking permits and
instructions upon arrival at the building.
IX. Special Accommodations
Individuals requiring sign-language interpretation or other special
accommodations must send a request for these services to the DFO by 5
p.m. (e.s.t.), Wednesday, August 29, 2007.
Authority: Section 1833(t)(9) of the Act (42 U.S.C. 13951(t)).
The Panel is governed by the provisions of Pub. L. 92-463, as
amended (5 U.S.C. Appendix 2).
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare-Hospital Insurance; and Program No. 93.774, Medicare-
Supplementary Medical Insurance Program)
Dated: May 1, 2007.
Leslie V. Norwalk,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E7-9521 Filed 5-24-07; 8:45 am]
BILLING CODE 4120-01-P