Medicare Program; Changes to the Medicare Claims Appeal Procedures; Continuation of Effectiveness and Extension of Timeline for Publication of Final Rule, 11043 [E8-3861]
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Federal Register / Vol. 73, No. 41 / Friday, February 29, 2008 / Rules and Regulations
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 401 and 405
[CMS–4064–RCN]
RIN 0938–AM73
Medicare Program; Changes to the
Medicare Claims Appeal Procedures;
Continuation of Effectiveness and
Extension of Timeline for Publication
of Final Rule
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Interim final rule; continuation
of effectiveness and extension of
timeline for publication of final rule.
AGENCY:
rfrederick on PROD1PC67 with RULES
SUMMARY: This notice announces the
continuation of effectiveness of a
Medicare interim final and the
extension of the timeline for publication
of the final rule. This notice is issued in
accordance with section 1871(a)(3)(C) of
the Social Security Act (the Act), which
allows an interim final rule to remain in
effect after the expiration of the timeline
specified in section 1871(a)(3)(B) of the
Act if prior to the expiration of the
timeline, the Secretary publishes in the
Federal Register a notice of
continuation and explains the
exceptional circumstances justifying the
extension of the timeline for publishing
a final rule.
DATES: Effective Date: February 29,
2008.
FOR FURTHER INFORMATION CONTACT:
David Danek, (617) 565–2682, or Arrah
Tabe-Bedward, (410) 786–7129.
SUPPLEMENTARY INFORMATION:
I. Background
Section 1871(a)(3)(A) of the Social
Security Act (the Act) requires the
Secretary, in consultation with the
Director of the Office of Management
and Budget (OMB), to establish and
publish a regular timeline for the
publication of a final rule based on the
previous publication of a proposed rule
or an interim final rule. In accordance
with section 1871(a)(3)(B) of the Act,
such regular timeline may vary among
different regulations, based on the
complexity of the rule, the number and
scope of the comments received, and
other relevant factors. The timeline for
publishing the final regulation;
however, cannot exceed 3 years from
the date of publication of the proposed
or interim final rule, unless there are
exceptional circumstances. After
consultation with the Director of OMB,
VerDate Aug<31>2005
15:40 Feb 28, 2008
Jkt 214001
we published a notice in the Federal
Register on December 30, 2004 (69 FR
78442) establishing a general 3-year
timeline for finalizing a Medicare
proposed and an interim final rule.
Section 1871(a)(3)(C) of the Act states
that a Medicare interim final rule shall
not continue in effect if the final rule is
not published before the expiration of
the regular timeline, unless the
Secretary publishes at the end of the
regular timeline a notice of continuation
that includes an explanation of why the
regular timeline was not met. Upon
publication of such a notice, the
timeline for publishing the final rule is
extended for 1 year.
II. Notice of Continuation
Section 521 of the Medicare,
Medicaid, and State Children’s Health
Insurance Program (SCHIP) Benefits
Improvement and Protection Act of
2000 (BIPA), amended section 1869 of
the Act to provide for significant
changes to the Medicare claims appeal
procedures. On November 15, 2002, we
published in the Federal Register a
proposed rule (67 FR 69312) consistent
with Section 521 of BIPA. An interim
final rule with comment implementing
the BIPA provisions as well as further
changes to the claim appeals procedures
enacted in Title IX of the Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA)
appeared in the Federal Register in
March 2005 (70 FR 11420). Under the
previously established regular timeline
for publication of a final rule, we must
publish a final rule responding to public
comments on the interim final rule with
comment period no later than March 1,
2008.
This notice announces an extension of
the timeline for publication of the final
rule and the continuation of
effectiveness of the interim final rule
with comment period. We are not able
to meet the 3-year timeline for
publication of the final rule due to the
complexity of the rule and the need to
ensure coordination with other
government agencies. Specifically, the
development of the final rule requires
collaboration among other HHS agencies
(that is, the Office of Medicare Hearings
and Appeals (OMHA), and the
Departmental Appeals Board (DAB), as
well as extensive involvement from the
HHS Office of the General Counsel).
Although OMHA was not in existence
when the interim final rule with
comment period was published, OMHA
is now a key component of the Medicare
claims appeal process. We note that
extensive coordination is needed to
ensure that there is a mutual
understanding of these provisions
PO 00000
Frm 00073
Fmt 4700
Sfmt 4700
11043
among all three affected administrative
agencies. In addition, the development
of the final rule requires significant
coordination with other HHS policy
related regulations (that is, the Provider
Reimbursement Determinations and
Appeals final rule and the Medicare
Prescription Drug Appeals Process
proposed rule (Part D proposed rule,))
which are currently under development.
We believe that an extension of the
publication timeline is necessary and
appropriate to ensure that we are able to
address all of the issues raised in
response to the interim final.
Therefore, this notice extends the
timeline for publication of the final rule
until March 1, 2009. In accordance with
section 1871(a)(3)(C) of the Act, interim
final rule shall remain in effect through
March 1, 2009 (unless the final rule is
published and becomes effective before
March 1, 2009).
(Catalog of Federal Domestic Assistance
Program No. 93.773 Medicare—Hospital
Insurance Program; and No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: February 25, 2008.
Ann Agnew,
Executive Secretary to the Department.
[FR Doc. E8–3861 Filed 2–28–08; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Part 488
[CMS–2278–IFC4]
RIN 0938–AP22
Revisit User Fee Program for Medicare
Survey and Certification Activities
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Interim final rule with comment
period.
AGENCY:
SUMMARY: This interim final rule with
comment period implements the
continuation of the revisit user fee
program for Medicare Survey and
Certification activities, in accordance
with the statutory authority in the
Continuing Appropriations Resolution
entitled, ‘‘Making further continuing
appropriations for the fiscal year 2008,
and for all other purposes,’’ Public Law
110–149 (‘‘Continuing Resolution’’)
signed into law on December 21, 2007.
On September 19, 2007, we published a
final rule that established a system of
revisit user fees applicable to health
E:\FR\FM\29FER1.SGM
29FER1
]]>Agencies
[Federal Register Volume 73, Number 41 (Friday, February 29, 2008)]
[Rules and Regulations]
[Page 11043]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-3861]
[[Page 11043]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 401 and 405
[CMS-4064-RCN]
RIN 0938-AM73
Medicare Program; Changes to the Medicare Claims Appeal
Procedures; Continuation of Effectiveness and Extension of Timeline for
Publication of Final Rule
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Interim final rule; continuation of effectiveness and extension
of timeline for publication of final rule.
-----------------------------------------------------------------------
SUMMARY: This notice announces the continuation of effectiveness of a
Medicare interim final and the extension of the timeline for
publication of the final rule. This notice is issued in accordance with
section 1871(a)(3)(C) of the Social Security Act (the Act), which
allows an interim final rule to remain in effect after the expiration
of the timeline specified in section 1871(a)(3)(B) of the Act if prior
to the expiration of the timeline, the Secretary publishes in the
Federal Register a notice of continuation and explains the exceptional
circumstances justifying the extension of the timeline for publishing a
final rule.
DATES: Effective Date: February 29, 2008.
FOR FURTHER INFORMATION CONTACT: David Danek, (617) 565-2682, or Arrah
Tabe-Bedward, (410) 786-7129.
SUPPLEMENTARY INFORMATION:
I. Background
Section 1871(a)(3)(A) of the Social Security Act (the Act) requires
the Secretary, in consultation with the Director of the Office of
Management and Budget (OMB), to establish and publish a regular
timeline for the publication of a final rule based on the previous
publication of a proposed rule or an interim final rule. In accordance
with section 1871(a)(3)(B) of the Act, such regular timeline may vary
among different regulations, based on the complexity of the rule, the
number and scope of the comments received, and other relevant factors.
The timeline for publishing the final regulation; however, cannot
exceed 3 years from the date of publication of the proposed or interim
final rule, unless there are exceptional circumstances. After
consultation with the Director of OMB, we published a notice in the
Federal Register on December 30, 2004 (69 FR 78442) establishing a
general 3-year timeline for finalizing a Medicare proposed and an
interim final rule.
Section 1871(a)(3)(C) of the Act states that a Medicare interim
final rule shall not continue in effect if the final rule is not
published before the expiration of the regular timeline, unless the
Secretary publishes at the end of the regular timeline a notice of
continuation that includes an explanation of why the regular timeline
was not met. Upon publication of such a notice, the timeline for
publishing the final rule is extended for 1 year.
II. Notice of Continuation
Section 521 of the Medicare, Medicaid, and State Children's Health
Insurance Program (SCHIP) Benefits Improvement and Protection Act of
2000 (BIPA), amended section 1869 of the Act to provide for significant
changes to the Medicare claims appeal procedures. On November 15, 2002,
we published in the Federal Register a proposed rule (67 FR 69312)
consistent with Section 521 of BIPA. An interim final rule with comment
implementing the BIPA provisions as well as further changes to the
claim appeals procedures enacted in Title IX of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
appeared in the Federal Register in March 2005 (70 FR 11420). Under the
previously established regular timeline for publication of a final
rule, we must publish a final rule responding to public comments on the
interim final rule with comment period no later than March 1, 2008.
This notice announces an extension of the timeline for publication
of the final rule and the continuation of effectiveness of the interim
final rule with comment period. We are not able to meet the 3-year
timeline for publication of the final rule due to the complexity of the
rule and the need to ensure coordination with other government
agencies. Specifically, the development of the final rule requires
collaboration among other HHS agencies (that is, the Office of Medicare
Hearings and Appeals (OMHA), and the Departmental Appeals Board (DAB),
as well as extensive involvement from the HHS Office of the General
Counsel). Although OMHA was not in existence when the interim final
rule with comment period was published, OMHA is now a key component of
the Medicare claims appeal process. We note that extensive coordination
is needed to ensure that there is a mutual understanding of these
provisions among all three affected administrative agencies. In
addition, the development of the final rule requires significant
coordination with other HHS policy related regulations (that is, the
Provider Reimbursement Determinations and Appeals final rule and the
Medicare Prescription Drug Appeals Process proposed rule (Part D
proposed rule,)) which are currently under development.
We believe that an extension of the publication timeline is
necessary and appropriate to ensure that we are able to address all of
the issues raised in response to the interim final.
Therefore, this notice extends the timeline for publication of the
final rule until March 1, 2009. In accordance with section
1871(a)(3)(C) of the Act, interim final rule shall remain in effect
through March 1, 2009 (unless the final rule is published and becomes
effective before March 1, 2009).
(Catalog of Federal Domestic Assistance Program No. 93.773
Medicare--Hospital Insurance Program; and No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: February 25, 2008.
Ann Agnew,
Executive Secretary to the Department.
[FR Doc. E8-3861 Filed 2-28-08; 8:45 am]
BILLING CODE 4120-01-P
