Medicare and Medicaid Programs; Hospice Conditions of Participation Extension of Timeline for Publication of Final Rule, 30355-30356 [E8-11801]

Download as PDF Federal Register / Vol. 73, No. 102 / Tuesday, May 27, 2008 / Proposed Rules 40 CFR Parts 52 and 60 [EPA–R08–OAR–2007–0617; FRL–8570–3] Clean Air Act Approval and Promulgation of Air Quality Implementation Plan Revision for North Dakota; Revisions to the Air Pollution Control Rules and Alternative Monitoring Plan for Mandan Refinery; Delegation of Authority for New Source Performance Standards Environmental Protection Agency (EPA). ACTION: Proposed rule and delegation of authority. mstockstill on PROD1PC66 with PROPOSALS AGENCY: SUMMARY: EPA is proposing to approve revisions to the State Implementation Plan (SIP) as submitted by the Governor of North Dakota with a letter dated March 8, 2007. The revisions affect certain air pollution control rules regarding general provisions, open burning restrictions, permitting, and fugitive emissions. In addition, EPA is proposing to take direct final action approving a revision to a chapter of the SIP regarding an alternative monitoring plan for the Tesoro Mandan Refinery. EPA is also providing notice that on August 22, 2007, North Dakota was delegated authority to implement and enforce certain New Source Performance Standards, as in effect on January 31, 2006. In the ‘‘Rules and Regulations’’ section of this Federal Register, EPA is approving the State’s SIP revision as a direct final rule without prior proposal because the Agency views this as a noncontroversial SIP revision and anticipates no adverse comments. A detailed rationale for the approval is set forth in the preamble to the direct final rule. If EPA receives no adverse comments, EPA will not take further action on this proposed rule. If EPA receives adverse comments, EPA will withdraw the direct final rule and it will not take effect. EPA will address all public comments in a subsequent final rule based on this proposed rule. EPA will not institute a second comment period on this action. Any parties interested in commenting must do so at this time. Please note that if EPA receives adverse comment on an amendment, paragraph, or section of this rule and if that provision may be severed from the remainder of the rule, EPA may adopt as final those provisions of the rule that are not the subject of an adverse comment. DATES: Written comments must be received on or before June 26, 2008. VerDate Aug<31>2005 17:40 May 23, 2008 Jkt 214001 Submit your comments, identified by DOCKET ID No. EPA– R08–OAR–2007–0617, by one of the following methods: • http://www.regulations.gov. Follow the on-line instructions for submitting comments. • E-mail: Platt.Amy@epa.gov. • Fax: (303) 312–6064 (please alert the individual listed in the FOR FURTHER INFORMATION CONTACT if you are faxing comments). • Mail: Callie Videtich, Director, Air Program, Environmental Protection Agency (EPA), Region 8, Mailcode 8P– AR, 1595 Wynkoop Street, Denver, Colorado 80202–1129. • Hand Delivery: Director, Air Program, EPA Region 8, Mailcode 8P– AR, 1595 Wynkoop Street, Denver, Colorado 80202–1129. Such deliveries are only accepted Monday through Friday, 8 a.m. to 4:30 p.m., excluding Federal holidays. Special arrangements should be made for deliveries of boxed information. Please see the direct final rule which is located in the Rules Section of this Federal Register for detailed instructions on how to submit comments. ADDRESSES: ENVIRONMENTAL PROTECTION AGENCY FOR FURTHER INFORMATION CONTACT: Amy Platt, Environmental Protection Agency, Region 8, 1595 Wynkoop Street, Denver, CO 80202–1129, (303) 312–6449, Platt.Amy@epa.gov. SUPPLEMENTARY INFORMATION: See the information provided in the Direct Final action of the same title which is located in the Rules and Regulations Section of this Federal Register. Authority: 42 U.S.C. 7401 et seq. Dated: May 7, 2008. Carol Rushin, Acting Regional Administrator, Region 8. [FR Doc. E8–11476 Filed 5–23–08; 8:45 am] BILLING CODE 6560–50–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 418 [CMS–3844–RCN] RIN 0938–AH27 Medicare and Medicaid Programs; Hospice Conditions of Participation Extension of Timeline for Publication of Final Rule Centers for Medicare & Medicaid Services (CMS), HHS. AGENCY: PO 00000 Frm 00035 Fmt 4702 Sfmt 4702 30355 Extension of timeline for publication of final rule. ACTION: SUMMARY: This notice announces an extension of the timeline for publication of the ‘‘Medicare and Medicaid Programs; Hospice Conditions of Participation’’ final rule. This notice is issued in accordance with section 1871(a)(3)(B) of the Social Security Act (the Act) which requires notice be provided in the Federal Register if a final regulation, due to exceptional circumstances, will take longer to publish than 3 years after the publication date of the proposed rule. In this case, the complexity of the rule and scope of comments warrants the extension of the timeline for publication. Effective Date: This notice is effective on May 27, 2008. FOR FURTHER INFORMATION CONTACT: Mary Rossi-Coajou, (410) 786–6051, or Danielle Shearer, (410) 786–6617. SUPPLEMENTARY INFORMATION: DATES: I. Background On May 27, 2005, we published in the Federal Register a proposed rule (70 FR 30840) that would establish new conditions of participation for Medicare-participating hospices. The proposed revisions would focus on the care delivered to patients and their families and the outcomes of that care by reflecting an interdisciplinary, patient-centered approach to care planning and delivery and allowing hospices flexibility in meeting quality standards. II. Notice of Continuation This notice announces an extension of the timeline for publication of a final rule responding to comments on the above proposed rule. Section 1871(a)(3)(B) of the Act requires the Secretary to publish final regulations no later than 3 years after the publication date of the proposed rule. To meet this 3-year timeframe, the final rule would have to be published by May 27, 2008. Section 1871(a)(3)(B) also provides that under ‘‘exceptional circumstances,’’ the Secretary may extend the initial targeted publication date of a final regulation. The Secretary is required, prior to the regulation’s previously established proposed publication date, to provide public notice of this extension in the Federal Register, including a brief explanation of the justification for the variation. This notice extends the timeline based on the following exceptional circumstances, which we believe, justify such an extension. We are not able to E:\FR\FM\27MYP1.SGM 27MYP1 30356 Federal Register / Vol. 73, No. 102 / Tuesday, May 27, 2008 / Proposed Rules meet the 3-year timeline for publication of the final rule due to the complexity of the rule and the large number of public comments we received. We received a large volume of timely comments on the proposed rule. The commenters presented extremely complex and detailed policy and legal issues, which require extensive consultation, review, and analysis. Also, the development of the final rule requires collaboration among other agencies under the Department of Health and Human Services (DHHS). We note that extensive coordination has been needed to ensure that these provisions follow guidelines and rules of all affected administrative agencies. In addition, this final rule is extremely comprehensive because it updates and revises policies, some of which were originally established in 1983, regarding patient assessment, patient care planning and delivery, quality assessment and performance improvement, drug and biologicals management, inpatient care facilities, and the role of hospice care in long term care facilities. Therefore, the incorporation of these updates has required extensive time, outreach, and collaboration to ensure that the final rule’s provisions are consistent with current best practices in the provision of hospice services. We believe that an extension of the publication timeline is necessary and appropriate to ensure that we are able to address all of the comments and issues raised in response to the May 27, 2005 proposed rule. Therefore, this notice extends the timeline for publication of the final rule until May 27, 2009. Authority: Section 1871 of the Social Security Act (42 U.S.C. 1395hh). (Catalog of Federal Domestic Assistance Program No. 93.773 Medicare—Hospital Insurance Program; and No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: May 21, 2008. Ann Agnew, Executive Secretary to the Department. [FR Doc. E8–11801 Filed 5–23–08; 8:45 am] mstockstill on PROD1PC66 with PROPOSALS BILLING CODE 4120–01–P VerDate Aug<31>2005 17:40 May 23, 2008 Jkt 214001 DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency 44 CFR Part 67 [Docket No. FEMA–B–7783] Proposed Flood Elevation Determinations Federal Emergency Management Agency, DHS. ACTION: Proposed rule. AGENCY: SUMMARY: Comments are requested on the proposed Base (1 percent annualchance) Flood Elevations (BFEs) and proposed BFE modifications for the communities listed in the table below. The purpose of this notice is to seek general information and comment regarding the proposed regulatory flood elevations for the reach described by the downstream and upstream locations in the table below. The BFEs and modified BFEs are a part of the floodplain management measures that the community is required either to adopt or show evidence of having in effect in order to qualify or remain qualified for participation in the National Flood Insurance Program (NFIP). In addition, these elevations, once finalized, will be used by insurance agents, and others to calculate appropriate flood insurance premium rates for new buildings and the contents in those buildings. DATES: Comments are to be submitted on or before August 25, 2008. ADDRESSES: The corresponding preliminary Flood Insurance Rate Map (FIRM) for the proposed BFEs for each community are available for inspection at the community’s map repository. The respective addresses are listed in the table below. You may submit comments, identified by Docket No. FEMA–B–7783, to William R. Blanton, Jr., Chief, Engineering Management Branch, Mitigation Directorate, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472, (202) 646–3151, or (e-mail) bill.blanton@dhs.gov. FOR FURTHER INFORMATION CONTACT: William R. Blanton, Jr., Chief, Engineering Management Branch, Mitigation Directorate, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472, (202) 646–3151 or (e-mail) bill.blanton@dhs.gov. SUPPLEMENTARY INFORMATION: The Federal Emergency Management Agency (FEMA) proposes to make PO 00000 Frm 00036 Fmt 4702 Sfmt 4702 determinations of BFEs and modified BFEs for each community listed below, in accordance with section 110 of the Flood Disaster Protection Act of 1973, 42 U.S.C. 4104, and 44 CFR 67.4(a). These proposed BFEs and modified BFEs, together with the floodplain management criteria required by 44 CFR 60.3, are the minimum that are required. They should not be construed to mean that the community must change any existing ordinances that are more stringent in their floodplain management requirements. The community may at any time enact stricter requirements of its own, or pursuant to policies established by other Federal, State, or regional entities. These proposed elevations are used to meet the floodplain management requirements of the NFIP and are also used to calculate the appropriate flood insurance premium rates for new buildings built after these elevations are made final, and for the contents in these buildings. Comments on any aspect of the Flood Insurance Study and FIRM, other than the proposed BFEs, will be considered. A letter acknowledging receipt of any comments will not be sent. Administrative Procedure Act Statement. This matter is not a rulemaking governed by the Administrative Procedure Act (APA), 5 U.S.C. 553. FEMA publishes flood elevation determinations for notice and comment; however, they are governed by the Flood Disaster Protection Act of 1973, 42 U.S.C. 4105, and the National Flood Insurance Act of 1968, 42 U.S.C. 4001 et seq., and do not fall under the APA. National Environmental Policy Act. This proposed rule is categorically excluded from the requirements of 44 CFR part 10, Environmental Consideration. An environmental impact assessment has not been prepared. Regulatory Flexibility Act. As flood elevation determinations are not within the scope of the Regulatory Flexibility Act, 5 U.S.C. 601–612, a regulatory flexibility analysis is not required. Executive Order 12866, Regulatory Planning and Review. This proposed rule is not a significant regulatory action under the criteria of section 3(f) of Executive Order 12866, as amended. Executive Order 13132, Federalism. This proposed rule involves no policies that have federalism implications under Executive Order 13132. Executive Order 12988, Civil Justice Reform. This proposed rule meets the applicable standards of Executive Order 12988. E:\FR\FM\27MYP1.SGM 27MYP1

Agencies

[Federal Register Volume 73, Number 102 (Tuesday, May 27, 2008)]
[Proposed Rules]
[Pages 30355-30356]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-11801]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 418

[CMS-3844-RCN]
RIN 0938-AH27


Medicare and Medicaid Programs; Hospice Conditions of 
Participation Extension of Timeline for Publication of Final Rule

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Extension of timeline for publication of final rule.

-----------------------------------------------------------------------

SUMMARY: This notice announces an extension of the timeline for 
publication of the ``Medicare and Medicaid Programs; Hospice Conditions 
of Participation'' final rule. This notice is issued in accordance with 
section 1871(a)(3)(B) of the Social Security Act (the Act) which 
requires notice be provided in the Federal Register if a final 
regulation, due to exceptional circumstances, will take longer to 
publish than 3 years after the publication date of the proposed rule. 
In this case, the complexity of the rule and scope of comments warrants 
the extension of the timeline for publication.

DATES: Effective Date: This notice is effective on May 27, 2008.

FOR FURTHER INFORMATION CONTACT: Mary Rossi-Coajou, (410) 786-6051, or 
Danielle Shearer, (410) 786-6617.

SUPPLEMENTARY INFORMATION: 

I. Background

    On May 27, 2005, we published in the Federal Register a proposed 
rule (70 FR 30840) that would establish new conditions of participation 
for Medicare-participating hospices. The proposed revisions would focus 
on the care delivered to patients and their families and the outcomes 
of that care by reflecting an interdisciplinary, patient-centered 
approach to care planning and delivery and allowing hospices 
flexibility in meeting quality standards.

II. Notice of Continuation

    This notice announces an extension of the timeline for publication 
of a final rule responding to comments on the above proposed rule. 
Section 1871(a)(3)(B) of the Act requires the Secretary to publish 
final regulations no later than 3 years after the publication date of 
the proposed rule. To meet this 3-year timeframe, the final rule would 
have to be published by May 27, 2008.
    Section 1871(a)(3)(B) also provides that under ``exceptional 
circumstances,'' the Secretary may extend the initial targeted 
publication date of a final regulation. The Secretary is required, 
prior to the regulation's previously established proposed publication 
date, to provide public notice of this extension in the Federal 
Register, including a brief explanation of the justification for the 
variation.
    This notice extends the timeline based on the following exceptional 
circumstances, which we believe, justify such an extension. We are not 
able to

[[Page 30356]]

meet the 3-year timeline for publication of the final rule due to the 
complexity of the rule and the large number of public comments we 
received.
    We received a large volume of timely comments on the proposed rule. 
The commenters presented extremely complex and detailed policy and 
legal issues, which require extensive consultation, review, and 
analysis. Also, the development of the final rule requires 
collaboration among other agencies under the Department of Health and 
Human Services (DHHS). We note that extensive coordination has been 
needed to ensure that these provisions follow guidelines and rules of 
all affected administrative agencies.
    In addition, this final rule is extremely comprehensive because it 
updates and revises policies, some of which were originally established 
in 1983, regarding patient assessment, patient care planning and 
delivery, quality assessment and performance improvement, drug and 
biologicals management, inpatient care facilities, and the role of 
hospice care in long term care facilities. Therefore, the incorporation 
of these updates has required extensive time, outreach, and 
collaboration to ensure that the final rule's provisions are consistent 
with current best practices in the provision of hospice services.
    We believe that an extension of the publication timeline is 
necessary and appropriate to ensure that we are able to address all of 
the comments and issues raised in response to the May 27, 2005 proposed 
rule. Therefore, this notice extends the timeline for publication of 
the final rule until May 27, 2009.

    Authority: Section 1871 of the Social Security Act (42 U.S.C. 
1395hh).

(Catalog of Federal Domestic Assistance Program No. 93.773 
Medicare--Hospital Insurance Program; and No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: May 21, 2008.
Ann Agnew,
Executive Secretary to the Department.
[FR Doc. E8-11801 Filed 5-23-08; 8:45 am]
BILLING CODE 4120-01-P