Medicare Program; First Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment Classification Groups-February 17-19, 2010, 67234-67237 [E9-30123]
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sroberts on DSKD5P82C1PROD with NOTICES
67234
Federal Register / Vol. 74, No. 242 / Friday, December 18, 2009 / Notices
interstate compact on Medicaid and
CHIP for children, States can more
readily recognize each other’s eligibility
determinations and reimburse out-ofstate providers. As a result, they can
provide more seamless Medicaid and
CHIP coverage to low-income children.
States currently participate in a variety
of interstate compacts including one
pertaining to Federal adoption
assistance/Medicaid recipients entitled
the ‘‘Interstate Compact on Adoption
and Medical Assistance’’ (ICAMA).
Further information related to ICAMA
can be viewed at: https://
www.aaicama.org/cms/.
(2) Demonstration Projects. Section
1115(a) of the Social Security Act (the
Act) provides the Secretary of Health
and Human Services with the authority
to authorize experimental, pilot, or
demonstration projects which, in the
judgment of the Secretary, are likely to
assist in promoting the objectives of the
Medicaid statute. States can request
section 1115 authority to create a
standard set of benefits or eligibility
coverage across States that differ from
the set of benefits provided under the
State plan in each of those States or to
expand coverage to groups of
individuals, including parents and
caretaker relatives, or to provide greater
flexibility in their programs. Budget
neutrality is required for title XIX
programs approved under section 1115
authority under the policies of the
Office of Management and Budget. A
recent example of how CMS used
section 1115 authority was in 2005, in
response to the devastation caused by
Hurricane Katrina on the health care
system of the Gulf coast of Louisiana
and Mississippi; the Secretary was
granted the authority to approve section
1115 demonstration waivers that
granted States time-limited waiver
authority to facilitate expedited
enrollment into Medicaid and CHIP
programs for survivors of Hurricane
Katrina who needed to access healthcare
services in locations other than their
home States. Under Hurricane Katrina
demonstrations, we granted timelimited waiver authorities to States for
the following:
• Simplified eligibility criteria for
Medicaid and CHIP eligible groups.
• Comparability/amount, duration,
and scope of benefit packages.
• Simplified eligibility determination
processes in order to permit evacuees to
access needed health care services in
their host State.
(3) State Activities under Current
Law’s Flexibility. States may explore
current flexibility under State plan
authority to improve the continuity of
coverage for Medicaid and CHIP eligible
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children. Some of the flexibility offered
under the State plan authority may be
designed to improve service delivery
coordination; enhance enrollment and
portability arrangements; and enhance
Medicaid and CHIP managed care
coordination at the State and health
plan levels to facilitate enrollment and
portability. Under this model for
example, a State may choose to align/
standardize their eligibility and
enrollment processes with a neighboring
State in order to improve coordination
of Medicaid and CHIP coverage for
children.
(4) Public-Private Partnerships. States
may engage in public-private
partnerships in order to research or pilot
initiatives that improve the portability
of Medicaid and CHIP coverage for lowincome children.
(5) National Children’s Health
Coverage Option. This model would
develop a national health insurance
plan for children with a minimum
benefit plan to be offered by every State.
Under this option, certain statutory
changes would be required related to
the definition of residency and
eligibility criteria for children,
specifically a minimum national
coverage for all children under age 21
years and a change in the income
standard to a specified minimum level
for all children. State residency could be
defined to make it easier to cover
children in the State where they are
living, even if they do not intend to
remain there permanently or for an
indefinite period.
C. Request for Comments
We request public comments on the
proposed models to include the
following:
(1) Advantages (benefits) and/or
disadvantages (negatives) related to each
of the proposed models.
(2) Best practices States may currently
have in place to ensure interstate
continuity and coordination of
enrollment for Medicaid and CHIP
children.
(3) Recommendations for new models
that will facilitate coordination of
enrollment, retention, and coverage for
Medicaid and CHIP children.
(4) Additional comments related to
programmatic operations and/or
statutory changes that may be required
in order to create the model process.
D. Use of Public Comments
We will review the public comments
and consider the information received
in the development of the model
process for the coordination of
enrollment, retention, and coverage for
Medicaid and CHIP children who
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frequently move from their State of
residence.
II. Provisions of the Notice With
Comment
The purpose of this notice is to
provide the opportunity for public
input/consultation in developing a
model process for the coordination of
enrollment, retention and coverage for
Medicaid and CHIP eligible children
who, because of migration of families,
emergency evacuations, natural or other
disasters, public health emergencies,
educational needs, or otherwise,
frequently change their State of
residency or otherwise are temporarily
located outside the State of their
residency.
III. Response to Comments
Because of the large number of public
comments we normally receive on
Federal Register documents, we are not
able to acknowledge or respond to them
individually. We will consider all
comments we receive by the date and
time specified in the DATES section of
this preamble, and, when we proceed
with a subsequent document, we will
respond to the comments in the
preamble to that document.
In accordance with the provisions of
Executive Order 12866, this notice was
not reviewed by the Office of
Management and Budget.
Authority: Section 1115 of the Social
Security Act.
(Catalog of Federal Domestic Assistance
Program No. 93.778, Medical Assistance
Program)
Dated: November 2, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. E9–29724 Filed 12–17–09; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1416–N]
Medicare Program; First Semi-Annual
Meeting of the Advisory Panel on
Ambulatory Payment Classification
Groups—February 17–19, 2010
AGENCY: Centers for Medicare &
Medicaid Services, Department of
Health and Human Services.
ACTION: Notice.
SUMMARY: This notice announces the
first semi-annual meeting of the
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Federal Register / Vol. 74, No. 242 / Friday, December 18, 2009 / Notices
Advisory Panel on Ambulatory Payment
Classification (APC) Groups (the Panel)
for 2010. 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 proposed and
final rules that would update the
hospital Outpatient Prospective
Payment System (OPPS) for CY 2011.
DATES: Meeting Dates: We are
scheduling the first semi-annual
meeting in 2010 for the following dates
and times:
• Wednesday, February 17, 2010, 1
p.m. to 5 p.m. eastern standard time
(e.s.t.) 1
• Thursday, February 18, 2010, 8 a.m.
to 5 p.m. (e.s.t.) 1
• Friday, February 19, 2010, 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, February 18, 2010, there will be no
meeting on Friday, February 19, 2010.
Deadlines:
Deadline for Hardcopy Comments/
Suggested Agenda Topics—5 p.m.
(e.s.t.), Monday, January 13, 2010.
Deadline for Hardcopy
Presentations—5 p.m. (e.s.t.), Monday,
January 13, 2010.
Deadline for Attendance
Registration—5 p.m. (e.s.t.), Wednesday,
February 10, 2010.
Deadline for Special
Accommodations—5 p.m. (e.s.t.),
Wednesday, February 10, 2010.
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Submission of Materials to the
Designated Federal Official
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.
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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.
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.
• Do not send pictures of patients in
any of the documents unless their faces
have been blocked out.
• Do not send documents
electronically that have been archived.
• Mail (or send by courier) to the
Designated Federal Official (DFO) all
hardcopies, accompanied by Form
CMS–20017 (revised 01/07), if they are
presenting, as specified in the FOR
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: We recommend that you advise
couriers of the following information: When
delivering hardcopies of presentations to
CMS, if no one answers at the above phone
number, please call (410) 786–4532 or (410)
786–9316.
The 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.
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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: The following information
is available on the CMS Web site at
https://www.cms.hhs.gov/FACA/05_
AdvisoryPanelonAmbulatoryPayment
ClassificationGroups.asp#TopOfPage.
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
• 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) to consult with an expert,
outside advisory panel on the clinical
integrity of the APC groups and weights
established under the Medicare 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. The Secretary or Administrator
selects the Panel membership based
upon either self-nominations or
nominations submitted by Medicare
providers and other interested
organizations.
All members must have technical
expertise to enable them to participate
fully in the Panel’s work. Such expertise
encompasses hospital payment systems;
hospital medical care delivery systems;
provider billing systems; APC groups;
Current Procedural Terminology codes;
and alpha-numeric Health Care
Common Procedure Coding System
codes; and the use of, and payment for,
drugs, medical devices, and other
services in the outpatient setting, as
well as other forms of relevant expertise.
Details regarding membership
requirements for the APC Panel are
found on the FACA and CMS Web sites
as listed above.
The Panel presently consists of the
following members:
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• E. L. Hambrick, M.D., J.D., Chair,
CMS Medical Officer.
• Ruth L. Bush, M.D., M.P.H.
• Dawn L. Francis, M.D., M.H.S.
• Patrick A. Grusenmeyer, Sc.D.,
F.A.C.H.E.
• Kathleen Graham, R.N., M.S.H.A.,
C.P.H.Q., A.C.M.
• David Halsey, M.D.
• Judith T. Kelly, B.S.H.A., R.H.I.T.,
R.H.I.A., C.C.S.
• Michael D. Mills, Ph.D.
• Thomas M. Munger, M.D., F.A.C.C.
• Agatha L. Nolen, D.Ph., M.S.,
F.A.S.H.P.
• Randall A. Oyer, M.D.
• Beverly Khnie Philip, M.D.
• Daniel Pothen, M.S., R.H.I.A.,
C.P.H.I.M.S., C.C.S.-P, C.H.C.
• Russ Ranallo, M.S., B.S.
• Michael A. Ross, M.D., F.A.C.E.P.
• Patricia Spencer-Cisek, M.S.,
A.P.R.N.-B.C., A.O.C.N.
II. Agenda
The agenda for the February 2010
meeting will provide for discussion and
comment on the following topics as
designated in the Panel’s Charter:
• Addressing whether procedures
within an APC group are similar both
clinically and in terms of resource use.
• Evaluating APC group weights.
• Reviewing the packaging of OPPS
services and costs, including the
methodology and the impact on APC
groups and payment.
• Removing procedures from the
inpatient list for payment under the
OPPS.
• Using single and multiple
procedure claims data for CMS’
determination of APC group weights.
• Addressing other technical issues
concerning APC group structure.
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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 the Department of Health and
Human Services (DHHS) and CMS, in
conducting its review. We recommend
organizations to submit data for the
Panel’s and CMS staff’s review.
III. Written Comments and Suggested
Agenda Topics
Hardcopy and electronic written
comments and suggested agenda topics
should be sent to the DFO as specified
in the ADDRESSES section of this notice.
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The DFO must receive these items by 5
p.m. (e.s.t.), Monday, January 13, 2010.
There will be no exceptions. We
appreciate your cooperation on this
matter.
The written comments and suggested
agenda topics submitted for the
February 2010 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.), Monday, January
13, 2010, 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. Collection of Information
Requirements
This document does not impose any
information collection and
recordkeeping requirements.
Consequently, it need not be reviewed
by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35).
VII. Oral Comments
In addition to formal oral
presentations, there will be opportunity
during the meeting for public oral
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comments, which will be limited to 1
minute for each individual and a total
of 3 minutes per organization.
VIII. 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 DFO to
register in advance no later than 5 p.m.
(e.s.t.), Wednesday, February 10, 2010.
A confirmation will be sent to the
requester(s) by 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).
• Telephone number(s).
IX. 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
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.
• All persons entering the building
must pass through a metal detector.
• All items brought into CMS
including personal items, such as
laptops, cell phones, and palm pilots,
are subject to physical inspection.
• The public may enter the building
30 to 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.
X. 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, February 10, 2010.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
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Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program).
Dated: December 11, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. E9–30123 Filed 12–17–09; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2009–N–0575]
Incorporation of New Science Into
Regulatory Decisionmaking Within the
Center for Devices and Radiological
Health; Public Meeting; Request for
Comments
AGENCY:
Food and Drug Administration,
HHS.
sroberts on DSKD5P82C1PROD with NOTICES
ACTION: Notice of public meeting;
request for comments.
The Food and Drug Administration
(FDA) is announcing a public meeting
entitled: ‘‘Incorporation of New Science
Into Regulatory Decisionmaking Within
the Center for Devices and Radiological
Health.’’ The purpose of the public
meeting is to identify strategies and
means for incorporating new science
into the regulatory decisionmaking
process within the agency’s Center for
Devices and Radiological Health
(CDRH). New science may include novel
technologies or novel uses of existing
technologies, evolving information and
knowledge, or new methods to support
decisionmaking. FDA is seeking input
on a number of specific questions
regarding how CDRH should anticipate
and respond to new or evolving
scientific knowledge in a manner that is
consistent with our mission to protect
and promote the public health, and
requests comments on this topic.
Dates and Time: The public workshop
will be held on February 9, 2010, from
8 a.m. to 5 p.m. Persons interested in
attending the meeting must register by
5 p.m. on February 3, 2010.
Location: The public meeting will be
held at the Hilton Washington DC
North/Gaithersburg, 620 Perry Pkwy.,
Gaithersburg, MD 20877.
Contact Person: Maggie Dietrich, Food
and Drug Administration, Center for
Devices and Radiological Health, 10903
New Hampshire Ave., Bldg. 66, rm.
5449, Silver Spring, MD 20993–0002,
301–796–5094, FAX: 301–847–8510, email: maggie.dietrich@fda.hhs.gov.
Registration: Register online at https://
www.fda.gov/MedicalDevices/News
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17:33 Dec 17, 2009
Jkt 220001
Events/WorkshopsConferences/
default.htm (select the appropriate
meeting from the list). Provide complete
contact information for each attendee,
including name, title, affiliation,
address, e-mail, and telephone number.
Registration requests should be received
by February 3, 2010. Registration is free
and will be on a first-come, first-served
basis. Early registration is recommended
because seating is limited. FDA may
limit the number of participants from
each organization based on space
limitations. Registrants will receive
confirmation once they have been
accepted. Onsite registration on the day
of the public meeting will be provided
on a space-available basis beginning at
7 a.m.
If you need special accommodations
due to a disability, please contact
Maggie Dietrich (see Contact Person) at
least 7 days in advance.
Comments: FDA is holding this public
meeting to obtain information on a
number of specific questions regarding
how CDRH should anticipate and
respond to new or evolving scientific
knowledge in a manner that is
consistent with FDA’s mission to
protect and promote the public health.
The deadline for submitting comments
regarding this public meeting is
February 24, 2010.
Regardless of attendance at the public
meeting, interested persons may submit
written or electronic comments. Submit
written comments to the Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, rm. 1061, Rockville, MD 20852.
Submit electronic comments to https://
www.regulations.gov. Submit a single
copy of electronic comments or two
paper copies of any mailed comments,
except that individuals may submit one
paper copy. Comments are to be
identified with the docket number
found in brackets in the heading of this
document. Please also indicate the
specific question(s) addressed. (See
section II of this document.) Received
comments may be seen in the Division
of Dockets Management between 9 a.m.
and 4 p.m., Monday through Friday.
SUPPLEMENTARY INFORMATION:
I. Background
FDA’s CDRH uses science to guide
our regulatory decisions, including
those related to premarket approval or
clearance, postmarket oversight, and
compliance.
CDRH faces unique challenges in that
the products we regulate are constantly
changing, either through incremental or
disruptive advances. Simultaneously,
our understanding of the products we
oversee is subject to change as we obtain
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67237
new scientific information or develop
new methods to assess existing data.
Given the ever-changing environment
in which we operate, CDRH’s regulatory
decisionmaking process must be able to
adapt as science evolves and as new
information emerges about the risks or
benefits of particular medical devices or
radiation-emitting electronic products.
For example, in some cases, new
information gathered about the riskbenefit profile of a device on the market
may justify requiring additional data on
similar types of devices during
premarket review, in order to provide
sufficient confidence in the product’s
safety and effectiveness. At the same
time, the center seeks to foster
innovation by providing industry with a
reasonable degree of predictability in
our regulatory pathways. Determining
the optimal way to anticipate and
respond to new science is an important
challenge, and the center seeks public
input on how to best address it.
CDRH has formed an internal Task
Force on Utilization of New Science in
Regulatory Decisionmaking to review
how the center uses science in our
regulatory decisionmaking process, and
to make recommendations for
enhancements. The principal goals of
the Task Force are: (1) To propose
systems that will allow CDRH to be
‘‘predictably adaptive’’ to new science;
and (2) to identify proactive steps that
CDRH can take to keep staff abreast of
new science and increase our technical
competence and analytic capability in
order to enhance our decisionmaking.
The notion of ‘‘predictable
adaptability’’ refers to having the
flexibility to appropriately respond to
changes in science, while doing so
through a reasonably consistent process.
Given that scientific knowledge is
continually changing, the model of
being ‘‘predictable’’ by always requiring
the same type and level of scientific
evidence to justify decisions will not
necessarily suffice. As the scientific
landscape changes, the kind of
information we need in order to make
well-supported decisions may change.
In the past, CDRH has sometimes
incorporated new science into our
regulatory decisionmaking on an ad hoc,
non-transparent basis. Such an
approach can result in inconsistent
regulatory expectations and less
predictable decisionmaking.
CDRH seeks to move toward a
different model of predictability:
Creating and adhering to clear
procedures for adapting to new science,
and applying a consistent rationale for
doing so in as timely and transparent a
manner as is appropriate and feasible. In
order to achieve this goal, the center
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Agencies
[Federal Register Volume 74, Number 242 (Friday, December 18, 2009)]
[Notices]
[Pages 67234-67237]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-30123]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1416-N]
Medicare Program; First Semi-Annual Meeting of the Advisory Panel
on Ambulatory Payment Classification Groups--February 17-19, 2010
AGENCY: Centers for Medicare & Medicaid Services, Department of Health
and Human Services.
ACTION: Notice.
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SUMMARY: This notice announces the first semi-annual meeting of the
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Advisory Panel on Ambulatory Payment Classification (APC) Groups (the
Panel) for 2010. 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 proposed and final rules that would update the hospital
Outpatient Prospective Payment System (OPPS) for CY 2011.
DATES: Meeting Dates: We are scheduling the first semi-annual meeting
in 2010 for the following dates and times:
Wednesday, February 17, 2010, 1 p.m. to 5 p.m. eastern
standard time (e.s.t.) \1\
Thursday, February 18, 2010, 8 a.m. to 5 p.m. (e.s.t.) \1\
Friday, February 19, 2010, 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, February
18, 2010, there will be no meeting on Friday, February 19, 2010.
Deadlines:
Deadline for Hardcopy Comments/Suggested Agenda Topics--5 p.m.
(e.s.t.), Monday, January 13, 2010.
Deadline for Hardcopy Presentations--5 p.m. (e.s.t.), Monday,
January 13, 2010.
Deadline for Attendance Registration--5 p.m. (e.s.t.), Wednesday,
February 10, 2010.
Deadline for Special Accommodations--5 p.m. (e.s.t.), Wednesday,
February 10, 2010.
Submission of Materials to the Designated Federal Official
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.
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.
Do not send pictures of patients in any of the documents
unless their faces have been blocked out.
Do not send documents electronically that have been
archived.
Mail (or send by courier) to the Designated Federal
Official (DFO) all hardcopies, accompanied by Form CMS-20017 (revised
01/07), if they are presenting, as specified in the FOR 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: We recommend that you advise couriers of the following
information: When delivering hardcopies of presentations to CMS, if
no one answers at the above phone number, please call (410) 786-4532
or (410) 786-9316.
The 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: The following information is available on the CMS Web
site at https://www.cms.hhs.gov/FACA/05_AdvisoryPanelonAmbulatoryPaymentClassificationGroups.asp#TopOfPage.
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
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) to consult with an expert, outside advisory
panel on the clinical integrity of the APC groups and weights
established under the Medicare 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. The Secretary or Administrator selects the Panel membership
based upon either self-nominations or nominations submitted by Medicare
providers and other interested organizations.
All members must have technical expertise to enable them to
participate fully in the Panel's work. Such expertise encompasses
hospital payment systems; hospital medical care delivery systems;
provider billing systems; APC groups; Current Procedural Terminology
codes; and alpha-numeric Health Care Common Procedure Coding System
codes; and the use of, and payment for, drugs, medical devices, and
other services in the outpatient setting, as well as other forms of
relevant expertise. Details regarding membership requirements for the
APC Panel are found on the FACA and CMS Web sites as listed above.
The Panel presently consists of the following members:
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E. L. Hambrick, M.D., J.D., Chair, CMS Medical Officer.
Ruth L. Bush, M.D., M.P.H.
Dawn L. Francis, M.D., M.H.S.
Patrick A. Grusenmeyer, Sc.D., F.A.C.H.E.
Kathleen Graham, R.N., M.S.H.A., C.P.H.Q., A.C.M.
David Halsey, M.D.
Judith T. Kelly, B.S.H.A., R.H.I.T., R.H.I.A., C.C.S.
Michael D. Mills, Ph.D.
Thomas M. Munger, M.D., F.A.C.C.
Agatha L. Nolen, D.Ph., M.S., F.A.S.H.P.
Randall A. Oyer, M.D.
Beverly Khnie Philip, M.D.
Daniel Pothen, M.S., R.H.I.A., C.P.H.I.M.S., C.C.S.-P,
C.H.C.
Russ Ranallo, M.S., B.S.
Michael A. Ross, M.D., F.A.C.E.P.
Patricia Spencer-Cisek, M.S., A.P.R.N.-B.C., A.O.C.N.
II. Agenda
The agenda for the February 2010 meeting will provide for
discussion and comment on the following topics as designated in the
Panel's Charter:
Addressing whether procedures within an APC group are
similar both clinically and in terms of resource use.
Evaluating APC group weights.
Reviewing the packaging of OPPS services and costs,
including the methodology and the impact on APC groups and payment.
Removing procedures from the inpatient list for payment
under the OPPS.
Using single and multiple procedure claims data for CMS'
determination of APC group weights.
Addressing other technical issues concerning APC group
structure.
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 the Department of Health and Human Services
(DHHS) and CMS, in conducting its review. We recommend organizations to
submit data for the Panel's and CMS staff's review.
III. Written Comments and Suggested Agenda Topics
Hardcopy and electronic written comments and suggested agenda
topics should be sent to the DFO as specified in the ADDRESSES section
of this notice. The DFO must receive these items by 5 p.m. (e.s.t.),
Monday, January 13, 2010. There will be no exceptions. We appreciate
your cooperation on this matter.
The written comments and suggested agenda topics submitted for the
February 2010 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.), Monday, January 13, 2010,
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. Collection of Information Requirements
This document does not impose any information collection and
recordkeeping requirements. Consequently, it need not be reviewed by
the Office of Management and Budget under the authority of the
Paperwork Reduction Act of 1995 (44 U.S.C. 35).
VII. 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.
VIII. 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 DFO to register in advance no later than 5
p.m. (e.s.t.), Wednesday, February 10, 2010. A confirmation will be
sent to the requester(s) by 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).
Telephone number(s).
IX. 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
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.
All persons entering the building must pass through a
metal detector.
All items brought into CMS including personal items, such
as laptops, cell phones, and palm pilots, are subject to physical
inspection.
The public may enter the building 30 to 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.
X. 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, February 10, 2010.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital
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Insurance; and Program No. 93.774, Medicare--Supplementary Medical
Insurance Program).
Dated: December 11, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E9-30123 Filed 12-17-09; 8:45 am]
BILLING CODE 4120-01-P