National Advisory Committee on Rural Health and Human Services; Notice of Meeting, 3744-3745 [2010-1178]
Download as PDF
<![CDATA[
erowe on DSK5CLS3C1PROD with NOTICES
3744
Federal Register / Vol. 75, No. 14 / Friday, January 22, 2010 / Notices
proposed changes in regulations and
manual instructions related to physician
services, as identified by the Secretary.
To the extent feasible and consistent
with statutory deadlines, the Council’s
consultation must occur before Federal
Register publication of the proposed
changes. The Council submits an annual
report on its recommendations to the
Secretary and the Administrator of the
Centers for Medicare & Medicaid
Services (CMS) not later than December
31 of each year.
The Council consists of 15 physicians,
including the Chair. Members of the
Council include both participating and
nonparticipating physicians, and
physicians practicing in rural and
underserved urban areas. At least 11
members of the Council must be
physicians as described in section
1861(r)(1) of the Act; that is, Statelicensed doctors of medicine or
osteopathy. The remaining 4 members
may include dentists, podiatrists,
optometrists, and chiropractors.
Members serve for overlapping 4-year
terms.
Section 1868(a)(2) of the Act requires
that the Council meet quarterly to
discuss certain proposed changes in
regulations and manual issuances that
relate to physicians’ services, identified
by the Secretary. Section 1868(a)(3) of
the Act provides for payment of
expenses and per diem for Council
members in the same manner as
members of other advisory committees
appointed by the Secretary. In addition
to making these payments, the
Department of Health and Human
Services and CMS provide management
and support services to the Council. The
Secretary will appoint new members to
the Council from among those
candidates determined to have the
expertise required to meet specific
agency needs in a manner to ensure
appropriate balance of the Council’s
membership.
The Council held its first meeting on
May 11, 1992. The current members are:
Chiledum A. Ahaghotu, M.D.; John E.
Arradondo, M.D., MPH; Vincent J.
Bufalino, M.D., Chairperson; Joseph A.
Giaimo, D.O.; Pamela A. Howard, M.D.;
Roger L. Jordan, O.D.; Janice A. Kirsch,
M.D.; Tye J. Ouzounian, M.D.; Jeffrey A.
Ross, DPM, M.D.; Jonathan E. Siff, M.D.,
MBA; Fredrica E. Smith, M.D.; Richard
E. Smith, M.D.; Arthur D. Snow, Jr.,
M.D.; Christopher J. Standaert, M.D.;
and Karen S. Williams, M.D.
II. Meeting Format and Agenda
The meeting will commence with the
Council’s Executive Director providing a
status report, and the CMS responses to
the recommendations made by the
VerDate Nov<24>2008
14:43 Jan 21, 2010
Jkt 220001
Council at the December 7, 2009
meeting, as well as prior meeting
recommendations. Additionally, an
update will be provided on the
Physician Regulatory Issues Team. In
accordance with the Council charter, we
are requesting assistance with the
following agenda topics:
• Provider Enrollment and Chain
Ownership System (PECOS) Update.
• Fraud and Abuse Update.
• Electronic Health Records (EHR)
Update.
For additional information and
clarification on these topics, contact the
DFO as provided in the FOR FURTHER
INFORMATION CONTACT section of this
notice. Individual physicians or medical
organizations that represent physicians
wishing to present a 5-minute oral
testimony on agenda issues must
register with the DFO by the date listed
in the DATES section of this notice.
Testimony is limited to agenda topics
only. The number of oral testimonies
may be limited by the time available. A
written copy of the presenter’s oral
remarks must be submitted to the DFO
for distribution to Council members for
review before the meeting by the date
listed in the DATES section of this notice.
Physicians and medical organizations
not scheduled to speak may also submit
written comments to the DFO for
distribution by the date listed in the
DATES section of this notice.
III. Meeting Registration and Security
Information
The meeting is open to the public, but
attendance is limited to the space
available. Persons wishing to attend this
meeting must register by contacting the
DFO at the address listed in the
ADDRESSES section of this notice or by
telephone at the number listed in the
FOR FURTHER INFORMATION CONTACT
section of this notice by the date
specified in the DATES section of this
notice.
Since this meeting will be held in a
Federal Government Building, the
Hubert H. Humphrey Building, Federal
security measures are applicable. In
planning your arrival time, we
recommend allowing additional time to
clear security. To gain access to the
building, participants will be required
to show a government-issued photo
identification (for example, driver’s
license, or passport), and must be listed
on an approved security list before
persons are permitted entrance. Persons
not registered in advance will not be
permitted into the Hubert H. Humphrey
Building and will not be permitted to
attend the Council meeting.
All persons entering the building
must pass through a metal detector. In
PO 00000
Frm 00049
Fmt 4703
Sfmt 4703
addition, all items brought to the Hubert
H. Humphrey Building, whether
personal or for the purpose of
presentation, are subject to inspection.
We cannot assume responsibility for
coordinating the receipt, transfer,
transport, storage, set-up, safety, or
timely arrival of any personal
belongings or items used for the purpose
of presentation.
Individuals requiring sign language
interpretation or other special
accommodations must contact the DFO
via the contact information specified in
the FOR FURTHER INFORMATION CONTACT
section of this notice by the date listed
in the DATES section of this notice.
Authority: (Section 1868 of the Social
Security Act (42 U.S.C. 1395ee) and section
10(a) of Pub. L. 92–463 (5 U.S.C. App. 2,
section 10(a)).)
Dated: January 14, 2010.
Charlene Frizzera,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. 2010–1333 Filed 1–21–10; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
National Advisory Committee on Rural
Health and Human Services; Notice of
Meeting
In accordance with section 10(a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92–463), notice is hereby given
that the following committee will
convene its sixty-fourth meeting.
Name: National Advisory Committee on
Rural Health and Human Services.
Dates and Times: February 17, 2010, 1
p.m.–5 p.m.
February 18, 2010, 9 a.m.–5 p.m.
February 19, 2010, 9 a.m.–10:30 a.m.
Place: The Sofitel Lafayette Square, 806
15th Street, NW., Washington, DC, 20005,
Phone: 202–730–8800.
Status: The meeting will be open to the
public.
Purpose: The National Advisory
Committee on Rural Health and Human
Services provides advice and
recommendations to the Secretary with
respect to the delivery, research,
development and administration of health
and human services in rural areas.
Agenda: Wednesday afternoon, February
17, at 1 p.m., the meeting will be called to
order by the Chairperson of the Committee,
the Honorable David Beasley and the Vice
Chairperson, the Honorable Larry Otis. The
Chair will open with a review of the
Committee’s 2010 Report to the Secretary and
a vote on the approval of that report. The
meeting will then focus on the Committee’s
E:\FR\FM\22JAN1.SGM
22JAN1
Federal Register / Vol. 75, No. 14 / Friday, January 22, 2010 / Notices
work for the 2011 report, which will focus on
the implications of health system change in
rural communities. The meeting will include
an address by HRSA Administrator
Dr. Mary Wakefield as well as
presentations by experts in the fields of
hospital and health care delivery as well as
workforce. Committee discussion on the
issues and an overview of rest of the meeting
will follow. The Wednesday meeting will
close at 5 p.m.
Thursday morning, February 18, at 9 a.m.,
the Committee will open with presentations
by experts in the area of human service
delivery and will be followed by another
presentation by a speaker from the Rural
Policy Research Institute. This will be
followed by Committee discussion and
overview from staff to the Committee.
Following these presentations,
Subcommittees will be selected and meet for
small group discussions. There will be a
review of the Subcommittee meetings and
action items will be developed for the
Committee members and staff. The formal
meeting for Thursday will close at 5 p.m.
The final session will be convened Friday
morning, February 19, at 9 a.m. The
Committee will hear additional presentations
on emerging rural policy issues from both
internal and external experts. This will be
followed by Committee discussion on the
Report format and an overview of the Work
Plan. The Committee will draft the letter to
the Secretary and discuss the June meeting.
The meeting will be adjourned at 10:30 a.m.
For Further Information Contact: Anyone
requiring information regarding the
Committee should contact Thomas F. Morris,
MPA, Acting Executive Secretary, National
Advisory Committee on Rural Health and
Human Services, Health Resources and
Services Administration, Parklawn Building,
Room 9A–42, 5600 Fishers Lane, Rockville,
MD 20857, Telephone (301) 443–0835, Fax
(301) 443–2803.
Persons interested in attending any portion
of the meeting should contact Michele Pray
Gibson, Office of Rural Health Policy
(ORHP), Telephone (301) 443–0835. The
Committee meeting agenda will be posted on
ORHP’s Web site https://
www.ruralhealth.hrsa.gov.
Dated: January 14, 2010.
Sahira Rafiullah,
Deputy Director, Division of Policy Review
and Coordination.
[FR Doc. 2010–1178 Filed 1–21–10; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
erowe on DSK5CLS3C1PROD with NOTICES
National Institutes of Health
NIH Consensus Development
Conference on Vaginal Birth After
Cesarean: New Insights; Notice
Notice is hereby given by the National
Institutes of Health (NIH) of the ‘‘NIH
Consensus Development Conference on
Vaginal Birth After Cesarean: New
VerDate Nov<24>2008
14:43 Jan 21, 2010
Jkt 220001
Insights’’ to be held March 8–10, 2010,
in the NIH Natcher Conference Center,
45 Center Drive, Bethesda, Maryland
20892. The conference will begin at 8:30
a.m. on March 8 and 9 and at 9 a.m. on
March 10, and it will be open to the
public.
Vaginal birth after cesarean (VBAC) is
the delivery of a baby through the
vagina after a previous cesarean
delivery. For most of the 20th century,
once a woman had undergone a
cesarean (the delivery of a baby through
an incision made in the abdominal wall
and uterus), many clinicians believed
that all of her future pregnancies
required delivery by cesarean as well.
However, in 1980, an NIH Consensus
Development Conference panel
questioned the necessity of routine
repeat cesarean deliveries and outlined
situations in which VBAC could be
considered. The option for a woman
with a previous cesarean delivery to try
to labor and deliver vaginally rather
than plan a cesarean delivery was thus
offered and exercised more often from
the 1980s through the early 1990s. Since
1996, however, VBAC rates in the
United States have consistently
declined, while cesarean delivery rates
have been steadily rising.
The exact causes of these shifts are
not entirely understood. A frequently
cited concern about VBAC is the
possibility of uterine rupture during
labor because a cesarean delivery leaves
a scar in the wall of the uterus at the
incision site, which is weaker than other
uterine tissue. Attempted VBAC may
also be associated with endometritis
(infection of the lining of the uterus),
the need for a hysterectomy (removal of
the uterus) or blood transfusion, as well
as neurologic injury to the baby.
However, repeat cesarean delivery may
also carry a risk of bleeding or
hysterectomy, uterine infections, and
respiratory problems for the newborn.
Having multiple cesarean deliveries
may also be associated with placental
problems in future pregnancies. Other
important considerations that may
influence decisionmaking include the
number of previous cesarean deliveries
a woman has experienced, the surgical
incision used during previous cesarean
delivery, the reason for the previous
surgical delivery, her age, how far along
the pregnancy is relative to her due
date, and the size and position of her
baby. Given the complexity of this issue,
a thorough examination of the relative
balance of benefits and harms to mother
and baby will be of immediate utility to
practitioners and pregnant mothers in
deciding upon a planned mode of
delivery.
PO 00000
Frm 00050
Fmt 4703
Sfmt 4703
3745
A number of nonclinical factors are
involved in this decision as well and
may be influencing the decline in VBAC
rates. Some individual practitioners and
hospitals in the U.S. have decreased or
eliminated their use of VBAC.
Professional society guidelines may
influence utilization rates because some
medical centers do not offer the
recommended supporting services for a
trial of labor after cesarean (e.g.,
immediate availability of a surgeon who
can perform a cesarean delivery and onsite anesthesiologists). Information
related to complications of an
unsuccessful attempt at VBAC, medicolegal concerns, personal preferences of
patients and clinicians, and insurance
policies and economic considerations
may all play a role in changing practice
patterns. Improved understanding of the
clinical risks and benefits and how they
interact with legal, ethical, and
economic forces to shape provider and
patient choices about VBAC may have
important implications for health
services planning.
To advance understanding of these
important issues, the Eunice Kennedy
Shriver National Institute of Child
Health and Human Development and
the Office of Medical Applications of
Research of the NIH will convene a
Consensus Development Conference
from March 8 to 10, 2010. The
conference will address the following
key questions:
• What are the rates and patterns of
utilization of trial of labor after prior
cesarean, vaginal birth after cesarean,
and repeat cesarean delivery in the
United States?
• Among women who attempt a trial
of labor after prior cesarean, what are
the vaginal delivery rate and the factors
that influence it?
• What are the short- and long-term
benefits and harms to the mother of
attempting trial of labor after prior
cesarean versus elective repeat cesarean
delivery, and what factors influence
benefits and harms?
• What are the short- and long-term
benefits and harms to the baby of
maternal attempt at trial of labor after
prior cesarean versus elective repeat
cesarean delivery, and what factors
influence benefits and harms?
• What are the nonmedical factors
that influence the patterns and
utilization of trial of labor after prior
cesarean?
• What are the critical gaps in the
evidence for decision-making, and what
are the priority investigations needed to
address these gaps?
An impartial, independent panel will
be charged with reviewing the available
published literature in advance of the
E:\FR\FM\22JAN1.SGM
22JAN1
]]>Agencies
[Federal Register Volume 75, Number 14 (Friday, January 22, 2010)]
[Notices]
[Pages 3744-3745]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-1178]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
National Advisory Committee on Rural Health and Human Services;
Notice of Meeting
In accordance with section 10(a)(2) of the Federal Advisory
Committee Act (Pub. L. 92-463), notice is hereby given that the
following committee will convene its sixty-fourth meeting.
Name: National Advisory Committee on Rural Health and Human
Services.
Dates and Times: February 17, 2010, 1 p.m.-5 p.m.
February 18, 2010, 9 a.m.-5 p.m.
February 19, 2010, 9 a.m.-10:30 a.m.
Place: The Sofitel Lafayette Square, 806 15th Street, NW.,
Washington, DC, 20005, Phone: 202-730-8800.
Status: The meeting will be open to the public.
Purpose: The National Advisory Committee on Rural Health and
Human Services provides advice and recommendations to the Secretary
with respect to the delivery, research, development and
administration of health and human services in rural areas.
Agenda: Wednesday afternoon, February 17, at 1 p.m., the meeting
will be called to order by the Chairperson of the Committee, the
Honorable David Beasley and the Vice Chairperson, the Honorable
Larry Otis. The Chair will open with a review of the Committee's
2010 Report to the Secretary and a vote on the approval of that
report. The meeting will then focus on the Committee's
[[Page 3745]]
work for the 2011 report, which will focus on the implications of
health system change in rural communities. The meeting will include
an address by HRSA Administrator
Dr. Mary Wakefield as well as presentations by experts in the
fields of hospital and health care delivery as well as workforce.
Committee discussion on the issues and an overview of rest of the
meeting will follow. The Wednesday meeting will close at 5 p.m.
Thursday morning, February 18, at 9 a.m., the Committee will
open with presentations by experts in the area of human service
delivery and will be followed by another presentation by a speaker
from the Rural Policy Research Institute. This will be followed by
Committee discussion and overview from staff to the Committee.
Following these presentations, Subcommittees will be selected and
meet for small group discussions. There will be a review of the
Subcommittee meetings and action items will be developed for the
Committee members and staff. The formal meeting for Thursday will
close at 5 p.m.
The final session will be convened Friday morning, February 19,
at 9 a.m. The Committee will hear additional presentations on
emerging rural policy issues from both internal and external
experts. This will be followed by Committee discussion on the Report
format and an overview of the Work Plan. The Committee will draft
the letter to the Secretary and discuss the June meeting. The
meeting will be adjourned at 10:30 a.m.
For Further Information Contact: Anyone requiring information
regarding the Committee should contact Thomas F. Morris, MPA, Acting
Executive Secretary, National Advisory Committee on Rural Health and
Human Services, Health Resources and Services Administration,
Parklawn Building, Room 9A-42, 5600 Fishers Lane, Rockville, MD
20857, Telephone (301) 443-0835, Fax (301) 443-2803.
Persons interested in attending any portion of the meeting
should contact Michele Pray Gibson, Office of Rural Health Policy
(ORHP), Telephone (301) 443-0835. The Committee meeting agenda will
be posted on ORHP's Web site https://www.ruralhealth.hrsa.gov.
Dated: January 14, 2010.
Sahira Rafiullah,
Deputy Director, Division of Policy Review and Coordination.
[FR Doc. 2010-1178 Filed 1-21-10; 8:45 am]
BILLING CODE 4165-15-P
