Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2010, 36786-37185 [2010-15257]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–9059–N]
Medicare and Medicaid Programs;
Quarterly Listing of Program
Issuances—January Through March
2010
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AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
SUMMARY: This notice lists CMS manual
instructions, substantive and
interpretive regulations, and other
Federal Register notices that were
published from January through March
2010, relating to the Medicare and
Medicaid programs. This notice
provides information on national
coverage determinations (NCDs)
affecting specific medical and health
care services under Medicare.
Additionally, this notice identifies
certain devices with investigational
device exemption (IDE) numbers
approved by the Food and Drug
Administration (FDA) that potentially
may be covered under Medicare. This
notice also includes listings of all
approval numbers from the Office of
Management and Budget for collections
of information in CMS regulations and
a list of Medicare-approved carotid stent
facilities. Included in this notice is a list
of the American College of Cardiology’s
National Cardiovascular Data registry
sites, active CMS coverage-related
guidance documents, and special onetime notices regarding national coverage
provisions. Also included in this notice
is a list of National Oncologic Positron
Emissions Tomography Registry sites, a
list of Medicare-approved ventricular
assist device (destination therapy)
facilities, a list of Medicare-approved
lung volume reduction surgery facilities,
a list of Medicare-approved clinical
trials for fluorodeoxyglucose positron
emissions tomogrogphy for dementia,
and a list of Medicare-approved
bariatric surgery facilities.
Section 1871(c) of the Social Security
Act requires that we publish a list of
Medicare issuances in the Federal
Register at least every 3 months.
Although we are not mandated to do so
by statute, for the sake of completeness
of the listing, and to foster more open
and transparent collaboration efforts, we
are also including all Medicaid
issuances and Medicare and Medicaid
substantive and interpretive regulations
(proposed and final) published during
this 3-month time frame.
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FOR FURTHER INFORMATION CONTACT: It is
possible that an interested party may
need specific information and not be
able to determine from the listed
information whether the issuance or
regulation would fulfill that need.
Consequently, we are providing contact
persons to answer general questions
concerning these items. Copies are not
available through the contact persons.
(See Section III of this notice for how to
obtain listed material.)
Questions concerning CMS manual
instructions in Addendum III may be
addressed to Ismael Torres, Office of
Strategic Operations and Regulatory
Affairs, Centers for Medicare &
Medicaid Services, C4–26–05, 7500
Security Boulevard, Baltimore, MD
21244–1850, or you can call (410) 786–
1864.
Questions concerning regulation
documents published in the Federal
Register in Addendum IV may be
addressed to Kathleen Smith, Office of
Strategic Operations and Regulatory
Affairs, Centers for Medicare &
Medicaid Services, C4–14–03, 7500
Security Boulevard, Baltimore, MD
21244–1850, or you can call (410) 786–
0626.
Questions concerning Medicare NCDs
in Addendum V may be addressed to
Patricia Brocato-Simons, Office of
Clinical Standards and Quality, Centers
for Medicare & Medicaid Services, C1–
09–06, 7500 Security Boulevard,
Baltimore, MD 21244–1850, or you can
call (410) 786–0261.
Questions concerning FDA-approved
Category B IDE numbers listed in
Addendum VI may be addressed to John
Manlove, Office of Clinical Standards
and Quality, Centers for Medicare &
Medicaid Services, C1–13–04, 7500
Security Boulevard, Baltimore, MD
21244–1850, or you can call (410) 786–
6877.
Questions concerning approval
numbers for collections of information
in Addendum VII may be addressed to
Melissa Musotto, Office of Strategic
Operations and Regulatory Affairs,
Regulations Development and Issuances
Group, Centers for Medicare & Medicaid
Services, C5–14–03, 7500 Security
Boulevard, Baltimore, MD 21244–1850,
or you can call (410) 786–6962.
Questions concerning Medicareapproved carotid stent facilities in
Addendum VIII may be addressed to
Sarah J. McClain, Office of Clinical
Standards and Quality, Centers for
Medicare & Medicaid Services, C1–09–
06, 7500 Security Boulevard, Baltimore,
MD 21244–1850, or you can call (410)
786–2994.
Questions concerning Medicare’s
recognition of the American College of
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Cardiology-National Cardiovascular
Data Registry sites in Addendum IX may
be addressed to JoAnna Baldwin, MS,
Office of Clinical Standards and
Quality, Centers for Medicare &
Medicaid Services, C1–09–06, 7500
Security Boulevard, Baltimore, MD
21244–1850, or you can call (410) 786–
7205.
Questions concerning Medicare’s
active coverage-related guidance
documents in Addendum X may be
addressed to Beverly Lofton, Office of
Clinical Standards and Quality, Centers
for Medicare & Medicaid Services, C1–
09–06, 7500 Security Boulevard,
Baltimore, MD 21244–1850, or you can
call (410) 786–7136.
Questions concerning one-time
notices regarding national coverage
provisions in Addendum XI may be
addressed to Beverly Lofton, Office of
Clinical Standards and Quality, Centers
for Medicare & Medicaid Services, C1–
09–06, 7500 Security Boulevard,
Baltimore, MD 21244–1850, or you can
call (410) 786–7136.
Questions concerning National
Oncologic Positron Emission
Tomography Registry sites in
Addendum XII may be addressed to
Stuart Caplan, RN, MAS, Office of
Clinical Standards and Quality, Centers
for Medicare & Medicaid Services, C1–
09–06, 7500 Security Boulevard,
Baltimore, MD 21244–1850, or you can
call (410) 786–8564.
Questions concerning Medicareapproved ventricular assist device
(destination therapy) facilities in
Addendum XIII may be addressed to
JoAnna Baldwin, MS, Office of Clinical
Standards and Quality, Centers for
Medicare & Medicaid Services, C1–09–
06, 7500 Security Boulevard, Baltimore,
MD 21244–1850, or you can call (410)
786–7205.
Questions concerning Medicareapproved lung volume reduction
surgery facilities listed in Addendum
XIV may be addressed to JoAnna
Baldwin, MS, Office of Clinical
Standards and Quality, Centers for
Medicare & Medicaid Services, C1–09–
06, 7500 Security Boulevard, Baltimore,
MD 21244–1850, or you can call (410)
786–7205.
Questions concerning Medicareapproved bariatric surgery facilities
listed in Addendum XV may be
addressed to Kate Tillman, RN, MA,
Office of Clinical Standards and
Quality, Centers for Medicare &
Medicaid Services, C1–09–06, 7500
Security Boulevard, Baltimore, MD
21244–1850, or you can call (410) 786–
9252.
Questions concerning
fluorodeoxyglucose positron emission
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tomography for dementia trials listed in
Addendum XVI may be addressed to
Stuart Caplan, RN, MAS, Office of
Clinical Standards and Quality, Centers
for Medicare & Medicaid Services, C1–
09–06, 7500 Security Boulevard,
Baltimore, MD 21244–1850, or you can
call (410) 786–8564.
Questions concerning all other
information may be addressed to
Kathleen Smith, Office of Strategic
Operations and Regulatory Affairs,
Regulations Development Group,
Centers for Medicare & Medicaid
Services, C5–14–03, 7500 Security
Boulevard, Baltimore, MD 21244–1850,
or you can call (410) 786–0626.
SUPPLEMENTARY INFORMATION:
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I. Program Issuances
The Centers for Medicare & Medicaid
Services (CMS) is responsible for
administering the Medicare and
Medicaid programs. These programs pay
for health care and related services for
39 million Medicare beneficiaries and
35 million Medicaid recipients.
Administration of the two programs
involves (1) furnishing information to
Medicare beneficiaries and Medicaid
recipients, health care providers, and
the public and (2) maintaining effective
communications with regional offices,
State governments, State Medicaid
agencies, State survey agencies, various
providers of health care, all Medicare
contractors that process claims and pay
bills, and others. To implement the
various statutes on which the programs
are based, we issue regulations under
the authority granted to the Secretary of
the Department of Health and Human
Services under sections 1102, 1871,
1902, and related provisions of the
Social Security Act (the Act). We also
issue various manuals, memoranda, and
statements necessary to administer the
programs efficiently.
Section 1871(c)(1) of the Act requires
that we publish a list of all Medicare
manual instructions, interpretive rules,
statements of policy, and guidelines of
general applicability not issued as
regulations at least every 3 months in
the Federal Register. We published our
first notice June 9, 1988 (53 FR 21730).
Although we are not mandated to do so
by statute, for the sake of completeness
of the listing of operational and policy
statements, and to foster more open and
transparent collaboration, we are
continuing our practice of including
Medicare substantive and interpretive
regulations (proposed and final)
published during the respective 3month time frame.
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II. How To Use the Addenda
This notice is organized so that a
reader may review the subjects of
manual issuances, memoranda,
substantive and interpretive regulations,
NCDs, and FDA-approved IDEs
published during the subject quarter to
determine whether any are of particular
interest. We expect this notice to be
used in concert with previously
published notices. Those unfamiliar
with a description of our Medicare
manuals may wish to review Table I of
our first three notices (53 FR 21730, 53
FR 36891, and 53 FR 50577) published
in 1988, and the notice published March
31, 1993 (58 FR 16837). Those desiring
information on the Medicare NCD
Manual (NCDM, formerly the Medicare
Coverage Issues Manual (CIM)) may
wish to review the August 21, 1989,
publication (54 FR 34555). Those
interested in the revised process used in
making NCDs under the Medicare
program may review the September 26,
2003, publication (68 FR 55634).
To aid the reader, we have organized
and divided this current listing into 11
addenda:
• Addendum I lists the publication
dates of the most recent quarterly
listings of program issuances.
• Addendum II identifies previous
Federal Register documents that
contain a description of all previously
published CMS Medicare and Medicaid
manuals and memoranda.
• Addendum III lists a unique CMS
transmittal number for each instruction
in our manuals or Program Memoranda
and its subject matter. A transmittal may
consist of a single or multiple
instruction(s). Often, it is necessary to
use information in a transmittal in
conjunction with information currently
in the manuals.
• Addendum IV lists all substantive
and interpretive Medicare and Medicaid
regulations and general notices
published in the Federal Register
during the quarter covered by this
notice. For each item, we list the—
Æ Date published;
Æ Federal Register citation;
Æ Parts of the Code of Federal
Regulations (CFR) that have changed (if
applicable);
Æ Agency file code number; and
Æ Title of the regulation.
• Addendum V includes completed
NCDs, or reconsiderations of completed
NCDs, from the quarter covered by this
notice. Completed decisions are
identified by the section of the NCDM
in which the decision appears, the title,
the date the publication was issued, and
the effective date of the decision.
• Addendum VI includes listings of
the FDA-approved IDE categorizations,
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using the IDE numbers the FDA assigns.
The listings are organized according to
the categories to which the device
numbers are assigned (that is, Category
A or Category B), and identified by the
IDE number.
• Addendum VII includes listings of
all approval numbers from the Office of
Management and Budget (OMB) for
collections of information in CMS
regulations in title 42; title 45,
subchapter C; and title 20 of the CFR.
• Addendum VIII includes listings of
Medicare-approved carotid stent
facilities. All facilities listed meet CMS
standards for performing carotid artery
stenting for high risk patients.
• Addendum IX includes a list of the
American College of Cardiology’s
National Cardiovascular Data registry
sites. We cover implantable cardioverter
defibrillators (ICDs) for certain
indications, as long as information
about the procedures is reported to a
central registry.
• Addendum X includes a list of
active CMS guidance documents. As
required by section 731 of the Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) (Pub.
L. 108–173, enacted on December 8,
2003), we will begin listing the current
versions of our guidance documents in
each quarterly listings notice.
• Addendum XI includes a list of
special one-time notices regarding
national coverage provisions. We are
publishing a list of issues that require
public notification, such as a particular
clinical trial or research study that
qualifies for Medicare coverage.
• Addendum XII includes a listing of
National Oncologic Positron Emission
Tomography Registry (NOPR) sites. We
cover positron emission tomography
(PET) scans for particular oncologic
indications when they are performed in
a facility that participates in the NOPR.
• Addendum XIII includes a listing of
Medicare-approved facitilites that
receive coverage for ventricular assist
devices used as destination therapy. All
facilities were required to meet our
standards in order to receive coverage
for ventricular assist devices implanted
as destination therapy.
• Addendum XIV includes a listing of
Medicare-approved facilities that are
eligible to receive coverage for lung
volume reduction surgery. Until May
17, 2007, facilities that participated in
the National Emphysema Treatment
Trial are also eligible to receive
coverage.
• Addendum XV includes a listing of
Medicare-approved facilities that meet
minimum standards for facilities
modeled in part on professional society
statements on competency. All facilities
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must meet our standards in order to
receive coverage for bariatric surgery
procedures.
• Addendum XVI includes a listing of
Medicare-approved clinical trials for
fluorodeoxyglucose positron emission
tomography (FDG–PET) for dementia
and neurodegenerative diseases.
III. How To Obtain Listed Material
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A. Manuals
Those wishing to subscribe to
program manuals should contact either
the Government Printing Office (GPO)
or the National Technical Information
Service (NTIS) at the following
addresses:
Superintendent of Documents,
Government Printing Office, ATTN:
New Orders, P.O. Box 371954,
Pittsburgh, PA 15250–7954,
Telephone (202) 512–1800, Fax
number (202) 512–2250 (for credit
card orders); or
National Technical Information Service,
Department of Commerce, 5825 Port
Royal Road, Springfield, VA 22161,
Telephone (703) 487–4630.
In addition, individual manual
transmittals and Program Memoranda
listed in this notice can be purchased
from NTIS. Interested parties should
identify the transmittal(s) they want.
GPO or NTIS can give complete details
on how to obtain the publications they
sell. Additionally, most manuals are
available at the following Internet
address:
https://cms.hhs.gov/manuals/
default.asp.
B. Regulations and Notices
Regulations and notices are published
in the daily Federal Register. Interested
individuals may purchase individual
copies or subscribe to the Federal
Register by contacting the GPO at the
address given above. When ordering
individual copies, it is necessary to cite
either the date of publication or the
volume number and page number.
The Federal Register is also available
on 24x microfiche and as an online
database through GPO Access. The
online database is updated by 6 a.m.
each day the Federal Register is
published. The database includes both
text and graphics from Volume 59,
Number 1 (January 2, 1994) forward.
Free public access is available on a
Wide Area Information Server (WAIS)
through the Internet and via
asynchronous dial-in. Internet users can
access the database by using the World
Wide Web; the Superintendent of
Documents home page address is https://
www.gpoaccess.gov/fr/, by
using local WAIS client software, or by
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telnet to swais.gpoaccess.gov, then log
in as guest (no password required). Dialin users should use communications
software and modem to call (202) 512–
1661; type swais, then log in as guest
(no password required).
C. Rulings
We publish rulings on an infrequent
basis. CMS Rulings are decisions of the
Administrator that serve as precedent
final opinions and orders and
statements of policy and interpretation.
They provide clarification and
interpretation of complex or ambiguous
provisions of the law or regulations
relating to Medicare, Medicaid,
Utilization and Quality Control Peer
Review, private health insurance, and
related matters. Interested individuals
can obtain copies from the nearest CMS
Regional Office or review them at the
nearest regional depository library. We
have, on occasion, published rulings in
the Federal Register. Rulings, beginning
with those released in 1995, are
available online, through the CMS
Home Page. The Internet address is
https://cms.hhs.gov/rulings.
D. CMS’ Compact Disk-Read Only
Memory (CD–ROM)
Our laws, regulations, and manuals
are also available on CD–ROM and may
be purchased from GPO or NTIS on a
subscription or single copy basis. The
Superintendent of Documents list ID is
HCLRM, and the stock number is 717–
139–00000–3. The following material is
on the CD–ROM disk:
• Titles XI, XVIII, and XIX of the Act.
• CMS-related regulations.
• CMS manuals and monthly
revisions.
• CMS program memoranda.
The titles of the Compilation of the
Social Security Laws are current as of
January 1, 2005. (Updated titles of the
Social Security Laws are available on
the Internet at https://www.ssa.gov/
OP_Home/ssact/comp-toc.htm.) The
remaining portions of CD–ROM are
updated on a monthly basis.
Because of complaints about the
unreadability of the Appendices
(Interpretive Guidelines) in the State
Operations Manual (SOM), as of March
1995, we deleted these appendices from
CD–ROM. We intend to re-visit this
issue in the near future and, with the
aid of newer technology, we may again
be able to include the appendices on
CD–ROM.
Any cost report forms incorporated in
the manuals are included on the CD–
ROM disk as LOTUS files. LOTUS
software is needed to view the reports
once the files have been copied to a
personal computer disk.
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IV. How To Review Listed Material
Transmittals or Program Memoranda
can be reviewed at a local Federal
Depository Library (FDL). Under the
FDL program, government publications
are sent to approximately 1,400
designated libraries throughout the
United States. Some FDLs may have
arrangements to transfer material to a
local library not designated as an FDL.
Contact any library to locate the nearest
FDL.
In addition, individuals may contact
regional depository libraries that receive
and retain at least one copy of most
Federal Government publications, either
in printed or microfilm form, for use by
the general public. These libraries
provide reference services and
interlibrary loans; however, they are not
sales outlets. Individuals may obtain
information about the location of the
nearest regional depository library from
any library.
For each CMS publication listed in
Addendum III, CMS publication and
transmittal numbers are shown. To help
FDLs locate the materials, use the CMS
publication and transmittal numbers.
For example, to find the Medicare
Benefit Policy publication titled
‘‘Outpatient Intravenous Insulin
Treatment (Therapy),’’ use CMS–Pub.
100–03, Transmittal No. 112.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance, Program No. 93.774, Medicare—
Supplementary Medical Insurance Program,
and Program No. 93.714, Medical Assistance
Program)
Dated: June 15, 2010.
Jacquelyn Y. White,
Director, Office of Strategic Operations and
Regulatory Affairs.
Addendum I
This addendum lists the publication
dates of the most recent quarterly
listings of program issuances.
April 1, 2008 (73 FR 17422)
June 27, 2008 (73 FR 36596)
September 26, 2008 (73 FR 55902)
December 30, 2008 (73 FR 79982)
March 27, 2009 (74 FR 13516)
June 26, 2009 (74 FR 30689)
September 25, 2009 (74 FR 49076)
December 18, 2009 (74 FR 67310)
March 26, 2010 (75 FR 14906)
Addendum II—Description of Manuals,
Memoranda, and CMS Rulings
An extensive descriptive listing of
Medicare manuals and memoranda was
published on June 9, 1988, at 53 FR
21730 and supplemented on September
22, 1988, at 53 FR 36891 and December
16, 1988, at 53 FR 50577. Also, a
complete description of the former CIM
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(now the NCDM) was published on
August 21, 1989, at 54 FR 34555. A brief
description of the various Medicaid
manuals and memoranda that we
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maintain was published on October 16,
1992, at 57 FR 47468.
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ADDENDUM III
Medicare and Medicaid Manual
Instructions
January Through March 2010
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Addendum IV—Regulation Documents
Published in the Federal Register
January Through March 2010
Publication date
FR Vol. 75
Page No.
42 CFR Parts affected
File code
Title of regulation
Medicare and Medicaid Programs; Electronic
Health Record Incentive Program.
Medicare Program; Meeting of the Advisory
Panel on Medicare Education; Cancellation of
the February 3, 2010 Meeting and Announcement of the March 31, 2010 Meeting.
Medicare Program; Meeting of the Practicing
Physicians Advisory Council, March 8, 2010.
Medicare Program; Approval of Independent Accrediting Organizations To Participate in the
Advanced Diagnostic Imaging Supplier Accreditation Program.
Medicare Program; Meeting of the Medicare Evidence Development and Coverage Advisory
Committee, March 24, 2010.
Interim Final Rules Under the Paul Wellstone
and Pete Domenici Mental Health Parity and
Addiction Equity Act of 2008.
Medicare and Medicaid Programs; Announcement of Applications From Hospitals Requesting Waiver for Organ Procurement Service
Area.
Medicare Program; Meeting of the Practicing
Physicians Advisory Council, March 8, 2010,
Correction.
Medicare Program; Public Meetings in Calendar
Year 2010 for All New Public Requests for Revisions to the Healthcare Common Procedure
Coding System (HCPCS) Coding and Payment Determinations.
Medicare Program; Meeting of the Medicare Evidence Development and Coverage Advisory
Committee—April 22, 2010.
Medicare Program; Request for Nominations for
Members of the Medicare Evidence Development & Coverage Advisory Committee.
Medicare Program; Request for Nominations to
the Advisory Panel on Ambulatory Payment
Classification Groups.
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—October Through
December 2009.
Medicaid and CHIP Programs; Meeting of the
CHIP Working Group—April 26, 2010.
January 13, 2010 ...........
1844
412, 413, 422, and 495
CMS–0033–P ................
January 22, 2010 ...........
3742
.......................................
CMS–7017–N2 .............
3743
.......................................
CMS–1566–N ...............
4088
.......................................
CMS–6023–N2 .............
4095
.......................................
CMS–3222–N ...............
February 2, 2010 ...........
5410
45 CFR 146 ..................
CMS–4140–IFC ............
February 3, 2010 ...........
5599
.......................................
CMS–1341–NC .............
February 24, 2010 .........
8374
.......................................
CMS–1566–CN .............
February 26, 2010 .........
8971
.......................................
CMS–1514–N ...............
February 26, 2010 .........
8980
.......................................
CMS–3223–N ...............
February 26, 2010 .........
8982
.......................................
CMS–3224–N ...............
March 26, 2010 .............
14606
.......................................
CMS–1570–N ...............
March 26, 2010 .............
14906
.......................................
CMS–9057–N ...............
March 31, 2010 .............
16149
.......................................
CMS–2312–N ...............
January 26, 2010 ...........
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Addendum V—National Coverage
Determinations [January Through
March 2010]
A national coverage determination
(NCD) is a determination by the
Secretary with respect to whether or not
a particular item or service is covered
nationally under Title XVIII of the
Social Security Act, but does not
include a determination of what code, if
any, is assigned to a particular item or
service covered under this title, or
determination with respect to the
amount of payment made for a
particular item or service so covered.
We include below all of the NCDs that
were issued during the quarter covered
by this notice. The entries below
include information concerning
completed decisions as well as sections
on program and decision memoranda,
which also announce pending decisions
NCDM
Section
Title
Repeal of Section 20.10, Cardiac Rehabilitation (CR) Programs ...........
Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery
Concurrent with Stenting ......................................................................
Outpatient Intravenous Insulin Treatment (Therapy) ..............................
Screening for the Human Immunodeficiency Virus (HIV) Infection .........
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or, in some cases, explain why it was
not appropriate to issue an NCD. We
identify completed decisions by the
section of the NCDM in which the
decision appears, the title, the date the
publication was issued, and the
effective date of the decision.
Information on completed decisions as
well as pending decisions has also been
posted on the CMS Web site at https://
cms.hhs.gov/coverage.
TN No.
Issue date
Effective date
20.10
03/05/2010
02/22/2010
20.70
40.70
210.70
Sfmt 4703
R116NCD
R115NCD
R117NCD
R118NCD
03/05/2010
03/09/2010
03/23/2010
12/09/2009
12/23/2009
12/08/2009
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NCDM
Section
Title
Positron Emission Tomography (NaF–18) to Identify Bone Metastasis
of Cancer ..............................................................................................
Changes to the Laboratory National Coverage Determination (NCD)
Edit Software for July 2010 ..................................................................
Addendum VI—FDA-Approved
Category B IDEs [January Through
March 2010]
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Under the Food, Drug, and Cosmetic
Act (21 U.S.C. 360c) devices fall into
one of three classes. To assist CMS
under this categorization process, the
FDA assigns one of two categories to
each FDA-approved IDE. Category A
refers to experimental IDEs, and
Category B refers to non-experimental
IDEs. To obtain more information about
the classes or categories, please refer to
the Federal Register notice published
on April 21, 1997 (62 FR 19328).
The following list includes all
Category B IDEs approved by FDA
during the first quarter, January through
March 2010.
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Effective date
R119NCD
03/26/2010
02/26/2010
190.00
R1963CP
04/30/2010
07/01/2010
Category
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
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Issue date
220.60
IDE
BB14319
BB14334
BB14335
G080150
G090029
G090050
G090105
G090188
G090221
G090230
G090251
G090255
G090258
G090259
G090267
G090270
G090272
G090273
G090277
G100008
TN No.
Sfmt 4703
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
IDE
G100009
G100020
G100024
G100031
G100032
G100035
G100041
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
.........................................
Category
B
B
B
B
B
B
B
Addendum VII—Approval Numbers for
Collections of Information
Below we list all approval numbers
for collections of information in the
referenced sections of CMS regulations
in Title 42; Title 45, Subchapter C; and
Title 20 of the Code of Federal
Regulations, which have been approved
by the Office of Management and
Budget:
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Addendum VIII—Medicare-Approved
Carotid Stent Facilities [January
Through March 2010]
On March 17, 2005, we issued our
decision memorandum on carotid artery
stenting. We determined that carotid
artery stenting with embolic protection
is reasonable and necessary only if
performed in facilities that have been
determined to be competent in
performing the evaluation, procedure,
and follow-up necessary to ensure
optimal patient outcomes. We have
Facility
Provider No.
Palm Springs General Hospital, 1475 West 49th Street, Hialeah, FL 33012 .....
Parrish Medical Center, 951 N. Washington Avenue, Titusville, FL 32796 ........
New York Presbyterian Hospital, 177 Ft. Washington Avenue, New York, NY
10032.
Northside Hospital & Tampa Bay Heart Institute, 6000 49th Street North, St. ...
Petersburg, FL 33709 ..........................................................................................
Orange Park Medical Center, 2001 Kingsley Avenue, ........................................
Orange Park, FL 32073 .......................................................................................
Saint Thomas Hospital, 4220 Harding Road, Nashville, TN 37205 ....................
Marshall Medical Center North, 8000 Alabama HWT 69, Guntersville, AL
35976.
Oklahoma Heart Hospital South LLC, 5200 E. I–240 Service Road, Oklahoma
City, OK 73135–2610.
Great River Medical Center, 1221 S. Gear Avenue, West Burlington, IA
52655–1681.
Liberty Hospital, P.O. Box 1002, Liberty, MO 64069–1002 ................................
Scripps Memorial Hospital, Encinitas, 354 Santa Fe Drive ENC01, Encinitas,
CA 92024.
University of Maryland Medical Center, 22 South Greene Street, Baltimore,
MD 21201–1595.
Addendum IX
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American College of Cardiology’s
National Cardiovascular Data Registry
Sites [January Through March 2010]
In order to obtain reimbursement,
Medicare national coverage policy
requires that providers implanting ICDs
for primary prevention clinical
indications (that is, patients without a
history of cardiac arrest or spontaneous
arrhythmia) report data on each primary
prevention ICD procedure. This policy
became effective January 27, 2005.
Details of the clinical indications that
are covered by Medicare and their
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Effective date
State
100050
100028
330101
01/12/2010
01/12/2010
05/05/2005
1205880945
02/26/2010
FL
100226
02/26/2010
FL
440082
15082417
02/26/2010
04/02/2010
TN
AL
1841442274
04/02/2010
OK
420680407
04/16/2010
IA
260177
050503
04/16/2010
04/16/2010
MO
CA
210002
04/16/2010
Additional
information
FL
FL
NY
MD
respective data reporting requirements
are available in the Medicare National
Coverage Determination (NCD) Manual,
which is on the Centers for Medicare &
Medicaid Services (CMS) Web site at
https://www.cms.hhs.gov/Manuals/IOM/
itemdetail.asp?filterType=
none&filterByDID=99&sortByDID=1&
sortOrder=ascending&
itemID=CMS014961.
A provider can use either of two
mechanisms to satisfy the data reporting
requirement. Patients may be enrolled
either in an Investigational Device
Exemption trial studying ICDs as
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created a list of minimum standards for
facilities modeled in part on
professional society statements on
competency. All facilities must at least
meet our standards in order to receive
coverage for carotid artery stenting for
high risk patients.
identified by the FDA or in the
American College of Cardiology’s
National Cardiovascular Data Registry
(ACC–NCDR) ICD registry. Therefore, in
order for a beneficiary to receive a
Medicare-covered ICD implantation for
primary prevention, the beneficiary
must receive the scan in a facility that
participates in the ACC–NCDR ICD
registry.
We maintain a list of facilities that
have been enrolled in this registry.
Addendum IX includes the facilities
that have been designated in the quarter
covered by this notice.
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Addendum X
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Active CMS Coverage-Related Guidance
Documents [January Through March
2010]
On September 24, 2004, we published
a notice in the Federal Register (69 FR
57325), in which we explained how we
would develop coverage-related
guidance documents. These guidance
documents are required under section
731 of the MMA. In our notice, we
committed to the public that, ‘‘At regular
intervals, we will update a list of all
guidance documents in the Federal
Register.’’
Addendum X includes a list of active
CMS guidance documents as of the
ending date of the period covered by
this notice. To obtain full-text copies of
these documents, visit the CMS
Coverage Web site at https://
www.cms.hhs.gov/mcd/
index_list.asp?list_type=mcd_1.
Document Name: Factors CMS
Considers in Commissioning External
Technology Assessments.
Date of Issuance: April 11, 2006.
Document Name: Factors CMS
Considers in Opening a National
Coverage Determination.
Date of Issuance: April 11, 2006.
Document Name: (Draft) Factors CMS
Considers in Referring Topics to the
Medicare Coverage Advisory
Committee.
Date of Issuance: March 9, 2005.
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Document Name: National Coverage
Determinations with Data Collection as
a Condition of Coverage: Coverage With
Evidence Development.
Date of Issuance: July 12, 2006.
Addendum XI
List of Special One-Time Notices
Regarding National Coverage Provisions
[January Through March 2010]
As medical technologies, the contexts
under which they are delivered, and the
health needs of Medicare beneficiaries
grow increasingly complex, our national
coverage determination (NCD) process
must adapt to accommodate these
complexities. As part of this adaptation,
our national coverage decisions often
include multi-faceted coverage
determinations, which may place
conditions on the patient populations
eligible for coverage of a particular item
or service, the providers who deliver a
particular service, or the methods in
which data are collected to supplement
the delivery of the item or service (such
as participation in a clinical trial).
We outline these conditions as we
release new or revised NCDs. However,
details surrounding these conditions
may need to be shared with the public
as ‘‘one-time notices’’ in the Federal
Register. For example, we may require
that a particular medical service may be
delivered only in the context of a CMSrecognized clinical research study,
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which was not named in the NCD itself.
We would then use Addendum XI of
this notice, along with our coverage
Web site at https://www.cms.hhs.gov/
coverage, to provide the public with
information about the clinical research
study that it ultimately recognizes.
Addendum XI includes any
additional information we may need to
share about the conditions under which
an NCD was issued as of the ending date
of the period covered by this notice.
There were no Special One-Time
Notices Regarding National Coverage
Provisions published this quarter.
Addendum XII—National Oncologic
PET Registry (NOPR)
In January 2005, we issued our
decision memorandum on positron
emission tomography (PET) scans,
which stated that CMS would cover PET
scans for particular oncologic
indications, as long as they were
performed in the context of a clinical
study. We have since recognized the
National Oncologic PET Registry as one
of these clinical studies. Therefore, in
order for a beneficiary to receive a
Medicare-covered PET scan, the
beneficiary must receive the scan in a
facility that participates in the Registry.
The following facilities have met the
CMS’s requirements for performing PET
scans under National Coverage
Determination CAG–00181N.
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Addendum XIII
Medicare-Approved Ventricular Assist
Device (Destination Therapy) Facilities
[January Through March 2010]
On October 1, 2003, we issued our
decision memorandum on ventricular
assist devices for the clinical indication
of destination therapy. We determined
that ventricular assist devices used as
destination therapy are reasonable and
necessary only if performed in facilities
that have been determined to have the
experience and infrastructure to ensure
optimal patient outcomes. We
established facility standards and an
application process. All facilities were
required to meet our standards in order
Facility
Provider No.
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Advocate Christ Medical Center, 4440 W 95th Street, Oak Lawn,
Illinois.
California Pacific Medical Center, 2333 Buchanan Street, San
Francisco, California.
Baptist Memorial Hospital, 6019 Walnut Grove Road, Memphis,
Tennessee.
Duke University Medical Center, DUMC Box 3943, Durham, North
Carolina.
Fairview-University Medical Center, 2450 Riverside Avenue, Minneapolis, Minnesota.
Allegheny General Hospital, 320 E North Avenue, Pittsburgh,
Pennsylvania.
Barnes-Jewish Hospital, One Barnes-Jewish Hospital Plaza, Saint
Louis, Missouri.
Brigham and Women’s Hospital, 15 Francis Street, Boston, Massachusetts.
Bryan LGH Medical Center East, 1600 S 48 Street, Lincoln, Nebraska.
Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California.
Clarian Health Partners, Inc., 1701 N. Senate Avenue, Indianapolis, Indiana.
Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio ..................
Hahnemann University Hospital, Broad and Vine Streets, Philadelphia, Pennsylvania.
Hospital of the University of Pennsylvania, 3400 Spruce Street,
Philadelphia, Pennsylvania.
Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, Michigan
Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, Virginia
Jewish Hospital, 200 Abraham Flexner Way, Louisville, Kentucky ..
Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, Florida
LDS Hospital, 8th Avenue and C Street, Salt Lake City, Utah ........
Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, Maryland
Loyola University Medical Center, 2160 S. 1st Avenue, Maywood,
Illinois.
Lutheran Hospital of Indiana, 7950 W. Jefferson Boulevard, Fort
Wayne, Indiana.
Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts.
Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida ...............
Medical City Dallas Hospital, 7777 Forest Lane, Dallas, Texas ......
The Methodist Hospital, 6565 Fannin Street, Houston, Texas ........
Montefiore Medical Center, 111 E. 210th Street, Bronx, New York
Methodist Specialty and Transplant Hospital, 8026 Floyd Curl
Drive, San Antonio, Texas.
Newark Beth Israel Medical Center, 201 Lyons Avenue, Newark,
New Jersey.
Mount Sinai Medical Center, 1190 5th Avenue, New York, New
York.
New York-Presbyterian Hospital, 177 Fort Washington Avenue,
New York, New York.
Ohio State University Medical Center, 410 W. 10th Avenue, Columbus, Ohio.
Oregon Health and Sciences University, 3181 SW Sam Jackson
Park Road, Portland, Oregon.
OSF St Francis Medical Center, 530 NE Glen Oak Avenue, Peoria, Illinois.
Penn State Milton S Hershey Medical Center, 500 University
Drive, Hershey, Pennsylvania.
Rush-Presbyterian-St Luke Medical Center, 1653 W Congress
Parkway, Chicago, Illinois.
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to receive coverage for ventricular assist
devices implanted as destination
therapy.
VAD Destination Therapy Facilities
The following facilities have met the
CMS facility standards for destination
therapy VADs.
Date approved
Other
information
State
140208
12/17/2003
IL
050047
03/19/2004
CA
440048
04/07/2004
TN
340030
10/31/2003
NC
240080
10/28/2003
MN
390050
12/10/2003
PA
260032
10/27/2003
MO
220110
01/09/2004
MA
280003
10/23/2003
NE
050625
12/29/2003
CA
150056
11/25/2003
IN
360180
390290
12/03/2003
12/22/2003
OH
PA
390111
10/28/2003
PA
Joint Commission Certified on
09/19/2008.
Joint Commission Certified on
05/23/2008.
230053
490063
180040
100022
460010
210009/
1790700904
140276
01/06/2004
03/31/2004
11/10/2003
01/12/2004
10/23/2003
10/28/2003
MI
VA
KY
FL
UT
MD
University of Miami.
01/30/2004
IL
150017
10/29/2003
IN
220071
12/15/2003
MA
100151
450647
450358
330059
450388
11/06/2003
12/03/2003
11/03/2003
11/14/2003
11/19/2003
FL
TX
TX
NY
TX
310002
11/14/2003
NJ
330024
11/25/2003
NY
330101
10/28/2003
NY
360085
11/12/2003
OH
380009
11/21/2003
OR
140067
11/12/2003
IL
390256
10/29/2003
PA
140119
11/14/2003
IL
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Joint Commission Certified on
05/26/2007.
Joint Commission Certified on
03/28/2008.
Joint Commission Certified on
08/22/2008.
Joint Commission Certified on
07/09/2008.
Columbia
Center.
University
Medical
Joint Commission Certified on
05/19/2008.
28JNN2
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Facility
Provider No.
Sentara Norfolk General Hospital, 600 Gresham Drive, Norfolk,
Virginia.
Sacred Heart Medical Center, 101 W 8th Avenue, Spokane,
Washington.
Seton Medical Center, 1201 W. 38th Street, Austin, Texas ............
Shands at the University of Florida, 1600 SW Archer Road,
Gainesville, Florida.
Sharp Memorial Hospital, 7901 Frost Street, San Diego, California
Date approved
490007
11/10/2003
VA
500054
01/12/2004
WA
450056
100113
01/13/2004
11/26/2003
TX
FL
050100
12/01/2003
CA
050441
12/22/2003
CA
370091
520138
01/09/2004
11/03/2003
OK
WI
450193
10/28/2003
TX
150084
01/05/2004
IN
450044
12/10/2003
TX
330285
10/29/2003
NY
100128
390027
11/26/2003
11/03/2003
FL
PA
220116
11/06/2003
MA
050262
12/10/2003
CA
030064
10/29/2003
AZ
010033
10/29/2003
AL
060024
11/06/2003
CO
The University of Chicago Hospitals and Health System, 5841
South Maryland Avenue, Chicago, Illinois.
University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa
City, Iowa.
University of Maryland Medical Center, 22 S. Greene Street, Baltimore, Maryland.
University of Michigan Health System, 1500 E. Medical Center
Drive, Ann Arbor, Michigan.
University of North Carolina Hospitals, 101 Manning Drive, Chapel
Hill, North Carolina.
University of Utah Hospital, 50 N Medical Drive, Salt Lake City,
Utah.
University of Virginia Health System, 1215 Lee Street, Charlottesville, Virginia.
University of Washington Medical Center, 1959 NE Pacific Street,
Seattle, Washington.
University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, Wisconsin.
USC University Hospital, 1500 San Pablo, Los Angeles, California
UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, Pennsylvania
140088
02/25/2004
IL
160058
11/12/2003
IA
210002
11/12/2003
MD
230046
10/27/2003
MI
340061
05/05/2004
NC
460009
12/22/2003
UT
490009
01/12/2004
VA
500008
01/15/2004
WA
520098
12/03/2003
WI
050696
390164
01/09/2004
10/23/2003
CA
PA
Virginia Commonwealth University Medical Center, 401 North 12th
Street, Richmond, Virginia.
Vanderbilt University Medical Center, 1161 21st Avenue S, Nashville, Tennessee.
Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, Louisiana.
Baylor University Medical Center, 3500 Gaston Avenue, Dallas,
TX.
The University of Michigan Hospitals and Health Centers, 1500
East Medical Center Drive, Ann Arbor, MI.
Saint Mary’s Hospital, 1216 Southwest Second Street, Rochester,
MN.
Allegheny General Hospital, 320 East North Avenue, Pittsburgh,
PA.
Washington Hospital Center, 110 Irving Street, NW, Washington,
DC.
490032
04/08/2004
VA
440039
10/28/2003
TN
190036
06/29/2004
LA
N/A
10/04/2007
TX
230046
03/28/2008
MI
N/A
02/27/2008
MN
N/A
03/08/2008
PA
09–0011
04/23/2008
DC
Stanford University Hospital and Clinics, 300 Pasteur Drive, Stanford, California.
St Francis Hospital, 6161 S. Yale Avenue, Tulsa, Oklahoma ..........
St Luke’s Medical Center, 2900 W Oklahoma Avenue, Milwaukee,
Wisconsin.
St Luke’s Episcopal Hospital, 6720 Bertner Avenue, Houston,
Texas.
St Vincent Hospital and Health Services, 2001 W. 86th Street, Indianapolis, Indiana.
St Paul Medical Center, 5909 Harry Hines Boulevard, Dallas,
Texas.
Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, New
York.
Tampa General Hospital, 2 Columbia Drive, Tampa, Florida ..........
Temple University Hospital, 3401 N. Broad Street, Philadelphia,
Pennsylvania.
Tufts-New England Medical Center, 750 Washington Street, Boston, Massachusetts.
UCLA Medical Center, 10833 Le Conte Avenue, Los Angeles,
California.
University Medical Center, 1501 N. Campbell Avenue, Tucson,
Arizonia.
University of Alabama at Birmingham Health System, 500 22nd
Street S, Birmingham, Alabama.
University of Colorado Hospital, 4200 E. Ninth Avenue, Denver,
Colorado.
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Other
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State
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Joint Commission Certified on
07/18/2008.
Stanford University Medical Center.
Joint Commission Certified on
06/18/2008.
9th & Colorado Campus, Joint
Commission Certified on 07/
23/2008.
Joint Commission Certified on
03/28/2008.
Joint Commission Certified on
06/11/2008.
Medical College of Virginia Hospitals.
Joint Commission Certified on
10/04/2007.
Joint Commission Certified on
03/28/2008.
Joint Commission Certified on
02/27/2008.
Joint Commission Certified on
04/23/2008.
28JNN2
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Facility
Provider No.
Date approved
Integris Baptist Medical Center, 3300 Northwest Expressway,
Oklahoma City, OK.
Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ .....
1831103654
08/13/2008
OK
030103
02/27/2009
AZ
Northwestern Memorial Hospital, 251 E. Huron Street, Chicago, IL
140281
03/17/2009
IL
Lancaster General Hospital, 555 North Duke Street, Lancaster, PA
390100
05/20/2009
PA
Hartford Hospital, 80 Seymour Street, Hartford, CT ........................
070025
05/29/2009
CT
Morristown Memorial Hospital, 100 Madison Avenue, Morristown,
NJ.
Thomas Jefferson University Hospital, 111 South 11th Street,
Philadelphia, PA.
Emory University Hospital, 1364 Clifton Road, Atlanta, GA .............
310015
06/17/09
NJ
390174
08/05/09
PA
110010
08/19/09
GA
Maine Medical Center, 22 Bramhall Street, Portland, ME ...............
200009
02/03/09
ME
University of Kentucky Health Care—Chandler Hospital, 800 Rose
Street, Lexington, KY.
Sutter Memorial Hospital, 5151 F Street, Sacramento, California ...
........................
02/11/09
KY
050108
10/21/09
CA
Baptist Health Medical Center—Little Rock, 9601 Interstate 630,
Exit 7, Little Rock, Arizona.
Westchester Medical Center, 100 Woods Road, Valhalla, New
York.
040114
12/02/09
AR
330234
01/05/10
NY
Addendum XIV
Lung Volume Reduction Surgery (LVRS)
[January Through March 2010]
Three types of facilities are eligible for
reimbursement for Lung Volume
Reduction Surgery (LVRS): National
Emphysema Treatment Trial (NETT)
approved (Beginning 05/07/2007, these
will no longer automatically qualify and
can qualify only with the other
programs), Credentialed by the Joint
Commission (formerly, the Joint
Facility name
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Other
information
State
Date approved
Baylor College of Medicine, Houston, Texas .........................
Brigham and Women’s Hospital, Boston, MA ........................
Cedars-Sinai Medical Center, Los Angeles, CA ....................
Chapman Medical Center, Orange, CA .................................
Cleveland Clinic Foundation, Cleveland, OH .........................
Columbia University, New York, NY .......................................
Duke University Medical Center, Durham, NC .......................
Johns Hopkins Hospital, Baltimore, MD .................................
Kaiser Foundation Hospital—Riverside, Riverside, CA .........
Long Island Jewish Medical Center, New Hyde Park, NY .....
Mayo Clinic, Rochester, MN ...................................................
Memorial Medical Center, Springfield, IL ...............................
National Jewish Medical Center, Denver, CO ........................
The Ohio State University Hospital, Columbus, OH ..............
Ohio State University Medical Center, Columbus, OH ..........
Saint Louis University, Saint Louis, MO .................................
Temple University Hospital, Philadelphia, PA ........................
UCLA Medical Center, Los Angeles, CA ...............................
University of California, San Diego, San Diego, CA ..............
University of Maryland Medical Center, Baltimore, MD .........
University of Michigan Medical Center, Ann Arbor, MI ..........
University of Pennsylvania, Philadelphia, PA .........................
University of Pittsburgh, Pittsburgh, PA .................................
University of Washington, Seattle, WA ..................................
Washington University/Barnes Hospital, Saint Louis, MO .....
Allegheny General Hospital, Pittsburgh, PA ...........................
Addendum XV—Medicare-Approved
Bariatric Surgery Facilities
On February 21, 2006, we issued our
decision memorandum on bariatric
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N/A
N/A
N/A
N/A
N/A
N/A
N/A
09/20/2006
N/A
N/A
12/13/2006
N/A
N/A
N/A
N/A
08/23/2008
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
04/23/2008
Frm 00345
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Joint Commission Certified on
10/21/09.
Joint Commission Certified on
12/02/09.
Joint Commission Certified on
01/05/10.
Commision on Accreditation of
Healthcare Organizations (JCAHO))
under their Disease Specific
Certification Program for LVRS, and
Medicare approved for lung transplants.
Only the first two types are in the list.
State
Type of certification
TEXAS ...................................
MASSACHUSETTS ...............
CALIFORNIA .........................
CALIFORNIA .........................
OHIO ......................................
NEW YORK ...........................
NORTH CAROLINA ...............
MARYLAND ...........................
CALIFORNIA .........................
NEW YORK ...........................
MINNESOTA ..........................
ILLINOIS ................................
COLORADO ..........................
OHIO ......................................
OHIO ......................................
MISSOURI .............................
PENNSYLVANIA ...................
CALIFORNIA .........................
CALIFORNIA .........................
MARYLAND ...........................
MICHIGAN .............................
PENNSYLVANIA ...................
PENNSYLVANIA ...................
WASHINGTON ......................
MISSOURI .............................
PENNSYLVANIA ...................
surgery procedures. We determined that
bariatric surgical procedures are
reasonable and necessary for Medicare
beneficiaries who have a body-mass
PO 00000
Joint Commission Certified on
08/13/08.
Joint Commission Certified on
02/27/09.
Joint Commission Certified on
03/17/09.
Joint Commission certified on 05/
20/09.
Joint Commission certified on 05/
29/09.
Joint Commission certified on 6/
17/09.
Joint Commission certified on 8/
5/09.
Joint Commission certified on 8/
19/09.
Joint Commission certified on 02/
03/09.
NETT
NETT
NETT
NETT
NETT
NETT
NETT
NETT
Joint Commission
NETT
NETT
Joint Commission
NETT
Joint Commission
NETT
NETT
Joint Commission
NETT
NETT
NETT
Joint Commission
NETT
NETT
NETT
Joint Commission
Joint Commission
index (BMI) greater than or equal to 35,
have at least one co-morbidity related to
obesity, and have been previously
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unsuccessful with medical treatment for
obesity.
This decision also stipulated that
covered bariatric surgery procedures are
reasonable and necessary only when
performed at facilities that are: (1)
Certified by the American College of
Surgeons (ACS) as a Level 1 Bariatric
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Surgery Center (program standards and
requirements in effect on February 15,
2006); or (2) certified by the American
Society for Bariatric Surgery (ASBS) as
a Bariatric Surgery Center of Excellence
(BSCOE) (program standards and
requirements in effect on February 15,
2006).
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The following facilities have met our
minimum facility standards for bariatric
surgery and have been certified by
American College of Surgeons (ACS) or
American Society for Metabolic and
Bariatric Surgery (ASMBS).
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Addendum XVI—FDG–PET for
Dementia and Neurodegenerative
Diseases Clinical Trials
In a National Coverage Determination
for fluorodeoxyglucose positron
emission tomography (FDG–PET) for
Dementia and Neurodegenerative
Diseases (220.6.13) we indicated that an
FDG–PET scan is considered reasonable
and necessary in patients with mild
cognitive impairment or early dementia
Facility name
Provider No.
UCLA Medical Center ............
10833 Le Conte Avenue
Los Angeles, CA 90095
Santa Monica-UCLA Medical
Center.
1245 16th Street
Suite 105
Santa Monica, CA 90404
University of Buffalo ...............
3435 Main Street
Buffalo, NY 14214
Center for Alzheimer’s Care,
Imaging and Research
(University of Utah).
650 Komas Drive
Suite 106–A
Salt Lake City, UT 84108
Medical University of South
Carolina.
169 Ashley Avenue
PO Box 250322
Charleston, SC 29425
Cedars-Sinai Medical Center
8700 Beverly Boulevard
Nuc Suite 1239
Los Angeles, CA 90048
HW13029 ..........
Date approved
only in the context of an approved
clinical trial that contains patient
safeguards and protections to ensure
proper administration, use, and
evaluation of the FDG–PET scan.
State
Name of trial
Principal investigator
06/07/2006
CA .......
Dr. Daniel Silverman.
W11817A ..........
01/12/2007
CA .......
Early and Long-Term Value
of Imaging Brain Metabolism.
N/A ........................................
14414A .............
03/12/2007
NY .......
Dr. Daniel Silverman.
460009 .............
02/17/2009
UT .......
Metabolic Cerebral Imaging
in Incipient Dementia
(MCI–ID).
Metabolic Cerebral Imaging
in Incipient Dementia
(MCI–ID).
1073605879 .....
02/17/2009
SC .......
N/A ........................................
Kenneth Spicer.
951644600 .......
10/09/2009
CA .......
‘‘Early and Long-term Value
of Imaging Brain Metabolism’’.
Dr. Alan Waxman.
N/A.
Norman Foster, M.D.
[FR Doc. 2010–15257 Filed 6–25–10; 8:45 am]
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BILLING CODE 4120–01–P
Agencies
[Federal Register Volume 75, Number 123 (Monday, June 28, 2010)]
[Notices]
[Pages 36786-37185]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-15257]
[[Page 36785]]
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Part II
Book 2 of 2 Books
Pages 36785-37286
Department of Health and Human Services
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Centers for Medicare & Medicaid Services
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Medicare and Medicaid Programs; Quarterly Listing of Program; Notice
Federal Register / Vol. 75, No. 123 / Monday, June 28, 2010 /
Notices
[[Page 36786]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9059-N]
Medicare and Medicaid Programs; Quarterly Listing of Program
Issuances--January Through March 2010
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice lists CMS manual instructions, substantive and
interpretive regulations, and other Federal Register notices that were
published from January through March 2010, relating to the Medicare and
Medicaid programs. This notice provides information on national
coverage determinations (NCDs) affecting specific medical and health
care services under Medicare. Additionally, this notice identifies
certain devices with investigational device exemption (IDE) numbers
approved by the Food and Drug Administration (FDA) that potentially may
be covered under Medicare. This notice also includes listings of all
approval numbers from the Office of Management and Budget for
collections of information in CMS regulations and a list of Medicare-
approved carotid stent facilities. Included in this notice is a list of
the American College of Cardiology's National Cardiovascular Data
registry sites, active CMS coverage-related guidance documents, and
special one-time notices regarding national coverage provisions. Also
included in this notice is a list of National Oncologic Positron
Emissions Tomography Registry sites, a list of Medicare-approved
ventricular assist device (destination therapy) facilities, a list of
Medicare-approved lung volume reduction surgery facilities, a list of
Medicare-approved clinical trials for fluorodeoxyglucose positron
emissions tomogrogphy for dementia, and a list of Medicare-approved
bariatric surgery facilities.
Section 1871(c) of the Social Security Act requires that we publish
a list of Medicare issuances in the Federal Register at least every 3
months. Although we are not mandated to do so by statute, for the sake
of completeness of the listing, and to foster more open and transparent
collaboration efforts, we are also including all Medicaid issuances and
Medicare and Medicaid substantive and interpretive regulations
(proposed and final) published during this 3-month time frame.
FOR FURTHER INFORMATION CONTACT: It is possible that an interested
party may need specific information and not be able to determine from
the listed information whether the issuance or regulation would fulfill
that need. Consequently, we are providing contact persons to answer
general questions concerning these items. Copies are not available
through the contact persons. (See Section III of this notice for how to
obtain listed material.)
Questions concerning CMS manual instructions in Addendum III may be
addressed to Ismael Torres, Office of Strategic Operations and
Regulatory Affairs, Centers for Medicare & Medicaid Services, C4-26-05,
7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call
(410) 786-1864.
Questions concerning regulation documents published in the Federal
Register in Addendum IV may be addressed to Kathleen Smith, Office of
Strategic Operations and Regulatory Affairs, Centers for Medicare &
Medicaid Services, C4-14-03, 7500 Security Boulevard, Baltimore, MD
21244-1850, or you can call (410) 786-0626.
Questions concerning Medicare NCDs in Addendum V may be addressed
to Patricia Brocato-Simons, Office of Clinical Standards and Quality,
Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security
Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-0261.
Questions concerning FDA-approved Category B IDE numbers listed in
Addendum VI may be addressed to John Manlove, Office of Clinical
Standards and Quality, Centers for Medicare & Medicaid Services, C1-13-
04, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call
(410) 786-6877.
Questions concerning approval numbers for collections of
information in Addendum VII may be addressed to Melissa Musotto, Office
of Strategic Operations and Regulatory Affairs, Regulations Development
and Issuances Group, Centers for Medicare & Medicaid Services, C5-14-
03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call
(410) 786-6962.
Questions concerning Medicare-approved carotid stent facilities in
Addendum VIII may be addressed to Sarah J. McClain, Office of Clinical
Standards and Quality, Centers for Medicare & Medicaid Services, C1-09-
06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call
(410) 786-2994.
Questions concerning Medicare's recognition of the American College
of Cardiology-National Cardiovascular Data Registry sites in Addendum
IX may be addressed to JoAnna Baldwin, MS, Office of Clinical Standards
and Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500
Security Boulevard, Baltimore, MD 21244-1850, or you can call (410)
786-7205.
Questions concerning Medicare's active coverage-related guidance
documents in Addendum X may be addressed to Beverly Lofton, Office of
Clinical Standards and Quality, Centers for Medicare & Medicaid
Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850,
or you can call (410) 786-7136.
Questions concerning one-time notices regarding national coverage
provisions in Addendum XI may be addressed to Beverly Lofton, Office of
Clinical Standards and Quality, Centers for Medicare & Medicaid
Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850,
or you can call (410) 786-7136.
Questions concerning National Oncologic Positron Emission
Tomography Registry sites in Addendum XII may be addressed to Stuart
Caplan, RN, MAS, Office of Clinical Standards and Quality, Centers for
Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard,
Baltimore, MD 21244-1850, or you can call (410) 786-8564.
Questions concerning Medicare-approved ventricular assist device
(destination therapy) facilities in Addendum XIII may be addressed to
JoAnna Baldwin, MS, Office of Clinical Standards and Quality, Centers
for Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard,
Baltimore, MD 21244-1850, or you can call (410) 786-7205.
Questions concerning Medicare-approved lung volume reduction
surgery facilities listed in Addendum XIV may be addressed to JoAnna
Baldwin, MS, Office of Clinical Standards and Quality, Centers for
Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard,
Baltimore, MD 21244-1850, or you can call (410) 786-7205.
Questions concerning Medicare-approved bariatric surgery facilities
listed in Addendum XV may be addressed to Kate Tillman, RN, MA, Office
of Clinical Standards and Quality, Centers for Medicare & Medicaid
Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850,
or you can call (410) 786-9252.
Questions concerning fluorodeoxyglucose positron emission
[[Page 36787]]
tomography for dementia trials listed in Addendum XVI may be addressed
to Stuart Caplan, RN, MAS, Office of Clinical Standards and Quality,
Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security
Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-8564.
Questions concerning all other information may be addressed to
Kathleen Smith, Office of Strategic Operations and Regulatory Affairs,
Regulations Development Group, Centers for Medicare & Medicaid
Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850,
or you can call (410) 786-0626.
SUPPLEMENTARY INFORMATION:
I. Program Issuances
The Centers for Medicare & Medicaid Services (CMS) is responsible
for administering the Medicare and Medicaid programs. These programs
pay for health care and related services for 39 million Medicare
beneficiaries and 35 million Medicaid recipients. Administration of the
two programs involves (1) furnishing information to Medicare
beneficiaries and Medicaid recipients, health care providers, and the
public and (2) maintaining effective communications with regional
offices, State governments, State Medicaid agencies, State survey
agencies, various providers of health care, all Medicare contractors
that process claims and pay bills, and others. To implement the various
statutes on which the programs are based, we issue regulations under
the authority granted to the Secretary of the Department of Health and
Human Services under sections 1102, 1871, 1902, and related provisions
of the Social Security Act (the Act). We also issue various manuals,
memoranda, and statements necessary to administer the programs
efficiently.
Section 1871(c)(1) of the Act requires that we publish a list of
all Medicare manual instructions, interpretive rules, statements of
policy, and guidelines of general applicability not issued as
regulations at least every 3 months in the Federal Register. We
published our first notice June 9, 1988 (53 FR 21730). Although we are
not mandated to do so by statute, for the sake of completeness of the
listing of operational and policy statements, and to foster more open
and transparent collaboration, we are continuing our practice of
including Medicare substantive and interpretive regulations (proposed
and final) published during the respective 3-month time frame.
II. How To Use the Addenda
This notice is organized so that a reader may review the subjects
of manual issuances, memoranda, substantive and interpretive
regulations, NCDs, and FDA-approved IDEs published during the subject
quarter to determine whether any are of particular interest. We expect
this notice to be used in concert with previously published notices.
Those unfamiliar with a description of our Medicare manuals may wish to
review Table I of our first three notices (53 FR 21730, 53 FR 36891,
and 53 FR 50577) published in 1988, and the notice published March 31,
1993 (58 FR 16837). Those desiring information on the Medicare NCD
Manual (NCDM, formerly the Medicare Coverage Issues Manual (CIM)) may
wish to review the August 21, 1989, publication (54 FR 34555). Those
interested in the revised process used in making NCDs under the
Medicare program may review the September 26, 2003, publication (68 FR
55634).
To aid the reader, we have organized and divided this current
listing into 11 addenda:
Addendum I lists the publication dates of the most recent
quarterly listings of program issuances.
Addendum II identifies previous Federal Register documents
that contain a description of all previously published CMS Medicare and
Medicaid manuals and memoranda.
Addendum III lists a unique CMS transmittal number for
each instruction in our manuals or Program Memoranda and its subject
matter. A transmittal may consist of a single or multiple
instruction(s). Often, it is necessary to use information in a
transmittal in conjunction with information currently in the manuals.
Addendum IV lists all substantive and interpretive
Medicare and Medicaid regulations and general notices published in the
Federal Register during the quarter covered by this notice. For each
item, we list the--
[cir] Date published;
[cir] Federal Register citation;
[cir] Parts of the Code of Federal Regulations (CFR) that have
changed (if applicable);
[cir] Agency file code number; and
[cir] Title of the regulation.
Addendum V includes completed NCDs, or reconsiderations of
completed NCDs, from the quarter covered by this notice. Completed
decisions are identified by the section of the NCDM in which the
decision appears, the title, the date the publication was issued, and
the effective date of the decision.
Addendum VI includes listings of the FDA-approved IDE
categorizations, using the IDE numbers the FDA assigns. The listings
are organized according to the categories to which the device numbers
are assigned (that is, Category A or Category B), and identified by the
IDE number.
Addendum VII includes listings of all approval numbers
from the Office of Management and Budget (OMB) for collections of
information in CMS regulations in title 42; title 45, subchapter C; and
title 20 of the CFR.
Addendum VIII includes listings of Medicare-approved
carotid stent facilities. All facilities listed meet CMS standards for
performing carotid artery stenting for high risk patients.
Addendum IX includes a list of the American College of
Cardiology's National Cardiovascular Data registry sites. We cover
implantable cardioverter defibrillators (ICDs) for certain indications,
as long as information about the procedures is reported to a central
registry.
Addendum X includes a list of active CMS guidance
documents. As required by section 731 of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-
173, enacted on December 8, 2003), we will begin listing the current
versions of our guidance documents in each quarterly listings notice.
Addendum XI includes a list of special one-time notices
regarding national coverage provisions. We are publishing a list of
issues that require public notification, such as a particular clinical
trial or research study that qualifies for Medicare coverage.
Addendum XII includes a listing of National Oncologic
Positron Emission Tomography Registry (NOPR) sites. We cover positron
emission tomography (PET) scans for particular oncologic indications
when they are performed in a facility that participates in the NOPR.
Addendum XIII includes a listing of Medicare-approved
facitilites that receive coverage for ventricular assist devices used
as destination therapy. All facilities were required to meet our
standards in order to receive coverage for ventricular assist devices
implanted as destination therapy.
Addendum XIV includes a listing of Medicare-approved
facilities that are eligible to receive coverage for lung volume
reduction surgery. Until May 17, 2007, facilities that participated in
the National Emphysema Treatment Trial are also eligible to receive
coverage.
Addendum XV includes a listing of Medicare-approved
facilities that meet minimum standards for facilities modeled in part
on professional society statements on competency. All facilities
[[Page 36788]]
must meet our standards in order to receive coverage for bariatric
surgery procedures.
Addendum XVI includes a listing of Medicare-approved
clinical trials for fluorodeoxyglucose positron emission tomography
(FDG-PET) for dementia and neurodegenerative diseases.
III. How To Obtain Listed Material
A. Manuals
Those wishing to subscribe to program manuals should contact either
the Government Printing Office (GPO) or the National Technical
Information Service (NTIS) at the following addresses:
Superintendent of Documents, Government Printing Office, ATTN: New
Orders, P.O. Box 371954, Pittsburgh, PA 15250-7954, Telephone (202)
512-1800, Fax number (202) 512-2250 (for credit card orders); or
National Technical Information Service, Department of Commerce, 5825
Port Royal Road, Springfield, VA 22161, Telephone (703) 487-4630.
In addition, individual manual transmittals and Program Memoranda
listed in this notice can be purchased from NTIS. Interested parties
should identify the transmittal(s) they want. GPO or NTIS can give
complete details on how to obtain the publications they sell.
Additionally, most manuals are available at the following Internet
address: https://cms.hhs.gov/manuals/default.asp.
B. Regulations and Notices
Regulations and notices are published in the daily Federal
Register. Interested individuals may purchase individual copies or
subscribe to the Federal Register by contacting the GPO at the address
given above. When ordering individual copies, it is necessary to cite
either the date of publication or the volume number and page number.
The Federal Register is also available on 24x microfiche and as an
online database through GPO Access. The online database is updated by 6
a.m. each day the Federal Register is published. The database includes
both text and graphics from Volume 59, Number 1 (January 2, 1994)
forward. Free public access is available on a Wide Area Information
Server (WAIS) through the Internet and via asynchronous dial-in.
Internet users can access the database by using the World Wide Web; the
Superintendent of Documents home page address is https://www.gpoaccess.gov/fr/, by using local WAIS client software,
or by telnet to swais.gpoaccess.gov, then log in as guest (no password
required). Dial-in users should use communications software and modem
to call (202) 512-1661; type swais, then log in as guest (no password
required).
C. Rulings
We publish rulings on an infrequent basis. CMS Rulings are
decisions of the Administrator that serve as precedent final opinions
and orders and statements of policy and interpretation. They provide
clarification and interpretation of complex or ambiguous provisions of
the law or regulations relating to Medicare, Medicaid, Utilization and
Quality Control Peer Review, private health insurance, and related
matters. Interested individuals can obtain copies from the nearest CMS
Regional Office or review them at the nearest regional depository
library. We have, on occasion, published rulings in the Federal
Register. Rulings, beginning with those released in 1995, are available
online, through the CMS Home Page. The Internet address is https://cms.hhs.gov/rulings.
D. CMS' Compact Disk-Read Only Memory (CD-ROM)
Our laws, regulations, and manuals are also available on CD-ROM and
may be purchased from GPO or NTIS on a subscription or single copy
basis. The Superintendent of Documents list ID is HCLRM, and the stock
number is 717-139-00000-3. The following material is on the CD-ROM
disk:
Titles XI, XVIII, and XIX of the Act.
CMS-related regulations.
CMS manuals and monthly revisions.
CMS program memoranda.
The titles of the Compilation of the Social Security Laws are
current as of January 1, 2005. (Updated titles of the Social Security
Laws are available on the Internet at https://www.ssa.gov/OP_Home/ssact/comp-toc.htm.) The remaining portions of CD-ROM are updated on a
monthly basis.
Because of complaints about the unreadability of the Appendices
(Interpretive Guidelines) in the State Operations Manual (SOM), as of
March 1995, we deleted these appendices from CD-ROM. We intend to re-
visit this issue in the near future and, with the aid of newer
technology, we may again be able to include the appendices on CD-ROM.
Any cost report forms incorporated in the manuals are included on
the CD-ROM disk as LOTUS files. LOTUS software is needed to view the
reports once the files have been copied to a personal computer disk.
IV. How To Review Listed Material
Transmittals or Program Memoranda can be reviewed at a local
Federal Depository Library (FDL). Under the FDL program, government
publications are sent to approximately 1,400 designated libraries
throughout the United States. Some FDLs may have arrangements to
transfer material to a local library not designated as an FDL. Contact
any library to locate the nearest FDL.
In addition, individuals may contact regional depository libraries
that receive and retain at least one copy of most Federal Government
publications, either in printed or microfilm form, for use by the
general public. These libraries provide reference services and
interlibrary loans; however, they are not sales outlets. Individuals
may obtain information about the location of the nearest regional
depository library from any library.
For each CMS publication listed in Addendum III, CMS publication
and transmittal numbers are shown. To help FDLs locate the materials,
use the CMS publication and transmittal numbers. For example, to find
the Medicare Benefit Policy publication titled ``Outpatient Intravenous
Insulin Treatment (Therapy),'' use CMS-Pub. 100-03, Transmittal No.
112.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance, Program No. 93.774, Medicare--
Supplementary Medical Insurance Program, and Program No. 93.714,
Medical Assistance Program)
Dated: June 15, 2010.
Jacquelyn Y. White,
Director, Office of Strategic Operations and Regulatory Affairs.
Addendum I
This addendum lists the publication dates of the most recent
quarterly listings of program issuances.
April 1, 2008 (73 FR 17422)
June 27, 2008 (73 FR 36596)
September 26, 2008 (73 FR 55902)
December 30, 2008 (73 FR 79982)
March 27, 2009 (74 FR 13516)
June 26, 2009 (74 FR 30689)
September 25, 2009 (74 FR 49076)
December 18, 2009 (74 FR 67310)
March 26, 2010 (75 FR 14906)
Addendum II--Description of Manuals, Memoranda, and CMS Rulings
An extensive descriptive listing of Medicare manuals and memoranda
was published on June 9, 1988, at 53 FR 21730 and supplemented on
September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR
50577. Also, a complete description of the former CIM
[[Page 36789]]
(now the NCDM) was published on August 21, 1989, at 54 FR 34555. A
brief description of the various Medicaid manuals and memoranda that we
maintain was published on October 16, 1992, at 57 FR 47468.
ADDENDUM III
Medicare and Medicaid Manual Instructions
January Through March 2010
[[Page 36790]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.001
[[Page 36791]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.002
[[Page 36792]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.003
[[Page 36793]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.004
[[Page 36794]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.005
[[Page 36795]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.006
[[Page 36796]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.007
[[Page 36797]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.008
[[Page 36798]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.009
[[Page 36799]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.010
[[Page 36800]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.011
[[Page 36801]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.012
[[Page 36802]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.013
[[Page 36803]]
Addendum IV--Regulation Documents Published in the Federal Register
January Through March 2010
----------------------------------------------------------------------------------------------------------------
FR Vol. 75 42 CFR Parts
Publication date Page No. affected File code Title of regulation
----------------------------------------------------------------------------------------------------------------
January 13, 2010................ 1844 412, 413, 422, and CMS-0033-P......... Medicare and Medicaid
495. Programs; Electronic
Health Record
Incentive Program.
January 22, 2010................ 3742 ................... CMS-7017-N2........ Medicare Program;
Meeting of the
Advisory Panel on
Medicare Education;
Cancellation of the
February 3, 2010
Meeting and
Announcement of the
March 31, 2010
Meeting.
3743 ................... CMS-1566-N......... Medicare Program;
Meeting of the
Practicing Physicians
Advisory Council,
March 8, 2010.
January 26, 2010................ 4088 ................... CMS-6023-N2........ Medicare Program;
Approval of
Independent
Accrediting
Organizations To
Participate in the
Advanced Diagnostic
Imaging Supplier
Accreditation Program.
4095 ................... CMS-3222-N......... Medicare Program;
Meeting of the
Medicare Evidence
Development and
Coverage Advisory
Committee, March 24,
2010.
February 2, 2010................ 5410 45 CFR 146......... CMS-4140-IFC....... Interim Final Rules
Under the Paul
Wellstone and Pete
Domenici Mental Health
Parity and Addiction
Equity Act of 2008.
February 3, 2010................ 5599 ................... CMS-1341-NC........ Medicare and Medicaid
Programs; Announcement
of Applications From
Hospitals Requesting
Waiver for Organ
Procurement Service
Area.
February 24, 2010............... 8374 ................... CMS-1566-CN........ Medicare Program;
Meeting of the
Practicing Physicians
Advisory Council,
March 8, 2010,
Correction.
February 26, 2010............... 8971 ................... CMS-1514-N......... Medicare Program;
Public Meetings in
Calendar Year 2010 for
All New Public
Requests for Revisions
to the Healthcare
Common Procedure
Coding System (HCPCS)
Coding and Payment
Determinations.
February 26, 2010............... 8980 ................... CMS-3223-N......... Medicare Program;
Meeting of the
Medicare Evidence
Development and
Coverage Advisory
Committee--April 22,
2010.
February 26, 2010............... 8982 ................... CMS-3224-N......... Medicare Program;
Request for
Nominations for
Members of the
Medicare Evidence
Development & Coverage
Advisory Committee.
March 26, 2010.................. 14606 ................... CMS-1570-N......... Medicare Program;
Request for
Nominations to the
Advisory Panel on
Ambulatory Payment
Classification Groups.
March 26, 2010.................. 14906 ................... CMS-9057-N......... Medicare and Medicaid
Programs; Quarterly
Listing of Program
Issuances--October
Through December 2009.
March 31, 2010.................. 16149 ................... CMS-2312-N......... Medicaid and CHIP
Programs; Meeting of
the CHIP Working
Group--April 26, 2010.
----------------------------------------------------------------------------------------------------------------
Addendum V--National Coverage Determinations [January Through March
2010]
A national coverage determination (NCD) is a determination by the
Secretary with respect to whether or not a particular item or service
is covered nationally under Title XVIII of the Social Security Act, but
does not include a determination of what code, if any, is assigned to a
particular item or service covered under this title, or determination
with respect to the amount of payment made for a particular item or
service so covered. We include below all of the NCDs that were issued
during the quarter covered by this notice. The entries below include
information concerning completed decisions as well as sections on
program and decision memoranda, which also announce pending decisions
or, in some cases, explain why it was not appropriate to issue an NCD.
We identify completed decisions by the section of the NCDM in which the
decision appears, the title, the date the publication was issued, and
the effective date of the decision. Information on completed decisions
as well as pending decisions has also been posted on the CMS Web site
at https://cms.hhs.gov/coverage.
----------------------------------------------------------------------------------------------------------------
Title NCDM Section TN No. Issue date Effective date
----------------------------------------------------------------------------------------------------------------
Repeal of Section 20.10, Cardiac 20.10 R116NCD 03/05/2010 02/22/2010
Rehabilitation (CR) Programs...............
Percutaneous Transluminal Angioplasty (PTA) 20.70 R115NCD 03/05/2010 12/09/2009
of the Carotid Artery Concurrent with
Stenting...................................
Outpatient Intravenous Insulin Treatment 40.70 R117NCD 03/09/2010 12/23/2009
(Therapy)..................................
Screening for the Human Immunodeficiency 210.70 R118NCD 03/23/2010 12/08/2009
Virus (HIV) Infection......................
[[Page 36804]]
Positron Emission Tomography (NaF-18) to 220.60 R119NCD 03/26/2010 02/26/2010
Identify Bone Metastasis of Cancer.........
Changes to the Laboratory National Coverage 190.00 R1963CP 04/30/2010 07/01/2010
Determination (NCD) Edit Software for July
2010.......................................
----------------------------------------------------------------------------------------------------------------
Addendum VI--FDA-Approved Category B IDEs [January Through March 2010]
Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c) devices
fall into one of three classes. To assist CMS under this categorization
process, the FDA assigns one of two categories to each FDA-approved
IDE. Category A refers to experimental IDEs, and Category B refers to
non-experimental IDEs. To obtain more information about the classes or
categories, please refer to the Federal Register notice published on
April 21, 1997 (62 FR 19328).
The following list includes all Category B IDEs approved by FDA
during the first quarter, January through March 2010.
------------------------------------------------------------------------
IDE Category
------------------------------------------------------------------------
BB14319..................................... B
BB14334..................................... B
BB14335..................................... B
G080150..................................... B
G090029..................................... B
G090050..................................... B
G090105..................................... B
G090188..................................... B
G090221..................................... B
G090230..................................... B
G090251..................................... B
G090255..................................... B
G090258..................................... B
G090259..................................... B
G090267..................................... B
G090270..................................... B
G090272..................................... B
G090273..................................... B
G090277..................................... B
G100008..................................... B
G100009..................................... B
G100020..................................... B
G100024..................................... B
G100031..................................... B
G100032..................................... B
G100035..................................... B
G100041..................................... B
------------------------------------------------------------------------
Addendum VII--Approval Numbers for Collections of Information
Below we list all approval numbers for collections of information
in the referenced sections of CMS regulations in Title 42; Title 45,
Subchapter C; and Title 20 of the Code of Federal Regulations, which
have been approved by the Office of Management and Budget:
[[Page 36805]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.014
[[Page 36806]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.015
[[Page 36807]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.016
[[Page 36808]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.017
[[Page 36809]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.018
[[Page 36810]]
[GRAPHIC] [TIFF OMITTED] TN28JN10.019
[[Page 36811]]
Addendum VIII--Medicare-Approved Carotid Stent Facilities [January
Through March 2010]
On March 17, 2005, we issued our decision memorandum on carotid
artery stenting. We determined that carotid artery stenting with
embolic protection is reasonable and necessary only if performed in
facilities that have been determined to be competent in performing the
evaluation, procedure, and follow-up necessary to ensure optimal
patient outcomes. We have created a list of minimum standards for
facilities modeled in part on professional society statements on
competency. All facilities must at least meet our standards in order to
receive coverage for carotid artery stenting for high risk patients.
----------------------------------------------------------------------------------------------------------------
Facility Provider No. Effective date State Additional information
----------------------------------------------------------------------------------------------------------------
Palm Springs General Hospital, 100050 01/12/2010 FL ..........................
1475 West 49th Street, Hialeah,
FL 33012.
Parrish Medical Center, 951 N. 100028 01/12/2010 FL ..........................
Washington Avenue, Titusville, FL
32796.
New York Presbyterian Hospital, 330101 05/05/2005 NY ..........................
177 Ft. Washington Avenue, New
York, NY 10032.
Northside Hospital & Tampa Bay 1205880945 02/26/2010 FL ..........................
Heart Institute, 6000 49th Street
North, St..
Petersburg, FL 33709.............
Orange Park Medical Center, 2001 100226 02/26/2010 FL ..........................
Kingsley Avenue,.
Orange Park, FL 32073.............
Saint Thomas Hospital, 4220 440082 02/26/2010 TN ..........................
Harding Road, Nashville, TN 37205.
Marshall Medical Center North, 15082417 04/02/2010 AL ..........................
8000 Alabama HWT 69,
Guntersville, AL 35976.
Oklahoma Heart Hospital South LLC, 1841442274 04/02/2010 OK ..........................
5200 E. I-240 Service Road,
Oklahoma City, OK 73135-2610.
Great River Medical Center, 1221 420680407 04/16/2010 IA ..........................
S. Gear Avenue, West Burlington,
IA 52655-1681.
Liberty Hospital, P.O. Box 1002, 260177 04/16/2010 MO ..........................
Liberty, MO 64069-1002.
Scripps Memorial Hospital, 050503 04/16/2010 CA ..........................
Encinitas, 354 Santa Fe Drive
ENC01, Encinitas, CA 92024.
University of Maryland Medical 210002 04/16/2010 MD ..........................
Center, 22 South Greene Street,
Baltimore, MD 21201-1595.
----------------------------------------------------------------------------------------------------------------
Addendum IX
American College of Cardiology's National Cardiovascular Data Registry
Sites [January Through March 2010]
In order to obtain reimbursement, Medicare national coverage policy
requires that providers implanting ICDs for primary prevention clinical
indications (that is, patients without a history of cardiac arrest or
spontaneous arrhythmia) report data on each primary prevention ICD
procedure. This policy became effective January 27, 2005. Details of
the clinical indications that are covered by Medicare and their
respective data reporting requirements are available in the Medicare
National Coverage Determination (NCD) Manual, which is on the Centers
for Medicare & Medicaid Services (CMS) Web site at https://www.cms.hhs.gov/Manuals/IOM/itemdetail.asp?filterType=none&filterByDID=99&sortByDID=1&sortOrder=ascending&itemID=CMS014961.
A provider can use either of two mechanisms to satisfy the data
reporting requirement. Patients may be enrolled either in an
Investigational Device Exemption trial studying ICDs as identified by
the FDA or in the American College of Cardiology's National
Cardiovascular Data Registry (ACC-NCDR) ICD registry. Therefore, in
order for a beneficiary to receive a Medicare-covered ICD implantation
for primary prevention, the beneficiary must receive the scan in a
facility that participates in the ACC-NCDR ICD registry.
We maintain a list of facilities that have been enrolled in this
registry. Addendum IX includes the facilities that have been designated
in the quarter covered by this notice.
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Addendum X
Active CMS Coverage-Related Guidance Documents [January Through March
2010]
On September 24, 2004, we published a notice in the Federal
Register (69 FR 57325), in which we explained how we would develop
coverage-related guidance documents. These guidance documents are
required under section 731 of the MMA. In our notice, we committed to
the public that, ``At regular intervals, we will update a list of all
guidance documents in the Federal Register.''
Addendum X includes a list of active CMS guidance documents as of
the ending date of the period covered by this notice. To obtain full-
text copies of these documents, visit the CMS Coverage Web site at
https://www.cms.hhs.gov/mcd/index_list.asp?list_type=mcd_1.
Document Name: Factors CMS Considers in Commissioning External
Technology Assessments.
Date of Issuance: April 11, 2006.
Document Name: Factors CMS Considers in Opening a National Coverage
Determination.
Date of Issuance: April 11, 2006.
Document Name: (Draft) Factors CMS Considers in Referring Topics to
the Medicare Coverage Advisory Committee.
Date of Issuance: March 9, 2005.
Document Name: National Coverage Determinations with Data
Collection as a Condition of Coverage: Coverage With Evidence
Development.
Date of Issuance: July 12, 2006.
Addendum XI
List of Special One-Time Notices Regarding National Coverage Provisions
[January Through March 2010]
As medical technologies, the contexts under which they are
delivered, and the health needs of Medicare beneficiaries grow
increasingly complex, our national coverage determination (NCD) process
must adapt to accommodate these complexities. As part of this
adaptation, our national coverage decisions often include multi-faceted
coverage determinations, which may place conditions on the patient
populations eligible for coverage of a particular item or service, the
providers who deliver a particular service, or the methods in which
data are collected to supplement the delivery of the item or service
(such as participation in a clinical trial).
We outline these conditions as we release new or revised NCDs.
However, details surrounding these conditions may need to be shared
with the public as ``one-time notices'' in the Federal Register. For
example, we may require that a particular medical service may be
delivered only in the context of a CMS-recognized clinical research
study, which was not named in the NCD itself. We would then use
Addendum XI of this notice, along with our coverage Web site at https://www.cms.hhs.gov/coverage, to provide the public with information about
the clinical research study that it ultimately recognizes.
Addendum XI includes any additional information we may need to
share about the conditions under which an NCD was issued as of the
ending date of the period covered by this notice.
There were no Special One-Time Notices Regarding National Coverage
Provisions published this quarter.
Addendum XII--National Oncologic PET Registry (NOPR)
In January 2005, we issued our decision memorandum on positron
emission tomography (PET) scans, which stated that CMS would cover PET
scans for particular oncologic indications, as long as they were
performed in the context of a clinical study. We have since recognized
the National Oncologic PET Registry as one of these clinical studies.
Therefore, in order for a beneficiary to receive a Medicare-covered PET
scan, the beneficiary must receive the scan in a facility that
participates in the Registry. The following facilities have met the
CMS's requirements for performing PET scans under National Coverage
Determination CAG-00181N.
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