Medicare Program; Solicitation of Two Nominations to the Advisory Panel on Hospital Outpatient Payment, 51542-51543 [2012-20069]
Download as PDF
51542
Federal Register / Vol. 77, No. 165 / Friday, August 24, 2012 / Notices
Dated: August 9, 2012.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare
& Medicaid Services.
IV. Provisions of the Final Notice
A. Differences Between AAAHC’s
Standards and Requirements for
Accreditation and Medicare’s
Conditions and Survey Requirements
[FR Doc. 2012–20195 Filed 8–23–12; 8:45 am]
BILLING CODE 4120–01–P
We compared the standards and
survey process contained in AAAHC’s
application with the Medicare
conditions for accreditation. Our review
and evaluation of AAAHC’s application
for continued CMS-approval were
conducted as described in section III of
this final notice, and yielded the
following:
• To meet the requirements at
§ 488.10(b), AAAHC modified its
policies to include ‘‘person(s) receiving
hospice benefits prior to completing an
enrollment request for an MSA plan’’ as
an exception where an MAO may deny
enrollment based on medical status.
• AAAHC amended its crosswalk to
ensure current AAAHC standards are
clearly crosswalked to the following
regulatory requirements:
§§ 422.112(a)(7); 422.118(d);
422.202(d)(1); and 422.204(b)(2).
• To meet the amendments made at
§ 422.156 by the final rule published in
the April 15, 2011 Federal Register (76
CFR 21498), AAAHC removed Quality
Improvement Projects and Chronic Care
Improvement Programs from its
deeming process.
B. Term of Approval
Based on the review and observations
described in section III of this final
notice, we have determined that
AAAHC’s accreditation program
requirements meet or exceed our
requirements. Therefore, we approve
AAAHC as a national accreditation
organization with deeming authority for
MA HMOs and PPOs, effective July 11,
2012 through July 10, 2018.
V. Collection of Information
Requirements
erowe on DSK2VPTVN1PROD with
This document does not impose
information collection and
recordkeeping requirements.
Consequently, it need not be reviewed
by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35).
Authority: Section 1865 of the Social
Security Act (42 U.S.C. 1395bb).
(Catalog of Federal Domestic Assistance
Program No. 93.778, Medical Assistance
Program; No. 93.773, Medicare—Hospital
Insurance Program; and No. 93.774,
Medicare—Supplemental Medical Insurance
Program).
VerDate Mar<15>2010
15:22 Aug 23, 2012
Jkt 226001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1596–N]
Medicare Program; Solicitation of Two
Nominations to the Advisory Panel on
Hospital Outpatient Payment
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
This notice solicits
nominations for two new members to
the Advisory Panel on Hospital
Outpatient Payment (HOP, the Panel).
There will be two vacancies on the
Panel beginning September 30, 2012.
The purpose of the Panel is to advise
the Secretary of the Department of
Health and Human Services (DHHS)
(the Secretary) and the Administrator of
the Centers for Medicare & Medicaid
Services (CMS) (the Administrator) on
the clinical integrity of the Ambulatory
Payment Classification (APC) groups
and their associated weights, and
supervision of hospital outpatient
services.
The Secretary rechartered the Panel in
2011 for a 2-year period effective
through November 15, 2013.
DATES: Submission of Nominations: We
will consider nominations if they are
received no later than 5 p.m. (e.s.t.)
October 23, 2012.
ADDRESSES: Please mail or hand deliver
nominations to the following address:
Centers for Medicare & Medicaid
Services; Attn: Raymond Bulls,
Advisory Panel on HOP; Center for
Medicare, Hospital & Ambulatory Policy
Group, Division of Outpatient Care;
7500 Security Boulevard, Mail Stop C4–
05–17; Baltimore, MD 21244–1850.
Web site: For additional information
on the Panel and updates to the Panel’s
activities, we refer readers to our Web
site at the following: https://
www.cms.gov/RegulationsandGuidance/Guidance/FACA/
AdvisoryPanelonAmbulatoryPayment
ClassificationGroups.html.
FOR FURTHER INFORMATION CONTACT:
Contact: Persons wishing to nominate
individuals to serve on the Panel or to
obtain further information may also
SUMMARY:
PO 00000
Frm 00032
Fmt 4703
Sfmt 4703
contact Raymond Bulls at the following
email address: APCPanel@cms.hhs.gov
or call 410–786–7267.
Advisory Committees’ Information
Lines: You may also refer to the CMS
Federal Advisory Committee Hotlines at
1–877–449–5659 (toll-free) or 410–786–
3985 (local) for additional information.
News Media: Representatives should
contact the CMS Press Office at 202–
690–6145.
SUPPLEMENTARY INFORMATION:
I. Background
The Secretary is required by section
1833(t)(9)(A) of the Social Security Act
(the Act), and section 222 of the Public
Health Service Act (PHS Act) to consult
with an expert outside advisory panel
regarding the clinical integrity of the
APC groups and relative payment
weights that are components of the
Medicare Hospital Outpatient
Prospective Payment System (OPPS),
and the appropriate supervision level
for hospital outpatient services. The
panel may use data collected or
developed by entities and organizations
(other than DHHS) in conducting the
review. The Panel is governed by the
provisions of the Federal Advisory
Committee Act (FACA) (Public Law 92–
463), as amended (5 U.S.C. Appendix 2),
which sets forth standards for the
formation and use of advisory panels.
The Charter requires that the Panel
meet up to three times annually. CMS
considers the technical advice provided
by the Panel as we prepare the proposed
and final rules to update the OPPS for
the following calendar year.
The Panel shall consist of a chair and
up to 19 members who are full-time
employees of hospitals, hospital
systems, or other Medicare providers
that are subject to the OPPS. (For
purposes of the Panel, consultants or
independent contractors are not
considered to be full-time employees in
these organizations.)
The current Panel members are as
follows: (Note: The asterisk [*] indicates
the Panel members whose terms end on
September 30, 2012.)
• E. L. Hambrick, M.D., J.D., Chair, a
CMS Medical Officer
• Karen Borman, M.D.
• Ruth L. Bush, M.D., M.P.H.
• Lanny Copeland, M.D.
• Kari S. Cornicelli, C.P.A., FHFMA
• Dawn L. Francis, M.D., M.H.S.
• David A. Halsey, M.D.
• Brain D. Kavanagh, M.D., M.P.H.
• Judith T. Kelly, B.S.H.A., RHIT, RHIA,
CCS*
• Scott Manaker, M.D., Ph.D.
• John Marshall, CRA, RCC, RT
• Jim Nelson
E:\FR\FM\24AUN1.SGM
24AUN1
Federal Register / Vol. 77, No. 165 / Friday, August 24, 2012 / Notices
•
•
•
•
erowe on DSK2VPTVN1PROD with
Leah Osbahr
Randall A. Oyer, M.D.*
Jacqueline Phillips
Daniel J. Pothen, M.S., RHIA, CHPS,
CPHIMS, CCS, CCS–P, CHC
• Gregory J. Przbylski, M.D.
• Traci Rabine
• Marianna V. Spanki-Varelas M.D.,
Ph.D., M.B.A.
• Gale Walker
Panel members serve without
compensation, according to an advance
written agreement; however, for the
meetings, CMS reimburses travel, meals,
lodging, and related expenses in
accordance with standard Government
travel regulations. CMS has a special
interest in ensuring, while taking into
account the nominee pool, that the
Panel is diverse in all respects of the
following: geography; rural or urban
practice; race, ethnicity, sex, and
disability; medical or technical
specialty; and type of hospital, hospital
health system, or other Medicare
provider subject to the OPPS.
Based upon either self-nominations or
nominations submitted by providers or
interested organizations, the Secretary,
or her designee, appoints new members
to the Panel from among those
candidates determined to have the
required expertise. New appointments
are made in a manner that ensures a
balanced membership under the FACA
guidelines.
II. Criteria for Nominees
The Panel must be fairly balanced in
its membership in terms of the points of
view represented and the functions to
be performed. Each Panel member must
be employed full-time by a hospital,
hospital system, or other Medicare
provider subject to payment under the
OPPS. All members must have technical
expertise to enable them to participate
fully in the Panel’s work. Such expertise
encompasses hospital payment systems;
hospital medical care delivery systems;
provider billing systems; APC groups;
Current Procedural Terminology codes;
and alpha-numeric Health Care
Common Procedure Coding System
codes; and the use of, and payment for,
drugs, medical devices, and other
services in the outpatient setting, as
well as other forms of relevant expertise.
For supervision deliberations, the Panel
shall have members that represent the
interests of Critical Access Hospitals
(CAHs), who advise CMS only regarding
the level of supervision for hospital
outpatient services.
It is not necessary for a nominee to
possess expertise in all of the areas
listed, but each must have a minimum
of 5 years experience and currently have
full-time employment in his or her area
VerDate Mar<15>2010
15:22 Aug 23, 2012
Jkt 226001
of expertise. Generally, members of the
Panel serve overlapping terms up to 4
years, based on the needs of the Panel
and contingent upon the rechartering of
the Panel. A member may serve after the
expiration of his or her term until a
successor has been sworn in.
Any interested person or organization
may nominate one or more qualified
individuals. Self-nominations will also
be accepted. Each nomination must
include the following:
• Letter of Nomination stating the
reasons why the nominee should be
considered.
• Curriculum Vitae or resume of the
nominee.
• Written and signed statement from
the nominee that the nominee is willing
to serve on the Panel under the
conditions described in this notice and
further specified in the Charter.
• The hospital or hospital system
name and address, or CAH name and
address, as well as all Medicare hospital
and or Medicare CAH billing numbers
of the facility where the nominee is
employee.
III. Copies of the Charter
To obtain a copy of the Panel’s
Charter, we refer readers to our Web site
at the following: https://www.cms.gov/
Regulations-and-Guidance/Guidance/
FACA/AdvisoryPanelonAmbulatory
PaymentClassificationGroups.html.
IV. Collection of Information
Requirements
This document does not impose
information collection and
recordkeeping requirements.
Consequently, it need not be reviewed
by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35).
(Catalog of Federal Domestic Assistance
Program No. 93.774, Medicare—
Supplementary Medical Insurance Program).
Dated: August 8, 2012.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. 2012–20069 Filed 8–23–12; 8:45 am]
BILLING CODE 4120–01–P
PO 00000
Frm 00033
Fmt 4703
Sfmt 4703
51543
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
National Advisory Committee on Rural
Health and Human Services; Notice of
Meeting
In accordance with section 10(a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92–463), notice is hereby given
that the following committee will
convene its seventy-second meeting.
Name: National Advisory Committee
on Rural Health and Human Services.
Dates and Times: September 26, 2012,
9:00 a.m.–5 p.m.; September 27, 2012,
9:00 a.m.–5 p.m.; September 28, 2012,
8:45 a.m.–11:15 a.m.
Place: Radisson Hotel & Suites Austin
Downtown, 111 East Cesar Chavez
Street, Austin, TX 78701.
Phone: (512) 478–9611.
Status: The meeting will be open to
the public.
Purpose: The National Advisory
Committee on Rural Health and Human
Services provides advice and
recommendations to the Secretary with
respect to the delivery, research,
development, and administration of
health and human services in rural
areas.
Agenda: Wednesday morning at 9:00
a.m., the meeting will be called to order
by the Chairman of the Committee, the
Honorable Ronnie Musgrove. The
Committee will be examining the future
of the rural health care infrastructure
and the rural effects of recent changes
to the Temporary Assistance for Needy
Families (TANF) Program. The day will
conclude with a period of public
comment at approximately 5:00 p.m.
Thursday morning at approximately
9:00 a.m., the Committee will break into
Subcommittees and depart for site visits
to rural healthcare and human services
providers in Texas. One panel from the
Health Infrastructure Subcommittee will
visit the Llano Memorial Hospital in
Llano, TX. Another panel from the
Health Infrastructure Subcommittee will
visit Gonzales Healthcare System—
Memorial Hospital, in Gonzales, TX.
The day will conclude at the Radisson
Hotel & Suites Austin Downtown with
a period of public comment at
approximately 5:00 p.m.
The final session will be convened on
Friday morning at 9 a.m. The Committee
will summarize key findings from the
meeting and develop a work plan for the
next quarter and the following meeting.
The meeting will adjourn at 11:15 a.m.
FOR FURTHER INFORMATION CONTACT:
Steve Hirsch, MSLS, Executive
E:\FR\FM\24AUN1.SGM
24AUN1
Agencies
[Federal Register Volume 77, Number 165 (Friday, August 24, 2012)]
[Notices]
[Pages 51542-51543]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-20069]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1596-N]
Medicare Program; Solicitation of Two Nominations to the Advisory
Panel on Hospital Outpatient Payment
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice solicits nominations for two new members to the
Advisory Panel on Hospital Outpatient Payment (HOP, the Panel). There
will be two vacancies on the Panel beginning September 30, 2012.
The purpose of the Panel is to advise the Secretary of the
Department of Health and Human Services (DHHS) (the Secretary) and the
Administrator of the Centers for Medicare & Medicaid Services (CMS)
(the Administrator) on the clinical integrity of the Ambulatory Payment
Classification (APC) groups and their associated weights, and
supervision of hospital outpatient services.
The Secretary rechartered the Panel in 2011 for a 2-year period
effective through November 15, 2013.
DATES: Submission of Nominations: We will consider nominations if they
are received no later than 5 p.m. (e.s.t.) October 23, 2012.
ADDRESSES: Please mail or hand deliver nominations to the following
address: Centers for Medicare & Medicaid Services; Attn: Raymond Bulls,
Advisory Panel on HOP; Center for Medicare, Hospital & Ambulatory
Policy Group, Division of Outpatient Care; 7500 Security Boulevard,
Mail Stop C4-05-17; Baltimore, MD 21244-1850.
Web site: For additional information on the Panel and updates to
the Panel's activities, we refer readers to our Web site at the
following: https://www.cms.gov/Regulations-andGuidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.
FOR FURTHER INFORMATION CONTACT:
Contact: Persons wishing to nominate individuals to serve on the
Panel or to obtain further information may also contact Raymond Bulls
at the following email address: APCPanel@cms.hhs.gov or call 410-786-
7267.
Advisory Committees' Information Lines: You may also refer to the
CMS Federal Advisory Committee Hotlines at 1-877-449-5659 (toll-free)
or 410-786-3985 (local) for additional information.
News Media: Representatives should contact the CMS Press Office at
202-690-6145.
SUPPLEMENTARY INFORMATION:
I. Background
The Secretary is required by section 1833(t)(9)(A) of the Social
Security Act (the Act), and section 222 of the Public Health Service
Act (PHS Act) to consult with an expert outside advisory panel
regarding the clinical integrity of the APC groups and relative payment
weights that are components of the Medicare Hospital Outpatient
Prospective Payment System (OPPS), and the appropriate supervision
level for hospital outpatient services. The panel may use data
collected or developed by entities and organizations (other than DHHS)
in conducting the review. The Panel is governed by the provisions of
the Federal Advisory Committee Act (FACA) (Public Law 92-463), as
amended (5 U.S.C. Appendix 2), which sets forth standards for the
formation and use of advisory panels.
The Charter requires that the Panel meet up to three times
annually. CMS considers the technical advice provided by the Panel as
we prepare the proposed and final rules to update the OPPS for the
following calendar year.
The Panel shall consist of a chair and up to 19 members who are
full-time employees of hospitals, hospital systems, or other Medicare
providers that are subject to the OPPS. (For purposes of the Panel,
consultants or independent contractors are not considered to be full-
time employees in these organizations.)
The current Panel members are as follows: (Note: The asterisk [*]
indicates the Panel members whose terms end on September 30, 2012.)
E. L. Hambrick, M.D., J.D., Chair, a CMS Medical Officer
Karen Borman, M.D.
Ruth L. Bush, M.D., M.P.H.
Lanny Copeland, M.D.
Kari S. Cornicelli, C.P.A., FHFMA
Dawn L. Francis, M.D., M.H.S.
David A. Halsey, M.D.
Brain D. Kavanagh, M.D., M.P.H.
Judith T. Kelly, B.S.H.A., RHIT, RHIA, CCS*
Scott Manaker, M.D., Ph.D.
John Marshall, CRA, RCC, RT
Jim Nelson
[[Page 51543]]
Leah Osbahr
Randall A. Oyer, M.D.*
Jacqueline Phillips
Daniel J. Pothen, M.S., RHIA, CHPS, CPHIMS, CCS, CCS-P, CHC
Gregory J. Przbylski, M.D.
Traci Rabine
Marianna V. Spanki-Varelas M.D., Ph.D., M.B.A.
Gale Walker
Panel members serve without compensation, according to an advance
written agreement; however, for the meetings, CMS reimburses travel,
meals, lodging, and related expenses in accordance with standard
Government travel regulations. CMS has a special interest in ensuring,
while taking into account the nominee pool, that the Panel is diverse
in all respects of the following: geography; rural or urban practice;
race, ethnicity, sex, and disability; medical or technical specialty;
and type of hospital, hospital health system, or other Medicare
provider subject to the OPPS.
Based upon either self-nominations or nominations submitted by
providers or interested organizations, the Secretary, or her designee,
appoints new members to the Panel from among those candidates
determined to have the required expertise. New appointments are made in
a manner that ensures a balanced membership under the FACA guidelines.
II. Criteria for Nominees
The Panel must be fairly balanced in its membership in terms of the
points of view represented and the functions to be performed. Each
Panel member must be employed full-time by a hospital, hospital system,
or other Medicare provider subject to payment under the OPPS. All
members must have technical expertise to enable them to participate
fully in the Panel's work. Such expertise encompasses hospital payment
systems; hospital medical care delivery systems; provider billing
systems; APC groups; Current Procedural Terminology codes; and alpha-
numeric Health Care Common Procedure Coding System codes; and the use
of, and payment for, drugs, medical devices, and other services in the
outpatient setting, as well as other forms of relevant expertise. For
supervision deliberations, the Panel shall have members that represent
the interests of Critical Access Hospitals (CAHs), who advise CMS only
regarding the level of supervision for hospital outpatient services.
It is not necessary for a nominee to possess expertise in all of
the areas listed, but each must have a minimum of 5 years experience
and currently have full-time employment in his or her area of
expertise. Generally, members of the Panel serve overlapping terms up
to 4 years, based on the needs of the Panel and contingent upon the
rechartering of the Panel. A member may serve after the expiration of
his or her term until a successor has been sworn in.
Any interested person or organization may nominate one or more
qualified individuals. Self-nominations will also be accepted. Each
nomination must include the following:
Letter of Nomination stating the reasons why the nominee
should be considered.
Curriculum Vitae or resume of the nominee.
Written and signed statement from the nominee that the
nominee is willing to serve on the Panel under the conditions described
in this notice and further specified in the Charter.
The hospital or hospital system name and address, or CAH
name and address, as well as all Medicare hospital and or Medicare CAH
billing numbers of the facility where the nominee is employee.
III. Copies of the Charter
To obtain a copy of the Panel's Charter, we refer readers to our
Web site at the following: https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.
IV. Collection of Information Requirements
This document does not impose information collection and
recordkeeping requirements. Consequently, it need not be reviewed by
the Office of Management and Budget under the authority of the
Paperwork Reduction Act of 1995 (44 U.S.C. 35).
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program).
Dated: August 8, 2012.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2012-20069 Filed 8-23-12; 8:45 am]
BILLING CODE 4120-01-P