Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2013, 26038-26051 [2013-10106]

Download as PDF 26038 Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices compliance with ACHC’s program requirements. These monitoring procedures are used only when ACHC identifies noncompliance. If noncompliance is identified through validation reviews or complaint surveys, the State survey agency monitors corrections as specified at § 488.7(d). ++ ACHC’s capacity to report deficiencies to the surveyed facilities and respond to the facility’s plan of correction in a timely manner. ++ ACHC’s capacity to provide CMS with electronic data and reports necessary for effective validation and assessment of the organization’s survey process. ++ ACHC’s staff adequacy and other resources, and its financial viability. ++ ACHC’s capacity to adequately fund required surveys. ++ ACHC’s policies with respect to whether surveys are announced or unannounced, to assure that surveys are unannounced. ++ ACHC’s agreement to provide CMS with a copy of the most current accreditation survey together with any other information related to the survey as CMS may require (including corrective action plans). 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). DEPARTMENT OF HEALTH AND HUMAN SERVICES V. Response to Comments Because of the large number of public comments we normally receive on Federal Register documents, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, when we proceed with a subsequent document, we will respond to the comments in the preamble to that document. Upon completion of our evaluation, including evaluation of comments received as a result of this notice, we will publish a final notice in the Federal Register announcing the result of our evaluation. [CMS–9079–N] (Catalog of Federal Domestic Assistance Program No. 93.778, Medical Assistance Program; No. 93.773, Medicare—Hospital Insurance Program; and No. 93.774, Medicare—Supplementary Medical Insurance Program) Centers for Medicare & Medicaid Services Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—January Through March 2013 Centers for Medicare & Medicaid Services (CMS), HHS. AGENCY: ACTION: Notice. SUMMARY: This quarterly notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from January through March 2013, relating to the Medicare and Medicaid programs and other programs administered by CMS. This document does not impose information collection and [FR Doc. 2013–10421 Filed 5–2–13; 8:45 am] BILLING CODE 4120–01–P 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 each of the addenda published in this notice. I. Background health care providers, and the public; and (2) maintaining effective communications with CMS regional offices, state governments, state Medicaid agencies, state survey agencies, various providers of health care, all Medicare contractors that process claims and pay bills, National Association of Insurance Commissioners (NAIC), health insurers, and other stakeholders. 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) and Public Health Service Act. We also issue various manuals, memoranda, and statements necessary to administer and oversee the programs efficiently. The Centers for Medicare & Medicaid Services (CMS) is responsible for administering the Medicare and Medicaid programs and coordination and oversight of private health insurance. Administration and oversight of these programs involves the following: (1) Furnishing information to Medicare and Medicaid beneficiaries, VerDate Mar<15>2010 14:52 May 02, 2013 Jkt 229001 PO 00000 Frm 00100 Fmt 4703 Sfmt 4703 E:\FR\FM\03MYN1.SGM 03MYN1 EN03MY13.000</GPH> erowe on DSK2VPTVN1PROD with NOTICES IV. Collection of Information Requirements Dated: April 19, 2013. Marilyn Tavenner, Acting Administrator, Centers for Medicare & Medicaid Services. FOR FURTHER INFORMATION CONTACT: Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices Section 1871(c) 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. erowe on DSK2VPTVN1PROD with NOTICES II. Revised Format for the Quarterly Issuance Notices While we are publishing the quarterly notice required by section 1871(c) of the Act, we will no longer republish duplicative information that is available to the public elsewhere. We believe this approach is in alignment with CMS’ commitment to the general principles of the President’s Executive Order 13563 released January 2011 entitled ‘‘Improving Regulation and Regulatory Review,’’ which promotes modifying and streamlining an agency’s regulatory program to be more effective in achieving regulatory objectives. Section 6 of Executive Order 13563 requires agencies to identify regulations that may be ‘‘outmoded, ineffective, insufficient, or excessively burdensome, and to modify, streamline, expand or repeal them in accordance with what has been VerDate Mar<15>2010 14:52 May 02, 2013 Jkt 229001 learned.’’ This approach is also in alignment with the President’s Open Government and Transparency Initiative that establishes a system of transparency, public participation, and collaboration. Therefore, this quarterly notice provides only the specific updates that have occurred in the 3-month period along with a hyperlink to the full listing that is available on the CMS Web site or the appropriate data registries that are used as our resources. This information is the most current up-to-date information and will be available earlier than we publish our quarterly notice. We believe the Web site list provides more timely access for beneficiaries, providers, and suppliers. We also believe the Web site offers a more convenient tool for the public to find the full list of qualified providers for these specific services and offers more flexibility and ‘‘real time’’ accessibility. In addition, many of the Web sites have listservs; that is, the public can subscribe and receive immediate notification of any updates to the Web site. These listservs avoid the need to check the Web site, as notification of PO 00000 Frm 00101 Fmt 4703 Sfmt 4703 26039 updates is automatic and sent to the subscriber as they occur. If assessing a Web site proves to be difficult, the contact person listed can provide information. III. How To Use the Notice This notice is organized into 15 addenda so that a reader may access the subjects published during the quarter covered by the notice 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 should view the manuals at https:// www.cms.gov/manuals. Authority: (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: April 24, 2013. Kathleen Cantwell, Director, Office of Strategic Operations and Regulatory Affairs. BILLING CODE 4120–01–P E:\FR\FM\03MYN1.SGM 03MYN1 erowe on DSK2VPTVN1PROD with NOTICES 26040 VerDate Mar<15>2010 Jkt 229001 PO 00000 Frm 00102 Fmt 4703 Addendum I: Medicare and Medicaid Manual Instructions (January through March 2013) The CMS Manual System is used by CMS program components, partners, providers, contractors, Medicare Advantage organizations, and State Survey Agencies to administer CMS programs. It offers day-to-day operating instructions, policies, and procedures based on statutes and regulations, guidelines, models, and directives. In 2003, we transformed the CMS Program Manuals into a web user-friendly presentation and renamed it the CMS Online Manual System. Sfmt 4725 E:\FR\FM\03MYN1.SGM 03MYN1 How to Obtain Manuals The Internet-only Manuals (lOMs) are a replica of the Agency's official record copy. Paper-based manuals are CMS manuals that were officially released in hardcopy. The majority of these manuals were transferred into the Internet-only manual (10M) or retired. Pub 15-1, Pub 15-2 and Pub 45 are exceptions to this rule and are still active paper-based manuals. The remaining paper-based manuals are for reference purposes only. If you notice policy contained in the paper-based manuals that was not transferred to the 10M, send a message via the CMS Feedback tool. Those wishing to subscribe to old versions ofCMS manuals should contact the National Technical Information Service, Department of Commerce, 5301 Shawnee Road, Alexandria, VA 22312 Telephone (703605-6050). You can download copies of the listed material free of charge at: ill1r~!!JlhgQYLl:!lll!!lli1~. How to Review Transmittals or Program Memoranda Those wishing to review transmittals and program memoranda can access this information at a local Federal Depository Library (FDL). Under the FDL program, government publications are sent to approximately 1,400 EN03MY13.001</GPH> 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. This information is av ailab Ie at lillJ[;il}"IIYf:li:.ill1!~9J!1.liJ2]:ill1YiiL 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. CMS publication and transmittal numbers are shown in the listing entitled Medicare and Medicaid Manual Instructions. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the Medicare National Coverage Determination publication titled Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Pain (CLBP) use CMS-Pub. 100-03, Transmittal No. 149. Addendum I lists a unique CMS transmittal number for each instruction in our manuals or program memoranda and its subject number. 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 manual. For the purposes of this quarterly notice, we list only the specific updates to the list of manual instructions that have occurred in the 3-month period. This information is available on our website at ~~£Il~~@1ill:!!illlli. Transmittal Number ManuaUSubject/Publication Number 00 None 166 Chapter 13 of the Benefit Policy Manual has been reorganized and updated Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services Expansion of Medicare Telehealth Services for CY 2013 List of Medicare Telehealth Services April 2013 Update of the Hospital Outpatient Prospective Payment System (OPPS) Coverage of Outpatient Therapeutic Services Incident to a Physician's Service Furnished on or after January 1, 2010 Non-Surgical Extended Duration Therapeutic Services 167 169 Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 Publication Dates for the Previous Four Quarterly Notices We publish this notice at the end of each quarter reflecting information released by CMS during the previous quarter. The publication dates of the previous four Quarterly Listing of Program Issuances notices are: February 21, 2012 (77 FR 9931), May 18,2012 (77 FR 29648), August 17,2012 (77 FR 49799) and November 9,2012 (77 FR 67368). For the purposes of this quarterly notice, we are providing only the specific updates that have occurred in the 3-month period along with a hyperlink to the website to access this information and a contact person for questions or additional information. erowe on DSK2VPTVN1PROD with NOTICES VerDate Mar<15>2010 150 Jkt 229001 152 2627 PO 00000 Frm 00103 2628 Fmt 4703 Sfmt 4725 2629 E:\FR\FM\03MYN1.SGM 2630 2631 2632 03MYN1 2633 2634 2635 2636 2637 2638 2639 2640 2641 General Billing In struction s Qualified Nonphysician Anesthetist Special Bi lling and Paymnet Situations Qualified Nonphysician Anesthetist and an Anesthesiologist in a Single Anesthesia Procedure Payment for Medical or Surgical Services Furnished by CRNAs Conversion Factors for Anesthesia Services of Qualified Nonphysician Anesthetists Furnished on or After January I, 1992 Emergency Update to the CY 2013 Medicare Physician Fee Schedule Database (MPFSDB) Nationa l Correct Coding Initiative (NCCI) Add-On Codes Replacement of Identical Letter, Dated December 19, 1996 with Subject Line, Correct Coding Initiative Add-On (ZZZ) Codes- ACTION 2013 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List Manual Updates to Clarify IRF Claims Processing Inpatient Rehabilitation Faci lity Prospective Payment System (IRF PPS) Medicare IRF Classification Requirements Criteria That Must Be Met By Inpatient Rehabilitation Faci lities Additional Criteria That Must Be Met By Inpatient Rehabilitation Units Verification Process Used to Determine if the Inpatient Rehabilitation Facility Met the New IRFs Classification Criteria Changes in the Status of an IRF Unit New IRF Beds Change of Ownership or Leasing Mergers Retroactive Adjustments For Provisionally Excluded IRFs or IRF Beds Payment Provisions Under IRF PPS Phase-In Implementation Payment Adjustment Factors and Rates Case-Mix Groups Case-Level Adjustments Facility-Level Adjustments Area Wage Adjustments Rural Adjustment Low-Income Patient (LIP) Adjustment: The Supplemental Security Income (SSI) Medicare Beneficiary Data for Inpatient Rehabilitation Facilities (IRFs) Paid Under the Prospective Payment System (PPS) FTE Resident Cap Outliers Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded trom Clinical Laboratory Improvement Amendments (CLlA) Edits Issued to a specific aud ience not posted to Internet/Intranet due to Confidential ofTnstruction Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Determination, Addition of Laparoscopic Sleeve Gastrectomy (LSG) General HCPCS Procedure Codes for Bariatric Surgery ICD-9 Procedure Codes for Bariatric Surgery (Fls only) Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 151 Medicare National Coverage Determination (CMS-Pub. 100-03) Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Determination, Addition of Laparoscopic Sleeve Gastrostomy (LSG) Bariatric Surgery for Treatment of Morbid Obesity Change of Address for Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting Facility Approval and Recertification Letter Submission Percutaneous Transluminal Angioplasty (PTA) Autologous Platelet-Rich Plasma (PRP) for Chron ic Non-Healing Wounds Blood-Derived Products for Chronic Non-Healing Wounds Medicare Claims Processin!! (CMS-Pub. 100-04) Fiscal Year (FY) 2013 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (L TCH) PPS Changes Medicare Code Editor (MCE) Disproportionate Share Hospital (DSH) Policy Changes Effective for Cost Reporting Periods beginning on or after October I, 2009 Disproportionate Share Hospital (DSH) Policy Changes Effective for Cost Reporting Periods Beginning on or after October], 2012 NCD: Transcatheter Aortic Valve Replacement (TAVR) Cod ing Coding Requirements for TA VR Services Furnished On or After January 2013 Update/Policy Clarification Claims Processing Requirements for TA VR Services on Professional Claim s Claims Processing Requirements for TA VR Services for Medicare Advantage (MA) Plan Participants Updating the VMAP/4D Table with B5 Ocularist Specialty Code Billing for Durable Medical Eq uipment (DME) and Orthotic/ Prosthetic Devices Provider Billing for Prosthetics and Orthotic Devices Calendar Year (CY) 2013 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment Summary of Policies in the CY 2013 Medicare Physician Fee Schedule (MPFS) Final Rule and the Telehealth Originating Site Facility Fee Payment Amount CY 2013 Update for Durable Medical Eq uipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Gap-filling DMEPOS Fees Common Edits and Enhancements Modules (CEM) Code Set Update Qualified Nonphysician Anesthetist Services Qualified Nonphysician Anesthetist Services Qualified Nonphysician Anesthetists Issuances ofUPINs Annual Review ofCRNA Certifications Entity or Individual to Whom Fee Schedule is Payable for Qualified Nonphysician anesthetists Anesthesia Fee Schedule Payment for Qualified Nonphysician Anesthetists Conversion Factors Used on or After January], ]997 for Qualified Nonphysician Anestheti sts Anesthesia Time and Calculation of Anesthesia Time Units Billing Modifiers 26041 EN03MY13.002</GPH> erowe on DSK2VPTVN1PROD with NOTICES 26042 VerDate Mar<15>2010 2643 Jkt 229001 PO 00000 Frm 00104 Fmt 4703 Sfmt 4725 2644 2645 E:\FR\FM\03MYN1.SGM 2646 2647 2648 2649 2650 03MYN1 2651 2652 2653 2654 EN03MY13.003</GPH> 2655 2656 2657 2658 2659 2660 2661 2662 2663 2664 2665 2666 Revocation of RNBCl Election Completion of the Notice of Election for RNHCI Common Working File (CWF) Processing of Elections, Revocations and Cancelled Elections When to Bill for RNHCI Services Required Data Elements on Claims for RNHCI Services RNHCI Claims Processing By the Medicare Contractor with RNCHI Specialty Workload RNHCI Claims Not Billed to Original Medicare Informing Beneficiaries of the Results ofRNHCI Claims Processing Billing and Payment ofRNHCI Item and Services Furnished in the Home Processing Claims For Beneficiaries With RNHCl Elections by Contractors Without RNHCI Specialty Workloads Recording Determinations of ExceptediNonexcepted Care on Claim Records Informing Beneficiaries of the Results of ExceptedlNonexcepted Care Determinalions by the Non-specially Conlra<.:lor Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction Update To Publication 100-04, Claims Processing Instructions For Chapter 12, Non-Physician Practitioners (NPPs) Assistant-at-Surgery Services Physician Assistant (PA) Services Payment Methodology Global Surgical Payments Limitations for Assistant-at-Surgery Services Furnished by Physician Assistants Outpatient Mental Health Treatment Limitation Expansion of Medicare Telehealth Services for CY 2013 List of Medicare Telehealth Services Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction Instructions for Downloading the Medicare ZIP Code File for July 2013 Healthcare Provider Taxonomy Codes (HPTC) Update, April 2013 April Quarterly Update for 2013 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule April 2013 Update of the Ambulatory Surgical Center (ASC) Payment System April Update to the CY 2013 Medicare Physician Fee Schedule Database (MPFSDB) April 2013 Update of the Hospital Outpatient Prospective Payment System (OPPS) Issued to a specific audience not posted to Internet/Intranet due to Confidentiality of Instruction Autologous Platelet-Rich Plasma (PRP) for Chronic Non-Healing Wounds Autologous Platelet-Rich Plasma (PRP) for Chronic Non-Healing Wounds Policy Healthcare Common Procedure Coding System (HCPCS) Codes and Diagnosis Coding Payment Method Place of Service (POS) Professional Claims Medicare Summary Notices (MSNs), Remittance Advice Remark Codes Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 2642 ICD-9 Diagnosis Codes for BMI2:35 Claims Guidance for Payment Hospice Monthly Billing Requirement Frequency of Billing and Same Day Billing Streamlining the Process for Updating the Abstract Files Used to Price Institutional Claims Optional Method for Outpatient Services: Cost-Based Facility Services Plus 115 Percent Fee Schedule Payment for Professional Services RESERVED Clinical Diagnostic Laboratory Fee Schedule Access to Clinical Diagnostic Lab Fee Schedule Files Institutional Claim Record Layout for Clinical Laboratory Fee Schedule Fee Schedules Used by Medicare Contractors Processing Institutional Claims Institutional Claim Record Layout for the Durable Medical Equipment, Prosthetic, Orthotic and Supply Fee Schedule Institutional Claim Record Layout for Hospice, Radiology and Other Diagnostic Prices and Local HCPCS Codes Institutional Claim Record Layout for the Outpatient Rehabilitation and CORF Services Fee Schedule Institutional Claim Record Layout for the Skilled Nursing Facility Fce Schedule RESERVED Physician Fee Schedule Payment Policy Indicator File Record Layout Institutional Claim Record Layout for the Mammography Fcc Schedule Institutional Claim Record Layout for the Ambulance Fee Schedule Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction Issued to a specific audience, not posted to Internet/Intranet/ due to Sensitivity of Instruction Issued to a specific audience, not posted to Internet/Intranet/ due to Confidentialitv ofInstruction Issued to a specific audience, not posted to Internet/Intranct due to Confidentiality of Instruction Adjustment to Fiscal Intermediary Shared System (FISS) Consistency Edit to Validate Attending Physician NPI. Issued to a specific audience, not posted to Internet/Intranet/ due to Confidentiality of Instruction Data Reporting on Home Health Prospective Payment System (BB PI'S) Claims HH PI'S Claims Input/output Record Layout Emergency Update to the CY 2013 Medicare Physician Fee Schedule Database (MPFSDB) Expansion of Medicare Telehealth Services for CY 2013 Summary of Policies in the CY 2013 Medicare Physician Fee Schedule (MPFS) Final Rule and the Tclehealth Originating Site Facility Fee Payment Amount Updates to Claims Processing Instructions Regarding Religious Nonmedical Health Care Instructions (RNHCI) Requirement for RNHCI Election erowe on DSK2VPTVN1PROD with NOTICES VerDate Mar<15>2010 2667 Jkt 229001 PO 00000 Frm 00105 Fmt 4703 2669 Sfmt 4725 2670 E:\FR\FM\03MYN1.SGM 2671 2672 2673 2674 2675 Low-Income Patient (LIP) Adjustment: The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Inpatient Rehabilitation Facilities (lRFs) Paid Under the Prospective Payment System (PPS) Teaching Status Adjustment FTE Resident Cap Outliers Changes to Contractor Designation in Processing Foreign, Emergency and Shipboard Claims Contractors Designated to Process Foreign Claims Source of Part B Claims Designated Contractors Clinical Laboratory Fee Schedule Medicare Travel Allowance Fees for Collection of Specimens ···MedicareSec(mdary: P\tyer(CMS~Pllb.l00~(l~1· . .. .... 90 Inpatient Hospital Claims and Medicare Secondary Payer (MSP) Claims with Medicare Coinsurance Days and/or Medicare Lifetime Reserve Days Occurring in the Third or More Calendar Years Return Codes Installation Part A Processing Requirements Error Resolution Payment Calculation For Inpatient Bills (MSPPA YAI Module) 215 Update MCS HVSRPARC- Participating Physicians/Suppliers Report- Group Codes Modification/Addition of Group Codes/Specialty Codes Non-Physician Practitioner/Supplier Specialty Codes Notice of New Interest Rate for Medicare Overpayments and Underpayments-2nd qtr. Notification for FY 2013 216 217 03MYN1 83 Revisions to Appendix E and Chapter 2 sections 2290-2308 of the State Operations Manual (SOM) 447 Medical Review Timeliness Requirements Complex Medical Review Deletion ofMR Operations mailbox Contractor Medical Director (CMD) Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction Update to Chapter 15 of the Program Integrity Manual (PIM) Provider and Supplier Types/Services Mammography Screening Centers Owning and Managing Organizations Owning and Managing Individuals Processing Form CMS-855R Applications Special Program Integrity Procedures Intervening Change of Ownership (CHOW) Returns Rejections 448 449 450 . Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 2668 (RARCs), Claim Adjustment Reason Codes (CARCS), and Group Codes April20J3 Integrated Outpatient Code Editor (1I0CE) Specitlcations Version 14.1 Internet Only Manual (10M) Update to Payment for Medical or Surgical Services Furnished by CRNAs. This CR rescinds and fully replaces CR 8027. Qualified Nonphysician Anesthetists Services Qualified Nonphysician Anesthetists Issuance of UP INs Annual Review of CRNA Certificates Entity or Individual to Whom Fee Schedule is Payable for Qualitled Nonphysician anesthetists Anesthesia Fee Schedule Payment for Qualified Nonphysician Anesthetists Conversion Factors Used on or Aller January I, 1997 for Qualified Nonphysician Anesthetists Anesthesia Time and Calculation of Anesthesia Time Units Billing Modifiers General Billing Instructions An Anesthesiologist and Qualitled Nonphysician Anesthetist Work Together Qualified Nonphysician Anesthetist Special Billing and Payment Situations Qualitled Nonphysician Anesthetist and an Anesthesiologist in a Single Anesthesia Procedure Payment for Medical or Surgical Services Furnished by CRNAs Conversion Factors for Anesthesia Services of Qualitled Nonphysician Anesthetists Furnished on or After January I, 1992. Quarterly Update to the Correct Coding Initiative (CCl) Edits, Version 19.1, Effective April I, 2013 Moditlcation to CWF, FISS, MCS and VMS to Return Submitted Information when there is a CWF Name and HIC Number Mismatch New Waived Tests Quarterly Update ofHCPCS Codes Used for Home Health Consolidated Billing Enforcement Manual Updates to Clarity IRF Claims Processing Inpatient Rehabilitation Facility Prospective Payment System (lRF PPS) Medicare IRF Classification Requirements Criteria That Must Be Met By Inpatient Rehabilitation Facilities Additional Criteria That Must Be Met By Inpatient Rehabilitation Units Verification Process Used to Determine if the Inpatient Rehabilitation Facility Met the ClNew IRFs Classification Criteria Changes in the Status of an IRF Unit New IRF Beds Change of Ownership or Leasing Mergers Retroactive Adjustments For Provisionally Excluded IRFs or IRF Beds Payment Provisions Under IRF PPS Phase-In Implementation Case-Mix Groups Case-Level Adjustments Facility-Level Adjustments Area Wage Adjustments Rural Adjustment 26043 EN03MY13.004</GPH> erowe on DSK2VPTVN1PROD with NOTICES 26044 VerDate Mar<15>2010 1172 1173 1174 Jkt 229001 1175 1176 00 None 'i; 00 00 None 00 None 00 None Fmt 4703 87 1177 None Frm 00106 PO 00000 '1:;;;"$,7, 1178 .~./'7;;z; 1180 Sfmt 4725 >{li:i; '''0/''', Implementation Support and Payment Processing for the Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration- Processing of Shared Savings Payments lor Practices in Pennsylvania 1181 1182 1183 i· 1162 E:\FR\FM\03MYN1.SGM 1163 1164 1165 1166 03MYN1 1167 1168 1169 1170 1171 EN03MY13.005</GPH> 1179 International Classification of Diseases (lCD)-1 0 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS National Coverage Determinations (NCDs) (CR Medicare Remit Easy Print (MREP) Enhancement Implementation of New and Revised Medicare Summary Notice (MSN) Messages and Discontinuation of Obsolete MSN Messages International Classification of Diseases (ICD)-I 0 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS National Coverage Determinations (NCDs) (CR Issued to specific audience, not posted to Internetflntranet due to Confidentiality of Instruction Correction to Common Working File (CWF) A/B Crossover Edit 7272 for Transfer to Home for Home Health Services Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality oflnstruction Modification of Payment Window Edit in the Common Working File (CWF) to ModifY Diagnostic Service List Common Working File (CWF) Informational Unsolicited Response (IUR) or Reject for place of service billed by physician office and either ambulatory surgical center or inpatient hospital, for the same beneficiary, same date of service, and same procedure, based on sequence received of the Part B claim. Instructions to Contractors for Implementing Section 5506 of the Affordable 1184 1185 1186 1187 1188 1189 1190 1191 1192 1193 1194 1195 Care Act (ACA)-Preservation of Resident Cap Positions from Closed Teaching Hospitals-Round I and Round 2 Only Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program: Correction to the Medicare Summary Notice Message for PEN Items FUlllished to Traveling Beneficiaries Changes to the Laboratory National Coverage Determination (NCD) Software for ICD-IO Issued to specific audience, not posted to Internet/Intranet due to Confidentiality of!nstruction Health Insurance Portability and Accountability Act (HIPAA) ED! Front End Updates for July 2013 Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction Issued to a specific audience, not posted to Intellletf Intranet due to Sensitivity of Instruction Issued to a specific audience, not posted to Intelllet/ Intranet due to Confidentiality of Instruction Issued to a specific audience, not posted to Internet! Intranet due to Contidentiality of Instruction Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction Incentive Payment Related to Prior Authorization for Power Mobility Devices (PMD). Revision to CWF and VMS: Reject or Informational Unsolicited Response (IUR) Edit for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Provided During an Inpatient Stay Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) National Competitive Bidding (NCB): Using the "KY" Modifier to Bill for Accessories for Non-NCB Wheelchair Base Units Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instruction FISS Prepayment Review Report Standardizing the standard - Operating Rules for code usage in Remittance Advice Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of! nstruction Bundled Payments for Care Improvement Model 4 - I'll and SMI Payment Attribution and Outlier Payments Recovery of Annual Wellness Visit (AWV) Overpayments ICD-IO CR--Updates to National Coverage Determination/Local Coverage The Inclusion of Veterans Administration (VA) Skilled Nursing Facility (SNF) claims to the VA Medicare Remittance Advice (eMRA) ProcessImplementation Standardizing the Standard - Phase I Multiple Procedure Payment Reduction (MPPR) for Selected Therapy Services Inpatient Prospective Payment System (IPPS) Hospital Extensions per the Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 451 Non-Certified Suppliers and Individual Practitioners Changes of Information-General Procedures Electronic Fund Transfers (EFT) Application Fees Corrective Action Plans (CAPs) HHA Ownership Changes Deactivations and Reactivations Zone Program Integrity Contractor (ZPIC) Identified Revocations Minor changes to Chapter I of the Program Integrity Manual The Affiliated Contractor (AC) and MAC Medical Review Program Provider Self Audits erowe on DSK2VPTVN1PROD with NOTICES VerDate Mar<15>2010 1198 1199 Jkt 229001 1200 PO 00000 1201 1202 Frm 00107 1203 1204 Fmt 4703 American Taxpayer Relief Act of2012 Outpatient Therapy Functional Reporting Non-Compliance Alerts Implementation of the Award for Jurisdiction 6 Part NPart B Medicare Administrative Contractor (J6 AlB MAC Issued to a specific audience, not posted to Internetllntranet due to Sensitivity of Instruction International Classification of Diseases (ICD)-I 0 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as they relate to CMS National Coverage Determinations (NCDs) The Supplemental Security Income (SSI)/Medicare Beneiiciary Data for Fiscal Year 2010 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs) Implementation ofthe Award for Jurisdiction E Part AlPart B Medicare Administrative Contractor (JE AlB MAC). Transition to New Centers for Medicare and Medicaid Services (CMS) Identity Mark CMS Administrator's Ruling: Part A to Part B Rebilling of Denied Hospital Inpatient Claims Issued to a specific audience, not posted to Internetl Intranet due to Coniidentiality of Instruction Sfmt 4725 E:\FR\FM\03MYN1.SGM 03MYN1 Addendum II: Regulation Documents Published in the Federal Register (January through March 2013) Regulations and Notices Regulations and notices are published in the daily Federal Register. To purchase individual copies or subscribe to the Federal Register, contact GPO at 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 available 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 I (January 2, 1994) through the present date and can be accessed at The following website provides information on how to access electronic editions, printed editions, and reference copies. This information is available on our website at: Addendum III: CMS Rulings 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. The rulings can be accessed at For questions or additional information, contact Tiffany Lafferty (410-786-7548). Addendum IV: Medicare National Coverage Determinations (January through March 2013) Addendum IV includes completed national coverage determinations (NCDs), or reconsiderations of completed NCDs, from the quarter covered by this notice. Completed decisions are identified by the section of the NCD Manual (NCDM) in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. An NCD is a determination by the Secretary for whether or not a particular item or service is covered nationally under the Medicare Program (title XVIII of the Act), but does not include a determination of the code, if any, that is assigned to a particular covered item or service, or payment determination for a particular covered item or service. The entries below include information concerning completed decisions, as well as sections on program and decision memoranda, which also announce decisions or, in some cases, explain why it was not appropriate to issue an NCD. Information on completed decisions as well as pending decisions has also been posted on the CMS website. For the purposes of this quarterly notice, we list only the specific updates that have occurred in the 3-month period. This information is available at: ~~&lJ]~~@!~jf!ll@::fQ~M~ For questions or additional information, contact Wanda Belle (410-786-7491). Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 1196 1197 For questions or additional information, contact Terri Plumb (410-786-4481). 26045 EN03MY13.006</GPH> erowe on DSK2VPTVN1PROD with NOTICES 14:52 May 02, 2013 International Classification of Diseases (ICD)-IO Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS National Coverage Determinations (NCDs) 26046 VerDate Mar<15>2010 Title PO 00000 Frm 00108 Fmt 4703 Sfmt 4725 E:\FR\FM\03MYN1.SGM Transmittal Number 270.3 RI52NCD Issue Date Effective Date 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 investigational device exemption (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 notice published in the April 21, 1997 Federal Register (62 FR 19328). IDE G120280 G120286 G120287 GI20289 RI190TN 03/15/2013 711/2013 and 1011114 G120291 GI20296 G120301 GI20193 G130003 G120298 G120093 GI30020 GI30011 G130016 GI20039 GI20270 03/08/2013 08/02/2012 03MYN1 Addendum V: FDA-Approved Category B Investigational Device Exemptions (IDEs) (January through March 2013) Addendum V includes listings of the FDA-approved investigational device exemption (IDE) numbers that the FDA assigns. The listings are organized according to the categories to which the devices are assigned (that is, Category A or Category B), and identified by the IDE number. For the purposes ofthis quarterly notice, we list only the specific updates to the Category B IDEs as of the ending date of the period covered by this notice and a contact person for questions or additional information. For questions or additional information, contact John Manlove (410-7866877). BBI5363 GI20228 G120276 G120239 GI30026 GI30027 G130030 GI30028 G120115 G120250 G130032 GI30031 G130035 G130041 GI30043 G130038 Device Strattice Tissue Matrix The Vysis Cll CDX FISH Kit Neural Communication System (NCS) NMARQ Multi-Electrode Pulmonary Vein Isolation Ablation System Transcatheter Valve Therapy (TVT) Registry Assessment of Alternative Access Approaches For Transcatheter Aortic Valve Noninvasive Electrical Stimulation of Acupuncture Points (NESAP) Precision Bead Envista One-Piece Hydrophobic Acrylic Toric Intraocular Lens Gunther Tulip Vena Cava Filter Constellation Catheter The Paradym RF Sonr Cardiac Resynchronization Therapy With Difibrillation Device (Model 9770) N euro-Thrombectomy Devices Renal Artery Irradiation For Sympathetic Renal Denervation Pediatric Gene Target Analysis Platform Circulite Synergy Circulatory Assist Device Pclitaxel-Coated Percutaneous Transluminal Angioplasty Balloon Catheter Celution System JUVE'DERM Volift XC Medeor Matrix Nectar HF Feasibility Study SIDUS Stem-Free Shoulder Valiant Mona LSA Thoracic Stent Graft System Cook Zenith Fenestrated Endovascular Graft InnFocus Microshunt Glaucoma Drainage System ON-X Prosthetic Heart Valve Laduscope A Randomized Trial of Routine Aspiraiton Thrombectomy With PCl Versus PCI Alone in Patients with Stemi Undergoing Eon Mini Or Eon Ncurostimulation System Wearable Artificial Kidney MRI Guided High Intensity Focused Ultrasound System Liposonix System Model 2 Gore Excluder Iliac Branch Endoprosthesis Start Date 01102/2013 01/04/2013 0110912013 0111112013 01/17/2013 01118/2013 01125/2013 01125/2013 02/06/2013 02/08/2013 02/13/2013 02/2112013 02/22/2013 02/22/2013 02/22/2013 02/22/2013 02/22/2013 02/26/2013 02/26/2013 02/26/2013 03/01/2013 03/0112013 03/05/2013 03/08/2013 03/08/2013 03/08/2013 03/14/2013 03114/2013 03115/2013 03118/2013 03/2112013 03/27/2013 Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices Jkt 229001 EN03MY13.007</GPH> Autologous Platelet-Rich Plasma (PRP) for Chronic NonHealing Wounds NCDM Section 100.14 110.4 110.8.1 150.10 180.1 190.1 190.11 190.3 190.5 190.8 20.31 20.32 20.16 20.30 20.31 20.4 20.7 210.10 210.2 210.4 210.41 210.7 220.6 220.4 220.6.16 260.9 260.1 40.1 40.7 50.3 erowe on DSK2VPTVN1PROD with NOTICES VerDate Mar<15>2010 03/27/2013 03/28/2013 03/28/2013 03/28/2013 03/29/2013 Abbott Realtime Prame Desyne NX Novolimus Eluting Coronary Stent System Evolution Biliary Stent System-Fully Covered Evolution Biliary Stent System-Partially Covered Precision SCS System Adapted For High Rate Spinal Cord Stimulation Jkt 229001 PO 00000 Addendum VI: Approval Numbers for Collections of Information (January through March 2013) All approval numbers are available to the public at Reginfo.gov. Under the review process, approved infonnation collection requests are assigned OMB control numbers. A single control number may apply to several related information collections. This infonnation is available at For questions or additional information, contact Mitch Bryman (4lO-786-5258). Frm 00109 Fmt 4703 Sfmt 4725 E:\FR\FM\03MYN1.SGM Addendum VII: Medicare-Approved Carotid Stent Facilities, (January through March 2013) Addendum VII includes listings of Medicare-approved carotid stent facilities. All facilities listed meet CMS standards for perfonning carotid artery stenting for high risk patients. On March 17,2005, we issued our decision memorandum on carotid artery stenting. We detennined that carotid artery stenting with embolic protection is reasonable and necessary only if perfonned in facilities that have been detennined to be competent in perfonning 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. For the purposes of this quarterly notice, we are providing only the specific updates that have occurred in the 3-month period. This infonnation is available at: 03MYN1 For questions or additional infonnation, contact Lori Ashby (4lO-786-6322). Facility Provider Number Effective Date State Providence Memorial Hospital 1625 Medical Center Drive EI Paso, lX 79902 Guadalupe Regional Medical Center 1215 E. Court Street Seguin, lX 78155 450002 02/14/2013 /5 ;j~S TX 450104 02/14/2013 TX Facility South Bay Hospital 4016 Sun City Boulevard Sun City Center, FL 33573-5256 McLaren Bay Region 1900 Columbus Avenue Bay City, Ml48708 Trumbull Memorial Hospital 1350 E. Market Street P.O. Box 1269 Warren, OH 44482-1269 St. Francis Hospital 2122 Manchester Expressway P.O. Box 7000 Columbus, GA 31908-7000 Georgia Regents Medical Center 1120 15th Street Augusta, GA 30912 Mercy Hospital 3663 South Miami Avenue Miami, FL 33133 From: St. Luke's Community Medical To: St. Luke's The Woodlands Hospital 71200 St. Luke's Way The Woodlands, IX 77384 From: Baptist Hospital West To: Tennova Healthcare-Turkey Creek Medical Center 10820 Parks ide Drive Knoxville, TN 37934 Provider Number 100259 Effective Date 03/05/2013 State FL 230041 03/14/2013 MI 1043526023 03/14/2013 OH 1033228168 03/14/2013 GA 110034 03/14/2013 GA 100167 08/26/2005 FL 450862 02/24/2006 IX 440226 10106/2006 TN Addendum VIII: American College of Cardiology's National Cardiovascular Data Registry Sites (January through March 2013) Addendum VIII includes a list ofthe American College of Cardiology's National Cardiovascular Data Registry Sites. We cover implantable cardioverter defibrillators (ICDs) for certain clinical indications, as long as infonnation about the procedures is reported to a central registry. Detailed descriptions of the covered indications are available in the NCD. In January 2005, CMS established the ICD Abstraction Tool through the Quality Network Exchange (QNet) as a temporary data collection mechanism. On October 27,2005, CMS announced that the American College of Cardiology's National Cardiovascular Data Registry (ACC-NCDR) JCD Registry satisfies the data reporting requirements in the NCO. Hospitals needed to transition to the ACC-NCDR ICD Registry by April 2006. Effective January 27, 2005, to obtain reimbursement, Medicare NCO 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 Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 G 130053 GI20187 GI30051 Gl30052 G130044 26047 EN03MY13.008</GPH> erowe on DSK2VPTVN1PROD with NOTICES 26048 VerDate Mar<15>2010 Jkt 229001 PO 00000 Frm 00110 Fmt 4703 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 ACC-NCDR ICD registry. Therefore, 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. The entire list offacilities that participate in the ACC-NCDR rCD registry can be found at !YYlliJl£QL!;m!1iY~'!!2lkL!;mnmilll For the purposes of this quarterly notice, we are providing only the specific updates that have occurred in the 3-month period. This information is available by accessing our website and clicking on the link for the American College of Cardiology's National Cardiovascular Data Registry at: For questions or additional information, contact Marie Casey, BSN, MPH (410-786-7861). Sfmt 4725 Facility City State ;",;;>,1, E:\FR\FM\03MYN1.SGM 03MYN1 Cedar Park Regional Medical Center Intermountain Primary Children's Medical Center Putnam Community Medical Center Kentucky River Medical Center Southern Hills Medical Center Beverly Hospital - CA Bellevue Medical Center Via Christi Hospital - Pittsburgh KS Platte Valley Medical Center Mercy Hospital Washington East Community Laughlin Memorial Hospital Medical Center of Lewisville The Western Pennsylvania Hospital Cardiovascular Specialty Care Center Jennings American Legion Hospital The Kingston Hospital Texas Children's Hospital Florida Hospital Wesley Chapel Euclid Hospital California Hospital Medical Center McAlester Regional Health Center Lakeway Regional Medical Center Cedar Park Salt Lake City Palatka Jackson Nashville Montebello Bellevue Pittsburg Brighton Washington Greeneville Lewisville Pittsburgh Baton Rouge Jennings Kingston Houston Wesley Chapel Euclid Los Angeles McAlester Lakeway TX UT FL KY TN CA NE KS CO MO TN TX PA LA LA NY TX FL OH CA OK TX Facility City State I,; Halifax Regional Medical Center Henry Ford Health System West Bloomtield Northwest Texas Surgery Center North Okaloosa Medical Center (CHS) Citizens Memorial Hospital Integris Grove Hospital Roanoke Rapids West Bloomfield Amarillo Crestview Bolivar Grove NC MI TX FL MO OK Sisters of Charity Hospital Aurora West Allis Memorial Hospital Greene Memorial Hospital Buffalo West Allis Xenia NY WI OH I Addendum IX: Active CMS Coverage-Related Guidauce Documents (January through March 2013) There are no CMS coverage-related guidance documents published in the January through March 2013 quarter. To obtain the document, visit the CMS coverage website at h!!J@~~,QI!l!Uill!:Lm~.£ill:£:S~~~ For questions or additional information, contact Lori Ashby (410-7866322). Addendum X: List of Special One-Time Notices Regarding National Coverage Provisions (October through December 2012) There were no special one-time notices regarding national coverage provisions published in the January through March 2013 quarter. This information is available at For questions or additional information, contact Lori Ashby (4lO-786-6322). Addendum XI: National Oncologic PET Registry (NOPR) (January through March 2013) Addendum XI 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. 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 Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 EN03MY13.009</GPH> procedure. Details of the clinical indications that are covered by Medicare and their respective data reporting requirements are available in the Medicare NCD Manual, which is on the CMS website at erowe on DSK2VPTVN1PROD with NOTICES VerDate Mar<15>2010 Bryan Medical Center I 280003 1600 South 48th Street Lincoln NE 68506 Palmetto Health Richland I 420018 5 Richland Medical Park Drive Columbia SC 29203 Facility PO 00000 For questions or additional information, contact Stuart Caplan, RN, MAS (410-786-8564 ) Jkt 229001 For questions or additional information, contact Marie Casey, BSN, MPH (410-786-7861 ). Old name: Hematology Oncology Associates of Baton Rouge New name: OLOL Hospital Inc,. 4950 Essen Lane Baton Rouge LA 70809 Provider Number Effective Date Frm 00111 Fmt 4703 Old 05/3112011 Medicare Prov#: 1861590234 New Medicare Prov#: 190064 Old Name: Rochester Radiology Associates, PC Old Med#:19 08/07/2006 New Name: Rochester General Imaging Center-No New Med#: Heights 1277 Portland Avenue Rochester NY 14621 J100058113 State LA NY Sfmt 4725 E:\FR\FM\03MYN1.SGM 03MYN1 Addendum XII: Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities (January through March 2013) Addendum XII includes a listing of Medicare-approved facilities that receive coverage for ventricular assist devices (VADs) used as destination therapy. All facilities were required to meet our standards in order to receive coverage for V ADs implanted as destination therapy. On October 1, 2003, we issued our decision memorandum on VADs for the clinical indication of destination therapy. We determined that VADs 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 to receive coverage for VADs implanted as destination therapy. For the purposes of this quarterly notice, we are providing only the specific updates that have occurred to the list of Medicare-approved facilities that meet our standards in the 3-month period. This information is available at Facility Provider Number I Date Ajlproved I State 03/06/2013 NE 03/07/2013 SC Addendum XIII: Lung Volume Reduction Surgery (LVRS) (January through March 2013) Addendum XIII 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 were also eligible to receive coverage. The following 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 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. There were no additions to the listing of facilities for lung volume reduction surgery published in the January through March 2013 quarter. This information is available at ~~~~~~~~~~~~~~~UL~~w~~Im~fm~. For questions or additional information, contact Marie Casey, BSN, MPH (410-786-7861). "I Facility Provider Number I Date Avproved The Ohio State University Hospital 410 W. 10th Avenue, DN 168 rOlllmhllS. OH 43210 N/A I N/A I OH Ohio State University Medical Center 410 W 10th Avenue Columbus, OH 43210 N/A I N/A Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 scan, the beneficiary must receive the scan in a facility that participates in the registry. There were no updates to the listing of National Oncologic Positron Emission Tomography Registry (NOPR) in the January through March 2013 quarter. This information is available at I OH State 26049 EN03MY13.010</GPH> erowe on DSK2VPTVN1PROD with NOTICES 26050 VerDate Mar<15>2010 Jkt 229001 PO 00000 Frm 00112 Fmt 4703 Sfmt 4725 E:\FR\FM\03MYN1.SGM Facility Provider Number Date Approved State .;;/J;;{ 03MYN1 Conway Medical Center 300 Singleton Ridge Road Conway, SC 29526 Excela Health Westmoreland Hospital 501 West Otterman Street Greensburg, PA 15601 West Georgia Health System 1514 Vernon Road LaGrange, GA 30240 Turkey Creek Medical Center 10820 Parkside Drive Knoxville, TN 37934 Christus St. Frances Cabrini Hospital 3330 Masonic Drive Alexandria, LA 71301 Christus Hospital St. Elizabeth 2830 Calder A venue Beaumont, TX 77702 Doctors Hospital of Laredo 10700 McPherson Road Laredo. TX 78045 1134172000 09/27/2012 SC 390145 10118/2012 PA 1356664247 10/23112012 GA 1043292899 01104/2013 TN 1639160799 11127/2012 LA 1679557888 11128/2012 IX 1396731105 12/07/2012 TX St. Mary Medical Center 1400 S. Lake Park Avenue Hobart. IN 46342 Mercy Hospital and Medical Center 2600 S Michigan Avenue Chicago, IL 60616 Lancaster General Hospital 2150 Harrisburg Pike Suite 300 Lancaster, PA 17604 Akron General Medical Center 400 Wabash Avenue Akron, OH 44307 Pikeville Medical Center 911 S Bypass Road Pikeville, KY 4150 The Western Pennsylvania Hospital 4727 Friendship Avenue, Suite 140 Pittsburgh, PA 15224 St. John Hospital and Medical Center 22101 Moross Road Detroit, Ml48236 Shawnee Mission Medical Center 23401 Prairie Star Parkway Lenexa, KS 66227 Saint Luke's Hospital of Kansas City 4401 Wornall Road Kansas City, MO 64111 From: The Reading Hospital and Medical Center To: Reading Hospital 2603 Keiser Boulevard Wyomissing, PA 19610 Upstate Medical University 750 E. Adams Street, University Hospital Syracuse, NY 13210 New York-Presbyterian HospitallWeill Cornell Medical Center 627 West 165th Street New York, NY 10032 University of Washington Medical Center 1957 NE Pacific Street, PO Box 356165 Seattle, W A 98195-6151 Massachusetts General Hospital MGH Weight Center 50 Staniford St, 4th Floor Boston, MA 02114-2696 Harford Memorial Hospital 421 South Union Avenue, Suite 201 Havre de Grace, MD 21078 North Shore University Health System 2650 Ridge Avenue Evanston, IL 60201 st. Luke's-Roosevelt Hospital Center 1111 Amsterdam Avenue New York, NY 10025 Methodist Healthcare System 8026 Floyd Curl Drive San Antonio, TX 78229 University of Virginia Health System P.O. Box 800809 UV A HSC Charlottesville, V A 22908-0809 University Hospitals Case Medical Center 11100 Euclid Avenue Cleveland OH 44106 1558463745 12/07/2012 IN 1730166224 01115112013 IL 390100 0113112013 PA 360027 0111412013 OH 1285621623 01125/2013 KY 028672 10117/2012 PA 230165 05/14/2011 MI 170104 01122/2007 KS 26-0138 01102/2010 MO 390044 03/25/2008 PA 1578554630 03/27/2012 NY 330101 08/04/2012 NY 1326002049 12/05/2012 WA 220071 1012412012 MA 1770589533 12/22/2012 MD 1497701882 01126/2012 IL 330046, 1104982917 450388 10/1112012 NY 02/24/2006 TX 490009 07/12/2012 VA 360137 08/28/2006 OH Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices 14:52 May 02, 2013 EN03MY13.011</GPH> Addendum XIV: Medicare-Approved Bariatric Surgery Facilities (January through March 2013) Addendum XIV includes a listing of Medicare-approved facilities that meet minimum standards for facilities modeled in part on professional society statements on competency. All facilities must meet our standards in order to receive coverage for bariatric surgery procedures. On February 21, 2006, we issued our decision memorandum on bariatric surgery procedures. We determined that bariatric surgical procedures are reasonable and necessary for Medicare beneficiaries who have a body-mass index (BMI) greater than or equal to 35, have at least one co-morbidity related to obesity and have been previously 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 Levell Bariatric 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). For the purposes of this quarterly notice, we list only the specific updates to Medicare-approved facilities that meet CMS's minimum facility standards for bariatric surgery and have been certified by ACS and/or ASMBS in the 3-month period. This information is available at For questions or additional information, contact Kate Tillman, RN, MAS (410-786-9252). Federal Register / Vol. 78, No. 86 / Friday, May 3, 2013 / Notices BILLING CODE 4120–01–C DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services erowe on DSK2VPTVN1PROD with NOTICES Statement of Organization, Functions, and Delegations of Authority Part F of the Statement of Organization, Functions, and Delegations of Authority for the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), (last amended at Federal Register, Vol. 76, No. 75, p. 21909, dated April 19, 2011) is amended to revise the functions of the Office of Communications (OC). Under Part F., Section FC. 20 (Functions) for OC is revised as follows: • Serves as CMS’ focal point for internal and external strategic and tactical communications providing leadership for CMS in the areas of customer service; Web site operations; traditional and new media including web initiatives such as social media supported by innovative, increasingly mobile technologies; media relations; call center operations; consumer materials; public information campaigns; and public engagement. • Serves as senior advisor to the Administrator in all activities related to the media. Provides consultation, advice, and training to CMS’ senior staff with respect to relations with the news media. • Coordinates with external partners including the Department of Health and Human Services (HHS) and the White VerDate Mar<15>2010 14:52 May 02, 2013 Jkt 229001 House on key communication and public engagement initiatives, leveraging CMS resources to strategically support these activities. • Contributes to the formulation of policies, programs, and systems as related to strategic and tactical communications. • Coordinates with the Office of Legislation on the development and advancement of new legislative initiatives and improvements. • Oversees communications research, design and development, evaluation and continuous improvement activities for improving internal and external communication tools, including but not limited to brochures, public information campaigns, handbooks, Web sites, reports, presentations/briefings. • Identifies communication best practices for the benefit of CMS beneficiaries (i.e., of the Medicare and Medicaid programs) and other CMS customers. • Formulates and implements a customer service plan that serves as a roadmap for the effective treatment and advocacy of customers and the quality of information provided to them. • Oversees beneficiary and consumer call centers and provides leadership for CMS in the area of call center operations. • Oversees all CMS interactions and collaborations with key stakeholders (external advocacy groups, contractors, local and State governments, HHS, the White House, other CMS components, and other Federal entities) related to the Medicare and Medicaid and other Agency programs. • Coordinates stakeholder relations, community outreach, and public engagement with the CMS Regional Offices. PO 00000 Frm 00113 Fmt 4703 Sfmt 4703 Authority: 44 U.S.C 3101. Dated: April 25, 2013. Marilyn B. Tavenner, Acting Administrator and Chief Operating Officer, Centers for Medicare & Medicaid Services. [FR Doc. 2013–10426 Filed 5–2–13; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed Information Collection Activity; Comment Request Proposed Projects Title: Notice of Interstate Lien. OMB No.: 0970–0153. Description: Section 452(a)(11) of the Social Security Act requires the Secretary of Health and Human Services to promulgate a form for imposition of liens to be used by the State child support enforcement (Title IV–D) agencies in interstate cases. Section 454(9)(E) of the Social Security Act requires each State to cooperate with any other State in using the Federal form for imposition of liens in interstate child support cases. Tribal IV–D agencies are not required to use this form but may choose to do so. OMB approval of this form is expiring in May 2014 and the Administration for Children and Families is requesting an extension of this form. Respondents: State, local or Tribal agencies administering a child support enforcement program under title IV–D of the Social Security Act. E:\FR\FM\03MYN1.SGM 03MYN1 EN03MY13.012</GPH> [FR Doc. 2013–10106 Filed 5–2–13; 8:45 am] 26051

Agencies

[Federal Register Volume 78, Number 86 (Friday, May 3, 2013)]
[Notices]
[Pages 26038-26051]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-10106]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9079-N]


Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--January Through March 2013

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

ACTION: Notice.

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

SUMMARY: This quarterly notice lists CMS manual instructions, 
substantive and interpretive regulations, and other Federal Register 
notices that were published from January through March 2013, relating 
to the Medicare and Medicaid programs and other programs administered 
by CMS.

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 each of the addenda published in this 
notice.
[GRAPHIC] [TIFF OMITTED] TN03MY13.000

I. Background

    The Centers for Medicare & Medicaid Services (CMS) is responsible 
for administering the Medicare and Medicaid programs and coordination 
and oversight of private health insurance. Administration and oversight 
of these programs involves the following: (1) Furnishing information to 
Medicare and Medicaid beneficiaries, health care providers, and the 
public; and (2) maintaining effective communications with CMS regional 
offices, state governments, state Medicaid agencies, state survey 
agencies, various providers of health care, all Medicare contractors 
that process claims and pay bills, National Association of Insurance 
Commissioners (NAIC), health insurers, and other stakeholders. 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) and 
Public Health Service Act. We also issue various manuals, memoranda, 
and statements necessary to administer and oversee the programs 
efficiently.

[[Page 26039]]

    Section 1871(c) 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.

II. Revised Format for the Quarterly Issuance Notices

    While we are publishing the quarterly notice required by section 
1871(c) of the Act, we will no longer republish duplicative information 
that is available to the public elsewhere. We believe this approach is 
in alignment with CMS' commitment to the general principles of the 
President's Executive Order 13563 released January 2011 entitled 
``Improving Regulation and Regulatory Review,'' which promotes 
modifying and streamlining an agency's regulatory program to be more 
effective in achieving regulatory objectives. Section 6 of Executive 
Order 13563 requires agencies to identify regulations that may be 
``outmoded, ineffective, insufficient, or excessively burdensome, and 
to modify, streamline, expand or repeal them in accordance with what 
has been learned.'' This approach is also in alignment with the 
President's Open Government and Transparency Initiative that 
establishes a system of transparency, public participation, and 
collaboration.
    Therefore, this quarterly notice provides only the specific updates 
that have occurred in the 3-month period along with a hyperlink to the 
full listing that is available on the CMS Web site or the appropriate 
data registries that are used as our resources. This information is the 
most current up-to-date information and will be available earlier than 
we publish our quarterly notice. We believe the Web site list provides 
more timely access for beneficiaries, providers, and suppliers. We also 
believe the Web site offers a more convenient tool for the public to 
find the full list of qualified providers for these specific services 
and offers more flexibility and ``real time'' accessibility. In 
addition, many of the Web sites have listservs; that is, the public can 
subscribe and receive immediate notification of any updates to the Web 
site. These listservs avoid the need to check the Web site, as 
notification of updates is automatic and sent to the subscriber as they 
occur. If assessing a Web site proves to be difficult, the contact 
person listed can provide information.

III. How To Use the Notice

    This notice is organized into 15 addenda so that a reader may 
access the subjects published during the quarter covered by the notice 
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 should view the 
manuals at https://www.cms.gov/manuals.

    Authority:  (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: April 24, 2013.
Kathleen Cantwell,
Director, Office of Strategic Operations and Regulatory Affairs.
BILLING CODE 4120-01-P

[[Page 26040]]

[GRAPHIC] [TIFF OMITTED] TN03MY13.001


[[Page 26041]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.002


[[Page 26042]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.003


[[Page 26043]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.004


[[Page 26044]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.005


[[Page 26045]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.006


[[Page 26046]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.007


[[Page 26047]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.008


[[Page 26048]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.009


[[Page 26049]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.010


[[Page 26050]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.011


[[Page 26051]]


[GRAPHIC] [TIFF OMITTED] TN03MY13.012

[FR Doc. 2013-10106 Filed 5-2-13; 8:45 am]
BILLING CODE 4120-01-C
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.