Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-October Through December 2014, 5537-5551 [2015-01904]

Download as PDF Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices By direction of the Commission. Donald S. Clark, Secretary. [FR Doc. 2015–01856 Filed 1–27–15; 8:45 am] BILLING CODE 6750–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION: Notice of meeting. AGENCY: The Centers for Disease Control and Prevention (CDC) announces the next meeting of the Community Preventive Services Task Force (Task Force). The Task Force is an independent, nonpartisan, nonfederal, and unpaid panel. Its members represent a broad range of research, practice, and policy expertise in prevention, wellness, health promotion, and public health, and are appointed by the CDC Director. The Task Force was convened in 1996 by the Department of Health and Human Services (HHS) to identify community preventive programs, services, and policies that increase healthy longevity, save lives and dollars and improve Americans’ quality of life. CDC is mandated to provide ongoing administrative, research, and technical support for the operations of the Task Force. During its meetings, the Task Force considers the findings of systematic reviews on existing research and issues recommendations. Task Force recommendations provide information about evidence-based options that decision makers and stakeholders can consider when determining what best meets the specific needs, preferences, available resources, and constraints of their jurisdictions and constituents. The Task Force’s recommendations, along with the systematic reviews of the scientific evidence on which they are based, are compiled in The Guide to Community Preventive Services (Community Guide). DATES: The meeting will be held on Wednesday, February 25, 2015 from 8:30 a.m. to 6:00 p.m. EST and Thursday, February 26, 2015 from 8:30 a.m. to 1:00 p.m. EST. ADDRESSES: The Task Force Meeting will be held at CDC Edward R. Roybal Campus, Tom Harkin Global Communications Center (Building 19), mstockstill on DSK4VPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 19:24 Jan 30, 2015 Jkt 235001 1600 Clifton Road NE., Atlanta, GA 30333. You should be aware that the meeting location is in a Federal government building; therefore, Federal security measures are applicable. For additional information, please see Roybal Campus Security Guidelines under SUPPLEMENTARY INFORMATION. Information regarding meeting logistics will be available on the Community Guide Web site (www.thecommunityguide.org). Meeting Accessibility: This meeting is open to the public, limited only by space availability in the meeting location. All meeting attendees must RSVP to ensure the required security procedures are completed to gain access to the CDC’s Global Communications Center. U.S. citizens must RSVP by 2/15/ 2015. Non U.S. citizens must RSVP by 2/9/ 2015 due to additional security steps that must be completed. In addition to in-person participation, individuals may view presentations via live video stream on the Internet. Those interested in accessing the live stream must also RSVP, and additional information will be sent to registrants requesting connectivity via the Internet in advance of the meeting. Failure to RSVP by the dates identified could result in an inability to attend the Task Force meeting due to the strict security regulations on federal facilities. For Further Information and to RSVP Contact: Terica Scott, The Community Guide Branch; Division of Epidemiology, Analysis, and Library Services; Center for Surveillance, Epidemiology and Laboratory Services; Office of Public Health Scientific Services; Centers for Disease Control and Prevention, 1600 Clifton Road, MS– E–69, Atlanta, GA 30333, phone: (404) 498–6360, email: CPSTF@cdc.gov. SUPPLEMENTARY INFORMATION: Purpose: The purpose of the meeting is for the Task Force to consider the findings of systematic reviews and issue findings and recommendations. Task Force recommendations provide information about evidence-based options that decision makers and stakeholders can consider when determining what best meets the specific needs, preferences, available resources, and constraints of their jurisdictions and constituents. Matters To Be Discussed: Vaccinations, Obesity, Cardiovascular Disease, and Health Equity. Topics are subject to change. Roybal Campus Security Guidelines: The Edward R. Roybal Campus is the headquarters of the U.S. Centers for PO 00000 Frm 00036 Fmt 4703 Sfmt 4703 5537 Disease Control and Prevention and is located at 1600 Clifton Road NE., Atlanta, Georgia. The meeting is being held in a Federal government building; therefore, Federal security measures are applicable. All meeting attendees must RSVP by the dates outlined under Meeting Accessability. In planning your arrival time, please take into account the need to park and clear security. All visitors must enter the Roybal Campus through the entrance on Clifton Road. Your car may be searched, and the guard force will then direct visitors to the designated parking area. Upon arrival at the facility, visitors must present government issued photo identification (e.g., a valid federal identification badge, state driver’s license, state nondriver’s identification card, or passport). Non-United States citizens must complete the required security paperwork prior to the meeting date and must present a valid passport, visa, Permanent Resident Card, or other type of work authorization document upon arrival at the facility. All persons entering the building must pass through a metal detector. Visitors will be issued a visitor’s ID badge at the entrance to Building 19 and may be escorted to the meeting room. All items brought to HHS/CDC are subject to inspection. Dated: January 27, 2015. Ron A. Otten, Acting Deputy Associate Director for Science, Centers for Disease Control and Prevention. [FR Doc. 2015–01875 Filed 1–30–15; 8:45 am] BILLING CODE 4163–18–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS–9088–N] Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—October Through December 2014 Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. AGENCY: This quarterly notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from October through December 2014, 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 SUMMARY: E:\FR\FM\02FEN1.SGM 02FEN1 5538 Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 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 various manuals, memoranda, and statements necessary to administer and oversee the programs efficiently. 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. 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. VerDate Sep<11>2014 19:24 Jan 30, 2015 Jkt 235001 II. Format for the Quarterly Issuance Notices 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 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’’ PO 00000 Frm 00037 Fmt 4703 Sfmt 4703 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. Dated: January 23, 2015. Kathleen Cantwell, Director, Office of Strategic Operations and Regulatory Affairs. BILLING CODE 4120–01–P E:\FR\FM\02FEN1.SGM 02FEN1 EN02FE15.000</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 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 mstockstill on DSK4VPTVN1PROD with NOTICES VerDate Sep<11>2014 Jkt 235001 PO 00000 Frm 00038 Fmt 4703 Addendum 1: Medicare and Medicaid Manual Instructions (October through December 2014) 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\02FEN1.SGM 02FEN1 How to Obtain Manuals The Internet-only Manuals (IOMs) 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: !lliJQ.;LL9!!;~1Y!.Illi!Il!!illi1'. 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 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 available at=~'-'-'-~'-'-"'"==~==:.=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 fonn, 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 Coverage of Ultrasound Screening for Abdominal Aortic Aneurysms (AAA) and Screening Fecal-Occult Blood Tests (FOBT) Coverage Criteria use CMS-Pub. 100-02, Transmittal No. 196. 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 usc 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 YJ.J~~~~!_!!_~~~~· Transmittal Number Manual/Subject/Publication Number 15,\' ~;;~j ~\'~ 1:''~: ;\;\~;~\'~, <•.· \;\ ''\\". \c\\ii:c'.~!i, None If'>'' c;~~~,, '+;. ;•i'\Fi~'~''~l')•? 195 196 197 198 \\,~\\(; ~':i:~.i. •;;, ~~ '[\i\\; Issued to a specific audience, not posted to Internetllntranet due to Sensitivity of Instruction Medicare Coverage of Ultrasound Screening for Ahdominal Aortic Aneurysms (AAA) and Screening Fecal-Occult Blood Tests (FOBT) Coverage Criteria Issued to a specific audience, not posted to lnternetllntranet due to Sensitivity of Instruction Medicare Coverage ofltems and Services in Category A and B Investigational Device Exemption (IDE) Studies Coverage of Medical Devices Food and Drug Administration (FDA)-Approved Investigational Device Exemption (IDE) Studies Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 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: January 31,2014 (79 FR 5419), April25, 2014 (79 FR 22976), July 25, 2014 (79 FR 43475) and November 14, 2014 (79 FR 68253). 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. 5539 EN02FE15.001</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 5540 VerDate Sep<11>2014 Jkt 235001 PO 00000 Frm 00039 Fmt 4703 200 Sfmt 4725 E:\FR\FM\02FEN1.SGM 02FEN1 EN02FE15.002</GPH> 201 202 i~'[\ii;i\ 175 176 177 178 RHCs and FQHCs Billing Under the AIR RHC Per-Visit Payment Limit and Exceptions FQHC Per-Visit Payment Limit FQHCs Billing Under the PPS Payment Rate and Adjustments Payment Codes for FQHCs Billing Under the PPS Cost Reports Productivity Standards RIIC and FQIIC Patient Charges, Coinsurance, Deductible and Waivers Charges and Waivers Graduate Medical Education Transitional Care Management (TCM) Services Services and Supplies Furnished Incident to Physician's Services Provision ofincident to Services and Supplies Payment for Incident to Services and Supplies Nurse Practitioner, Physician Assistant, and Certified Nurse Midwife Services Outpatient Mental Ilealth Treatment Limitation Physical and Occupational Therapy Description of Visiting Nursing Services Requirements of Visiting Nursing Services Home Health Agency Shortage Area Tclchcalth Services Preventive Health Services Preventive Health Services in RHCs Copayment and Deductible for RliC Preventive I Icalth Services Preventive Health Services in FQHCs FQHC General Information Modifications to Medicare Part B Coverage of Pneumococcal Vaccinations Immunizations ;: ;';\',}:;!,~~i!i~i:.t. Intensive Cardiac Rehabilitation Program - Benson-Henry Institute Cardiac Wellness Program Medicare Coverage of Ultrasound ~crcening for Abdominal Aortic Aneurysms (AAA) and Screening Fecal-Occult Blood Tests (FOBT) Colorectal Cancer Screening Tests Screening for Hepatitis C Virus (HCV) in Adults Issued to a specific audience, not posted to lnternet/Intranet due to Sensitivity of Instruction ,i;;;t;; :::~;·.~~~~t~'g.j ;;}:;::: \{'jt;.; •;:·t~:tt.'"'').;;;:; • ,i;· 3083 Form CMS-1500 Instructions: Revised for Form Version 02/12 Items 14-33 Provider of Service or Supplier Information Items l-11 Patient and Insured Information Items II a-13 Patient and Insured Information Health Insurance Claim Form CMS-1500 3084 Intensive Cardiac Rehabilitation Program - Benson-Henry Institute Cardiac Wellness Program Requirements for CR and ICR Services on Institutional Claims 3085 Update to Pub. I 00-04, Chapter 17 to Provide Language-Only Changes for Updating ICD-10 and ASC Xl2 Claims Processing Requirements -General Billing Drugs Electronically- NCPDP Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 199 Medicare Requirements for Coverage of Items and Services in FDAApproved Category A and B IDE Studies Payment for Items and Services in Categmy A and B IDE Studies FDA Withdrawal of IDE Approval or Change in Categorization 1611 0/General Exclusions from Coverage Re-evaluation of FDA-approved IDE Device Categorization Decision Hospital Institutional Review Board (IRB) Approved Non-significant Risk Devices 14/30.1/Payment for Hospital IRB Approved Non-significant Risk Devices Services Related to and Required as a Result of Services Which are Not Covered Under Medicare Confidentiality of IDE Information Implementation of Changes in the End-Stage Renal Disease Prospective Payment System (ESR[) PPS) for Calendar Year (CY) 2015 ESRD PPS Case-Mix Adjustments Renal Dialysis Items and Services Laboratory Services Drugs and Biologicals Definitions Relating to ESRD Home Dialysis Items and Services Equipment and Supplies Other Services ESRD Prospective Payment System (PPS) Base Rate Home Dialvsis Training Implementation of Changes in the End-Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2015 Definitions Relating to ESRD Renal Dialysis Items and Services Laboratory Services ESRD PPS Case-Mix Adjustments Equipment and Supplies Home Dialysis Items and Services Home Dialysis Training Other Services ESRD Prospective Payment System (PPS) Base Rate Drugs and Biologicals Medicare Benefit Policy Manual- RHC and FQHC Update- Chapter 13 RHC General Information Copayment for FQHC Preventive Health Services Requirements FQHC Staffing RHC and FQHC Visits Location Hours of Operation Multiple Visits on Same Day and Exceptions Global Billing RHC Services FQHC Services Non RHC/FQHC Services Description of Non RHC/FQHC Services RHC and FQHC Payment Rates, Exceptions, and Adjustments mstockstill on DSK4VPTVN1PROD with NOTICES VerDate Sep<11>2014 3087 3088 3089 3090 Jkt 235001 3091 PO 00000 Frm 00040 Fmt 4703 Sfmt 4725 E:\FR\FM\02FEN1.SGM 3092 3093 3094 3095 02FEN1 3096 3097 Consistency Edits for Institutional Claims 2015 Annual Update for the Health Professional Sh01tage Area (HPSA) Bonus Payments 2015 Annual Update ofHealthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instmction Ambulance Inflation Factor for CY 2015 and Productivity Adjustment Ambulance Inflation Factor (AJF) Update to Pub. 100-04 Chapter 13 to Provide Language-Only Changes for Updating ICD-10 and ASC Xl2 lCD Coding for Diagnostic Tests AlB MAC (A)Payment for Low Osmolar Contrast Material (LOCM) (Radiology) Special Billing Instructions for RHCs Payment Requirements Medicare Summary Notices (MSN), Reason Codes, and Remark Codes Billing Instructions Coverage for PET Scans for Dementia and Neurodegenerative Diseases Payment Methodology and HCPCS Coding Billing and Coverage Changes for PET Scans Billing and Coverage Changes tor PET Scans tor Cervical Cancer Effective tor Services on or After November I 0, 2009 Billing and Coverage Changes for PET (l\'aF-18) Scans to IdentifY Bone Metastasis of Cancer Effective for Claims With Dates of Services on or After February 26,2010 EMC Formats Billing Requirements for CMS - Approved Clinical Trials and Coverage With Evidence Development Claims tor PET Scans tor Neurodegcnerative Diseases, Previously Specitied Cancer Indications, and All Other Cancer Indications Not Previously Specified Annual Medicare Physician Fcc Schedule (MPFS) Files Delivery and Implementation Issued to a specific audience, not posted to lnternet/lntranet due to Sensitivity oflnstruction Issued to a specific audience, not posted to Internet/lntranet due to Sensitivity of Instruction Issued to a specitic audience, not posted to Internet/Intranet due to Sensitivity ofinstruction Medicare Coverage of Ultrasound Screening for Abdominal Aortic Aneurysms (AAA) and Screening Fecal-Occult Blood Tests (FOBT) Coverage Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV) Initial Preventive Physical Examination (IPPE) Ultrasound Screening for Abdominal Aortic Aneurysm (AAA) Detinitions HCPCS Codes, Frequency Requirements, and Age Requirements (lf Applicable) October Update to the CY 2014 Medicare Physician Fee Schedule Database Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 3086 MS~/Claim Adjustment Message Codes for Oral Cancer Drug Denials HCPCD Codes for Oral Anti-Emetic Urugs Submitting the Prescription Order Numbers and No Pay Modi tiers Billing and Payment Instructions for AlB MACs (A) Requirements for Billing A/B MAC (A) for Immunosuppressive Drugs MSN/Remittance Messages for Immunosuppressive Drugs Intravenous Immune Globulin Claims Processing Rules for ESAs Administered to Cancer Patients for AntiAnemia Therapy Hospital Outpatient Payment Under OPPS for New, Unclassified Drugs and Biologicals After FDA Approval But Before Assignment of a ProductSpecit1c Drug or Biological HCPCS Code Hospital Billing For Take-Home Drugs The Competitive Acquisition Program (CAP) for Drugs and Biologicals Not Paid on a Cost or Prospective Payment Basis Denial/Claim Adjustment and Remark Messages for Anti-Emetic Drugs Update to Pub. l 00-04, Chapter l to Provide Language-Only Changes for Updating JCD-10 and ASC X12 Foreword Formats for Submitting Claims to Medicare Electronic Submission Requirements Paper Formats for Institutional Claims Paper Formats for Professional and Supplier Claims Remittance Advices Payment Jurisdiction Among Local A/B MACs tor Services Paid Onder the Physician Fee Schedule Claims Processing Instructions for Payment Jurisdiction Payment to Physician or Other Supplier for Diagnostic Tests Subject to the Anti-0 1/Markup Payment Limitation/ Claims Submitted to AlB MACs (B) Billing Procedures for Entities Qualified to Receive Payment on Basis of Reassignment/ for A/B MACs(B) Processed Claims Rilling for Diagnostic Tests (Other Than Clinical Diagnostic Lahoratory Tests) Subject to the Anti-Markup Payment Limitation/ Claims Submitted to AB/MACs(B) Billing Form as Request for Payment Beneficiary Request for Payment on Provider Record Institutional Claims ASC Xl2 837 Institutional Claim Format and Form CMS 1450 Definition of a Claim for Payment Policy and Billing Instructions for Condition Code 44 General Information on Non-covered Charges on Institutional Claims Determining Start Date of Timely Filing Period-- Date of Service Form Prcscrib~:d by CMS In Accordance with CMS Instructions Handling Incomplete or Invalid Submissions Claims Forms C'viS 1490S and CMS-1450 Conditional Data Element Requirements for AlB MACs (B) and DME MACs B MAC(B) Specific Requirements for Certain Specialties/ Services Payer Only Codes Utilized by Medicare Inpatient Pmt A Hospital Adjustment Bills 5541 EN02FE15.003</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 5542 VerDate Sep<11>2014 3Q<;g Jkt 235001 PO 00000 Frm 00041 3100 Fmt 4703 3101 3102 Sfmt 4725 1103 E:\FR\FM\02FEN1.SGM 02FEN1 3104 3105 EN02FE15.004</GPH> 3106 3107 3108 3109 3110 3111 3112 3113 3114 3115 3116 3117 3118 3119 3120 3121 3122 3123 3124 3125 Billing Requirements for Providers Billing for Routine Care Items and Services in Category A IDE Studies Investigational Device Exemption (IDE) Studies Implementing the Payment Policies related to Patient Status fi·mn CMS-1599-F Inpatient Part B Hospital Services Medicare Shared Systems Modifications Necessary to Capture various HIP AA compliant fields Payments on the MPFS for Providers With Multiple Service Locations Issued to a speci fie audience, not posted to Internet/Intranet due to Confidentiality of Instruction Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction Issued lo a sped lie audience, not posted to Intcrnclllnlranet uuc to Conlidentiality of Instruction Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of lnstmction Issued to a specific audience, not posted to lnternet/Intranet due to Confidentiality of Instruction Issued to a specilic audience, not posted to Internet/lntranet due to Conlidentiality of Instruction Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction Moditlcations to the National Coordination of Benefits Agreement (CORA) Crossover Process Claims Crossover Disposition and Coordination of Benefits Agreement ByPass Indicators Elimination of the 50/50 Payment Rule for Laboratory Services on End Stage Renal Disease (ESRD) Claims Lab Services Automated Multi-Channel Chemistry (AMCC) Tests for ESRD Beneliciaries Issued to a specilic audience, not posted to Internet/Intranet due to Confidentiality of lnstmction Correction to Remittance Messages When Hospice Claims are Reduced Due to Late Filing of the Notice of Election. Data Required on the Institutional Claim to Medicare Contractor Notice of Election (NOE)- Form CMS 1450 Issued to a specific audience, not posted to Internet/lntranet due to Confidentiality of lnstmction Therapy Cap Values for Calendar Year (CY) 2015 20 15 Annual Update to the Therapy Code List Issued to a specific audience, not posted to Internet/lntranet due to Confidentiality of lnstmction October Quarterly Update for 2014 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule 2015 Healthcare Common Procedure Coding System (HCPCS) Annual Update Reminder Implementation of Changes in the End-Stage Renal Disease Prospective Payment System (ESRD PPS) tor Calendar Year (CY) 2015 Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 3099 (MPFSDB) Reporting the Service Location National Provider ldentitier (NPl) on AntiMarkup and Reference Laboratory Claims 3099Payment Jurisdiction for Services Subject to the Anti-Markup Payment Limitation Diagnostic Tests Subject to the Anti-Markup Payment Limitation Billing for Diagnostic Tests (Other Than Clinical Diagnostic Laboratory Tests) Subject to the Anti-Markup Pa)ment Limitation/Claims Submitted to A/B MACs (B) Conditional Data Element Requirements lor AlB MACs (B) and DMEMACs Carrier Specific Requirements for Certain Specialties/Services Paper Claim Submission To Can·iers/B MACs (B) Electronic Claim Submission to Carriers/B MACs B) Items 14-33 -Provider of Service or Supplier Information Payment to Physician or Other Supplier fur Diagnostic Tests Subject to the Anti-Markup Payment Limitation - Claims Submitted to AlB MACs (B) Instructions for Retrieving the 2015 Pricing and HCPCS Data Files through CMS' Mainframe Telecommunications Systems Issued to a specific audience, not posted to lnternet/lntranet due to Sensitivity oflnstruction Issued to a specilic audience, not posted to lnternet/Intranet due to Sensitivity of Instruction Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction Reporting the Service I "ocation National Provider ldentitler (NPI) on AntiMarkup and Reference Laboratmy Claims Payment Jurisdiction for Services Subject to the Anti-Markup Payment Limitation Diagnostic Tests Subject to the Anti-Markup Payment Limitation Billing tor Diagnostic Tests (Other Than Clinical Diagnostic Laboratory Tests) Subject to the Anti-Markup Payment Limitation/Claims Submitted to A/B MACs(B) Conditional Data Element Requirements for A/B MACs (B) and DMEMACs Carrier Specific Requirements for Certain Specialties/Services Paper Claim Submission To Carricrs/B MACs (B) Electronic Claim Submission to Carriers/B MACs B) Items 14-33- Provider of Service or Supplier Information Payment to Physician or Other Supplier for Diagnostic Tests Subject to the Anti- Markup Payment Limitation- Claims Submitted to AlB MACs (B) Correction to Remittance Information When HIPPS Codes are Re-ceded by Medicare Systems Decision Logic Used by the Pricer on Claims HI-I PPS Claims Adjustments of Episode Payment - Contirming OASl S Assessment Items Medicare Coverage of Items and Services in Category A and B Investigational Device Exemption (IDE) Studies Billing Requirements for Providers Billing for Category BIDE Devices and Routine Care Items and Services in Category B IDE Studies mstockstill on DSK4VPTVN1PROD with NOTICES VerDate Sep<11>2014 3127 Jkt 235001 3128 PO 00000 3129 Frm 00042 3131 3132 3130 Fmt 4703 3133 3134 3135 Sfmt 4725 3136 E:\FR\FM\02FEN1.SGM 3137 3138 3139 02FEN1 3140 3141 3142 3143 3144 3145 3146 for Obesity, Screening Digital Tomosynthesis Mammography, and Anesthesia Associated with Screening Colonoscopy 3147 Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR) and Urban and Rural Designations for FQHCs Billing Under the AIR 2015 Durable Medical Equipment Prosthetics, Orthotics, and Supplies 3148 Hcalthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List 3149 New Waived Tests 3150 January 2015 Update of the Hospital Outpatient Prospective Payment System (OPPS) Billing tor "Sometimes Therapy" Services that May be Paid as NonTherapy Services for ll ospital Outpatients Packaging Billing for Linear Accelerator (Robotic Image-Guided and Non-Robotic !mage-Guided) SRS Planning and Delivery Comprehensive APCs 3151 Correction to Remittance Information When HIPPS Codes are Re-coded by Medicare Systems Adjustments of Episode Payment- Confirming OASIS Assessment Items HH PPS Claims Decision Logic Used by the Pricer on Claims Calendar Year (CY) 2015 Annual Update for Clinical Laboratory Fee 3152 Schedule and Laboratory Services Subject to Reasonable Charge Payment January 2015 Integrated Outpatient Code Editor (l!OCE) Specifications 3153 Version 16.0 3154 Automation ofthe Request tor Reopening Claims Process Application to Special Claim Types 3155 Issued to a specific audience not posted to Internet/ Intranet due to Confidentiality of lnstmction January 2015 Update of the Hospital Outpatient Prospective Payment System 3156 (OPPS) Billing for "Sometimes Therapy" Services that May be Paid as Non-Therapy Services for Hospital Outpatients Packaging Billing for Linear Accelerator (Robotic Image-Guided and Non-Robotic Image-Guided) SRS Planning and Delivery Comprehensive APCs 3157 Summary ofPolicies in the CY 2015 Medicare Physician Fee Schedule (MPFS) Final Rule and Telehealth Originating Site Facility Fee Payment Amount January 2015 Update of the Ambulatory Surgical Center (ASC) Payment 3158 System Modifications to Medicare Part B Coverage of Pneumococcal Vaccinations 3159 Roster Claims Submitted to Carriers/ AH MACs tor Mass Immunization Pneumococcal Vaccine '~> .,,,,,,,,;:,;,!,:~; S~il'~;i:l •.• ••;v; .•''i\ •• !c<:;;; . . '.~ ~ ;\i~,~~;• .: 105 Electronic Correspondence Referral System (ECRS) notification regarding Defense of Marriage Act (DOMA) and ICD-10 changes COBC Electronic Correspondence Referral System (ECRS) Medicare Secondary Payer (MSP) Uroup Health Plan (UHP) Working Aged 106 Policy-- Definition of"Spouse"; Same-Sex Marriages Delinitions Working Aged Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 3126 Required Information for In-Facility Claims Paid Under the Composite Rate and the ESRD PPS Issued to a specific audience, not posted to lnternet/Intranct due to Conlidentiality of Instruction Screening for Hepatitis C Virus (HCV) in Adults Common Working File (CWF) Edits Institutional Billing Requirements Professional Billing Requirements Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MS\f) Messages Screening for Hepatitis C Virus (HCV Issued to a specitic audience, not posted to Internetllntranet due to Confidentiality oflnstmction CY 2015 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity ofTnstruction Common Edits and Enhancements Modules (CEM) Code Set Update Quarterly Update to the Correct Coding Initiative (CCI) Edits, Version 21.1, Ellective April!, 2015 Issued to a specific audience, not posted to Internet/ Intranet due to Confidentiality of Instruction Instmctions for Downloading the Medicare ZIP Code File for April 2015 Implement Operating Rules- Phase Ill ERA EFT: CORE 360 Uniform Usc of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) Rule- Update from CAQH CORE Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Biddin<> Program (CBP)- April 2015 Issued to a specific audience, not posted to Internet/ Intranet due to Conlidentiality oflnstmction Fiscal Year (FY) 2015 Inpatient Prospective Payment System (lPPS) and Long Term Care Hospital (LTCH) PPS Changes Implementation of Changes in the End-Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2015 Required Information for In-Facility Claims Paid Under the Composite Rate and the ESRD PPS Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2015 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 Claim Status Category and Claim Status Codes Update Medicare Physician Fee Schedule Database (MPFSDB) 2015 File Layout Manual Addendum Home Health Prospective Payment System (HH PPS) Rate Update tor Calendar Year (CY) 201 S Preventive and Screening Services · ·· Update- Intensive Behavioral Therapy 5543 EN02FE15.005</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 5544 VerDate Sep<11>2014 Jkt 235001 PO 00000 Frm 00043 .. Fmt 4703 Sfmt 4725 E:\FR\FM\02FEN1.SGM 02FEN1 •. rc.·'.:'''\'~, ,,,,.~,,i,'· 123 124 EN02FE15.006</GPH> :::,,;;J::; 't;');;:,;;•,;, 125 126 127 128 129 130 ~~>%~~;\\!:; <j)~'~;;:', 546 547 548 549 550 55! 552 553 554 555 556 557 558 .;x> Notice of :--Jew Interest Rate for Medicare Overpayments and Underpayments -1st Qtr Notfication for FY 2015 Revisions to State Operations Manual (SOM), Appendix W, Interpretive Guidelines for Critical Access Hospitals 559 560 Revisions to State Operations Manual (SOM) Chapter 2 Revisions to State Operations Manual (SOM), Chapter 4- "Program Administration and Fiscal Management" Revisions to State Operations Manual (SOM), Chapter 4- "Program Administration and Fiscal Management" Revisions to State Operations Manual (SOM) Table of Contents Appendix J and Appendix Table of Contents Letter J Description State Operations Manual (SOM) Appendix Y- Organ Procurement Organization (OPO) Interpretive Guidance Revisions to §486.318 Condition: Outcome Measures Revisions to State Operations Manual (SOM). Appendix PP "Guidance to Surveyors for Long Term Care Facilities" /i>'c:<t l~~,,.,,~~~>;:~>i;>l\2:~::~\ ;t> Documentation for Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) Repair Claims. This CR rescinds and fully replaces CR 8843. Suppliers Documentation for DMEPOS Repair Claims Review Timeliness Requirements for Complex Review Complex Medical Review Requesting Additional Documentation During Prepayment and Postpayment Review Deletion of Program Integrity Manual Exhibit 34 Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instruction One on One Education 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 Confidentiality of Instruction Issued to a specific audience, not posted to Internet/ Intranet due to Confidentiality of lnstrudion New Timeframe for Response to Additional Documentation Requests TimeFrames for Submission Issued to a specific audience, not posted to Internet/ Intranet due to Confidentialitv oflnstruction Revisions to Pub. 100-08, Program Integrity Manual (PIM), Chapter IS Background Owning and Managing Organizations End-Stage Renal Disease Facilities (ESRDs) Update to CMS Publication 100-08. Chapter 3, Section 3.2.3,4 (Additional Documentation Request Required and Optional l:Ciements) Additional Documentation Request Required and Optional Elements Update to the Program Integrity Manual (Pub. I 00-08) Exhibit 36 Overview of the Comprehensive Error Rate Testing (CERT) Process CERT Formats for A/B MACs (B) and DME MACs and Shared Systems CERT Formats for AlB MAC (A) MACS and Shared Systems Overview of the CERT Process Issued to a specific audience not, to lnternet/Intranet due to Confidentiality of Instruction Program Integrity Manual Chapter 12 Revision Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 Update to Pub. I 00-05. Chapters 05 and 06 to Provide Language-Only Changes for Updating ICD-10 and ASC Xl2 Medicare Sccondmy Payment Pm1 A Claims Determination for Services Received on ASC X12 837 Institutional Electronic or Hard Copy Claim Formats Identification of Liability and No-Fault Situations Conditional Medicare Payment Medicare Secondary Payment Part B Claims Determination for Services Received on ASC X 12 837 Professional Electronic Claims Sources That May Identify Other Insurance Coverage Inpatient Hospital Claims and Medicare Secondaty Payer (MSP) Claims with 108 Medicare Coinsurance Days and/or Medicare Lifetime Reserve Days Occurring in the Seventh to Fifteenth Years Return Codes Payment Calculation for Inpatient Bills (MSPPA YAI Module) Electronic Correspondence Referral System (ECRS) notification regarding 109 Defense of Marriage Act (DOMA) and ICD-10 changes ,, (\1:;~2/;;\}.',,;,~\ fi;.·;\; >''(,~)· ~~~i'l;:J<t ;., 242 Medicare Financial Management Manual, Chapter 7, Internal Controls Certification Package for Internal Controls (CPIC) Requirements List of CMS Contractor Control Objectives Certification Statement CPIC - Report oflnternal Control Deficiencies Statement on Standards for Attestation Engagements (SSAE) Number 16, Reporting on Controls at Service Providers Submission, Review, and Approval of Corrective Action Plans Corrective Action Plan (CAP) Reports CMS Finding Numbers Quarterly CAP Report OMB Circular A-123, Appendix A: Internal Controls Over Financial Reporting (ICOFR) 243 Notice of :'-Jew Interest Rate for Medicare Overpayments and Cnderpayments -1st Qtr Notlication for FY 2015 244 l'reasury Report on Receivables ('l'ROR) Reporting Debts RTA, Pending Final Disposition Required Changes to the Company Entry Description Value in the Batch 245 Header Record for Backup Withholding Files 246 Recovery Auditor Appeal Adjustments with "Rl" Indicator Tracking Appeals and Reopenings 247 Issued to a specific audience, not posted to IntcrneV Intranet due to Confidentiality of Instruction 248 Revision of Pub. I 00-06 - Medicare Financial Management Manual, Chapter f)- Intermediary and Carrier Financial Reports, and Puh. 100-09 Medicare Contractor Beneficiary and Provider Communications, Chapter 6 - Provider Customer Service Program Part B - Inquiries Body of Report 107 mstockstill on DSK4VPTVN1PROD with NOTICES VerDate Sep<11>2014 Jkt 235001 PO 00000 Frm 00044 Fmt 4703 Sfmt 4725 E:\FR\FM\02FEN1.SGM 02FEN1 562 563 564 565 ;tr •I"; None Revision of Pub. I 00-06 - Medicare Financial Management Manual, Chapter 6 Intermediary and Carrier Financial Reports, and Pub. 100-09 Medicare Contractor Beneficiary and Provider Communications, Chapter 6Provider Customer Service Program Reporting Provider and Beneficiary Inquiry Workload Data in the Contractor Reporting of Operational Workload Data (CROWD) 30 lt~i. ·~~;;:'(.~ §"''\;'~,~ lJ;.\ri(!\;/;i\2.}~2'•• None '<lrai!itl~ti'!ll1 J;;;;~{;; 00 •'\i;,r,.·;\ None ~(wr; fl't',~t\:;(\;;;;; Nunc ;•;' ,';;/;r,';'r;;)'f;';:;; j~i~;~~i\( ,iJ!; (~;~ i';f)r:!~rr\\i:J;•)l\\\l::;'r,il~$\if~~ Chapter 16b: Special Needs Plans The majority of sections of the chapter were revised and rearranged. Additionallv there are several sections with new content. 119 ~· '~'<l}.'c\~c <· •:j''i~\~~~;<'.2\ Non~ t\',\ ;~;j;l, 109 110 Ill 112 113 114 l'J)\;)';'1,!\ 'Xl'' :ll't';···.··••· ;,:~,r; :;~;.~ ;'i;'.'ll~· ·•;<;;;·;~. i 1429 1430 1431 1432 1433 1434 1435 •\•iiB''.1tl\r\i.:•;ir•;,~\~Z~rt::;,\;~i?'(,i·\r(l'?\~i!;(\:.:~ Updates to the Model4 Bundled Payment of Care Initiative (BPCI) Payment Calculation to Include Uncompensated Care Payment (UCP) and Reduction in Payment Due to Sequestration Termination of Multi-Payer Advance Primary Care Practice (MAPCP) Demonstration in Minnesota and Pennsylvania Issued to a specific audience, not posted to Internet!Intranet due to Sensitivity of Instruction Issued to a specific audience, not posted to Internet/lntranet due to Sensitivity of Instruction Issued to a specific audience, not posted to I nternet/Intranet due to Sensitivity of Instruction Affordable Care Act Bundled Payments for Care Improvement Initiative Recurring File Updates Models 2 and 4 April2015 Updates ~ l~:i\\;.,:i~:.:l?!t':\~(i£:~ .•• ~~ Fee for Service Beneficiary Data Streamlining (FFS BDS) Updates to Operational Issues Issued to a specific audience not posted to lntemeti Intranet due to Sensitivity ofinstruction 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 Sensitivity of Instruction Additional Instruction on the Use of Claims Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) with Regard lo Operating Rule: 360 Compliance Issued to a specific audience not posted to Intemet/ Intranet due to Sensitivity of Instruction New Informational Unsolicited Response (IUR) Process for Durable Medical Equipment (DME) Items Furnished during a Part A Hospital Inpatient Stay Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 561 Contacting Non-Responders and Documentation Requests MAC Communication with the CERT Program Overview of the CERT Process Providing Sample Information to the CERT Review Contractor MAC Responsibility After Workload Transition Providing Feedback Information to the CERT Review Contractor Disputing/Disagreeing with a CERT Decision Handling Overpayments and Underpayments Resulting From the CERT Findings Disseminating CERT Information MAC Error Rate Reduction Plan (ERRPs) The Comprehensive Error Rate Testing (CERT) Program Incorporation of Certain Provider Enrollment Policies in CMS-4159-F into Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 Indian Health Services (IHS) Facilities Skilled Nursing Fadlilies (SNFs) Ambulatory Surgical Centers (ASCs) CLIALabs Mammography Screening Centers Pharmacies 21Revocations Radiation Therapy Centers Suppliers of Ambulance Services Intensive Cardiac Rehabilitation (ICR) Diabetes Self-Management Training (DSMT) Mass Immunizers Who Roster Bill Inter-Jurisdictional Reassignments Receiving Missing/Claritying Data/Documentation Documentation Denials Non-Certified Suppliers and Individual Practitioners Certitied Providers and Certified Suppliers Establishing an Effective lJate of Medicare Billing Privileges Application Fees Claims against Surety Bonds Release of Information Deactivations Reactivations Reactivations -Deactivation for Reasons Other Than Non-Submission of a Claim/Reactivations- Deactivation for Non-Submission of a Claim Portable X-Ray Suppliers (PXRSs) Issued to a specific audience not, to Internet/Intranet due to Confidentiality of Instruction Issued to a specific audience not, to lnternet/Intranet due to Confidentiality of Instruction Issued to a specitic audience not, to Internet/Intranet due to Confidentiality of Instruction Update to CMS Publication 100-08, Chapter 3, Section 3.2.3.2 (Time Frames for Submission) 5545 EN02FE15.007</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 5546 VerDate Sep<11>2014 1436 1437 1439 1440 Jkt 235001 1441 PO 00000 1442 1443 Frm 00045 1444 Fmt 4703 1445 1446 Sfmt 4725 1447 E:\FR\FM\02FEN1.SGM 1448 1449 ~~~'x:~~,~~i 35 36 02FEN1 37 38 ?.~~;t(•'~\!; Issued to a specific audience not posted to Confidentiality oflnstructions Issued to a specific audience not posted to Confidentiality of Instructions Issued to a specific audience not posted to Confidentiality oflnstructions Issued to a specific audience not posted to Confidentiality of Instructions Internet/ Intranet due to Internet/ Intranet due to Internet/ Intranet due to Internet/ Intranet due to Addendum II: Regulation Documents Published in the Federal Register (October through December 2014) Regulations and Notices Regulations and notices are published in the daily Federal Register. To purchase individual copies or subscribe to the Federal When ordering individual Register, contact GPO at EN02FE15.008</GPH> 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 1 (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: For questions or additional information, contact Terri Plumb ( 410-786-4481 ). 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 ""f!·! 1 vv vv vv ·"!!'"·!:'", 1 """tsuu<u,;u;,For questions or additional information, contact Tiffany Lafferty ( 41 0-786-7548). Addendum IV: Medicare National Coverage Determinations (October through December 2014) 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 detennination 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 detem1ination 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 Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 1438 Fee for Service Beneficiary Data Streamlining (FFS BDS) Phase II Analysis Data Quality Between the Multi Carrier System (MCS) and YiPS Medicare System (VMS) and the Common Working File (CWF) Data Quality between the Fiscal Intermediary Shared System (FISS) and the Common Working File (CWF) Issued to a specific audience not posted to Internet/ Intranet due to Sensitivity of Instruction Health Insurance Portability and Accountability Act (HIPAA) ED! Front End Updates for April20I5 Implementation Instructions for the A/B and DME Medicare Administrative Contractors (MACs) and their Designated Shared Systems to Send the Correct Cost Avoided Indicator and Special Project Type to the Common Working File (CWF) To Ensure Correct Savings is Applied Both to the Medicare Secondary Payer (MSP) Savings Report and the Originating Contractor Issued to a specitlc audience not posted to Internet! Intranet due to Sensitivity of Instruction Issued to a specific audience not posted to Internet/ Intranet due to Sensitivity of Instruction Analysis and Design to Automate Adjustments That Arc Completed In The Common Working File (CWF) When Inpatient (INP) Or Skilled Nursing Facility (SNF) Claims Are Processed Out Of Sequence Rescind and Replace of CR l\409: Reclassification of Certain Durable Medical Equipment from the Inexpensive and Routinely Purchased Payment Category to the Capped Rental Payment Category !DR Shared Systems Daily Claims Feeds Expansion to Accommodate Medical Review Data Elements Rescind and Replace of CR 8409: Reclassification of Certain Durable Medical Equipment from the Inexpensive and Routinely Purchased Payment Category to the Capped Rental Payment Category Fee for Service Beneficiary Data Streamlining (FFS BDS) Updates to Operational Issues 20 15 Electronic Health Record System Payment A Letter mstockstill on DSK4VPTVN1PROD with NOTICES VerDate Sep<11>2014 Jkt 235001 Title PO 00000 Frm 00046 Fmt 4703 Medicare Coverage of Ultrasound Screening for Abdominal Aortic Aneurysms (AAA) and Screening Fecal-Occult Blood Tests (FOBT) Screening Hepatitis C Virus in Adults Transcatheter Mitral Valve Repair (TMVR)-National Coverage Determination (NCD) NCDM Section Transmittal Number Issue Date Effective Date NCD210.3 R176 10/17/2014 01/24/2014 NCD210.13 Rl77 11/19/2014 06/02/2014 NCD20.33 Rl78 12/05/2014 08/07/2014 Sfmt 4725 E:\FR\FM\02FEN1.SGM 02FEN1 Addendum V: FDA-Approved Category B Investigational Device Exemptions (IDEs) (October through December 2014) 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 of this quarterly notice, we list only the specific updates to the Category BIDEs 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). 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 April21, 1997 Federal Register (62 FR 19328). IDE Ul40170 Ul40120 Gl40171 G140174 Gl40175 Ul40177 G140172 Gl30249 G140055 Gl40104 Ul40173 Device Start Date Syncardia Temporary Total Aliiticial Heart (TAH-T) System 10/03/2014 10/08/2014 Revanesse Ultra 10/08/2014 Juvederm Voluma XC Gel Implant 10/08/2014 Spiration Valve System Model PIV-C26N IlluminOss Bone Stabilization System 10/08/2014 10/08/2014 Tiara Valve; Tiara Delivery System 10/09/2014 AMICUS Separator System Rodo Abutment Svstem 10/15/2014 Oncozene Microspheres 10116/2014 Celotres 10/17/2014 A Randomize Trial Comparing Usc of Continuous Glucose 10/20/2014 Monitoring with and without Routine Blood Glucose Monitoring in Adults with Type I Diabetes Mcdtronic Activa PC+S 10/29/2014 U140181 TriGuard IIDII Embolic Deflection Device 10/29/2014 G140074 NovoTTF-100A System 10/30/2014 G140184 Gl40185 CompuFio Epidural Computer Controlled Anesthesia System 10/3112014 EPI 6000 G140187 Mcdtronic Activa PC+S 10/31/2014 G140189 ThermoCool SmartT ouch SF Catheter D-1347-XX-SI And D10/31/2014 1348-XX-SI Vcntana PD-Ll (SP263) Rabbit Monoclonal Primary Antibody Gl40188 10/31/2014 aura6000 Targeted Hypoglossal Neurostimulation (THN) System lli06/2014 Gl40158 (y140194 11/07/2014 Lumifi With Crux Vena Cava Filter System Model 7070 Gl40198 11/07/2014 Vysis Egfr CDx Fish Kit (LISZT NO. 08N75) Gl40199 11/07/2014 Brainsway Deep TMS Device For The Treatment of PostTraumatic Stress Disorder (PTSD) 11/13/2014 G L_4()2Q()__ L}\_c_ti_va_P_C:::-i' ]'J~ur_osti !llu!ation_System Activa PC-S Ncurostimulation System and Ncurosiim~tlation- --rli;1472o14-G140203 Systems for DBS G140201 11/14/2014 Pediatric Cystoscope For Use in Fetal Neural Tube Defect Repair G140207 11!20/2014 TAAA Dcbranching Stent Graft System G140107 11/21/2014 Bionir Ridatorolimus Eluting Coronary Stent System G140190 11/24/2014 EXALE)JZ BREATHID LF System 13C-Mcthacetin Breath Test U140212 11!25/2014 Self Expanding Mitral Transcatheter Heart Valve System, Model 9800 11/28/2014 Magnap (Magnetic Apnea Prevention) Device Gl30285 XprESS Device for Eustachian Tube Dilation 12/03/2014 Gl40214 Ventana PD-Ll (SP263) Rabbit Monoclonal Primary Antibody 12/03/2014 Gl40215 Cervical Pessary 12/04/2014 G140219 12/10/2014 Med-El Maestro Cochlear Implant System G140226 0140223 12/11/2014 Acell Matristem SurgicalMatrix PSMX-6 Layers-IOcm x !Scm (Acell, Inc.); Boston Scientilic Walll1ex Fully Covered Esophageal Stent Alfapump 12/12/2014 G140126 Early Feasibility Study ofThe Networked J\europrosthesis for Gl40225 12/12/2014 Grasp and Trunk Function in Spinal Cord Injury Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 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: -~-~~--~Y..~;:-"!!.~c!O~..!.L'-!.~.~'-'-~''~-"-~-;,_'C::::!-'!l:"-".: For questions or additional information, contact Wanda Belle (410-786-7491). 5547 EN02FE15.009</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 5548 VerDate Sep<11>2014 Jkt 235001 Device Gore Tag Thoracic Branch Endoprosthesis Exalenz BreathiD For Use With C-Laeled Palmitate Juvederm Voluma (AIIergan) 2008K(a)homc Noctumal Hemodialysis Indication 1.5T And 3.0T MRI Scanners Bioprosthetic Mitral Valve System Starflo Glaucoma lmplantMode192101 Doctormate Renqiao Remote Ischemic Conditioning Device Type: IPC-906X PO 00000 Addendum VI: Approval Numbers for Collections of Information (October through December 2014) Frm 00047 Fmt 4703 All approval numbers are available to the public at Reginfo.gov. Under the review process, approved information collection requests are assigned OMB control numbers. A single control number may apply to several related information collections. This information is available at For questions or additional information, contact Mitch Bryrnan (41 0-786-5258). Sfmt 4725 Addendum VII: Medicare-Approved Carotid Stent Facilities, (October through December 2014) E:\FR\FM\02FEN1.SGM 02FEN1 Addendum VII includes listings of Medicare-approved carotid stent facilities. All facilities listed meet CMS standards for performing carotid artery stenting for high risk patients. 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 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 infom1ation is available at: For questions or additional information, contact Lori Ashby ( 41 0-786-6322). EN02FE15.010</GPH> Start Date 12/17/2014 12/18/2014 12/19/2014 12/19/2014 12/19/2014 12/19/2014 12/19/2014 12/21/2014 Facility Provider Number Effective Date 050551 10/10/2014 CA 670092 10/30/2014 TX 390329 12/15/2014 PA •,·~~;:i%• · • •~c'';;<';!;,i>'~ '' Los Alamitos Medical Center 3751 Katella Avenue Los Alamitos, CA 90720 Walnut Hill Medical Center 7502 Greenville Avenue Dallas, TX 75231 Einstein Medical Center Montgomery 559 West Germantown Pike East Norriton. PA 19403 ~0~'~;'t':~;,>s ,,::'A'''\'"' 0 ( .•,~, :z;,' Physicians Regional Health care System, Collier Boulevard 8300 Collier Boulevard Naples, FL 34114 Physicians Regional Healthcare System, Pine Ridge 610 I Pine Ridge Road Naples, FL 34119 FROM: Heart Hospital of New Mexico TO: Heart Hospital of New Mexico at Lovelace Medical Center 504 Elm StreetN.E. Albuquerque, NM 87102 FROM: Swedish Medical Center-Providence Campus TO: Swedish Medical Center- Cherry Hill 500 17th Avenue Seattle WA 98122 FROM: The Indiana Heart Hospital, LLC TO: Community Heart and Vascular Hospital 1500 N. Ritter Indianapolis, IN 46219 State ,. ;•~;;:~'11~~~! ~~'~\ ;t;;,E~;,;:. 100286 04/12/2012 FL 100286 11116/2006 FL 32009 06/20/2005 NM 500025 05/23/2005 WA 15-0074 08/04/2005 I~ Addendum VIII: American College of Cardiology's National Cardiovascular Data Registry Sites (October through December 2014) Addendum VIII includes a list of the American College of Cardiology's National Cardiovascular Data Registry Sites. We cover implantable cardioverter defibrillators (ICDs) for certain clinical indications, as long as information 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) lCD Registry satisfies the data reporting requirements in the NCD. Hospitals needed to transition to the ACC-NCDR lCD Registry by April 2006. Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 IDE Gl40230 Gl40235 Gl40229 Gl40233 Gl40234 Gl40240 G140193 GJ40239 mstockstill on DSK4VPTVN1PROD with NOTICES VerDate Sep<11>2014 Jkt 235001 PO 00000 Frm 00048 Fmt 4703 Sfmt 4725 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 of facilities that participate in the ACC-NCDR lCD registry can be found at~'-'-'-===-=~-'-===~== 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 infonnation, contact Marie Casey, BSN, MPH (410-786-7861). E:\FR\FM\02FEN1.SGM Facility >>'. ;,;:~; :;~';,'zf :·,'." ; 02FEN1 University of Arkansas Medical Sciences Physician Verdugo Hills Hospital Morris Hospital Truman Medical Centers Great Plains Health St. Vincent Blount Citizens Medical Center Ililo Medical Center Seton Medical Center Hays City Little Rock Glendale Morris Kansas City North Platte Oneonta Victoria llilo Kyle ;,~~',''iJ.;,;ii;~~;: ..i}~'i\cJ Watsonville Community Hospital Owensboro Health Regional Hospital Bartow Regional Medical Center Camden Clark Medical Center-St Joseph Campus Carlsbad Medical Center Bayfront Health Spring Hill State '.;l'> ll''~.Li;\\';i~ Watsonville Owensboro Bartow Parkersburg Carlsbad Spring Hill ..,,.,,,,, AR CA lL MO NE AL TX Ill TX ;,{. .\\';/•.:',;; CA KY FL wv NM FL Addendum IX: Active CMS Coverage-Related Guidance Documents (October through December 2014) CMS issued a guidance document on November 20, 2014 titled "Guidance for the Public, Industry, and CMS Staff: Coverage with Evidence Development Document". Although CMS has several policy vehicles relating to evidence development activities including the investigational device exemption (IDE), the clinical trial policy, national coverage detenninations and local coverage determinations, this guidance document is principally intended to help the public understand CMS's implementation of coverage with evidence development (CED) through the national coverage detennination process. The document is available at For questions or additional information, contact JoAnna Baldwin (41 0-786-7205). Addendum X: List of Special One-Time Notices Regarding National Coverage Provisions (October through December 2014) There were no special one-time notices regarding national coverage provisions published in the October through December 2014 quarter. This infom1ation is available at For questions or additional information, contact JoAnna Baldwin (410-786 7205). Addendum XI: National Oncologic PET Registry (NOPR) (October through December 2014) 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 perfom1ed 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 perfonned 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. There were no additions, deletions, or editorial changes to the listing ofNational Oncologic Positron Emission Tomography Registry (NOPR) in the October through December 2014 quarter. This information is Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 Effective January 27, 2005, to obtain reimbursement, Medicare NCD 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. 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 5549 EN02FE15.011</GPH> mstockstill on DSK4VPTVN1PROD with NOTICES 5550 VerDate Sep<11>2014 For questions or additional information, contact Stuart Caplan, RN, MAS (41 0-786-8564). Jkt 235001 PO 00000 Frm 00049 Fmt 4703 Sfmt 4725 Addendum XII: Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities (October through December 2014) 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 VADs 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 E:\FR\FM\02FEN1.SGM For questions or additional information, contact Marie Casey, BSN, MPH (410-786-7861 ). Provider Number 02FEN1 Rush University Medical Center 1653 West Congress Parkway Chicago, IL 60612 140119 Addendum XIII: Lung Volume Reduction Surgery (LVRS) (October through December 2014) 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 ofHealthcare 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 updates to the listing offacilities for lung volume reduction surgery published in the October through December 2014 quarter. This infonnation is available at ~~~~~~~~~~£W~~~~~~Ull~~~- For questions or additional infonnation, contact Marie Casey, BSN, MPH (410-786-7861). Addendum XIV: Medicare-Approved Bariatric Surgery Facilities (October through December 2014) 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 Fcbruary 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 barialric 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). There were no additions, deletions, or editorial changes to Medicare-approved facilities that meet CMS 's minimum facility standards for bariatric surgery that have been certified by ACS and/or ASMBS in the October through December 2014 period. This information is available at For questions or additional information, contact Jamie Hermansen (410-786-2064). Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices 19:24 Jan 30, 2015 EN02FE15.012</GPH> available at Federal Register / Vol. 80, No. 21 / Monday, February 2, 2015 / Notices Belinda Gravel, (410) 786–8934. News media representatives must contact CMS’ Public Affairs Office at (202) 690–6145 or email them at press@ cms.hhs.gov. SUPPLEMENTARY INFORMATION: I. Background Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Extension of temporary moratoria. A. CMS’ Imposition of Temporary Enrollment Moratoria Section 6401(a) of the Affordable Care Act added a new section 1866(j)(7) to the Social Security Act (the Act) to provide the Secretary with authority to impose a temporary moratorium on the enrollment of new Medicare, Medicaid or CHIP providers and suppliers, including categories of providers and suppliers, if the Secretary determines a moratorium is necessary to prevent or combat fraud, waste, or abuse under these programs. For a more detailed explanation of these authorities, please see the July 31, 2013 notice (78 FR 46339) or February 4, 2014 extension and establishment of a temporary moratoria document (hereinafter referred to as the February 4, 2014 moratoria document or notice) (79 FR 6475). Based on this authority and our regulations at § 424.570, we have implemented three phases of the moratoria to date. In the notice issued on July 31, 2013 (78 FR 46339), we imposed moratoria on the enrollment of home health agencies in Miami-Dade County, Florida and Cook County, Illinois and surrounding counties and on the enrollment of ground ambulance suppliers in the Harris County, Texas area and surrounding counties. Then, in the notice published on February 4, 2014 (79 FR 6475), we extended the initial moratoria and imposed moratoria on the enrollment of home health agencies in Broward County, Florida, Dallas County, Texas, Harris County, Texas and Wayne County, Michigan and surrounding counties and on the enrollment of ground ambulance suppliers in Philadelphia, PA and surrounding counties. In the notice published on August 1, 2014 (79 FR 44702), CMS extended all of the abovementioned moratoria. This document announces the extension of temporary moratoria on the enrollment of new ambulance suppliers and home health agencies (HHAs) in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. DATES: Effective Dates: January 29, 2015. B. Determination of the Need for Extending a Moratorium In extending these enrollment moratoria, CMS considered both qualitative and quantitative factors suggesting a high risk of fraud, waste, or abuse. CMS relied on law enforcement’s longstanding experience with ongoing and emerging fraud trends and activities through civil, criminal, and [FR Doc. 2015–01904 Filed 1–30–15; 8:45 am] BILLING CODE 4120–01–C DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS–6059–N2] Medicare, Medicaid, and Children’s Health Insurance Programs: Announcement of the Extended Temporary Moratoria on Enrollment of Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations AGENCY: mstockstill on DSK4VPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 19:24 Jan 30, 2015 Jkt 235001 PO 00000 Frm 00050 Fmt 4703 Sfmt 4703 administrative investigations and prosecutions. CMS’ determination of a high risk of fraud, waste, or abuse in these provider and supplier types within these geographic locations was then confirmed by CMS’ data analysis, which relied on factors the agency identified as strong indicators of risk. (For a more detailed explanation of this determination process and of these authorities, see the July 31, 2013 notice (78 FR 46339) or February 4, 2014 moratoria document (79 FR 6475)). 1. Consultation With Law Enforcement In consultation with the HHS-Office of Inspector General (OIG) and the Department of Justice (DOJ), CMS identified two provider and supplier types in nine geographic locations that warrant a temporary enrollment moratorium. For a more detailed discussion of this consultation process, see the July 31, 2013 notice (78 FR 46339) or February 4, 2014 moratoria document (79 FR 6475). 2. Beneficiary Access to Care Beneficiary access to care in Medicare, Medicaid, and CHIP is of critical importance to CMS and its state partners, and CMS carefully evaluated access for the target moratorium locations. Prior to imposing and extending these moratoria, CMS consulted with the appropriate State Medicaid Agencies and with the appropriate State Department of Emergency Medical Services to determine if the moratoria would create an access to care issue for Medicaid and CHIP beneficiaries in the targeted locations and surrounding counties. All of CMS’ state partners were supportive of CMS analysis and proposals, and together with CMS, determined that these moratoria will not create access to care issues for Medicaid or CHIP beneficiaries. CMS also reviewed Medicare data for these areas and found there are no current problems with access to HHAs or ground ambulance suppliers. 3. Lifting a Temporary Moratorium In accordance with § 424.570(b), a temporary enrollment moratorium imposed by CMS will remain in effect for 6 months. (For a more detailed explanation of how CMS can lift a temporary moratorium, see the July 31, 2013 notice (78 FR 46339) or February 4, 2014 moratoria document (79 FR 6475)). If CMS deems it necessary, the moratorium may be extended in 6month increments. CMS will evaluate whether to extend or lift the moratorium before any subsequent moratorium periods. If one or more of the moratoria E:\FR\FM\02FEN1.SGM 02FEN1 EN02FE15.013</GPH> FOR FURTHER INFORMATION CONTACT: 5551

Agencies

[Federal Register Volume 80, Number 21 (Monday, February 2, 2015)]
[Notices]
[Pages 5537-5551]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-01904]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9088-N]


Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--October Through December 2014

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

ACTION: Notice.

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SUMMARY: This quarterly notice lists CMS manual instructions, 
substantive and interpretive regulations, and other Federal Register 
notices that were published from October through December 2014, 
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

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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.
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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.
    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. Format for the Quarterly Issuance Notices

    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 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.

    Dated: January 23, 2015.
Kathleen Cantwell,
Director, Office of Strategic Operations and Regulatory Affairs.
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[FR Doc. 2015-01904 Filed 1-30-15; 8:45 am]
BILLING CODE 4120-01-C
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