Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability; Corrections, 37-40 [2016-31650]
Download as PDF
sradovich on DSK3GMQ082PROD with RULES
Federal Register / Vol. 82, No. 1 / Tuesday, January 3, 2017 / Rules and Regulations
(2) Optionally, may attest that it:
(i) Acknowledges the option to
cooperate in good faith with ONC–ACB
surveillance of his or her health
information technology certified under
the ONC Health IT Certification Program
if a request to assist in ONC–ACB
surveillance is received; and
(ii) If requested, cooperated in good
faith with ONC–ACB surveillance of his
or her health information technology
certified under the ONC Health IT
Certification Program as authorized by
45 CFR part 170, subpart E, to the extent
that such technology meets (or can be
used to meet) the definition of CEHRT,
including by permitting timely access to
such technology and demonstrating its
capabilities as implemented and used
by the eligible hospital or CAH in the
field.
(I) Support for health information
exchange and the prevention of
information blocking. For an EHR
reporting period in CY 2017 and
subsequent years, the eligible hospital
or CAH must attest that it—
(1) Did not knowingly and willfully
take action (such as to disable
functionality) to limit or restrict the
compatibility or interoperability of
certified EHR technology.
(2) Implemented technologies,
standards, policies, practices, and
agreements reasonably calculated to
ensure, to the greatest extent practicable
and permitted by law, that the certified
EHR technology was, at all relevant
times—
(i) Connected in accordance with
applicable law;
(ii) Compliant with all standards
applicable to the exchange of
information, including the standards,
implementation specifications, and
certification criteria adopted at 45 CFR
part 170;
(iii) Implemented in a manner that
allowed for timely access by patients to
their electronic health information; and
(iv) Implemented in a manner that
allowed for the timely, secure, and
trusted bidirectional exchange of
structured electronic health information
with other health care providers (as
defined by 42 U.S.C. 300jj(3)), including
unaffiliated providers, and with
disparate certified EHR technology and
vendors.
(3) Responded in good faith and in a
timely manner to requests to retrieve or
exchange electronic health information,
including from patients, health care
providers (as defined by 42 U.S.C.
300jj(3)), and other persons, regardless
of the requestor’s affiliation or
technology vendor.’’.
*
*
*
*
*
VerDate Sep<11>2014
22:11 Dec 30, 2016
Jkt 241001
Dated: December 27, 2016.
Madhura Valverde,
Executive Secretary to the Department,
Department of Health and Human Services.
[FR Doc. 2016–31774 Filed 12–30–16; 8:45 am]
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 431, 433, 438, 440, 457,
and 495
[CMS–2390–F3]
RIN–0938–AS25
Medicaid and Children’s Health
Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP
Delivered in Managed Care, and
Revisions Related to Third Party
Liability; Corrections
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting
amendment.
AGENCY:
This document corrects
technical errors that appeared in the
final rule published in the May 6, 2016
Federal Register (81 FR 27498 through
27901) entitled, ‘‘Medicaid and
Children’s Health Insurance Program
(CHIP) Programs; Medicaid Managed
Care, CHIP Delivered in Managed Care,
and Revisions Related to Third Party
Liability.’’ The effective date for the rule
was July 5, 2016.
DATES: Effective Date: This correcting
document is effective December 30,
2016.
Applicability Date: The corrections
indicated in this document are
applicable beginning immediately.
FOR FURTHER INFORMATION CONTACT:
John Giles, (410) 786–1255, Medicaid
Managed Care Operations.
Heather Hostetler, (410) 786–4515,
Medicaid Managed Care Quality.
Melissa Williams, (410) 786–4435,
CHIP.
Nancy Dieter, (410) 786–7219, Third
Party Liability.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
In FR Doc. 2016–09581 (81 FR 27498
through 27901), the final rule entitled,
‘‘Medicaid and Children’s Health
Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP
Delivered in Managed Care, and
Revisions Related to Third Party
Liability’’ there were technical errors
Frm 00033
Fmt 4700
that are identified and corrected in this
correcting document. These corrections
are applicable immediately.
II. Summary of Errors
A. Summary of Errors in the Preamble
BILLING CODE 4120–01–P
PO 00000
37
Sfmt 4700
On page 27560 we made a technical
error in the response to comments of
§ 438.6(e). In this response, we
inadvertently identified the effective
date and the date by which we would
enforce compliance for the regulation,
which is correctly identified in the
Compliance section on page 27499.
On page 27679 we made a technical
error in the preamble text of § 438.330
(Quality Assessment and Performance
Improvement Program) in a response to
comment. We stated, ‘‘Note that
standards for risk adjustment are
provided in §§ 438.5(g) and 438.7(b)(5).’’
We inadvertently omitted the words
‘‘for payment purposes’’ after ‘‘risk
adjustment’’ in this sentence to clarify
that these cross-referenced sections are
related to risk adjustment for payment
purposes.
On page 27708 we made a technical
error in the preamble text of § 438.358
(Activities Related to External Quality
Review) in a response to comment about
§ 438.358(b)(iv) (Validation of MCO,
PIHP, or PAHP validation of network
adequacy). We inadvertently included
PIHPs and PAHPs in a statement about
the match rate for this EQR-related
activity for MCOs. We stated, ‘‘. . . the
validation of MCOs, PIHPs, and PAHPs
would be eligible for the 75 percent
match rate under § 438.370(a).’’ This
was in error, as it conflicts with
§ 438.370 of the final rule and the
preamble discussion of that section on
pages 27715 through 27717.
On page 27712 we made a technical
error in the preamble text of § 438.360
(Nonduplication of mandatory activities
with Medicare or accreditation review)
in a response to comment about
updating the EQR protocols to
incorporate data from a Medicare or
private accrediting entity review. We
referenced three of the mandatory EQRrelated activities using the citation from
the proposed rule (§ 438.358(b)(1) to
(b)(3)), rather than the citation from the
final rule (§ 438.358(b)(1)(i) to
(b)(1)(iii)).
On page 27738 we made a technical
error in the response to comments of
§ 438.242(b)(2). In this response, we
inadvertently mistyped ‘‘T–MSIS.’’
On page 27766 we made a technical
error in the preamble text of § 457.1233.
We inadvertently did not note that CHIP
is also adopting the changes discussed
in the Medicaid preamble to include
PCCM entities as subject to § 438.230 in
E:\FR\FM\03JAR1.SGM
03JAR1
38
Federal Register / Vol. 82, No. 1 / Tuesday, January 3, 2017 / Rules and Regulations
sradovich on DSK3GMQ082PROD with RULES
response to public comments and
consideration of a managed care plan’s
subcontracted or delegated obligations,
services, or activities.
B. Summary of Errors in Regulation Text
On page 27860 we made a technical
error in the regulation text of
§ 438.6(c)(2)(i). In this paragraph, we
inadvertently omitted ‘‘actuarial’’ before
‘‘principles and practices.’’
On page 27862 we made a technical
error in the regulation text of
§ 438.8(e)(1). In this paragraph, we
inadvertently referenced fraud
reduction activities instead of fraud
prevention activities.
On page 27863 we made a technical
error in the regulation text of
§ 438.8(f)(2)(i). In this paragraph, we
inadvertently included an extra word
‘‘to.’’
On page 27867 we made a technical
error in the regulation text of
§ 438.10(g)(2)(xiii). In this paragraph, we
inadvertently included an extra word
‘‘in.’’
On page 27879 we made a technical
error in the regulation text of
§ 438.210(a)(2). In this paragraph, we
inadvertently referenced part 440
instead of part 441.
On page 27884 we made a technical
error in the regulation text of
§ 438.350(d). We incorrectly crossreferenced § 438.364(a)(1)(i) through (iv)
instead of § 438.364(a)(2)(i) through (iv).
On page 27885 we made a technical
error in the regulation text of
§ 438.358(a)(2) (Activities related to
external quality review). We incorrectly
cross-referenced § 438.364(a)(i) through
(iv) instead of § 438.364(a)(2)(i) through
(iv).
On page 27885 we made a technical
error in the regulation text of
§ 438.358(c)(3) (Activities related to
external quality review). We incorrectly
cross-referenced § 438.358(b)(2) instead
of § 438.358(b)(1)(ii).
On page 27885 we made a technical
error in the regulation text of
§ 438.358(c)(4) (Activities related to
external quality review). We incorrectly
cross-referenced § 438.358(b)(1) instead
of § 438.358(b)(1)(i).
On page 27891 we made a technical
error in the regulation text of
§ 438.604(a)(2). In this paragraph, we
inadvertently referenced § 438.3 instead
of § 438.4.
On page 27898 we made a technical
error in the regulation text of
§ 457.1201(l). In this paragraph, we
inadvertently cross-referenced the
Medicaid requirements related to
MHPAEA at § 438.3(n) instead of CHIP
MHPAEA requirements at § 457.496.
Both the Medicaid and CHIP MHPAEA
VerDate Sep<11>2014
22:11 Dec 30, 2016
Jkt 241001
provisions were issued on March 30,
2016, at 81 FR 18390, 18436 and 18442.
They are parallel provisions and the
change in the cross-reference will not
result in any substantive change in the
applicable requirements.
On page 27898 we made a technical
error in the regulation text of
§ 457.1201(n)(2). In this paragraph, we
inadvertently omitted a cross-reference
to § 438.330(b)(2) as we discussed in the
preamble on page 27757.
On page 27898 we made a technical
error in the regulation text of
§ 457.1203(a). In this paragraph, we
inadvertently included a parenthesis
before the word ‘‘implementing.’’
On page 27898 we made a technical
error in the regulation text of
§ 457.1203(e). In this paragraph, we
inadvertently did not include a comma
after the word ‘‘MCOs’’ and we
inadvertently included the word ‘‘to’’
after the word ‘‘under.’’
On page 27899 we made a technical
error in the regulation text of
§ 457.1210(c)(2) and § 457.1210(c)(4). In
this paragraph, we incorrectly used the
word ‘‘Explains’’ instead of the word
‘‘Explain.’’
On page 27899 we made a technical
error in the regulation text of
§ 457.1214. In this section, we
referenced § 438.58, the conflict of
interest safeguards required for
Medicaid managed care plans. However,
we inadvertently did not specify that
references to § 438.54(b) (relating to the
Medicaid managed care enrollment
processes) in § 438.58 should refer to
the enrollment processes for CHIP
described in § 457.1210(a).
On page 27899 we made a technical
error in the regulation text of
§ 457.1228. We inadvertently omitted
the words ‘‘and poststabilization care’’
before the word ‘‘services.’’
Additionally, we are replacing the crossreference to § 457.10 with a cross
reference to § 438.114 to reflect the
intended alignment with Medicaid
definitions that was clearly expressed in
the preamble on page 27764 in
discussing § 457.1228. In that preamble
discussion, we expressly indicated that
we would be adopting the definitions at
§ 438.114.
On page 27899 we made a technical
error in the regulation text of
§ 457.1230(c). We inadvertently did not
provide that the applicability date for
the Medicaid requirements in
§ 438.208(d) does not apply to CHIP.
On page 27899 we made a technical
error in the regulation text of
§ 457.1230(d). We inadvertently did not
provide the applicability date for the
Medicaid requirements in § 438.210(f)
does not apply to CHIP.
PO 00000
Frm 00034
Fmt 4700
Sfmt 4700
On page 27900 we made a technical
error in the regulation text of
§ 457.1233(b). As indicated in the
preamble on page 27766, we intended to
align the structure and operation
standards for CHIP managed care
entities with parallel Medicaid
standards, but we inadvertently omitted
PCCM entities from the list of managed
care entities that the state must ensure
are in compliance with § 438.230.
On page 27900 we made technical
errors in the regulation text of
§ 457.1240(e). We inadvertently left in
an obsolete cross reference from the
proposed rule to § 438.340(e).
On page 27900 we made technical
errors in the regulation text of
§ 457.1240(f). In this paragraph, we
incorrectly spelled ‘‘PCCM entities’’ as
‘‘PPCM entities.’’
On page 27900 we made technical
errors in the regulation text of
§ 457.1250(a), relating to external
quality review. We inadvertently did
not provide that while the terms of
Medicaid external quality review
provisions at § 438.350 applies to PCCM
entities, § 438.362, which is crossreferenced in § 438.350, does not apply
to PCCM entities in CHIP.
On page 27900 we made technical
errors in the regulation text of
§ 457.1260. We inadvertently did not
include an exception to the Medicaid
applicability date as described in
§ 438.400(c).
III. Waiver of Proposed Rulemaking
and Delay in Effective Date
Under 5 U.S.C. 553(b) of the
Administrative Procedure Act (APA),
the agency is required to publish a
notice of the proposed rule in the
Federal Register before the provisions
of a rule take effect. In addition, section
553(d) of the APA mandates a 30-day
delay in effective date after issuance or
publication of a rule. Sections 553(b)(B)
and 553(d)(3) of the APA provide for
exceptions from the APA notice and
comment, and delay in effective date
requirements. Section 553(b)(B) of the
APA authorizes an agency to dispense
with normal notice and comment
rulemaking procedures for good cause if
the agency makes a finding that the
notice and comment process is
impracticable, unnecessary, or contrary
to the public interest; and includes a
statement of the finding and the reasons
for it in the notice.
In our view, this correcting document
does not constitute a rulemaking that
would be subject to these requirements.
This document merely corrects
technical errors in the Medicaid and
Children’s Health Insurance Program
(CHIP) Programs; Medicaid Managed
E:\FR\FM\03JAR1.SGM
03JAR1
sradovich on DSK3GMQ082PROD with RULES
Federal Register / Vol. 82, No. 1 / Tuesday, January 3, 2017 / Rules and Regulations
39
Care, CHIP Delivered in Managed Care,
and Revisions Related to Third Party
Liability final rule. The corrections
contained in this document are
consistent with, and do not make
substantive changes to, the policies and
payment methodologies that were
adopted subject to notice and comment
procedures in the Medicaid and
Children’s Health Insurance Program
(CHIP) Programs; Medicaid Managed
Care, CHIP Delivered in Managed Care,
and Revisions Related to Third Party
Liability final rule. As a result, the
corrections made through this correcting
document are intended to ensure that
the Medicaid and Children’s Health
Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP
Delivered in Managed Care, and
Revisions Related to Third Party
Liability final rule accurately reflects
the policies adopted in that rule.
Even if this were a rulemaking to
which the notice and comment and
delayed effective date requirements
applied, we find that there is good cause
to waive such requirements.
Undertaking further notice and
comment procedures to incorporate the
corrections in this document into the
Medicaid and Children’s Health
Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP
Delivered in Managed Care, and
Revisions Related to Third Party
Liability final rule or delaying the
effective date of the corrections would
be contrary to the public interest
because it could result in a period of
confusion about the applicability of the
rules while those procedures are
pending. Further, such procedures
would be unnecessary, because the
corrections in this document do not
make substantive changes in the
underlying policies but are limited to
elimination of typographical errors,
incorrect cross references, confusing or
inconsistent language, and obvious
errors. This correcting document is
intended solely to ensure that the
Medicaid and Children’s Health
Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP
Delivered in Managed Care, and
Revisions Related to Third Party
Liability final rule accurately reflects
the final policy determinations that
were set forth in the overall rulemaking
record. For these reasons, we believe
there is good cause to waive the
requirements for notice and comment
and delay in effective date.
1. On page 27560, in the first column;
in the second full paragraph, line 13, the
phrase ‘‘for contracts starting on or after
July 1, 2017’’ is corrected to read ‘‘no
later than the effective date of this rule’’.
2. On page 27679, in the third
column; in the first full paragraph, line
eight, the phrase ‘‘Note that standards
for risk adjustment . . . .’’ is corrected
to read ‘‘Note that standards for risk
adjustment for payment
purposes. . . .’’.
3. On page 27708, in the second
column; in the first full paragraph,
beginning at line seven, the phrase
‘‘validation of MCOs, PIHPs, and
PAHPs’’ is corrected to read ‘‘validation
of MCOs’’.
4. On page 27712, in the second
column; in the fourth full paragraph,
line 20, the phrase ‘‘§ 438.358(b)(1) to
(b)(3)’’ is corrected to read
‘‘§ 438.358(b)(1)(i) to (b)(1)(iii)’’.
5. On page 27738, in the third
column; in the fifth full paragraph, line
11, the term ‘‘TSIS’’ is corrected to read
‘‘T–MSIS’’.
6. On page 27766, in the second
column; in the second full paragraph,
beginning with line one, the sentence
‘‘After consideration of the public
comments, we are adding a cross
reference to § 457.1110 in a new
paragraph (e), and otherwise finalizing
§ 457.1233 as proposed.’’ is corrected to
read ‘‘After consideration of the public
comments, we are adding a cross
reference to § 457.1110 in a new
paragraph (e) and adopting the changes
to § 438.230 to include PCCM entities as
discussed in the Medicaid preamble
above. The remaining provisions of
§ 457.1233 are finalized as proposed.’’.
§ 438.6
List of Subjects
■
Corrections of Errors
In FR Doc. 2016–09581 of May 6,
2016 (81 FR 27498), make the following
corrections:
■
1. The authority citation for part 438
continues to read as follows:
■
Authority: Sec. 1102 of the Social Security
Act (42 U.S.C. 1302).
Authority: Sec. 1102 of the Social Security
Act (42 U.S.C. 1302).
VerDate Sep<11>2014
22:11 Dec 30, 2016
Jkt 241001
42 CFR Part 438
Grant programs-health, Medicaid,
Reporting and recordkeeping
requirements.
Administrative practice and
procedure, Grant programs-health,
Health insurance, Reporting and
recordkeeping requirements.
Accordingly, 42 CFR chapter IV is
corrected by making the following
correcting amendments to parts 438 and
457:
Fmt 4700
[Amended]
3. In § 438.8—
a. Amend paragraph (e)(1) by
removing the phrase ‘‘fraud reduction
activities’’ and adding in its place the
phrase ‘‘fraud prevention activities’’.
■ b. Amend paragraph (f)(2)(i) by
removing the phrase ‘‘under to
§ 438.6(d).’’ and adding in its place the
phrase ‘‘under § 438.6(d).’’.
■
■
§ 438.10
[Amended]
4. In § 438.10 amend paragraph
(g)(2)(xiii) by removing the phrase ‘‘in in
alternative formats or languages.’’ and
adding in its place the phrase ‘‘in
alternative formats or languages.’’.
■
§ 438.210
[Amended]
5. In § 438.210 amend paragraph (a)(2)
by removing the phrase ‘‘of part 440’’
and adding in its place ‘‘of part 441’’.
■
§ 438.350
[Amended]
6. In § 438.350 amend paragraph (d)
by removing the reference
‘‘§ 438.364(a)(1)(i) through (iv).’’ and
adding in its place the reference
‘‘§ 438.364(a)(2)(i) through (iv).’’.
■
§ 438.358
[Amended]
7. In § 438.358 amend paragraph (a)(2)
by removing the reference
‘‘§ 438.364(a)(i) through (iv).’’ and
adding in its place the reference
‘‘§ 438.364(a)(2)(i) through (iv).’’.
■
§ 438.358
[Amended]
8. In § 438.358 amend paragraph (c)(3)
by removing the reference
‘‘§ 438.358(b)(2)’’ and adding in its place
the reference ‘‘§ 438.358(b)(1)(ii)’’.
§ 438.358
[Amended]
9. In § 438.358 amend paragraph (c)(4)
by removing the reference
‘‘§ 438.358(b)(1)’’ and adding in its place
the reference ‘‘§ 438.358(b)(1)(i)’’.
Sfmt 4700
§ 438.604
[Amended]
10. In § 438.604 amend paragraph
(a)(2) by removing the reference
‘‘§ 438.3’’ and adding in its place the
reference ‘‘§ 438.4’’.
■
PART 457—ALLOTMENTS AND
GRANTS TO STATES
PART 438—MANAGED CARE
Frm 00035
§ 438.8
■
42 CFR Part 457
PO 00000
[Amended]
2. In § 438.6 amend paragraph (c)(2)(i)
by removing the phrase ‘‘accepted
principles and practices’’ and adding in
its place the phrase ‘‘accepted actuarial
principles and practices’’.
■
11. The authority citation for part 457
continues to read as follows:
E:\FR\FM\03JAR1.SGM
03JAR1
40
§ 457.1201
Federal Register / Vol. 82, No. 1 / Tuesday, January 3, 2017 / Rules and Regulations
[Amended]
12. In § 457.1201—
a. Amend paragraph (l) by removing
the reference ‘‘§ 438.3(n).’’ and adding
in its place the reference ‘‘§ 457.496.’’.
■ b. Amend paragraph (n)(2) by
removing the phrase ‘‘(cross-referencing
§ 438.330(b)(3), (c),’’ and adding in its
place the phrase ‘‘(cross-referencing
§ 438.330(b)(2), (b)(3), (c),’’.
PAHP complies with the coverage and
authorization of services requirements
in accordance with the terms of
§ 438.210 of this chapter, except that the
following do not apply: § 438.210(a)(5)
of this chapter (related to medical
necessity standard); § 438.210(b)(2)(iii)
of this chapter (related to authorizing
LTSS), and § 438.210(f) (relating to the
applicability date).
DEPARTMENT OF HOMELAND
SECURITY
§ 457.1203
§ 457.1233
Update of FEMA’s Public Assistance
and Fire Management Assistance
Grant Regulations To Reflect the
Terminology of Uniform Administrative
Requirements, Cost Principles, and
Audit Requirements
■
■
[Amended]
13. In § 457.1203—
a. Amend paragraph (a) by removing
the open parenthesis ‘‘(’’ before the
word ‘‘implementing’’.
■ b. Amend paragraph (e) by adding a
comma ‘‘,’’ after the term ‘‘MCOs’’ and
by removing the word ‘‘to’’ after the
word ‘‘under’’.
■
■
§ 457.1210
[Amended]
14. In § 457.1210—
a. Amend paragraph (c)(2) by
removing the word ‘‘Explains’’ and
adding in its place the word ‘‘Explain’’.
■ b. Amend paragraph (c)(4) by
removing the word ‘‘Explains’’ and
adding in its place the word ‘‘Explain’’.
■ 15. Section 457.1214 is revised to read
as follows:
■
■
§ 457.1214
Conflict of interest safeguards.
The State must have in effect
safeguards against conflict of interest in
accordance with the terms of § 438.58 of
this chapter, except that references to
§ 438.54(b) should be read to refer to the
enrollment processes described in
§ 457.1210(a).
■ 16. Section 457.1228 is revised to read
as follows:
§ 457.1228 Emergency and
poststabilization services.
The State must ensure that emergency
and poststabilization care services are
available and accessible to enrollees in
accordance with the terms of § 438.114
of this chapter.
■ 17. Section 457.1230 is amended by
revising paragraphs (c) and (d) to read
as follows:
§ 457.1230
sradovich on DSK3GMQ082PROD with RULES
*
*
*
*
(c) Coordination and continuity of
care. The State must ensure, through its
contracts, that each MCO, PIHP and
PAHP complies with the coordination
and continuity of care requirements in
accordance with the terms of § 438.208
of this chapter, except that the
applicability date in § 438.208(d) does
not apply.
(d) Coverage and authorization of
services. The State must ensure, through
its contracts, that each MCO, PIHP or
22:11 Dec 30, 2016
18. In § 457.1233 amend paragraph (b)
by removing the phrase ‘‘and PAHP’’
and adding in its place the term ‘‘PAHP,
and PCCM’’.
■
19. Section 457.1240 is amended by
revising paragraph (e) and correcting the
heading for paragraph (f) to read as
follows:
■
§ 457.1240 Quality measurement and
improvement.
*
*
*
*
*
(e) Managed care quality strategy. The
State must draft and implement a
written quality strategy for assessing
and improving the quality of health care
and services furnished CHIP enrollees
as described in § 438.340 of this chapter.
(f) Applicability to PCCM entities.
* * *
20. Section 457.1250 is amended by
revising paragraph (a) to read as follows:
■
§ 457.1250
External quality review.
(a) Each State that contracts with
MCOs, PIHPs, or PAHPs must follow all
applicable external quality review
requirements as set forth in §§ 438.350
(except for references to §§ 438.362),
438.352, 438.354, 438.356, 438.358,
438.360 (only with respect to
nonduplication of EQR activities with
private accreditation) and § 438.364 of
this chapter. In the case of a contract
with a PCCM entity described in
§ 457.1240(f), § 438.350 (except for
references to § 438.362) of this chapter
applies.
*
*
*
*
*
21. Section 457.1260 is revised by
adding a sentence at the end of the
section to read as follows:
■
Access Standards
*
VerDate Sep<11>2014
[Amended]
Jkt 241001
§ 457.1260
Grievance system.
* * * The applicability date in
§ 438.400(c) does not apply to CHIP.
Dated: December 21, 2016.
Wilma M. Robinson,
Deputy Executive Secretary to the
Department, Department of Health and
Human Services.
[FR Doc. 2016–31650 Filed 12–30–16; 8:45 am]
BILLING CODE 4120–01–P
PO 00000
Frm 00036
Fmt 4700
Sfmt 4700
Federal Emergency Management
Agency
44 CFR Parts 204, 206, and 207
[Docket ID: FEMA–2016–0034]
RIN 1660–AA89
Federal Emergency
Management Agency, DHS.
ACTION: Final rule.
AGENCY:
The Federal Emergency
Management Agency (FEMA) is
amending its Public Assistance and Fire
Management Assistance Grant
regulations to update the terms it uses
to describe grantees and subgrantees, to
reflect the terminology used in the
Office of Management and Budget
(OMB) Uniform Guidance on
Administrative Requirements, Cost
Principles, and Audit Requirements for
Federal Awards.
DATES: Effective January 3, 2017.
FOR FURTHER INFORMATION CONTACT:
Christopher Logan, Director, Public
Assistance Division, Federal Emergency
Management Agency, 500 C Street SW.,
Washington, DC 20472, 202–646–3834.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
The Robert T. Stafford Disaster Relief
and Emergency Assistance Act, as
amended (Stafford Act), Title 42 of the
United States Code (U.S.C.) 5121 et seq.,
authorizes the President to provide
Federal assistance when the magnitude
of an incident or threatened incident
exceeds the affected State, Territorial,
Indian Tribal, and local government
capabilities to respond or recover.
FEMA provides assistance to State,
Territorial, Indian Tribal, and local
governments and certain types of
private nonprofit (PNP) organizations
via its Public Assistance program.
Through the Public Assistance program,
FEMA provides supplemental Federal
disaster grant assistance for debris
removal, emergency protective
measures, and the restoration of
disaster-damaged, publicly owned
facilities and the facilities of certain
PNP organizations. The Public
Assistance program also encourages
protection of these damaged facilities
from future events by providing
E:\FR\FM\03JAR1.SGM
03JAR1
Agencies
[Federal Register Volume 82, Number 1 (Tuesday, January 3, 2017)]
[Rules and Regulations]
[Pages 37-40]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31650]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 431, 433, 438, 440, 457, and 495
[CMS-2390-F3]
RIN-0938-AS25
Medicaid and Children's Health Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions
Related to Third Party Liability; Corrections
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting amendment.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical errors that appeared in the
final rule published in the May 6, 2016 Federal Register (81 FR 27498
through 27901) entitled, ``Medicaid and Children's Health Insurance
Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in
Managed Care, and Revisions Related to Third Party Liability.'' The
effective date for the rule was July 5, 2016.
DATES: Effective Date: This correcting document is effective December
30, 2016.
Applicability Date: The corrections indicated in this document are
applicable beginning immediately.
FOR FURTHER INFORMATION CONTACT:
John Giles, (410) 786-1255, Medicaid Managed Care Operations.
Heather Hostetler, (410) 786-4515, Medicaid Managed Care Quality.
Melissa Williams, (410) 786-4435, CHIP.
Nancy Dieter, (410) 786-7219, Third Party Liability.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2016-09581 (81 FR 27498 through 27901), the final rule
entitled, ``Medicaid and Children's Health Insurance Program (CHIP)
Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and
Revisions Related to Third Party Liability'' there were technical
errors that are identified and corrected in this correcting document.
These corrections are applicable immediately.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 27560 we made a technical error in the response to comments
of Sec. 438.6(e). In this response, we inadvertently identified the
effective date and the date by which we would enforce compliance for
the regulation, which is correctly identified in the Compliance section
on page 27499.
On page 27679 we made a technical error in the preamble text of
Sec. 438.330 (Quality Assessment and Performance Improvement Program)
in a response to comment. We stated, ``Note that standards for risk
adjustment are provided in Sec. Sec. 438.5(g) and 438.7(b)(5).'' We
inadvertently omitted the words ``for payment purposes'' after ``risk
adjustment'' in this sentence to clarify that these cross-referenced
sections are related to risk adjustment for payment purposes.
On page 27708 we made a technical error in the preamble text of
Sec. 438.358 (Activities Related to External Quality Review) in a
response to comment about Sec. 438.358(b)(iv) (Validation of MCO,
PIHP, or PAHP validation of network adequacy). We inadvertently
included PIHPs and PAHPs in a statement about the match rate for this
EQR-related activity for MCOs. We stated, ``. . . the validation of
MCOs, PIHPs, and PAHPs would be eligible for the 75 percent match rate
under Sec. 438.370(a).'' This was in error, as it conflicts with Sec.
438.370 of the final rule and the preamble discussion of that section
on pages 27715 through 27717.
On page 27712 we made a technical error in the preamble text of
Sec. 438.360 (Nonduplication of mandatory activities with Medicare or
accreditation review) in a response to comment about updating the EQR
protocols to incorporate data from a Medicare or private accrediting
entity review. We referenced three of the mandatory EQR-related
activities using the citation from the proposed rule (Sec.
438.358(b)(1) to (b)(3)), rather than the citation from the final rule
(Sec. 438.358(b)(1)(i) to (b)(1)(iii)).
On page 27738 we made a technical error in the response to comments
of Sec. 438.242(b)(2). In this response, we inadvertently mistyped
``T-MSIS.''
On page 27766 we made a technical error in the preamble text of
Sec. 457.1233. We inadvertently did not note that CHIP is also
adopting the changes discussed in the Medicaid preamble to include PCCM
entities as subject to Sec. 438.230 in
[[Page 38]]
response to public comments and consideration of a managed care plan's
subcontracted or delegated obligations, services, or activities.
B. Summary of Errors in Regulation Text
On page 27860 we made a technical error in the regulation text of
Sec. 438.6(c)(2)(i). In this paragraph, we inadvertently omitted
``actuarial'' before ``principles and practices.''
On page 27862 we made a technical error in the regulation text of
Sec. 438.8(e)(1). In this paragraph, we inadvertently referenced fraud
reduction activities instead of fraud prevention activities.
On page 27863 we made a technical error in the regulation text of
Sec. 438.8(f)(2)(i). In this paragraph, we inadvertently included an
extra word ``to.''
On page 27867 we made a technical error in the regulation text of
Sec. 438.10(g)(2)(xiii). In this paragraph, we inadvertently included
an extra word ``in.''
On page 27879 we made a technical error in the regulation text of
Sec. 438.210(a)(2). In this paragraph, we inadvertently referenced
part 440 instead of part 441.
On page 27884 we made a technical error in the regulation text of
Sec. 438.350(d). We incorrectly cross-referenced Sec.
438.364(a)(1)(i) through (iv) instead of Sec. 438.364(a)(2)(i) through
(iv).
On page 27885 we made a technical error in the regulation text of
Sec. 438.358(a)(2) (Activities related to external quality review). We
incorrectly cross-referenced Sec. 438.364(a)(i) through (iv) instead
of Sec. 438.364(a)(2)(i) through (iv).
On page 27885 we made a technical error in the regulation text of
Sec. 438.358(c)(3) (Activities related to external quality review). We
incorrectly cross-referenced Sec. 438.358(b)(2) instead of Sec.
438.358(b)(1)(ii).
On page 27885 we made a technical error in the regulation text of
Sec. 438.358(c)(4) (Activities related to external quality review). We
incorrectly cross-referenced Sec. 438.358(b)(1) instead of Sec.
438.358(b)(1)(i).
On page 27891 we made a technical error in the regulation text of
Sec. 438.604(a)(2). In this paragraph, we inadvertently referenced
Sec. 438.3 instead of Sec. 438.4.
On page 27898 we made a technical error in the regulation text of
Sec. 457.1201(l). In this paragraph, we inadvertently cross-referenced
the Medicaid requirements related to MHPAEA at Sec. 438.3(n) instead
of CHIP MHPAEA requirements at Sec. 457.496. Both the Medicaid and
CHIP MHPAEA provisions were issued on March 30, 2016, at 81 FR 18390,
18436 and 18442. They are parallel provisions and the change in the
cross-reference will not result in any substantive change in the
applicable requirements.
On page 27898 we made a technical error in the regulation text of
Sec. 457.1201(n)(2). In this paragraph, we inadvertently omitted a
cross-reference to Sec. 438.330(b)(2) as we discussed in the preamble
on page 27757.
On page 27898 we made a technical error in the regulation text of
Sec. 457.1203(a). In this paragraph, we inadvertently included a
parenthesis before the word ``implementing.''
On page 27898 we made a technical error in the regulation text of
Sec. 457.1203(e). In this paragraph, we inadvertently did not include
a comma after the word ``MCOs'' and we inadvertently included the word
``to'' after the word ``under.''
On page 27899 we made a technical error in the regulation text of
Sec. 457.1210(c)(2) and Sec. 457.1210(c)(4). In this paragraph, we
incorrectly used the word ``Explains'' instead of the word ``Explain.''
On page 27899 we made a technical error in the regulation text of
Sec. 457.1214. In this section, we referenced Sec. 438.58, the
conflict of interest safeguards required for Medicaid managed care
plans. However, we inadvertently did not specify that references to
Sec. 438.54(b) (relating to the Medicaid managed care enrollment
processes) in Sec. 438.58 should refer to the enrollment processes for
CHIP described in Sec. 457.1210(a).
On page 27899 we made a technical error in the regulation text of
Sec. 457.1228. We inadvertently omitted the words ``and
poststabilization care'' before the word ``services.'' Additionally, we
are replacing the cross-reference to Sec. 457.10 with a cross
reference to Sec. 438.114 to reflect the intended alignment with
Medicaid definitions that was clearly expressed in the preamble on page
27764 in discussing Sec. 457.1228. In that preamble discussion, we
expressly indicated that we would be adopting the definitions at Sec.
438.114.
On page 27899 we made a technical error in the regulation text of
Sec. 457.1230(c). We inadvertently did not provide that the
applicability date for the Medicaid requirements in Sec. 438.208(d)
does not apply to CHIP.
On page 27899 we made a technical error in the regulation text of
Sec. 457.1230(d). We inadvertently did not provide the applicability
date for the Medicaid requirements in Sec. 438.210(f) does not apply
to CHIP.
On page 27900 we made a technical error in the regulation text of
Sec. 457.1233(b). As indicated in the preamble on page 27766, we
intended to align the structure and operation standards for CHIP
managed care entities with parallel Medicaid standards, but we
inadvertently omitted PCCM entities from the list of managed care
entities that the state must ensure are in compliance with Sec.
438.230.
On page 27900 we made technical errors in the regulation text of
Sec. 457.1240(e). We inadvertently left in an obsolete cross reference
from the proposed rule to Sec. 438.340(e).
On page 27900 we made technical errors in the regulation text of
Sec. 457.1240(f). In this paragraph, we incorrectly spelled ``PCCM
entities'' as ``PPCM entities.''
On page 27900 we made technical errors in the regulation text of
Sec. 457.1250(a), relating to external quality review. We
inadvertently did not provide that while the terms of Medicaid external
quality review provisions at Sec. 438.350 applies to PCCM entities,
Sec. 438.362, which is cross-referenced in Sec. 438.350, does not
apply to PCCM entities in CHIP.
On page 27900 we made technical errors in the regulation text of
Sec. 457.1260. We inadvertently did not include an exception to the
Medicaid applicability date as described in Sec. 438.400(c).
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of the proposed rule in the
Federal Register before the provisions of a rule take effect. In
addition, section 553(d) of the APA mandates a 30-day delay in
effective date after issuance or publication of a rule. Sections
553(b)(B) and 553(d)(3) of the APA provide for exceptions from the APA
notice and comment, and delay in effective date requirements. Section
553(b)(B) of the APA authorizes an agency to dispense with normal
notice and comment rulemaking procedures for good cause if the agency
makes a finding that the notice and comment process is impracticable,
unnecessary, or contrary to the public interest; and includes a
statement of the finding and the reasons for it in the notice.
In our view, this correcting document does not constitute a
rulemaking that would be subject to these requirements. This document
merely corrects technical errors in the Medicaid and Children's Health
Insurance Program (CHIP) Programs; Medicaid Managed
[[Page 39]]
Care, CHIP Delivered in Managed Care, and Revisions Related to Third
Party Liability final rule. The corrections contained in this document
are consistent with, and do not make substantive changes to, the
policies and payment methodologies that were adopted subject to notice
and comment procedures in the Medicaid and Children's Health Insurance
Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in
Managed Care, and Revisions Related to Third Party Liability final
rule. As a result, the corrections made through this correcting
document are intended to ensure that the Medicaid and Children's Health
Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP
Delivered in Managed Care, and Revisions Related to Third Party
Liability final rule accurately reflects the policies adopted in that
rule.
Even if this were a rulemaking to which the notice and comment and
delayed effective date requirements applied, we find that there is good
cause to waive such requirements. Undertaking further notice and
comment procedures to incorporate the corrections in this document into
the Medicaid and Children's Health Insurance Program (CHIP) Programs;
Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions
Related to Third Party Liability final rule or delaying the effective
date of the corrections would be contrary to the public interest
because it could result in a period of confusion about the
applicability of the rules while those procedures are pending. Further,
such procedures would be unnecessary, because the corrections in this
document do not make substantive changes in the underlying policies but
are limited to elimination of typographical errors, incorrect cross
references, confusing or inconsistent language, and obvious errors.
This correcting document is intended solely to ensure that the Medicaid
and Children's Health Insurance Program (CHIP) Programs; Medicaid
Managed Care, CHIP Delivered in Managed Care, and Revisions Related to
Third Party Liability final rule accurately reflects the final policy
determinations that were set forth in the overall rulemaking record.
For these reasons, we believe there is good cause to waive the
requirements for notice and comment and delay in effective date.
Corrections of Errors
In FR Doc. 2016-09581 of May 6, 2016 (81 FR 27498), make the
following corrections:
1. On page 27560, in the first column; in the second full
paragraph, line 13, the phrase ``for contracts starting on or after
July 1, 2017'' is corrected to read ``no later than the effective date
of this rule''.
2. On page 27679, in the third column; in the first full paragraph,
line eight, the phrase ``Note that standards for risk adjustment . . .
.'' is corrected to read ``Note that standards for risk adjustment for
payment purposes. . . .''.
3. On page 27708, in the second column; in the first full
paragraph, beginning at line seven, the phrase ``validation of MCOs,
PIHPs, and PAHPs'' is corrected to read ``validation of MCOs''.
4. On page 27712, in the second column; in the fourth full
paragraph, line 20, the phrase ``Sec. 438.358(b)(1) to (b)(3)'' is
corrected to read ``Sec. 438.358(b)(1)(i) to (b)(1)(iii)''.
5. On page 27738, in the third column; in the fifth full paragraph,
line 11, the term ``TSIS'' is corrected to read ``T-MSIS''.
6. On page 27766, in the second column; in the second full
paragraph, beginning with line one, the sentence ``After consideration
of the public comments, we are adding a cross reference to Sec.
457.1110 in a new paragraph (e), and otherwise finalizing Sec.
457.1233 as proposed.'' is corrected to read ``After consideration of
the public comments, we are adding a cross reference to Sec. 457.1110
in a new paragraph (e) and adopting the changes to Sec. 438.230 to
include PCCM entities as discussed in the Medicaid preamble above. The
remaining provisions of Sec. 457.1233 are finalized as proposed.''.
List of Subjects
42 CFR Part 438
Grant programs-health, Medicaid, Reporting and recordkeeping
requirements.
42 CFR Part 457
Administrative practice and procedure, Grant programs-health,
Health insurance, Reporting and recordkeeping requirements.
Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments to parts 438 and 457:
PART 438--MANAGED CARE
0
1. The authority citation for part 438 continues to read as follows:
Authority: Sec. 1102 of the Social Security Act (42 U.S.C.
1302).
Sec. 438.6 [Amended]
0
2. In Sec. 438.6 amend paragraph (c)(2)(i) by removing the phrase
``accepted principles and practices'' and adding in its place the
phrase ``accepted actuarial principles and practices''.
Sec. 438.8 [Amended]
0
3. In Sec. 438.8--
0
a. Amend paragraph (e)(1) by removing the phrase ``fraud reduction
activities'' and adding in its place the phrase ``fraud prevention
activities''.
0
b. Amend paragraph (f)(2)(i) by removing the phrase ``under to Sec.
438.6(d).'' and adding in its place the phrase ``under Sec.
438.6(d).''.
Sec. 438.10 [Amended]
0
4. In Sec. 438.10 amend paragraph (g)(2)(xiii) by removing the phrase
``in in alternative formats or languages.'' and adding in its place the
phrase ``in alternative formats or languages.''.
Sec. 438.210 [Amended]
0
5. In Sec. 438.210 amend paragraph (a)(2) by removing the phrase ``of
part 440'' and adding in its place ``of part 441''.
Sec. 438.350 [Amended]
0
6. In Sec. 438.350 amend paragraph (d) by removing the reference
``Sec. 438.364(a)(1)(i) through (iv).'' and adding in its place the
reference ``Sec. 438.364(a)(2)(i) through (iv).''.
Sec. 438.358 [Amended]
0
7. In Sec. 438.358 amend paragraph (a)(2) by removing the reference
``Sec. 438.364(a)(i) through (iv).'' and adding in its place the
reference ``Sec. 438.364(a)(2)(i) through (iv).''.
Sec. 438.358 [Amended]
0
8. In Sec. 438.358 amend paragraph (c)(3) by removing the reference
``Sec. 438.358(b)(2)'' and adding in its place the reference ``Sec.
438.358(b)(1)(ii)''.
Sec. 438.358 [Amended]
0
9. In Sec. 438.358 amend paragraph (c)(4) by removing the reference
``Sec. 438.358(b)(1)'' and adding in its place the reference ``Sec.
438.358(b)(1)(i)''.
Sec. 438.604 [Amended]
0
10. In Sec. 438.604 amend paragraph (a)(2) by removing the reference
``Sec. 438.3'' and adding in its place the reference ``Sec. 438.4''.
PART 457--ALLOTMENTS AND GRANTS TO STATES
0
11. The authority citation for part 457 continues to read as follows:
Authority: Sec. 1102 of the Social Security Act (42 U.S.C.
1302).
[[Page 40]]
Sec. 457.1201 [Amended]
0
12. In Sec. 457.1201--
0
a. Amend paragraph (l) by removing the reference ``Sec. 438.3(n).''
and adding in its place the reference ``Sec. 457.496.''.
0
b. Amend paragraph (n)(2) by removing the phrase ``(cross-referencing
Sec. 438.330(b)(3), (c),'' and adding in its place the phrase
``(cross-referencing Sec. 438.330(b)(2), (b)(3), (c),''.
Sec. 457.1203 [Amended]
0
13. In Sec. 457.1203--
0
a. Amend paragraph (a) by removing the open parenthesis ``('' before
the word ``implementing''.
0
b. Amend paragraph (e) by adding a comma ``,'' after the term ``MCOs''
and by removing the word ``to'' after the word ``under''.
Sec. 457.1210 [Amended]
0
14. In Sec. 457.1210--
0
a. Amend paragraph (c)(2) by removing the word ``Explains'' and adding
in its place the word ``Explain''.
0
b. Amend paragraph (c)(4) by removing the word ``Explains'' and adding
in its place the word ``Explain''.
0
15. Section 457.1214 is revised to read as follows:
Sec. 457.1214 Conflict of interest safeguards.
The State must have in effect safeguards against conflict of
interest in accordance with the terms of Sec. 438.58 of this chapter,
except that references to Sec. 438.54(b) should be read to refer to
the enrollment processes described in Sec. 457.1210(a).
0
16. Section 457.1228 is revised to read as follows:
Sec. 457.1228 Emergency and poststabilization services.
The State must ensure that emergency and poststabilization care
services are available and accessible to enrollees in accordance with
the terms of Sec. 438.114 of this chapter.
0
17. Section 457.1230 is amended by revising paragraphs (c) and (d) to
read as follows:
Sec. 457.1230 Access Standards
* * * * *
(c) Coordination and continuity of care. The State must ensure,
through its contracts, that each MCO, PIHP and PAHP complies with the
coordination and continuity of care requirements in accordance with the
terms of Sec. 438.208 of this chapter, except that the applicability
date in Sec. 438.208(d) does not apply.
(d) Coverage and authorization of services. The State must ensure,
through its contracts, that each MCO, PIHP or PAHP complies with the
coverage and authorization of services requirements in accordance with
the terms of Sec. 438.210 of this chapter, except that the following
do not apply: Sec. 438.210(a)(5) of this chapter (related to medical
necessity standard); Sec. 438.210(b)(2)(iii) of this chapter (related
to authorizing LTSS), and Sec. 438.210(f) (relating to the
applicability date).
Sec. 457.1233 [Amended]
0
18. In Sec. 457.1233 amend paragraph (b) by removing the phrase ``and
PAHP'' and adding in its place the term ``PAHP, and PCCM''.
0
19. Section 457.1240 is amended by revising paragraph (e) and
correcting the heading for paragraph (f) to read as follows:
Sec. 457.1240 Quality measurement and improvement.
* * * * *
(e) Managed care quality strategy. The State must draft and
implement a written quality strategy for assessing and improving the
quality of health care and services furnished CHIP enrollees as
described in Sec. 438.340 of this chapter.
(f) Applicability to PCCM entities. * * *
0
20. Section 457.1250 is amended by revising paragraph (a) to read as
follows:
Sec. 457.1250 External quality review.
(a) Each State that contracts with MCOs, PIHPs, or PAHPs must
follow all applicable external quality review requirements as set forth
in Sec. Sec. 438.350 (except for references to Sec. Sec. 438.362),
438.352, 438.354, 438.356, 438.358, 438.360 (only with respect to
nonduplication of EQR activities with private accreditation) and Sec.
438.364 of this chapter. In the case of a contract with a PCCM entity
described in Sec. 457.1240(f), Sec. 438.350 (except for references to
Sec. 438.362) of this chapter applies.
* * * * *
0
21. Section 457.1260 is revised by adding a sentence at the end of the
section to read as follows:
Sec. 457.1260 Grievance system.
* * * The applicability date in Sec. 438.400(c) does not apply to
CHIP.
Dated: December 21, 2016.
Wilma M. Robinson,
Deputy Executive Secretary to the Department, Department of Health and
Human Services.
[FR Doc. 2016-31650 Filed 12-30-16; 8:45 am]
BILLING CODE 4120-01-P