Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-October Through December 2018, 4805-4818 [2019-02672]

Download as PDF Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices services, reviewing stakeholder comments, drafting final recommendation documents, and participating in workgroups on specific topics and methods. Members can expect to receive frequent emails, can expect to participate in multiple conference calls each month, and can expect to have periodic interaction with stakeholders. AHRQ estimates that members devote approximately 200 hours a year outside of in-person meetings to their USPSTF duties. The members are all volunteers and do not receive any compensation beyond support for travel to in person meetings. Francis D. Chesley, Jr., Acting Deputy Director. [FR Doc. 2019–02643 Filed 2–15–19; 8:45 am] BILLING CODE 4160–90–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Healthcare Improvement, Inc. PSO Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services (HHS). ACTION: Notice of delisting. AGENCY: The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule) authorizes AHRQ, on behalf of the Secretary of HHS, to list as a patient safety organization (PSO) an entity that attests that it meets the statutory and regulatory requirements for listing. A PSO can be ‘‘delisted’’ by the Secretary if it is found to no longer meet the requirements of the Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act) and Patient Safety Rule, when a PSO chooses to voluntarily relinquish its status as a PSO for any reason, or when a PSO’s listing expires. AHRQ has accepted a notification of voluntary relinquishment from the Healthcare Improvement, Inc. PSO, PSO number P0123, of its status as a PSO, and has delisted the PSO accordingly. DATES: The delisting was applicable at 12:00 Midnight ET (2400) on December 31, 2018. ADDRESSES: The directories for both listed and delisted PSOs are ongoing tkelley on DSKBCP9HB2PROD with NOTICES SUMMARY: VerDate Sep<11>2014 17:46 Feb 15, 2019 Jkt 247001 and reviewed weekly by AHRQ. Both directories can be accessed electronically at the following HHS website: https://www.pso.ahrq.gov/listed. FOR FURTHER INFORMATION CONTACT: Cathryn Bach, Center for Quality Improvement and Patient Safety, AHRQ, 5600 Fishers Lane, MS 06N100B, Rockville, MD 20857; Telephone (toll free): (866) 403–3697; Telephone (local): (301) 427–1111; TTY (toll free): (866) 438–7231; TTY (local): (301) 427–1130; Email: pso@ahrq.hhs.gov. SUPPLEMENTARY INFORMATION: Background The Patient Safety Act, 42 U.S.C. 299b–21 to 299b–26, and the related Patient Safety Rule, 42 CFR part 3, published in the Federal Register on November 21, 2008, 73 FR 70732– 70814, establish a framework by which individuals and entities that meet the definition of provider in the Patient Safety Rule may voluntarily report information to PSOs listed by AHRQ, on a privileged and confidential basis, for the aggregation and analysis of patient safety events. The Patient Safety Act authorizes the listing of PSOs, which are entities or component organizations whose mission and primary activity are to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety Act. AHRQ administers the provisions of the Patient Safety Act and Patient Safety Rule relating to the listing and operation of PSOs. The Patient Safety Rule authorizes AHRQ to list as a PSO an entity that attests that it meets the statutory and regulatory requirements for listing. A PSO can be ‘‘delisted’’ if it is found to no longer meet the requirements of the Patient Safety Act and Patient Safety Rule, when a PSO chooses to voluntarily relinquish its status as a PSO for any reason, or when a PSO’s listing expires. Section 3.108(d) of the Patient Safety Rule requires AHRQ to provide public notice when it removes an organization from the list of federally approved PSOs. AHRQ has accepted a notification from Healthcare Improvement, Inc. PSO, a component entity of Inspirien Insurance Company, to voluntarily relinquish its status as a PSO. Accordingly, Healthcare Improvement, Inc. PSO, P0123, was delisted effective PO 00000 Frm 00043 Fmt 4703 Sfmt 4703 4805 at 12:00 Midnight ET (2400) on December 31, 2018. Healthcare Improvement, Inc. PSO has patient safety work product (PSWP) in its possession. The PSO will meet the requirements of section 3.108(c)(2)(i) of the Patient Safety Rule regarding notification to providers that have reported to the PSO and of section 3.108(c)(2)(ii) regarding disposition of PSWP consistent with section 3.108(b)(3). According to section 3.108(b)(3) of the Patient Safety Rule, the PSO has 90 days from the effective date of delisting and revocation to complete the disposition of PSWP that is currently in the PSO’s possession. More information on PSOs can be obtained through AHRQ’s PSO website at https://www.pso.ahrq.gov. Francis D. Chesley, Jr., Acting Deputy Director. [FR Doc. 2019–02642 Filed 2–15–19; 8:45 am] BILLING CODE 4160–90–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS–9112–N] Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—October Through December 2018 Centers for Medicare & Medicaid Services (CMS), HHS. AGENCY: ACTION: Notice. This quarterly notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from October through December 2018, relating to the Medicare and Medicaid programs and other programs administered by CMS. SUMMARY: It is possible that an interested party may need specific information and not be able to determine from the listed information whether the issuance or regulation would fulfill that need. Consequently, we are providing contact persons to answer general questions concerning each of the addenda published in this notice. FOR FURTHER INFORMATION CONTACT: E:\FR\FM\19FEN1.SGM 19FEN1 4806 Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices tkelley on DSKBCP9HB2PROD 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 VerDate Sep<11>2014 17:46 Feb 15, 2019 Jkt 247001 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 website 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 website list provides more timely access for beneficiaries, providers, and suppliers. We also believe the website 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 00044 Fmt 4703 Sfmt 4703 accessibility. In addition, many of the websites have listservs; that is, the public can subscribe and receive immediate notification of any updates to the website. These listservs avoid the need to check the website, as notification of updates is automatic and sent to the subscriber as they occur. If assessing a website 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 17, 2019. Kathleen Cantwell, Director, Office of Strategic Operations and Regulatory Affairs. BILLING CODE 4120–01–P E:\FR\FM\19FEN1.SGM 19FEN1 EN19FE19.001</GPH> I. Background tkelley on DSKBCP9HB2PROD with NOTICES VerDate Sep<11>2014 Jkt 247001 PO 00000 Frm 00045 Fmt 4703 Addendum 1: Medicare and Medicaid Manual Instructions (October through December 2018) 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\19FEN1.SGM 19FEN1 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 lhal were officially released in hardcopy. The majority of these manuals were transferred into the Internet-only manual (IOM) 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 IOM, send a message via the CMS Feedback tool. Those wishing to subscribe to old versions of CMS manuals should contact the National Technical Information Service, Department of Commerce, 5301 Shawnee Road, Alexandria, VA 22312 Telephone (703-605-6050). You can download copies of the listed material free of charge at: https://cms.gov/manuals. 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 https://www.gpo.gov/libraries/ Tn addition, individuals may contact regional depository libraries that receive and retain at least one copy of most federal government publications, either in printed or microfilm form, for use by the general public. These libraries provide reference services and interlibrary loans; however, they are not sales outlets. Individuals may obtain information about the location of the nearest regional depository library from any library. CMS publication and transmittal numbers are shown in the listing entitled Medicare and Medicaid Manual Instructions. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the manual for Home Health Rural Add-on Payments Based on County of Residence, use (CMS-Pub. 100-04) Transmittal No. 4190. Addendum I lists a unique CMS transmittal number for each instruction in our manuals or program memoranda and its subject number. A transmittal may consist of a single or multiple instruction(s). Often, it is necessary to use information in a transmittal in conjunction with information currently in the manual. For the purposes of this quarterly notice, we list only the specific updates to the list of manual instructions that have occurred in the 3-month period. This information is available on our website al www .cms.gov /Manuals. Manual/Subject/Publication Number 119 120 121 122 248 249 Issued to a specific audience, not posted to Internet/Intranet due to Confidentialit of Instructions Update to Medicare Deductible, Coinsurance and Premium Rates for 2019 Internet Only Manual Updates to Pub. 100-01, 100-02 and 100-04 to Correct Errors and Omissions SNF 2018 Q4 Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instructions Updated Instructions for the Change Request Implementation Report (CRIR) and Technical Direction Letter Report Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instructions Internet Only Manual Updates to Pub. 100-01, 100-02 and 100-04 to Correct Errors and Omissions (SNF) (2018 Q4) Medicare SJ\F PPS Overview Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 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 oft he previous four Quarterly Listing of Program Issuances notices are: January 26, 2018 (83 FR 3716), May 4, 2018 (83 FR 19769), August 13,2018 (83 FR 40043) and November 2, 2018 (83 FR 55174). 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. 4807 EN19FE19.002</GPH> tkelley on DSKBCP9HB2PROD with NOTICES 4808 VerDate Sep<11>2014 251 Jkt 247001 252 PO 00000 253 Frm 00046 Fmt 4703 Sfmt 4725 E:\FR\FM\19FEN1.SGM 254 19FEN1 ,,, :,c;;.::l:::'Si:" 208 209 210 211 ~;.~,·~:''\ Magnetic Resonance Imaging (MRI) National Coverage Determination (NCD) 20.4 Implantable Cardiac Implantable Cardioverter Defibrillators (!CD) National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) National Coverage Detennination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) !;£.. ':~·,:;·~;;;.,··:,;:.•£ 4143 4144 4145 4146 4147 4148 4149 4150 4151 4152 4153 4154 4155 4156 4157 4158 EN19FE19.003</GPH> l$ ,... :;;;),\ ,,,,,,·;,;;~'1!/;~'' ;:; ·'2019 ' " Annual Update ofHealthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instructions Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity ofTnstructions Magnetic Resonance Imaging (MRI) Magnetic Resonance Imaging (MRI) Procedures Payment Requirements Medicare Summary Notices (MSN), Claim Adjustment Reason Codes (CARCs), and Remittance Advice Remark Codes (RARCs) Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instructions Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instructions Update to Bone Mass Measurements (l:lMM) Code 77085 Deductible and Coinsurance Payment Methodology and HCPCS Coding Table of Preventive and Screening Services Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instructions Redesign of Hospice Periods -Additional Requirements Kotice of Election (NOE) Kotice of Termination/Revocation (NOTR) Change of Provider/Transfer Notice Cancellation of an Election Change of Ownership Notice Hospice Election Periods and Benefit Periods in Medicare Data Required on the Institutional Claim to AlB MAC (HHH) Incomplete Colonoscopies Billed with Modifier 53 for Critical Access Hospital (CAH) Method II Providers Incomplete Colonoscopies (Codes 44388, 45378, G0105 and G0121) Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instructions Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instructions Hospital and Critical Access Hospital (CAH) Swing-Bed Manual Revisions and Shared Systems Changes Swing-Bed Services 100.2/Payment for CRNA or AA Services Addendum A- Provider Specific File Payment for CRNA Pass- Through Services Payment for CRNA Services (Method II CAH only Types of Facilities Subject to the Consolidated Billing Requirement for SNFs Issued to a specific audience, not posted to Internet/Intranet due to Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 250 Three-Day Prior Hospitalization Daily Skilled Services Defined Services Furnished Under Arrangements With Providers Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for ESRD PPS Case-Mix Adjustments Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2019 Revision of Definition ofthe Physician Supervision of Diagnostic Procedures, Clarification of DSMT Telehealth Services, and Establishing a Modifier for Expanding the Use of Telehealth for Individuals with Stroke Revision of Definition of the Physician Supervision of Diagnostic Procedures, Clarification of DSMT Telehealth Services, and Establishing a Modifier for Expanding the Use of Telehealth for Individuals with Stroke Updates to the Inpatient Psychiatric Facility Benefit Policy Manual Background Statutory Requirements Affected Medicare Providers Conditions for Payment Under the IPF Prospective Payment System Admission Requirements Medical Records Reqnirements Data Psychiatric Evaluation Certification and Recertification Requirements Certification Recertification Delayed/Lapsed Certification and Recertification Treatment Plan Individualized Treatment or Diagnostic Plan Services Expected to Improve the Condition or for Purpose of Diagnosis Recording Progress Discharge Planning and Discharge Summary Director oflnpatient Psychiatric Services; Medical Staff l\ursing Services Social Services Benefit Limits in Psychiatric Hospitals Benefits Exhaust Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2019 tkelley on DSKBCP9HB2PROD with NOTICES VerDate Sep<11>2014 4160 Confidentiality of Instructions Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Modifications to the National Coordination of Benefits Agreement (CORA) Crossover Process Jkt 247001 4161 4162 PO 00000 4163 4164 Frm 00047 4165 Fmt 4703 4166 4167 Sfmt 4725 4168 E:\FR\FM\19FEN1.SGM 4169 4170 19FEN1 4173 4171 4172 4174 4175 Coordination of Benefits Agreement (COBA) Detailed Error Report Notification Process Coordination of Benefits Agreement (COBA) Eligibility File Claims Recovery Process Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Instructions for Retrieving the 2019 Pricing and Healthcare Common Procedure Coding System (HCPCS) Data Files through CMS' Mainframe Telecommunications Systems Calendar Year (CY) 2019 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDP ARD) Procedure Revisions to Medicare Claims Processing Manual Reference to Burn Medicare Severity-Diagnostic Related Groups (MS-DRGs) for Transfer Policy Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easv Print (MREP) and PC Print Update Implement Operating Rules- Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment CTroup Code (CAGC) Rule- Update from Council for Affordable Quality Healthcare (CAQH) CORE New Waived Tests Quarterly Update ofHCPCS Codes Used for Home Health Consolidated Billing Enforcement Instructions for Downloading the Medicare ZIP Code Files for April2019 Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment Revision of Definition of the Physician Supervision of Diagnostic Procedures, Clarification of DSMT Telehealth Services, and Establishing a Modifier for Expanding the Use of Telehealth for Individuals with Stroke Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.0 EITeclive January I, 2019 4176 Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions Annual Update to the Per-Beneficiary Therapy Amounts Combined Common Edits/Enhancements Modules (CCEM) Code Set Update Issued to a specific audience, not posted to Intemet/Intranet due to Sensitivity of Instructions Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fcc Schedule Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment Claim Status Category and Claim Status Codes Update New Physician Specialty Code for Undersea and Hyperbaric Medicine January 2019 Integrated Outpatient Code Editor (I!OCE) Specifications Version 20.0 Issued to a specific audience, not posted to Intemet/Intranet due to Sensitivity of Instructions Ensuring Only the Active Billing Hospice Can Submit a Revocation Medicare Claims Processing Manual Chapter 23 - Fee Schedule Administration and Coding Requirements Updates to Innuunosuppressive Guidance Home Health Rural Add-on Payments Based on County of Residence January 2019 Update of the Ambulatory Surgical Center (ASC) Payment System 4177 4178 4179 4180 4181 4182 4183 41S4 4185 4186 4187 4188 4189 4190 4191 ;:S.<::;: ;•{,;~;{,;':}: ;"y ·:~>;:' None ~~;::·; ,:,::!'~ r;;~~:5::,j"j;::'•'•': 307 10S 309 ::;.1;~ ::'?.;~:;: 1ss ·.:: : "S ! ;c)>s.: ;;::: ::';,.:;c: ·'~ : ;.:~:\~~;: L•"' >!>;:;:;\§ Notice of 'lew Interest Rate for Medicare Overpayments and Underpayments -1st Qtr Notification for FY 2019 The Fiscal Year 2019 Updates for the Centers for Medicare & Medicaid Services (CMS) Internet Only Manual (IOM) Publication (Pub.) 100-06, Medicare Financial Management Manual, Chapter 7 - Internal Control Requirements New Physician Specialty Code for Undersea and Hyperbaric Medicine :;:~~·\;,,;z;,:v";g:::s.•: Revisions to the State Operations Manual (SOM) Chapter 7 Survey Frequency: 15-Month Survey Interval and 12-Month State-wide Average Setting the Mandatory 3-Month and 6-Month Sanction Time Frames Mandatory Immediate Imposition of Federal Remedies Criteria for Mandatory Immediate Imposition of Federal Remedies Prior to the Facility's Correction of Deficiencies Effective Dates for Immediate Imposition of Federal Remedies Responsibilities of the State Survey Agency and the CMS Regional Office (RO) when there is an Immediate Imposition of Federal Remedies « Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 4159 4809 EN19FE19.004</GPH> tkelley on DSKBCP9HB2PROD with NOTICES 4810 VerDate Sep<11>2014 [;1\ii}';~~ :.j 1{;\·~~i:;·;c,.: 829 Jkt 247001 PO 00000 Frm 00048 Fmt 4703 Sfmt 4725 E:\FR\FM\19FEN1.SGM 831 832 19FEN1 833 S34 835 S36 837 EN19FE19.005</GPH> 838 Issued to a specific audience, not posted to Intemet/Intranet due to Contldentiality of Instructions New Instructions for Home Health Agency Misuse of Requests for 839 Anticipated Payments (RAPs) Home Health Agency Misuse of Requests for Anticipated Payments RAP Monitoring Education and Additional Monitoring Corrective Action Plans Notification to the HHA CAP Submission CAP Acceptance and Monitoring CAP Closeout RAP Suppression Notice of RAP Suppression Monitoring During RAP Suppression Resull oflnilial RAP Suppression Moniloring Period Reinstatement of RAP Authorization Continuation of RAP Suppression Coordination and Referral to the UPIC S40 Issued to a specific audience, not posted to lntemet/lntranet due to Confidentiality of Instruction 841 Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions S42 Issued to a specitlc audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Issued to a specific audience, not posted to Intemet/Intranet due to 843 Confidentiality of Instructions 844 Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions 845 Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Issued to a specific audience, not posted to Intemet/Intranet due to 846 Confidentiality of Instructions 847 Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Update to Chapter 4, Section 4.18.1.4 and Exhibit 16 in Publication (Pub.) 848 100-0S 849 Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions 850 Medical Review of Diagnostic Laboratory Tests 851 Updates to Chapter 4 of Publication (Pub.) 100-08 852 Update to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) of Publication (Pub.) 100-08 (Medicare Program Integrity Manual) :\'>\iM~~~~~~~~-tlJe:~ '"'' .. '''<~l'~~lt~:tl,u$1~~1ti.~t:~HI~f"'ti.i\l~1A:1: 40 Medicare Contractor Beneficiary and Provider Communications Manual IOM Pub. 100-09 Chapter 5 Correct Coding Initiative None ~-tit ..... ... :;~i·;,;•,tc; rc:,~'ti \;,\ Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 S30 :.~. .~~~.;);\;,;zi1F';i,\:*i\:''0i:\j' Glossary of Acronyms LCD Definition and Statutory Authority for LCDs LCD Process General LCD Process Overview Requests Informal Meetings New LCD Requests New LCD Request Requirements Proposed LCD Proposed Decision and Posting of LCD Summary Sheet Public Comment Contractor Advisory Committee (CAC Open Meeting Final Determination Response lo Public Commenl Notice Period Reconsideration Request Web site Requirements for the LCD Reconsideration Process Valid LCD Reconsideration Request Requirements Process Requirements Challenge of an LCD LCD Content General Requirements Consultation Consultation Summary CAC Recommendations Evidentiary Content Reasonable and Necessary Provision in an LCD Public Comment Final Decision Record Issued to a specitlc audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Update to Exhibit 16- Model Payment Suspension Letters in Publication (Pub.) 100-08 Modification to Chapter 6, Section 6.3 (Medical Review of Certification and Recertification of Residents in SNFs) of Publication (Pub.) 100-08 Medical Review of Certification and Recertification of Residents in S'IFs Templates in Medical Review Progress Notes and Templates Order Requirements When Prescribing Practitioner is Also the Supplier and is Permitted to Furnish Specific Items of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) One-on-One Educalion Medical Review of Diagnostic Laboratory Tests Medical Review of Diagnostic Tests Medical Review of Diagnostic Laboratory Tests Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions tkelley on DSKBCP9HB2PROD with NOTICES VerDate Sep<11>2014 k•,Ti <; n~~~;\i,:::z:~~; None ''·. •\}ii~t:i'":~· ;1~.: 'i' None 1'\li"'i'i,••J~>.i:•v<:.ci• None Jkt 247001 ~,;."..~; ~;.~~~4·'> 208 209 PO 00000 210 Frm 00049 212 Fmt 4703 214 211 213 215 Sfmt 4725 216 f~~ii2'·'<(•:~s; ~~:;; E:\FR\FM\19FEN1.SGM 2144 2145 2146 2147 19FEN1 2148 2149 2150 2151 2152 2153 2154 ;: ii'.',~· 2155 •.. 2156 •.. •••0 \;:2~;! ~?*:~ , .,,.,rz•·i~l; 2157 . ······~····•v.?i\.~·.~;\g"..~.';;;~,;: 2158 Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Next Generation Accountable Care Organization (ACO) Model2019 Benefit Enhancement Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visit HCPCS Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visit HCPCS Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visit HCPCS ·~i,;'!};i;{;;!. ; ,;.: "'i\1 0;:1\2·~·~' ,s;.;~~~'•· User CR; FISS to Add Location/Statuses to the 6H File Fix Shared System Enhancement 2018; Implementation of the Medicare Summary Notice (MSN) Zip Code Analvzer Tool Update to Common Working File (CWF) Benefit Period Logic for Occurrence Code 22 on Skilled Nursing Facility (SNF) and Swing Bed Inpatient Claims Update to the Long Description for Spanish Records on The Procedure Descriptor Master File for all Adds and Updates That Were Not Loaded with Change Request (CR) 10286 Claim Based Incentive Programs- Non-Assigned Claim Update Analysis to Implement the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instructions Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates Procedures for Shared Systems to Handle Foreign (non US) Addresses Medicare Cost Report E-Filing (MCReF) Shared System Enhancement 2018; Streamline National Provider Identifier (NPI) Processing in the VIPS Medicare System (V:v!S) 2159 2160 2161 2162 2163 2164 2165 2166 2167 2168 2169 2170 2171 2172 2173 2174 2175 2176 Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instructions Update to Common Working File (CWF) Edit of Medicare Advantage (MA) Enrollees' Inpatient Claims from Approved Teaching Hospitals Billed with Indirect Medical Education (IME) or Coverage with Evidence Development (CEO Systems Changes to Address Acute Kidney Injury (AKI) Claims and Outlier Payments Shared System Enhancement 2018; Establish Beneficiary Data Streaming (BDS) Log Files Shared System Enhancement 2018; Remove Remaining Obsolete Access Restriction by Granular User Services (ARGUS) Processing Shared System Enhancement2018; Eliminate action code logic Correct the CWF Handling of Beneficiaries with 14+ MSP Occurrences for HETS Shared System Enhancement 2018; Remove Default Automated Development System (ADS) and Field ADS Questions Modify Common Working File (CWF) Editing to Apply Code G0476 to Female Beneficiaries Only Shared System Enhancement 2018 ViPS Medicare Systems (VMS); Streamline the use of Assembler Language Code (ALC) Modules Shared System Enhancement 2018; Enhance Common Working File (CWF) Data Exiract Process Fiscal Intermediary Shared System (FISS) AGILE Development and Implementation of Application Programming Interface (API) for Medicare Administrative Contractors (MACs) Shared System Enhancement 2018; Enhance Common Working File (CWF) Internal Testing Facility (ITF) Response Records Decommissioning of the Client Letter Application within VIPS Medicare System (VMS) Provider Enrollment Chain and Ownership System (PECOS) Data Source Change Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instructions Analysis of the Combined Common Edits/Enhancements Module (CCEM) and Intelligent Data Stream (IDS) Reporting Software to Ensure Effective Operation Under Java Version 8 Analysis to Implement Changes to Regulations Allowing Inpatient Prospective Payment System (IPPS)-Exduded Hospitals to Operate IPPSExcluded Units Shared System Enhancement 2018; Remove Obsolete VIPS Medicare System (VMS) logic Related to the ViPS Medicare Automated Parameter (VMAP) Carrier Parameter Table Shared System Enhancement 2018: Renovate 2029 Serial Date ProcessingAnalysis Only Correction to Common Working File (CWF) Infonnational Unsolicited Response (IUR) 7272 for Intervening Stay Shared System Enhancement 2018: Establish a HMBI Query/Response Log Revision of Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Services Rendered to Beneficiaries in a Part A SNF Stay Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 None 4811 EN19FE19.006</GPH> tkelley on DSKBCP9HB2PROD with NOTICES 4812 VerDate Sep<11>2014 2177 2179 2180 Jkt 247001 2181 2182 PO 00000 2183 2184 Frm 00050 2185 2186 Fmt 4703 2187 Sfmt 4725 2188 2189 2190 E:\FR\FM\19FEN1.SGM 2191 2192 2193 19FEN1 2194 2195 2196 2197 2198 2199 EN19FE19.007</GPH> 2200 2202 2203 2204 2205 2206 2207 22Qg 2209 2210 2211 2212 2213 2214 2215 2216 2217 \:;,,;5>,),;;;,;; 80 81 ,!.·2i£: International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) International Classification of Diseases, lOth Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) User CR: FISS to Add Location/Statuses to the 6H File Fix Update to the Long Description for Spanish Records on T11e Procedure Descriptor Master File for all Adds and Updates That Were Not Loaded with Change Request (CR) 10286 Issued to a specific audience, not posted to Intemet/Intranet due to Sensitivity of Instructions Implementation of a Bundled Payment for Multi-Component Durable Medical Equipment (DME) Targeted Probe and Educate Implementing the Insertion of a Sheet of Paper Promoting the Electronic Medicare Summary Notices (eMSNs) into Mailed Medicare Summary Notices (MSNs) Implementing the Insertion of a Sheet of Paper Promoting the Electronic Medicare Summary Notices (eMSNs) into Mailed Medicare Summary Notices (MSNs) Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Update Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Update New CWF Edit for Part A Outpatient .\i!edicare Advantage (MA), Health Maintenance Organization (liMO) Implementing the Revised Patient's Request for Medical Payment Form CMS-1490S, Version 01/18 Transitioning the Pricing, Data Analysis and Coding (PDAC) to the New Contractor Analysis of the Combined Common Edits/Enhancements Module (CCEM) and MSSQL and Oracle Relational Data Base Management Systems Clarification of Part B Recovery Audit Contractor (RAC) Appeals Case File Sharing Process Multi-CaiTier System (MCS) Prepayment Review File .,;;~.,,;~:?~!. ~l!~ililfi~~~(;l\~ Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions Issued to a specific audience, not posted to Intemet/Intranet due to Confidentiality of Instructions ·Iii' :~1illli15l'•\'3~t:~+·<·;~~~·\J, None Addendum II: Regulation Documents Published in the Federal Register (October through December 2018) Regulations and Notices Regulations and notices are published in the daily Federal Register. To purchase individual copies or subscribe to the Federal Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 2178 Issued to a specific audience, not posted to Internet/ Intranet due to Sensitivity of Instructions Removal of the Provider Requirement for Reporting on an Institutional Claim a Value Code (VC) 05- Professional Component-Split Implementation User Change Request (CR): ViPS Medicare System (VMS) Changes to Edit Dispensing and Supply Fcc Codes Allowed when Related Drug Codes arc Denied in Batch FISS Integrated Outpatient Code Editor (IOCE) Claim and Return Buffer Interface Changes Related to new Contractor Line Level Bypass Updates User CR: ViPS Medicare System (VMS) Changes to Bypass Claim Edit 0192 on an Adjustment Claim when Payment was Suppressed on the Previous Adjustment User Change Request (CR): Multi-CaiTier System (MCS)- Analysis to Enhance the Maximum Claim Counter Process for Edits and Audits Shared System Enhancement 2018: Move Authorized Reason Code OveiTide Processing to FSSBSTUF Issued to a specific audience, not posted to Intemet/Intranet due to Sensitivity of Instructions User Change Request (CR): Multi-Carrier System (MCS)- Enhance System Control Facility (SCF) to Add Fraud Prevention System (FPS) Criteria Redesign of Flu Vaccines in Fiscal Intermediary Shared System (FISS) Shared System Enhancement 2018: Analysis to Minimize Data for Medicare Beneficiary Database (MBD) Extract Shared System Enhancement 2018: Rewrite Fiscal Intermediary Shared System (FISS) module FSSB6001, Common Working File (CWF) Unsolicited Response Function Fiscal Intermediary Standard System (FISS) Prepayment Review Report User CR: Update FISS Utility to Retain Original Claim Receipt Date Shared System Enhancement 201 S: Improve Organization of the International Code of Diseases, Tenth Revision (ICD-10) File durin<> Creation Multi-CaiTier System (MCS) Prepayment Review File Implementation ofHealthcare Common Procedure Coding System (HCPCS) Code J3591 and Additional Changes for End Stage Renal Disease (ESRD) Claims Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Update Medicare Cost Report E-Filing (MCReF) Analysis to Discuss and Resolve the Challenges Around the Design of (Pre/Post-Pay) Electronic Medical Documentation Requests (e.\i!DR) via the Electronic Submission of Medical Documentation (esMD) System Analysis to Create a Standard Coded List of Document Types to be used by Review Contractors (RC) for Requesting Documentation in Pre-Pay and PostPay Additional Documentation Request (ADR) Letters (and/or Electronic Medical Documentation Requests (eMDR) via the Electronic Submission of Medical Documentation (esMD) System) ViPS Medicare Svstem (VMS) Prepayment Review File Enhancing the Verification Process of Common Working File (CWF) Part A Provider Inquiries Appeon PowerBuilder Upgrade Analysis Only tkelley on DSKBCP9HB2PROD with NOTICES VerDate Sep<11>2014 Jkt 247001 PO 00000 Frm 00051 Fmt 4703 Sfmt 4725 E:\FR\FM\19FEN1.SGM Addendum III: CMS Rulings (October through December 2018) 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 mq,ut w\~ w .~.uD.t;uvl "C!?uwuuu::-.For questions or additional information, contact Tiffany Lafferty (410-786-7548). 19FEN1 Addendum IV: Medicare National Coverage Determinations (October through December 2018) Addendum IV includes completed national coverage determinations (NCDs), or reconsiderations of completed NCDs, from the quarter covered by this notice. Completed decisions are identified by the section of the NCD Manual (NCDM) in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. An NCD is a determination by the Secretary for whether or not a particular item or service is covered nationally under the Medicare Program (title XVIII of the Act), but does not include a determination of the code, if any, that is assigned to a particular covered item or service, or payment determination for a particular covered item or service. The entries below include information concerning completed decisions, as well as sections on program and decision memoranda, which also mmounce decisions or, in some cases, explain why it was not appropriate to issue an NCD. Information on completed decisions as well as pending decisions has also been posted on the CMS website. For the purposes of this quarterly notice, we are providing only the specific updates that have occurred in the 3montl1 period. There were no national coverage detenninations (NCDs), or reconsiderations of completed NCDs published in the 3-month period. This information is available at: www.cms.gov/medicare-coverage-database/. For questions or additional information, contact Wanda Belle, MP A (410-786-7491) Title Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) NCDM Section NCD 20.35 NCD90.2 Transmittal Number Issue Date 211 12/13/2018 210 11130/2018 Effective Date 02/15/2018 03/16/2018 Addendum V: FDA-Approved Category B Investigational Device Exemptions (IDEs) (October through December 2018) (Inclusion of this addenda is under discussion internally.) Addendum VI: Approval Numbers for Collections of Information (October through December 2018) 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 www.reginfo.gov/public/do/PRAMain. For questions or additional information, contact William ParhaiU (410-786-4669). Addendum VII: Medicare-Approved Carotid Stent Facilities, (October through December 2018) 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 Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 Register, contact GPO at www.gpo.gov/fdsys. When ordering individual copies, it is necessary to cite either the date of publication or the volume number and page number. The Federal Register is available as an online database through GPO Access. The online database is updated by 6 a.m. each day the Federal Register is published. The database includes both text and graphics from Volume 59, Number 1 (January 2, 1994) through the present date and can be accessed at https://www.gpoaccess.gov/fr/. The following website https://www.archives.gov/federal-register/ provides information on how to access electronic editions, printed editions, and reference copies. This information is available on our website at: https://www. ems. govI quarterlyprovidempdates/downloads/Re gs3Ql8QPU.pdf For questions or additional information, contact Terri Plumb (410-786-4481 ). 4813 EN19FE19.008</GPH> tkelley on DSKBCP9HB2PROD with NOTICES 4814 VerDate Sep<11>2014 Jkt 247001 PO 00000 l<'acility Frm 00052 ·:'l.:'\h:>' (~18/.i Fmt 4703 Sfmt 4725 E:\FR\FM\19FEN1.SGM Northside Hospital - Forsyth 1200 Northside Forsyth Drive Cummings, GA 30041 Northside Hospital - Cherokee 450 Northside Cherokee Boulevard Canton, GA 30115 Blessing Hospital 1005 Broadway Quincy, IL 62301 New York-Presbyterian/Weill Cornell Medical Center (NYP/WC) 525 East 68th Street New York, NY 10021 12:{;,: Provider Number Effective Date State 110005 10/15/2018 110008 10/15/2018 GA 1760571699 11130/2018 IL 330101 05/05/2005 'IY .';.;;(i ~;;:I~::/~~?;;. GA H>\• ~;:. 19FEN1 330101 05/05/2005 New York-Presbyteriau/Columbia University Medical Center 622 West 168th Street New York, NY 10032 : ...·. ..... ·The folll>willl!fllellitv.has been removed: Tennova Healthcare -Physicians 440120 10/1112005 Regional Medical Center 900 E. Oak Hill Avenue Knoxville, TN 37917 'IY .· TN Addendum VIII: American College of Cardiology's National Cardiovascular Data Registry Sites (October through December 2018) The initial data collection requirement through the American College of Cardiology's National Cardiovascular Data Registry (ACCNCDR) has served to develop and improve the evidence base for the use of EN19FE19.009</GPH> ICDs in certain Medicare beneficiaries. The data collection requirement ended with the posting of the final decision memo for Implantable Cardioverter Defibrillators on February 15, 2018. For questions or additional information, contact Sarah Fulton, MHS (410-786-2749). Addendum IX: Active CMS Coverage-Related Guidance Documents (October through December 2018) 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 determinations 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 determination process. The document is available at https://www. ems. gov/medicare-coverage-database/details/medicarecoverage-document-details.aspx?MCDid=27. There are no additional Active CMS Coverage-Related Guidance Documents for the 3-month period. For questions or additional information, contact JoAnna Baldwin, MS (410-786-7205). Addendum X: List of Special One-Time Notices Regarding National Coverage Provisions (October through December 2018) There were no special one-time notices regarding national coverage provisions published in the 3-month period. This information is available at www.cms.hhs.gov/coverage. For questions or additional information, contact JoAnna Baldwin, MS (410-786 7205). Addendum XI: National Oncologic PET Registry (NOPR) (October through December 2018) Addendum XI includes a listing of National Oncologic Positron Emission Tomography Registry (NOPR) sites. We cover positron emission tomography (PET) scans for particular oncologic indications when they are performed in a facility that participates in the NOPR. In January 2005, we issued our decision memorandum on positron emission tomography (PET) scans, which stated that CMS would cover PET scans for particular oncologic indications, as long as they were Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 carotid artery stenting with embolic protection is reasonable and necessary only if performed in facilities that have been determined to be competent in performing the evaluation, procedure, and follow-up necessary to ensure optimal patient outcomes. We have created a list of minimum standards for facilities modeled in part on professional society statements on competency. All facilities must at least meet our standards in order to receive coverage for carotid artery stenting for high risk patients. 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 at: https://www. ems. gov/MedicareApprovedF acilitie/CASF/list. asp#TopOfPage For questions or additional information, contact Sarah Fulton, MHS (410-786-27 49). tkelley on DSKBCP9HB2PROD with NOTICES VerDate Sep<11>2014 Jkt 247001 PO 00000 Addendum XII: Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities (October through December 2018) Frm 00053 Fmt 4703 Sfmt 4725 E:\FR\FM\19FEN1.SGM 19FEN1 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 V ADs 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 V ADs implanted as destination therapy. For the purposes of tlris quarterly notice, we are providing only the specific updates to the list of Medicare-approved facilities that meet our standards that have occurred in the 3-month period. This information is available at https://www. ems. gov/MedicareApprovedF acilitie/VAD/list.asp#TopOfPage. For questions or additional information, contact David Dolan, JD, (410-786-3365). Facility f.i~C\;i!i!''····>q:. George Washington University Hospital 900 23rd Street, NW Washington, DC 20037 Provider Number Date of Initial Certification 090001 09/12/2018 Date of Recertification State ··• •:: s~~ •~ \'\ ·~·;r\;\'' DC Facility Other information: Joint Commission ID # 6310 Jersey Shore University Medical Center 1945 Route 33 Neptune City, NJ 07753 Other information: DNV Certificate#: 277447-2018VAD Rochester General Hospital 1425 Portland Avenue Rochester, NY 14621 Pro">ider Number Date of Initial Certification 310073 10/16/2018 NJ 330125 10/29/2018 NY 500030 09/17/2014 ••;~~•• i •;,i.•• :c;• ·''~~ .cl ••;.: 10118/2016 WA 520177 08/01/2012 08/08/2018 WI 100038 08/20/2014 08/15/2018 FL DNV GL Certitlcate #: 278376-2018-VAD ••••.. '•(ii:::'''.~\3l•.,:.t.{ PeaceHealth St. Joseph Medical Center 2901 Squalicum Pakrway Bellingham, W A 98225 Date of Recertification State Other information: Joint Commission ID #9574 Joint Commission Withdrawal Date: 2018-10-01 Froedtert Memorial Lutheran Hospital 9200 West Wisconsin Avenue Milwaukee, WI 53226 Other information: Joint Commission ID #7718 Previous Re-certification Dates: 2014-07-08; 2016-08-09 FROM: South Broward Hospital District DBA Memorial Regional Hospital TO: Memorial Regional Hospital Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 performed in the context of a clinical study. We have since recognized the National Oncologic PET Registry as one of these clinical studies. Therefore, in order for a beneficiary to receive a Medicare-covered PET scan, the beneficiary must receive the scan in a facility that participates in the registry. There were no additions, deletions, or editorial changes to the listing of National Oncologic Positron Emission Tomography Registry (NOPR) in the 3-month period. This information is available at https://wwwcms.gov/}.AedicareApprovedFacilitie/NOPR!list.asp#TopOfPage. For questions or additional information, contact Stuart Caplan, RN, MAS (410-786-8564 ). 3 50 I Johnson Street Hollywood, FL 33021 Other Information: 4815 EN19FE19.010</GPH> tkelley on DSKBCP9HB2PROD with NOTICES 4816 VerDate Sep<11>2014 Facility Date of Recertification State Jkt 247001 Previous Re-certification Dates: 2016-08-11 FROM: University Hospitals and Health System TO: University of Mississippi Medical Center 2500 North State Street Jackson, MS 39216 PO 00000 Frm 00054 Other information: Joint Commission ID #8064 Advocate Christ Medical Center. 4440 W. 95th Street Oak Lawn, IL 60505 Fmt 4703 Sfmt 4725 DNV Certificate#: 2773502018-VAD Sharp Memorial Hospital 7901 Frost Street San Diego, CA 92123 250001 140208 050100 08/17/2016 09/28/2005 12/01/2003 08/08/2018 10/01/2018 08/15/2018 MS IL CA Other information: Joint Commission ID #3910 E:\FR\FM\19FEN1.SGM 19FEN1 Other information: Joint Commission ID #9880 VAD Previous Re-certification Dates: 20 14-09-09; 2016-10-08 Maimonides Medical Center 4S02 Tenth Avenue Brooklyn, NY 11219 Other information: Joint Commission ID #5734 050324 11116/2012 10/24/2018 DC Facility V AD Previous Re-certification Dates: 20 14-07-29; 2016-09-13 Kaiser Sunnyside Medical Center 10180 SE Sunnyside Road Clackamas, OR 97015 Other information: Joint Commission ID #4858 University of .\i!aryland Medical Center 22 S Greene Street Baltimore, MD 21201 08/24/2012 10/1112018 NY Date of Initial Certification Date of Recertification State 380091 09/14/2016 09/19/2018 OR 210002 11/12/2003 09/26/2018 MD 340002 09/28/2016 09/19/2018 IN Other information: Joint Commission ID #6264 V AD Previous Re-certification Dates: 2008-09-16; 2010-08-25; 2012-08-15; 2014-08-19; 201609-20 FROM: Indiana University Health, Inc. (Methodist Hospital) TO: Indiana University Health Methodist Hospital 1701 N. Senate Boulevard Indianapolis, IN 46206 Other information: Joint Commission ID #188549 V AD Previous Re-certification Dates: 2008-10-06; 2010-08-17; 2012-08-17; 2014-08-19; 201610-04 330194 Pro-.ider Number Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 Date of Initial Certification Joint Commission 6811 Previous Re-certification Dates: 2008-07-18; 2010-06-29; 201208-14; 2014-09-09; 2016-08-09 Scripps Memorial Hospital- La Jolla 9SSS Genesee Avenue La Jolla, CA 92037 EN19FE19.011</GPH> Provider Number tkelley on DSKBCP9HB2PROD with NOTICES VerDate Sep<11>2014 Jkt 247001 Provider Number PO 00000 Frm 00055 Fmt 4703 Sfmt 4725 Date of Recertification State 330106 Date of Initial Certification 09/28/2016 FROM: North Shore University Health System TO: North Shore University Hospital 300 Community Drive 'v!anhasset, NY 11030 09/19/2018 NY 200009 02/03/2009 10/03/2018 ME 260065 02/11/2015 04/04/2017 MO Other information: Joint Commission ID #2091 Previous Re-ceitification Dates: 2008-03-27; 2010-0318; 2012-03-07; 2014-02-04; 2016-03-15 'v!aine Medical Center 22 Bramhall Street Portland, ME 04102 Other information: Joint Commission ID #5445 E:\FR\FM\19FEN1.SGM VAD Previous Re-certification Dates: 2016-09-28 'v!ercy Hospital Springfield 123 5 East Cherokee Springfield, MO 65804 Other information: Joint Commission ID #4234 Joint Commission Withdrawal Date: 2018-12-06 19FEN1 Addendum XIII: Lung Volume Reduction Surgery (LVRS) (October through December 2018) 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 (L VRS): • National Emphysema Treatment Trial (NETT) approved (Beginning 05/07/2007, these will no longer automatically qualify and can qualify only with the other programs); • Credentialed by the Joint Commission (formerly, the Joint Commision on Accreditation of Healthcare Organizations (JCAHO)) under their Disease Specific Certification Program for L VRS; and • Medicare approved for lung transplants. Only the first two types are in the list. There were no editorial updates to the listing of facilities for lung volume reduction surgery published in the 3-month period. This information is available at www.cms.gov/MedicareApprovedFacilitie/L VRS/list.asp#TopOfPage. For questions or additional information, contact Sarah Fulton, MHS (410-786-27 49). Addendum XIV: Medicare-Approved Bariatric Surgery Facilities (October through December 2018) Addendum XIV includes a listing of Medicare-approved facilities that meet minimum standards for facilities modeled in part on professional society statements on competency. All facilities must meet our standards in order to receive coverage for bariatric surgery procedures. On February 21, 2006, we issued our decision memorandum on bariatric surgery procedures. We determined that bariatric surgical procedures are reasonable and necessary for Medicare beneficiaries who have a body-mass index (BMI) greater than or equal to 35, have at least one co-morbidity related to obesity and have been previously unsuccessful with medical treatment for obesity. This decision also stipulated that covered bariatric surgery procedures are reasonable and necessary only when performed at facilities that are: (1) certified by the American College of Surgeons (ACS) as a Levell Bariatric Surgery Center (program standards and requirements in effect on February 15, 2006); or (2) certified by the American Society for Bariatric Surgery (ASBS) as a Bariatric Surgery Center of Excellence (ESCOE) (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' minimum facility standards for bariatric surgery that have been certified by ACS and/or ASMBS in the 3-month period. This infonnation is available at www. ems. gov/MedicareApprovedF acilitie/B SF/list.asp#TopOfPage. For questions or additional information, contact Sarah Fulton, MHS (410-786-27 49). Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices 17:46 Feb 15, 2019 Facility 4817 EN19FE19.012</GPH> 4818 Federal Register / Vol. 84, No. 33 / Tuesday, February 19, 2019 / Notices Centers for Medicare & Medicaid Services [CMS–3364–FN] Application From the Joint Commission (TJC) for Continued Approval of Its Psychiatric Hospital Accreditation Program Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final notice. AGENCY: This final notice announces our decision to approve the Joint Commission for continued recognition as a national accrediting organization for psychiatric hospitals that wish to participate in the Medicare or Medicaid programs. DATES: The approval announced in this final notice is effective February 25, 2019 through February 25, 2023. FOR FURTHER INFORMATION CONTACT: Mary Ellen Palowitch (410) 786–4496, Monda Shaver (410) 786–3410, Tara Lemons (410) 786–3030. SUPPLEMENTARY INFORMATION: SUMMARY: I. Background [FR Doc. 2019–02672 Filed 2–15–19; 8:45 am] tkelley on DSKBCP9HB2PROD with NOTICES BILLING CODE 4120–01–C VerDate Sep<11>2014 17:46 Feb 15, 2019 Jkt 247001 Under the Medicare program, eligible beneficiaries may receive covered services from a psychiatric hospital provided certain requirements are met. Section 1861(f) of the Social Security Act (the Act) establishes distinct criteria for facilities seeking designation as a psychiatric hospital. Regulations concerning provider agreements are at 42 CFR part 489 and those pertaining to activities relating to the survey and certification of facilities are at 42 CFR part 488. The regulations at 42 CFR part 482 subparts A, B, C and E specify the minimum conditions that a psychiatric hospital must meet to participate in the Medicare program, the scope of covered services and the conditions for Medicare payment for psychiatric hospitals. Generally, to enter into an agreement, a psychiatric hospital must first be certified by a State Survey Agency as complying with the conditions or requirements set forth in part 482 subpart A, B, C and E of our regulations. Thereafter, the psychiatric hospital is subject to regular surveys by a State Survey Agency to determine whether it continues to meet these requirements. There is an alternative, however, to surveys by State agencies. Section 1865(a)(1) of the Act provides that, if a provider entity demonstrates through accreditation by an approved national accrediting organization that all PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 applicable Medicare conditions are met or exceeded, we may treat the provider entity as having met those conditions, that is, we may ‘‘deem’’ the provider entity as having met the requirements. Accreditation by an accrediting organization is voluntary and is not required for Medicare participation. If an accrediting organization is recognized by the Secretary of the Department of Health and Human Services as having standards for accreditation that meet or exceed Medicare requirements, any provider entity accredited by the national accrediting body’s approved program may be deemed to meet the Medicare conditions. A national accrediting organization applying for approval of its accreditation program under part 488, subpart A, must provide the Centers for Medicare & Medicaid Services (CMS) with reasonable assurance that the accrediting organization requires the accredited provider entities to meet requirements that are at least as stringent as the Medicare conditions. Our regulations concerning the approval of accrediting organizations are set forth at § 488.5. The regulations at § 488.5(e)(2)(i) require accrediting organizations to reapply for continued approval of its accreditation program every 6 years or sooner as determined by CMS. The Joint Commission’s current term of approval for their psychiatric hospital accreditation program expires February 25, 2019. II. Application Approval Process Section 1865(a)(3)(A) of the Act provides a statutory timetable to ensure that our review of applications for CMSapproval of an accreditation program is conducted in a timely manner. The Act provides us 210 days after the date of receipt of a complete application, with any documentation necessary to make the determination, to complete our survey activities and application process. Within 60 days after receiving a complete application, we must publish a notice in the Federal Register that identifies the national accrediting body making the request, describes the request, and provides no less than a 30day public comment period. At the end of the 210-day period, we must publish a notice in the Federal Register approving or denying the application. III. Provisions of the Proposed Notice On August 15, 2018, we published a proposed notice in the Federal Register (83 FR 40514), announcing the Joint Commission’s (TJC’s) request for continued approval of its Medicare psychiatric hospital accreditation E:\FR\FM\19FEN1.SGM 19FEN1 EN19FE19.013</GPH> DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agencies

[Federal Register Volume 84, Number 33 (Tuesday, February 19, 2019)]
[Notices]
[Pages 4805-4818]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-02672]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9112-N]


Medicare and Medicaid Programs; Quarterly Listing of Program 
Issuances--October Through December 2018

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 2018, 
relating to the Medicare and Medicaid programs and other programs 
administered by CMS.

FOR FURTHER INFORMATION CONTACT:  It is possible that an interested 
party may need specific information and not be able to determine from 
the listed information whether the issuance or regulation would fulfill 
that need. Consequently, we are providing contact persons to answer 
general questions concerning each of the addenda published in this 
notice.

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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 website 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 website list provides more timely 
access for beneficiaries, providers, and suppliers. We also believe the 
website 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 websites have listservs; that is, the public can 
subscribe and receive immediate notification of any updates to the 
website. These listservs avoid the need to check the website, as 
notification of updates is automatic and sent to the subscriber as they 
occur. If assessing a website 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 17, 2019.
Kathleen Cantwell,
Director, Office of Strategic Operations and Regulatory Affairs.
BILLING CODE 4120-01-P

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[FR Doc. 2019-02672 Filed 2-15-19; 8:45 am]
 BILLING CODE 4120-01-C
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