Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2020, 61058-61059 [2019-24443]
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61058
Federal Register / Vol. 84, No. 218 / Tuesday, November 12, 2019 / Notices
In a subsequent notice, Draft IDLH
Value profiles for these chemicals will
be made available for public comment.
Reference
NIOSH [2013]. Current intelligence
bulletin 66: derivation of immediately
dangerous to life or health (IDLH)
values. Cincinnati, OH: US Department
of Health and Human Services, Centers
for Disease Control and Prevention,
National Institute for Occupational
Safety and Health, DHHS (NIOSH)
Publication 2014–100.
John J. Howard,
Director, National Institute for Occupational
Safety and Health, Centers for Disease Control
and Prevention.
[FR Doc. 2019–24465 Filed 11–8–19; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–6089–N]
Medicare, Medicaid, and Children’s
Health Insurance Programs; Provider
Enrollment Application Fee Amount for
Calendar Year 2020
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
This notice announces a
$595.00 calendar year (CY) 2020
application fee for institutional
providers that are initially enrolling in
the Medicare or Medicaid program or
the Children’s Health Insurance
Program (CHIP); revalidating their
Medicare, Medicaid, or CHIP
enrollment; or adding a new Medicare
practice location. This fee is required
with any enrollment application
submitted on or after January 1, 2020
and on or before December 31, 2020.
DATES: The application fee announced
in this notice is effective on January 1,
2020.
FOR FURTHER INFORMATION CONTACT:
Melissa Singer, (410) 786–0365.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
In the February 2, 2011 Federal
Register (76 FR 5862), we published a
final rule with comment period titled
‘‘Medicare, Medicaid, and Children’s
Health Insurance Programs; Additional
Screening Requirements, Application
Fees, Temporary Enrollment Moratoria,
Payment Suspensions and Compliance
Plans for Providers and Suppliers.’’ This
VerDate Sep<11>2014
17:47 Nov 08, 2019
Jkt 250001
rule finalized, among other things,
provisions related to the submission of
application fees as part of the Medicare,
Medicaid, and CHIP provider
enrollment processes. As provided in
section 1866(j)(2)(C)(i) of the Social
Security Act (the Act) and in 42 CFR
424.514, ‘‘institutional providers’’ that
are initially enrolling in the Medicare or
Medicaid programs or CHIP,
revalidating their enrollment, or adding
a new Medicare practice location are
required to submit a fee with their
enrollment application. An
‘‘institutional provider’’ for purposes of
Medicare is defined at § 424.502 as (a)ny
provider or supplier that submits a
paper Medicare enrollment application
using the CMS–855A, CMS–855B (not
including physician and non-physician
practitioner organizations), CMS–855S,
CMS–20134, or associated internetbased PECOS enrollment application.
As we explained in the February 2, 2011
final rule (76 FR 5914), in addition to
the providers and suppliers subject to
the application fee under Medicare,
Medicaid-only and CHIP-only
institutional providers would include
nursing facilities, intermediate care
facilities for persons with intellectual
disabilities (ICF/IID), psychiatric
residential treatment facilities, and may
include other institutional provider
types designated by a state in
accordance with their approved state
plan.
As indicated in §§ 424.514 and
455.460, the application fee is not
required for either of the following:
• A Medicare physician or nonphysician practitioner submitting a
CMS–855I.
• A prospective or revalidating
Medicaid or CHIP provider—
++ Who is an individual physician or
non-physician practitioner; or
++ That is enrolled in Title XVIII of
the Act or another state’s Title XIX or
XXI plan and has paid the application
fee to a Medicare contractor or another
state.
II. Provisions of the Notice
Section 1866(j)(2)(C)(i)(I) of the Act
established a $500 application fee for
institutional providers in calendar year
(CY) 2010. Consistent with section
1866(j)(2)(C)(i)(II) of the Act,
§ 424.514(d)(2) states that for CY 2011
and subsequent years, the preceding
year’s fee will be adjusted by the
percentage change in the consumer
price index (CPI) for all urban
consumers (all items; United States city
average, CPI U) for the 12 month period
ending on June 30 of the previous year.
Each year since 2011, accordingly, we
have published in the Federal Register
PO 00000
Frm 00054
Fmt 4703
Sfmt 4703
an announcement of the application fee
amount for the forthcoming CY based on
the above formula. Most recently, in the
November 19, 2018 Federal Register (83
FR 58255), we published a notice
announcing a fee amount for the period
of January 1, 2019 through December 31,
2019 of $586.00. The $586.00 fee
amount for CY 2019 was used to
calculate the fee amount for CY 2020 as
specified in § 424.514(d)(2).
According to Bureau of Labor
Statistics (BLS) data, the CPU–U
increase for the period of July 1, 2018
through June 30, 2019 was 1.6 percent.
As required by § 424.514(d)(2), the
preceding year’s fee of $586 will be
adjusted by the CPI–U of 1.6 percent.
This results in a CY 2020 application fee
amount of $595.376 ($586 × 1.016). As
we must round this to the nearest whole
dollar amount, the resultant application
fee amount for CY 2020 is $595.00.
III. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting, recordkeeping, or
third-party disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995.
However, it does reference previously
approved information collections. The
Forms CMS–855A, CMS–855B, and
CMS–855I are approved under OMB
control number 0938–0685; the Form
CMS–855S is approved under OMB
control number 0938–1056.
IV. Regulatory Impact Statement
A. Background
We have examined the impact of this
notice as required by Executive Order
12866 on Regulatory Planning and
Review (September 30, 1993), Executive
Order 13563 on Improving Regulation
and Regulatory Review (January 18,
2011), the Regulatory Flexibility Act
(RFA) (September 19, 1980, Pub. L. 96–
354), section 1102(b) of the Social
Security Act, section 202 of the
Unfunded Mandates Reform Act of 1995
(March 22, 1995; Pub. L. 104–4),
Executive Order 13132 on Federalism
(August 4, 1999), the Congressional
Review Act (5 U.S.C. 804(2)), and
Executive Order 13771 on Reducing
Regulation and Controlling Regulatory
Costs (January 30, 2017).
Executive Orders 12866 and 13563
direct agencies to assess all costs and
benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits,
E:\FR\FM\12NON1.SGM
12NON1
Federal Register / Vol. 84, No. 218 / Tuesday, November 12, 2019 / Notices
including potential economic,
environmental, public health and safety
effects, distributive impacts, and equity.
A regulatory impact analysis (RIA) must
be prepared for major rules with
economically significant effects ($100
million or more in any 1 year). As
explained in this section of the notice,
we estimate that the total cost of the
increase in the application fee will not
exceed $100 million. Therefore, this
notice does not reach the $100 million
economic threshold and is not
considered a major notice.
B. Estimated Costs
The costs associated with this notice
involve the increase in the application
fee amount that certain providers and
suppliers must pay in CY 2020. The CY
2020 cost estimates are as follows:
1. Medicare
Based on CMS data, we estimate that
in CY 2020 approximately—
• 14,852 newly enrolling institutional
providers will be subject to and pay an
application fee; and
• 41,747 revalidating institutional
providers will be subject to and pay an
application fee.
Using a figure of 56,599 (14,852 newly
enrolling + 41,747 revalidating)
institutional providers, we estimate an
increase in the cost of the Medicare
application fee requirement in CY 2020
of $509,391 (or 56,599 × $9 (or $595
minus $586)) from our CY 2019
projections.
2. Medicaid and CHIP
Based on CMS and state statistics, we
estimate that approximately 30,000
(9,000 newly enrolling + 21,000
revalidating) Medicaid and CHIP
institutional providers will be subject to
an application fee in CY 2020. Using
this figure, we project an increase in the
cost of the Medicaid and CHIP
application fee requirement in CY 2020
of $270,000 (or 30,000 × $9 (or $595
minus $586)) from our CY 2019
projections.
3. Total
Based on the foregoing, we estimate
the total increase in the cost of the
application fee requirement for
Medicare, Medicaid, and CHIP
providers and suppliers in CY 2020 to
be $779,391 ($509,391 + $270,000) from
our CY 2019 projections.
The RFA requires agencies to analyze
options for regulatory relief of small
businesses. For purposes of the RFA,
small entities include small businesses,
nonprofit organizations, and small
governmental jurisdictions. Most
hospitals and most other providers and
VerDate Sep<11>2014
17:47 Nov 08, 2019
Jkt 250001
suppliers are small entities, either by
nonprofit status or by having revenues
of less than $7.5 million to $38.5
million in any 1 year. Individuals and
states are not included in the definition
of a small entity. As we stated in the
RIA for the February 2, 2011 final rule
with comment period (76 FR 5952), we
do not believe that the application fee
will have a significant impact on small
entities.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area for
Medicare payment regulations and has
fewer than 100 beds. We are not
preparing an analysis for section 1102(b)
of the Act because we have determined,
and the Secretary certifies, that this
notice would not have a significant
impact on the operations of a substantial
number of small rural hospitals.
Section 202 of the Unfunded
Mandates Reform Act of 1995 (UMRA)
also requires that agencies assess
anticipated costs and benefits before
issuing any rule whose mandates
require spending in any 1 year of $100
million in 1995 dollars, updated
annually for inflation. In 2019, that
threshold is approximately $154
million. The Agency has determined
that there will be minimal impact from
the costs of this notice, as the threshold
is not met under the UMRA.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it promulgates a
proposed rule (and subsequent final
rule) that imposes substantial direct
requirement costs on state and local
governments, preempts state law, or
otherwise has federalism implications.
Since this notice does not impose
substantial direct costs on state or local
governments, the requirements of
Executive Order 13132 are not
applicable.
Executive Order 13771, titled
‘‘Reducing Regulation and Controlling
Regulatory Costs,’’ was issued on
January 30, 2017 (82 FR 9339, February
3, 2017). It has been determined that
this notice is a transfer notice that does
not impose more than de minimis costs
and thus is not a regulatory action for
the purposes of E.O. 13771.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
PO 00000
Frm 00055
Fmt 4703
Sfmt 4703
61059
Dated: September 26, 2019.
Seema Verma,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 2019–24443 Filed 11–8–19; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Community Living
Agency Information Collection
Activities; Proposed Collection;
Comment Request; Development
Disabilities State Plan Information
Collection; OMB #0985–0029
Administration for Community
Living, HHS.
ACTION: Notice.
AGENCY:
The Administration for
Community Living (ACL) is announcing
an opportunity for the public to
comment on the proposed collection of
information listed above. Under the
Paperwork Reduction Act of 1995 (the
PRA), Federal agencies are required to
publish a notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension of an existing collection of
information, and to allow 60 days for
public comment in response to the
notice. This notice solicits comments on
the Proposed Extension without Change
and solicits comments on the
information collection requirements
related to Development Disabilities
State Plan.
DATES: Comments on the collection of
information must be submitted
electronically by 11:59 p.m. (EST) or
postmarked by January 13, 2020.
ADDRESSES: Submit electronic
comments on the collection of
information to Sara Newell-Perez.
Submit written comments on the
collection of information to
Administration for Community Living,
Washington, DC 20201, Attention: Sara
Newell-Perez.
FOR FURTHER INFORMATION CONTACT: Sara
Newell-Perez, Administration for
Community Living, Washington, DC
20201, 202–795–7413 sara.newellperez@acl.hhs.gov.
SUPPLEMENTARY INFORMATION: Under the
PRA (44 U.S.C. 3501–3520), Federal
agencies must obtain approval from the
Office of Management and Budget
(OMB) for each collection of
information they conduct or sponsor.
‘‘Collection of information’’ is defined
in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests
or requirements that members of the
SUMMARY:
E:\FR\FM\12NON1.SGM
12NON1
]]>Agencies
[Federal Register Volume 84, Number 218 (Tuesday, November 12, 2019)]
[Notices]
[Pages 61058-61059]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-24443]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-6089-N]
Medicare, Medicaid, and Children's Health Insurance Programs;
Provider Enrollment Application Fee Amount for Calendar Year 2020
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces a $595.00 calendar year (CY) 2020
application fee for institutional providers that are initially
enrolling in the Medicare or Medicaid program or the Children's Health
Insurance Program (CHIP); revalidating their Medicare, Medicaid, or
CHIP enrollment; or adding a new Medicare practice location. This fee
is required with any enrollment application submitted on or after
January 1, 2020 and on or before December 31, 2020.
DATES: The application fee announced in this notice is effective on
January 1, 2020.
FOR FURTHER INFORMATION CONTACT: Melissa Singer, (410) 786-0365.
SUPPLEMENTARY INFORMATION:
I. Background
In the February 2, 2011 Federal Register (76 FR 5862), we published
a final rule with comment period titled ``Medicare, Medicaid, and
Children's Health Insurance Programs; Additional Screening
Requirements, Application Fees, Temporary Enrollment Moratoria, Payment
Suspensions and Compliance Plans for Providers and Suppliers.'' This
rule finalized, among other things, provisions related to the
submission of application fees as part of the Medicare, Medicaid, and
CHIP provider enrollment processes. As provided in section
1866(j)(2)(C)(i) of the Social Security Act (the Act) and in 42 CFR
424.514, ``institutional providers'' that are initially enrolling in
the Medicare or Medicaid programs or CHIP, revalidating their
enrollment, or adding a new Medicare practice location are required to
submit a fee with their enrollment application. An ``institutional
provider'' for purposes of Medicare is defined at Sec. 424.502 as
(a)ny provider or supplier that submits a paper Medicare enrollment
application using the CMS-855A, CMS-855B (not including physician and
non-physician practitioner organizations), CMS-855S, CMS-20134, or
associated internet-based PECOS enrollment application. As we explained
in the February 2, 2011 final rule (76 FR 5914), in addition to the
providers and suppliers subject to the application fee under Medicare,
Medicaid-only and CHIP-only institutional providers would include
nursing facilities, intermediate care facilities for persons with
intellectual disabilities (ICF/IID), psychiatric residential treatment
facilities, and may include other institutional provider types
designated by a state in accordance with their approved state plan.
As indicated in Sec. Sec. 424.514 and 455.460, the application fee
is not required for either of the following:
A Medicare physician or non-physician practitioner
submitting a CMS-855I.
A prospective or revalidating Medicaid or CHIP provider--
++ Who is an individual physician or non-physician practitioner; or
++ That is enrolled in Title XVIII of the Act or another state's
Title XIX or XXI plan and has paid the application fee to a Medicare
contractor or another state.
II. Provisions of the Notice
Section 1866(j)(2)(C)(i)(I) of the Act established a $500
application fee for institutional providers in calendar year (CY) 2010.
Consistent with section 1866(j)(2)(C)(i)(II) of the Act, Sec.
424.514(d)(2) states that for CY 2011 and subsequent years, the
preceding year's fee will be adjusted by the percentage change in the
consumer price index (CPI) for all urban consumers (all items; United
States city average, CPI U) for the 12 month period ending on June 30
of the previous year. Each year since 2011, accordingly, we have
published in the Federal Register an announcement of the application
fee amount for the forthcoming CY based on the above formula. Most
recently, in the November 19, 2018 Federal Register (83 FR 58255), we
published a notice announcing a fee amount for the period of January 1,
2019 through December 31, 2019 of $586.00. The $586.00 fee amount for
CY 2019 was used to calculate the fee amount for CY 2020 as specified
in Sec. 424.514(d)(2).
According to Bureau of Labor Statistics (BLS) data, the CPU-U
increase for the period of July 1, 2018 through June 30, 2019 was 1.6
percent. As required by Sec. 424.514(d)(2), the preceding year's fee
of $586 will be adjusted by the CPI-U of 1.6 percent. This results in a
CY 2020 application fee amount of $595.376 ($586 x 1.016). As we must
round this to the nearest whole dollar amount, the resultant
application fee amount for CY 2020 is $595.00.
III. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping, or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995. However, it does reference previously approved information
collections. The Forms CMS-855A, CMS-855B, and CMS-855I are approved
under OMB control number 0938-0685; the Form CMS-855S is approved under
OMB control number 0938-1056.
IV. Regulatory Impact Statement
A. Background
We have examined the impact of this notice as required by Executive
Order 12866 on Regulatory Planning and Review (September 30, 1993),
Executive Order 13563 on Improving Regulation and Regulatory Review
(January 18, 2011), the Regulatory Flexibility Act (RFA) (September 19,
1980, Pub. L. 96-354), section 1102(b) of the Social Security Act,
section 202 of the Unfunded Mandates Reform Act of 1995 (March 22,
1995; Pub. L. 104-4), Executive Order 13132 on Federalism (August 4,
1999), the Congressional Review Act (5 U.S.C. 804(2)), and Executive
Order 13771 on Reducing Regulation and Controlling Regulatory Costs
(January 30, 2017).
Executive Orders 12866 and 13563 direct agencies to assess all
costs and benefits of available regulatory alternatives and, if
regulation is necessary, to select regulatory approaches that maximize
net benefits,
[[Page 61059]]
including potential economic, environmental, public health and safety
effects, distributive impacts, and equity. A regulatory impact analysis
(RIA) must be prepared for major rules with economically significant
effects ($100 million or more in any 1 year). As explained in this
section of the notice, we estimate that the total cost of the increase
in the application fee will not exceed $100 million. Therefore, this
notice does not reach the $100 million economic threshold and is not
considered a major notice.
B. Estimated Costs
The costs associated with this notice involve the increase in the
application fee amount that certain providers and suppliers must pay in
CY 2020. The CY 2020 cost estimates are as follows:
1. Medicare
Based on CMS data, we estimate that in CY 2020 approximately--
14,852 newly enrolling institutional providers will be
subject to and pay an application fee; and
41,747 revalidating institutional providers will be
subject to and pay an application fee.
Using a figure of 56,599 (14,852 newly enrolling + 41,747
revalidating) institutional providers, we estimate an increase in the
cost of the Medicare application fee requirement in CY 2020 of $509,391
(or 56,599 x $9 (or $595 minus $586)) from our CY 2019 projections.
2. Medicaid and CHIP
Based on CMS and state statistics, we estimate that approximately
30,000 (9,000 newly enrolling + 21,000 revalidating) Medicaid and CHIP
institutional providers will be subject to an application fee in CY
2020. Using this figure, we project an increase in the cost of the
Medicaid and CHIP application fee requirement in CY 2020 of $270,000
(or 30,000 x $9 (or $595 minus $586)) from our CY 2019 projections.
3. Total
Based on the foregoing, we estimate the total increase in the cost
of the application fee requirement for Medicare, Medicaid, and CHIP
providers and suppliers in CY 2020 to be $779,391 ($509,391 + $270,000)
from our CY 2019 projections.
The RFA requires agencies to analyze options for regulatory relief
of small businesses. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and small governmental
jurisdictions. Most hospitals and most other providers and suppliers
are small entities, either by nonprofit status or by having revenues of
less than $7.5 million to $38.5 million in any 1 year. Individuals and
states are not included in the definition of a small entity. As we
stated in the RIA for the February 2, 2011 final rule with comment
period (76 FR 5952), we do not believe that the application fee will
have a significant impact on small entities.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule may have a significant impact on
the operations of a substantial number of small rural hospitals. This
analysis must conform to the provisions of section 604 of the RFA. For
purposes of section 1102(b) of the Act, we define a small rural
hospital as a hospital that is located outside of a Metropolitan
Statistical Area for Medicare payment regulations and has fewer than
100 beds. We are not preparing an analysis for section 1102(b) of the
Act because we have determined, and the Secretary certifies, that this
notice would not have a significant impact on the operations of a
substantial number of small rural hospitals.
Section 202 of the Unfunded Mandates Reform Act of 1995 (UMRA) also
requires that agencies assess anticipated costs and benefits before
issuing any rule whose mandates require spending in any 1 year of $100
million in 1995 dollars, updated annually for inflation. In 2019, that
threshold is approximately $154 million. The Agency has determined that
there will be minimal impact from the costs of this notice, as the
threshold is not met under the UMRA.
Executive Order 13132 establishes certain requirements that an
agency must meet when it promulgates a proposed rule (and subsequent
final rule) that imposes substantial direct requirement costs on state
and local governments, preempts state law, or otherwise has federalism
implications. Since this notice does not impose substantial direct
costs on state or local governments, the requirements of Executive
Order 13132 are not applicable.
Executive Order 13771, titled ``Reducing Regulation and Controlling
Regulatory Costs,'' was issued on January 30, 2017 (82 FR 9339,
February 3, 2017). It has been determined that this notice is a
transfer notice that does not impose more than de minimis costs and
thus is not a regulatory action for the purposes of E.O. 13771.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
Dated: September 26, 2019.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2019-24443 Filed 11-8-19; 8:45 am]
BILLING CODE 4120-01-P
