Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2022, 58917-58918 [2021-23143]
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Federal Register / Vol. 86, No. 203 / Monday, October 25, 2021 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–6091–N]
RIN 0938–ZB70
Medicare, Medicaid, and Children’s
Health Insurance Programs; Provider
Enrollment Application Fee Amount for
Calendar Year 2022
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
This notice announces a
$631.00 calendar year (CY) 2022
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, 2022
and on or before December 31, 2022.
DATES: The application fee announced
in this notice is effective on January 1,
2022.
FOR FURTHER INFORMATION CONTACT:
Frank Whelan, (410) 786–1302.
SUPPLEMENTARY INFORMATION:
SUMMARY:
jspears on DSK121TN23PROD with NOTICES1
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 § 424.502 as ‘‘any
provider or supplier that submits a
VerDate Sep<11>2014
18:46 Oct 22, 2021
Jkt 256001
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; they may
also 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 as an institutional
provider 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
an announcement of the application fee
amount for the forthcoming CY based on
the formula noted previously. Most
recently, in the November 23, 2020
Federal Register (85 FR 74724), we
published a notice announcing a fee
amount for the period of January 1, 2021
through December 31, 2021 of $599.00.
The $599.00 fee amount for CY 2021
was used to calculate the fee amount for
2022 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, 2020
PO 00000
Frm 00059
Fmt 4703
Sfmt 4703
58917
through June 30, 2021 was 5.4 percent.
As required by § 424.514(d)(2), the
preceding year’s fee of $599 will be
adjusted by 5.4 percent. This results in
a CY 2022 application fee amount of
$631.35 ($599 × 1.054). As we must
round this to the nearest whole dollar
amount, the resultant application fee
amount for CY 2022 is $631.00.
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 and Review
Requirements
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 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), and the
Congressional Review Act (5 U.S.C.
804(2)).
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,
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
E:\FR\FM\25OCN1.SGM
25OCN1
jspears on DSK121TN23PROD with NOTICES1
58918
Federal Register / Vol. 86, No. 203 / Monday, October 25, 2021 / Notices
economic threshold and is not
considered a major notice.
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 2021, that
threshold was approximately $158
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.
B. Costs
The costs associated with this notice
involve the increase in the application
VerDate Sep<11>2014
18:00 Oct 22, 2021
Jkt 256001
fee amount that certain providers and
suppliers must pay in CY 2022. The CY
2022 cost estimates are as follows:
1. Medicare
Based on CMS data, we estimate that
in CY 2022 approximately—
• 10,214 newly enrolling institutional
providers will be subject to and pay an
application fee; and
• 42,117 revalidating institutional
providers will be subject to and pay an
application fee.
Using a figure of 52,331 (10,214 newly
enrolling + 42,117 revalidating)
institutional providers, we estimate an
increase in the cost of the Medicare
application fee requirement in CY 2022
of $1,674,592 (or 52,331 × $32 (or $631
minus $599)) from our CY 2021
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 2022. Using
this figure, we project an increase in the
cost of the Medicaid and CHIP
application fee requirement in CY 2022
of $960,000 (or 30,000 × $32 (or $631
minus $599)) from our CY 2021
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 2022 to
be $2,634,592 ($1,674,592 + $960,000)
from our CY 2021 projections.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
The Administrator of the Centers for
Medicare & Medicaid Services (CMS),
Chiquita Brooks-LaSure, having
reviewed and approved this document,
authorizes Lynette Wilson, who is the
Federal Register Liaison, to
electronically sign this document for
purposes of publication in the Federal
Register.
Dated: October 19, 2021.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare
& Medicaid Services.
[FR Doc. 2021–23143 Filed 10–22–21; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
National Library of Medicine; Notice of
Closed Meetings
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of the
following meeting.
The meeting will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable materials,
and personal information concerning
individuals associated with the grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
Name of Committee: National Library of
Medicine Special Emphasis Panel; U24.
Date: December 10, 2021.
Time: 11:00 a.m. to 3:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Video Assisted Meeting.
Contact Person: Manana Sukhareva, Ph.D.,
Director, Office of Scientific Review, NIBIB/
NIH, 6707 Democracy Boulevard, Suite 920,
Bethesda, MD 20892–5496, 301–451–3397,
sukharem@mail.nih.gov.
(Catalogue of Federal Domestic Assistance
Program No. 93.879, Medical Library
Assistance, National Institutes of Health,
HHS)
Miguelina Perez,
Program Analyst, Office of Federal Advisory
Committee Policy.
[FR Doc. 2021–23134 Filed 10–22–21; 8:45 am]
BILLING CODE 4140–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Office of the Secretary; Notice of
Meeting
Pursuant to section 10(a) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of a
meeting of the Interagency Pain
Research Coordinating Committee.
The meeting will be open to the
public. Individuals who plan to
participate and need special assistance,
such as sign language interpretation or
other reasonable accommodations,
should notify the Contact Person listed
below in advance of the meeting.
Name of Committee: Interagency Pain
Research Coordinating Committee.
E:\FR\FM\25OCN1.SGM
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Agencies
[Federal Register Volume 86, Number 203 (Monday, October 25, 2021)]
[Notices]
[Pages 58917-58918]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-23143]
[[Page 58917]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-6091-N]
RIN 0938-ZB70
Medicare, Medicaid, and Children's Health Insurance Programs;
Provider Enrollment Application Fee Amount for Calendar Year 2022
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces a $631.00 calendar year (CY) 2022
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, 2022 and on or before December 31, 2022.
DATES: The application fee announced in this notice is effective on
January 1, 2022.
FOR FURTHER INFORMATION CONTACT: Frank Whelan, (410) 786-1302.
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
``any 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; they may also include other institutional
provider types designated by a state in accordance with their approved
state plan.
As indicated in Sec. 424.514 and Sec. 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 as an institutional provider 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 formula noted
previously. Most recently, in the November 23, 2020 Federal Register
(85 FR 74724), we published a notice announcing a fee amount for the
period of January 1, 2021 through December 31, 2021 of $599.00. The
$599.00 fee amount for CY 2021 was used to calculate the fee amount for
2022 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, 2020 through June 30, 2021 was 5.4
percent. As required by Sec. 424.514(d)(2), the preceding year's fee
of $599 will be adjusted by 5.4 percent. This results in a CY 2022
application fee amount of $631.35 ($599 x 1.054). As we must round this
to the nearest whole dollar amount, the resultant application fee
amount for CY 2022 is $631.00.
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 and Review Requirements
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 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), and the
Congressional Review Act (5 U.S.C. 804(2)).
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, 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
[[Page 58918]]
economic threshold and is not considered a major notice.
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 2021, that
threshold was approximately $158 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.
B. Costs
The costs associated with this notice involve the increase in the
application fee amount that certain providers and suppliers must pay in
CY 2022. The CY 2022 cost estimates are as follows:
1. Medicare
Based on CMS data, we estimate that in CY 2022 approximately--
10,214 newly enrolling institutional providers will be
subject to and pay an application fee; and
42,117 revalidating institutional providers will be
subject to and pay an application fee.
Using a figure of 52,331 (10,214 newly enrolling + 42,117
revalidating) institutional providers, we estimate an increase in the
cost of the Medicare application fee requirement in CY 2022 of
$1,674,592 (or 52,331 x $32 (or $631 minus $599)) from our CY 2021
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
2022. Using this figure, we project an increase in the cost of the
Medicaid and CHIP application fee requirement in CY 2022 of $960,000
(or 30,000 x $32 (or $631 minus $599)) from our CY 2021 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 2022 to be $2,634,592 ($1,674,592 +
$960,000) from our CY 2021 projections.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Chiquita Brooks-LaSure, having reviewed and approved this
document, authorizes Lynette Wilson, who is the Federal Register
Liaison, to electronically sign this document for purposes of
publication in the Federal Register.
Dated: October 19, 2021.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2021-23143 Filed 10-22-21; 8:45 am]
BILLING CODE 4120-01-P