Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-October Through December 2023, 5897-5907 [2024-01785]
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5897
Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices
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Abstract: The Federal Cigarette
Labeling and Advertising Act, 15 U.S.C.
1331 et seq. (2006 ed.) (‘‘FCLAA’’),
requires cigarette manufacturers,
packagers, and importers to place one of
four statutorily-prescribed Surgeon
General’s health warnings on cigarette
packaging and in advertisements, on a
rotational basis in accordance with
plans reviewed and approved by the
FTC. Each manufacturer, packager, and
importer (hereinafter, also referred to as
‘‘respondents’’) wishing to import for
sale or distribute cigarettes in the
United States is required to submit a
plan to the FTC that (1) explains how
the respondent intends to comply with
the statutory requirement to display the
statutorily-prescribed health warnings
on its packaging, (2) identifies each of
the respondent’s brands and brand
styles, (3) includes a schedule (or other
explanation) showing the warnings that
will be assigned to each brand during
each quarter of the year, and (4)
specifies when in the manufacturing
process the respondent will consult its
rotation schedule for that particular
brand in order to assign the appropriate
quarterly warning. Respondents wishing
to engage in advertising of cigarettes in
the United States are required to submit
to the FTC a plan that (1) includes a
rotation schedule for the four
statutorily-prescribed health warnings
for each brand the respondent intends to
advertise, (2) specifies how the
respondent will determine which health
warnings will appear on different kinds
of advertisements, and (3) specifies how
the respondent will handle
advertisements that feature more than
one of the respondent’s brands.
The FCLAA also provides for an
alternative method for displaying the
required health warnings on
packaging—that is, equalization.
Specifically, manufacturers, packagers,
and importers may seek the FTC’s
approval to display the health warnings
on a particular cigarette brand style an
equal number of times. In order to
obtain approval for equalization,
respondents must submit an additional
plan to the FTC that establishes (1) that
their sales satisfy the statutory-
prescribed requirements for
equalization, and (2) how the
respondent will ensure that all four
health warnings will be equally
displayed during the one-year period
following the plan’s approval (e.g., by
using printing plates that produce an
even number of all four warnings
simultaneously on each print run).
Respondents seeking to equalize must
submit new plans annually to
demonstrate that their sales continue to
qualify for equalization.
The Commission uses the information
to assess—as it is required to do under
the FCLAA—whether a manufacturer or
importer will display the Surgeon
General’s health warnings in
compliance with the governing statutory
provisions in the FCLAA.
Affected Public: Private Sector:
Businesses and other for-profit entities.
Estimated Annual Burden Hours: 328.
Estimated Annual Labor Costs:
$16,695.
Estimated Annual Non-Labor Costs:
$0.
D. Request for Comment
Pursuant to OMB regulations, 5 CFR
part 1320, which implement the PRA,
44 U.S.C. 3501 et seq., the FTC is
providing this second opportunity for
public comment while submitting to
OMB its request for clearance for the
information collection requirements
contained in the FCLAA. For more
details about the requirements and the
basis for the calculations summarized
above, see 88 FR 60941.
Your comment—including your name
and your state—will be placed on the
public record of this proceeding.
Because your comment will be made
public, you are solely responsible for
making sure that your comment does
not include any sensitive personal
information, such as anyone’s Social
Security number; date of birth; driver’s
license number or other state
identification number or foreign country
equivalent; passport number; financial
account number; or credit or debit card
number. You are also solely responsible
for ensuring that your comment does
not include any sensitive health
information, such as medical records or
other individually identifiable health
information. In addition, your comment
should not include any ‘‘[t]rade secret or
any commercial or financial information
which is . . . privileged or
confidential’’—as provided in Section
6(f) of the FTC Act 15 U.S.C. 46(f), and
FTC Rule 4.10(a)(2), 16 CFR 4.10(a)(2)—
including, in particular, competitively
sensitive information, such as costs,
sales statistics, inventories, formulas,
patterns devices, manufacturing
processes, or customer names.
Josephine Liu,
Assistant General Counsel for Legal Counsel.
[FR Doc. 2024–01798 Filed 1–29–24; 8:45 am]
BILLING CODE 6750–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–9145–N]
Medicare and Medicaid Programs;
Quarterly Listing of Program
Issuances—October Through
December 2023
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
This quarterly notice lists
CMS manual instructions, substantive
and interpretive regulations, and other
Federal Register notices that were
published in the 3-month period,
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.
SUMMARY:
Addenda
Contact
I. CMS Manual Instructions ......................................................................................
II. Regulation Documents Published in the Federal Register ................................
III. CMS Rulings .......................................................................................................
IV. Medicare National Coverage Determinations .....................................................
V. FDA-Approved Category B IDEs .........................................................................
VI. Collections of Information ...................................................................................
VII. Medicare-Approved Carotid Stent Facilities ......................................................
VIII. American College of Cardiology—National Cardiovascular Data Registry
Sites.
IX. Medicare’s Active Coverage-Related Guidance Documents .............................
X. One-time Notices Regarding National Coverage Provisions ..............................
Ismael Torres ..........................................
Terri Plumb .............................................
Tiffany Lafferty ........................................
Wanda Belle, MPA .................................
John Manlove .........................................
William Parham ......................................
Sarah Fulton, MHS .................................
Sarah Fulton, MHS .................................
(410)
(410)
(410)
(410)
(410)
(410)
(410)
(410)
Lori Ashby, MA .......................................
JoAnna Baldwin, MS ..............................
(410) 786–6322
(410) 786–7205
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Phone No.
786–1864
786–4481
786–7548
786–7491
786–6877
786–4669
786–2749
786–2749
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Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices
Addenda
Contact
XI. National Oncologic Positron Emission Tomography Registry Sites ...................
XII. Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities
XIII. Medicare-Approved Lung Volume Reduction Surgery Facilities ......................
XIV. Medicare-Approved Bariatric Surgery Facilities ...............................................
XV. Fluorodeoxyglucose Positron Emission Tomography for Dementia Trials .......
All Other Information ................................................................................................
David Dolan, MBA ..................................
David Dolan, MBA ..................................
Sarah Fulton, MHS .................................
Sarah Fulton, MHS .................................
David Dolan, MBA ..................................
Annette Brewer .......................................
SUPPLEMENTARY INFORMATION:
khammond on DSKJM1Z7X2PROD with NOTICES
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
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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.
The Director of the Office of Strategic
Operations and Regulatory Affairs of the
Centers for Medicare & Medicaid
Services (CMS), Kathleen Cantwell,
having reviewed and approved this
document, authorizes Trenesha FultzMimms, who is the Federal Register
Liaison, to electronically sign this
document for purposes of publication in
the Federal Register.
Phone No.
(410)
(410)
(410)
(410)
(410)
(410)
786–3365
786–3365
786–2749
786–2749
786–3365
786–6580
Addendum I: Medicare and Medicaid
Manual Instructions (October Through
December 2023)
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.
Publication Dates for the Previous Four
Quarterly Notices
How To Obtain Manuals
The internet-only Manuals (IOMs) are
a replica of the Agency’s official record
copy. Paper-based manuals are CMS
manuals that were officially released in
hardcopy. The majority of these
manuals were transferred into the
internet-only manual (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.
We publish this notice at the end of
each quarter reflecting information
released by CMS during the previous
quarter. The publication dates of the
previous four Quarterly Listing of
Program Issuances notices are: February
1, 2023 (88 FR 6729), May 12, 2023 (88
FR 30752), August 4, 2023 (88 FR
51814) and October 26, 2023 (88 FR
73591). 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.
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/.
Trenesha Fultz-Mimms,
Federal Register Liaison, Department of
Health and Human Services.
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Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices
In addition, individuals may contact
regional depository libraries that receive
and retain at least one copy of most
federal government publications, either
in printed or microfilm 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
Updates to Medicare Benefit Policy
Manual and Medicare Claims Processing
Manual for Opioid Treatment Programs
(OTPs) (CMS-Pub. 100–02) Transmittal
No. 12418.
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.
Transmittal
No.
5899
Fee-For Service Transmittal Numbers
Please Note: Beginning Friday, March
20, 2020, there will be the following
change regarding the Advance Notice of
Instructions due to a CMS internal
process change. Fee-For Service
Transmittal Numbers will no longer be
determined by Publication. The
Transmittal numbers will be issued by
a single numerical sequence beginning
with Transmittal Number 10000.
For the purposes of this quarterly
notice, we list only the specific updates
to the list of manual instructions that
have occurred in the 3-month period.
This information is available on our
website at www.cms.gov/Manuals.
Manual/subject/publication No.
Medicare General Information (CMS-Pub. 100–01)
12037 ..............
12341 ..............
12425 ..............
Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2024.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Enforcing Billing Requirements for Intensive Outpatient Program (IOP) Services with New Condition Code 92—Additional Publication Update.
Medicare Benefit Policy (CMS-Pub. 100–02)
12283 ..............
12291 ..............
12299 ..............
12385 ..............
12400 ..............
12418 ..............
12421 ..............
12425 ..............
Internet Only Manual Updates to Pub. 100–02 and 100–04 to Implement Consolidated Appropriations Act 2023 Changes for
Skilled Nursing Facility (SNF).
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
An Omnibus CR to Implement Policy Updates in the CY 2023 PFS Final Rule, Including (1) Removal of Selected NCDs (NCD
160.22 Ambulatory EEG Monitoring), and, (2) Expanding Coverage of Colorectal Cancer Screening—Full Agile Pilot CR.
Hospice Benefit Policy Manual Updates Related to the Addition of Marriage and Family Therapists (MFTs) or Mental Health
Counselors (MHCs) to the Hospice Interdisciplinary Team.
Hospice Benefit Policy Manual Updates Related to the Addition of Marriage and Family Therapists (MFTs) or Mental Health
Counselors (MHCs) to the Hospice Interdisciplinary Team.
Updates to Medicare Benefit Policy Manual and Medicare Claims Processing Manual for Opioid Treatment Programs (OTPs).
January 2024 Update of the Hospital Outpatient Prospective Payment System (OPPS).
Enforcing Billing Requirements for Intensive Outpatient Program (IOP) Services with New Condition Code 92—Additional Publication Update.
Medicare National Coverage Determination (CMS-Pub. 100–03)
12299 ..............
12352 ..............
An Omnibus CR to Implement Policy Updates in the CY 2023 PFS Final Rule, Including (1) Removal of Selected NCDs (NCD
160.22 Ambulatory EEG Monitoring), and, (2) Expanding Coverage of Colorectal Cancer Screening—Full Agile Pilot CR.
Manual Updates for Coverage of Intravenous Immune Globulin (IVIG) For Treatment of Primary Immune Deficiency Diseases
in the Home.
Medicare Claims Processing (CMS-Pub. 100–04)
12283 ..............
12284 ..............
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12287
12288
12289
12290
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..............
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12291 ..............
12298 ..............
12299 ..............
12301 ..............
12305 ..............
12306 ..............
12315 ..............
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Internet Only Manual Updates to Pub. 100–02 and 100–04 to Implement Consolidated Appropriations Act 2023 Changes for
Skilled Nursing Facility (SNF) Physician’s Services and Other Professional Services Excluded From Part A PPS Payment
and the Consolidated Billing Requirement.
Deleting Internet Only Manuals (IOM) Pub. 100–04, Chapter 4, Section 190, Payer Only Codes Utilized by Medicare Payer
Only Codes Utilized by Medicare.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Diagnosis Code Update for Add-on Payments for Blood Clotting Factor Administered to Hemophilia Inpatients Payment for
Blood Clotting Factor Administered to Hemophilia Inpatients.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
An Omnibus CR to Implement Policy Updates in the CY 2023 PFS Final Rule, Including (1) Removal of Selected NCDs (NCD
160.22 Ambulatory EEG Monitoring), and, (2) Expanding Coverage of Colorectal Cancer Screening—Full Agile Pilot CR.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Calendar Year (CY) 2024 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD)
Procedures.
Processing Claims When the Dates of Service Are Beyond the Time Limit for the Patient Assessment Actions When a Claim
Does Not Match the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF–PAI) Payment Adjustments—Applying OASIS Assessment Items to Determine HIPPS Codes.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
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Transmittal
No.
12316
12321
12322
12325
Manual/subject/publication No.
..............
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..............
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12326 ..............
12337
12339
12342
12343
12344
..............
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12347
12354
12357
12359
12360
12361
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12364
12369
12375
12389
..............
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12391 ..............
12396 ..............
12398 ..............
12399 ..............
12401 ..............
12402
12403
12404
12406
..............
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12407
12411
12413
12414
12415
12416
12418
12419
12420
12421
12422
12423
12424
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12426 ..............
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Implementation of Rural Emergency Hospital (REH) Provider Type.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Update to the Internet Only Manual (IOM) Publication (Pub.) 100–04, Chapter 18 Section 50.3–50.4, To Remove 0359U Per
The International Classification of Diseases, 10th Revision (ICD–10) and Other Coding Revisions to National Coverage Determinations (NCDs)—October 2023.
Internet-Only Manual Update, Pub. 100–04, Chapter 23 (Fee Schedule Administration and Coding Requirements), Section
50.6.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
April 2024 Healthcare Common Procedure Coding System (HCPCS) Quarterly Update Reminder.
Quarterly Update to Home Health (HH) Grouper.
File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Implementation of New Benefit Category for Lymphedema Compression Treatment Items.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Updates to Chapter 1 of the Medicare Claims Processing Manual (Publication (Pub.) 100–04) to Include Newly Created and
Utilized Payer Only Codes.
NCD 220.6.20—Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease.
Implementation of Rural Emergency Hospital (REH) Provider Type.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
Calendar Year (CY) 2024 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable
Charge Payment.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Update to the Internet Only Manual (IOM) Publication (Pub.) 100–04, Chapter 32 Sections 320.3.3 and 370.1 for Coding Revisions to the National Coverage Determinations (NCDs)—April 2024 Change Request (CR) 13390.
Calendar Year 2024 Update for Durable Medical Equipment, Orthotics and Supplies (DMEPOS) Fee Schedule.
April 2024 Bi-Annual Update of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD–10–CM).
Instructions for Retrieving the 2024 Pricing and Healthcare Common Procedure Coding System (HCPCS) Data Files through
CMS’ Mainframe Telecommunications Systems.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
Instructions for Downloading the Medicare ZIP Code File for April 2024 Files.
CY 2024 Home Infusion Therapy (HIT) Payment Rates and Instructions for Retrieving the January 2024 Home Infusion Therapy (HIT) Services Payment Rates Through the CMS Mainframe Telecommunications System.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
New Place of Service (POS) Code 27—‘‘Outreach Site/Street’’.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Ambulance Inflation Factor (AIF) for Calendar Year (CY) 2024 and Productivity Adjustment.
New Waived Tests.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Updates to Medicare Benefit Policy Manual and Medicare Claims Processing Manual for Opioid Treatment Programs (OTPs).
January 2024 Integrated Outpatient Code Editor (I/OCE) Specifications Version 25.0.
January 2024 Update of the Ambulatory Surgical Center (ASC) Payment System.
January 2024 Update of the Hospital Outpatient Prospective Payment System (OPPS).
April 2024 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing.
Enforcing Billing Requirements for Intensive Outpatient Program (IOP) Services with New Condition Code 92.
Implement Edits to Prevent Payment of Complexity Add-On Code G2211 When Associated Office/Outpatient Evaluation and
Management Visit (Codes 99202–99205, 99211–99215) is Reported With Modifier 25.
Calendar Year (CY) 2024 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable
Charge Payment.
Medicare Secondary Payer (CMS-Pub. 100–05)
12304 ..............
Changes to The Electronic Correspondence Referral System (ECRS) Web, Including Modified Medicare Secondary Payer
(MSP) Health Insurance Master Record (HIMR) Screen and Remote Identity Process (RIDP).
Attachment 1—ECRS Web User Guide, Software Version 7.4 2023/October 2.
Attachment 2—ECRS Web Quick Reference Card Version 7.4 2023/October 2.
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Medicare Financial Management (CMS-Pub. 100–06)
12297 ..............
12323 ..............
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Notice of New Interest Rate for Medicare Overpayments and Underpayments—1st Qtr Notification for FY 2024.
Revisions and Deletions to the Internet Only Manual (IOM), Publication 100–06, Chapter 4, Debt Collection Related to Extended Repayment Schedules (ERS) and Debt Management.
Rates of Interest.
Procedures for Applying Interest During Overpayment Recoupment.
Recoupment by Withholding Payments.
Establishing an Extended Repayment Schedule.
Extended Repayment Schedule (ERS) Required Documentation—Physician is a Sole Proprietor.
Extended Repayment Schedule (ERS) Required Documentation—Provider is an Entity Other Than a Sole Proprietor.
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Transmittal
No.
5901
Manual/subject/publication No.
12329 ..............
12346 ..............
Extended Repayment Schedule (ERS) Approval Process.
Sending the Extended Repayment Schedule (ERS) Request to the Regional Office (RO).
Monitoring an Approved Extended Repayment Schedule (ERS) and Reporting Requirement.
Requests from Terminated Providers or Debts that are Pending Referral to Department of Treasury.
The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement
(PS&R) System.
Revisions and Deletions to the Internet Only Manual (IOM), Publication 100–06, Chapter 4, Debt Collection Related to Extended Repayment Schedules (ERS) and Debt Management.
Rates of Interest.
Procedures for Applying Interest During Overpayment Recoupment.
Recoupment by Withholding Payments.
Establishing an Extended Repayment Schedule (ERS).
Extended Repayment Schedule (ERS) Required Documentation—Physician is a Sole Proprietor.
Extended Repayment Schedule (ERS) Required Documentation—Provider is an Entity Other Than a Sole Proprietor.
4/50.3/Extended Repayment Schedule (ERS) Approval Process.
4/50.4/Sending the Extended Repayment Schedule (ERS) Request to the Regional Office (RO).
Monitoring an Approved Extended Repayment Schedule (ERS) and Reporting Requirements.
Requests from Terminated Providers or Debts that are Pending Referral to Department of Treasury.
Medicare State Operations Manual (CMS-Pub. 100–07)
None.
Medicare Program Integrity (CMS-Pub. 100–08)
12279
12280
12281
12295
12296
12300
12302
12333
..............
..............
..............
..............
..............
..............
..............
..............
12336 ..............
12356 ..............
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12358 ..............
12393 ..............
12394 ..............
12395 ..............
12408 ..............
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction.
Updates of Chapter 4 and Chapter 8 in Publication (Pub.) 100–08, Including Adding Guidance Regarding Handling of Freedom
Information Act (FOIA) Requests.
Requests for Information From Outside Organizations.
Duration of the Payment Suspension.
DME Payment Suspensions (MACs and UPICs).
Non-DME National Payment Suspensions (MACs and UPICs).
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100–08—Physician Fee Schedule (PFS) Final Rule.
Additional Definitions.
Marriage and Family Therapists (MFTs).
Mental Health Counselors (MHCs).
Medicare Diabetes Prevention Program (MDPP) Suppliers.
Providers/Suppliers Not Eligible to Enroll.
Denials—General Principles.
Denial Reasons.
Additional Denial Policies.
Changes of Information.
Revocation Effective Dates.
Revocation Reasons.
Reenrollment Bar.
Additional Revocation Policies.
Establishing Effective Dates.
Opting-Out of Medicare.
Appeals Process.
Revalidation Notification Letters.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100–08—Home
Health Prospective Payment System (HH PPS) Final Rule.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Medicare Contractor Beneficiary and Provider Communications (CMS-Pub. 100–09)
None.
Medicare Quality Improvement Organization (CMS-Pub. 100–10)
None.
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Transmittal
No.
Manual/subject/publication No.
Medicare Program of All-Inclusive Care for the Elderly (CMS-Pub. 100–11)
12338 ..............
Update to the Internet Only Manual (IOM) Publication (Pub.) 100–11, IOM Chapter 4 Enrollment and Disenrollment.
Medicare End Stage Renal Disease Network Organizations (CMS Pub 100–14)
None.
Medicaid Program Integrity Disease Network Organizations (CMS Pub 100–15)
None.
Medicare Managed Care (CMS-Pub. 100–16).
None.
Medicare Business Partners Systems Security (CMS-Pub. 100–17).
None.
Medicare Prescription Drug Benefit (CMS-Pub. 100–18)
None.
Demonstrations (CMS-Pub. 100–19).
12320
12348
12365
12366
12383
12390
12412
..............
..............
..............
..............
..............
..............
..............
Issued to a specific audience, not posted to Internet/Intranet due to a Sensitivity
Issued to a specific audience, not posted to Internet/Intranet due to a Sensitivity
Guiding an Improved Dementia Experience (GUIDE) Model Implementation.
Issued to a specific audience, not posted to Internet/Intranet due to a Sensitivity
Issued to a specific audience, not posted to Internet/Intranet due to a Sensitivity
Making Care Primary (MCP) Model Implementation.
Issued to a specific audience, not posted to Internet/Intranet due to a Sensitivity
of Instruction.
of Instruction.
of Instruction.
of Instruction.
of Instruction.
One Time Notification (CMS-Pub. 100–20).
12286 ..............
12292 ..............
12303 ..............
12308 ..............
12309 ..............
12310 ..............
12313 ..............
12314 ..............
12317 ..............
12318 ..............
12319 ..............
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12324
12327
12328
12330
12331
12334
..............
..............
..............
..............
..............
..............
12335 ..............
12340 ..............
12345 ..............
12349 ..............
12350 ..............
12351 ..............
12353 ..............
VerDate Sep<11>2014
Patient Driven Payment Model (PDPM) Corrections to Interrupted Stay Edits.
Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits in Length
($99,999,999.99)—Phase 2.
Adjustment to Fraud Prevention System (FPS) and Unified Program Integrity Contractor (UPIC) Edits to Increase Billing Increments From 30 Days to 90 Days for Continuous Glucose Monitor (CGM) Supplies.
User Enhancement Change Request (UECR): ViPS Medicare System (VMS)—Hold Data on the Program Integrity Management Reporting (PIMR) Audit Record History Screen (BUDS19).
Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR)—Expiration of a Unique Tracking
Number (UTN) on the Prior Authorization (PA) Tracking File.
Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR)—New Reason Code to Prevent Adjustments and Cancels From Being Submitted for the Same Claim, on the Same Day.
User Enhancement Change Request (UECR)—Update the Multi-Carrier System (MCS) to Add a Location Field to the Data
Correction Window in the MCS Desktop Tool (MCSDT).
User Enhancement Request (UECR)—Update the Multi-Carrier System (MCS) to Create a Summary Report for Healthcare Integrated General Ledger Accounting System (HIGLAS) Interface File Errors.
User Enhancement Change Request (UECR): New Multi-Carrier System (MCS) Inquiry Search Screen Using a Procedure
Code to Display an Associated Edit or Audit.
International Classification of Diseases, 10th Revision (ICD–10) and Other Coding Revisions to National Coverage Determinations (NCDs)—April 2024 Update—CR 1 of 2.
International Classification of Diseases, 10th Revision (ICD–10) and Other Coding Revisions to National Coverage Determinations (NCDs)—April 2024 Update—CR 2 of 2.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction.
Implement Edits on Hospice Claims.
Report of Hospice Election for Part D (Response File).
Remittance Advice (RA) Changes due to Durable Medical Equipment Medicare Administrative Contractors (DME MACs) Transition to Healthcare Integrated General Ledger Accounting System (HIGLAS).
Allowing Audiologists to Furnish Certain Diagnostic Tests Without a Physician Order.
Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits in Length
($99,999,999.99)—Phase 3.
Implementation of a National Fee Schedule for Medicare Part B Vaccine Administration CMS.
Pricing and Coding Services (PCS) Application Programming Interface (API) Report Dissemination Proof of Concept.
International Classification of Diseases, 10th Revision (ICD–10) and Other Coding Revisions to National Coverage Determinations (NCDs)—April 2024 Update—CR 2 of 2.
Requirements for a Provider Direct Mailing and Education & Outreach for Behavioral Health Initiatives.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
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Transmittal
No.
Manual/subject/publication No.
12355 ..............
International Classification of Diseases, 10th Revision (ICD–10) and Other Coding Revisions to National Coverage Determinations (NCDs)—January 2024 Update.
User Enhancement Change Request (UECR): ViPS Medicare System (VMS)—Fix Beneficiary Update and Display System
(BUDS) Queries for Remark Code and Biller Number.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
Enforcing Billing Requirements for Intensive Outpatient Program (IOP) Services with Revenue Code 0905 for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC).
Payment of Codes for Chemotherapy Administration and Nonchemotherapy Injections and Infusions.
Direct Mailing Notification to Hospice Providers Regarding the Value-Based Insurance Design (VBID) Model, Hospice Benefit
Component, Participating Medicare Advantage Organizations.
Updating Calendar Year (CY) 2024 Medicare Diabetes Prevention Program (MDPP) Payment Rates.
Provider Education for the Review Choice Demonstration (RCD) for Inpatient Rehabilitation Facility Services (IRFs).
12362 ..............
12363
12367
12368
12392
..............
..............
..............
..............
12397 ..............
12405 ..............
12410 ..............
12428 ..............
Medicare Quality Reporting Incentive Programs (CMS-Pub. 100–22)
12293 ..............
12294 ..............
Payments to Home Health Agencies That Do Not Submit Required Quality Data This CR Rescinds and Fully Replaces CR
10874.
Issued to a specific audience, not posted to Internet/Intranet due to a Confidentiality of Instruction.
State Payment of Medicare Premiums (CMS-Pub. 100–24).
None.
Information Security Acceptable Risk Safeguards (CMS-Pub. 100–25).
None.
For questions or additional
information, contact Ismael Torres (410–
786–1864).
Addendum II: Regulation Documents
Published in the Federal Register
(October Through December 2023)
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Regulations and Notices
Regulations and notices are published
in the daily Federal Register. To
purchase individual copies or subscribe
to the Federal 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/
index.html. The following website
https://www.archives.gov/federalregister/ provides information on how to
access electronic editions, printed
editions, and reference copies.
For questions or additional
information, contact Terri Plumb (410–
786–4481).
Addendum III: CMS Rulings (October
Through December 2023)
CMS Rulings are decisions of the
Administrator that serve as precedent
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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 https://
www.cms.gov/Regulations-andGuidance/Guidance/Rulings.
For questions or additional
information, contact Tiffany Lafferty
(410–786–7548).
Addendum IV: Medicare National
Coverage Determinations (October
Through December 2023)
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
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entries below include information
concerning completed decisions, as well
as sections on program and decision
memoranda, which also announce
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, there
were no specific updates to national
coverage determinations (NCDs), or
reconsiderations of completed NCDs
published in the 3-month period. This
information is available at:
www.cms.gov/medicare-coveragedatabase/.
For questions or additional
information, contact Wanda Belle, MPA
(410–786–7491).
Addendum V: FDA-Approved Category
B Investigational Device Exemptions
(IDEs) (October Through December
2023)
(Inclusion of this addenda is under
discussion internally.)
Addendum VI: Approval Numbers for
Collections of Information (October
Through December 2023)
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
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information is available at
www.reginfo.gov/public/do/PRAMain.
For questions or additional
information, contact William Parham
(410–786–4669).
Addendum VII: Medicare-Approved
Carotid Stent Facilities (October
Through December 2023)
Addendum VII includes listings of
Medicare-approved carotid stent
facilities. All facilities listed meet CMS
standards for performing carotid artery
stenting for high risk patients. On March
17, 2005, we issued our decision
memorandum on carotid artery stenting.
We determined that carotid artery
stenting with embolic protection is
reasonable and necessary only if
performed in facilities that have been
determined to be competent in
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.cms.gov/MedicareApproved
Facilitie/CASF/list.asp#TopOfPage.
For questions or additional
information, contact Sarah Fulton, MHS
(410–786–2749).
Facility
The following facilities are new listings for this quarter
HCA Florida Englewood Hospital, 700 Medical Boulevard, Englewood, FL 34223 ...........................................
Kaiser Permanente San Francisco, Medical Center, 2425 Geary Blvd Provider, San Francisco, CA 94115 ...
Sanford Bemidji Medical Center, 1300 Anne Street NW, Bemidji, MN 56601 ...................................................
The following facilities have editorial changes (in bold)
From: Galichia Heart Hospital, To: Wesley Woodlawn Hospital, 2610 N. Woodlawn Boulevard, Wichita, KS
67220–2729.
From: Presence Resurrection Medical Center, To: Ascension Resurrection, 7435 West Talcott Avenue, Chicago, IL 60631.
From: Fort Walton Beach Medical Center, To: HCA Fort Walton—Destin Hospital, 1000 Mar Walt Drive,
Fort Walton Beach, FL 32547.
From: Trumbull Memorial Hospital, To: Trumbull Regional Medical Center, 1350 E Market Street, Warren,
OH 44483.
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Addendum VIII: American College of
Cardiology’s National Cardiovascular
Data Registry Sites (October Through
December 2023)
The initial data collection
requirement through the American
College of Cardiology’s National
Cardiovascular Data Registry (ACC–
NCDR) has served to develop and
improve the evidence base for the use of
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 CoverageRelated Guidance Documents (October
Through December 2023)
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
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17:23 Jan 29, 2024
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the national coverage determination
process. The document is available at
https://www.cms.gov/medicare-coveragedatabase/details/medicare-coveragedocument-details.aspx?MCDId=27.
CMS published three proposed
guidance documents on June 22, 2023 to
provide a framework for more
predictable and transparent evidence
development and encourage innovation
and accelerate beneficiary access to new
items and services. The documents are
available at:
https://www.cms.gov/medicarecoverage-database/view/medicarecoverage-document.aspx?mcdid=35&
docTypeId=1&sortBy=title&bc=16.
https://www.cms.gov/medicarecoverage-database/view/medicarecoverage-document.aspx?mcdid=34&
docTypeId=1&sortBy=title&bc=16.
https://www.cms.gov/medicarecoverage-database/view/medicarecoverage-document.aspx?mcdid=33&
docTypeId=1&sortBy=title&bc=16.
For questions or additional
information, contact Lori Ashby, MA
(410 786 6322).
Addendum X: List of Special One-Time
Notices Regarding National Coverage
Provisions (October Through December
2023)
There were no special one-time
notices regarding national coverage
provisions published in the 3-month
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Provider No.
Date
approved
State
1639122864
050076
240100
09/09/2023
09/09/2023
09/09/2023
FL
CA
MN
170123
05/16/2005
KS
140117
04/12/2005
IL
100223
04/14/2005
FL
1053844671
03/14/2013
OH
period. This information is available at
https://www.cms.gov.
For questions or additional
information, contact JoAnna Baldwin,
MS (410–786 7205).
Addendum XI: National Oncologic PET
Registry (NOPR)
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
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 3month period. This information is
available at https://www.cms.gov/
MedicareApprovedFacilitie/NOPR/
list.asp#TopOfPage.
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For questions or additional
information, contact David Dolan, MBA
(410–786–3365).
Addendum XII: Medicare-Approved
Ventricular Assist Device (Destination
Therapy) Facilities (October Through
December 2023)
Addendum XII includes a listing of
Medicare-approved facilities that
receive coverage for ventricular assist
devices (VADs) used as destination
therapy. All facilities were required to
meet our standards in order to receive
coverage for VADs implanted as
destination therapy. On October 1, 2003,
we issued our decision memorandum
on VADs for the clinical indication of
destination therapy. We determined that
VADs used as destination therapy are
reasonable and necessary only if
performed in facilities that have been
determined to have the experience and
infrastructure to ensure optimal patient
outcomes. We established facility
standards and an application process.
All facilities were required to meet our
standards in order to receive coverage
Provider
No.
Facility
for VADs implanted as destination
therapy.
For the purposes of this quarterly
notice, we are providing only the
specific updates to the list of Medicareapproved facilities that meet our
standards that have occurred in the 3month period. This information is
available at https://www.cms.gov/
MedicareApprovedFacilitie/VAD/
list.asp#TopOfPage.
For questions or additional
information, contact David Dolan, MBA,
(410–786–3365).
Date of
initial
certification
Date of
re-certification
State
The following facility is a new listing.
St. Bernard’s Medical Center, 225 East Washington, Jonesboro, AR 72401 ............
Other information: DNV–GL ID #: C624530
Previous Re-certification Dates: n/a
040020
08/31/2023
AR
khammond on DSKJM1Z7X2PROD with NOTICES
The following facilities have editorial changes (in bold).
Sentara Norfolk General Hospital, 600 Gresham Drive, Norfolk, VA 23507 ..............
Other information: DNV–GL ID #: C592382
Previous Re-certification Dates: 11/13/2008; 12/21/2010; 02/05/2013; 01/13/2015;
03/14/2017; 4/20/2019; 10/07/2021
Presbyterian Medical Center of the UPHS, 51 North 39th Street, Philadelphia, PA
19104.
Other information: Joint Commission ID #6145
Previous Re-certification Dates: 10/05/2010; 11/07/2012; 12/09/2014; 03/21/2017;
4/17/2019; 07/29/2021
University of Alabama at Birmingham, 619 19th S. South, Birmingham, AL 35249–
1900.
Other information: Joint Commission ID # 2814
Previous Re-certification Dates: 12/09/2008; 04/22/2011; 04/09/2013; 04/07/2015;
05/16/2017; 7/3/2019; 08/21/2021
Virginia Commonwealth University Health System Authority, 1250 East Marshall
Street, Richmond, VA 23298–051.
Other information: Joint Commission ID # 6381
Previous Re-certification Dates: 11/04/2008; 12/14/2010; 12/21/2012;12/16/2014;
02/14/2017; 04/10/2019; 08/07/2021
Fresno Community Hospital and Medical Center, 2823 Fresno St., Fresno, CA
93721.
Other information: Joint Commission ID # 9832
Previous Re-certification Dates: 1/04/2014; 12/13/2016; 2/13/2019; 08/11/2021
University Hospital (Stony Brook), Health Sciences Center Suny Stony Brook,
Stony Brook, NY 11794–8503.
Other information: Joint Commission ID # 5188
Previous Re-certification Dates: 01/30/2013; 01/15/2015; 03/14/2017; 05/08/2019;
09/17/2021
Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219–2916 .........
Other information: Joint Commission ID #5734
Previous Re-certification Dates: 08/23/2012; 07/29/2014; 09/13/2016; 10/11/2018;
10/27/2021
The General Hospital Corporation, 55 Fruit Street, Boston, MA 02114 .....................
Other information: Joint Commission ID# 5513
Previous Re-certification Dates: 12/08/2008; 01/19/2011; 02/13/2013; 01/06/2015;
02/28/2017; 05/22/2019; 10/14/2021
Montefiore Health System, 111 East 210th StreetM Bronx, NY 10467 .....................
Other information: Joint Commission ID #2514
Previous Re-certification Dates: 09/23/2008; 10/08/2010; 10/23/2012; 09/23/2014;
10/08/2016; 11/07/2018; 10/29/2021
Bryan Medical Center, 1600 South 48th Street, Lincoln, NE 68506 ..........................
Other information: Joint Commission ID # 244330
Previous Re-certification Dates: 03/05/2013; 02/12/2015; 04/18/2017; 07/17/2019;
09/22/2021
Nebraska Medical Center, 987400 Nebraska Medical Center, Omaha, NE 68198–
7400.
Other information: Joint Commission ID # 186313
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17:23 Jan 29, 2024
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49–0007
11/13/2008
09/05/2023
VA
390223
10/05/2010
06/28/2023
PA
010033
10/29/2003
07/27/2023
AL
490032
04/08/2004
07/19/2023
VA
050060
01/04/2014
08/09/2023
CA
330393
03/02/2011
08/09/2023
NY
330194
08/23/2012
10/18/2023
NY
220071
12/15/2003
09/07/2023
MA
330059
11/14/2003
10/04/2023
NY
280003
03/05/2013
08/23/2023
NE
280013
02/02/2011
08/16/2023
NE
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Provider
No.
Facility
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Previous Re-certification Dates: 01/20/2011; 01/29/2013; 02/24/2015; 02/14/2017;
04/17/2019; 09/09/2021
Dignity Health, 350 West Thomas Road, Phoenix, AZ 85013 ...................................
Other information: Joint Commission ID # 9494
Previous Re-certification Dates: 05/08/2019; 08/19/2021
From: Norton Hospitals Inc. ........................................................................................
To: Norton Audubon Hospital, 1 Audubon Plaza Drive, Louisville, KY 40217
Other information: DNV ID #: C553570
Previous Re-certification Dates: 09/17/2020
From: University of Virginia Medical Center ...............................................................
To: Rector & Visitors of the University of Virginia, 1215 Lee Street, Charlottesville,
VA 22903
Other information: Joint Commission ID #: 6329
Previous Re-certification Dates: 03/21/2012; 05/06/2014; 06/07/2016; 06/06/2018;
10/13/2021
Temple University Hospital, Inc., 3401 North Broad Street, Philadelphia, PA 19140
Other information: Joint Commission ID #: 6152
Previous Re-certification Dates: 02/08/2012; 02/11/2014; 04/07/2016; 04/04/2018;
10/13/2021
Prisma Health Richland, 5 Richland Medical Park Drive, Columbia, SC 29203 ........
Other information: Joint Commission ID #: 6588
Previous Re-certification Dates: 03/06/2013; 04/21/2015; 06/06/2017; 6/28/2019;
10/08/2021
Hillcrest Medical Center, 1120 S. Utica, Tulsa, OK 74104 .........................................
Other information: DNV #: C584663
Previous Re-certification Dates: 12/04/2017; 11/25/2020
Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
Other information: Joint Commission ID #: 5501
Previous Re-certification Dates: 4/25/2017; 05/22/2019; 11/04/2021
Yale New Haven Hospital, 20 York Street, New Haven, CT 06510–3203 .................
Other information: Joint Commission ID #: 5677
Previous Re-certification Dates: 01/25/2011; 01/15/2013; 12/16/2014; 02/28/2017;
5/22/2019; 11/24/2021
UMass Memorial Health Care, Inc, One Biotech Park 365 Plantation Street,
Worcester, MA 01605.
Other information: Joint Commission ID #: 5640
Previous Re-certification Dates: 02/06/2019; 11/06/2021
North Carolina Baptist Hospital, dba Atrium Health Wake Forest Baptist, Medical
Center Boulevard, Winston Salem, NC 27157.
Other information: Joint Commission ID #: 6571
Previous Re-certification Dates: 06/28/2011; 08/13/2013; 08/04/2015; 08/18/2017;
10/9/2019; 10/16/2021
Memorial Hermann—Texas Medical Center, 6411 Fannin Street, Houston, TX
77030–1501.
Other information: Joint Commission ID #: 9081
Previous Re-certification Dates: 03/19/2013; 04/14/2015; 05/24/2017; 06/26/2019;
12/23/2021
Cleveland Clinic Florida, 3100 Weston Road, Weston, FL 33331 .............................
Other information: Joint Commission ID #: 334451
Previous Re-certification Dates: 05/19/2015; 06/20/2017; 7/24/2019; 11/04/2021
Addendum XIII: Lung Volume
Reduction Surgery (LVRS) (October
Through December 2023)
Addendum XIII includes a listing of
Medicare-approved facilities that are
eligible to receive coverage for lung
volume reduction surgery. Until May
17, 2007, facilities that participated in
the National Emphysema Treatment
Trial were also eligible to receive
coverage. The following three types of
facilities are eligible for reimbursement
for Lung Volume Reduction Surgery
(LVRS):
• National Emphysema Treatment
Trial (NETT) approved (Beginning 05/
07/2007, these will no longer
VerDate Sep<11>2014
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Date of
re-certification
State
030024
05/08/2019
08/26/2023
AZ
180088
09/17/2020
10/13/2023
KY
490009
02/12/2010
09/15/2023
VA
390027
02/08/2012
09/13/2023
PA
420018
03/07/2013
09/13/2023
SC
370001
12/04/2017
11/17/2023
OK
220086
04/25/2017
09/29/2023
MA
070022
01/25/2011
12/13/2023
CT
220163
02/06/2019
10/27/2023
MA
340047
06/28/2011
10/25/2023
NC
450068
03/19/2013
12/22/2023
TX
100289
05/19/2015
11/02/2023
FL
automatically qualify and can qualify
only with the other programs);
• Credentialed by the Joint
Commission (formerly, the Joint
Commission on Accreditation of
Healthcare Organizations (JCAHO))
under their Disease Specific
Certification Program for LVRS; and
• Medicare approved for lung
transplants.
Only the first two types are in the list.
For the purposes of this quarterly
notice, there are no additions and
deletions to a listing of Medicareapproved facilities that are eligible to
receive coverage for lung volume
reduction surgery. This information is
PO 00000
Date of
initial
certification
available at www.cms.gov/Medicare
ApprovedFacilitie/LVRS/list.asp#
TopOfPage.
For questions or additional
information, contact Sarah Fulton, MHS
(410–786–2749).
Addendum XIV: Medicare-Approved
Bariatric Surgery Facilities (October
Through December 2023)
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
E:\FR\FM\30JAN1.SGM
30JAN1
Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices
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 comorbidity 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 Level 1 Bariatric
Surgery Center (program standards and
requirements in effect on February 15,
2006); or (2) certified by the American
Society for Bariatric Surgery (ASBS) as
a Bariatric Surgery Center of Excellence
(BSCOE) (program standards and
requirements in effect on February 15,
2006).
There were no additions, deletions, or
editorial changes to Medicare-approved
facilities that meet CMS’ minimum
facility standards for bariatric surgery
that have been certified by ACS and/or
ASMBS in the 3-month period. This
information is available at
www.cms.gov/MedicareApproved
Facilitie/BSF/list.asp#TopOfPage.
For questions or additional
information, contact Sarah Fulton, MHS
(410–786–2749).
Addendum XV: FDG–PET for Dementia
and Neurodegenerative Diseases
Clinical Trials (October Through
December 2023)
There were no FDG–PET for Dementia
and Neurodegenerative Diseases
Clinical Trials published in the 3-month
period.
This information is available on our
website at www.cms.gov/Medicare
ApprovedFacilitie/PETDT/list.asp#
TopOfPage.
For questions or additional
information, contact David Dolan, MBA
(410–786–3365).
[FR Doc. 2024–01785 Filed 1–29–24; 8:45 am]
khammond on DSKJM1Z7X2PROD with NOTICES
BILLING CODE 4120–01–P
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Jkt 262001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–4207–NC]
RIN 0938–ZB84
Medicare Program; Request for
Information on Medicare Advantage
Data
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (HHS).
ACTION: Request for information.
AGENCY:
This request for information
(RFI) seeks input from the public
regarding various aspects of Medicare
Advantage (MA) data. Responses to this
RFI may be used to inform general
efforts to strengthen Centers for
Medicare & Medicaid Services’ (CMS’)
MA data capabilities and guide
policymaking.
SUMMARY:
To be assured consideration,
comments must be received at one of
the addresses provided below, by May
29, 2024.
ADDRESSES: In commenting, refer to file
code CMS–4207–NC.
Comments, including mass comment
submissions, must be submitted in one
of the following three ways (please
choose only one of the ways listed):
1. Electronically. You may submit
electronic comments on this document
to https://www.regulations.gov. Follow
the ‘‘Submit a comment’’ instructions.
2. By regular mail. You may mail
written comments to the following
address ONLY: Centers for Medicare &
Medicaid Services, Department of
Health and Human Services, Attention:
CMS–4207–NC, P.O. Box 8013,
Baltimore, MD 21244–8013.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments to the
following address ONLY: Centers for
Medicare & Medicaid Services,
Department of Health and Human
Services, Attention: CMS–4207–NC,
Mail Stop C4–26–05, 7500 Security
Boulevard, Baltimore, MD 21244–1850.
For information on viewing public
comments, see the beginning of the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Ilina
Chaudhuri, (410) 786–8628.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All
comments received before the close of
the comment period are available for
DATES:
PO 00000
Frm 00053
Fmt 4703
Sfmt 4703
5907
viewing by the public, including any
personally identifiable or confidential
business information that is included in
a comment. We post all comments
received before the close of the
comment period on the following
website as soon as possible after they
have been received: https://
www.regulations.gov. Follow the search
instructions on that website to view
public comments. CMS will not post on
Regulations.gov public comments that
make threats to individuals or
institutions or suggest that the
individual will take actions to harm the
individual. CMS continues to encourage
individuals not to submit duplicative
comments. We will post acceptable
comments from multiple unique
commenters even if the content is
identical or nearly identical to other
comments.
I. Background
In a request for information that
appeared in the Federal Register on
August 1, 2022 (87 FR 46918)
(hereinafter referred to as 2022 General
MA RFI), CMS sought feedback on ways
to strengthen Medicare Advantage (MA)
to align with the Vision for Medicare
(https://www.cms.gov/blog/buildingcms-strategic-vision-working-togetherstronger-medicare) and the CMS
Strategic Pillars (https://www.cms.gov/
about-cms/what-we-do/cms-strategicplan). The 2022 General MA RFI set out
to create more opportunities for
stakeholders to engage with CMS, and
in alignment with the agency’s Strategic
Pillars, prioritize increased engagement
throughout the policy process with our
partners and the communities we serve.
As a result of this commitment, we
received more than 4,000 responses
from a wide variety of voices. One key
theme that emerged was an interest in
greater beneficiary protections, such as
strengthened MA marketing regulations
and prior authorization protections.
Respondents also focused on issues
related to payment, including accurate
risk adjustment and value-based
payment arrangements between
providers and insurers, as well as
competition in the market, such as
topics related to insurer consolidation
and vertical integration. Additionally,
we received strong feedback from
respondents who stated that CMS
should have comprehensive highquality MA programmatic data and
promote more program transparency
through increased public releases of MA
data. Respondents underscored the
urgency for more complete MA data and
data transparency as enrollment in MA
E:\FR\FM\30JAN1.SGM
30JAN1
]]>Agencies
[Federal Register Volume 89, Number 20 (Tuesday, January 30, 2024)]
[Notices]
[Pages 5897-5907]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-01785]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9145-N]
Medicare and Medicaid Programs; Quarterly Listing of Program
Issuances--October Through December 2023
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This quarterly notice lists CMS manual instructions,
substantive and interpretive regulations, and other Federal Register
notices that were published in the 3-month period, 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.
------------------------------------------------------------------------
Addenda Contact Phone No.
------------------------------------------------------------------------
I. CMS Manual Instructions...... Ismael Torres...... (410) 786-1864
II. Regulation Documents Terri Plumb........ (410) 786-4481
Published in the Federal
Register.
III. CMS Rulings................ Tiffany Lafferty... (410) 786-7548
IV. Medicare National Coverage Wanda Belle, MPA... (410) 786-7491
Determinations.
V. FDA-Approved Category B IDEs. John Manlove....... (410) 786-6877
VI. Collections of Information.. William Parham..... (410) 786-4669
VII. Medicare-Approved Carotid Sarah Fulton, MHS.. (410) 786-2749
Stent Facilities.
VIII. American College of Sarah Fulton, MHS.. (410) 786-2749
Cardiology--National
Cardiovascular Data Registry
Sites.
IX. Medicare's Active Coverage- Lori Ashby, MA..... (410) 786-6322
Related Guidance Documents.
X. One-time Notices Regarding JoAnna Baldwin, MS. (410) 786-7205
National Coverage Provisions.
[[Page 5898]]
XI. National Oncologic Positron David Dolan, MBA... (410) 786-3365
Emission Tomography Registry
Sites.
XII. Medicare-Approved David Dolan, MBA... (410) 786-3365
Ventricular Assist Device
(Destination Therapy)
Facilities.
XIII. Medicare-Approved Lung Sarah Fulton, MHS.. (410) 786-2749
Volume Reduction Surgery
Facilities.
XIV. Medicare-Approved Bariatric Sarah Fulton, MHS.. (410) 786-2749
Surgery Facilities.
XV. Fluorodeoxyglucose Positron David Dolan, MBA... (410) 786-3365
Emission Tomography for
Dementia Trials.
All Other Information........... Annette Brewer..... (410) 786-6580
------------------------------------------------------------------------
SUPPLEMENTARY INFORMATION:
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.
The Director of the Office of Strategic Operations and Regulatory
Affairs of the Centers for Medicare & Medicaid Services (CMS), Kathleen
Cantwell, having reviewed and approved this document, authorizes
Trenesha Fultz-Mimms, who is the Federal Register Liaison, to
electronically sign this document for purposes of publication in the
Federal Register.
Trenesha Fultz-Mimms,
Federal Register Liaison, Department of Health and Human Services.
Publication Dates for the Previous Four Quarterly Notices
We publish this notice at the end of each quarter reflecting
information released by CMS during the previous quarter. The
publication dates of the previous four Quarterly Listing of Program
Issuances notices are: February 1, 2023 (88 FR 6729), May 12, 2023 (88
FR 30752), August 4, 2023 (88 FR 51814) and October 26, 2023 (88 FR
73591). 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.
Addendum I: Medicare and Medicaid Manual Instructions (October Through
December 2023)
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.
How To Obtain Manuals
The internet-only Manuals (IOMs) are a replica of the Agency's
official record copy. Paper-based manuals are CMS manuals that were
officially released in hardcopy. The majority of these manuals were
transferred into the internet-only manual (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/.
[[Page 5899]]
In addition, individuals may contact regional depository libraries
that receive and retain at least one copy of most federal government
publications, either in printed or microfilm 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
Updates to Medicare Benefit Policy Manual and Medicare Claims
Processing Manual for Opioid Treatment Programs (OTPs) (CMS-Pub. 100-
02) Transmittal No. 12418.
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.
Fee-For Service Transmittal Numbers
Please Note: Beginning Friday, March 20, 2020, there will be the
following change regarding the Advance Notice of Instructions due to a
CMS internal process change. Fee-For Service Transmittal Numbers will
no longer be determined by Publication. The Transmittal numbers will be
issued by a single numerical sequence beginning with Transmittal Number
10000.
For the purposes of this quarterly notice, we list only the
specific updates to the list of manual instructions that have occurred
in the 3-month period. This information is available on our website at
www.cms.gov/Manuals.
------------------------------------------------------------------------
Transmittal No. Manual/subject/publication No.
------------------------------------------------------------------------
Medicare General Information (CMS-Pub. 100-01)
------------------------------------------------------------------------
12037................... Update to Medicare Deductible, Coinsurance and
Premium Rates for Calendar Year (CY) 2024.
12341................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12425................... Enforcing Billing Requirements for Intensive
Outpatient Program (IOP) Services with New
Condition Code 92--Additional Publication
Update.
------------------------------------------------------------------------
Medicare Benefit Policy (CMS-Pub. 100-02)
------------------------------------------------------------------------
12283................... Internet Only Manual Updates to Pub. 100-02
and 100-04 to Implement Consolidated
Appropriations Act 2023 Changes for Skilled
Nursing Facility (SNF).
12291................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12299................... An Omnibus CR to Implement Policy Updates in
the CY 2023 PFS Final Rule, Including (1)
Removal of Selected NCDs (NCD 160.22
Ambulatory EEG Monitoring), and, (2)
Expanding Coverage of Colorectal Cancer
Screening--Full Agile Pilot CR.
12385................... Hospice Benefit Policy Manual Updates Related
to the Addition of Marriage and Family
Therapists (MFTs) or Mental Health Counselors
(MHCs) to the Hospice Interdisciplinary Team.
12400................... Hospice Benefit Policy Manual Updates Related
to the Addition of Marriage and Family
Therapists (MFTs) or Mental Health Counselors
(MHCs) to the Hospice Interdisciplinary Team.
12418................... Updates to Medicare Benefit Policy Manual and
Medicare Claims Processing Manual for Opioid
Treatment Programs (OTPs).
12421................... January 2024 Update of the Hospital Outpatient
Prospective Payment System (OPPS).
12425................... Enforcing Billing Requirements for Intensive
Outpatient Program (IOP) Services with New
Condition Code 92--Additional Publication
Update.
------------------------------------------------------------------------
Medicare National Coverage Determination (CMS-Pub. 100-03)
------------------------------------------------------------------------
12299................... An Omnibus CR to Implement Policy Updates in
the CY 2023 PFS Final Rule, Including (1)
Removal of Selected NCDs (NCD 160.22
Ambulatory EEG Monitoring), and, (2)
Expanding Coverage of Colorectal Cancer
Screening--Full Agile Pilot CR.
12352................... Manual Updates for Coverage of Intravenous
Immune Globulin (IVIG) For Treatment of
Primary Immune Deficiency Diseases in the
Home.
------------------------------------------------------------------------
Medicare Claims Processing (CMS-Pub. 100-04)
------------------------------------------------------------------------
12283................... Internet Only Manual Updates to Pub. 100-02
and 100-04 to Implement Consolidated
Appropriations Act 2023 Changes for Skilled
Nursing Facility (SNF) Physician's Services
and Other Professional Services Excluded From
Part A PPS Payment and the Consolidated
Billing Requirement.
12284................... Deleting Internet Only Manuals (IOM) Pub. 100-
04, Chapter 4, Section 190, Payer Only Codes
Utilized by Medicare Payer Only Codes
Utilized by Medicare.
12287................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12288................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12289................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12290................... Diagnosis Code Update for Add-on Payments for
Blood Clotting Factor Administered to
Hemophilia Inpatients Payment for Blood
Clotting Factor Administered to Hemophilia
Inpatients.
12291................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12298................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12299................... An Omnibus CR to Implement Policy Updates in
the CY 2023 PFS Final Rule, Including (1)
Removal of Selected NCDs (NCD 160.22
Ambulatory EEG Monitoring), and, (2)
Expanding Coverage of Colorectal Cancer
Screening--Full Agile Pilot CR.
12301................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12305................... Calendar Year (CY) 2024 Participation
Enrollment and Medicare Participating
Physicians and Suppliers Directory (MEDPARD)
Procedures.
12306................... Processing Claims When the Dates of Service
Are Beyond the Time Limit for the Patient
Assessment Actions When a Claim Does Not
Match the Inpatient Rehabilitation Facility-
Patient Assessment Instrument (IRF-PAI)
Payment Adjustments--Applying OASIS
Assessment Items to Determine HIPPS Codes.
12315................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
[[Page 5900]]
12316................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12321................... Implementation of Rural Emergency Hospital
(REH) Provider Type.
12322................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12325................... Update to the Internet Only Manual (IOM)
Publication (Pub.) 100-04, Chapter 18 Section
50.3-50.4, To Remove 0359U Per The
International Classification of Diseases,
10th Revision (ICD-10) and Other Coding
Revisions to National Coverage Determinations
(NCDs)--October 2023.
12326................... Internet-Only Manual Update, Pub. 100-04,
Chapter 23 (Fee Schedule Administration and
Coding Requirements), Section 50.6.
12337................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12339................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12342................... April 2024 Healthcare Common Procedure Coding
System (HCPCS) Quarterly Update Reminder.
12343................... Quarterly Update to Home Health (HH) Grouper.
12344................... File Conversions Related to the Spanish
Translation of the Healthcare Common
Procedure Coding System (HCPCS) Descriptions.
12347................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12354................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12357................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12359................... Implementation of New Benefit Category for
Lymphedema Compression Treatment Items.
12360................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12361................... Updates to Chapter 1 of the Medicare Claims
Processing Manual (Publication (Pub.) 100-04)
to Include Newly Created and Utilized Payer
Only Codes.
12364................... NCD 220.6.20--Beta Amyloid Positron Emission
Tomography in Dementia and Neurodegenerative
Disease.
12369................... Implementation of Rural Emergency Hospital
(REH) Provider Type.
12375................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12389................... Calendar Year (CY) 2024 Annual Update for
Clinical Laboratory Fee Schedule and
Laboratory Services Subject to Reasonable
Charge Payment.
12391................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12396................... Update to the Internet Only Manual (IOM)
Publication (Pub.) 100-04, Chapter 32
Sections 320.3.3 and 370.1 for Coding
Revisions to the National Coverage
Determinations (NCDs)--April 2024 Change
Request (CR) 13390.
12398................... Calendar Year 2024 Update for Durable Medical
Equipment, Orthotics and Supplies (DMEPOS)
Fee Schedule.
12399................... April 2024 Bi-Annual Update of the
International Classification of Diseases,
Tenth Revision, Clinical Modification (ICD-10-
CM).
12401................... Instructions for Retrieving the 2024 Pricing
and Healthcare Common Procedure Coding System
(HCPCS) Data Files through CMS' Mainframe
Telecommunications Systems.
12402................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12403................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12404................... Instructions for Downloading the Medicare ZIP
Code File for April 2024 Files.
12406................... CY 2024 Home Infusion Therapy (HIT) Payment
Rates and Instructions for Retrieving the
January 2024 Home Infusion Therapy (HIT)
Services Payment Rates Through the CMS
Mainframe Telecommunications System.
12407................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12411................... New Place of Service (POS) Code 27--``Outreach
Site/Street''.
12413................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12414................... Ambulance Inflation Factor (AIF) for Calendar
Year (CY) 2024 and Productivity Adjustment.
12415................... New Waived Tests.
12416................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12418................... Updates to Medicare Benefit Policy Manual and
Medicare Claims Processing Manual for Opioid
Treatment Programs (OTPs).
12419................... January 2024 Integrated Outpatient Code Editor
(I/OCE) Specifications Version 25.0.
12420................... January 2024 Update of the Ambulatory Surgical
Center (ASC) Payment System.
12421................... January 2024 Update of the Hospital Outpatient
Prospective Payment System (OPPS).
12422................... April 2024 Quarterly Average Sales Price (ASP)
Medicare Part B Drug Pricing Files and
Revisions to Prior Quarterly Pricing.
12423................... Enforcing Billing Requirements for Intensive
Outpatient Program (IOP) Services with New
Condition Code 92.
12424................... Implement Edits to Prevent Payment of
Complexity Add-On Code G2211 When Associated
Office/Outpatient Evaluation and Management
Visit (Codes 99202-99205, 99211-99215) is
Reported With Modifier 25.
12426................... Calendar Year (CY) 2024 Annual Update for
Clinical Laboratory Fee Schedule and
Laboratory Services Subject to Reasonable
Charge Payment.
------------------------------------------------------------------------
Medicare Secondary Payer (CMS-Pub. 100-05)
------------------------------------------------------------------------
12304................... Changes to The Electronic Correspondence
Referral System (ECRS) Web, Including
Modified Medicare Secondary Payer (MSP)
Health Insurance Master Record (HIMR) Screen
and Remote Identity Process (RIDP).
Attachment 1--ECRS Web User Guide, Software
Version 7.4 2023/October 2.
Attachment 2--ECRS Web Quick Reference Card
Version 7.4 2023/October 2.
------------------------------------------------------------------------
Medicare Financial Management (CMS-Pub. 100-06)
------------------------------------------------------------------------
12297................... Notice of New Interest Rate for Medicare
Overpayments and Underpayments--1st Qtr
Notification for FY 2024.
12323................... Revisions and Deletions to the Internet Only
Manual (IOM), Publication 100-06, Chapter 4,
Debt Collection Related to Extended Repayment
Schedules (ERS) and Debt Management.
Rates of Interest.
Procedures for Applying Interest During
Overpayment Recoupment.
Recoupment by Withholding Payments.
Establishing an Extended Repayment Schedule.
Extended Repayment Schedule (ERS) Required
Documentation--Physician is a Sole
Proprietor.
Extended Repayment Schedule (ERS) Required
Documentation--Provider is an Entity Other
Than a Sole Proprietor.
[[Page 5901]]
Extended Repayment Schedule (ERS) Approval
Process.
Sending the Extended Repayment Schedule
(ERS) Request to the Regional Office (RO).
Monitoring an Approved Extended Repayment
Schedule (ERS) and Reporting Requirement.
Requests from Terminated Providers or Debts
that are Pending Referral to Department of
Treasury.
12329................... The Fiscal Intermediary Shared System (FISS)
Submission of Copybook Files to the Provider
and Statistical Reimbursement (PS&R) System.
12346................... Revisions and Deletions to the Internet Only
Manual (IOM), Publication 100-06, Chapter 4,
Debt Collection Related to Extended Repayment
Schedules (ERS) and Debt Management.
Rates of Interest.
Procedures for Applying Interest During
Overpayment Recoupment.
Recoupment by Withholding Payments.
Establishing an Extended Repayment Schedule
(ERS).
Extended Repayment Schedule (ERS) Required
Documentation--Physician is a Sole
Proprietor.
Extended Repayment Schedule (ERS) Required
Documentation--Provider is an Entity Other
Than a Sole Proprietor.
4/50.3/Extended Repayment Schedule (ERS)
Approval Process.
4/50.4/Sending the Extended Repayment
Schedule (ERS) Request to the Regional
Office (RO).
Monitoring an Approved Extended Repayment
Schedule (ERS) and Reporting Requirements.
Requests from Terminated Providers or Debts
that are Pending Referral to Department of
Treasury.
------------------------------------------------------------------------
Medicare State Operations Manual (CMS-Pub. 100-07)
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Medicare Program Integrity (CMS-Pub. 100-08)
------------------------------------------------------------------------
12279................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12280................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12281................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12295................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12296................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12300................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12302................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
12333................... Updates of Chapter 4 and Chapter 8 in
Publication (Pub.) 100-08, Including Adding
Guidance Regarding Handling of Freedom
Information Act (FOIA) Requests.
Requests for Information From Outside
Organizations.
Duration of the Payment Suspension.
DME Payment Suspensions (MACs and UPICs).
Non-DME National Payment Suspensions (MACs
and UPICs).
12336................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12356................... Incorporation of Recent Provider Enrollment
Regulatory Changes into Chapter 10 of CMS
Publication (Pub.) 100-08--Physician Fee
Schedule (PFS) Final Rule.
Additional Definitions.
Marriage and Family Therapists (MFTs).
Mental Health Counselors (MHCs).
Medicare Diabetes Prevention Program (MDPP)
Suppliers.
Providers/Suppliers Not Eligible to Enroll.
Denials--General Principles.
Denial Reasons.
Additional Denial Policies.
Changes of Information.
Revocation Effective Dates.
Revocation Reasons.
Reenrollment Bar.
Additional Revocation Policies.
Establishing Effective Dates.
Opting-Out of Medicare.
Appeals Process.
Revalidation Notification Letters.
12358................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12393................... Incorporation of Recent Provider Enrollment
Regulatory Changes into Chapter 10 of CMS
Publication (Pub.) 100-08--Home Health
Prospective Payment System (HH PPS) Final
Rule.
12394................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12395................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
12408................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
------------------------------------------------------------------------
Medicare Contractor Beneficiary and Provider Communications (CMS-Pub.
100-09)
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Medicare Quality Improvement Organization (CMS-Pub. 100-10)
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
[[Page 5902]]
Medicare Program of All-Inclusive Care for the Elderly (CMS-Pub. 100-11)
------------------------------------------------------------------------
12338................... Update to the Internet Only Manual (IOM)
Publication (Pub.) 100-11, IOM Chapter 4
Enrollment and Disenrollment.
------------------------------------------------------------------------
Medicare End Stage Renal Disease Network Organizations (CMS Pub 100-14)
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Medicaid Program Integrity Disease Network Organizations (CMS Pub 100-
15)
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Medicare Managed Care (CMS-Pub. 100-16).
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Medicare Business Partners Systems Security (CMS-Pub. 100-17).
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Medicare Prescription Drug Benefit (CMS-Pub. 100-18)
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Demonstrations (CMS-Pub. 100-19).
------------------------------------------------------------------------
12320................... Issued to a specific audience, not posted to
Internet/Intranet due to a Sensitivity of
Instruction.
12348................... Issued to a specific audience, not posted to
Internet/Intranet due to a Sensitivity of
Instruction.
12365................... Guiding an Improved Dementia Experience
(GUIDE) Model Implementation.
12366................... Issued to a specific audience, not posted to
Internet/Intranet due to a Sensitivity of
Instruction.
12383................... Issued to a specific audience, not posted to
Internet/Intranet due to a Sensitivity of
Instruction.
12390................... Making Care Primary (MCP) Model
Implementation.
12412................... Issued to a specific audience, not posted to
Internet/Intranet due to a Sensitivity of
Instruction.
------------------------------------------------------------------------
One Time Notification (CMS-Pub. 100-20).
------------------------------------------------------------------------
12286................... Patient Driven Payment Model (PDPM)
Corrections to Interrupted Stay Edits.
12292................... Implementation to Expand Monetary Amount
Fields Related to Billing and Payment to
Accommodate 10-Digits in Length
($99,999,999.99)--Phase 2.
12303................... Adjustment to Fraud Prevention System (FPS)
and Unified Program Integrity Contractor
(UPIC) Edits to Increase Billing Increments
From 30 Days to 90 Days for Continuous
Glucose Monitor (CGM) Supplies.
12308................... User Enhancement Change Request (UECR): ViPS
Medicare System (VMS)--Hold Data on the
Program Integrity Management Reporting (PIMR)
Audit Record History Screen (BUDS19).
12309................... Fiscal Intermediary Shared System (FISS) User
Enhancement Change Request (UECR)--Expiration
of a Unique Tracking Number (UTN) on the
Prior Authorization (PA) Tracking File.
12310................... Fiscal Intermediary Shared System (FISS) User
Enhancement Change Request (UECR)--New Reason
Code to Prevent Adjustments and Cancels From
Being Submitted for the Same Claim, on the
Same Day.
12313................... User Enhancement Change Request (UECR)--Update
the Multi-Carrier System (MCS) to Add a
Location Field to the Data Correction Window
in the MCS Desktop Tool (MCSDT).
12314................... User Enhancement Request (UECR)--Update the
Multi-Carrier System (MCS) to Create a
Summary Report for Healthcare Integrated
General Ledger Accounting System (HIGLAS)
Interface File Errors.
12317................... User Enhancement Change Request (UECR): New
Multi-Carrier System (MCS) Inquiry Search
Screen Using a Procedure Code to Display an
Associated Edit or Audit.
12318................... International Classification of Diseases, 10th
Revision (ICD-10) and Other Coding Revisions
to National Coverage Determinations (NCDs)--
April 2024 Update--CR 1 of 2.
12319................... International Classification of Diseases, 10th
Revision (ICD-10) and Other Coding Revisions
to National Coverage Determinations (NCDs)--
April 2024 Update--CR 2 of 2.
12324................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12327................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12328................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
12330................... Implement Edits on Hospice Claims.
12331................... Report of Hospice Election for Part D
(Response File).
12334................... Remittance Advice (RA) Changes due to Durable
Medical Equipment Medicare Administrative
Contractors (DME MACs) Transition to
Healthcare Integrated General Ledger
Accounting System (HIGLAS).
12335................... Allowing Audiologists to Furnish Certain
Diagnostic Tests Without a Physician Order.
12340................... Implementation to Expand Monetary Amount
Fields Related to Billing and Payment to
Accommodate 10-Digits in Length
($99,999,999.99)--Phase 3.
12345................... Implementation of a National Fee Schedule for
Medicare Part B Vaccine Administration CMS.
12349................... Pricing and Coding Services (PCS) Application
Programming Interface (API) Report
Dissemination Proof of Concept.
12350................... International Classification of Diseases, 10th
Revision (ICD-10) and Other Coding Revisions
to National Coverage Determinations (NCDs)--
April 2024 Update--CR 2 of 2.
12351................... Requirements for a Provider Direct Mailing and
Education & Outreach for Behavioral Health
Initiatives.
12353................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
[[Page 5903]]
12355................... International Classification of Diseases, 10th
Revision (ICD-10) and Other Coding Revisions
to National Coverage Determinations (NCDs)--
January 2024 Update.
12362................... User Enhancement Change Request (UECR): ViPS
Medicare System (VMS)--Fix Beneficiary Update
and Display System (BUDS) Queries for Remark
Code and Biller Number.
12363................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12367................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12368................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
12392................... Enforcing Billing Requirements for Intensive
Outpatient Program (IOP) Services with
Revenue Code 0905 for Federally Qualified
Health Centers (FQHC) and Rural Health
Clinics (RHC).
12397................... Payment of Codes for Chemotherapy
Administration and Nonchemotherapy Injections
and Infusions.
12405................... Direct Mailing Notification to Hospice
Providers Regarding the Value-Based Insurance
Design (VBID) Model, Hospice Benefit
Component, Participating Medicare Advantage
Organizations.
12410................... Updating Calendar Year (CY) 2024 Medicare
Diabetes Prevention Program (MDPP) Payment
Rates.
12428................... Provider Education for the Review Choice
Demonstration (RCD) for Inpatient
Rehabilitation Facility Services (IRFs).
------------------------------------------------------------------------
Medicare Quality Reporting Incentive Programs (CMS-Pub. 100-22)
------------------------------------------------------------------------
12293................... Payments to Home Health Agencies That Do Not
Submit Required Quality Data This CR Rescinds
and Fully Replaces CR 10874.
12294................... Issued to a specific audience, not posted to
Internet/Intranet due to a Confidentiality of
Instruction.
------------------------------------------------------------------------
State Payment of Medicare Premiums (CMS-Pub. 100-24).
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
Information Security Acceptable Risk Safeguards (CMS-Pub. 100-25).
------------------------------------------------------------------------
None.
------------------------------------------------------------------------
For questions or additional information, contact Ismael Torres
(410-786-1864).
Addendum II: Regulation Documents Published in the Federal Register
(October Through December 2023)
Regulations and Notices
Regulations and notices are published in the daily Federal
Register. To purchase individual copies or subscribe to the Federal
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.
For questions or additional information, contact Terri Plumb (410-
786-4481).
Addendum III: CMS Rulings (October Through December 2023)
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 https://www.cms.gov/Regulations-and-Guidance/Guidance/Rulings.
For questions or additional information, contact Tiffany Lafferty
(410-786-7548).
Addendum IV: Medicare National Coverage Determinations (October Through
December 2023)
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 announce 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, there were no specific updates to
national coverage determinations (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, MPA
(410-786-7491).
Addendum V: FDA-Approved Category B Investigational Device Exemptions
(IDEs) (October Through December 2023)
(Inclusion of this addenda is under discussion internally.)
Addendum VI: Approval Numbers for Collections of Information (October
Through December 2023)
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
[[Page 5904]]
information is available at www.reginfo.gov/public/do/PRAMain.
For questions or additional information, contact William Parham
(410-786-4669).
Addendum VII: Medicare-Approved Carotid Stent Facilities (October
Through December 2023)
Addendum VII includes listings of Medicare-approved carotid stent
facilities. All facilities listed meet CMS standards for performing
carotid artery stenting for high risk patients. On March 17, 2005, we
issued our decision memorandum on carotid artery stenting. We
determined that carotid artery stenting with embolic protection is
reasonable and necessary only if performed in facilities that have been
determined to be competent in 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.cms.gov/MedicareApprovedFacilitie/CASF/list.asp#TopOfPage.
For questions or additional information, contact Sarah Fulton, MHS
(410-786-2749).
------------------------------------------------------------------------
Provider Date
Facility No. approved State
------------------------------------------------------------------------
The following facilities are new listings for this quarter..............
HCA Florida Englewood Hospital, 1639122864 09/09/2023 FL
700 Medical Boulevard, Englewood,
FL 34223.
Kaiser Permanente San Francisco, 050076 09/09/2023 CA
Medical Center, 2425 Geary Blvd
Provider, San Francisco, CA 94115.
Sanford Bemidji Medical Center, 240100 09/09/2023 MN
1300 Anne Street NW, Bemidji, MN
56601.
The following facilities have editorial changes (in bold)...............
From: Galichia Heart Hospital, To: 170123 05/16/2005 KS
Wesley Woodlawn Hospital, 2610 N.
Woodlawn Boulevard, Wichita, KS
67220-2729.
From: Presence Resurrection 140117 04/12/2005 IL
Medical Center, To: Ascension
Resurrection, 7435 West Talcott
Avenue, Chicago, IL 60631.
From: Fort Walton Beach Medical 100223 04/14/2005 FL
Center, To: HCA Fort Walton--
Destin Hospital, 1000 Mar Walt
Drive, Fort Walton Beach, FL
32547.
From: Trumbull Memorial Hospital, 1053844671 03/14/2013 OH
To: Trumbull Regional Medical
Center, 1350 E Market Street,
Warren, OH 44483.
------------------------------------------------------------------------
Addendum VIII: American College of Cardiology's National Cardiovascular
Data Registry Sites (October Through December 2023)
The initial data collection requirement through the American
College of Cardiology's National Cardiovascular Data Registry (ACC-
NCDR) has served to develop and improve the evidence base for the use
of 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 2023)
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.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=27.
CMS published three proposed guidance documents on June 22, 2023 to
provide a framework for more predictable and transparent evidence
development and encourage innovation and accelerate beneficiary access
to new items and services. The documents are available at:
https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?mcdid=35&docTypeId=1&sortBy=title&bc=16.
https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?mcdid=34&docTypeId=1&sortBy=title&bc=16.
https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?mcdid=33&docTypeId=1&sortBy=title&bc=16.
For questions or additional information, contact Lori Ashby, MA
(410 786 6322).
Addendum X: List of Special One-Time Notices Regarding National
Coverage Provisions (October Through December 2023)
There were no special one-time notices regarding national coverage
provisions published in the 3-month period. This information is
available at https://www.cms.gov.
For questions or additional information, contact JoAnna Baldwin, MS
(410-786 7205).
Addendum XI: National Oncologic PET Registry (NOPR)
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
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://www.cms.gov/MedicareApprovedFacilitie/NOPR/list.asp#TopOfPage.
[[Page 5905]]
For questions or additional information, contact David Dolan, MBA
(410-786-3365).
Addendum XII: Medicare-Approved Ventricular Assist Device (Destination
Therapy) Facilities (October Through December 2023)
Addendum XII includes a listing of Medicare-approved facilities
that receive coverage for ventricular assist devices (VADs) used as
destination therapy. All facilities were required to meet our standards
in order to receive coverage for VADs implanted as destination therapy.
On October 1, 2003, we issued our decision memorandum on VADs for the
clinical indication of destination therapy. We determined that VADs
used as destination therapy are reasonable and necessary only if
performed in facilities that have been determined to have the
experience and infrastructure to ensure optimal patient outcomes. We
established facility standards and an application process. All
facilities were required to meet our standards in order to receive
coverage for VADs implanted as destination therapy.
For the purposes of this quarterly notice, we are providing only
the specific updates 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.cms.gov/MedicareApprovedFacilitie/VAD/list.asp#TopOfPage.
For questions or additional information, contact David Dolan, MBA,
(410-786-3365).
----------------------------------------------------------------------------------------------------------------
Provider Date of initial Date of re-
Facility No. certification certification State
----------------------------------------------------------------------------------------------------------------
The following facility is a new listing.
----------------------------------------------------------------------------------------------------------------
St. Bernard's Medical Center, 225 East 040020 08/31/2023 AR
Washington, Jonesboro, AR 72401.
Other information: DNV-GL ID #: C624530
Previous Re-certification Dates: n/a
----------------------------------------------------------------------------------------------------------------
The following facilities have editorial changes (in bold).
----------------------------------------------------------------------------------------------------------------
Sentara Norfolk General Hospital, 600 49-0007 11/13/2008 09/05/2023 VA
Gresham Drive, Norfolk, VA 23507.
Other information: DNV-GL ID #: C592382
Previous Re-certification Dates: 11/13/
2008; 12/21/2010; 02/05/2013; 01/13/2015;
03/14/2017; 4/20/2019; 10/07/2021
Presbyterian Medical Center of the UPHS, 390223 10/05/2010 06/28/2023 PA
51 North 39th Street, Philadelphia, PA
19104.
Other information: Joint Commission ID
#6145
Previous Re-certification Dates: 10/05/
2010; 11/07/2012; 12/09/2014; 03/21/2017;
4/17/2019; 07/29/2021
University of Alabama at Birmingham, 619 010033 10/29/2003 07/27/2023 AL
19th S. South, Birmingham, AL 35249-1900.
Other information: Joint Commission ID #
2814
Previous Re-certification Dates: 12/09/
2008; 04/22/2011; 04/09/2013; 04/07/2015;
05/16/2017; 7/3/2019; 08/21/2021
Virginia Commonwealth University Health 490032 04/08/2004 07/19/2023 VA
System Authority, 1250 East Marshall
Street, Richmond, VA 23298-051.
Other information: Joint Commission ID #
6381
Previous Re-certification Dates: 11/04/
2008; 12/14/2010; 12/21/2012;12/16/2014;
02/14/2017; 04/10/2019; 08/07/2021
Fresno Community Hospital and Medical 050060 01/04/2014 08/09/2023 CA
Center, 2823 Fresno St., Fresno, CA 93721.
Other information: Joint Commission ID #
9832
Previous Re-certification Dates: 1/04/
2014; 12/13/2016; 2/13/2019; 08/11/2021
University Hospital (Stony Brook), Health 330393 03/02/2011 08/09/2023 NY
Sciences Center Suny Stony Brook, Stony
Brook, NY 11794-8503.
Other information: Joint Commission ID #
5188
Previous Re-certification Dates: 01/30/
2013; 01/15/2015; 03/14/2017; 05/08/2019;
09/17/2021
Maimonides Medical Center, 4802 Tenth 330194 08/23/2012 10/18/2023 NY
Avenue, Brooklyn, NY 11219-2916.
Other information: Joint Commission ID
#5734
Previous Re-certification Dates: 08/23/
2012; 07/29/2014; 09/13/2016; 10/11/2018;
10/27/2021
The General Hospital Corporation, 55 Fruit 220071 12/15/2003 09/07/2023 MA
Street, Boston, MA 02114.
Other information: Joint Commission ID#
5513
Previous Re-certification Dates: 12/08/
2008; 01/19/2011; 02/13/2013; 01/06/2015;
02/28/2017; 05/22/2019; 10/14/2021
Montefiore Health System, 111 East 210th 330059 11/14/2003 10/04/2023 NY
StreetM Bronx, NY 10467.
Other information: Joint Commission ID
#2514
Previous Re-certification Dates: 09/23/
2008; 10/08/2010; 10/23/2012; 09/23/2014;
10/08/2016; 11/07/2018; 10/29/2021
Bryan Medical Center, 1600 South 48th 280003 03/05/2013 08/23/2023 NE
Street, Lincoln, NE 68506.
Other information: Joint Commission ID #
244330
Previous Re-certification Dates: 03/05/
2013; 02/12/2015; 04/18/2017; 07/17/2019;
09/22/2021
Nebraska Medical Center, 987400 Nebraska 280013 02/02/2011 08/16/2023 NE
Medical Center, Omaha, NE 68198-7400.
Other information: Joint Commission ID #
186313
[[Page 5906]]
Previous Re-certification Dates: 01/20/
2011; 01/29/2013; 02/24/2015; 02/14/2017;
04/17/2019; 09/09/2021
Dignity Health, 350 West Thomas Road, 030024 05/08/2019 08/26/2023 AZ
Phoenix, AZ 85013.
Other information: Joint Commission ID #
9494
Previous Re-certification Dates: 05/08/
2019; 08/19/2021
From: Norton Hospitals Inc................ 180088 09/17/2020 10/13/2023 KY
To: Norton Audubon Hospital, 1 Audubon
Plaza Drive, Louisville, KY 40217
Other information: DNV ID #: C553570
Previous Re-certification Dates: 09/17/
2020
From: University of Virginia Medical 490009 02/12/2010 09/15/2023 VA
Center.
To: Rector & Visitors of the University of
Virginia, 1215 Lee Street,
Charlottesville, VA 22903
Other information: Joint Commission ID #:
6329
Previous Re-certification Dates: 03/21/
2012; 05/06/2014; 06/07/2016; 06/06/2018;
10/13/2021
Temple University Hospital, Inc., 3401 390027 02/08/2012 09/13/2023 PA
North Broad Street, Philadelphia, PA
19140.
Other information: Joint Commission ID #:
6152
Previous Re-certification Dates: 02/08/
2012; 02/11/2014; 04/07/2016; 04/04/2018;
10/13/2021
Prisma Health Richland, 5 Richland Medical 420018 03/07/2013 09/13/2023 SC
Park Drive, Columbia, SC 29203.
Other information: Joint Commission ID #:
6588
Previous Re-certification Dates: 03/06/
2013; 04/21/2015; 06/06/2017; 6/28/2019;
10/08/2021
Hillcrest Medical Center, 1120 S. Utica, 370001 12/04/2017 11/17/2023 OK
Tulsa, OK 74104.
Other information: DNV #: C584663
Previous Re-certification Dates: 12/04/
2017; 11/25/2020
Beth Israel Deaconess Medical Center, 330 220086 04/25/2017 09/29/2023 MA
Brookline Avenue, Boston, MA 02215.
Other information: Joint Commission ID #:
5501
Previous Re-certification Dates: 4/25/
2017; 05/22/2019; 11/04/2021
Yale New Haven Hospital, 20 York Street, 070022 01/25/2011 12/13/2023 CT
New Haven, CT 06510-3203.
Other information: Joint Commission ID #:
5677
Previous Re-certification Dates: 01/25/
2011; 01/15/2013; 12/16/2014; 02/28/2017;
5/22/2019; 11/24/2021
UMass Memorial Health Care, Inc, One 220163 02/06/2019 10/27/2023 MA
Biotech Park 365 Plantation Street,
Worcester, MA 01605.
Other information: Joint Commission ID #:
5640
Previous Re-certification Dates: 02/06/
2019; 11/06/2021
North Carolina Baptist Hospital, dba 340047 06/28/2011 10/25/2023 NC
Atrium Health Wake Forest Baptist,
Medical Center Boulevard, Winston Salem,
NC 27157.
Other information: Joint Commission ID #:
6571
Previous Re-certification Dates: 06/28/
2011; 08/13/2013; 08/04/2015; 08/18/2017;
10/9/2019; 10/16/2021
Memorial Hermann--Texas Medical Center, 450068 03/19/2013 12/22/2023 TX
6411 Fannin Street, Houston, TX 77030-
1501.
Other information: Joint Commission ID #:
9081
Previous Re-certification Dates: 03/19/
2013; 04/14/2015; 05/24/2017; 06/26/2019;
12/23/2021
Cleveland Clinic Florida, 3100 Weston 100289 05/19/2015 11/02/2023 FL
Road, Weston, FL 33331.
Other information: Joint Commission ID #:
334451
Previous Re-certification Dates: 05/19/
2015; 06/20/2017; 7/24/2019; 11/04/2021
----------------------------------------------------------------------------------------------------------------
Addendum XIII: Lung Volume Reduction Surgery (LVRS) (October Through
December 2023)
Addendum XIII includes a listing of Medicare-approved facilities
that are eligible to receive coverage for lung volume reduction
surgery. Until May 17, 2007, facilities that participated in the
National Emphysema Treatment Trial were also eligible to receive
coverage. The following three types of facilities are eligible for
reimbursement for Lung Volume Reduction Surgery (LVRS):
National Emphysema Treatment Trial (NETT) approved
(Beginning 05/07/2007, these will no longer automatically qualify and
can qualify only with the other programs);
Credentialed by the Joint Commission (formerly, the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO)) under
their Disease Specific Certification Program for LVRS; and
Medicare approved for lung transplants.
Only the first two types are in the list. For the purposes of this
quarterly notice, there are no additions and deletions to a listing of
Medicare-approved facilities that are eligible to receive coverage for
lung volume reduction surgery. This information is available at
www.cms.gov/MedicareApprovedFacilitie/LVRS/list.asp#TopOfPage.
For questions or additional information, contact Sarah Fulton, MHS
(410-786-2749).
Addendum XIV: Medicare-Approved Bariatric Surgery Facilities (October
Through December 2023)
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
[[Page 5907]]
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 Level 1 Bariatric Surgery
Center (program standards and requirements in effect on February 15,
2006); or (2) certified by the American Society for Bariatric Surgery
(ASBS) as a Bariatric Surgery Center of Excellence (BSCOE) (program
standards and requirements in effect on February 15, 2006).
There were no additions, deletions, or editorial changes to
Medicare-approved facilities that meet CMS' minimum facility standards
for bariatric surgery that have been certified by ACS and/or ASMBS in
the 3-month period. This information is available at www.cms.gov/MedicareApprovedFacilitie/BSF/list.asp#TopOfPage.
For questions or additional information, contact Sarah Fulton, MHS
(410-786-2749).
Addendum XV: FDG-PET for Dementia and Neurodegenerative Diseases
Clinical Trials (October Through December 2023)
There were no FDG-PET for Dementia and Neurodegenerative Diseases
Clinical Trials published in the 3-month period.
This information is available on our website at www.cms.gov/MedicareApprovedFacilitie/PETDT/list.asp#TopOfPage.
For questions or additional information, contact David Dolan, MBA
(410-786-3365).
[FR Doc. 2024-01785 Filed 1-29-24; 8:45 am]
BILLING CODE 4120-01-P
