Reimbursement Rates for Calendar Year 2025, 101607-101608 [2024-29505]

Download as PDF Federal Register / Vol. 89, No. 241 / Monday, December 16, 2024 / Notices document(s) that are accepting comments. 2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development. Attention: Document Identifier/OMB Control Number: ll, Room C4–26–05, 7500 Security Boulevard, Baltimore, Maryland 21244–1850. To obtain copies of a supporting statement and any related forms for the proposed collection(s) summarized in this notice, please access the CMS PRA website by copying and pasting the following web address into your web browser: https://www.cms.gov/ Regulations-and-Guidance/Legislation/ PaperworkReductionActof1995/PRAListing. FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786–4669. SUPPLEMENTARY INFORMATION: lotter on DSK11XQN23PROD with NOTICES1 Contents This notice sets out a summary of the use and burden associated with the following information collections. More detailed information can be found in each collection’s supporting statement and associated materials (see ADDRESSES). CMS–10538 Hospice Information for Medicare Part D Plans Under the PRA (44 U.S.C. 3501– 3520), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term ‘‘collection of information’’ is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA requires Federal agencies to publish a 60-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice. Information Collections 1. Type of Information Collection Request: Reinstatement without change of a previously approved collection; Title of Information Collection: Hospice Information for Medicare Part D Plans; Use: The Social Security Act in section 1861(dd) and Federal regulations in 42 CFR 418.106 and 418.202(f) require hospice programs to provide individuals VerDate Sep<11>2014 17:41 Dec 13, 2024 Jkt 265001 under hospice care with drugs and biologicals related to the palliation and management of the terminal illness as defined in the hospice plan of care. Medicare payment is made to the hospice for each day an eligible beneficiary is under the hospice’s care, regardless of the amount of services provided on any given day. Because hospice care is a Medicare Part A benefit, drugs provided by the hospice and covered under the Medicare payment to the hospice program are not covered under Part D. The form would be completed by the prescriber or the beneficiary’s hospice, or if the prescriber or hospice provides the information verbally to the Part D sponsor, the form would be completed by the sponsor. Information provided on the form would be used by the Part D sponsor to establish coverage of the drug under Medicare Part D. Per statute, drugs that are necessary for the palliation and management of the terminal illness and related conditions are not eligible for payment under Part D. The standard form provides a vehicle for the hospice provider, prescriber or sponsor to document that the drug prescribed is ‘‘unrelated’’ to the terminal illness and related conditions. It also gives a hospice organization the option to communicate a beneficiary’s change in hospice status and/care plan to Part D sponsors. Form Number: CMS– 10538 (OMB control number: 0938– 1296); Frequency: Yearly; Affected Public: Private Sector (business or other for-profits); Number of Respondents: 319; Number of Responses: 57,027; Total Annual Hours: 2,329. (For policy questions regarding this collection, contact Chad Buskirk at (410) 786–1630 or chad.buskirk@cms.hhs.gov.) William N. Parham, III, Director, Division of Information Collections and Regulatory Impacts, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2024–29458 Filed 12–13–24; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES RIN 0917–AA25 Reimbursement Rates for Calendar Year 2025 Indian Health Service, HHS. ACTION: Notice. AGENCY: Notice is provided that the Director of the Indian Health Service (IHS) has approved the rates for inpatient and outpatient medical care PO 00000 Frm 00059 Fmt 4703 Sfmt 4703 provided by the IHS facilities for Calendar Year 2025. SUPPLEMENTARY INFORMATION: Background The Director of the Indian Health Service, under the authority of sections 321(a) and 322(b) of the Public Health Service Act (42 U.S.C. 248 and 249(b)), Public Law 83–568 (42 U.S.C. 2001(a)), and the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.), has approved the following rates for inpatient and outpatient medical care provided by IHS facilities for Calendar Year 2025 for Medicare and Medicaid beneficiaries, beneficiaries of other Federal programs, and for recoveries under the Federal Medical Care Recovery Act (42 U.S.C. 2651– 2653). The inpatient rates for Medicare Part A are excluded from the table below. That is because Medicare inpatient payments for IHS hospital facilities are made based on the prospective payment system, or (when IHS facilities are designated as Medicare Critical Access Hospitals) on a reasonable cost basis. Since the inpatient per diem rates set forth below do not include all physician services and practitioner services, additional payment shall be available to the extent that those services are provided. Please note that the Centers for Medicare and Medicaid Services (CMS) has issued a Final Rule to pay an addon to the Medicare Outpatient Per Visit Rate listed below for certain high-cost drugs for people with Medicare who receive care at IHS or Tribal hospitals. See 89 FR 93912, (November 27, 2024), also available at https:// www.federalregister.gov/documents/ 2024/11/27/2024-25521/medicare-andmedicaid-programs-hospital-outpatientprospective-payment-and-ambulatorysurgical. Further information regarding this proposal will be issued directly from CMS. Inpatient Hospital Per Diem Rate (Excludes Physician/Practitioner Services) Calendar Year 2025 Lower 48 States: $5,580. Alaska: $5,074. Indian Health Service SUMMARY: 101607 Outpatient Per Visit Rate (Excluding Medicare) Calendar Year 2025 Lower 48 States: $801. Alaska: $1,209. Outpatient Per Visit Rate (Medicare) Calendar Year 2025 Lower 48 States: $718. E:\FR\FM\16DEN1.SGM 16DEN1 101608 Federal Register / Vol. 89, No. 241 / Monday, December 16, 2024 / Notices Alaska: $1,193. Medicare Part B Inpatient Ancillary Per Diem Rate Calendar Year 2025 Lower 48 States: $1,074. Alaska: $1,567. Outpatient Surgery Rate (Medicare) Established Medicare rates for freestanding Ambulatory Surgery Centers. Effective Date for Calendar Year 2025 Rates Consistent with previous annual rate revisions, the Calendar Year 2025 rates will be effective for services provided on or after January 1, 2025, to the extent consistent with payment authorities, including the applicable Medicaid State plan. Roselyn Tso, Director, Indian Health Service. [FR Doc. 2024–29505 Filed 12–13–24; 8:45 am] BILLING CODE 4166–14–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Notice of Proposed Purchased/ Referred Care Delivery Area Redesignation for the ShoshoneBannock Tribes Indian Health Service, HHS. Notice. AGENCY: ACTION: This Notice advises the public that the Indian Health Service (IHS) proposes to expand the geographic boundaries of the Purchased/Referred Care Delivery Area (PRCDA) for the Shoshone-Bannock Tribes of the Fort Hall Indian Reservation in Idaho to include the Idaho counties of Ada, Bear Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, Elmore, Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, Minidoka, Oneida, Payette, Teton, Twin Falls, and Washington. The current PRCDA for the Shoshone-Bannock Tribes includes the Idaho counties of Bannock, Bingham, Caribou, Lemhi, and Power. ShoshoneBannock Tribal members who reside outside of the PRCDA are eligible for direct care services; however, they are not eligible for Purchased/Referred Care (PRC) services. The sole purpose of this expansion would be to authorize additional Shoshone-Bannock Tribal members and beneficiaries to receive PRC services. DATES: Comments must be submitted by January 15, 2025. lotter on DSK11XQN23PROD with NOTICES1 SUMMARY: VerDate Sep<11>2014 17:41 Dec 13, 2024 Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in one of four ways (please choose only one of the ways listed): 1. Electronically. You may submit electronic comments on this regulation 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: Carl Mitchell, Director, Division of Regulatory and Policy Coordination, Indian Health Service, 5600 Fishers Lane, Mail Stop: 09E70, Rockville, Maryland 20857. 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 above address. 4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments before the close of the comment period to the address above. If you intend to deliver your comments to the Rockville address, please call telephone number (301) 443– 1116 in advance to schedule your arrival with a staff member. FOR FURTHER INFORMATION CONTACT: CAPT John Rael, Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mail Stop: 10E85C, Rockville, Maryland 20857. Telephone (301) 443– 0969 (This is not a toll-free number). SUPPLEMENTARY INFORMATION: Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment. Background: The IHS provides services under regulations in effect as of September 15, 1987, and republished at 42 CFR part 136, subparts A–C. Subpart C defines a Contract Health Service Delivery Area (CHSDA), now referred to as a PRCDA, as the geographic area within which PRC will be made available by the IHS to members of an identified Indian community who reside in the PRCDA. Residence within a PRCDA by a person who is within the scope of the Indian health program, as set forth in 42 CFR 136.12, creates no legal entitlement to PRC services but only potential eligibility for services. Services needed, but not available at an IHS/Tribal facility, are provided under the PRC program depending on the availability of funds, the relative ADDRESSES: Jkt 265001 PO 00000 Frm 00060 Fmt 4703 Sfmt 4703 medical priority of the services to be provided, and the actual availability and accessibility of alternate resources in accordance with the regulations. The regulations at 42 CFR part 136, subpart C provide that, unless otherwise designated, a PRCDA shall consist of a county which includes all or part of a reservation and any county or counties which have a common boundary with the reservation. 42 CFR 136.22(a)(6). The regulations also provide that after consultation with the Tribal governing body or bodies on those reservations included within the PRCDA, the Secretary may, from time to time, redesignate areas within the United States for inclusion in or exclusion from a PRCDA. 42 CFR 136.22(b). The regulations require that certain criteria be considered before any redesignation is made. The criteria are as follows: (1) The number of Indians residing in the area proposed to be so included or excluded; (2) Whether the Tribal governing body has determined that Indians residing in the area near the reservation are socially and economically affiliated with the Tribe; (3) The geographic proximity to the reservation of the area whose inclusion or exclusion is being considered; and (4) The level of funding which would be available for the provision of PRC. Additionally, the regulations require that any redesignation of a PRCDA be made in accordance with the procedures of the Administrative Procedure Act (5 U.S.C. 553). 42 CFR 136.22(c). In compliance with this requirement, the IHS is publishing this Notice and requesting public comments. The Shoshone-Bannock Tribes of the Fort Hall Indian Reservation is located in Fort Hall, Idaho, and operates their PRC program under an Indian SelfDetermination and Education Assistance Act (ISDEAA) agreement with the IHS. The IHS and the Shoshone-Bannock Tribes estimate that approximately 323 Tribal members reside in Ada, Bear Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, Elmore, Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, Minidoka, Oneida, Payette, Teton, Twin Falls, and Washington Counties of Idaho and would become PRC eligible through the proposed redesignation and expansion of the Tribes’ PRCDA. The Shoshone-Bannock Tribes states that the Tribal members who reside in the proposed expansion counties are socially and economically affiliated with the Tribe, and that the Tribe would like to recognize these persons as eligible for PRC services. Accordingly, the IHS proposes to expand the PRCDA E:\FR\FM\16DEN1.SGM 16DEN1

Agencies

[Federal Register Volume 89, Number 241 (Monday, December 16, 2024)]
[Notices]
[Pages 101607-101608]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-29505]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

RIN 0917-AA25


Reimbursement Rates for Calendar Year 2025

AGENCY: Indian Health Service, HHS.

ACTION: Notice.

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SUMMARY: Notice is provided that the Director of the Indian Health 
Service (IHS) has approved the rates for inpatient and outpatient 
medical care provided by the IHS facilities for Calendar Year 2025.

SUPPLEMENTARY INFORMATION:

Background

    The Director of the Indian Health Service, under the authority of 
sections 321(a) and 322(b) of the Public Health Service Act (42 U.S.C. 
248 and 249(b)), Public Law 83-568 (42 U.S.C. 2001(a)), and the Indian 
Health Care Improvement Act (25 U.S.C. 1601 et seq.), has approved the 
following rates for inpatient and outpatient medical care provided by 
IHS facilities for Calendar Year 2025 for Medicare and Medicaid 
beneficiaries, beneficiaries of other Federal programs, and for 
recoveries under the Federal Medical Care Recovery Act (42 U.S.C. 2651-
2653). The inpatient rates for Medicare Part A are excluded from the 
table below. That is because Medicare inpatient payments for IHS 
hospital facilities are made based on the prospective payment system, 
or (when IHS facilities are designated as Medicare Critical Access 
Hospitals) on a reasonable cost basis. Since the inpatient per diem 
rates set forth below do not include all physician services and 
practitioner services, additional payment shall be available to the 
extent that those services are provided.
    Please note that the Centers for Medicare and Medicaid Services 
(CMS) has issued a Final Rule to pay an add-on to the Medicare 
Outpatient Per Visit Rate listed below for certain high-cost drugs for 
people with Medicare who receive care at IHS or Tribal hospitals. See 
89 FR 93912, (November 27, 2024), also available at https://www.federalregister.gov/documents/2024/11/27/2024-25521/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical. Further information regarding this proposal will 
be issued directly from CMS.

Inpatient Hospital Per Diem Rate (Excludes Physician/Practitioner 
Services)

Calendar Year 2025
    Lower 48 States: $5,580.
    Alaska: $5,074.

Outpatient Per Visit Rate (Excluding Medicare)

Calendar Year 2025
    Lower 48 States: $801.
    Alaska: $1,209.

Outpatient Per Visit Rate (Medicare)

Calendar Year 2025
    Lower 48 States: $718.

[[Page 101608]]

    Alaska: $1,193.

Medicare Part B Inpatient Ancillary Per Diem Rate

Calendar Year 2025
    Lower 48 States: $1,074.
    Alaska: $1,567.

Outpatient Surgery Rate (Medicare)

    Established Medicare rates for freestanding Ambulatory Surgery 
Centers.
Effective Date for Calendar Year 2025 Rates
    Consistent with previous annual rate revisions, the Calendar Year 
2025 rates will be effective for services provided on or after January 
1, 2025, to the extent consistent with payment authorities, including 
the applicable Medicaid State plan.

Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2024-29505 Filed 12-13-24; 8:45 am]
BILLING CODE 4166-14-P
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