Department of Health and Human Services August 18, 2006 – Federal Register Recent Federal Regulation Documents

The purpose of the Community Economic Development (CED) grants is to create new employment and business development opportunities for low-income individuals. The Office of Community Services (OCS) awarded a $663,263 CED grant (Grant No. 90EE0720) to Hall Neighborhood House in Bridgeport, Connecticut, on September 29, 2005. Prior to the expenditure of any of the grant funds, the grantee informed OCS in a letter dated April 17, 2006, that it wished to ``relinquish the management and operation of this program effective immediately.'' The letter stated the grantee's ``current financial instability'' as the reason for the action. In an attempt not to lose the benefits for the community that were intended through the CED grant, OCS identified a possible replacement recipient: Action for Bridgeport Community Development, Inc (ABCD). The organization is being considered as a replacement recipient for the following reasons: ABCD is a previously successful CED grantee (grant 90EE0546). ABCD is headquartered approximately a mile and a half from the offices of Hall Neighborhood House (HNH) in Bridgeport, CT and will serve the same community. Also, ABCD and HNH have worked together in the past and reportedly have maintained a good working relationship. ABCD has a significantly sophisticated budget to manage this project effectively. (In 2003, the organization had gross receipts of approximately $20 million.). ABCD was recently selected by the Head Start Bureau to be the successor grantee of HNH's active Head Start grant. ACF Region I Administrator Hugh Galligan speaks highly of the performance of ABCD and has recommended that it be the replacement recipient. OCS has received and reviewed an application from ABCD. Upon finding that the proposed project is significantly similar to the one chosen for funding through HNH, OCS has requested that ABCD be approved as the permanent replacement recipient for Grant No. 90EE0720.

The Food and Drug Administration (FDA) is announcing that a collection of information entitled ``Prescription Drug Marketing Act of 1987'' has been approved by the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995.

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs to implement changes arising from our continuing experience with these systems, and to implement a number of changes made by the Deficit Reduction Act of 2005 (Pub. L. 109-171). In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the IPPS that are paid in full or in part on a reasonable cost basis subject to these limits. These changes are applicable to discharges occurring on or after October 1, 2006. In this final rule, we discuss public comments we received on our proposals to refine the diagnosis-related group (DRG) system under the IPPS to better recognize severity of illness among patientsto use a hospital-specific relative value (HSRV) cost center weighting methodology to adjust DRG relative weights; and to implement consolidated severity-adjusted DRGs or alternative severity adjustment methods. Among the other policy changes that we are making are those changes related to: limited revisions of the reclassification of cases to DRGs; the long-term care (LTC)-DRGs and relative weights; the wage data, including the occupational mix data, used to compute the wage index; applications for new technologies and medical services add-on payments; payments to hospitals for the direct and indirect costs of graduate medical education; submission of hospital quality data; payments to sole community hospitals and Medicare-dependent, small rural hospitals; and provisions governing emergency services under the Emergency Medical Treatment and Labor Act of 1986 (EMTALA). We are responding to requested public comments on a number of other issues that include performance-based hospital payments for services and health information technology, as well as how to improve health data transparency for consumers. In addition, we are responding to public comments received on a proposed rule issued in the Federal Register on May 17, 2006 that proposed to revise the methodology for calculating the occupational mix adjustment to the wage index for the FY 2007 hospital inpatient prospective payment system by applying an adjustment to 100 percent of the wage index using new 2006 occupational mix survey data collected from hospitals. We are finalizing two policy documents published in the Federal Register relating to the implementation of the Health Care Infrastructure Improvement Program, a hospital loan program for cancer research, established under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. This final rule also revises the definition of the term ``unit'' to specify the exclusion of units of drugs sold to approved Medicare Competitive Acquisition Program (CAP) vendors for use under the CAP from average sales price (ASP) calculations for a period of up to 3 years, at which time we will reevaluate our policy.