Medicare program: Ambulatory surgical centers; ratesetting methodology update, payment rates, payment policies and covered procedures list,

[Federal Register: March 12, 1999 (Volume 64, Number 48)]

[Proposed Rules]

[Page 12278-12279]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr12mr99-22]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 416 and 488

[HCFA-1885-5N]

RIN 0938-AH81

Medicare Program; Update of Ratesetting Methodology, Payment Rates, Payment Policies, and the List of Covered Procedures for Ambulatory Surgical Centers Effective October 1, 1998; Extension of Comment Period

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Notice of extension of comment period for proposed rule.

SUMMARY: This notice extends the comment period for the fifth time on a proposed rule published in the Federal Register on June 12, 1998 (63 FR 32290). In that rule we proposed to make various changes, including changes to the ambulatory surgical center (ASC) payment methodology and the list of Medicare covered procedures.

DATES: The comment period is extended to 5 p.m. on June 30, 1999.

ADDRESSES: Mail written comments (one original and three copies) to the following address: Health Care Financing Administration, Department of Health and Human Services, Attention: HCFA-1885-P, P.O. Box 26688, Baltimore, MD 21207-0488.

If you prefer, you may deliver your written comments (one original and three copies) to one of the following addresses: Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or Room C5-09-26, Central Building, 7500 Security Boulevard, Baltimore, MD 21244-1850.

Because of staffing and resource limitations, we cannot accept comments by facsimile (FAX) transmission. In commenting, please refer to file code HCFA-1885-P. Comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, in Room 443-G of the Department's offices at 200 Independence Avenue, SW., Washington, DC, on Monday through Friday of each week from 8:30 a.m. to 5 p.m. (phone: (202) 690-7890).

For comments that relate to information collection requirements, mail a copy of comments to: Health Care Financing Administration.

Office of Information Services, Standards And Security Group, Division of HCFA Enterprise Standards, Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850. Attn: John Burke HCFA-1885-P, and Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Allison Herron Eydt, HCFA Desk Officer.

FOR FURTHER INFORMATION CONTACT: Terri Harris, (410) 786-6830.

SUPPLEMENTARY INFORMATION:

On June 12, 1998, we issued a proposed rule in the Federal Register (63 FR 32290) that would do the following:

‹bullet› Update the criteria for determining which surgical procedures can be appropriately and safely performed in an ASC.

‹bullet› Make additions to and deletions from the current list of Medicare covered ASC procedures based on the revised criteria.

‹bullet› Rebase the ASC payment rates using cost, charge, and utilization data collected by a 1994 survey of ASCs.

‹bullet› Refine the ratesetting methodology that was implemented by a final notice published on February 8, 1990, in the Federal Register.

‹bullet› Require that ASC payment, coverage, and wage index updates be implemented annually on January 1 rather than having these updates occur randomly throughout the year.

‹bullet› Reduce regulatory burden.

‹bullet› Make several technical policy changes.

The proposed rule would also implement requirements of section 1833(i)(1) and (2) of the Social Security Act. We indicated that comments would be considered if we received them by August 11, 1998.

We received requests from numerous ASCs and professional associations for more time to analyze the potential consequences of the rule. We issued a notice in the Federal Register on August 14, 1998, (63 FR 43655) announcing extension of the public comment period to September 10, 1998.

On September 8, 1998, we published a proposed rule in the Federal Register entitled ``Medicare Program; Prospective Payment System for Hospital Outpatient Services'' (63 FR 47552). We received additional requests from ASCs and professional associations for more time to analyze the impact of the hospital outpatient proposed rule, and for a delay in the implementation of the ASC final rule to be concurrent with implementation of the hospital outpatient prospective payment system.

On October 1, 1998, we reopened the comment period for the June 12, 1998, ASC proposed rule until November 9, 1998, to coincide with the comment period for the September 8, 1998, hospital outpatient proposed rule. We also gave notice in the October 1, 1998, Federal Register (63 FR 52663) of a delay in the adoption of the provisions of the June 12, 1998, ASC proposed rule as a final rule to be concurrent with the adoption as final of the hospital outpatient prospective payment system as soon as possible after January 1, 2000. In the November 13, 1998, Federal Register (63 FR 63430), we further extended the comment period until January 8, 1999. In the January 12, 1999, Federal Register (64 FR 1785), we again extended the comment period until March 9, 1999.

Published elsewhere in this issue of the Federal Register is a notice extending the comment period for the September 8, 1998, hospital outpatient proposed rule (63 FR 47552) until June 30, 1999. Because Medicare payments to ASCs are closely linked to the way Medicare proposes to pay hospitals under a prospective payment system for surgical services furnished on an outpatient basis, we are extending the comment period for the June 12, 1998, ASC proposed rule to be concurrent with the extended comment period for the September 8, 1998, hospital outpatient proposed rule. The comment period will close at 5 p.m. on June 30, 1999.

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare--Supplementary Medical Insurance Program)

[[Page 12279]]

Dated: March 1, 1999. Nancy-Ann Min DeParle, Administrator, Health Care Financing Administration.

Dated: March 9, 1999. Donna E. Shalala, Secretary.

[FR Doc. 99-6135Filed3-9-99; 2:08pm]

BILLING CODE 4120-01-P