Medicaid: Program issuances and coverage decisions; quarterly listing,
[Federal Register: May 11, 1999 (Volume 64, Number 90)]
[Notices]
[Page 25351-25359]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr11my99-78]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-9000-N]
RIN 0938-AJ37
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances--Third Quarter, 1998
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice.
SUMMARY: This notice lists HCFA manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published during July, August, and September of 1998, relating to the Medicare and Medicaid programs. This notice also identifies certain devices with investigational device exemption numbers approved by the Food and Drug Administration that potentially may be covered under Medicare.
Section 1871(c) of the Social Security Act requires that we publish a list of Medicare issuances in the Federal Register at least every 3 months. Although we are not mandated to do so by statute, for the sake of completeness of the listing, we are also including all Medicaid issuances and Medicare and Medicaid substantive and interpretive regulations (proposed and final) published during this timeframe.
FOR FURTHER INFORMATION CONTACT: It is possible that an interested party may have a specific information need and not be able to determine from the listed information whether the issuance or regulation would fulfill that need. Consequently, we are providing information contact persons to answer general questions concerning these
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items. Copies are not available through the contact persons.
Questions concerning Medicare items in Addendum III may be addressed to Bridget Wilhite, Office of Communications and Operations Support, Division of Regulations and Issuances, Health Care Financing Administration, (410) 786-5248.
Questions concerning Medicaid items in Addendum III may be addressed to Betty Stanton, Center for Medicaid State Operations, Policy Coordination and Planning Group, Health Care Financing Administration, S2-26-13, 7500 Security Boulevard, Baltimore, MD 21244- 1850, (410) 786-3247.
Questions concerning Food and Drug Administration-approved investigational device exemptions may be addressed to Sharon Hippler, Office of Clinical Standards and Quality, Coverage and Analysis Group, Health Care Financing Administration, C4-11-04, 7500 Security Boulevard, Baltimore, MD 21244-1850, (410) 786-4633.
Questions concerning all other information may be addressed to Kristy Nishimoto, Office of Communications and Operations Support, Division of Regulations and Issuances, Health Care Financing Administration, C5-16-03, 7500 Security Boulevard, Baltimore, MD 21244- 1850, (410) 786-8517.
SUPPLEMENTARY INFORMATION:
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Program Issuances
The Health Care Financing Administration (HCFA) is responsible for administering the Medicare and Medicaid programs. These programs pay for health care and related services for 39 million Medicare beneficiaries and 35 million Medicaid recipients. Administration of these programs involves (1) Furnishing information to Medicare beneficiaries and Medicaid recipients, health care providers, and the public and (2) effective communications with regional offices, State governments, State Medicaid Agencies, State Survey Agencies, various providers of health care, fiscal intermediaries and carriers that process claims and pay bills, and others. 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). We also issue various manuals, memoranda, and statements necessary to administer the programs efficiently.
Section 1871(c)(1) of the Act requires that we publish a list of all Medicare manual instructions, interpretive rules, and guidelines of general applicability not issued as regulations at least every 3 months in the Federal Register. We published our first notice June 9, 1988 (53 FR 21730). Although we are not mandated to do so by statute, for the sake of completeness of the listing of operational and policy statements, we are continuing our practice of including Medicare substantive and interpretive regulations (proposed and final) published during the 3-month time frame.
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How To Use the Addenda
This notice is organized so that a reader may review the subjects of all manual issuances, memoranda, substantive and interpretive regulations, or Food and Drug Administration-approved investigational device exemptions published during the timeframe to determine whether any are of particular interest. We expect it to be used in concert with previously published notices. Those unfamiliar with a description of our Medicare manuals may wish to review Table I of our first three notices (53 FR 21730, 53 FR 36891, and 53 FR 50577) published in 1988, and the notice published March 31, 1993 (58 FR 16837). Those desiring information on the Medicare Coverage Issues Manual may wish to review the August 21, 1989 publication (54 FR 34555).
To aid the reader, we have organized and divided this current listing into five addenda:
‹bullet› Addendum I lists the publication dates of the most recent quarterly listings of program issuances.
‹bullet› Addendum II identifies previous Federal Register documents that contain a description of all previously published HCFA Medicare and Medicaid manuals and memoranda.
‹bullet› Addendum III lists a unique HCFA transmittal number for each instruction in our manuals or Program Memoranda and its subject matter. A transmittal may consist of a single instruction or many. Often, it is necessary to use information in a transmittal in conjunction with information currently in the manuals.
‹bullet› Addendum IV lists all substantive and interpretive Medicare and Medicaid regulations and general notices published in the Federal Register during the quarter covered by this notice. For each item we list the--
+ Date published;
+ Federal Register citation;
+ Parts of the Code of Federal Regulations (CFR) that have changed (if applicable);
+ Agency file code number;
+ Title of the regulation;
+ Ending date of the comment period (if applicable); and
+ Effective date (if applicable).
‹bullet› Addendum V includes listings of the Food and Drug Administration-approved investigational device exemption numbers that have been approved or revised during the quarter covered by this notice. On September 19, 1995, we published a final rule (60 FR 48417) establishing in regulations at 42 CFR 405.201 et seq. that certain devices with an investigational device exemption approved by the Food and Drug Administration and certain services related to those devices may be covered under Medicare. It is our practice to announce all investigational device exemption categorizations, using the investigational device exemption numbers the Food and Drug Administration assigns. The listings are organized according to the categories to which the device numbers are assigned (that is, Category A or Category B, and identified by the investigational device exemption number).
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How To Obtain Listed Material
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Manuals
Those wishing to subscribe to program manuals should contact either the Government Printing Office (GPO) or the National Technical Information Service (NTIS) at the following addresses:
Superintendent of Documents, Government Printing Office, ATTN: New Orders, PO Box 371954, Pittsburgh, PA 15250-7954, Telephone (202) 512- 1800, Fax number (202) 512-2250 (for credit card orders); or National Technical Information Service, Department of Commerce, 5825 Port Royal Road, Springfield, VA 22161, Telephone (703) 487-4630.
In addition, individual manual transmittals and Program Memoranda listed in this notice can be purchased from NTIS. Interested parties should identify the transmittal(s) they want. GPO or NTIS can give complete details on how to obtain the publications they sell. Additionally, all manuals are available at the following Internet address: http://www.hcfa.gov/pubforms/progman.htm.
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Regulations and Notices
Regulations and notices are published in the daily Federal Register. Interested individuals may purchase individual copies or subscribe to the Federal Register by contacting the GPO at the address given above. When ordering individual copies, it is necessary to cite
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either the date of publication or the volume number and page number.
The Federal Register is also available on 24x microfiche and 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) forward. Free public access is available on a Wide Area Information Server (WAIS) through the Internet and via asynchronous dial-in. Internet users can access the database by using the World Wide Web; the Superintendent of Documents home page address is http:// www.access.gpo.gov/su--docs/, by using local WAIS client software, or by telnet to swais.access.gpo.gov, then log in as guest (no password required). Dial-in users should use communications software and modem to call (202) 512-1661; type swais, then log in as guest (no password required).
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Rulings
We publish rulings on an infrequent basis. Interested individuals can obtain copies from the nearest HCFA Regional Office or review them at the nearest regional depository library. We have, on occasion, published rulings in the Federal Register. Rulings, beginning with those released in 1995, are available online, through the HCFA Home Page. The Internet address is http://www.hcfa.gov/regs/rulings.htm.
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HCFA's Compact Disk-Read Only Memory (CD-ROM)
Our laws, regulations, and manuals are also available on CD-ROM and may be purchased from GPO or NTIS on a subscription or single copy basis. The Superintendent of Documents list ID is HCLRM, and the stock number is 717-139-00000-3. The following material is on the CD-ROM disk:
‹bullet› Titles XI, XVIII, and XIX of the Act.
‹bullet› HCFA-related regulations.
‹bullet› HCFA manuals and monthly revisions.
‹bullet› HCFA program memoranda.
The titles of the Compilation of the Social Security Laws are current as of January 1, 1995. (Updated titles of the Social Security Laws are available on the Internet at http://www.ssa.gov/OP__Home/ssact/comp- toc.htm.) The remaining portions of CD-ROM are updated on a monthly basis.
Because of complaints about the unreadability of the Appendices (Interpretive Guidelines) in the State Operations Manual (SOM), as of March 1995, we deleted these appendices from CD-ROM. We intend to re- visit this issue in the near future and, with the aid of newer technology, we may again be able to include the appendices on CD-ROM.
Any cost report forms incorporated in the manuals are included on the CD-ROM disk as LOTUS files. LOTUS software is needed to view the reports once the files have been copied to a personal computer disk.
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How To Review Listed Material
Transmittals or Program Memoranda can be reviewed 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.
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. Superintendent of Documents numbers for each HCFA publication are shown in Addendum III, along with the HCFA publication and transmittal numbers.
To help FDLs locate the materials, use the Superintendent of Documents number, plus the HCFA transmittal number. For example, to find the Intermediary Manual, (HCFA Pub. 113-3) transmittal entitled ``Electronic Data Interchange Security, Privacy, Audit and Legal Issues,'' use the Superintendent of Documents No. HE 22.8/6 and the HCFA transmittal number 1748.
(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare--Hospital Insurance, Program No. 93.774, Medicare-- Supplementary Medical Insurance Program, and Program No. 93.714, Medical Assistance Program)
Dated: April 23, 1999. Elizabeth Cusick, Acting Director, Office of Communications and Operations Support.
Addendum I
This addendum lists the publication dates of the most recent quarterly listings of program issuances.
November 21, 1997 (62 FR 62325) June 4, 1998 (63 FR 30499) August 11, 1998 (63 FR 42857) September 16, 1998 (63 FR 49598) December 9, 1998 (63 FR 67899)
Addendum II--Description of Manuals, Memoranda, and HCFA Rulings
An extensive descriptive listing of Medicare manuals and memoranda was published on June 9, 1988, at 53 FR 21730 and supplemented on September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR 50577. Also, a complete description of the Medicare Coverage Issues Manual was published on August 21, 1989, at 54 FR 34555. A brief description of the various Medicaid manuals and memoranda that we maintain was published on October 16, 1992, at 57 FR 47468.
Addendum III.--Medicare and Medicaid Manual Instructions [July 1998 Through September 1998]
Trans. No.
Manual/Subject/Publication No.
Intermediary Manual Part 3--Claims Process (HCFA Pub. 13-3) (Superintendent of Documents No. HE 22.8/6)
1748
‹bulle Electronic Data Interchange Security, t Privacy, Audit and Legal Issues. Contractor Data Security and Confidentially Requirements. Electronic Data Interchange Audit Trail. Security-Related Requirements for Subcontractor Arrangements With Network Services. 1749
‹bulle Completing Quarterly Report on Provider t Enrollment. Checking Reports. Type of Provider. Completing Lines Twenty-Seven Through Thirty- One--Age of Applications Pending. Completing Lines Thirty-Two Through Thirty- Seven--Change of Ownership Workloads.
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1750
‹bulle Requirements for Submission of Electronic t Media Claims Data. 1751
‹bulle Pneumococcal Pneumonia, Influenza Virus and t Hepatitis B Vaccines. Mammography Screening. 1752
‹bulle Millennium Readiness. t
Carriers Manual Part 3--Claims Process (HCFA Pub. 14-3) (Superintendent of Documents No. HE 22.8/7)
1609
‹bulle Electronic Data Interchange Security, t Privacy, Audit and Legal Issues. Contractor Data Security and Confidentiality Requirements. Audit Trails. Security-Related Requirements for Subcontractor Arrangements With Network Services. 1610
‹bulle The System for Processing Electronic Media t Claims. Electronic Media Claims Testing and Verification. 1611
‹bulle Identifying a Screening Mammography Claim. t Adjudicating the Claim.
Program Memorandum Intermediaries (HCFA Pub. 60A) (Superintendent of Documents No. HE 22.8/6-5)
A-98-21
‹bulle Payment to Hospitals for Direct Costs of t Graduate Medical Education and Operating Indirect Medical Education Costs for Medicare+Choice Enrollees. A-98-22
‹bulle Hospital Encounter Data Requirements From the t Balanced Budget Act of 1997. A-98-23
‹bulle Coding for Adequacy of Hemodialysis Dialysis t on Claim Form--Additional Modifier. A-98-24
‹bulle Change to Reporting of Outpatient t Rehabilitation Services and All Comprehensive Outpatient Rehabilitation Facilities Services Using HCFA Common Procedure Coding System. A-98-25
‹bulle Home Health Agency Surety Bond Requirements. t A-98-26
‹bulle Prospective Payment System PRICER Changes for t Fiscal Year 1999, Including Changes for Discharges to Post-Acute Care Providers and a Millennium Compliant Provider Specific File. A-98-27
‹bulle Hospice Provisions Enacted by the Balanced t Budget Act of 1997. A-98-28
‹bulle Medicare Home Health Benefit--The Balanced t Budget Act of 1997--Clarification of Part- Time or Intermittent Skilled Nursing Care. A-98-29
‹bulle UB-92 Claims That Are Not Millennium t Compliant. A-98-30
‹bulle Extension of the Effective Date for t Intermediary Usage of the 4A.01 Implementation of the Version 3051 Based 835 Transaction for Electronic Remittance Advice. A-98-31
‹bulle Discharges to Swing Bed Units and Other Post- t Acute Care Providers.
Program Memorandum Carriers (HCFA Pub. 60B) (Superintendent of Documents No. HE 22.8/6-5)
B-98-25
‹bulle Changes to Correct Coding Edits, Version 4.1. t B-98-26
‹bulle Durable Medical Equipment Regional Carrier t Instructions to Implement Balanced Budget Act of 1997 Provisions Sec. 4105 to Provide Expanded Coverage of Blood Glucose Monitors and Test Strips for all Diabetics--Implement July 1, 1998. B-98-27
‹bulle Implementation of Additional Commercial Edits t Effective for Dates of Service on or after October 1, 1998. B-98-28
‹bulle Modifications to Form HCFA-1500 Instructions. t B-98-29
‹bulle Private Contracts Between Beneficiaries and t Physicians/Practitioners. B-98-30
‹bulle Millennium Changes for Forms HCFA-1491, t 1490S, and 1490U. B-98-31
‹bulle Change to Health Insurance Claim Form HCFA- t 1500 Instructions for Processing Physician Claims in Global Payment Systems. B-98-32
‹bulle Changes to the 1998 Medicare Physician Fee t Schedule Database. B-98-33
‹bulle Durable Medical Equipment Carrier Operating t Instructions to Implement Balanced Budget Act of 1997 Provisions Sec. 4105 to Provide Expanded Coverage of Blood Glucose Monitors and Test Strips for All Diabetes. Implement July 1, 1998. (Corrects and updates Transmittal B-98-17, dated April 1998, Change Request #485). B-98-34
‹bulle Elimination of Funding Toll-Free Lines for t Participating Physicians and Suppliers. B-98-35
‹bulle Receipt of Electronic Claims That Are Not t Millennium Compliant. B-98-36
‹bulle This document will be released in the fourth t Quarter Federal Register Notice. B-98-37
‹bulle Requiring Entities Who Are Ineligible to t Receive Direct Medicare Payments for Services Provided by Independent Contractors to Comply with 42 USC 1395u(b)(6), and Medicare Regulations in 42 CFR 424.80(b).
Program Memorandum Intermediaries/Carriers (HCFA Pub. 60A/ B)(Superintendent of Documents No. HE 22.8/6-5)
AB-98-32
‹bulle Standardization of Medicare Coverage of Bone t Marrow Measurements. AB-98-33
‹bulle Medicare Travel Allowance Fees for Collection t of Specimens. AB-98-34
‹bulle Modifications of Medicare Policy for t Erythropoietin. AB-98-35
‹bulle Consolidated Billing for Skilled Nursing t Facilities--The Balanced Budget Act of 1997. AB-98-36
‹bulle Coverage of Diabetes Outpatient Self- t Management Training Services, Effective: July 1, 1998.
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AB-98-37
‹bulle Contractor Coordination of Benefits File t Formats and Trading Partner Agreements. AB-98-38
‹bulle Distribution of 1/98 Versions of Form HCFA- t 855. AB-98-39
‹bulle FDA Approves Two Cancer Tests, the Abbott t AxSYM CA 15-3 test and the Abbott Imx CA 15- 3 test. AB-98-40
‹bulle New Interest Rate Payable on Clean Claims Not t Paid Timely. AB-98-41
‹bulle Promoting Influenza and Pneumococcal t Vaccinations. AB-98-42
‹bulle Revision of Troponin (CPT Code 84484 and t 84512) Policy. AB-98-43
‹bulle New Waived Tests. t AB-98-44
‹bulle Suspension of National Coverage Policy on t Electrostimulation for Wound Healing. AB-98-45
‹bulle Consolidated Billing for Skilled Nursing t Facilities. AB-98-46
‹bulle Notice of New Interest Rate for Medicare t Overpayments and Underpayments. AB-98-47
‹bulle Health Care Financing Administration Public t Awareness Activities. AB-98-48
‹bulle Year 2000 Contingency for Non-Millennium t Compliant Electronic Transactions and Publication of Year 2000 Article in Provider Bulletins. AB-98-49
‹bulle New Waived Tests. t AB-98-50
‹bulle Physician Ownership and Compensation Interest t System. AB-98-51
‹bulle Implementation of Section 4105 of the t Balanced Budget Act Regarding Coverage of Diabetes Outpatient Self-Management Training Services. AB-98-52
‹bulle Interim Tracking Procedures for Implementing t the Medicare Fraud and Abuse Incentive Reward Program. State Operations Manual Provider Certification (HCFA Pub. 7) (Superintendent of Documents No. HE 22.8/12)
3
‹bulle Medicare Health Care Provider/Supplier t Enrollment. Prioritizing State Agency Survey Workload-- Initial Surveys and Recertifications. Transmitting Materials. List of Documents in Certification Packet. Notification to Application that the Medicare General Enrollment Health Care Provider/ Supplier Application has been Denied. Notification of Pending Involuntary Termination Based on Change of Home Ownership Review of the Medicare General Enrollment Health Care Provider/Supplier Application. Notification of Involuntary Termination Based on Change of Home Ownership Review of the Medicare General Enrollment Health Care Provider/Supplier Application. Medicare and Other Federal Health Care Program General Enrollment Health Care Provider/Supplier Application. Medicare and Other Federal Health Care Program Change of Information Health Care Provider/Supplier Application. Medicare and Other Federal Health Care Program Individual Reassignment of Benefits Health Care Provider/Supplier Application.
Peer Review Organization Manual (HCFA Pub. 19) (Superintendent of Documents No. HE 22.8/8-15)
66
‹bulle Introduction. t Definition. Requirements. Disagreements. 67
‹bulle Opportunity to Discuss. t Authority. Scope of Review. Referrals. Receive Medical Records. Request for a Review. Timing of Rereview. 68
‹bulle Interaction with Beneficiary Groups. t Evaluation.
Hospital Manual (HCFA Pub. 10) (Superintendent of Documents No. HE 22.8/2)
730
‹bulle Billing for Mammography Screening. t
Skilled Nursing Facility Manual (HCFA Pub. 12) (Superintendent of Documents No. HE 22.8/3)
354
‹bulle Billing for Mammography Screening. t
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End Stage Renal Disease Network Organizations Manual (HCFA Pub. 81) (Superintendent of Documents No. HE 22.9/4)
7
‹bulle Background and Responsibilities. t Authority. Purpose of End Stage Renal Disease Network Organizations. Requirements for End Stage Renal Disease Network Organizations. Responsibilities of End Stage Renal Disease Network Organizations. Health Care Quality Improvement Program. Goals. Network Organization's Role in Health Care Quality Improvement Program. Organizational Structure. Network Council. Board of Directors. Medical Review Board. Other Committees. Network Staff. Required Administrative Reports. Internal Quality Control Program. Health Care Financing Administration Meetings. Cooperative Activities with State Survey Agencies and Peer Review Organizations. Annual Report Format. Statutory and Regulatory Requirements. General Requirements. Nonconfidential Information. Confidential Information. Disclosure of Network Deliberations. Disclosure of Confidential Network Information to Officials and Agencies. Disclosure of Network Information Involving Beneficiary Complaints. Disclosure of Network Information for Research Purposes. Disclosure of Network Sanction Information. Redisclosure of Network Information. 8
‹bulle Authority. t End Stage Renal Disease Health Care Quality Improvement Program. Responsibilities. Quality of Care Improvement Projects. Components of Quality of Care Improvement Projects. Developing and Planning the Project. Identifying and Confirming an Opportunity to Improve Care. Developing a Network Intervention Activity. Measuring Impact and Project Evaluation. Disseminating Results. Identifying Additional Opportunities for Improvement. Project Reporting System. Improvement Plan. End Stage Renal Disease Core Clinical Indicators. Core Indicators--Network National Sample. Core Indicators--Sampling Method. Core Indicators--Data Collection. Core Indicators--Data Validation. Core Indicators--Data Reporting. Health Care Financing Administration-Compiled Data Reports. Quality Improvement Projects Versus Research Studies. Network Resources to Support the National Renal Registry. Core Indicators--Targeted Patient Population, and Clinical Measures. Annual Patient Sample Per Network for Conducting National Renal Registry Special Studies. Network Quality Improvement Project Report.
Provider Reimbursement Manual--Part 1 (HCFA Pub. 15-1) (Superintendent of Documents No. HE 22.8/4)
405
Low Medicare Volume Prospective Payment Rates for Skilled Nursing Facilities Effective for Cost Reporting Periods Beginning on or After October 1, 1986 and Prior to Cost Reporting Periods Beginning on or After July 1, 1998. Calculation of the Low Medicare Volume Prospective Payment Rate. Methodology for Determining Per Diem Prospective Payment Rates Effective for Cost Reporting Periods Beginning on or After October 1, 1977 and Before July 1, 1998. General Provisions.
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Methodology for Determining Per Diem Prospective Payment Rates Effective for Cost Reporting Periods Beginning on or After July 1, 1998. Determination of Facility Specific Per Diem Rates. Calculating Payment Under Skilled Nursing Facility Prospective Payment System. Use of Skilled Nursing Facility PRICER. Skilled Nursing Facility Prospective Payment System--Payment Requirements and Adjustments. Reporting Rehabilitative Therapy Minutes on the Minimum Data Set for Purposes of Medicare Payment. 406
Principle of Cost Apportionment.
State Medicaid Manual--Part 2 State Organization and General Administration (HCFA Pub. 45-2) (Superintendent of Documents No. HE 22.8/10)
90
Annual Report on Home and Community-Based Services Waivers. 91
Statistical Report on Medical Care: Eligibles, Recipients, Payments and Services. Federal Reporting Requirements. Requirements for the Medicaid Statistical Information System.
State Medicaid Manual--Part 5 Early and Periodic Screening, Diagnosis, and Treatment (HCFA Pub. 45-5) (Superintendent of Documents No. HE 22.8/10)
12
Screening Service Content.
State Medicaid Manual--Part 6 Payment for Services (HCFA Pub. 45-6) (Superintendent of Documents No. HE 22.8/10)
35
‹bulle Upper Limits for Prescription Drugs. t
State Medicaid Manual--Part 11 Medicaid Management Information System (HCFA Pub. 45-11) (Superintendent of Documents No. HE 22.8/10)
18
‹bulle Background. t Applicable Federal Approval Requirements. Approval Process and Documentation Submissions. List of Reimbursable Costs for State Systems. Eligibility Verification Systems, Switching Companies, Electronic Claims Capture, and Electronic Claims Management System- Overview. Electronic Fund Transfer and Electronic Remittance Advices. General (System) Requirements. Future Additional System Requirements. Claims Processing Subsystem. Data Requirements. Applicable Federal Approval Requirements. Acquisition of Automated Data Processing Equipment and Services. Implementation Advance Planning Document. Approval Process and Documentation Submissions. Cost Reimbursable at 75 Percent Federal Financial Participation. Cost Reimbursable at 75 Percent Federal Financial Participation for Management Administration Reporting Subsystem and Surveillance and Utilization Review Subsystem. List of Reimbursable Costs for State Systems. Definitions. Considerations and Options. Detailed Implementation Schedule. Projected Reporting Requirements. Preliminary Evaluation. Contractual Services. Required Assurances. Replacement Systems. Approval Process and Documentation Submissions. Approval of Eligibility Determination Systems--Required System Documentation for Onsite Review. General Requirements. List of Reimbursable Costs for State Systems. Approval of Eligibility Determination Systems. Enumeration Verification System as a Component of Medicaid Management Information System. Surveillance and Utilization Review Subsystem.
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Program Memorandum Regional Office--General (HCFA Pub. 51) (Superintendent of Documents No. HE 22.28/5:90-1)
98-3
‹bulle Home Health Agency Surety Bond Requirements. t
Program Memorandum State Survey Agencies (HCFA Pub. 65) (Superintendent of Documents No. HE 22.8/6-5)
98-1
‹bulle Home Health Agency Parent, Branch, and t Subunit Criteria.
Medicare/Medicaid Sanction--Reinstatement Report (HCFA Pub. 69)
98-7
‹bulle Report of Physicians/Practitioners, Providers t and/or Other Health Care Suppliers Excluded/ Reinstated--June 1998. 97-8
‹bulle Report of Physicians/Practitioners, Providers t and/or Other Health Care Suppliers Excluded/ Reinstated--July 1998. 97-9
‹bulle Report of Physicians/Practitioners, Providers t and/or Other Health Care Suppliers Excluded/ Reinstated--August 1998.
Addendum IV--Regulation Documents Published in the Federal Register
End of Publication date
FR Vol. 63
CFR part(s)
File code*
Regulation title comment Effective page
period
date
07/06/98....................
36488 422........................ HCFA-1030-IFC
Medicare Program; ........... 07/06/98 Establishment of the Medicare+Choice Program; Correction. 07/13/98.................... 37498-37499 409, 410, 411, 413, 424, HCFA-1913-N
Medicare Program;
09/11/98 483, and 489.
Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Extension of Comment Period. 07/29/98.................... 40534-40536 ........................... HCFA-3009-N
Medicare Program; Peer 08/28/98 ........... Review Organization Contracts: Solicitation of Statements of Interest From In- State Organizations-- Alaska, Delaware, the District of Columbia, Hawaii, Idaho, Illinois, Kentucky, Maine, Nebraska, Nevada, South Carolina, Vermont, and Wyoming. 07/31/98.................... 40954-41131 405, 412, and 413.......... HCFA-1003-F
Medicare Program; ........... 10/01/98 Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1999 Rates 07/31/98.................... 41170-41171 441 and 489................ HCFA-1152-2-F
Medicare and Medicaid ........... 07/31/98 Programs; Surety Bond Requirements for Home Health Agencies 08/06/98....................
42055 ........................... HCFA-2030-N
Medicaid Program; ........... ........... Decision on Funding for the AIDS Healthcare Foundation START Program 08/07/98.................... 42270-42275 233........................ HCFA-2106-FC
Medicaid and Title IV- 10/06/98 08/07/98 E Programs; Revision to the Definition of an Unemployed Parent. 08/11/98.................... 42912-42938 ........................... HCFA-1035-NC
Medicare Program;
10/13/98 10/01/98 Schedules of Per- Visit and Per- Beneficiary Limitations on Home Health Agency Costs for Cost Reporting Periods Beginning On or After October 1, 1998. 08/11/98.................... 42797-42801413 ........................... HCFA-1883-P
Medicare Program;
10/13/98 Revision of the Procedures for Requesting Exceptions to Cost Limits for Skilled Nursing Facilities and Elimination of Reclassifications. 08/11/98....................
42796 ........................... HCFA-3250-N
Medicare Program; Negotiated Rulemaking; Coverage and Administrative Policies for Clinical Diagnostic Laboratory Tests; Change in Meeting Time. 08/11/98.................... 42857-42864 ........................... HCFA-9879-N
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances--Fourth Quarter 1997. 08/14/98....................
43655 416 and 488................ HCFA-1885-N
Medicare Program;
09/10/98 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.
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09/08/98.................... 47506-47513 ........................... HCFA-1045-N
Medicare Program;
10/06/98 Request for Public Comments on Implementation of Risk Adjusted Payment for the Medicare+Choice Program and Announcement of Public Meeting. 09/08/98.................... 47513-47514 ........................... HCFA-1046-N
Medicare Program; September 23 and 24, 1998, Meeting of the Competitive Pricing Advisory Committee 09/08/98.................... 47552-48036 409, 410, 411, 412, 413, HCFA-1005-P
Medicare Program;
11/09/98 419, 489, 493, and 1003.
Prospective Payment System for Hospital Outpatient Services. 09/10/98....................
48517 ........................... HCFA-3432-N
Medicare Program; September 25, 1998, Open Town Hall Meeting to Discuss the Medicare Coverage Process 09/11/98.................... 48735-48736 ........................... HCFA-2029-PN
Medicare and Medicaid 10/13/98 Programs; Recognition of the Community Health Accreditation Program, Inc. (CHAP) and Joint Commission for Accreditation of Healthcare Organizations (JCAHO) for Hospices. 09/11/98.................... 48736-48737 ........................... HCFA-1097-N
Medicare Program; September 28, 1998, Meeting of the Practicing Physicians Advisory Council 09/16/98.................... 49598-49605 ........................... HCFA-9879-N
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances--First Quarter, 1998 09/22/98.................... 50545-50547 405, 410, 413, 414, 415, HCFA-1006-CN
Medicare Program; 424, and 485.
Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 1999; Correction 09/23/98.................... 50919-50920 ........................... HCFA-1047-NC
Medicare and Medicaid 11/23/98 Programs; Announcement of Additional Applications From Hospitals Requesting Waivers for Organ Procurement Service Area. 09/29/98.................... 52022-52092 400, 430, 431, 434, 435, HCFA-2001-P
Medicaid Program;
11/30/98 438, 440, and 447.
Medicaid Managed Care.
A*N--General Notice; PN--Proposed Notice; NC--Notice with Comment Period; FN--Final Notice; P--Notice of Proposed Rulemaking (NPRM); F--Final Rule; FC-- Final Rule with Comment Period; CN--Correction Notice; IFC--Interim Final Rule with Comment Period
Addendum V--Categorization of Food and Drug Administration-Allowed Investigational Device Exemptions
Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c), devices fall into one of three classes. Also, under the new categorization process to assist HCFA, the Food and Drug Administration assigns each device with a Food and Drug Administration-approved investigational device exemption to one of two categories. To obtain more information about the classes or categories, please refer to the Federal Register notice published on April 21, 1997 (62 FR 19328).
The following information presents the device number, category (in this case, A), and criterion code.
G980020 A1 G980150 A1 G980164 A1 G980165 A1 G980171 A1 G980175 A1 G980176 A2 G980185 A2 G980202 A1 G980207 A1 G980212 A1
The following information presents the device number, category (in this case, B), and criterion code.
G970277 B4 G980105 B2 G980108 B1 G980132 B G980134 B1 G980135 B2 G980136 B2 G980140 B2 G980142 B2 G980144 B2 G980146 B2 G980147 B4 G980152 B2 G980156 B2 G980157 B2 G980160 B4 G980161 B4 G980162 B4 G980163 B4 G980166 B1 G980169 B1 G980174 B1 G980180 B4 G980181 B4 G980182 B4 G980184 B4 G980190 B G980192 B4 G980194 B4 G980196 B1 G980197 B4 G980198 B3 G980200 B1 G980201 B1 G980205 B4 G980206 B4 G980208 B3 G980209 B2 G980210 B2 G980211 B2 G980213 B2 G980217 B4 G980218 B5 G980219 B4
[FR Doc. 99-11754Filed5-10-99; 8:45 am]
BILLING CODE 4120-10-P
