Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2021

Cited as:85 FR 74724
Court:Centers For Medicare & Medicaid Services
Publication Date:23 Nov 2020
Record Number:2020-25715
74724
Federal Register / Vol. 85, No. 226 / Monday, November 23, 2020 / Notices
A. OMB Control Number, Title, and
Any Associated Form(s)
9000–0064, Organization and Direction
of the Work
B. Need and Uses
This clearance covers the information
that contractors must submit to comply
with the following Federal Acquisition
Regulation (FAR) requirement:
52.236–19, Organization and
Direction of the Work. This clause
requires contractors, under cost-
reimbursement construction contracts,
to submit to the contracting officer a
chart showing the general executive and
administrative organization, the
personnel to be employed in connection
with the work under the contract, and
their respective duties. The contractor
must keep the data furnished current by
supplementing it as additional
information becomes available.
The contracting officer uses the
information to ensure the work is
performed by qualified personnel at a
reasonable cost to the Government.
C. Annual Burden
Respondents: 34.
Total Annual Responses: 34.
Total Burden Hours: 26.
Obtaining Copies: Requesters may
obtain a copy of the information
collection documents from the GSA
Regulatory Secretariat Division by
calling 202–501–4755 or emailing
GSARegSec@gsa.gov. Please cite OMB
Control No. 9000–0064, Organization
and Direction of the Work.
William F. Clark,
Director, Federal Acquisition Policy Division,
Office of Governmentwide Acquisition Policy,
Office of Acquisition Policy, Office of
Governmentwide Policy.
[FR Doc. 2020–25801 Filed 11–20–20; 8:45 am]
BILLING CODE 6820–EP–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–6090–N]
Medicare, Medicaid, and Children’s
Health Insurance Programs; Provider
Enrollment Application Fee Amount for
Calendar Year 2021
AGENCY
: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION
: Notice.
SUMMARY
: This notice announces a
$599.00 calendar year (CY) 2021
application fee for institutional
providers that are initially enrolling in
the Medicare or Medicaid program or
the Children’s Health Insurance
Program (CHIP); revalidating their
Medicare, Medicaid, or CHIP
enrollment; or adding a new Medicare
practice location. This fee is required
with any enrollment application
submitted on or after January 1, 2021
and on or before December 31, 2021.
DATES
: The application fee announced
in this notice is effective on January 1,
2021.
FOR FURTHER INFORMATION CONTACT
:
Melissa Singer, (410) 786–0365.
SUPPLEMENTARY INFORMATION
:
I. Background
In the February 2, 2011 Federal
Register (76 FR 5862), we published a
final rule with comment period titled
‘‘Medicare, Medicaid, and Children’s
Health Insurance Programs; Additional
Screening Requirements, Application
Fees, Temporary Enrollment Moratoria,
Payment Suspensions and Compliance
Plans for Providers and Suppliers.’’ This
rule finalized, among other things,
provisions related to the submission of
application fees as part of the Medicare,
Medicaid, and CHIP provider
enrollment processes. As provided in
section 1866(j)(2)(C)(i) of the Social
Security Act (the Act) and in 42 CFR
424.514, ‘‘institutional providers’’ that
are initially enrolling in the Medicare or
Medicaid programs or CHIP,
revalidating their enrollment, or adding
a new Medicare practice location are
required to submit a fee with their
enrollment application. An
‘‘institutional provider’’ for purposes of
Medicare is defined at § 424.502 as ‘‘any
provider or supplier that submits a
paper Medicare enrollment application
using the CMS–855A, CMS–855B (not
including physician and non-physician
practitioner organizations), CMS–855S,
CMS–20134, or associated internet-
based PECOS enrollment application.’’
As we explained in the February 2, 2011
final rule (76 FR 5914), in addition to
the providers and suppliers subject to
the application fee under Medicare,
Medicaid-only and CHIP-only
institutional providers would include
nursing facilities, intermediate care
facilities for persons with intellectual
disabilities (ICF/IID), psychiatric
residential treatment facilities, and may
include other institutional provider
types designated by a state in
accordance with their approved state
plan.
As indicated in § 424.514 and
§ 455.460, the application fee is not
required for either of the following:
A Medicare physician or non-
physician practitioner submitting a
CMS–855I.
A prospective or revalidating
Medicaid or CHIP provider—
++ Who is an individual physician or
non-physician practitioner; or
++ That is enrolled in Title XVIII of
the Act or another state’s Title XIX or
XXI plan and has paid the application
fee to a Medicare contractor or another
state.
II. Provisions of the Notice
Section 1866(j)(2)(C)(i)(I) of the Act
established a $500 application fee for
institutional providers in calendar year
(CY) 2010. Consistent with section
1866(j)(2)(C)(i)(II) of the Act,
§ 424.514(d)(2) states that for CY 2011
and subsequent years, the preceding
year’s fee will be adjusted by the
percentage change in the consumer
price index (CPI) for all urban
consumers (all items; United States city
average, CPI U) for the 12 month period
ending on June 30 of the previous year.
Each year since 2011, accordingly, we
have published in the Federal Register
an announcement of the application fee
amount for the forthcoming CY based on
the formula noted previously. Most
recently, in the November 12, 2019
Federal Register (84 FR 61058), we
published a notice announcing a fee
amount for the period of January 1, 2020
through December 31, 2020 of $595.00.
The $595.00 fee amount for CY 2020
was used to calculate the fee amount for
2021 as specified in § 424.514(d)(2).
According to Bureau of Labor
Statistics (BLS) data, the CPU–U
increase for the period of July 1, 2019
through June 30, 2020 was 0.6 percent.
As required by § 424.514(d)(2), the
preceding year’s fee of $595 will be
adjusted by the CPI–U of 0.6 percent.
This results in a CY 2021 application fee
amount of $598.57 ($595 × 1.006). As
we must round this to the nearest whole
dollar amount, the resultant application
fee amount for CY 2021 is $599.
III. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting, recordkeeping, or
third-party disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995.
However, it does reference previously
approved information collections. The
Forms CMS–855A, CMS–855B, and
CMS–855I are approved under OMB
control number 0938–0685; the Form
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74725
Federal Register / Vol. 85, No. 226 / Monday, November 23, 2020 / Notices
CMS–855S is approved under OMB
control number 0938–1056.
IV. Regulatory Impact Statement
A. Background
We have examined the impact of this
notice as required by Executive Order
12866 on Regulatory Planning and
Review (September 30, 1993), Executive
Order 13563 on Improving Regulation
and Regulatory Review (January 18,
2011), the Regulatory Flexibility Act
(RFA) (September 19, 1980, Pub. L. 96–
354), section 1102(b) of the Social
Security Act, section 202 of the
Unfunded Mandates Reform Act of 1995
(March 22, 1995; Pub. L. 104–4),
Executive Order 13132 on Federalism
(August 4, 1999), the Congressional
Review Act (5 U.S.C. 804(2)), and
Executive Order 13771 on Reducing
Regulation and Controlling Regulatory
Costs (January 30, 2017).
Executive Orders 12866 and 13563
direct agencies to assess all costs and
benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits,
including potential economic,
environmental, public health and safety
effects, distributive impacts, and equity.
A regulatory impact analysis (RIA) must
be prepared for major rules with
economically significant effects ($100
million or more in any 1 year). As
explained in this section of the notice,
we estimate that the total cost of the
increase in the application fee will not
exceed $100 million. Therefore, this
notice does not reach the $100 million
economic threshold and is not
considered a major notice.
B. Costs
The costs associated with this notice
involve the increase in the application
fee amount that certain providers and
suppliers must pay in CY 2021. The CY
2021 cost estimates are as follows:
1. Medicare
Based on CMS data, we estimate that
in CY 2021 approximately—
10,214 newly enrolling institutional
providers will be subject to and pay an
application fee; and
42,117 revalidating institutional
providers will be subject to and pay an
application fee.
Using a figure of 52,331 (10,214 newly
enrolling + 42,117 revalidating)
institutional providers, we estimate an
increase in the cost of the Medicare
application fee requirement in CY 2021
of $209,324 (or 52,331 × $4 (or $599
minus $595)) from our CY 2020
projections.
2. Medicaid and CHIP
Based on CMS and state statistics, we
estimate that approximately 30,000
(9,000 newly enrolling + 21,000
revalidating) Medicaid and CHIP
institutional providers will be subject to
an application fee in CY 2021. Using
this figure, we project an increase in the
cost of the Medicaid and CHIP
application fee requirement in CY 2021
of $120,000 (or 30,000 × $4 (or $599
minus $595)) from our CY 2020
projections.
3. Total
Based on the foregoing, we estimate
the total increase in the cost of the
application fee requirement for
Medicare, Medicaid, and CHIP
providers and suppliers in CY 2021 to
be $329,324 ($209,324 + $120,000) from
our CY 2020 projections.
The RFA requires agencies to analyze
options for regulatory relief of small
businesses. For purposes of the RFA,
small entities include small businesses,
nonprofit organizations, and small
governmental jurisdictions. Most
hospitals and most other providers and
suppliers are small entities, either by
nonprofit status or by having revenues
of less than $7.5 million to $38.5
million in any 1 year. Individuals and
states are not included in the definition
of a small entity. As we stated in the
RIA for the February 2, 2011 final rule
with comment period (76 FR 5952), we
do not believe that the application fee
will have a significant impact on small
entities.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area for
Medicare payment regulations and has
fewer than 100 beds. We are not
preparing an analysis for section 1102(b)
of the Act because we have determined,
and the Secretary certifies, that this
notice would not have a significant
impact on the operations of a substantial
number of small rural hospitals.
Section 202 of the Unfunded
Mandates Reform Act of 1995 (UMRA)
also requires that agencies assess
anticipated costs and benefits before
issuing any rule whose mandates
require spending in any 1 year of $100
million in 1995 dollars, updated
annually for inflation. In 2020, that
threshold was approximately $156
million. The Agency has determined
that there will be minimal impact from
the costs of this notice, as the threshold
is not met under the UMRA.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it promulgates a
proposed rule (and subsequent final
rule) that imposes substantial direct
requirement costs on state and local
governments, preempts state law, or
otherwise has federalism implications.
Since this notice does not impose
substantial direct costs on state or local
governments, the requirements of
Executive Order 13132 are not
applicable.
Executive Order 13771, titled
‘‘Reducing Regulation and Controlling
Regulatory Costs,’’ was issued on
January 30, 2017 (82 FR 9339, February
3, 2017). It has been determined that
this notice is a transfer notice that does
not impose more than de minimis costs
and thus is not a regulatory action for
the purposes of E.O. 13771.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
The Administrator of the Centers for
Medicare & Medicaid Services (CMS),
Seema Verma, having reviewed and
approved this document, authorizes
Lynette Wilson, who is the Federal
Register Liaison, to electronically sign
this document for purposes of
publication in the Federal Register.
Dated: November 17, 2020.
Lynette Wilson,
Federal Register Liaison, Department of
Health and Human Services.
[FR Doc. 2020–25715 Filed 11–20–20; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare and Medicaid
Services
[CMS–6063–N6]
Medicare Program; National Expansion
of the Prior Authorization Model for
Repetitive, Scheduled Non-Emergent
Ambulance Transports
AGENCY
: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION
: Notice.
SUMMARY
: This notice announces the
national expansion of the Prior
Authorization Model for Repetitive,
Scheduled Non-Emergent Ambulance
Transports to all states, but we are
delaying the implementation of the
expansion to all additional states due to
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