Medicare and Medicaid programs; OBRA '87 conforming amendments--HCFA. Final rule with comment period

These regulations amend certain sections of Medicare and Medicaid rules to reflect 15 self-executing provisions of the Omnibus Budget Reconciliation Act of 1987 (OBRA '87) and changes made by sections 102, 103, and 211(b) of the Medicare Catastrophic Coverage Act of 1988 (MCCA), section 608(d)(3)(G) of the Family Support Act of 1988 (Pub. L. 100-485), and sections 6113 and 6301 of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89). They also clarify related rules. The amendments are needed to make HCFA rules consistent with current provisions of law and to ensure that users of the regulations are not confused by outdated provisions or unclear language. This document also makes technical amendments, primarily to correct internal cross-references, make nomenclature changes, and revise an outdated definition.     

Medicare program; hospice care amendments. Final rule

This final rule revises existing regulations that govern coverage and payment for hospice care under the Medicare program. These revisions reflect the statutory changes required by the Balanced Budget Act of 1997 (BBA), the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), and the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA). Additionally, these revisions reflect current policy on the documentation needed to support a certification of terminal illness, admission to Medicare hospice, and a new requirement that allows for discharges from hospice for cause under very limited circumstances. This final rule does not address the requirement for hospice data collection, the changes to the limitation of liability rules, or the changes to the hospice conditions of participation that were included in the BBA. The intent of this final rule is to expand the hospice benefit periods, improve documentation requirements to support certification and recertification of terminal illness, provide guidance on hospice admission procedures, clarify hospice discharge procedures, update coverage and payment requirements, and address the changing needs of beneficiaries, suppliers, and the Medicare program.     

Medicare program; prospective payment system for inpatient hospital capital-related costs; correction--HCFA. Final rule; correction

In the August 30, 1991 issue of the Federal Register (FR Doc. 91-20779) (56 FR 43358), we revised the Medicare payment methodology for inpatient hospital capital-related costs for hospitals paid under the prospective payment system. We replaced the reasonable cost-based payment methodology with a prospective payment methodology for capital-related costs. This notice corrects errors made in that document.     

Medicaid Program; eligibility groups, coverage, and conditions of eligibility; legislative changes under OBRA '87, COBRA, and TEFRA--HCFA. Final rule; correction notice

This notice corrects 42 CFR 440.210, Required services for the categorically needy, 42 CFR 440.220, Required services for the medically needy, and 42 CFR 440.250, Limits on comparability of services, to restore current text which was inadvertently deleted in the final rule and to make conforming redesignation changes. This notice rescinds a correction notice published on March 14, 1991, in which certain corrections pertaining to sections 440.220 and 440.250 were inadvertently omitted.     

Medicare program; Medicare secondary payer for individuals entitled to Medicare and also covered under group health plans; correction--HCFA. Final rule with comment period; correcting amendments

This document makes corrections to the final rule with comment period entitled "medicare program; medicare secondary payer for individuals entitled to medicare and also covered under group health plans" that was published in the Federal Register on Thursday, August 31, 1995 (60 FR 45344).     

Medicare program; changes to the inpatient hospital prospective payment system and FY 1991 rates; correction--HCFA. Final rule; correction

In the September 4, 1990 issue of the Federal Register (FR Doc. 90-20677), (55 FR 35990), we made revisions to the Medicare inpatient hospital prospective payment system and set forth the prospective payment rates for FY 1991. This notice corrects errors made in that document.     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 1995 rates; correction--HCFA. Final rule; correction

In the September 1, 1994 issue of the Federal Register (59 FR 45330), we published a final rule with comment period revising the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement necessary changes arising from our continuing experience with the system. In the addendum to that final rule with comment period, we announced the prospective payment rates for Medicare hospital inpatient services for operating costs and capital-related costs applicable to discharges occurring on or after October 1, 1994, and set forth update factors for the rate-of-increase limits for hospitals and hospital units excluded from the prospective payment systems. This notice corrects errors made in that document.     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 1993 rates; correction--HCFA. Final rule; correction

In the September 1, 1992, issue of the Federal Register (FR Doc 92-20647) (57 FR 39746), we revised the Medicare inpatient hospital prospective payment systems for operating costs and capital-related costs. Additionally, in the addendum to that final rule, we described changes in the amounts and factors necessary to determine prospective payment rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 1992. This notice corrects errors made in that document.     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 1994 rates; correction--HCFA. Final rule; correction

In the September 1, 1993, issue of the Federal Register (FR Doc 93-21026) (58 FR 46270), we revised the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement necessary changes arising from our continuing experience with the system. Additionally, in the addendum to that final rule, we announced the prospective payment rates for Medicare hospital inpatient services for operating costs and capital-related costs applicable to discharges occurring on or after October 1, 1993, and set forth update factors for the rate-of-increase limits for hospitals and hospital units excluded from the prospective payment systems. This notice corrects errors made in that document.     

Medicare program: changes to the inpatient hospital prospective payment system and fiscal year 1992 rates; correction--HCFA. Final rule; correction

In the August 30, 1991, issue of the Federal Register (FR Doc. 91-20778), (56 FR 43196), we revised the Medicare inpatient hospital prospective payment system and the amounts and factors necessary to determine prospective payment rates for Medicare inpatient hospital services. These changes are applicable to discharges occurring on or after October 1, 1991. This notice corrects errors made in that document.     

Medicare program; mid-year FY 1991 changes to the inpatient hospital prospective payment system; correction--HCFA. Final rule with comment period; correction

In the January 7, 1991 issue of the Federal Register (FR Doc. 90-30619), (56 FR 568), we implemented several provisions of section 4002 of the Omnibus Budget Reconciliation Act of 1990 (Pub. L. 101-508) that affected Medicare payment under the inpatient hospital prospective payment system for discharges occurring on or after January 1, 1991. This notice corrects errors made in that document.     

Medicare program; hospice care amendments: Medicare--HCFA. Final rule with comment period

These rules amend the hospice care provisions on physician certification of terminal illness-- To allow up to 8 days to obtain written certification of terminal illness, provided oral certification is obtained within 2 days after the initial period of care begins; and To modify the certification statement which, in its previous form, was shown to discourage physicians from certifying terminal illness and thereby discourage hospice participation in Medicare. These changes are necessary-- To conform HCFA rules to amendments made by section 6005(b) of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89); and To carry out the recommendations of the General Accounting Office (GAO), aimed at encouraging greater participation of hospices in the Medicare program. These rules also simplify and clarify other hospice policies, remove outdated content, and correct cross-references.     

Medicare program; Medicare Shared Savings Program: Accountable Care Organizations. Final rule

This final rule implements section 3022 of the Affordable Care Act which contains provisions relating to Medicare payments to providers of services and suppliers participating in Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program. Under these provisions, providers of services and suppliers can continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, and be eligible for additional payments if they meet specified quality and savings requirements.     

Medicare program; establishment of the Medicare Advantage Program; interpretation. Final rule; interpretation

This final rule clarifies our interpretation of the meaning of "entity" in the final rule titled "Medicare Program; Establishment of the Medicare Advantage Program" published in the Federal Register on January 28, 2005 (70 FR 4588). Subsequent to the publication of the Medicare Advantage (MA) final rule on January 28, 2005, we have received inquiries from parties interested in offering an MA Regional Plan concerning whether they could jointly enter into a contract with us to offer a single MA Regional Plan in a multistate region. The participating health plans wish to contract with each other to create a single "joint enterprise." They have asked us whether such a joint enterprise could be considered an "entity" under sections 1859(a)(1)and 1855(a)(1) of the Social Security Act, for purposes of offering an MA Regional Plan. The MA final rule is scheduled to take effect on March 22, 2005. Our interpretation of the word "entity" that follows in the "Supplementary Information" section of this final rule is deemed to be included in that final rule.     

Medicaid program; eligibility groups, coverage, and conditions of eligibility; legislative changes under OBRA '87, COBRA, and TEFRA--HCFA. Final rule; correction notice

This notice corrects 42 CFR 440.210, Required services for the categorically needy, and 42 CFR 440.220, Required services for the medically needy, to restore current text which was inadvertently deleted in the final rule and to make conforming redesignation changes.     

Federal Employees Health Benefits Program improving carrier performance; conforming changes--OPM. Final rule

The Office of Personnel Management (OPM) is issuing a final regulation that implements OPM's initiative to ensure high quality customer service to its enrollees in the Federal Employees Health Benefits (FEHB) Program by establishing a performance evaluation program that will hold community-rated carriers accountable for their performance. The regulation would enable OPM to better manage carriers' performance in key contract areas, including customer service measures, information and reporting requirements, and significant events that might affect service to enrollees.     

Medicare and Medicaid programs; revaluation of assets; correction--HCFA. Correcting amendments

This document contains corrections to final regulations (BPD-311-F) that were published September 23, 1992 (F.R. Doc. 92-22582) (57 FR 43906). The regulations describe new limitations on the valuations of assets acquired as the result of changes in ownership occurring on or after July 18, 1984. These changes affect hospitals and skilled nursing facilities under the Medicare program, and hospitals, nursing facilities, and intermediate care facilities for the mentally retarded under the Medicaid program.     

Revised standards for protection against radiation; minor amendments--NRC. Final rule: minor corrective and conforming amendments

This final rule makes a number of minor corrective and conforming amendments to the NRC's revised standards for protection against radiation. The final rule is necessary to correct recently discovered errors in the text of the revised standards, to conform portions of regulatory text to the Commission's decision to defer mandatory implementation of the revised standards until 1994, and to reflect the recent OMB approval of the use of NRC Forms 4 and 5.