97-28972. Medicare and Medicaid Programs; Quarterly Listing of Program IssuancesFirst Quarter 1997  

  • [Federal Register Volume 62, Number 212 (Monday, November 3, 1997)]
    [Notices]
    [Pages 59358-59365]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 97-28972]
    
    
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    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    
    Health Care Financing Administration
    [BPO-150-N]
    
    
    Medicare and Medicaid Programs; Quarterly Listing of Program 
    Issuances--First Quarter 1997
    
    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 January, February, and March of 1997 that relate to 
    the Medicare and Medicaid programs. It also identifies certain devices 
    with investigational device exemption numbers approved by the Food and 
    Drug Administration that may be potentially 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
    
    [[Page 59359]]
    
    by statute, for the sake of completeness of the listing, we are 
    including all Medicaid issuances and Medicare and Medicaid substantive 
    and interpretive regulations (proposed and final) published during this 
    time frame.
    
    FOR FURTHER INFORMATION CONTACT:
    
    Bridget Wilhite, (410) 786-5248 (For Medicare instruction information).
    Betty Stanton, (410) 786-3247 (For Medicaid instruction information).
    Sharon Hippler, (410) 786-4633 (For Food and Drug Administration-
    approved investigational device exemption information).
    Cathy Johnson, (410) 786-5241 (For all other information).
    
    SUPPLEMENTARY INFORMATION:
    
    I. Program Issuances
    
        The Health Care Financing Administration (HCFA) is responsible for 
    administering the Medicare and Medicaid programs, which pay for health 
    care and related services for 38 million Medicare beneficiaries and 36 
    million Medicaid recipients. Administration of these programs involves 
    (1) providing 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 the Secretary 
    under sections 1102, 1871, and 1902 and related provisions of the 
    Social Security Act (the Act) and also issue various manuals, 
    memoranda, and statements necessary to administer the programs 
    efficiently.
        Section 1871(c)(1) of the Act requires that we publish in the 
    Federal Register at least every 3 months a list of all Medicare manual 
    instructions, interpretive rules, and guidelines of general 
    applicability not issued as regulations. 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. Since the publication of our quarterly 
    listing on June 12, 1992 (57 FR 24797), we decided to add Medicaid 
    issuances to our quarterly listings. Accordingly, we list in this 
    notice Medicaid issuances and Medicaid substantive and interpretive 
    regulations published during January through March 1997.
    
    II. 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 time frame to determine whether 
    any are of particular interest. We expect it to be used in concert with 
    previously published notices. Most notably, 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) and the 
    notice published March 31, 1993 (58 FR 16837), and 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. Addendum I lists the publication dates of 
    the most recent quarterly listings of program issuances.
        Addendum II identifies previous Federal Register documents that 
    contain a description of all previously published HCFA Medicare and 
    Medicaid manuals and memoranda.
        Addendum III of this notice lists, for each of our manuals or 
    Program Memoranda, a HCFA transmittal number unique to that instruction 
    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.
        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, the Federal Register citation, the parts of 
    the Code of Federal Regulations (CFR) that have changed (if 
    applicable), the agency file code number, the title of the regulation, 
    the ending date of the comment period (if applicable), and the 
    effective date (if applicable).
        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. That final rule states that we will 
    announce in this quarterly notice all investigational device exemption 
    categorizations, using the investigational device exemption numbers the 
    Food and Drug Administration assigns. 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. 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.
    
    III. How To Obtain Listed Material
    
    A. Manuals
    
        An individual or organization interested in routinely receiving any 
    manual and revisions to it may purchase a subscription to that manual. 
    Those wishing to subscribe 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).
    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.
    
    B. 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 
    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
    
    [[Page 59360]]
    
    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).
    
    C. 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. In addition, 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.
    
    D. HCFA's Compact Disk-Read Only Memory (CD-ROM)
    
        Our laws, regulations, and manuals are also available on CD-ROM, 
    which 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:
         Titles XI, XVIII, and XIX of the Social Security Act.
         HCFA-related regulations.
         HCFA manuals and monthly revisions.
         HCFA program memoranda.
        The titles of the Compilation of the Social Security Act are 
    current as of January 1, 1995. 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.
    
    IV. 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 1400 designated libraries 
    throughout the United States. Interested parties may examine the 
    documents at any one of the FDLs. Some may have arrangements to 
    transfer material to a local library not designated as an FDL. To 
    locate the nearest FDL, contact any library.
        In addition, individuals may contact regional depository libraries, 
    which 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 
    instruction, use the Superintendent of Documents number, plus the HCFA 
    transmittal number. For example, to find the Intermediary Manual, Part 
    3--Claims Process (HCFA Pub 13-3) transmittal entitled ``Oral Cancer 
    Drugs,'' use the Superintendent of Documents No. HE 22.8/6 and the HCFA 
    transmittal number 1700.
    
    V. General Information
    
        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 items. Copies are not available 
    through the contact persons. Copies can be purchased or reviewed as 
    noted above.
        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, Telephone (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, C4-25-02, 7500 Security Boulevard, Baltimore, MD 21244-
    1850, Telephone (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 Analysis Group, 
    Health Care Financing Administration, C4-11-04, 7500 Security 
    Boulevard, Baltimore, MD 21244-1850, Telephone (410) 786-4633.
        Questions concerning all other information may be addressed to 
    Cathy Johnson, Office of Communications and Operations Support, 
    Division of Regulations and Issuances, Health Care Financing 
    Administration, C5-12-16, 7500 Security Boulevard, Baltimore, MD 21244-
    1850, Telephone (410) 786-5241.
    
    (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: October 10, 1997.
    Pamela J. Gentry,
    Director, Office of Communications and Operations Support.
    
    Addendum I
    
        This addendum lists the publication dates of the most recent 
    quarterly listings of program issuances.
    
    June 26, 1996 (61 FR 33119)
    December 18, 1996 (61 FR 66676)
    April 21, 1997 (62 FR 19328)
    May 12, 1997 (62 FR 25957)
    
    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.
    
    [[Page 59361]]
    
    
    
            Addendum III.--Medicare and Medicaid Manual Instructions        
                        [January 1997 through March 1997]                   
    ------------------------------------------------------------------------
       Trans. No.                     Manual/Subject/Publication No.        
    ------------------------------------------------------------------------
           Intermediary Manual Part 3--Claims Process (HCFA Pub. 13-3)      
                   (Superintendent of Documents No. HE 22.8/6)              
    ------------------------------------------------------------------------
    1696                 Review of Form HCFA-1450 for Inpatient and    
                               Outpatient Bills.                            
                              Bill Review for Partial Hospitalization       
                               Services Provided in Community Mental Health 
                               Centers.                                     
                              Pneumoccocal Pneumonia Influenza Virus and    
                               Hepatitis B Vaccines.                        
    1697                 Laboratory Tests for Hemodialysis,            
                               Intermittent Peritoneal Dialysis and         
                               Continuous Cycling Peritoneal Dialysis       
                               Included in Composite Rate.                  
                              Laboratory Tests for CAPD Covered Routinely   
                               and Separately Billable.                     
    1698                 Review of Form HCFA-1450 for Inpatient and    
                               Outpatient Bills.                            
                              Review of Hospice Bills.                      
    1699                 Medical--Subject to Waiver.                   
    1700                 Oral Cancer Drugs.                            
                              Self-Administered Antiemetic Drugs            
                              Mammography Quality Standards Act.            
    1701                 Hospital Outpatient Partial Hospitalization   
                               Services.                                    
    1702                 Billing for Durable Medical Equipment Orthotic/
                               Prosthetic Devices and Surgical Dressings.   
    1703                 Applicability of Limitation on Liability to   
                               Items or Services Furnished by Providers of  
                               Services Payable Under Part A                
                              When to Make Limitation on Liability          
                               Decisions.                                   
    1704                 Contractor Data Security and Confidentiality  
                               Requirements.                                
                              File Specifications, Records Specifications,  
                               and Data Element Definitions for EMC Bills.  
                              Electronic Media Claims.                      
                              Requirements for Submission of EMC Data.      
                              Claims Processing Timeliness.                 
    1705                 Federal BL Program Address.                   
    1706                 Ambulance Services.                           
    1707                 Review of Form HCFA-1450 for Inpatient and    
                               Outpatient Bills.                            
                              EMC Flat File Record for ESRD Medical         
                               Documentation--Record Type (RT) 76.          
                              Flat File Requirements for RT 76, ESRD Medical
                               Documentation.                               
                              Provider Electronic Billing File and Record   
                               Format.                                      
                              Alphabetic Listing of Data Elements.          
                              Medical Review Attachment Data Definitions and
                               Codes.                                       
    1708                 Routine Services and Appliances.              
    ------------------------------------------------------------------------
         Carriers Manual Part 2--Program Administration (HCFA Pub. 14-2)    
                 (Superintendent of Documents No. HE 22.8/7-3)              
    ------------------------------------------------------------------------
    13                   Claims Processing Timeliness.                 
                              Functional Standards for Claims Processing    
                               Operations.                                  
    ------------------------------------------------------------------------
     Carriers Manual Part 3--Claims Process (HCFA Pub. 14-3) (Superintendent
                           of Documents No. HE 22.8/7)                      
    ------------------------------------------------------------------------
    1555                 Reasonableness and Necessity.                 
    1556                 Beneficiary Address Change.                   
    1557                 Laboratory Tests.                             
                              Separately Billable Tests Furnished to        
                               Patients of Independent Dialysis Facilities. 
    1558                 Type of Service.                              
    1559                 Reasonableness and Necessity.                 
    1560                 Contractor Data Security and Confidentiality  
                               Requirements.                                
                              EMC Testing and Verification.                 
                              Data Sets and Formats for EMC and Electronic  
                               Remittance Advice.                           
                              Requirements for Processing EMC.              
                              Technical Requirements.                       
                              Requirements for Processing EMC.              
    1561                 Federal Black Lung Program Address.           
                              Charges by Relative or Member of Immediate    
                               Household.                                   
                              Duplicate and/or Overlapping Bills With       
                               Discrepant Charges.                          
                              Evidence of Medical Necessity for Parenteral  
                               and Enteral Nutrition.                       
                              TPP Pays Primary Benefits When Not Required.  
                              Federal Government's Right to Sue and Collect 
                               Double Damages.                              
                              Documentation of Conformance.                 
                              When Medicare Secondary Benefits are Payable. 
                              When Medicare Secondary Benefits are Not      
                               Payable.                                     
                              Calculating Medicare Secondary Payments for   
                               Services Reimbursed on Reasonable Charge or  
                               Other Basis Under Part B.                    
                              Effect of Failure to File Proper Claim.       
                              Effect of Primary Payments on Deductibles and 
                               Coinsurance.                                 
                              Right of Physician or Supplier to Charge      
                               Beneficiary.                                 
                              Charging Expenses Against Annual Limit on     
                               Incurred Expenses for Services of            
                               Independently Practicing Physical Therapist. 
                              Nondiscrimination.                            
                              Medicare Secondary Payment for Managed Care   
                               Organization Copayments.                     
                              Individuals Receiving Delayed Compensation    
                               Payments Subject to FICA Taxes.              
                              Referral to Internal Revenue Services.        
                              Primary Payer is Bankrupt or Insolvent.       
    
    [[Page 59362]]
    
                                                                            
                              Determining Size of Employers.                
                              Current Employment Status.                    
                              Limitation on Payment for Services to         
                               Individuals Entitled to Benefits on the Basis
                               of ESRD Who are Covered by GHPs.             
                              Prohibition Against Taking into Account,      
                               Medicare Eligibility or Entitlement and      
                               Benefit Differentiation During Coordination  
                               Period.                                      
                              Determining Period During Which Medicare May  
                               Be Secondary Payer.                          
                              Dual Eligibility/Entitlement Situations.      
                              Effect of ESRD MSP on Consolidated Omnibus    
                               Budget Reconciliation Act Continuation       
                               Coverage.                                    
                              Medicare Secondary Payer Provision for        
                               Disabled Beneficiaries                       
                              Items and Services Furnished on or After      
                               August 10, 1993 and Before October 1, 1998.  
                              Individuals Not Subject to MSP Provision.     
                              The 100-or-More Employees Requirement.        
                              Disabled Individuals Who Return to Work.      
                              Dually-Entitled Individuals.                  
                              Items and Services Furnished on or After      
                               January 1, 1987 and Before August 10, 1993.  
                              Prohibition Against Financial and Other       
                               Incentives.                                  
                              Federal Government's Right to Sue and Collect 
                               Double Damages.                              
                              Excise Tax Penalties for Contributors to      
                               Nonconforming Group Health Plans.            
    1563                 Paper Remittance Notice Requirements.         
    ------------------------------------------------------------------------
       Program Memorandum Intermediaries (HCFA Pub. 60A) (Superintendent of 
                           Documents No. HE 22.8/6-5)                       
    ------------------------------------------------------------------------
    A-97-1               Extension of Due Date for Filing Provider 2552-
                               96 Cost Reports.                             
    A-97-2               Hospital Outpatient Procedures: Medicare      
                               Changes for Radiology and Other Diagnostic   
                               Coding Due to the 1997 HCPCS Update and New  
                               Dermatology HCPCS Codes.                     
    A-97-3               Cost Report Filing Requirements for Hospitals 
                               with Multiple Skilled Nursing Facilities.    
    ------------------------------------------------------------------------
          Program Memorandum Intermediaries/Carriers (HCFA Pub. 60A/B)      
                  (Superintendent of Documents No. HE 22.8/6-5)             
    ------------------------------------------------------------------------
    AB-96-12             Sterile Intravitreal Implant with Cytovene    
                               (Trade Name: Vitrasert).                     
    AB-96-13             Revaccination of Beneficiaries Who Received   
                               Recalled Influenza Virus Vaccine.            
    AB-97-1              New Interest Rate Payable on Clean Claims Not 
                               Paid Timely.                                 
    AB-97-2              Calculation Methodology for Hematocrit Levels 
                               Used to Determine the Applicability of       
                               Payment for EPO Provided to ESRD Patients.   
    AB-97-3              Binding Contractor Hearing Officers to L/RMRP.
    AB-97-4              Common Working File (CWF) Crossover Edits in  
                               Release 97.1.                                
    AB-97-5              New Panels Approved by CPT.                   
    ------------------------------------------------------------------------
           State Operations Manual Provider Certification (HCFA Pub. 7)     
                  (Superintendent of Documents No. HE 22.8/12)              
    ------------------------------------------------------------------------
    279                  Model Letter to Provider (Send with Form HCFA-
                               2567) (Immediate Jeopardy Does Not Exist)    
                               Model Letter Notifying Provider Acceptance of
                               Allegation of Compliance.                    
                              Model Letter Notifying Provider of Results of 
                               Revisit.                                     
                              Notice Requirements.                          
                              Timing of CMPs.                               
                              Procedures for Recommending Enforcement       
                               Remedies When Immediate Jeopardy Does Not    
                               Exist.                                       
                              Response to Allegation of Compliance.         
                              Basis for Imposing CMPs.                      
    280                  Updates of Interpretive Guidelines and Survey 
                               Procedures for Hospitals.                    
    ------------------------------------------------------------------------
     Hospital Manual (HCFA Pub. 10) (Superintendent of Documents No. HE 22.8/
                                       2)                                   
    ------------------------------------------------------------------------
    704                  Outpatient Therapeutic Services.              
    705                  Pneumococcal Pneumonia Influenza Virus and    
                               Hepatitis B Vaccines.                        
    706                  Laboratory Tests for Hemodialysis,            
                               Intermittent Peritoneal Dialysis (IPD) and   
                               Continuous Cycling Peritoneal Dialysis (CCPD)
                               Included in Composite Rate.                  
                              Laboratory Tests for CAPD Covered Routinely   
                               and Separately Billable.                     
    707                  Oral Cancer Drugs.                            
                              Self-Administered Antiemetic Drugs.           
    708                  Billing for Hospital Outpatient Partial       
                               Hospitalization Services.                    
    709                  Billing for DME, Orthotic/Prosthetic Devices  
                               and Surgical Dressings.                      
    710                  Ambulance Service Claims.                     
    711                  Outpatient Therapeutic Services.              
    ------------------------------------------------------------------------
    
    [[Page 59363]]
    
                                                                            
      Home Health Agency Manual (HCFA Pub. 11) (Superintendent of Documents 
                                 No. HE 22.8/5)                             
    ------------------------------------------------------------------------
    282                  Billing for Oral Cancer Drugs.                
                              Self-Administered Antiemetic Drugs.           
    ------------------------------------------------------------------------
      Medicare Renal Dialysis Facility Manual (Non-Hospital Operated) (HCFA 
             Pub. 29) (Superintendent of Documents No. HE 22.8/13)          
    ------------------------------------------------------------------------
    77                   Laboratory Tests for Hemodialysis, IPD and    
                               CCPD.                                        
    ------------------------------------------------------------------------
        Medicare Outpatient Physical Therapy and Comprehensive Outpatient   
         Rehabilitation Facility Manual (HCFA Pub. 9) (Superintendent of    
                            Documents No. HE 22.8/9)                        
    ------------------------------------------------------------------------
    129                  Billing Instructions for Partial              
                               Hospitalization Services Provided in         
                               Community Mental Health Centers.             
    ------------------------------------------------------------------------
         Medicare Coverage Issues Manual (HCFA Pub. 6) (Superintendent of   
                            Documents No. HE 22.8/14)                       
    ------------------------------------------------------------------------
    91                   Laboratory Tests--CRD Patients.               
    92                   Osteogenic Stimulation.                       
    93                   Treatment of Motor Function Disorders with    
                               Electric Nerve Stimulation.                  
                              Transmyocardial Revascularization With Laser--
                               Not Covered.                                 
                              Intraocular Lenses (IOL).                     
                              Partial Ventriculectomy (Also known as        
                               Ventricular Reduction, Ventricular Remodeling
                               or Heart Volume Reduction Surgery).          
                              Cryosurgery of Prostate.                      
                              Vertebral Axial Decompression (VAX-D).        
                              Infusion Pumps.                               
    ------------------------------------------------------------------------
         Medicare Provider Reimbursement Manual Part 1--(HCFA Pub.15-1)     
                   (Superintendent of Documents No. HE 22.8/4)              
    ------------------------------------------------------------------------
    398                  Regional Medicare Swing-Bed SNF Rates.        
    ------------------------------------------------------------------------
       Provider Reimbursement Manual Part II--Provider Cost Reporting Forms 
     and Instructions (HCFA Pub. 15-II-AF) (Superintendent of Documents No. 
                                   HE 22.8/4)                               
    ------------------------------------------------------------------------
    3                    Home Health Agency Complex Identification     
                               Data.                                        
                              Adjustments to Expenses.                      
                              Cost Allocation--General Service Costs, and   
                              Cost Allocation--Statistical Basis.           
    4                    Home Health Agency Cost Report.               
                              Home Health Agency Complex Identification     
                               Data.                                        
                              Cost Allocation--General Service Costs, and   
                              Cost Allocation--Statistical Basis.           
                              Cost Center Coding.                           
    ------------------------------------------------------------------------
           State Medicaid Manual--Part 3--Eligibility (HCFA Pub. 45-3)      
                  (Superintendent of Documents No. HE 22.8/10)              
    ------------------------------------------------------------------------
    67                   Changes Due to Welfare Reform.                
                              Changes in SSI Definition of Disability Due to
                               Welfare Reform.                              
                              Citizenship and Alienage.                     
                              Aliens.                                       
    ------------------------------------------------------------------------
             State Medicaid Manual--Part 4--Services (HCFA Pub. 45-4)       
                  (Superintendent of Documents No. HE 22.8/10)              
    ------------------------------------------------------------------------
    70                   Home Respiratory Care for Ventilator-Dependent
                               Individuals.                                 
                              Home and Community-Based Services--Basis,     
                               Scope, and Purpose.                          
                              Description of Waiver Participants.           
                              Definition of Services.                       
                              Safeguards--Assurances and Documentation.     
                              Evaluations--Assurances and Documentation.    
                              Cost Effectiveness--Assurances and            
                               Documentation.                               
                              Annual Report--Assurances and Documentations. 
                              Independent Assessment of the Waiver.         
                              Home and Community-Based Services--Model      
                               Waiver Request.                              
                              Home and Community-Based Services--Procedures 
                               to Request Renewal of Approved Waivers.      
                              Home and Community-Based Services--Amendments.
    ------------------------------------------------------------------------
       State Medicaid Manual--Part 6 Payment for Services (HCFA Pub. 45-6)  
                  (Superintendent of Documents No. HE 22.8/10)              
    ------------------------------------------------------------------------
    33                   Physician Services to Children Under 21.      
                              Physician Services to Pregnant Women.         
    ------------------------------------------------------------------------
         Medicare/Medicaid Sanction--Reinstatement Report (HCFA Pub. 69)    
    ------------------------------------------------------------------------
    97-1                 Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers Excluded/ 
                               Reinstated--December 1996.                   
    
    [[Page 59364]]
    
                                                                            
    97-2                 Cumulative Report of Physicians/Practitioners,
                               Providers and/or Other Health Care Suppliers 
                               Sanctioned/Reinstated.                       
    97-3                 Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers Excluded/ 
                               Reinstated--January 1997.                    
    97-4                 Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers Excluded/ 
                               Reinstated--February 1997.                   
    ------------------------------------------------------------------------
    
    
                                              Addendum IV.--Regulation Documents Published in the Federal Register                                          
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                       End of               
            Publication date            FR vol. 61       CFR                File code*                     Regulation title           comment     Effective 
                                           page        part(s)                                                                         period        date   
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    01/02/97........................     26-31              413  BPD-788-F                         Medicare Program; Electronic     ...........     02/01/97
                                                                                                    Cost Reporting for Skilled                              
                                                                                                    Nursing Facilities and Home                             
                                                                                                    Health Agencies.                                        
    01/13/97........................  1682-1685             435  MB-105-FC                         Medicaid Program;                   03/14/97     01/13/97
                                                                                                    Redeterminations of Medicaid                            
                                                                                                    Eligibility Due to Welfare                              
                                                                                                    Reform.                                                 
    01/13/97........................  1768-1776       .........  BPD-882-N                         Notification Procedures for      ...........  ...........
                                                                                                    States Implementing                                     
                                                                                                    ``Alternative Mechanisms'' in                           
                                                                                                    the Individual Health                                   
                                                                                                    Insurance Market.                                       
    01/16/97........................  2373-2374       .........  ORD-095-N                         New and Pending Demonstration    ...........  ...........
                                                                                                    Project Proposals Submitted                             
                                                                                                    Pursuant to Section 1115(a) of                          
                                                                                                    the Social Security Act:                                
                                                                                                    November 1996.                                          
    01/23/97........................      3563        .........  BPD-886-N                         Department of Health and Human   ...........  ...........
                                                                                                    Services, Health Care                                   
                                                                                                    Financing Administration;                               
                                                                                                    Department of Labor, Pension                            
                                                                                                    and Welfare Benefits                                    
                                                                                                    Administration; and Department                          
                                                                                                    of the Treasury, Office of Tax                          
                                                                                                    Policy and Internal Revenue                             
                                                                                                    Service  (the Agencies );                               
                                                                                                    Health Insurance Portability;                           
                                                                                                    Correction.                                             
    01/29/97........................  4305-4311       .........  ORD-089-N                         Medicare and Medicaid Programs;  ...........  ...........
                                                                                                    Small Business Innovation                               
                                                                                                    Research Grants for Fiscal                              
                                                                                                    Year 1997.                                              
    01/31/97........................  4772-4776       .........  MB-104-N                          Medicaid Program; Preliminary    ...........  ...........
                                                                                                    Limitations on Aggregate                                
                                                                                                    Payments to Disproportionate                            
                                                                                                    Share Hospitals: Federal                                
                                                                                                    Fiscal Year 1997.                                       
    02/05/97........................  5433-5442       .........  HSQ-244-N                         CLIA Program; Clinical           ...........     10/28/96
                                                                                                    Laboratory Improvement                                  
                                                                                                    Amendments of 1988--Denial of                           
                                                                                                    Exemption of Laboratories in                            
                                                                                                    the Commonwealth of Puerto                              
                                                                                                    Rico.                                                   
    02/21/97........................  7945-7946             410  BPD-852-CN                        Medicare Program; Revisions to   ...........     01/01/97
                                                            415                                     Payment Policies and Five-Year                          
                                                                                                    Review of and Adjustments to                            
                                                                                                    the Relative Value Units Under                          
                                                                                                    the Physician Fee Schedule for                          
                                                                                                    Calendar Year 1997; Correction.                         
    02/25/97........................  8451-8452       .........  ORD-096-N                         New and Pending Demonstration    ...........  ...........
                                                                                                    Project Proposals Submitted                             
                                                                                                    Pursuant to Section 1115(a) of                          
                                                                                                    the Social Security Act:                                
                                                                                                    December 1996.                                          
    03/06/97........................     10286        .........  OPL-014-N                         Medicare Program; March 24,      ...........  ...........
                                                                                                    1997 Meeting of the Practicing                          
                                                                                                    Physicians Advisory Council.                            
    03/10/97........................  11035-11064           484  HSQ-238-P                         Medicare and Medicaid Programs;     06/09/97  ...........
                                                                                                    Use of the OASIS as Part of                             
                                                                                                    the Conditions of                                       
                                                                                                    Participation for Home Health                           
                                                                                                    Agencies.                                               
    03/10/97........................  11005-11035           484  BPD-819-P                         Medicare and Medicaid Programs;     06/09/97  ...........
                                                                                                    Conditions of Participation                             
                                                                                                    for Home Health Agencies.                               
    03/28/97........................  14851-14878           413  BPD-808-P                         Medicare and Medicaid Programs;     05/27/97  ...........
                                                                                                    Salary Equivalency Guidelines                           
                                                                                                    for Physical Therapy,                                   
                                                                                                    Respiratory Therapy, Speech                             
                                                                                                    Language Pathology, and                                 
                                                                                                    Occupational Therapy Services.                          
    03/31/97........................  15187-15191     .........  ORD-097-N                         New and Pending Demonstration    ...........  ...........
                                                                                                    Project Proposals Submitted                             
                                                                                                    Pursuant to Section 1115(a) of                          
                                                                                                    the Social Security Act:                                
                                                                                                    January 1997 and Supplement to                          
                                                                                                    December 1996 Listing.                                  
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    
    
    [[Page 59365]]
    
    Addendum V--Categorization of Food and Drug Administration-Approved 
    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.
    
    G960213  A2
    G960218  A1
    G960258  A1
    G960266  A1
    G970004  A1
    G970007  A1
    G970015  A2
    G970016  A2
    G970018  A2
    G970022  A2
    G970035  A2
    G970051  A2
    G970053  A2
    
        The following information presents the device number category (in 
    this case, B), and criterion code.
    
    G950115  B1
    G956391  B2
    G960193  B4
    G960199  B2
    G960208  B1
    G960229  B1
    G960230  B2
    G960231  B3
    G960234  B4
    G960235  B3
    G960241  B2
    G960243  B2
    G960245  B2
    G960246  B1
    G960247  B1
    G960248  B4
    G960249  B4
    G960250  B3
    G960252  B2
    G960253  B4
    G960254  B2
    G960255  B2
    G960256  B1
    G960257  B3
    G960259  B4
    G960262  B3
    G960263  B3
    G960264  B3
    G960267  B1
    G970001  B3
    G970002  B4
    G970003  B3
    G970005  B4
    G970011  B2
    G970012  B4
    G970019  B3
    G970023  B4
    G970025  B3
    G970026  B3
    G970028  B3
    G970029  B3
    G970030  B1
    G970031  B3
    G970032  B3
    G970033  B4
    G970034  B4
    G970037  B4
    G970038  B4
    G970039  B4
    G970040  B3
    G970041  B4
    G970046  B1
    G970047  B3
    G970052  B1
    G970054  B4
    G970059  B3
    
    [FR Doc. 97-28972 Filed 10-31-97; 8:45 am]
    BILLING CODE 4120-03-P
    
    
    

Document Information

Published:
11/03/1997
Department:
Health Care Finance Administration
Entry Type:
Notice
Action:
Notice.
Document Number:
97-28972
Pages:
59358-59365 (8 pages)
Docket Numbers:
BPO-150-N
PDF File:
97-28972.pdf