E7-3040. Medicare Program; Announcement of New Members to the Advisory Panel on Ambulatory Payment Classification (APC) Groups

AGENCY:

Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (DHHS).

ACTION:

Notice.

SUMMARY:

This notice announces five new members selected to serve on the Advisory Panel on Ambulatory Payment Classification (APC) Groups (the Panel). The purpose of the Panel is to review the APC groups and their associated weights and to advise the Secretary, DHHS, (the Secretary) and the Administrator, CMS, (the Administrator) concerning the clinical integrity of the APC groups and their associated weights. We will consider the Panel's advice as we prepare the annual updates of the hospital outpatient prospective payment system (OPPS).

FURTHER INFORMATION CONTACT:

For inquiries about the Panel, please contact the Designated Federal Official (DFO): Shirl Ackerman-Ross, DFO, CMS, CMM, HAPG, DOC, 7500 Security Boulevard, Mail Stop C4-05-17, Baltimore, MD 21244-1850, Phone [phone].

E-Mail Address: The E-mail address for the Panel is as follows: CMS [e-mail]. News media representatives must contact our Public Affairs Office at [phone].

Advisory Committees' Information Lines: The CMS Advisory Committees' Information Line is 1-877-449-5659 (toll free) and [phone] (local).

Web Site: For additional information regarding the APC Panel membership, meetings, agendas, and updates to the Panel's activities, please search our Web site at the following: http://www.cms.hhs.gov/​FACA/​05_​AdvisoryPanelonAmbulatoryPaymentClassificationGroups.asp. A copy of the Panel's Charter is on that Web site. You may also e-mail the Panel DFO at the above-mentioned e-mail address for a copy of the Charter.

SUPPLEMENTARY INFORMATION:

 

I. Background

The Secretary is required by section 1833(t)(9)(A) of the Social Security Act (the Act), [as amended by section 201(h) of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 106-113), and redesignated by section 202(a)(2) of the BBRA] to consult with an expert outside advisory panel regarding the clinical integrity of the APC groups and weights that are components of the hospital OPPS.

The APC Panel meets up to three times annually. The Charter requires that the Panel must be fairly balanced in its membership in terms of the points of view represented and the functions to be performed. The Panel shall consist of up to 15 members who are representatives of providers and a Chair. Each Panel member must be employed full-time by a hospital, hospital system, or other Medicare provider subject to payment under the OPPS. The Secretary or Administrator selects the Panel membership based upon either self-nominations or nominations submitted by Medicare providers and other interested organizations. All members must have technical expertise to enable them to participate fully in the work of the Panel. This expertise encompasses hospital payment systems; hospital medical-care delivery systems; provider billing systems; APC groups; Current Procedural Terminology and alpha-numeric Healthcare Common Procedure Coding System codes; and the use and payment of drugs and medical devices in the outpatient setting, as well as other forms of relevant expertise.

The Charter requires that all members have a minimum of 5 years experience in their area(s) of expertise, but it is not necessary that any member be an expert in all of the areas listed above. For purposes of this Panel, consultants or independent contractors are not considered to be full-time employees of hospitals, hospital systems, or other Medicare providers that are subject to the OPPS. Panel members serve up to 4-year terms. A member may serve after the expiration of his or her term until a successor has been sworn in. All terms are contingent upon the renewal of the Panel's Charter by appropriate action before its termination. The Secretary re-chartered the APC Panel effective November 21, 2006.

II. Announcement of New Members

The Panel may consist of a Chair and up to 15 Panel members who serve without compensation, according to an advance written agreement. Travel, meals, lodging, and related expenses for the meeting are reimbursed in accordance with standard Government travel regulations. We have a special interest in ensuring that women, minorities, representatives from various geographical locations, and the physically challenged are adequately represented on the Panel.

The Secretary, or his designee, appoints new members to the Panel from among those candidates determined to have the required expertise. New appointments are made in a manner that ensures a balanced membership.

The Panel presently consists of the following 13 members and a Chair:

• Edith Hambrick, M.D., J.D., Chair
• Gloryanne Bryant, B.S., R.H.I.A., R.H.I.T., C.C.S.
• Albert Brooks Einstein, Jr., M.D.
• Hazel Kimmel, R.N., C.C.S., C.P.C.
• Sandra J. Metzler, M.B.A., R.H.I.A., C.P.H.Q.
• Frank G. Opelka, M.D., F.A.C.S.
• Louis Potters, M.D., F.A.C.R.
• Lou Ann Schraffenberger, M.B.A., R.H.I.A., C.C.S.-P.
• Judie S. Snipes, R.N., M.B.A., F.A.C.H.E.
• Timothy Gene Tyler, Pharm.D.
• Thomas M. Munger, M.D., F.A.C.C.
• James V. Rawson, M.D.
• Kim Allan Williams, M.D., F.A.C.C., F.A.B.C.
• Robert Matthew Zwolak, M.D., Ph.D., F.A.C.S.

On November 22, 2006, we published the notice titled “Request for Nominations to the Advisory Panel on Ambulatory Payment Classification Groups,” (CMS-1305-N) in the Federal Register requesting nominations to the Panel replacing Panel members whose terms would expire by September 30, 2007. As a result of that Federal Register notice, we are announcing five new members to the Panel. Two new 31/2-year appointments commence on March 1, 2007; two new 31/2-year appointments commence on April 1, 2007; and one new 4-year appointment commences on October 1, 2007, as indicated below:

New panel members	Terms
Patricia Spencer-Cisek, M.S	03/01/2007-09/30/2010
Russ Ranallo, M.S., B.S	03/01/2007-09/30/2010
Beverly Philip, M.D	04/01/2007-09/30/2010
Michael A. Ross, M.D	04/01/2007-09/30/2010
Agatha L. Nolen, M.S., D.Ph	10/01/2007-09/30/2011

Authority: Section 1833(t) of the Act (42 U.S.C. 1395l(t)). The Panel is governed by the provisions of Pub. L. 92-463, as amended (5 U.S.C. Appendix 2).(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare-Hospital Insurance; and Program No. 93.774, Medicare-Supplementary Medical Insurance Program).

Dated: February 15, 2007.

Leslie V. Norwalk,

Acting Administrator, Centers for Medicare & Medicaid Services.