97-12262. Medicare and Medicaid Programs; Quarterly Listing of Program Issuances; Fourth Quarter 1996  

  • [Federal Register Volume 62, Number 91 (Monday, May 12, 1997)]
    [Notices]
    [Pages 25957-25964]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 97-12262]
    
    
    -----------------------------------------------------------------------
    
    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    
    Health Care Financing Administration
    [BPO-148-N]
    
    
    Medicare and Medicaid Programs; Quarterly Listing of Program 
    Issuances; Fourth Quarter 1996
    
    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 October, November, and December of 1996 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 by statute, for the sake 
    of completeness
    
    [[Page 25958]]
    
    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)
    Pat Prete, (410) 786-3246 (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 October through December 1996.
    
    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, P.O. 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.
    
    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 text and graphics from Volume 59,
    
    [[Page 25959]]
    
    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, we anticipate 
    that Rulings, beginning with those released in 1995, will soon be 
    available online, through the HCFA Home Page.
    
    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 Act.
         HCFA-related regulations.
         HCFA manuals and monthly revisions.
         HCFA program memoranda.
        The titles of the Compilation of the Social Security Laws 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 
    2--Fiscal Administration (HCFA Pub. 13-2) transmittal entitled 
    ``Beneficiary Services,'' use the Superintendent of Documents No. HE 
    22.8/6-2 and the HCFA transmittal number 408.
    
    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, Bureau of Program Operations, Issuances 
    Staff, Health Care Financing Administration, N2-05-03, 7500 Security 
    Boulevard, Baltimore, 21244-1850, Telephone (410) 786-5248.
        Questions concerning Medicaid items in Addendum III may be 
    addressed to Pat Prete, Medicaid Bureau, Office of Medicaid Policy, 
    Health Care Financing Administration, C4-25-02, 7500 Security 
    Boulevard, Baltimore, MD 21244-1850, Telephone (410) 786-3246.
        Questions concerning Food and Drug Administration-approved 
    investigational device exemptions may be addressed to Sharon Hippler, 
    Bureau of Policy Development, Office of Chronic Care and Insurance 
    Policy, 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, Bureau of Policy Development, Office of Regulations, 
    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: April 18, 1997.
    Gary Kavanagh,
    Acting Director, Bureau of Program Operations.
    
    Addendum I
    
        This addendum lists the publication dates of the most recent 
    quarterly listings of program issuances.
    
    November 15, 1995 (60 FR 57435)
    April 8, 1996 (61 FR 15491)
    June 26, 1996 (61 FR 33119)
    December 18, 1996 (61 FR 66676)
    April 21, 1997 (62 FR 19328)
    
    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 25960]]
    
    
    
            Addendum III.--Medicare and Medicaid Manual Instructions        
                         [October Through December 1996]                    
    ------------------------------------------------------------------------
       Trans. No.                     Manual/Subject/Publication No.        
    ------------------------------------------------------------------------
                              Intermediary Manual                           
                 Part 2--Fiscal Administration (HCFA Pub. 13-2)             
                  (Superintendent of Documents No. HE 22.8/6-2)             
    ------------------------------------------------------------------------
    408                   o   Beneficiary Services.                         
                              Provider Services.                            
    ------------------------------------------------------------------------
                               Intermediary Manual                          
                             Part 3--Claims Process                         
                                (HCFA Pub. 13-3)                            
                   (Superintendent of Documents No. HE 22.8/6)              
    ------------------------------------------------------------------------
    1689                  o   Outpatient Observation Services.              
                              Bill Review for Partial Hospitalization       
                               Services Provided in Community Mental Health 
                               Centers.                                     
                              Hospital Outpatient Partial Hospitalization   
                               Services.                                    
                              Billing for Hospital Outpatient Services      
                               Furnished By Clinical Social Workers.        
    1690                  o   HCPCS for Hospital Outpatient Radiology       
                               Services and Other Diagnostic Procedures.    
                              Radiology HCPCS Codes Subject to the Payment  
                               Limit.                                       
                              Other Diagnostic Services HCPCS Codes Subject 
                               to the Payment Limit.                        
    1691                  o   Mammography Screening.                        
    1692                  o   Outpatient Therapeutic Services.              
                              Drugs and Biologicals.                        
    1693                  o   Rural Health Clinics--General.                
                              Federally Qualified Health Centers.           
    1694                  o   Outpatient Therapeutic Services.              
                              Drugs and Biologicals.                        
    1695                  o   Beneficiary Address Change.                   
    ------------------------------------------------------------------------
                                 Carriers Manual                            
                Part 2--Program Administration (HCFA Pub. 14-2)             
                 (Superintendent of Documents No. HE 22.8/7-3)              
    ------------------------------------------------------------------------
    134                   o   Beneficiary Services.                         
                              Provider Services.                            
    ------------------------------------------------------------------------
                                 Carriers Manual                            
                    Part 3--Claims Process (HCFA Pub. 14-3)                 
                   (Superintendent of Documents No. HE 22.8/7)              
    ------------------------------------------------------------------------
    1552                  o   Paper Remittance Notice.                      
                              Paper Remittance Notice Requirements.         
                              Use of Standard Codes on the Paper Remittance 
                               Notice.                                      
                              Paper Remittance Notice Abbreviations.        
                              Participation Program and Billing Limitations.
    1553                  o   Incident to Physician's Professional Services.
                              Commonly Furnished in Physician's Offices.    
                              Services and Supplies.                        
    1554                  o   Correct Coding Initiative.                    
    ------------------------------------------------------------------------
                               Program Memorandum                           
                         Intermediaries (HCFA Pub. 60A)                     
                  (Superintendent of Documents No. HE 22.8/6-5)             
    ------------------------------------------------------------------------
    A-96-8                o   Medicare's Partial Hospitalization Benefit-   
                               Eligibility and Scope of Services            
    A-96-9                o   Home Health Agency Cost Limits--Correction to 
                               the Budget Neutrality Factor.                
    A-96-10               o   Change in Hospice Payment Rates.              
    A-96-11               o   Home Health Agency Cost Limits--Revised       
                               Correction to the Budget Neutrality Factor.  
    ------------------------------------------------------------------------
                               Program Memorandum                           
                            Carriers (HCFA Pub. 60B)                        
                  (Superintendent of Documents No. HE 22.8/6-5)             
    ------------------------------------------------------------------------
    B-96-3                o   Coverage of Epoetin Alfa for HIV/AIDS and     
                               Cancer Patients Undergoing Chemotherapy.     
    ------------------------------------------------------------------------
     
    [[Page 25961]]
    
                                                                            
                               Program Memorandum                           
                   Intermediaries/Carriers (HCFA Pub. 60A/B)                
                  (Superintendent of Documents No. HE 22.8/6-5)             
    ------------------------------------------------------------------------
    AB-96-10              o   Current Status of Medicare Program Memorandums
                               and Letters Issued Before Calendar Year 1996.
    AB-96-11              o   Nonpayment of Viral Load Testing (Roche       
                               Diagnostic Amplicor Test).                   
    ------------------------------------------------------------------------
                               Program Memorandum                           
                            Medicaid State Agencies                         
                                 (HCFA Pub. 17)                             
                  (Superintendent of Documents No. HE 22.8/6-5)             
    ------------------------------------------------------------------------
    96-1                  o   Current Status of Medicaid Program Memorandums
                               and Action Transmittals Issued Before        
                               Calendar Year 1996.                          
    ------------------------------------------------------------------------
                         Peer Review Organization Manual                    
                                 (HCFA Pub. 19)                             
                 (Superintendent of Documents No. HE 22.8/8-15)             
    ------------------------------------------------------------------------
    63                    o   Consumer Representative                       
                                Hospital Manual                             
                                 (HCFA Pub. 10)                             
                   Superintendent of Documents No. HE 22.8/2)               
    ------------------------------------------------------------------------
    701                   o   Outpatient Observation Services.              
                              Billing for Hospital Outpatient Partial       
                               Hospitalization Services.                    
                              Billing for Hospital Outpatient Services      
                               Furnished by Clinical Social Workers.        
    702                   o   HCPCS for Hospital Outpatient Radiology and   
                               Other Diagnostic Procedures.                 
                              Radiology HCPCS Codes Subject to the Payment  
                               Limit.                                       
                              Other Diagnostic Services HCPCS Codes Subject 
                               to the Payment Limit.                        
    703                   o   Billing for Mammography Screening.            
    ------------------------------------------------------------------------
                           Home Health Agency Manual                        
                                 (HCFA Pub. 11)                             
                   (Superintendent of Documents No. HE 22.8/5)              
    ------------------------------------------------------------------------
    281                   o   Billing for Ambulance Services.               
                              HCPCS Reporting Requirement.                  
    ------------------------------------------------------------------------
                         Skilled Nursing Facility Manual                    
                                 (HCFA Pub. 12)                             
                   (Superintendent of Documents No. HE 22.8/3)              
    ------------------------------------------------------------------------
    346                   o   Billing for Mammography Screening.            
    347                   o   Billing for Ambulance Services.               
    ------------------------------------------------------------------------
                           HCPCS Reporting Requirement                      
                   Medicare Rural Health Clinic and Federally               
                        Qualified Health Centers Manual                     
                                 (HCFA Pub. 27)                             
                (Superintendent of Documents No. HE 22.8/19:985)            
    ------------------------------------------------------------------------
    24                    o   Billing for Mammography Screening by Rural    
                               Health Clinics and Federally Qualified Health
                               Centers.                                     
    ------------------------------------------------------------------------
                  Outpatient Physical Therapy and Comprehensive             
                   Outpatient Rehabilitation Facility Manual                
                                 (HCFA Pub. 9)                              
                   (Superintendent of Documents No. HE 22.8/9)              
    ------------------------------------------------------------------------
    128                   o   Billing Instructions for Partial              
                               Hospitalization Services Provided in         
                               Community Mental Health Centers.             
    ------------------------------------------------------------------------
                             Coverage Issues Manual                         
                                 (HCFA Pub. 6)                              
                   Superintendent of Documents No. HE 22.8/14)              
    ------------------------------------------------------------------------
    90                    o   Antigens Prepared for Sublingual              
                               Administration.                              
    ------------------------------------------------------------------------
     
    [[Page 25962]]
    
                                                                            
                         Provider Reimbursement Manual                      
                            Part 1--(HCFA Pub. 15-1)                        
                   (Superintendent of Documents No. HE 22.8/4)              
    ------------------------------------------------------------------------
    397                   o   Travel Expense.                               
    ------------------------------------------------------------------------
                          Provider Reimbursement Manual                     
                     Part II--Provider Cost Reporting Forms                 
                     and Instructions (HCFA Pub. 15-II-AC)                  
                   (Superintendent of Documents No. HE 22.8/4)              
    ------------------------------------------------------------------------
    4                     o   Independent Rural Health Clinic/Federally     
                               Qualified Health Center Statistical Data and 
                               Certification Statement.                     
                              Determination of Total Payment.               
    ------------------------------------------------------------------------
                          Provider Reimbursement Manual                     
    Part II--Provider Cost Reporting Forms and Instructions (HCFA Pub. 15-II-
                                      AJ)                                   
                   (Superintendent of Documents No. HE 22.8/4)              
    ------------------------------------------------------------------------
    1                     o   Hospital and Hospital Health Care Complex Cost
                               Report--Form HCFA 2552-96.                   
    2                     o   Form HCFA-2552-96 Worksheet.                  
    ------------------------------------------------------------------------
                               State Buy-In Manual                          
                                 (HCFA Pub. 24)                             
                  (Superintendent of Documents No. HE 22.8/11)              
    ------------------------------------------------------------------------
    1                     o   Describe the Policies and Procedures Governing
                               the Enrollment of Individuals in the Part A  
                               and Part B State Buy-In Program.             
    ------------------------------------------------------------------------
                          State Medicaid Manual--Part 6                     
                              Payment for Services                          
                                (HCFA Pub. 45-6)                            
                  (Superintendent of Documents No. HE 22.8/10)              
    ------------------------------------------------------------------------
    32                    o   Upper Limits for Prescription Drugs.          
    ------------------------------------------------------------------------
                                Medicare/Medicaid                           
                         Sanction--Reinstatement Report                     
                                 (HCFA Pub. 69)                             
    ------------------------------------------------------------------------
    96-9                  o   Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers.          
                              Excluded/Reinstated--August 1996.             
    96-10                 o   Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers.          
                              Excluded/Reinstated--September 1996.          
    96-11                 o   Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers.          
                              Excluded/Reinstated--October 1996.            
    96-12                 o   Report of Physicians/Practitioners, Providers 
                               and/or Other Health Care Suppliers.          
                              Excluded/Reinstated--November 1996.           
    ------------------------------------------------------------------------
    
    Medicare Coverage Issues Manual
    
        For the Medicare Coverage Issues Manual instruction that was 
    published during the quarter covered by this notice, we give the 
    transmittal number, the title of the section, and a brief synopsis of 
    the revisions. The full text of these revisions is available at the 
    following Internet address: http://www.hcfa.gov/pubforms/pub6/
    pub6toc.htm
    Transmittal No. 90
    
    New Implementing Instruction--Effective Date: 11/17/96
    
        Section 45-28, Antigens Prepared for Sublingual Administration.--
    This section is added to provide a national determination that 
    antigens, which are to be administered sublingually, are not covered by 
    Medicare.
    
                                              Addendum IV.--Regulation Documents Published in the Federal Register                                          
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                 End of                     
        Publication date       FR vol. 61 page         CFR part(s)               File code*             Regulation title        comment      Effective date 
                                                                                                                                 period                     
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    10/01/96................  51295-51298       ........................  BPD-874-N                 Medicare Program; Update  ...........  10/01/96         
                                                                                                     of Ambulatory Surgical                                 
                                                                                                     Center Payment Rates                                   
                                                                                                     Effective for Services                                 
                                                                                                     on or After October 1,                                 
                                                                                                     1996.                                                  
    
    [[Page 25963]]
    
                                                                                                                                                            
    10/01/96................       51217        412, 413, 489...........  BPD-847-N                 Medicare Program; Notice  ...........  10/01/96         
                                                                                                     of Effective Date for                                  
                                                                                                     Changes to the Hospital                                
                                                                                                     Inpatient Prospective                                  
                                                                                                     Payment Systems and                                    
                                                                                                     Fiscal Year 1997 Rates.                                
    10/03/96................  51611-51617       413.....................  BPD-805-F                 Medicare and Medicaid     ...........  1/04/96          
                                                                                                     Programs; New Payment                                  
                                                                                                     Methodology for Routine                                
                                                                                                     Extended Care Services                                 
                                                                                                     Provided in a Swing-Bed                                
                                                                                                     Hospital.                                              
    10/23/96................  55002-55009       ........................  OACT-052-N                Medicare Program;         ...........  01/01/97         
                                                                                                     Monthly Actuarial Rates                                
                                                                                                     and Monthly                                            
                                                                                                     Supplementary Medical                                  
                                                                                                     Insurance Premium Rate                                 
                                                                                                     Beginning January 1,                                   
                                                                                                     1997.                                                  
    11/04/96................  56691-56693       ........................  OACT-053-N                Medicare Program; Part A  ...........  01/01/97         
                                                                                                     Premium for 1997 for                                   
                                                                                                     the Uninsured Aged and                                 
                                                                                                     for Certain Disabled                                   
                                                                                                     Individuals Who Have                                   
                                                                                                     Exhausted Other                                        
                                                                                                     Entitlement.                                           
    11/04/96................  56690-56691       ........................  OACT-054-N                Medicare Program;         ...........  01/01/97         
                                                                                                     Inpatient Hospital                                     
                                                                                                     Deductible and Hospital                                
                                                                                                     and Extended Care                                      
                                                                                                     Services Coinsurance                                   
                                                                                                     Amounts for 1997.                                      
    11/08/96................  57876-57878       ........................  BPD-879-NC                Medicare and Medicaid        01/07/97  .................
                                                                                                     Programs; Announcement                                 
                                                                                                     of Additional                                          
                                                                                                     Application From                                       
                                                                                                     Hospital Requesting                                    
                                                                                                     Waivers for Organ                                      
                                                                                                     Procurement Service                                    
                                                                                                     Area and Technical                                     
                                                                                                     Correction.                                            
    11/13/97................  58140-58143       431.....................  MB-092-F                  Medicaid and Aid to       ...........  11/13/96         
                                                                                                     Families With Dependent                                
                                                                                                     Children; Certain                                      
                                                                                                     Provisions of the                                      
                                                                                                     National Voter                                         
                                                                                                     Registration Act of                                    
                                                                                                     1993.                                                  
    11/18/96................       58631        413.....................  BPD-805-CN                Medicare and Medicaid     ...........  11/04/96         
                                                                                                     Programs; New Payment                                  
                                                                                                     Methodology for Routine                                
                                                                                                     Extended Care Services                                 
                                                                                                     Provided in a Swing-Bed                                
                                                                                                     Hospital; Correction.                                  
    11/19/96................       58885        ........................  ORD-093-N                 New and Pending           ...........  .................
                                                                                                     Demonstration Project                                  
                                                                                                     Proposals Submitted                                    
                                                                                                     Pursuant to Section                                    
                                                                                                     1115(a) of the Social                                  
                                                                                                     Security Act: September                                
                                                                                                     1996.                                                  
    11/19/96................  58885-58886       ........................  OPL-012-CN                Medicare Program;         ...........  .................
                                                                                                     December 16, 1996                                      
                                                                                                     Meeting of the                                         
                                                                                                     Practicing Physicians                                  
                                                                                                     Advisory Council.                                      
    11/21/96................       59198        440.....................  MB-102-F                  Medicaid Program; Family  ...........  11/10/94         
                                                                                                     Planning Services and                                  
                                                                                                     Supplies for                                           
                                                                                                     Individuals of Child-                                  
                                                                                                     Bearing Age.                                           
    11/22/96................  59490-59716       410, 415................  BPD-852-FC                Medicare Program;            01/21/97  01/01/97         
                                                                                                     Revisions to Payment                                   
                                                                                                     Policies and Five-Year                                 
                                                                                                     Review of and                                          
                                                                                                     Adjustments to the                                     
                                                                                                     Relative Value Units                                   
                                                                                                     Under the Physician Fee                                
                                                                                                     Schedule for Calendar                                  
                                                                                                     Year 1997.                                             
    11/22/96................  59717-59724       ........................  BPD-853-FN                Medicare Program;         ...........  10/01/96-01/01/97
                                                                                                     Physician Fee Schedule                                 
                                                                                                     Update for Calendar                                    
                                                                                                     Year 1997 and Physician                                
                                                                                                     Volume Performance                                     
                                                                                                     Standard Rates of                                      
                                                                                                     Increase for Federal                                   
                                                                                                     Fiscal Year 1997.                                      
    12/02/96................  63740-63749       401, 403, 405, 411, 413,  BPO-118-FC                Medicare Program;            01/31/97  01/02/97         
                                                 447, 493.                                           Changes Concerning                                     
                                                                                                     Suspension of Medicare                                 
                                                                                                     Payments, and                                          
                                                                                                     Determinations of                                      
                                                                                                     Allowable Interest                                     
                                                                                                     Expenses.                                              
    12/09/96................  64914-64918       ........................  ORD-094-N                 New and Pending           ...........  .................
                                                                                                     Demonstration Project                                  
                                                                                                     Proposals Submitted                                    
                                                                                                     Pursuant to Section                                    
                                                                                                     1115(a) of the Social                                  
                                                                                                     Security Act: October                                  
                                                                                                     1996.                                                  
    12/18/96................       66676        ........................  OPL-013-N                 Medicare Program;         ...........  .................
                                                                                                     Request for Nominations                                
                                                                                                     for Members for the                                    
                                                                                                     Practicing Physicians                                  
                                                                                                     Advisory Council.                                      
    12/18/96................  66676-66687       ........................  BPO-140-N                 Medicare and Medicaid     ...........  .................
                                                                                                     Programs; Quarterly                                    
                                                                                                     Listing of Program                                     
                                                                                                     Issuances and Coverage                                 
                                                                                                     Decisions--Second                                      
                                                                                                     Quarter 1996.                                          
    
    [[Page 25964]]
    
                                                                                                                                                            
    12/19/96................  66919-66923       412, 413, 489...........  BPD-847-FCN               Medicare Program;         ...........  10/01/96         
                                                                                                     Changes to the Hospital                                
                                                                                                     Inpatient Prospective                                  
                                                                                                     Payment Systems and                                    
                                                                                                     Fiscal Year 1997 Rates;                                
                                                                                                     Corrections.                                           
    12/19/96................  67041-67047       ........................  BPD-849-FN                Medicare Program;         ...........  12/19/96 through 
                                                                                                     Recognition of the                     12/19/02        
                                                                                                     Ambulatory Surgical                                    
                                                                                                     Center Standards of the                                
                                                                                                     Joint Commission on the                                
                                                                                                     Accreditation of                                       
                                                                                                     Healthcare                                             
                                                                                                     Organizations and the                                  
                                                                                                     Accreditation                                          
                                                                                                     Association for                                        
                                                                                                     Ambulatory Health Care.                                
    12/30/96................  68697-68698       ........................  BPD-886-N                 Department of Health and     02/03/97  .................
                                                                                                     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 Services (the                                  
                                                                                                     Agencies); Health                                      
                                                                                                     Insurance Portability.                                 
    12/31/96................       69034        401, 405................  BPD-869-CN                Medicare Program; Waiver  ...........  10/21/96         
                                                                                                     of Recovery of                                         
                                                                                                     Overpayments.                                          
    12/31/96................  69034-69050       417, 434................  OMC-010-F                 Medicare and Medicaid     ...........  01/01/97         
                                                                                                     Programs; Requirements                                 
                                                                                                     for Physician Incentive                                
                                                                                                     Plans in Prepaid Health                                
                                                                                                     Care Organizations.                                    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    
    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.
    
    G960164  A2
    G960186  A2
    G960190  A1
    G960200  A1
    G960203  A2
    G960213  A1
    
        The following information presents the device number category (in 
    this case, B), and criterion code.
    
    G940148  B2
    G940193  B2
    G950094  B1
    G960065  Be
    G960072  B4
    G960106  B5
    G960115  Be
    G960134  B4
    G960144  B4
    G960166  Be
    G960183  B2
    G960187  B1
    G960189  B2
    G960191  Be
    G960197  Be
    G960198  B2
    G960199  B2
    G960201  Be
    G960202  B4
    G960204  Be
    G960205  B4
    G960206  B2
    G960210  B4
    G960211  B4
    G960212  B4
    G960215  B2
    G960217  B4
    G960219  Be
    G960221  B2
    G960223  B1
    G960224  B2
    G960225  B4
    G960226  B2
    G960227  B2
    G960229  B1
    G960232  B4
    G960236  Be
    G960238  B4
    G960239  B1
    G960242  B4Q
        This quarter we are listing previously published IDE numbers that 
    have changed reimbursement category. They are:
    
    G870181 from A2 to B2
    G880210 from A2 to B4
    G890210 from A2 to B2
    G900143 from A2 to B4
    G900246 from A2 to B2
    G910064 from A2 to B4
    G910078 from A2 to B4
    G910170 from A2 to B4
    G910197 from A2 to B4
    G910202 from A2 to B4
    G920142 from B2 to B4
    G920143 from A2 to B4
    G930017 from B2 to A2
    G930054 from A2 to B4
    G930115 from A2 to B4
    G930190 from A2 to B4
    G930192 from A2 to B4
    G940084 from A2 to B2
    G940088 from A2 to B4
    G950083 from A2 to B2
    G950168 from A2 to B4
    G950175 from A2 to B4
    G960060 from A1 to A2
    G960113 from A2 to B4
    
    [FR Doc. 97-12262 Filed 5-9-97; 8:45 am]
    BILLING CODE 4120-01-P
    
    
    

Document Information

Published:
05/12/1997
Department:
Health Care Finance Administration
Entry Type:
Notice
Action:
Notice.
Document Number:
97-12262
Dates:
11/17/96
Pages:
25957-25964 (8 pages)
Docket Numbers:
BPO-148-N
PDF File:
97-12262.pdf