98-13040. Medicare and Medicaid Programs: Request for Public Comments on the Quality Improvement System for Managed Care

[Federal Register Volume 63, Number 93 (Thursday, May 14, 1998)]
[Notices]
[Pages 26811-26812]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-13040]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-3888-NC]


Medicare and Medicaid Programs: Request for Public Comments on 
the Quality Improvement System for Managed Care

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Solicitation of comments; notice of public meeting.

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SUMMARY: The Quality Improvement System for Managed Care (QISMC) is a 
document that represents the best thinking on what managed care 
organizations contracting with Medicare and Medicaid should do to 
protect and improve the health and satisfaction of enrolled 
beneficiaries. This notice solicits comments on the review draft of the 
QISMC document, and informs the public of a meeting to discuss the 
quality improvement system initiative.

DATES: We request that comments be submitted on or before May 26, 1998.
    Public Meeting: In addition to seeking written comments from the 
public, we will hold a public meeting on Tuesday, May 26, 1998, from 
8:30 a.m. to 3:30 p.m. e.d.t.

ADDRESSES: The May 26, 1998 public meeting will be held in the Health 
Care Financing Administration Auditorium at 7500 Security Boulevard, 
Baltimore, Maryland 21207. (For details, see section III of this 
notice.)
    Mail written comments (1 original and 3 copies) to the following 
address: Health Care Financing Administration, Department of Health and 
Human Services, Attention: HCFA-3888-NC, P.O. Box 26688, Baltimore, MD 
21207.
    If you prefer, you may deliver your written comments (1 original 
and 3 copies) to one of the following addresses:
Room 309-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., 
Washington, DC 20201,
or

Room C5-09-26, 7500 Security Boulevard, Baltimore, MD 21244-1850

    Comments may also be submitted electronically to the following e-
mail address: hcfa3888nc.hcfa.gov. E-mail comments must include the 
full name and address of the sender and must be submitted to the 
referenced address in order to be considered. All comments must be 
incorporated in the e-mail message because we may not be able to access 
attachments. Because of staffing and resource limitations, we cannot 
accept comments by facsimile (FAX) transmission. In commenting, please 
refer to file code HCFA-3888-NC. Comments received timely will be 
available for public inspection as they are received, generally 
beginning approximately 3 weeks after publication of a document, in 
Room 309-G of the Department's offices at 200 Independence Avenue, SW., 
Washington, DC, on Monday through Friday of each week from 8:30 a.m. to 
5 p.m. (phone: [phone]).

FOR FURTHER INFORMATION CONTACT: Brian Agnew, [phone].

SUPPLEMENTARY INFORMATION:

I. Background

    The QISMC initiative began in 1996 with the following basic goals:
     To develop a coordinated Medicare and Medicaid quality 
oversight system that would reduce duplicative or conflicting efforts 
and send a uniform

[[Page 26812]]

message on quality to organizations and consumers.
     To make the most efficient use of available quality 
measurement and improvement tools, while allowing sufficient 
flexibility to incorporate new developments in the rapidly advancing 
state of the art.
    To support the development of QISMC, HCFA contracted with the 
National Academy for State Health Policy to produce a conceptual 
framework for a unified Medicare-Medicaid quality oversight system, a 
set of quality standards for managed care organizations, and 
interpretive guidelines for these standards.
    The National Academy for State Health Policy gave selected 
individuals and organizations the opportunity to comment on a review 
draft of the QISMC document in January 1998, and the breadth and depth 
of the comments received have convinced us that further investigation 
is necessary before we make any final policy decisions. Therefore, we 
have decided to give all interested parties an opportunity to comment 
on the review draft of the QISMC document.
    At this time, the QISMC standards are not binding on Medicare and 
Medicaid managed care organizations. However, we intend to draw upon 
the QISMC document in establishing regulatory quality assurance 
requirements under Medicaid managed care and Medicare+Choice 
regulations yet to be published.

II. Issues To Be Resolved

    As mentioned, we have already received comments from selected 
individuals and organizations on the review draft of the QISMC 
document. However, to ensure that we consider the full range of public 
opinion, we are using this notice as a vehicle to inform the general 
public that now it too has an opportunity to comment on the review 
draft of the QISMC document. We will consider written public comments 
that are received timely as we finalize the QISMC document.
    The review draft of the QISMC document is available on our internet 
web site (http://www.hcfa.gov/quality/qlty-3e.htm). Although we welcome 
comments on all aspects of the draft, we are particularly interested in 
comments on certain issues identified as especially significant in 
comments received during the January 1998 comment period. These issues 
will be identified on our internet web site as well.
    For those unable to access the QISMC document via the internet, 
hard copies may be obtained by calling Ms. Bronwyn Price of Casals and 
Associates, Inc. (C & A) at [phone].

III. May 26, 1998 Public Meeting

    In addition to seeking written comments from the public, we will 
hold a public meeting on Tuesday, May 26, 1998, from 8:30 a.m. to 3:30 
p.m., in our auditorium at 7500 Security Boulevard, Baltimore, 
Maryland. In the morning, we will hold a plenary session devoted to 
general information about QISMC. In the afternoon, we will convene 
three breakout sessions: the first devoted to technical aspects of 
quality improvement activities, such as setting minimum performance 
levels and establishing the phase-in; the second devoted to issues 
relating to quality monitoring (such as deeming and external review); 
and the third devoted to issues affecting HCFA and the State Medicaid 
agencies in their roles as purchasers.
    Because seating is limited, attendees must register for the meeting 
in advance. Registration must be made by May 18. In order to obtain a 
registration form for this meeting, please contact Ms. Jennifer Fink at 
C & A. Ms. Fink can be reached via telephone, [phone]; fax, 
[phone]; or email, [e-mail]. Once your registration form 
has been received and processed, C & A will provide you with a 
confirmation form. You must bring the confirmation form with you in 
order to be guaranteed participation in the meeting. C & A will also 
provide you with directions to HCFA Central Office.

(Section 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 
and 1395hh))

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: May 4, 1998.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 98-13040 Filed 5-12-98; 2:54 pm]
BILLING CODE 4120-01-P