05-12525. Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2005
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AGENCY:
Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION:
Notice.
SUMMARY:
This notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from January 2005 through March 2005, relating to the Medicare and Medicaid programs. This notice provides information on national coverage determinations (NCDs) affecting specific medical and health care services under Medicare. Additionally, this notice identifies certain devices with investigational device exemption (IDE) numbers approved by the Food and Drug Administration (FDA) that potentially may be covered under Medicare. This notice also includes listings of all approval numbers from the Office of Management and Budget for collections of information in CMS regulations. Finally, for the first time, this notice includes a list of Medicare-approved carotid stent facilities.
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 of the listing, and to foster more open and transparent collaboration efforts, we are also including all Medicaid issuances and Medicare and Medicaid substantive and interpretive regulations (proposed and final) published during this 3-month time frame.
Start Further InfoFOR FURTHER INFORMATION CONTACT:
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. (See Section III of this notice for how to obtain listed material.)
Questions concerning items in Addendum III may be addressed to Timothy Jennings, Office of Strategic Operations and Regulatory Affairs, Centers for Medicare & Medicaid Services, C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2134.
Questions concerning Medicare NCDs in Addendum V may be addressed to Patricia Brocato-Simons, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-0261.
Questions concerning FDA-approved Category B IDE numbers listed in Addendum VI may be addressed to John Manlove, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, S3-26-10, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-6877.
Questions concerning approval numbers for collections of information in Addendum VII may be addressed to Jim Wickliffe, Office of Strategic Operations and Regulatory Affairs, Regulations Development and Issuances Group, Centers for Medicare & Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-4596.
Questions concerning Medicare-approved carotid stent facilities may be addressed to Rana A. Hogarth, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, C1-Start Printed Page 3662109-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2112; or to Sarah J. McClain, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2994.
Questions concerning all other information may be addressed to Gwendolyn Johnson, Office of Strategic Operations and Regulatory Affairs, Regulations Development Group, Centers for Medicare & Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-6954.
End Further Info End Preamble Start Supplemental InformationSUPPLEMENTARY INFORMATION:
I. Program Issuances
The Centers for Medicare & Medicaid Services (CMS) is responsible for administering the Medicare and Medicaid programs. These programs pay for health care and related services for 39 million Medicare beneficiaries and 35 million Medicaid recipients. Administration of the two programs involves (1) furnishing information to Medicare beneficiaries and Medicaid recipients, health care providers, and the public and (2) maintaining effective communications with regional offices, State governments, State Medicaid agencies, State survey agencies, various providers of health care, all Medicare contractors 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 to the Secretary of the Department of Health and Human Services under sections 1102, 1871, 1902, and related provisions of the Social Security Act (the Act). We also issue various manuals, memoranda, and statements necessary to administer the programs efficiently.
Section 1871(c)(1) of the Act requires that we publish a list of all Medicare manual instructions, interpretive rules, statements of policy, and guidelines of general applicability not issued as regulations at least every 3 months in the Federal Register. 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, and to foster more open and transparent collaboration, we are continuing our practice of including Medicare substantive and interpretive regulations (proposed and final) published during the respective 3-month time frame.
II. How To Use the Addenda
This notice is organized so that a reader may review the subjects of manual issuances, memoranda, substantive and interpretive regulations, NCDs, and FDA-approved IDEs published during the subject quarter to determine whether any are of particular interest. We expect this notice to be used in concert with previously published notices. 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) published in 1988, and the notice published March 31, 1993 (58 FR 16837). Those desiring information on the Medicare NCD Manual (NCDM, formerly the Medicare Coverage Issues Manual (CIM)) may wish to review the August 21, 1989, publication (54 FR 34555). Those interested in the revised process used in making NCDs under the Medicare program may review the September 26, 2003, publication (68 FR 55634).
To aid the reader, we have organized and divided this current listing into eight 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 CMS Medicare and Medicaid manuals and memoranda.
- Addendum III lists a unique CMS transmittal number for each instruction in our manuals or Program Memoranda and its subject matter. A transmittal may consist of a single or multiple instruction(s). 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;
○ Federal Register citation;
○ Parts of the Code of Federal Regulations (CFR) that have changed (if applicable);
○ Agency file code number; and
○ Title of the regulation.
- Addendum V includes completed NCDs, or reconsiderations of completed NCDs, from the quarter covered by this notice. Completed decisions are identified by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision.
- Addendum VI includes listings of the FDA-approved IDE categorizations, using the IDE numbers the FDA assigns. 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 IDE number.
- Addendum VII includes listings of all approval numbers from the Office of Management and Budget (OMB) for collections of information in CMS regulations in title 42; title 45, subchapter C; and title 20 of the CFR.
- Addendum VIII includes listings of Medicare-approved carotid stent facilities. All facilities listed meet CMS's standards for performing carotid artery stenting for high risk patients.
III. How To Obtain Listed Material
A. Manuals
Those wishing to subscribe to program manuals 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, most manuals are available at the following Internet address: http://cms.hhs.gov/manuals/default.asp.
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, Number 1 (January 2, 1994) forward. Free public access is available on a Wide Area Information Server (WAIS) Start Printed Page 36622through 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.gpoaccess.gov/fr/index.html, by using local WAIS client software, or by telnet to swais.gpoaccess.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 CMS Regional Office or review them at the nearest regional depository library. We have, on occasion, published rulings in the Federal Register. Rulings, beginning with those released in 1995, are available online, through the CMS Home Page. The Internet address is http://cms.hhs.gov/rulings.
D. CMS' Compact Disk-Read Only Memory (CD-ROM)
Our laws, regulations, and manuals are also available on CD-ROM and 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.
- CMS-related regulations.
- CMS manuals and monthly revisions.
- CMS program memoranda.
The titles of the Compilation of the Social Security Laws are current as of January 1, 1999. (Updated titles of the Social Security Laws are available on the Internet at http://www.ssa.gov/OP_Home/ssact/comp-toc.htm.) 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 1,400 designated libraries throughout the United States. Some FDLs may have arrangements to transfer material to a local library not designated as an FDL. Contact any library to locate the nearest FDL.
In addition, individuals may contact regional depository libraries that 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. For each CMS publication listed in Addendum III, CMS publication and transmittal numbers are shown. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the Medicare NCD publication titled “Implantable Automatic Defibrillators,” use CMS-Pub. 100-03, Transmittal No. 29.
Start Signature(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: June 20, 2005.
Jacquelyn White,
Director, Office of Strategic Operations and Regulatory Affairs.
Addendum I
This addendum lists the publication dates of the most recent quarterly listings of program issuances.
December 27, 2002 (67 FR 79109).
March 28, 2003 (68 FR 15196).
June 27, 2003 (68 FR 38359).
September 26, 2003 (68 FR 55618).
December 24, 2003 (68 FR 74590).
March 26, 2004 (69 FR 15837).
June 25, 2004 (69 FR 35634).
September 24, 2004 (69 FR 57312).
December 30, 2004 (69 FR 78428).
February 25, 2005 (70 FR 9338).
Addendum II—Description of Manuals, Memoranda, and CMS 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 former CIM (now the NCDM) 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.
Addendum III.—Medicare and Medicaid Manual Instructions
[January Through March 2005]
Transmittal No. Manual/subject/publication No. Medicare General Information (CMS Pub. 100-01) 15 Review of Contractor Implementation of Change Requests (Replacement for expired CR 944). Review of Contractor Implementation of Change Requests. CR Implementation Report—Summary Page. CR Implementation Report—Details Page. CR Implementation Report—Sample Cover Letter/ Attestation Statement. 16 Standard Terminology for Claims Processing Systems. 17 This Transmittal rescinded and replaced Transmittal 15. 18 Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System. Items Subject to Blood Deductibles. Blood. 19 Revisions to Chapter 5, Section 50 of Publication 100-01 in the Internet Only. Manual to Clarify Current Policy. Home Health Agency Defined. Arrangements by Home Health Agencies. Start Printed Page 36623 Rehabilitation Centers. Medicare Benefit Policy (CMS Pub. 100-02) 29 Telehealth Originating Site Facility Fee Payment Amount Update. 30 Policy for Repair and Replacement of Durable Medical Equipment. Medicare National Coverage Determinations (CMS Pub. 100-03) 27 Infusion Pumps: C-Peptide Levels As A Criterion for Use. 28 Update of Laboratory NCDs to Reference New Screening Benefits. Blood Glucose Testing. Lipid Testing. 29 Implantable Automatic Defibrillators. 30 Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials. Anti-Cancer Chemotherapy for Colorectal Cancer (Effective January 28, 2005). Medicare Claims Processing (CMS Pub. 100-04) 423 January 2005 Update of the Hospital Outpatient Prospective Payment System: Summary of Payment Policy Changes. 424 Implementation of the Annual Desk Review Program for Hospital Wage Data: Cost Reporting Periods Beginning on or After October 1, 2001, Through September 30, 2002 (FY 2006 Wage Index). 425 Section 630 of the Medicare Modernization Act allows for the Reimbursement for Ambulance Services Provided by Indian Health Service/Tribal Hospitals, Including Critical Access Hospitals, Which Manage and Operate Hospital-Based Ambulances. General Coverage and Payment Policies. Indian Health Service/Tribal Billing. 426 Modification to Reporting of Diagnosis Codes for Screening Mammography Claims. Healthcare Common Procedure Coding System and Diagnosis Codes for Mammography Services. 427 Revision of Change Request 2928: Implementation of Payment Safeguards for Home Health Prospective Payment System Claims Failing to Report Prior Hospitalizations. Adjustments of Episode Payment—Hospitalization Within 14 Days of Start of Care. 428 Update to Billing Requirements for FDG-Positron Emission Tomography Scans For Use in the Differential Diagnosis of Alzheimer's Disease and Fronto-Temporal Dementia and Update to the Fiscal Intermediaries Billing Requirements for Special Payment Procedures for All Positron Emission Tomography Scan. Claims for Services Performed in a Critical Access Hospital. Billing Instructions. Coverage for Positron Emission Tomography Scans for Dementia and Neurodegenerative Disease. 429 Change to the Common Working File Skilled Nursing Facility Consolidated Billing Edits for Critical Access Hospitals That Have Elected Method II Payment Option and Bill Physician Services to Their Fiscal Intermediaries. Physician's Services and Other Professional Services Excluded From Part A PPS Payment and the Consolidated Billing Requirement. 430 Mandatory Assignment for Medicare Modernization Act § 630 Claims. Other Part B Services. Durable Medical Equipment Regional Carrier Drugs. Claims Processing Requirements for Medicare Modernization Act § 630. Claims Processing for Durable Medical Equipment Prosthetic, Orthotics & Supplies and Durable Medical Equipment Regional Carrier Drugs. Enrollment for Durable Medical Equipment Prosthetic, Orthotics & Supplies and Durable Medical Equipment Regional Carrier Drugs. Enrollment and Billing for Clinical Laboratory and Ambulance Services and Part B Drugs. Claims Submission and Processing for Clinical Laboratory and Ambulance Services and Part B Drugs. 431 Updated Skilled Nursing Facility No Pay File for April 2005. 432 Adding an Indicator to the National Claims History to Indicate That Durable Medical Regional Carriers, Carriers, and Fiscal Intermediaries Have Reviewed a Potentially Duplicate Claim. Detection of Duplicate Claims. 433 Issued to a specific audience, not posted to the Internet/Intranet due to the Sensitivity of Instruction. 434 Addition of Clinical Laboratory Improvement Act Edits to Certain Health Care Procedure Coding System Codes for Mohs Surgery. 435 This Transmittal has been rescinded and replaced by Transmittal 450. 436 Remittance Advice Remark Code and Claim Adjustment Reason Code Update. 437 Revisions and Corrections to the Medicare Claims Processing Manual, Chapter 6, Section 30 and Various Sections in Chapter 15. Billing Skilled Nursing Facility Prospective Payment System Services General Coverage and Payment Policies. Air Ambulance for Deceased Beneficiary. General Billing Guidelines for Intermediaries and Carriers. Intermediary Guidelines. 438 Fiscal Intermediary Standard Paper Remittance Advice Changes. 439 Modification to the Fiscal Intermediary Standard System Regarding Ambulance Services Billed on 18x and 21x Types of Bill. 440 Updating the Common Working File Editing for Pap Smear (Q0091) and Adding a New Low Risk Diagnosis Code (V72.31) for Pap Smear and Pelvic Examination. Start Printed Page 36624 Healthcare Common Procedure Coding System Codes for Billing. Diagnoses Codes. Payment Method. Revenue Codes and Healthcare Common Procedure Coding System Codes for Billing. Medicare Summary Notice Messages. Remittance Advice Codes. 441 Viable Medicare Systems Changes to Durable Medical Equipment Regional Carrier Processing of Method II Home Dialysis Claims. 442 Hospital Outpatient Prospective Payment System: Use of Modifiers -52, -73 and -74 for Reduced or Discontinued Services Use of Modifiers. Use of Modifiers for Discontinued Services. 443 This Transmittal is rescinded and replaced by Transmittal 505. 444 Further Information Related to Inpatient Psychiatric Facility Prospective Payment System 445 Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics. Provider Billing for Prosthetics and Orthotic Services. 446 Diabetes Screening Tests. 447 Common Working File Editing for Method Selection on Durable Medical Equipment Regional Carrier Claims for EPO and Aranesp Epoetin Alfa Furnished to Home Patients. Darbepoetin Alfa Furnished to Home Patients. 448 Timeframe for Continued Execution of Crossover Agreements and Update on the Transition to the National Coordination of Benefits Agreement Program Crossover Claims Requirements. Fiscal Intermediaries Requirements. Durable Medical Equipment Regional Carrier Requirements. Consolidation of the Claims Crossover Process. Electronic Transmission - General Requirements. ANSI X12N 837 Coordination of Benefit Transaction Fee Collection. Medigap Electronic Claims Transfer Agreements. Intermediary Crossover Claim Requirements. Carrier/Durable Medical Equipment Regional Carrier Crossover Claims Requirements. 449 April Quarterly Update to 2005 Annual Update of Healthcare Common Procedure Coding System Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement 450 Enforcement of Mandatory Electronic Submission of Medicare Claims Failure To Furnish Information Medicare Summary Notice Message. Falta De Information Sometida Medicare Summary Notice Message Enforcement. 451 April 2005 Quarterly Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orhtotics, and Supplies. 452 New Remittance Advice Message for Referred Clinical Diagnostic/ Purchased Diagnostic Service Duplicate Claims. 453 Instructions for Downloading the Medicare Zip Code File. 454 Definitions of Electronic and Paper Claims. Payment Ceiling Standards. 455 This transmittal is rescinded and replaced by Transmittal 509. 456 Independent Laboratory Billing for the Technical Component of Physician. Pathology Services Furnished to Hospital Patients (Supplemental to Change Request 3467) 457 Diabetes Screening Tests. Healthcare Common Procedure Coding System Coding for Diabetes Screening. Carrier Billing Requirements. Modifier Requirements for Pre-Diabetes. Fiscal Intermediary Billing Requirements. Diagnosis Code Reporting. Medicare Summary Notices. Remittance Advice Remark Codes. Claims Adjustment Reason Codes. 458 Hospice Physician Recertification Requirements. Data Required on Claim to Fiscal Intermediaries. 459 Full Replacement of Change Request 3427, Transmittal 342, Issued on October 29, 2004—Change to the Common Working File Skilled Nursing Facility. Consolidated Billing Edits for Ambulance Transports to or From a Diagnostic or Therapeutic Site. Ambulance Services. Skilled Nursing Facility Billing. 460 Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction. 461 Processing Durable Medical Equipment, Orthotics, Prosthetics, Drugs, and Surgical Dressings Claims for Indian Health Services and Tribally Owned and Operated Hospitals or Hospital Based Facilities Including Critical Access. Hospital. Other Part B Services. Prosthetics and Orthotics. Prosthetic Devices. Surgical Dressings and Splints and Casts. Drugs Dispensed by IHS Hospital-Based or Freestanding Facilities. Claims Processing for Durable Medical Equipment Prosthetics, Orthotics & Supplies. Start Printed Page 36625 Enrollment for Durable Medical Equipment Prosthetics, Orthotics & Supplies. Claims Submission for Durable Medical Equipment Prosthetics, Orthotics & Supplies. 462 Durable Medical Equipment Regional Carrier Only—Dispensing Fees for Immunosuppressive Drugs. 463 Update to 100-04 and Therapy Code Lists. Healthcare Common Procedure Coding System Coding Requirement. Part B Outpatient Rehabilitation and Comprehensive Outpatient Rehabilitation Facility Services—General. Discipline Specific Outpatient Rehabilitation Modifiers—All Claims. The Financial Limitation. Reporting of Service Units With HCPCS—Form CMS-1500 and Form CMS-1450. 464 Implementation of the Abstract File for Purchased Diagnostic. Test/Interpretations (Supplemental to CR 3481). Payment Jurisdiction Among Local Carriers for Services Paid Under the Physician Fee Schedule and Anesthesia Services. Payment Jurisdiction for Purchased Services. Payment to Physician or Other Supplier for Purchased Diagnostic Tests—Claims Submitted to Carriers. Payment to Supplier of Diagnostic Tests for Purchased Interpretations. 465 Billing Requirements for Physician Services in Method II Critical Access Hospitals. Payment for Inpatient Services Furnished by a Critical Access Hospital. Special Rules for Critical Access Hospital Outpatient Billing. Billing and Payment in a Physician Scarcity Area. 466 Quarterly Update to Correct Coding Initiative Edits, Version 11.1, Effective April 1, 2005. 467 Modifications to Duplicate Editing for Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Anti-Emetic, Immunosuppressive and Inhalation Drugs. 468 Appeals Transition—Benefits, Improvement & Protection Act Section 521. Appeals. 469 New Waived Tests—April 1, 2005. 470 Standardization of Fiscal Intermediary Use of Group and Claim Adjustment. Reason Codes and Calculation and Balancing of TS2 and TS3 Segment. Data Elements. 471 This Transmittal is rescinded and replaced by Transmittal 513. 472 Revisions to Payment for Services Provided Under a Contractual Arrangement—Carrier Claims Only. Exceptions to Assignment of Provider's Right to Payment—Claims Submitted to Fiscal Intermediaries and Carriers. Payment for Services Provided Under a Contractual Arrangement—Carrier Claims Only. 473 Use of 12X Type of Bill for Billing Vaccines and Their Administration Bills Submitted to Fiscal Intermediaries. 474 Coordination of Benefits Agreement Detailed Error Report Notification Process. 475 1st Update to the 2005 Medicare Physician Fee Schedule Database. 476 Type of Service Corrections. 477 New Case-Mix Adjusted End-Stage Renal Disease Composite Payment Rates And New Composite Rate Exceptions Window for Pediatric End-Stage Renal Disease Facilities. Outpatient Provider-Specific File. Calculation of Case-Mix Adjustment Composite Rate. Required Information for In-Facility Claims Paid Under the Composite Rate. 478 Clarification of the Verification Process to be Used to Determine If the Inpatient Rehabilitation Facility Meets the Inpatient Rehabilitation Classification Criteria Verification Process To Be Used To Determine If the Inpatient Rehabilitation Facility Met the Classification Criteria. 479 Update to the Healthcare Provider Taxonomy Codes Version 5.0. 480 April 2005 Quarterly Average Sale Price Medicare Part B Drug Pricing File, Effective April 1, 2005, and New January 2005 Quarterly Average Sale Price File. 481 Updated Manual Instructions for the Medicare Claims Processing Manual, Chapter 10. General Guidelines for Processing Home Health Agency Claims. Effect of Election of Medicare Advantage Organization and Eligibility Changes on Home Health Prospective Payment System Episodes. General Guidance on Line Item Billing Under the Home Health Prospective Payment System. Request for Anticipated Payment. Home Health Prospective Payment System Claims. Special Billing Situations Involving Outcome & Assessment Information Set Assessments. Medical and Other Health Services Not Covered Under the Plan of Care (Bill Type 34X). 482 Manualization of Payment Change for Diagnostic Mammography and Diagnostic Computer Aided Detection. Screening Mammography Services. Computer Aided Design Billing Charts. Payment for Screening Mammography Services Provided Prior to January 1, 2002. Payment for Screening Mammography Services Provided On and After January 1, 2002. Outpatient Hospital Mammography Payment Table. Payment for Computer Add-On Diagnostic and Screening Mammograms for Fiscal Intermediaries and Carriers. Mammograms Performed With New Technologies. 483 Hospital Partial Hospitalization Services Billing Requirements. Special Partial Hospitalization Billing Requirements for Hospitals, Community Mental Health Centers, and Critical Access Hospitals. Bill Review for Partial Hospitalization Services Provided in Community Mental Health Centers. 484 New Remittance Advice Message for Referred Clinical Diagnostic/Purchased Diagnostic Service Duplicate Claims. Start Printed Page 36626 485 Calculating Payment-to-Cost Ratios for Purposes of Determining Transitional Corridor Payments Under the Outpatient Prospective Payment System. 486 Manualization of Carrier Claims Processing Instructions for Stem Cell Transplantation. Stem Cell Transplantation. General. Healthcare Common Procedure Coding System and Diagnosis Coding. Non-Covered Conditions. Edits. Suggested Medicare Summary Notice and Remittance Advice Messages. 487 Medicare Qualifying Clinical Trials. Chapter 32, Section 69.0—Qualifying Clinical Trials. 488 This Transmittal has been rescinded and replaced by Transmittal 497. 489 Correction to Healthcare Common Procedure Coding System Code A4217. Payment of Durable Medical Equipment Prosthetics, Orthotics & Supplies Items Based on Modifiers. 490 Claims Status Code/Claims Status Category Code Update. Health Care Claims Status Category Codes and Health Care Claims Status Codes for Use With Health Care Claims Status Request and Response ASC X12N 276/277. 491 Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction. 492 Adding an Indicator to the National Claims History to Indicate That Durable Medical Equipment Regional Carrier, Carriers and Fiscal Intermediaries Have Reviewed a Potentially Duplicate Claim. Detection of Duplicate Claims. 493 Revision to Chapter 1, and Removal of Section 70 from Chapter 25 of the Medicare Claims Processing Manual. Inpatient Billing From Hospitals and Skilled Nursing Facilities. Submitting Bills in Sequence for a Continuous Inpatient Stay or Course of Treatment. Intermediary Processing of No-Payment Bills. Time Limitations for Filing Provider Claims to Fiscal Intermediaries. Statement of Intent. Filing Request for Payment to Carriers—Medicare Part B. Fiscal Intermediary Consistency Edits. Patient is a Member of a Medicare Advantage Organization for Only a Portion of the Billing Period. Late Charges. Inpatient Part A Hospital Adjustment Bills. 494 April 2005 Outpatient Prospective Payment System Code Editor Specifications Version 6.1. 495 Inpatient Psychiatric Facility Prospective Payment System—Further Clarifications. 496 Billing for Blood and Blood Products Under the Hospital Outpatient Prospective Payment System. When a Provider Paid Under the Outpatient Prospective Payment System Does Not Purchase the Blood or Blood Products That It Procures From a Community Blood Bank, or When a Provider Paid Under the Outpatient Prospective Payment System Does Not Assess a Charge for Blood or Blood Products Supplied by the Provider's Own Blood Bank Other Than Blood Processing and Storage. When a Provider Paid Under the Outpatient Prospective Payment System Purchases Blood or Blood Products from a Community Blood Bank or When a Provider Paid Under the Outpatient Prospective Payment System Assesses a Charge for Blood or Blood Products Collected by Its Own Blood Bank That Reflects More Than Blood Processing and Storage. Billing for Autologous Blood (Including Salvaged Blood) and Directed Donor Blood. Billing for Split Unit of Blood. Billing for Irradiation of Blood Products. Billing for Frozen and Thawed Blood and Blood Products. Billing for Unused Blood. Billing for Transfusion Services. Billing for Pheresis and Apheresis Services. Correct Coding Initiative Edits. Blood Products and Drugs Classified in Separate Average Projected Costs for Hospital Outpatients. 497 Billing for Implantable Automatic Defibrillators for Beneficiaries in a Medicare Advantage Plan and Use of the Quarterly Refund Modifier to Identify Patient Registry Participation. 498 Billing of the Diagnosis and Treatment of Peripheral Neuropathy With Loss of Protective Sensation in People With Diabetes. General Billing Requirements. Applicable Healthcare Common Procedure Coding System Codes. Diagnosis Codes. Payment. Applicable Revenue Codes. Editing Instructions for Fiscal Intermediaries. Common Working File General Information. Common Working File Utilization Edits. 499 2005 Scheduled Release for April Updates to Software Programs and Pricing/Coding Files. 500 Changes to the Laboratory National Coverage Determination Edit. Software for April 2005. 501 Bone Mass Measurements—Procedure Coding. 502 New Contrast Agents Healthcare Common Procedure Coding System Codes. 503 April Update to the Medicare Non-Outpatient Prospective Payment Systems. Outpatient Code Editor Specification Version 20.2. 504 Update to Pub 100-04, Chapter 12, Section 200 of the Internet Only Manual. Start Printed Page 36627 Allergy Testing and Immunotherapy. 505 Unprocessable Unassigned Form CMS-1500 Claims. Incomplete or Invalid Claims Processing Terminology. 506 Updated Manual Instructions for Item 24G (Days or Units), Chapter 26. 507 New Healthcare Common Procedure Coding System for Intravenous Immune Globulin. 508 This Transmittal is rescinded and replaced by Transmittal 514. 509 Number of Drug Pricing Files That Must Be Maintained Online for Medicare—Durable Medical Equipment Regional Carriers Only. Online Pricing Files for Average Sales Price. 510 Update to Fiscal Year 2005 Pricer for IPPS Hospitals. 511 Type of Service Corrections. 512 Coverage of Colorectal Anti-Cancer Drugs Included in Clinical Trials. 513 Infusion Pumps: C-Peptide Levels As a Criterion for Use. 514 April 2005 Update of the Hospital Outpatient Prospective Payment System: Summary of Payment Policy Changes. Medicare Secondary Payer (CMS Pub. 100-05) 23 Modification to Online Medicare Secondary Payer Questionnaire. Admission Questions to Ask Medicare Beneficiaries. 24 Issued to a specific audience, not posted to Internet/Intranet, due to Sensitivity of Instruction. 25 Update Medicare Secondary Payer Manual Publication 100-05 to reflect Statutory Changes included in the Medicare Modernization Act. General Provisions. Conditional Primary Medicare Benefits. When Conditional Primary Medicare Benefits May Be Paid. When Medicare Secondary Benefits Are Payable and Not Payable. Definitions. Beneficiary's Rights and Responsibility. Statutory Provisions. No-Fault Insurance. Situations in Which Medicare Secondary Payer Billing Applies. Incorrect Group Health Plan Primary Payments. General Policy. Conditional Primary Medicare Benefits. Conditional Medicare Payment. Medicare Right of Recovery. Conflicting Claims by Medicare and Medicaid. Third Party Payer Refund Requests Served on Medicare. General Operational Instructions. Conditional Primary Medicare Benefits. Existence of Overpayment. 26 Clarification for Change Request (CR) 3267. General Policy. 27 Updates to the Electronic Correspondence Referral System User Guide v8.0 and Quick Reference Card v8.0. Coordination of Benefits Contractor Electronic Correspondence Referral System. Providing Written Documents to the Coordination of Benefits Contractor. Medicare Financial Management (CMS Pub. 100-06) 55 Reporting Appeals Redetermination Information on Forms CMS-2591 and 2590. 56 Revision to Balancing Requirement on Form 5, Line 10, of the Contractor. Reporting of Operational and Workload Data. 57 Revised Reporting Requirements for Contractor Reporting of Operational Workload Data Health Professional Shortage Area Quarterly Report. 58 Issued to specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction. 59 Notice of New Interest Rate for Medicare Overpayments and Underpayments. 60 Revised instructions on contractor procedures for provider audit and the Provider. Statistical & Reimbursement Report. Submission of Cost Report Data to CMS. Desk Review Exceptions Resolution Process. Definition of Field Audits. Purpose of Field Audits. Establishing the Objective/Scope of the Field Audit. Audit Confirmation Letter. Entrance Conference. Tests of Internal Control. Designing Tests/Sampling. Pre-Exit Conference. Finalization of Audit Adjustments. Exit Conference. Start Printed Page 36628 Medicare Cost Report and All Related Documents. Qualifications. Internal Quality Control. Final Settlement of the Cost Report. Audit Responsibility When Provider Changes Contractors. Audits of Home Offices. Standards for Issuance of an Audit Report for a Home Office. Provider Permanent File. Contractor Responsibility in Suspected Fraud or Abuse Cases. 61 New Location Code Interstate Commerce Commission, Status Code AR and Modified Intent Letter for Unfiled Cost Reports Only. Recovery of Overpayment Due to Overdue Cost Report. Provider Overpayment Recovery System User Manual. List of Status Codes. Content of Demand Letters-Fiscal Intermediary Serviced Providers. 62 Timeframe for Continued Execution of Crossover Agreements and Updated on the Transition to the National Coordination of Benefits Agreement Program. Coordination of Medicare and Complementary Insurance Programs. 63 Notice of New Interest Rate for Medicare Overpayments and Underpayments. 64 For Fiscal Intermediaries, a New Provider Type 80, Status Code CH, and Method of Recoupment Codes. For Carriers and Durable Medical Equipment. Regional Carriers Status Code 2. Provider Overpayment Reporting System User Manual. List of Status Codes. Physician/Supplier Overpayment Reporting System User Manual. 65 Revised Reporting Requirements for Contractor Reporting of Operational Workload Data Physician Scarcity Area Quarterly Report (CMS Form—1565F, CROWD Form6). Completing Physician Scarcity Area Quarterly Report Form CMS 1565F, CROWD Form 6. Physician Scarcity Area Quarterly Report, Line Descriptors. Error Descriptors. Checking Reports. 66 Chapter 7, Internal Control Requirements Update. Federal Managers' Financial Integrity Act of 1982. Federal Managers Financial Integrity Act and the CMS Medicare Contractor Contract. Chief Financial Officers Act of 1990. Office of Management & Budget Circular A-123. General Accounting Office Standards for Internal Controls in the Federal Government. Fundamental Concepts. Control Activities. Monitoring. Risk Assessment. Internal Control Objectives. Fiscal Year 2005 Medicare Control Objectives. Policies and Procedures. Control Activities. Testing Methods. Documentation and Working Papers. Requirements. Certification Statement. Executive Summary. Certification Package for Internal Controls Report of Material Weaknesses. Certification Package for Internal Controls Report of Reportable Conditions. Definitions and Examples of Reportable Conditions and Material Weaknesses. Material Weaknesses Identified During the Fiscal Year. Corrective Action Plans. Submission, Review, and Approval of Corrective Action Plans. Corrective Action Plan Reports. CMS Finding Numbers. Initial Corrective Action Plan Report. Quarterly Corrective Action Plan Report. Entering Data: Initial or Quarterly Corrective Action Plan Report. Medicare State Operations Manual (CMS Pub. 100-07) 00 None Medicare Program Integrity (CMS Pub. 100-08)) 93 This Transmittal has been rescinded and replaced by Transmittal 102. Start Printed Page 36629 94 Informing Beneficiaries About Which Local Medical Review Policy and/or Local Coverage Determination and/or National Coverage. Determination Is Associated With Their Claim Denial. Prepayment Edits. 95 Change in Provider Enrollment Appeals Process. Administrative Appeals. 96 Consent Settlements. Postpayment Review Case Selection. Location of Postpayment Reviews. Re-adjudication of Claims. Calculation of the Correct Payment Amount and Subsequent Over/Underpayment. Notification of Provider(s) or Supplier(s) and Beneficiaries of the Postpayment Review Results. Provider(s) or Supplier(s) Rebuttal(s) of Findings. Evaluation of the Effectiveness of Postpayment Review and Next Steps. Consent Settlement Instructions. Background on Consent Settlement. Opportunity to Submit Additional Information Before Consent Settlement Offer. Consent Settlement Offer. Election to Proceed to Statistical Sampling for Overpayment Estimation. Acceptance of Consent Settlement Offer. Consent Settlement Budget and Performance Requirements for Medicare Contractors. 97 Provider Enrollment and Inpatient Rehabilitation Facility (IRF) Compliance Reviews. 98 Psychotherapy Notes. Additional Documentation Requests During Prepayment or Postpayment Medical Review. 99 Program Integrity Manual Modification—Changes Waivers Approved by the Regional Office by Replacing Regional Office With Central Office. Contractor Medical Director. Benefit Integrity Security Requirements. The Carrier Advisory Committee. 100 Review of Documentation During Medical Review. Additional Documentation Requests During Prepayment or Postpayment Medical Review. Documentation in the Patient's Medical Records. 101 Benefit Integrity Personal Information Manager Revisions. Sources of Data for Program Safeguard Contractors. Procedural Requirements. Benefit Integrity Security Requirements. Requests for Information From Outside Organizations. Program Safeguard Contractor and Medicare Contractor Coordination With Other Program. Safeguard Contractors and Medicare Contractors. Complaint Screening. Types of Fraud Alerts. Alert Specifications. Editorial Requirements. Coordination. Distribution of Alerts. Information Not Captured in the Fraud Investigation Database. Initial Entry Requirements for Investigations. Designated Program Safe Guard and Medicare Contractor Background Investigation. Unit Staff and the Fraud Investigation Database. Affiliated Contractor and Program Safeguard Contractor Coordination on Voluntary Refunds. Referral of Cases to the Office of the Inspector General/Office of Investigations. Referral to State Agencies or Other Organizations. Civil Monetary Penalties Delegated to Office of the Inspector General. Annual Deceased-Beneficiary Postpayment Review. Vulnerability Report. 102 Medical Review of Rural Air Ambulance Services. “Reasonable” Requests. Emergency Medical Services Protocols. Prohibited Air Ambulance Relationships. Reasonable and Necessary Services. Definition of Rural Air Ambulance Services. 103 Discontinuation of Medical Review Reports—The Medicare Status Report. Report of Benefit Savings, Medicare Focused Medical Review Status Report, and Focused Medical Review Report. 104 Requirement that Medicare Carrier System Not Allow the Re-review of Previously Denied Claims. Contractor Administrative Budget & Financial Management II Reporting for Medical Review Activities. 105 The Medically Unbelievable Edits. 106 Inclusion of Interventional Pain Management Specialists on Carrier Advisory Committee Membership Physicians. Start Printed Page 36630 Medicare Contractor Beneficiary and Provider Communications (CMS Pub. 100-09) 08 Medicare Beneficiary Call Centers Will Begin Offering Preventive Services Information. Promote Medicare Preventive Services. Medicare Managed Care (CMS Pub. 100-16) 65 Surveys, Contracting Strategy, and Appeals. Medicare Business Partners Systems Security (CMS Pub. 100-17) 00 None. Demonstrations (CMS Pub. 100-19) 15 Issued to a specific audience, not posted to Internet/Intranet due to the Confidentiality of Instruction 16 Issued to a specific audience, not posted to Internet/Intranet due to the Sensitivity of Instruction. 17 Demonstration Project for Medical Adult Day-Care Services. 18 Demonstration Project to Clarify the Definition of Homebound, the Home Health Independence Demonstration. 19 Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction. 20 Full Replacement of CR 3220, Method of Reimbursement for Inpatient Services for Rural Hospital Participating Under Demonstration Authorized by Section 410A of the Medicard Modernization Act, CR 3220 Is Rescinded. 21 Full Replacement of CR 3639, Expansion of Coverage for Chiropractic Services Demonstration. One Time Notification (CMS Pub. 100-20) 134 Revisions to January 2005 Quarterly Average Sales Price Medicare Part B Drug Pricing File. 135 Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act Transaction Release Testing. 136 Medlearn Matters Article Related to the Flu Demonstration. 137 Instruction to Contractors Regarding Aged, Pre-settlement Cases and Inter-Contractor Notices. 138 Production of Provider Flat Files, Including Taxpayer Identification Numbers, From the Fiscal Intermediary Standard System, Financial Master Files. 139 Update to the Evaluation Plan for the CD-Rom Initiative Used in the Mailing of 2005 Annual Participation Enrollment Material. 140 Revisions to January 2005 Quarterly Average Sales Price Medicare Part B Drug Pricing File. 141 Shared System and Common Working File Renovation of Override Code Process (Phase 3). 142 This Transmittal Is Rescinded and Will Not Be Replaced at this Time. 143 Shared System Maintainer Hours to Begin Work and Analysis on the Implementation of the National Provider Identifier—FOR ANALYSIS ONLY. 144 Debt Collection Improvement Act Backlog Non-Medicare Secondary Payor Collections From February 1998 to September 2004. 145 Frequent Hemodialysis Network Payment Changes for Approved Clinical Trial Costs. 146 Appeals Transition—BIPA Section 521 Appeals. Addendum IV.—Regulation Documents Published in the Federal Register January Through March 2005
Publication date FR Vol. 70 page No. CFR parts affected File code Title of regulation January 19, 2005 3036 CMS-2230-NC State Children's Health Insurance Program (SCHIP); Redistribution of Unexpended SCHIP Funds From the Appropriation for Fiscal Year 2002. January 28, 2005 4588 417 and 422 CMS-4069-F Medicare Program; Establishment of the Medicare Advantage Program. January 28, 2005 4194 400, 403, 411, 417, and 423 CMS-4068-F Medicare Program; Medicare Prescription Drug Benefit. January 28, 2005 4133 CMS-3150-N Medicare Program; Meeting of the Medicare Coverage Advisory Committee—March 29, 2005. January 28, 2005 4132 CMS-5033-N2 Medicare Program; Meeting of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services. January 28, 2005 4130 CMS-5037-N Medicare Program; Demonstration of Coverage of Chiropractic Services Under Medicare. January 28, 2005 4129 CMS-4079-N Medicare Program; Re-Chartering of the Advisory Panel on Medicare Education (APME) and Notice of the APME Meeting—February 24, 2005. February 3, 2005 5724 412 CMS-1483-P Medicare Program; Prospective Payment System for Long-Term Care Hospitals: Proposed Annual Payment Rate Updates, Policy Changes, and Clarification. Start Printed Page 36631 February 4, 2005 6526 423 CMS-0011-P Medicare Program; E-Prescribing and the Prescription Drug Program. February 4, 2005 6184 400, 405, 410, 412, 413, 414, 488, and 494 CMS-3818-P Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities February 4, 2005 6140 405, 482, and 488 CMS-3835-P Medicare Program; Hospital Conditions of Participation: Requirements for Approval and Re-Approval of Transplant Centers To Perform Organ Transplants. February 4, 2005 6086 413, 441, 486, and 498 CMS-3064-P Medicare and Medicaid Programs; Conditions for Coverage for Organ Procurement Organizations (OPOs). February 4, 2005 6014 CMS-1366-N Medicare Program; Meeting of the Practicing Physicians Advisory Council—March 7, 2005. February 4, 2005 6013 CMS-1299-N Medicare Program; Monthly Payment Amounts for Oxygen and Oxygen Equipment for 2005, in Accordance with Section 302(c) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. February 4, 2005 6012 CMS-3155—N Medicare Program; Quality Improvement Organization Contracts: Solicitation of Statements of Interest From In-State Organizations—Alaska, Hawaii, Idaho, Maine, South Carolina, Vermont, and Wyoming. February 25, 2005 9362 CMS-4089-N Medicare Program; Meeting of the Advisory Panel on Medicare Education—March 22, 2005. February 25, 2005 9360 CMS-4088-N Medicare Program; Part D Reinsurance Payment Demonstration. February 25, 2005 9358 CMS-1219-N Medicare Program; Changes in Geographical Boundaries of Durable Medical Equipment Regional Service Areas. February 25, 2005 9355 CMS-3119-FN Medicare Program; Procedures for Maintaining Code Lists in the Negotiated National Coverage Determinations for Clinical Diagnostic Laboratory Services. February 25, 2005 9338 CMS-9025-N Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—October Through December 2004. February 25, 2005 9337 CMS-5011-WN2 Medicare and Medicaid Programs; Solicitation of Proposals for the Private, For-Profit Demonstration Project for the Program of All-Inclusive Care for the Elderly (PACE); Cancellation of Withdrawal. February 25, 2005 9336 CMS-1296-N Medicare Program; Request for Nominations to the Advisory Panel on Ambulatory Payment Classification Groups. February 25, 2005 9232 421 CMS-1219-F Medicare Program; Durable Medical Equipment Regional Carrier Service Areas and Related Matters. March 4, 2005 10746 414 CMS-1325-P Medicare Program; Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B. March 4, 2005 10645 CMS-4089-N2 Medicare Program; Meeting of Advisory Panel on Medicare Education—March 22, 2005: Location Change. March 8, 2005 11420 401 and 405 CMS-4064-IFC Medicare Program; Changes to the Medicare Claims Appeal Procedures. March 11, 2005 12691 CMS-1269-N3 Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG) Meeting and Announcement of Members. March 21, 2005 13401 417 and 422 CMS-4069-F2 Medicare Program; Establishment of the Medicare Advantage Program; Interpretation. March 21, 2005 13397 400, 403, 411, 417, and 423 CMS-4068-F2 Medicare Program; Medicare Prescription Drug Benefit; Interpretation. March 25, 2005 15394 CMS-4080-N Medicare Program; Recognition of NAIC Model Standards for Regulation of Medicare Supplemental Insurance. March 5, 2005 15343 CMS-5033-N3 Medicare Program; Meeting of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services. Start Printed Page 36632 March 25, 2005 15341 CMS-3151-N Medicare Program; Meeting of the Medicare Coverage Advisory Committee—May 24, 2005. March 25, 2005 15340 CMS-1297-N Medicare Program; Public Meetings in Calendar Year 2005 for All New Public Requests for Revisions to the Healthcare Common Procedures Coding System (HCPS) Coding and Payment Determinations. March 25, 2005 15337 CMS-3112-FN Medicare Program; Disapproval of Adjustment in Payment Amounts for New Technology Intraocular Lenses Furnished by Ambulatory Surgical Centers. March 25, 2005 15335 CMS-2256-FN Medicare and Medicaid Programs; Reapproval of the Deeming Authority of the Community Health Accreditation Program (CHAP) for Home Health Agencies. March 25, 2005 15333 CMS-2208—FN Medicare and Medicaid Programs; Recognition of the American Osteopathic Association (AOA) for Continued Approval of Deeming Authority for Hospitals. March 25, 2005 15331 CMS-2204-FN Medicare and Medicaid Programs; Reapproval of the Deeming Authority of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for Home Health Agencies. March 25, 2005 15329 CMS-0014-N Procedures for Non-Privacy Administrative Simplification Complaints Under the Health Insurance Portability and Accountability Act of 1996. March 25, 2005 15324 CMS-2211-N Medicare, Medicaid, and CLIA Programs; Continuance of the Approval of the American Society for Histocompatibility and Immunogentics as a CLIA Accreditation Organization. March 25, 2005 15266 482 CMS-3122-P Medicare and Medicaid Programs; Hospital Conditions of Participation: Requirements for History and Physical Examinations; Authentication of Verbal Orders; Securing Medications; and Postanesthesia Evaluations. March 25, 2005 15265 413, 441, 486, and 498 CMS-3064-N Medicare and Medicaid Programs; Conditions for Coverage for Organ Procurement Organizations (OPOs); Extension of Comment Period. March 25, 2005 15264 405, 482, and 488 CMS-3835-N Medicare Program; Hospital Conditions of Participation: Requirements for Approval and Re-Approval of Transplant Centers To Perform Organ Transplants; Extension of Comment Period. March 25, 2005 15229 403, 416, 418, 460, 482, 483, and 485 CMS-3145-IFC Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities; Amendment. Addendum V.—National Coverage Determinations [January Through March 2005]
A national coverage determination (NCD) is a determination by the Secretary with respect to whether or not a particular item or service is covered nationally under Title XVIII of the Social Security Act, but does not include a determination of what code, if any, is assigned to a particular item or service covered under this title, or determination with respect to the amount of payment made for a particular item or service so covered. We include below all of the NCDs that were issued during the quarter covered by this notice. The entries below include information concerning completed decisions as well as sections on program and decision memoranda, which also announce pending decisions or, in some cases, explain why it was not appropriate to issue an NCD. We identify completed decisions by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. Information on completed decisions as well as pending decisions has also been posted on the CMS Web site at http://cms.hhs.gov/coverage.
National Coverage Determinations
[January Through March 2005]
Title NCDM section TN No. Issue date Effective date Infusion Pumps: C-Peptide Levels as a Criterion for Use 280.14 R27NCD 02/04/05 12/17/04 Update of Laboratory NCDs to Reference New Screening Benefits 190.20/190.23 R28NCD 02/11/05 01/01/05 Implantable Automatic Defibrillators 20.4 R29NCD 03/04/05 01/27/05 Start Printed Page 36633 Anti-Cancer Chemotherapy for Colorectal Cancer 110.17 R30NCD 03/29/05 01/28/05 Addendum VI. FDA-Approved Category B IDEs [January Through March 2005]
Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c) devices fall into one of three classes. To assist CMS under this categorization process, the FDA assigns one of two categories to each FDA-approved IDE. Category A refers to experimental IDEs, and Category B refers to non-experimental IDEs. 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 list includes all Category B IDEs approved by FDA during the first quarter, January through March 2005.
IDE Category G030069 G040051 G040161 G040166 G040195 G040196 G040218 G040219 G040224 G040227 G040228 G040230 G040232 G040233 G050001 G050004 G050009 G050011 G050018 G050019 G050021 G050022 G050024 G050026 G050029 G050034 G050038 G050043 G050045 Addendum VII.—Approval Numbers for Collections of Information
Below we list all approval numbers for collections of information in the referenced sections of CMS regulations in Title 42; Title 45, Subchapter C; and Title 20 of the Code of Federal Regulations, which have been approved by the Office of Management and Budget:
OMB control Nos.- Approved CFR Sections in Title 42, Title 45, and Title 20 (Note: Sections in Title 45 are preceded by “45 CFR,” and sections in Title 20 are preceded by “20 CFR”) 0938-0008 414.40, 424.32, 424.44 0938-0022 413.20, 413.24, 413.106 0938-0023 424.103 0938-0025 406.28, 407.27 0938-0027 486.100-486.110 0938-0033 405.807 0938-0035 407.40 0938-0037 413.20, 413.24 0938-0041 408.6, 408.22 0938-0042 410.40, 424.124 0938-0045 405.711 0938-0046 405.2133 0938-0050 413.20, 413.24 0938-0062 431.151, 435.1009, 440.220, 440.250, 442.1, 442.10-442.16, 442.30, 442.40, 442.42, 442.100-442.119, 483.400-483.480, 488.332, 488.400, 498.3-498.5 0938-0065 485.701-485.729 0938-0074 491.1-491.11 0938-0080 406.7, 406.13 0938-0086 420.200-420.206, 455.100-455.106 0938-0101 430.30 0938-0102 413.20, 413.24 0938-0107 413.20, 413.24 0938-0146 431.800-431.865 0938-0147 431.800-431.865, 493.1405, 493.1411, 493.1417, 493.1423, 493.1443, 493.1449, 493.1455 0938-0151 493.1461, 493.1469, 493.1483, 493.1489 0938-0155 405.2470 0938-0170 493.1269-493.1285 0938-0193 430.10-430.20, 440.167 0938-0202 413.17, 413.20 0938-0214 411.25, 489.2, 489.20 0938-0236 413.20, 413.24 0938-0242 442.30, 488.26 0938-0245 407.10, 407.11 0938-0246 431.800-431.865 0938-0251 406.7 0938-0266 416.41, 416.47, 416.48, 416.83 0938-0267 410.65, 485.56, 485.58, 485.60, 485.64, 485.66 0938-0269 412.116, 412.632, 413.64, 413.350, 484.245 0938-0270 405.376 0938-0272 440.180, 441.300-441.305 Start Printed Page 36634 0938-0273 485.701-485.729 0938-0279 424.5 0938-0287 447.31 0938-0296 413.170, 413.184 0938-0301 413.20, 413.24 0938-0302 418.22, 418.24, 418.28, 418.56, 418.58, 418.70, 418.74, 418.83, 418.96, 418.100 0938-0313 489.11, 489.20 0938-0328 482.12, 482.13, 482.21, 482.22, 482.27, 482.30, 482.41, 482.43, 482.45, 482.53, 482.56, 482.57, 482.60, 482.61, 482.62, 482.66, 485.618, 485.631 0938-0334 491.9, 491.10 0938-0338 486.104, 486.106, 486.110 0938-0354 441.60 0938-0355 442.30, 488.26 0938-0357 409.40-409.50, 410.36, 410.170, 411.4-411.15, 421.100, 424.22, 484.18, 489.21 0938-0358 412.20-412.30 0938-0359 412.40-412.52 0938-0360 488.60 0938-0365 484.10, 484.11, 484.12, 484.14, 484.16, 484.18, 484.20, 484.36, 484.48, 484.52 0938-0372 414.330 0938-0378 482.60-482.62 0938-0379 442.30, 488.26 0938-0382 442.30, 488.26 0938-0386 405.2100-405.2171 0938-0391 488.18, 488.26, 488.28 0938-0426 476.104, 476.105, 476.116, 476.134 0938-0429 447.53 0938-0443 473.18, 473.34, 473.36, 473.42 0938-0444 1004.40, 1004.50, 1004.60, 1004.70 0938-0445 412.44, 412.46, 431.630, 456.654, 466.71, 466.73, 466.74, 466.78 0938-0447 405.2133 0938-0448 405.2133, 45 CFR 5, 5b; 20 CFR parts 401, 422E 0938-0449 440.180, 441.300-441.310 0938-0454 424.20 0938-0456 412.105 0938-0463 413.20, 413.24, 413.106 0938-0467 431.17, 431.306, 435.910, 435.920, 435.940-435.960 0938-0469 417.126, 422.502, 422.516 0938-0470 417.143, 417.800-417.840, 422.6 0938-0477 412.92 0938-0484 424.123 0938-0501 406.15 0938-0502 433.138 0938-0512 486.304, 486.306, 486.307 0938-0526 475.102, 475.103, 475.104, 475.105, 475.106 0938-0534 410.38, 424.5 0938-0544 493.1-493.2001 0938-0564 411.32 0938-0565 411.20-411.206 0938-0566 411.404, 411.406, 411.408 0938-0573 412.230, 412.256 0938-0578 447.534 0938-0581 493.1-493.2001 0938-0599 493.1-493.2001 0938-0600 405.371, 405.378, 413.20 0938-0610 417.436, 417.801, 422.128, 430.12, 431.20, 431.107, 434.28, 483.10, 484.10, 489.102 0938-0612 493.801, 493.803, 493.1232, 493.1233, 493.1234, 493.1235, 493.1236, 493.1239, 493.1241, 493.1242, 493.1249, 493.1251, 493.1252, 493.1253, 493.1254, 493.1255, 493.1256, 493.1261, 493.1262, 493.1263, 493.1269, 493.1273, 493.1274, 493.1278, 493.1283, 493.1289, 493.1291, 493.1299 0938-0618 433.68, 433.74, 447.272 0938-0653 493.1771, 493.1773, 493.1777 0938-0657 405.2110, 405.2112 0938-0658 405.2110, 405.2112 0938-0667 482.12, 488.18, 489.20, 489.24 0938-0679 410.38 0938-0685 410.32, 410.71, 413.17, 424.57, 424.73, 424.80, 440.30, 484.12 0938-0686 493.551-493.557 0938-0688 486.304, 486.306, 486.307, 486.310, 486.316, 486.318, 486.325 0938-0690 488.4-488.9, 488.201 0938-0691 412.106 0938-0692 466.78, 489.20, 489.27 0938-0701 422.152 0938-0702 45 CFR 146.111, 146.115, 146.117, 146.150, 146.152, 146.160, 146.180 0938-0703 45 CFR 148.120, 148.124, 148.126, 148.128 Start Printed Page 36635 0938-0714 411.370-411.389 0938-0717 424.57 0938-0721 410.33 0938-0723 421.300-421.318 0938-0730 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, 424.24 0938-0732 417.126, 417.470 0938-0734 45 CFR 5b 0938-0739 413.337, 413.343, 424.32, 483.20 0938-0742 422.300-422.312 0938-0749 424.57 0938-0753 422.000-422.700 0938-0754 441.151, 441.152 0938-0758 413.20, 413.24 0938-0760 Part 484 subpart E, 484.55 0938-0761 484.11, 484.20 0938-0763 422.1-422.10, 422.50-422.80, 422.100-422.132, 422.300-422.312, 422.400-422.404, 422.560-422.622 0938-0770 410.2 0938-0778 422.64, 422.111 0938-0779 417.126, 417.470, 422.64, 422.210 0938-0781 411.404-411.406, 484.10 0938-0786 438.352, 438.360, 438.362, 438.364 0938-0787 406.28, 407.27 0938-0790 460.12, 460.22, 460.26, 460.30, 460.32, 460.52, 460.60, 460.70, 460.71, 460.72, 460.74, 460.80, 460.82, 460.98, 460.100, 460.102, 460.104, 460.106, 460.110, 460.112, 460.116, 460.118, 460.120, 460.122, 460.124, 460.132, 460.152, 460.154, 460.156, 460.160, 460.164, 460.168, 460.172, 460.190, 460.196, 460.200, 460.202, 460.204, 460.208, 460.210 0938-0792 491.8, 491.11 0938-0798 413.24, 413.65, 419.42 0938-0802 419.43 0938-0818 410.141, 410.142, 410.143, 410.144, 410.145, 410.146, 414.63 0938-0829 422.568 0938-0832 Parts 489 and 491 0938-0833 483.350-483.376 0938-0841 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 457.440, 457.525, 457.560, 457.570, 457.740, 457.750, 457.810, 457.940, 457.945, 457.965, 457.985, 457.1005, 457.1015, 457.1180 0938-0842 412.23, 412.604, 412.606, 412.608, 412.610, 412.614, 412.618, 412.626, 413.64 0938-0846 411.352-411.361 0938-0857 Part 419 0938-0860 Part 419 0938-0866 45 CFR part 162 0938-0872 413.337, 483.20 0938-0873 422.152 0938-0874 45 CFR parts 160 and 162 0938-0878 Part 422 subpart F & G 0938-0883 45 CFR parts 160 and 164 0938-0884 405.940 0938-0887 45 CFR 148.316, 148.318, 148.320 0938-0897 412.22, 412.533 0938-0907 412.230, 412.304, 413.65 0938-0910 422.620, 422.624, 422.626 0938-0911 426.400, 426.500 0938-0916 483.16 0938-0920 438.6, 438.8, 438.10, 438.12, 438.50, 438.56, 438.102, 438.114, 438.202, 438.206, 438.207, 438.240, 438.242, 438.402, 438.404, 438.406, 438.408, 438.410, 438.414, 438.416, 438.710, 438.722, 438.724, 438.810 0938-0921 414.804 0938-0931 45 CFR part 142.408, 162.408, and 162.406 0938-0933 438.50 0938-0934 403.766 0938-0936 423 0938-0940 484 and 488 0938-0944 422.250, 422.252, 422.254, 422.256, 422.258, 422.262, 422.264, 422.266, 422.270, 422.300, 422.304, 422.306, 422.308, 422.310, 422.312, 422.314, 422.316, 422.318, 422.320, 422.322, 422.324, 423.251, 423.258, 423.265, 423.272, 423.279, 423.286, 423.293, 423.301, 423.308, 423.315, 423.322, 423.329, 423.336, 423.343, 423.346, 423.350 Addendum VIII—Medicare-Approved Carotid Stent Facilities (January Through March 2005)
On March 17, 2005, we issued our decision memorandum on carotid artery stenting. We determined that carotid artery stenting with embolic protection is reasonable and necessary only if performed in facilities that have been determined to be competent in performing the evaluation, procedure, and follow-up necessary to ensure optimal patient outcomes. We have created a list of minimum standards for facilities modeled in part on professional society statements on competency. All facilities must at least meet our standards in order to receive coverage for carotid artery stenting for high risk patients.Start Printed Page 36636
Start Printed Page 36640 End Supplemental InformationFacility Provider No. Effective date 1. Advocate Christ Medical Center, 4440 West 95th Street, Oak Lawn, IL 60453 140208 05/03/2005 2. Advocate Lutheran General Hospital, 1775 Dempster Street, Park Ridge, IL 60068 140223 05/05/2005 3. Aiken Regional Medical Centers, 302 University Parkway, P.O. Drawer 1117, Aiken, SC 29802-1117 420082 05/10/2005 4. Akron General Medical Center, 400 Wabash Avenue, Akron, OH 44266 360027 05/16/2005 5. Albany Medical Center Hospital, 43 New Scotland Avenue, Albany, NY 12208 330013 05/16/2005 6. Alexian Brothers Medical Center, 800 W. Biesterfied Road, Elk Grove Village, IL 60007 140258 04/18/2005 7. Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212-4772 390050 05/11/2005 8. Arizona Heart Hospital, 1930 E. Thomas Road, Phoenix, AZ 85016 030102 04/18/2005 9. Aspirus Wausau Hospital, Inc, 333 Pine Ridge Boulevard, Wausau, WI 54401 520030 05/10/2005 10. Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53201 520064 05/03/2005 11. Avera Heart Hospital of South Dakota, 4500 West 69th Street, Sioux Falls, SD 57108 430095 05/05/2005 12. Bakersfield Heart Hospital, 3001 Sillect Avenue, Bakersfield, CA 93308 050724 05/25/2005 13. Bakersfield Memorial Hospital, 420 34th Street, Bakersfield, CA 93301 050036 05/23/2005 14. The Baldwin County Eastern Shore Health Care Authority, d/b/a Thomas Hospital, 750 Morphy Avenue, Fairhope, AL 36532 010100 04/07/2005 15. Banner Good Samaritan Medical Center, 1111 E. McDowell Road, Phoenix, AZ 85006 030002 05/23/2005 16. Baptist Hospital East, 4000 Kresge Way, Louisville, KY 40207 180130 04/12/2005 17. Baptist Hospital of East Tennessee, 137 Blount Avenue, Knoxville, TN 37920 440019 04/12/2005 18. Baptist Hospital-Pensacola, 1000 West Moreno Street, Post Office Box 17500, Pensacola, FL 32522-7500 100093 04/27/2005 19. Baptist Medical Center, 1225 North State Street, Jackson, MS 39202 250102 05/05/2005 20. Baptist Medical Center South, 2105 East South Boulevard, P.O. Box 11010, Montgomery, AL 36111-0010 010023 04/20/2005 21. Baptist Memorial Hospital, 6019 Walnut Grove Road, Memphis, TN 38120 440048 04/18/2005 22. Baptist Memorial Hospital-DeSoto, 7601 Southcrest Parkway, Southaven, MS 38671 250141 05/05/2005 23. Baptist Montclair Medical Center, 800 Montclair Road, Birmingham, AL 35213 010104 04/26/2005 24. Barnes-Jewish Hospital, One Barnes-Jewish Hospital Plaza, St. Louis, MO 63110 260032 05/05/2005 25. Bay Medical Center, 615 North Bonita Avenue, Panama City, FL 32401 100026 05/23/2005 26. Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199 220077 05/16/2005 27. Benefis Healthcare, 1101 26th Street South, Great Falls, MT 59405 270012 05/26/2005 28. Bethesda Hospital, 10500 Montgomery Road, Cincinnati, OH 45242-9508 360179 05/05/2005 29. Blanchard Valley Regional Health Center, 145 West Wallace Street, Findlay, OH 45840 360095 05/26/2005 30. Borgess Medical Center, 1521 Gull Road, Kalamazoo, MI 49048 020117 04/12/2005 31. Bon Secours St. Mary's Hospital, 5801 Bremo Road, Richmond, VA 23226 490059 04/01/2005 32. Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115 220110 05/16/2005 33. Caritas St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA 02135-2997 220036 04/26/2005 34. Cascade Healthcare Community, Dba: St Charles Medical Center Bend, 2500 NE. Neff Road, Bend, OR 97701 380040 05/03/2005 35. Central Baptist Hospital, 1740 Nicholasville Road, Lexington, KY 40503 180103 04/27/2005 36. Central Dupage Hospital, 25 North Winfield Road, Winfield, IL 60190 140242 05/26/2005 37. Central Georgia Health Systems, dba The Medical Center of Central Georgia, 777 Hemlock Street, Macon, GA 31208 110107 05/11/2005 38. Charleston Area Medical Center, 3200 MacCorkle Avenue, SE, Charleston, WV 25304 510022 04/27/2005 39. Charlotte Regional Medical Center, 809 East Marion Avenue, Punta Gorda, FL 33950 100047 05/11/2005 40. [The] Christ Hospital, 2139 Auburn Avenue, Cincinnati, OH 45219 360163 05/26/2005 41. Christiana Care Health Services, 4755 Ogletown-Stanton Road, P.O. Box 6001, Newark, DE 19718-6001 080001 05/23/2005 42. CHRISTUS St. Frances Cabrini Hospital, 3330 Masonic Drive, Alexandria, LA 71301 190019 04/18/2005 43. CJW Medical Center, Chippenham Hospital, 7101 Jahnke Road, Richmond, VA 23225 490112 05/03/2005 44. Clarian Health Partners, Inc, I-65 at 21st Street, P.O. Box 1367, Indianapolis, IN 46206-1367 150056 05/23/2005 45. Clear Lake Regional Medical Center, 500 Medical Center Blvd, Webster, TX 77598 450617 04/01/2005 46. The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195 360180 04/12/2005 47. College Station Medical Center, 1604 Rock Prairie Road, College Station, TX 77845 450299 05/25/2005 48. Community Health Partners, 3700 Kolbe Road, Lorain, OH 44053-1697 360172 05/23/2005 49. Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756 300003 04/27/2005 50. Deaconess Medical Center, PO Box 248, Spokane, WA 99210-0248 500044 05/10/2005 51. Doylestown Hospital, 595 West State Street, Doylestown, PA 18901 390203 04/27/2005 52. Eastern Maine Medical Center, 489 State Street, P.O. Box 404, Bangor, ME 04402-404 200033 04/18/2005 53. El Camino Hospital, 2500 Grant Road, P.O. Box 7025, Mountain View, CA 94039-7025 050308 05/10/2005 54. Eliza Coffee Memorial Hospital, P.O. Box 818, Florence, AL 35631 010006 05/05/2005 55. EMH Regional Medical Center, 630 East River Street, Elyria, OH 44035 360145 05/23/2005 56. Emory Crawford Long Hospital, 550 Peachtree Street, NE, Atlanta, GA 30308-2225 110078 05/16/2005 57. Emory University Hospital, 1364 Clifton Road, NE, Atlanta, GA 30322 110010 04/04/2005 58. Erlanger Health System, 975 East Third Street, Chattanooga, TN 37403 440104 05/23/2005 59. Evanston Hospital, 2650 Ridge Avenue, Evanston, IL 60201 140010 03/30/2005 60. Exempla St. Joseph Hospital, 1835 Franklin Street, Denver, CO 80218-1191 060009 05/10/2005 61. Fletcher Allen Health Care, Medical Center Campus, 111 Colchester Avenue, Burlington, VT 05401-1473 470003 05/26/2005 62. Forsyth Medical Center, 3333 Silas Creek Parkway, Winston Salem, NC 27103 340014 04/20/2005 63. Fort Sanders Regional Medical Center, 1901 W. Clinch Avenue, Knoxville, TN 37916-2398 440125 05/11/2005 64. Fort Walton Beach Medical Center, 1000 Mar Walt Drive, Fort Walton Beach, FL 32547 100223 04/14/2005 65. Fresno Heart Hospital, 15 E. Audubon Drive, Fresno, CA 93720 050732 04/26/2005 66. Fountain Valley Regional Hospital and Medical Center, 17100 Euclid Street, P.O. Box 8010, Fountain Valley, CA 92708 050570 04/26/2005 67. Galichia Heart Hospital, 2610 N. Woodlawn, Wichita, KS 67220-2729 170192 05/16/2005 68. Geisinger Medical Center, 100 North Academy Avenue, Danville, PA 17822 390006 05/05/2005 69. Geisinger Wyoming Valley Medical Center, 1000 East Mountain Boulevard, Wilkes-Barre, PA 18711 390270 05/05/2005 70. Good Samaritan Hospital, 1225 Wilshire Boulevard, Los Angeles, CA 90017 050471 04/12/2005 Start Printed Page 36637 71. Good Samaritan Hospital, 2425 Samaritan Drive, San Jose, CA 95124 050380 04/12/2005 72. Good Samaritan Hospital, 255 Lafayette Avenue, Suffern, NY 10901 330158 04/27/2005 73. Good Samaritan Hospital, 2222 Philadelphia Drive, Dayton, OH 45406-1891 360052 05/25/2005 74. Good Samaritan Hospital, 375 Dixmyth Avenue, Cincinnati, OH 45220-489 360134 04/18/2005 75. Grandview Hospital and Medical Center, 405 Grand Avenue, Dayton, OH 45405 360133 05/05/2005 76. Greater Baltimore Medical Center, 6701 N. Charles Street, Baltimore, MD 21204 210044 05/11/2005 77. Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ 07601 310001 04/27/2005 78. Hahnemann University Hospital/Tenet, 230 N. Broad Street, Mailstop 119, Philadelphia, PA 19102-1192 390290 05/10/2005 79. Hamot Medical Center, 201 State Street, Erie, PA 16550 390063 05/05/2005 80. Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502 050376 04/12/2005 81. Harper-Hutzel Hospital, 3990 John R Street, Detroit, MI 48201 230104 04/19/2005 82. Harris Methodist Fort Worth Hospital, 1301 Pennsylvania Avenue, Fort Worth, TX 76104 450135 04/20/2005 83. Harris Methodist HEB, 1600 Hospital Parkway, Bedford, TX 76022 450639 05/16/2005 84. Hartford Hospital, 80 Seymour Street, P.O. Box 5037, Hartford, CT 06102-5037 070025 05/23/2005 85. Hays Medical Center, 2220 Canterbury Road, Hays, KS 67601 170013 05/23/2005 86. Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415-1829 240004 05/16/2005 87. Hialeah Hospital, 651 East 25th Street, Hialeah, FL 33013 100053 05/05/2005 88. High Point Regional Health System, 601 North Elm Street, P.O. Box HP-5, High Point, NC 27261 340004 05/16/2005 89. Hillcrest Hospital, 6780 Mayfield Road, Mayfield Hts., OH 44124 360230 05/16/2005 90. Hoag Memorial Hospital Presbyterian, One Hoag Drive, Newport Beach, CA 92663 050224 04/04/2005 91. Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 390111 05/23/2005 92. Hunterdon Medical Center, 2100 Wescott Drive, Flemington, NJ 08822 310005 04/12/2005 93. Huntington Hospital, 100 W. California Boulevard, P.O. Box 7013, Pasadena, CA 91109-7013 050438 05/05/2005 94. Iowa Methodist Medical Center, 1200 Pleasant Street, Des Moines, IA 50309 160082 04/18/2005 95. Irvine Regional Hospital & Medical Center, 16200 Sand Canyon Avenue, Irvine, CA 92618 050693 05/10/2005 96. Jewish Hospital, 200 Abraham Flexner Way, Louisville, KY 40202 180040 04/12/2005 97. John Muir Medical Center, 1601 Ygnacio Valley Road, Walnut Creek, CA 94598-3194 050180 05/10/2005 98. Jupiter Medical Center, 1210 S. Old Dixie Hwy, Jupiter, FL 33458 100253 04/20/2005 99. Kaleida Health, Millard Fillmore Hospital, 3 Gates Circle, Buffalo, NY 14209 330005 05/03/2005 100. Kansas Heart Hospital, 3601 N. Webb Road, Wichita, KS 67226 170186 05/23/2005 101. Kent Hospital, 455 Toll Gate Road, Warwick, RI 02886 410009 04/20/2005 102. Kettering Medical Center, 3535 Southern Blvd, Kettering, OH 45429 360079 05/05/2005 103. King's Daughters Medical Center, 2201 Lexington Avenue, Ashland, KY 41101 180009 05/23/2005 104. Lakeland Hospital, 1234 Napier Avenue, St. Joseph, Mi 49085 230021 04/04/2005 105. Lakeland Regional Medical Center, 1324 Lakeland Hills Boulevard, Lakeland, FL 33805 100157 05/25/2005 106. Lakeview Regional Medical Center, 95 E. Fairway Drive, Covington, LA 70433 190177 05/03/2005 107. Lawnwood Medical Center, Inc, d/b/a Lawnwood Regional Medical Center and Heart Institute, 1700 South 23rd Street, Fort Pierce, FL 34950 100246 04/20/2005 108. LDS Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143 460010 04/20/2005 109. Lee's Summit Hospital, 530 NW. Murray Road, Lee's Summit, MO 64081 260190 05/17/2005 110. Lenox Hill Hospital, 100 East 77 Street, New York, NY 10021 330119 05/16/2005 111. Los Alamitos Medical Center, 3751 Katella Avenue, Los Alamitos, CA 90720 050551 05/23/2005 112. Los Robles Hospital and Medical Center, 215 West Janss Road, Thousand Oaks, CA 91360 050549 05/16/2005 113. Louisiana Heart Hospital, 64030 Louisiana Highway 434, Lacombe, LA 70445 190250 04/01/2005 114. Lourdes Vascular Center, Lourdes Hospital, 1530 Lone Oak Road, Paducah, KY 42003 180102 03/30/2005 115. Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153 140276 05/05/2005 116. Lutheran Hospital of Indiana, 7950 West Jefferson Boulevard, Fort Wayne, IN 46804 150017 04/18/2005 117. Maricopa Integrated Health System, Maricopa Medical Center, Cardiac Catheterization Laboratory, 2601 E. Roosevelt, Phoenix, AZ 85008 032595 05/23/2005 118. Martha Jefferson Hospital, 459 Locust Avenue, Charlottesville, VA 22902 490077 04/07/2005 119. Mary Greeley Medical Center, 1111 Duff Avenue, Ames, IA 50010 160030 03/30/2005 120. Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 220071 05/03/2005 121. Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054 030103 05/23/2005 122. Medical Center of Plano, 3901 West 15th Street, Plano, TX 75075 450651 05/16/2005 123. Medical College of Ohio, 3000 Arlington Avenue, Toledo, OH 43614 360048 04/27/2005 124. Medical University of South Carolina Hospital Authority, 169 Ashley Avenue, PO Box 250347, Charleston, SC 29425 420004 05/26/2005 125. Memorial Hospital Jacksonville, 3625 University Boulevard, South, Jacksonville, FL 32216 100179 04/27/2005 126. Memorial Medical Center, 2700 Napoleon Ave, New Orleans, LA 70115 190135 05/16/2005 127. Mercy Health Center, 4300 West Memorial Road, Oklahoma City, OK 73120-8304 370013 04/12/2005 128. Mercy Hospital, 500 E. Market Street, Iowa City, IA 52245 160029 05/05/2005 129. Mercy Hospital Fairfield, 3000 Mack Road, Fairfield, OH 45014 360056 05/17/2005 130. Mercy Hospital and Medical Center, 2525 South Michigan Avenue, Chicago, IL 60616 140158 05/05/2005 131. Mercy Medical Center, 701 10th Street SE, Cedar Rapids, IA 52403 160079 04/07/2005 132. Mercy Medical Center, 1111 6th Avenue, Des Moines, IA 50314 160083 04/12/2005 133. Mercy Medical Center, 301 St. Paul Place, Baltimore, MD 21202 210008 05/25/2005 134. Methodist Hospital, 300 West Huntington Drive, P.O. Box 60016, Arcadia, CA 91066-6016 050238 04/12/2005 135. Methodist Medical Center of Oak Ridge, 990 Oak Ridge Turnpike, Oak Ridge, TN 37830 440034 05/03/2005 136. Mid Michigan Medical Center-Midland, 4005 Orchard Drive, Midland, MI 48670 230222 05/10/2005 137. Missouri Baptist Medical Center, 3015 N. Ballas Road, St. Louis, MO 63131 260108 05/23/2005 138. Morton Plant Hospital, 300 Pinellas Street, Clearwater, FL 33756 100127 05/16/2005 139. Moses H. Cone Memorial Hospital, 1200 N. Elm Street, Greensboro, NC 27401 340091 04/18/2005 140. Mount Carmel St. Ann's Hospital, 500 South Cleveland Avenue, Westerville, OH 43081-8998 360012 05/25/2005 141. Mount Diablo Medical Center, 2540 East Street, PO Box 4110, Concord, CA 94524-4110 050496 05/10/2005 Start Printed Page 36638 142. [The] Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029 330024 05/26/2005 143. Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140 100034 04/07/2005 144. Mountain View Regional Medical Center, 4311 E. Lohman Avenue, Las Cruces, NM 88011 320085 04/26/2005 145. Munroe Regional Medical Center, 1500 SW. 1st Avenue, Ocala, FL 34474 100062 05/23/2005 146. New York Presbyterian Hospital, 161 Ft. Washington Avenue, HIP1412, New York, NY 10032 330101 05/05/2005 147. Norman Regional Hospital, 901 North Porter, Box 1308, Norman, OK 73070-1308 370008 05/23/2005 148. North Austin Medical Center, 12221 MoPac Expressway North, Austin, TX 78758 450809 04/12/2005 149. North Florida Regional Medical Center, 6500 Newberry Road, Gainesville, FL 32605 100204 04/19/2005 150. North Memorial Health Care, 3300 Oakdale Avenue North, Robbinsdale, MN 55422 240001 05/26/2005 151. North Oakland Medical Centers, 461 W. Huron Street, Pontiac, MI 48341-1651 230013 05/03/2005 152. Northeast Methodist Hospital, 12412 Judson Road, Live Oak, TX 78233 450388 05/11/2005 153. Northwestern Memorial Hospital, 251 East Huron Street, Chicago, IL 60611 140281 04/26/2005 154. Norton Healthcare, P.O. Box 35070, Louisville, KY 40232-5070 180088 05/03/2005 155. Ochsner Clinic Foundation, Department of Cardiology, 1514 Jefferson Highway, New Orleans, LA 70121-2483 190036 04/12/2005 156. Ohio State University, University Medical Center, 452 West 10th Avenue, Columbus, OH 43210 360085 05/05/2005 157. Oklahoma Heart Hospital, 4050 West Memorial Road, Oklahoma City, OK 73120 370215 05/23/2005 158. Orlando Regional Healthcare System, Inc, 1414 Kuhl Avenue, Orlando, FL 32806 100006 05/23/2005 159. [The] Ortenzio Heart Center and Holy Spirit, 503 North 21st Street, Camp Hill, PA 17011-2288 390004 04/27/2005 160. OSF Saint Francis Medical Center, 530 NE. Glen Oak Avenue, Peoria, IL 61637 140067 04/27/2005 161. Our Lady of Bellefonte Hospital, St. Christopher Drive, Ashland, KY 41101 180036 05/26/2005 162. Our Lady of Lourdes Medical Center, 1600 Haddon Avenue, Camden, NJ 08103 310029 05/05/2005 163. Our Lady of Lourdes Regional Medical Center, 611 St. Landry Street, Lafayette, LA 70506 190102 05/03/2005 164. Palomar Medical Center, 555 East Valley Parkway, Escondido, CA 92025 050115 05/10/2005 165. Parkwest Medical Center, 9352 Park West Boulevard, Knoxville, TN 37923 440173 05/05/2005 166. Parkview Hospital, 2200 Randallia Drive, Fort Wayne, IN 46805 150021 05/11/2005 167. Parma Community General Hospital, 7007 Powers Boulevard, Parma, OH 44129-5495 360041 05/05/2005 168. Phoenix Baptist Hospital, Cardiac Catheterization Laboratory/Interventional Radiology Suite, 2000 West Bethany Home Road, Phoenix, AZ 85015 030030 04/01/2005 169. Phoenix Memorial Hospital, Cardiac Catheterization Laboratory/Interventional Radiology Suite, 1201 South 7th Avenue, Phoenix, AZ 85007 030106 05/16/2005 170. Pinnacle Health Hospitals, 111 South Front Street, Harrisburg, PA 17101 390067 05/23/2005 171. Plaza Medical Center of Fort Worth, 900 Eighth Avenue, Fort Worth, TX 76104 450672 05/23/2005 172. Pomerado Hospital, 15615 Pomerado Road, Poway, CA 92064 050636 05/10/2005 173. Presbyterian Hospital of Dallas, 8200 Walnut Hill Lane, Dallas, TX 75231-4496 450462 05/10/2005 174. Princeton Baptist Medical Center, 701 Princeton Avenue, SW, Birmingham, AL 35211-1399 010103 04/12/2005 175. Provena Saint Joseph Hospital, 77 North Airlite Street, Elgin, IL 60123-4912 140217 05/11/2005 176. Providence Portland Medical Center, 4805 Northeast Glisan Street, Portland, OR 97213-2967 380061 05/16/2005 177. Providence St. Vincent Medical Center, 9205 S.W. Barnes Road, Portland, OR 97225 380004 05/16/2005 178. Rapid City Regional Hospital, 353 Fairmont Boulevard, Rapid City, SD 57701 430077 05/26/2005 179. Rapides Regional Medical Center, Box 30101, 211 Fourth Street, Alexandria, LA 71301-8454 190026 05/23/2005 180. Research Medical Center, 2316 East Meyer Boulevard, Kansas City, MO 64132 260027 05/23/2005 181. Resurrection Medical Center, 7435 West Talcott, Chicago, Illinois 60631 140117 04/12/2005 182. Riverside Methodist Hospital, 3535 Olentangy River Road, Columbus, OH 43214 360006 04/20/2005 183. Robert Packer Hospital, One Guthrie Square, Sayre, PA 18840-1698 390079 04/18/2005 184. Rogue Valley Medical Center, 2825 East Barnett Road, Medford, OR 97504 380018 05/05/2005 185. Rush University Medical Center, 1725 West Harrison Street, Suite 364, Chicago, IL 60612-3824 140119 04/20/2005 186. Sacred Heart Health System, 5151 N. Ninth Avenue, P.O. Box 2700, Pensacola, FL 32513 100025 05/05/2005 187. Sacred Heart Medical Center, Oregon Heart & Vascular Institute, 1255 Hilyard Street, P.O. Box 10905, Eugene, OR 97440 380033 05/26/2005 188. Saint Joseph Health Center, 1000 Carondelet Drive, Kansas City, MO 64114 260085 05/16/2005 189. Saint Joseph Medical Center, Twelfth and Walnut Streets, P.O. Box 316, Reading, PA 19603-316 390096 04/01/2005 190. Saint Louis University Hospital, 3635 Vista at Grand Boulevard, P.O. Box 15250, St. Louis, MO 63110 260105 05/17/2005 191. Saint Luke's Hospital of Kansas City, 4401 Wornall Road, Kansas City, MO 64111 260138 04/27/2005 192. Saint Raphael Healthcare System, 1450 Chapel Street, New Haven, CT 06511 070001 05/05/2005 193. Saints Memorial Medical Center, 1 Hospital Drive, Lowell, MA 01852-1389 220082 04/27/2005 194. Samaritan Hospital, 310 South Limestone Street, Lexington, KY 40508 180007 05/17/2005 195. Seton Medical Center, 1900 Sullivan Avenue, Daly City, CA 94015 050289 05/05/2005 196. Shady Grove Adventist Hospital, 9901 Medical Center Drive, Rockville, MD 20850 210057 04/20/2005 197. Shands Jacksonville Medical Center, 655 West Eighth Street, Jacksonville, FL 32209 100001 05/26/2005 198. Shawnee Mission Medical Center, 9100 W. 74th Street, Shawnee Mission, KS 66204 170104 05/16/2005 199. Sierra Medical Center, 1625 Medical Center Drive, El Paso, TX 79902 450668 05/16/2005 200. Sinai-Grace Hospital, 6071 W. Outer Drive, Detroit, MI 48235 230024 04/19/2005 201. Sioux Valley Hospital USD Medical Center, 1305 W. 18th Street, Sioux Falls, SD 57117-5039 430027 04/19/2005 202. Skyline Medical Center, 3441 Dickerson Pike, Nashville, TN 37207 440006 04/07/2005 203. South Austin Hospital, 901 W. Ben White, Austin, TX 78704 450713 04/12/2005 204. Southern Baptist Hospital of Florida, Inc., d/b/a Baptist Medical Center, 800 Prudential Drive, Jacksonville, FL 32207 100088 05/05/2005 205. Southern Maryland Hospital Center, 7503 Surratts Road, Clinton, MD 20735 520054 05/26/2005 206. Southwest Washington Medical Center, P.O. Box 1600, Vancouver, WA 98668 500050 05/26/2005 207. Spectrum Health Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503 230038 04/18/2005 208. SSM St. Joseph Health Center, 300 First Capitol Drive, St. Charles, MO 63301 260005 04/26/2005 209. St. Anthony's Hospital, 1200 7th Avenue North, St. Petersburg, FL 33705 100067 04/19/2005 210. St. Bernardine Medical Center, 2101 N. Waterman Avenue, San Bernardino, CA 92404-4836 050129 05/05/2005 Start Printed Page 36639 211. St. David's Medical Center, 919 East 32nd Street 78705, P.O. Box 4039, Austin, TX 78765-4039 450431 05/05/2005 212. St. Elizabeth Medical Center, South Unit, 1 Medical Village Drive, Edgewood, KY 41017 180035 04/26/2005 213. St. Francis Hospital and Health Center, 12935 S. Gregory Street, Blue Island, IL 60406 140118 05/11/2005 214. St. Francis Hospital & Health Centers, 1600 Albany Street, Beech Grove, IN 46107 150033 04/01/2005 215. St. John Hospital and Medical Center, 22151 Moross Road, Detroit, MI 48236 230165 04/27/2005 216. St John's Hospital, 800 East Carpenter Street, Springfield, IL 62769 140053 05/10/2005 217. St. John's Regional Medical Center, 2727 McClelland Boulevard, Joplin, MO 64804-1694 260001 04/19/2005 218. St. John West Shore Hospital, 29000 Center Ridge Road, Westlake, OH 44145 360123 05/03/2005 219. St. Joseph Medical Center, Heart Institute, 7601 Osler Drive, Towson, MD 21204-7582 210007 05/17/2005 220. St. Joseph Mercy Hospital, 5301 E. Huron River Drive, P.O. Box 995, Ann Arbor, MI 48106 230156 05/16/2005 221. St. Joseph Regional Medical Center, 5000 West Chambers Street, Milwaukee, WI 53210-1688 520136 05/10/2005 222. St. Joseph's Medical Center, 1800 N. California Street, Stockton, CA 95204 050084 05/17/2005 223. St. Joseph's Mercy Health Center, 300 Werner Street, Hot Springs, AR 71903 040026 05/26/2005 224. St. Joseph's Wayne Hospital, 224 Hamburg Turnpike, Wayne, NJ 07470 310116 03/30/2005 225. St. Luke's, 915 East First Street, Duluth, MN 55805 240047 04/19/2005 226. St. Lukes Episcopal Hospital, 6720 Bertner Avenue, Houston, TX 77030 450193 03/30/2005 227. St. Luke's Hospital, 1026 A Avenue NE, P.O. Box 3026, Cedar Rapids, IA 52406-3026 160045 05/10/2005 228. St. Luke's Medical Center, 2900 W. Oklahoma Avenue, P.O. Box 2901, Milwaukee, WI 53201-2901 520138 04/18/2005 229. St. Luke's-Roosevelt Hospital Center, 1000 Tenth Avenue, New York, NY 10019 330046 05/23/2005 230. St. Mary's Hospital and Medical Center, 2635 North Seventh Street, P.O. Box 1628, Grand Junction, CO 81501 060023 04/20/2005 231. St Mary's Medical Center, 407 East Third Street, Duluth, MN 55805 240002 05/16/2005 232. St. Mary's Medical Center, 3700 Washington Avenue, Evansville, IN 47740-001 150100 05/17/2005 233. St. Patrick Hospital and Health Sciences Center, 500 West Broadway, Missoula, MT 59802 270014 04/12/2005 234. St. Thomas Hospital, 4220 Harding Road, Nashville, TN 37205 440082 04/19/2005 235. Strong Memorial Hospital, 601 Elmwood Avenue, Box 679, Rochester, NY 14642 330285 04/19/2005 236. Swedish American Hospital, 1401 East State Street, Rockford, IL 61104 140228 05/03/2005 237. Swedish Medical Center, 501 East Hampden Ave, Englewood, CO 80113 060034 05/16/2005 238. Swedish Medical Center-First Hill Campus, 747 Broadway, Seattle, WA 98122 500027 05/17/2005 239. Swedish Medical Center-Providence Campus, 747 Broadway, Seattle, WA 98122 500025 05/23/2005 240. Tallahassee Memorial, 1300 Miccosukee Road, Tallahassee, FL 32308 100135 05/16/2005 241. Terrebonne General Medical Center, 8166 Main Street, Houma, LA 70360 190008 04/20/2005 242. Texan Heart Hospital, 6700 IH-10 West, San Antonio, TX 78201 450878 05/26/2005 243. Town and Country Hospital, 6001 Webb Road, Tampa, FL 33615-3241 100255 05/05/2005 244. UC Davis Cardiac Cath Lab/UC Davis Medical Center, 2315 Stockton Boulevard, Sacramento, CA 95817 050599 04/19/2005 245. Union Hospital, 1606 North Seventh Street, Terre Haute, IN 47804-2780 150023 04/27/2005 246. Union Memorial Hospital, 201 East University Parkway, Baltimore, MD 21218-2895 210024 04/07/2005 247. United Regional Health Care System, Eleventh Street Campus, 1600 Eleventh Street, Wichita Falls, TX 76301 450010 05/16/2005 248. University of Alabama Hospital, 619 South 19th Street, Birmingham, AL 35233 010033 05/26/2005 249. University Health System, 1520 Cherokee Trail, Suite 200, Knoxville, TN 37920-2205 440015 05/26/2005 250. University Health System, 4502 Medical Drive, San Antonio, TX 78229 450213 04/27/2005 251. University of Kentucky Hospital, 800 Rose Street, Lexington, KY 40536-0293 180067 05/16/2005 252. University of Louisville Hospital, 530 South Jackson Street, Louisville, KY 40202 180141 05/05/2005 253. University of Pennsylvania Medical Center-Presbyterian, 39th and Market Streets, Philadelphia, PA 19104 390223 04/01/2005 254. UPMC Presbyterian Shadyside, 200 Lothrop Street, Pittsburgh, PA 15213 390164 05/03/2005 255. Utah Valley Regional Medical Center, 1034 North 500 West, Provo, Utah 84605 460001 05/26/2005 256. The Valley Hospital, 223 N. Van Dien Avenue, Ridgewood, NJ 07450-2736 310012 04/20/2005 257. Vassar Brothers Medical Center, 45 Reade Place, Poughkeepsie, NY 12601 330023 05/05/2005 258. Washoe Medical Center, 75 Pringle Way, Reno, NV 89502 290001 04/27/2005 259. Washington Hospital Center, 110 Irving Street, NW., Washington, DC 20010 090011 05/16/2005 260. Wellmont Holston Valley Medical Center, Holston Valley Vascular Institute, 130 W. Ravine Road, Kingsport, TN 37660 440017 05/16/2005 261. Wentworth-Douglass Hospital, 789 Central Avenue, Dover, NH 03820 300018 05/10/2005 262. West Allis Memorial Hospital, 8901 West Lincoln Avenue, West Allis, WI 53227 520139 05/26/2005 263. Westchester Medical Center, 95 Grasslands Road, Valhalla, NY 10595 330234 05/16/2005 264. Western Baptist Hospital, 2501 Kentucky Avenue, Paduach, KY 42003-3200 180104 05/05/2005 265. Western Medical Center-Santa Ana, 1001 North Tustin Avenue, Santa Ana, CA 92705 050746 05/25/2005 266. William Beaumont Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073 230130 05/10/2005 267. Willis Knighton Bossier, 2400 Hospital Drive, Bossier City, LA 71111 190236 04/27/2005 268. Willis Knighton Medical Center, 2600 Greenwood Road, Shreveport, LA 71103 190111 04/27/2005 269. Winchester Medical Center, P.O. Box 3340, Winchester, VA 22604-2540 490005 05/16/2005 270. The Wisconsin Heart Hospital, LLC, 10000 West Blue Mound Road, Wauwatosa, WI 53226 520199 05/05/2005 271. Wyoming Valley Health Care System, 575 North River Street, Wilkes Barre, PA 18764 390137 04/26/2005 272. York Hospital, 15 Hospital Drive, York, ME 03909 200020 04/14/2005 [FR Doc. 05-12525 Filed 6-23-05; 8:45 am]
BILLING CODE 4120-01-P
Document Information
- Published:
- 06/24/2005
- Department:
- Centers for Medicare & Medicaid Services
- Entry Type:
- Notice
- Action:
- Notice.
- Document Number:
- 05-12525
- Pages:
- 36620-36640 (21 pages)
- Docket Numbers:
- CMS-9028-N
- PDF File:
- 05-12525.pdf