[Federal Register Volume 64, Number 127 (Friday, July 2, 1999)]
[Notices]
[Pages 36021-36022]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-17025]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-3019-N]
Medicare Program; July 19, 1999 Open Town Hall Meeting To Discuss
the Implementation of the Peer Review Organizations' (PROs) Sixth Round
Contract Activities
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice of meeting.
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SUMMARY: This notice announces a Town Hall meeting to provide an
opportunity for national health care organizations, beneficiary
advocates, and other interested parties to ask questions and raise
issues regarding the August 1999 implementation of the Peer Review
Organizations' (PROs) Sixth Round Contract activities. The meeting will
also explore how the entire health care community can identify ways to
collaborate on quality improvement projects that will raise the quality
of care provided to Medicare beneficiaries. The agency views this new
round of contracts as an opportunity to develop partnerships with the
provider, practitioner, plan, purchaser and beneficiary communities.
The meeting will address how PROs, health care organizations and
Medicare beneficiaries can form partnerships in the following areas:
National quality improvement projects;
Local quality improvement projects;
Quality improvement projects in conjunction with
Medicare+Choice plans; and
Inclusion of disadvantaged populations within each of the
quality improvement projects.
The meeting will also address the Payment Error Prevention Program,
which deals with reducing the occurrence of provider billing errors and
consequent payment errors, including both over- and under-payment.
DATES: The meeting is scheduled for Monday, July 19, 1999 from 9 a.m.
until 3 p.m., E.D.T.
ADDRESSES: The meeting will be held in the Health Care Financing
Administration Main Auditorium, 7500 Security Boulevard, Baltimore,
Maryland 21244.
FOR FURTHER INFORMATION CONTACT: Donald Forgione, (410) 786-3504,
Yvette Williams, (410) 786-6844.
SUPPLEMENTARY INFORMATION:
Background
The Town Hall meeting will provide an opportunity for organizations
representing practitioners, providers, health plans, other purchasers,
beneficiaries and other interested parties to ask questions and raise
issues regarding the activities of the PRO Sixth Round Contract and how
they can partner with PROs in achieving quality improvements for
Medicare beneficiaries and improved payment accuracy. This Town Hall
meeting provides an opportunity for information exchange concerning
Request For Proposals (RFP) and the Payment Error Prevention Program
(Task 4). RFP No. HCFA-99-00/ELM (March 1, 1999) Sec. C (3.1-3.4, pp.
17-30.
Task 1 concerns National Quality Improvement Projects and focuses
on specific national health improvement clinical topics, acute
myocardial infarction, heart failure, pneumonia,
[[Page 36022]]
stroke/transient ischemic attack/atrial fibrillation, diabetes, and
breast cancer. The PROs, in conjunction with their partners, will use
standardized sets of quality indicators to identify the greatest
opportunities to improve the care of Medicare beneficiaries.
Task 2 on Local Quality Improvement Projects directs each PRO to
initiate local projects within its State in response to local
interests, needs, and opportunities. HCFA is interested in broadening
the PROs' experience in collaborating with providers, practitioners,
plans, purchasers, and beneficiaries to improve the quality of care
they deliver. We are also interested in the testing of quality
indicators and intervention strategies that reflect care in settings
other than acute-care hospitals and Medicare+Choice plans.
Task 3 on Quality Improvement Projects conducted in conjunction
with Medicare+Choice Plans, requires the plans to implement quality
improvement projects as part of the Quality Improvement System for
Managed Care standards. Each Medicare+Choice plan must initiate two
performance improvement projects annually. The Balanced Budget Act of
1997 (BBA) requires most M+C plans to have an agreement with the PRO to
carry out all required review activities.
Task 4 on the Payment Error Prevention Program is a modified review
activity that strives to identify opportunities for improvement in the
billing process to reduce the occurrence of incorrect payments
resulting from provider billing errors. Errors may include both over-
billings and under-billings. The error rate would be the total dollars
paid in error, either above or below the correct amount. PROs will
conduct the Payment Error Prevention Program in two areas: unnecessary
admissions and miscoded diagnosis-related group assignments.
While the meeting is open to the public, attendance is limited to
space available. Individuals must register in advance as described
below.
Registration
The Office of Clinical Standards and Quality will handle
registration for the meeting. Individuals may register by sending a fax
to the attention of Don Forgione, Yvette Williams, or Ida Sarsitis, in
the Division of Contract Policy and Performance. Please provide your
name, address, telephone number, e-mail, and fax number on your
registration request.
Receipt of your fax will constitute confirmation of your
registration. You will be provided with meeting materials at the time
of the meeting. If there is no available seating for the Town Meeting,
you will receive a notice that the meeting is at capacity.
For fax registration, the number is (410) 786-4005.
If you have questions regarding registration, please contact Don
Forgione at (410) 786-3504 or Yvette Williams at (410) 786-6844.
Inquiries via e-mail should be sent to DForgione@hcfa.gov or to
YWilliams@hcfa.gov.
The agency will accept written questions or other statements (not
to exceed four single-spaced, typed pages), preferably before the
meeting, or up to 14 days after the meeting. Written submissions must
be sent to: Health Care Financing Administration, ATTN: Steven Jencks,
M.D., Director, Quality Improvement Group, Office of Clinical Standards
and Quality, S3-01-17, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
Authority: Section 1102 of the Social Security Act (42 U.S.C.
1302) (42 CFR 462.167).
Dated: June 29, 1999.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 99-17025 Filed 7-1-99; 8:45 am]
BILLING CODE 4120-01-P
