Medicare and Medicaid Programs; Quarterly Listing of Program IssuancesThird Quarter 1997

Federal RegisterJun 4, 1998

Ask Donna

What actually matters in this document.

Text

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[HCFA-9152-N]

Medicare and Medicaid Programs; Quarterly Listing of Program

Issuances--Third Quarter 1997

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

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice lists HCFA manual instructions, substantive and

interpretive regulations, and other Federal Register notices that were

published during July, August, and September of 1997 that relate to the

Medicare and Medicaid programs. It also identifies certain devices with

investigational device exemption numbers approved by the Food and Drug

Administration that may be potentially covered under Medicare.

Section 1871(c) of the Social Security Act requires that we publish

a list of Medicare issuances in the Federal Register at least every 3

months. Although we are not mandated to do so by statute, for the sake

of completeness of the listing, we are including all Medicaid issuances

and Medicare and Medicaid substantive and interpretive regulations

(proposed and final) published during this timeframe.

FOR FURTHER INFORMATION CONTACT:

Bridget Wilhite, (410) 786-5248 (For Medicare instruction information).

Betty Stanton, (410) 786-3247 (For Medicaid instruction information).

Sharon Hippler, (410) 786-4633 (For Food and Drug Administration-

approved investigational device exemption information).

Pamela Gulliver, (410) 786-4659 (For all other information).

SUPPLEMENTARY INFORMATION:

I. Program Issuances

The Health Care Financing Administration (HCFA) is responsible for

administering the Medicare and Medicaid programs, which pay for health

care and related services for 38 million Medicare beneficiaries and 36

million Medicaid recipients. Administration of these programs involves

(1) providing information to Medicare beneficiaries and Medicaid

recipients, health care providers, and the public, and (2) effective

communications with regional offices, State governments, State Medicaid

Agencies, State Survey Agencies, various providers of health care,

fiscal intermediaries and carriers that process claims and pay bills,

and others. To implement the various statutes on which the programs are

based, we issue regulations under the authority granted the Secretary

under sections 1102, 1871, and 1902 and related provisions of the

Social Security Act (the Act) and also issue various manuals,

memoranda, and statements necessary to administer the programs

efficiently.

Section 1871(c)(1) of the Act requires that we publish in the

Federal Register at least every 3 months a list of all Medicare manual

instructions, interpretive rules, and guidelines of general

applicability not issued as regulations. We published our first notice

June 9, 1988 (53 FR 21730). Although we are not mandated to do so by

statute, for the sake of completeness of the listing of operational and

policy statements, we are continuing our practice of including Medicare

substantive and interpretive regulations (proposed and final) published

during the 3-month time frame. Since the publication of our quarterly

listing on June 12, 1992 (57 FR 24797), we decided to add Medicaid

issuances to our quarterly listings. Accordingly, we list in this

notice Medicaid issuances and Medicaid substantive and interpretive

regulations published during July through September 1997.

II. How To Use the Addenda

This notice is organized so that a reader may review the subjects

of all manual issuances, memoranda, substantive and interpretive

regulations, or Food and Drug Administration-approved investigational

device exemptions published during the timeframe to determine whether

any are of particular interest. We expect it to be used in concert with

previously published notices. Most notably, those unfamiliar with a

description of our Medicare manuals may wish to review Table I of our

first three notices (53 FR 21730, 53 FR 36891, and 53 FR 50577) and the

notice published March 31, 1993 (58 FR 16837), and those desiring

information on the Medicare Coverage Issues Manual may wish to review

the August 21, 1989 publication (54 FR 34555).

To aid the reader, we have organized and divided this current

listing into five addenda. Addendum I lists the publication dates of

the most recent quarterly listings of program issuances.

Addendum II identifies previous Federal Register documents that

contain a description of all previously published HCFA Medicare and

Medicaid manuals and memoranda.

Addendum III of this notice lists, for each of our manuals or

Program Memoranda, a HCFA transmittal number unique to that instruction

and its subject matter. A transmittal may consist of a single

instruction or many. Often it is necessary to use information in a

transmittal in conjunction with information currently in the manuals.

Addendum IV lists all substantive and interpretive Medicare and

Medicaid regulations and general notices published in the Federal

list the date published, the Federal Register citation, the parts of

the Code of Federal Regulations (CFR) that have changed (if

applicable), the agency file code number, the title of the regulation,

the ending date of the comment period (if applicable), and the

effective date (if applicable).

On September 19, 1995, we published a final rule (60 FR 48417)

establishing in regulations at 42 CFR 405.201 et seq. that certain

devices with an investigational device exemption approved by the Food

and Drug Administration and certain services related to those devices

may be covered under Medicare. It is HCFA's practice to announce in

this quarterly notice all investigational device exemption

categorizations, using the investigational device exemption numbers the

Food and Drug Administration assigns. Addendum V includes listings of

the Food and Drug Administration-approved investigational device

exemption numbers that have been approved or revised during the quarter

covered by

[[Page 30500]]

this notice. The listings are organized according to the categories to

which the device numbers are assigned (that is, Category A or Category

B, and identified by the investigational device exemption number).

III. How To Obtain Listed Material

A. Manuals

An individual or organization interested in routinely receiving any

manual and revisions to it may purchase a subscription to that manual.

Those wishing to subscribe should contact either the Government

Printing Office (GPO) or the National Technical Information Service

(NTIS) at the following addresses:

Superintendent of Documents, Government Printing Office, ATTN: New

Orders, P.O. Box 371954, Pittsburgh, PA 15250-7954, Telephone (202)

512-1800, Fax number (202) 512-2250 (for credit card orders); or

National Technical Information Service, Department of Commerce, 5825

Port Royal Road, Springfield, VA 22161, Telephone (703) 487-4630.

In addition, individual manual transmittals and Program Memoranda

listed in this notice can be purchased from NTIS. Interested parties

should identify the transmittal(s) they want. GPO or NTIS can give

complete details on how to obtain the publications they sell.

Additionally, all manuals are available at the following Internet

address: http//www.hcfa.gov/pubforms/progman.htm.

B. Regulations and Notices

Regulations and notices are published in the daily Federal

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) through the Internet and via asynchronous dial-in.

Internet users can access the database by using the World Wide Web; the

Superintendent of Documents home page address is http://

www.access.gpo.gov/su__docs/, by using local WAIS client software, or

by telnet to swais.access.gpo.gov, then log in as guest (no password

required). Dial-in users should use communications software and modem

to call (202) 512-1661; type swais, then log in as guest (no password

required).

C. Rulings

We publish Rulings on an infrequent basis. Interested individuals

can obtain copies from the nearest HCFA Regional Office or review them

at the nearest regional depository library. We have, on occasion,

published Rulings in the Federal Register. In addition, Rulings,

beginning with those released in 1995, are available online, through

the HCFA Home Page. The Internet address is http://www.hcfa.gov/regs/

rulings.htm.

D. HCFA's Compact Disk-Read Only Memory (CD-ROM)

Our laws, regulations, and manuals are also available on CD-ROM,

which may be purchased from GPO or NTIS on a subscription or single

copy basis. The Superintendent of Documents list ID is HCLRM, and the

stock number is 717-139-00000-3. The following material is on the CD-

ROM disk:

Titles XI, XVIII, and XIX of the Act.

HCFA-related regulations.

HCFA manuals and monthly revisions.

HCFA program memoranda.

The titles of the Compilation of the Social Security Laws are

current as of January 1, 1995. The remaining portions of CD-ROM are

updated on a monthly basis.

Because of complaints about the unreadability of the Appendices

(Interpretive Guidelines) in the State Operations Manual (SOM), as of

March 1995, we deleted these appendices from CD-ROM. We intend to re-

visit this issue in the near future, and, with the aid of newer

technology, we may again be able to include the appendices on CD-ROM.

Any cost report forms incorporated in the manuals are included on

the CD-ROM disk as LOTUS files. LOTUS software is needed to view the

reports once the files have been copied to a personal computer disk.

IV. How To Review Listed Material

Transmittals or Program Memoranda can be reviewed at a local

Federal Depository Library (FDL). Under the FDL program, government

publications are sent to approximately 1400 designated libraries

throughout the United States. Interested parties may examine the

documents at any one of the FDLs. Some may have arrangements to

transfer material to a local library not designated as an FDL. To

locate the nearest FDL, contact any library.

In addition, individuals may contact regional depository libraries,

which receive and retain at least one copy of most Federal government

publications, either in printed or microfilm form, for use by the

general public. These libraries provide reference services and

interlibrary loans; however, they are not sales outlets. Individuals

may obtain information about the location of the nearest regional

depository library from any library. Superintendent of Documents

numbers for each HCFA publication are shown in Addendum III, along with

the HCFA publication and transmittal numbers. To help FDLs locate the

instruction, use the Superintendent of Documents number, plus the HCFA

transmittal number. For example, to find the Home Health Agency Manual,

(HCFA Pub. 11) transmittal entitled ``Billing for Durable Medical

Equipment, Orthotic/Prosthetic Devices,'' use the Superintendent of

Documents No. HE 22.8/5 and the HCFA transmittal number 283.

V. General Information

It is possible that an interested party may have a specific

information need and not be able to determine from the listed

information whether the issuance or regulation would fulfill that need.

Consequently, we are providing information contact persons to answer

general questions concerning these items. Copies are not available

through the contact persons. Copies can be purchased or reviewed as

noted above.

Questions concerning Medicare items in Addendum III may be

addressed to Bridget Wilhite, Office of Communications and Operations

Support, Division of Regulations and Issuances, Health Care Financing

Administration, Telephone (410) 786-5248.

Questions concerning Medicaid items in Addendum III may be

addressed to Betty Stanton, Center for Medicaid State Operations,

Policy Coordination and Planning Group, Health Care Financing

Administration, C4-25-02, 7500 Security Boulevard, Baltimore, MD 21244-

1850, Telephone (410) 786-3247.

Questions concerning Food and Drug Administration-approved

investigational device exemptions may be addressed to Sharon Hippler,

Office of Clinical Standards and Quality, Coverage Analysis Group,

Health Care Financing Administration, C4-11-04, 7500 Security

Boulevard, Baltimore, MD 21244-1850, Telephone (410) 786-4633.

Questions concerning all other information may be addressed to

Pamela Gulliver, Office of Communications and

[[Page 30501]]

Operations Support, Division of Regulations and Issuances, Health Care

Financing Administration, C5-09-26, 7500 Security Boulevard, Baltimore,

MD 21244-1850, Telephone (410) 786-4659.

(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: May 5, 1998.

Pamela J. Gentry,

Director, Office of Communications and Operations Support.

Addendum I

This addendum lists the publication dates of the most recent

quarterly listings of program issuances.

December 18, 1996 (61 FR 66676)

April 21, 1997 (62 FR 19328)

May 12, 1997 (62 FR 25957)

November 3, 1997 (62 FR 59358)

November 21, 1997 (62 FR 62325)

Addendum II--Description of Manuals, Memoranda, and HCFA Rulings

An extensive descriptive listing of Medicare manuals and memoranda

was published on June 9, 1988, at 53 FR 21730 and supplemented on

September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR

50577. Also, a complete description of the Medicare Coverage Issues

Manual was published on August 21, 1989, at 54 FR 34555. A brief

description of the various Medicaid manuals and memoranda that we

maintain was published on October 16, 1992, at 57 FR 47468.

Addendum III--Medicare and Medicaid Manual Instructions July 1997

Through September 1997

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Trans. Manual/Subject/Publication No,

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Intermediary Manual

Part 1--Fiscal Administration

(HCFA Pub. 13-1)

(Superintendent of Documents No. HE 22.8/6-3)

------------------------------------------------------------------------

128......................... Coordination of Medicare and

Complementary Insurance Programs.

Coordination of Medicare With the Federal

Grants in Aid Program (Medicaid).

------------------------------------------------------------------------

Intermediary Manual

Part 3--Claims Process

(HCFA Pub. 13-3)

(Superintendent of Documents No. HE 22.8/6)

------------------------------------------------------------------------

1715........................ Self-Administered Drug

Administered In An Emergency Situation.

1716........................ Mammography Screening.

1717........................ HCPCS for Hospital Outpatient

Radiology Services and Other Diagnostic

Procedures.

1718........................ Billing for Durable Medical

Equipment, Orthotic/Prosthetic Devices

and Surgical Dressings.

1719........................ CFA Common Procedure Coding

System.

1720........................ Completing Quarterly Report on

Provider Enrollment.

1721........................ Laboratory Tests for

Hemodialysis, Intermittent Peritoneal

Dialysis, Continuous Cycling Peritoneal

Dialysis and Hemofiltration.

Laboratory Tests.

1722........................ HCPCS Codes for Diagnostic

Services and Medical Services (Correction

to Transmittal Number 1719, dated July

1997).

1723........................ Claims Processing Timeliness.

1724........................ HCPCS Codes for Diagnostic

Services and Medical Services--Correction

to Transmittal Number 1722, Dated August

1997.

1725........................ Mammography Screening.

Focused Medical Review.

Focused Medical Review Activity Report.

1726........................ Review of Form HCFA-1450 for

Inpatient and Outpatient Bills.

Provider Electronic Billing File and

Record Formats.

Alphabetic Listing of Data Elements.

------------------------------------------------------------------------

Intermediary Manual.

Part 4--Audit Procedures

(HCFA Pub. 13-4)

(Superintendent of Documents No. HE 22.8/6-4)

------------------------------------------------------------------------

33.......................... Home Office Uniform Desk Review.

------------------------------------------------------------------------

Carriers Manual

Part 1--Fiscal Administration (HCFA Pub. 14-1)

(Superintendent of Documents No. HE 22.8/7-2)

------------------------------------------------------------------------

122......................... Coordination of Medicare and

Complementary Insurance Programs.

Coordination of Medicare With the

Federal Grants in Aid Program (Medicaid).

------------------------------------------------------------------------

Carriers Manual

Part 2--Claims Process (HCFA Pub. 14-2)

(Superintendent of Documents No. HE 22.8/7-3)

------------------------------------------------------------------------

136......................... Functional Standards for Claims

Processing Operations.

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[[Page 30502]]

Carriers Manual

Part 3--Claims Process

(HCFA Pub. 14-3)

(Superintendent of Documents No. HE 22.8/7)

------------------------------------------------------------------------

1573........................ Evidence of Medical Necessity for

Durable Medical Equipment.

General Claims Processing Requirements.

Billing Requirements.

Simplified Roster Bills.

Health Insurance Maintenance Organization

Processing Requirements.

Speciality Code/Place of Service

Processing Requirements.

Suppression of EOMBs.

Billing Requirements for Global Surgeries.

Claims Review for Global Surgeries.

Payment for Return Trips to the Operating

Room for Treatment of Complications.

EOMB and Remittance Messages.

Payment for Eyeglasses, Contact Lenses,

and Related Services.

Interpretation of Diagnostic Tests.

1574........................ Identifying a Screening

Mammography Claim.

1575........................ Claims Processing Terminology.

Handling Incomplete or Invalid Claims.

Conditional Data Element Requirements.

Data Element Requirements Matrix.

Data Element Requirements.

Incomplete or Invalid Claims.

1576........................ Exception to Sec. 7560 A and B

When Physician, Other Practitioner, or

Supplier Is Excluded From Participation

in Medicare Program.

Authority to Exclude Practitioners,

Providers, and Suppliers of Services.

1577........................ Evidence of Medicaid Necessity

for Durable Medical Equipment (Correction

to Transmittal Number 1573, dated July

1997).

1578........................ Assistant at Surgery Services.

Purchased Diagnostic Tests.

Inpatient Dialysis On Same Date As

Evaluation and Management.

Consultations.

Threshold Times For Codes 99354 and 99355.

1579........................ Services Eligible for HPSA Bonus

Payments.

Remittance Messages.

1580........................ Doctor of Medicine and

Osteopathy.

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Carriers Manual

Part 4--Professional Relations

(HCFA Pub. 14-4)

(Superintendent of Documents No. HE 22.8/7-4)

------------------------------------------------------------------------

14.......................... Patient and Insured Information.

Provider of Service or Supplier

Information.

Place of Service Codes and Definitions.

------------------------------------------------------------------------

Program Memorandum

Intermediaries (HCFA Pub. 60A)

(Superintendent of Documents No. HE 22.8/6-5)

------------------------------------------------------------------------

A-97-5...................... Application of Medicare

Reasonable Cost Reimbursement Principles

to Rural Health Clinics.

A-97-6...................... Extension of Due Date for Filing

Form HCFA-2540-96 and Form HCFA-1728-94

Cost Reports.

A-97-7...................... Home Health Agency Requests to

Intermediaries to Change Cost Center

Allocation Sequence or Statistical

Allocation Basis.

A-97-8...................... Instructions to Implement the New

Medicare Summary Notice.

A-97-9...................... Hospital Outpatient Procedures:

Medicare Changes Due to 1997 HCPCS

Update--New Dermatology Codes

(Clarification).

A-97-10..................... Change in Hospice Payment Rates.

A-97-11..................... Hospice Provisions Enacted by the

Balanced Budget Act of 1997.

A-97-12..................... Medicare Home Health Benefit--The

Balanced Budget Act of 1997 Clarification

of Part-Time or Intermittent Skilled

Nursing Care.

A-97-13..................... FY 1998 Prospective Payment

System, TEFRA Hospital and Other Bill

Processing Changes.

A-97-14..................... Hospital Outpatient Procedures:

Billing for Contrast Material

(Clarification).

------------------------------------------------------------------------

Program Memorandum

Carriers

(HCFA Pub. 60B)

(Superintendent of Documents No. HE 22.8/6-5)

------------------------------------------------------------------------

B-97-2...................... Changes to Correct Coding Edits,

Version 4.0.

B-97-3...................... Instructions for CLIA Compliance

for Part B Laboratory Claims Submitted to

Carriers.

B-97-4...................... Instructions for CLIA Compliance

for Part B Laboratory Claims Submitted to

Carriers-- Correction to Transmittal

Number B-97-3, dated September 1997.

B-97-5...................... Update of Rates and Wage Index

for Ambulatory Surgical Center Payments

Effective October 1, 1997.

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[[Page 30503]]

Program Memorandum

Intermediaries/Carriers

(HCFA Pub. 60A/B)

(Superintendent of Documents No. HE 22.8/6-5)

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AB-97-10.................... Claims for Separately Billable

End Stage Renal Disease Laboratory

Services Performed by Certified

Independent Dialysis Facilities.

AB-97-11.................... Counting of Non-Medicare Home

Health Visits and the Reporting of the

Associated Costs in Determining the

Average Cost Per Visit for Home Health

Services.

AB-97-12.................... New Implementation Date for

Hematocrit Levels for Erythropoietin.

AB-97-13.................... Extension of the Limitation on

Payment for Services to Individuals

Entitled to Benefits on the Basis of End

Stage Renal Disease Who are Covered by

Group Health Plans.

AB-97-14.................... Extension of the Limitation on

Payment for Services to Individuals

Entitled to Benefits on the Basis of End

Stage Renal Disease Who are Covered by

Group Health Plans (GHP)-- Correction to

Program Memorandum Number AB-97-13, dated

September 1997.

AB-97-15.................... Update to the Hospice Wage Index.

AB-97-16.................... Balanced Budget Act of 1997, P.L.

105-33 (H.R. 2015)--Home Health Payment

Provisions.

AB-97-17.................... New Panels Approved by Common

Procedural Terminology--Clarification of

Program Memorandum AB-97-5.

AB-97-18.................... Balanced Budget Act of 1997, P.L.

105-33 (H.R.)-Home Health Payment

Provisions.

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State Operations Manual

Provider Certification

(HCFA Pub. 7)

(Superintendent of Documents No. HE 22.8/12)

------------------------------------------------------------------------

283......................... Interpretive Guidelines and

Survey Procedures.

------------------------------------------------------------------------

Peer Review Organization Manual

(HCFA Pub. 19)

(Superintendent of Documents No. HE 22.8/8-15)

------------------------------------------------------------------------

64.......................... Opportunity to Discuss.

Authority.

Scope of Review.

Complaints That Do Not Meet Statutory

Requirements.

Referrals.

Review Process.

------------------------------------------------------------------------

Hospital Manual

(HCFA Pub. 10)

(Superintendent of Documents No. HE 22.8/2)

------------------------------------------------------------------------

716......................... Self-Administered Drug

Administered In An Emergency Situation.

717......................... Billing for Mammography

Screening.

718......................... HCPCS for Hospital Outpatient

Radiology Services and Other Diagnostic

Procedures.

719......................... Billing for Durable Medical

Equipment, Orthotic/Prosthetic Devices,

and Surgical Dressings.

720......................... HCFA Common Procedure Coding

System.

721......................... HCPCS Codes for Diagnostic

Services and Medical Services.

722......................... Billing for Mammography

Screening.

------------------------------------------------------------------------

Home Health Agency Manual

(HCFA Pub. 11)

(Superintendent of Documents No. HE 22.8/5)

------------------------------------------------------------------------

283......................... Billing for Durable Medical

Equipment, Orthotic/Prosthetic Devices.

------------------------------------------------------------------------

Skilled Nursing Facility Manual

(HCFA Pub. 12)

(Superintendent of Documents No. HE 22.8/3)

------------------------------------------------------------------------

348......................... Billing for Mammography

Screening.

349......................... Billing for Durable Medical

Equipment (DME), Orthotic/Prosthetic

Devices, and Surgical Dressings.

350......................... Billing for Mammography

Screening.

------------------------------------------------------------------------

Outpatient Physical Therapy and Comprehensive Outpatient Rehabilitation

Facility Manual

(HCFA Pub. 9)

(Superintendent of Documents No. HE 22.8/9)

------------------------------------------------------------------------

130......................... Billing for Durable Medical

Equipment Orthotic/Prosthetic Devices,

and Surgical Dressings.

------------------------------------------------------------------------

Coverage Issues Manual

(HCFA Pub. 6)

(Superintendent of Documents No. HE 22.8/18)

------------------------------------------------------------------------

102......................... Hyperbaric Oxygen Therapy

[[Page 30504]]

Lung Volume Reduction Surgery (Reduction

Pneumoplasty, Also Called Lung Shaving or

Lung Contouring) Unilateral or Bilateral

by Open or Thoracoscopic Approach for

Treatment of Emphysema or Chronic

Obstructive Pulmonary Disease.

------------------------------------------------------------------------

Provider Reimbursement Manual--Part 1

(HCFA Pub. 15-1)

(Superintendent of Documents No. 22.8/4)

------------------------------------------------------------------------

400......................... Provider Requests Regarding

Applicability of Cost Limits.

Request for Exemption From Skilled Nursing

Facility Cost Limits.

------------------------------------------------------------------------

Provider Reimbursement Manual--Part I

Chapter 27--Reimbursement for ESRD and Transplant Services

(HCFA Pub. 15-1-27)

(Superintendent of Documents No. 22.8/4)

------------------------------------------------------------------------

29.......................... Allowable Compensation for

Physician Owners and Medical Directors

Allowable Compensation for Owners,

Administrators, and Assistant

Administrators.

Submission of Documentation.

------------------------------------------------------------------------

Provider Reimbursement Manual--Part II

Provider Cost Reporting Forms and Instructions

(HCFA Pub. 15-II-A)

(Superintendent of Documents No. 22.8/4)

------------------------------------------------------------------------

19.......................... Electronic Submission of Cost

Reports.

Electronic Submission of Hospital Cost

Reports.

Electronic Submission of SNF and HHA Cost

Reports.

Provider Reimbursement Manual--Part II

Provider Cost Reporting Forms and Instructions

(HCFA Pub. 15-II-A)

(Superintendent of Documents No. 22.8/4)

------------------------------------------------------------------------

3........................... Hospital and Hospital Health Care

Complex Cost Report, Form HCFA-2552-96.

------------------------------------------------------------------------

State Medicaid Manual--Part 2

State Organization and General Administration

(HCFA Pub. 45-2)

(Superintendent of Documents No. HE22.8/10)

------------------------------------------------------------------------

89.......................... Statistical Report on Medical

Care: Eligibles, Recipients, Payments,

and Services (Form HCFA-2082).

Requirements for State Participation in

the Medicaid Statistical Information

System.

------------------------------------------------------------------------

State Medicaid Manual--Part 3

Eligibility

(HCFA Pub. 45-3)

(Superintendent of Documents No. HE22.8/10)

------------------------------------------------------------------------

68.......................... Retroactive Medicaid Coverage.

------------------------------------------------------------------------

State Medicaid Manual--Part 6

Payment for Services

(HCFA Pub. 45-6)

(Superintendent of Documents No. HE22.8/10)

------------------------------------------------------------------------

34.......................... Ingredient Prices Used by States

to Establish Upper Limits for

Prescription Drugs.

------------------------------------------------------------------------

Rural Health Clinic Manual and Federally

Qualified Health Centers Manual

(HCFA Pub. 27)

(Superintendent of Documents No. HE22.8/19:985)

------------------------------------------------------------------------

27.......................... Billing for Mammography Screening

by Rural Health Clinics and Federally

Qualified Health Centers.

28.......................... Billing for Mammography Screening

by Rural Health Clinics and Federally

Qualified Health Centers.

------------------------------------------------------------------------

Program Memorandum

State Survey Agencies

(HCFA Pub. 65)

------------------------------------------------------------------------

97-1........................ Policy Clarification: Home Health

Agency Parent, Branch, and Subunit

Criteria.

------------------------------------------------------------------------

Medicare/Medicaid

Sanction--Reinstatement Report

(HCFA Pub. 69)

------------------------------------------------------------------------

97-7........................ Report of Physicians/

Practitioners, Providers and/or Other

Health Care Suppliers Excluded/

Reinstated--May 1997.

[[Page 30505]]

97-8........................ Report of Physicians/

Practitioners, Providers and/or Other

Health Care Suppliers Excluded/

Reinstated--June 1997.

97-9........................ Report of Physicians/

Practitioners, Providers and/or Other

Health Care Suppliers Excluded/

Reinstated--July 1997.

97-10....................... Report of Physicians/

Practitioners, Providers and/or Other

Health Care Suppliers Excluded/

Reinstated--August 1997.

------------------------------------------------------------------------

Addendum IV.--Regulation Documents Published in the Federal Register

----------------------------------------------------------------------------------------------------------------

End of

Publication date FR Vol. 62, CFR part(s) File code* Regulation title comment Effective

page period date

----------------------------------------------------------------------------------------------------------------

07/01/97........ 35513-35516 ........... HSQ-243-N........... Medicare, Medicaid, ........... 07/01/97

and CLIA Programs;

Clinical Laboratory

Improvement

Amendments of 1988

Continuance of

Exemption of

Laboratories

Licensed by the

State of Washington.

07/01/97........ 35608-35634 ........... BPD-889-NC.......... Medicare Program; 09/02/97 07/01/97

Schedule of Limits

on Home Health

Agency Costs Per

Visit for Cost

Reporting Periods

Beginning on or

After July 1, 1997.

07/02/97........ 35824-35826 ........... HSQ-207-NC.......... Medicare Program; 09/02/97 07/02/97

Description of the

Health Care

Financing

Administration's

Evaluation

Methodology for the

Peer Review

Organization 5th

Scope of Work

Contracts.

07/16/97........ 38100-38107 ........... BPD-845-PN.......... Medicare Program; 09/15/97 07/16/97

Special Payment

Limits for Home

Oxygen.

07/17/97........ 38314-38315 ........... ORD-101-N........... New and Pending ........... 07/17/97

Demonstration

Project Proposals

Submitted Pursuant

to Section 1115(a)

of the Social

Security Act: May

1997.

07/29/97........ 40568 ........... BPD-889-NC.......... Medicare Program; ........... 07/01/97

Schedule of Limits

on Home Health

Agency Costs Per

Visit for Cost

Reporting Periods

Beginning on or

After July 1, 1997;

CORRECTION.

08/08/97........ 42860-42883 418 BPD-820-F........... Medicare Program; ........... 10/01/97

Hospice Wage Index.

08/14/97........ 43541-43542 ........... ORD-102-N........... New and Pending ........... 08/14/97

Demonstration

Project Proposals

Submitted Pursuant

to Section 1115(a)

of the Social

Security Act: June

1997.

08/15/97........ 43657-43674 412 413 414 BPD-763-F........... Medicare Program; ........... 08/15/97

End-Stage Renal

Disease (ESRD)

Payment Exception

Requests and Organ

Procurement Costs.

08/18/97........ 43962-43963 400 405 410 BPD-884-CN.......... Medicare Program; ........... ...........

414 Revisions to

Payment Policies

Under the Physician

Fee Schedule, Other

Part B Payment

Policies, and

Establishment of

the Clinical

Psychologist Fee

Schedule for

Calendar Year 1998;

CORRECTION.

08/18/97........ 43931-43937 431 442 488 HSQ-139-F........... Medicare and ........... 09/17/97

489 498 Medicaid Programs;

Effective Dates of

Provider Agreements

and Supplier

Approvals.

08/20/97........ 44221 488 HSQ-156-CN.......... Medicare and ........... 07/01/95

Medicaid Programs;

Survey,

Certification and

Enforcement of

Skilled Nursing

Facilities and

Nursing Facilities.

08/29/97........ 45815-45821 ........... HSQ-219-GNC......... CLIA Program; Fee 10/28/97 01/01/98

Schedule Revision.

08/29/97........ 45823 ........... OPL-016-N........... Medicare Program; ........... ...........

September 22, 1997,

Meeting of the

Practicing

Physician Ad visory

Council.

08/29/97........ 45966-46140 400 409 410 BPD-878-FC.......... Medicare Program; 10/28/97 10/01/97

411 412 413 Changes to the

424 440 485 Hospital Inpatient

488 489 498 Prospective Payment

Systems and Fiscal

Year 1998 Rates.

09/04/97........ 46698-46707 416 BPD-831-P........... Medicare Program; 11/03/97 09/04/97

Adjustment in

Payment Amounts for

New Technology

Intraocular Lenses.

09/08/97........ 47237 416 BPD-878-FC.......... Medicare Program;

Changes to the

Hospital Inpatient

Prospective Payment

Systems and Fiscal

Year 1998 Rates;

CORRECTION.

09/11/97........ 47896-47903 440 MB-071-F............ Medicaid Program; ........... 11/10/97

Coverage of

Personal Care

Services.

09/12/97........ 48098-48105 ........... MB-115-N............ State Children's ........... ...........

Health Insurance

Program; Reserved

Allotments to

States for Fiscal

Year 1998; Enhanced

Federal Medical

Assistance

Percentages.

09/15/97........ 48292-48297 ........... MB-110-N............ Medicaid Program; ........... ...........

Final Limitations

on Aggregate

Payments to

Disproportionate

Share Hospitals:

Federal Fiscal Year

1997.

[[Page 30506]]

09/17/97........ 48872-48873 ........... BPD-898-NC.......... Medicare and 11/17/97 ...........

Medicaid Programs;

Announcement of

Additional

Applications From

Hospitals

Requesting Waivers

for Organ

Procurement Service

Area.

09/18/97........ 49049 400 409 410 BPD-878-FC.......... Medicare Program; ........... ...........

411 412 413 Changes to the

424 440 485 Hospital Inpatient

488 489 498 Prospective Payment

Systems and Fiscal

Year 1998 Rates;

CORRECTION.

09/23/97........ 49649-49654 ........... OMC-029-N........... Medicare Program; 10/08/97 ...........

Solvency Standards

for Provider-