Medicare Program; Establishment of the Medicare+Choice Program

DEPARTMENT OF HEALTH AND HUMAN SERVICE

Health Care Financing Administration

42 CFR Parts 400, 403, 410, 411, 417, and 422

[HCFA-1030-CN]

RIN 0938-A129

Medicare Program; Establishment of the Medicare+Choice Program

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

ACTION: Correction of interim final rule with comment period.

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

SUMMARY: On June 26, 1998, we published in the Federal Register, at 63

FR 34968. an interim final rule with comment period that explains and

implements those provisions of the Balanced Budget Act of 1997 that

established the Medicare+Choice program. This notice corrects errors

made in the June 26 document.

EFFECTIVE DATE: July 27, 1998.

FOR FURTHER INFORMATION CONTACT:

Anthony Culotta (410) 786-4661.

SUPPLEMENTARY INFORMATION:

Background

In drafting Federal Register Document 98-16731, we attempted to

avoid setting forth identical provisions in two CFR parts. Our plan was

to replace certain existing provisions in part 417 with a cross-

reference to identical (in effect, if not wording) provisions being

established in part 422. In doing this, however, we inadvertently and

incorrectly applied the marketing activity provisions of Sec. 422.80

and the beneficiary appeals and grievance procedures of subpart M of

part 422 to health maintenance organizations and competitive medical

plans with contracts under section 1876 of the Social Security Act (the

Act). This notice corrects this error by removing amendatory items 5,

10, and 11. Thus organizations with contracts under section 1876 of the

Act remain subject to subpart K, which includes marketing, and subpart

Q, which includes beneficiary appeals, of part 417.

In some cases, an M+C organization that has both a Medicare

contract and a contract with an employer group health plan arranges for

the employer to process election forms for Medicare-entitled group

members who wish to enroll under the Medicare contract. However, there

can be a delay between the time the beneficiary enrolls through the

employer and he or she becomes entitled to receive services from the

M+C organization, and when the election form is actually received by

the M+C organization. The statute at section 1853(a)(2)(B) of the Act

allows for adjustments in payment to account for these situations. We

inadvertently failed to address this situation in the June 26, 1998,

interim final rule. This notice corrects that by adding Secs. 422.60(f)

and 422.66(f), and revising Sec. 422.250(b) to allow for adjustments in

effective dates to conform with the payment adjustments.

We inadvertently omitted the statutory limitation at section

1854(a)(5)(A) of the Act on cost sharing for supplemental benefits

offered by M+C private fee-for-service plans. Therefore, we are

correcting Sec. 422.308(b) by adding that, for supplemental benefits,

the actuarial value of its cost-sharing may not exceed the amounts

approved in the ACR for those benefits, as determined under

Sec. 422.310 on an annual basis. Also, to clarify that additional

adjustments are not limited to a reduction in the adjusted community

rate ``in addition'' was added to the beginning of the second sentence

of Sec. 422.310(c)(4).

In addition, we are also making a number of clarifying changes and

technical corrections to paragraph designations and cross-references.

Correction of Errors

Preamble

1. On page 34984, in column 3, in the first full paragraph, in the

ninth line, ``1854(h)(4)'' is corrected to read ``1851(h)(4)''.

2. On page 35011, in column 2, in the heading of section I.1,

``Sec. 422.500'' is corrected to read ``Sec. 422.400''.

3. On page 35012, in column 1, in the heading of section I.2,

``Sec. 422.502'' is corrected to read ``Sec. 422.402''.

4. On page 35034, in column 2, in the third full paragraph, in the

14th line, ``Sec. 422.58(d)(2)'' is corrected to read

``Sec. 422.62(b)''.

5. On page 35034, in column 3, 22 lines from the top of the column,

``Sec. 422.110(b)(2)(ii)'' is corrected to read

``Sec. 422.111(b)(2)(ii)''.

6. On page 35034, in column 3, in the heading of section D.1,

``Sec. 422.102'' is corrected to read ``Sec. 422.103''.

7. On page 35034, in column 3, in the first full paragraph, in the

first line, ``Sec. 422.102'' is corrected to read ``Sec. 422.103''.

8. On page 35034, in column 3, in the first full paragraph, in the

fifth line, ``Sec. 422.102(a)'' is corrected to read

``Sec. 422.103(a)''.

9. On page 35034, in column 3, in the second full paragraph, in the

first line,

[[Page 52611]]

``Sec. 422.102(b)'' is corrected to read ``Sec. 422.103(b)''.

10. On page 35035, in column 1, in the first full paragraph,

``Sec. 422.102(c)'' is corrected to read ``Sec. 422.103(c)'' each time

it appears (twice).

11. On page 35035, in column 3, in the heading of section D.2.,

``422.103'' is corrected to read ``422.104''.

12. On page 35035, in column 3, in the first full paragraph, in the

ninth line, ``Sec. 422.103(a)'' is corrected to read

``Sec. 422.104(a)''.

13. On page 35035, in column 3, in the first full paragraph, the

reference to ``Sec. 422.103(a)(2)'' is corrected to read

``Sec. 422.104(b)'' each time it appears (twice).

14. On page 35036, in column 2, in the first full paragraph

``Sec. 422.154(b)(1)'' is corrected to read ``Sec. 422.154(c)''.

15. On page 35038, in column 2, in the first full paragraph, in the

first line, ``Sec. 422.500(b)(2)'' is corrected to read

``Sec. 422.502(b)''.

16. On page 35062, in column 1, in the fourth full paragraph, ``but

no later than 30 calendar days'' is corrected to read ``but no later

than 14 calendar days''.

17. On page 35062, in column 1, the fourth full paragraph is

corrected by adding the following sentence at the end: ``The M+C

organization may extend the 14-day deadline by up to 14 calendar days

if the enrollee requests the extension or if the organization justifies

a need for additional information and how the delay is in the interest

of the enrollee (for example, the receipt of additional medical

evidence may change an M+C organization's decision to deny).''

18. On page 35062, in column 2, in the first full paragraph,

``using the 30-calendar-day timeframe'' is corrected to read ``using

the 14 calendar-day timeframe''.

19. On page 35062, in column 2, in the fifth full paragraph,

beginning in the fourth line, ``if the organization finds that it needs

additional information and the delay'' is corrected to read ``if the

organization justifies a need for additional information and how the

delay''.

20. On page 35063, in column 1, in the third full paragraph,

beginning in the second line, ``or a health care professional'' is

corrected to read ``or a physician''.

21. On page 35063, in column 1, in the fourth full paragraph, the

phrase ``the 45-day timeframe'' is corrected to read ``the 30-day

timeframe'' each time it appears (twice).

22. On page 35063, in column 1, in the seventh full paragraph, ``If

the M+C organization makes'' is corrected to read ``For service

requests, if the M+C organization makes''.

23. On page 35063, in column 1, in the seventh full paragraph,

``but no later than 45 calendar days'' is corrected to read ``but no

later than 30 calendar days''.

24. On page 35063, in column 1, the seventh full paragraph is

corrected by adding a sentence after the end of the first sentence to

read: ``The M+C organization may extend the 30-day deadline by up to 14

calendar days if the enrollee requests the extension or if the

organization justifies a need for additional information and how the

delay is in the interest of the enrollee.''

25. On page 35063, in column 1 and continuing into column 2, the

eighth full paragraph that begins with ``If the M+C organization

affirms, * * *'' and ends with ``to the independent entity'' is

corrected to read: ``If the M+C organization affirms, in whole or in

part, its adverse organization determination, it must prepare a written

explanation and send the case file to the independent entity contracted

by us no later than 30 calendar days from the date it receives the

request for a standard reconsideration (or no later than the expiration

of an extension described in Sec. 422.590(a)(1)). The organization must

make reasonable and diligent efforts to assist in gathering and

forwarding information to the independent entity.''

26. On page 35063, in column 2, in the first full paragraph,

beginning in the fifth line, ``or to obtain a good cause extension

described in paragraph (e) of this section,'' is removed.

27. On page 35063, in column 2, in the second full paragraph,

beginning in the fourth line, ``if the organization finds that it needs

additional information and the delay'' is corrected to read ``if the

organization justifies a need for additional information and how the

delay''.

Regulations Text

1. On page 35065, in the third column, amendatory instruction

``2.'' is corrected to read as follows: ``In Sec. 400.200, the

definition for ``PRO'' is revised, the definition for ``Utilization and

Quality Control Peer Review Organization'' is removed, and the

following definitions are added in alphabetical order.''

2. On page 35066, in column 3 and continuing on page 35067, column

1, amendatory instruction 5 is removed.

3. On page 35067, in column 1, amendatory instructions 6, 7, 8, and

9 are renumbered as amendatory instructions 5, 6, 7, and 8,

respectively.

4. On page 35067, renumbered amendatory instruction 6 is corrected

to read as follows:

``Sections 417.520, 417.522, and 417.523 of subpart M are

redesignated as Secs. 422.550, 422.522, and 422.553, respectively, in a

new subpart L in part 422, and the heading for the new subpart L to

part 422 is added to read `Effect of Change of Ownership or Leasing of

Facilities During Term of Contract'.''

5. On page 35067, in column 1, amendatory instruction 10 is

removed.

6. On page 35067, in column 2, amendatory instruction 11 is

removed, and amendatory instruction 12 is renumbered as amendatory

instruction 9.

Sec. 417.800 [Corrected]

7. On page 35067, in column 2, the definition of ``Health care

prepayment plan'' is corrected to read as follows:

Sec. 417.800 Payment to HCPPS: Definitions and basic rules.

* * * * *

Health care prepayment plan (HCPP) means an organization that meets

the following conditions:

(1) Effective January 1, 1999, (or on the effective date of the

HCPP agreement in the case of a 1998 applicant) either--

(A) Is union or employer sponsored; or

(B) Does not provide, or arrange for the provision of, any

inpatient hospital services.

(2) Is responsible for the organization, financing, and delivery of

covered Part B services to a defined population on a prepayment basis.

(3) Meets the conditions specified in paragraph (b) of this

section.

(4) Elects to be reimbursed on a reasonable cost basis.

* * * * *

8. On page 35071, in column 1, in the subpart heading, ``Subpart

B'' is corrected to read ``Subpart B''.

Sec. 422.50 [Corrected]

9. In Sec. 422.50 the following changes are made:

a. On page 35071, in the first column, in paragraph (a)

introductory text, the first ``an'' is corrected to read ``An''.

b. On page 35071, in the first column, in paragraph (a)(1), the

second appearance of ``may continue to be enrolled in the M+C

organization'' is removed.

Sec. 422.54 [Corrected]

10. On page 35071, in the second column, in Sec. 422.54, in

paragraph (d)(2)(i), ``meet requirements'' is corrected to read ``meet

the requirement''.

[[Page 52612]]

Sec. 422.56 [Corrected]

11. On page 35071, in the third column, in Sec. 422.56, in

paragraph (d), ``Sec. 422.103'' is corrected to read ``Sec. 422.104''.

Sec. 422.60 [Corrected]

12. In Sec. 422.60, the following changes are made:

a. On page 35072, in the first column, in paragraph (a)(1), ``plan

that M+C organization'' is corrected to read ``plan that the M+C

organizaton''.

b. On the same page, in the same column, in paragraph (b)(1),

``Sec. 422.306(a)(2)'' is corrected to read ``Sec. 422.306(a)(1)''.

c. On the same page, in the same column, in paragraph (c)(1), in

the second sentence, the word ``beneficiary'' is removed.

d. On the same page, in the second column, in paragraph (3)(4)(i),

``Promptly informs'' is corrected to read ``Informs''.

e. On the same page, in the second column, Sec. 422.60 is further

corrected by adding a new paragraph (f) to read as follows:

Sec. 422.60 Election process.

* * * * *

(f) Exception for employer group health plans. (1) In cases in

which an M+C organization has both a Medicare contract and a contract

with an employer group health plan, and in which the M+C organization

arranges for the employer to process election forms for Medicare-

entitled group members who wish to enroll under the Medicare contract,

the effective date of the election may be up to, but may not exceed, 90

days before the date the M+C organization received the election from

the employer. Any adjustment in effective date must conform with

adjustments in payment, as described under Sec. 422.250(b).

(2) In order to obtain the effective date described in paragraph

(f)(1) of this section, the beneficiary must certify that, at the time

of enrollment in the M+C organization, he or she received the

disclosure statement specified in Sec. 422.111.

(3) The M+C organization must submit the enrollment within 30 days

from receipt of the election form from the employer.

Sec. 422.62 [Corrected]

13. In Sec. 422.62, the following changes are made:

a. On page 35073, in the first column, in paragraph (b),

introductory text, beginning in the second line, ``for M+C plans, and

as of January 1, 2002, for all MSA other types of M+C MSA plans,'' is

corrected to read ``for M+C MSA plans, and as of January 1, 2002, for

all other types of M+C plans,''.

b. On the same page, in the same column, in paragraph (c), in the

fifth line, ``coverage election'' is corrected to read ``enrollment''.

c. On the same page, in the second column, in paragraph (d), in the

heading, ``M+C plans'' is corrected to read ``M+C MSA plans''.

d. On the same page, in the same column, in paragraph (d)(1), ``M+C

plan'' is corrected to read ``M+C MSA plan''.

e. On the same page, in the same column, in paragraph (d)(2)

introductory text, ``M+C plan'' is corrected to read ``M+C MSA plan''.

Sec. 422.66 [Corrected]

14. On page 35074, in the third column, Sec. 422.66 is corrected by

adding a new paragraph (f) to read as follows:

Sec. 422.66 Coordination of enrollment and disenrollment through M+C

organizations.

(f) Exception for employer group health plans. (1) In cases when an

M+C organization has both a Medicare contract and a contract with an

employer group health plan, and when the M+C organization arranges for

the employer to process election forms for Medicare-entitled group

members who wish to disenroll from the Medicare contract, the effective

date of the election may be up to, but may not exceed, 90 days before

the date the M+C organization received the election from the employer.

Any adjustment in effective date must conform with adjustments in

payment, as described under Sec. 422.250(b).

(2) The M+C organization must submit a disenrollment notice to NCFA

within 15 days of receipt of the notice from the employer.

Sec. 422.74 [Corrected]

15. On page 35075, in the first column, in Sec. 422.74, in

paragraph (b)(3), ``reduces service'' is corrected to read ``reduces

the service''.

Sec. 422.80 [Corrected]

16. In Sec. 422.80, the following changes are made:

a. On page 35076, in the third column, in paragraph (c)(3) ``the

organization'' is corrected to read ``the M+C organization''.

b. On the same page, in the same column, in paragraph (d) the word

``material'' is corrected to read ``materials''.

c. On the same page, in the same column, in paragraph (e)(1)(iv),

in teh fourth line, ``organization, the'' is corrected to read

``organization. The''.

d. On page 35077, in the first column, in paragraph (e)(3)(i),

``Demonstrate the HCFA's'' is corrected to read ``Demonstrate to

HCFA's''.

e. On the same page, in the same column, in paragraph (f),

``potions'' is corrected to read ``portions''.

Sec. 422.110 [Corrected]

17. On page 35079, in the third column, in Sec. 422.110, in

paragraph (c), ``(see Sec. 422.501(h))'' is corrected to read ``(see

Sec. 422.502(h))''.

Sec. 422.112 [Corrected]

18. Beginning on page 35080, in the second column, in order to make

numerous paragraph redesignations and other corrections, Sec. 422.112

is corrected to read as follows:

Sec. 422.112 Access to services.

(a) Rules for coordinated care plans and network M+C MSA plans. An

M+C organization that offers an M+C coordinated care plan or network

M+C MSA plan may specify the networks of providers from whom enrollees

may obtain services if the M+C organization ensures that all covered

services, including additional or supplemental services contracted for

by (or on behalf of) the Medicare enrollee, are available and

accessible under the plan. To accomplish this, the M+C organization

must meet the following requirements:

(1) Provider network. Maintain and monitor a network of appropriate

providers that is supported by written agreements and is sufficient to

provide adequate access to covered services to meet the needs of the

population served. These providers are typically utilized in the

network as primary care providers (PCPs), specialists, hospitals,

skilled nursing facilities, home health agencies, ambulatory clinics,

and other providers.

(2) PCP panel. Establish the panel of PCPs from which the enrollee

selects a PCP.

(3) Specialty care. Provide or arrange for necessary specialty

care, and in particular give women enrollees the option of direct

access to a women's health specialist within the network for women's

routine and preventive health care services provided as basic benefits

(as defined in Sec. 422.2) notwithstanding that the plan maintains a

PCP or some other means for continuity of care.

(4) Serious medical conditions. Ensure that each plan has in effect

HCFA-approved procedures that enable the plan to--

(i) Identify individuals with complex or serious medical

conditions;

(ii) Assess those conditions, and use medical procedures to

diagnose and monitor them on an ongoing basis; and

[[Page 52613]]

(iii) Establish and implement a treatment plan that--

(A) Is appropriate to those conditions;

(B) Includes an adequate number of direct access visits to

specialists consistent with the treatment plan; and

(C) Is time-specific and updated periodically by the PCP.

(5) Involuntary termination. If the M+C organization terminates an

M+C plan or any specialists for a reason other than for cause, the M+C

organization must do the following:

(i) Inform beneficiaries, at the time of termination, of their

right to maintain access to specialists.

(ii) Provide the names of other M+C plans in the area that contract

with specialists of the beneficiary's choice.

(iii) Explain the process the beneficiary would need to follow

should he or she decide to return to original Medicare.

(6) Service area expansion. If seeking a service area expansion for

an M+C plan, demonstrate that the number and type of providers

available to plan enrollees are sufficient to meet projected needs of

the population to be served.

(7) Credentialed providers. Demonstrate to HCFA that its providers

in an M+C plan are credentialed through the process set forth at

Sec. 422.204(a).

(8) Written standards. Establish written standards for the

following:

(i) Timeliness of access to care and member services that meet or

exceed standards established by HCFA. Timely access to care and member

services within a plan's provider network must be continuously

monitored to ensure compliance with these standards, and the M+C

organization must take corrective action as necessary.

(ii) Policies and procedures (coverage rules, practice guidelines,

payment policies, and utilization management) that allow for individual

medical necessity determinations.

(iii) Provider consideration of beneficiary input into the

provider's proposed treatment plan.

(9) Hours of operation. Ensure, for each M+C plan, that--

(i) The hours of operation of its M+C plan providers are convenient

to the population served by the plan and do not discriminate against

Medicare enrollees; and

(ii) The plan makes plan services available 24 hours a day, 7 days

a week, when medically necessary.

(10) Cultural considerations. (i) Ensure that services are provided

in a culturally competent manner to all enrollees, including those with

limited English proficiency or reading skills, diverse cultural and

ethnic backgrounds, and physical or mental disabilities.

(ii) Provide coverage for emergency and urgent care services in

accordance with paragraph (c) of this section.

(b) Rules for all M+C organizations to ensure continuity of care.

The M+C organization must ensure continuity of care and integration of

services through arrangements that include, but are not limited to the

following--

(1) Use of a practitioner who is specifically designated as having

primary responsibility for coordinating the enrollee's overall health

care.

(2) Policies that specify whether services are coordinated by the

enrollee's primary care practitioner or through some other means.

(3) An ongoing source of primary care, regardless of the mechanism

adopted for coordination of services.

(4) Programs for coordination of plan services with community and

social services generally available through contracting or

noncontracting providers in the area served by the M+C plan, including

nursing home and community-based services.

(5) Procedures to ensure that the M+C organization and its provider

network have the information required for effective and continuous

patient care and quality review, including procedures to ensure that--

(i) An initial assessment of each enrollee's health care needs is

completed within 90 days of the effective date of enrollment;

(ii) Each provider, supplier, and practitioner furnishing services

to enrollees maintains an enrollee health record in accordance with

standards established by the M+C organization, taking into account

professional standards; and

(iii) That there is appropriate and confidential exchange of

information among provider network components.

(6) Procedures to ensure that enrollees are informed of specific

health care needs that require follow-up and receive, as appropriate,

training in self-care and other measures they may take to promote their

own health; and

(7) Systems to address barriers to enrollee compliance with

prescribed treatments or regimens.

(c) Special rules for all M+C organizations for emergency and

urgently needed services--(1) Coverage. The M+C organization covers

emergency and urgently needed services--

(i) Regardless of whether the services are obtained within or

outside the organization; and

(ii) Without required prior authorization.

(2) Financial Responsibility. The M+C organization may not deny

payment for a condition--

(i) That is an emergency medical condition as defined in

Sec. 422.2; or

(ii) For which a plan provider or other M+C organization

representative instructs an enrollee to seek emergency services within

or outside the plan.

(3) Stabilized condition. The physician treating the enrollee must

decide when the enrollee may be considered stabilized for transfer or

discharge, and that decision is binding on the M+C organization.

(4) Limits on charges to enrollees. For emergency services obtained

outside the M+C plan's provider network, the organization may not

charge the enrollee more than $50 or what it would charge the enrollee

if he or she obtained the services through the organization, whichever

is less.

19. On page 35090, in the third column, in Sec. 422.250, paragraph

(b) is corrected to read as follows:

Sec. 422.250 general provisions.

* * * * *

(b) Adjustment of payments to reflect number of Medicare

enrollees--(1) General rule. HCFA adjusts payments retroactively to

take into account any difference between the actual number of Medicare

enrollees and the number on which it based an advance monthly payment.

(2) Special rules for certain enrollees. (i) Subject to paragraph

(b)(2)(ii) of this section, HCFA may make adjustments, for a period

(not to exceed 90 days) that begins when a beneficiary elects a group

health plan (as defined in Sec. 411.101 of this chapter) offered by an

M+C organization, and ends when the beneficiary is enrolled in an M+C

plan offered by the M+C organization.

(ii) HCFA does not make an adjustment unless the beneficiary

certifies that, at the time of enrollment under the M+C plan, he or she

received from the organization the disclosure statement specified in

Sec. 422.111.

* * * * *

Sec. 422.268 [Corrected]

20. On page 35093, in the third column, in Sec. 422.268, in

paragraph (b), in the third line, ``Secs. 422.105'' is corrected to

read ``Secs. 422.109''.

Sec. 422.308 [Corrected]

21. In Sec. 422.308 the following corrections are made:

a. On the same page, in the same column, the text of paragraph (b)

is redesignated as paragraph (b)(1) and a new paragraph (b)(2) is added

to read as follows:

[[Page 52614]]

Sec. 422.308 Limits on premiums and cost sharing amounts.

* * * * *

(b) * * *

(2) For supplemental benefits, the actuarial value of its cost-

sharing may not exceed the amounts approved in the ACR for those

benefits, as determined under Sec. 422.310 on an annual basis.

* * * * *

Sec. 422.310 [Corrected]

22. On page 35096, in the second column, in Sec. 422.310 (that

section begins on page 35095), in paragraph (c)(4), ``component.

Adjustments will be'' is corrected to read ``component. In addition,

adjustments will be''.

Sec. 422.502 [Corrected]

23. In Sec. 422.502, the following corrections are made:

a. On page 35100, in the third column, in paragraph (a)(2),

``Sec. 422.108'' is corrected to read ``Sec. 422.110''.

b. On the same page, in the same column, in paragraph (a)(3)(i),

``Sec. 422.100'' is corrected to read ``Sec. 422.101'', and

``Sec. 422.101'' is corrected to read ``Sec. 422.102''.

c. On page 35101, in the first column, in paragraph (a)(4),

``Sec. 422.110'' is corrected to read ``Sec. 422.111''.

d. On page 35103, in the second column, paragraph (m) is

redesignated as paragraph (1)(4) and is corrected to read as follows:

Sec. 422.502 Contract provisions.

* * * * *

(l) * * *

(4) The CEO or CFO must certify that the information in its ACR

submission is accurate and fully conforms to the requirements in

Sec. 422.310.

Sec. 422.550 [Corrected]

24. On page 35106, in the second column, amendatory instruction

``19. a.'' is corrected to read as follows:

a. In paragraph (b)(1), the following sentence is added at the end:

``The M+C organization must also provide updated financial information

and a discussion of the financial and solvency impact of the change of

ownership on the surviving organization.''

Sec. 422.608 [Corrected]

25. On page 35111, in the third column, in Sec. 422.608, in the

heading, the acronym ``(DAB)'' is corrected to read ``(the Board)'' and

in the text ``DAB'' is corrected to read ``Board'' each time it appears

(twice).

Sec. 422.612 [Corrected]

26. In Sec. 422.612, the following corrections are made:

a. On page 35111, in the third column, in paragraph (a)(1) ``DAB''

is corrected to read ``Board''.

b. On the same page, in the same column, in the heading of

paragraph (b), ``DAB'' is corrected to read ``Board''.

c. On the same page, in the same column, in the text of paragraph

(b) introductory text, ``DAB'' is corrected to read ``Board''.

Sec. 422.616 [Corrected]

27. On page 35111, in the third column that continues on page

35112, in Sec. 422.616(a), ``DAB'' is corrected to read ``Board''.

Sec. 422.620 [Corrected]

28. On page 35112, in the second column, in Sec. 422.620, in

paragraph (a), ``Sec. 422.112(b)'' is corrected to read

``Sec. 422.112(c)''.

Sec. 422.622 [Corrected]

29. On page 35112, in the third column, in Sec. 422.622, in

paragraph (c)(1)(i) ``Sec. 422.112(b)'' is corrected to read

``Sec. 422.112(c)'' each time it appears (twice).

Sec. 422.752 [Corrected]

30. On page 35115, in the second column, in Sec. 422.752, in

paragraph (a)(6), ``Sec. 422.204'' is corrected to read

``Sec. 422.206''.

(Catalog of Federal Domestic Assistance Program No. 93,773,

Medicare--Hospital Insurance; and Program No. 93.766, Medicare--

Supplementary Medical Insurance Program)

Dated: September 25, 1998.

Neil J. Stillman,

Deputy Assistant Secretary for Information Resources Management.

[FR Doc. 98-26242 Filed 9-30-98; 8:45 am]

BILLING CODE 4120-01-M