# Medicare and Medicaid Programs; Quarterly Listing of Program IssuancesThird Quarter, 1998

> Briefs, arguments, decisions, and more.

URL: https://www.frixlaw.com/law-library/documents/fr%3A99-11754

## Record

- **Collection:** Federal Register
- **Document type:** Notice
- **Published:** May 11, 1999
- **Citation:** 64 FR 25351

## Text

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-9000-N]
RIN 0938-AJ37

Medicare and Medicaid Programs; Quarterly Listing of Program
Issuances--Third Quarter, 1998

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 1998, relating to the
Medicare and Medicaid programs. This notice also identifies certain
devices with investigational device exemption numbers approved by the
Food and Drug Administration that potentially may be 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 also including all Medicaid
issuances and Medicare and Medicaid substantive and interpretive
regulations (proposed and final) published during this timeframe.

FOR 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

[[Page 25352]]

items. Copies are not available through the contact persons.
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, (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, S2-26-13, 7500 Security Boulevard, Baltimore, MD 21244-
1850, (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 and Analysis Group,
Health Care Financing Administration, C4-11-04, 7500 Security
Boulevard, Baltimore, MD 21244-1850, (410) 786-4633.
Questions concerning all other information may be addressed to
Kristy Nishimoto, Office of Communications and Operations Support,
Division of Regulations and Issuances, Health Care Financing
Administration, C5-16-03, 7500 Security Boulevard, Baltimore, MD 21244-
1850, (410) 786-8517.

SUPPLEMENTARY INFORMATION:

I. Program Issuances

The Health Care Financing Administration (HCFA) 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
these programs involves (1) Furnishing 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 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, 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, we are continuing our practice of including Medicare
substantive and interpretive regulations (proposed and final) published
during the 3-month time frame.

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. 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 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 lists a unique HCFA transmittal number for
each instruction in our manuals or Program Memoranda 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 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;
+ Title of the regulation;
+ Ending date of the comment period (if applicable); and
+ Effective date (if applicable).
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 this
notice. 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 our practice to announce all
investigational device exemption categorizations, using the
investigational device exemption numbers the Food and Drug
Administration 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 investigational device exemption
number).

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, PO 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
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

[[Page 25353]]

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. 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 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.
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. (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. 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 materials, use the Superintendent of
Documents number, plus the HCFA transmittal number. For example, to
find the Intermediary Manual, (HCFA Pub. 113-3) transmittal entitled
``Electronic Data Interchange Security, Privacy, Audit and Legal
Issues,'' use the Superintendent of Documents No. HE 22.8/6 and the
HCFA transmittal number 1748.

(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: April 23, 1999.
Elizabeth Cusick,
Acting Director, Office of Communications and Operations Support.

Addendum I

This addendum lists the publication dates of the most recent
quarterly listings of program issuances.

November 21, 1997 (62 FR 62325)
June 4, 1998 (63 FR 30499)
August 11, 1998 (63 FR 42857)
September 16, 1998 (63 FR 49598)
December 9, 1998 (63 FR 67899)

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 1998 Through September 1998]
------------------------------------------------------------------------
Trans. No. Manual/Subject/Publication No.
------------------------------------------------------------------------
Intermediary Manual
Part 3--Claims Process
(HCFA Pub. 13-3)
(Superintendent of Documents No. HE 22.8/6)
------------------------------------------------------------------------
1748 <bulle Electronic Data Interchange Security,
t Privacy, Audit and Legal Issues.
Contractor Data Security and Confidentially
Requirements.
Electronic Data Interchange Audit Trail.
Security-Related Requirements for
Subcontractor Arrangements With Network
Services.
1749 <bulle Completing Quarterly Report on Provider
t Enrollment.
Checking Reports.
Type of Provider.
Completing Lines Twenty-Seven Through Thirty-
One--Age of Applications Pending.
Completing Lines Thirty-Two Through Thirty-
Seven--Change of Ownership Workloads.

[[Page 25354]]

1750 <bulle Requirements for Submission of Electronic
t Media Claims Data.
1751 <bulle Pneumococcal Pneumonia, Influenza Virus and
t Hepatitis B Vaccines.
Mammography Screening.
1752 <bulle Millennium Readiness.
t
------------------------------------------------------------------------
Carriers Manual
Part 3--Claims Process
(HCFA Pub. 14-3)
(Superintendent of Documents No. HE 22.8/7)
------------------------------------------------------------------------
1609 <bulle Electronic Data Interchange Security,
t Privacy, Audit and Legal Issues.
Contractor Data Security and Confidentiality
Requirements.
Audit Trails.
Security-Related Requirements for
Subcontractor Arrangements With Network
Services.
1610 <bulle The System for Processing Electronic Media
t Claims.
Electronic Media Claims Testing and
Verification.
1611 <bulle Identifying a Screening Mammography Claim.
t
Adjudicating the Claim.
------------------------------------------------------------------------
Program Memorandum
Intermediaries (HCFA Pub. 60A)
(Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
A-98-21 <bulle Payment to Hospitals for Direct Costs of
t Graduate Medical Education and Operating
Indirect Medical Education Costs for
Medicare+Choice Enrollees.
A-98-22 <bulle Hospital Encounter Data Requirements From the
t Balanced Budget Act of 1997.
A-98-23 <bulle Coding for Adequacy of Hemodialysis Dialysis
t on Claim Form--Additional Modifier.
A-98-24 <bulle Change to Reporting of Outpatient
t Rehabilitation Services and All
Comprehensive Outpatient Rehabilitation
Facilities Services Using HCFA Common
Procedure Coding System.
A-98-25 <bulle Home Health Agency Surety Bond Requirements.
t
A-98-26 <bulle Prospective Payment System PRICER Changes for
t Fiscal Year 1999, Including Changes for
Discharges to Post-Acute Care Providers and
a Millennium Compliant Provider Specific
File.
A-98-27 <bulle Hospice Provisions Enacted by the Balanced
t Budget Act of 1997.
A-98-28 <bulle Medicare Home Health Benefit--The Balanced
t Budget Act of 1997--Clarification of Part-
Time or Intermittent Skilled Nursing Care.
A-98-29 <bulle UB-92 Claims That Are Not Millennium
t Compliant.
A-98-30 <bulle Extension of the Effective Date for
t Intermediary Usage of the 4A.01
Implementation of the Version 3051 Based 835
Transaction for Electronic Remittance
Advice.
A-98-31 <bulle Discharges to Swing Bed Units and Other Post-
t Acute Care Providers.
------------------------------------------------------------------------
Program Memorandum
Carriers
(HCFA Pub. 60B)
(Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
B-98-25 <bulle Changes to Correct Coding Edits, Version 4.1.
t
B-98-26 <bulle Durable Medical Equipment Regional Carrier
t Instructions to Implement Balanced Budget
Act of 1997 Provisions Sec. 4105 to Provide
Expanded Coverage of Blood Glucose Monitors
and Test Strips for all Diabetics--Implement
July 1, 1998.
B-98-27 <bulle Implementation of Additional Commercial Edits
t Effective for Dates of Service on or after
October 1, 1998.
B-98-28 <bulle Modifications to Form HCFA-1500 Instructions.
t
B-98-29 <bulle Private Contracts Between Beneficiaries and
t Physicians/Practitioners.
B-98-30 <bulle Millennium Changes for Forms HCFA-1491,
t 1490S, and 1490U.
B-98-31 <bulle Change to Health Insurance Claim Form HCFA-
t 1500 Instructions for Processing Physician
Claims in Global Payment Systems.
B-98-32 <bulle Changes to the 1998 Medicare Physician Fee
t Schedule Database.
B-98-33 <bulle Durable Medical Equipment Carrier Operating
t Instructions to Implement Balanced Budget
Act of 1997 Provisions Sec. 4105 to Provide
Expanded Coverage of Blood Glucose Monitors
and Test Strips for All Diabetes. Implement
July 1, 1998. (Corrects and updates
Transmittal B-98-17, dated April 1998,
Change Request #485).
B-98-34 <bulle Elimination of Funding Toll-Free Lines for
t Participating Physicians and Suppliers.
B-98-35 <bulle Receipt of Electronic Claims That Are Not
t Millennium Compliant.
B-98-36 <bulle This document will be released in the fourth
t Quarter Federal Register Notice.
B-98-37 <bulle Requiring Entities Who Are Ineligible to
t Receive Direct Medicare Payments for
Services Provided by Independent Contractors
to Comply with 42 USC 1395u(b)(6), and
Medicare Regulations in 42 CFR 424.80(b).
------------------------------------------------------------------------
Program Memorandum Intermediaries/Carriers (HCFA Pub. 60A/
B)(Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
AB-98-32 <bulle Standardization of Medicare Coverage of Bone
t Marrow Measurements.
AB-98-33 <bulle Medicare Travel Allowance Fees for Collection
t of Specimens.
AB-98-34 <bulle Modifications of Medicare Policy for
t Erythropoietin.
AB-98-35 <bulle Consolidated Billing for Skilled Nursing
t Facilities--The Balanced Budget Act of 1997.
AB-98-36 <bulle Coverage of Diabetes Outpatient Self-
t Management Training Services, Effective:
July 1, 1998.

[[Page 25355]]

AB-98-37 <bulle Contractor Coordination of Benefits File
t Formats and Trading Partner Agreements.
AB-98-38 <bulle Distribution of 1/98 Versions of Form HCFA-
t 855.
AB-98-39 <bulle FDA Approves Two Cancer Tests, the Abbott
t AxSYM CA 15-3 test and the Abbott Imx CA 15-
3 test.
AB-98-40 <bulle New Interest Rate Payable on Clean Claims Not
t Paid Timely.
AB-98-41 <bulle Promoting Influenza and Pneumococcal
t Vaccinations.
AB-98-42 <bulle Revision of Troponin (CPT Code 84484 and
t 84512) Policy.
AB-98-43 <bulle New Waived Tests.
t
AB-98-44 <bulle Suspension of National Coverage Policy on
t Electrostimulation for Wound Healing.
AB-98-45 <bulle Consolidated Billing for Skilled Nursing
t Facilities.
AB-98-46 <bulle Notice of New Interest Rate for Medicare
t Overpayments and Underpayments.
AB-98-47 <bulle Health Care Financing Administration Public
t Awareness Activities.
AB-98-48 <bulle Year 2000 Contingency for Non-Millennium
t Compliant Electronic Transactions and
Publication of Year 2000 Article in Provider
Bulletins.
AB-98-49 <bulle New Waived Tests.
t
AB-98-50 <bulle Physician Ownership and Compensation Interest
t System.
AB-98-51 <bulle Implementation of Section 4105 of the
t Balanced Budget Act Regarding Coverage of
Diabetes Outpatient Self-Management Training
Services.
AB-98-52 <bulle Interim Tracking Procedures for Implementing
t the Medicare Fraud and Abuse Incentive
Reward Program.
State Operations Manual
Provider Certification
(HCFA Pub. 7)
(Superintendent of Documents No. HE 22.8/12)
------------------------------------------------------------------------
3 <bulle Medicare Health Care Provider/Supplier
t Enrollment.
Prioritizing State Agency Survey Workload--
Initial Surveys and Recertifications.
Transmitting Materials.
List of Documents in Certification Packet.
Notification to Application that the Medicare
General Enrollment Health Care Provider/
Supplier Application has been Denied.
Notification of Pending Involuntary
Termination Based on Change of Home
Ownership Review of the Medicare General
Enrollment Health Care Provider/Supplier
Application.
Notification of Involuntary Termination Based
on Change of Home Ownership Review of the
Medicare General Enrollment Health Care
Provider/Supplier Application.
Medicare and Other Federal Health Care
Program General Enrollment Health Care
Provider/Supplier Application.
Medicare and Other Federal Health Care
Program Change of Information Health Care
Provider/Supplier Application.
Medicare and Other Federal Health Care
Program Individual Reassignment of Benefits
Health Care Provider/Supplier Application.
------------------------------------------------------------------------
Peer Review Organization Manual
(HCFA Pub. 19)
(Superintendent of Documents No. HE 22.8/8-15)
------------------------------------------------------------------------
66 <bulle Introduction.
t
Definition.
Requirements.
Disagreements.
67 <bulle Opportunity to Discuss.
t
Authority.
Scope of Review.
Referrals.
Receive Medical Records.
Request for a Review.
Timing of Rereview.
68 <bulle Interaction with Beneficiary Groups.
t
Evaluation.
------------------------------------------------------------------------
Hospital Manual
(HCFA Pub. 10)
(Superintendent of Documents No. HE 22.8/2)
------------------------------------------------------------------------
730 <bulle Billing for Mammography Screening.
t
------------------------------------------------------------------------
Skilled Nursing Facility Manual
(HCFA Pub. 12)
(Superintendent of Documents No. HE 22.8/3)
------------------------------------------------------------------------
354 <bulle Billing for Mammography Screening.
t
------------------------------------------------------------------------

[[Page 25356]]

End Stage Renal Disease Network
Organizations Manual
(HCFA Pub. 81)
(Superintendent of Documents No. HE 22.9/4)
------------------------------------------------------------------------
7 <bulle Background and Responsibilities.
t
Authority.
Purpose of End Stage Renal Disease Network
Organizations.
Requirements for End Stage Renal Disease
Network Organizations.
Responsibilities of End Stage Renal Disease
Network Organizations.
Health Care Quality Improvement Program.
Goals.
Network Organization's Role in Health Care
Quality Improvement Program.
Organizational Structure.
Network Council.
Board of Directors.
Medical Review Board.
Other Committees.
Network Staff.
Required Administrative Reports.
Internal Quality Control Program.
Health Care Financing Administration
Meetings.
Cooperative Activities with State Survey
Agencies and Peer Review Organizations.
Annual Report Format.
Statutory and Regulatory Requirements.
General Requirements.
Nonconfidential Information.
Confidential Information.
Disclosure of Network Deliberations.
Disclosure of Confidential Network
Information to Officials and Agencies.
Disclosure of Network Information Involving
Beneficiary Complaints.
Disclosure of Network Information for
Research Purposes.
Disclosure of Network Sanction Information.
Redisclosure of Network Information.
8 <bulle Authority.
t
End Stage Renal Disease Health Care Quality
Improvement Program.
Responsibilities.
Quality of Care Improvement Projects.
Components of Quality of Care Improvement
Projects.
Developing and Planning the Project.
Identifying and Confirming an Opportunity to
Improve Care.
Developing a Network Intervention Activity.
Measuring Impact and Project Evaluation.
Disseminating Results.
Identifying Additional Opportunities for
Improvement.
Project Reporting System.
Improvement Plan.
End Stage Renal Disease Core Clinical
Indicators.
Core Indicators--Network National Sample.
Core Indicators--Sampling Method.
Core Indicators--Data Collection.
Core Indicators--Data Validation.
Core Indicators--Data Reporting.
Health Care Financing Administration-Compiled
Data Reports.
Quality Improvement Projects Versus Research
Studies.
Network Resources to Support the National
Renal Registry.
Core Indicators--Targeted Patient Population,
and Clinical Measures.
Annual Patient Sample Per Network for
Conducting National Renal Registry Special
Studies.
Network Quality Improvement Project Report.
------------------------------------------------------------------------
Provider Reimbursement Manual--Part 1
(HCFA Pub. 15-1)
(Superintendent of Documents No. HE 22.8/4)
------------------------------------------------------------------------
405 Low Medicare Volume Prospective Payment Rates
for Skilled Nursing Facilities Effective for
Cost Reporting Periods Beginning on or After
October 1, 1986 and Prior to Cost Reporting
Periods Beginning on or After July 1, 1998.
Calculation of the Low Medicare Volume
Prospective Payment Rate.
Methodology for Determining Per Diem
Prospective Payment Rates Effective for Cost
Reporting Periods Beginning on or After
October 1, 1977 and Before July 1, 1998.
General Provisions.

[[Page 25357]]

Methodology for Determining Per Diem
Prospective Payment Rates Effective for Cost
Reporting Periods Beginning on or After July
1, 1998.
Determination of Facility Specific Per Diem
Rates.
Calculating Payment Under Skilled Nursing
Facility Prospective Payment System.
Use of Skilled Nursing Facility PRICER.
Skilled Nursing Facility Prospective Payment
System--Payment Requirements and
Adjustments.
Reporting Rehabilitative Therapy Minutes on
the Minimum Data Set for Purposes of
Medicare Payment.
406 Principle of Cost Apportionment.
------------------------------------------------------------------------
State Medicaid Manual--Part 2
State Organization and General Administration
(HCFA Pub. 45-2)
(Superintendent of Documents No. HE 22.8/10)
------------------------------------------------------------------------
90 Annual Report on Home and Community-Based
Services Waivers.
91 Statistical Report on Medical Care:
Eligibles, Recipients, Payments and
Services.
Federal Reporting Requirements.
Requirements for the Medicaid Statistical
Information System.
------------------------------------------------------------------------
State Medicaid Manual--Part 5
Early and Periodic Screening,
Diagnosis, and Treatment
(HCFA Pub. 45-5)
(Superintendent of Documents No. HE 22.8/10)
------------------------------------------------------------------------
12 Screening Service Content.
------------------------------------------------------------------------
State Medicaid Manual--Part 6 Payment for Services (HCFA Pub. 45-6)
(Superintendent of Documents No. HE 22.8/10)
------------------------------------------------------------------------
35 <bulle Upper Limits for Prescription Drugs.
t
------------------------------------------------------------------------
State Medicaid Manual--Part 11 Medicaid Management Information System
(HCFA Pub. 45-11) (Superintendent of Documents No. HE 22.8/10)
------------------------------------------------------------------------
18 <bulle Background.
t
Applicable Federal Approval Requirements.
Approval Process and Documentation
Submissions.
List of Reimbursable Costs for State Systems.
Eligibility Verification Systems, Switching
Companies, Electronic Claims Capture, and
Electronic Claims Management System-
Overview.
Electronic Fund Transfer and Electronic
Remittance Advices.
General (System) Requirements.
Future Additional System Requirements.
Claims Processing Subsystem.
Data Requirements.
Applicable Federal Approval Requirements.
Acquisition of Automated Data Processing
Equipment and Services.
Implementation Advance Planning Document.
Approval Process and Documentation
Submissions.
Cost Reimbursable at 75 Percent Federal
Financial Participation.
Cost Reimbursable at 75 Percent Federal
Financial Participation for Management
Administration Reporting Subsystem and
Surveillance and Utilization Review
Subsystem.
List of Reimbursable Costs for State Systems.
Definitions.
Considerations and Options.
Detailed Implementation Schedule.
Projected Reporting Requirements.
Preliminary Evaluation.
Contractual Services.
Required Assurances.
Replacement Systems.
Approval Process and Documentation
Submissions.
Approval of Eligibility Determination
Systems--Required System Documentation for
Onsite Review.
General Requirements.
List of Reimbursable Costs for State Systems.
Approval of Eligibility Determination
Systems.
Enumeration Verification System as a
Component of Medicaid Management Information
System.
Surveillance and Utilization Review
Subsystem.
------------------------------------------------------------------------

[[Page 25358]]

Program Memorandum Regional Office--General (HCFA Pub. 51)
(Superintendent of Documents No. HE 22.28/5:90-1)
------------------------------------------------------------------------
98-3 <bulle Home Health Agency Surety Bond Requirements.
t
------------------------------------------------------------------------
Program Memorandum State Survey Agencies (HCFA Pub. 65) (Superintendent
of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
98-1 <bulle Home Health Agency Parent, Branch, and
t Subunit Criteria.
------------------------------------------------------------------------
Medicare/Medicaid Sanction--Reinstatement Report (HCFA Pub. 69)
------------------------------------------------------------------------
98-7 <bulle Report of Physicians/Practitioners, Providers
t and/or Other Health Care Suppliers Excluded/
Reinstated--June 1998.
97-8 <bulle Report of Physicians/Practitioners, Providers
t and/or Other Health Care Suppliers Excluded/
Reinstated--July 1998.
97-9 <bulle Report of Physicians/Practitioners, Providers
t and/or Other Health Care Suppliers Excluded/
Reinstated--August 1998.
------------------------------------------------------------------------

Addendum IV--Regulation Documents Published in the Federal Register
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Publication date FR Vol. 63 CFR part(s) File code* Regulation title comment Effective
page period date
--------------------------------------------------------------------------------------------------------------------------------------------------------
07/06/98.................... 36488 422........................ HCFA-1030-IFC Medicare Program; ........... 07/06/98
Establishment of the
Medicare+Choice
Program; Correction.
07/13/98.................... 37498-37499 409, 410, 411, 413, 424, HCFA-1913-N Medicare Program; 09/11/98
483, and 489. Prospective Payment
System and
Consolidated Billing
for Skilled Nursing
Facilities; Extension
of Comment Period.
07/29/98.................... 40534-40536 ........................... HCFA-3009-N Medicare Program; Peer 08/28/98 ...........
Review Organization
Contracts:
Solicitation of
Statements of
Interest From In-
State Organizations--
Alaska, Delaware, the
District of Columbia,
Hawaii, Idaho,
Illinois, Kentucky,
Maine, Nebraska,
Nevada, South
Carolina, Vermont,
and Wyoming.
07/31/98.................... 40954-41131 405, 412, and 413.......... HCFA-1003-F Medicare Program; ........... 10/01/98
Changes to the
Hospital Inpatient
Prospective Payment
Systems and Fiscal
Year 1999 Rates
07/31/98.................... 41170-41171 441 and 489................ HCFA-1152-2-F Medicare and Medicaid ........... 07/31/98
Programs; Surety Bond
Requirements for Home
Health Agencies
08/06/98.................... 42055 ........................... HCFA-2030-N Medicaid Program; ........... ...........
Decision on Funding
for the AIDS
Healthcare Foundation
START Program
08/07/98.................... 42270-42275 233........................ HCFA-2106-FC Medicaid and Title IV- 10/06/98 08/07/98
E Programs; Revision
to the Definition of
an Unemployed Parent.
08/11/98.................... 42912-42938 ........................... HCFA-1035-NC Medicare Program; 10/13/98 10/01/98
Schedules of Per-
Visit and Per-
Beneficiary
Limitations on Home
Health Agency Costs
for Cost Reporting
Periods Beginning On
or After October 1,
1998.
08/11/98.................... 42797-42801413 ........................... HCFA-1883-P Medicare Program; 10/13/98
Revision of the
Procedures for
Requesting Exceptions
to Cost Limits for
Skilled Nursing
Facilities and
Elimination of
Reclassifications.
08/11/98.................... 42796 ........................... HCFA-3250-N Medicare Program;
Negotiated
Rulemaking; Coverage
and Administrative
Policies for Clinical
Diagnostic Laboratory
Tests; Change in
Meeting Time.
08/11/98.................... 42857-42864 ........................... HCFA-9879-N Medicare and Medicaid
Programs; Quarterly
Listing of Program
Issuances--Fourth
Quarter 1997.
08/14/98.................... 43655 416 and 488................ HCFA-1885-N Medicare Program; 09/10/98
Update of Ratesetting
Methodology, Payment
Rates, Payment
Policies, and the
List of Covered
Procedures for
Ambulatory Surgical
Centers Effective
October 1, 1998;
Extension of Comment
Period.

[[Page 25359]]

09/08/98.................... 47506-47513 ........................... HCFA-1045-N Medicare Program; 10/06/98
Request for Public
Comments on
Implementation of
Risk Adjusted Payment
for the
Medicare+Choice
Program and
Announcement of
Public Meeting.
09/08/98.................... 47513-47514 ........................... HCFA-1046-N Medicare Program;
September 23 and 24,
1998, Meeting of the
Competitive Pricing
Advisory Committee
09/08/98.................... 47552-48036 409, 410, 411, 412, 413, HCFA-1005-P Medicare Program; 11/09/98
419, 489, 493, and 1003. Prospective Payment
System for Hospital
Outpatient Services.
09/10/98.................... 48517 ........................... HCFA-3432-N Medicare Program;
September 25, 1998,
Open Town Hall
Meeting to Discuss
the Medicare Coverage
Process
09/11/98.................... 48735-48736 ........................... HCFA-2029-PN Medicare and Medicaid 10/13/98
Programs; Recognition
of the Community
Health Accreditation
Program, Inc. (CHAP)
and Joint Commission
for Accreditation of
Healthcare
Organizations (JCAHO)
for Hospices.
09/11/98.................... 48736-48737 ........................... HCFA-1097-N Medicare Program;
September 28, 1998,
Meeting of the
Practicing Physicians
Advisory Council
09/16/98.................... 49598-49605 ........................... HCFA-9879-N Medicare and Medicaid
Programs; Quarterly
Listing of Program
Issuances--First
Quarter, 1998
09/22/98.................... 50545-50547 405, 410, 413, 414, 415, HCFA-1006-CN Medicare Program;
424, and 485. Revisions to Payment
Policies Under the
Physician Fee
Schedule for Calendar
Year 1999; Correction
09/23/98.................... 50919-50920 ........................... HCFA-1047-NC Medicare and Medicaid 11/23/98
Programs;
Announcement of
Additional
Applications From
Hospitals Requesting
Waivers for Organ
Procurement Service
Area.
09/29/98.................... 52022-52092 400, 430, 431, 434, 435, HCFA-2001-P Medicaid Program; 11/30/98
438, 440, and 447. Medicaid Managed Care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
A*N--General Notice; PN--Proposed Notice; NC--Notice with Comment Period; FN--Final Notice; P--Notice of Proposed Rulemaking (NPRM); F--Final Rule; FC--
Final Rule with Comment Period; CN--Correction Notice; IFC--Interim Final Rule with Comment Period

Addendum V--Categorization of Food and Drug Administration-Allowed
Investigational Device Exemptions

Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c), devices
fall into one of three classes. Also, under the new categorization
process to assist HCFA, the Food and Drug Administration assigns
each device with a Food and Drug Administration-approved
investigational device exemption to one of two categories. 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 information presents the device number, category
(in this case, A), and criterion code.

G980020 A1
G980150 A1
G980164 A1
G980165 A1
G980171 A1
G980175 A1
G980176 A2
G980185 A2
G980202 A1
G980207 A1
G980212 A1

The following information presents the device number, category
(in this case, B), and criterion code.

G970277 B4
G980105 B2
G980108 B1
G980132 B
G980134 B1
G980135 B2
G980136 B2
G980140 B2
G980142 B2
G980144 B2
G980146 B2
G980147 B4
G980152 B2
G980156 B2
G980157 B2
G980160 B4
G980161 B4
G980162 B4
G980163 B4
G980166 B1
G980169 B1
G980174 B1
G980180 B4
G980181 B4
G980182 B4
G980184 B4
G980190 B
G980192 B4
G980194 B4
G980196 B1
G980197 B4
G980198 B3
G980200 B1
G980201 B1
G980205 B4
G980206 B4
G980208 B3
G980209 B2
G980210 B2
G980211 B2
G980213 B2
G980217 B4
G980218 B5
G980219 B4

[FR Doc. 99-11754 Filed 5-10-99; 8:45 am]
BILLING CODE 4120-10-P

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A99-11754. Public record. Not legal advice.
