Medicare and Medicaid Programs; Quarterly Listing of Program IssuancesFourth Quarter, 1998
Federal RegisterNov 2, 1999
Ask Donna
What actually matters in this document.
Text
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-9003-N]
Medicare and Medicaid Programs; Quarterly Listing of Program
Issuances--Fourth 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 October, November, and December 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: If you need specific information,
please contact the following staff. Copies are not available through
the staff. 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, S2-25-13, 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, S3-02-01, 7500 Security
Boulevard, Baltimore, MD 21244-1850, (410) 786-4633.
Questions concerning all other information may be addressed to
Trenesha Fultz, 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) 786-3822.
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 you 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
[[Page 59186]]
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 assist you, 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, 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
Register. Interested individuals may purchase individual copies or
subscribe to the Federal Register by contacting the GPO at the address
given above. When ordering individual copies, it is necessary to cite
either the date of publication or the volume number and page number.
The Federal Register is also available on 24x microfiche and as an
online database through GPO Access. The online database is updated by 6
a.m. each day the Federal Register is published. The database includes
both text and graphics from Volume 59, Number 1 (January 2, 1994)
forward. Free public access is available on a Wide Area Information
Server (WAIS) 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
You may review transmittals or Program Memoranda 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, you 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;
[[Page 59187]]
however, they are not sales outlets. You 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. 13-3) transmittal entitled
``Mammography Screening,'' use the Superintendent of Documents No. HE
22.8/6 and the HCFA transmittal number 1754.
(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: September 20, 1999.
Elizabeth Cusick,
Director, Office of Communications and Operations Support.
Addendum I
This addendum lists the publication dates of the most recent
quarterly listings of program issuances.
June 4, 1998 (63 FR 30499)
August 11, 1998 (63 FR 42857)
September 16, 1998 (63 FR 49598)
December 9, 1998 (63 FR 67899)
May 11, 1999 (64 FR 25351)
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 (57 FR 47468).
Addendum III.--Medicare and Medicaid Manual Instructions
[October 1998 through December 1998]
------------------------------------------------------------------------
Transmittal No. Manual/Subject/Publication No.
------------------------------------------------------------------------
Intermediary Manual
Part 3--Claims Process
(HCFA Pub. 13-3)
(Superintendent of Documents No. HE 22.8/6)
------------------------------------------------------------------------
1753 <bu Requirement That Bills Be Submitted in
l Sequence for a Continuous Inpatient Stay
or Course of Treatment
<bu Need to Reprocess Inpatient or Hospice
l Claims in Sequence
1754 <bu Mammography Screening
l
1755 <bu Bill Review for Partial Hospitalization
l Services Provided in Community Mental
Health Centers
Bill Review for Partial Hospitalization
Services Provided in Community Mental
Health Centers and Hospital Outpatient
Partial Hospitalization Services
1756 <bu Provider Enrollment
l
Description of Process
Implementation
Enrollment Instructions for Certified
Medicare Providers
Provider Based Versus Freestanding or
Independent Providers
Outcomes of Processing Applications
Payment of Claims
Enrollment Procedures for General
Application
Recommendation for Approval
Recommendation for Denial
Request for Additional Information
Transmission of Recommendations
Change(s) of Information
Application Changes
Change of Ownership
Applicant/State Agency/Regional Office
Liaison and Assistance
Carrier Liaison
Application Routing
Use of Other Than an Official HCFA-855
Enrollment Form
Processing Time Frames
Provider/Supplier Education
Special Processing Situations
Tracking Requirements
1757 <bu Ambulance Services
l
1758 <bu Claims Processing Timeliness
l
1759 <bu Therapeutic Services
l
1760 <bu Pneumococcal Pneumonia, Influenza Virus
l and Hepatitis B Vaccines
1761 <bu Bill Review for Partial Hospitalization
l Services Provided in Community Mental
Health Centers
1762 <bu Therapeutic Services
l
1763 <bu Revision Number 1763 Will Not Be Published
l In This or Any Future Federal Register
Because the Information Contained In It
Has Been Combined and Published in
Revision Number 1764
1764 <bu Oral Cancer Drugs
l
Oral Anti-Nausea Drugs as Full-Replacement
for Intravenous Dosage Forms as Part of a
Cancer Chemotherapeutic Regimen
Mammography Quality Standards Act
Colorectal Screening
1765 <bu Colorectal Screening
l
------------------------------------------------------------------------
[[Page 59188]]
Carriers
Manual Part 2--Program Administration
(HCFA Pub. 14-2)
(Superintendent of Documents No. HE 22.8/7)
------------------------------------------------------------------------
139 <bu Functional Standards for Claims Processing
l Claims Operations
------------------------------------------------------------------------
Carriers Manual
Part 3--Claims Process
(HCFA Pub. 14-3)
(Superintendent of Documents No. HE 22.8/7)
------------------------------------------------------------------------
1612 <bu Identifying a Screening Mammography Claim
l
1613 <bu Claims Review for Global Surgeries
l
1614 <bu Furnishing Medicare Physician Fee Schedule
l Database Pricing Files and File
Specifications
1615 <bu Type of Service
l
1616 <bu Chiropractic Services
l
1617 <bu Self-Administered Drugs and Biologicals
l
1618 <bu Medicare Physician Fee Schedule Database
l 1999 File Layout
Maintenance Process for the Medicare
Physician Fee Schedule Database
1619 <bu Billing for Pneumococcal, Hepatitis B, and
l Influenza Virus Vaccines
1620 <bu The Carrier Advisory Committee, Membership
l On the Carrier Advisory Committee,
Beneficiaries
1621 <bu Self-Administered Drugs and Biologicals
l
1622 <bu Furnishing Fee Schedule (Excluding
l Physician Fee Schedule) Prevailing Charge
and Conversion Factor Data to United
Health Care, Fiscal Intermediaries, State
Agencies, Indian Health Services and
United Mine Workers
1623 <bu Maintaining a Directory of Electronic
l Billing Vendors
------------------------------------------------------------------------
Carriers Manual
Part 4--Professional Relations
(HCFA Pub. 14-4)
(Superintendent of Documents No. HE 22.8/7)
------------------------------------------------------------------------
16 <bu Health Care Provider/Supplier Enrollment
l
Enrollment Instructions
Request for Additional Information
Denial
Approval
Enrollment Procedures for General
Application
HCFA-855R, Individual Reassignment of
Benefits
Change of Information Form
Enrolling Certified Providers/Suppliers
Who Enroll With Carriers
Appeals
Validate Data Elements Collected from
Applicant
Application Data Collection/Maintenance
Requirement
Tracking Requirements
Provider Enrollment Quarterly Workload
Report
Data Requirement Changes to the Medicare
and Other Federal Health Care Programs
Provider/Supplier Enrollment Applications
17 <bu Registry of Physicians/Health Care
l Practitioners/Group Practices
Ongoing Data Collection on Physicians/
Health Care Practitioners/Group Practices
Applications
Physician/Health Care Practitioners/Group
Practices Record-Required Information and
Format
Maintaining Physician/Health Care and
Practitioner/Group Practices Memberships
Update Records
Batching Procedures
Privacy Act Requirements
18 <bu Purpose of Health Insurance Claim Form
l HCFA-1500
User Print File Specifications
------------------------------------------------------------------------
Program Memorandum
Intermediaries
(HCFA Pub. 60A)
(Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
A-98-32 <bu Postponement of Change Requests 472 and
l 294
A-98-33 <bu File Descriptions and Instructions for
l Retrieving the 1999 Physician, Clinical
Lab, Durable Medical Equipment,
Prosthetics/Orthotics and Supplies Fee
Schedule Payment Amounts Through HCFA's
Mainframe Telecommunications Systems,
Formerly Known as the Network Data Mover
System
A-98-34 <bu Change in Hospice Payment Rates
l
A-98-35 <bu Hospital Outpatient Procedures: Medicare
l Changes for Radiology and Other
Diagnostic Coding Due to the 1999 HCPCS
Update; Revised Modifiers
[[Page 59189]]
A-98-36 <bu The Supplemental Security Income Medicare
l Beneficiary Data for Fiscal Year 1997 for
Prospective Payment System Hospitals
A-98-37 <bu Consolidated Billing for Skilled Nursing
l Facility Patients When Receiving
Outpatient/Emergency Care in a Medicare-
Participating Hospital or Critical Access
Hospital
A-98-38 <bu Implementation and Corrections to the
l Federal Register Notice Published August
11, 1998 for Home Health Agency Cost
Limitation Effective October 1, 1998 and
Implementation of Sec. 5101 of the
Omnibus Consolidated and Emergency
Supplemental Appropriations Act, Fiscal
Year 1999 Enacted on October 21, 1998
A-98-39 <bu Surety Bonds from Home Health Agencies
l
A-98-40 <bu Intermediary Updating of the International
l Classification of Diseases, Ninth
Revisions, Clinical Modification
A-98-41 <bu Retrospective Review of Hospital Requests
l for Higher-Weighted Diagnostic Related
Groups
A-98-42 <bu Renewal of Program Memorandum A-97-8--
l Instructions to Implement the New
Medicare Summary Notice Combined with
Program Memorandum AB-98-31
A-98-43 <bu Requirements for Billing and Processing
l Claims for Services Subject to Line Item
Date of Service Reporting
A-98-44 <bu FY 1999 Prospective Payment System, Tax
l Equity and Fiscal Responsibility Act,
Hospital and Other Bill Processing
Changes
A-98-45 <bu Clarification to Program Memorandum A-98-
l 16 Issued May 1998, ``Coverage and Claims
Processing for Prospective Payment for
Skilled Nursing Facilities--The Balanced
Budget Act of 1977''
A-98-46 <bu Implementation of Surety Bond Requirement
l for Home Health Agencies
A-98-47 <bu Revision to PM A-98-10 Year 2000 Update
l Pages for the ASC X12 837 Version 3051
Implementations 3A.01 and 1A.C1
Institutional Claim/Coordination of
Benefits
A-98-48 <bu Retrospective Review of Hospital Requests
l for Higher-Weighted Diagnostic Related
Groups
A-98-49 <bu Medicare Home Health Benefit--The Balanced
l Budget Act of 1997--Financing Shift of
Home Health Services From Part A to Part
B
------------------------------------------------------------------------
Program Memorandum
Carriers
(HCFA Pub. 60B)
(Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
B-98-36 <bu 1999 Fee Screens Edit Package for the
l Medicare Physician Fee Schedule Database
B-98-37 <bu This Program Memorandum Was Published in
l the 3rd Quarter Federal Register
B-98-38 <bu Delaying Y2K Return as Unprocessable Edits
l for Paper and Electronic Media Claims
B-98-39 <bu Reviewing Reassignment Agreements of Five
l or More
B-98-40 <bu Changes to Correct Coding Edits, Version
l 5.0
B-98-41 <bu 1999 Participation Enrollment and Medicare
l Participating Physician/Supplier
Directory Procedures
B-98-42 <bu Schedule for Completing the 1999 Update
l and Enrollment Process for the Medicare
Physician Fee Schedule Database
B-98-43 <bu Changes in the Medicare Limiting Charge
l Monitoring Program for Fiscal Year 1999
B-98-44 <bu Evaluating the Medical Necessity for
l Laboratory Panel Common Procedural
Terminology Codes
B-98-45 <bu Enrollment of Independent Diagnostic
l Testing Facilities
B-98-46 <bu 1999 Physician Fee Schedule Disclosure
l Reports
B-98-47 <bu Discontinuing the Surrogate Unique
l Physician Identification Number NPP000
for Nurse Practitioners, Clinical Nurse
Specialists, and Physician Assistants
B-98-48 <bu Medicare Physician Fee Schedule Database
l 1999--Announcement of Revised File
B-98-49 <bu This Revision Will Not Be Published In
l This or Any Future Federal Register
B-98-50 <bu Continuing the Use of the Modifiers for
l Nurse Practitioner Physician Assistant
and Clinical Nurse Specialist Claims
B-98-51 <bu Clarification-Implementation of Additional
l Commercial Edits Effective for Dates of
Service on or After October 1, 1998.
Refer to Transmittal Number B-98-27,
Change Request Number 502
B-98-52 <bu Enrollment of Independent Diagnostic
l Testing Facilities
B-98-53 <bu Durable Medical Equipment Carrier Billing
l Procedures
B-98-54 <bu Changes to Correct Coding Edits, Version
l 5.1
B-98-55 <bu Delay of Change to HCFA-1500 Instructions
l for Processing Physician Claims in Global
Payment Systems
B-98-56 <bu Medicare Physician Fee Schedule Database
l 1999--Announcement of Revised File
B-98-57 <bu Provider Notification Concerning Child
l Support Enforcement Activities
B-98-58 <bu Delay of Change Request Numbers 521 and
l 705
B-98-59 <bu Medicare Enrollment of Physical Therapists
l in Private Practice and Occupational
Therapists in Private Practice--Effective
on or After January 1, 1999
B-98-60 <bu Change in Correct Coding Initiative Edits
l Update for January 1, 1999 and April 1,
1999
------------------------------------------------------------------------
Program Memorandum
Intermediaries/Carriers
(HCFA Pub. 60A/B)
(Superintendent of Documents No. HE 22.8/6-5)
------------------------------------------------------------------------
AB-98-53 <bu Business Continuity and Contingency Plans
l for the Millennium Change
AB-98-54 <bu 1999 HCFA Common Procedure Coding System
l Update
AB-98-55 <bu Extension of the Limitation on Payment for
l Services to Individuals Entitled to
Benefits on the Basis of End Stage Renal
Disease Who are Covered by Group Health
Plans
AB-98-56 <bu Year 2000 Automated Response Unit
l Compliance Regarding Periphonics
Equipment
AB-98-57 <bu Contingency Planning for Increased
l Beneficiary Call Volumes
AB-98-58 <bu Continue Using the Fiscal Year 1998 Rates
l and Wage Index Values for Ambulatory
Surgical Center Payments
[[Page 59190]]
AB-98-59 <bu Map Between Medicare Summary Notice
l Messages for Beneficiaries and the
Corresponding Remittance Advice Messages
for Providers
AB-98-60 <bu Medicare Summary Notice/Explanation of
l Medicare Benefits and Notice of
Utilization Mammography Message for the
Month of October
AB-98-61 <bu Instructions for Implementing and Updating
l 1999 Payment Amounts for Durable Medical
Equipment, Prosthetics, Orthotics, and
Supplies
AB-98-62 <bu Medicare Participating Centers of
l Excellence Demonstration; Extension of
Discard Date for PM's AB-98-11 and AB-98-
13
AB-98-63 <bu Prospective Payment System for Outpatient
l Rehabilitation Services and Application
of Financial Limitation
AB-98-64 <bu Medicare Coverage Expansion of Certain
l Oral Anti-Cancer Drugs to Include Food
and Drug Administration Approved Oral
Anti-cancer Prodrugs
AB-98-65 <bu Notice of New Interest Rate for Medicare
l Overpayments and Underpayments
AB-98-66 <bu Balanced Budget Act Requirements to
l Furnish Diagnostic Information
AB-98-67 <bu 1999 Payment Limit for Ambulance Services
l
AB-98-68 <bu Identifying Employer in Other-than-Data
l Match Group Health Plan Medicare
Secondary Payer Recovery Situations
AB-98-69 <bu Medicare Health Plan Choices--Inquiry
l Guidelines for Medicare Contractors
AB-98-70 <bu New Waived Tests
l
AB-98-71 <bu Implementation of 1999 Clinical Diagnostic
l Laboratory Fee Schedule and Mapping for
1999 Laboratory Coding Changes
AB-98-72 <bu Medicare Contractor Coordination of
l Benefits File Formats
AB-98-73 <bu Access to Eligibility Data by Eligibility
l Verification Vendors
AB-98-74 <bu Fiscal Year 1999 Budget and Performance
l Requirements--Contractor Customer Service
Plan (Beneficiaries)
AB-98-75 <bu Implementing Instructions--Positron
l Emission Tomography Scans for
Characterizing Solitary Pulmonary Nodules
or Staging Lung Cancer Performed on or
After January 1, 1998
AB-98-76 <bu Implementation of the New Payment Limit
l for Drugs and Biologicals
AB-98-77 <bu Referral of Cases to the Office of
l Inspector General
AB-98-78 <bu Temporary Conversion from Bundled Payments
l to Regular Medicare Payments for the
Participating Centers of Excellence
Demonstration Testing Beginning With
Discharges after December 31, 1998
------------------------------------------------------------------------
State Operations Manual
Provider Certification
(HCFA Pub. 7)
(Superintendent of Documents No. HE 22.8/12)
------------------------------------------------------------------------
4 <bu Survey Procedures for Intermediate Care
l Facilities for Persons With Mental
Retardation.
------------------------------------------------------------------------
Hospital Manual
(HCFA Pub. 10)
(Superintendent of Documents No. HE 22.8/2)
------------------------------------------------------------------------
731 <bu Requirement That Bills Be Submitted In
l Sequence for a Continuous Inpatient Stay
or Course of Treatment.
Need to Reprocess Inpatient or Hospice
Claims In Sequence.
732 <bu Billing for Mammography Screening.
l
733 <bu Billing for Hospital Outpatient Partial
l Hospitalization Services.
734 <bu Claims Processing Timeliness.
l
735 <bu Pneumococcal Pneumonia, Influenza Virus,
l and Hepatitis B Vaccines.
736 <bu Ambulance Service Claims.
l
737 <bu Billing for Colorectal Screening.
l
738 <bu Completion of Form HCFA-1450 for Inpatient
l and/or Outpatient Billing.
Provider Electronic Billing File and
Record Formats.
Alphabetic Listing of Data Elements.
------------------------------------------------------------------------
Religious Nonmedical Health Care Institutions
(Hospital Manual Supplement)
(HCFA Pub. 32)
(Superintendent of Documents No. HE 22.8/2-2)
------------------------------------------------------------------------
39 <bu Pneumococcal Pneumonia, Influenza Virus
l and Hepatitis B Vaccines.
40 <bu Inpatient Admission and Billing Religious
l Nonmedical Health Care Institutions (Form
HCFA-1450.
Completion of Form HCFA-1450 for Religious
Nonmedical Health Care Institutions.
------------------------------------------------------------------------
Home Health Agency Manual
(HCFA Pub. 11)
(Superintendent of Documents No. HE 22.8/5)
------------------------------------------------------------------------
287 <bu Completion of Form HCFA-1450 for Inpatient
l and/or Outpatient Billing.
Provider Electronic Billing File and
Record Formats.
Alphabetic Listing of Data Elements.
288 <bu Billing for Pneumococcal Pneumonia,
l Influenza Virus, and Hepatitis B
Vaccines.
289 <bu Billing for Ambulance Services.
l
------------------------------------------------------------------------
[[Page 59191]]
Skilled Nursing Facility Manual
(HCFA Pub. 12)
(Superintendent of Documents No. HE 22.8/3)
------------------------------------------------------------------------
355 <bu Billing for Mammography Screening.
l
356 <bu Special Billing Instructions for
l Pneumococcal Pneumonia, Influenza Virus,
and Hepatitis B Vaccines.
357 <bu Billing for Ambulance Services.
l
------------------------------------------------------------------------
Rural Health Clinic and Federally Qualified Health Centers Manual
(HCFA Pub. 27)
(Superintendent of Documents No. HE 22.8/19:985)
------------------------------------------------------------------------
30 <bu Billing for Mammography Screening by Rural
l Health Clinics and Federally Qualified
Health Centers.
31 <bu Completion of Form HCFA-1450 by Rural
l Health Clinics and Federally Qualified
Health Centers.
32 <bu Completion of Form HCFA-1450 by Rural
l Health Clinics and Federally Qualified
Health Centers.
<bu Billing for Mammography Screening by Rural
l Health Clinics and Federally Qualified
Health Centers.
------------------------------------------------------------------------
Renal Dialysis Facility Manual
(Non-Hospital Operated)
(HCFA Pub. 29)
(Superintendent of Documents No. HE 22.8/13)
------------------------------------------------------------------------
83 <bu Pneumococcal Pneumonia, Influenza Virus,
l and Hepatitis B Vaccines.
52 <bu Special Billing Instructions for
l Pneumococcal Pneumonia, Influenza Virus,
and Hepatitis B Vaccines.
53 <bu Completing the Uniform (Institutional
l Provider) Bill (Form HCFA-1450) Notice of
Election.
Completion of the Uniform (Institutional
Provider) Bill (Form 53 HCFA-1450) for
Hospice Bills.
------------------------------------------------------------------------
Hospice Manual
(HCFA Pub. 21)
(Superintendent of Documents No. HE 22.8/18)
------------------------------------------------------------------------
52 <bu Special Billing Instructions for
l Pneumococcal Pneumonia, Influenza Virus,
and Hepatitis B Vaccines.
53 <bu Completing the Uniform (Institutional
l Provider) Bill (Form HCFA-1450) Notice of
Election.
Completion of the Uniform (Institutional
Provider) Bill (Form HCFA-1450) for
Hospice Bills.
------------------------------------------------------------------------
Outpatient Physical Therapy, Comprehensive Outpatient Rehabilitation
Facility and Community Mental Health Center Manual
(HCFA Pub. 9)
(Superintendent of Documents No. HE 22.8/9)
------------------------------------------------------------------------
3 <bu Billing Instructions for Partial
l Hospitalization Services Provided in
Community Mental Health Centers.
4 <bu Pneumococcal Pneumonia, Influenza Virus
l and Hepatitis B Vaccines.
5 <bu Completion of Form HCFA-1450 for Billing
l Comprehensive Outpatient Rehabilitation
Facility, Outpatient Physical Therapy,
Occupational Therapy, Speech Therapy, or
Community Mental Health Center Manual.
------------------------------------------------------------------------
Provider Reimbursement Manual--Part 1
(HCFA Pub. 15-1)
(Superintendent of Documents No. HE 22.8/4)
------------------------------------------------------------------------
407 <bu Regional Medicare Swing-Bed Skilled
l Nursing Facility Rates.
------------------------------------------------------------------------
Provider Reimbursement Manual--Part 2
Provider Cost Reporting Forms and Instructions
Chapter 32--Form HCFA 1728-94
(HCFA Pub. 15-2)
(Superintendent of Documents No. HE 22.8/4)
------------------------------------------------------------------------
6 <bu Instructions and Cost Reporting Forms as a
l Result of the Balanced Budget Act of
1997.
------------------------------------------------------------------------
Provider Reimbursement Manual--Part 2
Provider Cost Reporting Forms and Instructions
Chapter 36--Form HCFA 2552-96
(HCFA Pub. 15-2)
(Superintendent of Documents No. HE 22.8/4)
------------------------------------------------------------------------
4 <bu Instructions and Cost Reporting Forms as a
l Result of the Balanced Budget Act of
1997.
------------------------------------------------------------------------
[[Page 59192]]
Provider Reimbursement Manual--Part 2
Provider Cost Reporting Forms and Instructions
Chapter 18--Form HCFA 2088-92
(HCFA Pub. 15-2)
(Superintendent of Documents No. HE 22.8/4)
------------------------------------------------------------------------
2 <bu Instructions and Cost Reporting Forms as a
l Result of the Balanced Budget Act of
1997.
------------------------------------------------------------------------
Program Memorandum
Regional Office--General
(HCFA Pub. 51)
(Superintendent of Documents No. HE 22.28/5:90-1)
------------------------------------------------------------------------
98-4 <bu Home Health Agency Surety Bond
l Requirements.
98-5 <bu Surety Bond Requirements (HCFA 1152-FC).
l
------------------------------------------------------------------------
Medicare/Medicaid
Sanction--Reinstatement Report
(HCFA Pub. 69)
------------------------------------------------------------------------
98-10 <bu Report of Physicians/Practitioners,
l Providers and/or Other Health Care
Suppliers Excluded/Reinstated--September
1998.
98-11 <bu Report of Physicians/Practitioners,
l Providers and/or Other Health Care
Suppliers Excluded/Reinstated--October
1998.
98-12 <bu Report of Physicians/Practitioners,
l Providers and/or Other Health Care
Suppliers Excluded/Reinstated--November
1998.
------------------------------------------------------------------------
Addendum IV.--Regulation Documents Published in the Federal Register
--------------------------------------------------------------------------------------------------------------------------------------------------------
End of
Publication date FR Vol. 63 CFR \1\ part(s) File code \2\ Regulation title comment Effective
page period date
--------------------------------------------------------------------------------------------------------------------------------------------------------
10/01/98............... 52610-52614 400, 403, 410, 411, 417, and 422 HCFA-1030-CN.................... Medicare Program; .......... 07/27/98
Establishment of the
Medicare+Choice
Program; Correction.
10/01/98............... 52614-52615 405, 412, and 413............... HCFA-1003-CN.................... Medicare Program; .......... 10/01/98
Changes to the
Hospital Inpatient
Prospective Payment
Systems and Fiscal
Year 1999 Rates;
Correction.
10/01/98............... 52663-52665 416 and 488..................... HCFA-1885-2N.................... Medicare Program; 11/09/98 ..........
Update of
Ratesetting
Methodology, Payment
Rates, Payment
Policies, and the
List of Covered
Procedures for
Ambulatory Surgical
Centers Effective
October 1, 1998;
Reopening of Comment
Period and Delay in
Adoption of the
Proposed Rule as
Final.
10/05/98............... 53446-53456 ................................ HCFA-1039-N..................... Medicare Program; .......... 10/01/98
Hospice Wage Index.
10/05/98............... 53301-53308 409, 410, 411, 413, 424, 483, HCFA-1913-CN.................... Medicare Program; .......... 07/01/98
and 489. Prospective Payment
System and
Consolidated Billing
for Skilled Nursing
Facilities;
Correction.
10/08/98............... 54142-54148 ................................ HCFA-2012-N..................... Medicaid Program; .......... 10/01/98
Disproportionate
Share Hospital
Payments-
Institutions for
Mental Disease.
10/09/98............... 54526 422............................. HCFA-1030-CN.................... Medicare Program; .......... 07/27/98
Establishment of the
Medicare+Choice
Program; Correction.
10/13/98............... 54721 ................................ HCFA-1099-N..................... Medicare Program; .......... ..........
October 28, 1998,
Meeting of the
Competitive Pricing
Advisory Committee.
10/14/98............... 55031-55034 493............................. HCFA-2024-FC.................... Medicare, Medicaid, 12/14/98 10/14/98
and CLIA Programs;
Extension of Certain
Effective Dates for
Clinical Laboratory
Requirements Under
CLIA.
10/21/98............... 56212-56214 ................................ HCFA-8000-N..................... Medicare Program; .......... 01/01/99
Part A Premium for
1999 for the
Uninsured Aged and
for Certain Disabled
Individuals Who Have
Exhausted Other
Entitlement.
10/21/98............... 56199-56201 ................................ HCFA-8001-N..................... Medicare Program; .......... 01/01/99
Inpatient Hospital
Deductible and
Hospital and
Extended Care
Services Coinsurance
Amounts for 1999.
10/21/98............... 56201-56212 ................................ HCFA-8003-N..................... Medicare Program; .......... 01/01/99
Monthly Actuarial
Rates and Monthly
Supplementary
Medical Insurance
Premium Rate
Beginning January 1,
1999.
10/27/98............... 57546-57564 45 CFR 144, 146, and 148........ HCFA-2892-IFC................... Interim Rules for 01/25/99 01/01/99
Group Health Plans
and Health Insurance
Issuers Under the
Newborns' and
Mothers' Health
Protection Act.
10/28/98............... 57698-57699 ................................ HCFA-1035-CN.................... Medicare Program; .......... 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; Correction.
[[Page 59193]]
11/02/98............... 58814-59187 405, 410, 413, 414, 415, 424, HCFA-1006-FC.................... Medicare Program; 01/04/99 01/01/99
and 485. Revisions to Payment
Policies and
Adjustments to the
Relative Value Units
Under the Physician
Fee Schedule for
Calendar Year 1999.
11/02/98............... 59188-59190 ................................ HCFA-1021-NC.................... Medicare Program; 12/02/98 10/01/98
Sustainable Growth
Rate for Fiscal Year
1999.
11/10/98............... 63068-63069 ................................ HCFA-1048-N..................... Medicare Program; 11/30/98 ..........
Request for
Nominations for the
Practicing
Physicians Advisory
Council.
11/12/98............... 63326 ................................ HCFA-1039-CN.................... Medicare Program; .......... 10/01/98
Hospice Wage Index;
Correction.
11/13/98............... 63429-63430 409, 410, 411, 412, 413, 419, HCFA-1005-N..................... Medicare Program; 01/08/99 ..........
489, 498, and 1003. Prospective Payment
System for Hospital
Outpatient Services;
Extension of Comment
Period.
11/13/98............... 63430-63431 416 and 488..................... HCFA-1885-3N.................... Medicare Program; 01/08/99 ..........
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.
11/19/98............... 64191-64195 412............................. HCFA-1049-FC.................... Medicare Program; 12/21/98 11/19/98
Limited Additional
Opportunity to
Request Certain
Hospital Wage Data
Revisions for FY
1999.
11/19/98............... 64195-64199 440 and 441..................... HCFA-2060-F..................... Medicaid Program; .......... 12/21/98
Inpatient
Psychiatric Services
Benefit for
Individuals Under
Age 21.
11/25/98............... 65213-65214 ................................ HCFA-1051-N..................... Medicare Program; .......... ..........
December 14, 1998,
Meeting of the
Practicing
Physicians Advisory
Council.
11/27/98............... 65561-65562 409, 410, 411, 413, 413, 424, HCFA-1913-N2.................... Medicare Program; 12/28/98 ..........
483, and 489. Prospective Payment
System and
Consolidated Billing
for Skilled Nursing
Facilities;
Reopening of Comment
Period.
12/02/98............... 66554-66556 ................................ HCFA-2008-FN.................... Medicare Program; .......... 12/02/98
Recognition of the
American Association
for Accreditation of
Ambulatory Surgical
Facilities, Inc. for
Ambulatory Surgical
Centers Program.
12/04/98............... 67078-67121 ................................ HCFA-2025-N..................... Medicare Program; .......... 07/01/98
Recognition of NAIC
Model Standards for
Regulation of
Medicare
Supplemental
Insurance.
12/09/98............... 67899-67908 ................................ HCFA-9002-N..................... Medicare and Medicaid .......... ..........
Programs; Quarterly
Listing of Program
Issuances--Second
Quarter, 1998.
12/11/98............... 68464-68465 ................................ HCFA-4002-GNC................... Medicare Program; 02/09/99 12/11/98
Criteria and
Standards for
Evaluating
Intermediary and
Carrier Performance;
Millennium
Compliance.
12/14/98............... 68780 ................................ HCFA-3432-N2.................... Medicare Program; 01/29/99 ..........
Establishment of the
Medicare Coverage
Advisory Committee
and Request for
Nominations for
Members.
12/14/98............... 68687-68697 400 and 402..................... HCFA-6135-FC.................... Medicare and Medicaid 02/12/99 01/13/99
Program; Civil Money
Penalties,
Assessments,
Exclusions, and
Related Appeals
Procedures.
12/17/98............... 69638 ................................ HCFA-1061-N..................... Medicare Program; .......... ..........
Meeting of the
Competitive Pricing
Advisory Committee.
12/24/98............... 71296-71297 ................................ HCFA-2036-NC.................... Medicare and Medicaid 01/25/99 ..........
Programs;
Recognition of the
Commission for
Accreditation of
Rehabilitation
Facilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ 42 CFR except where noted.
\2\ 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; GNC--General Notice 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.
G960065 A1 (Correction)
G980224 A1
G980229 A2
G980236 A2
G980240 A1
G980247 A2
G980248 A2
G980253 A2
G980262 A1
G980265 A2
G980306 A1
The following information presents the device number, category (in
this case, B), and criterion code.
G980220 B2
G980223 B2
G980225 B4
G980230 B1
G980231 B1
G980235 B4
G980238 B4
G980239 B2
G980241 B3
G980244 B4
G980246 B1
G980252 B1
G980255 B4
G980256 B4
G980259 B2
G980261 B2
G980267 B4
[[Page 59194]]
G980268 B1
G980269 B3
G980270 B4
G980272 B4
G980274 B3
G980275 B2
G980276 B1
G980277 B2
G980279 B1
G980280 B2
G980284 B1
G980285 B
G980286 B4
G980289 B3
G980295 B4
G980296 B2
G980298 B1
G980299 B1
G980301 B2
G980302 B4
G980303 B4
G980304 B4
G980305 B4
[FR Doc. 99-28629 Filed 11-1-99; 8:45 am]
BILLING CODE 4120-01-P
This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.