Medicare Program; Prospective Payment System for Hospital Outpatient Services; Extension of Comment Period

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

Office of the Inspector General

42 CFR Parts 409, 410, 411, 412, 413, 419, 489, 498, and 1003

[HCFA-1005-2N]

RIN 0938-AI56

Medicare Program; Prospective Payment System for Hospital

Outpatient Services; Extension of Comment Period

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

ACTION: Notice of extension of comment period for proposed rule.

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SUMMARY: This document extends the comment period for the second time

on a proposed rule published in the Federal Register on September 8,

1998, (63 FR 47552). In that rule, as required by sections 4521, 4522,

and 4523 of the Balanced Budget Act of 1997, we proposed to eliminate

the formula-driven overpayment for certain outpatient hospital

services, extend reductions in payment for costs of hospital outpatient

services, and establish in regulations a prospective payment system for

hospital outpatient services (and for Medicare Part B services

furnished to inpatients who have no Part A coverage.) The comment

period is extended for 60 days.

DATES: The comment period is extended to 5 p.m. on March 9, 1999.

ADDRESSES: Mail written comments (one original and three copies) to the

following address: Health Care Financing Administration, Department of

Health and Human Services, Attention: HCFA-1005-P, P.O. Box 26688,

Baltimore, MD 21207-0488.

If you prefer, you may deliver your written comments (one original

and three copies) to one of the following addresses: Room 443-G, Hubert

H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC

20201, or Room C5-09-26, Central Building, 7500 Security Boulevard,

Baltimore, MD 21244-1850.

Because of staffing and resource limitations, we cannot accept

comments by facsimile (FAX) transmission. In commenting, please refer

to file code HCFA-1005-P. Comments received timely will be available

for public inspection as they are received, generally beginning

approximately 3 weeks after publication of a document, in Room 443-G of

the Department's offices at 200 Independence Avenue, SW, Washington,

DC, on Monday through Friday of each week from 8:30 a.m. to 5 p.m.

(phone: (202) 690-7890).

For comments that relate to information collection requirements,

mail a copy of comments to: Office of Information and Regulatory

Affairs, Office of Management and Budget, Room 10235, New Executive

Office Building, Washington, DC 20503, Attn: Allison Herron Eydt, HCFA

Desk Officer.

FOR FURTHER INFORMATION CONTACT: Janet Wellham, (410) 786-4510.

SUPPLEMENTARY INFORMATION: On September 8, 1998, we issued a proposed

rule in the Federal Register (63 FR 47552) that would do the following:

Eliminate the formula-driven overpayment for certain

outpatient hospital services;

Extend reductions in payment for costs of hospital

outpatient services;

Establish in regulations a prospective payment system for

hospital outpatient services, for partial hospitalization services

furnished by community mental health centers, and for certain Medicare

Part B services furnished to inpatients who have no Part A coverage;

Propose new requirements for provider departments and

provider-based entities;

Implement section 9343(c) of the Omnibus Budget

Reconciliation Act of 1986, which prohibits Medicare payment for

nonphysician services furnished to a hospital outpatient by a provider

or supplier other than a hospital unless the services are furnished

under an arrangement with the hospital;

Authorize the Department of Health and Human Services'

Office of Inspector General to impose a civil money penalty against any

individual or entity who knowingly presents a bill for non-physician or

other bundled services not provided directly or under such an

arrangement.

The comment period for the proposed rule closed on November 9,

1998. Because of the scope of the proposed rule, hospitals and numerous

professional associations requested more time to analyze the potential

consequences of the rule. Therefore, we published a notice on November

13, 1998 (63 FR 63429), which extended the comment period until January

8, 1999. Because of further requests from hospitals and professional

associations, we are again extending the public comment period for an

additional 60 days, until March 9, 1999.

[[Page 1785]]

Published elsewhere in this issue of the Federal Register is a

document extending for an additional 60 days, the comment period for

the proposed rule published in the June 12, 1998, Federal Register in

which we propose to rebase Medicare payment rates and update the list

of approved procedures for ambulatory surgical centers (ASCs) (63 FR

32290). We are extending the comment period for the June 12, 1998, ASC

proposed rule to be concurrent with the extended comment period for the

September 8, 1998, hospital outpatient proposed rule because Medicare

payments to ASCs are closely linked to the manner in which Medicare

proposes to pay hospitals under a prospective payment system for

surgical services furnished on an outpatient basis.

Authority: Secs. 1102 and 1871 of the Social Security Act (42

U.S.C. 1302 and 1395hh).

(Catalog of Federal Domestic Assistance Program No. 93.774,

Medicare--Supplementary Medical Insurance Program)

Dated: January 4, 1999.

Nancy-Ann Min DeParle,

Administrator, Health Care Financing Administration.

Dated: January 6, 1999.

Donna E. Shalala,

Secretary.

[FR Doc. 99-641 Filed 1-8-99; 9:17 am]

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