[Federal Register Volume 61, Number 18 (Friday, January 26, 1996)]
[Notices]
[Page 2516]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-1261]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[ORD-078-N]


Medicare Program; Announcement of Funding Availability for a 
Cooperative Agreement for an End-Stage Renal Disease (ESRD) Managed 
Care Demonstration

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

ACTION: Notice.

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SUMMARY: This notice is to inform interested parties of an opportunity 
to apply for funds for a cooperative agreement from HCFA's Office of 
Research and Demonstrations for the ``End-Stage Renal Disease (ESRD) 
Managed Care Demonstration.''

FOR FURTHER INFORMATION, CONTACT: Bonnie Edington (410) 786-6617.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 2355 of the Deficit Reduction Act of 1984 (Pub. L. 98-369) 
required the Secretary to grant demonstration waivers for social health 
maintenance organization (SHMO) projects that provide for the 
integration of health and social services at a fixed annual prepaid 
capitation rate.
    Section 4207(b)(4)(B) of the Omnibus Budget Reconciliation Act of 
1990 (Pub. L. 101-508) amended section 2355 of Pub. L. 98-369 to 
include a requirement that the Secretary conduct up to four additional 
SHMO projects to demonstrate the effectiveness and feasibility of 
innovative approaches to refining current targeting and financing 
methodologies and benefit design for SHMOs.
    Section 13567(b) of the Omnibus Budget Reconciliation Act (OBRA) of 
1993 (Pub. L. 103-66) further amended section 2355 of Pub. L. 98-369, 
requiring the Secretary to include the integration of acute and chronic 
care management for patients with end-stage renal disease through 
expanded community care case management services in at least one of the 
four additional SHMO projects.

II. Provisions of this Notice

    This notice is to inform interested parties of the opportunity to 
apply for funds for a cooperative agreement to operate an ``End-Stage 
Renal Disease (ESRD) Managed Care Demonstration,'' involving the 
treatment of Medicare-eligible ESRD patients in a managed care setting 
as required by OBRA 1993. Interested parties are required to submit an 
offical application for consideration for grant funding and 
commencement of site development activities. Subject to funds 
availability, a one-time award of approximately $175,000 is expected to 
be given to each selected awardee. HCFA expects to award one or more 
demonstrations through the application process.
    Any organizational entity may apply. However, the applicant must be 
capable of assuring that the service delivery system under the 
demonstration will integrate acute and chronic care services, through 
expanded community care case management services, for ESRD patients. In 
addition, the applicant must meet all applicable State requirements for 
bearing financial risk.
    Awardees are expected to have a 9 to 12-month development period 
subsequent to award and prior to service delivery. In the three-year 
service delivery phase of the demonstration, awardees will be paid on a 
capitation basis in which the capitation amount will be adjusted to 
reflect treatment status (that is, maintenance dialysis, transplant, or 
functioning graft.
    Potential applicants who wish to request the full solicitation and 
application packet should call Ms. Edington at the above telephone 
number, send an E-mail message to [email protected], or write to the 
following address: Bonnie Edington, Health Care Financing 
Administration, Office of Research and Demonstrations, Mail Stop C3-24-
07, 7500 Security Boulevard, Baltimore, MD 21244-1850. These packets 
will be mailed to all requestors within approximately 10 days from the 
date of this notice. Completed applications, including full proposals, 
will be due approximately 70 days following the date of this notice. 
The exact due date for applications will be specified in the 
application packet. Awards are expected to be made in 1996.

    Authority: Section 402 of the Social Security Amendments of 
1967, as amended (42 U.S.C. 1395b-1); section 222(a) of the Social 
Security Amendments of 1972, as amended (42 U.S.C. 1395-1(note)); 
section 2355 of the Deficit Reduction Act of 1984, as amended; 
section 4207(b)(4)(B) of the Omnibus Budget Reconciliation Act of 
1990; section 13567(b) of the Omnibus Budget Reconciliation Act of 
1993.

    In accordance with the provisions of Executive Order 12866, this 
notice was reviewed by the Office of Management and Budget.

(Catalog of Federal Domestic Assistance Program No. 93.779 Health 
Financing Research, Demonstrations and Experiments)

    Dated: October 3, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 96-1261 Filed 1-25-96; 8:45 am]
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