[Federal Register Volume 64, Number 7 (Tuesday, January 12, 1999)]
[Proposed Rules]
[Pages 1784-1785]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-641]


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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]
BILLING CODE 4120-01-P