[Federal Register Volume 64, Number 127 (Friday, July 2, 1999)]
[Notices]
[Pages 36021-36022]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-17025]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[HCFA-3019-N]


Medicare Program; July 19, 1999 Open Town Hall Meeting To Discuss 
the Implementation of the Peer Review Organizations' (PROs) Sixth Round 
Contract Activities

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

ACTION: Notice of meeting.

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SUMMARY: This notice announces a Town Hall meeting to provide an 
opportunity for national health care organizations, beneficiary 
advocates, and other interested parties to ask questions and raise 
issues regarding the August 1999 implementation of the Peer Review 
Organizations' (PROs) Sixth Round Contract activities. The meeting will 
also explore how the entire health care community can identify ways to 
collaborate on quality improvement projects that will raise the quality 
of care provided to Medicare beneficiaries. The agency views this new 
round of contracts as an opportunity to develop partnerships with the 
provider, practitioner, plan, purchaser and beneficiary communities. 
The meeting will address how PROs, health care organizations and 
Medicare beneficiaries can form partnerships in the following areas:
     National quality improvement projects;
     Local quality improvement projects;
     Quality improvement projects in conjunction with 
Medicare+Choice plans; and
     Inclusion of disadvantaged populations within each of the 
quality improvement projects.
    The meeting will also address the Payment Error Prevention Program, 
which deals with reducing the occurrence of provider billing errors and 
consequent payment errors, including both over- and under-payment.

DATES: The meeting is scheduled for Monday, July 19, 1999 from 9 a.m. 
until 3 p.m., E.D.T.

ADDRESSES: The meeting will be held in the Health Care Financing 
Administration Main Auditorium, 7500 Security Boulevard, Baltimore, 
Maryland 21244.

FOR FURTHER INFORMATION CONTACT: Donald Forgione, (410) 786-3504, 
Yvette Williams, (410) 786-6844.

SUPPLEMENTARY INFORMATION:

Background

    The Town Hall meeting will provide an opportunity for organizations 
representing practitioners, providers, health plans, other purchasers, 
beneficiaries and other interested parties to ask questions and raise 
issues regarding the activities of the PRO Sixth Round Contract and how 
they can partner with PROs in achieving quality improvements for 
Medicare beneficiaries and improved payment accuracy. This Town Hall 
meeting provides an opportunity for information exchange concerning 
Request For Proposals (RFP) and the Payment Error Prevention Program 
(Task 4). RFP No. HCFA-99-00/ELM (March 1, 1999) Sec. C (3.1-3.4, pp. 
17-30.
    Task 1 concerns National Quality Improvement Projects and focuses 
on specific national health improvement clinical topics, acute 
myocardial infarction, heart failure, pneumonia,

[[Page 36022]]

stroke/transient ischemic attack/atrial fibrillation, diabetes, and 
breast cancer. The PROs, in conjunction with their partners, will use 
standardized sets of quality indicators to identify the greatest 
opportunities to improve the care of Medicare beneficiaries.
    Task 2 on Local Quality Improvement Projects directs each PRO to 
initiate local projects within its State in response to local 
interests, needs, and opportunities. HCFA is interested in broadening 
the PROs' experience in collaborating with providers, practitioners, 
plans, purchasers, and beneficiaries to improve the quality of care 
they deliver. We are also interested in the testing of quality 
indicators and intervention strategies that reflect care in settings 
other than acute-care hospitals and Medicare+Choice plans.
    Task 3 on Quality Improvement Projects conducted in conjunction 
with Medicare+Choice Plans, requires the plans to implement quality 
improvement projects as part of the Quality Improvement System for 
Managed Care standards. Each Medicare+Choice plan must initiate two 
performance improvement projects annually. The Balanced Budget Act of 
1997 (BBA) requires most M+C plans to have an agreement with the PRO to 
carry out all required review activities.
    Task 4 on the Payment Error Prevention Program is a modified review 
activity that strives to identify opportunities for improvement in the 
billing process to reduce the occurrence of incorrect payments 
resulting from provider billing errors. Errors may include both over-
billings and under-billings. The error rate would be the total dollars 
paid in error, either above or below the correct amount. PROs will 
conduct the Payment Error Prevention Program in two areas: unnecessary 
admissions and miscoded diagnosis-related group assignments.
    While the meeting is open to the public, attendance is limited to 
space available. Individuals must register in advance as described 
below.

Registration

    The Office of Clinical Standards and Quality will handle 
registration for the meeting. Individuals may register by sending a fax 
to the attention of Don Forgione, Yvette Williams, or Ida Sarsitis, in 
the Division of Contract Policy and Performance. Please provide your 
name, address, telephone number, e-mail, and fax number on your 
registration request.
    Receipt of your fax will constitute confirmation of your 
registration. You will be provided with meeting materials at the time 
of the meeting. If there is no available seating for the Town Meeting, 
you will receive a notice that the meeting is at capacity.
    For fax registration, the number is (410) 786-4005.
    If you have questions regarding registration, please contact Don 
Forgione at (410) 786-3504 or Yvette Williams at (410) 786-6844. 
Inquiries via e-mail should be sent to DF[email protected] or to 
YW[email protected].
    The agency will accept written questions or other statements (not 
to exceed four single-spaced, typed pages), preferably before the 
meeting, or up to 14 days after the meeting. Written submissions must 
be sent to: Health Care Financing Administration, ATTN: Steven Jencks, 
M.D., Director, Quality Improvement Group, Office of Clinical Standards 
and Quality, S3-01-17, 7500 Security Boulevard, Baltimore, Maryland 
21244-1850.

    Authority: Section 1102 of the Social Security Act (42 U.S.C. 
1302) (42 CFR 462.167).

    Dated: June 29, 1999.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 99-17025 Filed 7-1-99; 8:45 am]
BILLING CODE 4120-01-P