[Federal Register Volume 64, Number 136 (Friday, July 16, 1999)]
[Proposed Rules]
[Pages 38395-38396]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-18117]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Part 405

[HCFA-1083-N]


Medicare Program; Meetings of the Negotiated Rulemaking Committee 
on Ambulance Fee Schedule

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

ACTION: Notice of meeting.

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SUMMARY: In accordance with section 10(a) of the Federal Advisory 
Committee Act, this notice announces the dates and location for the 
fifth meeting of the Negotiated Rulemaking Committee on the Ambulance 
Fee Schedule. This meeting is open to the public.
    The purpose of this committee is to develop a proposed rule that 
establishes a fee schedule for the payment of ambulance services under 
the Medicare program through negotiated rulemaking, as mandated by 
section 4531(b) of the Balanced Budget Act (BBA) of 1997.

DATES: The fifth meeting is scheduled for August 2, 1999 from 9:00 a.m. 
until 5 p.m. and August 3, 1999 from 8:30 a.m. until 4 p.m. E.D.T.

ADDRESSES: The 2-day August meeting will be held at The Phoenix Park 
Hotel, 520 North Capitol Street NW, Washington, D.C., (202) 638-6900.

FOR FURTHER INFORMATION CONTACT: Inquiries regarding this meeting 
should be addressed to Bob Niemann ((410) 786-4569) or Margot Blige 
((410) 786-4642) for general issues related to ambulance services or to 
Lynn Sylvester, ((202) 606-9140) or Elayne Tempel, ((207) 780-3408) 
facilitators.

SUPPLEMENTARY INFORMATION: Section 4531(b)(2) of the Balanced Budget 
Act (BBA), Public Law 105-33, added a new section 1834(l) to the Social 
Security Act (the Act). Section 1834(l) of the Act mandates 
implementation, by January 1, 2000, of a national fee schedule for 
payment of ambulance services furnished under Medicare Part B. The fee 
schedule is to be established through negotiated rulemaking. Section 
4531(b)(2) also provides that in establishing such fee schedule, the 
Secretary will--
     Establish mechanisms to control increases in expenditures 
for ambulance services under Part B of the program;
     Establish definitions for ambulance services that link 
payments to the type of services furnished;
     Consider appropriate regional and operational differences;
     Consider adjustments to payment rates to account for 
inflation and other relevant factors; and
     Phase in the fee schedule in an efficient and fair manner.
    The Negotiated Rulemaking Committee on the Ambulance Fee Schedule 
has been established to provide advice and make recommendations to the 
Secretary with respect to the text and content of a proposed rule that 
establishes a fee schedule for the payment of ambulance services under 
Part B of the Medicare program.
    The Committee held its third meeting on May 24 and 25, 1999. At 
this meeting, the Committee heard presentations from HCFA staff, 
including a data presentation. The Committee requested another 
presentation by HCFA's Office of Actuary to obtain clarification about 
its calculation of the fee schedule payment cap. Additionally, a 
Medical Issues workgroup was formed.
    The Committee held its fourth meeting on June 28 and 29, 1999. At 
this meeting a presentation was made by a HCFA Office of the Actuary 
staff member. The presentation clarified that budget neutrality will be 
evaluated by using all ambulance claims for the most current year and 
comparing the results of the proposed models with those paid claims. 
HCFA staff presented more historical Medicare hospital and supplier 
ambulance billing data. Consensus was reached on one possible basic 
structure for the fee schedule. HCFA indicated that the fee schedule 
must be effective as soon as operationally possible after January 1, 
2000. Subcommittees were formed to produce, by July 19, proposals for:
    (1) A rural/urban adjustment; and
    (2) A fee schedule model based on the structure agreed to at the 
June meeting combined with relative values. These proposals, along with 
the results of the medical issues workgroup, will serve as the basis 
for the Committee's next meeting.
    During the August meeting, the Committee will work toward achieving 
consensus on the criteria to be considered in evaluating options for 
the fee schedule. Discussions will then begin on the options.
    The announced meeting is open to the public without advanced 
registration. Public attendance at the meeting may be limited to space 
available. Interested parties can file statements with the Committee. 
Mail written statements to the following address: Federal Mediation and 
Conciliation Service, 2100 K Street, NW, Washington, D.C. 20427, 
Attention: Lynn Sylvester. Notice of future meetings will be published 
in the Federal Register at a later date. A summary of all proceedings 
will be available for public inspection 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), and can be accessed through the HCFA Internet site at 
http://www.hcfa.gov/medicare/ambmain.htm. Additional information 
related to the Committee will also be available on the web site.

    Authority: Sec. 1834(l) of the Social Security Act (42 U.S.C. 
1395m).

    (Catalog of Federal Domestic Assistance Program No. 93.774, 
Medicare--Supplementary Medical Insurance Program)


[[Page 38396]]


    Dated: July 11, 1999.
Michael M. Hash,
Deputy Administrator, Health Care Financing Administration.
[FR Doc. 99-18117 Filed 7-15-99; 8:45 am]
BILLING CODE 4120-01-P