[Federal Register Volume 65, Number 160 (Thursday, August 17, 2000)]
[Proposed Rules]
[Pages 50171-50172]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-21084]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Part 405

[HCFA-3432-N4]


Medicare Program; Open Town Hall Meeting to Discuss Criteria for 
Making Coverage Decisions--August 31, 2000

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

ACTION: Notice of meeting.

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SUMMARY: This document announces a town hall meeting for all interested 
parties to discuss criteria we would use to make certain national 
coverage decisions. This meeting presents one aspect of the evolving 
process for making the Medicare coverage process more open and 
responsive to the public.

DATES: August 31, 2000, from 9 a.m. until 12 noon, E.D.T.

ADDRESSES: The meeting will be held at the HCFA headquarters 
auditorium, 7500 Security Boulevard, Baltimore, Maryland 21244.

FOR FURTHER INFORMATION CONTACT: Patricia Brocato-Simons at 410-786-
0261.

SUPPLEMENTARY INFORMATION:

I. Background

    On April 27, 1999, we published a notice in the Federal Register 
(64 FR 22619) that announced the process we use to make national 
coverage decisions under the Medicare program. We also announced that 
we would not be adopting, as final, a 1989 proposed rule that set forth 
the criteria we would have used to make coverage decisions under 
Medicare. On May 16, 2000, we published a notice of intent (NOI) in the 
Federal Register (65 FR 31124) that announced our intention to issue a 
proposed rule and solicited advance public comments on the criteria we 
would use to make national coverage decisions under the ``reasonable 
and necessary'' provisions of section 1862(a)(1) of the Social Security 
Act (the Act). We extended the closing date of the comment period from 
June 15, 2000 to July 17, 2000. We received 118 public comments from 
major organizations and individuals with an interest in our coverage 
process. Commenters expressed their views on the following issues:
     Cost as a coverage criterion.
     Increased evidence burden.
     Limited choice or interference with the practice of 
medicine.
     Withdrawal of coverage.
     Burden of proof.
    In the NOI, we explained that these coverage decisions are 
prospective, population-based policies that apply to a clinical subset 
or class of Medicare beneficiaries. We described the clinical 
circumstances and setting under which an item or service is available 
(or not available). We included information and approaches we are 
considering at this time for making coverage decisions. We also 
clarified that the NOI was not intended to address individual medical 
necessity determinations and claims adjudications by our contractors 
and other adjudicators, nor was it intended to address changes in 
current Medicare payment policies.

II. Format of Meeting

    We will begin the meeting with a brief overview of the May NOI that 
solicited advance public comments on proposed criteria we would use in 
making future, national coverage decisions. Following this introduction 
will be a more detailed explanation of HCFA's NOI criteria for sake of 
clarity. This discussion will then be followed by a specified amount of 
time for public presentations by participants who submit a prior 
request to speak.

III. Registration

    Individuals may register by contacting Ms. Patricia Brocato-Simons 
either by telephone at 410-786-0261, by mail, at 7500 Security 
Boulevard, Mail Stop S3-02-01, Baltimore, Maryland 21244-1850, fax, at 
410-786-9286, or electronically at [email protected]. Please 
provide, as applicable, your name, title, firm name, address, telephone 
number, fax number, and electronic mailing address. Participants who 
wish to display an exhibit or make a presentation at the meeting are 
asked to contact Ms. Brocato-Simons at 410-786-0261 or via E-mail at 
[email protected] as soon as possible. Please identify the 
topic(s) for your presentation and an estimate of the amount of time 
required to make the presentation. Because of time constraints, we may 
need to limit the number of individuals who make presentations. We will 
notify participants who have been selected to make a presentation. We 
will assign presentation times before the meeting. While the meeting is 
open to the public, attendance is limited to the space available.
    We will accept written questions, comments, or other materials, 
before and during the meeting, or up to 14 days after the meeting. 
Address comments to: DHHS, HCFA, ATTN: Patricia Brocato-

[[Page 50172]]

Simons, Office of Clinical Standards and Quality/CAG, Room S3-02-01, 
7500 Security Boulevard, Baltimore, Maryland 21244-1850, Telephone 
Number: (410) 786-0261, Fax Number: (410) 786-9286, E-mail: 
[email protected]. Although there is no special format for the 
materials, we request that commenters be clear about the issue or 
aspect of the proposed process on which they have a question, comment, 
or suggestion.

    Authority: Sections 1102 and 1871 of the Act (42 U.S.C. 1302 and 
1395hh).


(Catalog of Federal Domestic Assistance Program No. 98.773, 
Medicare-Hospital Insurance; and Program No. 93.774, Medicare-
Supplementary Medicare insurance Program.)
    Dated: August 14, 2000.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 00-21084 Filed 8-16-00; 8:45 am]
BILLING CODE 4120-01-P