[Federal Register Volume 66, Number 241 (Friday, December 14, 2001)]
[Notices]
[Pages 64839-64840]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-30991]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers For Medicare & Medicaid Services

[CMS-4031-N]


Medicare Program; Open Public Meeting on January 16, 2002 to 
Discuss Activities Related to the Collection of Diagnostic Data from 
Medicare+Choice Organizations for Risk Adjustment

AGENCY: Centers for Medicare & Medicaid Services (CMS), Health and 
Human Services.

ACTION: Notice of meeting.

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SUMMARY: This notice announces a public meeting to provide 
Medicare+Choice Organizations (M+COs), providers, practitioners, and 
other interested parties an opportunity to ask questions and raise 
issues regarding the risk adjustment model that will be selected for 
use beginning in 2004 and reporting requirements for diagnostic 
information. The purpose of the meeting is to provide information about 
risk adjustment model options and associated data collection issues and 
to allow for public comment regarding the models and data collection.

DATES: The meeting is scheduled for January 16, 2002 from 9 a.m. until 
4 p.m., EST.

ADDRESSES: The meeting will be held in the CMS Auditorium, 7500 
Security Boulevard, Baltimore, Maryland, 21244-1850.

FOR FURTHER INFORMATION CONTACT: Bobbie Knickman at (410) 786-4161. To 
submit public comment no later than February 1, 2002, email: Bobbie 
Knickman at [email protected] or fax to (410) 786-1048.

SUPPLEMENTARY INFORMATION:

Background

    The Balanced Budget Act of 1997 (BBA) (Public Law 105-33) 
established the Medicare+Choice program that significantly expanded the 
health care options available to Medicare beneficiaries. Under the BBA, 
the Secretary of the Department of Health and Human Services (the 
Secretary) must implement a risk adjustment methodology that accounts 
for variations in per capita costs based on health status and other 
demographic factors for payment to Medicare+Choice organizations 
(M+COs). The BBA also gives the Secretary the authority to collect 
inpatient hospital data for discharges on or after July 1, 1997, and 
additional data for other services occurring on or after July 1, 1998. 
Risk adjustment implementation began January 1, 2000. Payments to M+COs 
are made at 10 percent risk adjusted rates and 90 percent 
demographically adjusted rates for years 2000 through 2003. The 
Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act 
(BIPA), enacted in December 2000, stipulates that the risk adjustment 
methodology for 2004 and succeeding years should be based on data from 
inpatient hospital and ambulatory settings. BIPA contains a provision 
that phases in future risk adjusted payments as follows: 30 percent in 
2004; 50 percent in 2005; 75 percent in 2006; and 100 percent in 2007. 
The collection of physician encounter data, which began on October 1, 
2000, and hospital outpatient encounter data, which began on April 1, 
2001, was suspended on May 25, 2001 through July 1, 2002. The Secretary 
indicated that we will be working closely with all interested parties 
to explore and implement a risk adjustment process for M+C payments 
that balances accuracy with administrative burden. The meeting will 
address the following topics:
     Risk adjustment models incorporating ambulatory and 
inpatient diagnoses;
     Collection/reporting of beneficiary and diagnostic 
information for Medicare+Choice enrollees in hospital inpatient, 
outpatient, and physician settings for use in risk adjustment models; 
and
     Data issues.
    The agenda will include presentations by our staff and a question 
and answer sessions. Written public comments are preferred following 
the meeting and will be accepted until February 1, 2002.

Registration

    Registration for this public meeting is required and will be on a 
first-come, first-serve basis, limited to two attendees per 
organization. A waiting list will be available for additional requests. 
The registration deadline will be January 11, 2002 at 5:00 pm. EST. 
Registration will be done via the Internet at http://www.hcfa.gov/events/events.htm. A confirmation notice will be sent to attendees upon 
finalization of registration.

[[Page 64840]]

    Persons who are not registered in advance will not be permitted 
into the Federal Building and thus not be able to attend the meeting. 
Persons attending the meeting will be required to show a photographic 
identification, preferably a valid drivers' license before entering the 
building. Please note that if the meeting is cancelled we will post 
that information on our website.
    Attendees will be provided with meeting materials at the time of 
the meeting. Written meeting materials will be posted on the CMS 
website before the January 16, 2002 meeting at: http://www.hcfa.gov and 
http://www.cms.hhs.gov. We will accept written questions about meeting 
logistics or requests for meeting materials either before the meeting 
or up to 14 days after the meeting. Written submissions must be sent 
to:
    Aspen Systems Corporation, ATTN: Kim Slaughter, 2275 Research 
Boulevard, Mail Stop 5W, Rockville, Maryland 20850.
    You may also contact Encounter Data Representative: Kim Slaughter, 
Telephone Number: (301) 519-5388, Fax Number: (301) 519-6360, E-mail: 
[email protected].
    Written public comments will be accepted until February 1, 2002. 
Written public comments should be sent to Bobbie Knickman at 
[email protected] or fax to (410) 786-1048.
(Authority: Sections 1851 through 1859 of the Social Security Act 
(42 U.S.C. 1395w-21 through 1395w-28))

(Catalog of Federal Domestic Assistance Program No. 93.773 
Medicare--Hospital Insurance Program; and No. 93.774, Medicare--
Supplementary Medical Insurance Program)


    Dated: December 11, 2001.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 01-30991 Filed 12-13-01; 8:45 am]
BILLING CODE 4120-01-P