[Federal Register Volume 67, Number 198 (Friday, October 11, 2002)]
[Notices]
[Pages 63434-63435]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-25948]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[CMS-3109-N]


Medicare Program; Town Hall Meeting on the Hospital ``1-hour'' 
Rule Related to the Use of Restraint and Seclusion

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of meeting.

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SUMMARY: This notice announces a town hall meeting to obtain and 
discuss general comments from the public concerning the impact of the 
hospital ``1-hour'' rule related to the use of restraint and seclusion. 
Specifically, the meeting will attempt to solicit individual comments 
and experiences from providers, advocates, consumers, and other 
interested parties concerning the application of the ``1-hour'' rule 
requiring a physician or a licensed independent practitioner to make a 
face-to-face assessment within 1 hour of any patient being placed in 
restraint or seclusion for behavioral reasons. We are particularly 
interested in data that show how this requirement may be imposing 
burdens on patient care, including, but not limited to, financial 
burdens on hospitals and physicians. We would be happy to address/
discuss other concerns related to the provision of hospital services to 
this population of patients.
    Hospitals, provider representatives, advocacy groups, physicians, 
and other interested parties are invited to this meeting to present 
their views on this issue. The opinions and alternatives provided 
during this meeting will assist us as we evaluate our policy on the 
``1-hour'' rule. The meeting is open to the public, but attendance is 
limited to space available.

DATES: Meeting Date: The town hall meeting announced in this notice 
will be held on Tuesday, October 29, 2002, from 10 a.m. to 1 p.m. 
(eastern standard time).

ADDRESSES: The town hall meeting will be held in the auditorium at the 
Centers for Medicare & Medicaid Services, 7500 Security Boulevard, 
Baltimore, MD 21244.

FOR FURTHER INFORMATION CONTACT: Nancy Archer (410) 786-0596. You may 
also send inquiries about this meeting via e-mail to 
[email protected].

SUPPLEMENTARY INFORMATION: 

I. Background

    On July 2, 1999, we published an interim final rule with comment 
introducing a new Patients' Rights Condition of Participation (CoP) 
that hospitals must meet to be approved for, or to continue 
participation in, the Medicare and Medicaid programs (64 FR 36070). One 
of the requirements mandates that, for restraint or seclusion applied 
for behavioral reasons, a physician, or licensed independent 
practitioner (LIP), must make a face-to-face assessment of that patient 
within 1 hour of implementation of the intervention (64 FR 26088).
    The ``1-hour'' requirement was subsequently challenged in the 
United States District Court for the District of Columbia. Although the 
Court ruled in the Secretary's favor with respect to this provision, 
hospitals and their provider groups have continued to inform us that 
requiring a physician or LIP to perform the 1-hour face-to-face 
assessment causes undue burden on hospitals, without specific evidence 
that the quality of care has improved.

II. Meeting Format

    The meeting will begin with an overview of the goals of the meeting 
and an introduction of the meeting moderator, followed by remarks from 
Thomas A. Scully, Administrator, Centers for Medicare & Medicaid 
Services, and Charles G. Curie, Administrator, Substance Abuse and 
Mental Health Services Administration. The Acting Director, Office of 
Clinical Standards and Quality, will present the context for the 
discussion. Participants that have requested to speak will then be 
given time to present their information. The moderator will solicit 
comments and recommendations from the audience about issues concerning 
the implementation of the 1-hour rule, as time permits.
    The information about the town hall meeting will be posted at the 
following website address: http://www.cms.hhs.gov/opendoor/hospitals.asp. At this address, interested parties will find an agenda 
for the meeting and instructions on how to call into the meeting if 
unable to attend in person.
    We will limit the time for participants to make formal statements 
according to

[[Page 63435]]

the number of participants who have registered in advance to speak at 
the meeting. Individuals who wish to make formal statements must 
contact Nancy Archer at (410) 786-0596 or via e-mail, 
[email protected] as soon as possible. Those individuals must 
subsequently submit their formal statements in writing no later than 5 
p.m., Thursday, October 24, 2002. Send written submissions to: Nancy 
Archer, Centers for Medicare & Medicaid Services, 7500 Security 
Boulevard, Mail Stop S3-02-01, Baltimore, Maryland 21244 or 
[email protected]. Comments from individuals not registered to speak 
will be heard following individuals with scheduled statements, as time 
permits.

III. Registration Instructions

    The Clinical Standards Group is coordinating registration for the 
meeting. While there is no registration fee, all individuals must 
register to attend. Because this meeting will be located on Federal 
property, for security reasons, any persons wishing to attend this 
meeting must call or e-mail Nancy Archer at (410) 786-0596 
([email protected]) to register at least 72 hours in advance. 
Attendees must show photographic identification to the Federal 
Protective Service or Guard Service personnel before they will be 
permitted to enter CMS grounds. Individuals who have not registered in 
advance will not be allowed to enter the building to attend the 
meeting. Seating capacity is limited to the first 250 registrants. 
Individuals requiring sign language interpretation for the hearing 
impaired or other special accommodations should contact Aileen Bullock 
at (410) 786-5637 ([email protected]) at least 10 days before the 
meeting. There will be a TTY system access number available.

    Authority: 42 U.S.C 1395x(e) and (f).

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance)

    Dated: October 7, 2002.
Thomas A. Scully,
Administrator, Centers for Medicare and Medicaid Services.
[FR Doc. 02-25948 Filed 10-10-02; 8:45 am]
BILLING CODE 4165-15-P