[Federal Register Volume 69, Number 39 (Friday, February 27, 2004)]
[Rules and Regulations]
[Pages 9323-9324]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-4275]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-4090-N]


Medicare Program; Town Hall Meeting on Proposed Collection--
Comment Request for Skilled Nursing Facility Advance Beneficiary Notice 
(SNFABN)

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

[[Page 9324]]


ACTION: Notice of meeting.

-----------------------------------------------------------------------

SUMMARY: This notice announces a Town Hall meeting to solicit input 
from the public on the proposed use of a Skilled Nursing Facility 
Advance Beneficiary Notice (SNFABN). Interested persons are invited to 
comment on the SNFABN Notice (CMS-10055 form) collection instrument, 
the associated burden or any other aspect of this collection of 
information, including any of the following subjects: (1) The necessity 
and utility of the proposed information collection for the proper 
performance of the agency's functions; (2) the associated time burden; 
(3) ways to enhance the quality, utility, and clarity of the 
information to be collected; and (4) the use of automated collection 
techniques or other forms of information technology to minimize the 
information collection burden. The meeting is open to the public, but 
attendance is limited to space available.

DATES: The Town Hall meeting will be held on Wednesday, March 16, 2004, 
from 1 p.m. to 4 p.m., e.s.t.

ADDRESSES: The Town Hall meeting will be held in the Multi-Purpose Room 
at the Centers for Medicare & Medicaid Services (CMS), 7500 Security 
Boulevard, Baltimore, Maryland 21244.

FOR FURTHER INFORMATION CONTACT: E. Joan Collins by phone at (410) 786-
4618, via e-mail at [email protected], or by fax at (410) 786-9963.

SUPPLEMENTARY INFORMATION: 

I. Background

    The Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) 
replaces the Skilled Nursing Facility (SNF) Notices Of Non-Coverage 
previously used for notification purposes. SNFs must also meet the 
advance beneficiary notice (ABN) Standards in Sec.  40.3 of chapter 30, 
Financial Liability Protections, of the IOM Pub. 100-4 at http://www.cms.hhs.gov/manuals/104_claims/clm104c30.pdf in completing and 
delivering SNFABNs.
    A SNFABN is a CMS-approved written notice that the SNF gives to a 
Medicare beneficiary, or to their authorized representative, before 
extended care services or items are furnished, reduced, or terminated 
when the SNF, the Utilization Review entity, the Quality Improvement 
Organization, or the Medicare contractor believes that Medicare will 
not pay for, or will not continue to pay for, extended care services 
that the SNF furnishes and that a physician ordered on the basis of one 
of the following statutory exclusions:
     Not reasonable and necessary (``medical necessity'') for 
the diagnosis or treatment of illness, injury, or to improve the 
functioning of a malformed body member--section 1862(a)(1) of the 
Social Security Act (the Act); or
     Custodial care (``not a covered level of care'')--section 
1862(a)(9) of the Act.

These exclusions provide the only statutory authority for application 
of the limitation on liability (LOL) provision at section 1879 of the 
Act to denied SNF claims.
    The SNFABN (CMS-10055 form) is for use with SNF Prospective Payment 
System services. This form satisfies the requirements under LOL for 
advance beneficiary notice and the beneficiary's agreement to pay. The 
use of any other notices or of modified SNFABNs may be ineffective in 
protecting users from liability. The SNFABN must be prepared with an 
original and at least one patient copy, a SNF copy containing the 
signature of the patient or authorized representative, an attending 
physician copy, and (when necessary) a Medicare contractor copy. SNFs 
may produce SNFABNs using self-carboning paper and other methods of 
producing copies, including photocopying, printing, and electronic 
generation, but they must conform to the Form CMS-10055 design.
    This Town Hall meeting is intended to provide a forum for all 
interested individuals to comment on and discuss the SNFABN. The SNFABN 
form and instructions may be reviewed prior to the public meeting by 
accessing http://www.cms.hhs.gov/medicare/bni on the Internet. This 
information is available for immediate review.

II. Meeting Format

    Registered persons from the public may discuss and make individual 
recommendations concerning the Skilled Nursing Facility Advance 
Beneficiary Notice. Individuals who wish to make formal presentations 
must include that information when registering. Presentations must be 
brief, and three written copies must be submitted to accompany the oral 
presentation. Presenters may also make copies available for 
approximately 70 meeting participants.

III. Registration Instructions

    Representatives of providers and suppliers furnishing skilled 
nursing facility services, health care consumer advocacy groups, and 
other members of the public who wish to participate in the public 
meeting are asked to notify us, in advance, of their interest in 
attending. Interested persons may register by providing notification to 
E. Joan Collins either by telephone at (410) 786-4618, fax at (410) 
786-9963, or by e-mail at [email protected]. Please submit the 
following information when registering: name, company name, address, 
telephone number, and e-mail address and an indication of whether you 
wish to make a formal presentation.
    Because this meeting will be located on Federal property, for 
security reasons, any persons wishing to attend this meeting must 
register by close of business on March 10, 2004. In order to gain 
access to the building and grounds, participants must show to the 
Federal Protective Service or guard service personnel government-issued 
photo identification and a copy of their registration confirmation. 
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.
    The on-site check-in for visitors will be held from 12 noon until 1 
p.m., followed by opening remarks. Please allow sufficient time to 
arrive to go through the security checkpoints. It is suggested that you 
arrive at 7500 Security Boulevard no later than 12 noon so that you 
will be able to arrive promptly at the meeting by 1 p.m. All items 
brought to us, whether personal or for the purpose of demonstration or 
to support a presentation, are subject to inspection.
    Individuals requiring sign language interpretation or other special 
accommodations must provide that information upon registering for the 
meeting.

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

    Dated: February 12, 2004.
Dennis G. Smith,
Acting Administrator, Centers for Medicare and Medicaid Services.
[FR Doc. 04-4275 Filed 2-26-04; 8:45 am]
BILLING CODE 4120-01-P