[Federal Register Volume 69, Number 54 (Friday, March 19, 2004)]
[Notices]
[Pages 13045-13046]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-6271]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: Open Door]


Agency Information Collection Activities: March 29, 2004 Special 
Open Door Listening Session--Proposed Collection--Comment Request for 
Federal Reimbursement of Emergency Health Services Furnished to 
Undocumented Aliens

AGENCY: Centers for Medicare and Medicaid Services, HHS.
    In support of the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid 
Services (CMS), Department of Health and Human Services, will be 
holding an open door listening session to solicit input from the public 
on the issues surrounding the implementation of recently enacted 
legislation on Federal reimbursement of Emergency Health Services 
Furnished to Undocumented Aliens.
    Interested persons are invited to provide input on the development 
of methods and procedures for implementing section 1011 of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003, 
regarding Federal reimbursement of emergency health services furnished 
to undocumented aliens. The primary topics for consideration are: How 
to obtain reliable information on the amount or volume of emergency 
services provided to undocumented aliens; how to ensure that the 
methods or procedures selected to implement this provision do not 
impose requirements on providers that are inconsistent with their 
EMTALA obligations; and, how to reliably determine or approximate 
individual hospitals', physicians', or ambulance providers' un-
reimbursed costs for providing emergency care for undocumented aliens 
without imposing costly and burdensome reporting and record-keeping 
requirements. The format of an Open Door Listening Session is such that 
there will not be an opportunity for CMS to directly respond to 
individual comments, testimony, or questions posed.

DATES: The open door listening session announced in this notice will be 
held on Monday, March 29, 2004, from 2 p.m. to 4 p.m., E.S.T. at the 
CMS Baltimore Central Site campus.

SUPPLEMENTARY INFORMATION: 

I. Background

    Section 1867 of the Social Security Act (EMTALA) requires a 
hospital that has an emergency department to provide appropriate 
medical screening to individuals who request examination or treatment 
to determine whether or not an emergency medical condition exists. If 
such a condition does exist, the hospital is required to stabilize the 
condition and/or provide an appropriate transfer, regardless of the 
individual's ability to pay for treatment.
    Undocumented aliens are frequently unable to pay for the EMTALA-
required care they receive from hospitals and associated physician and 
ambulance services
    Section 1011 of the Medicare Modernization Act (Pub. L. 108-173) 
provides $250 million per year for FY 2005-2008 for payments to 
eligible providers for emergency health services for undocumented 
aliens. Two-thirds of the funds will be divided among all 50 states 
(and the District of Columbia) based on their relative percentages of 
undocumented aliens. One-third will be divided among the six states 
with the largest number of undocumented alien apprehensions. The data 
used to identify these states will come from the Department of Homeland 
Security.
    The amounts of money set aside for each state will be paid directly 
to eligible providers. The Secretary must directly pay hospitals, 
physicians, and ambulance providers for the costs of providing 
emergency health care required under EMTALA and related hospital 
inpatient, outpatient, and ambulance services (including those operated 
by the Indian Health Service

[[Page 13046]]

and Indian Tribes and Tribal organizations) to undocumented aliens.
    Payments will be made quarterly and may be made based on advance 
estimates with retrospective adjustments. The Secretary must establish 
a process no later than September 1, 2004, for eligible providers to 
request payments. The process must include measures to ensure that the 
payments are not inappropriate, fraudulent, or excessive.
    CMS will hold this special open door listening session to gather 
your input related to the implementation of this new provision and to 
allow interested parties to hear and be heard by other members of the 
healthcare industry.
    The primary topics for consideration are: how to obtain reliable 
information on the amount or volume of emergency services provided to 
undocumented aliens; how to ensure that the methods or procedures used 
to implement this provision do not impose requirements on providers 
that are inconsistent with their EMTALA obligations; and, how to 
reliably approximate or determine individual hospitals', physicians' or 
ambulance providers' un-reimbursed costs on providing emergency care 
for undocumented aliens without imposing costly and burdensome 
reporting and record keeping requirements.

II. Participation

    We ask that all interested persons who wish to present their 
information prepare to speak within a restricted time limit that will 
depend upon the number of requests we receive by close of business 
Wednesday, March 24th, 2004 (see RSVP information below). Telephone 
call-in participants will be given an opportunity to speak as well, and 
if necessary will be under similar time limitations.
    CMS additionally requests that interested parties please prepare 
their comments or input in written form and submit this information to 
the same (RSVP) e-mail address as listed below. If not possible at the 
time of RSVP, we request that you bring a hard copy of your written 
material for collection at the meeting in Baltimore. There are two ways 
to participate, by phone or in-person.
    To participate by phone:
    Dial: 1-800-837-1935 & Reference Conference ID: 614131
    Persons participating by phone are not required to RSVP.


    Note: TTY Communications Relay Services are available for the 
Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and 
for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.


    To participate in-person at the CMS Baltimore Site, an RSVP is 
required.
    To register, please RSVP (by close of business Wednesday, March 24, 
2004) via e-mail to Section [email protected] if you plan to attend. 
Please include the word ``Registration'' in the subject line of your 
message, send us your name along with the name of your organization and 
contact information, and indicate whether or not you plan to speak.
    Please arrive no later than 1:30 p.m. Photo identification is 
required at security points.

ADDRESSES: CMS Single Site Building, Auditorium, 7500 Security 
Boulevard, Baltimore, MD 21244.
    Map & Directions: http://cmsnet.cms.hhs.gov/hpages/ocsq/cmsdirections-north.htm.

ENCORE: 1-800-642-1687; Conf. ID 614131

    ``Encore'' is a recording of this call that can be accessed by 
dialing 1-800-642-1687 and entering the Conf. ID beginning on March 30, 
2004. The recording expires after 4 days. For Forum Schedule updates, 
Listserv registration and Frequently Asked Questions please visit our 
Web site at http://www.cms.hhs.gov/opendoor/.

FOR FURTHER INFORMATION CONTACT: George Morey, (410) 786-4487, e-mail 
address Section [email protected] (include the word ``Question'' in the 
subject line of your message) or by fax (410) 786-9963.

    Dated: March 16, 2004.
John P. Burke, III,
Paperwork Reduction Act Team Leader, Office of Strategic Operations and 
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 04-6271 Filed 3-18-04; 8:45 am]
BILLING CODE 4120-03-P