[Federal Register Volume 69, Number 106 (Wednesday, June 2, 2004)]
[Notices]
[Pages 31123-31124]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-12421]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5033-N]


Medicare Program; Establishment of the Advisory Board on the 
Demonstration of a Bundled Case-Mix Adjusted Payment System for End 
Stage Renal Disease Services and Request for Nominations for Members

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

ACTION: Notice.

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SUMMARY: This notice announces the establishment of the Advisory Board 
on the Demonstration of a Bundled Case-Mix Adjusted Payment System for 
End Stage Renal Disease (ESRD) Services and discusses the group's 
purpose and charter. It also solicits nominations for members.

DATES: Nominations for membership will be considered if they are 
received by July 2, 2004.

ADDRESSES: Send nominations and written requests for copies of the 
Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted 
Payment System for ESRD Services Charter to--

Centers for Medicare & Medicaid Services, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.
Medicare Demonstrations Program Group, Mail stop C4-17-27, Attention: 
Pamela Kelly.

[[Page 31124]]


FOR FURTHER INFORMATION CONTACT: [email protected] or 
Pamela Kelly, (410) 786-2461.
    Press inquiries are handled through the CMS Press Office at (202) 
690-6145.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 623(e) of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (MMA) (Pub. L. 108-173) requires us to 
establish a demonstration project of the use of a fully case-mix 
adjusted payment system for end stage renal disease (ESRD) services 
under section 1881 of the Social Security Act (42 U.S.C. 1395rr) for 
patient characteristics. Section 623(f) of the MMA requires the patient 
characteristics to be identified in a Report to Congress on a bundled 
prospective payment system for ESRD Services by October 1, 2005. The 
payment rates will bundle amounts for drugs and biologicals, including 
erythropoietin, which are separately billed by ESRD facilities, from 
the date of enactment of MMA, December 8, 2003, and clinical laboratory 
tests related to these drugs and biologicals.
    Section 623(e) of MMA also requires us to establish an Advisory 
Board to provide advice and recommendations with respect to the 
establishment and operation of this demonstration project.

II. Charter, General Responsibilities, and Composition of the Advisory 
Board on the Demonstration of a Bundled Case-Mix Adjusted Payment 
System for ESRD Services

A. Charter Information and General Responsibilities

    On May 11, 2004, the Secretary signed the charter establishing the 
Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted 
Payment System for ESRD Services. The MMA provides that the Advisory 
Board will terminate on December 31, 2008. The Advisory Board, as 
chartered under the legal authority of section 623(e) of the MMA, is 
also governed by the provisions of the Federal Advisory Committee Act 
(FACA), 5 U.S.C. Appendix 2, section 10(a) (Pub. L. 92-463).
    You may obtain a copy of the Secretary's charter for the Advisory 
Board on the Demonstration of a Bundled Case-Mix Adjusted Payment 
System for ESRD Services from http://www.cms.hhs.gov/faca/stcomm.asp on 
the day this notice is published or by mailing a written request to the 
address specified in the ADDRESSES section of this notice.
    As specified in the charter, before implementation of the 
demonstration, the Advisory Board will study and make recommendations 
on the following issues:
     The drugs, biologicals, and clinical laboratory tests to 
be bundled into the demonstration payment rates.
     The method and approach to be used for the patient 
characteristics to be included in the fully case-mix adjusted 
demonstration payment system.
     The manner in which payment for bundled services provided 
by non-demonstration providers should be handled for beneficiaries 
participating in the demonstration.
     The feasibility of providing financial incentives and 
penalties to plans operating under the demonstration that meet or fail 
to meet applicable quality standards.
     The specific quality standards to be used.
     The feasibility of using disease management techniques to 
improve quality and patient satisfaction and reduce costs of care for 
the beneficiaries participating in the demonstration.
     The selection criteria for demonstration organizations.
    Upon implementation of the demonstration, the Advisory Board will 
continue to advise the Secretary and the Administrator on the operation 
of the demonstration.

B. Composition of the Advisory Board on the Demonstration of a Bundled 
Case-Mix Adjusted Payment System for ESRD Services

    Section 623(e) of MMA specifies the composition of the Advisory 
Board on the Demonstration of a Bundled Case-Mix Adjusted Payment 
System for ESRD Services. It states that the Advisory Board will be 
composed of representatives of the following:
     Patient organizations.
     Individuals with expertise in ESRD dialysis services, such 
as clinicians, economists, and researchers.
     The Medicare Payment Advisory Commission, established 
under section 1805 of the Social Security Act (42 U.S.C. 1395b-6).
     The National Institutes of Health.
     Network Organizations under section 1881(c) of the Social 
Security Act (42 U.S.C. 1395rr(c)).
     Medicare contractors to monitor quality of care.
     Providers of services and renal dialysis facilities 
furnishing ESRD services.
     The charter specifies there will be 11 members on the 
Advisory Board.

III. Submission of Nominations

    We are requesting nominations for membership on the Advisory Board 
on the Demonstration of a Bundled Case-Mix Adjusted Payment System for 
ESRD Services. We will consider qualified individuals who are self-
nominated or are nominated by organizations representing patients and 
providers when we select these representatives. The Secretary will 
appoint members to serve on the Advisory Board from among those 
candidates that we determine have the technical expertise to meet 
specific agency needs in a manner to ensure an appropriate balance of 
membership.
    Any interested person may nominate one or more qualified 
individuals for each of the categories listed in section II.B. of this 
notice. Each nomination must include the following information:
    1. A letter of nomination that contains contact information for 
both the nominator and nominee (if not the same).
    2. A statement from the nominee that he or she is willing to serve 
on the Advisory Board for its duration (that is, through December 31, 
2008) and an explanation of the nominee's interest in serving on the 
Advisory Board. The nominee should also indicate whether he or she 
would be willing to serve as the chair of the Advisory Board. (For 
self-nominations, this information may be included in the nomination 
letter.)
    3. A curriculum vitae that indicates the nominee's educational and 
ESRD-related experiences.
    4. Two letters of reference that support the nominee's 
qualifications for participation on the Advisory Board. (For 
nominations other than self-nominations, a nomination letter that 
includes information supporting the nominee's qualifications may be 
counted as one of the letters of reference.)
    To ensure that a nomination is considered, we must receive all of 
the nomination information specified in section III of this notice by 
July 2, 2004. Nominations should be mailed to the address specified in 
the ADDRESSES section of this notice.

    Authority: Section 623(e) of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (MMA). (Catalog of 
Federal Domestic Assistance Program No. No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: May 26, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-12421 Filed 5-28-04; 8:45 am]
BILLING CODE 4120-01-P