[Federal Register Volume 69, Number 246 (Thursday, December 23, 2004)]
[Notices]
[Pages 76947-76949]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-27527]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5036-N]


Medicare Program; Solicitation for Proposals for the Cancer 
Prevention and Treatment Demonstration for Ethnic and Racial Minorities

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

ACTION: Notice.

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SUMMARY: This notice informs interested parties of an opportunity to 
apply for cooperative agreements to implement and operate demonstration 
projects under the Cancer Prevention and Treatment Demonstration for 
Ethnic and Racial Minorities as required by Section 122 of the 
Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act 
of 2000 (BIPA). In addition, this notice contains information on how to 
obtain the complete solicitation and supporting information.

DATES: Applications will be considered timely if we receive them on or 
before March 23, 2005.

ADDRESSES: Mail applications to--Centers for Medicare & Medicaid 
Services; Office of Operations Management, AGG, Cooperative Agreements 
Management Staff; Attention: Judith L. Norris; 7500 Security Boulevard, 
Mailstop C2-21-15; Baltimore, Maryland 21244-1850.
    Please refer to file code CMS-5036-N on the application. Because of 
staffing and resource limitations, we cannot accept applications by 
facsimile (FAX) transmission. Applications postmarked after the closing 
date, or postmarked on or before the closing date but not received in 
time for panel review, will be considered late applications.

FOR FURTHER INFORMATION CONTACT: Diane Merriman, CMS Project Officer, 
at (410) 786-7237 or [email protected]. General information regarding 
this initiative is available on the DHHS Web site at http://www.grants.gov.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 122(b) of the Medicare, Medicaid, and SCHIP Benefits 
Improvement and Protection Act of 2000 (BIPA) (Pub. L. 106-554) 
requires us to evaluate best practices in the private sector, community 
programs, and academic research to identify methods that reduce 
disparities among

[[Page 76948]]

individuals of ethnic and racial minority groups in the prevention and 
treatment of cancer.
    As specified in Sections 122(a) and (b) of BIPA, we are to design 
and implement at least nine demonstration projects in specific target 
populations for the purpose of developing models and evaluating methods 
that: (1) Improve the quality of items and services provided to target 
individuals in order to facilitate reduced disparities in early 
detection and treatment of cancer; (2) improve clinical outcomes, 
satisfaction, quality of life, and appropriate use of Medicare-covered 
services and referral patterns among those target individuals with 
cancer; (3) eliminate disparities in the rate of preventive cancer 
screening measures; and (4) promote collaboration with community-based 
organizations to ensure cultural competency of health care 
professionals and linguistic access for persons with limited English 
proficiency.
    Each of the following four legislatively-mandated target 
populations are required to be the subject of two separate 
demonstration projects: American Indians (including Alaskan Natives, 
Eskimos and Aleuts); Asian Americans and Pacific Islanders; Blacks; and 
Hispanics. At least one of the nine required demonstration projects 
must be implemented in a rural area, and one must be implemented in an 
inner-city area. In addition, one of the nine demonstration projects 
must be implemented in the Pacific Islands.
    If the initial demonstration evaluation indicates that these 
projects: (1) Reduce Medicare expenditures; or (2) do not increase 
Medicare expenditures, reduce ethnic and racial health disparities, and 
increase beneficiary and health care provider satisfaction, the 
existing demonstration projects will continue, and the number of 
demonstration projects may be expanded in the future.

II. Provisions of the Notice

    The purpose of this notice is to inform interested parties of an 
opportunity to apply for cooperative agreements to implement cancer 
prevention and treatment demonstration projects for ethnic and racial 
minorities.
    As specified in Section 122 of BIPA, we will award at least nine 
cooperative agreement demonstration projects that will identify methods 
to reduce disparities in early cancer screening, diagnosis, and 
treatment for Black, Hispanic, Asian American and Pacific Islander, and 
American Indian (including Alaskan Natives, Eskimos, and Aleuts) 
Medicare beneficiary populations. Award recipients are expected to use 
the best available scientific evidence to identify promising models of 
cancer screening, diagnosis and treatment interventions to promote 
health and the appropriate utilization of Medicare covered services, 
eliminate disparities in cancer detection and treatment among ethnic 
and racial populations of Medicare beneficiaries, and provide 
information to improve the effectiveness of the Medicare program.
    The Congress authorized the Cancer Prevention and Treatment 
Demonstration for Ethnic and Racial Minorities project for a 
potentially indefinite period of time, and appropriated $25 million in 
funding for the initial phase of the program. The demonstration 
projects will have a 3- to 5-year operation period. We will consider an 
award of up to $50,000 per demonstration project to cover initial 
implementation costs. The entire award will not be made initially but 
will be distributed incrementally between the time of conditional 
awards and the approval of the demonstration by the Office of 
Management and Budget (OMB). We also expect the costs of conducting 
these demonstration projects to range from $400,000 to $1.5 million per 
project per year. These costs will be reimbursed through capitation 
payment to the demonstration site. No State or local matching funds are 
required. Furthermore, we anticipate that projects will be awarded in 
mid-2005, and that project startup activities would begin immediately 
after completion of the waiver cost process (in late 2005).
    The facilitation activities to be funded under these demonstration 
projects will focus on three areas of potential cancer disparity 
reduction: screening, diagnosis, and treatment. The applicant will 
provide facilitation services for two populations: (1) Medicare 
beneficiaries belonging to a defined ethnic or racial minority group 
who do not have a current diagnosis of cancer before enrollment in the 
demonstration project; and (2) Medicare beneficiaries belonging to a 
defined ethnic or racial minority who have been diagnosed with cancer 
before enrollment in the demonstration project.
    For the first population, the applicant must propose strategies for 
improving outcomes for cancers of the breast, cervix, colon and/or 
rectum, and prostate through facilitation of: (1) Cancer screening 
services; (2) follow-up of abnormal findings and diagnosis; and (3) 
improved access to and follow-up of treatment and adjuvant treatment 
services. For the second population, the applicant must propose 
facilitation strategies to improve access to and follow-up of treatment 
and adjuvant treatment services for confirmed diagnosis of at least one 
of the demonstration-specified cancers and/or lung cancer.
    Potentially qualified applicants include, but are not limited to: 
Disease management organizations; health insurers; physician group 
practices; coordinated care services providers; provider-sponsored 
organizations; academic medical centers; comprehensive cancer centers; 
special population networks; community clinical oncology programs; 
community-based health organizations; community health centers; 
federally qualified health centers; minority institutions such as, 
among others, Historically Black Colleges and Universities, Hispanic 
Serving Institutions, and Hispanic health organizations and 
associations; tribal organizations; a consortium of the above entities; 
or any other legal entity that the Secretary determines to be 
appropriate. We strongly encourage the establishment of collaborative 
consortia for this demonstration. The applicant must demonstrate its 
ability to effectively deliver cancer screening, diagnosis, and 
treatment facilitation services on a capitation basis to one or more of 
the following populations: Black, Hispanic, Asian American and Pacific 
Islander, and American Indian (including Alaskan Natives, Eskimos, and 
Aleuts) Medicare beneficiaries. Interested parties are to obtain 
complete solicitation and supporting information on the DHHS Web site 
at http://www.grants.gov.

III. Collection of Information Requirements

    The application associated with this demonstration entitled 
``Medicare Waiver Demonstration Application'' is currently approved 
under OMB approval number 0938-0880, with a current expiration date of 
July 31, 2006.
    In addition, the collection requirements associated with this 
demonstration do not impose information collection and record keeping 
requirements, because they meet the ``information'' definition 
exception under 5 CFR 1320.3(h)(5) which states: `` `Information' does 
not generally include items in the following categories: (5) facts or 
opinions obtained initially or in follow-on requests, from individuals 
(including individuals in control groups) under treatment or clinical 
examination in connection with research on or prophylaxis to prevent a 
clinical disorder, direct treatment of that disorder, or the 
interpretation of biological analyses of body fluids, tissues, or other 
specimens, or the

[[Page 76949]]

identification or classification of such specimens. * * *''

    Authority: Section 122 of the Medicare, Medicaid, and SCHIP 
Benefits Improvement and Protection Act of 2000 (BIPA) (Pub. L. 106-
554).

(Catalog of Federal Domestic Assistance Program No. 93.779, Medical 
Assistance Program; No. 93.773, Medicare--Hospital Insurance 
Program; and No. 93.774, Medicare--Supplementary Medical Insurance 
Program)

    Dated: September 15, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-27527 Filed 12-14-04; 8:45 am]
BILLING CODE 4120-01-P