[Federal Register Volume 69, Number 250 (Thursday, December 30, 2004)]
[Notices]
[Pages 78464-78466]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-28151]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1285-N]


Medicare Program: Meeting of the Advisory Panel on Ambulatory 
Payment Classification (APC) Groups (Panel)--February 23, 24, and 25, 
2005, and Re-chartering of APC Panel on November 8, 2004

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (DHHS).

ACTION: Notice of meeting and re-chartering of Panel.

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SUMMARY: In accordance with section 10(a) of the Federal Advisory 
Committee Act (FACA) (5 U.S.C. Appendix 2), this notice announces the 
first biannual meeting of the Ambulatory Payment Classification (APC) 
Panel for 2005.
    The purpose of the Panel is to review the APC groups and their 
associated weights and to advise the Secretary of the Department of 
Health and Human Services and the Administrator of the Centers for 
Medicare and Medicaid Services concerning the clinical integrity of the 
APC groups and their associated weights. The advice provided by the 
Panel will be considered as CMS prepares its annual updates of the

[[Page 78465]]

hospital Outpatient Prospective Payment System (OPPS) through 
rulemaking.

DATES: Meeting Dates: The first biannual meeting for 2005 is scheduled 
for the following dates and times:
     Wednesday, February 23, 2005, 1 p.m. to 5 p.m. (e.s.t.)
     Thursday, February 24, 2005, 8 a.m. to 5 p.m. (e.s.t.)
     Friday, February 25, 2005, 8 a.m. to 12 noon (e.s.t.)

DEADLINES: 

Deadline for Hardcopy Comments/Suggested Agenda Topics--

     5 p.m. (e.s.t.), Wednesday, January 26, 2005

Deadline for Hardcopy Presentations--

     5 p.m. (e.s.t.), Wednesday, January 26, 2005

Deadline for Attendance Registration--

     5 p.m. (e.s.t.), Wednesday, February 9, 2005.

Deadline for Special Accommodations--

     5 p.m. (e.s.t.), Wednesday, February 9, 2005.

Submittal of Materials to the Designated Federal Officer (DFO): Because 
of staffing and resource limitations, we cannot accept written comments 
and presentations by FAX, nor can we print written comments and 
presentations received electronically for dissemination at the meeting.
    Only hardcopy comments and presentations will be accepted for 
placement in the meeting booklets. All hardcopy presentations must be 
accompanied by Form CMS-20017. The form is now available through the 
CMS Forms Web site. The URL for linking to this form is (http://www.cms.hhs.gov/forms/cms20017.pdf.)
    We are also requiring electronic versions of the written comments 
and presentations (in addition to the hardcopies), so we can send them 
to the Panel members for their review prior to the meeting.
    You must send BOTH electronic and hardcopy versions of your 
presentations and written comments by the prescribed deadlines. 
(Electronic transmission must be sent to the e-mail address, and 
hardcopies (accompanied by Form CMS-20017) must be mailed to the 
Designated Federal Officer [DFO], as specified in the FOR FURTHER 
INFORMATION CONTACT section of this notice.)

ADDRESS: The meeting will be held in the Multipurpose Room, 1st Floor, 
at the CMS Central Office, 7500 Security Boulevard, Baltimore, Maryland 
21244-1850.

FOR FURTHER INFORMATION CONTACT: For inquiries regarding the meeting; 
meeting registration; and hardcopy submissions of oral presentations, 
agenda items, and comments, please contact the DFO: Shirl Ackerman-
Ross, DFO, CMS, CMM, HAPG, DOC, 7500 Security Boulevard, Mail Stop C4-
05-17, Baltimore, MD 21244-1850. Phone (410) 786-4474.
     E-mail Address for comments, presentations, and 
registration requests [email protected]
     News media representatives must contact our Public Affairs 
Office at (202) 690-6145.

Advisory Committees' Information Lines:
    The CMS Advisory Committees' Information Line is 1-877-449-5659 
(toll free) and (410) 786-9379 (local).

Web Sites:
     For additional information on the APC meeting agenda 
topics and updates to the Panel's activities, search our Web site at: 
http://www.cms.hhs.gov/faca/apc/default.asp.
     To obtain Charter copies, search our Web site at http://www.cms.hhs.gov/faca or e-mail the Panel DFO.

SUPPLEMENTARY INFORMATION:

I. Background

    The Secretary is required by section 1833(t)(9)(A) of the Act, as 
amended and redesignated by sections 201(h) and 202(a)(2) of the 
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 
(BBRA) (Pub. L. 106-113), respectively, to establish and consult with 
an expert, outside advisory panel on APC groups. The Panel meets up to 
three times annually to review the APC groups and to provide technical 
advice to the Secretary and the Administrator concerning the clinical 
integrity of the groups and their associated weights. All members must 
have technical expertise that shall enable them to participate fully in 
the work of the Panel. Such expertise encompasses hospital payment 
systems, hospital medical-care delivery systems, outpatient payment 
requirements, APCs, Physicians' Current Procedural Terminology Codes 
(CPTs), the use and payment of drugs and medical devices in the 
outpatient setting, and other forms of relevant expertise. It is not 
necessary that any member be an expert on all areas.
    We will consider the technical advice provided by the Panel as we 
prepare the proposed rule that proposes changes to the OPPS for the 
next calendar year. The Secretary recently re-chartered the Panel on 
November 8, 2004.
    The Panel may consist of up to 15 representatives who are full-time 
employees (not consultants) of Medicare providers, which are subject to 
the OPPS, and a Chair.
    The Administrator selected the Panel membership based upon either 
self-nominations or nominations submitted by providers or interested 
organizations. The Panel presently consists of the following members 
and a Chair:
     Edith Hambrick, M.D., J.D., Chair
     Marilyn Bedell, M.S., R.N., O.C.N.
     Albert Brooks Einstein, Jr., M.D.
     Lee H. Hilborne, M.D., M.P.H.
     Stephen T. House, M.D.
     Kathleen Kinslow, C.R.N.A., Ed.D.
     Mike Metro, R.N., B.S.
     Sandra J. Metzler, M.B.A., R.H.I.A., C.P.H.Q.
     Gerald V. Naccarelli, M.D.
     Frank G. Opelka, M.D., F.A.C.S.
     Louis Potters, M.D., F.A.C.R.*
     Lou Ann Schraffenberger, M.B.A., R.H.I.A., C.C.S.-P.
     Judie S. Snipes, R.N., M.B.A., C.H.E.*
     Lynn R. Tomascik, R.N., M.S.N., C.N.A.A.
     Timothy Gene Tyler, Pharm.D.
     William Van Decker, M.D.
    (*New member as of 10/1/2004)

II. Agenda

    The agenda for the February 2005 meeting will provide for 
discussion and comment on the following topics as designated in the 
Panel's Charter:
     Reconfiguration of APCs (for example, splitting of APCs, 
moving Healthcare Common Procedure Coding System (HCPCS) codes from one 
APC to another and moving HCPCS codes from new technology APCs to 
clinical APCs).
     Evaluation of APC weights.
     Packaging devices and drug costs into APCs: Methodology, 
effect on APCs, and need for reconfiguring APCs based upon device and 
drug packaging.
     Removal of procedures from the inpatient list for payment 
under the OPPS.
     Use of single and multiple procedure claims data.
     Packaging of HCPCS codes.
     Other technical issues concerning APC structure.

III. Written Comments and Suggested Agenda Topics

    Hardcopy written comments and suggested agenda topics should be 
sent to the DFO. Such items must be received by the DFO 5 p.m. 
(e.s.t.), Wednesday, January 26, 2005.
    Additionally, the written comments and suggested agenda topics must 
fall within the subject categories outlined in the Panel's Charter 
listed in the Agenda section of this notice.

[[Page 78466]]

IV. Oral Presentations

    Individuals or organizations wishing to make 5-minute oral 
presentations must contact the DFO. The DFO must receive hardcopy 
presentations by 5 p.m. (e.s.t.), on Wednesday, January 26, 2005, in 
order to be scheduled.
    The number of oral presentations may be limited by the time 
available. Oral presentations should not exceed 5 minutes in length.
    The Chair may further limit time allowed for presentations due to 
the number of oral presentations, if necessary.

V. Presenter and Presentation Criteria

    The additional criteria below must be supplied to the DFO by the 
January 26, 2005 deadline (along with hardcopies of presentations).
     Required personal information regarding presenter(s):
    + Name of presenter(s);
    + Title(s);
    + Organizational affiliation;
    + Address;
    + E-mail address, and
    + Telephone number(s).
     All presentations must contain, at a minimum, the 
following supporting information and data:
    + Financial relationship(s) of presenter(s), if any, with any 
company whose products, services, or procedures that are under 
consideration;
    + Physicians' Current Procedural Terminology (CPT) codes involved;
    + APC(s) affected;
    + Description of the issue(s);
    + Clinical description of the service under discussion (with 
comparison to other services within the APC);
    + Recommendations and rationale for change;
    + Expected outcome of change; and
    + Potential consequences of not making the change(s).

VI. Oral Comments

    In addition to formal oral presentations, there will be opportunity 
during the meeting for public oral comments that will be limited to 1 
minute for each individual and a total of 5 minutes per organization.

VII. Meeting Attendance

    The meeting is open to the public; however, attendance is limited 
to space available. Attendance will be determined on a first-come, 
first-served basis.
    Persons wishing to attend this meeting, which is located on Federal 
property, must call or e-mail the Panel DFO to register in advance no 
later than 5 p.m. (e.s.t.), Wednesday, February 9, 2005.
    The following information must be e-mailed or telephoned to the DFO 
by the date and time above:
     Name(s) of attendee(s);
     Title(s);
     Organization;
     E-mail address(es); and
     Telephone number(s).

VIII. Security, Building, and Parking Guidelines

    Persons attending the meeting must present photographic 
identification to the Federal Protective Service or Guard Service 
personnel before they will be allowed to enter the building.
    Individuals who are not registered in advance will not be permitted 
to enter the building and will be unable to attend the meeting. The 
public may not enter the building earlier than 30-45 minutes prior to 
the convening of the meeting each day. (Please note that the meeting on 
Wednesday, February 23, 2005 does not convene until 1 p.m.)
    All visitors must be escorted in areas other than the lower and 
first-floor levels in the Central Building.
    Parking permits and instructions are issued upon arrival by the 
guards at the main entrance.

IX. Special Accommodations

    Individuals requiring sign-language interpretation or other special 
accommodations must send a request for these services to the DFO by 5 
p.m. (e.s.t.), Wednesday, February 9, 2005.

    Authority: Section 1833(t) of the Act (42 U.S.C. 1395l(t), as 
amended by section 201(h) of the BBRA of 1999 (Pub. L. 106-113). The 
Panel is governed by the provisions of Pub. L. 92-463, as amended (5 
U.S.C. Appendix 2).

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


    Dated: December 9, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-28151 Filed 12-29-04; 8:45 am]
BILLING CODE 4120-01-P