[Federal Register Volume 70, Number 246 (Friday, December 23, 2005)]
[Notices]
[Pages 76313-76315]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-24290]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1289-N]


Medicare Program: Meeting of the Advisory Panel on Ambulatory 
Payment Classification (APC) Groups--March 1, 2, and 3, 2006

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

ACTION: Notice.

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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 (the Panel) for 2006.
    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 (HHS) and the Administrator of the Centers 
for Medicare & Medicaid Services (CMS) 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 hospital Outpatient Prospective Payment System (OPPS) 
through rulemaking.

DATES: Meeting Dates: The first biannual meeting for 2006 is scheduled 
for the following dates and times:
     Wednesday, March 1, 2006, 1 p.m. to 5 p.m. (e.s.t.).
     Thursday, March 2, 2006, 8 a.m. to 5 p.m. (e.s.t.).
     Friday, March 3, 2006, 8 a.m. to 12 noon (e.s.t.).
    Deadlines:
    Deadline for Hardcopy Comments/Suggested Agenda Topics--
    5 p.m. (e.s.t.), Wednesday, February 1, 2006.
    Deadline for Hardcopy Presentations--
    5 p.m. (e.s.t.), Wednesday, February 1, 2006.
    Deadline for Attendance Registration--
    5 p.m. (e.s.t.), Wednesday, February 8, 2006.
    Deadline for Special Accommodations--
    5 p.m. (e.s.t.), Wednesday, February 8, 2006.
    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 
electronically to the Panel members for their review before the 
meeting.
    Consequently, 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 below, 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.)

ADDRESSES: The meeting will be held in the Multipurpose Room, 1st 
Floor, 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 is [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 Ambulatory Payment Classification 
(APC) groups. The APC Panel (the Panel), which was re-chartered by the 
Secretary on November 1, 2004, 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

[[Page 76314]]

work of the Panel. Such expertise encompasses hospital payment systems, 
hospital medical-care delivery systems, outpatient payment 
requirements, APCs, Current Procedural Terminology (CPT) codes, and the 
use and payment of drugs and medical devices in the outpatient setting, 
as well as other forms of relevant expertise. However, it is not 
necessary that any one member be an expert in all of the areas listed 
above. All members shall have a minimum of 5 years experience in their 
areas of expertise, and they must be currently employed full-time in 
their areas of expertise. For purposes of this Panel, consultants or 
independent contractors are not considered to be full-time employees.
    We will consider the technical advice provided by the Panel as we 
prepare the proposed changes to the OPPS for the next calendar year.
    The Panel may consist of a Chair and up to 15 representatives who 
are full-time employees (not consultants) of Medicare providers, which 
are subject to the OPPS.
    The Administrator selects 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.
     Gloryanne Bryant, B.S., R.H.I.A., R.H.I.T., C.C.S.
     Albert Brooks Einstein, Jr., M.D.
     Hazel Kimmel, R.N., C.C.S., C.P.C.
     Sandra J. Metzler, M.B.A., R.H.I.A., C.P.H.Q.
     Thomas M. Munger, M.D., F.A.C.C.
     Frank G. Opelka, M.D., F.A.C.S.
     Louis Potters, M.D., F.A.C.R.
     James V. Rawson, M.D.
     Lou Ann Schraffenberger, M.B.A., R.H.I.A., C.C.S.-P.
     Judie S. Snipes, R.N., M.B.A., F.A.C.H.E.
     Lynn R. Tomascik, R.N., M.S.N., C.N.A.A.
     Timothy Gene Tyler, Pharm.D.
     Kim Allan Williams, M.D., F.A.C.C., F.A.B.C.
     Robert Matthew Zwolak, M.D., Ph.D., F.A.C.S.

II. Agenda

    The agenda for the March 2006 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.
    The subject matter before the Panel shall be limited to these and 
related topics. Unrelated topics are not subjects for discussion. 
Unrelated topics include, but are not limited to, the conversion 
factor, cost compression, pass-through payments for medical devices and 
drugs, and wage adjustments. These subjects will not be addressed by 
the Panel.
    The Panel may use data collected or developed by entities and 
organizations, other than DHHS and CMS, in conducting its review.

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 date and time 
specified in the DATES section of this notice.
    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.

IV. Oral Presentations

    Individuals or organizations wishing to make 5-minute oral 
presentations must contact the DFO. The DFO must receive hardcopy 
presentations by the date and time specified in the DATES section of 
this notice 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 
date specified in the DATES section of this notice (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' CPTs 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).


    Note: All presenters must also submit Form CMS-20017.

VI. Oral Comments

    In addition to formal oral presentations, there will be opportunity 
during the meeting for public oral comments, which 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 e-mail the Panel DFO to register by the date and time 
specified in the DATES section of this notice. A confirmation will be 
sent to the requester(s) via return e-mail.
    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.
    Security measures will include inspection of vehicles, inside and 
out, at the entrance to the grounds. In addition, all persons entering 
the building must pass through a metal detector. All items brought to 
CMS, including personal items such as desktops, cell phones,

[[Page 76315]]

palm pilots, etc., are subject to physical inspection.
    Individuals who are not registered in advance will not be permitted 
to enter the building and will be unable to attend the meeting. (Note: 
Presenters must also be registered for attendance at the meeting.) The 
public may enter the building 30-45 minutes before when the meeting 
convenes each day. (The meeting convenes at the date and time specified 
in the DATES section of this notice.)
    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 the 
date and time specified in the DATES section of this notice.

    Authority: Section 1833(t)(9) of the Act (42 U.S.C. 13951(t)). 
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: November 10, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 05-24290 Filed 12-22-05; 8:45 am]
BILLING CODE 4120-01-P