[Federal Register Volume 72, Number 164 (Friday, August 24, 2007)]
[Notices]
[Pages 48651-48652]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-16583]



[[Page 48651]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1481-N4]


Medicare Program; Emergency Medical Treatment and Labor Act 
(EMTALA) Technical Advisory Group (TAG) Meeting--September 17-18, 2007

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

ACTION: Notice of meeting.

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SUMMARY: This notice announces the seventh and final meeting of the 
Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory 
Group (TAG). In addition, this notice announces the selection of a new 
member of the EMTALA TAG. The purpose of the EMTALA TAG is to review 
regulations affecting hospital and physician responsibilities under 
EMTALA to individuals who come to a hospital seeking examination or 
treatment for medical conditions. The primary purpose of the seventh 
meeting is to enable the EMTALA TAG to hear additional testimony, to 
further consider written responses from medical societies and other 
organizations on specific issues considered by the TAG at previous 
meetings, and to finalize the recommendations for the Secretary. 
However, the public is permitted to attend this meeting and, to the 
extent that time permits and at the discretion of the Chairperson, the 
EMTALA TAG may hear comments from the floor.

DATES: Meeting Date: The meetings of the EMTALA TAG announced in this 
notice are to be held on the following dates:
    Monday, September 17, 2007, 9 a.m. to 5 p.m. EST.
    Tuesday, September 18, 2007, 9 a.m. to 5 p.m. EST.
    Registration Deadline: All individuals must register in order to 
attend this meeting. Individuals who wish to attend the meeting but do 
not wish to present testimony must register by September 10, 2007. 
Individuals who wish to attend the meeting and to present their 
testimony must register by August 27, 2007 and must submit copies of 
their testimony in writing by September 3, 2007. See section IV for 
more detailed registration instructions.
    Comment Deadline: Written comments/statements to be presented to 
the EMTALA TAG must be received by September 3, 2007.
    Special Accommodations: Individuals requiring sign-language 
interpretation or other special accommodations should send a request 
for these services to Eric Ruiz by 5 p.m. on September 3, 2007, at the 
address listed below.

ADDRESSES: Meeting Address: The EMTALA TAG meeting will be held in Room 
5051 of the Wilbur J. Cohen Building, 330 Independence Avenue, SW., 
Washington, DC 20201.
    Mailing and E-mail Addresses for Inquiries or Comments: Inquiries 
or comments regarding this meeting may be sent to--Eric Ruiz, Division 
of Acute Care, Centers for Medicare & Medicaid Services, Mail Stop C4-
08-06, 7500 Security Boulevard, Baltimore, MD 21244-1850. Inquiries or 
comments may also be e-mailed to [email protected] or 
[email protected].
    Web Site Address for Additional Information: For additional 
information on the EMTALA TAG meeting agenda topics, updated 
activities, and to obtain Charter copies, please go to our Internet Web 
site at (http://www.cms.hhs.gov/faca/07_emtalatag.asp).

FOR FURTHER INFORMATION CONTACT: Eric Ruiz (410) 786-0247. Renate 
Rockwell (410) 786-4645. Press inquiries are handled through the CMS 
Press Office at (202) 690-6145.

SUPPLEMENTARY INFORMATION:

I. Background

    Sections 1866(a)(1)(I), 1866(a)(1)(N), and 1867 of the Social 
Security Act (the Act) impose specific obligations on Medicare-
participating hospitals that offer emergency services. These 
obligations concern individuals who come to a hospital emergency 
department and request or have a request made on their behalf for 
examination or treatment for a medical condition. The Emergency Medical 
Treatment and Labor Act (EMTALA) applies to all these individuals, 
regardless of whether or not they are beneficiaries of any program 
under the Act. Section 1867 of the Act sets forth requirements for 
medical screening examinations for emergency medical conditions, as 
well as necessary stabilizing treatment or appropriate transfer.
    Regulations implementing the EMTALA legislation are set forth at 42 
CFR 489.20(l), (m), (q) and (r) and 489.24. Section 945 of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) 
(Pub. L. 108-173), mandates that the Secretary establish a Technical 
Advisory Group (TAG) for advice concerning issues related to EMTALA 
regulations and implementation.
    Section 945 of the MMA specifies that the EMTALA TAG--
     Shall review the EMTALA regulations;
     May provide advice and recommendations to the Secretary 
concerning these regulations and their application to hospitals and 
physicians;
     Shall solicit comments and recommendations from hospitals, 
physicians, and the public regarding implementation of such 
regulations; and
     May disseminate information concerning the application of 
these regulations to hospitals, physicians, and the public.
    The EMTALA TAG, as chartered under section 945 of the MMA, is also 
governed by the provisions of the Federal Advisory Committee Act (FACA) 
(5 U.S.C. Appendix 2) for the selection of members and the conduct of 
all meetings.
    In the May 28, 2004 Federal Register (69 FR 30654), we specified 
the statutory requirements regarding the charter, general 
responsibilities, and structure of the EMTALA TAG. That notice also 
solicited nominations for members based on the statutory requirements 
for the EMTALA TAG. In the August 27, 2004 Federal Register (69 FR 
52699), we solicited nominations again for members in two categories 
(patient representatives and a State survey agency representative) for 
which no nominations were received in response to the May 28, 2004 
Federal Register notice. Section 945(b) of the MMA specifies the 
composition of the TAG. (For more information regarding the TAG 
composition, see the May 28, 2004 Federal Register (69 FR 30655).
    In the March 15, 2005 Federal Register (70 FR 12691), we announced 
the inaugural meeting of the EMTALA TAG and the membership selection. 
In the May 18, 2005 Federal Register (70 FR 28541), the September 23, 
2005 Federal Register (70 FR 55903), the April 7, 2006 Federal Register 
(71 FR 17888), the September 29, 2006 Federal Register (71 FR 57543), 
and the March 23, 2007 Federal Register (72 FR 13803), we announced the 
second, third, fourth, fifth, and sixth meetings of the EMTALA TAG, 
respectively, with a purpose to hear public testimony and consider 
written responses from medical societies and other organizations on 
specific issues considered by the EMTALA TAG at its previous meetings. 
The EMTALA TAG has established the following three subcommittees:
     On-Call Subcommittee (Chairperson, John Kusske, M.D.) 
charged with reviewing the testimony and other materials provided to 
the TAG to identify some specific issues related to on-call 
requirements.

[[Page 48652]]

     Action Subcommittee (Chairperson, Julie Nelson, J.D.) 
charged with identifying issues other than on-call issues.
     Framework Subcommittee (Chairperson, Charlotte Yeh, M.D.) 
charged with clarifying the historical context and conceptual basis for 
the TAG's recommendations and developing a document for review and 
approval by the TAG.

II. Meeting Format, Agenda, and Presentation Topics

A. Meeting Format

    The initial portion of the meeting, which will convene at 9 a.m. on 
September 17, will involve opening remarks and will be followed by a 
limited period of public testimony on issues related to EMTALA and its 
implementation. TAG members will have the opportunity to ask questions, 
prioritize the topics presented, and to conduct other necessary 
business. At the conclusion of each day's meeting, to the extent that 
time is available and at the discretion of the Chairperson, the public 
will be permitted a reasonable time to comment on issues being 
considered by the TAG.

B. Tentative Meeting Agenda

    The tentative agenda for the EMTALA TAG meetings is as follows:
Day 1
    Convenes at 9 a.m.
     Welcome, Call to Order, and Opening Remarks
     Administrative and Housekeeping Issues
     Public Testimony on Issues Related to EMTALA and Its 
Implementation
     Subcommitte Reports
     Public Comment.
Day 2
    Convenes at 9 a.m.
     Subcommittee Reports (cont.)
     Public Comment.

C. Public Presentations

    Only individuals who register and submit written testimony as 
specified in the SECURITY INFORMATION section of this notice will be 
considered registered presenters. The time allotted for each 
presentation will be approximately 5 minutes and will be based on the 
number of registered presenters. Presenters will speak in their 
assigned order. If registered presenters are not given an opportunity 
to speak because of time restrictions, we will accept and present their 
written testimony to the TAG members. Comments from other participants 
(individuals who are not registered presenters) may be heard after the 
scheduled testimonies, if time permits.
    If there are individuals who cannot attend the meeting but wish to 
submit comments/statements regarding issues related to the EMTALA TAG, 
we will accept and present their written comments/statements at the 
meeting if their comments/statements are received by postal mail or 
email at the address listed in the ADDRESSES section of this notice by 
September 3, 2007.

III. Registration Instructions

    The Center for Medicare Management of CMS is coordinating meeting 
registration. While there is no registration fee, all individuals must 
register to attend due to limited seating. As specified in the DATES 
section of this notice, individuals who wish to attend the meeting but 
do not plan to present testimony must register by September 10, 2007. 
Individuals who would like both to attend and to present testimony on 
issues relating to the EMTALA TAG must register by August 27, 2007 and 
must state specifically in their registration request that they wish to 
present testimony for EMTALA TAG consideration. A copy of the 
presenter's written testimony must be received by CMS at the address 
specified in the ADDRESSES section of this notice by September 3, 2007.
    You may register by sending an e-mail to Marianne Myers at 
[email protected], by fax to the attention of Marianne Myers 
at (410) 786-0681, or by telephone at (410) 786-5962. All registration 
requests must include your name, name of the organization (if 
applicable), address, telephone and fax numbers, e-mail address (if 
available). Individuals will receive a registration confirmation with 
instructions for your arrival at the Wilbur J. Cohen Building. If 
seating capacity has been reached, registrants will be notified that 
the meeting has reached capacity. All registrants are asked to arrive 
at the Wilbur J. Cohen Building no later than 20 minutes before the 
scheduled starting time of each meeting session they wish to attend.

IV. Security Information

    Since this meeting will be held in a Federal government building, 
Federal security measures are applicable. As noted above, in planning 
your arrival time, we recommend allowing additional time to clear 
security. In order to gain access to the building, participants must 
bring a government-issued photo identification such as a driver's 
license or a passport and a copy of your registration information for 
the meeting. Access may be denied to persons without proper 
identification.
    All persons entering the building must pass through a metal 
detector. In addition, all items brought to CMS, whether personal or 
for the purpose of demonstration or to support a presentation, are 
subject to inspection. We cannot assume responsibility for coordinating 
the receipt, transfer, transport, storage, set-up, safety, or timely 
arrival of any personal belongings or items used for demonstration or 
to support a presentation.

V. Selection of New EMTALA TAG Member

    In the March 15, 2005 Federal Register (70 FR 12691), we announced 
the EMTALA TAG membership. One of those original members, a hospital 
representative, is unable to complete his term of service. In selecting 
a replacement, the TAG must maintain the member composition described 
in section 945(b) of the MMA. We note that section 945(b)(1) of the MMA 
specifies that: ``4 [members of the TAG] shall be representatives of 
hospitals.'' For this reason and to ensure that the concerns of 
hospitals are appropriately considered during TAG deliberations, 
another hospital representative has been selected to serve as a member 
of the TAG. The new member is Rachel Seifert of Community Health 
Systems in Franklin, Tennessee.

    Authority: Section 945 of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (MMA).

    Dated: August 16, 2007.
Herb Kuhn,
Administrator, Centers for Medicare & Medicaid Services.
 [FR Doc. E7-16583 Filed 8-23-07; 8:45 am]
BILLING CODE 4120-01-P