[Federal Register Volume 73, Number 211 (Thursday, October 30, 2008)]
[Notices]
[Pages 64618-64619]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-25833]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1422-N]


Medicare Program; Listening Session on Hospital-Acquired 
Conditions in Inpatient Settings and Hospital Outpatient Healthcare-
Associated Conditions in Outpatient Settings, December 18, 2008

AGENCY: Centers for Medicare & Medicaid Services (CMS) and Centers for 
Disease Control and Prevention (CDC), HHS.

ACTION: Notice of meeting.

-----------------------------------------------------------------------

SUMMARY: This notice announces a listening session being conducted by 
the Centers for Medicare & Medicaid Services and Centers for Disease 
Control and Prevention to solicit informal comments on hospital-
acquired conditions (HACs) and hospital outpatient healthcare-
associated conditions (HOP-HACs) in preparation for the fiscal year 
(FY) 2010 inpatient prospective payment systems (IPPS) and calendar 
year (CY) 2010 outpatient prospective payment system (OPPS) rulemaking 
processes. Hospitals, hospital associations, representatives of 
consumer purchasers, payors of health care services, and other 
interested parties are invited to attend and make comments in person or 
in writing. It will also be possible to listen to the session by 
teleconference. Verbal comments will be taken from telephone 
participants as time permits. This meeting is open to the public, but 
registration is required. Further information regarding this listening 
session will be posted on the HAC section of the CMS Web site at http://www.cms.hhs.gov/HospitalAcqCond/01_Overview.asp and the OPPS section 
of the CMS Web site at http://www.cms.hhs.gov/hospitaloutpatientpps/.

DATES: Meeting Date: The listening session will be held on Thursday, 
December 18, 2008 from 10 a.m. e.s.t. until 5 p.m. e.s.t.
    Deadline for Meeting Registration and Submitting Requests for 
Special Accommodations Registration must be completed no later than 5 
p.m. e.s.t. Thursday, December 11, 2008. Requests for special 
accommodations must be received no later than 5 p.m. e.s.t. Thursday, 
December 11, 2008.
    Deadline for Submission of Written Comments or Statements: Written 
comments may be sent electronically to the address specified in the 
ADDRESSES section of this notice and must be received by 5 p.m. e.s.t. 
on Wednesday, December 31, 2008.

ADDRESSES: Meeting Location: The meeting will be held in the main 
auditorium of the Central Building of the Centers for Medicare & 
Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244-1850.
    Registration and Special Accommodations: Persons interested in 
attending the meeting or listening by teleconference must register by 
completing the on-line registration at http://registration.intercall.com/go/cms2. Individuals who need special 
accommodations should contact Karen Jackson via phone on (410) 786-0079 
or via e-mail at [email protected].
    Written Comments or Statements: Written comments may be sent by e-
mail to [email protected] or via mail to Karen Jackson, Centers for 
Medicare & Medicaid Services, Mailstop C5-15-02, 7500 Security 
Boulevard, Baltimore, MD 21244-1850.

FOR FURTHER INFORMATION CONTACT: Karen Jackson, (410) 786-0079 or via 
e-mail at [email protected]. Press inquiries are handled through the 
CMS Press Office at 202-690-6145.

[[Page 64619]]

I. Background

    Section 1886(d)(4)(D) of the Social Security Act (the Act) requires 
the Secretary to select, by October 1, 2007, at least two conditions 
that: (1) Are high cost or high volume or both; (2) result in the 
assignment of a case to a Medicare Severity Diagnosis-Related Group 
(MS-DRG) that has a higher payment when present as a secondary 
diagnosis; and (3) could reasonably have been prevented through the 
application of evidence-based guidelines.
    For discharges occurring on or after October 1, 2008, hospitals 
will not receive additional payment for cases in which one of the 
selected conditions occurring during hospitalization was not present on 
admission. That is, the case would be paid as though the secondary 
diagnosis was not present. Section 1886(d)(4)(D) of the Act provides 
that we can revise the list of conditions from time to time, as long as 
it contains at least two conditions.
    We have discussed the selection of hospital-acquired conditions 
(HAC) in the inpatient prospective payment systems (IPPS) fiscal year 
(FY) 2007 (71 FR 23996 and 71 FR 47870), FY 2008 (72 FR 24680 and 72 FR 
47130), and FY 2009 (73 FR 23528 and 73 FR 48434) proposed and final 
rules, respectively. For discharges occurring on or after October 1, 
2008, hospitals will not receive additional payment for cases in which 
one of the selected conditions occurring during hospitalization was not 
present on admission. That is, the case would be paid as though the 
secondary diagnosis was not present. Section 1886(d)(4)(D) of the Act 
provides that we can revise the list of conditions from time to time, 
as long as it contains at least two conditions. In addition, we 
discussed the expansion of the principles behind the hospital 
outpatient healthcare-associated conditions (HOP-HACs) payment 
provision in the outpatient prospective payment systems (OPPS) calendar 
year (CY) 2009 proposed rule (73 FR 41416).

II. Listening Session Format

    This listening session is being held as a joint partnership between 
the Centers for Medicare and Medicaid Services (CMS) and the Centers 
for Disease Control and Prevention (CDC). The listening session will 
begin at 10 a.m. e.s.t. with an overview of the objectives for the 
session. A brief overview regarding the implementation strategy for 
selecting the IPPS HAC's will then be presented. Next, we will present 
a review of the regulatory language included in the FY 2009 IPPS final 
rule followed by a public comment session. There will be a lunch break 
from approximately 12:30 p.m. e.s.t. to 1:30 p.m. e.s.t. Following 
lunch, we will review the CY 2009 OPPS final rule that discussed the 
expansion of the principles behind the HOP-HACs payment provision to 
the outpatient setting. An additional public comment period will follow 
the afternoon presentations. The meeting will conclude by 5 p.m. e.s.t.
    We note that, due to time constraints, telephone participants will 
be allowed to make verbal comments during the meeting as time permits. 
We also note that any interested party, irrespective of participation 
at the listening session, may submit written comments to the address 
listed in the ADDRESSES section by the date specified in the DATES 
section of this notice.

III. Registration Instructions

    For security reasons, space limitations, and limited availability 
of teleconference lines, any persons wishing to attend this meeting or 
listen via teleconference must register by the date listed in the DATES 
section of this notice. Persons interested in attending the meeting or 
listening by teleconference must register by completing the on-line 
registration located at http://registration.intercall.com/go/cms2. The 
on-line registration system will generate a confirmation page to 
indicate the completion of your registration. Please print this page as 
your registration receipt.
    The number of call-in lines will be limited for individuals 
participating in the listening session by teleconference. The call-in 
number will be provided upon confirmation of registration.
    An audio download of the listening session will be available 
through the CMS Hospital-Acquired Conditions Web site at http://www.cms.hhs.gov/HospitalAcqCond/01_Overview.asp after the listening 
session.

IV. Security, Building, and Parking Guidelines

    This meeting will be held in a Federal government building; 
therefore, Federal security measures are applicable. In planning your 
arrival time, we recommend allowing additional time to clear security. 
The on-site check-in for visitors will begin at 9:15 a.m. e.s.t. Please 
allow sufficient time to complete security checkpoints.
    Security measures include the following:
     Presentation of government-issued photographic 
identification to the Federal Protective Service or Guard Service 
personnel.
     Interior and exterior inspection of vehicles (this 
includes engine and trunk inspection) at the entrance to the grounds. 
Parking permits and instructions will be issued after the vehicle 
inspection.
     Passing through a metal detector and inspection of items 
brought into the building. We note that all items brought to CMS, 
whether personal or for the purpose of demonstration or to support a 
demonstration, 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 
demonstration.

    Note: 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 45 
minutes prior to the convening of the meeting.

    All visitors must be escorted in areas other than the lower and 
first floor levels in the Central Building. Seating capacity is limited 
to the first 550 registrants.

    Authority: Section 1886(d)(4)(D) of the Act.

    Dated: October 23, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E8-25833 Filed 10-29-08; 8:45 am]
BILLING CODE 4120-01-P