[Federal Register Volume 74, Number 127 (Monday, July 6, 2009)]
[Notices]
[Pages 31964-31966]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-15880]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1412-N]


Medicare Program; Second Semi-Annual Meeting of the Advisory 
Panel on Ambulatory Payment Classification Groups--August 5-7, 2009

AGENCY: Centers for Medicare & Medicaid Services, Department of Health 
and Human Services.

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 
second semi-annual meeting of the Advisory Panel on Ambulatory Payment 
Classification (APC) Groups (the Panel) for 2009. 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 
(the Secretary) and the Administrator of the Centers for Medicare & 
Medicaid Services (CMS) (the Administrator) concerning the clinical 
integrity of the APC groups and their associated weights. We will 
consider the Panel's advice as we address comments and complete the 
final rule that updates the hospital Outpatient Prospective Payment 
System (OPPS) for CY 2010.

DATES: Meeting Dates: We are scheduling the second semi-annual meeting 
in 2009 for the following dates and times:
     Wednesday, August 5, 2009, 1 p.m. to 5 p.m. (e.s.t.) \1\
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    \1\ The times listed in this notice are approximate times; 
consequently, the meetings may last longer than listed in this 
notice--but will not begin before the posted times.
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     Thursday, August 6, 2009, 8 a.m. to 5 p.m. (e.s.t.) \1\
     Friday, August 7, 2009, 8 a.m. to 12 noon (e.s.t.) \2\
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    \2\ If the business of the Panel concludes on Thursday, August 
6, 2009, there will be no Friday (August 7, 2009) meeting.
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    Deadlines:
    Deadline for Hardcopy Comments/Suggested Agenda Topics--5 p.m. 
(e.s.t.), Wednesday, July 22, 2009.
    Deadline for Hardcopy Presentations--5 p.m. (e.s.t.), Wednesday, 
July 22, 2009.
    Deadline for Attendance Registration--5 p.m. (e.s.t.), Wednesday, 
July 29, 2009.
    Deadline for Special Accommodations--5 p.m. (e.s.t.), Wednesday, 
July 29, 2009.
    Submission 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 can be reproduced for 
public dissemination. All hardcopy presentations must be accompanied by 
Form CMS-20017 (revised 01/07). The form is now available through the 
CMS Forms Web site. The Uniform Resource Locator (URL) for linking to 
this form is as follows: http://www.cms.hhs.gov/cmsforms/downloads/cms20017.pdf.
    Presenters must use the most recent copy of CMS-20017 (updated 01/
07) at the above URL. Additionally, presenters must clearly explain the 
action(s) that they are requesting CMS to take in the appropriate 
section of the form. They must also clarify their relationship to the 
organization that they represent in the presentation.

    Note: Issues that are vague, or that are outside the scope of 
the APC Panel's purpose, will not be considered for presentations 
and comments. There will be no exceptions to this rule. We 
appreciate your cooperation on this matter.

    We are also requiring electronic versions of the written comments 
and presentations, in addition to the hardcopies.
    In summary, presenters and/or commenters must do the following:
     Send both electronic and hardcopy versions of their 
presentations and written comments by the prescribed deadlines.
     Send electronic transmissions--preferably in PowerPoint 
presentation format--to the e-mail address below.
     Do not send pictures of patients in any of the documents 
unless their faces have been blocked out.
     Do not send documents electronically that have been 
archived.
     Mail (or send by courier) to the DFO all hardcopies, 
accompanied by Form CMS-20017 (revised 01/07), if they are presenting, 
as specified in the FOR FURTHER INFORMATION CONTACT section of this 
notice.
     Commenters are not required to send Form CMS-20017 with 
their written comments.

ADDRESSES: The meeting will be held in the Auditorium, CMS Central 
Office, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

FOR FURTHER INFORMATION CONTACT: For further information, contact: 
Shirl Ackerman-Ross, DFO, CMS, CMM, HAPG, DOC, 7500 Security Boulevard, 
Mail Stop C4-05-17, Baltimore, MD 21244-1850. Phone: (410) 786-4474.

    Note: We recommend that you advise couriers of the following 
information: When delivering hardcopies of presentations to CMS, if 
no one answers at the above phone number, please call (410) 786-4532 
or (410) 786-9316.

    E-mail addresses for comments, presentations, and registration 
requests are CMS [email protected], or [email protected].

    Note: There is NO underscore in the APC Panel e-mail address; 
there is a SPACE between CMS and APCPanel.

    News media representatives must contact our Public Affairs Office 
at (202) 690-6145.
    Advisory Committees' Information Lines: The phone numbers for the 
CMS Federal Advisory Committee Hotline are 1-877-449-5659 (toll free) 
and (410) 786-9379 (local).
    Web Sites: The following information is available on the CMS Web 
site at http://www.cms.hhs.gov/FACA/05_AdvisoryPanelonAmbulatoryPaymentClassificationGroups.asp#TopOfPage in 
order to obtain the following information:

    Note: There is an UNDERSCORE after FACA/05(like this--); there 
is no space.

     Additional information on the APC meeting agenda topics,
     Updates to the Panel's activities,
     Copies of the current Charter, and
     Membership requirements.
    You may also search information about the APC Panel and its 
membership in the FACA database at the following URL: https://www.fido.gov/facadatabase/public.asp.

SUPPLEMENTARY INFORMATION:

I. Background

    The Secretary is required by section 1833(t)(9)(A) of the Social 
Security Act (the Act) to consult with an expert, outside advisory 
panel on the clinical integrity of the Ambulatory Payment 
Classification (APC) groups and weights established under the Medicare 
hospital Outpatient Prospective Payment System (OPPS).
    The APC Panel meets up to three times annually. The Charter 
requires

[[Page 31965]]

that the Panel must be fairly balanced in its membership in terms of 
the points of view represented and the functions to be performed. The 
Panel consists of up to 15 members who are representatives of providers 
and a Chair.
    Each Panel member must be employed full-time by a hospital, 
hospital system, or other Medicare provider subject to payment under 
the OPPS. The Secretary or Administrator selects the Panel membership 
based upon either self-nominations or nominations submitted by Medicare 
providers and other interested organizations.
    All members must have technical expertise to enable them to 
participate fully in the Panel's work. The expertise encompasses 
hospital payment systems; hospital medical care delivery systems; 
provider billing systems; APC groups; Current Procedural Terminology 
codes; and alpha-numeric Health Care Common Procedure Coding System 
codes; and the use of, and payment for, drugs, medical devices, and 
other services in the outpatient setting, as well as other forms of 
relevant expertise. Details regarding membership requirements for the 
APC Panel are found on the CMS and FACA Web sites as listed above.
    The Panel presently consists of the following members:
     E. L. Hambrick, M.D., J.D., Chair, a CMS Medical Officer.
     Gloryanne Bryant, B.S., RHIA, RHIT, CCS.
     Patrick A. Grusenmeyer, Sc.D., FACHE.
     Kathleen Graham, R.N., MSHA, CPHQ, ACM.
     Judith T. Kelly, B.S.H.A., RHIT, RHIA, CCS.
     Michael D. Mills, Ph.D.
     Thomas M. Munger, M.D., FACC.
     Agatha L. Nolen, D.Ph., M.S.
     Randall A. Oyer, M.D.
     Beverly Khnie Philip, M.D.
     Russ Ranallo, M.S., B.S.
     James V. Rawson, M.D.
     Michael A. Ross, M.D., FACEP.
     Patricia Spencer-Cisek, M.S., APRN-BC, 
AOCN[reg].
     Kim Allen Williams, M.D., FACC, FABC.
     Robert M. Zwolak, M.D., Ph.D., FACS.

II. Agenda

    The agenda for the August 2009 meeting will provide for discussion 
and comment on the following topics as designated in the Panel's 
Charter:
     Addressing whether procedures within an APC group are 
similar both clinically and in terms of resource use.
     Evaluating APC group weights.
     Reviewing the packaging of OPPS services and costs, 
including the methodology and the impact on APC groups and payment.
     Removing procedures from the inpatient list for payment 
under the OPPS.
     Using single and multiple procedure claims data for CMS' 
determination of APC group weights.
     Addressing other technical issues concerning APC group 
structure.

    Note: The subject matter before the Panel will be limited to 
these and related topics. Issues related to calculation of the OPPS 
conversion factor, charge compression, pass-through payments, or 
wage adjustments are not within the scope of the Panel's purpose. 
Therefore, these issues will not be considered for presentations 
and/or comments. There will be no exceptions to this rule. We 
appreciate your cooperation on this matter.

    The Panel may use data collected or developed by entities and 
organizations, other than DHHS and CMS, in conducting its review. We 
recommend that organizations submit data for the Panel's and CMS 
staff's review.

III. Written Comments and Suggested Agenda Topics

    Send hardcopy and electronic written comments and suggested agenda 
topics to the DFO at the address indicated above. The DFO must receive 
these items by 5 p.m. (e.s.t.), Wednesday, July 22, 2009. There will be 
no exceptions. We appreciate your cooperation on this matter.
    The written comments and suggested agenda topics submitted for the 
August 2009 APC Panel meeting must fall within the subject categories 
outlined in the Panel's Charter and as listed in the Agenda section of 
this notice.

IV. Oral Presentations

    Individuals or organizations wishing to make 5-minute oral 
presentations must submit hardcopy and electronic versions of their 
presentations to the DFO by 5 p.m. (e.s.t.), Wednesday, July 22, 2009, 
for consideration.
    Concise PowerPoint presentations, not lengthy written statements, 
are easier for the Panel and audience to follow.
    The number of oral presentations may be limited by the time 
available. Oral presentations should not exceed 5 minutes in length for 
an individual or an organization.
    The Chair may further limit time allowed for presentations due to 
the number of oral presentations, if necessary.

V. Presenter and Presentation Information

    All presenters must submit Form CMS-20017 (revised 01/07). 
Hardcopies are required for oral presentations; however, electronic 
submissions of Form CMS-20017 are optional. The DFO must receive the 
following information from those wishing to make oral presentations:
     Form CMS-20017 completed with all pertinent information 
identified on the first page of the presentation,
     One hardcopy of presentation,
     Electronic copy of presentation, and
     Personal registration information as described in the 
Meeting Attendance section below.
    (Those persons wishing to submit comments only must send hardcopy 
and electronic versions of their comments, but they are not required to 
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 3 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 DFO to register in advance no later than 5 
p.m. (e.s.t.), Wednesday, July 29, 2009. A confirmation will be sent to 
the requester(s) via return e-mail.
    The following personal information must be e-mailed to the DFO by 
the date and time above:
     Name(s) of attendee(s),
     Title(s),
     Organization,
     E-mail addresses of all attendees, and
     Telephone number(s).

VIII. Security, Building, and Parking Guidelines

    The following are the security, building, and parking guidelines:
     Persons attending the meeting including presenters must be 
registered and on the attendance list by the prescribed date.
     Individuals who are not registered in advance will not be 
permitted to enter the building and will be unable to attend the 
meeting.
     Attendees must present U.S. Federal Government or State

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photographic identification (preferably a valid driver's license or 
passport) to the Federal Protective Service or Guard Service personnel 
before entering the building.
     CMS is a tobacco-free campus; violators are subject to 
legal action.
     Security measures 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 into CMS including personal items, for 
example laptops, cell phones, and palm pilots, are subject to physical 
inspection.
     The public may enter the building 30 to 45 minutes before 
the meeting convenes each day.
     All visitors must be escorted in areas other than the 
lower and first-floor levels in the Central Building.
     The main-entrance guards will issue parking permits and 
instructions upon arrival at the building.
     At CMS, security is a primary concern and is taken very 
seriously. These security issues are for your and our protection.

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, July 29, 2009.

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

    Dated: June 11, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E9-15880 Filed 7-2-09; 8:45 am]
BILLING CODE 4120-01-P