[Federal Register Volume 77, Number 56 (Thursday, March 22, 2012)]
[Notices]
[Pages 16841-16842]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-6940]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5052-N]


Medicare Program; Solicitation for Proposals for the Medicare 
Graduate Nurse Education Demonstration Program

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

ACTION: Notice.

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

SUMMARY: This notice informs interested parties of an opportunity to 
apply to participate in the Medicare Graduate Nurse Education (GNE) 
Demonstration. The primary goal of the GNE Demonstration is to increase 
the number of advanced practice registered nurses (APRNs) in order to 
meet the health care needs of the growing Medicare population.

DATES: Proposals will be considered timely if they are received on or 
before 5 p.m., Eastern Standard Time (E.S.T.) on May 21, 2012.

ADDRESSES: Proposals should be mailed to the following address: Centers 
for Medicare & Medicaid Services, Center for Medicare & Medicaid 
Innovation, Attention: Alexandre Laberge, Mail Stop: WB-06-05, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

FOR FURTHER INFORMATION CONTACT: Alexandre Laberge (410) 786-8625 or by 
email at [email protected].

SUPPLEMENTARY INFORMATION: 
    General Information: Please refer to file code (CMS-5052-N) on the 
application. Proposals (an unbound original and 10 electronic copies on 
CD-ROM) must be typed for clarity and should not exceed 50 double-
spaced pages, exclusive of cover letter, the executive summary, 
resumes, forms, and no more than 15 pages supporting documentation. 
Because of staffing and resource limitations, we cannot accept 
proposals by facsimile (Fax) transmission. Applicants may, but are not 
required to, submit a total of 10 copies to assure that each reviewer 
receive a proposal in the manner intended by the applicant (for 
example, collated, tabulated color copies). Hard copies and electronic 
copies must be identical.
    Eligible Organizations: As set forth in section 5509 of the 
Affordable Care Act (ACA) (Pub. L. 111-148, as amended by Pub. L. 111-
152), an ``eligible hospital'' may apply to perform the 
responsibilities specified. Section 5509(e)(5) of the ACA defines an 
``eligible hospital'' to mean a hospital (as defined in section 1861(e) 
of the Social Security Act (the Act) (42 U.S.C. 1395x)) or a critical 
access hospital (as defined in section 1861(mm)(1) of the Act) that has 
a written agreement in place with--(A) 1 or more applicable schools of 
nursing; and (B) 2 or more applicable non-hospital community-based care 
settings. The written agreement must meet specific requirements set 
forth in section 5509 of the ACA including--(1) the obligations of the 
eligible partners with respect to the provision of qualified training; 
and (2) the obligation of the eligible hospital to reimburse such 
eligible partners applicable (in a timely manner) for the costs of such 
qualified training attributable to partner. The demonstration will 
include up to five eligible hospitals.

I. Provisions of This Notice

    We are seeking eligible hospital applicants, which includes 
critical access hospitals, to partner with one or more applicable 
schools of nursing (SONs) and two or more applicable nonhospital 
community-based care settings (CCSs) to provide advanced practice 
registered nurse (APRN) students with qualified training. See section 
5509(e) of the ACA for the definitions of the terms used in the 
preceding sentence. At least half of the clinical training must be 
provided in non-hospital CCSs which may include federally qualified 
health centers (FQHCs), rural health clinics (RHCs), and other 
nonhospital settings as determined appropriate by the Secretary. 
However, the Secretary may waive the requirement under section

[[Page 16842]]

5509(e)(7)(A)(ii) of the ACA with respect to eligible hospitals located 
in rural or medically underserved areas.
    In general terms, the demonstration provides a source of Medicare 
funding for the reasonable costs for clinical training attributable to 
the incremental increase in the number of APRN students enrolled in 
participating SONs during the demonstration relative to an established 
baseline. Section 5509 of the ACA sets forth limitations on the 
reasonable costs reimbursable under the demonstration. We will make 
interim payments to selected hospitals with a cost settlement process 
using Medicare reasonable cost principles. Participating eligible 
hospitals must establish written agreements with one or more applicable 
SONs and two or more applicable non-hospital CCSs that define the 
obligations of each partner with respect to the provision of qualified 
training and the corresponding eligible hospital's obligation to 
reimburse eligible partners applicable (in a timely manner) for the 
costs of such qualified training attributable to the partner and the 
mechanism for partner reimbursement. As outlined in the GNE 
Solicitation, applicant hospitals may partner with other hospitals in 
the demonstration and we will support an expanded configuration of 
hospital relationships under certain circumstances.
    The GNE Demonstration will run for 4 years. Applicants must 
identify how they propose to significantly increase the APRN student 
enrollment and graduation rates for clinical nurse specialist, nurse 
practitioner, certified registered nurse anesthetist, and certified 
nurse midwife specialty programs. The proposal must present evidence 
that the applicant hospital and partner organizations are not only 
capable of successfully recruiting students but also providing relevant 
clinical training programs responsive to our changing health care 
system due to the growing number of insured by 2014. Applicants will be 
required to provide a detailed budget and narrative describing the 
rationale for the proposed GNE payment rate and why this would be an 
efficient investment for CMS.
    A competitive process will be used to select eligible 
organizations. We will accept proposal applications in the standard 
format outlined in the GNE solicitation in order to be considered for 
review by an internal technical panel. Applications that are not 
received in this format will not be considered for review.
    For more specific details regarding the GNE demonstration, please 
refer to the informational materials on our Web site at http://www.cms.hhs.gov/DemoProjectsEvalRpts/downloads/.

II. Information Collection Requirements

    In accordance with section 5509(a)(4) of the ACA, this information 
collection requirement is not subject to the Paperwork Reduction Act of 
1995. Consequently, it need not be reviewed by the Office of Management 
and Budget under the authority of the Paperwork Reduction Act of 1995 
(44 U.S.C. Chapter 35).

    Authority: Section 5509 of the ACA (Pub. L. 111-148, as amended 
by Pub. L. 111-152)

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


    Dated: January 19, 2012.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2012-6940 Filed 3-21-12; 8:45 am]
BILLING CODE 4120-01-P