[Federal Register Volume 81, Number 98 (Friday, May 20, 2016)]
[Notices]
[Pages 31941-31943]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-11949]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1665-N]


Medicare Program; Announcement of the Advisory Panel on Hospital 
Outpatient Payment (the Panel) Meeting on August 22-23, 2016 and 
Announcement of Transition to One Meeting of the Panel Per Year

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

ACTION: Notice.

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

SUMMARY: This notice announces the summer meeting of the Advisory Panel 
on Hospital Outpatient Payment (the Panel) for 2016. It also announces 
that the Panel will begin meeting once a year in the summer, beginning 
in Calendar Year 2017. Currently, the Panel convenes twice yearly. The 
purpose of the Panel is to advise the Secretary of the Department of 
Health and Human Services (DHHS) (the Secretary) and the Administrator 
of the Centers for Medicare & Medicaid Services (CMS) (the 
Administrator) on the clinical integrity of the Ambulatory Payment 
Classification (APC) groups and their associated weights and hospital 
outpatient therapeutic services supervision issues.

DATES: Meeting Dates: The second semi-annual meeting in 2016 is 
scheduled for the following dates and times. The times listed in this 
notice are Eastern Daylight Time (EDT) and are approximate times; 
consequently, the meetings may last longer or be shorter than the times 
listed in this notice, but will not begin before the posted times:
     Monday, August 22, 2016, 9 a.m. to 5 p.m. EDT.
     Tuesday, August 23, 2016, 9 a.m. to 5 p.m. EDT.
    Meeting Information Updates: The actual meeting hours and days will 
be posted in the agenda. As information and updates regarding the 
onsite, webcast and teleconference meeting, and agenda become 
available, they will be posted to the CMS Web site at: http://cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.

Deadlines

Deadline for Presentations and Comments

    Presentations or comments and form CMS-20017, (located at http://www.cms.hhs.gov/cmsforms/downloads/cms20017.pdf) must be received by 5 
p.m. EDT, Friday, July 15, 2016. Presentations and comments that are 
not received by the due date and time will be considered late and will 
not be included on the agenda. In commenting, please refer to file code 
CMS-1665-N.
    Meeting Registration Timeframe: Monday, June 27, 2016, through 
Friday, July 29, 2016 at 5 p.m. EDT.
    Participants planning to attend this meeting in person must 
register online, during the above specified timeframe at: https://www.cms.gov/apps/events/default.asp. On this Web page, double click the 
``Upcoming Events'' hyperlink, and then double click the ``HOP Panel'' 
event title link and enter the required information. Include any 
requests for special accommodations.

    Note:  Participants who do not plan to attend the meeting in 
person should not register. No registration is required for 
participants who plan to view the meeting via webcast.

    Because of staff and resource limitations, we cannot accept 
comments and presentations by facsimile (FAX) transmission.

Meeting Location, Webcast, and Teleconference

    The meeting will be held in the Auditorium, CMS Central Office, 
7500 Security Boulevard, Woodlawn, Maryland 21244-1850. Alternately, 
the public may either view this meeting via a webcast or listen by 
teleconference. During the scheduled meeting, webcasting is accessible 
online at: http://cms.gov/live. Teleconference dial-in information will 
appear on the final meeting agenda, which will be posted on the CMS Web 
site when available at: http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.

News Media

    Representatives must contact our Public Affairs Office at (202) 
690-6145.

Advisory Committees' Information Lines

    The phone number for the CMS Federal Advisory Committee Hotline is 
(410) 786-3985.

[[Page 31942]]

Web Sites

    For additional information on the Panel and updates to the Panel's 
activities, we refer readers to view our Web site at: http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.
    Information about the Panel and its membership in the Federal 
Advisory Committee Act (FACA) database are also located at: http://facadatabase.gov/.

FOR FURTHER INFORMATION CONTACT: Carol Schwartz, Designated Federal 
Official (DFO), 7500 Security Boulevard, Mail Stop: C4-04-25, Woodlawn, 
MD 21244-1850. Phone: (410) 786-3985. Email: [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    The Secretary of the Department of Health and Human Services (DHHS) 
(the Secretary) is required by section 1833(t)(9)(A) of the Social 
Security Act (the Act) and is allowed by section 222 of the Public 
Health Service Act (PHS Act) to consult with an expert outside panel, 
that is, the Advisory Panel on Hospital Outpatient Payment (the Panel) 
regarding the clinical integrity of the Ambulatory Payment 
Classification (APC) groups and relative payment weights. The Panel is 
governed by the provisions of the Federal Advisory Committee Act (Pub. 
L. 92-463), as amended (5 U.S.C. Appendix 2), to set forth standards 
for the formation and use of advisory panels. We consider the technical 
advice provided by the Panel as we prepare the proposed and final rules 
to update the hospital outpatient prospective payment system (OPPS). 
The Panel (formerly the Advisory Panel on Ambulatory Payment 
Classification Groups) was originally chartered on November 21, 2000, 
and most recently re-chartered on November 6, 2014. The Panel Charter 
provides that the Panel shall meet up to 3 times annually. The first 
meeting of the Panel (was in Calendar Year (CY) 2001). For CY 2001 and 
2002, the Panel convened once a year. At that time, the OPPS was new 
and there were many issues where the Panel provided important technical 
advice to the Centers for Medicare & Medicaid (CMS). Agendas for these 
2-day meetings were very full and it was decided that two, 2-day 
meetings per year would be warranted to accommodate the workload of the 
Panel. Beginning in CY 2003, the Panel has convened twice yearly, in 
the summer and in the winter. Over time and as the OPPS has matured, 
policies have become more stable and the volume of issues that the 
Panel has been requested to provide technical advice on has decreased 
significantly. The duration of these meetings has decreased 
significantly, with the most recent four meetings each averaging a half 
day or less in length.
    Beginning in CY 2016, new Current Procedural Terminology (CPT) 
codes (effective on January 1 of the following year) are assigned 
status indicators and APC assignments in the OPPS proposed rule instead 
of being first assigned status indicators and APC assignments in the 
final rule. With this process change, stakeholders now provide their 
comments on the status indicators and APC assignments during the 
proposed rule comment period.

II. Panel Meeting Transition to One Meeting of the Panel Per Year

    Beginning in CY 2003 and through CY 2016, we had 13 consecutive 
years of two Panel meetings a year. However, due to a significant 
decline in the volume of requests for technical advice from the Panel, 
beginning in CY 2017, we will transition back to 1 Panel meeting a 
year, which will be scheduled in the summer. Since the summer meeting 
occurs during the comment period for the OPPS proposed rule, we 
anticipate that there will be more requests for technical advice 
including the CMS treatment of new CPT codes, during this meeting than 
during a winter meeting. The winter Panel meeting is no longer 
necessary as a forum to discuss interim final status indicators and APC 
assignments of new codes because this process no longer exists. In CY 
2017 and thereafter, (unless CMS programmatic need suggests otherwise) 
there will not be a winter Panel meeting; there will be only one Panel 
meeting per year that will occur in the summer.

III. Agenda

    The agenda for the August 22 through August 23, 2016 Panel 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 structure.
     Reviewing the packaging of OPPS services and costs, 
including the methodology and the impact on APC groups and payment.
     Removing procedures from the inpatient-only 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.
     Recommending the appropriate supervision level (general, 
direct, or personal) for individual hospital outpatient therapeutic 
services.
    The Agenda will be posted on the CMS Web site at http://cms.hhs.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html approximately 
1 week before the meeting.

IV. Presentations

    The subject matter of any presentation and/or comment matter must 
be within the scope of the Panel designated in the Charter. Any 
presentations or comments outside of the scope of this Panel will be 
returned or requested for amendment. Unrelated topics include, but are 
not limited to, the conversion factor, charge compression, revisions to 
the cost report, pass-through payments, correct coding, new technology 
applications (including supporting information/documentation), provider 
payment adjustments, supervision of hospital outpatient diagnostic 
services and the types of practitioners that are permitted to supervise 
hospital outpatient services. The Panel may not recommend that services 
be designated as nonsurgical extended duration therapeutic services.
    The Panel may use data collected or developed by entities and 
organizations other than DHHS and CMS in conducting its review. We 
recommend organizations submit data for CMS staff and the Panel's 
review.
    All presentations are limited to 5 minutes, regardless of the 
number of individuals or organizations represented by a single 
presentation. Presenters may use their 5 minutes to represent either 
one or more agenda items.

Section 508 Compliance

    For this meeting, we are aiming to have all presentations and 
comments available on the CMS Web site. Materials on the CMS Web site 
must be Section 508 compliant to ensure access to federal employees and 
members of the public with and without disabilities. We encourage 
presenters and commenters to refer to guidance on making documents 
Section 508 compliant as they draft their submissions, and, whenever 
possible, to submit their presentations and comments in a 508 compliant 
form. Such guidance is available at http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/Section508/508-Compliant-doc.html. CMS will review

[[Page 31943]]

presentations and comments for 508 compliance, and place compliant 
materials on its Web site. As resources permit, CMS will also convert 
non-compliant submissions to 508 compliant forms, and offer assistance 
to submitters who wish to make their submissions 508 compliant. All 
non-508 compliant presentations and comments will be shared with the 
public onsite and through the webcast and made available to the public 
upon request.
    Those wishing to access such materials should contact the DFO (the 
DFO's address, email and phone number are provided below).
    In order to consider presentations and/or comments, we will need to 
receive the following:
    1. An email copy of the presentation or comments sent to the DFO 
mailbox, [email protected] or, if unable to submit by email, a hard 
copy sent to the DFO at the address noted under FOR FURTHER INFORMATION 
CONTACT.
    2. Form CMS-20017 with complete contact information that includes 
name, address, phone number, and email addresses for all presenters and 
commenters and a contact person that can answer any questions and or 
provide revisions that are requested for the presentation. Presenters 
and commenters must clearly explain the actions that they are 
requesting CMS to take in the appropriate section of the form. A 
presenter's/commenter's relationship with the organization that they 
represent must also be clearly listed.
     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.
     We encourage presenters to make efforts to ensure that 
their presentations and comments are 508 compliant.

V. Oral Comments

    In addition to formal oral presentations, which are limited to 5 
minutes total per presentation, there will be an 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.

VI. Meeting Attendance

    The meeting is open to the public; however, attendance is limited 
to space available. Priority will be given to those who pre-register 
and attendance may be limited based on the number of registrants and 
the space available.
    Persons wishing to attend this meeting, which is located on Federal 
property, must register by following the instructions in the ``Meeting 
Registration Timeframe'' section of this notice. A confirmation email 
will be sent to the registrants shortly after completing the 
registration process.

VII. Security, Building, and Parking Guidelines

    The following are the security, building, and parking guidelines:
     Persons attending the meeting, including presenters, must 
be pre-registered and on the attendance list by the prescribed date.
     Individuals who are not pre-registered in advance may not 
be permitted to enter the building and may be unable to attend the 
meeting.
     Attendees must present a government-issued photo 
identification to the Federal Protective Service or Guard Service 
personnel before entering the building. Without a current, valid photo 
ID, persons may not be permitted entry to the building.
     Security measures include inspection of vehicles, inside 
and out, at the entrance to the grounds.
     All persons entering the building must pass through a 
metal detector.
     All items brought into CMS including personal items, for 
example, laptops and cell phones 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.
     Foreign nationals visiting any CMS facility require prior 
approval. If you are a foreign national and wish to attend the meeting 
onsite, in addition to registering for the meeting, you must also send 
a separate email to [email protected] prior to the close of 
registration to request authorization to attend as a foreign national.

VIII. Special Accommodations

    Individuals requiring special accommodations must include the 
request for these services during registration.

IX. Panel Recommendations and Discussions

    The Panel's recommendations at any Panel meeting generally are not 
final until they have been reviewed and approved by the Panel on the 
last day of the meeting, before the final adjournment. These 
recommendations will be posted to the CMS Web site after the meeting.

X. Collection of Information Requirements

    This document does not impose information collection requirements, 
that is, reporting, recordkeeping or third-party disclosure 
requirements. Consequently, there is no need for review by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995 (44 U.S.C. 3501 et seq.).

    Dated: April 28, 2016.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2016-11949 Filed 5-19-16; 8:45 am]
 BILLING CODE 4120-01-P