[Federal Register Volume 84, Number 108 (Wednesday, June 5, 2019)]
[Notices]
[Pages 26117-26120]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-11756]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1726-N]


Medicare Program; the Announcement of the Annual Advisory Panel 
on Hospital Outpatient Payment (HOP Panel) Meeting in August 2019 and 
New Panel Members

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

ACTION: Notice of meeting.

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SUMMARY: This notice announces the annual public meeting of the 
Advisory Panel on Hospital Outpatient Payment (the Panel) for 2019. In 
addition, it announces 6 new membership appointments to the Panel. The 
purpose of the Panel is to advise the Secretary of the Department of 
Health and Human Services and the Administrator of the Centers for 
Medicare & Medicaid Services concerning the clinical integrity of the 
Ambulatory Payment Classification groups and their associated weights, 
and supervision of hospital outpatient therapeutic services. The 
recommendations provided by the Panel will be considered as we prepare 
the annual updates for the hospital outpatient prospective payment 
system.

DATES: 
    Meeting Dates: The public meeting is scheduled for Monday, August 
19, 2019, from 9:30 a.m. to 5:00 p.m. Eastern Daylight Time (EDT), and 
Tuesday, August 20, 2019, from 9:30 a.m. to 12:00 p.m. Eastern Daylight 
Time (EDT). The times listed in this notice 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.
    Deadline for Meeting Registration, Presentations and Comments: 
Presentations or comments, and form CMS-20017 (located at https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20017.pdf) must 
be received by 5:00 p.m. EDT on Monday, July 22, 2019. Form CMS-20017 
must accompany each presentation or comment submission. Presentations 
and comments that are not received by the due date and time or that do 
not include a completed form CMS-20017 will be considered late or 
incomplete and will not be included on the agenda. In commenting, refer 
to file code CMS-1726-N.
    Meeting Registration Timeframe: Monday, June 24, 2019, through 
Monday, July 29, 2019 at 5 p.m. EDT. Participants planning to attend 
this meeting in person must register online, during the 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

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who plan to participate in the meeting via webcast or teleconference.
    Deadline for Requesting Special Accommodations: Requests for 
special accommodations must be received no later than Monday, July 30, 
2018 at 5:00 p.m. EDT.

ADDRESSES: 
    Meeting Location, Webcast and Teleconference: The meeting will be 
held in the Auditorium at the CMS Single Site Campus, 7500 Security 
Boulevard, Baltimore, MD 21244. Alternately, the public may either view 
this meeting via webcast or listen by teleconference. During the 
scheduled meeting, webcasting is accessible online at: http://cms.gov/live. Teleconference instructions will be available approximately one 
week prior to the meeting, on the CMS website at: https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.
    News Media: Press inquiries are handled through the CMS Press 
Office at (202) 690-6145.
    Advisory Committees Information Line: The telephone number for the 
Advisory Panel on Hospital Outpatient Payment Committee Hotline is 
(410) 786-3985.
    Websites: For additional information on the Panel, including the 
Panel charter, teleconference dial-in information that will appear on 
the final meeting agenda, and updates to the Panel's activities, we 
refer readers to view our website 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 database are also located at: http://facadatabase.gov.
    Registration: The meeting is open to the public but attendance is 
limited to the space available and registration is required. 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 DATES section of 
this notice under ``Meeting Registration Timeframe.'' A confirmation 
email will be sent to the registrants shortly after completing the 
registration process.

FOR FURTHER INFORMATION CONTACT: Elise Barringer, Designated Federal 
Official (DFO), (410) 786-9222, email at [email protected]. Centers 
for Medicare & Medicaid Services, 7500 Security Boulevard, Mail Stop: 
C4-04-25, Baltimore, MD 21244-1850.

SUPPLEMENTARY INFORMATION: 

I. Background

    The Secretary of the Department of Health and Human Services (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, such as 
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.
    The Secretary rechartered the Panel in 2018 for a 2-year period 
effective through November 20, 2020. The current charter is available 
on the CMS website at: https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/Downloads/2018-HOP-Panel-Charter. On January 26, 2018, we 
published a notice in the Federal Register entitled, ``Medicare 
Program; Request for Nominations to the Advisory Panel on Hospital 
Outpatient Payment'' (83 FR 3715). The notice solicited nominations for 
Panel members on a continuous basis to fill the vacancies on the Panel. 
The notice also stated that the Centers for Medicare & Medicaid 
Services (CMS) would consider the nominations submitted in response to 
the December 23, 2016 notice published in the Federal Register 
entitled, ``Medicare Program; Renewal of the Advisory Panel on Hospital 
Outpatient Payment and Solicitation of Nominations to the Advisory 
Panel on Hospital Outpatient Payment'' (81 FR 94378), unless they were 
withdrawn or the nominees' qualifications had changed. The 6 new 
members announced in this notice will each serve a 4-year period, with 
terms that begin in Calendar Year (CY) 2019 and end in CY 2023. We will 
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) for the following CY.

II. Annual Advisory Panel Meeting

A. Meeting Agenda

    The agenda for the August 19, 2019 through August 20, 2019 Panel 
meeting will be posted on the CMS website at: https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html approximately 
1 week before the meeting. The Agenda 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.
     Reconfiguring APCs (for example, splitting APCs, moving 
Healthcare Common Procedure Coding System (HCPCS) codes from one APC to 
another, and moving HCPCS codes from new technology APCs to clinical 
APCs).
     Evaluating APC group weights.
     Reviewing packaging the cost of items and services, 
including drugs and devices into procedures and services, including the 
methodology for packaging and the impact of packaging the cost of those 
items and services on APC group structure and payment.
     Removing procedures from the inpatient list for payment 
under the OPPS.
     Using claims and cost report data for CMS's determination 
of APC group costs.
     Addressing other technical issues concerning APC group 
structure.
     Evaluating the required level of supervision for hospital 
outpatient services.
     OPPS APC rates for covered ASC procedures.

B. Presentations and Comment Letters

    The subject matter of any presentation and comment matter must be 
within the scope of the Panel designated in the charter. Any 
presentations or comments outside of the scope of the 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. Presentations or comment letters that address 
OPPS APC rates as they relate to covered ASC procedures are within the 
scope of the panel; however, ASC payment rates, ASC payment indicators, 
the ASC covered procedures list, or other ASC payment system matters 
will be considered out of scope.

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    The Panel may use data collected or developed by entities and 
organizations other than the Department of Health and Human Services 
(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 website. Materials on our website 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 reference the 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. The 
guidance is available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/Section508/508-Compliant-doc.html. We will review presentations and comments for 508 compliance 
and place compliant materials on the CMS website. As resources permit, 
we will also convert non-compliant submissions to 508 compliant forms 
and offer assistance to submitters who wish to make their submissions 
508 compliant. All 508 compliant presentations and comments will be 
shared with the public onsite, webcasted, and made available on the CMS 
website. Those wishing to access such materials should contact the DFO 
(the DFO's address, email, and phone number are provided in the FOR 
FURTHER INFORMATION CONTACT section of this notice).
    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 in the FOR FURTHER 
INFORMATION CONTACT section of this notice.
    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 
provide revisions that are requested, for the presentation or comment 
letter. 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 or commenter's relationship with the organization that 
they represent must also be clearly listed.
     The form is now available through the CMS Forms website 
at: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20017.pdf.
     We encourage submitters to make efforts to ensure that 
their presentations and comments are 508 compliant.

C. Oral Comments

    In addition to formal oral presentations (limited to 5 minutes 
total per presentation), there will be an opportunity during the 
meeting for public oral comments (limited to 1 minute for each 
individual) and a total of 3 minutes per organization.

D. 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 website after the meeting.

E. Security, Building, and Parking Guidelines

    The meeting is open to the public but attendance is limited to the 
space available. Persons wishing to attend this meeting in person must 
register within the noted timeframe, by following the instructions in 
the DATES section of this notice under ``Meeting Registration 
Timeframe.''
    This meeting will be held in a Federal government building; 
therefore, Federal security measures are applicable. Individuals who 
are not registered in advance may not be permitted to enter the 
building and would be unable to attend the meeting. We recommend that 
confirmed registrants arrive reasonably early, but no earlier than 45 
minutes prior to the start of the meeting to allow additional time to 
clear security. Security measures include the following:
     Presentation of valid government-issued photographic 
identification to the Federal Protective Service or Guard Service 
personnel.
     Inspection of vehicle's interior and exterior (this 
includes engine and trunk inspection) at the entrance to the grounds. 
Parking permits and instructions will be issued after the vehicle 
inspection.
     Inspection, via metal detector or other applicable means, 
of all persons entering the building. We note that all items brought 
into CMS, whether personal or for the purpose of presentation 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 presentation or to support a presentation.
    Note: Individuals who are not registered in advance may not be 
permitted to enter the building and would 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.

II. Nominees and Membership Appointments to the Advisory Panel on 
Hospital Outpatient Payment

A. Panel Appointments Requirements

    The Panel shall consist of a chair and up to 15 members who are 
full-time employees of hospitals, hospital systems, or other Medicare 
providers that are subject to the OPPS. The panel may also include a 
representative of the provider with ASC expertise, who shall advise CMS 
only on OPPS APC rates, as appropriate, impacting ASC covered 
procedures within the context and purview of the panel's scope. The 
Secretary or a designee selects the Panel membership based upon either 
self-nominations or nominations submitted by Medicare providers and 
other interested organizations of candidates determined to have the 
required expertise. For supervision deliberations, the Panel shall also 
include members that represent the interests of Critical Access 
Hospitals (CAHs), who advise CMS only regarding the level of 
supervision for hospital outpatient therapeutic services.
    New appointments are made in a manner that ensures a balanced 
membership under the FACA guidelines.
    The Panel consists of the following current members and a Chair:
 E. L. Hambrick, M.D., J.D., CMS Chairperson
 Shelly Dunham, R.N.
 Kenneth Michael Flowe, M.D., M.B.A.
 Erika Hardy, R.H.I.A.
 Karen A. Lambert
 Ruth Lande
 Scott Manaker, M.D., Ph.D.
 Agatha L. Nolen, Ph.D., D.Ph.
 Richard Nordahl, M.B.A.
 Michael Schroyer, R.N.

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B. Request and Submission of the Panel Nominations

    The Request for Nominations to the Advisory Panel on Hospital 
Outpatient Payment notice (83 FR 3715) provides for nominations to be 
accepted on a continuous basis to fill upcoming panel vacancies. CMS 
encourages additional submissions. Any interested person or 
organization may nominate qualified individuals. Self-nominations from 
qualified individuals are also accepted. Additional information 
including criteria for nominees as well as submission requirements are 
available in the notice, which is accessible from the CMS website at: 
https://www.govinfo.gov/content/pkg/FR-2018-01-26/pdf/2018-01474.pdf.
    As a result of that notice, we are announcing 6 new members to the 
Panel. These 6 new Panel member appointments will assure that we 
continue to have a Chair and up to 15 members available to attend our 
scheduled meeting.
New Appointments to the Panel
    New members of the Panel will have terms beginning on March 1, 2019 
and continuing through February 28, 2023. The new members of the Panel 
are as follows:

 Terry Bohlke, CPA, CMA, MHA, CASC
 Carmen Cooper-Oguz, PT, DPT, MBA, CWS, WCC
 Paul Courtney, M.D.
 Peter Duffy, M.D.
 Lisa Gangarosa, M.D.
 Michael Kuettel, M.D., MBA, Ph.D.

IV. 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: May 31, 2019.
Paul Mango,
Chief Principal Deputy Administrator and Chief of Staff, Centers for 
Medicare & Medicaid Services.
[FR Doc. 2019-11756 Filed 6-4-19; 8:45 am]
 BILLING CODE 4120-01-P