[Federal Register Volume 88, Number 10 (Tuesday, January 17, 2023)]
[Rules and Regulations]
[Pages 2546-2550]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-00718]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 410 and 414
[CMS-6088-N]
RIN 0938-ZB76
Medicare Program; Updates to Face-to-Face Encounter and Written
Order Prior to Delivery List
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Update to certain codes.
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SUMMARY: This document announces updates to the Healthcare Common
Procedure Coding System (HCPCS) codes on the Required Face-to-Face
Encounter and Written Order Prior to Delivery List.
DATES: The implementation is effective on April 17, 2023.
FOR FURTHER INFORMATION CONTACT:
Cristine Egan (410) 786-8088.
Olufemi Shodeke (410) 786-1649.
Jennifer Phillips (410) 786-1023.
Misty Whitaker (410) 786-4975.
SUPPLEMENTARY INFORMATION:
I. Background
On November 8, 2019, the Centers for Medicare & Medicaid Services
published a final rule titled, ``Medicare Program; End-Stage Renal
Disease Prospective Payment System, Payment for Renal Dialysis Services
Furnished to Individuals with Acute Kidney Injury, End-Stage Renal
Disease Quality Incentive Program, Durable Medical Equipment,
Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Amounts,
DMEPOS Competitive Bidding Program (CBP) Amendments, Standard Elements
for a DMEPOS Order, and Master List of DMEPOS Items Potentially Subject
to a Face-to-Face Encounter and Written Order Prior to Delivery and/or
Prior Authorization Requirements'' (84 FR 60648). The rule became
effective January 1, 2020, harmonizing the lists of DMEPOS items
created by former rules and establishing one ``Master List of DMEPOS
Items Potentially Subject to Face-to-Face Encounter and Written Orders
Prior to Delivery and/or Prior Authorization Requirements'' (the
``Master List''). The rule provided that items would be selected from
the Master List for inclusion on the Face-to-Face Encounter and Written
Orders Prior to Delivery List and/or Prior Authorization List through
the Federal Register. It also clarified that certain items (that is,
power mobility devices (PMDs)) require a face-to-face encounter per
statute and would remain on the list indefinitely.
On January 13, 2022, in accordance with the November 2019 final
rule (84 FR 60648), we selected codes from the Master List and
published the first iteration of the Required Face-to-Face Encounter
and Written Order Prior to Delivery List (hereinafter referred to as
``F2F/WOPD List''). (For more detailed information see 87 FR 2051). The
F2F/WOPD List became effective on April 13, 2022. It included 46 K-
codes representative of PMDs as well as 7 Healthcare Common Procedure
Coding System (HCPCS) that describe other items.
II. Provisions of the Document
This document announces that CMS has selected an additional set of
items to be added to the F2F/WOPD List.
A. Reiteration of the Face-to-Face Encounter and Written Order Prior to
Delivery List Process and DMEPOS Items Currently on The List
The F2F/WOPD List, as described at Sec. 410.38(c)(8), is comprised
of PMDs, per statute, and those items selected from the Master List
(which is described in Sec. Sec. 410.38(c)(7) and 414.234(b)). Items
on this list require a face-to-face encounter and a written order prior
to delivery as a condition of payment.
In the November 2019 final rule, we stated that since the face-to-
face encounter and written orders are statutorily required for PMDs,
per section 1834(a)(1)(E)(iv) of the Act, they are included on the
Master List and the F2F/WOPD List in accordance with our statutory
obligation, and will remain there. These codes, as listed in Table 1,
will remain on the F2F/WOPD List.
Table 1--Statutorily Required Power Mobility Devices
[Currently on the list]
------------------------------------------------------------------------
HCPCS Description
------------------------------------------------------------------------
K0800...................... Power Operated Vehicle, Group 1 Standard,
Patient Weight Capacity Up To And
Including 300 Pounds.
K0801...................... Power Operated Vehicle, Group 1 Heavy Duty,
Patient Weight Capacity, 301 To 450
Pounds.
K0802...................... Power Operated Vehicle, Group 1 Very Heavy
Duty, Patient Weight Capacity 451 To 600
Pounds.
K0806...................... Power Operated Vehicle, Group 2 Standard,
Patient Weight Capacity Up To And
Including 300 Pounds.
K0807...................... Power Operated Vehicle, Group 2 Heavy Duty,
Patient Weight Capacity 301 To 450 Pounds.
K0808...................... Power Operated Vehicle, Group 2 Very Heavy
Duty, Patient Weight Capacity 451 To 600
Pounds.
K0813...................... Power Wheelchair, Group 1 Standard,
Portable, Sling/Solid Seat And Back,
Patient Weight Capacity Up To And
Including 300 Pounds.
K0814...................... Power Wheelchair, Group 1 Standard,
Portable, Captains Chair, Patient Weight
Capacity Up To And Including 300 Pounds.
K0815...................... Power Wheelchair, Group 1 Standard, Sling/
Solid Seat And Back, Patient Weight
Capacity Up To And Including 300 Pounds.
K0816...................... Power Wheelchair, Group 1 Standard,
Captains Chair, Patient Weight Capacity Up
To And Including 300 Pounds.
K0820...................... Power Wheelchair, Group 2 Standard,
Portable, Sling/Solid Seat/Back, Patient
Weight Capacity Up To And Including 300
Pounds.
[[Page 2547]]
K0821...................... Power Wheelchair, Group 2 Standard,
Portable, Captains Chair, Patient Weight
Capacity Up To And Including 300 Pounds.
K0822...................... Power Wheelchair, Group 2 Standard, Sling/
Solid Seat/Back, Patient Weight Capacity
Up To And Including 300 Pounds.
K0823...................... Power Wheelchair, Group 2 Standard,
Captains Chair, Patient Weight Capacity Up
To And Including 300 Pounds.
K0824...................... Power Wheelchair, Group 2 Heavy Duty, Sling/
Solid Seat/Back, Patient Weight Capacity
301 To 450 Pounds.
K0825...................... Power Wheelchair, Group 2 Heavy Duty,
Captains Chair, Patient Weight Capacity
301 To 450 Pounds.
K0826...................... Power Wheelchair, Group 2 Very Heavy Duty,
Sling/Solid Seat/Back, Patient Weight
Capacity 451 To 600 Pounds.
K0827...................... Power Wheelchair, Group 2 Very Heavy Duty,
Captains Chair, Patient Weight Capacity
451 To 600 Pounds.
K0828...................... Power Wheelchair, Group 2 Extra Heavy Duty,
Sling/Solid Seat/Back, Patient Weight
Capacity 601 Pounds Or More.
K0829...................... Power Wheelchair, Group 2 Extra Heavy Duty,
Captains Chair, Patient Weight Capacity
601 Pounds Or More.
K0835...................... Power Wheelchair, Group 2 Standard, Single
Power Option, Sling/Solid Seat/Back,
Patient Weight Capacity Up To And
Including 300 Pounds.
K0836...................... Power Wheelchair, Group 2 Standard, Single
Power Option, Captains Chair, Patient
Weight Capacity Up To And Including 300
Pounds.
K0837...................... Power Wheelchair, Group 2 Heavy Duty,
Single Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 301 To 450
Pounds.
K0838...................... Power Wheelchair, Group 2 Heavy Duty,
Single Power Option, Captains Chair,
Patient Weight Capacity 301 To 450 Pounds.
K0839...................... Power Wheelchair, Group 2 Very Heavy Duty,
Single Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 451 To 600
Pounds.
K0840...................... Power Wheelchair, Group 2 Extra Heavy Duty,
Single Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 601 Pounds
Or More.
K0841...................... Power Wheelchair, Group 2 Standard,
Multiple Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity Up To And
Including 300 Pounds.
K0842...................... Power Wheelchair, Group 2 Standard,
Multiple Power Option, Captains Chair,
Patient Weight Capacity Up To And
Including 300 Pounds.
K0843...................... Power Wheelchair, Group 2 Heavy Duty,
Multiple Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 301 To 450
Pounds.
K0848...................... Power Wheelchair, Group 3 Standard, Sling/
Solid Seat/Back, Patient Weight Capacity
Up To And Including 300 Pounds.
K0849...................... Power Wheelchair, Group 3 Standard,
Captains Chair, Patient Weight Capacity Up
To And Including 300 Pounds.
K0850...................... Power Wheelchair, Group 3 Heavy Duty, Sling/
Solid Seat/Back, Patient Weight Capacity
301 To 450 Pounds.
K0851...................... Power Wheelchair, Group 3 Heavy Duty,
Captains Chair, Patient Weight Capacity
301 To 450 Pounds.
K0852...................... Power Wheelchair, Group 3 Very Heavy Duty,
Sling/Solid Seat/Back, Patient Weight
Capacity 451 To 600 Pounds.
K0853...................... Power Wheelchair, Group 3 Very Heavy Duty,
Captains Chair, Patient Weight Capacity,
451 To 600 Pounds.
K0854...................... Power Wheelchair, Group 3 Extra Heavy Duty,
Sling/Solid Seat/Back, Patient Weight
Capacity 601 Pounds Or More.
K0855...................... Power Wheelchair, Group 3 Extra Heavy Duty,
Captains Chair, Patient Weight Capacity
601 Pounds Or More.
K0856...................... Power Wheelchair, Group 3 Standard, Single
Power Option, Sling/Solid Seat/Back,
Patient Weight Capacity Up To And
Including 300 Pounds.
K0857...................... Power Wheelchair, Group 3 Standard, Single
Power Option, Captains Chair, Patient
Weight Capacity Up To And Including 300
Pounds.
K0858...................... Power Wheelchair, Group 3 Heavy Duty,
Single Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 301 To 450
Pounds.
K0859...................... Power Wheelchair, Group 3 Heavy Duty,
Single Power Option, Captains Chair,
Patient Weight Capacity 301 To 450 Pounds.
K0860...................... Power Wheelchair, Group 3 Very Heavy Duty,
Single Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 451 To 600
Pounds.
K0861...................... Power Wheelchair, Group 3 Standard,
Multiple Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity Up To And
Including 300 Pounds.
K0862...................... Power Wheelchair, Group 3 Heavy Duty,
Multiple Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 301 To 450
Pounds.
K0863...................... Power Wheelchair, Group 3 Very Heavy Duty,
Multiple Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 451 To 600
Pounds.
K0864...................... Power Wheelchair, Group 3 Extra Heavy Duty,
Multiple Power Option, Sling/Solid Seat/
Back, Patient Weight Capacity 601 Pounds
Or More.
------------------------------------------------------------------------
Section 1834(a)(11)(B) of the Act authorizes the Secretary to
select other DMEPOS HCPCS codes that will require a face-to-face
encounter and written order prior to delivery as a condition of
payment. The November 2019 final rule established a process of placing
other DMEPOS items, in addition to PMDs, on the F2F/WOPD List. We
included in the 2022 Federal Register seven additional DMEPOS HCPCS
codes not required by statute. These items were selected from the
Master List to be placed on the F2F/WOPD List and are listed in Table
2. The items listed in both Table 1 and Table 2 will remain on the F2F/
WOPD list.
[[Page 2548]]
Table 2--Non-Statutorily Required DMEPOS Items
[Currently on the list]
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HCPCS Description
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E0748...................... Osteogenesis Stimulator, Electrical, Non-
Invasive, Spinal Applications.
L0648...................... Lumbar-Sacral Orthosis, Sagittal Control,
With Rigid Anterior And Posterior Panels,
Posterior Extends From Sacrococcygeal
Junction To T-9 Vertebra, Produces
Intracavitary Pressure To Reduce Load On
The Intervertebral Discs, Includes Straps,
Closures, May Include Padding, Shoulder
Straps, Pendulous Abdomen Design,
Prefabricated, Off-The-Shelf.
L0650...................... Lumbar-Sacral Orthosis, Sagittal-Coronal
Control, With Rigid Anterior And Posterior
Frame/Panel(S), Posterior Extends From
Sacrococcygeal Junction To T-9 Vertebra,
Lateral Strength Provided By Rigid Lateral
Frame/Panel(S), Produces Intracavitary
Pressure To Reduce Load On Intervertebral
Discs, Includes Straps, Closures, May
Include Padding, Shoulder Straps,
Pendulous Abdomen Design, Prefabricated,
Off-The-Shelf.
L1832...................... Knee Orthosis, Adjustable Knee Joints
(Unicentric Or Polycentric), Positional
Orthosis, Rigid Support, Prefabricated
Item That Has Been Trimmed, Bent, Molded,
Assembled, Or Otherwise Customized To Fit
A Specific Patient By An Individual With
Expertise.
L1833...................... Knee Orthosis, Adjustable Knee Joints
(Unicentric Or Polycentric), Positional
Orthosis, Rigid Support, Prefabricated,
Off-The Shelf.
L1851...................... Knee Orthosis (KO), Single Upright, Thigh
And Calf, With Adjustable Flexion And
Extension Joint (Unicentric Or
Polycentric), Medial-Lateral And Rotation
Control, With Or Without Varus/Valgus
Adjustment, Prefabricated, Off-The-Shelf.
L3960...................... Shoulder Elbow Wrist Hand Orthosis,
Abduction Positioning, Airplane Design,
Prefabricated, Includes Fitting And
Adjustment.
------------------------------------------------------------------------
B. New DMEPOS Items Being Placed on the Face-to-Face Encounter and
Written Order Prior to Delivery List
PMDs are included on the F2F/WOPD List per statutory obligation.
For the other DMEPOS items, we consider factors such as operational
limitations, item utilization, cost-benefit analysis (for example,
comparing the cost of review versus the anticipated amount of improper
payment identified), emerging trends (for example, billing patterns,
medical review findings), vulnerabilities identified in official agency
reports, or other analysis such as acute needs and pandemic impacts.
When selecting items, we balance our program integrity goals with
the needs of Medicare enrollees, particularly those in need of medical
devices to assist with functional activities and ambulation within
their home. In consideration of access issues, we note that the face-
to-face regulation at 42 CFR 410.38(d)(2)(ii) allows for use of
telehealth, provided that the requirements in 42 CFR 410.78 and 414.65
are met.
The first iteration of the F2F/WOPD list was released earlier in
the COVID-19 Public Health Emergency (PHE). The unprecedented PHE,
coupled with the list's newness, led the Agency to initially proceed
with the selection of seven items. Feedback received to date has been
positive. We have not been notified of any issues related to Medicare
beneficiaries' access, and billing trends have been consistent with
anticipated volumes.
Lower limb orthoses (LLO) and lumbar-sacral orthoses (LSO) have
been identified by CMS' Comprehensive Error Rate Testing (CERT) program
as two of the top 20 DMEPOS service types with improper payments over
the past several years, and have been associated with recent fraud
schemes. In 2021, LLOs had an improper payment rate of 50.6 percent and
LSOs had an improper payment rate of 44.2 percent. The CERT improper
payment rate is a measurement of payments that that do not meet
Medicare requirements. Insufficient documentation and medical necessity
are the top two LLO and LSO errors noted in the 2021 CERT report.\1\
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\1\ 2021 Medicare Fee-for-Service Supplemental Improper Payment
Data https://www.cms.gov/files/document/2021-medicare-fee-service-supplemental-improper-payment-data.pdf-0.
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In an effort to ensure practitioner involvement, via in-person
face-to-face encounters or telehealth encounters meeting Medicare's
regulatory requirements, we are adding the following 10 additional
HCPCS codes for inclusion on the Required F2F/WOPD List. We are
releasing these codes in this Federal Register publication with 90
days' notice prior to implementation. At this time, we are not removing
any items from the F2F/WOPD List.
Table 3--New Non-Statutorily Required DMEPOS Items
------------------------------------------------------------------------
HCPCS Description
------------------------------------------------------------------------
L0631...................... Lumbar-Sacral Orthosis, Sagittal Control,
With Rigid Anterior And Posterior Panels,
Posterior Extends From Sacrococcygeal
Junction To T-9 Vertebra, Produces
Intracavitary Pressure To Reduce Load On
The Intervertebral Discs, Includes Straps,
Closures, May Include Padding, Shoulder
Straps, Pendulous Abdomen Design,
Prefabricated Item That Has Been Trimmed,
Bent, Molded, Assembled, Or Otherwise
Customized To Fit A Specific Patient By An
Individual With Expertise.
L0637...................... Lumbar-Sacral Orthosis, Sagittal-Coronal
Control, With Rigid Anterior And Posterior
Frame/Panels, Posterior Extends From
Sacrococcygeal Junction To T-9 Vertebra,
Lateral Strength Provided By Rigid Lateral
Frame/Panels, Produces Intracavitary
Pressure To Reduce Load On Intervertebral
Discs, Includes Straps, Closures, May
Include Padding, Shoulder Straps,
Pendulous Abdomen Design, Prefabricated
Item That Has Been Trimmed, Bent, Molded,
Assembled, Or Otherwise Customized To Fit
A Specific Patient By An Individual With
Expertise.
L1843...................... Knee Orthosis, Single Upright, Thigh And
Calf, With Adjustable Flexion And
Extension Joint (Unicentric Or
Polycentric), Medial-Lateral And Rotation
Control, With Or Without Varus/Valgus
Adjustment, Prefabricated Item That Has
Been Trimmed, Bent, Molded, Assembled, Or
Otherwise Customized To Fit A Specific
Patient By An Individual With Expertise.
[[Page 2549]]
L1932...................... Ankle Foot Orthosis, Rigid Anterior Tibial
Section, Total Carbon Fiber Or Equal
Material, Prefabricated, Includes Fitting
And Adjustment.
L1940...................... Ankle Foot Orthosis, Plastic Or Other
Material, Custom-Fabricated.
L1951...................... Ankle Foot Orthosis, Spiral, (Institute Of
Rehabilitative Medicine Type), Plastic Or
Other Material, Prefabricated, Includes
Fitting And Adjustment.
L1960...................... Ankle Foot Orthosis, Posterior Solid Ankle,
Plastic, Custom-Fabricated.
L1970...................... Ankle Foot Orthosis, Plastic With Ankle
Joint, Custom-Fabricated.
L2005...................... Knee Ankle Foot Orthosis, Any Material,
Single Or Double Upright, Stance Control,
Automatic Lock And Swing Phase Release,
Any Type Activation, Includes Ankle Joint,
Any Type, Custom Fabricated.
L2036...................... Knee Ankle Foot Orthosis, Full Plastic,
Double Upright, With Or Without Free
Motion Knee, With Or Without Free Motion
Ankle, Custom Fabricated.
------------------------------------------------------------------------
The current complete F2F/WOPD List is available on the following
CMS website: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Medical-Review/FacetoFaceEncounterRequirementforCertainDurableMedicalEquipment.
We believe transparency and education will aid in compliance with
these payment requirements and continued access. As such, we will make
information widely available to the public at appropriate literacy
levels regarding face-to-face encounter requirements, written order
prior to delivery requirements, and necessary documentation for items
on F2F/WOPD List.
We continue to believe greater practitioner involvement in the care
of Medicare enrollees in need of items included on the F2F/WOPD List
will help further our program integrity goals of reducing fraud, waste,
and abuse. It will also help ensure Medicare enrollee receipt of items
specific to their medical needs. For items on the F2F/WOPD List, the
written order/prescription must be communicated to the supplier prior
to delivery. For such items, we require the treating practitioner to
have a face-to-face encounter with the Medicare enrollee within the 6
months preceding the date of the written order/prescription. If the
face-to-face encounter is a telehealth encounter, the requirements of
42 CFR 410.78 and 414.65 must be met for DMEPOS coverage purposes.
Consistent with Sec. 410.38(d), the face-to-face encounter must be
documented in the pertinent portion of the medical record (for example,
history, physical examination, diagnostic tests, summary of findings,
progress notes, treatment plans or other sources of information that
may be appropriate). The supporting documentation must include
subjective and objective beneficiary specific information used for
diagnosing, treating, or managing a clinical condition for which the
DMEPOS item(s) is ordered. Upon request by CMS or its review
contractors, a supplier must submit additional documentation to support
and substantiate the medical necessity for the DMEPOS item.
Section 410.38(c)(8) of the Act states new additions to the F2F/
WOPD list will be communicated to the public and effective no less than
60 days after a Federal Register document publication and a CMS website
posting. To assist stakeholders in preparing for implementation of the
new items, these changes will become effective 90 days after
publication of this rule. Stakeholders may refer to the CMS website
posting for more information on the implementation date.
III. Collection of Information Requirements
This document announces the selection of additional HCPCS codes to
be placed on the F2F/WOPD List. These updates to the F2F/WOPD List do
not constitute information collections 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.).
IV. Regulatory Impact Statement
We have examined the impact of this regulatory document as required
by Executive Order 12866 on Regulatory Planning and Review (September
30, 1993), Executive Order 13563 on Improving Regulation and Regulatory
Review (January 18, 2011), the Regulatory Flexibility Act (RFA)
(September 19, 1980, Pub. L. 96-354), section 1102(b) of the Act,
section 202 of the Unfunded Mandates Reform Act of 1995 (March 22,
1995; Pub. L. 104-4), Executive Order 13132 on Federalism (August 4,
1999), and the Congressional Review Act (5 U.S.C. 804(2)).
Executive Orders 12866 and 13563 direct agencies to assess all
costs and benefits of available regulatory alternatives and, if
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, distributive impacts, and equity). A
Regulatory Impact Analysis (RIA) must be prepared for major rules with
significant regulatory action/s and/or with economically significant
effects ($100 million or more in any 1 year). This regulatory document
is not significant and does not reach the economic threshold and thus
is not considered a major regulatory document.
The RFA requires agencies to analyze options for regulatory relief
of small entities. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and small governmental
jurisdictions. Most hospitals and most other providers and suppliers
are small entities, either by nonprofit status or by having revenues of
less than $8.0 million to $41.5 million in any 1 year. Individuals and
States are not included in the definition of a small entity. We are not
preparing an analysis for the RFA because we have determined, and the
Secretary certifies, that this regulatory document will not have a
significant economic impact on a substantial number of small entities.
In addition, section 1102(b) of the Act requires us to prepare an
RIA if a rule may have a significant impact on the operations of a
substantial number of small rural hospitals. This analysis must conform
to the provisions of section 604 of the RFA. For purposes of section
1102(b) of the Act, we define a small rural hospital as a hospital that
is located outside of a Metropolitan Statistical Area for Medicare
payment regulations and has fewer than 100 beds. We are not preparing
an analysis for section 1102(b) of the Act because we have determined,
and the Secretary
[[Page 2550]]
certifies, that this regulatory document will not have a significant
impact on the operations of a substantial number of small rural
hospitals.
Section 202 of the Unfunded Mandates Reform Act of 1995 also
requires that agencies assess anticipated costs and benefits before
issuing any rule whose mandates require spending in any 1 year of $100
million in 1995 dollars, updated annually for inflation. In 2022, that
threshold is approximately $165 million. This regulatory document will
have no consequential effect on State, local, or tribal governments or
on the private sector.
Executive Order 13132 establishes certain requirements that an
agency must meet when it promulgates a proposed rule (and subsequent
final rule or other regulatory document) that imposes substantial
direct requirement costs on State and local governments, preempts State
law, or otherwise has Federalism implications. Since this regulatory
document does not impose any costs on State or local governments, the
requirements of Executive Order 13132 are not applicable.
In accordance with the provisions of Executive Order 12866, this
document was reviewed by the Office of Management and Budget.
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Chiquita Brooks-LaSure, having reviewed and approved this
document, authorizes Lynette Wilson, who is the Federal Register
Liaison, to electronically sign this document for purposes of
publication in the Federal Register.
Dated: January 11, 2023.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2023-00718 Filed 1-13-23; 8:45 am]
BILLING CODE 4120-01-P