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Federal Register / Vol. 72, No.

65 / Thursday, April 5, 2007 / Notices 16793

Dated: March 29, 2007. • Whether the amount or scope of Education Plan or Individual Family Service
Joan F. Karr, services reimbursed through the Plan. The Centers for Medicare & Medicaid
bundled rate is sufficiently constant so Services (CMS) disapproved the SPA because
Acting Reports Clearance Officer, Centers for
the State did not document that its proposed
Disease Control and Prevention. that the proposed methodologies would
reimbursement methodology meets the
[FR Doc. E7–6344 Filed 4–4–07; 8:45 am] be an economic and efficient method of conditions specified in sections 1902(a)(10),
BILLING CODE 4163–18–P payment; 1902(a)(30), and 1902(a)(32) of the Social
• Whether all of the component parts Security Act (the Act).
of the service are delivered as At issue in this reconsideration is whether
DEPARTMENT OF HEALTH AND recommended within the scope of Minnesota has demonstrated that the
HUMAN SERVICES practice of the physician or licensed bundled rate methodology proposed in SPA
practitioner of the healing arts; 05–10 is consistent with the requirements of
Centers for Medicare & Medicaid • Whether the actual practitioners section 1902(a)(30)(A) of the Act, which
Services requires that States have methods and
who will be furnishing services can be procedures to assure that payments to
readily identified; and providers are consistent with efficiency,
Notice of Hearing: Reconsideration of • Whether the bundled rates provide economy, and quality of care. A second issue
Disapproval of Minnesota State Plan for direct payment to the actual is whether the State has shown that the
Amendment 05–10 practitioners who provide the service. payment methodology is for care and services
AGENCY: Centers for Medicare & Section 1116 of the Social Security that are within the scope, and meet the
Act and Federal regulations at 42 CFR requirements, of section 1902(a)(10)(A) to
Medicaid Services (CMS), HHS. make available ‘‘medical assistance,’’ which
part 430, establish Department
ACTION: Notice of hearing. procedures that provide an is defined at section 1905(a) and
implementing requirements. Also at issue is
administrative hearing for
SUMMARY: This notice announces an whether the proposed payment methodology
reconsideration of a disapproval of a complies with the direct payment
administrative hearing to be held on
State plan or plan amendment. CMS is requirements of section 1902(a)(32) of the
May 30, 2007, at 233 N. Michigan
required to publish a copy of the notice Act, which precludes payment to anyone
Avenue, Suite 600, the Indiana Room,
to a State Medicaid agency that informs other than the individual, person, or
Chicago, IL 60601, to reconsider CMS’
the agency of the time and place of the institution providing the care and service
decision to disapprove Minnesota State (with specified exceptions). We discuss each
hearing, and the issues to be considered.
plan amendment 05–10. of these issues in more detail below in
If we subsequently notify the agency of
CLOSING DATE: Requests to participate in additional issues that will be considered relation to SPA 05–10.
the hearing as a party must be received Section 1902(a)(30)(A) of the Act requires
at the hearing, we will also publish that
by the presiding officer by (15 days after that States have methods and procedures to
notice. assure that payments to providers are
publication). Any individual or group that wants to consistent with efficiency, economy, and
FOR FURTHER INFORMATION CONTACT: participate in the hearing as a party quality of care. The per diem payment
Kathleen Scully-Hayes, Presiding must petition the presiding officer methodologies for mental health
Officer, CMS, Lord Baltimore Drive, within 15 days after publication of this rehabilitative services described in SPA 05–
Mail Stop LB–23–20, Baltimore, notice, in accordance with the 10 represent bundled payment
Maryland 21244. Telephone: (410) 786– requirements contained at 42 CFR methodologies under which the State pays a
2055. 430.76(b)(2). Any interested person or single rate for one or more of a group of
organization that wants to participate as different services furnished to an eligible
SUPPLEMENTARY INFORMATION: This individual during a fixed period of time. The
notice announces an administrative amicus curiae must petition the State has failed to demonstrate that its
hearing to reconsider CMS’ decision to presiding officer before the hearing methodologies are in compliance with
disapprove Minnesota State plan begins in accordance with the section 1902(a)(30)(A), in that it has not
amendment (SPA) 05–10 which was requirements contained at 42 CFR shown: that these methodologies accurately
submitted on September 21, 2005. This 430.76(c). If the hearing is later reflect true costs or reasonable fees for the
SPA was disapproved on December 29, rescheduled, the presiding officer will services included in the bundles; and that the
notify all participants. amount or scope of services reimbursed
2006.
through the bundled rate is sufficiently
Under this SPA, the State proposed to The Notice to Minnesota Announcing constant so that the proposed methodologies
revise coverage and reimbursement an Administrative Hearing To would be an economic and efficient method
methodology for Early and Periodic Reconsider the Disapproval of Its SPA of payment.
Screening, Diagnosis, and Treatment Reads as Follows Section 1902(a)(10)(A) requires that State
services related to children’s mental plans make available medical assistance,
health rehabilitative services and Ms. Christine Bronson, which is defined at section 1905(a) and in
Medicaid Director, implementing regulations. For a number of
rehabilitative services pursuant to an Minnesota Department of Human Services,
Individualized Education Plan or categories of medical assistance, there are
P.O. Box 64998, provider standards applicable to different
Individual Family Service Plan. St. Paul, MN 55164–0998 types of care and services, and for
The amendment was disapproved Dear Ms. Bronson: I am responding to your rehabilitative services there is a requirement
because CMS found that the amendment request for reconsideration of the decision to that rehabilitative services must be
violated the statute for reasons set forth disapprove the Minnesota State plan recommended by a physician or other
in the disapproval letter. amendment (SPA) 05–10, which was licensed practitioner of the healing arts.
The issues to be decided at the submitted on September 21, 2005, and Minnesota did not provide evidence of a
hearing are: disapproved on December 29, 2006. method to identify that providers of the
• Whether the per diem (bundled) Under this SPA, the State proposed to component parts of the care and services
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revise coverage and reimbursement would meet all applicable provider


payment methodologies for mental methodology for Early and Periodic requirements. Nor did Minnesota
health rehabilitative services described Screening, Diagnosis, and Treatment services demonstrate a method to ensure that all of
in Minnesota’s SPA 05–10 accurately related to children’s mental health the component parts of the care and services
reflect true costs or reasonable fees for rehabilitative services and rehabilitative furnished under the bundled payment
the services included in the bundles; services pursuant to an Individualized methodology proposed in SPA 05–10, would

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16794 Federal Register / Vol. 72, No. 65 / Thursday, April 5, 2007 / Notices

be delivered as recommended within the DEPARTMENT OF HEALTH AND includes a brief explanation of the
scope of practice of the physician or licensed HUMAN SERVICES justification for the variation.
practitioner of the healing arts. We announced in the December 2006
Furthermore, the information provided by Centers for Medicare & Medicaid Unified Agenda (December 11, 2006, 71
the State did not demonstrate compliance Services FR 72734) that we would issue the final
with section 1902(a)(32) of the Act, requiring rule in March 2007. However, we are
direct payment to the provider of care or [CMS–1270–RCN]
not able to meet the announced
services. Under the State’s bundled payment RIN 0938–AN14 publication target date due to the
methodology, the entities which would number of extensive comments received
receive the proposed bundled rates for Medicare Program; Competitive on the proposed rule and interagency
mental health rehabilitation services are not Acquisition for Certain Durable coordination. We received over 2,000
themselves providers of the service; they are Medical Equipment, Prosthetics, timely comments on the proposed rule.
not billing agents for such providers; nor are Orthotics, and Supplies; Extension of The commenters presented extremely
they recognized types of health care Timeline for Publication of Final Rule complex policy and legal issues, which
providers under Federal law. The underlying
AGENCY: Centers for Medicare & require extensive consultation and
services represent different types of
Medicaid Services (CMS), HHS. analysis.
individual services that are furnished by
ACTION: Extension of timeline for
This final rule also is extremely
individual practitioners. The State has failed
publication of final rule. complex because it will establish an
to show that the proposed payment
entirely new program that will affect the
methodology is within one of the statutory
SUMMARY: This notice announces an DMEPOS industry as well as Medicare
exceptions as implemented by Federal
regulations at 42 CFR 447.10. Indeed, the extension of the timeline for publication beneficiaries who use DMEPOS. This
State has not shown that, under its proposed of a Medicare final rule in accordance final rule will establish a new concept
payment methodology, the actual with section 1871(a)(3)(B) of the Social for Medicare payment for DMEPOS,
practitioners furnishing services can even be Security Act, which allows us to extend which necessitates the development of
readily identified. Thus, the State has not the timeline for publication of the final new regulations and a competitive
demonstrated that the use of bundled rates rule. bidding process in addition to extensive
will comply with the requirement for direct EFFECTIVE DATE: This notice is effective payment system changes.
payment to the actual practitioners who on March 30, 2007. This notice extends the timeline for
provide care or service. FURTHER INFORMATION CONTACT: Ralph
publication of the final rule until April
I am scheduling a hearing on your request Goldberg, (410) 786–4870. 30, 2007.
for reconsideration to be held on May 30, SUPPLEMENTARY INFORMATION: In the May Authority: Section 1871 of the Social
2007, at 233 N. Michigan Avenue, Suite 600, 1, 2006 Federal Register (71 FR 25654), Security Act (42 U.S.C. 201395hh).
the Indiana Room, 5th Floor, Chicago, IL, (Catalog of Federal Domestic Assistance
we published a proposed rule that
60601, to reconsider the decision to Program No. 093.774, Medicare—
would have implemented competitive
disapprove SPA 05–10. If this date is not Supplementary Medical Insurance Program)
bidding programs for certain covered
acceptable, we would be glad to set another Dated: March 30, 2007.
date that is mutually agreeable to the parties.
items of durable medical equipment,
prosthetics, orthotics, and supplies Ann Agnew,
The hearing will be governed by the
procedures prescribed by Federal regulations (DMEPOS) throughout the United States Executive Secretary to the Department.
at 42 CFR Part 430. in accordance with sections 1847(a) and [FR Doc. 07–1658 Filed 3–30–07; 4:01 pm]
I am designating Ms. Kathleen Scully- (b) of the Social Security Act (the Act). BILLING CODE 4120–01–P
Hayes as the presiding officer. If these These programs would change the way
arrangements present any problems, please that Medicare pays for these items
contact the presiding officer at (410) 786– under Part B of the Medicare program DEPARTMENT OF HEALTH AND
2055. In order to facilitate any by utilizing bids submitted by DMEPOS HUMAN SERVICES
communication which may be necessary suppliers to establish applicable
between the parties to the hearing, please payment amounts. Administration for Children and
notify the presiding officer to indicate Section 1871(a)(3)(A) of the Act Families
acceptability of the hearing date that has requires us to establish and publish a
been scheduled and provide names of the regular timeline for the publication of Public Education Study on Public
individuals who will represent the State at final regulations based on the previous Knowledge of Abstinence and
the hearing. publication of a proposed regulation. In Abstinence Education
Sincerely, accordance with section 1871(a)(3)(B) of OMB No.: New Collection.
Leslie V. Norwalk, Esq., the Act, the timeline may vary among Description: In support of the goal to
Acting Administrator. different regulations based on prevent unwed childbearing, pregnancy,
differences in the complexity of the and sexually transmitted diseases,
Section 1116 of the Social Security regulation, the number and scope of Congress has recently authorized
Act (42 U.S.C. section 1316); (42 CFR comments received, and other relevant funding increases to support abstinence
section 430.18). factors, but may not be longer than 3 education.
(Catalog of Federal Domestic Assistance years except under exceptional To learn more about the public’s
program No. 13.714, Medicaid Assistance circumstances. In addition, in views, the Administration for Children
Program) accordance with section 1871(a)(3)(B) of and Families (ACF) will conduct a
the Act, the Secretary may extend the public opinion survey of a nationally
Dated: March 30, 2007.
initial targeted publication date of the representative sample of adolescents
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Leslie V. Norwalk, final regulation, if the Secretary, no later (age 12 to 18) and their parents to
Acting Administrator, Centers for Medicare than the regulation’s previously examine current attitudes on abstinence
& Medicaid Services. established proposed publication date, and knowledge of abstinence education.
[FR Doc. E7–6312 Filed 4–4–07; 8:45 am] causes to have published a notice with The survey data will be used to inform
BILLING CODE 4120–01–P the new target date, and such notice current and future public education

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