34712 Federal Register / Vol. 76, No. 114 / Tuesday, June 14, 2011 / Notices 

until September 24, 2010, which was 

only 6 days prior to the date Colorado 

submitted the SPA to CMS. This issue 

is whether 6 days is a reasonable time 

period to allow for the submission and 

consideration of comments. 

• Sufficiency of Solicitation: Whether 

Colorado met the statutory requirement 

at section 1902(a)(73) to solicit advice 

when the notice to the tribes did not 

describe the potential impact that the 

rate reduction for transportation would 

have on the tribes, Indians, Indian 

health providers, or urban Indian 

organizations. 

Section 1116 of the Act and Federal 

regulations at 42 CFR part 430, establish 

Department procedures that provide an 

administrative hearing for 

reconsideration of a disapproval of a 

State plan or plan amendment. CMS is 

required to publish a copy of the notice 

to a State Medicaid agency that informs 

the agency of the time and place of the 

hearing, and the issues to be considered. 

If we subsequently notify the agency of 

additional issues that will be considered 

at the hearing, we will also publish that 

notice. 

Any individual or group that wants to 

participate in the hearing as a party 

must petition the presiding officer 

within 15 days after publication of this 

notice, in accordance with the 

requirements contained at 42 CFR 

430.76(b)(2). Any interested person or 

organization that wants to participate as 

amicus curiae must petition the 

presiding officer before the hearing 

begins in accordance with the 

requirements contained at 42 CFR 

430.76(c). If the hearing is later 

rescheduled, the presiding officer will 

notify all participants. 

The notice to Colorado announcing an 

administrative hearing to reconsider the 

disapproval of its SPAs reads as follows: 

Ms. Laurel Karabotsos, 

Acting Medical Director, 

Department of Health Care Policy and 

Financing, 

Medical & CHP+ Administration Office, 

1570 Grant Street, 

Denver, CO 80203–1818. 

Dear Ms. Karabotsos: 

I am responding to your request for 

reconsideration of Centers for Medicare 

& Medicaid Services’ (CMS) decision to 

disapprove the Colorado State Plan 

Amendment (SPA) 10–034, which was 

submitted to CMS on September 30, 

2010, and disapproved on March 10, 

2011. The SPA proposed to revise the 

methods and standards for establishing 

payment rates for non-brokered and 

brokered non-emergency medical 

transportation. The disapproval was 

based on a finding that the State had not 

complied with the requirements of 

section 1902(a)(73)(A) of the Social 

Security Act to solicit advice from 

designees of Indian Health Programs 

and Urban Indian Organizations prior to 

submission of a SPA likely to have a 

direct effect on Indians, Indian Health 

Programs, or Urban Indian 

Organizations. 

The issues to be considered at the 

hearing are: 

• Applicability: Whether the statutory 

requirement in section 1902(a)(73)(A) of 

the Social Security Act (the Act) for 

solicitation of advice prior to the 

submission of a SPA that is likely to 

have a direct effect on Indians, Indian 

Health Programs, or Urban Indian 

Organizations is applicable to this SPA 

when there are significant numbers of 

Indian beneficiaries who receive 

transportation services, and Indian 

Health Programs and Urban Indian 

Organizations that are transportation 

providers in the State. 

• Solicitation of advice: Whether 

Colorado met the statutory requirement 

at section 1902(a)(73)(A) to solicit 

advice when it did not include in any 

issuance to Indian health programs and 

Urban Indian Organizations prior to the 

submission of the SPA any specific 

solicitation of advice or comment on the 

SPA (or any description of a process for 

the submission of comments or 

initiation of a dialogue with the State). 

• Timing: Whether Colorado met the 

statutory requirement at section 

1902(a)(73)(A) to solicit advice when it 

issued general public notice on June 25, 

2010, of the rate reductions that were to 

go into effect July 1, 2010, but did not 

issue notice to the Indian health 

programs or Urban Indian Organizations 

until September 24, 2010, which was 

only 6 days prior to the date Colorado 

submitted the SPA to CMS. This issue 

is whether 6 days is a reasonable time 

period to allow for the submission and 

consideration of comments. 

• Sufficiency of Solicitation: Whether 

Colorado met the statutory requirement 

at section 1902(a)(73) to solicit advice 

when the notice to the tribes did not 

describe the potential impact that the 

rate reduction for transportation would 

have on the tribes, Indians, Indian 

health providers, or urban Indian 

organizations. 

I am scheduling a hearing on your 

request for reconsideration to be held on 

August 4, 2011, at the CMS Denver 

Regional Office, Colorado State Bank 

Building, 1600 Broadway, Suite 700, 

Denver, Colorado 80202–4367, in order 

to reconsider the decision to disapprove 

SPA 10–034. 

If this date is not acceptable, CMS 

rules provide that the hearing date may 

be changed by written agreement 

between CMS and the State. The hearing 

will be governed by the procedures 

prescribed by Federal regulations at 42 

CFR part 430. 

I am designating Mr. Benjamin Cohen 

as the presiding officer. If these 

arrangements present any problems, 

please contact the presiding officer at 

(410) 786–3169. In order to facilitate any 

communication which may be necessary 

between the parties to the hearing, 

please notify the presiding officer to 

indicate acceptability of the hearing 

date that has been scheduled, and to 

provide names of the individuals who 

will represent the State at the hearing. 

Sincerely, 

Donald M. Berwick, M.D. 

Section 1116 of the Social Security 

Act (42 U.S.C. section 1316; 42 CFR 

section 430.18) 

(Catalog of Federal Domestic Assistance 

program No. 13.714, Medicaid Assistance 

Program.) 

Dated: June 8, 2011, 

Donald M. Berwick, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2011–14674 Filed 6–13–11; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–5501–N2] 

Medicare Program; Pioneer 

Accountable Care Organization Model; 

Extension of the Submission 

Deadlines for the Letters of Intent and 

Applications 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice of extension of 

deadlines. 

SUMMARY: This notice extends the 

deadlines for the submission of the 

Pioneer Accountable Care Organization 

Model letters of intent to June 30, 2011 

and the applications to August 19, 2011. 

DATES: Letter of Intent Submission 

Deadline: Interested organizations must 

submit a non-binding letter of intent by 

June 30, 2011 as described on the 

Innovation Center Web site at http:// 

innovations.cms.gov/areas-of-focus/ 

seamless-and-coordinated-care-models/ 

pioneer-aco. 

Application Submission Deadline: 

Applications must be postmarked on or 

before August 19, 2011. The Pioneer 

Accountable Care Organization Model 


srobinson on DSK4SPTVN1PROD with NOTICES
Federal Register / Vol. 76, No. 114 / Tuesday, June 14, 2011 / Notices 34713 

Application is available at: http:// 

innovations.cms.gov/areas-of-focus/ 

seamless-and-coordinated-care-models/ 

pioneer-aco-application/. 

ADDRESSES: Applications should be 

submitted by mail to the following 

address by the date specified in the 

DATES section of this notice: 

Pioneer ACO Model, Attention: Maria 

Alexander, Center for Medicare and 

Medicaid Innovation, Centers for 

Medicare and Medicaid Services, Mail 

Stop S3–13–05, 7500 Security 

Boulevard, Baltimore, MD 21244– 

1850. 

FOR FURTHER INFORMATION CONTACT: 

Maria Alexander, (410) 786–4792. 

SUPPLEMENTARY INFORMATION: 

I. Background 

We are committed to achieving the 

three-part aim of better health, better 

health care, and lower per-capita costs 

for Medicare, Medicaid, and Children’s 

Health Insurance Program beneficiaries. 

One potential mechanism for achieving 

this goal is for CMS to partner with 

groups of health care providers of 

services and suppliers with a 

mechanism for shared governance that 

have formed an Accountable Care 

Organization (ACO) through which they 

work together to manage and coordinate 

care for a specified group of patients. 

We will pursue such partnerships 

through two complementary efforts, the 

Medicare Shared Savings Program, and 

initiatives undertaken by the Center for 

Medicare and Medicaid Innovation 

(Innovation Center). 

The Pioneer ACO Model is an 

Innovation Center initiative targeted at 

organizations that can demonstrate the 

improvements in financial and clinical 

performance with respect to the care of 

Medicare beneficiaries that are possible 

in a mature ACO. To be eligible to 

participate in the Pioneer ACO Model, 

organizations would ideally already be 

coordinating care for a significant 

portion of patients under financial risk 

sharing contracts and be positioned to 

transform both their care and financial 

models from fee-for-service to a threepart aim, value based model. 

On May 17, 2011, we posted a request 

for applications to participate in the 

Pioneer ACO Model on the Innovation 

Center Web site and we subsequently 

published a notice announcing the 

request for applications in the May 20, 

2011 Federal Register (76 FR 29249). 

On the Innovation Center Web site, we 

specified that the submission deadline 

for the letter of intent was June 10, 2011 

and that the application deadline was to 

be postmarked on or before July 18, 

2011. For more details see the request 

for application which is available on the 

Innovation Center Web site at http:// 

innovations.cms.gov/areas-of-focus/ 

seamless-and-coordinated-care-models/ 

pioneer-aco. However, in the May 20, 

2011 notice, we specified that the 

submission deadlines were June 10, 

2011 and not later than 5 p.m. on July 

19, 2011, respectively. Therefore, in the 

June 8, 2011 Federal Register (76 FR 

33306), we published a correction 

notice that corrected our error in the 

application submission deadline. 

II. Provisions of the Notice 

The Innovation Center is committed 

to working with stakeholders to develop 

initiatives to test innovative payment 

and service delivery models to reduce 

program expenditures while enhancing 

the quality of care available to 

beneficiaries. Being responsive to the 

suggestions of the stakeholder 

community is critical to the success of 

the Innovation Center’s efforts to 

achieve the three-part aim of better 

healthcare, better health, and reduced 

costs through improvement. As part of 

this commitment, and based on the 

feedback from the community of 

potential applicants, the Innovation 

Center is extending the following 

deadlines relating to the Pioneer ACO 

Model: (1) The deadline for submission 

of the letter of intent has been extended 

to June 30, 2011; and (2) the deadline 

for the submission of the application 

has been extended to August 19, 2011. 

Therefore in the DATES section of this 

notice, we included the new 

submissions deadlines and in the 

ADDRESSES section we provide the 

address to which the applications must 

be mailed. 

Authority: Section 1115A of the Social 

Security Act. 

Dated: June 8, 2011. 

Donald M. Berwick, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2011–14678 Filed 6–9–11; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–7031–NC3] 

Proposed Establishment of a Federally 

Funded Research and Development 

Center—Third Notice 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health & Human Services (DHHS). 

ACTION: Notice. 

SUMMARY: This notice announces our 

intention to sponsor Federally Funded 

Research and Development Center 

(FFRDC) to facilitate the modernization 

of business processes and supporting 

systems and their operations. This is the 

third of three notices which must be 

published over a 90-day period in order 

to advise the public of the agency’s 

intention to sponsor an FFRDC. 

DATES: We must receive comments on or 

before July 5, 2011. 

ADDRESSES: Comments on this notice 

must be mailed to the Centers for 

Medicare & Medicaid Services, Candice 

Savoy, Contracting Officer, 7500 

Security Boulevard, Mailstop C2–01–10, 

Baltimore, MD 21244 or e-mail at 

Candice.Savoy@cms.hhs.gov. 

FOR FURTHER INFORMATION CONTACT: 

Candice Savoy, (410) 786–7494 or 

Candice.Savoy@cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: The 

Centers for Medicare & Medicaid 

Services (CMS), an operating division 

within the Department of Health and 

Human Services (DHHS), intends to 

sponsor a Federally Funded Research 

and Development Center (FFRDC) to 

facilitate the modernization of business 

processes and supporting systems and 

their operations. Some of the broad task 

areas that will be utilized include 

strategic/tactical planning, conceptual 

planning, design and engineering, 

procurement assistance, organizational 

planning, research and development, 

continuous process improvement, 

Independent Verification and Validation 

(IV&V)/compliance, and security 

planning. Further analysis will consist 

of expert advice and guidance in the 

areas of program and project 

management focused on increasing the 

effectiveness and efficiency of strategic 

information management, prototyping, 

demonstrations, and technical activities. 

The FFRDC may also be utilized by nonsponsors, within DHHS. 

The FFRDC will be established under 

the Federal Acquisition Regulations (48 

CFR 35.017). 

The FFRDC will be available to 

provide a wide range of support 

including, but not limited to: 

• Strategic/tactical planning 

including assisting with planning for 

future CMS program policy, innovation, 

development, and support for Medicare 

and Medicaid. 

• Conceptual planning including 

operations, analysis, requirements, 

procedures, and analytic support. 

• Design and engineering including 

technical architecture direction. 


srobinson on DSK4SPTVN1PROD with NOTICES