72708 Federal Register / Vol. 76, No. 227 / Friday, November 25, 2011 / Notices 

however, in the topics that they choose 

to discuss. 

Procedure and Agenda: This meeting 

is open to the public. The Panel will 

likely hear presentations by panel 

members and HHS staff regarding long 

range projection methods and 

assumptions. After any presentations, 

the Panel will deliberate openly on the 

topic. Interested persons may observe 

the deliberations, but the Panel will not 

hear public comments during this time. 

The Panel will also allow an open 

public session for any attendee to 

address issues specific to the topic. 

Authority: 42 U.S.C. 217a; Section 222 of 

the Public Health Services Act, as amended. 

The panel is governed by provisions of 

Public Law 92–463, as amended (5 U.S.C. 

appendix 2), which sets forth standards for 

the formation and use of advisory 

committees. 

Dated: November 18, 2011. 

Sherry Glied, 

Assistant Secretary for Planning and 

Evaluation. 

[FR Doc. 2011–30337 Filed 11–23–11; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1593–N] 

Medicare Program; Renaming and 

Other Changes to the Advisory Panel 

on Hospital Outpatient Payment 

Charter (Formerly the Advisory Panel 

on Ambulatory Payment Classification 

Groups) and Request for Nominations 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

name change of the Advisory Panel on 

Ambulatory Payment Classification 

Groups to the Advisory Panel on 

Hospital Outpatient Payment (HOP) (the 

Panel). In addition, it announces the 

renewal and amendments to the charter 

including changing the scope of the 

Panel to include supervision of 

outpatient hospital services, changing 

the Panel membership to include 

Critical Access Hospitals (CAH), and the 

solicitation of six nominations for 

individuals to serve on the Panel in 

2012. 

DATES: Submission of Nominations: We 

will consider nominations if they are 

received no later than 5 p.m. (e.s.t.), 

December 27, 2011. 

ADDRESSES: Please email, mail or hand 

deliver nominations to the following 

address: Centers for Medicare & 

Medicaid Services; Attn: Paula Smith, 

Advisory Panel on HOP; Center for 

Medicare, Hospital & Ambulatory Policy 

Group, Division of Outpatient Care; 

7500 Security Boulevard, Mail Stop C4– 

05–17; Woodlawn, MD 21244–1850, 

Paula.Smith@cms.hhs.gov. 

FOR FURTHER INFORMATION CONTACT: For 

questions or other information about the 

Panel, submit a written request to Paula 

Smith at the addresses provided above 

or call (410) 786–4709. 

Advisory Committees’ Information 

Lines: You may also refer to the CMS 

Federal Advisory Committee Hotlines at 

1–(877) 449–5659 (toll-free) or (410) 

786–9379 (local) for additional 

information. 

Web site: For additional information 

on the Panel, the revised charter and 

updates to the Panel’s activities, please 

access our Web site: http://

www.cms.hhs.gov/FACA/05_Advisory

PanelonAmbulatoryPayment

ClassificationGroups.asp#TopOfPage. 

(Note: There is an UNDERSCORE after 

FACA/05_; there is no space.) 

News Media: Representatives should 

contact the CMS Press Office at (202) 

690–6145. 

Copies of the Charter: Copies of the 

Charter are available on the Internet at: 

http://www.cms.gov/FACA/05_Advisory

PanelonAmbulatoryPayment

ClassificationGroups.asp#TopOfPage. 

(Note: There is an UNDERSCORE after 

FACA/05_; there is no space.) 

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 section 222 of the Public 

Health Service Act (PHS Act) to consult 

with an expert outside advisory panel 

regarding the clinical integrity of the 

Ambulatory Payment Classification 

(APC) groups and relative payment 

weights. The Advisory Panel on 

Hospital Outpatient Payment (HOP) (the 

Panel, which was formerly known as the 

Advisory Panel on Ambulatory Payment 

Classification Groups) is governed by 

the provisions of the Federal Advisory 

Committee Act (FACA) (Pub. L. 92– 

463), as amended (5 U.S.C. Appendix 2), 

which sets forth standards for the 

formation and use of advisory panels. 

The Charter provides that the Panel 

shall meet up to 3 times annually. We 

consider the technical advice provided 

by the Panel as we prepare the proposed 

and final rules to update the outpatient 

prospective payment system (OPPS) for 

the next calendar year. 

The Panel shall consist of a chair and 

up to 19 members (previously 15) who 

are full-time employees of hospitals, 

hospital systems, or other Medicare 

providers. For purposes of the Panel, 

consultants or independent contractors 

are not considered to be full-time 

employees in these organizations. 

The current Panel consists of the 

following members: (The asterisk [*] 

indicates the Panel member whose term 

will end on February 29, 2012.) 

• E. L. Hambrick, M.D., J.D., Chair, a 

CMS Medical Officer. 

• Ruth L. Bush, M.D., M.P.H. 

• Kari S. Cornicelli, C.P.A., FHFMA. 

• Dawn L. Francis, M.D., M.H.S. 

• Kathleen Graham, R.N., M.S.H.A.* 

• David A. Halsey, M.D. 

• Brian D. Kavanagh, M.D., M.P.H. 

• Judith T. Kelly, B.S.H.A., RHIT, RHIA, 

CCS. 

• Scott Manaker, M.D., Ph.D. 

• John Marshall, CRA, RCC, CIRCC, 

RT(R), FAHRA. 

• Randall A. Oyer, M.D. 

• Jacqueline Phillips. 

• Daniel J. Pothen, M.S., RHIA, CHPS, 

CPHIMS, CCS, CCS–P, CHC. 

• Gregory J. Przbylski, M.D. 

• Marianna V. Spanaki-Varela, M.D., 

Ph.D., M.B.A. 

Panel members serve without 

compensation, according to an advance 

written agreement. For the meetings, we 

reimburse travel, meals, lodging, and 

related expenses in accordance with 

standard Government travel regulations. 

We have a special interest in attempting 

to ensure, while taking into account the 

nominee pool, that the Panel is diverse 

in all respects of the following: 

Geography, rural or urban practice, 

points of view, medical or technical 

specialty, type of hospital, hospital 

health system, or other Medicare 

provider. 

Based upon either self-nominations or 

nominations submitted by providers or 

interested organizations, the Secretary, 

or her designee, appoints new members 

to the Panel from among those 

candidates determined to have the 

required expertise. New appointments 

are made in a manner that ensures a 

balanced membership under the FACA 

guidelines. 

The Secretary signed the original 

charter establishing the Panel on 

November 21, 2000, and approved the 

renewal, renaming, and amendment of 

the Panel charter on November 15, 2011. 

The charter will terminate on November 

15, 2013, unless renewed or amended 

by appropriate actions. 

II. Criteria for Nominees 

The Panel must be fairly balanced in 

its membership in terms of the points of 


wreier-aviles on DSK7SPTVN1PROD with NOTICES
Federal Register / Vol. 76, No. 227 / Friday, November 25, 2011 / Notices 72709 

view represented and the functions to 

be performed. The Panel shall consist of 

up to 19 total members (previously 15) 

representing providers. The Secretary or 

the Administrator of the Centers for 

Medicare & Medicaid Services (the 

Administrator) selects the member 

based upon their technical expertise in 

hospital payment systems; hospital 

medical care delivery systems; provider 

billing and accounting systems; APC 

grouping; Current Procedural 

Terminology codes and Healthcare 

Common Procedure Coding System 

coding experts; the use of, and payment 

for, drugs and medical devices, and 

other services in the hospital outpatient 

setting; and other forms of relevant 

expertise. For supervision deliberations, 

the Panel shall have members that 

represent the interests of Critical Access 

Hospitals (CAHs), who advise CMS only 

regarding the level of supervision for 

hospital outpatient services. 

All members shall have a minimum of 

5 years experience in their areas of 

expertise, but it is not necessary that 

any member be an expert in all of the 

areas listed above. Panel members are 

full-time employees of hospitals, 

hospital systems, or other Medicare 

providers. 

For purposes of this Panel, 

consultants or independent contractors 

are not considered to be representatives 

of providers. All members shall serve on 

a voluntary basis, without 

compensation, pursuant to advance 

written agreement. Members of the 

Panel shall be entitled to receive 

reimbursement for travel expenses and 

per diem in lieu of subsistence, in 

accordance with standard government 

travel regulations. Panel members may 

serve for up to 4-year terms. A member 

may serve after the expiration of his or 

her term until a successor has been 

sworn in. 

Any interested person or organization 

may nominate one or more qualified 

individuals. Self-nominations will also 

be accepted. Each nomination must 

include the following: 

• Letter of Nomination stating the 

reasons why the nominee should be 

considered, 

• Curriculum vitae or resume of the 

nominee, 

• Written and signed statement from 

the nominee that the nominee is willing 

to serve on the Panel under the 

conditions described in this notice and 

further specified in the Charter, and 

• The hospital or hospital system 

name and address, or CAH name and 

address, as well as all Medicare hospital 

and or Medicare CAH billing numbers 

of the facility where the nominee is 

employed. 

III. Provisions of the Notice 

A. Renaming, Renewal, and 

Amendment of the Charter 

Over the last decade, the role of the 

Panel in assisting CMS in decisions 

about the clinical integrity of the APC 

groups and their associated weights, 

which are major elements of the OPPS, 

has led to the overall improved 

functioning of the OPPS. 

As previously stated, this notice 

renames the Advisory Panel on APC 

Groups (APC Panel), which is now 

called the Advisory Panel on Hospital 

Outpatient Payment (HOP Panel) and 

referred to as ‘‘the Panel.’’ The Panel 

advises the Secretary and Administrator 

on developing and implementing 

national practices that support 

consistent implementation of 

supervision for hospital outpatient 

services by determining the appropriate 

supervision level for hospital outpatient 

services, in addition to its current role 

of advising on clinical integrity of the 

APC groups and their associated 

weights. 

B. Increasing the Panel Membership 

From 15 to 19 Members 

We are also increasing the number of 

members on the Panel from 15 to 19, 

some of which will represent CAHs for 

the deliberation of supervision of 

outpatient hospital services. 

C. Changing the Scope of the Panel To 

Include Supervision 

The Panel may advise the Secretary 

and the Administrator on the following: 

• The clinical integrity of the APC 

groups and their associated weights, 

which are major elements of the OPPS; 

and 

• The appropriate supervision level 

for hospital outpatient services. With 

respect to supervision, the Panel may 

recommend a supervision level (general, 

direct, or personal) to ensure an 

appropriate level of quality and safety 

for delivery of a given service, as 

described by a Healthcare Common 

Procedure Code System (HCPCS) code. 

D. Description of Duties of Panel 

Members 

The Panel is technical in nature, and 

may consider the following issues: 

• Addressing whether procedures 

within an APC group are similar both 

clinically and in terms of resource use. 

• Reconfiguring APCs (for example, 

separating a single APC into two APCs, 

moving 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 determination of APC group 

costs. 

• Addressing other technical issues 

concerning APC group structure. 

• Evaluating the required level of 

supervision for hospital outpatient 

services. 

The subject matter before the Panel 

shall be limited to these and related 

topics. Unrelated topics are not subjects 

for discussion. Unrelated topics include, 

but are not limited to, the conversion 

factor, charge compression, revisions to 

the cost report, pass-through payments, 

correct code usage, new technology 

applications (including supporting 

information/documentation), provider 

payment adjustments, and which types 

of practitioners are permitted to 

supervise hospital outpatient services. 

E. Requests for Nominations 

We are soliciting six nominees to add 

to the Panel. With this expansion, we 

are particularly interested in adding 

representatives who have experience in 

working with issues related to CAHs 

and rural hospitals. 

IV. Collection of Information 

Requirements 

This document does not impose 

information collection and 

recordkeeping requirements. 

Consequently, it need not be reviewed 

by the Office of Management and 

Budget under the authority of the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 35). 

(Catalog of Federal Domestic Assistance 

Program; No. 93.773 Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: November 17, 2011. 

Donald M. Berwick, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2011–30417 Filed 11–23–11; 8:45 am] 

BILLING CODE 4120–01–P 


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