78464 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Notices 

TABLE 12.—PROJECTED IMPACT OF FY 2005 UPDATE TO THE SNF PPS—Continued

Number of 

facilities 

Wage index 

change 

Total FY 

2005 

change 

Freestanding urban .................................................................................................................................. 8,466 0.0% 2.8% 

Hospital based rural ................................................................................................................................. 640 0.1% 2.9% 

Freestanding rural .................................................................................................................................... 3,708 0.0% 2.8% 

Urban by region: 

New England .................................................................................................................................... 913 ¥0.6% 2.2% 

Middle Atlantic .................................................................................................................................. 1,526 ¥0.7% 2.1% 

South Atlantic ................................................................................................................................... 1,610 0.3% 3.1% 

East North Central ............................................................................................................................ 1,943 0.2% 3.0% 

East South Central ........................................................................................................................... 456 0.0% 2.8% 

West North Central ........................................................................................................................... 691 0.4% 3.2% 

West South Central .......................................................................................................................... 965 0.8% 3.6% 

Mountain ........................................................................................................................................... 432 ¥0.4% 2.4% 

Pacific ............................................................................................................................................... 1,473 0.4% 3.2% 

Rural by region: 

New England .................................................................................................................................... 149 0.4% 3.2% 

Middle Atlantic .................................................................................................................................. 254 ¥0.4% 2.4% 

South Atlantic ................................................................................................................................... 715 ¥0.3% 2.5% 

East North Central ............................................................................................................................ 948 0.1% 2.9% 

Central East South ........................................................................................................................... 595 ¥0.4% 2.4% 

West North Central ........................................................................................................................... 1,220 0.5% 3.3% 

West South Central .......................................................................................................................... 817 0.4% 3.2% 

Mountain ........................................................................................................................................... 330 ¥0.2% 2.6% 

Pacific ............................................................................................................................................... 208 0.0% 2.8% 

Ownership: 

Government ...................................................................................................................................... 712 0.0% 2.8% 

Proprietary ........................................................................................................................................ 9,457 0.0% 2.8% 

Voluntary ........................................................................................................................................... 3605 0.0% 2.8% 

III. Waiver of Proposed Rulemaking 

and Delayed Effective Date 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register to provide a period for public 

comment before the provisions of a 

notice such as this take effect in 

accordance with section 553(b) of the 

Administrative Procedure Act (APA) (5 

U.S.C. 553(b)). We also ordinarily 

provide a 30-day delay in the effective 

date of the provisions of a notice in 

accordance with section 553(d) of the 

APA (5 U.S.C. 553(d)). However, we can 

waive both the notice and comment 

procedure and the 30-day delay in 

effective date if the Secretary finds, for 

good cause, that a notice and comment 

process is impracticable, unnecessary or 

contrary to the public interest, and 

incorporates a statement of the finding 

and the reasons therefore in the notice. 

We find it unnecessary to undertake 

notice-and-comment rulemaking 

because this notice merely provides 

technical corrections to the regulations. 

We are not changing our payment 

methodology, but rather, are simply 

implementing correctly the payment 

methodology that we previously 

proposed, received comment on, and 

subsequently finalized. Thus, because 

the public has already had the 

opportunity to comment on the payment 

methodology being used to calculate 

wage indexes, additional comment 

would be unnecessary. 

Further, we believe a delayed 

effective date is unnecessary because 

this correction notice merely corrects 

inadvertent technical errors. Further, we 

believe imposing a 30-day delay in the 

effective date would be contrary to the 

public interest for SNF providers in the 

affected MSAs. We believe that it is 

imperative that these providers receive 

appropriate SNF PPS payments in as 

timely a manner as possible, and any 

delay in applying the appropriate wage 

index would be contrary to the public 

interest. Further, the changes noted 

above do not make any substantive 

changes to the SNF PPS payment 

methodology or underlying payment 

policies. Therefore, we find good cause 

to waive notice-and-comment 

procedures, as well as the 30-day delay 

in effective date.

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program)

Dated: December 15, 2004. 

Ann Agnew, 

Executive Secretary to the Department.

[FR Doc. 04–28157 Filed 12–29–04; 8:45 am] 

BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1285–N] 

Medicare Program: Meeting of the 

Advisory Panel on Ambulatory 

Payment Classification (APC) Groups 

(Panel)—February 23, 24, and 25, 2005, 

and Re-chartering of APC Panel on 

November 8, 2004

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (DHHS).

ACTION: Notice of meeting and rechartering of Panel. 

SUMMARY: In accordance with section 

10(a) of the Federal Advisory Committee 

Act (FACA) (5 U.S.C. Appendix 2), this 

notice announces the first biannual 

meeting of the Ambulatory Payment 

Classification (APC) Panel for 2005. 

The purpose of the Panel is to review 

the APC groups and their associated 

weights and to advise the Secretary of 

the Department of Health and Human 

Services and the Administrator of the 

Centers for Medicare and Medicaid 

Services concerning the clinical 

integrity of the APC groups and their 

associated weights. The advice provided 

by the Panel will be considered as CMS 

prepares its annual updates of the 

Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Notices 78465

hospital Outpatient Prospective 

Payment System (OPPS) through 

rulemaking.

DATES: Meeting Dates: The first biannual 

meeting for 2005 is scheduled for the 

following dates and times: 

• Wednesday, February 23, 2005, 1 

p.m. to 5 p.m. (e.s.t.) 

• Thursday, February 24, 2005, 8 a.m. 

to 5 p.m. (e.s.t.) 

• Friday, February 25, 2005, 8 a.m. to 

12 noon (e.s.t.)

DEADLINES: 

Deadline for Hardcopy Comments/

Suggested Agenda Topics—

• 5 p.m. (e.s.t.), Wednesday, January 

26, 2005 

Deadline for Hardcopy Presentations—

• 5 p.m. (e.s.t.), Wednesday, January 

26, 2005 

Deadline for Attendance Registration—

• 5 p.m. (e.s.t.), Wednesday, February 

9, 2005. 

Deadline for Special 

Accommodations—

• 5 p.m. (e.s.t.), Wednesday, February 

9, 2005.

SUBMITTAL OF MATERIALS TO THE

DESIGNATED FEDERAL OFFICER (DFO):

Because of staffing and resource 

limitations, we cannot accept written 

comments and presentations by FAX, 

nor can we print written comments and 

presentations received electronically for 

dissemination at the meeting. 

Only hardcopy comments and 

presentations will be accepted for 

placement in the meeting booklets. All 

hardcopy presentations must be 

accompanied by Form CMS–20017. The 

form is now available through the CMS 

Forms Web site. The URL for linking to 

this form is (http://www.cms.hhs.gov/

forms/cms20017.pdf.)

We are also requiring electronic 

versions of the written comments and 

presentations (in addition to the 

hardcopies), so we can send them to the 

Panel members for their review prior to 

the meeting. 

You must send BOTH electronic and 

hardcopy versions of your presentations 

and written comments by the prescribed 

deadlines. (Electronic transmission 

must be sent to the e-mail address, and 

hardcopies (accompanied by Form 

CMS–20017) must be mailed to the 

Designated Federal Officer [DFO], as 

specified in the FOR FURTHER

INFORMATION CONTACT section of this 

notice.)

ADDRESS: The meeting will be held in 

the Multipurpose Room, 1st Floor, at the 

CMS Central Office, 7500 Security 

Boulevard, Baltimore, Maryland 21244–

1850.

FOR FURTHER INFORMATION CONTACT: For 

inquiries regarding the meeting; meeting 

registration; and hardcopy submissions 

of oral presentations, agenda items, and 

comments, please contact the DFO: 

Shirl Ackerman-Ross, DFO, CMS, CMM, 

HAPG, DOC, 7500 Security Boulevard, 

Mail Stop C4–05–17, Baltimore, MD 

21244–1850. Phone (410) 786–4474. 

• E-mail Address for comments, 

presentations, and registration requests 

APCPanel@cms.hhs.gov

• News media representatives must 

contact our Public Affairs Office at (202) 

690–6145.

ADVISORY COMMITTEES’ INFORMATION

LINES: 

The CMS Advisory Committees’

Information Line is 1–877–449–5659 

(toll free) and (410) 786–9379 (local).

WEB SITES:

• For additional information on the 

APC meeting agenda topics and updates 

to the Panel’s activities, search our Web 

site at: http://www.cms.hhs.gov/faca/

apc/default.asp.

• To obtain Charter copies, search our 

Web site at http://www.cms.hhs.gov/

faca or e-mail the Panel DFO.

SUPPLEMENTARY INFORMATION: 

I. Background 

The Secretary is required by section 

1833(t)(9)(A) of the Act, as amended and 

redesignated by sections 201(h) and 

202(a)(2) of the Medicare, Medicaid, and 

SCHIP Balanced Budget Refinement Act 

of 1999 (BBRA) (Pub. L. 106–113), 

respectively, to establish and consult 

with an expert, outside advisory panel 

on APC groups. The Panel meets up to 

three times annually to review the APC 

groups and to provide technical advice 

to the Secretary and the Administrator 

concerning the clinical integrity of the 

groups and their associated weights. All 

members must have technical expertise 

that shall enable them to participate 

fully in the work of the Panel. Such 

expertise encompasses hospital 

payment systems, hospital medical-care 

delivery systems, outpatient payment 

requirements, APCs, Physicians’ Current 

Procedural Terminology Codes (CPTs), 

the use and payment of drugs and 

medical devices in the outpatient 

setting, and other forms of relevant 

expertise. It is not necessary that any 

member be an expert on all areas. 

We will consider the technical advice 

provided by the Panel as we prepare the 

proposed rule that proposes changes to 

the OPPS for the next calendar year. The 

Secretary recently re-chartered the Panel 

on November 8, 2004. 

The Panel may consist of up to 15 

representatives who are full-time 

employees (not consultants) of Medicare 

providers, which are subject to the 

OPPS, and a Chair. 

The Administrator selected the Panel 

membership based upon either selfnominations or nominations submitted 

by providers or interested organizations. 

The Panel presently consists of the 

following members and a Chair: 

• Edith Hambrick, M.D., J.D., Chair 

• Marilyn Bedell, M.S., R.N., O.C.N. 

• Albert Brooks Einstein, Jr., M.D. 

• Lee H. Hilborne, M.D., M.P.H.

• Stephen T. House, M.D. 

• Kathleen Kinslow, C.R.N.A., Ed.D. 

• Mike Metro, R.N., B.S. 

• Sandra J. Metzler, M.B.A., R.H.I.A., 

C.P.H.Q. 

• Gerald V. Naccarelli, M.D. 

• Frank G. Opelka, M.D., F.A.C.S. 

• Louis Potters, M.D., F.A.C.R.* 

• Lou Ann Schraffenberger, M.B.A., 

R.H.I.A., C.C.S.-P. 

• Judie S. Snipes, R.N., M.B.A., 

C.H.E.* 

• Lynn R. Tomascik, R.N., M.S.N., 

C.N.A.A. 

• Timothy Gene Tyler, Pharm.D. 

• William Van Decker, M.D. 

(*New member as of 10/1/2004) 

II. Agenda 

The agenda for the February 2005 

meeting will provide for discussion and 

comment on the following topics as 

designated in the Panel’s Charter: 

• Reconfiguration of APCs (for 

example, splitting of 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). 

• Evaluation of APC weights. 

• Packaging devices and drug costs 

into APCs: Methodology, effect on 

APCs, and need for reconfiguring APCs 

based upon device and drug packaging. 

• Removal of procedures from the 

inpatient list for payment under the 

OPPS. 

• Use of single and multiple 

procedure claims data. 

• Packaging of HCPCS codes. 

• Other technical issues concerning 

APC structure. 

III. Written Comments and Suggested 

Agenda Topics 

Hardcopy written comments and 

suggested agenda topics should be sent 

to the DFO. Such items must be 

received by the DFO 5 p.m. (e.s.t.), 

Wednesday, January 26, 2005. 

Additionally, the written comments 

and suggested agenda topics must fall 

within the subject categories outlined in 

the Panel’s Charter listed in the Agenda 

section of this notice. 

78466 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Notices 

IV. Oral Presentations 

Individuals or organizations wishing 

to make 5-minute oral presentations 

must contact the DFO. The DFO must 

receive hardcopy presentations by 5 

p.m. (e.s.t.), on Wednesday, January 26, 

2005, in order to be scheduled. 

The number of oral presentations may 

be limited by the time available. Oral 

presentations should not exceed 5 

minutes in length. 

The Chair may further limit time 

allowed for presentations due to the 

number of oral presentations, if 

necessary. 

V. Presenter and Presentation Criteria 

The additional criteria below must be 

supplied to the DFO by the January 26, 

2005 deadline (along with hardcopies of 

presentations). 

• Required personal information 

regarding presenter(s): 

+ Name of presenter(s); 

+ Title(s); 

+ Organizational affiliation; 

+ Address; 

+ E-mail address, and 

+ Telephone number(s). 

• All presentations must contain, at a 

minimum, the following supporting 

information and data: 

+ Financial relationship(s) of 

presenter(s), if any, with any company 

whose products, services, or procedures 

that are under consideration; 

+ Physicians’ Current Procedural 

Terminology (CPT) codes involved; 

+ APC(s) affected; 

+ Description of the issue(s); 

+ Clinical description of the service 

under discussion (with comparison to 

other services within the APC); 

+ Recommendations and rationale for 

change;

+ Expected outcome of change; and 

+ Potential consequences of not 

making the change(s). 

VI. Oral Comments 

In addition to formal oral 

presentations, there will be opportunity 

during the meeting for public oral 

comments that will be limited to 1 

minute for each individual and a total 

of 5 minutes per organization. 

VII. Meeting Attendance 

The meeting is open to the public; 

however, attendance is limited to space 

available. Attendance will be 

determined on a first-come, first-served 

basis. 

Persons wishing to attend this 

meeting, which is located on Federal 

property, must call or e-mail the Panel 

DFO to register in advance no later than 

5 p.m. (e.s.t.), Wednesday, February 9, 

2005. 

The following information must be emailed or telephoned to the DFO by the 

date and time above: 

• Name(s) of attendee(s); 

• Title(s); 

• Organization; 

• E-mail address(es); and 

• Telephone number(s). 

VIII. Security, Building, and Parking 

Guidelines 

Persons attending the meeting must 

present photographic identification to 

the Federal Protective Service or Guard 

Service personnel before they will be 

allowed to enter the building. 

Individuals who are not registered in 

advance will not be permitted to enter 

the building and will be unable to 

attend the meeting. The public may not 

enter the building earlier than 30–45 

minutes prior to the convening of the 

meeting each day. (Please note that the 

meeting on Wednesday, February 23, 

2005 does not convene until 1 p.m.) 

All visitors must be escorted in areas 

other than the lower and first-floor 

levels in the Central Building. 

Parking permits and instructions are 

issued upon arrival by the guards at the 

main entrance. 

IX. Special Accommodations 

Individuals requiring sign-language 

interpretation or other special 

accommodations must send a request 

for these services to the DFO by 5 p.m. 

(e.s.t.), Wednesday, February 9, 2005.

Authority: Section 1833(t) of the Act (42 

U.S.C. 1395l(t), as amended by section 201(h) 

of the BBRA of 1999 (Pub. L. 106–113). The 

Panel is governed by the provisions of Pub. 

L. 92–463, as amended (5 U.S.C. Appendix 

2).

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program).

Dated: December 9, 2004. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services.

[FR Doc. 04–28151 Filed 12–29–04; 8:45 am] 

BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1292–N] 

Medicare Program; Town Hall Meeting 

on the Fiscal Year 2006 Applications 

for New Medical Services and 

Technologies Add-on Payments Under 

the Hospital Inpatient Prospective 

Payment System Scheduled for 

February 23, 2005

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS.

ACTION: Notice of meeting.

SUMMARY: This notice, in accordance 

with section 503 of the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 (MMA), 

announces a Town Hall meeting to 

discuss fiscal year (FY) 2006 

applications for add-on payments for 

new medical services and technologies 

under the hospital inpatient prospective 

payment system (IPPS). Applicants, 

supporters, opponents, and other 

interested parties are invited to this 

meeting to present their comments, 

recommendations, and data regarding 

whether the FY 2006 new medical 

services and technologies applications 

meet the substantial clinical 

improvement criteria.

DATES: Meeting Date: The Town Hall 

meeting announced in this notice will 

be held on Wednesday, February 23, 

2005 at 9 a.m. and check-in will begin 

at 8:30 a.m. EST. 

Registration Deadline for Presenters:

All presenters, whether attending in 

person or by phone, must register and 

submit their agenda item(s) by February 

15, 2005. 

Registration Deadline for All Other 

Participants: All other participants must 

register by February 17, 2005. 

Comment Deadline: Written 

comments for discussion at the meeting 

must be received by February 15, 2005. 

All other written comments for 

consideration before publication of the 

IPPS proposed rule must be received by 

March 15, 2005.

ADDRESSES: The Town Hall meeting will 

be held in the Auditorium in the central 

building of the Centers for Medicare & 

Medicaid Services, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

Agenda Items or Written Comments:

Agenda items and written comments 

regarding whether a FY 2006 

application meets the substantial 

clinical improvement criterion may be 

sent by mail, fax, or electronically.