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[Federal Register Volume 79, Number 107 (Wednesday, June 4, 2014)]
[Notices]
[Pages 32300-32301]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-13006]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1620-N]

Medicare Program; Notification of Closure of Teaching Hospital 
and Opportunity To Apply for Available Slots

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice announces the closure of one teaching hospital and 
the initiation of an application process for hospitals to apply to the 
Centers for Medicare & Medicaid Services (CMS) to receive Long Beach 
Medical Center's full time equivalent (FTE) resident cap slots.

DATES: We will consider applications received no later than 5 p.m. 
(e.s.t.) September 2, 2014. Applications must be received, not 
postmarked, by this date.

FOR FURTHER INFORMATION CONTACT: Miechal Lefkowitz, (212) 616-2517.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 5506 of the Patient Protection and Affordable Care Act 
(Pub. L. 111-148), as amended by the Health Care and Education 
Reconciliation Act of 2010 (Pub. L. 111-152) (collectively, the 
``Affordable Care Act''), ``Preservation of Resident Cap Positions from 
Closed Hospitals,'' authorizes the Secretary of the Department of 
Health and Human Services (the Secretary) to redistribute residency 
slots after a hospital that trained residents in an approved medical 
residency program closes. Specifically, section 5506 of the Affordable 
Care Act amended the Social Security Act (the Act) by adding subsection 
(vi) to section 1886(h)(4)(H) of the Act and modifying language at 
section 1886(d)(5)(B)(v) of the Act, to instruct the Secretary to 
establish a process to increase the full time equivalent (FTE) resident 
caps for other hospitals based upon the FTE resident caps in teaching 
hospitals that closed ``on or after a date that is 2 years before the 
date of enactment'' (that is, March 23, 2008). In the November 24, 2010 
CY 2011 Outpatient Prospective Payment System (OPPS) final rule (75 FR 
72212), we established regulations and an application process for 
qualifying hospitals to apply to CMS to receive direct graduate medical 
education (GME) and indirect medical education (IME) FTE resident cap 
slots from the hospital that closed. We made certain modifications to 
those regulations in the FY 2013 Hospital Inpatient Prospective Payment 
System/Long Term Care Hospital final rule (FY 2013 IPPS/LTCH PPS final 
rule (77 FR 53434 through 53447)). The procedures we established apply 
both to teaching hospitals that closed on or after March 23, 2008 and 
on or before August 3, 2010, and to teaching hospitals that closed 
after August 3, 2010.

II. Provisions of the Notice

A. Notice of Closure of Teaching Hospital and Application Process

    CMS has learned of the closure of one teaching hospital, Long Beach 
Medical Center, of Long Beach, NY. The purpose of this notice is to 
notify the public of the closure of this teaching hospital, and to 
initiate another round of the application and selection process 
described in section 5506 of the Affordable Care Act. This round will 
be the seventh round (``Round 7'') of the application and selection 
process. The table below identifies the closed teaching hospital, which 
is part of the Round 7 application process under section 5506 of the 
Affordable Care Act:

[[Page 32301]]

                                                                Teaching Hospital Closure
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                                                                                                                      IME cap
                                                                                                                 (including  MMA Sec.     (including  MMA  Sec. 422
                                                                                                                    adjustments)      \2\  adjustments)
--------------------------------------------------------------------------------------------------------------------------------------------------------
330225....................  Long Beach Medical     Long Beach, NY.......       \1\ 35004   February 1, 2014....             26.79   26.79 + 2.10 section
                             Center.                                                                                                 422 increase =
                                                                                                                                     28.89.\3\
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The CBSA codes applicable to the Round 7 application process are those in effect for the FY 2014 IPPS, not the new CBSA codes proposed by CMS for
  the FY 2015 IPPS in the FY 2015 IPPS proposed rule (79 FR 28055).
\2\ Section 422 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Pub. L. 108-173, redistributed unused residency
  slots effective July 1, 2005.
\3\ Long Beach Medical Center's 1996 direct GME FTE cap is 26.79. Under section 422 of the MMA, the hospital received an increase of 2.10 to its direct
  GME FTE cap: 26.79 + 2.10 = 28.89. We note that under 42 CFR 413.77(g), direct GME FTE cap slots associated with an increase received under section
  422 of the MMA are to be paid using the appropriate locality-adjusted national average per resident amount (PRA).

B. Application Process for Available Resident Slots

    The application period for hospitals to apply for slots under 
section 5506 is 90 days following notification to the public of a 
hospital closure. Therefore, hospitals wishing to apply for and receive 
slots from the above hospitals' FTE resident caps must submit 
applications directly to the CMS Central Office no later than September 
2, 2014. The mailing address for the CMS Central Office is included on 
the application form. Applications must be received by the September 2, 
2014 deadline date. It is not sufficient for applications to be 
postmarked by this date. After an applying hospital sends a hard copy 
of a section 5506 application to the CMS Central Office mailing 
address, they must also send an email to: 
ACA5506application@cms.hhs.gov. In the email, the hospital should 
state: ``On behalf of [insert hospital name and Medicare CMS 
Certification Number], I am sending this email to notify CMS that I 
have mailed to CMS a hard copy of a section 5506 application under 
Round 7 due to the closure of Long Beach Medical Center.'' An applying 
hospital should not attach an electronic copy of the application to the 
email. The email will only serve as notification that a hard copy 
application has been mailed to the CMS Central Office.
    In the CY 2011 Outpatient Perspective Payment System/Ambulatory 
Surgical Center (OPPS/ASC) final rule with comment period, we did not 
establish a deadline by when CMS would issue the final determinations 
to hospitals that receive slots under section 5506 of the Affordable 
Care Act. However, we will review all applications received by the 
deadline and notify applicants of our determinations as soon as 
possible.
    We refer readers to the CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/dgme.html 
to download a copy of the application form (section 5506 CMS 
Application Form) that hospitals are to use to apply for slots under 
section 5506 of the Affordable Care Act. We also refer readers to this 
same Web site to access a copy of the CY 2011 OPPS/ASC final rule with 
comment period, a copy of the FY 2013 Inpatient Perspective Payment 
System Long Term Care Hospital (IPPS/LTCH) PPS final rule (77 FR 53434 
through 53447), and a list of additional section 5506 guidelines for an 
explanation of the policy and procedures for applying for slots, and 
the redistribution of the slots under sections 1886(h)(4)(H)(vi) and 
1886(d)(5)(B)(v) of the Act. (We note that in the FY 2015 IPPS proposed 
rule (79 FR 28154 through 28161), CMS proposed additional changes to 
the section 5506 application process. However, those proposed changes 
do not apply to this Round 7 application process).

III. Collection of Information Requirements

    This document does not impose any new information collection 
requirements, that is, any reporting, recordkeeping or third-party 
disclosure requirements, as defined under the Paperwork Reduction Act 
of 1995 (5 CFR 1320). Furthermore, all information collection 
requirements associated with the preservation of resident cap positions 
from closed hospitals are not subject to the Paperwork Reduction Act, 
as stated in section 5506 of the Affordable Care Act.

    Dated: May 29, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2014-13006 Filed 6-3-14; 8:45 am]
BILLING CODE 4120-01-P
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