Federal Register / Vol. 79, No. 230 / Monday, December 1, 2014 / Proposed Rules 71081 

year after the effective date of the final 

rule). 

V. Outreach 

Section VI of the proposed rule details 

EPA extensive outreach efforts prior to 

the proposed rule. EPA continued this 

outreach during the public comment 

period on the proposed rule (DCN 

0111). In particular, EPA held over 30 

webinars and meetings with over 1,200 

people to discuss the proposed rule. 

Upon publication of this notice, EPA 

will provide a new comment period and 

will conduct additional stakeholders 

meetings to further discuss and refine 

particular aspects of the rule prior to 

promulgation. Outreach to stakeholders 

will continue to be supported through 

the NPDES Electronic Reporting Rule 

Web site; however, the Web site may be 

expanded to include more robust rule 

schedules as the rule nears 

promulgation, as well as additional rule 

documentation that may or may not be 

included as part of the formal docket 

library. Stakeholders that wish to hold 

a meeting with EPA should send an 

email to Messrs. Hudock or Johnston 

(see FOR FURTHER INFORMATION CONTACT

section). 

Finally, EPA would also continue to 

provide technical assistance and 

support to states, tribes, and territories 

during the transition to electronic 

reporting. Outreach from EPA to the 

states, tribes, and territories may be very 

useful in the identification of specific 

needs and the development of such 

assistance, support, and funding. EPA 

also solicits comment and suggestions 

on how to reach and inform the broad 

range of facilities affected by this 

proposed rulemaking. 

VI. Executive Orders 12866 and 13563 

Under Executive Order (EO) 12866 

[58 FR 51735 (October 4, 1993)] this 

action is a ‘‘significant regulatory 

action.’’ Accordingly, EPA submitted 

this action to the Office of Management 

and Budget (OMB) for review under 

Executive Orders 12866 and 13563 and 

any changes made in response to OMB 

recommendations have been 

documented in the docket for this 

action. 

List of Subjects 

40 CFR Part 122 

Administrative practice and 

procedure, Confidential business 

information, Hazardous substances, 

Reporting and recordkeeping 

requirements, Water pollution control. 

40 CFR Part 123 

Administrative practice and 

procedure, Confidential business 

information, Hazardous substances, 

Indians—lands, Intergovernmental 

relations, Penalties, Reporting and 

recordkeeping requirements, Water 

pollution control. 

40 CFR Part 127 

Administrative practice and 

procedure, Electronic reporting 

requirements, Water pollution control. 

40 CFR Part 403 

Administrative practice and 

procedure, Compliance monitoring, 

Enforcement program and activities, 

Reporting and recordkeeping 

requirements, Water pollution control. 

40 CFR Part 501 

Administrative practice and 

procedure, Indians—lands, 

Intergovernmental relations, Penalties, 

requirements, Sewage disposal. 

40 CFR Part 503 

Reporting and recordkeeping 

requirements, Sewage disposal. 

Dated: November 18, 2014. 

Cynthia Giles, 

Assistant Administrator, Office of 

Enforcement and Compliance Assurance. 

[FR Doc. 2014–27918 Filed 11–28–14; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 409, 410, 418, 440, 484, 

485 and 488 

[CMS–3819–N] 

Medicare and Medicaid Programs; 

Conditions of Participation for Home 

Health Agencies; Extension of 

Comment Period 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice of extension of comment 

period. 

SUMMARY: This notice extends the 

comment period for the October 9, 2014 

proposed rule entitled ‘‘Conditions of 

Participation for Home Health 

Agencies’’ (79 FR 61164). The comment 

period for the proposed rule, which 

would have ended on December 8, 2014, 

is extended for 30 days. 

DATES: The comment period is extended 

to 5 p.m. Eastern Standard Time on 

January 7, 2015. 

ADDRESSES: In commenting, please refer 

to file code CMS–3819–P. Because of 

staff and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 

You may submit comments in one of 

four ways (please choose only one of the 

ways listed): 

1. Electronically. You may submit 

electronic comments on this regulation 

to http://www.regulations.gov. Follow 

the ‘‘Submit a comment’’ instructions. 

2. By regular mail. You may mail 

written comments to the following 

address ONLY: Centers for Medicare & 

Medicaid Services, Department of 

Health and Human Services, Attention: 

CMS–3819–P, P.O. Box 8016, Baltimore, 

MD 21244–8016. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By express or overnight mail. You 

may send written comments to the 

following address only: Centers for 

Medicare & Medicaid Services, 

Department of Health and Human 

Services, Attention: CMS–3819–P, Mail 

Stop C4–26–05, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

4. By hand or courier. Alternatively, 

you may deliver (by hand or courier) 

your written comments ONLY to the 

following addresses prior to the close of 

the comment period: 

a. For delivery in Washington, DC— 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Room 445–G, Hubert 

H. Humphrey Building, 200 

Independence Avenue SW., 

Washington, DC 20201. (Because access 

to the interior of the Hubert H. 

Humphrey Building is not readily 

available to persons without Federal 

government identification, commenters 

are encouraged to leave their comments 

in the CMS drop slots located in the 

main lobby of the building. A stamp-in 

clock is available for persons wishing to 

retain a proof of filing by stamping in 

and retaining an extra copy of the 

comments being filed.) 

b. For delivery in Baltimore, MD— 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

If you intend to deliver your 

comments to the Baltimore address, call 

telephone number (410) 786–9994 in 

advance to schedule your arrival with 

one of our staff members. 

Comments erroneously mailed to the 

addresses indicated as appropriate for 

hand or courier delivery may be delayed 

and received after the comment period. 

Inspection of Public Comments: All 

comments received before the close of 

the comment period are available for 

viewing by the public, including any 


asabaliauskas on DSK5VPTVN1PROD with PROPOSALS
71082 Federal Register / Vol. 79, No. 230 / Monday, December 1, 2014 / Proposed Rules 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following Web 

site as soon as possible after they have 

been received: http://

www.regulations.gov. Follow the search 

instructions on that Web site to view 

public comments. 

Comments received timely will also 

be available for public inspection as 

they are received, generally beginning 

approximately 3 weeks after publication 

of a document, at the headquarters of 

the Centers for Medicare & Medicaid 

Services, 7500 Security Boulevard, 

Baltimore, Maryland 21244, Monday 

through Friday of each week from 8:30 

a.m. to 4 p.m. To schedule an 

appointment to view public comments, 

phone 1–800–743–3951. 

FOR FURTHER INFORMATION CONTACT: 

Danielle Shearer (410) 786–6617. 

Jacqueline Leach (410) 786–4282. Maria 

Hammel (410) 786–1775. 

SUPPLEMENTARY INFORMATION: On 

October 9, 2014, we published a 

proposed rule in the Federal Register 

(79 FR 61164) entitled, ‘‘Conditions of 

Participation for Home Health 

Agencies’’ that would revise the health 

and safety requirements that home 

health agencies (HHAs) must meet in 

order to participate in the Medicare and 

Medicaid programs. Specifically, the 

proposed requirements would focus on 

the care delivered to patients by home 

health agencies, reflect an 

interdisciplinary view of patient care, 

allow HHAs greater flexibility in 

meeting quality care standards, and 

eliminate unnecessary procedural 

requirements. In addition, we proposed 

a set of fundamental requirements for 

HHA services that would encompass 

patient rights, comprehensive patient 

assessment, and patient care planning 

and coordination by an interdisciplinary 

team. Overarching these requirements 

would be a quality assessment and 

performance improvement program that 

would build on the philosophy that a 

provider’s own quality management 

system is key to improved patient care 

performance. The objective would be to 

achieve a balanced regulatory approach 

by ensuring that a HHA furnished 

health care that met essential health and 

quality standards, while ensuring that it 

monitored and improved its own 

performance. These changes are an 

integral part of our overall effort to 

achieve broad-based, measurable 

improvements in the quality of care 

furnished through the Medicare and 

Medicaid programs, while at the same 

time eliminating unnecessary 

procedural burdens on providers. 

We have received inquiries from statebased and national industry 

organizations regarding the 60 day turnaround time to submit comments 

regarding this proposed rule. The 

organizations stated that they needed 

additional time to respond to the rule 

due to the complex nature of the 

proposed revisions. Because of the 

scope of the proposed rule, and since 

we have specifically requested the 

public’s comments on various aspect of 

the rule in an attempt to benefit from 

the vast experiences of the HHA 

provider and patient communities, we 

believe that it is important to allow 

ample time for all sections of the public 

to comment on this proposed rule. 

Therefore, we have decided to extend 

the comment period for an additional 30 

days. This document announces the 

extension of the public comment period 

to January 7, 2015. 

Dated: November 24, 2014. 

Marilyn Tavenner, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2014–28266 Filed 11–28–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Coast Guard 

46 CFR Part 401 

[USCG–2014–0481; 1625–AC22] 

Great Lakes Pilotage Rates—2015 

Annual Review and Adjustment— 

Extension of Comment Period 

AGENCY: Coast Guard, DHS. 

ACTION: Notice. 

SUMMARY: The Coast Guard is extending 

the comment period for the notice of 

proposed rulemaking (NPRM) entitled 

‘‘Great Lakes Pilotage Rates—2015 

Annual Review and Adjustment,’’ 

published on September 4, 2014, for 30 

days. We have decided to extend the 

comment period as we have received 

new financial data that could affect the 

discretion provided by Step 7 of the 

Appendix A methodology and the final 

rate. 

DATES: Comments and related material 

must either be submitted to our online 

docket via http://www.regulations.gov 

on or before December 31, 2014 or reach 

the Docket Management Facility by that 

date. 

ADDRESSES: You may submit comments 

identified by docket number USCG– 

2014–0481 using any one of the 

following methods: 

(1) Federal eRulemaking Portal: 

http://www.regulations.gov. 

(2) Fax: 202–493–2251. 

(3) Mail: Docket Management Facility 

(M–30), U.S. Department of 

Transportation, West Building Ground 

Floor, Room W12–140, 1200 New Jersey 

Avenue SE., Washington, DC 20590– 

0001. 

(4) Hand delivery: Same as mail 

address above, between 9 a.m. and 5 

p.m., Monday through Friday, except 

Federal holidays. The telephone number 

is 202–366–9329. 

To avoid duplication, please use only 

one of these four methods. See the 

‘‘Public Participation and Request for 

Comments’’ portion of the 

SUPPLEMENTARY INFORMATION section 

below for instructions on submitting 

comments. 

FOR FURTHER INFORMATION CONTACT: If 

you have questions on this notice, call 

or email Mr. Todd Haviland, Director, 

Great Lakes Pilotage, Commandant (CG– 

WWM–2), Coast Guard; telephone 202– 

372–2037, email Todd.A.Haviland@

uscg.mil, or fax 202–372–1914. If you 

have questions on viewing or submitting 

material to the docket, call Ms. Cheryl 

Collins, Program Manager, Docket 

Operations, telephone 202–366–9826. 

SUPPLEMENTARY INFORMATION: 

I. Public Participation and Request for 

Comments 

We encourage you to participate in 

this rulemaking by submitting 

comments and related materials. All 

comments received will be posted 

without change to http://

www.regulations.gov and will include 

any personal information you have 

provided. 

A. Submitting Comments 

If you submit a comment, please 

include the docket number for this 

rulemaking (USCG–2014–0481), 

indicate the specific section of this 

document to which each comment 

applies, and provide a reason for each 

suggestion or recommendation. You 

may submit your comments and 

material online or by fax, mail, or hand 

delivery, but please use only one of 

these means. We recommend that you 

include your name and a mailing 

address, an email address, or a phone 

number in the body of your document 

so that we can contact you if we have 

questions regarding your submission. 

To submit your comment online, go to 

http://www.regulations.gov and insert 

‘‘USCG–2014–0481’’ in the ‘‘Search’’ 


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