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

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


### 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 industryorganizations 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’’