Federal Register / Vol. 77, No. 231 / Friday, November 30, 2012 / Notices 71423 

TABLE 2—DISASTER-RECOVERY ADJUSTED FMAP RATES

FISCAL YEAR 2013 REVISED DISASTER-RECOVERY ADJUSTED FMAP RATES

A B C D E F 

State FY13 FMAP FY12 disaster 

recovery 

adjusted 

FMAP 

Decrease in 

FMAP 

Disaster 

recovery 

adjustment 

increase 

Disaster 

recovery 

adjusted 

FMAP FY13 

Col C¥B 50% × Col D* Col B + E 

Louisiana .............................................................................. 61.24 69.78 8.54 4.27 65.51 

*Percentage determined in accordance with section 1905(aa)(1)(A) of the Social Security Act. 

FISCAL YEAR 2014 DISASTER-RECOVERY ADJUSTED FMAP RATES

A B C D E F 

State FY14 FMAP FY13 disaster 

recovery 

adjusted 

FMAP 

Decrease in 

FMAP 

Disaster 

recovery 

adjustment 

increase 

Disaster 

recovery 

adjusted 

FMAP FY14 

Col C¥B 25% × Col D* Col B + E 

Louisiana .............................................................................. 60.98 65.51 4.53 1.13 62.11 

*Percentage determined in accordance with section 1905(aa)(1)(B) of the Social Security Act. 

[FR Doc. 2012–29035 Filed 11–29–12; 8:45 am] 

BILLING CODE 4150–05–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Announcement of Intent To Establish 

the 2015 Dietary Guidelines Advisory 

Committee and Solicitation of 

Nominations for Appointment to the 

Committee Membership; Amendment 

AGENCY: Office of the Assistant 

Secretary for Health, Office of the 

Secretary, Department of Health and 

Human Services. 

ACTION: Notice; amendment. 

SUMMARY: A notice was published in the 

Federal Register of Friday, October 26, 

2012, Vol. 77, No. 208, to announce the 

intent to establish the 2015 Dietary 

Guidelines Advisory Committee and 

solicit nominations of individuals who 

are interested in being appointed to the 

Committee membership. This notice is 

being amended to extend the 

solicitation period to allow additional 

time for nominations to be received. The 

new due date for all nominations to be 

received is no later than close of 

business on December 11, 2012. 

FOR FURTHER INFORMATION CONTACT: 

Designated Federal Officer, 2015 DGAC: 

Richard D. Olson and/or Alternate 

Designated Federal Officer, 2015 DGAC: 

Kellie (O’Connell) Casavale, Ph.D., R.D.; 

Office of Disease Prevention and Health 

Promotion, OASH/DHHS; 1101 Wootton 

Parkway, Suite LL 100 Tower Building; 

Rockville, MD 20852; Telephone: (240) 

453–8280; Fax: (240) 453–8281. Lead 

USDA Co-Executive Secretary: Colette I. 

Rihane, M.S., R.D., Director, Nutrition 

Guidance and Analysis Division; Center 

for Nutrition Policy and Promotion; U.S. 

Department of Agriculture; 3101 Park 

Center Drive, Room 1034; Alexandria, 

VA 22302; Telephone: (703) 305–7600; 

Fax: (703) 305–3300. USDA CoExecutive Secretary, Shanthy A. 

Bowman, Ph.D., Nutritionist, Food 

Surveys Research Group; Beltsville 

Human Nutrition Research Center, 

Agricultural Research Service, USDA; 

10300 Baltimore Avenue, BARC-West 

Building 005, Room 125; Beltsville, MD 

20705–2350; Telephone: (301) 504– 

0619. Additional information about the 

2015 DGAC is available on the Internet 

at www.dietary guidelines.gov. 

Dated: November 26, 2012. 

Howard K. Koh, 

Assistant Secretary for Health. 

[FR Doc. 2012–28928 Filed 11–29–12; 8:45 am] 

BILLING CODE 4150–32–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–6044–N] 

Medicare, Medicaid, and Children’s 

Health Insurance Programs; Provider 

Enrollment Application Fee Amount for 

Calendar Year 2013 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces a 

$532.00 calendar year (CY) 2013 

application fee for institutional 

providers that are initially enrolling in 

the Medicare or Medicaid program or 

the Children’s Health Insurance 

Program (CHIP); revalidating their 

Medicare, Medicaid or CHIP enrollment; 

or adding a new Medicare practice 

location. This fee is required with any 

enrollment application submitted on or 

after January 1, 2013 and on or before 

December 31, 2013. 

DATES: Effective Date: This notice is 

effective on January 1, 2013. 

FOR FURTHER INFORMATION CONTACT: 

Frank Whelan, (410) 786–1302 for 

Medicare enrollment issues. Claudia 

Simonson, (312) 353–2115 for Medicaid 

and CHIP enrollment issues. 

SUPPLEMENTARY INFORMATION: 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
71424 Federal Register / Vol. 77, No. 231 / Friday, November 30, 2012 / Notices 

I. Background 

In the February 2, 2011 Federal 

Register (76 FR 5862), we published a 

final rule with comment period entitled: 

‘‘Medicare, Medicaid, and Children’s 

Health Insurance Programs; Additional 

Screening Requirements, Application 

Fees, Temporary Enrollment Moratoria, 

Payment Suspensions and Compliance 

Plans for Providers and Suppliers.’’ This 

rule finalized, among other things, 

provisions related to the submission of 

application fees as part of the Medicare, 

Medicaid, and CHIP provider 

enrollment processes. As stated in 42 

CFR 424.514, ‘‘institutional providers’’ 

that are initially enrolling in the 

Medicare, Medicaid or CHIP program, 

revalidating their enrollment, or adding 

a new Medicare practice location are 

required to submit a fee with their 

enrollment application. An 

‘‘institutional provider’’ is defined at 42 

CFR 424.502 as ‘‘(a)ny provider or 

supplier that submits a paper Medicare 

enrollment application using the CMS– 

855A, CMS–855B (not including 

physician and non-physician 

practitioner organizations), CMS–855S 

or associated Internet-based PECOS 

enrollment application.’’ 

As indicated in 42 CFR 424.514 and 

455.460, the application fee is not 

required for either of the following: 

• A Medicare physician or nonphysician practitioner submitting a 

CMS–855I. 

• A prospective or re-enrolling 

Medicaid or CHIP provider— 

++ Who is an individual physician or 

non-physician practitioner; or 

++ That is enrolled in Title XVIII of 

the Act or another state’s title XIX or 

XXI plan and has paid the application 

fee to a Medicare contractor or another 

state. 

In the March 23, 2011 Federal 

Register (76 FR 16422), we published a 

notice entitled ‘‘Medicare, Medicaid, 

and Children’s Health Insurance 

Programs; Provider Enrollment 

Application Fee Amount for Calendar 

Year 2012’’. This notice announced the 

following: 

• A CY 2011 application fee of $505 

for institutional providers that were 

initially enrolling in the Medicare, 

Medicaid, or CHIP program; revalidating 

their enrollment; or adding a new 

Medicare practice location. 

• That institutional providers were 

required to submit the $505 fee with 

enrollment applications submitted on or 

after March 25, 2011 and on or before 

December 31, 2011. 

• That prospective or re-enrolling 

Medicaid or CHIP providers must 

submit the application fee unless: (1) 

The provider is an individual physician 

or non-physician practitioner; or (2) the 

provider is enrolled in Title XVIII of the 

Act or another state’s title XIX or XXI 

plan and has paid the application fee to 

a Medicare contractor or another state. 

II. Provisions of the Notice 

A. CY 2012 Fee Amount 

In the November 2, 2011 Federal 

Register (76 FR 67743), we published a 

notice announcing a fee amount for the 

period of January 1, 2012 through 

December 31, 2012 of $523.00. This 

figure was calculated as follows: 

• Section 1866(j)(2)(C)(i)(I) of the 

Social Security Act (the Act) established 

a $500 application fee for institutional 

providers in CY 2010. 

• Consistent with section 

1866(j)(2)(C)(i)(II) of the Act, 42 CFR 

§ 424.514(d)(2) states that for CY 2011 

and subsequent years, the fee will be 

adjusted by the percentage change in the 

consumer price index (CPI) for all urban 

consumers (all items; United States city 

average) for the 12-month period ending 

in June of the previous year. 

• The CPI increase for CY 2011, 

which was calculated to be 1.0 percent, 

was based on data obtained from the 

Bureau of Labor Statistics. This resulted 

in an application fee for CY 2011 of 

$505 (or $500 × 1.01). (For more 

detailed information on the CPI and 

how the $505 application fee was 

calculated, see the February 2, 2011 

final rule with comment period (76 FR 

5955) and the March 23, 2011 notice (76 

FR 16423)). 

• The CPI increase for the period of 

July 2010 through June 2011 was 3.54 

percent, based on data obtained from 

the Bureau of Labor Statistics. This 

resulted in an application fee amount 

for the period of January 1, 2012 

through December 31, 2012 of $522.87 

($505 × 1.0354). In the February 2, 2011 

final rule with comment period (76 FR 

5907), we stated that if the adjustment 

sets the fee at an uneven dollar amount, 

we would round the fee to the nearest 

whole dollar amount. Accordingly, the 

application fee amount for CY 2012 was 

rounded to the nearest whole dollar 

amount, which was $523.00. 

B. CY 2013 Fee Amount 

Using data obtained from the Bureau 

of Labor Statistics, the CPI increase for 

the 12-month period ending on June 30, 

2012 was 1.664 percent, a figure lower 

than the 2.0 percent CPI increase we 

estimated for CY 2013 in the February 

2, 2011 final rule with comment period 

(76 FR 5953). This results in an 

application fee amount for the period of 

January 1, 2013 through December 31, 

2013 of $531.70 ($523 × 1.01664). As 

prescribed in the February 2, 2011 final 

rule with comment period (76 FR 5909), 

we must round this figure to the nearest 

whole dollar amount. The application 

fee amount for CY 2013 is therefore 

$532.00. This represents a $7.00 

difference from the $525 fee that we had 

originally projected for CY 2013 in the 

February 2, 2011 final rule with 

comment period (76 FR 5958). 

III. 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. Chapter 35). However, it does 

reference previously approved 

information collections. The forms 

CMS–855A, CMS–855B, and CMS–855I 

are approved under OMB control 

number 0938–0685; the CMS–855S is 

approved under OMB control number 

0938–1056. 

IV. Regulatory Impact Statement 

A. Introduction 

We have examined the impact of this 

notice as required by Executive Order 

12866 on Regulatory Planning and 

Review (September 30, 1993), Executive 

Order 13563 on Improving Regulation 

and Regulatory Review (January 18, 

2011), the Regulatory Flexibility Act 

(RFA) (September 19, 1980, Pub. L. 96– 

354), section 1102(b) of the Social 

Security Act, section 202 of the 

Unfunded Mandates Reform Act of 1995 

(March 22, 1995; Pub. L. 104–4), 

Executive Order 13132 on Federalism 

(August 4, 1999), and the Congressional 

Review Act (5 U.S.C. 804(2)). 

Executive Orders 12866 and 13563 

direct agencies to assess all costs and 

benefits of available regulatory 

alternatives and, if regulation is 

necessary, to select regulatory 

approaches that maximize net benefits, 

including potential economic, 

environmental, public health and safety 

effects, distributive impacts, and equity. 

A regulatory impact analysis (RIA) must 

be prepared for major rules with 

economically significant effects ($100 

million or more in any 1 year). As 

explained in section of the notice 

(section IV.), we estimate that the total 

cost of the increase in the application 

fee will not exceed $100 million. This 

notice therefore does not reach the $100 

million economic threshold and is not 

considered a major notice. 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 231 / Friday, November 30, 2012 / Notices 71425 

The RFA requires agencies to analyze 

options for regulatory relief of small 

businesses. For purposes of the RFA, 

small entities include small businesses, 

nonprofit organizations, and small 

governmental jurisdictions. Most 

hospitals and most other providers and 

suppliers are small entities, either by 

nonprofit status or by having revenues 

of $7.0 million to $34.5 million in any 

1 year. Individuals and states are not 

included in the definition of a small 

entity. As we stated in the RIA for the 

February 2, 2011 final rule with 

comment period (76 FR 5952), the 

regulatory impact statement of the 

March 23, 2011 notice (76 FR 16423), 

and the regulatory impact statement of 

the November 2, 2011 notice (76 FR 

67744), we do not believe that the 

application fee will have a significant 

impact on small entities. 

In addition, section 1102(b) of the Act 

requires us to prepare a regulatory 

impact analysis if a rule may have a 

significant impact on the operations of 

a substantial number of small rural 

hospitals. This analysis must conform to 

the provisions of section 604 of the 

RFA. For purposes of section 1102(b) of 

the Act, we define a small rural hospital 

as a hospital that is located outside of 

a Metropolitan Statistical Area for 

Medicare payment regulations and has 

fewer than 100 beds. We are not 

preparing an analysis for section 1102(b) 

of the Act because we have determined, 

and the Secretary certifies, that this 

notice would not have a significant 

impact on the operations of a substantial 

number of small rural hospitals. 

Section 202 of the Unfunded 

Mandates Reform Act of 1995 (UMRA) 

also requires that agencies assess 

anticipated costs and benefits before 

issuing any rule whose mandates 

require spending in any 1 year of $100 

million in 1995 dollars, updated 

annually for inflation. In 2012, that 

threshold is approximately $139 

million. The Agency has determined 

that there will be minimal impact from 

the costs of this notice, as the threshold 

is not met under the UMRA. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates a 

proposed rule (and subsequent final 

rule) that imposes substantial direct 

requirement costs on state and local 

governments, preempts state law, or 

otherwise has federalism implications. 

Since this notice does not impose 

substantial direct costs on state or local 

governments, the requirements of 

Executive Order 13132 are not 

applicable. 

B. Estimated Costs 

The costs associated with this notice 

involve the increase in the application 

fee that certain providers and suppliers 

must pay in CY 2013. As alluded to 

earlier, in the RIA for the February 2, 

2011 final rule with comment period (76 

FR 5955 through 5958), we estimated 

the total amount of application fees for 

CYs 2011 through 2015. For CY 2013, 

and based on a $525 application fee, we 

projected in tables 11 and 12 (76 FR 

5955 and 5956) a total cost in fees of 

$60,913,125 ($16,380,000 + 

$44,533,125) for Medicare institutional 

providers (or 116,025 providers × $525). 

We also projected in tables 13 and 14 

(76 FR 5957 and 5958) the total cost in 

CY 2013 for Medicaid providers to be 

$13,195,350 ($4,429,950 + $8,765,400 or 

25,134 (8,438 newly enrolling + 16,696 

re-enrolling) providers × $525). 

Based on CY 2009 and CY 2010 data 

furnished by State Medicaid agencies 

through the annual State Program 

Integrity Assessment, we are increasing 

the estimated number of affected 

Medicaid providers from 25,134 to 

27,859. We are also changing the 

Medicare provider estimate based on 

our ongoing program of revalidating all 

Medicare providers and suppliers by the 

end of 2015—even if the revalidation is 

considered ‘‘off-cycle’’ per 42 CFR 

424.515(e). 

1. Medicare 

For purposes of this notice only, we 

estimate that approximately 400,000 

Medicare providers and suppliers will 

be subject to revalidation in CY 2013. Of 

this total, and based on our experience, 

we believe that roughly 80 percent will 

be exempt from the application fee 

requirement because the provider or 

supplier: (1) Is of a type (for example, 

a physician) that is exempt from the 

requirement; or (2) qualifies for a 

hardship exception under 42 CFR 

424.514(c). This leaves 80,000 

revalidating providers and suppliers 

that will have to pay the fee. 

In the February 2, 2011 final rule with 

comment period (76 FR 5955), we 

estimated that 31,200 newly-enrolling 

institutional providers would be subject 

to the application fee in CY 2013. In the 

first quarter of CY 2012, there were 

1,030 initial enrollments that required a 

fee. Based on this, we must dramatically 

reduce our earlier estimate of 31,200 

Medicare institutional providers to 

4,120 (1,030 × 4) for purposes of this 

notice. Using a figure of 84,120 (80,000 

+ 4,120) institutional providers, we 

estimate an increase in the cost of the 

Medicare application fee requirement in 

CY 2013 of $588,840 (84,120 × $7.00) 

from CY 2012 estimates. 

2. Medicaid and CHIP 

We estimate that 27,859 (8,438 newly 

enrolling + 19,421 re-enrolling) 

Medicaid and CHIP providers would be 

subject to an application fee in CY 2013. 

Using this figure, we estimate an 

increase in the cost of the Medicaid and 

CHIP application fee requirements in 

CY 2013 of $195,013 (27,859 × $7.00) 

from CY 2012 estimates. 

3. Total 

Based on the foregoing, we estimate 

the total increase in the cost of the 

application fee requirement for 

Medicare, Medicaid, and CHIP 

providers and suppliers in CY 2013 to 

be $783,853 ($588,840 + $195,013) from 

CY 2012. 

In accordance with the provisions of 

Executive Order 12866, this notice was 

not reviewed by the Office of 

Management and Budget. 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program; No. 93.773 Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: October 9, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2012–29003 Filed 11–29–12; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Submission to OMB for 

Review and Approval; Public Comment 

Request 

AGENCY: Health Resources and Services 

Administration; HHS. 

ACTION: Notice. 

SUMMARY: In compliance with section 

3506(c)(2)(A) of the Paperwork 

Reduction Act of 1995 (44 U.S.C. 

chapter 35), the Health Resources and 

Services Administration (HRSA) will 

submit an Information Collection 

Request (ICR) to the Office of 

Management and Budget (OMB). 

Comments submitted during the first 

public review of this ICR will be 

provided to OMB. OMB will accept 

further comments from the public 

during the review and approval period. 

To request a copy of the clearance 

requests submitted to OMB for review, 


wreier-aviles on DSK5TPTVN1PROD with NOTICES