Federal Register / Vol. 65, No. 108 / Monday, June 5, 2000 / Rules and Regulations 35583

OHIO—SO2—Continued

Designated area

Does not meet

primary

standards

Does not meet

secondary

standards

Cannot be

classified

Better than

national

standards

Washington County:

Waterford Township ................................................................................. ........................ ........................ ........................ X

The remainder of Washington County ..................................................... ........................ ........................ ........................ X

All other counties in the State of Ohio ............................................................ ........................ ........................ ........................ X

1This area remains undesignated at this time as a result of a court remand in PPG Industries, Inc. v. Costle, 630 F.2d 462 (6th Cir. 1980). 2This area was affected by the Sixth Circuit Court remand but has since been designated.

3This area was not affected by the court remand in PPG Industries, Inc. v. Costle 630 F.2d 462 (6th Cir. 1980).

* * * * *

[FR Doc. 00–13199 Filed 6–2–00; 8:45 am]

BILLING CODE 6560–50–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Office of the Secretary

Office of Inspector General

42 CFR Parts 1001, 1003, 1005 and

1006

RIN 0991–AA90

Health Care Programs: Fraud and

Abuse; Revised OIG Civil Money

Penalties Resulting From Public Law

104–191

AGENCY: Office of Inspector General

(OIG), HHS.

ACTION: Final rule; correction

amendments.

SUMMARY: This document contains

several corrections to the final

regulations which were published in the

Federal Register on Wednesday, April

26, 2000 (65 FR 24400). These

regulations revised the OIG’s civil

money penalty (CMP) authorities in

conjunction with new or revised

provisions set forth in the Health

Insurance Portability and

Accountability Act of 1996, and

codified a number of technical

corrections to the regulations governing

the OIG’s sanction authorities.

Inadvertent errors appeared in the text

of the regulations concerning the

knowledge standard in § 1003.102 (a)(6),

and in § 1005.7 with respect to

discovery. In addition, an incorrect

cross-reference was cited in the

definition for the term ‘‘preventive

care,’’ as set forth in part 1003. As a

result, we are making corrections to 42

CFR 1003.101, 1003.102(a) and 1005.7

to assure the technical correctness of

these regulations.

EFFECTIVE DATE: June 5, 2000.

FOR FURTHER INFORMATION CONTACT: Joel

Schaer, (202) 619–0089, OIG

Regulations Officer.

SUPPLEMENTARY INFORMATION: The HHS

Office of Inspector General (OIG) issued

final regulations on April 26, 2000 (65

FR 24400) that revised the OIG’s CMP

authorities, in conjunction with new

and revised provisions set forth in the

Health Insurance Portability and

Accountability Act of 1996, Public Law

104–191. Among other provisions, this

final rulemaking codified new CMPs for

excluded individuals retaining

ownership or control interest in an

entity; upcoding and claims for

medically unnecessary services; offering

inducements to beneficiaries; and false

certification of eligibility for home

health services. The rule also codified a

number of technical corrections to the

regulations governing OIG’s sanction

authorities. In that final rule, several

inadvertent errors appeared in the

regulations text and are now being

corrected.

CMP Knowledge Standard—

§ 1003.102(a)(6)

In the preamble discussion regarding

revisions to § 1003.102(a)(6), addressing

the submission of claims for services

that are medically unnecessary, we

indicated that this paragraph was being

amended to include the ‘‘knows or

should know’’ standard found in the

statute and in the revision to

§ 1003.102(a)(1) to ensure that it is not

the OIG’s intent to subject providers to

penalties for legitimate disagreements

over the medical necessity of items and

services or for honest mistakes or errors

(65 FR 24403). As indicated in that

discussion, while the knowledge

standard in the statute requires that

providers assume responsibility for

appropriate billing of their services, the

OIG intends to impose CMPs only after

establishing that a provider knew that a

billed item or service was not medically

necessary, or that he or she deliberately

ignored or recklessly disregarded such

information. Accordingly, we indicated

that we were revising § 1003.102(a)(6)

by adding the words ‘‘knows or should

know’’ to have the paragraph read as:

‘‘An item or service that a person knows

or should know is medically

unnecessary, and which is part of a

pattern of such claims.’’ (emphasis

added). This language was inadvertently

omitted from the revised regulations

text. In order to be consistent with the

preamble discussion, we are correcting

the omission that occurred in

§ 1003.102(a)(6).

Discovery—§ 1005.7

In summarizing the provisions of the

final rule, we indicated that we were

amending § 1005.7 to provide for

motions to compel discovery once a

request for production of documents has

been received. The preamble stated that

any objections to a request for the

production of documents will have to be

filed with the opposing party within 15

days of receiving the discovery request,

and that the party seeking the

production of documents may then file

a motion to compel discovery within 15

days, unless a lengthier time frame is set

by the administrative law judge (ALJ)

(65 FR 24412–13). This discretion

afforded to the ALJ to grant an extension

was inadvertently omitted from the

regulations text in § 1005.7(e). We are

correcting this omission by

redesignating existing paragraph (e)(3)

in this section to read as (e)(4) and by

adding a new paragraph (e)(3) to address

the ALJ’s discretion in extending the

appropriate time frames

Preventive Care—§ 1003.101

In the definition for ‘‘preventive care’’

appearing in § 1003.101, the definition

incorrectly cites § 1003.102(b)(13) as the

applicable cross-reference. We are

amending this definition to cite the

correct cross-reference, which is to the

term ‘‘remuneration’’ that is set forth in

this same section.

Amendatory Language to § 1003.103(a)

Introductory Text and

§ 1003.105(a)(1)(i)

We are amending the language in the

introductory text for § 1003.103(a) and

35584 Federal Register / Vol. 65, No. 108 / Monday, June 5, 2000 / Rules and Regulations

in paragraph (a)(1)(i) for § 1003.105 to

make the references consistent with the

those provisions added in earlier final

rulemaking published on April 7, 2000

(65 FR 18434), which addressed OIG

CMP authority for unbundling hospital

outpatient services.

List of Subjects

42 CFR Part 1001

Administrative practice and

procedure, Fraud, Health facilities,

Health professions, Medicaid, Medicare.

42 CFR Part 1003

Administrative practice and

procedure, Fraud, Grant programs—

health, Health facilities, Health

professions, Maternal and child health,

Medicaid, Medicare, Penalties.

42 CFR Part 1005

Administrative practice and

procedure, Fraud, Penalties.

42 CFR Part 1006

Administrative practice and

procedure, Fraud, Investigations,

Penalties.

Accordingly, 42 CFR parts 1003 and

1005 are corrected by making the

following correcting amendments:

PART 1003—CIVIL MONEY

PENALTIES, ASSESSMENTS AND

EXCLUSIONS

1. The authority citation for part 1003

continues to read as follows:

Authority: 42 U.S.C. 1302, 1320–7, 1320a–

7a, 1320a–7e,1320b–10, 1395u(j), 1395u(k),

1395cc(g), 1395dd(d)(1), 1395mm, 1395nn(g),

1395ss(d), 1396b(m), 11131(c) and

11137(b)(2).

2. Section 1003.101 is amended by

republishing the introductory text, and

by revising the introductory paragraph

for the definition of the term Preventive

care to read as follows:

§ 1003.101 Definitions.

For purposes of this part:

* * * * *

Preventive care, for purposes of the

definition of the term Remuneration as

set forth in this section and the

preventive care exception to section

231(h) of HIPAA, means any service

that—

* * * * *

3. Section 1003.102 is amended by

republishing the introductory text of

paragraph (a) and by revising paragraph

(a)(6) to read as follows:

§ 1003.102 Basis for civil money penalties

and assessments.

(a) The OIG may impose a penalty and

assessment against any person whom it

determines in accordance with this part

has knowingly presented, or caused to

be presented, a claim which is for—

* * * * *

(6) An item or service that a person

knows or should know is medically

unnecessary, and which is part of a

pattern of such claims.

* * * * *

4. Section 1003.103 is amended by

revising the introductory text of

paragraph (a) to read as follows:

§ 1003.103 Amount of penalty.

(a) Except as provided in paragraphs

(b) through (k) of this section, the OIG

may impose a penalty of not more

than—

* * * * *

5. Section 1003.105 is amended by

revising paragraph (a)(1)(i) to read as

follows:

§ 1003.105 Exclusion from participation in

Medicare, Medicaid and all Federal health

care programs.

(a)(1) * * *

(i) Is subject to a penalty or

assessment under § 1003.102(a), (b)(1),

(b)(4), (b)(12), (b)(13) or (b)(15); or

* * * * *

PART 1005—APPEALS OF

EXCLUSIONS, CIVIL MONEY

PENALTIES AND ASSESSMENTS

1. The authority citation for part 1005

continues to read as follows:

Authority: 42 U.S.C. 405(a), 405(b), 1302,

1320a–7, 1320a–7a and 1320c–5.

2. Section 1005.7 is amended by

redesignating existing paragraph (e)(3)

as (e)(4) and by adding a new paragraph

(e)(3) to read as follows:

§ 1005.7 Discovery.

* * * * *

(e) * * *

(3) The ALJ may extend any of the

time frames set forth in paragraph (e)(1)

of this section.

Dated: May 26, 2000.

Michael Carelton,

Deputy Director for Information Resource

Management.

[FR Doc. 00–13994 Filed 6–2–00; 8:45 am]

BILLING CODE 4152–01–P

FEDERAL EMERGENCY

MANAGEMENT AGENCY

44 CFR Part 65

[Docket No. FEMA–7320]

Changes in Flood Elevation

Determinations

AGENCY: Federal Emergency

Management Agency (FEMA).

ACTION: Interim rule.

SUMMARY: This interim rule lists

communities where modification of the

base (1-percent-annual-chance) flood

elevations is appropriate because of new

scientific or technical data. New flood

insurance premium rates will be

calculated from the modified base flood

elevations for new buildings and their

contents.

DATES: These modified base flood

elevations are currently in effect on the

dates listed in the table and revise the

Flood Insurance Rate Map(s) in effect

prior to this determination for each

listed community.

From the date of the second

publication of these changes in a

newspaper of local circulation, any

person has ninety (90) days in which to

request through the community that the

Associate Director for Mitigation

reconsider the changes. The modified

elevations may be changed during the

90-day period.

ADDRESSES: The modified base flood

elevations for each community are

available for inspection at the office of

the Chief Executive Officer of each

community. The respective addresses

are listed in the table below.

FOR FURTHER INFORMATION CONTACT:

Matthew B. Miller, P.E., Chief, Hazards

Study Branch, Mitigation Directorate,

500 C Street SW., Washington, DC

20472, (202) 646–3461, or (e-mail)

matt.miller@fema.gov.

SUPPLEMENTARY INFORMATION: The

modified base flood elevations are not

listed for each community in this

interim rule. However, the address of

the Chief Executive Officer of the

community where the modified base

flood elevation determinations are

available for inspection is provided.

Any request for reconsideration must

be based upon knowledge of changed

conditions, or upon new scientific or

technical data.

The modifications are made pursuant

to Section 201 of the Flood Disaster

Protection Act of 1973, 42 U.S.C. 4105,

and are in accordance with the National

Flood Insurance Act of 1968, 42 U.S.C.

4001 et seq., and with 44 CFR Part 65.