41478 Federal Register / Vol. 65, No. 129 / Wednesday, July 5, 2000 / Notices

• How to address possible incentives

for drug manufacturers to make drugs

only in the form that cannot be selfadministered. How should oral versus

injectable drugs be evaluated?

• Considering the marketplace, how

should Medicare’s policy concerning

self-administered drugs take into

account a possible competitive

disadvantage for oral and subcutaneous

drugs that are self-administrable?

The purpose of the meeting on July

25, 2000 is to obtain focused input on

how this statutory provision should

reasonably be interpreted; how the

evolution of medical technology has

affected physician practice in selfadministration; how different

interpretations of the provision might

affect considerations of fairness and

equity among beneficiary populations;

and how physician practice may be

affected by different interpretations. We

are holding the second meeting to allow

the public to address in more detail the

issues raised during the first meeting by

way of panel presentations and

discussion. Due to time constraints, and

the need to focus on the above topics,

we are unable to undertake a discussion

of options or ideas that require a

statutory change.

Format

We will begin the meeting with a brief

summary of the first meeting and a brief

exposition of policy concerns that

should be considered when addressing

the issue of drugs and biologicals that

cannot be self-administered. This will

be followed by 15-minute panel

presentations by participants who

submit a prior request to speak.

Panels will be organized in the

following manner to address the general

categories of policy concerns:

1. Financial, including incentives/

marketplace advantage to manufacturers

of non self-administrable forms of drugs.

2. Beneficiary equity.

3. Physicians’ ethical dilemmas,

including prescription of drugs based on

coverage status versus the most

appropriate medical treatment.

After the last panel has concluded its

presentations the meeting will move to

an open dialogue.

Presentations

Individuals interested in making a

presentation at the meeting or who need

special arrangements should contact

Heidi Adams at (410) 786–1620, or via

e-mail at HAdams@hcfa.gov, no later

than July 14, 2000. Individuals should

identify the topics they wish to discuss

during their presentation. Because of

time constraints, only a limited number

of individuals will be able to make

presentations. In an effort to assure that

all viewpoints are represented, we will

notify participants who are selected to

make a presentation. We will not assign

presentation times until after July 14,

2000.

Registration

The Center for Health Plans and

Providers will handle registration for

the meeting. Individuals may register by

sending a fax to the attention of Heidi

Adams at (410) 786–0169. At the time

of registration, please provide your

name, address, telephone number,

company name, and fax number.

Receipt of your fax will constitute

confirmation of your registration.

Meeting materials will be provided at

the time of the meeting. If you have

questions regarding registration, please

contact Heidi Adams.

We will accept written comments,

questions, or other materials specifically

dealing with the issue that are received

no later than 5 p.m. on July 14, 2000 at

the address noted above.

While the meeting is open to the

public, attendance is limited to space

available. Individuals must register in

advance as described above. Individuals

requiring sign language interpretation

for the hearing impaired or other special

accommodations should contact Heidi

Adams at least 10 days before the

meeting.

Authority: Section 1102 of the Social

Security Act (42 U.S.C. 1302) and 5 CFR

1320.3(h)(4).

(Catalog of Federal Domestic Assistance

Program No. 93.773 Medicare—Hospital

Insurance Program; and No. 93.774,

Medicare—Supplementary Medical

Insurance Program)

Dated: June 28, 2000.

Nancy-Ann Min DeParle,

Administrator, Health Care Financing

Administration.

[FR Doc. 00–16887 Filed 7–3–00; 8:45 am]

BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Indian Health Service

Availability of Funds for Loan

Repayment Program for Repayment of

Health Professions Educational Loans

AGENCY: Indian Health Service, HHS.

ACTION: Revised notice of availability of

funds for loan repayment program for

repayment of health professions

educational loans for Fiscal Year (FY)

2000.

SUMMARY: The announcement for FY

2000 Availability of Funds for Loan

Repayment Program for Repayment of

Health Professions Educational Loans

was announced in 64 FR 53681 on

October 4, 1999. The Indian Health

Service (IHS) is republishing the full

notice, for the convenience of the

public, and in order to add that the IHS

Area Offices and Service Units may

provide additional funding to make

awards to participants in the Loan

Repayment Program (LRP), and to

describe the policy for administering

these funds.

The Administration’s budget request

for fiscal year (FY) 2000 includes

$11,000,000 for the Indian Health

Service Loan Repayment Program for

health professionals educational loans

(undergraduate and graduate) in return

for full-time clinical service in Indian

health programs. It is anticipated that

$11,000,000 will be available to support

approximately 275 competing awards

averaging $40,000 per award.

This program announcement is

subject to the appropriation of funds.

This notice is being published early to

coincide with the recruitment activity of

the IHS, which competes with other

Government and private health

management organizations to employ

qualified health professionals. Funds

must be expended by September 30 of

the fiscal year. This program is

authorized by Section 108 of the Indian

Health Care Improvement Act (IHCIA)

as amended, 25 U.S.C. 1601 et seq. The

IHS invites potential applications to

request an application for participation

in the Loan Repayment Program.

DATES: Applications for the FY 2000

Loan Repayment Program will be

accepted and evaluated monthly

beginning January 14, 2000, and will

continue to be accepted each month

thereafter until all funds are exhausted.

Subsequent monthly deadline dates are

scheduled for Friday of the second full

week of each month. Notice of awards

will be mailed on the last working day

of each month.

Applicants selected for participation

in the FY 2000 program cycle will be

expected to begin their service period

no later than September 30, 2000.

Applications shall be considered as

meeting the deadline if they are either:

1. Received on or before the deadline

date; or

2. Sent on or before the deadline date.

(Applicants should request a legibly

dated U.S. Postal Service post mark or

obtain a legibly dated receipt from a

commercial carrier or U.S. Postal

Service. Private metered postmarks are

not acceptable as proof of timely

mailing.)

Applications received after the

monthly closing date will be held for

Federal Register / Vol. 65, No. 129 / Wednesday, July 5, 2000 / Notices 41479

consideration in the next monthly

funding cycle. Applicants who do not

receive funding by September 30, 2000,

will be notified in writing.

Form to be Used for Application:

Applications will be accepted only if

they are submitted on the form entitled

‘‘Application for the Indian Health

Service Loan Repayment Program,’’

identified with the Office of

Management and Budget approval

number of OMB #0917–0014 (expires

11/30/99).

ADDRESSES: Application materials may

be obtained by calling or writing to the

address below. In addition, completed

applications should be returned to: IHS

Loan Repayment Program, 12300

Twinbrook Parkway—Suite 100,

Rockville, Maryland 20852, PH: 301/

443–3396 (between 8 a.m. and 5 p.m.

(EST) Monday through Friday, except

Federal holidays).

FOR FURTHER INFORMATION CONTACT:

Please address inquiries to Mr. Paul A.

Lofgren, Acting Chief, IHS Loan

Repayment Program, Twinbrook Metro

Plaza—Suite 100, 12300 Twinbrook

Parkway, Rockville, Maryland 20852,

PH: 301/443–3396 (between 8 a.m. and

5 p.m. (EST) Monday through Friday,

except Federal holidays).

SUPPLEMENTARY INFORMATION: Section

108 of the IHCIA, as amended by Public

Laws 100–713 and 102–573, authorizes

the IHS Loan Repayment Program and

provides in pertinent part as follows:

The Secretary, acting through the Service,

shall establish a program to be known as the

Indian Health Service Loan Repayment

Program (hereinafter referred to a the ‘‘Loan

Repayment Program’’) in order to assure an

adequate supply of trained health professions

necessary to maintain accreditation of, and

provide health care services to Indians

through, Indian health programs.

Section 4(n) of the IHCIA, as amended

by the Indian Health Care Improvement

Technical Corrections Act of 1996, Pub.

L. 104–313, provides that:

‘‘Health Profession’’ means allopathic

medicine, family medicine, internal

medicine, pediatrics, geriatric medicine,

obstetrics and gynecology, podiatric

medicine, nursing, public health nursing,

dentistry, psychiatry, osteopathy, optometry,

pharmacy, psychology, public health, social

work, marriage and family therapy,

chiropractic medicine, environmental health

and engineering, an allied health profession,

or any other health profession.

For the purposes of this program, the

term ‘‘Indian health program’’ is defined

in Section 108(a)(2)(A), as follows:

* * * any health program or facility funded,

in whole or in part, by the IHS for the benefit

of American Indians and Alaska Natives and

administered:

a. Directly by the service; or

b. By any Indian tribe or tribal or Indian

organization pursuant to a contract under:

(1) The Indian Self-Determination Act; or

(2) Section 23 of the Act of April 30, 1908,

(25 U.S.C. 47), popularly known as the Buy

Indian Act; or

(3) By an urban Indian organization

pursuant to Title V of this act.

Applicants may sign contractual

agreements with the Secretary for 2

years. The IHS will repay all, or a

portion of the applicant’s health

profession educational loans

(undergraduate and graduate) for tuition

expenses and reasonable educational,

and living expenses in amounts up to

$20,000 per year for each year of

contracted service. Payments will be

made annually to the participant for the

purpose of repaying his/her outstanding

health profession educational loans.

Repayment of health profession

education loans will be made to the

participant within 120 days after the

entry-on-duty of the participant has

been confirmed by the Indian Health

Service Loan Repayment Program.

The Secretary must approve the

contract before the disbursement of loan

repayments can be made to the

participant. Participants will be

required to fulfill their contract service

agreements through full-time clinical

practice at an Indian health program site

determined by the Secretary. Loan

repayment sites are characterized by

physical, cultural, and professional

isolation, and have histories of frequent

staff turnover. All Indian health

program sites are annually prioritized

within the Agency by discipline, based

on need or vacancy.

All health professionals will receive

up to $20,000 per year regardless of

their length of contract. Where the

amount of the Loan Repayment Program

award may result in an increase in

Federal income tax liability, the IHS

will pay an additional 20 percent of the

participant’s total loan repayments to

the Internal Revenue Service for the

increased tax liability.

Pursuant to Section 108(b), to be

eligible to participate in the Loan

Repayment Program, an individual

must:

(1) A. Be enrolled:

(i) In a course of study or program in

an accredited institution, as determined

by the Secretary, within a State and be

scheduled to complete such course of

study in the same year such individual

applies to participate in the Loan

Repayment Program. (This includes the

Commonwealth of Puerto Rico, the

Commonwealth of the Northern Mariana

Islands, the Virgin Islands, Guam,

American Samoa, the Federated States

of Micronesia, the Republic of the

Marshall Islands, and the Republic of

Palau); or

(ii) In an approved graduate training

program in a health profession; or

B. Have a degree in a health

profession and a license to practice; and

(2) A. Be eligible for, or hold an

appointment as a Commissioned Officer

in the Regular or Reserve Corps of the

Public Health Service; or

B. Be eligible for selection for civilian

service in the Regular or Reserve Corps

of the Public Health Service; or

C. Meet the professional standards for

civil service employment in the IHS; or

D. Be employed in an Indian health

program without service obligation; and

(3) Submit to the Secretary an

application and contract to the Loan

Repayment Program; and

(4) Sign and submit to the Secretary,

a written contract agreeing to accept

repayment of educational loans and to

serve for the applicable period of

obligated service in a priority site as

determined by the Secretary; and

(5) Sign an affidavit attesting to the

fact that they have been informed of the

relative merits of the U.S. Public Health

Service Commission Corps and the Civil

Service as employment options.

Once the applicant is approved for

participation in the Loan Repayment

Program, the applicant will receive

confirmation of his/her loan repayment

award and the duty site as which he/she

will serve his/her loan repayment

obligation.

The IHS has identified the positions

in each Indian health program for which

there is a need or vacancy and ranked

those positions in order of priority by

developing discipline-specific

prioritized lists of sites. Ranking criteria

for those sites include the following:

• Historically critical shortages

caused by frequent staff turnover;

• Current unmatched vacancies in a

Health Profession Discipline;

• Projected vacancies in a Health

Profession Discipline;

• Ensuring that the staffing needs of

Indian health programs administered by

an Indian tribe or tribal or health

organization receive consideration on an

equal basis with programs that are

administered directly by the Service;

and

• Giving priority to vacancies in

Indian health programs that have a need

for health professionals to provide

health care services as a result of

individuals having breached Loan

Repayment Program contracts entered

into under this section.

• Consistent with this priority

ranking, in determining applications to

be approved and contracts to accept, the

IHS will give priority to applications

41480 Federal Register / Vol. 65, No. 129 / Wednesday, July 5, 2000 / Notices

made by American Indians and Alaska

Natives and to individuals recruited

through the efforts of Indian tribes or

tribal or Indian organizations.

• Funds appropriated for the LRP in

FY 2000 will be distributed among the

health professions as follows:

Allopathic/osteopathic practitioners

will receive 30 percent, registered

nurses 15 percent, mental health

professionals 10 percent, dentists 15

percent, pharamacists 12.5 percent,

optometrists 7.5 percent, physician

assistants 5 percent, other professions 5

percent. This requirement does not

apply if the number of applicants from

these groups, respectively, is not

sufficient to meet the requirement.

• The IHS will give priority in

funding among health professionals to

physicians in the following priority

specialities: anesthesiology, emergency

room medicine, general surgery,

obstetrics/gynecology, ophthalmology,

orthopedic surgery, otolaryngology/

otorhinolaryngology, psychiatry,

radiology and dentistry. Funding for

these priority specialities is within the

30 percent established for allopathic/

osteopathic practitioners.

The following factors are equal in

weight when applied, and are applied

when all other criteria are equal and a

selection must be made between

applicants.

One or all of the following factors may

be applicable to an applicant, and the

applicant who has the most of these

factors, all other criteria being equal,

would be selected.

• An applicant’s length of current

employment in the IHS, tribal, or urban

program.

• Availability for service earlier than

other applicants (first come, first

served); and

• Date the individual’s application

was received.

Any individual who enters this

program and satisfactorily completes his

or her obligated period of service may

apply to extend his/her contract on a

year-by-year basis, as determined by the

IHS. Participants extending their

contracts will receive up to the

maximum amount of $20,000 per year

plus an additional 20 percent for

Federal Withholding. Participants who

were awarded loan repayment contracts

prior to FY 2000 will be awarded

extensions up to the amount of $30,000

a year and 31 percent in tax subsidy if

funds are available, and will not exceed

the total of the individual’s outstanding

eligible health profession educational

loans.

Any individual who owes an

obligation for health professional

service to the Federal Government, a

State, or other entity is not eligible for

the Loan Repayment Program unless the

obligation will be completely satisfied

before they begin service under this

program.

The IHS Area Offices and Service

Units are authorized to provide

additional funding to make awards to

applicants in the LRP, but must be in

compliance with any limits in the

appropriation and Section 108 of the

Indian Health Care Improvement Act

not to exceed the amount authorized in

the IHS appropriation (up to

$17,000,000 for FY 2000.) Federally

recognized tribes are also authorized to

provide funding to make supplemental

awards to participants who are tribal

employees. Civil Service or Commission

Corps employees are ineligible because

it would violate 18 U.S.C. 209(a). The

funding source cannot be from

appropriated monies pursuant to the

Indian Self Determination and

Education Assistant Act (ISDEA) or

other Federal funds. Tribes who elect to

provide additional monies must provide

certification in writing that the funds

are not from Federal appropriations.

Should an IHS Area Office contribute

to the LRP, those funds will be used for

only those sites located in that Area.

Those sites will retain their relative

ranking from the national site-ranking

list. For example, the Albuquerque Area

Office identifies supplemental monies

for dentists. Only the dental positions

within the Albuquerque Area will be

funded with the supplemental monies

consistent with the national ranking and

site index within that Area.

Should an IHS Service Unit

contribute to the LRP, those funds will

be used for only those sites located in

that service unit. These sites will retain

their relative ranking from the national

site-ranking list. For example, Chinle

Service Unit identifies supplemental

monies for nurses. The Chinle service

units consist of two facilities, namely

the Chinle Comprehensive Health Care

Facility and the Tsaile PHS Indian

Health Center. The national ranking will

be used for the Chinle Comprehensive

Health Care Facility (Score = 63) and the

Tsaile PHS Indian Health Center (Score

= 46). With a score of 63, the Chinle

Comprehensive Health Care Facility

would receive priority over the Tsaile

PHS Indian Health Center.

The IHS is authorized to accept

contributions from tribes to supplement

the LRP according to the IHS’s

conditional gift acceptance authority.

The Director of IHS will accept these

gifts on a case-by-case basis using the

following criteria: (1) The contribution

is not from prohibited 638 funds or

federally appropriate funds; (2) the LRP

applicant selection and placement is

consistent with the national ranking

criteria; (3) the extent to which the gift

is related to the agency’s mission for the

loan repayment program; (4) whether

the gift would benefit the agency, or

instead primarily benefit an individual

employee; and (5) the size and nature of

the gift.

This program is not subject to review

under Executive Order 12372.

The Catalog of Federal Domestic

Assistance number if 93.164.

Dated: June 28, 2000.

Michel E. Lincoln,

Deputy Director.

[FR Doc. 00–16875 Filed 7–4–00; 8:45 am]

BILLING CODE 4160–16–M

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Substance Abuse and Mental Health

Services Administration

Current List of Laboratories Which

Meet Minimum Standards To Engage in

Urine Drug Testing for Federal

Agencies and Laboratories That Have

Withdrawn From the Program

AGENCY: Substance Abuse and Mental

Health Services Administration, HHS.

ACTION: Notice.

SUMMARY: The Department of Health and

Human Services notifies Federal

agencies of the laboratories currently

certified to meet standards of Subpart C

of Mandatory Guidelines for Federal

Workplace Drug Testing Programs (59

FR 29916, 29925). A similar notice

listing all currently certified laboratories

will be published during the first week

of each month, and updated to include

laboratories which subsequently apply

for and complete the certification

process. If any listed laboratory’s

certification is totally suspended or

revoked, the laboratory will be omitted

from updated lists until such time as it

is restored to full certification under the

Guidelines.

If any laboratory has withdrawn from

the National Laboratory Certification

Program during the past month, it will

be listed at the end, and will be omitted

from the monthly listing thereafter.

This Notice is available on the

internet at the following website:

http://wmcare.samhsa.gov.

FOR FURTHER INFORMATION CONTACT: Mrs.

Giselle Hersh or Dr. Walter Vogl,

Division of Workplace Programs, 5600

Fishers Lane, Rockwall 2 Building,

Room 815, Rockville, Maryland 20857;

Tel.: (301) 443–6014, Fax: (301) 443–

3031.