30640 Federal Register / Vol. 70, No. 102 / Friday, May 27, 2005 / Rules and Regulations 

This rule does not use technical 

standards. Therefore, we did not 

consider the use of voluntary consensus 

standards. 

Environment 

We have analyzed this rule under 

Commandant Instruction M16475.lD, 

which guides the Coast Guard in 

complying with the National 

Environmental Policy Act of 1969 

(NEPA) (42 U.S.C. 4321–4370f), and 

have concluded that there are no factors 

in this case that would limit the use of 

a categorical exclusion under section 

2.B.2 of the Instruction. Therefore, this 

rule is categorically excluded, under 

figure 2–1, paragraph (34)(g), of the 

Instruction, from further environmental 

documentation because we are 

proposing to establish a safety zone. 

A final ‘‘Environmental Analysis 

Check List’’ and a final ‘‘Categorical 

Exclusion Determination’’ are available 

in the docket where indicated under 

ADDRESSES.

List of Subjects in 33 CFR Part 165

Harbors, Marine safety, Navigation 

(water), Reporting and recordkeeping 

requirements, Security measures, 

Waterways.

■ For the reasons discussed in the 

preamble, the Coast Guard amends 33 

CFR part 165 as follows:

PART 165—REGULATED NAVIGATION 

AREAS AND LIMITED ACCESS AREAS

■ 1. The authority citation for part 165 

continues to read as follows:

Authority: 33 U.S.C. 1226, 1231; 46 U.S.C. 

Chapter 701; 50 U.S.C. 191, 195; 33 CFR 

1.05–1(g), 6.04–1, 6.04–6, and 160.5; Pub. L. 

107–295, 116 Stat. 2064; Department of 

Homeland Security Delegation No. 0170.1.

■ 2. Add § 165.1156 to read as follows:

§ 165.1156 Safety Zone; Offshore Marine 

Terminal, El Segundo, CA. 

(a) Location. The following area is a 

safety zone: All waters of Santa Monica 

Bay, from surface to bottom, enclosed by 

a line beginning at latitude 33°54′59′′ N, 

longitude 118°26′50′′ W; then to latitude 

33°54′59′′ N, longitude 118°27′34′′ W; 

then to latitude 33°54′00′′ N, longitude 

118°27′34′′ W; then to latitude 33°54′00′′

N, longitude 118°26′50′′ W; then to the 

point of beginning (NAD 1983). 

(b) Regulations. (1) In accordance 

with the general regulations in § 165.23 

of this part, entry into or movement 

within this zone is prohibited except 

for: 

(i) Commercial vessels authorized to 

use the offshore marine terminal for 

loading or unloading; 

(ii) Commercial tugs, lighters, barges, 

launches, or other vessels authorized to 

engage in servicing the offshore marine 

terminal or vessels therein; 

(iii) Public vessels of the United 

States. 

(2) Persons desiring to transit the area 

of the safety zone may contact the 

Captain of the Port at telephone number 

1–800–221–8724 or on VHF–FM 

channel 16 (156.8 MHz). If permission 

is granted, all persons and vessels must 

comply with the instructions of the 

Captain of the Port or his or her 

designated representative. 

(3) Nothing in this section shall be 

construed as relieving the owner or 

person in charge of any vessel from 

complying with the Navigation Rules as 

defined in 33 CFR chapter I, 

subchapters D and E and safe navigation 

practice.

Dated: May 13, 2005. 

Peter V. Neffenger, 

Captain, U.S. Coast Guard, Captain of the 

Port, Los Angeles–Long Beach.

[FR Doc. 05–10594 Filed 5–26–05; 8:45 am] 

BILLING CODE 4910–15–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 413 

[CMS–1199–IFC] 

RIN 0938–AN87 

Medicare Program; Electronic 

Submission of Cost Reports: Revision 

to Effective Date of Cost Reporting 

Period

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS.

ACTION: Interim final rule with comment 

period. 

SUMMARY: This interim final rule with 

comment period revises the existing 

effective date by which all organ 

procurement organizations (OPOs), rural 

health clinics (RHCs), Federally 

qualified health centers (FQHCs), and 

community mental health centers 

(CMHCs) are required to submit their 

Medicare cost reports in a standardized 

electronic format from cost reporting 

periods ending on or after December 31, 

2004 to cost reporting periods ending on 

or after March 31, 2005. 

This interim final rule with comment 

does not affect the current cost reporting 

requirement for hospices and end-stage 

renal disease (ESRD) facilities. Hospices 

and ESRD facilities are required to 

continue to submit cost reports under 

the Medicare regulations in a 

standardized electronic format for cost 

reporting periods ending on or after 

December 31, 2004.

DATES: Effective date: These regulations 

are effective on June 27, 2005. 

Comment date: To be assured 

consideration, comments must be 

received at one of the addresses 

provided below, no later than 5 p.m. on 

July 26, 2005.

ADDRESSES: In commenting, please refer 

to file code CMS–1199–IFC. Because of 

staff and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 

You may submit comments in one of 

three ways (no duplicates, please): 

1. Electronically. You may submit 

electronic comments on specific issues 

in this regulation to http://

www.cms.hhs.gov/regulations/

ecomments. (Attachments should be in 

Microsoft Word, WordPerfect, or Excel; 

however, we prefer Microsoft Word.) 

2. By mail. You may mail written 

comments (one original and two copies) 

to the following address ONLY: Centers 

for Medicare & Medicaid Services, 

Department of Health and Human 

Services, Attention: CMS–1199–IFC, 

P.O. Box 8018, Baltimore, MD 21244–

8018. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By hand or courier. If you prefer, 

you may deliver (by hand or courier) 

your written comments (one original 

and two copies) before the close of the 

comment period to one of the following 

addresses. If you intend to deliver your 

comments to the Baltimore address, 

please call telephone number (410) 786–

7197 in advance to schedule your 

arrival with one of our staff members. 

Room 445–G, Hubert H. Humphrey 

Building, 200 Independence Avenue, 

SW., Washington, DC 20201; or 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

(Because access to the interior of the 

HHH 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.)

Comments mailed to the addresses 

indicated as appropriate for hand or 

courier delivery may be delayed and 

could be considered late. All comments 

received before the close of the 

comment period are available for 

viewing by the public, including any

Federal Register / Vol. 70, No. 102 / Friday, May 27, 2005 / Rules and Regulations 30641

personally identifiable or confidential 

business information that is included in 

a comment. After the close of the 

comment period, CMS posts all 

electronic comments received before the 

close of the comment period on its 

public Web site. 

For information on viewing public 

comments, see the beginning of the 

SUPPLEMENTARY INFORMATION section.

FOR FURTHER INFORMATION CONTACT:

Darryl E. Simms, (410) 786–4524.

SUPPLEMENTARY INFORMATION: 

Submitting Comments: We welcome 

comments from the public on all issues 

set forth in this rule to assist us in fully 

considering issues and developing 

policies. You can assist us by 

referencing the file code CMS–1199-IFC 

and the specific ‘‘issue identifier’’ that 

precedes the section on which you 

choose to comment. 

Inspection of Public Comments: All 

comments received before the close of 

the comment period are available for 

viewing by the public, including any 

personally identifiable or confidential 

business information that is included in 

a comment. We post all electronic 

comments received before the close of 

the comment period on its public Web 

site as soon as possible after they are 

received. Hard copy comments received 

timely will 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. 

I. Background 

On August 23, 2003, we published in 

the Federal Register (68 FR 50717), a 

final regulation that requires that all 

hospices, organ procurement 

organizations (OPOs), rural health 

clinics (RHCs), Federally qualified 

health centers (FQHCs), community 

mental health centers (CMHCs), and 

end-stage renal disease (ESRD) facilities 

submit Medicare cost reports in a 

standardized electronic format. This 

requirement is effective for cost 

reporting periods ending on or after 

December 31, 2004. 

The provider’s electronic program 

must be capable of producing the CMS 

standardized output file in a form that 

can be read by the fiscal intermediary’s 

automated system. This electronic file, 

which must contain the input data 

required to complete the cost report and 

to pass specified edits, must be 

forwarded to the fiscal intermediary for 

processing through its system. 

These facilities are generally paid 

under the Medicare program for the 

reasonable costs of the covered items 

and services they furnish to Medicare 

beneficiaries. Sections 1815(a) and 

1833(e) of the Social Security Act (the 

Act) provided that no payments will be 

made to a provider unless it has 

furnished the information, requested by 

the Secretary of the Department of 

Health and Human Services (Secretary), 

needed to determine the amount of 

payments due the provider. 

In general, providers submit this 

information through cost reports that 

cover a 12-month period. Regulations 

governing the submission of cost reports 

are set forth in § 413.20 and § 413.24. 

Section 413.20(a) specifies that all 

providers participating in the Medicare 

program are required to maintain 

sufficient financial records and 

statistical data for proper determination 

of costs payable under the Medicare 

program. In addition, providers must 

use standardized definitions and follow 

accounting, statistical, and reporting 

practices that are widely accepted in the 

health care industry and related fields. 

In § 413.20(b) and § 413.24(f), providers 

are required to submit cost reports 

annually, with the reporting period 

based on the provider’s accounting year. 

Section 412.52 specifies that all 

hospitals participating in the 

prospective payment system must meet 

cost reporting requirements set forth at 

§ 413.20 and § 413.24.

Section 1886(f)(1)(B)(i) of the Act 

requires the Secretary to establish a 

standardized electronic cost reporting 

system for all hospitals participating in 

the Medicare program. This provision 

was effective for hospital cost reporting 

periods beginning on or after October 1, 

1989. On January 2, 1997, we published 

a final rule in the Federal Register (62 

FR 26) that revised § 413.24(f)(4)(ii) to 

extend the electronic cost reporting 

requirements to skilled nursing facilities 

(SNFs) and home health agencies 

(HHAs). 

The required cost reports must be 

electronically transmitted to the 

intermediary in American Standard 

Code for Information Interchange 

(ASCII) format. In addition to the 

electronic file, hospitals, SNFs, and 

HHAs were initially required to submit 

a hard copy of the full cost report. The 

January 2, 1997 final rule revised 

§ 413.24(f)(4)(iv) to state that providers 

were required to submit, instead, a hard 

copy of a one-page settlement summary, 

a statement of certain worksheet totals 

found in the electronic file, and a 

statement signed by the provider’s 

administrator or chief financial officer 

certifying the accuracy of the electronic 

file. To preserve the integrity of the 

electronic file, in the January 2, 1997 

final rule we specified procedures 

regarding the processing of electronic 

cost reports once they are submitted to 

the intermediary. 

II. Provisions of the Interim Final Rule 

This interim final rule revises the 

existing effective date for submission of 

electronic cost reports for OPOs, RHCs, 

FQHCs, and CMHCs from cost reporting 

periods ending on or after December 31, 

2004 to cost reporting periods ending on 

or after March 31, 2005. As a result of 

the delays in the availability of the CMS 

free cost reporting software and 

commercially available cost reporting 

software, OPOs, RHCs, FQHCs, and 

CMHCs will now be required to file 

their cost reports in a standardized 

electronic format effective for cost 

reporting periods ending on or after 

March 31, 2005. This is a change from 

the August 23, 2003 final rule that 

established the electronic filing 

requirement for cost reporting periods 

ending on or after December 31, 2004. 

Hospices and ESRD facilities will 

continue to be subject to the electronic 

filing requirements as referenced in the 

August 23, 2003 final rule as software 

for these provider types is available. 

Therefore, all hospices and ESRD 

facilities are still required to submit 

standardized electronic cost reports for 

cost reporting periods ending on or after 

December 31, 2004. Standardized 

electronic cost reports have been in 

place since October 1989. Since that 

time, the accuracy of cost reporting has 

increased. Under this interim final rule, 

the only change is to the effective date 

for submission of electronic cost 

reporting for OPOs, RHCs, FQHCs, and 

CMHCs. These providers will still be 

given a transition period (described in 

the August 23, 2003 final rule (68 FR 

50717)) beginning with the new 

effective date and are still required to 

provide a hard copy of the settlement 

summary, statement of certain 

worksheet totals, and a statement signed 

by the administrator or chief financial 

officer certifying the accuracy of the 

electronic file or the manually prepared 

cost report under the new effective date. 

III. Response to Comments 

Because of the large number of public 

comments we normally receive on 

Federal Register documents, we are not 

able to acknowledge or respond to them 

individually. We will consider all 

comments we receive by the date and 

time specified in the DATES section of

30642 Federal Register / Vol. 70, No. 102 / Friday, May 27, 2005 / Rules and Regulations 

this preamble, and, when we proceed 

with a subsequent document, we will 

respond to the comments in the 

preamble to that document.

IV. Waiver of Proposed Rulemaking 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register and invite public comment on 

the proposed rule. The notice of 

proposed rulemaking includes a 

reference to the legal authority under 

which the rule is proposed, and the 

terms and substances of the proposed 

rule or a description of the subjects and 

issues involved. This procedure can be 

waived, however, if an agency finds 

good cause that a notice-and-comment 

procedure is impracticable, 

unnecessary, or contrary to the public 

interest and incorporates a statement of 

the finding and its reasons in the rule 

issued. 

Because of the delay in the 

availability of the requisite cost 

reporting software (CMS-provided and 

commercially available) needed to 

comply with the effective date 

provisions of the August 23, 2003 final 

rule, OPOs, RHCs, FQHCs, and CMHCs 

are not able to submit cost reports in a 

standardized electronic format for cost 

reporting periods ending December 31, 

2004. These cost reports are due to their 

respective fiscal intermediaries (FIs) 150 

days or 5 months following the close of 

the cost reporting period which is May 

31, 2005. Revising the reporting 

requirement to be effective for cost 

reporting periods ending on or after 

March 31, 2005, provides the time for 

the contractors to develop the requisite 

cost reporting software. The new 

electronic filing requirement for cost 

reporting periods ending on or after 

March 31, 2005 requires OPOs, RHCs, 

FQHCs, and CMHCs, with a March 31, 

2005 cost reporting ending date to 

submit cost reporting data to FIs by 

August 31, 2005. We find the noticeand-comment procedure impracticable 

since it is not feasible for these 

providers to meet the current effective 

date as the technology to meet the 

reporting requirement is not available. 

Also, this interim final rule with 

comment does not impose any 

additional requirements, but merely 

extends the effective date of the existing 

reporting requirement until the software 

is available. Therefore, we find good 

cause to waive notice-and-comment 

procedures and to issue this final rule 

on an interim basis. However, we are 

providing a 60-day public comment 

period. 

V. Collection of Information 

Requirements 

Under the Paperwork Reduction Act 

of 1995, we are required to provide 60-

day notice in the Federal Register and 

solicit public comment before a 

collection of information requirement is 

submitted to the Office of Management 

and Budget (OMB) for review and 

approval. However, the requirements 

referenced and discussed below are 

currently approved by OMB. 

Section 413.24 Adequate Cost Data 

and Cost Finding 

Currently § 413.24 requires hospitals, 

to submit cost reports in a standardized 

electronic format for cost reporting 

periods beginning on or after October 1, 

1989. SNFs, and HHAs must submit cost 

reports in a standardized electronic 

format for cost reporting periods ending 

on or after December 31, 1996. 

Hospices, ESRD facilities, OPOS, RHCs, 

FQHCs and CMHCs must submit cost 

reports in a standardized electronic 

format for cost reporting periods ending 

on or after December 31, 2004. These 

reporting requirements are currently 

approved as described below. 

This interim final rule revises the 

dates by which OPOs, RHCs, FQHCs, 

and CMHCs must submit cost reports in 

a standardized electronic format. Under 

the revised requirements OPOs, RHCs, 

FQHCs, and CMHCs must now submit 

cost reports in a standardized electronic 

format for cost reporting periods ending 

on or after March 31, 2005, rather than 

December 31, 2004. This change does 

not impose any new burden. 

As noted above, while all the above 

reporting requirements are subject to the 

PRA, they are currently approved under 

OMB approval numbers 0938–0050, 

‘‘Hospital/Healthcare Complex Cost 

Report,’’ with a current expiration date 

of November 30, 2005, 0938–0463; 

‘‘Skilled Nursing Facility Cost Report,’’

with a current expiration date of April 

30, 2007; 0938–0022, ‘‘Home Health 

Agency Cost Report,’’ with a current 

expiration date of April 30, 2007; 0938–

0758, ‘‘Hospice Cost Report,’’ with a 

current expiration date of January 31, 

2008; 0938–0102, ‘‘Organ Procurement 

Agency/Laboratory Statement of 

Reimbursable Costs,’’ with a current 

expiration date of August 31, 2006; 

0938–0107, ‘‘Independent Rural Health 

Clinic/Freestanding Federally Qualified 

Health Center Cost Report,’’ with a 

current expiration date of October 31, 

2005; 0938–0236, ‘‘Medicare 

Independent Renal Dialysis Facility 

Cost Report,’’ with a current expiration 

date of June 30, 2007; and 0938–0657, 

‘‘End Stage Renal Disease Network Cost 

Report,’’ with a current expiration date 

of September 30, 2006. 

If you comment on these information 

collection and recordkeeping 

requirements, please mail copies 

directly to the following:

Centers for Medicare & Medicaid 

Services, Office of Strategic 

Operations and Regulatory Affairs, 

Regulations Development Group, 

Attn: Jim Wickliffe, CMS–1199–IFC, 

Room C4–26–05, 7500 Security 

Boulevard, Baltimore, MD 21244–

1850; and 

Office of Information and Regulatory 

Affairs, Office of Management and 

Budget, Room 10235, New Executive 

Office Building, Washington, DC 

20503, Attn: Christopher Martin, CMS 

Desk Officer, CMS–1199–IFC, 

Christopher_Martin@omb.eop.gov,

Fax (202) 395–6974. 

VI. Regulatory Impact Statement 

We have examined the impact of this 

rule as required by Executive Order 

12866 (September 1993, Regulatory 

Planning and Review), the Regulatory 

Flexibility Act (RFA) (September 19, 

1980, Pub. L. 96–354), section 1102(b) of 

the Social Security Act (the Act), the 

Unfunded Mandates Reform Act of 1995 

(Pub. L. 104–4), and Executive Order 

13132. 

Executive Order 12866 directs 

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). This rule does not reach 

the economic threshold and thus is not 

considered a major rule. 

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 

government agencies. Most hospitals 

and most other providers and suppliers 

are small entities, either by nonprofit 

status or by having revenues of $6 

million to $29 million in any 1 year. 

Individuals and States are not included 

in the definition of a small entity. We 

are not preparing an analysis for the 

RFA because we have determined that 

this rule will not have a significant 

economic impact on a substantial 

number of small entities. 

In addition, section 1102(b) of the Act 

requires us to prepare a regulatory 

impact analysis if a rule may have a

Federal Register / Vol. 70, No. 102 / Friday, May 27, 2005 / Rules and Regulations 30643

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 and has 

fewer than 100 beds. We are not 

preparing an analysis for section 1102(b) 

of the Act because we have determined 

that this rule will 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 also 

requires that agencies assess anticipated 

costs and benefits before issuing any 

rule that may result in expenditure in 

any 1 year by State, local, or tribal 

governments, in the aggregate, or by the 

private sector, of $110 million. This rule 

will have no consequential effect on the 

governments mentioned or on the 

private sector. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it publishes 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 

regulation does not impose any costs on 

State or local governments, the 

requirements of E.O. 13132 are not 

applicable. 

In accordance with the provisions of 

Executive Order 12866, this regulation 

was reviewed by the Office of 

Management and Budget.

List of Subjects in 42 CFR Part 413 

Health facilities, Kidney diseases, 

Medicare, Reporting and recordkeeping 

requirements.

■ For the reasons set forth in the 

preamble, the Centers for Medicare & 

Medicaid Services amends 42 CFR 

chapter IV, as set forth below:

PART 413—PRINCIPLES OF 

REASONABLE COST 

REIMBURSEMENT; PAYMENT FOR 

END-STAGE RENAL DISEASE 

SERVICES; PROSPECTIVELY 

DETERMINED PAYMENT RATES FOR 

SKILLED NURSING FACILITIES

■ 1. The authority citation for part 413 

continues to read as follows:

Authority: Secs. 1102, 1812(d), 1814(b), 

1815, 1833(a), (i), and (n), 1871, 1881, 1883 

and 1886 of the Social Security Act (42 

U.S.C. 1302, 1395dd(d), 1395f(b), 1395g, 

1395l(a), (i) and (n), 1395hh, 1395rr, 1395tt, 

and 1395ww).

Subpart B—Accounting Records and 

Reports

■ 2. Section 413.24 is amended by—

■ A. Revising paragraph (f)(4)(ii).

■ B. Revising paragraph (f)(4)(iv).

The revisions read as follows:

§ 413.24 Adequate cost data and cost 

finding.

* * * * *

(f) * * * 

(4) * * * 

(i) * * * 

(ii) Effective for cost reporting periods 

beginning on or after October 1, 1989 for 

hospitals, cost reporting periods ending 

on or after December 31, 1996 for skilled 

nursing facilities and home health 

agencies, cost reporting periods ending 

on or after December 31, 2004 for 

hospices, and end-stage renal disease 

facilities, and cost reporting periods 

ending on or after March 31, 2005 for 

organ procurement organizations, rural 

health clinics, Federally qualified health 

centers, and community mental health 

centers, a provider is required to submit 

cost reports in a standardized electronic 

format. The provider’s electronic 

program must be capable of producing 

the CMS standardized output file in a 

form that can be read by the fiscal 

intermediary’s automated system. This 

electronic file, which must contain the 

input data required to complete the cost 

report and to pass specified edits, must 

be forwarded to the fiscal intermediary 

for processing through its system.

* * * * *

(iv) Effective for cost reporting 

periods ending on or after September 

30, 1994 for hospitals, cost reporting 

periods ending on or after December 31, 

1996 for skilled nursing facilities and 

home health agencies, cost reporting 

periods ending on or after December 31, 

2004 for hospices and end-stage renal 

disease facilities, and cost reporting 

periods ending on or after March 31, 

2005 for organ procurement 

organizations, rural health clinics, 

Federally qualified health centers, and 

community mental health centers, a 

provider must submit a hard copy of a 

settlement summary, a statement of 

certain worksheet totals found within 

the electronic file, and a statement 

signed by its administrator or chief 

financial officer certifying the accuracy 

of the electronic file or the manually 

prepared cost report. During a transition 

period (first two cost-reporting periods 

on or after December 31, 2004 for 

hospices and end-stage renal disease 

facilities, and the first two costreporting periods on or after March 31, 

2005 for organ procurement 

organizations, rural health clinics, 

Federally qualified health centers, 

community mental health centers) 

providers must submit a hard copy of 

the completed cost report forms in 

addition to the electronic file. The 

following statement must immediately 

precede the dated signature of the 

provider’s administrator or chief 

financial officer:

I hereby certify that I have read the above 

certification statement and that I have 

examined the accompanying electronically 

filed or manually submitted cost report and 

the Balance Sheet Statement of Revenue and 

Expenses prepared by _____ (Provider 

Name(s) and Number(s)) for the cost 

reporting period beginning ___ and ending 

___ and that to the best of my knowledge and 

belief, this report and statement are true, 

correct, complete and prepared from the 

books and records of the provider in 

accordance with applicable instructions, 

except as noted. I further certify that I am 

familiar with the laws and regulations 

regarding the provision of health care 

services, and that the services identified in 

this cost report were provided in compliance 

with such laws and regulations.

* * * * *

(Catalog of Federal Domestic Assistance; 

Program No. 93.774, Medicare—

Supplementary Medical Insurance 

Program)

Dated: April 14, 2005. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services. 

Approved: May 3, 2005. 

Michael O. Leavitt, 

Secretary.

[FR Doc. 05–10570 Filed 5–26–05; 8:45 am] 

BILLING CODE 4120–01–P

DEPARTMENT OF HOMELAND 

SECURITY 

Federal Emergency Management 

Agency 

44 CFR Part 65

[Docket No. FEMA–D–7569] 

Changes in Flood Elevation 

Determinations

AGENCY: Federal Emergency 

Management Agency (FEMA), 

Emergency Preparedness and Response 

Directorate, Department of Homeland 

Security.

ACTION: Interim rule.

SUMMARY: This interim rule lists 

communities where modification of the 

Base (1% annual chance) Flood 

Elevations (BFEs) is appropriate because 

of new scientific or technical data. New 

flood insurance premium rates will be