Federal Register / Vol. 83, No. 149 / Thursday, August 2, 2018 / Rules and Regulations 37747 

1As noted in the preamble to the final rule with 

comment period implementing the moratorium 

authority (February 2, 2011, 76 FR 5870), home 

health agency subunits and branch locations are 

subject to the moratoria to the same extent as any 

other newly enrolling home health agency. 

2CMS has identified an error in the provider and 

beneficiary saturation data described in our July 31, 

2013 Federal Register notice (78 FR 46339). We 

have subsequently revised the methodology by 

which we determine provider and beneficiary 

saturation. Following these revisions to the 

methodology, we simulated application of our 

current 2016 methodology to the 2013 data, and 

determined that the 2013 decision to impose the 

moratorium would not have been impacted had the 

revised methodology been applied. Provider 

saturation remains one of the criteria used to 

determine whether to implement a moratorium. 

CMS has made market saturation data publicly 

available at https://data.cms.gov/market-saturation. 

3CMS also concurrently announced a 

demonstration under the authority provided in 

section 402(a)(l)(J) of the Social Security 

Amendments of 1967 (42 U.S.C. 1395b–l(a)(l)(J)) 

that allows for access to care-based exceptions to 

the moratoria in certain limited circumstances after 

a heightened review of that provider has been 

conducted. This exception process also applies to 

Medicaid and CHIP providers in each state. This 

announcement may be found in the Federal 

Register document issued on August 3, 2016 (81 FR 

51116). 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 424 

[CMS–6059–N9] 

Medicare, Medicaid, and Children’s 

Health Insurance Programs: 

Announcement of the Extension of 

Temporary Moratoria on Enrollment of 

Part B Non-Emergency Ground 

Ambulance Suppliers and Home Health 

Agencies in Designated Geographic 

Locations 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Extension of temporary 

moratoria. 

SUMMARY: This document announces the 

extension of statewide temporary 

moratoria on the enrollment of new 

Medicare Part B non-emergency ground 

ambulance providers and suppliers and 

Medicare home health agencies and 

branch locations in Florida, Illinois, 

Michigan, Texas, Pennsylvania, and 

New Jersey, as applicable, to prevent 

and combat fraud, waste, and abuse. 

This extension also applies to the 

enrollment of new non-emergency 

ground ambulance suppliers and home 

health agencies and branch locations in 

Medicaid and the Children’s Health 

Insurance Program in those states. 

DATES: Applicable July 29, 2018. 

FOR FURTHER INFORMATION CONTACT: Jung 

Kim, (410) 786–9370. 

News media representatives must 

contact CMS’ Public Affairs Office at 

(202) 690–6145 or email them at press@

cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background 

A. CMS’ Implementation of Temporary 

Enrollment Moratoria 

The Social Security Act (the Act) 

provides the Secretary with tools and 

resources to combat fraud, waste, and 

abuse in Medicare, Medicaid, and the 

Children’s Health Insurance Program 

(CHIP). In particular, section 1866(j)(7) 

of the Act provides the Secretary with 

authority to impose a temporary 

moratorium on the enrollment of new 

Medicare, Medicaid, or CHIP providers 

and suppliers, including categories of 

providers and suppliers, if the Secretary 

determines a moratorium is necessary to 

prevent or combat fraud, waste, or abuse 

under these programs. Regarding 

Medicaid, section 1902(kk)(4) of the Act 

requires States to comply with any 

moratorium imposed by the Secretary 

unless the State determines that the 

imposition of such moratorium would 

adversely impact Medicaid 

beneficiaries’ access to care. In addition, 

section 2107(e)(1)(F) of the Act provides 

that the Medicaid provisions in section 

1902(kk) are also applicable to CHIP. 

In the February 2, 2011 Federal 

Register (76 FR 5862), CMS published a 

final rule with comment period titled, 

‘‘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,’’ 

which implemented section 1866(j)(7) of 

the Act by establishing new regulations 

at 42 CFR 424.570. Under 

§ 424.570(a)(2)(i) and (iv), CMS, or CMS 

in consultation with the Department of 

Health and Human Services’ Office of 

Inspector General (HHS OIG) or the 

Department of Justice (DOJ), or both, 

may impose a temporary moratorium on 

newly enrolling Medicare providers and 

suppliers if CMS determines that there 

is a significant potential for fraud, 

waste, or abuse with respect to a 

particular provider or supplier type, or 

particular geographic locations, or both. 

At § 424.570(a)(1)(ii), CMS stated that it 

would announce any temporary 

moratorium in a Federal Register 

document that includes the rationale for 

the imposition of such moratorium. This 

document fulfills that requirement. 

In accordance with section 

1866(j)(7)(B) of the Act, there is no 

judicial review under sections 1869 and 

1878 of the Act, or otherwise, of the 

decision to impose a temporary 

enrollment moratorium. A provider or 

supplier may use the existing appeal 

procedures at 42 CFR part 498 to 

administratively appeal a denial of 

billing privileges based on the 

imposition of a temporary moratorium; 

however, the scope of any such appeal 

is limited solely to assessing whether 

the temporary moratorium applies to the 

provider or supplier appealing the 

denial. Under § 424.570(c), CMS denies 

the enrollment application of a provider 

or supplier if the provider or supplier is 

subject to a moratorium. If the provider 

or supplier was required to pay an 

application fee, the application fee will 

be refunded if the application was 

denied as a result of the imposition of 

a temporary moratorium (see 

§ 424.514(d)(2)(v)(C)). 

Based on this authority and our 

regulations at § 424.570, we initially 

imposed moratoria to prevent 

enrollment of new home health 

agencies, subunits, and branch 

locations 1 (hereafter referred to as 

HHAs) in Miami-Dade County, Florida 

and Cook County, Illinois, as well as 

surrounding counties, and Medicare 

Part B ground ambulance suppliers in 

Harris County, Texas and surrounding 

counties, in a notice issued on July 31, 

2013 (78 FR 46339).2 We exercised this 

authority again in a notice published on 

February 4, 2014 (79 FR 6475) when we 

extended the existing moratoria for an 

additional 6 months and expanded them 

to include enrollment of HHAs in 

Broward County, Florida; Dallas 

County, Texas; Harris County, Texas; 

and Wayne County, Michigan and 

surrounding counties, and enrollment of 

ground ambulance suppliers in 

Philadelphia, Pennsylvania and 

surrounding counties. 

Then, we further extended these 

moratoria in documents issued on 

August 1, 2014 (79 FR 44702), February 

2, 2015 (80 FR 5551), July 28, 2015 (80 

FR 44967), and February 2, 2016 (81 FR 

5444). On August 3, 2016 (81 FR 51120), 

we extended the current moratoria for 

an additional 6 months and expanded 

them to statewide for the enrollment of 

new HHAs in Florida, Illinois, 

Michigan, and Texas, and Part B nonemergency ambulance suppliers in New 

Jersey, Pennsylvania, and Texas. Our 

August 3, 2016 publication also 

announced the lifting of temporary 

moratoria for all Part B emergency 

ambulance suppliers.3 On January 9, 

2017 (82 FR 2363) and July 28, 2017 (82 

FR 35122), CMS again issued a 


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37748 Federal Register / Vol. 83, No. 149 / Thursday, August 2, 2018 / Rules and Regulations 

document to extend the temporary 

moratoria for a period of 6 months. 

On September 1, 2017, CMS lifted the 

statewide temporary moratorium on the 

enrollment of new Medicare Part B nonemergency ground ambulance suppliers 

in Texas under the authority of 

§ 424.570(d). This lifting of the 

moratorium also applied to Medicaid 

and CHIP in Texas. This decision was 

a result of the Presidential Disaster 

Declaration signed on August 25, 2017 

for several counties in the State of Texas 

due to Hurricane Harvey. Upon 

declaration of the disaster, CMS 

carefully reviewed the potential impact 

of continued moratoria in Texas, and 

decided to lift the temporary enrollment 

moratorium on non-emergency ground 

ambulance suppliers in Texas in order 

to aid in the disaster response. CMS 

published a formal announcement of 

this decision on November 3, 2017 (82 

FR 51274). 

Most recently, on January 30, 2018 (83 

FR 4147), CMS announced the 

extension of the temporary moratoria for 

an additional six months. 

B. Determination of the Need for 

Moratoria 

In imposing these enrollment 

moratoria, CMS considered both 

qualitative and quantitative factors 

suggesting a high risk of fraud, waste, or 

abuse. CMS relied on law enforcement’s 

longstanding experience with ongoing 

and emerging fraud trends and activities 

through civil, criminal, and 

administrative investigations and 

prosecutions. CMS’ determination of a 

high risk of fraud, waste, or abuse in 

these provider and supplier types 

within these geographic locations was 

then confirmed by CMS’ data analysis, 

which relied on factors the agency 

identified as strong indicators of risk. 

(For a more detailed explanation of this 

determination process and of these 

authorities, see the July 31, 2013 notice 

(78 FR 46339) or February 4, 2014 

moratoria document (79 FR 6475)). 

Because fraud schemes are highly 

migratory and transitory in nature, 

many of CMS’ program integrity 

authorities and anti-fraud activities are 

designed to allow the agency to adapt to 

emerging fraud in different locations. 

The laws and regulations governing 

CMS’ moratoria authority give us 

flexibility to use any and all relevant 

criteria for future moratoria, and CMS 

may rely on additional or different 

criteria as the basis for future moratoria. 

1. Application to Medicaid and the 

Children’s Health Insurance Program 

(CHIP) 

The February 2, 2011, final rule also 

implemented section 1902(kk)(4) of the 

Act, establishing new Medicaid 

regulations at § 455.470. Under 

§ 455.470(a)(1) through (3), the Secretary 

may impose a temporary moratorium, in 

accordance with § 424.570, on the 

enrollment of new providers or provider 

types after consulting with any affected 

State Medicaid agencies. The State 

Medicaid agency must impose a 

temporary moratorium on the 

enrollment of new providers or provider 

types identified by the Secretary as 

posing an increased risk to the Medicaid 

program unless the State determines 

that the imposition of such moratorium 

would adversely affect Medicaid 

beneficiaries’ access to medical 

assistance and so notifies the Secretary. 

The final rule also implemented section 

2107(e)(1)(D) of the Act by providing, at 

§ 457.990 of the regulations, that all of 

the provisions that apply to Medicaid 

under sections 1902(a)(77) and 1902(kk) 

of the Act, as well as the implementing 

regulations, also apply to CHIP. 

Section 1866(j)(7) of the Act 

authorizes imposition of a temporary 

enrollment moratorium for Medicare, 

Medicaid, and/or CHIP, ‘‘if the Secretary 

determines such moratorium is 

necessary to prevent or combat fraud, 

waste, or abuse under either such 

program.’’ While there may be 

exceptions, CMS believes that generally, 

a category of providers or suppliers that 

poses a risk to the Medicare program 

also poses a similar risk to Medicaid 

and CHIP. Many of the anti-fraud 

provisions in the Act reflect this 

concept of ‘‘reciprocal risk’’ in which a 

provider that poses a risk to one 

program poses a risk to the other 

programs. For example, section 

1902(a)(39) of the Act requires State 

Medicaid agencies to terminate the 

participation of an individual or entity 

if such individual or entity is 

terminated under Medicare or any other 

State Medicaid plan. Additional 

provisions in the Act also support the 

determination that categories of 

providers and suppliers pose the same 

risk to Medicaid as to Medicare. Section 

1866(j) of the Act requires us to 

establish levels of screening for 

categories of providers and suppliers 

based on the risk of fraud, waste, and 

abuse determined by the Secretary. 

Section 1902(kk) of the Act requires 

State Medicaid agencies to screen 

providers and suppliers based on the 

same levels established for the Medicare 

program. This reciprocal concept is also 

reflected in the Medicare moratoria 

regulations at § 424.570(a)(2)(ii) and 

(iii), which permit CMS to impose a 

Medicare moratorium based solely on a 

State imposing a Medicaid moratorium. 

Accordingly, CMS has determined that 

there is a reasonable basis for 

concluding that a category of providers 

or suppliers that poses a risk to 

Medicare also poses a similar risk to 

Medicaid and CHIP, and that a 

moratorium in all of these programs is 

necessary to effectively combat this risk. 

2. Consultation With Law Enforcement 

In consultation with the HHS Office 

of Inspector General (OIG) and the 

Department of Justice (DOJ), CMS 

previously identified two provider and 

supplier types in nine geographic 

locations that warrant a temporary 

enrollment moratorium. For a more 

detailed discussion of this consultation 

process, see the July 31, 2013 notice (78 

FR 46339) or February 4, 2014 moratoria 

document (79 FR 6475). 

3. Data Analysis 

In addition to consulting with law 

enforcement, CMS also analyzed its own 

data to identify specific provider and 

supplier types within geographic 

locations with significant potential for 

fraud, waste or abuse, therefore 

warranting the imposition of enrollment 

moratoria. 

4. Beneficiary Access to Care 

Beneficiary access to care in 

Medicare, Medicaid, and CHIP is of 

critical importance to CMS and its State 

partners, and CMS carefully evaluated 

access for the target moratorium 

locations with every imposition and 

extension of the moratoria. Prior to 

imposing and extending these 

moratoria, CMS reviewed Medicare data 

for these areas and found no concerns 

with beneficiary access to HHAs or 

ground ambulance suppliers. CMS also 

consulted with the appropriate State 

Medicaid Agencies and with the 

appropriate State Departments of 

Emergency Medical Services to 

determine if the moratoria would create 

access to care concerns for Medicaid 

and CHIP beneficiaries. All of CMS’ 

State partners were supportive of CMS’ 

analysis and proposals, and together 

with CMS, determined that continuation 

of these moratoria would not create 

access to care issues for Medicaid or 

CHIP beneficiaries. 

5. When a Temporary Moratorium Does 

Not Apply 

Under § 424.570(a)(1)(iii), a temporary 

moratorium does not apply to any of the 

following: (1) Changes in practice 


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Federal Register / Vol. 83, No. 149 / Thursday, August 2, 2018 / Rules and Regulations 37749 

location (2) changes in provider or 

supplier information, such as phone 

number or address; or (3) changes in 

ownership (except changes in 

ownership of HHAs that require initial 

enrollment under § 424.550). Also, in 

accordance with § 424.570(a)(1)(iv), a 

temporary moratorium does not apply to 

any enrollment application that a 

Medicare contractor has already 

approved, but has not yet entered into 

the Provider Enrollment, Chain, and 

Ownership System (PECOS) at the time 

the moratorium is imposed. 

6. Lifting a Temporary Moratorium 

In accordance with § 424.570(b), a 

temporary enrollment moratorium 

imposed by CMS will remain in effect 

for 6 months. If CMS deems it 

necessary, the moratorium may be 

extended in 6-month increments. CMS 

will evaluate whether to extend or lift 

the moratorium before the end of the 

initial 6-month period and, if 

applicable, any subsequent moratorium 

periods. If one or more of the moratoria 

announced in this document are 

extended, CMS will publish a document 

regarding such extensions in the 

Federal Register. 

As provided in § 424.570(d), CMS 

may lift a moratorium at any time if the 

President declares an area a disaster 

under the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act, if 

circumstances warranting the 

imposition of a moratorium have abated, 

if the Secretary has declared a public 

health emergency, or if, in the judgment 

of the Secretary, the moratorium is no 

longer needed. 

Once a moratorium is lifted, the 

provider or supplier types that were 

unable to enroll because of the 

moratorium will be designated to the 

‘‘high’’ screening level in accordance 

with §§ 424.518(c)(3)(iii) and 

455.450(e)(2) if such provider or 

supplier applies at any time within 6 

months from the date the moratorium 

was lifted. 

II. Extension of Home Health and 

Ambulance Moratoria—Geographic 

Locations 

CMS currently has in place statewide 

moratoria on newly enrolling HHAs in 

Florida, Illinois, Michigan, and Texas 

and Part B non-emergency ambulance 

suppliers in New Jersey and 

Pennsylvania. 

As provided in § 424.570(b), CMS 

may deem it necessary to extend 

previously-imposed moratoria in 6- 

month increments. Under this authority, 

CMS is extending the temporary 

moratoria on the Medicare enrollment of 

HHAs and Part B non-emergency 

ground ambulance providers and 

suppliers in the geographic locations 

discussed herein. Under the regulations 

at § 455.470 and § 457.990, these 

moratoria also apply to the enrollment 

of HHAs and non-emergency ground 

ambulance providers and suppliers in 

Medicaid and CHIP in those locations. 

Under § 424.570(b), CMS is required to 

publish a document in the Federal 

Register announcing any extension of a 

moratorium, and this extension of 

moratoria document fulfills that 

requirement. 

CMS consulted with the HHS–OIG 

regarding the extension of the moratoria 

on new HHAs and Part B nonemergency ground ambulance providers 

and suppliers in all of the moratoria 

states, and HHS–OIG agrees that a 

significant potential for fraud, waste, 

and abuse continues to exist regarding 

those provider and supplier types in 

these geographic areas. The 

circumstances warranting the 

imposition of the moratoria have not yet 

abated, and CMS has determined that 

the moratoria are still needed as we 

monitor the indicators and continue 

with administrative actions to combat 

fraud and abuse, such as payment 

suspensions and revocations of 

provider/supplier numbers. (For more 

information regarding the monitored 

indicators, see the February 4, 2014 

moratoria document (79 FR 6475)). 

Based upon CMS’ consultation with 

the relevant State Medicaid agencies, 

CMS has concluded that extending 

these moratoria will not create an access 

to care issue for Medicaid or CHIP 

beneficiaries in the affected states at this 

time. CMS also reviewed Medicare data 

for these states and found there are no 

current problems with access to HHAs 

or ground ambulance providers or 

suppliers. Nevertheless, the agency will 

continue to monitor these locations to 

make sure that no access to care issues 

arise in the future. 

Based upon our consultation with law 

enforcement and consideration of the 

factors and activities described 

previously, CMS has determined that 

the current temporary enrollment 

moratoria should be extended for an 

additional 6 months. 

III. Summary of the Moratoria 

Locations 

CMS is executing its authority under 

sections 1866(j)(7), 1902(kk)(4), and 

2107(e)(1)(D) of the Act to extend and 

implement temporary enrollment 

moratoria on HHAs for all counties in 

Florida, Illinois, Michigan, and Texas, 

as well as Part B non-emergency ground 

ambulance providers and suppliers for 

all counties in New Jersey and 

Pennsylvania. 

IV. Clarification of Right to Judicial 

Review 

Section 1866(j)(7)(B) of the Act states 

that there shall be no judicial review 

under section 1869, section 1878, or 

otherwise, of a temporary moratorium 

imposed on the enrollment of new 

providers of services and suppliers if 

the Secretary determines that the 

moratorium is necessary to prevent or 

combat fraud, waste, or abuse. 

Accordingly, our regulations at 42 CFR 

498.5(l)(4) state that for appeals of 

denials based on a temporary 

moratorium, the scope of review will be 

limited to whether the temporary 

moratorium applies to the provider or 

supplier appealing the denial. The 

agency’s basis for imposing a temporary 

moratorium is not subject to review. Our 

regulations do not limit the right to seek 

judicial review of a final agency 

decision that the temporary moratorium 

applies to a particular provider or 

supplier. In the preamble to the 

February 2, 2011 (76 FR 5918) final rule 

with comment period establishing this 

regulation, we explained that ‘‘a 

provider or supplier may 

administratively appeal an adverse 

determination based on the imposition 

of a temporary moratorium up to and 

including the Department Appeal Board 

(DAB) level of review.’’ We are 

clarifying that providers and suppliers 

that have received unfavorable 

decisions in accordance with the 

limited scope of review described in 

§ 498.5(l)(4) may seek judicial review of 

those decisions after they exhaust their 

administrative appeals. However, we 

reiterate that section 1866(j)(7)(B) of the 

Act precludes judicial review of the 

agency’s basis for imposing a temporary 

moratorium. 

V. Collection of Information 

Requirements 

This document does not impose 

information collection requirements, 

that is, reporting, recordkeeping or 

third-party disclosure requirements. 

Consequently, there is no need for 

review by the Office of Management and 

Budget under the authority of the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 3501 et seq.). 

VI. Regulatory Impact Statement 

CMS has examined the impact of this 

document 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 


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37750 Federal Register / Vol. 83, No. 149 / Thursday, August 2, 2018 / Rules and Regulations 

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 regulatory actions with 

economically significant effects ($100 

million or more in any 1 year). This 

document will prevent the enrollment 

of new home health providers and Part 

B non-emergency ground ambulance 

suppliers in Medicare, Medicaid, and 

CHIP in certain states. Though savings 

may accrue by denying enrollments, the 

monetary amount cannot be quantified. 

Since the imposition of the initial 

moratoria on July 31, 2013, more than 

1204 HHAs and 26 ambulance 

companies in all geographic areas 

affected by the moratoria had their 

applications denied. We have found the 

number of applications that are denied 

after 60 days declines dramatically, as 

most providers and suppliers will not 

submit applications during the 

moratoria period. Therefore, this 

document does not reach the economic 

threshold, and thus is not considered a 

major action. 

The RFA requires agencies to analyze 

options for regulatory relief of small 

entities. 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 less than $7.5 million to $38.5 

million in any one year. Individuals and 

states are not included in the definition 

of a small entity. CMS is not preparing 

an analysis for the RFA because it has 

determined, and the Secretary certifies, 

that this document 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 an action 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, CMS defines a small rural 

hospital as a hospital that is located 

outside of a metropolitan statistical area 

(MSA) for Medicare payment purposes 

and has fewer than 100 beds. CMS is not 

preparing an analysis for section 1102(b) 

of the Act because it has determined, 

and the Secretary certifies, that this 

document 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 

regulatory action whose mandates 

require spending in any 1 year of $100 

million in 1995 dollars, updated 

annually for inflation. In 2018, that 

threshold is approximately $150 

million. This document will have no 

consequential effect on state, local, or 

tribal governments or on the private 

sector. 

Executive Order 13771, titled 

‘‘Reducing Regulation and Controlling 

Regulatory Costs,’’ was issued on 

January 30, 2017 (82 FR 9339, February 

3, 2017). It has been determined that 

this notice is a transfer notice that does 

not impose more than de minimis costs 

and thus is not a regulatory action for 

the purposes of E.O. 13771. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates a 

proposed regulatory action (and 

subsequent final action) that imposes 

substantial direct requirement costs on 

state and local governments, preempts 

state law, or otherwise has Federalism 

implications. Because this document 

does not impose any costs on state or 

local governments, the requirements of 

Executive Order 13132 are not 

applicable. 

In accordance with the provisions of 

Executive Order 12866, this document 

was reviewed by the Office of 

Management and Budget. 

Dated: July 17, 2018. 

Seema Verma, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2018–16547 Filed 7–30–18; 11:15 am] 

BILLING CODE 4120–01–P 

FEDERAL COMMUNICATIONS 

COMMISSION 

47 CFR Part 11 

[PS Docket No. 15–94; FCC 18–39] 

Emergency Alert System 

AGENCY: Federal Communications 

Commission. 

ACTION: Final rule. 

SUMMARY: In this document, the 

Commission amends its rules governing 

the Emergency Alert System (EAS) by 

establishing the Alert Reporting System 

(ARS), a comprehensive online filing 

system for EAS that combines the 

existing EAS Test Reporting System 

(ETRS) with a new, streamlined 

electronic system for the filing of State 

EAS Plans. By replacing paper-based 

State EAS Plans with an online filing 

system, the ARS will minimize the 

burdens on State Emergency 

Communications Committees (SECCs), 

and allow the FCC, the Federal 

Emergency Management Agency 

(FEMA), and other authorized entities to 

better access and use up-to-date 

information about the EAS, thus 

increasing its value as a tool to protect 

life and property for all Americans. 

DATES: Effective September 4, 2018. 

Mandatory compliance dates: FCC will 

publish a document in the Federal 

Register announcing dates as outlined 

in paragraphs 54–55 and 72–73 in 

SUPPLEMENTARY INFORMATION. 

FOR FURTHER INFORMATION CONTACT: 

Austin Randazzo, Attorney Advisor, 

Policy and Licensing Division, Public 

Safety and Homeland Security Bureau, 

at 202–418–1462, or by email at 

Austin.Randazzo@fcc.gov. For 

additional information concerning the 

information collection requirements 

contained in this document, send an 

email to PRA@fcc.gov or contact Nicole 

Ongele, Office of Managing Director, 

Performance Evaluation and Records 

Management, 202–418–2991, or by 

email to PRA@fcc.gov. 

SUPPLEMENTARY INFORMATION: This is a 

summary of the Commission’s Report 

and Order (Report and Order) in PS 

Docket No. 15–94, FCC 18–39, released 

on April 10, 2018. The full text of this 

document is available for inspection 

and copying during normal business 

hours in the FCC Reference Center 

(Room CY–1257), 445 12th Street SW, 

Washington, DC 20554, or online at: 

https://www.fcc.gov/document/fccmake-emergency-alert-system-moreeffective. 

Synopsis 

1. This Report and Order revises the 

Commission’s EAS rules to establish the 

Alert Reporting System (ARS), a 

comprehensive online filing system that 

will combine the existing EAS Test 

Reporting System (ETRS) with a new, 

streamlined electronic system for the 

filing of State EAS Plans. Further, to 

ensure that the rules for State EAS Plans 

are clear and unambiguous, the Report 

and Order combines all State EAS Plan 


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