12848 Federal Register / Vol. 77, No. 42 / Friday, March 2, 2012 / Notices 

Section 1311 for planning and 

establishment of an Exchange within 

one year of the enactment of the 

Affordable Care Act, by Statute, it will 

not be eligible for Section 1311 

Exchange planning and establishment 

money in the future. Section 1311 of the 

Affordable Care Act provides for grants 

to States for the planning and 

establishment of these Exchanges. Given 

the innovative nature of Exchanges and 

the statutorily prescribed relationship 

between the Secretary and States in 

their development and operation, it is 

critical that the Secretary work closely 

with States to provide necessary 

guidance and technical assistance to 

ensure that States can meet the 

prescribed timelines, federal 

requirements, and goals of the statute. 

In order to provide appropriate and 

timely guidance and technical 

assistance, the Secretary must have 

access to timely, periodic information 

regarding State progress. Consequently, 

the information collection associated 

with these grants is essential to 

facilitating reasonable and appropriate 

federal monitoring of funds, providing 

statutorily mandated assistance to States 

to implement Exchanges in accordance 

with Federal requirements, and to 

ensure that States have all necessary 

information required to proceed, such 

that retrospective corrective action can 

be minimized. 

There are two levels of awards for 

States to apply for the Establishment 

grants. Grants are open to States that 

received federal funding for Exchange 

Planning activities, awardees of the 

Cooperative Agreements to Support 

Innovative Exchange Information 

Technology Systems, and awardees 

under the Cooperative Agreement to 

Support Establishment of StateOperated Health Insurance Exchanges. 

Level One Establishment cooperative 

agreements provide one year of funding 

to States that are ready to initiate 

establishment activities having made 

progress under their Exchange Planning 

grant. Level Two Establishment 

cooperative agreements are designed to 

provide funding to applicants for the 

establishment of a State-based Exchange 

and that can demonstrate specific 

eligibility criteria. Level One 

Establishment grantees may apply for 

additional funding under Level Two 

Establishment grants once they have 

achieved the benchmarks identified in 

the Level Two Establishment review 

criteria. 

HHS anticipates releasing this 

funding opportunity on June 15, 2012. 

There will be four opportunities for 

applicants to apply for funding. HHS 

anticipates Level One Establishment 

and Level Two Establishment 

applications will be due: August 1, 

2012; November 1, 2012; February 1, 

2013; May 1, 2013; August 1, 2013; 

November 1, 2013; February 3, 2014; 

May 1, 2014; August 1, 2014; and 

November 3, 2014. The Period of 

Performance for Level One 

Establishment grants is up to one year 

after date of award. The Period of 

Performance for Level Two 

Establishment grants is up to three years 

after date of award. Form Number: 

CMS–10424 (OCN: 0938–NEW); 

Frequency: Annually; Affected Public: 

State, Local, or Tribal Governments. 

Number of Respondents: 50. Number of 

Responses: 325. Total Annual Hours: 

49,175. (For policy questions regarding 

this collection contact Katherine 

Harkins at 301–492–4445. For all other 

issues call 410–786–1326.) 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web site 

address at http://www.cms.hhs.gov/ 

PaperworkReductionActof1995, or 

Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786– 

1326. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by May 1, 2012: 

1. Electronically. You may submit 

your comments electronically to http:// 

www.regulations.gov. Follow the 

instructions for ‘‘Comment or 

Submission’’ or ‘‘More Search Options’’ 

to find the information collection 

document(s) accepting comments. 

2. By regular mail. You may mail 

written comments to the following 

address: CMS, Office of Strategic 

Operations and Regulatory Affairs, 

Division of Regulations Development, 

Attention: Document Identifier/OMB 

Control Number ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: February 27, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–5011 Filed 2–27–12; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–6043–N] 

Medicare Program; Solicitation of 

Independent Accrediting Organizations 

To Participate in the Advanced 

Diagnostic Imaging Supplier 

Accreditation Program 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice invites 

independent accreditation organizations 

who have not previously submitted 

applications to participate in the 

advanced diagnostic imaging supplier 

accreditation program as a designated 

accreditation organization, for the 

purpose of accrediting suppliers 

furnishing the technical component 

(TC) of advanced diagnostic imaging 

services. It also sets forth the 

application guidelines for approval of 

organizations wishing to accredit 

suppliers furnishing the TC of advanced 

diagnostic imaging services. 

DATES: Applications will be considered 

if received at the address provided in 

the ADDRESSES section of this notice, no 

later than 5 p.m. daylight savings time 

(d.s.t.) on May 1, 2012. 

ADDRESSES: Applications should be sent 

to the following: Attention: Sandra 

Bastinelli, Mail stop AR–18–50, Centers 

for Medicare & Medicaid Services, 7500 

Security Boulevard, Baltimore, 

Maryland 21244. 

FOR FURTHER INFORMATION CONTACT: 

Sandra Bastinelli, (410) 786–3630. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 135(a) of the Medicare 

Improvements for Patients and 

Providers Act of 2008 (MIPPA) added 

section 1834(e) to the Social Security 

Act (Act). Section 1834(e) of the Act 

requires the Secretary to designate 

organizations to accredit suppliers 

furnishing the technical component 

(TC) of advanced diagnostic imaging 

services (section 1834(e)(2)(B) of the 

Act), and to establish procedures to 

ensure that the criteria used by such 

accrediting organizations to accredit TC 

suppliers are specific to each imaging 

modality and meet the requirements of 

the statute (section 1834(e)(3)). Section 

1834 (e)(1)(B) of the Act defines 

advanced diagnostic imaging services 

as— 


tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 42 / Friday, March 2, 2012 / Notices 12849 

(i) Diagnostic magnetic resonance imaging, 

computed tomography, and nuclear 

medicine—including positron emission 

tomography, and 

(ii) Such other diagnostic imaging services, 

including services described in section 

1848(b)(4)(B) (excluding x-ray, ultrasound, 

and fluoroscopy), as specified by the 

Secretary in consultation with physician 

specialty organizations and other 

stakeholders. 

Section 1848(b)(4)(B) of the Act 

defines imaging services as ‘‘imaging 

and computer-assisted imaging services, 

including x-ray, ultrasound (including 

echocardiography), nuclear medicine 

(including positron emission 

tomography), magnetic resonance 

imaging, computed tomography, and 

fluoroscopy, but excluding diagnostic 

and screening mammography.’’ 

Suppliers of the TC of advanced 

diagnostic imaging services for which 

payment is made under the fee schedule 

established under section 1848(b) of the 

Act (that is, the Physician Fee Schedule 

(FFS)), must become accredited by an 

accreditation organization designated by 

the Secretary (for the TC of the defined 

advanced diagnostic imaging services) 

on or after January 1, 2012 in order to 

receive payment from Medicare. 

We implemented these statutory 

provisions via the CY 2010 PFS final 

rule which appeared in the November 

25, 2009 Federal Register (‘‘Medicare 

Program; Payment Policies Under the 

Physician Fee Schedule and Other 

Revisions to Part B for CY 2010’’ (74 FR 

61738). This final rule set out criteria for 

designating organizations to accredit 

suppliers furnishing the TC of advanced 

diagnostic imaging services, as specified 

in section 1834(e) of the Act. In 

addition, 45 CFR 414.68(h) specifies our 

procedures for ensuring that 

accreditation organizations correctly 

apply the criteria to ensure that 

suppliers are meeting minimum 

standards for each imaging modality. 

In the same issue of the Federal 

Register, we published a notice 

soliciting applicants for participation in 

the advanced diagnostic imaging 

supplier accreditation program as 

designated accreditation organizations 

(‘‘Medicare Program; Solicitation of 

Independent Accrediting Organizations 

To Participate in the Advanced 

Diagnostic Imaging Supplier 

Accreditation Program’’, (74 FR 62189), 

November 25, 2009). As a result of this 

solicitation, we published a second 

Federal Register notice (Medicare 

Program; Approval of Independent 

Accrediting Organizations To 

Participate in the Advanced Diagnostic 

Imaging Supplier Accreditation 

Program’’ (January 26, 2010 (75 FR 

4088)) announcing approval of three 

national accreditation organizations to 

accredit suppliers seeking to furnish the 

TC of advanced diagnostic imaging 

services under the Medicare program: 

the American College of Radiology 

(ACR); the Intersocietal Accreditation 

Commission (IAC); and The Joint 

Commission (TJC). 

II. Provisions of the Notice 

This notice solicits additional 

applications from accreditation 

organizations with the ability to accredit 

the TC of at least one of the categories 

of advanced diagnostic imaging services 

as defined at 42 CFR 414.68(b). 

A. Eligible Organizations 

Any accreditation organization that 

can show evidence of the ability to 

accredit at least one of the categories of 

advanced diagnostic imaging services as 

defined in sections 1834(e)(1)(B) and 

1848(b)(4)(B) of the Act is eligible to 

apply for approval as a designated 

imaging services accreditation 

organization. As previously noted, this 

notice solicits applications from 

accrediting organizations that have not 

previously applied; the three existing 

designated accreditation organizations 

and current applicants are not required 

to reapply. 

B. Application Requirements 

To be considered for approval as a 

designated accreditation organization 

for Medicare requirements under 42 

CFR 414.68 and as defined by sections 

1834(e)(1)(B) and 1848 (b)(4)(B) of the 

Act an accreditation organization must 

furnish us with the following, as 

specified in 42 CFR 414.68(c): 

• A detailed description of how the 

organization’s accreditation criteria 

satisfy the statutory standards at section 

1834(e)(3)of the Act, including— 

++ Qualifications of medical 

personnel who are not physicians and 

who furnish the TC of advanced 

diagnostic imaging services. 

++ Qualifications and responsibilities 

of medical directors and supervising 

physicians (who may be the same 

person), such as their training in 

advanced diagnostic imaging services in 

a residency program, expertise obtained 

through experience, or continuing 

medical education courses. 

++ Procedures to ensure the 

reliability, clarity, and accuracy of the 

technical quality of diagnostic images 

produced by the supplier, including a 

thorough evaluation of equipment 

performance and safety; 

++ Procedures to ensure the safety of 

persons who furnish the TC of advanced 

diagnostic imaging services and 

individuals to whom such services are 

furnished; 

++ Procedures to assist the 

beneficiary in obtaining the 

beneficiary’s imaging record on request; 

and 

++ Procedure to notify the 

accreditation organization of any 

changes to the modalities subsequent to 

the organizations’ accreditation 

decision. 

• An agreement to conform 

accreditation requirements to any 

changes in Medicare statutory 

requirements authorized by section 

1834(e) of the Act. The accreditation 

organization must maintain or adopt 

standards that are equal to, or more 

stringent than, those of Medicare. 

• Information that demonstrates the 

accreditation organization’s knowledge 

and experience in the advanced 

diagnostic imaging arena. 

• The organization’s proposed fees for 

accreditation for each modality in 

which the organization intends to offer 

accreditation, including any plans for 

reducing the burden and cost of 

accreditation to small and rural 

suppliers. 

• Any specific documentation 

requirements and attestations requested 

by CMS as a condition of designation 

under this part. 

• A detailed description of the 

organization’s survey process, including 

the following: 

++ Type and frequency of the surveys 

performed. 

++ The ability of the organization to 

conduct timely reviews of accreditation 

applications, to include the 

organizations national capacity. 

++ Description of the organization’s 

audit procedures, including random site 

visits, site audits, or other strategies for 

ensuring suppliers maintain compliance 

for the duration of accreditation. 

++ Procedures for performing 

unannounced site surveys. 

++ Copies of the organizations survey 

forms. 

++ A description of the accreditation 

survey review process and the 

accreditation status decision-making 

process, including the process for 

addressing deficiencies identified what 

the accreditation requirements, and the 

procedures used to monitor the 

correction of deficiencies found during 

an accreditation survey. 

++ Procedures for coordinating 

surveys with another accrediting 

organization if the organization does not 

accredit all products the supplier 

provides. 

++ Detailed information about the 

individuals who perform evaluations for 

the accreditation organization, 


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12850 Federal Register / Vol. 77, No. 42 / Friday, March 2, 2012 / Notices 

including all of the following 

information: 

—The number of professional and 

technical staff that are available for 

surveys. 

—The education, employment, and 

experience requirements surveyors 

must meet. 

—The content and length of the 

orientation program. 

++ The frequency and types of inservice training provided to survey 

personnel. 

++ The evaluation systems used to 

monitor the performance of individual 

surveyors and survey teams. 

++ The policies and procedures 

regarding an individual’s participation 

in the survey or accreditation decision 

process of any organization with which 

the individual is professionally or 

financially affiliated. 

++ The policies and procedures 

used when an organization has a 

dispute regarding survey findings or an 

adverse decision. 

• Detailed information about the size 

and composition of survey teams for 

each category of advanced medical 

imaging service supplier accredited. 

• A description of the organization’s 

data management and analysis system 

for its surveys and accreditation 

decisions, including the kinds of 

reports, tables, and other displays 

generated by that system. 

• The organization’s procedures for 

responding to and for the investigation 

of complaints against accredited 

facilities, including policies and 

procedures regarding coordination of 

these activities with appropriate 

licensing bodies and CMS. 

• The organization’s policies and 

procedures for the withholding or 

removal accreditation status for 

facilities that fail to meet the 

accreditation organization’s standards or 

requirement, and other actions taken by 

the organization in response to 

noncompliance with its standards and 

requirements. These policies and 

procedures must include notifying CMS 

of Medicare facilities that fail to meet 

the requirements of the accrediting 

organization. 

• A list of all currently accredited 

suppliers, the type and category of 

accreditation currently held by each 

supplier, and the expiration date of each 

supplier’s current accreditation. 

• A written presentation that 

demonstrates the organization’s ability 

to furnish CMS with electronic data in 

ASCII comparable code. 

• A resource analysis that 

demonstrates that the organization’s 

staffing, funding, and other resources 

are adequate to perform the required 

surveys and related activities. 

• A statement acknowledging that, as 

a condition for approval of designation, 

the organization agrees to: 

++ Notify CMS, in writing, of any 

Medicare supplier that had its 

accreditation revoked, withdrawn, 

revised, or any other remedial or 

adverse action taken against it by the 

accreditation organization within 30 

calendar days of any such action taken. 

++ Notify all accredited supplier 

within 10 calendar days of the 

organizations’ removal for the list of 

designated accreditation organizations. 

++ Notify CMS, in writing, at least 

30 calendar days in advance of the 

effective date of any significant 

proposed changes in its accreditation 

requirements. 

++ Permit its surveyors to serve as 

witnesses if CMS takes an adverse 

action based on accreditation findings. 

++ Notify CMS, in writing 

(electronically or hard copy), within 2 

business days of a deficiency identified 

in any accreditation supplier from any 

source where the deficiency poses an 

immediate jeopardy to the supplier’s 

beneficiaries or a hazard to the general 

public. 

++ Provide, on an annual basis, 

summary data specified by CMS that 

relates to the past year’s accreditations 

and trends. 

++ Attest that the organization will 

not perform any accreditation surveys of 

Medicare-participating suppliers with 

which it has a financial relationship in 

which it has an interest. 

++ Conform accreditation 

requirements to changes in Medicare 

requirements. 

++ If CMS withdraws an 

accreditation organization’s approved 

status, work collaboratively with CMS 

to direct suppliers to the remaining 

accreditation organizations within a 

reasonable period of time. 

C. Application Deadline and 

Notification of Receipt 

The deadline for the submission of 

applications is the date specified in the 

DATES section of this notice. We will 

acknowledge receipt of applications via 

email. 

D. Evaluation of Application 

A professional and medical panel will 

evaluate all applications from 

accreditation organizations seeking 

designation under section 1834(e) of the 

Act. 

If we determine that additional 

information is necessary to make a 

determination for approval or denial of 

the accreditation organization’s 

application for designation, we will 

notify the organization and afford it an 

opportunity to provide the additional 

information. We may also visit the 

organization’s offices to verify 

representations made by the 

organization in its application, 

including, but not limited to, reviewing 

documents and interviewing the 

organization’s staff. 

E. Approval of Application 

The accreditation organization will 

receive a formal notice via mail from 

CMS approving or denying the request 

for consideration. If denied, the notice 

will state the basis for denial, and 

include information about seeking 

reconsideration and reapplication 

procedures. An accreditation 

organization may withdraw its 

application for designation under 

section 1834(e) of the Act at any time 

prior to the formal notice of approval or 

denial is received. An accreditation 

organization notified of a denial of 

request for designation may request 

reconsideration in accordance with 42 

CFR 414.68(i). Any accreditation 

organization whose request for approval 

of designation has been denied may also 

resubmit the application to us if the 

organization— 

• Revises its accreditation program to 

address the rationale for denial of its 

previous request; 

• Provides reasonable assurance that 

its accredited companies meet 

applicable Medicare requirements; and 

• Resubmits the application in its 

entirety. 

An organization may not submit a 

new application for the same type of 

modality as that initially applied for, 

until any reconsideration proceedings 

under § 414.68(i) with respect to the 

previous application are completed. 

We will publish a Federal Register 

document notifying the public of the 

approved applicants. 

F. Term of Approval of Designation of 

Accreditation Organizations 

Under section 1834(e)(2)(C)(i) of the 

Act, the Secretary shall review the list 

of accreditation organizations 

designated, taking into account the 

performance of such organizations, and 

may, by regulation, modify the list of 

accreditation organizations designated. 

Our regulations at § 414.68(h) set out the 

specific criteria and procedures for 

continuing CMS oversight of approved 

accreditation organizations, and for 

withdrawing approval of a CMS 

approved accreditation organization. 

There is no stated period of performance 

related to this accreditation designation. 


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Federal Register / Vol. 77, No. 42 / Friday, March 2, 2012 / Notices 12851 

III. 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. In order to fairly evaluate 

whether an information collection 

should be approved by OMB, section 

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

Reduction Act of 1995 requires that we 

solicit comment on the following issues: 

• The need for the information 

collection and its usefulness in carrying 

out the proper functions of our agency. 

• The accuracy of our estimate of the 

information collection burden. 

• The quality, utility, and clarity of 

the information to be collected. 

• Recommendations to minimize the 

information collection burden on the 

affected public, including automated 

collection techniques. 

We detailed the burden associated 

with the submission of advanced 

diagnostic imaging provider 

accreditation applications from 

independent accrediting bodies in the 

CY 2010 PFS final rule that published 

November 25, 2009 (74 FR 61738). We 

are summarizing the discussion of the 

information collection requirements in 

this notice. 

Section 414.68(b) contains the 

application and reapplication 

procedures for accreditation 

organizations. Specifically, an 

independent accreditation organization 

applying for approval or reapproval of 

authority to survey suppliers for 

purposes of accrediting suppliers 

furnishing the technical component 

(TC) of advanced diagnostic imaging 

services must furnish CMS with all of 

the information listed in proposed 

§ 414.68(b)(1) through (14). The 

requirements include but are not limited 

to reporting, notification, 

documentation, and survey 

requirements. 

The burden associated with the 

collection requirements in § 414.68(b) is 

the time and effort necessary to develop, 

compile and submit the information 

listed in § 414.68(b)(1) through (14). We 

estimate that it will take an entity 80 

hours to submit a complete application 

for approval or reapproval authority to 

become an accrediting organization 

approved by CMS. Three entities 

complied with these requirements 

during the initial round of submissions. 

Currently, we are only aware of one 

other entity that is eligible to submit an 

application. In addition, the three 

currently approved accrediting 

organizations are not required to 

resubmit applications. Furthermore, we 

are not able to accurately quantify the 

total number of entities that are eligible 

to comply with these requirements 

beyond those previously identified. 

While these requirements are subject to 

the PRA, we believe the associated 

burden is exempt under 5 CFR 

1320.3(c)(4). This collection will impact 

less than 10 entities in a 12-month 

period. We cannot estimate the number 

of expected submissions from entities 

seeking to become accrediting 

organizations. We will review each 

submission on a case-by-case basis. If 

we determine that the number of 

submissions may exceed the threshold 

of 10 or more persons in a 12-month 

period, as defined in 5 CFR 1320.3(c)(4), 

we will develop an information 

collection request as part of the formal 

OMB approval process. 

Section 414.68(c) contains the 

information collection requirements 

pertaining to CMS approved accrediting 

organizations. An accrediting 

organization approved by CMS must 

undertake all of the activities listed in 

§ 414.68(c)(1) through (6). The burden 

associated with the collection 

requirements in § 414.68(c) is the time 

and effort necessary to develop, compile 

and submit the information listed in 

§ 414.68(c)(1) through (6). We estimate 

that it will take the applicant entity 80 

hours to submit the required 

information on an ongoing basis. As 

stated earlier, there are 3 currently 

approved accrediting organizations that 

have already complied with this 

requirement. In addition, we are only 

aware of one other entity that is eligible 

to submit an application; we are not 

able to accurately quantify the total 

number of entities that are eligible to 

comply with these requirements beyond 

those previously identified. While these 

requirements are subject to the PRA, we 

believe the associated burden is exempt 

under 5 CFR 1320.3(c)(4). This 

collection will impact less than 10 

entities in a 12-month period. Because 

we cannot estimate the number of 

expected submissions from new CMS 

approved accrediting organizations, we 

will review each submission on a caseby-case basis. If we determine that the 

number of submissions may exceed the 

threshold of 10 or more persons in a 12- 

month period, as defined in 5 CFR 

1320.3(c)(4), we will develop an 

information collection request as part of 

the formal OMB approval process. 

Section 414.68(d)(1) states that CMS 

or its contractor may conduct an audit 

of an accredited supplier, examine the 

results of a CMS approved accreditation 

organization’s survey of a supplier, or 

observe a CMS approved accreditation 

organization’s onsite survey of a 

supplier, in order to validate the CMS 

approved accreditation organizations 

accreditation process. The burden 

associated with this requirement is the 

time and effort necessary for an 

accrediting organization to comply with 

the components of the validation audit. 

While this requirement is subject to the 

PRA, we believe the associated burden 

is exempt as stated in 5 CFR 

1320.3(h)(6). The burden associated 

with a request for facts addressed to a 

single person, as defined in 5 CFR 

1320.3(j), is not subject to the PRA. 

As stated in § 414.68(e)(1), an 

accreditation organization dissatisfied 

with a determination that its 

accreditation requirements do not 

provide or do not continue to provide 

reasonable assurance that the suppliers 

accredited by the organization meet the 

applicable quality standards is entitled 

to a reconsideration. We reconsider any 

determination to deny, remove or not to 

renew the approval of deeming 

authority to an accreditation 

organization if the accrediting 

organization files a written request for 

reconsideration by its authorized 

officials or through its legal 

representative. The written request must 

be filed within 30 calendar days of the 

receipt of our notice of an adverse 

determination or nonrenewal. In 

addition, the request must also specify 

the findings or issues with which the 

accreditation organization disagrees and 

the reasons for the disagreement. 

The burden associated with this 

requirement is the time and effort 

necessary for an accrediting 

organization to file, develop and file 

written request for reconsideration. 

While this requirement is subject to the 

PRA, the associated burden is exempt 

under 5 CFR 1320.4. The information in 

question is being collected as a result of 

an administrative action; accrediting 

organizations are submitting requests for 

reconsideration after receiving a notice 

of an adverse determination. 

Authority: Section 1834(e) of the Act. 

(Catalog of Federal Domestic Assistance 

Program No. 93.774, Medicare— 

Supplementary Medical Insurance Program) 

Dated: February 24, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2012–5013 Filed 3–1–12; 8:45 am] 

BILLING CODE 4120–01–P 


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