52960 Federal Register / Vol. 75, No. 167 / Monday, August 30, 2010 / Notices 

appropriateness of clinical preventive 

services and formulating or updating 

recommendations for primary care 

clinicians regarding the appropriate 

provision of preventive services. See 42 

U.S.C. 299b–4(a)(1). AHRQ is charged 

with the dissemination of 

recommendations. In addition to hard 

copy materials (that may be obtained 

from the Publications Clearing house), 

current USPSTF recommendations and 

associated evidence reviews are 

available on the Internet (http:// 

www.preventiveservices@AHRQ.gov). 

Dated: August 18, 2010. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2010–21500 Filed 8–27–10; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–5051–N] 

Medicare Program; Rural Community 

Hospital Demonstration Program: 

Solicitation of Additional Participants 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS). 

ACTION: Notice. 

SUMMARY: This notice announces a 

solicitation for up to 20 additional 

eligible hospitals to participate in the 

Rural Community Hospital 

Demonstration program for a 5-year 

period. 

DATES: Application Submission 

Deadline: Applications must be received 

by 5 p.m. on or before October 14, 2010. 

Only applications that are considered 

‘‘timely’’ will be reviewed and 

considered by the technical panel. 

ADDRESSES: The applications should be 

mailed or sent by an overnight delivery 

service to the following address: Centers 

for Medicare & Medicaid Services, 

ATTN: Sid Mazumdar, Rural 

Community Hospital Demonstration, 

Medicare Demonstrations Program 

Group, Mail Stop C4–17–27, 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

Please allow sufficient time for mailed 

information to be received in a timely 

manner in the event of delivery delays. 

Because of staffing and resource 

limitations, and because we require an 

application containing an original 

signature, we cannot accept applications 

by facsimile (Fax) transmission. 

FOR FURTHER INFORMATION CONTACT: Sid 

Mazumdar at (410) 786–6673 or by 

e-mail at 

Siddhartha.mazumdar@cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 410A(a) of Public Law 108– 

173 required the Secretary to establish 

a demonstration program to test the 

feasibility and advisability of 

establishing cost-based reimbursement 

for ‘‘rural community hospitals’’ to 

furnish covered inpatient hospital 

services to Medicare beneficiaries. The 

demonstration pays rural community 

hospitals for such services under a costbased methodology for Medicare 

payment purposes for covered inpatient 

hospital services furnished to Medicare 

beneficiaries. A rural community 

hospital, as defined in section 

410A(f)(1) of Public Law 108–173, is a 

hospital that— 

• Has fewer than 51 acute care 

inpatient beds (excluding beds in a 

distinct psychiatric or rehabilitation 

unit of the hospital) as reported in its 

most recent cost report; 

• Provides 24-hour emergency care 

services; and 

• Is not designated or eligible for 

designation as a critical access hospital 

under section 1820 of the Social 

Security Act (the Act). 

Section 410A(a)(4) of Public Law 108– 

173 specified that the Secretary was to 

select for participation from among the 

applicants no more than 15 rural 

community hospitals in rural areas of 

States that the Secretary identified as 

having low population densities. Using 

2002 data from the U.S. Census Bureau, 

we identified the 10 States with the 

lowest population density in which 

rural community hospitals were to be 

located in order to participate in the 

demonstration: Alaska, Idaho, Montana, 

Nebraska, Nevada, New Mexico, North 

Dakota, South Dakota, Utah, and 

Wyoming. (Source: U.S. Census Bureau, 

Statistical Abstract of the United States: 

2003). We solicited eligible hospitals 

among these States in 2004 and again in 

2008. There are currently 10 hospitals 

participating in the demonstration. 

The demonstration is designed to test 

the feasibility and advisability of 

reasonable cost reimbursement for 

inpatient services to small rural 

hospitals. The demonstration is aimed 

at increasing the capability of the 

selected rural hospitals to meet the 

needs of their service areas. 

Section 410A(a)(5) of Public Law 108– 

173 required a 5-year demonstration 

period of participation. The 5-year 

periods of performance for the hospitals 

originally selected will end by June 30, 

2010. For the hospitals selected in 2008, 

the initial period of performance is 

scheduled to end on September 30, 

2010. Section 10313 of the Patient 

Protection and Affordable Care Act 

(ACA), (Pub. L. 111–148) mandates an 

extension and expansion of the Rural 

Community Hospital demonstration for 

5 years. In order for other hospitals to 

begin participation in this new 

demonstration for the 5-year extension 

period, rural community hospitals must 

be located among the 20 States with the 

lowest population density—according to 

the same criteria and data as the original 

demonstration. These States are: Alaska, 

Arizona, Arkansas, Colorado, Idaho, 

Iowa, Kansas, Maine, Minnesota, 

Mississippi, Montana, Nebraska, 

Nevada, New Mexico, North Dakota, 

Oklahoma, Oregon, South Dakota, Utah, 

and Wyoming. (Source: U.S. Census 

Bureau, Statistical Abstract of the 

United States: 2003). The statute States 

that no more than 30 rural community 

hospitals can participate, and that those 

hospitals participating in the 

demonstration program as of the date of 

the last day of the initial 5-year period 

will be allowed to continue in the 

program. Up to 20 additional hospitals 

will be able to begin participation in the 

demonstration. 

II. Provisions of the Notice 

This notice announces the solicitation 

for up to 20 additional hospitals to 

participate in the Rural Community 

Hospital Demonstration Program. 

Hospitals that enter the demonstration 

under this solicitation will be able to 

participate for 5 years. 

A. Demonstration Payment Methodology 

Hospitals selected for the 

demonstration will be paid the 

reasonable costs of providing covered 

inpatient hospital services, with the 

exclusion of services furnished in a 

psychiatric or rehabilitation unit that is 

a distinct part of the hospital, using the 

following rules. For discharges 

occurring— 

• In the first cost report period upon 

the hospital’s participation in the 

demonstration, reasonable costs for 

covered inpatient services; or 

• During the second or subsequent 

cost reporting period, the lesser of their 

reasonable costs or a target amount. The 

target amount in the second cost 

reporting period is defined as the 

reasonable costs of providing covered 

inpatient hospital services in the first 

cost reporting period, increased by the 

inpatient prospective payment system 

update factor (as defined in section 

1886(b)(3)(B) of the Act) for that 

particular cost reporting period. The 

target amount in subsequent cost 


jlentini on DSKJ8SOYB1PROD with NOTICES
Federal Register / Vol. 75, No. 167 / Monday, August 30, 2010 / Notices 52961 

reporting periods is defined as the 

preceding cost reporting period’s target 

amount increased by the hospital 

inpatient prospective payment system 

(IPPS) update factor for that particular 

cost reporting period. 

Covered inpatient hospital services 

means inpatient hospital services 

(defined in section 1861(b) of the Act) 

and includes extended care services 

furnished under an agreement under 

section 1883 of the Act. 

Section 410A of Public Law 108–173 

requires that, ‘‘in conducting the 

demonstration program under this 

section, the Secretary shall ensure that 

the aggregate payments made by the 

Secretary do not exceed the amount 

which the Secretary would have paid if 

the demonstration program under this 

section was not implemented.’’ In order 

to achieve budget neutrality for this 

demonstration program in fiscal years 

(FYs) 2005, 2006, 2007, 2008, 2009, and 

2010, we adjusted the national IPPS 

rates by an amount sufficient to offset 

the added costs of this demonstration 

program. We presented an estimate of 

the amount to offset additional costs 

due to the demonstration program in FY 

2011, including the costs of additional 

rural community hospitals, in the FY 

2011 inpatient prospective payment 

system/long-term care hospital 

prospective payment system (IPPS/ 

LTCH PPS) supplemental proposed rule 

(see the June 2, 2010 Federal Register 

(75 FR 30918)). 

B. Participation in the Demonstration 

To participate in the demonstration, a 

hospital must be located in one of the 

identified States with low-population 

density and meet the criteria for a rural 

community hospital. Eligible hospitals 

that desire to participate in the 

demonstration must properly submit a 

timely application. Information about 

the demonstration and details on how to 

apply can be found on the CMS Web 

site: http://www.cms.gov/ 

DemoProjectsEvalRpts/downloads/ 

2004_Rural_Community_ 

Hospital_Demonstration_Program.pdf. 

III. Collection of Information 

Requirements 

The information collection 

requirements contained in this notice 

are subject to the Paperwork Reduction 

Act of 1995. As discussed in section 

II.B. of this notice, a hospital must 

submit the required information on the 

cover sheet of the CMS Medicare Waiver 

Demonstration Application to receive 

consideration by the technical review 

panel. The burden associated is the time 

and effort necessary to complete the 

Medicare Waiver Application and 

submit the information to CMS. The 

burden associated with this requirement 

is currently approved under the Office 

of Management and Budget control 

number 0938–0880 with an expiration 

date of November 20, 2010. 

Authority: Section 10313 of the Patient 

Protection and Affordable Care Act (Pub. L. 

111–148) 

(Catalog of Federal Domestic Assistance 

Program No. 93.773 Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program). 

Dated: June 22, 2010. 

Marilyn Tavenner, 

Acting Administrator and Chief Operating 

Officer, Centers for Medicare & Medicaid 

Services. 

[FR Doc. 2010–21512 Filed 8–27–10; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HOMELAND 

SECURITY 

Transportation Security Administration 

[Docket No. TSA–2003–14610] 

Intent To Request Renewal From OMB 

of One Current Public Collection of 

Information: Security Threat 

Assessment for Individuals Applying 

for a Hazardous Materials 

Endorsement for a Commercial Drivers 

License 

AGENCY: Transportation Security 

Administration, DHS. 

ACTION: 60 day Notice. 

SUMMARY: The Transportation Security 

Administration (TSA) invites public 

comment on one currently approved 

Information Collection Request (ICR), 

Office of Management and Budget 

(OMB) control number 1652–0027, 

abstracted below that we will submit to 

OMB for renewal in compliance with 

the Paperwork Reduction Act (PRA). 

The ICR describes the nature of the 

information collection and its expected 

burden. The collection involves 

applicant submission of biometric and 

biographic information for TSA’s 

security threat assessment in order to 

obtain the hazardous materials 

endorsement (HME) on a commercial 

drivers license (CDL) issued by the U.S. 

States and the District of Columbia. 

DATES: Send your comments by October 

29, 2010. 

ADDRESSES: Comments may be e-mailed 

to TSAPRA@dhs.gov or delivered to the 

TSA PRA Officer, Office of Information 

Technology (OIT), TSA–11, 

Transportation Security Administration, 

601 South 12th Street, Arlington, VA 

20598–6011. 

FOR FURTHER INFORMATION CONTACT: 

Joanna Johnson at the above address, or 

by telephone (571) 227–3651. 

SUPPLEMENTARY INFORMATION: 

Comments Invited 

In accordance with the Paperwork 

Reduction Act of 1995 (44 U.S.C. 3501 

et seq.), an agency may not conduct or 

sponsor, and a person is not required to 

respond to, a collection of information 

unless it displays a valid OMB control 

number. The ICR documentation is 

available at http://www.reginfo.gov. 

Therefore, in preparation for OMB 

review and approval of the following 

information collection, TSA is inviting 

comments to— 

(1) Evaluate whether the proposed 

information requirement is necessary for 

the proper performance of the functions 

of the agency, including whether the 

information will have practical utility; 

(2) Evaluate the accuracy of the 

agency’s estimate of the burden; 

(3) Enhance the quality, utility, and 

clarity of the information to be 

collected; and 

(4) Minimize the burden of the 

collection of information on those who 

are to respond, including using 

appropriate automated, electronic, 

mechanical, or other technological 

collection techniques or other forms of 

information technology. 

Information Collection Requirement 

OMB Control Number 1652–0027; 

Security Threat Assessment for 

Individuals Applying for a Hazardous 

Materials Endorsement for a 

Commercial Drivers License, 49 CFR 

part 1572. TSA is requesting renewal of 

the currently approved ICR with minor 

changes. This collection supports the 

implementation of section 1012 of the 

USA PATRIOT Act (Pub. L. 107–56, 115 

Stat. 272, 396, Oct. 26, 2001), which 

mandates that no State or the District of 

Columbia may issue a hazardous 

materials endorsement (HME) on a 

commercial driver’s license (CDL) 

unless TSA has first determined the 

driver is not a threat to transportation 

security. On November 24, 2004, TSA 

published the final rule in the Federal 

Register (69 FR 68720), codified at 49 

CFR part 1572, that describes the 

procedures, standards, and eligibility 

criteria for security threat assessments 

on individuals seeking to obtain, renew, 

or transfer a HME on a CDL. TSA 

subsequently amended the rule on 

January 25, 2007 (72 FR 3492). In order 

to conduct the security threat 

assessment, States (or TSA’s agent in 


jlentini on DSKJ8SOYB1PROD with NOTICES