Federal Register / Vol. 65, No. 192 / Tuesday, October 3, 2000 / Rules and Regulations 58919

Executive Order 12866

This rule is not a significant

regulatory action under Executive Order

12866 and has not been reviewed by the

Office of Management and Budget. It

removes obsolete regulations.

Regulatory Flexibility Act

The HHS certifies that this document

will not have a significant economic

effect on a substantial number of small

entities under the Regulatory Flexibility

Act since it only removes obsolete

regulations.

Executive Order 12612

The Department has determined that

this rule does not have significant

Federalism effects because it pertains

solely to Federal-Tribal relations and

will not interfere with the roles, rights,

and responsibilities of States.

Paperwork Reduction Act of 1995

This regulation contains no

information collection requirement that

would require notification of the Office

of Management and Budget.

The authority to eliminate these

regulations is 42 U.S.C. 2003 and 25

U.S.C. 13.

List of Subjects in 42 CFR Part 36

American Indians, Alaska Natives,

Government health care, Indians—

business and finance, property.

Dated: September 12, 2000.

Michel E. Lincoln,

Deputy Director, Indian Health Service.

Approved: September 26, 2000.

Donna E. Shalala,

Secretary of Health and Human Services.

For the reasons set out in the

preamble, and under the authority of 42

U.S.C. 2003 and 25 U.S.C. 13, subpart I

of 42 CFR part 36 is removed and

reserved.

[FR Doc. 00–25292 Filed 10–2–00; 8:45 am]

BILLING CODE 4160–16–M

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 413, 489, and 498

[HCFA–1005–CN4]

RIN 0938–AI56

Medicare Program; Prospective

Payment System for Hospital

Outpatient Services: Provider-Based

Criteria; Delay of Effective Date and

Correction

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Notice of delay of effective date

and correction.

SUMMARY: In the April 7, 2000 Federal

Register (65 FR 18434), we published a

final rule with comment period entitled,

‘‘Prospective Payment System for

Hospital Outpatient Services.’’ New

§§ 413.24(d)(6) and 413.65 and revisions

to §§ 489.24, 498.2, and 498.3

established requirements for facilities or

organizations seeking provider-based

status. This document delays the

effective date of these provider-based

regulations from October 10, 2000 to

January 10, 2001, applicable for

provider cost reporting periods

beginning on or after January 10, 2001.

In this document, we are also making a

conforming change in the regulations

text at § 413.65(i) concerning

enforcement.

DATES: Effective date: The effective date

of new §§ 413.24(d)(6) and 413.65 and

revised §§ 489.24, 498.2, and 498.3 is

delayed until January 10, 2001.

Applicability date: New

§§ 413.24(d)(6) and 413.65 and revised

§§ 489.24, 498.2, and 498.3 are

applicable for provider cost reporting

periods beginning on or after January

10, 2001.

FOR FURTHER INFORMATION CONTACT:

George Morey, (410) 786–4653.

SUPPLEMENTARY INFORMATION:

I. Background

On April 7, 2000, we published in the

Federal Register (65 FR 18434), a final

rule with comment period entitled

‘‘Prospective Payment System for

Hospital Outpatient Services.’’ Among

the regulatory provisions included were

new §§ 413.24(d)(6) and 413.65 and

revisions to §§ 489.24, 498.2, and 498.3.

These regulations established

requirements for facilities or

organizations that seek provider-based

status (departments, provider-based

entities, satellite facilities, and remote

locations of hospitals). The effective

date of the provider-based regulations,

as stated in the April 2000 rule, is

October 10, 2000.

New § 413.65(i) states that we will

recover any overpayments resulting

from inappropriate treatment of a

facility or organization as providedbased. However, this provision states

that no recovery will be made for any

period prior to October 10, 2000, if the

management of the facility or

organization made a ‘‘good faith’’ effort

to operate it as provided-based (as

described in § 413.65(i)(3)). The

reference to October 10, 2000 was

included to limit the ‘‘good faith’’

exception to periods before the effective

date of the new requirements.

II. Provisions of This Notice

Based on the following concerns, we

have decided to delay the effective date

of the provider-based portions of the

April 2000 final rule until January 10,

2001, applicable for provider cost

reporting periods beginning on or after

January 10, 2001. For example, a

provider whose cost reporting periods

begins on April 1 will not be affected by

these provider-based regulations until

its cost reporting period beginning on

April 1, 2001.

To provide for smooth

implementation of the provider-based

regulations, we must clarify a number of

administrative, procedural, and

technical issues and provide our

regional offices, which are charged with

responsibility for making providerbased determinations, and hospitals

with further training and guidance. We

have completed a variety of training and

informational activities, developed

responses to ‘‘Frequently Asked

Questions,’’ and held numerous

meetings with individual providers and

provider associations in order to

communicate our policies and plans for

implementing the new regulations. In

the course of these activities, the need

for additional guidance interpreting the

regulations and addressing procedural

and administrative concerns has become

apparent. Given the time needed to

complete and disseminate this material,

we have concluded that implementation

of the new provider-based regulations

on October 10, 2000 would be

imprudent.

A delay in the effective date of the

provider-based regulations will allow

for dissemination of the additional

material described above, and will give

hospitals and other providers additional

time to fully assess the potential impact

of both the new hospital outpatient

prospective payment system and the

new provider-based regulations on their

facilities and organizations. A delay in

58920 Federal Register / Vol. 65, No. 192 / Tuesday, October 3, 2000 / Rules and Regulations

the effective date will also allow the

industry more time to prepare to comply

with the new regulations, and that in

turn will help reduce the number of

errors or other problems that might

occur as a result of transition to the new

rules. The phase-in of implementation

over 12-months, rather than a single

date, will allow for a more manageable

distribution of work for the regional

offices, fiscal intermediaries, and

hospitals. (As noted earlier,

implementation by cost reporting

periods means that a provider with a

cost reporting period starting after

January 10, 2001, would not be affected

by the new regulations until the start of

its next cost reporting period. Thus, a

provider with an April 1 cost period

would not be affected until April 1,

20001, a provider with a July 1 cost

period would not be affected until July

1, 20001, and so on.) We expect to issue

further clarification of administrative,

procedural, and technical issues as soon

as possible.

To provide for uniform and consistent

application of the ‘‘good faith’’

exception to periods before the revised

date, we are revising § 413.65(i)(2) to

state that the exception will be available

only for main provider cost reporting

periods beginning on or after January

10, 2001 or, in the case of a facility or

organization paid as a provider-based

entity, for that entity’s cost reporting

periods beginning on or after January

10, 2001.

In October 2000, we plan to host a

town hall meeting to discuss specific

aspects of the provider-based

regulations at our headquarters in

Baltimore, Maryland. The subjects of

this meeting will be the ways in which

a facility or organization can

demonstrate that it serves the same

patient population as the main provider

(§ 413.65(d)(7)(i)), and the applicability

of provisions on management contracts

(§ 413.65(f)) to certain on-campus

hospital departments. We will make

further details regarding the town hall

meeting available on our website,

www.hcfa.gov.

III. Impact Statement

In the April 2000 final rule, we

discussed the impact of the providerbased regulations on providers and

beneficiaries. Because we are delaying

the implementation of the final rule, the

current provider-based criteria, as stated

in HCFA program manuals, will remain

in effect for an additional period of

time. We believe that any impact on

small entities would be positive because

the delay in effective date will allow

more time for them to come into

compliance with the new regulations,

and also permit the new regulations to

be implemented in a more clear and

consistent manner.

Correction of Errors

In FR Doc. 00–8215 of April 7, 2000

(65 FR 18434), make the following

correction:

Regulations Text

§ 413.65 [Corrected]

On page 18540, in column 3, § 413.65

(i)(2) is corrected to read as follows:

§ 413.65 Requirements for a determination

that a facility or an organization has

provider-based status.

* * * * *

(i) * * *

(2) Recovery of overpayments. If

HCFA finds that payments for services

at the facility or organization have been

made as if the facility or organization

were provider-based, even though

HCFA had not previously determined

that the facility or organization qualified

for provider-based status, HCFA will

recover the difference between the

amount of payments that actually were

made and the amount of payments that

HCFA estimates should have been made

in the absence of a determination of

provider-based status. Recovery will not

be made for any main provider cost

reporting periods beginning before

January 10, 2001 or, in the case of a

facility organization paid as a providerbased entity, for that entity’s cost

reporting periods beginning before

January 10, 2001 if, during all of those

periods, the management of the facility

or organization made a good faith effort

to operate it as a provider-based facility

or organization, as described in

paragraph (h)(3) of this section.

* * * * *

(Authority: Section 1888(t) of the Social

Security Act (42 U.S.C. 1395yy(t))

(Catalog of Federal Domestic Assistance

Program No. 93.773, Medicare—Hospital

Insurance; and Program No. 93.774,

Medicare—Supplementary Medical

Insurance Program)

Dated: September 19, 2000.

Nancy-Ann Min DeParle,

Administrator, Health Care Financing

Administration.

Dated: September 22, 2000.

Donna E. Shalala,

Secretary.

[FR Doc. 00–25373 Filed 9–29–00; 12:41 pm]

BILLING CODE 4120–01–P

FEDERAL COMMUNICATIONS

COMMISSION

47 CFR Part 73

[DA 00–2207, MM Docket No. 00–103; RM–

9878]

Digital Television Broadcast Services;

Killeen, TX

AGENCY: Federal Communications

Commission.

ACTION: Final rule.

SUMMARY: The Commission, at the

request of White Knight Broadcasting of

Killeen License Corporation, licensee of

TV station KAKW(TV), substitutes DTV

Channel 13 for DTV Channel 23 at

Killeen, Texas. See 65 FR 37752, June

16, 2000. DTV Channel 13 can be

allotted to Killeen at coordinates (30–

43–33 N. and 97–59–24 W.) with a

power of 39.4, HAAT of 553 meters, and

with a DTV service population of 1307

thousand.

With this action, this proceeding is

terminated.

DATES: Effective November 16, 2000.

FOR FURTHER INFORMATION CONTACT: Pam

Blumenthal, Mass Media Bureau, (202)

418–1600.

SUPPLEMENTARY INFORMATION: This is a

synopsis of the Commission’s Report

and Order, MM Docket No. 00–103,

adopted September 29, 2000, and

released October 2, 2000. The full text

of this Commission decision is available

for inspection and copying during

normal business hours in the FCC

Reference Center, 445 12th Street, SW.,

Washington, DC. The complete text of

this decision may also be purchased

from the Commission’s copy contractor,

International Transcription Services,

Inc., (202) 857–3800, 1231 20th Street,

NW., Washington, DC 20036.

List of Subjects in 47 CFR Part 73

Television, Digital television

broadcasting.

Part 73 of Title 47 of the Code of

Federal Regulations is amended as

follows:

PART 73—[AMENDED]

1. The authority citation for part 73

continues to read as follows:

Authority: 47 U.S.C. 154, 303, 334. 336.

§ 73.622 [Amended]

2. Section 73.622(b), the Table of

Digital Television Allotments under

Texas, is amended by removing DTV

Channel 23 and adding DTV Channel 13

at Killeen.