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[Federal Register Volume 76, Number 175 (Friday, September 9, 2011)]
[Notices]
[Pages 55917-55918]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-23120]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1587-N2]

Medicare Program; Notification of Closure of St. Vincent's 
Medical Center; Extension of the Deadline for Submission of 
Applications

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of extension of the Deadline for Submission of 
Applications.

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SUMMARY: This notice extends the deadline for hospitals to apply to the 
Centers for Medicare & Medicaid Services (CMS) to receive St. Vincent's 
Medical Center's full time equivalent (FTE) resident cap slots. The 
application deadline, which was September 28, 2011, has been extended 
to December 1, 2011.

DATES: The application deadline is extended to 5 p.m. (e.s.t.) on 
December 1, 2011.

FOR FURTHER INFORMATION CONTACT:  Renate Dombrowski, (410) 786-4645. 
Miechal Lefkowitz, (212) 616-2517.

SUPPLEMENTARY INFORMATION:  On May 31, 2011, we published a notice in 
the Federal Register (76 FR 31340) to announce the closure of St. 
Vincent's Medical Center and the initiation of an application process 
for hospitals to apply to the Centers for Medicare & Medicaid Services 
(CMS) to receive St. Vincent's Medical Center's full time equivalent 
(FTE) resident cap slots, as provided under section 5506 of the Patient 
Protection and Affordable Care Act (Pub. L. 111-148), as amended by the 
Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-

[[Page 55918]]

152) (collectively, the ``Affordable Care Act''), ``Preservation of 
Resident Cap Positions from Closed Hospitals.'' Specifically, section 
5506 of the Affordable Care Act authorizes the Secretary to 
redistribute residency cap slots after a hospital that trained 
residents in an approved medical residency program(s) closes. St. 
Vincent's Medical Center's official date of termination of the Medicare 
provider agreement and date of closure is October 31, 2010. The 
published notice, announcing the hospital closure and initiating the 
application process to preserve St. Vincent's resident cap positions 
stated that the application deadline was September 28, 2011. The date 
of September 28, 2011, was chosen since the procedure described in the 
November 24, 2010 Federal Register (75 FR 72215) for initiating an 
application process specifies that the application deadline would be 4 
months after issuance of the notice to the public (that is, September 
28, 2011, is 4 months after May 31, 2011).
    Specifically, section 5506 of the Affordable Care Act instructs the 
Secretary to increase the FTE resident caps for other hospitals based 
upon the FTE resident positions in teaching hospitals that closed ``on 
or after a date that is 2 years before the date of enactment'' (that 
is, March 23, 2008). In the November 24, 2010 Federal Register (75 FR 
72215), we stated that hospitals wishing to apply for FTE resident cap 
slots from teaching hospitals that closed between March 23, 2008 and 
through and including August 3, 2010, must submit applications to CMS 
by April 1, 2011. We further stated that for any teaching hospital 
closures occurring after August 3, 2010, separate notice would be made 
announcing the closure and initiating an application process for those 
slots and a future application deadline. The first application process 
with the application deadline of April 1, 2011, spanned over a 2-year 
timeframe (covering all hospital closures between March 28, 2008 and 
through and including August 3, 2010), and involved 15 closed teaching 
hospitals, generating a very large number of applications and slots to 
be redistributed. The closure of St. Vincent's Medical Center occurred 
on October 31, 2010, and the notice announcing the closure and 
initiating the application process was published on May 31, 2011, 
establishing the September 28, 2011 application deadline. Thus, the 
application period CMS initiated for the preservation of FTE resident 
slots due to the closure of St. Vincent's Medical Center overlaps with 
the period during which CMS is processing and reviewing the 
applications received under the first expansive section 5506 
application process, and issuing final determinations to hospitals that 
may receive increases to their FTE resident caps. Moreover, we note 
that St. Vincent's Medical Center is located in the same CBSA as 3 (of 
the 15) hospitals that closed between March 23, 2008 through August 3, 
2010, and many of the hospitals wishing to apply for slots from St. 
Vincent's Medical Center have indicated that it would be helpful to 
receive the results of their applications submitted under the first 
section 5506 process in order to make informed decisions regarding the 
number of slots for which to apply from St. Vincent's Medical Center 
under this separate application process. CMS does not have a specific 
deadline by which to issue final determinations to hospitals that 
receive slots under section 5506 of the Affordable Care Act under the 
initial expansive application process, yet we understand the concerns 
of these hospitals and believe it is appropriate, in this case, to 
extend the application deadline for FTE resident slots from St. 
Vincent's Medical Center. Accordingly, we are extending the application 
deadline for FTE resident slots from St. Vincent's Medical Center from 
September 28, 2011 to December 1, 2011. We will consider applications 
received no later than 5 p.m. (e.s.t) December 1, 2011. Applications 
must be received, not postmarked, by this date.
    We continue to refer readers to http://www.cms.gov/AcuteInpatientPPS/06_dgme.asp# TopOfPage to download a copy of the CMS 
Evaluation Form 5506, which is the application form that hospitals are 
to use to apply for slots under section 5506 of the Affordable Care 
Act. In addition, readers can access this Web site for a copy of the CY 
2011 OPPS November 24, 2010 final rule, for an explanation of the 
policy and procedures for applying for slots and the redistribution of 
the slots under sections 1886(h)(4)(H)(vi) and 1886(d)(5)(B)(v) of the 
Social Security Act, as provided by section 5506 of the Affordable Care 
Act. The mailing addresses for the CMS New York Regional Office and the 
CMS Central Office are included in this application form.

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: September 1, 2011.
Donald M. Berwick,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2011-23120 Filed 9-8-11; 8:45 am]
BILLING CODE 4120-01-P
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