6380 Federal Register / Vol. 65, No. 27 / Wednesday, February 9, 2000 / Notices

TABLE1.—ESTIMATED ANNUAL REPORTING BURDEN1

Notification and Requests Number of

Respondents

Number of Responses per

Respondent

Total Annual

Responses

Hours per

Response Total Hours

Notification for Carcinogenicity Protocols 30 2.0 60 8 480

Requests for Special Protocol Assessment 70 2.57 180 15 2,700

Total 3,180

1There are no capital costs or operating and maintenance costs associated with this collection of information.

Dated: February 1, 2000.

Margaret M. Dotzel,

Acting Associate Commissioner for Policy.

[FR Doc. 00–2982 Filed 2–8–00; 8:45 am]

BILLING CODE 4160–01–F

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[HCFA–1085–N]

RIN 0938–AJ79

Medicare Program; Update of

Ambulatory Surgical Center Payment

Rates Effective for Services on or after

October 1, 1999

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Notice.

SUMMARY: This notice implements

section 1833(i)(2)(C) of the Social

Security Act, which mandates an

inflation adjustment to Medicare

payment amounts for ambulatory

surgical center (ASC) facility services

during the years when the payment

amounts are not updated based on a

survey of the audited costs incurred by

ASCs.

EFFECTIVE DATE: The payment rates

contained in this notice are effective for

services furnished on or after October 1,

1999.

FOR FURTHER INFORMATION CONTACT: Bob

Cereghino, (410) 786–4645.

SUPPLEMENTARY INFORMATION:

I. Background and Legislative

Authority

Section 1832(a)(2)(F)(i) of the Social

Security Act (the Act) provides that

benefits under the Medicare

Supplementary Medical Insurance

program (Part B) include services

furnished in connection with those

surgical procedures that, under section

1833(i)(1)(A) of the Act, are specified by

the Secretary and are performed on an

inpatient basis in a hospital but that also

can be performed safely on an

ambulatory basis in an ambulatory

surgical center (ASC), in a critical access

hospital. (Under section 4201(c)(1) of

the Balanced Budget Act of 1997 (BBA)

(Pub. L. 105–33), enacted on August 5,

1997, the term ‘‘rural primary care

hospital’’ is replaced with ‘‘critical

access hospital’’ applicable to services

furnished on or after October 1, 1997.)

To participate in the Medicare program

as an ASC, a facility must meet the

standards specified under section

1832(a)(2)(F)(i) of the Act and 42 CFR

416.25, which set forth basic

requirements for ASCs.

Generally, there are two elements in

the total charge for a surgical procedure:

A charge for the physician’s

professional services for performing the

procedure, and a charge for the facility’s

services (for example, use of an

operating room). Section 1833(i)(2)(A) of

the Act authorizes the Secretary to pay

ASCs a prospectively determined rate

for facility services associated with

covered surgical procedures. ASC

facility services are subject to the usual

Medicare Part B deductible and

coinsurance requirements. Therefore,

Medicare pays participating ASCs 80

percent of the prospectively determined

rate for facility services, adjusted for

regional wage variations. This rate is

intended to represent our estimate of a

fair payment that takes into account the

costs incurred by ASCs generally in

providing the services that are furnished

in connection with performing the

procedure. Currently, this rate is a

standard overhead amount that does not

include physician fees and other

medical items and services (for

example, durable medical equipment for

use in the patient’s home) for which

separate payment may be authorized

under other provisions of the Medicare

program.

We have grouped procedures into

nine groups for purposes of ASC

payment rates. The ASC facility

payment for all procedures in each

group is established at a single rate

adjusted for geographic variation. The

rate is a standard overhead amount that

covers the cost of services such as

nursing, supplies, equipment, and use

of the facility. (For an indepth

discussion of the methodology and ratesetting procedures, see our Federal

Register notice published on February

8, 1990, entitled ‘‘Medicare Program;

Revision of Ambulatory Surgical Center

Payment Rate Methodology’’ (55 FR

4526).)

Statutory Provisions

Section 1833(i)(2)(A) of the Act

requires the Secretary to review and

update standard overhead amounts

annually. Section 1833(i)(2)(A)(ii)

requires that the ASC facility payment

rates result in substantially lower

Medicare expenditures than would have

been paid if the same procedure had

been performed on an inpatient basis in

a hospital. Section 1833(i)(2)(A)(iii)

requires that payment for insertion of an

intraocular lens (IOL) include an

allowance for the IOL that is reasonable

and related to the cost of acquiring the

class of lens involved.

Under section 1833(i)(3)(A), the

aggregate payment to hospital outpatient

departments for covered ASC

procedures is equal to the lesser of the

following two amounts:

• The amount paid for the same

services that would be paid to the

hospital under section 1833(a)(2)(B)

(that is, the lower of the hospital’s

reasonable costs or customary charges

less deductibles and coinsurance).

• The amount determined under

section 1833(i)(3)(B)(i) based on a blend

of the lower of the hospital’s reasonable

costs or customary charges, less

deductibles and coinsurance, and the

amount that would be paid to a freestanding ASC in the same area for the

same procedures.

Under section 1833(i)(3)(B)(i), the

blend amount for a cost reporting period

is the sum of the hospital cost

proportion and the ASC cost proportion.

Under section 1833(i)(3)(B)(ii), the

hospital cost proportion and the ASC

cost proportion for portions of cost

reporting periods beginning on or after

January 1, 1991 are 42 and 58 percent,

respectively.

Section 13531 of the Omnibus Budget

Reconciliation Act of 1993 (OBRA 1993)

Federal Register / Vol. 65, No. 27 / Wednesday, February 9, 2000 / Notices 6381

(Pub. L. 103–66), enacted on August 10,

1993, prohibited the Secretary from

providing for any inflation update in the

payment amounts for ASCs determined

under section 1833(i)(2)(A) and (B) of

the Act for fiscal years (FYs) 1994 and

1995. Section 13533 of OBRA 1993

reduced the amount of payment for an

IOL inserted during or subsequent to

cataract surgery in an ASC on or after

January 1, 1994, and before January 1,

1999, to $150.

Section 141(a)(1) of the Social

Security Act Amendments of 1994

(SSAA 1994) (Public Law 103–432),

enacted on October 31, 1994, amended

section 1833(i)(2)(A)(i) of the Act to

require that, for the purpose of

estimating ASC payment amounts, the

Secretary survey not later than January

1, 1995, and every 5 years thereafter, the

actual audited costs incurred by ASCs,

based upon a representative sample of

procedures and facilities.

Section 141(a)(2) of SSAA 1994 added

section 1833(i)(2)(C) to the Act to

provide that, beginning with FY 1996,

there be an application of an inflation

adjustment during a fiscal year in which

the Secretary does not update ASC rates

based on survey data of actual audited

costs. Section 1833(i)(2)(C) of the Act

provides that ASC payment rates be

increased by the percentage increase in

the consumer price index for urban

consumers (CPI–U), as estimated by the

Secretary for the 12-month period

ending with the midpoint of the year

involved, if the Secretary has not

updated rates during a fiscal year,

beginning with FY 1996.

Section 141(a)(3) of SSAA 1994

amended section 1833(i)(1) of the Act to

require the Secretary to consult with

appropriate trade and professional

organizations in reviewing and updating

the list of Medicare-covered ASC

procedures.

Section 141(b) of SSAA 1994 requires

the Secretary to establish a process for

reviewing the appropriateness of the

payment amount provided under

section 1833(i)(2)(A)(iii) of the Act for

IOLs with respect to a class of newtechnology IOLs. A notice of proposed

rulemaking was published in the

Federal Register on June 16, 1999,

entitled ‘‘Adjustment in Payment

Amounts for New Technology

Intraocular Lenses Furnished by

Ambulatory Surgical Centers’ (BPD–

3831–F) (64 FR 32198).

Section 4555 of the BBA amends

section 1833(i)(2)(C) of the Act to

require, in each of the fiscal years 1998

through 2002, that the percentage

increase by which ASC rates are to be

adjusted be reduced (but not below

zero) by 2.0 percentage points.

We published our last ASC payment

rate update notice on October 1, 1998

(63 FR 52663). In this notice, we

explained that the current rates were

frozen and we stated the comment

period for proposed rule (HCFA–1885–

P) published in the Federal Register

June 12, 1998 entitled ‘‘Medicare

Program; Update of Ratesetting

Methodology, Payment Rates, Payment

Policies, and the List of Covered

Surgical Procedures for Ambulatory

Surgical Centers Effective October 1,

1998’’ would be extended to November

13, 1998. We further extended the

comment period for this proposed rule

in Federal Register notices published

January 12, 1999, March 12, 1999, and

July 6, 1999. The comment periods have

been running concurrently with those of

another proposed rule addressing a

prospective payment system (PPS) for

hospital outpatient services published

September 8, 1998 (63 FR 47552).

HCFA–1885–P proposes to update the

criteria for determining which surgical

procedures can be appropriately and

safely performed in an ASC, makes

additions and deletions from the current

list of procedures based on the revised

criteria, rebases the ASC payment rates

using cost, charge, and utilization data

collected by a 1994 survey of ASCs,

refines the ratesetting methodology that

was implemented by a final notice

published on February 8, 1990 in the

Federal Register, and requires that ASC

payment, coverage and wage index

updates be implemented annually on

January 1 rather than having these

updates occur randomly throughout the

year.

II. Provisions of This Notice

As previously stated, during years in

which the Secretary has not otherwise

updated ASC rates based on a survey of

actual audited costs, section

1833(i)(2)(C) of the Act requires

application of an inflation adjustment

equal to the percentage increase in the

CPI–U as estimated by the Secretary for

the 12-month period ending with the

midpoint of the year involved, reduced

(but not below zero) by 2.0 percentage

points in each of the fiscal years 1998

through 2002. (The CPI–U is a general

index that reflects prices paid by urban

consumers for a representative market

basket of goods and services.)

Based on estimates prepared by Data

Resources, Inc./McGraw Hill, the

forecast rate of increase in the CPI–U for

the fiscal year that ends March 31, 2000

is 2.8 percent. Reducing the CPI–U

factor by 2.0 percent results in an

adjustment factor of 0.8 percent.

Increasing the ASC payment rates

currently in effect by 0.8 percent results

in the following schedule of rates that

are payable for facility services

furnished on or after October 1, 1999:

Group 1—$317

Group 2—$425

Group 3—$486

Group 4—$600

Group 5—$683

Group 6—$794 (644 + 150)

Group 7—$949

Group 8—$934 (784 + 150)

ASC facility fees are subject to the

usual Medicare deductible and

copayment requirements. The allowance

for an IOL that is part of the payment

rates for group 6 and group 8 remains

$150.

A ninth payment group allotted

exclusively to extracorporeal shockwave

lithotripsy (ESWL) services was

established in the notice with comment

period published December 31, 1991 (56

FR 67666). The decision in American

Lithotripsy Society v. Sullivan, 785 F.

Supp. 1034 (D.D.C. 1992), prohibits

payment for these services under the

ASC benefit at this time. ESWL payment

rates were the subject of a separate

Federal Register proposed notice,

which was published October 1, 1993

(58 FR 51355).

We will continue to use the inpatient

hospital PPS wage index to standardize

ASC payment rates for variation due to

geographic wage differences in

accordance with the ASC payment rate

methodology published in the February

8, 1990 notice. The inpatient PPS wage

index final rule published on July 30,

1999 (64 FR 41490), for implementation

on October 1, 1999, will be used to

adjust the ASC payment rates

announced in this notice for facility

services furnished on or after October 1,

1999.

III. Regulatory Impact Analysis

A. Introduction

This notice implements section

1833(i)(2) of the Act, which mandates

an inflation adjustment to Medicare

payment amounts for ASC facility

services during the years in which the

payment amounts are not updated based

on a survey of the actual audited costs

incurred by ASCs.

Actuarial estimates of the cost of

updating the ASC rates by 0.8 percent

are as follows:

PROJECTED ADDITIONAL MEDICARE

COSTS

[In millions *]

FY 2000 ......................................................... $10

FY 2001 ......................................................... 10

FY 2002 ......................................................... 10

FY 2003 ......................................................... 10

6382 Federal Register / Vol. 65, No. 27 / Wednesday, February 9, 2000 / Notices

PROJECTED ADDITIONAL MEDICARE

COSTS—Continued

[In millions *]

FY 2004 ......................................................... 10

*Rounded to the nearest $10 million.

The BBA is considered in the

estimate, including the PPS for hospital

outpatient services, which will be

implemented in the mid-2000, and the

formula-driven overpayment

elimination effective October 1, 1997.

B. Regulatory Flexibility Act

We generally prepare a regulatory

flexibility analysis that is consistent

with the Regulatory Flexibility Act

(RFA) (5 U.S.C. 601 through 612) unless

we certify that a notice will not have a

significant economic impact on a

substantial number of small entities. For

purposes of the RFA, most ASCs and

hospitals are considered to be small

entities either by non-profit status or by

having resources of $5 million or less

annually. Section 1102(b) of the Act requires us

to prepare a regulatory impact analysis

if a notice 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, we define

a small rural hospital as a hospital that

is located outside of a Metropolitan

Statistical Area and has fewer than 50

beds.

Although we believe that this notice

will not have a significant impact on a

substantial number of small rural

hospitals, it may have a significant

impact on a substantial number of

ASCs. Therefore, we believe that a

regulatory flexibility analysis is required

for ASCs. In addition, we are voluntarily

providing a brief discussion of the

impact this notice may have on all

hospitals.

1. Impact on ASCs

Section 1833(i)(2)(C) of the Act

requires that for fiscal years 1998

through 2002, we automatically adjust

ASC rates for inflation during a fiscal

year in which we do not update ASC

payment rates based on survey data by

a CPI–U factor reduced (but not below

zero) by 2.0 percent. Therefore, we are

updating the current ASC payment

rates, which were published in our

October 1, 1997 Federal Register notice

(63 FR 8462), by incorporating the

projected rate of change in the CPI–U for

the 12-month period ending March 31,

2000 minus 2.0 percentage points. There

are other factors, however, that affect

the actual payments to an individual

ASC.

First, variations in an ASC’s Medicare

case mix affect the size of the ASC’s

aggregate payment increase. Although

we uniformly adjusted ASC payment

rates by the CPI–U forecast for the 12-

month period ending March 31, 2000,

we did not adjust the IOL payment

allowance that is included in the

payment rate for group 6 and group 8

because OBRA 1993 froze the amount of

payment for an IOL furnished by an

ASC at $150 for the period beginning

January 1, 1994 through December 31,

1998. Therefore, because the net

adjustment for inflation for procedures

in group 6 is 0.63 percent and for group

8 is 0.64 percent, ASCs that perform a

high percentage of the IOL insertion

procedures that comprise these groups

may expect a somewhat lower increase

in their aggregate payments than ASCs

that perform fewer IOL insertion

procedures. A second factor determining the effect

of the change in payment rates is the

percentage of total revenue an ASC

receives from Medicare. The larger the

proportion of revenue an ASC receives

from the Medicare program, the greater

the impact of the updated rates in this

notice. The percentage of revenue

derived from the Medicare program

depends on the volume and types of

services furnished. Since Medicare

patients account for as much as 80

percent of all IOL insertion procedures

performed in ASCs, an ASC that

performs a high percentage of IOL

insertion procedures will probably

receive a higher percentage of its

revenue from Medicare than would an

ASC with a case mix comprised largely

of procedures that do not involve

insertion of an IOL. For an ASC that

receives a large portion of its revenue

from the Medicare program, the changes

in this notice will likely have a greater

influence on the ASC’s operations and

management decisions than they will

have on an ASC that receives a large

portion of revenue from other sources. In general, we expect the rate changes

in this notice to affect ASCs positively

by increasing the rates upon which

payments are based.

2. Impact on Hospitals and Small Rural

Hospitals

Section 1833(i)(3)(A) of the Act

mandates the method of determining

payments to hospitals for ASC-approved

procedures performed in a hospital

outpatient setting. The Congress

believed some comparability should

exist in the amount of payment to

hospitals and ASCs for similar

procedures. The Congress recognized,

however, that hospitals have certain

overhead costs that ASCs do not and

allowed for those costs by establishing

a blended payment methodology. For

ASC procedures performed in an

outpatient setting, hospitals are paid

based on the lower of their aggregate

costs, aggregate charges, or a blend of 58

percent of the applicable wage-adjusted

ASC rate and 42 percent of the lower of

the hospital’s aggregate costs or charges.

According to statistics from the Office of

Strategic Planning within HCFA, 12

percent of Medicare payments to

hospitals by intermediaries is

attributable to services furnished in

conjunction with ASC-covered

procedures.

We would not expect an ASC rate

increase in every instance to keep pace

with actual hospital cost increases,

although we would fully recognize cost

increases resulting from inflation alone

to the extent that the blended payment

methodology includes aggregate

hospital costs. The weight of the ASC

portion of the blended payment amount,

which would reflect the ASC rate

increase, is offset to a degree when

hospital costs significantly exceed the

ASC rate. Another element that would

eliminate the effect of the ASC rate

increase on hospital outpatient

payments is the application of the

lowest payment screen in determining

payments. Applying the lowest of costs,

charges, or a blend can result in some

hospitals being paid entirely on the

basis of a hospital’s costs or charges. In

those instances, the increase in the ASC

rates will have no effect on hospital

payments. The number of Medicare

beneficiaries a hospital serves and its

case-mix variation would also influence

the total impact of the new ASC rates on

Medicare payments to hospitals. Based

on these factors, we have determined,

and we certify that this notice will not

have a significant impact on a

substantial number of small rural

hospitals. Therefore, we have not

prepared a small rural hospital impact

analysis.

We have reviewed this notice under

the threshold criteria of Executive Order

13132 of August 4, 1999, Federalism,

published in the Federal Register on

August 10, 1999 (64 FR 43255). The

Executive Order is effective November

2, 1999, which is 90 days after the date

of this Order. We have determined that

the notice does not significantly affect

the rights, roles, and responsibilities of

States.

IV. Waiver of 30-Day Delay in the

Effective Date

We ordinarily publish notices, such as

this, subject to a 30-day delay in the

effective date. However, if adherence to

this procedure would be impracticable,

unnecessary, or contrary to the public

interest, we may waive the delay in the

effective date. The provisions of this

Federal Register / Vol. 65, No. 27 / Wednesday, February 9, 2000 / Notices 6383

notice are effective for services

furnished on or after October 1, 1999.

These provisions will increase payment

rates to ASCs by 0.8 percent (before

applying the wage index), in accordance

with section 1833(i)(2)(C) of the Act, as

amended by the BBA. As a practical

matter, if we allowed a 30-day delay in

the effective date of this notice, ASCs

would be unable to take timely

advantage of the increase in payment

rates contained in this notice. Moreover,

we believe a delay is impracticable and

unnecessary because as explained

earlier, the statute provides that ASC

payment rates be increased by the

percentage increase in the CPI–U if the

Secretary has not updated rates during

a fiscal year, beginning with FY 1996.

Therefore, we find good cause to waive

the delay in the effective date.

In accordance with the provisions of

Executive Order 12866, this notice was

reviewed by the Office of Management

and Budget.

(Sections 1832(a)(2)(F) and 1833(i) (1) and

(2) of the Social Security Act (42 U.S.C.

1395k(a)(2)(F) and 1395l(i) (1) and (2)); 42

CFR 416.120, 416.125, and 416.130)

(Catalog of Federal Domestic Assistance

Programs No. 93.774, Medicare—

Supplementary Medical Insurance Program)

Dated: October 6, 1999.

Michael M. Hash,

Deputy Administrator, Health Care Financing

Administration.

Dated: October 25, 1999.

Donna E. Shalala,

Secretary.

[FR Doc. 00–2959 Filed 2–8–00; 8:45 am]

BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Resources and Services

Administration

Notice Regarding HRSA Grant

Requirement—Participation in the

340B Drug Pricing Program

AGENCY: Health Resources and Services

Administration, HHS.

ACTION: Notice.

SUMMARY: The Health Resources and

Services Administration (HRSA) is

announcing its decision to withdraw the

proposal to impose a grant award

requirement that would have required

HRSA grantees listed in section 340B of

the Public Health Service Act and

Federally Qualified Health Center

(FQHC) Look-Alikes to participate in the

340B Drug Pricing Program or provide

good cause for non-participation.

Instead of the proposed grant

requirement, HRSA will add a statement

to the Notice of Grant Award (NGA)

concerning the need for grantees to

determine the appropriateness of their

drug purchasing practices under

applicable cost principles.

FOR FURTHER INFORMATION CONTACT:

Captain Robert Staley, the Office of Drug

Pricing, Bureau of Primary Health Care,

Health Resources and Services

Administration, 10th Floor, East West

Towers, 4350 East-West Highway,

Bethesda, MD 20814; Phone (800) 628–

6297; Fax (301) 594–4982.

SUPPLEMENTARY INFORMATION: The

proposed grant requirement for eligible

HRSA grantee and FQHC Look-Alike

participation in the 340B Drug Pricing

Program was announced in the Federal

Register at 63 FR 56656 on October 22,

1998. A period of 60 days was

established to allow interested parties to

submit comments. HRSA received 21

comments. In light of the concerns

expressed about the potential adverse

impact of the proposed grant

requirement, HRSA has decided not to

institute the requirement at this time.

Instead, HRSA will implement another

administrative option to increase

participation in the 340B Drug Pricing

Program: a statement in the HRSA

Notice of Grant Award (NGA)

encouraging those grantees not

participating in the 340B Program to

determine whether their drug

purchasing practices meet Federal

requirements regarding reasonable and

cost effective purchasing. (See 42 CFR

part 50, subpart E, and OMB Circulars

A–122 and A–87 regarding cost

principles). If grantees can obtain drugs

through the Drug Pricing Program at

lower cost, it would be reasonable to

take advantage of such cost savings.

This policy will be implemented during

the fiscal year (FY) 2000 grant award

cycle.

Dated: January 3, 2000.

Claude Earl Fox,

Administrator.

[FR Doc. 00–2862 Filed 2–8–00; 8:45 am]

BILLING CODE 4160–15–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

National Institutes of Health

Center for Scientific Review; Notice of

Closed Meetings

Pursuant to section 10(d) of the

Federal Advisory Committee Act, as

amended (5 U.S.C. Appendix 2), notice

is hereby given of the following

meetings.

The meetings will be closed to the

public in accordance with the

provisions set forth in sections

552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,

as amended. The grant applications and

the discussions could disclose

confidential trade secrets or commercial

property such as patentable material,

and personal information concerning

individuals associated with the grant

applications, the disclosure of which

would constitute a clearly unwarranted

invasion of personal privacy.

Name of Committee: Center for Scientific

Review Special Emphasis Panel.

Date: February 10, 2000.

Time: 4:30 PM to 7 PM.

Agenda: To review and evaluate grant

applications.

Place: Holiday Inn Chevy Chase, 5520

Wisconsin Avenue, Chevy Chase, MD 20815.

Contact Person: Anita Miller Sostek, PHD,

Scientific Review Administrator, Center for

Scientific Review, National Institutes of

Health, 6701 Rockledge Drive, Room 3176,

MSC 7848, Bethesda, MD 20892, (301) 435–

1260.

This notice is being published less than 15

days prior to the meeting due to the timing

limitations imposed by the review and

funding cycle.

Name of Committee: Center for Scientific

Review Special Emphasis Panel.

Date: February 16, 2000.

Time: 1 PM to 4 PM.

Agenda: To review and evaluate grant

applications.

Place: Governor’s House Hotel,

Washington, DC 20036.

Contact Person: John Bishop, PHD,

Scientific Review Administrator, Center for

Scientific Review, National Institutes of

Health, 6701 Rockledge Drive, Room 5180,

MSC 7844, Bethesda, MD 20892, (301) 435–

1250.

This notice is being published less than 15

days prior to the meeting due to the timing

limitations imposed by the review and

funding cycle.

Name of Committee: Musculoskeletal and

Dental Sciences Initial Review Group, Oral

Biology and Medicine Subcommittee 1.

Date: February 21–22, 2000.

Time: 8 AM to 5 PM.

Agenda: To review and evaluate grant

applications.

Place: Holiday Inn Old Town Alexandria,

480 King Street, Alexandria, VA 22314.

Contact Person: Priscilla B. Chen, PHD,

Scientific Review Administrator, Center for

Scientific Review, National Institutes of

Health, 6701 Rockledge Drive, Room 4104,

MSC 7814, Bethesda, MD 20892, (301) 435–

1787.

This notice is being published less than 15

days prior to the meeting due to the timing

limitations imposed by the review and

funding cycle.

Name of Committee: Infectious Diseases

and Microbiology Initial Review Group,

Bacteriology and Mycology Subcommittee 1.

Date: February 21–22, 2000.

Time: 8:30 AM to 6 PM.