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[Federal Register Volume 70, Number 184 (Friday, September 23, 2005)]
[Notices]
[Pages 55903-55905]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-18925]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1269-N5]

Medicare Program; Emergency Medical Treatment and Labor Act 
(EMTALA) Technical Advisory Group (TAG) Meeting--October 26, 2005 
Through October 28, 2005

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

ACTION: Notice of meeting.

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SUMMARY: In accordance with section 10(a) of the Federal Advisory 
Committee Act (FACA) (5 U.S.C. Appendix 2), this notice announces the 
third meeting of the Emergency Medical Treatment and Labor Act (EMTALA) 
Technical Advisory Group (TAG). The purpose of the EMTALA TAG is to 
review regulations affecting hospital and physician responsibilities 
under EMTALA to individuals who come to a hospital seeking examination 
or treatment for medical conditions. The primary purpose of the third 
meeting is to enable the EMTALA TAG to hear additional testimony and 
further consider written responses from medical societies and other 
organizations on specific issues considered by the TAG at previous 
meetings. However, the public is permitted to attend this meeting and, 
to the extent that time permits and at the discretion of the 
Chairperson, the EMTALA TAG may hear comments from the floor.

DATES: Meeting Date: The meetings of the EMTALA TAG announced in this 
notice are as follows: Wednesday, October 26, 2005, 9 a.m. to 5 p.m. 
e.s.t.; Thursday, October 27, 2005, 11 a.m. to 5 p.m. e.s.t.; Friday, 
October 28, 2005, 9 a.m. to 12 noon e.s.t.
    Registration Deadline: All individuals must register to attend this 
meeting. Individuals who wish to attend the meeting but do not wish to 
present testimony must register by October 19, 2005. Individuals who 
wish both to attend the meeting and to present their testimony must 
register by October 5, 2005, and must submit copies of their testimony 
in writing by October 12, 2005.
    Comment Deadline: Written comments/statements to be presented to 
the EMTALA TAG must be received by October 12, 2005.
    Special Accommodations: Individuals requiring sign-language 
interpretation or other special accommodations should send a request to 
these services to Beverly J. Parker by 5 p.m., October 12, 2005 at 
address listed below.

ADDRESSES: Meeting Address: The EMTALA TAG meeting will be held in the 
Multipurpose Room at the CMS Headquarters (Central Bldg), 7500 Security 
Boulevard, Baltimore, MD 21244-1850.
    Mailing and E-mail Addresses for Inquiries or Comments: Inquiries 
or comments regarding this meeting may be sent to--Beverly J. Parker, 
Division of Acute Care, Centers for Medicare & Medicaid Services, Mail 
Stop C4-08-06, 7500 Security Boulevard, Baltimore, MD 21244-1850. 
Inquiries or comments may also be e-mailed to 
[email protected] or [email protected].
    Web Site Address for Additional Information: For additional 
information on the EMTALA TAG meeting agenda topics, updated 
activities, and to obtain Charter copies, please search our Internet 
Web site at: http://

[[Page 55904]]

www.cms.hhs.gov/faca/emtalatag/emtalatagpage.asp.

FOR FURTHER INFORMATION CONTACT: Beverly J. Parker, (410) 786-5320; 
George Morey, (410) 786-4653.
    Press inquiries are handled through the CMS Press Office at (202) 
690-6145.

SUPPLEMENTARY INFORMATION:

I. Background

    Sections 1866(a)(1)(I), 1866(a)(1)(N), and 1867 of the Social 
Security Act (the Act) impose specific obligations on Medicare-
participating hospitals that offer emergency services. These 
obligations concern individuals who come to a hospital emergency 
department and request or have a request made on their behalf for 
examination or treatment for a medical condition. EMTALA applies to all 
these individuals, regardless of whether or not they are beneficiaries 
of any program under the Act. Section 1867 of the Act sets forth 
requirements for medical screening examinations for emergency medical 
conditions, as well as necessary stabilizing treatment or appropriate 
transfer.
    Regulations implementing the EMTALA legislation are set forth at 42 
CFR 489.20(l), (m), (q) and (r)(1), (r)(2), (r)(3), and 489.24. Section 
945 of the Medicare Prescription Drug, Improvement, and Modernization 
Act of 2003 (MMA) (Pub. L. 108-173), requires that the Secretary 
establish a Technical Advisory Group (TAG) for advice concerning issues 
related to EMTALA regulations and implementation.
    Section 945 of the MMA specifies that the EMTALA TAG--
     Shall review the EMTALA regulations;
     May provide advice and recommendations to the Secretary 
concerning these regulations and their application to hospitals and 
physicians;
     Shall solicit comments and recommendations from hospitals, 
physicians, and the public regarding implementation of such 
regulations; and
     May disseminate information concerning the application of 
these regulations to hospitals, physicians, and the public.
    The EMTALA TAG, as chartered under the legal authority of section 
945 of the MMA, is also governed by the provisions of the Federal 
Advisory Committee Act (FACA) (5 U.S.C. Appendix 2) for the selection 
of members and the conduct of all meetings.
    In the May 28, 2004 Federal Register (69 FR 30654), we specified 
the statutory requirements regarding the charter, general 
responsibilities, and structure of the EMTALA TAG. That notice also 
solicited nominations for members based on the statutory requirements 
for the EMTALA TAG. In the August 27, 2004 Federal Register (69 FR 
52699), we solicited nominations again for members in two categories 
(patient representatives and a State survey agency representative) for 
which no nominations were received in response to the May 28, 2004 
Federal Register notice. In the March 15, 2005 Federal Register (70 FR 
12691), we announced the inaugural meeting of the EMTALA TAG and the 
membership selection. In the May 18, 2005 Federal Register (70 FR 
28541) we announced the second meeting of the EMTALA TAG with a purpose 
to hear public testimony and consider written responses from medical 
societies and other organizations on specific issues considered by the 
EMTALA TAG at its inaugural meeting. The EMTALA TAG has established the 
following three subcommittees:
     On-Call Subcommittee (Chairperson, John Kusske, M.D.) 
charged to review the testimony provided and other materials to 
identify some specific issues relating to on-call requirements.
     Action Subcommittee (Chairperson, Julie Nelson, J.D.) 
charged to identify issues other than on-call issues.
     Framework Subcommittee (Chairperson, Charlotte Yeh, M.D.) 
charged to clarify the historical context and conceptual basis for the 
TAG's recommendations and develop a document for review and approval by 
the TAG.

II. Meeting Format, Agenda, and Presentation Topics

A. Meeting Format

    The initial portion of the meeting (convening at 9 a.m. on October 
26) will involve opening remarks, followed by a limited period of 
public testimony on emergency medical services and specialty hospital 
issues. Participants wishing to present testimony on the EMTALA impact 
of specialty hospitals are requested to address their comments to the 
following issues:
     Whether there should be a Federal requirement for 
specialty hospitals to maintain emergency departments and, if so, 
whether this is best achieved by amending EMTALA or through some other 
means.
     Whether specialty hospitals, irrespective of whether they 
have emergency departments, are subject to the EMTALA requirement under 
which a Medicare participating hospitals with specialized capabilities 
or facilities may not refuse to accept an appropriate transfer of an 
individual who requires such specialized capabilities or facilities if 
the hospital has the capacity to treat the individual.
     Whether additional or different, on-call requirements 
should be established for specialty hospitals (for example, whether 
specialty hospitals should be required to participate in community 
protocols).
    The public testimony will be followed by discussion of emergency 
medical services (EMS), specialty hospitals, and other issues under 
consideration by the On-Call, Action, and Framework Subcommittees. TAG 
members will be afforded the opportunity to ask questions, prioritize 
the topics presented, and to conduct other necessary business. At the 
conclusion of each day's meeting, to the extent that time is available 
and at the discretion of the Chair, the public will be permitted a 
reasonable time to comment on issues being considered by the TAG.

B. Tentative Meeting Agenda

    The tentative agenda for the EMTALA TAG meetings is as follows:
Day 1
Convenes at 9 a.m.
     Welcome, Call to Order, and Opening Remarks.
     Administrative and Housekeeping Issues.
     Public Testimony on Emergency Medical Services and 
Specialty Hospital Issues.
     Report of On-Call Subcommittee.
     Discussion of On-Call Issues.
     Report of Action Subcommittee.
     Discussion of Action Subcommittee Issues (for example, 
psychiatric emergency medical conditions and stabilizing treatment; 
hospitals with specialized capabilities; follow-up on other issues 
discussed at the last TAG meeting).
     Public Comment.
Day 2
Convenes at 11 a.m.
     Report of Framework Subcommittee.
     Discussion of Framework Issues.
     Discussion of Specialty Hospital Issues.
     Continuation of discussion of On-Call issues.
     Continuation of discussion of Action Subcommittee Issues.
     Discussion of Current Business.
     Public Comment.

[[Page 55905]]

Day 3
Convening at 9 a.m.
     Discussion of Current Business (continued).

C. Public Presentations

    Only individuals who register and submit written testimony as 
specified in section IV. of this notice will be considered registered 
presenters. The time allotted for each presentation will be 
approximately 5 minutes but will be based on the number of registered 
presenters. Presenters will speak in their assigned order. If 
registered presenters are not given an opportunity to speak because of 
time restrictions, we will accept and present their testimony to the 
TAG members. Comments from other participants (individuals who are not 
registered presenters) may be heard after the scheduled testimonies, if 
time permits.
    If there are individuals who cannot attend the meeting but wish to 
submit comments/statements regarding emergency medical services or 
specialty hospitals, we will accept and present their written comments/
statements at the meeting if their comments/statements are received via 
postal mail or email at the address listed in the ADDRESSES section of 
this notice by October 12, 2005.

III. Registration Instructions

    The Center for Medicare Management is coordinating meeting 
registration. While there is no registration fee, all individuals must 
register to attend due to limited seating. As specified in the DATES 
section of this notice, individuals who wish to attend the meeting but 
do not plan to present testimony must register by October 19, 2005. 
Individuals who would like both to attend and to present testimony on 
the topics of emergency medical services or specialty hospitals must 
register by October 5, 2005 and must state specifically in their 
registration request that they wish to present testimony for EMTALA TAG 
consideration. A copy of the presenter's written testimony must be 
received by CMS at the address specified in the ADDRESSES section of 
this notice by October 12, 2005.
    You may register with Marianne Myers at [email protected] 
or by, fax to the attention of Marianne Myers at (410) 786-0681, or by 
telephone at (410) 786-5962. All registration requests must include 
your name, name of the organization (if applicable), address, telephone 
and fax numbers, e-mail address (if available). You will receive a 
registration confirmation with instructions for your arrival at the CMS 
Headquarters. If seating has been reached, you will be notified that 
the meeting has reached capacity. All registrants are asked to arrive 
at the CMS (Central Building) no later than 20 minutes before the 
scheduled starting time of each meeting session they wish to attend.

IV. Security Information

    Since this meeting will be held in a Federal government building, 
Federal security measures are applicable. As noted above, in planning 
your arrival time, we recommend allowing additional time to clear 
security. All vehicles will be inspected inside and out at the entrance 
to the grounds. In order to gain access to the building, participants 
must bring a government-issued photo identification (driver's license, 
passport, etc.) and a copy of your registration information for the 
meeting. Access may be denied to persons without proper identification.
    All persons entering the building must pass through a metal 
detector. In addition, all items brought to CMS, whether personal or 
for the purpose of demonstration or to support a presentation, are 
subject to inspection. We cannot assume responsibility for coordinating 
the receipt, transfer, transport, storage, set-up, safety, or timely 
arrival of any personal belongings or items used for demonstration or 
to support a presentation.

    Authority: Section 945 of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (MMA).

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

    Dated: September 13, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 05-18925 Filed 9-22-05; 8:45 am]
BILLING CODE 4120-01-P
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