Federal Register / Vol. 60, No. 5 / Monday, January 9, 1995 / Rules and Regulations 2325

actions necessary to address the unsafe

condition described in this AD. Such a

request should include an assessment of the

effect of the changed configuration on the

unsafe condition addressed by this AD. In no

case does the presence of any modification,

alteration, or repair remove any airplane from

the applicability of this AD.

Compliance: Required as indicated, unless

accomplished previously.

To prevent in-flight separation of the main

deck cargo door from the airplane,

accomplish the following:

Note 2: This AD references Pemco Alert

Service Letter 737–53–0003, Revision 3,

dated December 22, 1994, for information

concerning inspection and replacement

procedures. In addition, this AD specifies

replacement requirements different from

those included in the service letter. Where

there are differences between the AD and the

service letter, the AD prevails.

(a) Within 50 flight cycles after the

effective date of this AD or within 50 flight

cycles after installation of STC SA2969SO,

whichever occurs later, perform a visual

inspection to detect cracking in the radii on

the support angles on the lower jamb of the

main deck cargo door, in accordance with

Pemco Alert Service Letter 737–53–0003,

Revision 3, dated December 22, 1994.

(1) If no cracking is detected, repeat the

visual inspection thereafter at intervals not to

exceed 450 flight cycles.

(2) If any cracking is detected, prior to

further flight, replace the cracked part with

a new part in accordance with the service

letter. Repeat the visual inspection thereafter

at intervals not to exceed 450 flight cycles.

(b) An alternative method of compliance or

adjustment of the compliance time that

provides an acceptable level of safety may be

used if approved by the Manager, FAA,

Transport Airplane Directorate, Seattle

Aircraft Certification (ACO). Operators shall

submit their requests through an appropriate

FAA Principal Maintenance Inspector, who

may add comments and then send it to the

Manager, Seattle ACO.

Note 3: Information concerning the

existence of approved alternative methods of

compliance with this AD, if any, may be

obtained from the Seattle ACO.

(c) Special flight permits may be issued in

accordance with sections 21.197 and 21.199

of the Federal Aviation Regulations (14 CFR

21.197 and 21.199) to operate the airplane to

a location where the requirements of this AD

can be accomplished.

(d) The inspection and replacement

procedures shall be done in accordance with

Pemco Alert Service Letter 737–53–0003,

Revision 3, dated December 22, 1994. This

incorporation by reference was approved by

the Director of the Federal Register in

accordance with 5 U.S.C. 552(a) and 1 CFR

part 51. Copies may be obtained from Pemco

Aeroplex, Incorporated, P.O. Box 2287,

Birmingham, Alabama 35201–2287. Copies

may be inspected at the FAA, Transport

Airplane Directorate, 1601 Lind Avenue,

SW., Renton, Washington; or at the FAA,

Small Airplane Directorate, Atlanta Aircraft

Certification Office, Campus Building, 1701

Columbia Avenue, Suite 2–160, College Park,

Georgia; or at the Office of the Federal

Register, 800 North Capitol Street, NW., suite

700, Washington, DC.

(e) This amendment becomes effective on

January 24, 1995.

Issued in Renton, Washington, on

December 29, 1994.

S.R. Miller,

Acting Manager, Transport Airplane

Directorate, Aircraft Certification Service.

[FR Doc. 95–199 Filed 1–6–95; 8:45 am]

BILLING CODE 4910–13–U

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 400, 405, 410, 484, 485,

486, and 498

[BPD–798–FC]

Medicare Program; Providers and

Suppliers of Specialized Services:

Technical Amendments

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Final rule with comment period.

SUMMARY: This rule reorganizes

Medicare regulations that pertain to

providers and suppliers of specialized

services, in order to facilitate the

incorporation of future rules in logical

order.

The rule also makes minor technical

and editorial changes to clarify the rules

and eliminate duplication without

substantive change.

DATES: Effective date: These rules are

effective February 8, 1995.

Comment date: We will consider

comments received by March 10, 1995.

ADDRESSES: Please mail written

comments (an original and 3 copies) to

the following address: Health Care

Financing Administration, Department

of Health and Human Services,

Attention: BPD–798–FC, P.O. Box

26676, Baltimore, Maryland 21207.

If you prefer, you may deliver your

written comments (an original and 3

copies) to one of the following

addresses:

Room 309–G, Hubert H. Humphrey

Building, 200 Independence Avenue,

S.W., Washington, D.C. 20201, or

Room 132, East High Rise Building,

6325 Security Boulevard, Baltimore,

Maryland 21207.

Because of staffing and resource

limitations, we cannot accept comments

by facsimile (FAX) transmission. In

commenting, please refer to file code

BPD–798–FC. Comments received

timely will be available for public

inspection as they are received,

generally beginning approximately 3

weeks after publication of a document,

in Room 309–G of the Department’s

offices at 200 Independence Avenue,

SW., Washington, DC, on Monday

through Friday of each week from 8:30

a.m. to 5 p.m. (phone: (202) 690–7890).

FOR FURTHER INFORMATION CONTACT:

Luisa V. Iglesias, (202) 690–6383.

SUPPLEMENTARY INFORMATION: This rule

is part of an ongoing process of

relocating the content of part 405 to

separate parts devoted to particular

aspects of the Medicare program. In this

case, the rule—

1. Transfers to part 485 the

regulations that pertain to institutional

providers of physical therapy and

speech-language pathology services that

were in subpart Q of part 405; and

2. Establishes a new part 486 for

suppliers of specialized services,

including—

• Suppliers of portable X-Ray services

(from subpart N of part 405); and

• Physical therapists in independent

practice (from subpart Q of part 405).

The following subparts, which also

pertain to specialized services, are not

relocated at this time for the reasons

indicated:

• Subpart D of part 485—Conditions

for Coverage: Organ Procurement

Organizations—A final rule that makes

substantive changes is currently in

clearance.

• Subpart B of part 494—Conditions

for Coverage of Screening

Mammography Services—Recent

statutory amendments require

substantive changes.

The rule also—

• Simplifies and clarifies regulations,

without substantive change, by

removing extensive (and unnecessary)

verbatim statutory citations and

separating true definitions from

personnel qualification requirements;

and

• In § 400.310, which lists the

regulation sections for which OMB

control numbers have been assigned,

conforms those section numbers to

changes made by this rule.

Collection of Information Requirements

This rule contains no new

information collection requirements

subject to review by the Office of

Management and Budget under the

Paperwork Reduction Act of 1980 (44

U.S.C. 3501 et seq.).

Response to Comments

Although this is a final rule, we will

consider timely comments from anyone

who believes that the reorganization of
2326 Federal Register / Vol. 60, No. 5 / Monday, January 9, 1995 / Rules and Regulations

content and the clarifying technical and

editorial changes affect the substance of

the rules. If we revise this rule as a

result of comments, we will discuss all

timely comments in the preamble to the

revised rule.

Waiver of Proposed Rulemaking

The changes made by this rule are

purely technical and editorial and have

no substantive impact. Accordingly, we

find that there is good cause to waive

proposed rulemaking procedures as

unnecessary.

Regulatory Flexibility Analysis

Consistent with the Regulatory

Flexibility Act (RFA) and section

1102(b) of the Social Security Act, we

prepare a regulatory flexibility analysis

for each rule, unless the Secretary

certifies that the particular rule will not

have a significant economic impact on

a substantial number of small entities,

or a significant impact on the operation

of a substantial number of small rural

hospitals.

The RFA defines ‘‘small entity’’ as a

small business, a nonprofit enterprise,

or a governmental jurisdiction (such as

a county, city, or township) with a

population of less than 50,000. We also

consider all providers and suppliers of

services to be small entities. For

purposes of section 1102(b) of the Act,

we define small rural hospital as a

hospital that has fewer than 50 beds,

and is located anywhere but in a

metropolitan statistical area.

We have not prepared a regulatory

flexibility analysis because we have

determined, and the Secretary certifies,

that these rules will not have a

significant economic impact on a

substantial number of small entities or

a significant impact on the operation of

a substantial number of small rural

hospitals.

In accordance with the provisions of

Executive Order 12866, this rule was

not reviewed by the Office of

Management and Budget.

List of Subjects

42 CFR Part 400

Grant programs-health, Health

facilities, Health maintenance

organizations (HMO), Medicaid,

Medicare, Reporting and recordkeeping

requirements.

42 CFR Part 405

Administrative practice and

procedure, Health facilities, Health

professions, Kidney diseases, Medicare,

Reporting and recordkeeping

requirements, Rural areas, X-rays.

42 CFR Part 410

Health facilities, Health professions,

Kidney diseases, Laboratories,

Medicare, Rural areas, X-rays.

42 CFR Part 484

Health facilities, Health professions,

Medicare, Reporting and recordkeeping

requirements.

42 CFR Part 485

Grant programs-health, Health

facilities, Medicaid, Medicare,

Reporting and recordkeeping

requirements.

42 CFR Part 486

Health professionals, Medicare, Organ

procurement, X-rays.

42 CFR Part 498

Administrative practice and

procedure, Health facilities, Health

professions, Medicare, Reporting and

recordkeeping requirements.

42 CFR chapter IV is amended as set

forth below:

PART 400—INTRODUCTION;

DEFINITIONS

A. Part 400 is amended as set forth

below:

1. The authority citation for part 400

continues to read as follows:

Authority: Secs. 1102 and 1871 of the

Social Security Act (42 U.S.C. 1302 and

1395(hh)) and 44 U.S.C. Chapter 35.

§ 400.310 [Amended]

2. In the left-hand column of

§ 400.310, the following changes are

made:

a. ‘‘405.1716, 405.1717, 405.1720,

405.1721, 405.1722, 405.1724, 405.1725,

405.1726’’ is revised to read ‘‘485.709,

485.711, 485.717, 485.719, 485.721,

485.725, 485.727, 485.729.’’

b. ‘‘405.1733, 405.1736, 405.1737’’ is

revised to read ‘‘486.155, 486.161,

486.163’’.

PART 405—FEDERAL HEALTH

INSURANCE FOR THE AGED AND

DISABLED

Part 405 is amended as set forth

below:

§§ 405.1411, 405.1412, 405.1413, 405.1414,

405.1415, 1405.1416 [Redesignated]

1. Subpart N, consisting of

§§ 405.1411 through 405.1416 is

redesignated as subpart C under a new

part 486, in accordance with the

following redesignation table:

Old section (subpart

N of part 405)

New section (subpart

C of part 486)

405.1411 486.100

Old section (subpart

N of part 405)

New section (subpart

C of part 486)

405.1412 486.102

405.1413 486.104

405.1414 486.106

405.1415 486.108

405.1416 486.110

§§ 405.1701, 405.1730 [Amended]

2. In subpart Q, the undesignated

centered headings preceding § 405.1701

and § 405.1730, respectively, are

removed.

§§ 405.1701, 405.1702, 405.1715–405.1726

[Redesignated]

3. Subpart G to part 485 is added and

reserved and §§ 405.1701, 405.1702, and

405.1715 through 405.1726 of subpart Q

in part 405 are redesignated as new

subpart H under part 485 in accordance

with the following redesignation table:

Old section (subpart Q of part

405)

New section

(subpart H of

part 485)

405.1701 ................................. 485.701

405.1702, introductory text ..... Removed.

405.1702(a) ............................ 485.705(a)

405.1702(b) ............................ 485.703(a)

405.1702(c) ............................. 485.703(b)

405.1702(d) ............................ 485.705(b)

405.1702(e) ............................ 485.705(c)

405.1702(f) ............................. 485.705(d)

405.1702(g) ............................ 485.705(e)

405.1702(h) ............................ 485.703(c)

405.1702(i) .............................. 485.703(d)

405.1702(j) .............................. 485.705(f)

405.1702(k) ............................. 485.705(g)

405.1702(l) .............................. 485.703(e)

405.1702(m) ........................... 485.705(h)

405.1715 ................................. 485.707

405.1716 ................................. 485.709

405.1717 ................................. 485.711

405.1718 ................................. 485.713

405.1719 ................................. 485.715

405.1720 ................................. 485.717

405.1721 ................................. 485.719

405.1722 ................................. 485.721

405.1723 ................................. 485.723

405.1724 ................................. 485.725

405.1725 ................................. 485.727

405.1726 ................................. 485.729

§§ 405.1730–405.1737 [Redesignated]

4. Sections 405.1730 through

405.1737 are redesignated as subpart D

under a new part 486, in accordance

with the following redesignation table:

Old section (subpart

Q of part 405)

New section (subpart

D of part 486)

405.1730 486.150

405.1731 486.151

405.1732 486.153

405.1733 486.155

405.1734 486.157

405.1735 486.159

405.1736 486.161

405.1737 486.163
Federal Register / Vol. 60, No. 5 / Monday, January 9, 1995 / Rules and Regulations 2327

PART 485—CONDITIONS OF

PARTICIPATION AND CONDITIONS

FOR COVERAGE: SPECIALIZED

PROVIDERS

C. Part 485 is amended as set forth

below.

1. The authority citation for part 485

is revised to read as follows:

Authority: Secs. 1102 and 1871 of the

Social Security Act (42 U.S.C. 1302 and

1395(hh).

2. The heading of part 485 is revised

to read as follows:

PART 485—CONDITIONS OF

PARTICIPATION: SPECIALIZED

PROVIDERS

§ 485.70 [Amended]

3. In § 485.70, the following changes

are made:

a. In § 485.70(e), ‘‘§ 485.70(d) and (e)

of this chapter.’’ is revised to read

‘‘paragraphs (b) and (c) of § 485.705.’’

b. In § 485.70(m), ‘‘§ 405.1702(j) of

this chapter.’’ is revised to read

‘‘§ 485.705(f).’’.

4. The heading and table of contents

of newly designated subpart H read as

follows:

Subpart H—Conditions of Participation for

Clinics, Rehabilitation Agencies, and Public

Health Agencies as Providers of Outpatient

Physical Therapy and Speech-Language

Pathology Services

Sec.

485.701 Basis and scope.

485.703 Definitions.

485.705 Personnel qualifications.

485.707 Condition of participation:

Compliance with Federal, State, and

local laws.

485.709 Condition of participation:

Administrative management.

485.711 Condition of participation: Plan of

care and physician involvement.

485.713 Condition of participation:

Physical therapy services.

485.715 Condition of participation: Speech

pathology services.

485.717 Condition of participation:

Rehabilitation program.

485.719 Condition of participation:

Arrangements for physical therapy and

speech-language pathology services to be

performed by other than salaried

organization personnel.

485.721 Condition of participation: Clinical

records.

485.723 Condition of participation:

Physical environment.

485.725 Condition of participation:

Infection control.

485.727 Condition of participation: Disaster

preparedness.

485.729 Condition of participation: Program

evaluation.

§§ 485.707, 485.715, 485.723, 485.727,

485.729 [Amended]

5. In newly designated subpart H, in

the following sections, the section

heading is amended to change the dash

to a colon and to capitalize the first

word after the colon:

§§ 485.707, 485.715, 485.721, 485.723,

485.727, and 485.729.

6. Newly designated § 485.701 is

revised to read as follows:

§ 485.701 Basis and scope.

This subpart implements section

1861(p)(4) of the Act, which—

(a) Defines outpatient physical

therapy and speech pathology services;

(b) Imposes requirements with respect

to adequate program, facilities, policies,

staffing, and clinical records; and

(c) Authorizes the Secretary to

establish by regulation other health and

safety requirements.

§ 485.703 [Amended]

7. In newly designated § 485.703, the

heading is revised to read Definitions.,

and the paragraph designations are

removed.

§ 485.705 [Amended]

8. In newly designated § 485.705, a

section heading and introductory text

are added, to read as follows:

§ 485.705 Personnel qualifications.

The training, experience, and

membership requirements for personnel

involved in the furnishing of outpatient

physical therapy and speech-language

pathology services are as follows:

* * * * *

§ 485.707 [Amended]

9. In newly designated § 485.707, the

following changes are made:

a. In the introductory text and

paragraph (a), ‘‘clinic, rehabilitation

agency, or public health agency’’ and

the plural version of that phrase are

revised to read ‘‘organization’’ and

‘‘organizations’’, respectively.

b. In paragraph (a), ‘‘pursuant to such

law’’ is revised to read ‘‘in accordance

with applicable laws’’.

§ 485.709 [Amended]

10. In newly designated § 485.709, the

following changes are made:

a. Paragraph (b) is revised to read as

set forth below.

b. In paragraph (c), second sentence,

‘‘where’’ is revised to ‘‘if’’.

c. In paragraph (d), second sentence,

‘‘which’’ is revised to ‘‘that’’.

§ 485.709 Condition of participation:

Administrative management.

* * * * *

(b) Standard: Administrator. The

governing body—

(1) Appoints a qualified full-time

administrator;

(2) Delegates to the administrator the

internal operation of the clinic or

rehabilitation agency in accordance

with written policies;

(3) Defines clearly the administrator’s

responsibilities for procurement and

direction of personnel; and

(4) Designates a competent individual

to act during temporary absence of the

administrator.

* * * * *

§ 485.711 [Amended]

11. In newly designated § 485.711, the

following changes are made:

a. In paragraph (a), introductory text,

‘‘prior to’’ is revised to read ‘‘before’’.

b. Paragraph (b)(1) is revised to read

as set forth below.

c. In paragraph (b)(3), the

parenthetical statement, ‘‘at least every

30 days’’ is inserted immediately before

‘‘in accordance’’, and ‘‘§ 424.25(e)’’ is

revised to read ‘‘§ 410.61(e)’’.

d. Paragraph (b)(4) is revised to read

as set forth below.

e. In paragraph (c), second sentence,

‘‘There are’’ is revised to read ‘‘The’’,

and ‘‘that covers’’ is revised to read

‘‘cover’’.

§ 485.711 Condition of participation: Plan

of care and physician involvement.

* * * * *

(b) Standard: Plan of care—(1) For

each patient there is a written plan of

care established by the physician or by

the physical therapist or speechlanguage pathologist who furnishes the

services.

* * * * *

(4) Changes in the plan of care are

noted in the clinical record. If the

patient has an attending physician, the

therapist or speech-language pathologist

who furnishes the services promptly

notifies him or her of any change in the

patient’s condition or in the plan of

care.

* * * * *

§ 485.713 [Amended]

12. In newly designated § 485.713, the

following changes are made:

a. The introductory text is revised to

read as set forth below.

b. In paragraph (a)(1) introductory

text, ‘‘will be’’ is revised to read ‘‘is’’.

c. In paragraph (a)(1)(i), ‘‘utilizing’’ is

revised to ‘‘using’’.

d. Paragraph (a)(2) is revised to read

as set forth below.

e. In paragraph (b), ‘‘accepted’’ is

revised to read ‘‘it accepts’’.

f. In paragraph (d), ‘‘such’’ is revised

to ‘‘these’’.
2328 Federal Register / Vol. 60, No. 5 / Monday, January 9, 1995 / Rules and Regulations

§ 485.713 Conditions of participation:

Physical therapy services.

If the organization offers physical

therapy services, it provides an

adequate program of physical therapy

and has an adequate number of

qualified personnel and the equipment

necessary to carry out its program and

to fulfill its objectives.

(a) Standard: Adequate program.

* * *

(2) A qualified physical therapist is

present or readily available to offer

supervision when a physical therapist

assistant furnishes services.

(i) If a qualified physical therapist is

not on the premises during all hours of

operation, patients are scheduled so as

to ensure that the therapist is present

when special skills are needed, for

example, for evaluation and

reevaluation.

(ii) When a physical therapist

assistant furnishes services off the

organization’s premises, those services

are supervised by a qualified physical

therapist who makes an onsite

supervisory visit at least once every 30

days.

* * * * *

§ 485.715 [Amended]

13. In newly designated § 485.715, the

following changes are made:

a. In paragraph (a), ‘‘will be’’ is

revised to read ‘‘is’’.

b. In paragraph (b), ‘‘accepted’’ is

revised to read ‘‘it accepts’’.

c. In paragraph (c), ‘‘rendered’’ is

revised to read ‘‘furnished’’.

§ 485.717 [Amended]

14. In newly designated § 485.717, the

following changes are made:

a. The undesignated introductory text

is revised to read as set forth below.

b. In paragraph (a), ‘‘rendered, as

applicable’’ is revised to read

‘‘furnished as appropriate’’.

c. Paragraph (b) is revised to read as

set forth below.

§ 485.717 Condition of participation:

Rehabilitation program.

This condition and its standards

apply only to a rehabilitation agency’s

own patients, not to patients of

hospitals, skilled nursing facilities

(SNFs), or Medicaid nursing facilities

(NFs) to whom the agency furnishes

services. (The hospital, SNF, or NF is

responsible for ensuring that qualified

staff furnish services for which they

arrange or contract for their patients.)

The rehabilitation agency provides, in

addition to physical therapy and

speech-language pathology services,

social or vocational adjustment services

to all of its patients who need them. The

agency provides for special qualified

staff to evaluate the social and

vocational factors, to counsel and advise

on the social or vocational problems

that arise from the patient’s illness or

injury, and to make appropriate referrals

for needed services.

* * * * *

(b) Standard: Arrangements for social

or rehabilitation services—(1) If a

rehabilitation agency does not provide

social or vocational adjustment services

through salaried employees, it may

provide those services through a written

contract with others who meet the

requirements and responsibilities set

forth in this subpart for salaried

personnel.

(2) The contract must specify the term

of the contract and the manner of

termination or renewal and provide that

the agency retains responsibility for the

control and supervision of the services.

§ 485.719 [Amended]

15. In newly designated § 485.719, the

following changes are made:

a. In paragraph (a), ‘‘when’’ is revised

to ‘‘if’’; ‘‘and/or’’ is revised to read ‘‘or’’;

‘‘such’’ is revised to ‘‘the’’(twice);

‘‘provides for retention by the

organization’’ is revised to read

‘‘provides that the organization retains’’;

and ‘‘responsibility form and control

and supervision of’’ is corrected to read

‘‘responsibility for, and control and

supervision of,’’.

b. Paragraph (b) is revised to read as

set forth below:

§ 485.719 Condition of participation:

Arrangements for physical therapy and

speech-language pathology services to be

performed by other than salaried

organization personnel.

* * * * *

(b) Standard: Contract provisions. The

contract—

(1) Specifies the term of the contract

and the manner of termination or

renewal;

(2) Requires that personnel who

furnish the services meet the

requirements that are set forth in this

subpart for salaried personnel; and

(3) Provides that the contracting

outside resource may not bill the patient

or Medicare for the services. This

limitation is based on section

1861(w)(1) of the Act, which provides

that—

(i) Only the provider may bill the

beneficiary for covered services

furnished under arrangements; and

(ii) Receipt of Medicare payment by

the provider, on behalf of an entitled

individual, discharges the liability of

the individual or any other person to

pay for those services.

§ 485.721 [Amended]

16. In newly designated § 485.721, the

following changes are made:

a. In paragraph (b), the commas at the

end of paragraphs (b)(1) through (b)(6)

are changed to periods; in paragraph

(b)(1), ‘‘provided’’ is revised to

‘‘furnished’’; and the ‘‘and’’ at the end

of paragraph (b)(6) is removed.

b. In paragraph (c), the last sentence

is revised to read as set forth below.

c. In paragraph (d), the commas at the

end of the paragraphs (d)(1) and

(d)(2)(1) are changed to semicolons, and

in the introductory text, ‘‘a period of

time of not less than’’ is revised to read

‘‘at least’’.

d. In paragraph (d)(1), ‘‘That’’ is

revised to ‘‘The period’’.

e. In paragraph (d)(2), introductory

text, the colon is changed to a dash.

§ 485.721 Condition of Participation:

Clinical records.

* * * * *

(c) Standard: Completion of records

and centralization of reports. * * *

Each physician signs the entries that he

or she makes in the clinical record.

* * * * *

§ 485.723 [Amended]

17. In newly designated § 485.723, the

following changes are made:

a. In paragraph (a)(2), ‘‘organization’’

is revised to ‘‘premises’’ (twice).

b. In paragraph (b), at the end of the

introductory text, the colon is removed

and ‘‘that—’’ is inserted.

c. In paragraph (b)(1), ‘‘That’’ is

revised to ‘‘The’’, and the comma is

changed to a semicolon.

d. In paragraph (b)(2), ‘‘That the’’ is

revised to read ‘‘The’’, and ‘‘which’’ is

revised to ‘‘that’’.

e. In paragraph (c)(2), ‘‘utilization’’ is

revised to ‘‘use’’.

§ 485.725 [Amended]

18. In newly designated § 485.725, the

following changes are made:

a. Paragraph (b) is revised to read as

set forth below.

b. In paragraph (c), the designation

‘‘(1)’’ is inserted immediately before the

first sentence; ‘‘such’’ is revised to

‘‘housekeeping’’; the designation ‘‘(2)’’

is inserted immediately before the third

sentence; ‘‘and/or’’ is revised to read

‘‘or’’, and ‘‘meets’’ is revised to read ‘‘or

both meet’’.

c. In paragraph (e), ‘‘The organization

is maintained’’ is revised to read ‘‘The

organization’s premises are

maintained’’.

§ 485.725 Condition of participation:

Infection control.

* * * * *
Federal Register / Vol. 60, No. 5 / Monday, January 9, 1995 / Rules and Regulations 2329

(b) All personnel follow written

procedures for effective aseptic

techniques. The procedures are

reviewed annually and revised if

necessary to improve them.

§ 485.727 [Amended]

19. In newly designated § 485.727, in

the introductory text, ‘‘such disasters’’ is

revised to read ‘‘a disaster’’.

§ 485.729 [Amended]

20. In newly designated § 485.729, the

following changes are made:

a. In the introductory text, ‘‘which’’ is

revised to ‘‘that’’, and ‘‘assure’’ is

revised to ‘‘ensure’’.

b. In paragraph (a), ‘‘assure’’ is revised

to ‘‘ensure’’.

c. In paragraph (b) ‘‘such statistical

data as’’ is revised to read ‘‘statistical

data such as’’.

D. A new part 486 is added.

1. The heading and the table of

contents of the new part 486 read as

follows:

PART 486—CONDITIONS FOR

COVERAGE OF SERVICES OF

SPECIALIZED SUPPLIERS

Subparts A and B—[Reserved]

Subpart C—Conditions for Coverage:

Portable X-Ray Services

Sec.

486.100 Condition for coverage:

Compliance with Federal, State, and

local laws and regulations.

486.102 Condition for coverage:

Supervision by a qualified physician.

486.104 Condition for coverage:

Qualifications, orientation, and health of

technical personnel.

486.106 Condition for coverage: Referral for

service and preservation of records.

486.108 Condition for coverage: Safety

standards.

486.110 Condition for coverage: Inspection

of equipment.

Subpart D—Conditions for Coverage:

Outpatient Physical Therapy Services

Furnished by Physical Therapists in

Independent Practice

486.150 Condition for coverage: General

requirements.

486.151 Condition for coverage:

Supervision.

486.153 Condition for coverage:

Compliance with Federal, State, and

local laws.

486.155 Condition for coverage: Plan of

care.

486.157 Condition for coverage: Physical

therapy services.

486.159 Condition for coverage:

Coordination of services with other

organizations, agencies, or individuals.

486.161 Condition for coverage: Clinical

records.

486.163 Condition for coverage: Physical

environment.

Authority: Sections 1102 and 1871 of the

Social Security Act (42 U.S.C. 1302 and

1395hh).

2. In newly designated subpart D, in

the following sections, the section

heading is revised to change the dash to

a colon and capitalize the first word

after the colon: §§ 486.153, 486.155,

486.157, and 486.161.

3. Newly designated §§ 486.150 and

486.151 are revised to read as follows:

§ 486.150 Condition for coverage: General

requirements.

In order to be covered under Medicare

as a supplier of outpatient physical

therapy services, a physical therapist in

independent practice must meet the

following requirements:

(a) Be licensed in the State in which

he or she practices.

(b) Meet one of the personnel

qualifications specified in § 485.705(b).

(c) Furnish services under the

circumstances described in § 410.60 of

this chapter.

(d) Meet the requirements of this

subpart.

§ 486.151 Condition for coverage:

Supervision.

The services are furnished by or

under the direct supervision of a

qualified physical therapist in

independent practice.

§ 486.155 [Amended]

4. In newly designated § 486.155, the

following changes are made:

a. In paragraph (a), introductory text,

‘‘The following information is obtained

by the physical therapist prior to’’ is

revised to read ‘‘The physical therapist

obtains the following information

before’’.

b. In paragraph (b)(4), the second

sentence is revised to read: ‘‘If the

patient has an attending physician, the

therapist who furnishes the services

promptly notifies him or her of any

change in the patient’s condition or in

the plan of care.’’.

c. In the parenthetical statement in

paragraph (b)(4), ‘‘§ 424.25(e)’’ is revised

to read ‘‘§ 410.61(e)’’.

5. Newly designated § 486.159 is

revised to read as follows:

§ 486.159 Condition for coverage:

Coordination of services with other

organizations, agencies, or individuals.

The physical therapist coordinates her

physical therapy services with the

health and medical services the patient

receives from organizations or agencies

or other individual practitioners

through exchange of information that

meets the following standard:

If a patient is receiving or has recently

received, from other sources, services

related to the physical therapy program,

the physical therapist exchanges

pertinent documented information with

those other sources—

(a) On a regular basis;

(b) Subject to the requirements for

protection of the confidentiality of

medical records, as set forth in

§ 485.721 of this chapter; and

(c) With the aim of ensuring that the

services effectively complement one

another.

§ 486.163 [Amended]

6. In newly designated § 486.163, the

following changes are made:

a. In the introductory text, ‘‘and/or’’ is

revised to read ‘‘or’’.

b. In paragraph (b), first sentence, the

word ‘‘established’’ is removed.

c. In paragraph (c), second sentence,

‘‘such’’ is changed to ‘‘the’’.

d. Paragraph (d) is revised to read as

follows:

§ 486.163 Condition for coverage: Physical

environment.

* * * * *

(d) The physical therapist is alert to

the possibility of fire and other

nonmedical emergencies and has

written plans that include—

(1) The means for leaving the office

and the building safely, demonstrated,

for example, by fire exit signs; and

(2) Other provisions necessary to

ensure the safety of patients.

E. Technical corrections.

PART 410—[AMENDED]

1. In part 410, the following changes

are made:

a. the authority citation of part 410 is

revised to read as follows:

Authority: Secs. 1102 and 1871 of the

Social Security Act (42 U.S.C. 1302 and 1395

(hh)) unless otherwise indicated.

b. In § 410.60(a)(3)(ii), ‘‘§ 405.1702(d)

of this chapter’’ is revised to read

‘‘§ 485.705(b) of this chapter’’.

PART 484—[AMENDED]

2. In part 484, the following changes

are made:

a. The authority citation for part 484

is revised to read as follows:

Authority: Secs. 1102 and 1871 of the

Social Security Act (42 U.S.C. 1302 and 1395

(hh)) unless otherwise indicated.

§ 484.38 [Amended]

b. In § 484.38, ‘‘§§ 405.1717 through

405.1719, 405.1721, 405.1723, and

405.1725 of this chapter’’ is revised to

read ‘‘subpart H of part 485 of this

chapter’’.
2330 Federal Register / Vol. 60, No. 5 / Monday, January 9, 1995 / Rules and Regulations

PART 498—[AMENDED]

3. In part 498, the following changes

are made:

a. The authority citation for part 498

is revised to read as follows:

Authority: Secs. 1102 and 1871 of the

Social Security Act (42 U.S.C. 1302 and

1395(hh)) unless otherwise indicated.

§ 498.3 [Amended]

b. In § 498.3(b)(6), ‘‘§§ 405.1730

through 405.1737, or in § 410.22 of this

chapter, respectively,’’ is revised to read

‘‘subpart D of part 486 of this chapter

and § 410.22 of this chapter,

respectively.’’

(Catalog of Federal Domestic Assistance

Program No. 93.773, Medicare—Hospital

Insurance; and Program No. 93.774,

Medicare—Supplementary Medical

Insurance Program)

Dated: September 2, 1994.

Bruce C. Vladeck,

Administrator, Health Care Financing

Administration.

Dated: October 12, 1994.

Donna E. Shalala,

Secretary.

[FR Doc. 95–485 Filed 1–6–95; 8:45 am]

BILLING CODE 4120–01–P

LEGAL SERVICES CORPORATION

45 CFR Part 1607

Governing Bodies; Correction

AGENCY: Legal Services Corporation.

ACTION: Final rule.

SUMMARY: This rule corrects the final

regulation that was published on

Monday, December 19, 1994 (59 FR

65249). The regulation revised part 1607

of the Legal Services Corporation’s

(‘‘LSC’’ or ‘‘Corporation’’) regulations

relating to governing bodies of

recipients of LSC funds.

EFFECTIVE DATE: January 18, 1995.

FOR FURTHER INFORMATION CONTACT:

Victor M. Fortuno, General Counsel, at

(202) 336–8810.

SUPPLEMENTARY INFORMATION: As

published, § 1607.5(b) of the final

regulation refers to a waiver granted

under § 1607.6(c)(1). This reference is

incorrect.

Accordingly, the publication on

December 19, 1994, of the final

regulation which was the subject of FR

Doc. 94–31043 is corrected as follows:

§ 1607.5 [Corrected]

On page 65256, in the first column, in

§ 1607.5, paragraph (b) is corrected to

read as follows:

‘‘Pursuant to a waiver granted under

§ 1607.6(b)(1), a recipient may adopt

policies that would permit partners or

associates of attorney members to

participate in any compensated private

attorney involvement activities

supported by the recipient.’’

Dated: January 3, 1995.

Victor M. Fortuno,

General Counsel.

[FR Doc. 95–378 Filed 1–6–95; 8:45 am]

BILLING CODE 7050–01–P

DEPARTMENT OF DEFENSE

48 CFR Part 231

Defense Federal Acquisition

Regulation Supplement; Allowable

Individual Compensation

AGENCY: Department of Defense (DoD).

ACTION: Interim rule with request for

comments.

SUMMARY: The Director of Defense

Procurement has issued an interim rule

that places a ceiling on allowable

individual compensation under DoD

contracts.

DATES: Effective date: December 14,

1994.

Comment date: Comments on the

interim rule should be submitted in

writing at the address shown below on

or before March 10, 1995, to be

considered in the formulation of a final

rule.

ADDRESSES: Interested parties should

submit written comments to: Defense

Acquisition Regulations Council, ATTN:

Mr. Eric R. Mens, PDUSD(A&T)DP/DAR,

IMD 3D139, 3062 Defense Pentagon,

Washington, DC 20301–3062. Telefax

number (703) 602–0350. Please cite

DFARS Case 94–D318 in all

correspondence.

FOR FURTHER INFORMATION CONTACT:

Mr. Eric R. Mens, (703) 602–0131.

SUPPLEMENTARY INFORMATION:

A. Background

Section 8117 of the Department of

Defense Appropriations Act, 1995

(Public Law 103–335), limits allowable

costs for individual compensation to

$250,000 per year. This restriction

applies to DoD contracts awarded after

April 15, 1995, when payments are from

funds appropriated in fiscal year 1995.

The interim DFARS rule revises

DFARS Subpart 231.2, Contracts with

Commercial Organizations; Subpart

231.3, Contracts with Educational

Institutions; Subpart 231.6, Contracts

with State, Local, and Federally

Recognized Indian Tribal Governments;

and Subpart 231.7, Contracts with

Nonprofit Organizations to implement

the statutory ceiling on allowable

individual compensation costs. In

supplementing the cost principle at FAR

31.205–6, this DFARS rule relies upon

the same definition of compensation

found in the FAR cost principle, i.e.,

‘‘all remuneration paid currently or

accrued, in whatever form and whether

paid immediately or deferred, for

services rendered by employees to the

contractor.’’

B. Determination To Issue an Interim

Rule

A determination has been made under

the authority of the Secretary of Defense

to issue this rule as an interim rule.

Compelling reasons exist to promulgate

this rule without prior opportunity for

public comment because section 8117 of

the Defense Appropriations Act for

Fiscal Year 1995 (Public Law 103–335)

applies to DoD contracts awarded after

April 15, 1995, using funds

appropriated in FY 1995. An interim

rule will ensure that DoD contracting

activities become aware of the statutory

ceiling on allowable individual

compensation costs when forward

pricing contracts which will be awarded

after April 15, 1995, using FY 1995

funds. However, comments received in

response to the publication of this rule

will be considered in formulating the

final rule.

C. Regulatory Flexibility Act

The interim rule is not expected to

have a significant economic impact on

a substantial number of small entities

within the meaning of the Regulatory

Flexibility Act, 5 U.S.C. 601 et seq.,

because most small entities are not

subject to the contract cost principles in

FAR Part 31 or DFARS Part 231. The

contract cost principles normally apply

where contract award exceeds $500,000

and the price is based on certified cost

or pricing data. Most contracts awarded

to small entities are awarded on a

competitive, fixed-price basis. This

interim DFARS rule applies only to DoD

contractors which incur individual

compensation costs in excess of

$250,000 per year in performing new

contracts awarded after April 15, 1995,

using funds appropriated in FY 1995.

An Initial Regulatory Flexibility

Analysis has, therefore, not been

performed. Comments are invited from

small business entities and other

interested parties. Comments from small

entities concerning the affected DFARS

Subparts will also be considered in

accordance with section 610 of the Act.

Such comments must be submitted

separately and cite DFARS Case 94–

D318 in correspondence.