71082 Federal Register / Vol. 79, No. 230 / Monday, December 1, 2014 / Proposed Rules 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following Web 

site as soon as possible after they have 

been received: http://

www.regulations.gov. Follow the search 

instructions on that Web site to view 

public comments. 

Comments received timely will also 

be available for public inspection as 

they are received, generally beginning 

approximately 3 weeks after publication 

of a document, at the headquarters of 

the Centers for Medicare & Medicaid 

Services, 7500 Security Boulevard, 

Baltimore, Maryland 21244, Monday 

through Friday of each week from 8:30 

a.m. to 4 p.m. To schedule an 

appointment to view public comments, 

phone 1–800–743–3951. 

FOR FURTHER INFORMATION CONTACT: 

Danielle Shearer (410) 786–6617. 

Jacqueline Leach (410) 786–4282. Maria 

Hammel (410) 786–1775. 

SUPPLEMENTARY INFORMATION: On 

October 9, 2014, we published a 

proposed rule in the Federal Register 

(79 FR 61164) entitled, ‘‘Conditions of 

Participation for Home Health 

Agencies’’ that would revise the health 

and safety requirements that home 

health agencies (HHAs) must meet in 

order to participate in the Medicare and 

Medicaid programs. Specifically, the 

proposed requirements would focus on 

the care delivered to patients by home 

health agencies, reflect an 

interdisciplinary view of patient care, 

allow HHAs greater flexibility in 

meeting quality care standards, and 

eliminate unnecessary procedural 

requirements. In addition, we proposed 

a set of fundamental requirements for 

HHA services that would encompass 

patient rights, comprehensive patient 

assessment, and patient care planning 

and coordination by an interdisciplinary 

team. Overarching these requirements 

would be a quality assessment and 

performance improvement program that 

would build on the philosophy that a 

provider’s own quality management 

system is key to improved patient care 

performance. The objective would be to 

achieve a balanced regulatory approach 

by ensuring that a HHA furnished 

health care that met essential health and 

quality standards, while ensuring that it 

monitored and improved its own 

performance. These changes are an 

integral part of our overall effort to 

achieve broad-based, measurable 

improvements in the quality of care 

furnished through the Medicare and 

Medicaid programs, while at the same 

time eliminating unnecessary 

procedural burdens on providers. 

We have received inquiries from statebased and national industry 

organizations regarding the 60 day turnaround time to submit comments 

regarding this proposed rule. The 

organizations stated that they needed 

additional time to respond to the rule 

due to the complex nature of the 

proposed revisions. Because of the 

scope of the proposed rule, and since 

we have specifically requested the 

public’s comments on various aspect of 

the rule in an attempt to benefit from 

the vast experiences of the HHA 

provider and patient communities, we 

believe that it is important to allow 

ample time for all sections of the public 

to comment on this proposed rule. 

Therefore, we have decided to extend 

the comment period for an additional 30 

days. This document announces the 

extension of the public comment period 

to January 7, 2015. 

Dated: November 24, 2014. 

Marilyn Tavenner, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2014–28266 Filed 11–28–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Coast Guard 

46 CFR Part 401 

[USCG–2014–0481; 1625–AC22] 

Great Lakes Pilotage Rates—2015 

Annual Review and Adjustment— 

Extension of Comment Period 

AGENCY: Coast Guard, DHS. 

ACTION: Notice. 

SUMMARY: The Coast Guard is extending 

the comment period for the notice of 

proposed rulemaking (NPRM) entitled 

‘‘Great Lakes Pilotage Rates—2015 

Annual Review and Adjustment,’’ 

published on September 4, 2014, for 30 

days. We have decided to extend the 

comment period as we have received 

new financial data that could affect the 

discretion provided by Step 7 of the 

Appendix A methodology and the final 

rate. 

DATES: Comments and related material 

must either be submitted to our online 

docket via http://www.regulations.gov 

on or before December 31, 2014 or reach 

the Docket Management Facility by that 

date. 

ADDRESSES: You may submit comments 

identified by docket number USCG– 

2014–0481 using any one of the 

following methods: 

(1) Federal eRulemaking Portal: 

http://www.regulations.gov. 

(2) Fax: 202–493–2251. 

(3) Mail: Docket Management Facility 

(M–30), U.S. Department of 

Transportation, West Building Ground 

Floor, Room W12–140, 1200 New Jersey 

Avenue SE., Washington, DC 20590– 

0001. 

(4) Hand delivery: Same as mail 

address above, between 9 a.m. and 5 

p.m., Monday through Friday, except 

Federal holidays. The telephone number 

is 202–366–9329. 

To avoid duplication, please use only 

one of these four methods. See the 

‘‘Public Participation and Request for 

Comments’’ portion of the 

SUPPLEMENTARY INFORMATION section 

below for instructions on submitting 

comments. 

FOR FURTHER INFORMATION CONTACT: If 

you have questions on this notice, call 

or email Mr. Todd Haviland, Director, 

Great Lakes Pilotage, Commandant (CG– 

WWM–2), Coast Guard; telephone 202– 

372–2037, email Todd.A.Haviland@

uscg.mil, or fax 202–372–1914. If you 

have questions on viewing or submitting 

material to the docket, call Ms. Cheryl 

Collins, Program Manager, Docket 

Operations, telephone 202–366–9826. 

SUPPLEMENTARY INFORMATION: 

I. Public Participation and Request for 

Comments 

We encourage you to participate in 

this rulemaking by submitting 

comments and related materials. All 

comments received will be posted 

without change to http://

www.regulations.gov and will include 

any personal information you have 

provided. 

A. Submitting Comments 

If you submit a comment, please 

include the docket number for this 

rulemaking (USCG–2014–0481), 

indicate the specific section of this 

document to which each comment 

applies, and provide a reason for each 

suggestion or recommendation. You 

may submit your comments and 

material online or by fax, mail, or hand 

delivery, but please use only one of 

these means. We recommend that you 

include your name and a mailing 

address, an email address, or a phone 

number in the body of your document 

so that we can contact you if we have 

questions regarding your submission. 

To submit your comment online, go to 

http://www.regulations.gov and insert 

‘‘USCG–2014–0481’’ in the ‘‘Search’’ 


asabaliauskas on DSK5VPTVN1PROD with PROPOSALS
Federal Register / Vol. 79, No. 230 / Monday, December 1, 2014 / Proposed Rules 71083 

box. Click on ‘‘Submit a Comment’’ in 

the ‘‘Actions’’ column. If you submit 

your comments by mail or hand 

delivery, submit them in an unbound 

format, no larger than 81⁄2 by 11 inches, 

suitable for copying and electronic 

filing. If you submit comments by mail 

and would like to know that they 

reached the Facility, please enclose a 

stamped, self-addressed postcard or 

envelope. 

We will consider all comments and 

material received during the comment 

period and may change this notice of 

proposed rulemaking (NPRM) based on 

your comments. 

B. Viewing Comments and Documents 

To view comments, as well as 

documents mentioned in this preamble 

as being available in the docket, go to 

http://www.regulations.gov and insert 

‘‘USCG–2014–0481’’ in the ‘‘Search’’ 

box. Click ‘‘Search.’’ Click the ‘‘Open 

Docket Folder’’ in the ‘‘Actions’’ 

column. If you do not have access to the 

Internet, you may view the docket 

online by visiting the Docket 

Management Facility in Room W12–140 

on the ground floor of the Department 

of Transportation West Building, 1200 

New Jersey Avenue SE., Washington, 

DC 20590, between 9 a.m. and 5 p.m., 

Monday through Friday, except Federal 

holidays. We have an agreement with 

the Department of Transportation to use 

the Docket Management Facility. 

C. Privacy Act 

Anyone can search the electronic 

form of comments received into any of 

our dockets by the name of the 

individual submitting the comment (or 

signing the comment, if submitted on 

behalf of an association, business, labor 

union, etc.). You may review a Privacy 

Act notice regarding our public dockets 

in the January 17, 2008 issue of the 

Federal Register (73 FR 3316). 

II. Regulatory History and Information 

The Coast Guard published an NPRM 

entitled ‘‘Great Lakes Pilotage Rates— 

2015 Annual Review and Adjustment,’’ 

on September 4, 2014, (79 FR 52602) 

proposing rate adjustments for pilotage 

services on the Great Lakes, last 

amended in March 2014. The proposed 

adjustments would establish new base 

rates made in accordance with a full 

ratemaking procedure. Additionally, the 

Coast Guard proposed to exercise the 

discretion provided by Step 7 of the 

Appendix A methodology to result in an 

upward adjustment to match the rate 

increase of the Canadian Great Lakes 

Pilotage Authority. The NPRM also 

proposed temporary surcharges to 

accelerate recoupment of necessary and 

reasonable training costs for the pilot 

associations. All comments on this 

NPRM were originally due by November 

3, 2014. 

III. Background and Purpose 

On November 14, 2014, we received 

the final reports of the revenue audits 

conducted by CohnReznick, LLP for the 

three pilotage districts. Performance of 

these audits was unanimously 

recommended by the Great Lakes 

Pilotage Advisory Committee to the 

Coast Guard at the most recent 

committee meeting on July 23–24, 2014, 

in Washington, DC. The data found by 

the revenue audits are important to 

analyzing the proposed rule as the 

findings may alter the final rate. We 

believe that the data provided in the 

revenue audits are ‘‘other supportable 

circumstances’’ that may alter the rate 

through the discretion provided by Step 

7 of the ratemaking methodology. As 

these revenue audits were received after 

the comment period closed, we wish to 

give commenter’s the opportunity to 

review these revenue audits, which can 

be found in the docket, and make 

comments on the revenue audits. 

V. Authority 

This notice is issued under authority 

of 5 U.S.C. 552(a). 

Dated: November 25, 2014. 

Scott J. Smith, 

Captain, U.S. Coast Guard, Acting Director 

of Marine Transportation Systems, U.S. Coast 

Guard. 

[FR Doc. 2014–28272 Filed 11–28–14; 8:45 am] 

BILLING CODE 9110–04–P 


asabaliauskas on DSK5VPTVN1PROD with PROPOSALS