80 FR 75680 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2016
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 80, Issue 232 (December 3, 2015)
Centers for Medicare & Medicaid Services
Federal Register Volume 80, Issue 232 (December 3, 2015)
| Page Range | 75680-75681 | |
| FR Document | 2015-30686 |
[Federal Register Volume 80, Number 232 (Thursday, December 3, 2015)] [Notices] [Pages 75680-75681] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-30686] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6066-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2016 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: This notice announces a $554.00 calendar year (CY) 2016 application fee for institutional providers that are initially enrolling in the Medicare or Medicaid program or the Children's Health Insurance Program (CHIP); revalidating their Medicare, Medicaid, or CHIP enrollment; or adding a new Medicare practice location. This fee is required with any enrollment application submitted on or after January 1, 2016 and on or before December 31, 2016. DATES: This notice is effective on January 1, 2016. FOR FURTHER INFORMATION CONTACT: Frank Whelan, (410) 786-1302. SUPPLEMENTARY INFORMATION: I. Background In the February 2, 2011 Federal Register (76 FR 5862), we published a final rule with comment period titled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers.'' This rule finalized, among other things, provisions related to the submission of application fees as part of the Medicare, Medicaid, and CHIP provider enrollment processes. As provided in section 1866(j)(2)(C)(i) of the Social Security Act (the Act) (as amended by section 6401 of the Affordable Care Act) and in 42 CFR 424.514, ``institutional providers'' that are initially enrolling in the Medicare or Medicaid programs or CHIP, revalidating their enrollment, or adding a new Medicare practice location are required to submit a fee with their enrollment application. An ``institutional provider'' for purposes of Medicare is defined at Sec. 424.502 as ``(a)ny provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (not including physician and non-physician practitioner organizations), CMS-855S, or associated Internet-based PECOS enrollment application.'' As we explained in the February 2, 2011 final rule (76 FR 5914), in addition to the providers and suppliers subject to the application fee under Medicare, Medicaid-only, and CHIP- only institutional providers would include nursing facilities, intermediate care facilities for persons with intellectual disabilities (ICF/IID), psychiatric residential treatment facilities, and may include other institutional provider types designated by a state in accordance with their approved state plan. As indicated in Sec. Sec. 424.514 and Sec. 455.460, the application fee is not required for either of the following:A Medicare physician or non-physician practitioner submitting a CMS-855I. A prospective or revalidating Medicaid or CHIP provider-- ++ Who is an individual physician or non-physician practitioner; or ++ That is enrolled in Title XVIII of the Act or another state's Title XIX or XXI plan and has paid the application fee to a Medicare contractor or another state. II. Provisions of the Notice A. CY 2015 Fee Amount In the December 5, 2014 Federal Register (79 FR 72183), we published a notice announcing a fee amount for the period of January 1, 2015 through December 31, 2015 of $553.00. This figure was calculated as follows: Section 1866(j)(2)(C)(i)(I) of the Act established a $500 application fee for institutional providers in CY 2010. Consistent with section 1866(j)(2)(C)(i)(II) of the Act, Sec. 424.514(d)(2) states that for CY 2011 and subsequent years, the preceding year's fee will be adjusted by the percentage change in the consumer price index (CPI) for all urban consumers (all items; United States city average, CPI-U) for the 12-month period ending on June 30 of the previous year. The CPI-U increase for CY 2011 was 1.0 percent, based on data obtained from the Bureau of Labor Statistics (BLS). This resulted in an application fee amount for CY 2011 of $505 (or $500 x 1.01). The CPI-U increase for the period of July 1, 2010 through June 30, 2011 was 3.54 percent, based on BLS data. This resulted in an application fee amount for CY 2012 of $522.87 (or $505 x 1.0354). In the aforementioned February 2, 2011 final rule, we stated that if the adjustment sets the fee at an uneven dollar amount, we would round the fee to the nearest whole dollar amount. Accordingly, the application fee amount for CY 2012 was rounded to the nearest whole dollar amount, or $523.00. The CPI-U increase for the period of July 1, 2011 through June 30, 2012 was 1.664 percent, based on BLS data. This resulted in an application fee amount for CY 2013 of $531.70 ($523 x 1.01664). Rounding this figure to the nearest whole dollar amount resulted in a CY 2013 application fee amount of $532.00. The CPI-U increase for the period of July 1, 2012 through June 30, 2013 was 1.8 percent, based on BLS data. This resulted in an application fee amount for CY 2014 of $541.576 ($532 x 1.018). Rounding this figure to the nearest whole dollar amount resulted in a CY 2014 application fee amount of $542.00. The CPI-U increase for the period of July 1, 2013 through June 30, 2014 was 2.1 percent, based on BLS data. This resulted in an application fee amount for CY 2015 of $553.382 ($542 x 1.021). Rounding this figure to the nearest whole dollar amount resulted in a CY 2015 application fee amount of $553.00. B. CY 2016 Fee Amount Using BLS data, the CPI-U increase for the period of July 1, 2014 through June 30, 2015 was 0.2 percent. This results in a CY 2016 application fee amount of $554.106 ($553 x 1.002). As we must round this to the nearest whole dollar amount, the resultant application fee amount for CY 2016 is $554.00. III. Collection of Information Requirements This document does not impose information collection requirements, that is, reporting, recordkeeping, or third-party disclosure requirements. Consequently, there is no need for review by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995. However, it does reference previously approved information collections. The forms CMS-855A, CMS-855B, and CMS-855I are approved under OMB [[Page 75681]] control number 0938-0685; the CMS-855S is approved under OMB control number 0938-1056. IV. Regulatory Impact Statement A. Background We have examined the impact of this notice as required by Executive Order 12866 on Regulatory Planning and Review (September 30, 1993), Executive Order 13563 on Improving Regulation and Regulatory Review (January 18, 2011), the Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-354), section 1102(b) of the Social Security Act, section 202 of the Unfunded Mandates Reform Act of 1995 (March 22, 1995; Pub. L. 104-4), Executive Order 13132 on Federalism (August 4, 1999), and the Congressional Review Act (5 U.S.C. 804(2)). Executive Orders 12866 and 13563 direct agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits, including potential economic, environmental, public health and safety effects, distributive impacts, and equity. A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). As explained in this section of the notice, we estimate that the total cost of the increase in the application fee will not exceed $100 million. Therefore, this notice does not reach the $100 million economic threshold and is not considered a major notice. B. Costs The costs associated with this notice involve the increase in the application fee amount that certain providers and suppliers must pay in CY 2016. 1. Estimates of Number of Affected Institutional Providers in December 5, 2014 Fee Notice In the December 5, 2014 application fee notice, we estimated that based on CMS statistics-- 10,000 newly enrolling Medicare institutional providers would be subject to and pay an application fee in CY 2015. 35,000 revalidating Medicare institutional providers would be subject to and pay an application fee in CY 2015. 8,438 newly enrolling Medicaid and CHIP providers would be subject to and pay an application fee in CY 2015. 19,421 revalidating Medicaid and CHIP providers would be subject to and pay an application fee in CY 2015. 2. CY 2016 Estimates a. Medicare Based on CMS data, we estimate that in CY 2016 approximately-- 10,000 newly enrolling institutional providers will be subject to and pay an application fee; and 45,000 revalidating institutional providers will be subject to and pay an application fee. Using a figure of 55,000 (10,000 newly enrolling + 45,000 revalidating) institutional providers, we estimate an increase in the cost of the Medicare application fee requirement in CY 2016 of $5,585,000 (or (10,000 additional newly enrolling or revalidating institutional providers x $554) + (45,000 x $1.00) from our CY 2015 projections and as previously described. b. Medicaid and CHIP Based on CMS and state statistics, we estimate that approximately 30,000 (9,000 newly enrolling + 21,000 revalidating) Medicaid and CHIP institutional providers will be subject to an application fee in CY 2016. Using this figure, we project an increase in the cost of the Medicaid and CHIP application fee requirement in CY 2016 of $1,213,973 (or ((562 additional newly enrolling institutional providers + 1,579 additional revalidating institutional providers, or 2,141 total additional institutional providers) x $554) + 27,859 x $1.00) from our CY 2015 projections and as previously described. c. Total Based on the foregoing, we estimate the total increase in the cost of the application fee requirement for Medicare, Medicaid, and CHIP providers and suppliers in CY 2016 to be $6,798,973 ($5,585,000 + $1,213,973) from our CY 2015 projections. The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and small governmental jurisdictions. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of less than $7.5 million to $38.5 million in any 1 year. Individuals and states are not included in the definition of a small entity. As we stated in the RIA for the February 2, 2011 final rule with comment period (76 FR 5952), we do not believe that the application fee will have a significant impact on small entities. In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule 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 for Medicare payment regulations and has fewer than 100 beds. We are not preparing an analysis for section 1102(b) of the Act because we have determined, and the Secretary certifies, that this notice would not have a significant impact on the operations of a substantial number of small rural hospitals. Section 202 of the Unfunded Mandates Reform Act of 1995 (UMRA) also requires that agencies assess anticipated costs and benefits before issuing any rule whose mandates require spending in any 1 year of $100 million in 1995 dollars, updated annually for inflation. In 2015, that threshold is approximately $144 million. The Agency has determined that there will be minimal impact from the costs of this notice, as the threshold is not met under the UMRA. Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on state and local governments, preempts state law, or otherwise has federalism implications. Since this notice does not impose substantial direct costs on state or local governments, the requirements of Executive Order 13132 are not applicable. In accordance with the provisions of Executive Order 12866, this notice was reviewed by the Office of Management and Budget. Dated: November 14, 2015. Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services. [FR Doc. 2015-30686 Filed 12-2-15; 8:45 am] BILLING CODE 4120-01-P
![75680 Federal Register / Vol. 80, No. 232 / Thursday, December 3, 2015 / Notices
has 90 days from the effective date of the Medicare or Medicaid programs or (BLS). This resulted in an application
delisting and revocation to complete the CHIP, revalidating their enrollment, or fee amount for CY 2011 of $505 (or $500
disposition of PSWP that is currently in adding a new Medicare practice location × 1.01).
the PSO’s possession. are required to submit a fee with their • The CPI–U increase for the period
More information on PSOs can be enrollment application. An of July 1, 2010 through June 30, 2011
obtained through AHRQ’s PSO Web site ‘‘institutional provider’’ for purposes of was 3.54 percent, based on BLS data.
at http://www.pso.ahrq.gov/. Medicare is defined at § 424.502 as This resulted in an application fee
‘‘(a)ny provider or supplier that submits amount for CY 2012 of $522.87 (or $505
Sharon B. Arnold,
a paper Medicare enrollment × 1.0354). In the aforementioned
AHRQ Deputy Director. February 2, 2011 final rule, we stated
application using the CMS–855A, CMS–
[FR Doc. 2015–30586 Filed 12–2–15; 8:45 am] that if the adjustment sets the fee at an
855B (not including physician and non-
BILLING CODE 4160–90–P physician practitioner organizations), uneven dollar amount, we would round
CMS–855S, or associated Internet-based the fee to the nearest whole dollar
PECOS enrollment application.’’ As we amount. Accordingly, the application
DEPARTMENT OF HEALTH AND explained in the February 2, 2011 final fee amount for CY 2012 was rounded to
HUMAN SERVICES rule (76 FR 5914), in addition to the the nearest whole dollar amount, or
providers and suppliers subject to the $523.00.
Centers for Medicare & Medicaid • The CPI–U increase for the period
Services application fee under Medicare,
Medicaid-only, and CHIP-only of July 1, 2011 through June 30, 2012
[CMS–6066–N] institutional providers would include was 1.664 percent, based on BLS data.
nursing facilities, intermediate care This resulted in an application fee
Medicare, Medicaid, and Children’s facilities for persons with intellectual amount for CY 2013 of $531.70 ($523 ×
Health Insurance Programs; Provider disabilities (ICF/IID), psychiatric 1.01664). Rounding this figure to the
Enrollment Application Fee Amount for residential treatment facilities, and may nearest whole dollar amount resulted in
Calendar Year 2016 include other institutional provider a CY 2013 application fee amount of
AGENCY: Centers for Medicare & types designated by a state in $532.00.
accordance with their approved state • The CPI–U increase for the period
Medicaid Services (CMS), HHS.
plan. of July 1, 2012 through June 30, 2013
ACTION: Notice.
As indicated in §§ 424.514 and was 1.8 percent, based on BLS data.
SUMMARY: This notice announces a § 455.460, the application fee is not This resulted in an application fee
$554.00 calendar year (CY) 2016 required for either of the following: amount for CY 2014 of $541.576 ($532
application fee for institutional • A Medicare physician or non- × 1.018). Rounding this figure to the
providers that are initially enrolling in physician practitioner submitting a nearest whole dollar amount resulted in
the Medicare or Medicaid program or CMS–855I. a CY 2014 application fee amount of
the Children’s Health Insurance • A prospective or revalidating $542.00.
Program (CHIP); revalidating their Medicaid or CHIP provider— • The CPI–U increase for the period
Medicare, Medicaid, or CHIP ++ Who is an individual physician or of July 1, 2013 through June 30, 2014
enrollment; or adding a new Medicare non-physician practitioner; or was 2.1 percent, based on BLS data.
practice location. This fee is required ++ That is enrolled in Title XVIII of This resulted in an application fee
with any enrollment application the Act or another state’s Title XIX or amount for CY 2015 of $553.382 ($542
submitted on or after January 1, 2016 XXI plan and has paid the application × 1.021). Rounding this figure to the
and on or before December 31, 2016. fee to a Medicare contractor or another nearest whole dollar amount resulted in
state. a CY 2015 application fee amount of
DATES: This notice is effective on
$553.00.
January 1, 2016. II. Provisions of the Notice
FOR FURTHER INFORMATION CONTACT: B. CY 2016 Fee Amount
Frank Whelan, (410) 786–1302. A. CY 2015 Fee Amount
Using BLS data, the CPI–U increase
SUPPLEMENTARY INFORMATION: In the December 5, 2014 Federal for the period of July 1, 2014 through
Register (79 FR 72183), we published a June 30, 2015 was 0.2 percent. This
I. Background notice announcing a fee amount for the results in a CY 2016 application fee
In the February 2, 2011 Federal period of January 1, 2015 through amount of $554.106 ($553 × 1.002). As
Register (76 FR 5862), we published a December 31, 2015 of $553.00. This we must round this to the nearest whole
final rule with comment period titled figure was calculated as follows: dollar amount, the resultant application
‘‘Medicare, Medicaid, and Children’s • Section 1866(j)(2)(C)(i)(I) of the Act fee amount for CY 2016 is $554.00.
Health Insurance Programs; Additional established a $500 application fee for
Screening Requirements, Application institutional providers in CY 2010. III. Collection of Information
Fees, Temporary Enrollment Moratoria, • Consistent with section Requirements
Payment Suspensions and Compliance 1866(j)(2)(C)(i)(II) of the Act, This document does not impose
Plans for Providers and Suppliers.’’ This § 424.514(d)(2) states that for CY 2011 information collection requirements,
rule finalized, among other things, and subsequent years, the preceding that is, reporting, recordkeeping, or
provisions related to the submission of year’s fee will be adjusted by the third-party disclosure requirements.
application fees as part of the Medicare, percentage change in the consumer Consequently, there is no need for
Lhorne on DSK5TPTVN1PROD with NOTICES
Medicaid, and CHIP provider price index (CPI) for all urban review by the Office of Management and
enrollment processes. As provided in consumers (all items; United States city Budget under the authority of the
section 1866(j)(2)(C)(i) of the Social average, CPI–U) for the 12-month period Paperwork Reduction Act of 1995.
Security Act (the Act) (as amended by ending on June 30 of the previous year. However, it does reference previously
section 6401 of the Affordable Care Act) • The CPI–U increase for CY 2011 approved information collections. The
and in 42 CFR 424.514, ‘‘institutional was 1.0 percent, based on data obtained forms CMS–855A, CMS–855B, and
providers’’ that are initially enrolling in from the Bureau of Labor Statistics CMS–855I are approved under OMB
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![Federal Register / Vol. 80, No. 232 / Thursday, December 3, 2015 / Notices 75681
control number 0938–0685; the CMS– 2. CY 2016 Estimates significant impact on the operations of
855S is approved under OMB control a. Medicare a substantial number of small rural
number 0938–1056. hospitals. This analysis must conform to
Based on CMS data, we estimate that the provisions of section 604 of the
IV. Regulatory Impact Statement in CY 2016 approximately— RFA. For purposes of section 1102(b) of
A. Background • 10,000 newly enrolling institutional the Act, we define a small rural hospital
providers will be subject to and pay an as a hospital that is located outside of
We have examined the impact of this application fee; and
notice as required by Executive Order a Metropolitan Statistical Area for
• 45,000 revalidating institutional Medicare payment regulations and has
12866 on Regulatory Planning and providers will be subject to and pay an
Review (September 30, 1993), Executive fewer than 100 beds. We are not
application fee. preparing an analysis for section 1102(b)
Order 13563 on Improving Regulation Using a figure of 55,000 (10,000 newly
and Regulatory Review (January 18, of the Act because we have determined,
enrolling + 45,000 revalidating) and the Secretary certifies, that this
2011), the Regulatory Flexibility Act institutional providers, we estimate an
(RFA) (September 19, 1980, Pub. L. 96– notice would not have a significant
increase in the cost of the Medicare impact on the operations of a substantial
354), section 1102(b) of the Social application fee requirement in CY 2016
Security Act, section 202 of the number of small rural hospitals.
of $5,585,000 (or (10,000 additional Section 202 of the Unfunded
Unfunded Mandates Reform Act of 1995 newly enrolling or revalidating Mandates Reform Act of 1995 (UMRA)
(March 22, 1995; Pub. L. 104–4), institutional providers × $554) + (45,000 also requires that agencies assess
Executive Order 13132 on Federalism × $1.00) from our CY 2015 projections anticipated costs and benefits before
(August 4, 1999), and the Congressional and as previously described.
Review Act (5 U.S.C. 804(2)). issuing any rule whose mandates
Executive Orders 12866 and 13563 b. Medicaid and CHIP require spending in any 1 year of $100
direct agencies to assess all costs and million in 1995 dollars, updated
Based on CMS and state statistics, we
benefits of available regulatory annually for inflation. In 2015, that
estimate that approximately 30,000
alternatives and, if regulation is threshold is approximately $144
(9,000 newly enrolling + 21,000
necessary, to select regulatory million. The Agency has determined
revalidating) Medicaid and CHIP
approaches that maximize net benefits, that there will be minimal impact from
institutional providers will be subject to
including potential economic, the costs of this notice, as the threshold
an application fee in CY 2016. Using
environmental, public health and safety is not met under the UMRA.
this figure, we project an increase in the
effects, distributive impacts, and equity. Executive Order 13132 establishes
cost of the Medicaid and CHIP
A regulatory impact analysis (RIA) must certain requirements that an agency
application fee requirement in CY 2016
be prepared for major rules with must meet when it promulgates a
of $1,213,973 (or ((562 additional newly
economically significant effects ($100 proposed rule (and subsequent final
enrolling institutional providers + 1,579
million or more in any 1 year). As rule) that imposes substantial direct
additional revalidating institutional
explained in this section of the notice, requirement costs on state and local
providers, or 2,141 total additional
governments, preempts state law, or
we estimate that the total cost of the institutional providers) × $554) + 27,859
otherwise has federalism implications.
increase in the application fee will not × $1.00) from our CY 2015 projections
exceed $100 million. Therefore, this Since this notice does not impose
and as previously described.
notice does not reach the $100 million substantial direct costs on state or local
c. Total governments, the requirements of
economic threshold and is not
considered a major notice. Based on the foregoing, we estimate Executive Order 13132 are not
the total increase in the cost of the applicable.
B. Costs application fee requirement for In accordance with the provisions of
The costs associated with this notice Medicare, Medicaid, and CHIP Executive Order 12866, this notice was
involve the increase in the application providers and suppliers in CY 2016 to reviewed by the Office of Management
fee amount that certain providers and be $6,798,973 ($5,585,000 + $1,213,973) and Budget.
suppliers must pay in CY 2016. from our CY 2015 projections. Dated: November 14, 2015.
The RFA requires agencies to analyze Andrew M. Slavitt,
1. Estimates of Number of Affected options for regulatory relief of small
Institutional Providers in December 5, Acting Administrator, Centers for Medicare
businesses. For purposes of the RFA, & Medicaid Services.
2014 Fee Notice small entities include small businesses, [FR Doc. 2015–30686 Filed 12–2–15; 8:45 am]
In the December 5, 2014 application nonprofit organizations, and small BILLING CODE 4120–01–P
fee notice, we estimated that based on governmental jurisdictions. Most
CMS statistics— hospitals and most other providers and
• 10,000 newly enrolling Medicare suppliers are small entities, either by DEPARTMENT OF HEALTH AND
institutional providers would be subject nonprofit status or by having revenues HUMAN SERVICES
to and pay an application fee in CY of less than $7.5 million to $38.5
2015. million in any 1 year. Individuals and Food and Drug Administration
• 35,000 revalidating Medicare states are not included in the definition
institutional providers would be subject [Docket No. FDA–2014–D–2175]
of a small entity. As we stated in the
to and pay an application fee in CY RIA for the February 2, 2011 final rule Recommendations for Assessment of
Lhorne on DSK5TPTVN1PROD with NOTICES
2015. with comment period (76 FR 5952), we Blood Donor Suitability, Donor Deferral
• 8,438 newly enrolling Medicaid and do not believe that the application fee and Blood Product Management in
CHIP providers would be subject to and will have a significant impact on small Response to Ebola Virus; Draft
pay an application fee in CY 2015. entities. Guidance for Industry; Availability
• 19,421 revalidating Medicaid and In addition, section 1102(b) of the Act
CHIP providers would be subject to and requires us to prepare a regulatory AGENCY: Food and Drug Administration,
pay an application fee in CY 2015. impact analysis if a rule may have a HHS.
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Document Created: 2015-12-14 13:51:38
Document Modified: 2015-12-14 13:51:38
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | This notice is effective on January 1, 2016. | |
| Contact | Frank Whelan, (410) 786-1302. | |
| FR Citation | 80 FR 75680 |
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