80 FR 79343 - Medicare Program; Request for Information Regarding the Awarding and the Administration of Medicare Administrative Contractor Contracts
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 80, Issue 244 (December 21, 2015)
Centers for Medicare & Medicaid Services
Federal Register Volume 80, Issue 244 (December 21, 2015)
| Page Range | 79343-79345 | |
| FR Document | 2015-32027 |
[Federal Register Volume 80, Number 244 (Monday, December 21, 2015)] [Notices] [Pages 79343-79345] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-32027] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1653-NC] Medicare Program; Request for Information Regarding the Awarding and the Administration of Medicare Administrative Contractor Contracts AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Request for information. ----------------------------------------------------------------------- SUMMARY: This request for information solicits public comment on the processes and procedures that we could use to leverage new legal authorities to-- incentivize and reward exceptional Medicare Administrative Contractor (MAC) contract performance; publish performance information on each MAC, [[Page 79344]] to the extent permitted by law; and make MAC jurisdictional changes. DATES: To be assured consideration, written or electronic comments must be received at one of the addresses provided below, no later than 5 p.m. on February 19, 2016. ADDRESSES: In commenting, refer to file code CMS-1653-NC. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in one of four ways (please choose only one of the ways listed): 1. Electronically. You may submit electronic comments on this regulation to http://www.regulations.gov. Follow the ``Submit a comment'' instructions. 2. By regular mail. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1653-NC, P.O. Box 8013, Baltimore, MD 21244-8013. Please allow sufficient time for mailed comments to be received before the close of the comment period. 3. By express or overnight mail. You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1653-NC, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. 4. By hand or courier. Alternatively, you may deliver (by hand or courier) your written comments ONLY to the following addresses: a. For delivery in Washington, DC--Centers for Medicare & Medicaid Services, Department of Health and Human Services, Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201. (Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without Federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.) b. For delivery in Baltimore, MD--Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244-1850. If you intend to deliver your comments to the Baltimore address, call telephone number (410) 786-9994 in advance to schedule your arrival with one of our staff members. Comments erroneously mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period. FOR FURTHER INFORMATION CONTACT: Debra Bowman, (410) 786-4941. Phyllis Atkins-Mackey, (410) 786-9362. Megan Martino, (215) 861-4425. Sue Pelella, (215) 861-4245. SUPPLEMENTARY INFORMATION: Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any 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. I. Background For several decades after Medicare's inception in 1966, private health care insurers, known as Part A Fiscal Intermediaries (FI) and Part B carriers, processed medical claims for Medicare beneficiaries. Section 911 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173) added section 1874A to the Social Security Act (the Act) to require the Secretary of Health and Human Services (the Secretary) to replace Part A FIs and Part B carriers with Medicare Administrative Contractors (MACs). This contracting reform was intended to improve Medicare's administrative services to beneficiaries and health care providers through the use of new contracting tools, including competition and performance incentives. Currently, we award MAC contracts through use of competitive procedures in accordance with the Federal Acquisition Regulation (FAR). As authorized by the MMA, we established MACs as multistate, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims. The transition from the Part A FIs and Part B carriers to MACs began in 2006, and the last FI and carrier contractor operations ended by September 2013. We rely on a network of 16 MACs to process Medicare claims, including 12 MACs that administer both Part A and Part B claims and 4 MACs that specialize in administering Part B claims for durable medical equipment, prosthetics, orthotics, and supplies. MACs serve as the primary operational contact between the Medicare Fee-For-Service (FFS) program and approximately 1.5 million health care providers and suppliers enrolled in the program. MACs process Medicare claims, enroll health care providers and suppliers in the Medicare program, educate providers and suppliers on Medicare billing requirements, and answer provider and supplier inquiries. Collectively, the MACs process nearly 4.9 million Medicare claims each business day and disburse more than $365 billion annually in program payments. Section 509(a) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (Pub. L. 114-10) extended the maximum length of a MAC contract, inclusive of all option and renewal periods, from 5 years to 10 years. Section 509(c) of MACRA added a clause to section 1874A(b)(3)(A) of the Act that requires the Secretary, to the extent possible without compromising the process for entering into and renewing contracts with MACs, to make available to the public the performance of each MAC with respect to such performance requirements and measurement standards. II. Provisions of the Request for Information The Government Accountability Office (GAO) has recently noted that, now that we have accomplished the major milestone of fully implementing and transitioning to the MAC environment, we have the opportunity to consider whether some additional contracting mechanisms could be utilized to further improve MAC performance. Consistent with the new authority provided under MACRA and the recommendation provided by GAO, we are evaluating numerous elements of our MAC acquisition strategy, including potential adjustments to our MAC contract terms and conditions. The scope of our evaluation includes the processes and procedures that we use for awarding the MAC contracts and administering the MAC contracts after award. We currently use a cost-plus-award-fee contract type for the MAC contracts, meaning that MACs are financially incentivized and rewarded with [[Page 79345]] additional fee/profit for exceptional performance in areas critical to the success of the Medicare FFS program. For example, and specific to provider satisfaction, we currently measure, evaluate, and reward MACs for the quality (accuracy, completeness, customer skills, and adherence to the Privacy Act of 1974) of their customer service representatives' responses to provider telephone calls and the providers' level of satisfaction with the MAC's Web site. The amount of award fee earned by the MAC is based on our comprehensive evaluation of the MAC's performance against specific, written quality measures and evaluation criteria. Prior to the enactment of MACRA, the law required that MAC contracts be recompeted no less frequently than once every 5 years, which created the potential for frequent turnover in these critical contracts and disruption for Medicare providers and suppliers. With the enactment of MACRA, we are now able to renew a MAC contract for up to 10 years and reduce the potential for frequent turnover if the MAC meets or exceeds our performance objectives; conversely, we may still utilize competitive procedures sooner than 10 years in the event that a MAC does not meet our performance objectives. In concert with or in (partial or full) replacement of our award fee process, we are considering incorporating an ``award term'' concept into MAC contracting, meaning that we may incentivize and reward consistently, well-performing MACs with a longer-term contract (but not longer than 10 years). For example, MACs that consistently exceed our performance standards may be rewarded with a longer-term contract (up to 10 years); whereas, MACs that do not consistently exceed our performance standards may be limited to a shorter-term contract (more or less than 5 years). Therefore, we are soliciting public comment on the following questions regarding MAC incentives for exceptional performance:Do you have any concerns or suggestions related to development of a potential ``award term'' strategy and plan? Do you have any other suggestions for incentivizing and rewarding exceptional MAC performance? Are there any specific metrics or evaluation criteria that would be valuable in measuring the level and quality of the service provided by a MAC? Are there any specific metrics or evaluation criteria that would be valuable in measuring the level and quality of the MAC's relationships (including education and outreach) with providers? Section 509(c) of MACRA directs us to make some MAC performance metrics available to the public, to the extent that doing so can be done in a manner that does not compromise the competitive procurement process. Therefore, we are requesting comment on the following questions regarding MAC performance transparency: With regard to the MAC's quality and level of service and performance, what types or kinds of information should be published for public release? If we were to publish the results of the evaluation of a MAC's performance on our Web site, which types of metrics or information should be made available for public release? We are also soliciting public comment on potential MAC jurisdictional changes. Currently, there are 12 A/B MAC jurisdictions; in 2010, we announced a plan to consolidate FFS claims operations to 10 A/B MAC jurisdictions over the course of several years. However, in 2014, we announced that we were postponing the consolidation of Jurisdictions 8 (which encompasses the states of Indiana and Michigan) and 15 (which encompasses Kentucky and Ohio) to form ``Jurisdiction I'' and the consolidation of Jurisdictions 5 (Iowa, Kansas, Missouri and Nebraska) and 6 (Illinois, Minnesota, and Wisconsin) to form ``Jurisdiction G.'' For more information on our 2010 strategy for consolidating A/B MAC jurisdictions, as well as our 2014 decision to postpone the final 2 jurisdictional consolidations, see https://www.cms.gov/Medicare/Medicare-Contracting/Medicare-Administrative-Contractors/Downloads/RFI-Announcement-AB-MAC-March-2014.pdf Accordingly, we are requesting comment on the following question: What would the advantages and disadvantages be if CMS completed the last two MAC consolidations? III. Collection of Information Requirements This request for information document does not impose any information collection requirements. In accordance with the implementing regulations of the Paperwork Reduction Act of 1995 (PRA) at 5 CFR 1320.3(h)(4), we believe it is a general solicitation of comments from the public. Therefore, it is exempt from the requirements of the PRA (44 U.S.C. 3501 et seq.). IV. Response to Comments Because of the large number of public comments we normally receive on Federal Register documents, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, when we issue a subsequent document, we will respond to the comments in the preamble to that document. Dated: November 23, 2015. Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services. [FR Doc. 2015-32027 Filed 12-18-15; 8:45 am] BILLING CODE 4120-01-P
![Federal Register / Vol. 80, No. 244 / Monday, December 21, 2015 / Notices 79343
DEPARTMENT OF HEALTH AND added section 2126 to the Public Health Revised Vaccine Information Materials
HUMAN SERVICES Service Act. Section 2126, codified at 42 The multiple pediatric vaccines
U.S.C. 300aa–26, requires the Secretary information materials referenced in this
Centers for Disease Control and of Health and Human Services to notice were developed in consultation
Prevention develop and disseminate vaccine with the Advisory Commission on
[Docket No. CDC–2015–0001] information materials for distribution by Childhood Vaccines, the Food and Drug
all health care providers in the United Administration, and parent and
Final Revised Vaccine Information States to any patient (or to the parent or healthcare provider organizations.
Materials for Multiple Pediatric legal representative in the case of a Following consultation and review of
Vaccines (‘‘Your Child’s First child) receiving vaccines covered under comments submitted, the vaccine
Vaccines’’) the National Vaccine Injury information materials covering multiple
Compensation Program (VICP). pediatric vaccines (‘‘Your Child’s First
AGENCY: Centers for Disease Control and
Prevention (CDC), Department of Health Development and revision of the Vaccines’’) have been finalized and are
and Human Services (HHS) vaccine information materials, also available to download from http://www.
ACTION: Notice
known as Vaccine Information cdc.gov/vaccines/hcp/vis/index.html or
Statements (VIS), have been delegated http://www.regulations.gov (see Docket
SUMMARY: Under the National by the Secretary to the Centers for Number CDC–2015–0001). The Vaccine
Childhood Vaccine Injury Act Disease Control and Prevention (CDC). Information Statement (VIS) is ‘‘Your
(NCVIA)(42 U.S.C. 300aa–26), the CDC Section 2126 requires that the materials Child’s First Vaccines: What You Need
must develop vaccine information be developed, or revised, after notice to to Know’’ (publication date November 5,
materials that all health care providers the public, with a 60-day comment 2015).
are required to give to patients/parents period, and in consultation with the With publication of this notice, as of
prior to administration of specific Advisory Commission on Childhood March 1, 2016, all health care providers
vaccines. On January 9, 2015, CDC Vaccines, appropriate health care who choose to use the multiple
published a notice in the Federal provider and parent organizations, and pediatric vaccines Vaccine Information
Register (80 FR 1416) seeking public the Food and Drug Administration. The Statement (‘‘Your Child’s First
comments on proposed updated vaccine law also requires that the information Vaccines’’) when administering
information materials for multiple contained in the materials be based on multiple pediatric vaccines to any child
pediatric vaccines (‘‘Your Baby’s First available data and information, be in the United States shall provide copies
Vaccines’’). Following review of presented in understandable terms, and of the relevant vaccine information
comments submitted and consultation include: materials contained in this notice rather
as required under the law, CDC has than the previous edition (dated October
(1) A concise description of the
finalized the materials. A copy of the 22, 2014) in conformance with CDC’s
benefits of the vaccine,
final vaccine information materials for November 5, 2015 Instructions for the
multiple pediatric vaccines (‘‘Your (2) A concise description of the risks Use of Vaccine Information Statements.
Child’s First Vaccines’’) is available to associated with the vaccine,
Dated: December 16, 2015.
download from http://www.cdc.gov/ (3) A statement of the availability of Sandra Cashman,
vaccines/hcp/vis/index.html or http:// the National Vaccine Injury Executive Secretary, Centers for Disease
www.regulations.gov (see Docket Compensation Program, and Control and Prevention.
Number CDC–2015–0001). (4) Such other relevant information as [FR Doc. 2015–31990 Filed 12–18–15; 8:45 am]
DATES: Beginning no later than March 1, may be determined by the Secretary. BILLING CODE 4163–18–P
2016, each health care provider who
The vaccines initially covered under
chooses to use the multiple pediatric
the National Vaccine Injury
vaccines Vaccine Information Statement DEPARTMENT OF HEALTH AND
Compensation Program were diphtheria,
(‘‘Your Child’s First Vaccines’’) when HUMAN SERVICES
tetanus, pertussis, measles, mumps,
administering multiple pediatric
rubella and poliomyelitis vaccines. Centers for Medicare & Medicaid
vaccines to any child in the United
Since April 15, 1992, any health care Services
States shall provide copies of the
provider in the United States who
relevant vaccine information materials
intends to administer one of these
contained in this notice rather than the [CMS–1653–NC]
covered vaccines is required to provide
previous edition (dated October 22,
copies of the relevant vaccine
2014) in conformance with the Medicare Program; Request for
information materials prior to
November 5, 2015 CDC Instructions for Information Regarding the Awarding
administration of any of these vaccines.
the Use of Vaccine Information and the Administration of Medicare
Since then, the following vaccines have
Statements prior to providing such Administrative Contractor Contracts
been added to the National Vaccine
vaccinations.
Injury Compensation Program, requiring AGENCY: Centers for Medicare &
FOR FURTHER INFORMATION CONTACT: use of vaccine information materials for Medicaid Services (CMS), HHS.
Suzanne Johnson-DeLeon (msj1@ them as well: Hepatitis B, Haemophilus ACTION: Request for information.
cdc.gov), National Center for influenzae type b (Hib), varicella
Immunization and Respiratory Diseases,
mstockstill on DSK4VPTVN1PROD with NOTICES
(chickenpox), pneumococcal conjugate, SUMMARY: This request for information
Centers for Disease Control and rotavirus, hepatitis A, meningococcal, solicits public comment on the
Prevention, Mailstop A–19, 1600 Clifton human papillomavirus (HPV), and processes and procedures that we could
Road NE., Atlanta, Georgia 30329. seasonal influenza vaccines. use to leverage new legal authorities
SUPPLEMENTARY INFORMATION: The Instructions for use of the vaccine to— incentivize and reward exceptional
National Childhood Vaccine Injury Act information materials are found on the Medicare Administrative Contractor
of 1986 (Pub. L. 99–660), as amended by CDC Web site at: http://www.cdc.gov/ (MAC) contract performance; publish
section 708 of Public Law 103–183, vaccines/hcp/vis/index.html. performance information on each MAC,
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![Federal Register / Vol. 80, No. 244 / Monday, December 21, 2015 / Notices 79345
additional fee/profit for exceptional (including education and outreach) with Federal Register documents, we are not
performance in areas critical to the providers? able to acknowledge or respond to them
success of the Medicare FFS program. Section 509(c) of MACRA directs us individually. We will consider all
For example, and specific to provider to make some MAC performance metrics comments we receive by the date and
satisfaction, we currently measure, available to the public, to the extent that time specified in the DATES section of
evaluate, and reward MACs for the doing so can be done in a manner that this preamble, and, when we issue a
quality (accuracy, completeness, does not compromise the competitive subsequent document, we will respond
customer skills, and adherence to the procurement process. Therefore, we are to the comments in the preamble to that
Privacy Act of 1974) of their customer requesting comment on the following document.
service representatives’ responses to questions regarding MAC performance Dated: November 23, 2015.
provider telephone calls and the transparency: Andrew M. Slavitt,
providers’ level of satisfaction with the • With regard to the MAC’s quality
and level of service and performance, Acting Administrator, Centers for Medicare
MAC’s Web site. The amount of award
& Medicaid Services.
fee earned by the MAC is based on our what types or kinds of information
[FR Doc. 2015–32027 Filed 12–18–15; 8:45 am]
comprehensive evaluation of the MAC’s should be published for public release?
performance against specific, written • If we were to publish the results of BILLING CODE 4120–01–P
quality measures and evaluation the evaluation of a MAC’s performance
criteria. on our Web site, which types of metrics
Prior to the enactment of MACRA, the or information should be made available DEPARTMENT OF HEALTH AND
law required that MAC contracts be for public release? HUMAN SERVICES
recompeted no less frequently than once We are also soliciting public comment Food and Drug Administration
every 5 years, which created the on potential MAC jurisdictional
potential for frequent turnover in these changes. Currently, there are 12 A/B [Docket No. FDA–2015–N–0001]
critical contracts and disruption for MAC jurisdictions; in 2010, we
Medicare providers and suppliers. With announced a plan to consolidate FFS Allergenic Products Advisory
the enactment of MACRA, we are now claims operations to 10 A/B MAC Committee; Notice of Meeting
able to renew a MAC contract for up to jurisdictions over the course of several AGENCY: Food and Drug Administration,
10 years and reduce the potential for years. However, in 2014, we announced HHS.
frequent turnover if the MAC meets or that we were postponing the ACTION: Notice.
exceeds our performance objectives; consolidation of Jurisdictions 8 (which
conversely, we may still utilize encompasses the states of Indiana and This notice announces a forthcoming
competitive procedures sooner than 10 Michigan) and 15 (which encompasses meeting of a public advisory committee
years in the event that a MAC does not Kentucky and Ohio) to form of the Food and Drug Administration
meet our performance objectives. In ‘‘Jurisdiction I’’ and the consolidation of (FDA). The meeting will be open to the
concert with or in (partial or full) Jurisdictions 5 (Iowa, Kansas, Missouri public.
replacement of our award fee process, and Nebraska) and 6 (Illinois, Name of Committee: Allergenic
we are considering incorporating an Minnesota, and Wisconsin) to form Products Advisory Committee.
‘‘award term’’ concept into MAC ‘‘Jurisdiction G.’’ For more information General Function of the Committee:
contracting, meaning that we may on our 2010 strategy for consolidating To provide advice and
incentivize and reward consistently, A/B MAC jurisdictions, as well as our recommendations to the Agency on
well-performing MACs with a longer- 2014 decision to postpone the final 2 FDA’s regulatory issues.
term contract (but not longer than 10 jurisdictional consolidations, see Date and Time: The meeting will be
years). For example, MACs that https://www.cms.gov/Medicare/ held on January 21, 2016, from 8:30 a.m.
consistently exceed our performance Medicare-Contracting/Medicare- to 4 p.m.
standards may be rewarded with a Administrative-Contractors/Downloads/ Location: FDA White Oak Campus,
longer-term contract (up to 10 years); RFI-Announcement-AB–MAC-March- 10903 New Hampshire Ave., Bldg. 31
whereas, MACs that do not consistently 2014.pdf Conference Center, the Great Room (rm.
exceed our performance standards may Accordingly, we are requesting 1503), Silver Spring, MD 20993–0002.
be limited to a shorter-term contract comment on the following question: Answers to commonly asked questions
(more or less than 5 years). Therefore, • What would the advantages and including information regarding special
we are soliciting public comment on the disadvantages be if CMS completed the accommodations due to a disability,
following questions regarding MAC last two MAC consolidations? visitor parking, and transportation may
incentives for exceptional performance: be accessed at: http://www.fda.gov/
• Do you have any concerns or III. Collection of Information AdvisoryCommittees/AboutAdvisory
suggestions related to development of a Requirements Committees/ucm408555.htm.
potential ‘‘award term’’ strategy and This request for information Contact Person: Janie Kim or Denise
plan? document does not impose any Royster, Center for Biologics Evaluation
• Do you have any other suggestions information collection requirements. In and Research, Food and Drug
for incentivizing and rewarding accordance with the implementing Administration, 10903 New Hampshire
exceptional MAC performance? regulations of the Paperwork Reduction Ave., Bldg. 71, Silver Spring, MD
• Are there any specific metrics or Act of 1995 (PRA) at 5 CFR 1320.3(h)(4), 20993–0002, 301–796–9016 or 240–
mstockstill on DSK4VPTVN1PROD with NOTICES
evaluation criteria that would be we believe it is a general solicitation of 402–8158, email: Janie.kim@fda.hhs.gov
valuable in measuring the level and comments from the public. Therefore, it or Denise.royster@fda.hhs.gov, or FDA
quality of the service provided by a is exempt from the requirements of the Advisory Committee Information Line,
MAC? PRA (44 U.S.C. 3501 et seq.). 1–800–741–8138 (301–443–0572 in the
• Are there any specific metrics or Washington, DC area). A notice in the
evaluation criteria that would be IV. Response to Comments Federal Register about last minute
valuable in measuring the level and Because of the large number of public modifications that impact a previously
quality of the MAC’s relationships comments we normally receive on announced advisory committee meeting
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Document Created: 2015-12-19 02:57:37
Document Modified: 2015-12-19 02:57:37
| 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 | Request for information. | |
| Dates | To be assured consideration, written or electronic comments must | |
| Contact | Debra Bowman, (410) 786-4941. Phyllis Atkins-Mackey, (410) 786-9362. Megan Martino, (215) 861-4425. Sue Pelella, (215) 861-4245. | |
| FR Citation | 80 FR 79343 |
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