81 FR 78159 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2017
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 81, Issue 215 (November 7, 2016)
Centers for Medicare & Medicaid Services
Federal Register Volume 81, Issue 215 (November 7, 2016)
| Page Range | 78159-78160 | |
| FR Document | 2016-26828 |
[Federal Register Volume 81, Number 215 (Monday, November 7, 2016)] [Notices] [Pages 78159-78160] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-26828] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6071-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2017 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: This notice announces a $560.00 calendar year (CY) 2017 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, 2017 and on or before December 31, 2017. DATES: Effective Date: This notice is effective on January 1, 2017. 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. 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 2016 Fee Amount In the December 3, 2015 Federal Register (80 FR 75680), we published a notice announcing a fee amount for the period of January 1, 2016 through December 31, 2016 of $554.00. 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 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. The CPI-U increase for the period of July 1, 2014 through June 30, 2015 was 0.2 percent, based on BLS data. This resulted in an application fee amount for CY 2016 of $554.106 ($553 x 1.002). Rounding this figure to the nearest whole dollar amount resulted in a CY 2016 application fee amount of $554.00. B. CY 2017 Fee Amount Using BLS data, the CPI-U increase for the period of July 1, 2015 through June 30, 2016 was 1.0 percent. This results in a CY 2017 application fee amount of $559.56 ($554 x 1.01). As we must round this to the nearest whole dollar amount, the resultant application fee amount for CY 2017 is $560.00. 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 [[Page 78160]] approved information collections. The forms CMS-855A, CMS-855B, and CMS-855I are approved under OMB 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 2017. 1. Estimates of Number of Affected Institutional Providers in December 3, 2015 Fee Notice In the December 3, 2015 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 2016. 45,000 revalidating Medicare institutional providers would be subject to and pay an application fee in CY 2016. 9,000 newly enrolling Medicaid and CHIP providers would be subject to and pay an application fee in CY 2016. 21,000 revalidating Medicaid and CHIP providers would be subject to and pay an application fee in CY 2016. 2. CY 2017 Estimates a. Medicare Based on CMS data, we estimate that in CY 2017 approximately-- 10,000 newly enrolling institutional providers will be subject to and pay an application fee; and 43,792 revalidating institutional providers will be subject to and pay an application fee. Using a figure of 53,792 (10,000 newly enrolling + 43,792 revalidating) institutional providers, we estimate an increase in the cost of the Medicare application fee requirement in CY 2017 of $322,752 (or 53,792 x $6 (or $560 minus $554)) from our CY 2016 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 2017. Using this figure, we project an increase in the cost of the Medicaid and CHIP application fee requirement in CY 2017 of $180,000 (or 30,000 x $6 (or $560 minus $554)) from our CY 2016 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 2017 to be $502,752 ($180,000 + $322,752) from our CY 2016 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 2016, that threshold is approximately $146 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: September 22, 2016. Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services. [FR Doc. 2016-26828 Filed 11-4-16; 8:45 am] BILLING CODE 4120-01-P
![Federal Register / Vol. 81, No. 215 / Monday, November 7, 2016 / Notices 78159
Leroy A. Richardson, enrollment application. An was 3.54 percent, based on BLS data.
Chief, Information Collection Review Office, ‘‘institutional provider’’ for purposes of This resulted in an application fee
Office of Scientific Integrity, Office of the Medicare is defined at § 424.502 as amount for CY 2012 of $522.87 (or $505
Associate Director for Science, Office of the ‘‘(a)ny provider or supplier that submits × 1.0354). In the February 2, 2011 final
Director, Centers for Disease Control and a paper Medicare enrollment rule, we stated that if the adjustment
Prevention. application using the CMS–855A, CMS– sets the fee at an uneven dollar amount,
[FR Doc. 2016–26830 Filed 11–4–16; 8:45 am] 855B (not including physician and non- we would round the fee to the nearest
BILLING CODE 4163–18–P physician practitioner organizations), whole dollar amount. Accordingly, the
CMS–855S, or associated Internet-based application fee amount for CY 2012 was
PECOS enrollment application.’’ As we rounded to the nearest whole dollar
DEPARTMENT OF HEALTH AND explained in the February 2, 2011 final amount, or $523.00.
HUMAN SERVICES rule (76 FR 5914), in addition to the • The CPI–U increase for the period
providers and suppliers subject to the of July 1, 2011 through June 30, 2012
Centers for Medicare & Medicaid application fee under Medicare, was 1.664 percent, based on BLS data.
Services Medicaid-only, and CHIP-only This resulted in an application fee
[CMS–6071–N] institutional providers would include amount for CY 2013 of $531.70 ($523 ×
nursing facilities, intermediate care 1.01664). Rounding this figure to the
Medicare, Medicaid, and Children’s facilities for persons with intellectual nearest whole dollar amount resulted in
Health Insurance Programs; Provider disabilities (ICF/IID), psychiatric a CY 2013 application fee amount of
Enrollment Application Fee Amount for residential treatment facilities, and may $532.00.
Calendar Year 2017 include other institutional provider • The CPI–U increase for the period
AGENCY: Centers for Medicare & types designated by a state in of July 1, 2012 through June 30, 2013
Medicaid Services (CMS), HHS. accordance with their approved state was 1.8 percent, based on BLS data.
plan. This resulted in an application fee
ACTION: Notice. As indicated in § 424.514 and amount for CY 2014 of $541.576 ($532
SUMMARY: This notice announces a § 455.460, the application fee is not × 1.018). Rounding this figure to the
$560.00 calendar year (CY) 2017 required for either of the following: nearest whole dollar amount resulted in
application fee for institutional • A Medicare physician or non- a CY 2014 application fee amount of
providers that are initially enrolling in physician practitioner submitting a $542.00.
the Medicare or Medicaid program or CMS–855I. • The CPI–U increase for the period
• A prospective or revalidating of July 1, 2013 through June 30, 2014
the Children’s Health Insurance
Medicaid or CHIP provider— was 2.1 percent, based on BLS data.
Program (CHIP); revalidating their ++ Who is an individual physician or
Medicare, Medicaid, or CHIP This resulted in an application fee
non-physician practitioner; or amount for CY 2015 of $553.382 ($542
enrollment; or adding a new Medicare ++ That is enrolled in Title XVIII of
practice location. This fee is required × 1.021). Rounding this figure to the
the Act or another state’s Title XIX or nearest whole dollar amount resulted in
with any enrollment application XXI plan and has paid the application
submitted on or after January 1, 2017 a CY 2015 application fee amount of
fee to a Medicare contractor or another $553.00.
and on or before December 31, 2017. state. • The CPI–U increase for the period
DATES: Effective Date: This notice is
II. Provisions of the Notice of July 1, 2014 through June 30, 2015
effective on January 1, 2017.
was 0.2 percent, based on BLS data.
FOR FURTHER INFORMATION CONTACT: A. CY 2016 Fee Amount This resulted in an application fee
Frank Whelan, (410) 786–1302. In the December 3, 2015 Federal amount for CY 2016 of $554.106 ($553
SUPPLEMENTARY INFORMATION: Register (80 FR 75680), we published a × 1.002). Rounding this figure to the
I. Background notice announcing a fee amount for the nearest whole dollar amount resulted in
period of January 1, 2016 through a CY 2016 application fee amount of
In the February 2, 2011 Federal December 31, 2016 of $554.00. This $554.00.
Register (76 FR 5862), we published a figure was calculated as follows:
final rule with comment period titled • Section 1866(j)(2)(C)(i)(I) of the Act B. CY 2017 Fee Amount
‘‘Medicare, Medicaid, and Children’s established a $500 application fee for Using BLS data, the CPI–U increase
Health Insurance Programs; Additional institutional providers in CY 2010. for the period of July 1, 2015 through
Screening Requirements, Application • Consistent with section June 30, 2016 was 1.0 percent. This
Fees, Temporary Enrollment Moratoria, 1866(j)(2)(C)(i)(II) of the Act, results in a CY 2017 application fee
Payment Suspensions and Compliance § 424.514(d)(2) states that for CY 2011 amount of $559.56 ($554 × 1.01). As we
Plans for Providers and Suppliers.’’ This and subsequent years, the preceding must round this to the nearest whole
rule finalized, among other things, year’s fee will be adjusted by the dollar amount, the resultant application
provisions related to the submission of percentage change in the consumer fee amount for CY 2017 is $560.00.
application fees as part of the Medicare, price index (CPI) for all urban
Medicaid, and CHIP provider III. Collection of Information
consumers (all items; United States city
enrollment processes. As provided in Requirements
average, CPI–U) for the 12-month period
section 1866(j)(2)(C)(i) of the Social ending on June 30 of the previous year. This document does not impose
Security Act (the Act) (as amended by • The CPI–U increase for CY 2011 information collection requirements,
sradovich on DSK3GMQ082PROD with NOTICES
section 6401 of the Affordable Care Act) was 1.0 percent, based on data obtained that is, reporting, recordkeeping, or
and in 42 CFR 424.514, ‘‘institutional from the Bureau of Labor Statistics third-party disclosure requirements.
providers’’ that are initially enrolling in (BLS). This resulted in an application Consequently, there is no need for
the Medicare or Medicaid programs or fee amount for CY 2011 of $505 (or $500 review by the Office of Management and
CHIP, revalidating their enrollment, or × 1.01). Budget under the authority of the
adding a new Medicare practice location • The CPI–U increase for the period Paperwork Reduction Act of 1995.
are required to submit a fee with their of July 1, 2010 through June 30, 2011 However, it does reference previously
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![78160 Federal Register / Vol. 81, No. 215 / Monday, November 7, 2016 / Notices
approved information collections. The • 21,000 revalidating Medicaid and the provisions of section 604 of the
forms CMS–855A, CMS–855B, and CHIP providers would be subject to and RFA. For purposes of section 1102(b) of
CMS–855I are approved under OMB pay an application fee in CY 2016. the Act, we define a small rural hospital
control number 0938–0685; the CMS– as a hospital that is located outside of
2. CY 2017 Estimates
855S is approved under OMB control a Metropolitan Statistical Area for
number 0938–1056. a. Medicare Medicare payment regulations and has
Based on CMS data, we estimate that fewer than 100 beds. We are not
IV. Regulatory Impact Statement
in CY 2017 approximately— preparing an analysis for section 1102(b)
A. Background • 10,000 newly enrolling institutional of the Act because we have determined,
We have examined the impact of this providers will be subject to and pay an and the Secretary certifies, that this
notice as required by Executive Order application fee; and notice would not have a significant
12866 on Regulatory Planning and • 43,792 revalidating institutional impact on the operations of a substantial
Review (September 30, 1993), Executive providers will be subject to and pay an number of small rural hospitals.
application fee. Section 202 of the Unfunded
Order 13563 on Improving Regulation
Using a figure of 53,792 (10,000 newly Mandates Reform Act of 1995 (UMRA)
and Regulatory Review (January 18,
enrolling + 43,792 revalidating) also requires that agencies assess
2011), the Regulatory Flexibility Act institutional providers, we estimate an
(RFA) (September 19, 1980, Pub. L. 96– anticipated costs and benefits before
increase in the cost of the Medicare issuing any rule whose mandates
354), section 1102(b) of the Social application fee requirement in CY 2017
Security Act, section 202 of the require spending in any 1 year of $100
of $322,752 (or 53,792 × $6 (or $560 million in 1995 dollars, updated
Unfunded Mandates Reform Act of 1995 minus $554)) from our CY 2016
(March 22, 1995; Pub. L. 104–4), annually for inflation. In 2016, that
projections and as previously described. threshold is approximately $146
Executive Order 13132 on Federalism
(August 4, 1999), and the Congressional b. Medicaid and CHIP million. The Agency has determined
Review Act (5 U.S.C. 804(2)). that there will be minimal impact from
Based on CMS and state statistics, we the costs of this notice, as the threshold
Executive Orders 12866 and 13563 estimate that approximately 30,000
direct agencies to assess all costs and is not met under the UMRA.
(9,000 newly enrolling + 21,000 Executive Order 13132 establishes
benefits of available regulatory revalidating) Medicaid and CHIP
alternatives and, if regulation is certain requirements that an agency
institutional providers will be subject to must meet when it promulgates a
necessary, to select regulatory an application fee in CY 2017. Using
approaches that maximize net benefits, proposed rule (and subsequent final
this figure, we project an increase in the rule) that imposes substantial direct
including potential economic, cost of the Medicaid and CHIP
environmental, public health and safety requirement costs on state and local
application fee requirement in CY 2017 governments, preempts state law, or
effects, distributive impacts, and equity. of $180,000 (or 30,000 × $6 (or $560 otherwise has federalism implications.
A regulatory impact analysis (RIA) must minus $554)) from our CY 2016
be prepared for major rules with Since this notice does not impose
projections and as previously described. substantial direct costs on state or local
economically significant effects ($100
million or more in any 1 year). As c. Total governments, the requirements of
explained in this section of the notice, Based on the foregoing, we estimate Executive Order 13132 are not
we estimate that the total cost of the the total increase in the cost of the applicable.
increase in the application fee will not application fee requirement for In accordance with the provisions of
exceed $100 million. Therefore, this Medicare, Medicaid, and CHIP Executive Order 12866, this notice was
notice does not reach the $100 million providers and suppliers in CY 2017 to reviewed by the Office of Management
economic threshold and is not be $502,752 ($180,000 + $322,752) from and Budget.
considered a major notice. our CY 2016 projections. Dated: September 22, 2016.
The RFA requires agencies to analyze Andrew M. Slavitt,
B. Costs options for regulatory relief of small Acting Administrator, Centers for Medicare
The costs associated with this notice businesses. For purposes of the RFA, & Medicaid Services.
involve the increase in the application small entities include small businesses, [FR Doc. 2016–26828 Filed 11–4–16; 8:45 am]
fee amount that certain providers and nonprofit organizations, and small BILLING CODE 4120–01–P
suppliers must pay in CY 2017. governmental jurisdictions. Most
hospitals and most other providers and
1. Estimates of Number of Affected
suppliers are small entities, either by DEPARTMENT OF HEALTH AND
Institutional Providers in December 3,
nonprofit status or by having revenues HUMAN SERVICES
2015 Fee Notice
of less than $7.5 million to $38.5
In the December 3, 2015 application million in any 1 year. Individuals and Administration for Children and
fee notice, we estimated that based on states are not included in the definition Families
CMS statistics— of a small entity. As we stated in the
• 10,000 newly enrolling Medicare [OMB No.: 0970–0445]
RIA for the February 2, 2011 final rule
institutional providers would be subject with comment period (76 FR 5952), we Proposed Information Collection
to and pay an application fee in CY do not believe that the application fee Activity; Comment Request
2016.
sradovich on DSK3GMQ082PROD with NOTICES
will have a significant impact on small
• 45,000 revalidating Medicare entities. Title: Implementation Grants to
institutional providers would be subject In addition, section 1102(b) of the Act Develop a Model Intervention for
to and pay an application fee in CY requires us to prepare a regulatory Youth/Young Adults with Child Welfare
2016. impact analysis if a rule may have a Involvement at Risk of Homelessness:
• 9,000 newly enrolling Medicaid and significant impact on the operations of Phase II.
CHIP providers would be subject to and a substantial number of small rural Description: The Administration for
pay an application fee in CY 2016. hospitals. This analysis must conform to Children and Familes (ACF) at the U.S.
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Document Created: 2018-02-14 08:21:47
Document Modified: 2018-02-14 08:21:47
| 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 | Effective Date: This notice is effective on January 1, 2017. | |
| Contact | Frank Whelan, (410) 786-1302. | |
| FR Citation | 81 FR 78159 |
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