81 FR 94378 - Medicare Program; Renewal of the Advisory Panel on Hospital Outpatient Payment and Solicitation of Nominations to the Advisory Panel on Hospital Outpatient Payment

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 81, Issue 247 (December 23, 2016)

This notice announces the renewal of the Advisory Panel (the Panel) on Hospital Outpatient Payment (HOP) panel charter. The charter was approved on November 21, 2016 for a 2-year period effective through November 21, 2018. This notice also solicits nominations for up to two new members to the HOP Panel. There will be two vacancies on the Panel for 4-year terms that begin during Calendar Year (CY) 2017. The purpose of the Panel is to advise the Secretary of the Department of Health and Human Services (DHHS) (the Secretary) and the Administrator of the Centers for Medicare & Medicaid Services (CMS) (the Administrator) on the clinical integrity of the Ambulatory Payment Classification (APC) groups and their associated weights, and supervision of hospital outpatient therapeutic services.

[Federal Register Volume 81, Number 247 (Friday, December 23, 2016)]
[Notices]
[Pages 94378-94379]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-31022]



[[Page 94378]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1681-N]


Medicare Program; Renewal of the Advisory Panel on Hospital 
Outpatient Payment and Solicitation of Nominations to the Advisory 
Panel on Hospital Outpatient Payment

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice announces the renewal of the Advisory Panel (the 
Panel) on Hospital Outpatient Payment (HOP) panel charter. The charter 
was approved on November 21, 2016 for a 2-year period effective through 
November 21, 2018. This notice also solicits nominations for up to two 
new members to the HOP Panel. There will be two vacancies on the Panel 
for 4-year terms that begin during Calendar Year (CY) 2017.
    The purpose of the Panel is to advise the Secretary of the 
Department of Health and Human Services (DHHS) (the Secretary) and the 
Administrator of the Centers for Medicare & Medicaid Services (CMS) 
(the Administrator) on the clinical integrity of the Ambulatory Payment 
Classification (APC) groups and their associated weights, and 
supervision of hospital outpatient therapeutic services.

DATES: Submission of Nominations: We will consider nominations if they 
are received no later than 5 p.m. Eastern Standard Time (E.S.T) 
February 21, 2017.

ADDRESSES: Please submit nominations electronically to the following 
email address: [email protected].
    Web site: For additional information on the Panel and updates to 
the Panel's activities, we refer readers to our Web site at the 
following address: http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.

FOR FURTHER INFORMATION CONTACT: Persons wishing to nominate 
individuals to serve on the Panel or to obtain further information may 
submit an email to the following email address: [email protected].
    News Media: Representatives should contact the CMS Press Office at 
(202) 690-6145.

SUPPLEMENTARY INFORMATION:

I. Background

    The Secretary of the Department of Health and Human Services (DHHS) 
(the Secretary) is required by section 1833(t)(9)(A) of the Social 
Security Act (the Act), and allowed by section 222 of the Public Health 
Service Act (PHS Act) to consult with an expert outside panel, that is, 
the Advisory Panel on Hospital Outpatient Payment (the Panel) regarding 
the clinical integrity of the Ambulatory Payment Classification (APC) 
groups and relative payment weights that are components of the Medicare 
Hospital Outpatient Prospective Payment System (OPPS), and the 
appropriate supervision level for hospital outpatient therapeutic 
services. The Panel is governed by the provisions of the Federal 
Advisory Committee Act (FACA) (Pub. L. 92-463), as amended (5 U.S.C. 
Appendix 2), which sets forth standards for the formation and use of 
advisory panels. The Panel may consider data collected or developed by 
entities and organizations (other than the DHHS) as part of their 
deliberations.
    The Panel Charter provides that the Panel shall meet up to 3 times 
annually. As announced in the notice, published in the Federal Register 
on May 20, 2016, entitled ``Medicare Program; Announcement of the 
Advisory Panel on Hospital Outpatient Payment (the Panel) Meeting on 
August 22-23, 2016 and Announcement of Transition to One Meeting of the 
Panel Per Year'' (81 FR 31942), in Calendar Year (CY) 2017 and 
thereafter, (unless the Centers for Medicare & Medicaid (CMS) 
programmatic need suggests otherwise) there will be only one Panel 
meeting per year that will occur in the summer. We consider the 
technical advice provided by the Panel as we prepare the proposed and 
final rules to update the OPPS for the following CY.

II. Renewal of the Hospital Outpatient Payment (HOP) Panel

    The Panel was originally chartered on November 21, 2000 and the 
Panel requires a recharter every 2 years. In the April 24, 2015 Federal 
Register notice, (80 FR 23009), we inadvertently stated that the 
charter renewal was approved on November 6, 2014 for a 2-year period 
ending November 6, 2016, the correct approval date was November 21, 
2014 for a 2-year period effective through November 21, 2016.
    This notice announces the renewal of the HOP Panel charter, which 
was approved on November 21, 2016 for a 2-year period effective through 
November 21, 2018. The charter will terminate on November 21, 2018, 
unless renewed by appropriate action. CMS intends to recharter the 
Panel for another 2-year period prior to the expiration of the current 
charter.
    Pursuant to the renewed charter, the Panel will advise the 
Secretary and CMS concerning optimal strategies for the following:
     Addressing whether procedures within an APC group are 
similar both clinically and in terms of resource use.
     Reconfiguring APCs (for example, splitting of APCs, moving 
Healthcare Common Procedures Coding System (HCPCS) codes from one APC 
to another, and moving HCPCS codes from new technology APCs to clinical 
APCs).
     Evaluating APC group weights.
     Reviewing packaging the cost of items and services, 
including drugs and devices into procedures and services; including the 
methodology for packaging and the impact of packaging the cost of those 
items and services on APC group structure and payment.
     Removing procedures from the inpatient list for payment 
under the OPPS payment system.
     Using claims and cost report data for CMS' determination 
of APC group costs.
     Addressing other technical issues concerning APC group 
structure.
     Evaluating the required level of supervision for hospital 
outpatient services.

III. Solicitation of Nominations; Criteria for Nominees

    The Panel shall consist of a chair and up to 15 members who are 
full-time employees of hospitals, hospital systems, or other Medicare 
providers that are subject to the OPPS. For supervision deliberations, 
the Panel shall also include members that represent the interests of 
Critical Access Hospitals (CAHs), who advise CMS only regarding the 
level of supervision for hospital outpatient therapeutic services. (For 
purposes of the Panel, consultants or independent contractors are not 
considered to be full-time employees in these organizations.)
    The current Panel members are as follows:
    (Note: The asterisk [*] indicates the Panel members whose terms end 
during CY 2017, along with the month that the term ends.)

 E.L. Hambrick, M.D., J.D., Chair, a CMS Medical Officer.
 Shelly Dunham, R.N.
 Kenneth M. Flowe, M.D., M.B.A.
 Dawn L. Francis, M.D., M.H.S.
 Erika Hardy, R.H.I.A.
 Karen Lambert
 Ruth Lande
 Scott Manaker, M.D., Ph.D.

[[Page 94379]]

 Agatha Nolen, Ph.D., D.Ph
 Rick Nordahl, M.B.A.
 Johnathan Pregler, M.D.
 Michael Rabovsky, M.D. *(January 2017)
 Wendy Resnick, F.H.F.M.A.
 Michael K. Schroyer, R.N.
 Norman Thomson, III, M.D.
 Kris Zimmer *(January 2017)

    Panel members serve on a voluntary basis, without compensation, 
according to an advance written agreement; however, for the meetings, 
CMS reimburses travel, meals, lodging, and related expenses in 
accordance with standard Government travel regulations. CMS has a 
special interest in ensuring, while taking into account the nominee 
pool, that the Panel is diverse in all respects of the following: 
geography; rural or urban practice; race, ethnicity, sex, and 
disability; medical or technical specialty; and type of hospital, 
hospital health system, or other Medicare provider subject to the OPPS.
    Based upon either self-nominations or nominations submitted by 
providers or interested organizations, the Secretary, or his or her 
designee, appoints new members to the Panel from among those candidates 
determined to have the required expertise. New appointments are made in 
a manner that ensures a balanced membership under the FACA guidelines. 
For 2017, we are soliciting for up to two new nominees. Our appointment 
schedule will assure that we have the full complement of members for 
each Panel meeting.
    The Panel must be balanced in its membership in terms of the points 
of view represented and the functions to be performed. Each panel 
member must be employed full-time by a hospital, hospital system, or 
other Medicare provider subject to payment under the OPPS (except for 
the CAH members, since CAHs are not paid under the OPPS). All members 
must have technical expertise to enable them to participate fully in 
the Panel's work. Such expertise encompasses hospital payment systems; 
hospital medical care delivery systems; provider billing systems; APC 
groups; Current Procedural Terminology codes; and alpha-numeric Health 
Care Common Procedure Coding System codes; and the use of, and payment 
for, drugs, medical devices, and other services in the outpatient 
setting, as well as other forms of relevant expertise. For supervision 
deliberations, the Panel shall have members that represent the 
interests of CAHs, who advise CMS only regarding the level of 
supervision for hospital outpatient therapeutic services.
    It is not necessary for a nominee to possess expertise in all of 
the areas listed, but each must have a minimum of 5 years of experience 
and currently have full-time employment in his or her area of 
expertise. Generally, members of the Panel serve overlapping terms up 
to 4 years, based on the needs of the Panel and contingent upon the 
rechartering of the Panel. A member may serve after the expiration of 
his or her term until a successor has been sworn in.
    Any interested person or organization may nominate one or more 
qualified individuals. Self-nominations will also be accepted. Each 
nomination must include the following:
     Letter of Nomination stating the reasons why the nominee 
should be considered.
     Curriculum vitae or resume of the nominee that includes an 
email address where the nominee can be contacted.
     Written and signed statement from the nominee that the 
nominee is willing to serve on the Panel under the conditions described 
in this notice and further specified in the Charter.
     The hospital or hospital system name and address, or CAH 
name and address, as well as all Medicare hospital and or Medicare CAH 
billing numbers of the facility where the nominee is employed.

IV. Copies of the Charter

    To obtain a copy of the Panel's Charter, we refer readers to our 
Web site at http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups.html.

V. 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 (44 U.S.C. 3501 et seq.).

    Dated: December 13, 2016.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2016-31022 Filed 12-22-16; 8:45 am]
BILLING CODE 4120-01-P