82_FR_27335 82 FR 27222 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-Mix Methodology; Extension of Comment Period

82 FR 27222 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-Mix Methodology; Extension of Comment Period

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

Federal Register Volume 82, Issue 113 (June 14, 2017)

Page Range27222-27223
FR Document2017-12324

This document extends the comment period for the advance notice of proposed rulemaking with comment entitled ``Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology'' that appeared in the May 4, 2017 Federal Register (82 FR 20980) (the ANPRM). The comment period for the ANPRM, which would end on June 26, 2017, is extended until August 25, 2017.

Federal Register, Volume 82 Issue 113 (Wednesday, June 14, 2017) 
[Federal Register Volume 82, Number 113 (Wednesday, June 14, 2017)]
[Proposed Rules]
[Pages 27222-27223]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-12324]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 409 and 488

[CMS-1686-N]
RIN 0938-AT17


Medicare Program; Prospective Payment System and Consolidated 
Billing for Skilled Nursing Facilities: Revisions to Case-Mix 
Methodology; Extension of Comment Period

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

ACTION: Advance notice of proposed rulemaking with comment; extension 
of comment period.

-----------------------------------------------------------------------

SUMMARY: This document extends the comment period for the advance 
notice of proposed rulemaking with comment entitled ``Medicare Program; 
Prospective Payment System and Consolidated Billing for Skilled Nursing 
Facilities: Revisions to Case-mix Methodology'' that appeared in the 
May 4, 2017 Federal Register (82 FR 20980) (the ANPRM). The comment 
period for the ANPRM, which would end on June 26, 2017, is extended 
until August 25, 2017.

DATES: The comment period for the ANPRM (82 FR 20980) is extended to 5 
p.m., eastern daylight time, on August 25, 2017.

ADDRESSES: In commenting, please refer to file code CMS-1686-ANPRM. 
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. Within the search bar, enter 
the Regulation Identifier Number associated with this regulation, RIN 
0938-AT17, and then click on the ``Comment Now'' box.
    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-1686-ANPRM, P.O. Box 8016, 
Baltimore, MD 21244-8016.
    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-1686-ANPRM, 
Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
    4. By hand or courier. If you prefer, you may deliver (by hand or 
courier) your written comments before the close of the comment period 
to either of the following addresses:
    a. 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. 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, 
please call telephone number (410) 786-7195 in advance to schedule your 
arrival with one of our staff members.
    Comments 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: John Kane, (410) 786-0557.

SUPPLEMENTARY INFORMATION: In the advance notice of proposed rulemaking 
with comment that appeared in the Federal Register on May 4, 2017 
entitled, ``Medicare Program; Prospective Payment System and 
Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-
mix Methodology'' (82 FR 20980) (the ANPRM), we solicited public 
comments on potential options we may consider for revising certain 
aspects of the existing skilled nursing facility (SNF) prospective 
payment system (PPS) payment methodology to improve its accuracy, based 
on the results of our SNF Payment Models Research (SNF PMR) project. In 
particular, in the ANPRM, we sought comments on the possibility of 
proposing to replace the SNF PPS' existing case-mix classification 
model, the Resource Utilization Groups, Version 4 (RUG-IV), with a new 
model, the Resident Classification System, Version I (RCS-I). We also 
discussed options for how such a change could be implemented, as well

[[Page 27223]]

as a number of other policy changes we may consider proposing to 
complement implementation of RCS-I.
    We have received an inquiry from professional associations and 
national industry organizations regarding the 60-day comment period for 
the ANPRM. These organizations stated that by providing all 
stakeholders additional time to review and comment upon the ANPRM, they 
will be able to conduct a more comprehensive review of the refinements 
we are considering to the SNF PPS payment methodology and provide more 
meaningful comments. In order to maximize the opportunity for the 
public to provide meaningful input to CMS, we believe that it is 
important to allow additional time for the public to prepare comments 
on the ANPRM. In addition, we believe that granting an extension to the 
public comment period in this instance would further our overall 
objective to obtain public input on the potential refinements to the 
SNF PPS we are considering. Therefore, we are extending the comment 
period for the ANPRM for an additional 60 days. This document announces 
the extension of the public comment period for the ANPRM until August 
25, 2017.

    Dated: June 7, 2017.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2017-12324 Filed 6-13-17; 8:45 am]
 BILLING CODE 4120-01-P

27222 Federal Register / Vol. 82, No. 113 / Wednesday, June 14, 2017 / Proposed Rules 2008 8-hour ozone national ambient air DEPARTMENT OF HEALTH AND Services, Attention: CMS–1686– quality standards (NAAQS). The SIP HUMAN SERVICES ANPRM, Mail Stop C4–26–05, 7500 revision pertains to CAA 2008 ozone Security Boulevard, Baltimore, MD NAAQS requirements for vehicle Centers for Medicare & Medicaid 21244–1850. inspection and maintenance and Services 4. By hand or courier. If you prefer, nonattainment new source review in the you may deliver (by hand or courier) Dallas/Fort Worth ozone nonattainment 42 CFR Parts 409 and 488 your written comments before the close area. [CMS–1686–N] of the comment period to either of the following addresses: DATES: Written comments should be RIN 0938–AT17 a. Centers for Medicare & Medicaid received on or before July 14, 2017. Services, Department of Health and Medicare Program; Prospective Human Services, Room 445–G, Hubert ADDRESSES: Submit your comments, Payment System and Consolidated H. Humphrey Building, 200 identified by EPA–R06–OAR–2015– Billing for Skilled Nursing Facilities: Independence Avenue SW., 0833, at http://www.regulations.gov or Revisions to Case-Mix Methodology; Washington, DC 20201. via email to young.carl@epa.gov. For Extension of Comment Period (Because access to the interior of the additional information on how to Hubert H. Humphrey Building is not submit comments see the detailed AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. readily available to persons without instructions in the ADDRESSES section of Federal Government identification, the direct final rule located in the rules ACTION: Advance notice of proposed rulemaking with comment; extension of commenters are encouraged to leave section of this Federal Register. their comments in the CMS drop slots comment period. FOR FURTHER INFORMATION CONTACT: Carl located in the main lobby of the Young, (214) 665–6645, young.carl@ SUMMARY: This document extends the building. A stamp-in clock is available epa.gov. comment period for the advance notice for persons wishing to retain a proof of of proposed rulemaking with comment filing by stamping in and retaining an SUPPLEMENTARY INFORMATION: In the entitled ‘‘Medicare Program; Prospective extra copy of the comments being filed.) final rules section of this Federal Payment System and Consolidated b. Centers for Medicare & Medicaid Register, the EPA is approving the Billing for Skilled Nursing Facilities: Services, Department of Health and State’s SIP submittal as a direct rule Revisions to Case-mix Methodology’’ Human Services, 7500 Security without prior proposal because the that appeared in the May 4, 2017 Boulevard, Baltimore, MD 21244–1850. Agency views this as noncontroversial Federal Register (82 FR 20980) (the If you intend to deliver your submittal and anticipates no adverse ANPRM). The comment period for the comments to the Baltimore address, comments. A detailed rationale for the ANPRM, which would end on June 26, please call telephone number (410) 786– 2017, is extended until August 25, 2017. 7195 in advance to schedule your approval is set forth in the direct final DATES: The comment period for the arrival with one of our staff members. rule. If no relevant adverse comments ANPRM (82 FR 20980) is extended to 5 Comments mailed to the addresses are received in response to this action indicated as appropriate for hand or no further activity is contemplated. If p.m., eastern daylight time, on August 25, 2017. courier delivery may be delayed and the EPA receives relevant adverse received after the comment period. comments, the direct final rule will be ADDRESSES: In commenting, please refer to file code CMS–1686–ANPRM. FOR FURTHER INFORMATION CONTACT: John withdrawn and all public comments Because of staff and resource Kane, (410) 786–0557. received will be addressed in a limitations, we cannot accept comments SUPPLEMENTARY INFORMATION: In the subsequent final rule based on this by facsimile (FAX) transmission. advance notice of proposed rulemaking proposed rule. The EPA will not You may submit comments in one of with comment that appeared in the institute a second comment period. Any four ways (please choose only one of the Federal Register on May 4, 2017 parties interested in commenting on this entitled, ‘‘Medicare Program; ways listed): action should do so at this time. Prospective Payment System and 1. Electronically. You may submit For additional information, see the electronic comments on this regulation Consolidated Billing for Skilled Nursing direct final rule which is located in the to http://www.regulations.gov. Within Facilities: Revisions to Case-mix rules section of this Federal Register. the search bar, enter the Regulation Methodology’’ (82 FR 20980) (the Dated: June 1, 2017. Identifier Number associated with this ANPRM), we solicited public comments regulation, RIN 0938–AT17, and then on potential options we may consider Samuel Coleman, click on the ‘‘Comment Now’’ box. for revising certain aspects of the Acting Regional Administrator, Region 6. 2. By regular mail. You may mail existing skilled nursing facility (SNF) [FR Doc. 2017–12211 Filed 6–13–17; 8:45 am] written comments to the following prospective payment system (PPS) BILLING CODE 6560–50–P address ONLY: Centers for Medicare & payment methodology to improve its Medicaid Services, Department of accuracy, based on the results of our Health and Human Services, Attention: SNF Payment Models Research (SNF CMS–1686–ANPRM, P.O. Box 8016, PMR) project. In particular, in the Baltimore, MD 21244–8016. ANPRM, we sought comments on the mstockstill on DSK30JT082PROD with PROPOSALS Please allow sufficient time for mailed possibility of proposing to replace the comments to be received before the SNF PPS’ existing case-mix close of the comment period. classification model, the Resource 3. By express or overnight mail. You Utilization Groups, Version 4 (RUG–IV), may send written comments to the with a new model, the Resident following address ONLY: Centers for Classification System, Version I (RCS–I). Medicare & Medicaid Services, We also discussed options for how such Department of Health and Human a change could be implemented, as well VerDate Sep<11>2014 17:21 Jun 13, 2017 Jkt 241001 PO 00000 Frm 00006 Fmt 4702 Sfmt 4702 E:\FR\FM\14JNP1.SGM 14JNP1

Federal Register / Vol. 82, No. 113 / Wednesday, June 14, 2017 / Proposed Rules 27223 as a number of other policy changes we of Commerce. We are requesting FOR FURTHER INFORMATION CONTACT: may consider proposing to complement comments from the public on the Douglas Potts, Fishery Policy Analyst, implementation of RCS–I. amendment. Amendment 6 would 978–281–9341. We have received an inquiry from establish management measures for the SUPPLEMENTARY INFORMATION: We are professional associations and national blueline tilefish fishery north of the soliciting public comments on industry organizations regarding the 60- Virginia/North Carolina border, Amendment 6 and its incorporated day comment period for the ANPRM. including: Permitting, recordkeeping, documents through the end of the These organizations stated that by and reporting requirements; trip limits comment period stated in this notice of providing all stakeholders additional for both the commercial and availability. We will publish a proposed time to review and comment upon the recreational sectors of the fishery; and rule in the Federal Register that would ANPRM, they will be able to conduct a the process for setting specifications and implement the amendment’s more comprehensive review of the annual catch limits. In addition, this management measures for additional refinements we are considering to the action would set 2017 harvest limits. public comment, following NMFS’s SNF PPS payment methodology and DATES: Comments must be received on evaluation of the proposed rule under provide more meaningful comments. In or before August 14, 2017. the procedures of the Magnuson-Stevens order to maximize the opportunity for ADDRESSES: You may submit comments, Fishery Conservation and Management the public to provide meaningful input identified by NOAA–NMFS–2016–0025, Act. Public comments on the proposed to CMS, we believe that it is important by either of the following methods: rule must be received by the end of the to allow additional time for the public • Electronic Submissions: Submit all comment period provided in this notice to prepare comments on the ANPRM. In of availability to be considered in the electronic public comments via the addition, we believe that granting an approval/disapproval decision on the Federal e-Rulemaking Portal. Go to extension to the public comment period amendment. All comments received by www.regulations.gov/#!docketDetail;D= in this instance would further our August 14, 2017, whether specifically NOAA-NMFS-2016-0025, click the overall objective to obtain public input directed to the amendment or the ‘‘Comment Now!’’ icon, complete the on the potential refinements to the SNF proposed rule will be considered in the required fields, and enter or attach your PPS we are considering. Therefore, we approval/disapproval decision on the comments. are extending the comment period for • Mail: John K. Bullard, Regional amendment. To be considered, the ANPRM for an additional 60 days. comments must be received by close of Administrator, NMFS, Greater Atlantic This document announces the extension business on the last day of the comment Regional Fisheries Office, 55 Great of the public comment period for the period. Comments received after that Republic Drive, Gloucester, MA 01930. ANPRM until August 25, 2017. date will not be considered in the Mark the outside of the envelope: Dated: June 7, 2017. ‘‘Comments on Blueline Tilefish decision to approve or disapprove Seema Verma, Amendment.’’ Amendment 6, including those Administrator, Centers for Medicare & Instructions: Comments sent by any postmarked or otherwise transmitted by Medicaid Services. other method, to any other address or the last day of the comment period. [FR Doc. 2017–12324 Filed 6–13–17; 8:45 am] individual, or received after the end of The Mid-Atlantic Fishery BILLING CODE 4120–01–P the comment period, may not be Management Council developed this considered by NMFS. All comments amendment to establish management received are part of the public record measures for the blueline tilefish fishery DEPARTMENT OF COMMERCE and will generally be posted to north of the Virginia/North Carolina www.regulations.gov without change. border. This proposed action would National Oceanic and Atmospheric All personal identifying information establish the management framework for Administration (e.g., name, address, etc.) voluntarily this fishery including: Permitting, submitted by the commenter may be recordkeeping, and reporting 50 CFR Part 648 publicly accessible. Do not submit requirements; trip limits for both the confidential business information or commercial and recreational sectors of RIN 0648–BF86 otherwise sensitive or protected the fishery; and the process for setting information. specifications and annual catch limits. Fisheries of the Northeastern United NMFS will accept anonymous In addition, this action would set States; Amendment 6 to the Tilefish comments. Attachments to electronic harvest quotas and commercial and Fishery Management Plan comments will be accepted via recreational management measures for AGENCY: National Marine Fisheries Microsoft Word, Microsoft Excel, the 2017 fishing year. Additional details Service (NMFS), National Oceanic and WordPerfect, or Adobe PDF file formats of the proposed measures are available Atmospheric Administration (NOAA), only. in the amendment document and the Commerce. Copies of Amendment 6, and of the proposed rule. ACTION: Notice of availability; request draft Environmental Assessment and Authority: 16 U.S.C. 1801 et seq. for comments. preliminary Regulatory Impact Review (EA/RIR), are available from the Mid- Dated: June 9, 2017. SUMMARY: NMFS announces that the Atlantic Fishery Management Council, Margo B. Schulze-Haugen, Mid-Atlantic Fishery Management 800 North State Street, Suite 201, Dover, Acting Deputy Director, Office of Sustainable mstockstill on DSK30JT082PROD with PROPOSALS Council has submitted Amendment 6 to DE 19901. The EA/RIR is also accessible Fisheries, National Marine Fisheries Service. the Tilefish Fishery Management Plan via the Internet at: [FR Doc. 2017–12307 Filed 6–13–17; 8:45 am] for review and approval by the Secretary www.greateratlantic.fisheries.noaa.gov. BILLING CODE 3510–22–P VerDate Sep<11>2014 17:21 Jun 13, 2017 Jkt 241001 PO 00000 Frm 00007 Fmt 4702 Sfmt 9990 E:\FR\FM\14JNP1.SGM 14JNP1


Document Created: 2017-06-14 01:24:12
Document Modified: 2017-06-14 01:24:12
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionAdvance notice of proposed rulemaking with comment; extension of comment period.
DatesThe comment period for the ANPRM (82 FR 20980) is extended to 5 p.m., eastern daylight time, on August 25, 2017.
ContactJohn Kane, (410) 786-0557.
FR Citation82 FR 27222 
RIN Number0938-AT17
CFR Citation42 CFR 409
42 CFR 488
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