82_FR_57504 82 FR 57273 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2018

82 FR 57273 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2018

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

Federal Register Volume 82, Issue 231 (December 4, 2017)

Page Range57273-57275
FR Document2017-25972

This notice announces a $569.00 calendar year (CY) 2018 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, 2018 and on or before December 31, 2018.

Federal Register, Volume 82 Issue 231 (Monday, December 4, 2017)
[Federal Register Volume 82, Number 231 (Monday, December 4, 2017)]
[Notices]
[Pages 57273-57275]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-25972]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-6075-N]


Medicare, Medicaid, and Children's Health Insurance Programs; 
Provider Enrollment Application Fee Amount for Calendar Year 2018

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

ACTION: Notice.

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

SUMMARY: This notice announces a $569.00 calendar year (CY) 2018 
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, 2018 and on or before December 31, 2018.

DATES: This notice takes effect on January 1, 2018.

FOR FURTHER INFORMATION CONTACT: Melissa Singer, (410) 786-0365.

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) 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 2017 Fee Amount

    In the November 7, 2016 Federal Register (81 FR 78159), we 
published a notice announcing a fee amount for the period of January 1, 
2017 through December 31, 2017 of $560.00. 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.

[[Page 57274]]

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.
     The CPI-U increase for the period of July 1, 2015 through 
June 30, 2016 was 1.0 percent. This resulted in a CY 2017 application 
fee amount of $559.56 ($554 x 1.01). Rounding this figure to the 
nearest whole dollar amount resulted in a CY 2017 application fee 
amount of $560.00.

B. CY 2018 Fee Amount

    Using BLS data, the CPI-U increase for the period of July 1, 2015 
through June 30, 2016 was 1.6 percent. This results in a CY 2018 
application fee amount of $568.96 ($560 x 1.016). As we must round this 
to the nearest whole dollar amount, the resultant application fee 
amount for CY 2018 is $569.00.

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 control number 0938-0685; the Form 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), the Congressional Review Act (5 U.S.C. 804(2)), and Executive 
Order 13771 on Reducing Regulation and Controlling Regulatory Costs 
(January 30, 2017).
    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 2018.
1. Estimates of Number of Affected Institutional Providers in November 
7, 2016 Fee Notice
    In the November 7, 2016 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 2017.
     45,000 revalidating Medicare institutional providers would 
be subject to and pay an application fee in CY 2017.
     9,000 newly enrolling Medicaid and CHIP providers would be 
subject to and pay an application fee in CY 2017.
     21,000 revalidating Medicaid and CHIP providers would be 
subject to and pay an application fee in CY 2017.
2. CY 2018 Estimates
a. Medicare
    Based on CMS data, we estimate that in CY 2018 approximately--
     3,800 newly enrolling institutional providers will be 
subject to and pay an application fee; and
     7.500 revalidating institutional providers will be subject 
to and pay an application fee.
    Using a figure of 11,300 (3,800 newly enrolling + 7,500 
revalidating) institutional providers, we estimate an increase in the 
cost of the Medicare application fee requirement in CY 2018 of $101,700 
(or 11,300 x $9 (or $569 minus $560)) from our CY 2017 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 
2018. Using this figure, we project an increase in the cost of the 
Medicaid and CHIP application fee requirement in CY 2018 of $270,000 
(or 30,000 x $9 (or $569 minus $560)) from our CY 2017 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 2018 to be $371,700 ($270,000 + $101,700) 
from our CY 2017 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

[[Page 57275]]

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 2017, that 
threshold is approximately $148 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.
    Executive Order 13771, titled ``Reducing Regulation and Controlling 
Regulatory Costs,'' was issued on January 30, 2017 (82 FR 9339, 
February 3, 2017). It has been determined that this notice is a 
transfer notice that does not impose more than de minimis costs and 
thus is not a regulatory action for the purposes of E.O. 13771.
    In accordance with the provisions of Executive Order 12866, this 
notice was reviewed by the Office of Management and Budget.

    Dated: November 28, 2017.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2017-25972 Filed 12-1-17; 8:45 am]
BILLING CODE 4120-01-P



                                                                            Federal Register / Vol. 82, No. 231 / Monday, December 4, 2017 / Notices                                             57273

                                                Program (VSP) in the 1970s as a                         ACTION:   Notice.                                       As indicated in § 424.514 and
                                                cooperative activity with the cruise ship                                                                     § 455.460, the application fee is not
                                                industry. VSP helps the cruise ship                     SUMMARY:   This notice announces a                    required for either of the following:
                                                industry prevent and control the                        $569.00 calendar year (CY) 2018                         • A Medicare physician or non-
                                                introduction, transmission, and spread                  application fee for institutional                     physician practitioner submitting a
                                                of gastrointestinal illnesses (GI) on                   providers that are initially enrolling in             CMS–855I.
                                                cruise ships. VSP operates under the                    the Medicare or Medicaid program or                     • A prospective or revalidating
                                                authority of the Public Health Service                  the Children’s Health Insurance                       Medicaid or CHIP provider—
                                                Act (Section 361 of the Public Health                   Program (CHIP); revalidating their                      ++ Who is an individual physician or
                                                Service Act; 42 U.S.C. 264, ‘‘Control of                Medicare, Medicaid, or CHIP                           non-physician practitioner; or
                                                Communicable Diseases’’). Regulations                   enrollment; or adding a new Medicare                    ++ That is enrolled in Title XVIII of
                                                found at 42 CFR 71.41 state that carriers               practice location. This fee is required               the Act or another state’s Title XIX or
                                                arriving at U.S. ports from a foreign area              with any enrollment application                       XXI plan and has paid the application
                                                are subject to sanitary inspections to                  submitted on or after January 1, 2018                 fee to a Medicare contractor or another
                                                determine whether rodent, insect, or                    and on or before December 31, 2018.                   state.
                                                other vermin infestations exist, or                     DATES: This notice takes effect on
                                                                                                                                                              II. Provisions of the Notice
                                                whether contaminated food or water or                   January 1, 2018.
                                                other sanitary conditions requiring                     FOR FURTHER INFORMATION CONTACT:                      A. CY 2017 Fee Amount
                                                measures for the prevention of the                      Melissa Singer, (410) 786–0365.                          In the November 7, 2016 Federal
                                                introduction, transmission, or spread of                SUPPLEMENTARY INFORMATION:                            Register (81 FR 78159), we published a
                                                communicable diseases are present.                                                                            notice announcing a fee amount for the
                                                  VSP established the public health                     I. Background
                                                                                                                                                              period of January 1, 2017 through
                                                standards found in the current version                     In the February 2, 2011 Federal                    December 31, 2017 of $560.00. This
                                                of the VSP Operations Manual and VSP                    Register (76 FR 5862), we published a                 figure was calculated as follows:
                                                Construction Guidelines. These                          final rule with comment period titled                    • Section 1866(j)(2)(C)(i)(I) of the Act
                                                standards target the control and                        ‘‘Medicare, Medicaid, and Children’s                  established a $500 application fee for
                                                prevention of GI illnesses on cruise                    Health Insurance Programs; Additional                 institutional providers in CY 2010.
                                                ships.                                                  Screening Requirements, Application                      • Consistent with section
                                                  VSP is updating the VSP Operations                    Fees, Temporary Enrollment Moratoria,                 1866(j)(2)(C)(i)(II) of the Act,
                                                Manual to reflect new technologies,                     Payment Suspensions and Compliance                    § 424.514(d)(2) states that for CY 2011
                                                current food science, disease patterns                  Plans for Providers and Suppliers.’’ This             and subsequent years, the preceding
                                                and trends, and emerging pathogens.                     rule finalized, among other things,                   year’s fee will be adjusted by the
                                                VSP also is updating the VSP                            provisions related to the submission of               percentage change in the consumer
                                                Construction Guidelines as a framework                  application fees as part of the Medicare,             price index (CPI) for all urban
                                                of consistent construction and design                   Medicaid, and CHIP provider                           consumers (all items; United States city
                                                guidelines related to public health,                    enrollment processes. As provided in                  average, CPI–U) for the 12-month period
                                                including vessel facilities related to food             section 1866(j)(2)(C)(i) of the Social                ending on June 30 of the previous year.
                                                storage, preparation, and service and                   Security Act (the Act) and in 42 CFR                     • The CPI–U increase for CY 2011
                                                water bunkering, storage, disinfection,                 424.514, ‘‘institutional providers’’ that             was 1.0 percent, based on data obtained
                                                and distribution.                                       are initially enrolling in the Medicare or            from the Bureau of Labor Statistics
                                                  The draft VSP Operations Manual and                   Medicaid programs or CHIP,                            (BLS). This resulted in an application
                                                the draft VSP Construction Guidelines                   revalidating their enrollment, or adding              fee amount for CY 2011 of $505 (or $500
                                                are available online at                                 a new Medicare practice location are                  × 1.01).
                                                www.regulations.gov, Docket No. CDC–                    required to submit a fee with their                      • The CPI–U increase for the period
                                                2017–0115, under Supplemental                           enrollment application. An                            of July 1, 2010 through June 30, 2011
                                                Materials.                                              ‘‘institutional provider’’ for purposes of            was 3.54 percent, based on BLS data.
                                                  Dated: November 27, 2017.                             Medicare is defined at § 424.502 as                   This resulted in an application fee
                                                Sandra Cashman,                                         ‘‘(a)ny provider or supplier that submits             amount for CY 2012 of $522.87 (or $505
                                                Executive Secretary, Centers for Disease                a paper Medicare enrollment                           × 1.0354). In the February 2, 2011 final
                                                Control and Prevention.                                 application using the CMS–855A, CMS–                  rule, we stated that if the adjustment
                                                [FR Doc. 2017–25955 Filed 12–1–17; 8:45 am]             855B (not including physician and non-                sets the fee at an uneven dollar amount,
                                                BILLING CODE 4163–18–P
                                                                                                        physician practitioner organizations),                we would round the fee to the nearest
                                                                                                        CMS–855S, or associated Internet-based                whole dollar amount. Accordingly, the
                                                                                                        PECOS enrollment application.’’ As we                 application fee amount for CY 2012 was
                                                DEPARTMENT OF HEALTH AND                                explained in the February 2, 2011 final               rounded to the nearest whole dollar
                                                HUMAN SERVICES                                          rule (76 FR 5914), in addition to the                 amount, or $523.00.
                                                                                                        providers and suppliers subject to the                   • The CPI–U increase for the period
                                                Centers for Medicare & Medicaid                         application fee under Medicare,                       of July 1, 2011 through June 30, 2012
                                                Services                                                Medicaid-only and CHIP-only                           was 1.664 percent, based on BLS data.
                                                                                                        institutional providers would include                 This resulted in an application fee
                                                [CMS–6075–N]                                            nursing facilities, intermediate care                 amount for CY 2013 of $531.70 ($523 ×
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                                                Medicare, Medicaid, and Children’s                      facilities for persons with intellectual              1.01664). Rounding this figure to the
                                                Health Insurance Programs; Provider                     disabilities (ICF/IID), psychiatric                   nearest whole dollar amount resulted in
                                                Enrollment Application Fee Amount for                   residential treatment facilities, and may             a CY 2013 application fee amount of
                                                Calendar Year 2018                                      include other institutional provider                  $532.00.
                                                                                                        types designated by a state in                           • The CPI–U increase for the period
                                                AGENCY: Centers for Medicare &                          accordance with their approved state                  of July 1, 2012 through June 30, 2013
                                                Medicaid Services (CMS), HHS.                           plan.                                                 was 1.8 percent, based on BLS data.


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                                                57274                       Federal Register / Vol. 82, No. 231 / Monday, December 4, 2017 / Notices

                                                This resulted in an application fee                     and Regulatory Review (January 18,                      • 7.500 revalidating institutional
                                                amount for CY 2014 of $541.576 ($532                    2011), the Regulatory Flexibility Act                 providers will be subject to and pay an
                                                × 1.018). Rounding this figure to the                   (RFA) (September 19, 1980, Pub. L. 96–                application fee.
                                                nearest whole dollar amount resulted in                 354), section 1102(b) of the Social                     Using a figure of 11,300 (3,800 newly
                                                a CY 2014 application fee amount of                     Security Act, section 202 of the                      enrolling + 7,500 revalidating)
                                                $542.00.                                                Unfunded Mandates Reform Act of 1995                  institutional providers, we estimate an
                                                  • The CPI–U increase for the period                   (March 22, 1995; Pub. L. 104–4),                      increase in the cost of the Medicare
                                                of July 1, 2013 through June 30, 2014                   Executive Order 13132 on Federalism                   application fee requirement in CY 2018
                                                was 2.1 percent, based on BLS data.                     (August 4, 1999), the Congressional                   of $101,700 (or 11,300 × $9 (or $569
                                                This resulted in an application fee                     Review Act (5 U.S.C. 804(2)), and                     minus $560)) from our CY 2017
                                                amount for CY 2015 of $553.382 ($542                    Executive Order 13771 on Reducing                     projections and as previously described.
                                                × 1.021). Rounding this figure to the                   Regulation and Controlling Regulatory                 b. Medicaid and CHIP
                                                nearest whole dollar amount resulted in                 Costs (January 30, 2017).
                                                a CY 2015 application fee amount of                        Executive Orders 12866 and 13563                      Based on CMS and state statistics, we
                                                $553.00.                                                direct agencies to assess all costs and               estimate that approximately 30,000
                                                  • The CPI–U increase for the period                   benefits of available regulatory                      (9,000 newly enrolling + 21,000
                                                of July 1, 2014 through June 30, 2015                   alternatives and, if regulation is                    revalidating) Medicaid and CHIP
                                                was 0.2 percent, based on BLS data.                     necessary, to select regulatory                       institutional providers will be subject to
                                                This resulted in an application fee                     approaches that maximize net benefits,                an application fee in CY 2018. Using
                                                amount for CY 2016 of $554.106 ($553                                                                          this figure, we project an increase in the
                                                                                                        including potential economic,
                                                × 1.002). Rounding this figure to the                                                                         cost of the Medicaid and CHIP
                                                                                                        environmental, public health and safety
                                                nearest whole dollar amount resulted in                                                                       application fee requirement in CY 2018
                                                                                                        effects, distributive impacts, and equity.
                                                a CY 2016 application fee amount of                                                                           of $270,000 (or 30,000 × $9 (or $569
                                                                                                        A regulatory impact analysis (RIA) must
                                                $554.00.                                                                                                      minus $560)) from our CY 2017
                                                                                                        be prepared for major rules with
                                                  • The CPI–U increase for the period                                                                         projections and as previously described.
                                                                                                        economically significant effects ($100
                                                of July 1, 2015 through June 30, 2016                   million or more in any 1 year). As                    c. Total
                                                was 1.0 percent. This resulted in a CY                  explained in this section of the notice,                 Based on the foregoing, we estimate
                                                2017 application fee amount of $559.56                  we estimate that the total cost of the                the total increase in the cost of the
                                                ($554 × 1.01). Rounding this figure to                  increase in the application fee will not              application fee requirement for
                                                the nearest whole dollar amount                         exceed $100 million. Therefore, this                  Medicare, Medicaid, and CHIP
                                                resulted in a CY 2017 application fee                   notice does not reach the $100 million                providers and suppliers in CY 2018 to
                                                amount of $560.00.                                      economic threshold and is not                         be $371,700 ($270,000 + $101,700) from
                                                                                                        considered a major notice.                            our CY 2017 projections.
                                                B. CY 2018 Fee Amount
                                                                                                        B. Costs                                                 The RFA requires agencies to analyze
                                                  Using BLS data, the CPI–U increase                                                                          options for regulatory relief of small
                                                for the period of July 1, 2015 through                    The costs associated with this notice               businesses. For purposes of the RFA,
                                                June 30, 2016 was 1.6 percent. This                     involve the increase in the application               small entities include small businesses,
                                                results in a CY 2018 application fee                    fee amount that certain providers and                 nonprofit organizations, and small
                                                amount of $568.96 ($560 × 1.016). As                    suppliers must pay in CY 2018.                        governmental jurisdictions. Most
                                                we must round this to the nearest whole                                                                       hospitals and most other providers and
                                                                                                        1. Estimates of Number of Affected
                                                dollar amount, the resultant application                                                                      suppliers are small entities, either by
                                                                                                        Institutional Providers in November 7,
                                                fee amount for CY 2018 is $569.00.                                                                            nonprofit status or by having revenues
                                                                                                        2016 Fee Notice
                                                III. Collection of Information                                                                                of less than $7.5 million to $38.5
                                                                                                          In the November 7, 2016 application                 million in any 1 year. Individuals and
                                                Requirements                                            fee notice, we estimated that based on                states are not included in the definition
                                                  This document does not impose                         CMS statistics—                                       of a small entity. As we stated in the
                                                information collection requirements,                      • 10,000 newly enrolling Medicare                   RIA for the February 2, 2011 final rule
                                                that is, reporting, recordkeeping, or                   institutional providers would be subject              with comment period (76 FR 5952), we
                                                third-party disclosure requirements.                    to and pay an application fee in CY                   do not believe that the application fee
                                                Consequently, there is no need for                      2017.                                                 will have a significant impact on small
                                                review by the Office of Management and                    • 45,000 revalidating Medicare                      entities.
                                                Budget under the authority of the                       institutional providers would be subject                 In addition, section 1102(b) of the Act
                                                Paperwork Reduction Act of 1995.                        to and pay an application fee in CY                   requires us to prepare a regulatory
                                                However, it does reference previously                   2017.                                                 impact analysis if a rule may have a
                                                approved information collections. The                     • 9,000 newly enrolling Medicaid and                significant impact on the operations of
                                                Forms CMS–855A, CMS–855B, and                           CHIP providers would be subject to and                a substantial number of small rural
                                                CMS–855I are approved under OMB                         pay an application fee in CY 2017.                    hospitals. This analysis must conform to
                                                control number 0938–0685; the Form                        • 21,000 revalidating Medicaid and                  the provisions of section 604 of the
                                                CMS–855S is approved under OMB                          CHIP providers would be subject to and                RFA. For purposes of section 1102(b) of
                                                control number 0938–1056.                               pay an application fee in CY 2017.                    the Act, we define a small rural hospital
                                                                                                                                                              as a hospital that is located outside of
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                                                IV. Regulatory Impact Statement                         2. CY 2018 Estimates
                                                                                                                                                              a Metropolitan Statistical Area for
                                                A. Background                                           a. Medicare                                           Medicare payment regulations and has
                                                  We have examined the impact of this                     Based on CMS data, we estimate that                 fewer than 100 beds. We are not
                                                notice as required by Executive Order                   in CY 2018 approximately—                             preparing an analysis for section 1102(b)
                                                12866 on Regulatory Planning and                          • 3,800 newly enrolling institutional               of the Act because we have determined,
                                                Review (September 30, 1993), Executive                  providers will be subject to and pay an               and the Secretary certifies, that this
                                                Order 13563 on Improving Regulation                     application fee; and                                  notice would not have a significant


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                                                                            Federal Register / Vol. 82, No. 231 / Monday, December 4, 2017 / Notices                                            57275

                                                impact on the operations of a substantial               year (FY) 2019 applications for add-on                Meeting via live stream technology or
                                                number of small rural hospitals.                        payments for new medical services and                 webinar. These options are discussed in
                                                   Section 202 of the Unfunded                          technologies under the hospital                       section II.B. of this notice.
                                                Mandates Reform Act of 1995 (UMRA)                      inpatient prospective payment system                     Registration and Special
                                                also requires that agencies assess                      (IPPS). Interested parties are invited to             Accommodations: Individuals wishing
                                                anticipated costs and benefits before                   this meeting to present their comments,               to participate in the meeting must
                                                issuing any rule whose mandates                         recommendations, and data regarding                   register by following the on-line
                                                require spending in any 1 year of $100                  whether the FY 2019 new medical                       registration instructions located in
                                                million in 1995 dollars, updated                        services and technologies applications                section III. of this notice or by
                                                annually for inflation. In 2017, that                   meet the substantial clinical                         contacting staff listed in the FOR
                                                threshold is approximately $148                         improvement criterion.                                FURTHER INFORMATION CONTACT section of
                                                million. The Agency has determined                      DATES:                                                this notice. Individuals who need
                                                that there will be minimal impact from                     Meeting Date: The Town Hall Meeting                special accommodations should contact
                                                the costs of this notice, as the threshold              announced in this notice will be held on              staff listed in the FOR FURTHER
                                                is not met under the UMRA.                              Tuesday, February 13, 2018. The Town                  INFORMATION CONTACT section of this
                                                   Executive Order 13132 establishes                    Hall Meeting will begin at 9:00 a.m.                  notice.
                                                certain requirements that an agency                     Eastern Standard Time (e.s.t.) and                       Submission of Agenda Item(s) or
                                                must meet when it promulgates a                         check-in will begin at 8:30 a.m. e.s.t.               Written Comments for the Town Hall
                                                proposed rule (and subsequent final                        Deadline for Registration for                      Meeting: Each presenter must submit an
                                                rule) that imposes substantial direct                   Participants (not Presenting) at the                  agenda item(s) regarding whether a FY
                                                requirement costs on state and local                    Town Hall Meeting: The deadline to                    2019 application meets the substantial
                                                governments, preempts state law, or                     register to attend the Town Hall Meeting              clinical improvement criterion. Agenda
                                                otherwise has federalism implications.                  is 5:00 p.m., e.s.t. on Wednesday,                    items, written comments, questions or
                                                Since this notice does not impose                       February 7, 2018.                                     other statements must not exceed three
                                                substantial direct costs on state or local                 Deadline for Requesting Special                    single-spaced typed pages and may be
                                                governments, the requirements of                        Accommodations: The deadline to                       sent via email to newtech@cms.hhs.gov.
                                                Executive Order 13132 are not                           submit requests for special                           FOR FURTHER INFORMATION CONTACT:
                                                applicable.                                             accommodations is 5:00 p.m., e.s.t. on                Michelle Joshua, (410) 786–6050,
                                                   Executive Order 13771, titled                        Tuesday, January 16, 2018.                            michelle.joshua@cms.hhs.gov; or
                                                ‘‘Reducing Regulation and Controlling                      Deadline for Registration of Presenters            Michael Treitel, (410) 786–4552,
                                                Regulatory Costs,’’ was issued on                       at the Town Hall Meeting: The deadline                michael.treitel@cms.hhs.gov.
                                                January 30, 2017 (82 FR 9339, February                  to register to present at the Town Hall                  Alternatively, you may forward your
                                                3, 2017). It has been determined that                   Meeting is 5:00 p.m., e.s.t. on Monday,               requests via email to newtech@
                                                this notice is a transfer notice that does              January 29, 2018.                                     cms.hhs.gov.
                                                not impose more than de minimis costs                      Deadline for Submission of Agenda
                                                and thus is not a regulatory action for                                                                       SUPPLEMENTARY INFORMATION:
                                                                                                        Item(s) or Written Comments for the
                                                the purposes of E.O. 13771.                             Town Hall Meeting: Written comments                   I. Background on the Add-On Payments
                                                   In accordance with the provisions of                                                                       for New Medical Services and
                                                                                                        and agenda items for discussion at the
                                                Executive Order 12866, this notice was                                                                        Technologies Under the IPPS
                                                                                                        Town Hall Meeting, including agenda
                                                reviewed by the Office of Management
                                                                                                        items by presenters, must be received by                 Sections 1886(d)(5)(K) and (L) of the
                                                and Budget.
                                                                                                        5:00 p.m. e.s.t. on Monday, January 29,               Social Security Act (the Act) require the
                                                  Dated: November 28, 2017.                             2018.                                                 Secretary to establish a process of
                                                Seema Verma,                                               Deadline for Submission of Written                 identifying and ensuring adequate
                                                Administrator, Centers for Medicare &                   Comments after the Town Hall Meeting                  payments to acute care hospitals for
                                                Medicaid Services.                                      for consideration in the FY 2019 IPPS                 new medical services and technologies
                                                [FR Doc. 2017–25972 Filed 12–1–17; 8:45 am]             proposed rule: Individuals may submit                 under Medicare. Effective for discharges
                                                BILLING CODE 4120–01–P                                  written comments after the Town Hall                  beginning on or after October 1, 2001,
                                                                                                        Meeting, as specified in the ADDRESSES                section 1886(d)(5)(K)(i) of the Act
                                                                                                        section of this notice, on whether the                requires the Secretary to establish (after
                                                DEPARTMENT OF HEALTH AND                                service or technology represents a                    notice and opportunity for public
                                                HUMAN SERVICES                                          substantial clinical improvement. These               comment) a mechanism to recognize the
                                                                                                        comments must be received by 5:00                     costs of new services and technologies
                                                Centers for Medicare & Medicaid                         p.m. e.s.t. on Friday, February 23, 2018,             under the hospital inpatient prospective
                                                Services                                                for consideration in the FY 2019 IPPS                 payment system (IPPS). In addition,
                                                [CMS–1684–N]                                            proposed rule.                                        section 1886(d)(5)(K)(vi) of the Act
                                                                                                        ADDRESSES:                                            specifies that a medical service or
                                                Medicare Program; Town Hall Meeting                        Meeting Location: The Town Hall                    technology will be considered ‘‘new’’ if
                                                on the FY 2019 Applications for New                     Meeting will be held in the main                      it meets criteria established by the
                                                Medical Services and Technologies                       Auditorium in the central building of                 Secretary (after notice and opportunity
                                                Add-On Payments                                         the Centers for Medicare & Medicaid                   for public comment). (See the fiscal year
                                                                                                        Services located at 7500 Security
sradovich on DSK3GMQ082PROD with NOTICES




                                                AGENCY: Centers for Medicare &                                                                                (FY) 2002 IPPS proposed rule (66 FR
                                                Medicaid Services (CMS), HHS.                           Boulevard, Baltimore, MD 21244–1850.                  22693, May 4, 2001) and final rule (66
                                                ACTION: Notice of meeting.                                 In addition, we are providing two                  FR 46912, September 7, 2001) for a more
                                                                                                        alternatives to attending the meeting in              detailed discussion.)
                                                SUMMARY:  This notice announces a                       person—(1) there will be an open toll-                   In the September 7, 2001 final rule (66
                                                Town Hall meeting in accordance with                    free phone line to call into the Town                 FR 46914), we noted that we evaluated
                                                section 1886(d)(5)(K)(viii) of the Social               Hall Meeting; or (2) participants may                 a request for special payment for a new
                                                Security Act (the Act) to discuss fiscal                view and participate in the Town Hall                 medical service or technology against


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Document Created: 2017-12-02 00:40:52
Document Modified: 2017-12-02 00:40:52
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesThis notice takes effect on January 1, 2018.
ContactMelissa Singer, (410) 786-0365.
FR Citation82 FR 57273 

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