83_FR_55318 83 FR 55105 - Medicare and Medicaid Programs; Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies; Extension of Timeline for Publication of Final Rule

83 FR 55105 - Medicare and Medicaid Programs; Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies; Extension of Timeline for Publication of Final Rule

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

Federal Register Volume 83, Issue 213 (November 2, 2018)

Page Range55105-55106
FR Document2018-23922

This document announces the extension of the timeline for publication of the ``Medicare and Medicaid Program; Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies'' final rule. We are issuing this document in accordance with section 1871(a)(3)(B) of the Social Security Act (the Act), which requires notice to be provided in the Federal Register if there are exceptional circumstances that cause us to publish a final rule more than 3 years after the publication date of the proposed rule. In this case, the complexity of the rule and scope of public comments warrants the extension of the timeline for publication.

Federal Register, Volume 83 Issue 213 (Friday, November 2, 2018)
[Federal Register Volume 83, Number 213 (Friday, November 2, 2018)]
[Rules and Regulations]
[Pages 55105-55106]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-23922]



[[Page 55105]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 482, 484, and 485

[CMS-3317-RCN]
RIN 0938-AS59


Medicare and Medicaid Programs; Revisions to Requirements for 
Discharge Planning for Hospitals, Critical Access Hospitals, and Home 
Health Agencies; Extension of Timeline for Publication of Final Rule

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

ACTION: Extension of timeline for publication of a final rule.

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

SUMMARY: This document announces the extension of the timeline for 
publication of the ``Medicare and Medicaid Program; Revisions to 
Requirements for Discharge Planning for Hospitals, Critical Access 
Hospitals, and Home Health Agencies'' final rule. We are issuing this 
document in accordance with section 1871(a)(3)(B) of the Social 
Security Act (the Act), which requires notice to be provided in the 
Federal Register if there are exceptional circumstances that cause us 
to publish a final rule more than 3 years after the publication date of 
the proposed rule. In this case, the complexity of the rule and scope 
of public comments warrants the extension of the timeline for 
publication.

DATES: This extension is effective on November 2, 2018.

FOR FURTHER INFORMATION CONTACT: Alpha-Banu Wilson, (410) 786-8687.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 1871(a)(3)(A) of the Social Security Act (the Act) requires 
the Secretary of the Department of Health and Human Services (the 
Secretary), in consultation with the Director of the Office of 
Management and Budget (OMB), to establish a regular timeline for the 
publication of a final rule based on the previous publication of a 
proposed rule or an interim final rule. Section 1871(a)(3)(B) of the 
Act allows the timeline for publishing Medicare final regulations to 
vary based on the complexity of the regulation, number and scope of 
comments received, and other related factors. The timeline for 
publishing the final regulation, however, cannot exceed 3 years from 
the date of publishing the proposed regulation unless there are 
exceptional circumstances. The Secretary may extend the initial 
targeted publication date of the final regulation, if the Secretary 
provides public notice including a brief explanation of the 
justification for the variation no later than the regulation's 
previously established proposed publication date.
    After consultation with the Director of OMB, the Department, 
through the Centers for Medicare & Medicaid Services (CMS), published a 
notice in the Federal Register on December 30, 2004 (69 FR 78442) 
establishing a general 3-year timeline for publishing Medicare final 
rules after the publication of a proposed or interim final rule.

II. Notification of Continuation

    Section 1861(e)(1) through (9), section 1861(m), section 1861(mm), 
section 1861(o), section 1891, and section 1820(e) of the Act list the 
requirements that hospitals, home health agencies (HHAs), and critical 
access hospitals (CAHs) must meet to be eligible for Medicare and 
Medicaid participation. The Medicare Conditions of Participation (CoPs) 
and Conditions for Coverage (CfCs) set forth the federal health and 
safety standards that providers and suppliers must meet to participate 
in the Medicare and Medicaid programs. The purposes of these conditions 
are to protect patient health and safety and to ensure that quality 
care is furnished to all patients in Medicare and Medicaid-
participating facilities. The statute also specifies that the Secretary 
may establish other requirements as necessary in the interest of the 
health and safety of patients.
    On November 3, 2015, we published a proposed rule in the Federal 
Register titled, ``Medicare and Medicaid Program; Revisions to 
Requirements for Discharge Planning for Hospitals, Critical Access 
Hospitals, and Home Health Agencies'' (80 FR 68126) that would update 
the discharge planning requirements for hospitals, CAHs, and HHAs. We 
also proposed to implement the discharge planning requirements of the 
Improving Medicare Post-Acute Care Transformation Act of 2014 (Pub. L. 
113-185), that requires hospitals, including, but not limited to, 
short-term acute care hospitals, CAHs and certain post-acute care (PAC) 
providers, including long term care hospitals, inpatient rehabilitation 
facilities, HHAs, and skilled nursing facilities, to take into account 
quality measures and resource use measures to assist patients and their 
families during the discharge planning process in order to encourage 
patients and their families to become active participants in the 
planning of their transition to the PAC setting (or between PAC 
settings). In response to the proposed rule, we received 299 public 
comments. Commenters included individuals, health care professionals 
and corporations, national associations and coalitions, state health 
departments, patient advocacy organizations, and individual facilities 
that would be impacted by the rule. The commenters presented procedural 
and cost information related to their specific circumstances, and the 
information presented requires additional analysis.
    This document announces an extension of the timeline for 
publication of the final rule based on the following exceptional 
circumstances, which we believe, justify such an extension. Based on 
both public comments received and stakeholder feedback, we have 
determined that there are significant policy issues that need to be 
resolved in order to address all of the issues raised by public 
comments to the proposed rule and to ensure appropriate coordination 
with other government agencies. Specifically, the development of the 
final rule requires collaboration with the Department of Health and 
Human Services' Office of the National Coordinator for Health 
Information Technology.
    We, therefore, are not able to meet the 3-year timeline for 
publication of the final rule and are instead extending the timeline 
for publication of the final rule.
    Our decision to extend the timeline for issuing a final rule that 
would update the CoPs should not be viewed as a diminution of the 
Department's commitment to timely and effective rulemaking in this 
area. We are committed to publishing a final rule that provides clear 
health and safety standards for hospitals, HHAs, and CAHs. At this 
time, we believe we can best achieve this balance by issuing this 
notification of continuation.
    This document extends the timeline for publication of the final 
rule until November 3, 2019.

III. Collection of Information

    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.).


[[Page 55106]]


    Dated: October 24, 2018.
Ann C. Agnew,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2018-23922 Filed 10-30-18; 4:15 pm]
BILLING CODE 4120-01-P



                       Federal Register / Vol. 83, No. 213 / Friday, November 2, 2018 / Rules and Regulations                                         55105

     DEPARTMENT OF HEALTH AND                                circumstances. The Secretary may                      their transition to the PAC setting (or
     HUMAN SERVICES                                          extend the initial targeted publication               between PAC settings). In response to
                                                             date of the final regulation, if the                  the proposed rule, we received 299
     Centers for Medicare & Medicaid                         Secretary provides public notice                      public comments. Commenters included
     Services                                                including a brief explanation of the                  individuals, health care professionals
                                                             justification for the variation no later              and corporations, national associations
     42 CFR Parts 482, 484, and 485                          than the regulation’s previously                      and coalitions, state health departments,
     [CMS–3317–RCN]                                          established proposed publication date.                patient advocacy organizations, and
                                                                After consultation with the Director of
                                                                                                                   individual facilities that would be
     RIN 0938–AS59                                           OMB, the Department, through the
                                                                                                                   impacted by the rule. The commenters
                                                             Centers for Medicare & Medicaid
     Medicare and Medicaid Programs;                         Services (CMS), published a notice in                 presented procedural and cost
     Revisions to Requirements for                           the Federal Register on December 30,                  information related to their specific
     Discharge Planning for Hospitals,                       2004 (69 FR 78442) establishing a                     circumstances, and the information
     Critical Access Hospitals, and Home                     general 3-year timeline for publishing                presented requires additional analysis.
     Health Agencies; Extension of                           Medicare final rules after the                           This document announces an
     Timeline for Publication of Final Rule                  publication of a proposed or interim                  extension of the timeline for publication
     AGENCY:  Centers for Medicare &                         final rule.                                           of the final rule based on the following
     Medicaid Services (CMS), HHS.                           II. Notification of Continuation                      exceptional circumstances, which we
     ACTION: Extension of timeline for                                                                             believe, justify such an extension. Based
                                                                Section 1861(e)(1) through (9), section
     publication of a final rule.                                                                                  on both public comments received and
                                                             1861(m), section 1861(mm), section
                                                                                                                   stakeholder feedback, we have
     SUMMARY:    This document announces the                 1861(o), section 1891, and section
                                                             1820(e) of the Act list the requirements              determined that there are significant
     extension of the timeline for publication                                                                     policy issues that need to be resolved in
     of the ‘‘Medicare and Medicaid                          that hospitals, home health agencies
                                                             (HHAs), and critical access hospitals                 order to address all of the issues raised
     Program; Revisions to Requirements for                                                                        by public comments to the proposed
     Discharge Planning for Hospitals,                       (CAHs) must meet to be eligible for
                                                             Medicare and Medicaid participation.                  rule and to ensure appropriate
     Critical Access Hospitals, and Home
                                                             The Medicare Conditions of                            coordination with other government
     Health Agencies’’ final rule. We are
                                                             Participation (CoPs) and Conditions for               agencies. Specifically, the development
     issuing this document in accordance
     with section 1871(a)(3)(B) of the Social                Coverage (CfCs) set forth the federal                 of the final rule requires collaboration
     Security Act (the Act), which requires                  health and safety standards that                      with the Department of Health and
     notice to be provided in the Federal                    providers and suppliers must meet to                  Human Services’ Office of the National
     Register if there are exceptional                       participate in the Medicare and                       Coordinator for Health Information
     circumstances that cause us to publish                  Medicaid programs. The purposes of                    Technology.
     a final rule more than 3 years after the                these conditions are to protect patient
                                                                                                                      We, therefore, are not able to meet the
     publication date of the proposed rule. In               health and safety and to ensure that
                                                                                                                   3-year timeline for publication of the
     this case, the complexity of the rule and               quality care is furnished to all patients
                                                             in Medicare and Medicaid-participating                final rule and are instead extending the
     scope of public comments warrants the                                                                         timeline for publication of the final rule.
                                                             facilities. The statute also specifies that
     extension of the timeline for
                                                             the Secretary may establish other                        Our decision to extend the timeline
     publication.
                                                             requirements as necessary in the interest             for issuing a final rule that would
     DATES: This extension is effective on                   of the health and safety of patients.                 update the CoPs should not be viewed
     November 2, 2018.                                          On November 3, 2015, we published                  as a diminution of the Department’s
     FOR FURTHER INFORMATION CONTACT:                        a proposed rule in the Federal Register               commitment to timely and effective
     Alpha-Banu Wilson, (410) 786–8687.                      titled, ‘‘Medicare and Medicaid                       rulemaking in this area. We are
     SUPPLEMENTARY INFORMATION:                              Program; Revisions to Requirements for                committed to publishing a final rule that
                                                             Discharge Planning for Hospitals,                     provides clear health and safety
     I. Background                                           Critical Access Hospitals, and Home                   standards for hospitals, HHAs, and
        Section 1871(a)(3)(A) of the Social                  Health Agencies’’ (80 FR 68126) that
                                                                                                                   CAHs. At this time, we believe we can
     Security Act (the Act) requires the                     would update the discharge planning
                                                                                                                   best achieve this balance by issuing this
     Secretary of the Department of Health                   requirements for hospitals, CAHs, and
     and Human Services (the Secretary), in                  HHAs. We also proposed to implement                   notification of continuation.
     consultation with the Director of the                   the discharge planning requirements of                   This document extends the timeline
     Office of Management and Budget                         the Improving Medicare Post-Acute Care                for publication of the final rule until
     (OMB), to establish a regular timeline                  Transformation Act of 2014 (Pub. L.                   November 3, 2019.
     for the publication of a final rule based               113–185), that requires hospitals,
     on the previous publication of a                        including, but not limited to, short-term             III. Collection of Information
     proposed rule or an interim final rule.                 acute care hospitals, CAHs and certain                  This document does not impose
     Section 1871(a)(3)(B) of the Act allows                 post-acute care (PAC) providers,                      information collection requirements,
     the timeline for publishing Medicare                    including long term care hospitals,                   that is, reporting, recordkeeping or
     final regulations to vary based on the                  inpatient rehabilitation facilities, HHAs,            third-party disclosure requirements.
     complexity of the regulation, number                    and skilled nursing facilities, to take               Consequently, there is no need for
     and scope of comments received, and                     into account quality measures and
                                                                                                                   review by the Office of Management and
     other related factors. The timeline for                 resource use measures to assist patients
                                                                                                                   Budget under the authority of the
     publishing the final regulation,                        and their families during the discharge
     however, cannot exceed 3 years from                     planning process in order to encourage                Paperwork Reduction Act of 1995 (44
     the date of publishing the proposed                     patients and their families to become                 U.S.C. 3501 et seq.).
     regulation unless there are exceptional                 active participants in the planning of


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     55106             Federal Register / Vol. 83, No. 213 / Friday, November 2, 2018 / Rules and Regulations

       Dated: October 24, 2018.                              service to a PSAP. The Order on                          Title: Revision of Commission’s Rules
     Ann C. Agnew,                                           Reconsideration stated that with the                  To Ensure Compatibility With Enhanced
     Executive Secretary to the Department,                  exception of certain rules requiring                  911 Emergency Calling Systems; City of
     Department of Health and Human Services.                OMB approval, the rules adopted in the                Richardson, Texas, Recon Order.
     [FR Doc. 2018–23922 Filed 10–30–18; 4:15 pm]            Order on Reconsideration would
                                                                                                                      Form Number: N/A.
     BILLING CODE 4120–01–P                                  become effective. With regard to rules
                                                             requiring OMB approval, the                              Respondents: Business or other for-
                                                             Commission stated it will publish a                   profit.
     FEDERAL COMMUNICATIONS                                  document in the Federal Register                         Type of Review: New Information
     COMMISSION                                              announcing the effective date of these                Collection.
                                                             rules, 68 FR 2914. The information
                                                                                                                      Number of Respondents and
     47 CFR Part 20                                          collection requirements in § 20.18(j)(4)
                                                             and (j)(5) were approved by OMB on                    Responses: 1,358 respondents; 1,358
     [CC Docket No. 94–102; FCC 02–318]
                                                             January 16, 2003, under OMB Control                   responses.
                                                             No. 3060–1031. Subsequent to OMB                         Estimated Time per Response: 2–40
     Compatibility With Enhanced 911
     Emergency Calling Systems; Petition                     approval, the Commission redesignated                 hours.
     of City of Richardson, Texas Order on                   § 20.18(j)(4) and (j)(5) as 20.18(m)(4) and              Frequency of Response: On occasion,
     Reconsideration II                                      (m)(5). 80 FR 11805, March 4, 2015.                   third party disclosure requirement, and
                                                             With publication of the instant                       recordkeeping requirement.
     AGENCY:   Federal Communications                        document in the Federal Register, all
     Commission.                                             rules adopted in the Order on                            Obligation to Respond: Mandatory.
     ACTION: Final rule; announcement of                     Reconsideration are now effective. If                 Statutory authority for this information
     effective date.                                         you have any comments on the burden                   collection is contained in 47 U.S.C. 154,
                                                             estimates listed below, or how the                    160, 201, 251–254, 303, and 332 of the
     SUMMARY:    In this document, the                       Commission can improve the                            Communications Act of 1934, as
     Commission announces that the Office                    collections and reduce any burdens                    amended.
     of Management and Budget (OMB) has                      caused thereby, please contact Nicole                    Total Annual Burden: 13,960 hours.
     approved, on an emergency basis, a new                  Ongele, Federal Communications
     information collection associated with                                                                           Total Annual Cost: No cost.
                                                             Commission, Room 1–A620, 445 12th
     Revision of Commission’s Rules to                       Street SW, Washington, DC 20554.                         Nature and Extent of Confidentiality:
     Ensure Compatibility with Enhanced                      Please include the OMB Control                        Respondents are not required to submit
     911 Emergency Calling Systems;                          Number, 3060–1031, in your                            proprietary trade secrets or other
     Petition of City of Richardson, Texas                   correspondence. The Commission will                   confidential information. However,
     Order on Reconsideration II. This                       also accept your comments via email at                carriers that believe the only way to
     document is consistent with the Order                   PRA@fcc.gov.                                          satisfy the requirements for information
     on Reconsideration, which stated that                                                                         is to submit what it considers to be
     the Commission would publish a                          Synopsis
                                                                                                                   proprietary trade secrets or other
     document in the Federal Register                          As required by the Paperwork                        confidential information, carriers are
     announcing the effective date of the                    Reduction Act of 1995 (44 U.S.C. 3507),               free to request that materials or
     rule.                                                   the FCC is notifying the public that it               information submitted to the
     DATES: The amendments to 47 CFR                         received OMB approval on January 27,
                                                                                                                   Commission be withheld from public
     20.18(j)(4) and (5), published at 68 FR                 2003, for the information collection
                                                                                                                   inspection (see section 0.459 of the
     2914, January 22, 2003, and                             requirements contained in the
                                                             modifications to the Commission’s rules               Commission’s rules).
     redesignated as 47 CFR 20.18(m)(4) and
     (5) at 80 FR 11805, March 4, 2015, are                  in 47 CFR 20.18(m)(4) and (m)(5),                        Privacy Act Impact Assessment: No
     effective November 2, 2018.                             formerly 47 CFR 20.18(j)(4) and (j)(5).               impact(s).
     FOR FURTHER INFORMATION CONTACT:
                                                               Under 5 CFR part 1320, an agency                       Needs and Uses: The information
     Nellie Foosaner, Attorney-Advisor,                      may not conduct or sponsor a collection               collection requirements contained in
     Policy and Licensing Division, Public                   of information unless it displays a                   this collection guarantee continued
     Safety and Homeland Security Bureau,                    current, valid OMB Control Number.
                                                                                                                   cooperation between wireless carriers
                                                               No person shall be subject to any
     at (202) 418–2925, or email:                                                                                  and Public Safety Answering Points
                                                             penalty for failing to comply with a
     nellie.foosaner@fcc.gov. For additional                                                                       (PSAPs) in complying with the
                                                             collection of information subject to the
     information concerning the Paperwork                                                                          Commission’s E911 requirements.
                                                             Paperwork Reduction Act that does not
     Reduction Act information collection
                                                             display a current, valid OMB Control                  Federal Communications Commission.
     requirements contact Nicole Ongele at
                                                             Number. The OMB Control Number is                     Marlene Dortch,
     (202) 418–2991 or via email at
                                                             3060–1031.                                            Secretary, Office of the Secretary.
     Nicole.Ongele@fcc.gov.                                    The foregoing notice is required by
     SUPPLEMENTARY INFORMATION: A                            the Paperwork Reduction Act of 1995,                  [FR Doc. 2018–24024 Filed 11–1–18; 8:45 am]
     summary of the Order on                                 Pub. L. 104–13, October 1, 1995, and 44               BILLING CODE 6712–01–P
     Reconsideration (FCC 02–318) was                        U.S.C. 3507.
     published in the Federal Register, 68 FR                  The total annual reporting burdens
     2914, on January 22, 2003. The Order on                 and costs for the respondents are as
     Reconsideration adopted rules designed                  follows:
     to facilitate the rapid implementation of                 OMB Control Number: 3060–1031.
     E911 by addressing what constitutes a                     OMB Approval Date: January 16,
     valid Public Safety Answering Point                     2003.
     (PSAP) request to trigger wireless                        OMB Expiration Date: August 31,
     carriers’ obligations to provide E911                   2003.


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Document Created: 2018-11-02 01:09:32
Document Modified: 2018-11-02 01:09:32
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionExtension of timeline for publication of a final rule.
DatesThis extension is effective on November 2, 2018.
ContactAlpha-Banu Wilson, (410) 786-8687.
FR Citation83 FR 55105 
RIN Number0938-AS59
CFR Citation42 CFR 482
42 CFR 484
42 CFR 485

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