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)
Centers for Medicare & Medicaid Services
Federal Register Volume 83, Issue 213 (November 2, 2018)
| Page Range | 55105-55106 | |
| FR Document | 2018-23922 |
[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]] ======================================================================= ----------------------------------------------------------------------- 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
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Rules and Regulations | |
| Action | Extension of timeline for publication of a final rule. | |
| Dates | This extension is effective on November 2, 2018. | |
| Contact | Alpha-Banu Wilson, (410) 786-8687. | |
| FR Citation | 83 FR 55105 | |
| RIN Number | 0938-AS59 | |
| CFR Citation | 42
CFR
482 42 CFR 484 42 CFR 485 |
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