[Federal Register Volume 64, Number 127 (Friday, July 2, 1999)] [Notices] [Pages 36021-36022] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 99-17025] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Care Financing Administration [HCFA-3019-N] Medicare Program; July 19, 1999 Open Town Hall Meeting To Discuss the Implementation of the Peer Review Organizations' (PROs) Sixth Round Contract Activities
Agency
Health Care Financing Administration (HCFA), HHS.
Action
Notice of meeting.
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Summary
This notice announces a Town Hall meeting to provide an opportunity for national health care organizations, beneficiary advocates, and other interested parties to ask questions and raise issues regarding the August 1999 implementation of the Peer Review Organizations' (PROs) Sixth Round Contract activities. The meeting will also explore how the entire health care community can identify ways to collaborate on quality improvement projects that will raise the quality of care provided to Medicare beneficiaries. The agency views this new round of contracts as an opportunity to develop partnerships with the provider, practitioner, plan, purchaser and beneficiary communities. The meeting will address how PROs, health care organizations and Medicare beneficiaries can form partnerships in the following areas: • National quality improvement projects; • Local quality improvement projects; • Quality improvement projects in conjunction with Medicare+Choice plans; and • Inclusion of disadvantaged populations within each of the quality improvement projects. The meeting will also address the Payment Error Prevention Program, which deals with reducing the occurrence of provider billing errors and consequent payment errors, including both over- and under-payment.
Dates
The meeting is scheduled for Monday, July 19, 1999 from 9 a.m. until 3 p.m., E.D.T.
Addresses
The meeting will be held in the Health Care Financing Administration Main Auditorium, 7500 Security Boulevard, Baltimore, Maryland 21244.
For Further Information Contact
Donald Forgione, (410) 786-3504, Yvette Williams, (410) 786-6844.
Supplementary Information
Background
The Town Hall meeting will provide an opportunity for organizations representing practitioners, providers, health plans, other purchasers, beneficiaries and other interested parties to ask questions and raise issues regarding the activities of the PRO Sixth Round Contract and how they can partner with PROs in achieving quality improvements for Medicare beneficiaries and improved payment accuracy. This Town Hall meeting provides an opportunity for information exchange concerning Request For Proposals (RFP) and the Payment Error Prevention Program (Task 4). RFP No. HCFA-99-00/ELM (March 1, 1999) Sec. C (3.1-3.4, pp. 17-30. Task 1 concerns National Quality Improvement Projects and focuses on specific national health improvement clinical topics, acute myocardial infarction, heart failure, pneumonia,
stroke/transient ischemic attack/atrial fibrillation, diabetes, and breast cancer. The PROs, in conjunction with their partners, will use standardized sets of quality indicators to identify the greatest opportunities to improve the care of Medicare beneficiaries. Task 2 on Local Quality Improvement Projects directs each PRO to initiate local projects within its State in response to local interests, needs, and opportunities. HCFA is interested in broadening the PROs' experience in collaborating with providers, practitioners, plans, purchasers, and beneficiaries to improve the quality of care they deliver. We are also interested in the testing of quality indicators and intervention strategies that reflect care in settings other than acute-care hospitals and Medicare+Choice plans. Task 3 on Quality Improvement Projects conducted in conjunction with Medicare+Choice Plans, requires the plans to implement quality improvement projects as part of the Quality Improvement System for Managed Care standards. Each Medicare+Choice plan must initiate two performance improvement projects annually. The Balanced Budget Act of 1997 (BBA) requires most M+C plans to have an agreement with the PRO to carry out all required review activities. Task 4 on the Payment Error Prevention Program is a modified review activity that strives to identify opportunities for improvement in the billing process to reduce the occurrence of incorrect payments resulting from provider billing errors. Errors may include both over- billings and under-billings. The error rate would be the total dollars paid in error, either above or below the correct amount. PROs will conduct the Payment Error Prevention Program in two areas: unnecessary admissions and miscoded diagnosis-related group assignments. While the meeting is open to the public, attendance is limited to space available. Individuals must register in advance as described below.
Registration
The Office of Clinical Standards and Quality will handle registration for the meeting. Individuals may register by sending a fax to the attention of Don Forgione, Yvette Williams, or Ida Sarsitis, in the Division of Contract Policy and Performance. Please provide your name, address, telephone number, e-mail, and fax number on your registration request. Receipt of your fax will constitute confirmation of your registration. You will be provided with meeting materials at the time of the meeting. If there is no available seating for the Town Meeting, you will receive a notice that the meeting is at capacity. For fax registration, the number is (410) 786-4005. If you have questions regarding registration, please contact Don Forgione at (410) 786-3504 or Yvette Williams at (410) 786-6844. Inquiries via e-mail should be sent to DForgione@hcfa.gov or to YWilliams@hcfa.gov. The agency will accept written questions or other statements (not to exceed four single-spaced, typed pages), preferably before the meeting, or up to 14 days after the meeting. Written submissions must be sent to: Health Care Financing Administration, ATTN: Steven Jencks, M.D., Director, Quality Improvement Group, Office of Clinical Standards and Quality, S3-01-17, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Authority: Section 1102 of the Social Security Act (42 U.S.C. 1302) (42 CFR 462.167).
Dated: June 29, 1999. Nancy-Ann Min DeParle, Administrator, Health Care Financing Administration. [FR Doc. 99-17025 Filed 7-1-99; 8:45 am] BILLING CODE 4120-01-P