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Federal Register Highlights – 5/15/14

May 15, 2014

Unpublished, time-sensitive and proposed rules for May 15, 2014:

PROPOSED RULE: We are proposing to revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the proposed changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Protecting Access to Medicare Act of 2014, and other legislation. These proposed changes would be applicable to discharges occurring on or after October 1, 2014, unless otherwise specified in this proposed rule. We also are proposing to update the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The proposed updated rate-of- increase limits would be effective for cost reporting periods beginning on or after October 1, 2014. We also are proposing to update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and to implement certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014. In addition we are proposing to revise the interruption of stay policy for LTCHs and to retire the ‘‘5 percent’’ payment adjustment for co-located LTCHs. While many of the statutory mandates of the Pathway for SGR Reform Act will apply to discharges occurring on or after October 1, 2014, others will not begin to apply until 2016 and beyond. However, in light of the degree of forthcoming change, we discuss changes infra and request public feedback to inform our proposals for FY 2016 in this proposed rule as well. In addition, we are proposing to make a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are proposing to establish new requirements or revise requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare. We are proposing to update policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. In addition, we are proposing changes to the regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports; updates to the reasonable compensation equivalent (RCE) limits for services furnished by physicians to teaching hospitals excluded from the IPPS; regulatory revisions to broaden the specified uses of risk adjustment data and to specify the conditions for release of risk adjustment data to entities outside of CMS; and changes to the enforcement procedures for organ transplant centers. We are proposing to align the reporting and submission timelines for clinical quality measures for the Medicare EHR Incentive Program for eligible hospitals and critical access hospitals (CAHs) with the reporting and submission timelines for the Hospital IQR Program. In addition, we provide guidance and clarification of certain policies for eligible hospitals and CAHs such as our policy for reporting zero denominators on clinical quality measures and our policy for case threshold exemptions. To be assured consideration, comments must be received no later than 5 p.m. EDT on June 30, 2014. (To submit comments, visit http://www.regulations.gov, reference file code CMS–1607–P.)

TEMPORARY RULE: The Coast Guard will enforce the Spangler Event Productions firework display safety zone on May 17, 2014. This marine event occurs on the navigable waters of San Diego Bay, immediately to the west of the USS MIDWAY, in San Diego, California. This action is necessary to provide for the safety of the participants, crew, spectators, safety vessels, and general users of the waterway. During the enforcement period, persons and vessels are prohibited from entering into, transiting through, or anchoring within this regulated area unless authorized by the Captain of the Port, or his designated representative. This rule is effective from 9:30 p.m. to 10:00 p.m. on May 17, 2014.

PROPOSED RULE: The Department of Energy (DOE) is proposing to revise existing regulations covering the administrative requirements for grants and cooperative agreements with for-profit organizations. The proposed regulations would modify title provisions, and requirements related to the handling of real property and equipment acquired with federal funds. They would also add provisions related to export control requirements and supporting U.S. manufacturing, reporting on utilization of subject inventions, novation of financial assistance agreements, and changes of control of recipients. DOE will accept comments, data, and information regarding this notice of proposed rulemaking (NOPR) no later than July 14, 2014. (To submit comments, visit http://www.regulations.gov, reference RIN 1991–AC02.)

PROPOSED RULE: This document requests comments on a Petition for Rule Making filed by Bryan Broadcasting License Corporation, permittee of new FM station, Channel 274A, Centerville, Texas, proposing to amend the FM Table of Allotment, § 73.202(b) of the Commission’s rules by substituting Channel 274A for vacant Channel 267A at Centerville, Texas. A staff engineering analysis indicates that Channel 274A can be allotted to Centerville, Texas consistent with the minimum distance separation requirements of the Commission’s rules with a site restriction located 4.3 kilometers (2.7 miles) east of Centerville. The reference coordinates are 31–15–00 NL and 95–56–00 WL. Comments must be filed on or before June 23, 2014, and reply comments on or before July 8, 2014. (To submit comments, visit http://fjallfoss.fcc.gov/ecfs2/. Follow the instructions for submitting comments, reference MB Docket No. 14–56 and/or RM–11718.)

PROPOSED RULE: This document requests comments on a Petition for Rule Making filed by Ashley A. Bruton, proposing the allotment of Channel 280A at McCall, Idaho, as the community’s eighth local service. A staff engineering analysis confirms that Channel 280A can be allotted to McCall, Idaho consistent with the minimum distance separation requirements of the rules with a site restriction 0.4 kilometers (0.2 miles) southwest of the community. The reference coordinates are 44–54–30 NL and 116–06–00 WL. Comments must be filed on or before June 23, 2014, and reply comments on or before July 8, 2014. (Submit written comments to: Secretary, Federal Communications Commission, 445 12th Street SW., Washington, DC 20554. In addition to filing comments with the FCC, interested parties should serve the petitioner as follows: Ashley A. Bruton, 25 Campbell Road, Walla Walla, Washington 99362.)

PROPOSED RULE: This document requests comments on a Petition for Rule Making filed The Navajo Nation, proposing to amend the FM Table of Allotments, of the Commission’s rules, by allotting FM Channel 258C2 at Rough Rock, Arizona, as a first local service. The facts presented by The Navajo Nation are sufficient to support consideration of the allotment of FM Channel 258C2 at Rough Rock, Arizona, as a Tribal Allotment. A staff engineering analysis confirms that Channel 258C2 can be allotted to Rough Rock, Arizona consistent with the minimum distance separation requirements of the Rules with a site restriction 7.1 km (4.4 miles) southeast of Rough Rock. The reference coordinates are: 36–21–08 NL and 109–49–54 WL. Comments must be filed on or before June 23, 2014, and reply comments on or before July 8, 2014. (Submit written comments to: Secretary, Federal Communications Commission, 445 12th Street SW., Washington, DC 20554. In addition to filing comments with the FCC, interested parties should serve the petitioner as follows: Lauren Lynch Flick, Esq., Pillsbury, Winthrop, Shaw, & Pittman LLP, 2300 N Street NW., Washington, DC 20037.)

PROPOSED RULE: The Board invites comment on a proposed rule (Regulation XX) that would implement section 622 of the Dodd-Frank Wall Street Reform and Consumer Protection Act. Section 622, which adds a new section 14 to the Bank Holding Company Act of 1956, establishes a financial sector concentration limit that generally prohibits a financial company from merging or consolidating with, or acquiring, another company if the resulting company’s liabilities upon consummation would exceed 10 percent of the aggregate liabilities of all financial companies as calculated under that section. In addition, the proposal would establish reporting requirements for certain financial companies that are necessary to implement section 622. Comments must be received no later than July 8, 2014. (To submit comments, visit http://www.regulations.gov, reference RIN 7100–AE18.)

EMERGENCY RULE: NMFS issues this emergency rule to revise the recreational accountability measures (AMs) by establishing a recreational annual catch target (ACT), and revise the 2014 recreational fishing season for red snapper in the exclusive economic zone (EEZ) of the Gulf of Mexico (Gulf), as requested by the Gulf of Mexico Fishery Management Council (Council). At its April 2014 meeting, the Council requested an emergency rule to revise the recreational AMs for red snapper by applying a 20-percent buffer to the recreational quota, which results in a recreational ACT of 4.312 million lb (1.956 million kg), round weight. The Council’s decision to request an emergency rule was made following the decision of the U.S. District Court for the District of Columbia (Court) in Guindon v. Pritzker, 2014 WL 1274076 (D.D.C. Mar. 26, 2014). After recalculating the season length based on the ACT and using the 2013 Marine Recreational Information Program (MRIP) landings estimates, NMFS is setting a 9-day fishing season. The purpose of this rulemaking is to better ensure red snapper recreational landings do not exceed the recreational quota established in the rebuilding plan, in accordance with sections 303(a)(15) and 407(d) of the Magnuson-Stevens Act (16 U.S.C. 1853(a)(15); 16 U.S.C. 1883(d)) and the Court’s ruling. This emergency rule is effective May 15, 2014, through November 11, 2014. The red snapper recreational fishing season will open at 12:01 a.m., local time, on June 1, 2014, and close at 12:01 a.m., local time, on June 10, 2014.

PROPOSED RULE: The Department of Veterans Affairs (VA) proposes to amend its medical regulations concerning eligibility for the Health Care for Homeless Veterans (HCHV) program. The HCHV program provides per diem payments to non-VA community-based facilities that provide housing, outreach services, case management services, and rehabilitative services, and may provide care and/or treatment to homeless veterans who are enrolled in or eligible for VA health care. The proposed rule would modify VA’s HCHV regulations to conform to changes enacted in the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. Specifically, the proposed rule would remove the requirement that homeless veterans be diagnosed with a serious mental illness or substance use disorder to qualify for the HCHV program. This change would make the program available to all homeless veterans who are enrolled in or eligible for VA health care. The proposed rule would also update the definition of homeless to match in part the one used by the Department of Housing and Urban Development (HUD). The proposed rule would further clarify that the services provided by the HCHV program through non-VA community-based providers must include case management services, including non-clinical case management, as appropriate. Comments must be received by VA on or before July 14, 2014. (To submit comments, visit http://www.regulations.gov, reference RIN 2900–AO71.)

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