[Federal Register: June 2, 2004 (Volume 69, Number 106)]
[Notices]
[Page 31123-31124]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr02jn04-61]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5033-N]
Medicare Program; Establishment of the Advisory Board on the
Demonstration of a Bundled Case-Mix Adjusted Payment System for End
Stage Renal Disease Services and Request for Nominations for Members
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice announces the establishment of the Advisory Board
on the Demonstration of a Bundled Case-Mix Adjusted Payment System for
End Stage Renal Disease (ESRD) Services and discusses the group's
purpose and charter. It also solicits nominations for members.
DATES: Nominations for membership will be considered if they are
received by July 2, 2004.
ADDRESSES: Send nominations and written requests for copies of the
Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted
Payment System for ESRD Services Charter to--
Centers for Medicare & Medicaid Services, 7500 Security Boulevard,
Baltimore, Maryland 21244-1850.
Medicare Demonstrations Program Group, Mail stop C4-17-27, Attention:
Pamela Kelly.
[[Page 31124]]
FOR FURTHER INFORMATION CONTACT: ESRDAdvisoryBoard@cms.hhs.gov or
Pamela Kelly, (410) 786-2461.
Press inquiries are handled through the CMS Press Office at (202)
690-6145.
SUPPLEMENTARY INFORMATION:
I. Background
Section 623(e) of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) (Pub. L. 108-173) requires us to
establish a demonstration project of the use of a fully case-mix
adjusted payment system for end stage renal disease (ESRD) services
under section 1881 of the Social Security Act (42 U.S.C. 1395rr) for
patient characteristics. Section 623(f) of the MMA requires the patient
characteristics to be identified in a Report to Congress on a bundled
prospective payment system for ESRD Services by October 1, 2005. The
payment rates will bundle amounts for drugs and biologicals, including
erythropoietin, which are separately billed by ESRD facilities, from
the date of enactment of MMA, December 8, 2003, and clinical laboratory
tests related to these drugs and biologicals.
Section 623(e) of MMA also requires us to establish an Advisory
Board to provide advice and recommendations with respect to the
establishment and operation of this demonstration project.
II. Charter, General Responsibilities, and Composition of the Advisory
Board on the Demonstration of a Bundled Case-Mix Adjusted Payment
System for ESRD Services
A. Charter Information and General Responsibilities
On May 11, 2004, the Secretary signed the charter establishing the
Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted
Payment System for ESRD Services. The MMA provides that the Advisory
Board will terminate on December 31, 2008. The Advisory Board, as
chartered under the legal authority of section 623(e) of the MMA, is
also governed by the provisions of the Federal Advisory Committee Act
(FACA), 5 U.S.C. Appendix 2, section 10(a) (Pub. L. 92-463).
You may obtain a copy of the Secretary's charter for the Advisory
Board on the Demonstration of a Bundled Case-Mix Adjusted Payment
System for ESRD Services from http://www.cms.hhs.gov/faca/stcomm.asp on
the day this notice is published or by mailing a written request to the
address specified in the ADDRESSES section of this notice.
As specified in the charter, before implementation of the
demonstration, the Advisory Board will study and make recommendations
on the following issues:
The drugs, biologicals, and clinical laboratory tests to
be bundled into the demonstration payment rates.
The method and approach to be used for the patient
characteristics to be included in the fully case-mix adjusted
demonstration payment system.
The manner in which payment for bundled services provided
by non-demonstration providers should be handled for beneficiaries
participating in the demonstration.
The feasibility of providing financial incentives and
penalties to plans operating under the demonstration that meet or fail
to meet applicable quality standards.
The specific quality standards to be used.
The feasibility of using disease management techniques to
improve quality and patient satisfaction and reduce costs of care for
the beneficiaries participating in the demonstration.
The selection criteria for demonstration organizations.
Upon implementation of the demonstration, the Advisory Board will
continue to advise the Secretary and the Administrator on the operation
of the demonstration.
B. Composition of the Advisory Board on the Demonstration of a Bundled
Case-Mix Adjusted Payment System for ESRD Services
Section 623(e) of MMA specifies the composition of the Advisory
Board on the Demonstration of a Bundled Case-Mix Adjusted Payment
System for ESRD Services. It states that the Advisory Board will be
composed of representatives of the following:
Patient organizations.
Individuals with expertise in ESRD dialysis services, such
as clinicians, economists, and researchers.
The Medicare Payment Advisory Commission, established
under section 1805 of the Social Security Act (42 U.S.C. 1395b-6).
The National Institutes of Health.
Network Organizations under section 1881(c) of the Social
Security Act (42 U.S.C. 1395rr(c)).
Medicare contractors to monitor quality of care.
Providers of services and renal dialysis facilities
furnishing ESRD services.
The charter specifies there will be 11 members on the
Advisory Board.
III. Submission of Nominations
We are requesting nominations for membership on the Advisory Board
on the Demonstration of a Bundled Case-Mix Adjusted Payment System for
ESRD Services. We will consider qualified individuals who are self-
nominated or are nominated by organizations representing patients and
providers when we select these representatives. The Secretary will
appoint members to serve on the Advisory Board from among those
candidates that we determine have the technical expertise to meet
specific agency needs in a manner to ensure an appropriate balance of
membership.
Any interested person may nominate one or more qualified
individuals for each of the categories listed in section II.B. of this
notice. Each nomination must include the following information:
1. A letter of nomination that contains contact information for
both the nominator and nominee (if not the same).
2. A statement from the nominee that he or she is willing to serve
on the Advisory Board for its duration (that is, through December 31,
2008) and an explanation of the nominee's interest in serving on the
Advisory Board. The nominee should also indicate whether he or she
would be willing to serve as the chair of the Advisory Board. (For
self-nominations, this information may be included in the nomination
letter.)
3. A curriculum vitae that indicates the nominee's educational and
ESRD-related experiences.
4. Two letters of reference that support the nominee's
qualifications for participation on the Advisory Board. (For
nominations other than self-nominations, a nomination letter that
includes information supporting the nominee's qualifications may be
counted as one of the letters of reference.)
To ensure that a nomination is considered, we must receive all of
the nomination information specified in section III of this notice by
July 2, 2004. Nominations should be mailed to the address specified in
the ADDRESSES section of this notice.
Authority: Section 623(e) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA). (Catalog of
Federal Domestic Assistance Program No. No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: May 26, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-12421 Filed 5-28-04; 8:45 am]
BILLING CODE 4120-01-P