[Federal Register: August 27, 2004 (Volume 69, Number 166)]
[Notices]
[Page 52699-52700]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr27au04-47]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1269-N2]
Medicare Program; Second Request for Nominations for Two Specific
Categories of Members of the Emergency Medical Treatment and Labor Act
(EMTALA) Technical Advisory Group (TAG)
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice solicits nominations for members in two
categories, patient representatives and State survey agency
representatives, for which no nominations were received in response to
our May 28, 2004 Federal Register notice. It also describes the
establishment of the Emergency Medical Treatment and Labor Act (EMTALA)
Technical Advisory Group (TAG).
DATES: Nominations for membership will be considered if they are
received by September 27, 2004.
ADDRESSES: Send nominations via mail or courier delivery to--Division
of Acute Care, Mail stop C4-08-06, Centers for Medicare & Medicaid
Services, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Attention: Beverly J. Parker, or Via email to EMTALATAG@cms.hhs.gov. To
allow for verification, all emailed items, including letters of
nomination and letters of support, must include the submitter's contact
information.
Send written requests for copies of the EMTALA TAG Charter to--
Division of Acute Care, Mail stop C4-08-06, Centers for Medicare &
Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244-
1850. Attention: Marianne M. Myers
FOR FURTHER INFORMATION CONTACT: Beverly J. Parker (410) 786-5320.
Press inquiries are handled through the CMS Press Office at (202)
690-6145.
SUPPLEMENTARY INFORMATION:
I. Background
Sections 1866(a)(1)(I), 1866(a)(1)(N), and 1867 of the Social
Security Act (the Act) impose specific obligations on Medicare-
participating hospitals that offer emergency services. These
obligations concern individuals who come to a hospital emergency
department and request examination or treatment for medical conditions,
and apply to all of these individuals, regardless of whether or not
they are beneficiaries of any program under the Act. These provisions,
taken together, are frequently referred to as the Emergency Medical
Treatment and Labor Act (EMTALA), also known as the patient antidumping
statute.
EMTALA was passed in 1986 as part of the Consolidated Omnibus
Budget Reconciliation Act of 1985 (COBRA). Congress enacted these
antidumping provisions in the Social Security Act because of its
concern with an ``increasing number of reports'' that hospital
emergency rooms were refusing to accept or treat individuals with
emergency conditions if the individuals did not have insurance.
Regulations implementing the EMTALA legislation are set forth in 42
CFR 489.20(l), (m), (q) and (r)(1), (r)(2), (r)(3), and 489.24. These
regulations incorporate changes made by a final rule published in the
September 9, 2003 Federal Register (68 FR 53222). We published that
final rule to clarify policies relating to the responsibilities of
Medicare-participating hospitals in treating individuals with emergency
medical conditions who present to a hospital under the provisions of
EMTALA.
Section 945 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) (Pub. L. 108-173), requires that the
Secretary establish a Technical Advisory Group (TAG) for advice
concerning issues related to EMTALA regulations and implementation. In
the May 28, 2004 Federal Register (69 FR 30654), we specified the
statutory requirements regarding the charter, general responsibilities,
and composition of the EMTALA TAG. That notice also solicited
nominations for members based on the statutory requirements for the
EMTALA TAG.
II. Charter, General Responsibilities, and Composition of the EMTALA
TAG
A. Charter Information and General Responsibilities
As explained in the May 28, 2004 notice, the Secretary signed the
charter establishing the EMTALA TAG on May 11, 2004. This charter will
terminate 30 months from the date of the EMTALA TAG's first meeting.
The EMTALA TAG, as chartered, under the legal authority of section 945
of the MMA, is also governed by the provisions of the Federal Advisory
Committee Act (FACA), 5 U.S.C. Appendix 2. In accordance with section
945 of the MMA, the EMTALA TAG will meet at least twice a year and all
meetings will be open to the public.
You may obtain a copy of the Secretary's charter for the EMTALA TAG
by mailing a written request to the address specified in the ADDRESSES
section of this notice.
Section 945 of the MMA specifies that the EMTALA TAG--
Shall review the EMTALA regulations;
May provide advice and recommendations to the Secretary
concerning these regulations and their application to hospitals and
physicians;
Shall solicit comments and recommendations from hospitals,
physicians, and the public regarding implementation of such
regulations; and
May disseminate information concerning the application of
these regulations to hospitals, physicians, and the public.
B. Composition of the EMTALA TAG
The May 28, 2004 notice stated that section 945 of the MMA
specifies the composition of the EMTALA TAG. It states that the EMTALA
TAG will be composed of 19 members including the Administrator of the
Centers for Medicare & Medicaid Services (CMS) and the Inspector
General of the Department of Health and Human Services (DHHS) in
addition to the number and type of individuals specified in each of the
following categories:
Four representatives of hospitals, including at least one
public hospital, that have experience with the application of EMTALA
and, at least, two hospitals that have not been cited for EMTALA
violations;
Seven practicing physicians drawn from the fields of
emergency medicine, cardiology or cardiothoracic surgery, orthopedic
surgery, neurosurgery, pediatrics or a pediatric subspecialty,
obstetrics-gynecology and psychiatry,
[[Page 52700]]
with not more than one physician from any particular field;
Two representatives of patients;
Two staff persons involved in EMTALA investigations from
different CMS regional offices;
One representative from a State survey agency involved in
EMTALA investigations and one representative from a Quality Improvement
Organization (QIO), both of whom shall be from areas other than the
regions represented by the CMS regional offices.
III. Response to May 28, 2004 Notice and Second Request for Nominations
for Patient Representatives and State Survey Agency Representative
In response to our May 28, 2004 notice, we received nominations of
individuals for the categories of hospital representatives, practicing
physician representatives, staff persons involved in EMTALA
investigations from CMS Regional Offices, and a QIO representative.
Therefore, we are not seeking, and will not consider, any further
nominations in any of these categories.
However, we did not receive any timely and complete nominations of
individuals for two categories--(1) Patient representatives and (2)
representative of a State survey agency involved in EMTALA
investigations. Therefore, we are requesting nominations for membership
on the EMTALA TAG in these categories. With respect to the category of
patient representatives, the Secretary will consider qualified
individuals who are nominated by organizations representing providers
and patients. With respect to the category of State survey agency staff
involved in EMTALA investigations, any interested person may nominate
one or more qualified individuals (self-nominations will also be
accepted). The Secretary will appoint members to serve on the EMTALA
TAG from among those candidates determined to have the technical
expertise required to meet specific agency needs and in a manner to
ensure an appropriate balance of membership.
Each nomination must include the following:
1. A letter of nomination that contains--
a. Contact information for both the nominator and nominee (if not
the same); and
b. The category, for which the nomination is being made (that is,
either patient representative or representative of a State survey
agency involved in EMTALA investigations).
2. A statement from the nominee that he or she is willing to serve
on the EMTALA TAG for its duration (that is, at least 30 months from
date of the first meeting) and an explanation of interest in serving on
the EMTALA TAG. (For self-nominations, this information may be included
in the nomination letter.)
3. A curriculum vitae that indicates the nominee's educational and
EMTALA-related experiences.
4. Three letters of reference that support the nominee's
qualifications for participation on the EMTALA TAG. (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.)
5. Additional information is required for representatives from a
State survey agency--in your statement regarding serving on the EMTALA
TAG indicate the extent of your experience with EMTALA investigations.
To ensure that a nomination is considered, we must receive all of
the nomination information specified in section III of this notice by
September 27, 2004.
Authority: Section 945 of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA).
(Catalog of Federal Domestic Assistance Program No. 93.773
Medicare--Hospital Insurance Program; and No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: August 24, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-19739 Filed 8-26-04; 8:45 am]
BILLING CODE 4120-01-P