[Federal Register: December 23, 2004 (Volume 69, Number 246)]
[Notices]
[Page 76947-76949]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23de04-74]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5036-N]
Medicare Program; Solicitation for Proposals for the Cancer
Prevention and Treatment Demonstration for Ethnic and Racial Minorities
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice informs interested parties of an opportunity to
apply for cooperative agreements to implement and operate demonstration
projects under the Cancer Prevention and Treatment Demonstration for
Ethnic and Racial Minorities as required by Section 122 of the
Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act
of 2000 (BIPA). In addition, this notice contains information on how to
obtain the complete solicitation and supporting information.
DATES: Applications will be considered timely if we receive them on or
before March 23, 2005.
ADDRESSES: Mail applications to--Centers for Medicare & Medicaid
Services; Office of Operations Management, AGG, Cooperative Agreements
Management Staff; Attention: Judith L. Norris; 7500 Security Boulevard,
Mailstop C2-21-15; Baltimore, Maryland 21244-1850.
Please refer to file code CMS-5036-N on the application. Because of
staffing and resource limitations, we cannot accept applications by
facsimile (FAX) transmission. Applications postmarked after the closing
date, or postmarked on or before the closing date but not received in
time for panel review, will be considered late applications.
FOR FURTHER INFORMATION CONTACT: Diane Merriman, CMS Project Officer,
at (410) 786-7237 or CPTDEMO@cms.hhs.gov. General information regarding
this initiative is available on the DHHS Web site at http://www.grants.gov
.
SUPPLEMENTARY INFORMATION:
I. Background
Section 122(b) of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 (BIPA) (Pub. L. 106-554)
requires us to evaluate best practices in the private sector, community
programs, and academic research to identify methods that reduce
disparities among
[[Page 76948]]
individuals of ethnic and racial minority groups in the prevention and
treatment of cancer.
As specified in Sections 122(a) and (b) of BIPA, we are to design
and implement at least nine demonstration projects in specific target
populations for the purpose of developing models and evaluating methods
that: (1) Improve the quality of items and services provided to target
individuals in order to facilitate reduced disparities in early
detection and treatment of cancer; (2) improve clinical outcomes,
satisfaction, quality of life, and appropriate use of Medicare-covered
services and referral patterns among those target individuals with
cancer; (3) eliminate disparities in the rate of preventive cancer
screening measures; and (4) promote collaboration with community-based
organizations to ensure cultural competency of health care
professionals and linguistic access for persons with limited English
proficiency.
Each of the following four legislatively-mandated target
populations are required to be the subject of two separate
demonstration projects: American Indians (including Alaskan Natives,
Eskimos and Aleuts); Asian Americans and Pacific Islanders; Blacks; and
Hispanics. At least one of the nine required demonstration projects
must be implemented in a rural area, and one must be implemented in an
inner-city area. In addition, one of the nine demonstration projects
must be implemented in the Pacific Islands.
If the initial demonstration evaluation indicates that these
projects: (1) Reduce Medicare expenditures; or (2) do not increase
Medicare expenditures, reduce ethnic and racial health disparities, and
increase beneficiary and health care provider satisfaction, the
existing demonstration projects will continue, and the number of
demonstration projects may be expanded in the future.
II. Provisions of the Notice
The purpose of this notice is to inform interested parties of an
opportunity to apply for cooperative agreements to implement cancer
prevention and treatment demonstration projects for ethnic and racial
minorities.
As specified in Section 122 of BIPA, we will award at least nine
cooperative agreement demonstration projects that will identify methods
to reduce disparities in early cancer screening, diagnosis, and
treatment for Black, Hispanic, Asian American and Pacific Islander, and
American Indian (including Alaskan Natives, Eskimos, and Aleuts)
Medicare beneficiary populations. Award recipients are expected to use
the best available scientific evidence to identify promising models of
cancer screening, diagnosis and treatment interventions to promote
health and the appropriate utilization of Medicare covered services,
eliminate disparities in cancer detection and treatment among ethnic
and racial populations of Medicare beneficiaries, and provide
information to improve the effectiveness of the Medicare program.
The Congress authorized the Cancer Prevention and Treatment
Demonstration for Ethnic and Racial Minorities project for a
potentially indefinite period of time, and appropriated $25 million in
funding for the initial phase of the program. The demonstration
projects will have a 3- to 5-year operation period. We will consider an
award of up to $50,000 per demonstration project to cover initial
implementation costs. The entire award will not be made initially but
will be distributed incrementally between the time of conditional
awards and the approval of the demonstration by the Office of
Management and Budget (OMB). We also expect the costs of conducting
these demonstration projects to range from $400,000 to $1.5 million per
project per year. These costs will be reimbursed through capitation
payment to the demonstration site. No State or local matching funds are
required. Furthermore, we anticipate that projects will be awarded in
mid-2005, and that project startup activities would begin immediately
after completion of the waiver cost process (in late 2005).
The facilitation activities to be funded under these demonstration
projects will focus on three areas of potential cancer disparity
reduction: screening, diagnosis, and treatment. The applicant will
provide facilitation services for two populations: (1) Medicare
beneficiaries belonging to a defined ethnic or racial minority group
who do not have a current diagnosis of cancer before enrollment in the
demonstration project; and (2) Medicare beneficiaries belonging to a
defined ethnic or racial minority who have been diagnosed with cancer
before enrollment in the demonstration project.
For the first population, the applicant must propose strategies for
improving outcomes for cancers of the breast, cervix, colon and/or
rectum, and prostate through facilitation of: (1) Cancer screening
services; (2) follow-up of abnormal findings and diagnosis; and (3)
improved access to and follow-up of treatment and adjuvant treatment
services. For the second population, the applicant must propose
facilitation strategies to improve access to and follow-up of treatment
and adjuvant treatment services for confirmed diagnosis of at least one
of the demonstration-specified cancers and/or lung cancer.
Potentially qualified applicants include, but are not limited to:
Disease management organizations; health insurers; physician group
practices; coordinated care services providers; provider-sponsored
organizations; academic medical centers; comprehensive cancer centers;
special population networks; community clinical oncology programs;
community-based health organizations; community health centers;
federally qualified health centers; minority institutions such as,
among others, Historically Black Colleges and Universities, Hispanic
Serving Institutions, and Hispanic health organizations and
associations; tribal organizations; a consortium of the above entities;
or any other legal entity that the Secretary determines to be
appropriate. We strongly encourage the establishment of collaborative
consortia for this demonstration. The applicant must demonstrate its
ability to effectively deliver cancer screening, diagnosis, and
treatment facilitation services on a capitation basis to one or more of
the following populations: Black, Hispanic, Asian American and Pacific
Islander, and American Indian (including Alaskan Natives, Eskimos, and
Aleuts) Medicare beneficiaries. Interested parties are to obtain
complete solicitation and supporting information on the DHHS Web site
at http://www.grants.gov.
III. Collection of Information Requirements
The application associated with this demonstration entitled
``Medicare Waiver Demonstration Application'' is currently approved
under OMB approval number 0938-0880, with a current expiration date of
July 31, 2006.
In addition, the collection requirements associated with this
demonstration do not impose information collection and record keeping
requirements, because they meet the ``information'' definition
exception under 5 CFR 1320.3(h)(5) which states: `` `Information' does
not generally include items in the following categories: (5) facts or
opinions obtained initially or in follow-on requests, from individuals
(including individuals in control groups) under treatment or clinical
examination in connection with research on or prophylaxis to prevent a
clinical disorder, direct treatment of that disorder, or the
interpretation of biological analyses of body fluids, tissues, or other
specimens, or the
[[Page 76949]]
identification or classification of such specimens. * * *''
Authority: Section 122 of the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000 (BIPA) (Pub. L. 106-
554).
(Catalog of Federal Domestic Assistance Program No. 93.779, Medical
Assistance Program; No. 93.773, Medicare--Hospital Insurance
Program; and No. 93.774, Medicare--Supplementary Medical Insurance
Program)
Dated: September 15, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-27527 Filed 12-14-04; 8:45 am]
BILLING CODE 4120-01-P