[Federal Register: February 27, 2004 (Volume 69, Number 39)]
[Page 9323-9324]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr27fe04-59]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-4090-N]
Medicare Program; Town Hall Meeting on Proposed Collection--
Comment Request for Skilled Nursing Facility Advance Beneficiary Notice
(SNFABN)
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
[[Page 9324]]
ACTION: Notice of meeting.
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SUMMARY: This notice announces a Town Hall meeting to solicit input
from the public on the proposed use of a Skilled Nursing Facility
Advance Beneficiary Notice (SNFABN). Interested persons are invited to
comment on the SNFABN Notice (CMS-10055 form) collection instrument,
the associated burden or any other aspect of this collection of
information, including any of the following subjects: (1) The necessity
and utility of the proposed information collection for the proper
performance of the agency's functions; (2) the associated time burden;
(3) ways to enhance the quality, utility, and clarity of the
information to be collected; and (4) the use of automated collection
techniques or other forms of information technology to minimize the
information collection burden. The meeting is open to the public, but
attendance is limited to space available.
DATES: The Town Hall meeting will be held on Wednesday, March 16, 2004,
from 1 p.m. to 4 p.m., e.s.t.
ADDRESSES: The Town Hall meeting will be held in the Multi-Purpose Room
at the Centers for Medicare & Medicaid Services (CMS), 7500 Security
Boulevard, Baltimore, Maryland 21244.
FOR FURTHER INFORMATION CONTACT: E. Joan Collins by phone at (410) 786-
4618, via e-mail at ecollins1@cms.hhs.gov, or by fax at (410) 786-9963.
SUPPLEMENTARY INFORMATION:
I. Background
The Skilled Nursing Facility Advance Beneficiary Notice (SNFABN)
replaces the Skilled Nursing Facility (SNF) Notices Of Non-Coverage
previously used for notification purposes. SNFs must also meet the
advance beneficiary notice (ABN) Standards in Sec. 40.3 of chapter 30,
Financial Liability Protections, of the IOM Pub. 100-4 at http://www.cms.hhs.gov/manuals/104_claims/clm104c30.pdf
in completing and
delivering SNFABNs.
A SNFABN is a CMS-approved written notice that the SNF gives to a
Medicare beneficiary, or to their authorized representative, before
extended care services or items are furnished, reduced, or terminated
when the SNF, the Utilization Review entity, the Quality Improvement
Organization, or the Medicare contractor believes that Medicare will
not pay for, or will not continue to pay for, extended care services
that the SNF furnishes and that a physician ordered on the basis of one
of the following statutory exclusions:
Not reasonable and necessary (``medical
necessity'') for the diagnosis or treatment of illness, injury, or to
improve the functioning of a malformed body member--section 1862(a)(1)
of the Social Security Act (the Act); or
Custodial care (``not a covered level of
care'')--section 1862(a)(9) of the Act.
These exclusions provide the only statutory authority for application
of the limitation on liability (LOL) provision at section 1879 of the
Act to denied SNF claims.
The SNFABN (CMS-10055 form) is for use with SNF Prospective Payment
System services. This form satisfies the requirements under LOL for
advance beneficiary notice and the beneficiary's agreement to pay. The
use of any other notices or of modified SNFABNs may be ineffective in
protecting users from liability. The SNFABN must be prepared with an
original and at least one patient copy, a SNF copy containing the
signature of the patient or authorized representative, an attending
physician copy, and (when necessary) a Medicare contractor copy. SNFs
may produce SNFABNs using self-carboning paper and other methods of
producing copies, including photocopying, printing, and electronic
generation, but they must conform to the Form CMS-10055 design.
This Town Hall meeting is intended to provide a forum for all
interested individuals to comment on and discuss the SNFABN. The SNFABN
form and instructions may be reviewed prior to the public meeting by
accessing http://www.cms.hhs.gov/medicare/bni on the Internet. This
information is available for immediate review.
II. Meeting Format
Registered persons from the public may discuss and make individual
recommendations concerning the Skilled Nursing Facility Advance
Beneficiary Notice. Individuals who wish to make formal presentations
must include that information when registering. Presentations must be
brief, and three written copies must be submitted to accompany the oral
presentation. Presenters may also make copies available for
approximately 70 meeting participants.
III. Registration Instructions
Representatives of providers and suppliers furnishing skilled
nursing facility services, health care consumer advocacy groups, and
other members of the public who wish to participate in the public
meeting are asked to notify us, in advance, of their interest in
attending. Interested persons may register by providing notification to
E. Joan Collins either by telephone at (410) 786-4618, fax at (410)
786-9963, or by e-mail at ecollins1@cms.hhs.gov. Please submit the
following information when registering: name, company name, address,
telephone number, and e-mail address and an indication of whether you
wish to make a formal presentation.
Because this meeting will be located on Federal property, for
security reasons, any persons wishing to attend this meeting must
register by close of business on March 10, 2004. In order to gain
access to the building and grounds, participants must show to the
Federal Protective Service or guard service personnel government-issued
photo identification and a copy of their registration confirmation.
Individuals who have not registered in advance will not be allowed to
enter the building to attend the meeting. Seating capacity is limited
to the first 250 registrants.
The on-site check-in for visitors will be held from 12 noon until 1
p.m., followed by opening remarks. Please allow sufficient time to
arrive to go through the security checkpoints. It is suggested that you
arrive at 7500 Security Boulevard no later than 12 noon so that you
will be able to arrive promptly at the meeting by 1 p.m. All items
brought to us, whether personal or for the purpose of demonstration or
to support a presentation, are subject to inspection.
Individuals requiring sign language interpretation or other special
accommodations must provide that information upon registering for the
meeting.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program.)
Dated: February 12, 2004.
Dennis G. Smith,
Acting Administrator, Centers for Medicare and Medicaid Services.
[FR Doc. 04-4275 Filed 2-26-04; 8:45 am]
BILLING CODE 4120-01-P