[Federal Register: February 4, 2005 (Volume 70, Number 23)]
[Notices]
[Page 6013-6014]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr04fe05-93]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1299-N]
Medicare Program; Monthly Payment Amounts for Oxygen and Oxygen
Equipment for 2005, in Accordance with Section 302(c) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice discusses a reduction in the 2005 monthly payment
amounts for oxygen and oxygen equipment based on the percentage
difference between Medicare's 2002 monthly payment amounts for each
State and the median 2002 Federal Employee Health Benefit plan price
reported by the Office of Inspector General. This reduction is required
by section 302(c) of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003.
FOR FURTHER INFORMATION CONTACT: Joel Kaiser, (410) 786-4499,
jkaiser@cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
In accordance with section 302(c) of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-
173, enacted on December 8, 2003), Medicare's monthly payment amounts
for oxygen and oxygen equipment for 2005 are to include a reduction
based on the percentage difference between Medicare's 2002 monthly
payment amounts for each State and the median 2002 Federal Employee
Health Benefit (FEHB) plan price reported by the Office of Inspector
General (OIG). The OIG has alerted us that they will need to collect
additional information before the FEHB medians for oxygen and oxygen
equipment and portable oxygen equipment are finalized. Therefore,
Medicare claims for oxygen and oxygen equipment and portable oxygen
equipment furnished on or after January 1, 2005, and identified by the
Healthcare Common Procedure Coding System codes listed below, will be
temporarily paid based on the 2004 monthly payment amounts. In
accordance with the authority provided by section 1871(e)(1)(A)(ii) of
the Social Security Act, we are making this change retroactive for
items and services furnished on or after January 1, 2005, because we
have determined that it would be contrary to the public interest to
implement 2005 payment amounts based on preliminary and potentially
erroneous data.
E0424--Stationary Compressed Gaseous Oxygen System,
Rental: Includes container, contents, regulator, flowmeter, humidifier,
nebulizer, cannula or mask, and tubing;
E0439--Stationary Liquid Oxygen System, Rental: Includes
container, contents, regulator, flowmeter, humidifier, nebulizer,
cannula or mask, and tubing;
E1390--Oxygen Concentrator, Single delivery port, capable
of delivering 85 percent or greater oxygen concentration at the
prescribed flow rate delivery port, capable of delivering 85 percent or
greater oxygen concentration at the prescribed flow rate;
E1391--Oxygen Concentrator, Dual delivery port, capable of
delivering 85 percent or greater oxygen concentration at the prescribed
flow rate;
E0431--Portable Gaseous Oxygen System, Rental: Includes
portable container, regulator, flowmeter, humidifier, cannula or mask,
and tubing;
E0434--Portable Liquid Oxygen System, Rental: Includes
portable container, supply reservoir, humidifier, flowmeter, refill
adaptor, contents gauge, cannula or mask, and tubing.
Once we receive the FEHB medians from the OIG, we will calculate
and implement the 2005 monthly payment amounts and will begin paying
claims using these amounts. These amounts will apply prospectively
only. This is explained at http://www.cms.hhs.gov/suppliers/dmepos/.
Any future updates will also be published at this website.
[[Page 6014]]
II. Provisions of the Notice
The purpose of this notice is to notify the public that the OIG has
informed us of their need for additional information before the
provision may be used and implemented to reduce monthly payment amounts
for oxygen and oxygen equipment, based on the percentage difference
between Medicare's 2002 monthly payment amounts for each State and the
median 2002 Federal Employee Health Benefit plan price reported by the
OIG.
III. Collection of Information Requirements
This document does not impose information collection and
recordkeeping requirements. Consequently, it need not be reviewed by
the Office of Management and Budget under the authority of the
Paperwork Reduction Act of 1995.
IV. Regulatory Impact Statement
We have examined the impact of this notice as required by Executive
Order 12866 (September 1993, Regulatory Planning and Review), the
Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-354),
section 1102(b) of the Social Security Act, the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132.
Executive Order 12866 directs agencies to assess all costs and
benefits of available regulatory alternatives and, if regulation is
necessary, to select regulatory approaches that maximize net benefits
(including potential economic, environmental, public health and safety
effects, distributive impacts, and equity). A regulatory impact
analysis (RIA) must be prepared for major rules with economically
significant effects ($100 million or more in any 1 year). This notice
does not reach the economic threshold and thus is not considered a
major rule.
The RFA requires agencies to analyze options for regulatory relief
of small businesses. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and government agencies.
Most hospitals and most other providers and suppliers are small
entities, either by nonprofit status or by having revenues of $6
million to $29 million in any 1 year. Individuals and States are not
included in the definition of a small entity. We are not preparing an
analysis for the RFA because we have determined that this notice will
not have a significant economic impact on a substantial number of small
entities. In addition, section 1102(b) of the Act requires us to
prepare a regulatory impact analysis if a rule may have a significant
impact on the operations of a substantial number of small rural
hospitals. This analysis must conform to the provisions of section 604
of the RFA. For purposes of section 1102(b) of the Act, we define a
small rural hospital as a hospital that is located outside of a
Metropolitan Statistical Area and has fewer than 100 beds. We are not
preparing an analysis for section 1102(b) of the Act because we have
determined that this notice will not have a significant impact on the
operations of a substantial number of small rural hospitals.
Section 202 of the Unfunded Mandates Reform Act of 1995 also
requires that agencies assess anticipated costs and benefits before
issuing any rule that may result in expenditure in any 1 year by State,
local, or tribal governments, in the aggregate, or by the private
sector, of $110 million. This notice will have no consequential effect
on the governments mentioned or on the private sector.
Executive Order 13132 establishes certain requirements that an
agency must meet when it promulgates a proposed rule (and subsequent
final rule) that imposes substantial direct requirement costs on State
and local governments, preempts State law, or otherwise has Federalism
implications. Since this regulation does not impose any costs on State
or local governments, the requirements of E.O. 13132 are not
applicable.
In accordance with the provisions of Executive Order 12866, this
document was not reviewed by the Office of Management and Budget.
Authority: Section 302(c) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA).
(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare-
Supplemental Medical Insurance Program)
Dated: January 19, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 05-2176 Filed 2-3-05; 8:45 am]
BILLING CODE 4120-01-P