[Federal Register: April 7, 2005 (Volume 70, Number 66)]
[Notices]
[Page 17697-17698]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr07ap05-64]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5029-N]
Medicare Program; Rural Hospice Demonstration
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice provides interested parties with the information
necessary to apply for participation in the rural hospice
demonstration. The demonstration is designed to test whether hospice
services provided by a demonstration hospice program to Medicare
beneficiaries who lack an appropriate caregiver and who reside in rural
areas results in wider access, improved hospice services, benefits to
the rural community, and a sustainable pattern of care. A competitive
application process will be used to select up to three hospice
organizations or agencies to participate in this demonstration. The
demonstration is planned for up to 5 years.
DATES: Applications will be considered timely if we receive them on or
before June 6, 2005.
ADDRESSES: Mail applications to--Centers for Medicare & Medicaid
Services, Attention: Cindy Massuda, Mail Stop: C4-17-27, 7500 Security
Boulevard, Baltimore, Maryland 21244.
Because of staff and resource limitations, we cannot accept
applications by facsimile (FAX) transmission or by e-mail.
FOR FURTHER INFORMATION CONTACT: Cindy Massuda at (410) 786-0652 or
RURALHOSPICEDEMO@cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
A. Legislative Authority
Section 409 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) (Pub. L. 108-173) authorizes the
Secretary to conduct a demonstration project for the delivery of
hospice care to Medicare beneficiaries in rural areas. Under the
demonstration, Medicare beneficiaries who are unable to receive hospice
care
[[Page 17698]]
at home for lack of an appropriate caregiver are provided care in a
facility of 20 or fewer beds that offers, within its walls, the full
range of services provided by hospice programs under section 1861(dd)
of the Social Security Act (42 U.S.C. 1395x(dd)).
Under the demonstration project, the hospice program shall comply
with otherwise applicable requirements, except that it shall not be
required to offer services outside of the hospice facility or to meet
the requirements of section 1861(dd)(2)(A)(iii) of the Social Security
Act (SSA) regarding the 20-percent cap on inpatient care days.
The Secretary may require the hospice demonstration to comply with
additional quality assurance standards for provision of services. Upon
completion of the project, the Secretary shall submit a report to the
Congress on the project including recommendations regarding extensions
to hospice programs serving rural areas.
B. The Rural Hospice Demonstration
The demonstration will be offered to up to three hospice programs
and will not exceed a period of 5 years. The demonstration is designed
to test whether hospice services provided by a demonstration hospice
program to Medicare beneficiaries who lack an appropriate caregiver and
who reside in rural areas results in wider access, improved hospice
services, benefits to the rural community, and a sustainable pattern of
care. Hospice provides palliative care to individuals who have a
terminal illness with a prognosis of 6 months or less. The care is
provided typically in the individual's home or place of residence with
family members present. Individuals who lack family or someone to serve
as the primary caregiver need proportionately more support from hospice
staff. Due to long distances and difficult terrain, it can be
particularly difficult to provide the Medicare hospice benefit
efficiently in rural areas. There may be situations where the hospice
benefit could be provided to beneficiaries who would not otherwise be
able to receive these services if the location of hospice care is
altered. This demonstration will allow a hospice with up to 20 beds to
provide all levels of hospice services within its walls to individuals
who reside in rural areas and lack an appropriate caregiver, while not
having to provide services outside of the hospice facility or comply
with the 20-percent cap on inpatient care days.
While the demonstration provider will not have to meet the limit on
inpatient care days or provide care outside of the facility, it will
not alter the level of care requirements for general inpatient care. In
order to provide general inpatient care to hospice patients, a hospice
participating in the demonstration must assure that the need for
general inpatient care is met according to Medicare guidelines. The
demonstration will test whether hospice services provided by a facility
that does not meet the limit on inpatient care days or provide services
outside of the facility for hospice individuals residing in rural areas
who lack an appropriate caregiver results in wider access, improved
hospice services, benefits to the rural community, and a sustainable
pattern of care.
The demonstration is designed for a demonstration hospice to
provide the full range of services within its facility to Medicare
beneficiaries who reside in rural areas and lack an appropriate
caregiver. If a demonstration hospice provides care to any patient who
either lives outside a rural area or has an appropriate caregiver, then
the hospice must comply with all of Medicare hospice requirements at
1861(dd) of the SSA for these patients since they are not considered
part of the demonstration.
We plan to make up to three awards. Interested parties can obtain
complete solicitation and supporting information on the CMS Web site
at: http://www.cms.hhs.gov/researchers/demos/rmbh/default.asp. Paper
copies can be obtained by writing to Cindy Massuda at the address
listed in the ADDRESSES section of this notice.
II. Collection of Information Requirements
Since CMS will receive less than 10 applications to this
solicitation, the information collection requested reference in this
solicitation are not subject to the PRA as stipulated under 5 CFR
1320.3(c).
Authority: Section 409 of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173).
(Domestic Assistance No. 93.773 Medicare--Hospital insurance
Program; and No. 93.774, Medicare-Supplementary Medical Insurance
Program)
Dated: March 10, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 05-6861 Filed 4-1-05; 4:42 pm]
BILLING CODE 4120-01-P