Notice2021-15727

Medicare Program; Announcement of the Advisory Panel on Hospital Outpatient Payment Meeting

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Published
July 23, 2021

Issuing agencies

Health and Human Services DepartmentCenters for Medicare & Medicaid Services

Abstract

This notice announces a virtual meeting of the Advisory Panel on Hospital Outpatient Payment (the Panel) for Calendar Year 2021. The purpose of the Panel is to advise the Secretary of the Department of Health and Human Services and the Administrator of the Centers for Medicare & Medicaid Services concerning the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, and supervision of hospital outpatient therapeutic services. The advice provided by the Panel will be considered as we prepare the annual updates for the hospital outpatient prospective payment system.

Full Text

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<title>Federal Register, Volume 86 Issue 139 (Friday, July 23, 2021)</title>
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[Federal Register Volume 86, Number 139 (Friday, July 23, 2021)]
[Notices]
[Pages 39025-39027]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-15727]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1764-N]


Medicare Program; Announcement of the Advisory Panel on Hospital 
Outpatient Payment Meeting

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of meeting.

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SUMMARY: This notice announces a virtual meeting of the Advisory Panel 
on Hospital Outpatient Payment (the Panel) for Calendar Year 2021. The 
purpose of the Panel is to advise the Secretary of the Department of 
Health and Human Services and the Administrator of the Centers for 
Medicare & Medicaid Services concerning the clinical integrity of the 
Ambulatory Payment Classification groups and their associated weights, 
and supervision of hospital outpatient therapeutic services. The advice 
provided by the Panel will be considered as we prepare the annual 
updates for the hospital outpatient prospective payment system.

DATES: Meeting date: The virtual meeting of the Panel is scheduled for 
Monday, August 23, 2021, from 9:30 a.m. to 5:00 p.m. Eastern Daylight 
Time (EDT). The times listed in this notice are EDT and are approximate 
times. Consequently, the meetings may last longer or be shorter than 
the times listed in this notice, but would not begin before the posted 
time.
    Deadline for presentations and comment letters: Presentations or

[[Page 39026]]

comment letters, and form CMS-20017 (located at <a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20017.pdf">https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20017.pdf</a>), must be received 
by 5:00 p.m. EDT, Friday, August 6, 2021. We note that form CMS-20017 
must accompany each presentation or comment letter submission. 
Presentations and comment letters that are not received by the due date 
and time, or that do not include a completed form CMS-20017 are 
considered late or incomplete, and cannot be included on the agenda. In 
commenting, refer to file code CMS-1764-N.
    Meeting Registration Timeframe: All presentation or comment letter 
speakers, including any alternates, with items on the agenda must 
register electronically to our Panel mailbox, <a href="/cdn-cgi/l/email-protection#d091809380b1beb5bc90b3bda3feb8b8a3feb7bfa6"><span class="__cf_email__" data-cfemail="6928392a3908070c05290a041a4701011a470e061f">[email&#160;protected]</span></a> no 
later than 5:00 p.m. EDT, Friday, August 6, 2021. The subject of the 
email may state ``Agenda Speaker Registration for HOP Panel Meeting.''

ADDRESSES:
    Meeting location and webinar: The meeting will be held virtually. 
The public may participate in this meeting by webinar, or listen-only 
via teleconference. Closed captioning will be available on the webinar. 
Teleconference dial-in and webinar information will appear on the final 
meeting agenda, which will be posted on our website when available at: 
<a href="https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups">https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups</a>.
    News media: Press inquiries are handled through the CMS Press 
Office at (202) 690-6145.
    Advisory committees information line: The telephone number for the 
Advisory Panel on Hospital Outpatient Payment Committee Hotline is 
(410) 786-3985.
    Websites: For additional information on the Panel, including the 
Panel charter, and updates to the Panel's activities, we refer readers 
to view our website at: <a href="https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups">https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups</a>. 
Information about the Panel and its membership in the Federal Advisory 
Committee Act (FACA) database are also located at: <a href="https://www.facadatabase.gov">https://www.facadatabase.gov</a>.

FOR FURTHER INFORMATION CONTACT: Elise Barringer, Designated Federal 
Official (DFO) (410) 786-9222, email at: <a href="/cdn-cgi/l/email-protection#47061704172629222b07242a34692f2f3469202831"><span class="__cf_email__" data-cfemail="b8f9e8fbe8d9d6ddd4f8dbd5cb96d0d0cb96dfd7ce">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION:

I. Background

    The Secretary of the Department of Health and Human Services (the 
Secretary) is required by section 1833(t)(9)(A) of the Social Security 
Act (the Act) and is allowed by section 222 of the Public Health 
Service Act (PHA) to consult with an expert outside Panel, such as the 
Advisory Panel on Hospital Outpatient Payment (the Panel), regarding 
the clinical integrity of the Ambulatory Payment Classification (APC) 
groups and relative payment weights. The Panel is governed by the 
provisions of the Federal Advisory Committee Act (Pub. L. 92-463), as 
amended (5 U.S.C. Appendix 2), to set forth standards for the formation 
and use of advisory Panels. We consider the technical advice provided 
by the Panel as we prepare the proposed and final rules to update the 
Hospital Outpatient Prospective Payment System (OPPS) for the following 
calendar year (CY).

II. Annual Advisory Panel Meeting

A. Meeting Agenda

    The agenda for the August 23, 2021 Panel meeting will provide for 
discussion and comment on the following topics as designated in the 
Panel's Charter:
    <bullet> Addressing whether procedures within an APC group are 
similar both clinically and in terms of resource use.
    <bullet> Reconfiguring APCs.
    <bullet> Evaluating APC group weights.
    <bullet> Reviewing packaging the cost of items and services, 
including drugs and devices, into procedures and services, including 
the methodology for packaging and the impact of packaging the cost of 
those items and services on APC group structure and payment.
    <bullet> Removing procedures from the inpatient only list for 
payment under the OPPS.
    <bullet> Using claims and cost report data for Centers for Medicare 
& Medicaid Services (CMS) determination of APC group costs.
    <bullet> Addressing other technical issues concerning APC group 
structure.
    <bullet> Evaluating the required level of supervision for hospital 
outpatient services.
    <bullet> OPPS APC rates for covered Ambulatory Surgical Center 
(ASC) procedures.
    The Agenda will be posted on our website at: <a href="https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups">https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups</a> approximately 1 
week before the meeting.

B. Meeting Information Updates

    The actual meeting hours and days will be posted in the agenda. As 
information and updates regarding this webinar and listen-only 
teleconference, including the agenda, become available, they will be 
posted to our website at: <a href="https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups">https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/AdvisoryPanelonAmbulatoryPaymentClassificationGroups</a>.

C. Presentations and Comment Letters

    The subject matter of any presentation and comment letter must be 
within the scope of the Panel as designated in the Charter. Any 
presentations or comments outside of the scope of the Panel will be 
returned or requested for amendment. Unrelated topics include, but are 
not limited to: The conversion factor, charge compression, revisions to 
the cost report, pass-through payments, correct coding, new technology 
applications (including supporting information/documentation), provider 
payment adjustments, supervision of hospital outpatient diagnostic 
services, and the types of practitioners that are permitted to 
supervise hospital outpatient services. The Panel may not recommend 
that services be designated as nonsurgical extended duration 
therapeutic services. Presentations or Comment Letters that address 
OPPS APC rates as they relate to covered ASC procedures are within the 
scope of the Panel's charter; however, ASC payment rates, ASC payment 
indicators, the ASC covered procedures list, or other ASC payment 
system matters will be considered out of scope. The Panel may use data 
collected or developed by entities and organizations other than 
Department of Health and Human Services and CMS in conducting its 
review. We recommend organizations submit data for CMS staff and the 
Panel's review. All presentations are limited to 5 minutes, regardless 
of the number of individuals or organizations represented by a single 
presentation. Presenters may use their 5 minutes to present either one 
or more agenda items.
    In the email, all of the following information must be submitted 
when registering:
    <bullet> Speaker's name.
    <bullet> Speaker's organization or company name.
    <bullet> Company or organization that the speaker is representing 
that submitted a presentation or comment letter that is on the agenda.
    <bullet> Email addresses to which materials regarding meeting 
registration and instructions on connecting to the meeting may be sent.

[[Page 39027]]

    Registration details may not be revised once they are submitted. If 
registration details require changes, a new registration entry must be 
submitted by August 06, 2021. In addition, registration information 
must reflect individual-level content and not reflect an organization 
entry. Also, each individual may only register one person at a time 
(that is, one individual may not register multiple individuals at the 
same time).
    A confirmation email will be sent upon receipt of the registration. 
The email will provide information to the speaker in preparation for 
the meeting.
    Registration is only required for agenda speakers and alternates 
and must be submitted by the deadline specified above. We note that no 
registration is required for participants who plan to view the Panel 
meeting by webinar or listen teleconference.
Section 508 Compliance
    For this meeting, we are aiming to have all presentations and 
comment letters available on our website. Materials on our website must 
be Section 508 compliant to ensure access to federal employees and 
members of the public with and without disabilities. We encourage 
presenters and commenters to reference the guidance on making documents 
section 508 compliant as they draft their submissions, and, whenever 
possible, to submit their presentations and comment letters in a 508 
compliant form. Such guidance is available at: <a href="https://www.cms.gov/research-statistics-data-and-systems/cms-information-technology/section508">https://www.cms.gov/research-statistics-data-and-systems/cms-information-technology/section508</a>.
    We will review presentations and comment letters for 508 compliance 
and place compliant materials on our website. As resources permit, we 
will also convert non-compliant submissions to 508 compliant forms, and 
offer assistance to submitters who are making their submissions 508 
compliant. All 508 compliant presentations and comment letters will be 
made available on the CMS website. If difficulties are encountered 
accessing the materials, contact the Designated Federal Official (DFO) 
(the DFO's address, email, and phone number are provided in the FOR 
FURTHER INFORMATION CONTACT section of this notice).
    In order to consider presentations and/or comment letters, we will 
need to receive the following:
    1. An email copy of the presentation or comment letters sent to the 
DFO mailbox: <a href="/cdn-cgi/l/email-protection#5415041704353a3138143739277a3c3c277a333b22"><span class="__cf_email__" data-cfemail="b2f3e2f1e2d3dcd7def2d1dfc19cdadac19cd5ddc4">[email&#160;protected]</span></a>.
    2. Form CMS-20017, with complete contact information that includes 
the names, addresses, phone numbers, and email addresses for all 
presenters; comment letters; and a contact person who can answer any 
questions and provide revisions that are requested for the presentation 
or comment letter. Presenters and commenter letters must clearly 
explain the actions that they are requesting CMS take in the 
appropriate section of the form. A presenter or commenter's 
relationship with the organization that they represent must also be 
clearly listed.
    <bullet> The form is available through the CMS Forms website at: 
<a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20017.pdf">https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20017.pdf</a>.
    <bullet> We encourage submitters to make efforts to ensure that 
their presentations and comment letters are 508 compliant.

D. Formal Presentations

    In addition to formal presentations (limited to 5 minutes total per 
presentation), there will be an opportunity during the meeting for 
public comments as time permits (limited to 1 minute for each 
individual and a total of 3 minutes per organization).

E. Panel Recommendations and Discussions

    The Panel's recommendations at any Panel meeting generally are not 
final until they have been reviewed and approved by the Panel on the 
last day of the meeting, before the final adjournment. These 
recommendations will be posted to our website after the meeting.

F. Membership Appointments to the Advisory Panel on Hospital Outpatient 
Payment

    The Panel Charter provides that the Panel may meet up to 3 times 
annually. We consider the technical advice provided by the Panel as we 
prepare the proposed and final rules to update the OPPS for the 
following calendar year. The Panel may consist of a chair and up to 15 
members who are full-time employees of hospitals, hospital systems, or 
other Medicare providers that are subject to the OPPS. The Panel may 
also include a representative of the provider with ASC expertise, who 
may advise CMS only on OPPS APC rates, as appropriate, impacting ASC 
covered procedures within the context and purview of the Panel's scope. 
The Secretary or a designee selects the Panel membership based upon 
either self-nominations or nominations submitted by Medicare providers 
and other interested organizations of candidates determined to have the 
required expertise. For supervision deliberations, the Panel may 
include members that represent the interests of Critical Access 
Hospitals, who advise CMS only regarding the level of supervision for 
hospital outpatient therapeutic services. New appointments are made in 
a manner that ensures a balanced membership under the FACA guidelines. 
The Secretary rechartered the Panel in 2020 for a 2-year period 
effective through November 20, 2022. The current charter is available 
on the CMS website at: <a href="https://www.cms.gov/files/document/2020-hop-panel-charter.pdf">https://www.cms.gov/files/document/2020-hop-panel-charter.pdf</a>. The Panel presently consists of members and a Chair 
named below.

<bullet> E.L. Hambrick, M.D., J.D., CMS Chairperson
<bullet> Terry Bohlke, C.P.A., C.M.A, M.H.A., C.A.S.C
<bullet> Carmen Cooper-Oguz, P.T., D.P.T, M.B.A, C.W.S, W.C.C
<bullet> Paul Courtney, M.D.
<bullet> Peter Duffy, M.D.
<bullet> Lisa Gangarosa, M.D.
<bullet> Michael Kuettel, M.D., M.B.A, Ph.D.
<bullet> Scott Manaker, M.D., Ph.D.
<bullet> Brian Nester, D.O., M.B.A.
<bullet> Bo Gately, M.B.A.
<bullet> Matthew Wheatley, M.D., F.A.C.E.P.

III. Collection of Information Requirements

    This document does not impose information collection requirements, 
that is, reporting, recordkeeping or third-party disclosure 
requirements. Consequently, there is no need for review by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995 (44 U.S.C. 3501 et seq.).
    The Administrator of the Centers for Medicare & Medicaid Services 
(CMS), Chiquita Brooks-LaSure, having reviewed and approved this 
document, authorizes Lynette Wilson, who is the Federal Register 
Liaison, to electronically sign this document for purposes of 
publication in the Federal Register.

    Dated: July 20, 2021.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2021-15727 Filed 7-22-21; 8:45 am]
BILLING CODE 4120-01-P


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