Proposed Rule2022-23563
Medicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021; Extension of Timeline To Finalize a Rulemaking
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Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 1, 2022
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
The Social Security Act (the Act) requires us to publish a Medicare final rule no later than 3 years after the publication date of the proposed rule. This document announces an additional 3 month extension of the timeline for publication of a Medicare final rule in accordance with the Act, which allows us to extend the timeline for publication of the "Medicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021" final rule under exceptional circumstances.
Full Text
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<title>Federal Register, Volume 87 Issue 210 (Tuesday, November 1, 2022)</title>
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[Federal Register Volume 87, Number 210 (Tuesday, November 1, 2022)]
[Proposed Rules]
[Pages 65723-65724]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-23563]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 422, 423, 438, and 498
[CMS-4185-RCN2]
RIN 0938-AT59
Medicare and Medicaid Programs; Policy and Technical Changes to
the Medicare Advantage, Medicare Prescription Drug Benefit, Program of
All-Inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service,
and Medicaid Managed Care Programs for Years 2020 and 2021; Extension
of Timeline To Finalize a Rulemaking
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Extension of timeline for publication of final rule.
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SUMMARY: The Social Security Act (the Act) requires us to publish a
Medicare final rule no later than 3 years after the publication date of
the proposed rule. This document announces an additional 3 month
extension of the timeline for publication of a Medicare final rule in
[[Page 65724]]
accordance with the Act, which allows us to extend the timeline for
publication of the ``Medicare and Medicaid Programs; Policy and
Technical Changes to the Medicare Advantage, Medicare Prescription Drug
Benefit, Program of All-inclusive Care for the Elderly (PACE), Medicaid
Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and
2021'' final rule under exceptional circumstances.
DATES: As of October 28, 2022, the timeline for publication of a rule
to finalize the November 1, 2018 proposed rule (83 FR 54982) is
extended until February 1, 2023.
FOR FURTHER INFORMATION CONTACT: Joseph Strazzire, (410) 786-2775.
SUPPLEMENTARY INFORMATION: On November 1, 2018 (83 FR 54982), we
published a proposed rule, ``Medicare and Medicaid Programs; Policy and
Technical Changes to the Medicare Advantage, Medicare Prescription Drug
Benefit, Program of All-inclusive Care for the Elderly (PACE), Medicaid
Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and
2021,'' that would revise the Medicare Advantage (MA) Risk Adjustment
Data Validation (RADV) regulations to improve program efficiency and
payment accuracy. The proposed rule discussed the Secretary's authority
to: (1) extrapolate in the recovery of RADV overpayments, starting with
payment year 2011 contract-level audits; and (2) not apply a fee-for-
service (FFS) adjuster to the RADV overpayment determinations.
Section 1871(a)(3)(A) of the Act requires the Secretary to
establish and publish a regular timeline for the publication of final
regulations based on the previous publication of a proposed regulation.
In accordance with section 1871(a)(3)(B) of the Act, the timeline may
vary among different regulations based on differences in the complexity
of the regulation, the number and scope of comments received, and other
relevant factors, but may not be longer than 3 years except under
exceptional circumstances. In addition, in accordance with section
1871(a)(3)(B) of the Act, the Secretary may extend the initial targeted
publication date of the final regulation if the Secretary, no later
than the regulation's previously established proposed publication date,
publishes a notice with the new target date for publication, and such
notice includes a brief explanation of the justification for the
variation.
On October 21, 2021 (86 FR 58245), we published a notice of a 1-
year extension of the timeline for publication of a rule to finalize
the November 1, 2018, proposed rule (83 FR 54982) until November 1,
2022. However, we are unable to meet this November 1, 2022, timeline
for publication of the previously referenced RADV-audit related
provisions because of ongoing exceptional circumstances. As described
in the October 21, 2021 notice of extension of the timeline, we
provided several extensions of the comment period and we received
extensive public comments on the proposed rule and subsequent FFS
Adjuster study and related data. We continue to have ongoing delays
resulting from the agency's focus on the COVID-19 public health
emergency, and we have determined that additional time continues to be
needed to address the complex policy and operational issues that were
raised.
This document extends the timeline for publication of the final
rule for an additional 3 months, until February 1, 2023.
Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2022-23563 Filed 10-28-22; 4:15 pm]
BILLING CODE 4120-01-P
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