70 FR 246 pgs. 76290-76313 - Medicare and Medicaid Programs; Quarterly Listing of ProgramIssuances—July Through September 2005
Type: NOTICEVolume: 70Number: 246Pages: 76290 - 76313
Docket number: [CMS-9033-N]
FR document: [FR Doc. 05-24023 Filed 12-22-05; 8:45 am]
Agency: Health and Human Services Department
Sub Agency: Centers for Medicare Medicaid Services
Official PDF Version: PDF Version
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare Medicaid Services
[CMS-9033-N]
Medicare and Medicaid Programs; Quarterly Listing of ProgramIssuances-July Through September 2005
AGENCY:
Centers for Medicare Medicaid Services (CMS), HHS.
ACTION:
Notice.
SUMMARY:
This notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from July 2005 through September 2005, relating to the Medicare and Medicaid programs. This notice provides information on national coverage determinations (NCDs) affecting specific medical and health care services under Medicare. Additionally, this notice identifies certain devices with investigational device exemption (IDE) numbers approved by the Food and Drug Administration (FDA) that potentially may be covered under Medicare. This notice also includes listings of all approval numbers from the Office of Management and Budget for collections of information in CMS regulations. Finally, this notice includes a list of Medicare-approved carotid stent facilities.
Section 1871(c) of the Social Security Act requires that we publish a list of Medicare issuances in the Federal Register at least every 3 months. Although we are not mandated to do so by statute, for the sake of completeness of the listing, and to foster more open and transparent collaboration efforts, we are also including all Medicaid issuances and Medicare and Medicaid substantive and interpretive regulations (proposed and final) published during this 3-month time frame.
FOR FURTHER INFORMATION CONTACT:
It is possible that an interested party may have a specific information need and not be able to determine from the listed information whether the issuance or regulation would fulfill that need. Consequently, we are providing information contact persons to answer general questions concerning these items. Copies are not available through the contact persons. (See Section III of this notice for how to obtain listed material.)
Questions concerning items in Addendum III may be addressed to Timothy Jennings, Office of Strategic Operations and Regulatory Affairs, Centers for Medicare Medicaid Services, C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2134.
Questions concerning Medicare NCDs in Addendum V may be addressed to Patricia Brocato-Simons, Office of Clinical Standards and Quality, Centers for Medicare Medicaid Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-0261.
Questions concerning FDA-approved Category B IDE numbers listed in Addendum VI may be addressed to John Manlove, Office of Clinical Standards and Quality, Centers for Medicare Medicaid Services, C1-13-04, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-6877.
Questions concerning approval numbers for collections of information in Addendum VII may be addressed to Bonnie Harkless, Office of Strategic Operations and Regulatory Affairs, Regulations Development and Issuances Group, Centers for Medicare Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-5666.
Questions concerning Medicare-approved carotid stent facilities may be addressed to Sarah J. McClain, Office of Clinical Standards and Quality, Centers for Medicare Medicaid Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2994.
Questions concerning all other information may be addressed to Gwendolyn Johnson, Office of Strategic Operations and Regulatory Affairs, Regulations Development Group, Centers for Medicare Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-6954.
SUPPLEMENTARY INFORMATION:
I. Program Issuances
The Centers for Medicare Medicaid Services (CMS) is responsible for administering the Medicare and Medicaid programs. These programs pay for health care and related services for 39 million Medicare beneficiaries and 35 million Medicaid recipients. Administration of the two programs involves (1) furnishing information to Medicare beneficiaries and Medicaid recipients, health care providers, and the public and (2) maintaining effective communications with regional offices, State governments, State Medicaid agencies, State survey agencies, various providers of health care, all Medicare contractors that process claims and pay bills, and others. To implement the various statutes on which the programs are based, we issue regulations under the authority granted to the Secretary of the Department of Health and Human Services under sections 1102, 1871, 1902, and related provisions of the Social Security Act (the Act). We also issue various manuals, memoranda, and statements necessary to administer the programs efficiently.
Section 1871(c)(1) of the Act requires that we publish a list of all Medicare manual instructions, interpretive rules, statements of policy, and guidelines of general applicability not issued as regulations at least every 3 months in the Federal Register . We published our first notice June 9, 1988 (53 FR 21730). Although we are not mandated to do so by statute, for the sake of completeness of the listing of operational and policy statements, and to foster more open and transparent collaboration, we are continuing our practice of including Medicare substantive and interpretive regulations (proposed and final) published during the respective 3-month time frame.
II. How To Use the Addenda
This notice is organized so that a reader may review the subjects of manual issuances, memoranda, substantive and interpretive regulations, NCDs, and FDA-approved IDEs published during the subject quarter to determine whether any are of particular interest. We expect this notice to be used in concert with previously published notices. Those unfamiliar with a description of our Medicare manuals may wish to review Table I of our first three notices (53 FR 21730, 53 FR 36891, and 53 FR 50577) published in 1988, and the notice published March 31, 1993 (58 FR 16837). Those desiring information on the Medicare NCD Manual (NCDM, formerly the Medicare Coverage Issues Manual (CIM)) may wish to review the August 21, 1989, publication (54 FR 34555). Those interested in the revised process used in making NCDs under the Medicare program may review the September 26, 2003, publication (68 FR 55634).
To aid the reader, we have organized and divided this current listing into eight addenda:
• Addendum I lists the publication dates of the most recent quarterly listings of program issuances.
• Addendum II identifies previous Federal Register documents that contain a description of all previously published CMS Medicare and Medicaid manuals and memoranda.
• Addendum III lists a unique CMS transmittal number for each instruction in our manuals or Program Memoranda and its subject matter. A transmittal may consist of a single or multiple instruction(s). Often, it is necessary to use information in a transmittal in conjunction with information currently in the manuals.
• Addendum IV lists all substantive and interpretive Medicare and Medicaid regulations and general notices published in the Federal Register during the quarter covered by this notice. For each item, we list the-
? Date published;
? Federal Register citation;
? Parts of the Code of Federal Regulations (CFR) that have changed (if applicable);
? Agency file code number; and
? Title of the regulation.
• Addendum V includes completed NCDs, or reconsiderations of completed NCDs, from the quarter covered by this notice. Completed decisions are identified by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision.
• Addendum VI includes listings of the FDA-approved IDE categorizations, using the IDE numbers the FDA assigns. The listings are organized according to the categories to which the device numbers are assigned (that is, Category A or Category B), and identified by the IDE number.
• Addendum VII includes listings of all approval numbers from the Office of Management and Budget (OMB) for collections of information in CMS regulations in title 42; title 45, subchapter C; and title 20 of the CFR.
• Addendum VIII includes listings of Medicare-approved carotid stent facilities. All facilities listed meet CMS standards for performing carotid artery stenting for high risk patients.
III. How To Obtain Listed Material
A. Manuals
Those wishing to subscribe to program manuals should contact either the Government Printing Office (GPO) or the National Technical Information Service (NTIS) at the following addresses: Superintendent of Documents, Government Printing Office, ATTN: New Orders, P.O. Box 371954,Pittsburgh, PA 15250-7954,Telephone (202) 512-1800,Fax number (202) 512-2250 (for credit card orders); orNational Technical Information Service,Department of Commerce,5825 Port Royal Road,Springfield, VA 22161,Telephone (703) 487-4630.
In addition, individual manual transmittals and Program Memoranda listed in this notice can be purchased from NTIS. Interested parties should identify the transmittal(s) they want. GPO or NTIS can give complete details on how to obtain the publications they sell. Additionally, most manuals are available at the following Internet address: http://cms.hhs.gov/manuals/default.asp.
B. Regulations and Notices
Regulations and notices are published in the daily Federal Register . Interested individuals may purchase individual copies or subscribe to the Federal Register by contacting the GPO at the address given above. When ordering individual copies, it is necessary to cite either the date of publication or the volume number and page number.
The Federal Register is also available on 24x microfiche and as an online database through GPO Access. The online database is updated by 6 a.m. each day the Federal Register is published. The database includes both text and graphics from Volume 59, Number 1 (January 2, 1994) forward. Free public access is available on a Wide Area Information Server (WAIS) through the Internet and via asynchronous dial-in. Internet users can access the database by using the World Wide Web; the Superintendent of Documents home page address is http://www.gpoaccess.gov/fr/index.html , by using local WAIS client software, or by telnet to swais.gpoaccess.gov , then log in as guest (no password required). Dial-in users should use communications software and modem to call (202) 512-1661; type swais, then log in as guest (no password required).
C. Rulings
We publish rulings on an infrequent basis. Interested individuals can obtain copies from the nearest CMS Regional Office or review them at the nearest regional depository library. We have, on occasion, published rulings in the Federal Register . Rulings, beginning with those released in 1995, are available online, through the CMS Home Page. The Internet address is http://cms.hhs.gov/rulings.
D. CMS' Compact Disk-Read Only Memory (CD-ROM)
Our laws, regulations, and manuals are also available on CD-ROM and may be purchased from GPO or NTIS on a subscription or single copy basis. The Superintendent of Documents list ID is HCLRM, and the stock number is 717-139-00000-3. The following material is on the CD-ROM disk:
• Titles XI, XVIII, and XIX of the Act.
• CMS-related regulations.
• CMS manuals and monthly revisions.
• CMS program memoranda.
The titles of the Compilation of the Social Security Laws are current as of January 1, 2003. (Updated titles of the Social Security Laws are available on the Internet at http://www.ssa.gov/OP_Home/ssact/comp-toc.htm. ) The remaining portions of CD-ROM are updated on a monthly basis.
Because of complaints about the unreadability of the Appendices (Interpretive Guidelines) in the State Operations Manual (SOM), as of March 1995, we deleted these appendices from CD-ROM. We intend to re-visit this issue in the near future and, with the aid of newer technology, we may again be able to include the appendices on CD-ROM.
Any cost report forms incorporated in the manuals are included on the CD-ROM disk as LOTUS files. LOTUS software is needed to view the reports once the files have been copied to a personal computer disk.
IV. How To Review Listed Material
Transmittals or Program Memoranda can be reviewed at a local Federal Depository Library (FDL). Under the FDL program, government publications are sent to approximately 1,400 designated libraries throughout the United States. Some FDLs may have arrangements to transfer material to a local library not designated as an FDL. Contact any library to locate the nearest FDL.
In addition, individuals may contact regional depository libraries that receive and retain at least one copy of most Federal Government publications, either in printed or microfilm form, for use by the general public. These libraries provide reference services and interlibrary loans; however, they are not sales outlets. Individuals may obtain information about the location of the nearest regional depository library from any library. For each CMS publication listed in Addendum III, CMS publication and transmittal numbers are shown. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the Medicare NCD publication titled "Cochlear Implantation," use CMS-Pub. 100-03, Transmittal No. 42.
(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare-Hospital Insurance, Program No. 93.774, Medicare-Supplementary Medical Insurance Program, and Program No. 93.714, Medical Assistance Program)
Dated: December 7, 2005.
Jacquelyn Y. White,
Director, Office of Strategic Operations and Regulatory Affairs.
Addendum I
This addendum lists the publication dates of the most recent quarterly listings of program issuances.
June 27, 2003 (68 FR 38359)
September 26, 2003 (68 FR 55618)
December 24, 2003 (68 FR 74590)
March 26, 2004 (69 FR 15837)
June 25, 2004 (69 FR 35634)
September 24, 2004 (69 FR 57312)
December 30, 2004 (69 FR 78428)
February 25, 2005 (70 FR 9338)
June 24, 2005 (70 FR 36620)
September 23, 2005 (70 FR 55863)
Addendum II-Description of Manuals, Memoranda, and CMS Rulings
An extensive descriptive listing of Medicare manuals and memoranda was published on June 9, 1988, at 53 FR 21730 and supplemented on September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR 50577. Also, a complete description of the former CIM (now the NCDM) was published on August 21, 1989, at 54 FR 34555. A brief description of the various Medicaid manuals and memoranda that we maintain was published on October 16, 1992, at 57 FR 47468.
| Transmittal No. | Manual/Subject/Publication No. |
|---|---|
| Medicare General Information | |
| (CMS-Pub. 100-01) | |
| 25 | Next Generation Desktop Testing Requirements Definitions |
| Next Generation Desktop Maintainer Requirements | |
| 26 | Implement New Medicare Plan ID and Carrier Number for the Single Testing Contractor |
| Shared System Testing Requirements for Maintainers, Beta Testers, and Contractors | |
| 27 | Provider Extract File |
| 28 | Conforming Changes for Change Request 3648 to Pub. 100-01 |
| Hospital Insurance (Part A) for Inpatient Hospital, Hospice, and Skilled Nursing Facility Services-A Brief DescriptionHome Health Services | |
| Supplementary Medical Insurance (Part B)-A Brief Description | |
| Discrimination Prohibited | |
| Role of Part A Intermediaries | |
| Limitation on Physical Therapy, Occupational Therapy and Speech-Language Pathology Services | |
| Certification for Hospital Services Covered by the Supplementary Medical Insurance Program | |
| Content of the Physician's Certification | |
| Recertifications for Home Health Services | |
| Physician's Certification and Recertification for Outpatient Physical Therapy Occupational Therapy and Speech-Language Pathology Recertification | |
| Under Arrangements | |
| Term of Agreements | |
| Determining Payment for Services Furnished After Termination, Expiration, or Cancellation | |
| Home Health Agency Defined | |
| 29 | 2005 Scheduled Release for October Updates to Software Programs and Pricing/Coding Files |
| Medicare Benefit Policy | |
| (CMS-Pub. 100-02) | |
| 37 | Conforming Changes for Change Request 3648 to Pub. 100-02 |
| Medical and Other Health Services Furnished to Inpatients of Participating Hospitals Outpatient Hospital Services | |
| Distinguishing Outpatient Hospital Services Provided Outside the Hospital Coverage of Outpatient Therapeutic Services | |
| Medical and Other Health Services Furnished by Home Health Agencies Skilled Services Defined | |
| Speech-Language Pathology | |
| Physical Therapy, Speech-Language Pathology, and Occupational TherapyFurnished by the Skilled Nursing Facility or by Others Under ArrangementsWith the Facility and Under Its Supervision | |
| Inpatient Physical Therapy, Occupational Therapy, and Speech-LanguagePathology Services | |
| Services Furnished Under Arrangements With Providers | |
| Supplementary Medical Insurance Provisions | |
| Services Not Provided Within United States | |
| Medicare National Coverage Determinations | |
| (CMS-Pub. 100-03) | |
| 42 | Cochlear Implantation |
| Cochlear Implantation (Effective April 4, 2005) | |
| Medicare Claims Processing | |
| (CMS-Pub. 100-04) | |
| 601 | Cochlear Implantation |
| Billing Requirements for Expanded Coverage of Cochlear Implantation | |
| Intermediary Billing Procedures | |
| Applicable Bill Types | |
| Special Billing Requirements for Intermediaries | |
| Intermediary Payment Requirements | |
| Carrier Billing Procedures | |
| Healthcare Common Procedure Coding System | |
| 602 | Expansion of Various Alpha and Numeric Fields Within the OutpatientProspective Payment System Outpatient Code Editor |
| 603 | Modification to the Appeals Language on the Medicare Summary Notice; Full Replacement of Change Request 3808 |
| Appeals Section | |
| Back of Medicare Summary Notice-Carriers and IntermediariesCarrier Spanish Medicare Summary Notices Back Intermediary Spanish Medicare Summary Notices Back | |
| 604 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 605 | Frequency Instructions for Smoking and Tobacco-Use Cessation Counseling Services |
| Remittance Advice Notices | |
| Medicare Summary Notices | |
| 606 | Medicare Program-Update to the Hospice Payment Rates, Hospice Cap,Hospice Wage Index, and the Hospice Pricer for FY 2005 |
| Payment Rates | |
| 607 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 608 | New Health Professional Shortage Area Modifier |
| Zip Code Files | |
| Provider Education | |
| Claims Coding Requirements | |
| Services Eligible for Health Professional Shortage Area and Physician Scarcity Bonus Payments | |
| Post-payment Review | |
| Health Professional Shortage Area Incentive Payments for Physician Services Rendered in a Critical Access Hospital | |
| 609 | Remittance Advice Remark Code and Claim Adjustment Reason Code Update |
| 610 | This Transmittal is rescinded and replaced by Transmittal 634 |
| 611 | Payment Methodology for Rehabilitation Services in Indian Health Service/Tribally Owned and/or Operated Hospitals and Hospital Based Facilities |
| Services Paid Under the Physician Fee Schedule | |
| 612 | Abarelix for Treatment of Prostate Cancer |
| 613 | New Healthcare Common Procedure Coding System Codes and Systems Edits for Supplies and Accessories for Ventricular Assist Devices-Full Replacement of CR 3761 |
| 614 | Medicare Physician Fee Schedule Database 2006 File Layout |
| 615 | Revision of Chapter 24, Electronic Data Interchange Support Requirements |
| Electronic Data Interchange General Outreach Activities Carrier, Durable Medical Equipment Regional Carrier, and Fiscal IntermediaryAnalysis of Internal Information | |
| Systems Information | |
| Review of Provider Profiles | |
| Contact with New Providers | |
| Production and Distribution of Material to Increase Use of Electronic DataInterchange | |
| Electronic Data Interchange Enrollment | |
| New Enrollments and Maintenance of Existing Enrollments | |
| Submitter Number | |
| Release of Medicare Eligibility Data | |
| Network Service Vendor Agreement | |
| Electronic Data Interchange User Guidelines | |
| Directory of Billing Software Vendors and Clearinghouses | |
| Technical Requirements-Data, Media, and TelecommunicationsSystem Availability | |
| Media | |
| Telecommunications and Transmission Protocols | |
| Toll-Free Service | |
| Initial Editing | |
| Translators | |
| Required Electronic Data Interchange Formats | |
| General Health Insurance Portability and Accountability Act Electronic DataInterchange Requirements | |
| Continued Support of Pre-Health Insurance Portability and Accountability Act | |
| Electronic Data Interchange Formats | |
| National Council for Prescription Drug Program Claim Requirements | |
| Crossover Claim Requirements | |
| Direct Data Entry Screens | |
| Use of Imaging, External Key Shop, and In-House Keying for Entry of Transaction Data Submitted on Paper | |
| Electronic Funds Transfer | |
| Electronic Data Interchange Testing Requirements | |
| Shared System and Common Working File Maintainers Internal TestingRequirements | |
| Carrier, Durable Medical Equipment Regional Carrier, and IntermediaryInternal Testing Requirements | |
| Third-Party Certification Systems and Services | |
| Electronic Data Interchange Submitter/Receiver Testing by Carriers, DurableMedical Equipment Regional Carriers, and Fiscal Intermediaries | |
| Testing Accuracy | |
| Limitation on Testing of Multiple Providers That Use the Same Clearinghouse,Billing Service, or Vendor Software | |
| Carrier, Durable Medical Equipment Regional Carrier, and Fiscal IntermediarySubmitter/Receiver Testing With Legacy Formats During the Health InsurancePortability and Accountability Act Contingency Period | |
| Discontinuation of Use of Claim Legacy Formats following Successful HealthInsurance Portability and Accountability Act Format Testing | |
| Electronic Data Interchange Receiver Testing by Carriers, Durable MedicalEquipment Regional Carriers, and Intermediaries | |
| Changes in Provider's System or Vendor's Software, and Use of AdditionalElectronic Data Interchange Formats | |
| Support of Electronic Data Interchange Trading Partners | |
| User Guidelines | |
| Technical Assistance to Electronic Data Interchange Trading Partners | |
| Training Content and Frequency | |
| Prohibition Against Requiring Use of Proprietary Software or DirectData Entry | |
| Free Claim Submission Software | |
| Remittance Advice Print Software | |
| Medicare Remit Easy Print Software for Carrier and Durable MedicalEquipment Regional Carrier Provider Use | |
| Medicare Standard Fiscal Intermediary PC-Print Software | |
| Newsletters/Bulletin Board/Internet Publication of Electronic DataInterchange Information | |
| Provider Guidelines for Choosing a Vendor | |
| Determining Goals/Requirements | |
| Vendor Selection | |
| Negotiating With Vendors | |
| Electronic Data Interchange Edit Requirements | |
| Carrier, Durable Medical Equipment Regional Carrier, and Fiscal IntermediaryX12 Edit Requirements | |
| Supplemental Fiscal Intermediary-Specific Shared System Edit Requirements | |
| Fiscal Intermediary Health Insurance and Portability Accountability Act Claim | |
| Level Implementation Guide Edits | |
| Supplemental Carrier/Durable Medical Equipment Regional Carrier-SpecificShared System Implementation Guide Edit Requirements | |
| Keyshop and Image Processing | |
| Carrier, Durable Medical Equipment Regional Carrier, or Fiscal IntermediaryData Security and Confidentiality Requirements | |
| Carrier, Durable Medical Equipment Regional Carrier, and Fiscal IntermediaryElectronic Data Interchange Audit Trails | |
| Security-Related Requirements for Carrier, Durable Medical Equipment | |
| Regional Carrier, or Fiscal Intermediary Arrangements with ClearinghousesAnd Billing Services | |
| Mandatory Electronic Submission of Medicare Claims | |
| Small Providers and Full-Time Equivalent Employee Self-Assessments | |
| Exceptions | |
| Unusual Circumstance Waivers | |
| Unusual Circumstance Waivers Subject to Provider Self-Assessment | |
| Unusual Circumstance Waivers Subject to Medicare Contractor Approval | |
| Unusual Circumstance Waivers Subject to Contractor Evaluation and CMSDecision | |
| Electronic and Paper Claims Implications of Mandatory Electronic SubmissionEnforcement | |
| Provider Education | |
| 616 | Certified Registered Nurse Anesthetist Pass-Through Payments |
| Anesthesia and Certified Registered Nurse Anesthetist Services in a CriticalAccess Hospitals | |
| Payment for Certified Registered Nurse Anesthetist Pass-Through Services | |
| Payment for Anesthesia Services by a Certified Registered Nurse Anesthetist(Method II Critical Access Hospital Only) | |
| 617 | Administration of Drugs and Biologicals in a Method II Critical Access Hospital |
| Coding for Administering Drugs in a Method II Critical Access Hospital | |
| Coding for Low Osmolar Contrast Material | |
| 618 | Coding for the Administration of Other Drugs and Biologicals |
| Clarification for Carriers and Durable Medical Equipment Regional Carriers About Correction and Recoupment of Previously Processed Claims | |
| 619 | Late IRF-PAI Data Submission Penalty Protocol Within the InpatientRehabilitation Facility Prospective Payment System |
| Payment Adjustment for Late Transmission of Patient Assessment Data | |
| 620 | New Fiscal Intermediary (FI) Edit to Identify Potentially Excessive MedicarePayments |
| Fiscal Intermediary Edits Affecting Multiple Bill Types | |
| Threshold Edit for Outpatient and Inpatient Part B Claims | |
| 621 | Locality Codes for Purchased Diagnostic Tests |
| 622 | This Transmittal is rescinded and replaced by Transmittal 668 |
| 623 | Durable Medical Equipment Regional Carrier Only-Corrections to the BillingIndicator Field for Adjusted Claims |
| 624 | This Transmittal is rescinded and replaced by Transmittal 686 |
| 625 | Competitive Acquisition Program for Part B Drugs-Coding, Testing, andImplementation |
| 626 | Common Working File Expansion of Duplicate Claim Edit for Clinical Diagnostic Services |
| 627 | New Low Osmolar Contrast Material (LOCM) HCPCS Codes/Payment Criteria/Payment Level |
| Low Osmolar Contrast Media (HCPCS Codes Q9945-Q9951) | |
| Payment Criteria/Payment Level | |
| 628 | Radiopharmaceutical Diagnostic Imaging Agents Codes Applicable to Positron Emission Tomography Scan Services Performed on or After January 28, 2005 |
| Appropriate Common Procedure Terminology Codes Effective for Positron Emission Tomography Scan Services Performed on or After January 28, 2005 | |
| Tracer Codes Required for Positron Emission Tomography Scans | |
| 629 | Certificate of Medical Necessity Claim Edits Workload Reporting |
| Durable Medical Equipment Regional Carrier Systems | |
| 630 | Medicare Part A Skilled Nursing Facility Prospective Payment System Pricer |
| Update and Health Insurance Prospective Payment System Coding UpdateEffective January 1, 2006 | |
| Health Insurance Prospective Payment System Rate Code | |
| Skilled Nursing Facility Prospective Payment System Rate Components | |
| Decision Logic Used by the Pricer on Claims | |
| 631 | Claim Status Category Code and Claim Status Code Update |
| 632 | Billing and Claims Processing Instructions for Claims Subject to Expedited Determinations |
| Limitation of Liability Notification and Coordination With Quality | |
| Improvement Organizations | |
| Limitation on Liability-Overview | |
| Hospital Claims Subject to Hospital Issued Notices of Noncoverage | |
| Scope of Issuance of Hospital Issued Notices of Noncoverage | |
| General Responsibilities of Quality Improvement Organizations and Fiscal Intermediaries Related to Hospital Issued Notices of Noncoverage | |
| Billing and Claims Processing Requirements Related to Hospital Issued Notices of Noncoverage | |
| Skilled Nursing Facility, Home Health Agency, Hospice, and ComprehensiveOutpatient Rehabilitation Facility Claims Subject to Expedited Determinations | |
| Scope of Issuance of Expedited Determination Notices | |
| General Responsibilities of Quality Improvement Organizations and FiscalIntermediaries Related to Expedited Determinations | |
| Billing and Claims Processing Requirements Related to ExpeditedDeterminations | |
| Coordination With the Quality Improvement Organization | |
| 633 | Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus, Influenza Virus, and Hepatitis B Virus) and Their Administration Provided by Indian Health Service/Tribally-Owned and/or Operated Hospitals and Hospital Based Facilities |
| Billing Requirements | |
| Bills Submitted to Fiscal Intermediaries | |
| Vaccines and Vaccine Administration | |
| 634 | Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus,Influenza Virus, and Hepatitis B Virus) and Their Administration at Renal Dialysis Facilities |
| Vaccines Furnished to End-Stage Renal Disease Patients | |
| Fiscal Intermediary Payment for Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccine | |
| Bills Submitted by Hospices and Payment for Renal Dialysis Facilities | |
| 635 | Financial Liability for Services Subject to Home Health Consolidated Billing |
| Home Health Prospective Payment System Consolidated Billing and Primary | |
| Home Health Agencies | |
| Home Health Prospective Payment System Consolidated Billing Beneficiary Notification and Payment Liability Under Home Health Consolidated Billing | |
| Responsibilities of Home Health Agencies | |
| Responsibilities of Providers/Suppliers of Services Subject to Consolidated Billing | |
| Responsibilities of Hospitals Discharging Medicare Beneficiaries to Home Health Care | |
| Home Health Consolidated Billing Edits in Medicare Systems | |
| Non-routine Supply Editing | |
| Therapy Editing | |
| Other Editing Related to Home Health Consolidated Billing | |
| Only Request for Anticipated Payment Received and Services Fall Within 60 Days After Request for Anticipated Payment Start Date | |
| No Request for Anticipated Payment Received and Therapy Services Rendered in the Home | |
| Health Insurance Eligibility Query to Determine Episode Status | |
| Other Editing and Changes for Home Health Prospective Payment System Episodes | |
| Coordination of Home Health Prospective Payment System Claims and Episodes With Inpatient Claim Types | |
| 636 | Instructions for Implementation of CMS Ruling 05-01; Presbyopia-Correcting Intraocular Lens |
| 637 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 638 | New Medicare Summary Notice Messages |
| Adjustments | |
| Ajustes | |
| 639 | Cessation of Additional $50 Payment for New Technology Intraocular Lenses |
| Ambulatory Surgical Center Services on Ambulatory Surgical Center List | |
| Payment for Intraocular Lens | |
| 640 | Medicare Part A Skilled Nursing Facility Prospective Payment System PricerUpdate FY 2006 |
| 641 | October 2005 Quarterly Update to Skilled Nursing Facility Consolidated Billing |
| 642 | New Waived Tests |
| 643 | Nature and Effect of Assignment on Carrier Claims |
| 644 | October 2005 Non-Outpatient Prospective Payment System Code Editor Specifications Version 21 |
| 645 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 646 | Update to the Inpatient Provider Specific File and the Outpatient Provider |
| Specific File to Retain Provider Information | |
| 647 | The Supplemental Security Income/Medicare Beneficiary Data for Fiscal Year 2004 for Inpatient Prospective Payment System Hospitals |
| 648 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 649 | Competitive Acquisition Program for Part B Drugs-Coding, Testing, andImplementation |
| 650 | This Transmittal is rescinded and replaced by Transmittal 673 |
| 651 | Changes to the Laboratory National Coverage Determination Edit Software for October 2005 |
| 652 | This Transmittal is rescinded and replaced by Transmittal 661 |
| 653 | October 2005 Quarterly Average Sales Price Medicare Part B Drug PricingFile, Effective October 1, 2005 and Revisions to April 2005 and July 2005Quarterly Average Sale Price Medicare Part B Drug Pricing File |
| 654 | Services Not Provided Within the United States |
| Services Received by Medicare Beneficiaries Outside the United StatesSource of Part B Claims | |
| Appeals of Denied Charges for Physicians and Ambulance Services in Connection With Foreign Hospitalization | |
| Services Rendered in Nonparticipating Providers | |
| Coverage Requirements for Emergency Hospital Services in Foreign Countries | |
| Services Furnished in a Foreign Hospital Nearest to Beneficiary's U.S.Residence | |
| Coverage of Physician and Ambulance Services Furnished Outside U.S. | |
| Payment by the Railroad Retirement Beneficiaries for Services Furnished in Canada to Qualified Railroad Retirement Beneficiaries | |
| Foreign Religious Nonmedical Health Care Facility Claims | |
| Elections to Bill for Services Rendered at Nonparticipating Hospitals | |
| Processing Claims | |
| Appeals on Claims for Emergency and Foreign Services | |
| Payment for Services from Foreign Hospitals | |
| Full Denial-Foreign Claim-Beneficiary Filed | |
| 655 | This Transmittal is rescinded and replaced by Transmittal 663 |
| 656 | Full Replacement of Change Request 3607, Payment Edits in Applicable StatesFor Durable Medical Equipment Prosthetics, Orthotics Supplies |
| Provider Billing for Prosthetics and Orthotic Services | |
| 657 | Quarterly Update to Correct Coding Initiative Edits, Version V11.3, Effective October 1, 2005 |
| 658 | Billing for Devices Under the Hospital Outpatient Prospective Payment System |
| Billing for Devices Under the Outpatient Prospective Payment System | |
| Requirements that Hospitals Report Device Codes on Claims on Which They Report Specified Procedures | |
| Edits for Claims on Which Specified Procedures Are To Be Reported With Device Codes | |
| 659 | Instructions for Downloading the Medicare Zip Code File |
| 660 | This Transmittal is rescinded and replaced by Transmittal 664 |
| 661 | This Transmittal is rescinded and replaced by Transmittal 672 |
| 662 | This Transmittal is rescinded and replaced by Transmittal 691 |
| 663 | Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index, and the Hospice Pricer for Fiscal Year 2006 |
| 664 | This Transmittal is rescinded and replaced by Transmittal 683 |
| 665 | October Quarterly Update for 2005 Durable Medical Equipment, Prosthetics,Orthotics, and Supplies Fees Schedule |
| 666 | Updates to the Coordination of Benefits Contractor Detailed Error |
| Report File Layout | |
| Consolidation of the Claims Crossover Process | |
| Coordination of Benefits Agreement Detailed Error Notification Process | |
| 667 | Home Care and Domiciliary Care Visits (Codes 99321-99350) |
| 668 | Enforcement of Hospital Inpatient Bundling: Carrier Denial of AmbulanceClaims During an Inpatient Stay |
| Hospital Inpatient Bundling | |
| General Coverage and Payment Policies | |
| Common Working File Editing of Ambulance Claims for Inpatients | |
| Intermediary Guidelines | |
| Provider/Intermediary Bill Processing Guidelines Effective April 1, 2002, as a Result of Fee Schedule Implementation | |
| 669 | Schedule for Completing the Calendar Year 2006 Fee Updates and the Participating Physician Enrollment Procedures |
| 670 | Realignment of States and Medicare Claims Processing Workload FromDurable Medical Equipment Regional Carrier Regions A, B, C, and D to the Durable Medical Equipment Major Ambulatory Jurisdictions A, B, C and D |
| 671 | Updated Manual Instructions for the Medicare Claims Processing Manual,Regarding Smoking and Tobacco-Use Cessation Counseling Services |
| Healthcare Common Procedure Coding System and Diagnosis Coding | |
| Carrier Billing Requirements | |
| Fiscal Intermediary Billing Requirements | |
| Medicare Summary Notices | |
| 672 | October Update to the 2005 Medicare Physician Fee Schedule Database |
| 673 | Manual Update on Medical Nutrition Therapy Services-Manualization |
| Medicare Nutrition Therapy Services | |
| General Conditions and Limitations on Coverage | |
| Referrals for Medicare Nutrition Therapy Services | |
| Dietitians and Nutritionists Performing Medicare Nutrition Therapy Services | |
| Payment for Medicare Nutrition Therapy Services | |
| General Claims Processing Information | |
| Common Working File Edits | |
| 674 | This Transmittal is rescinded and replaced by Transmittal 692 |
| 675 | Changes to Appeals of Claims Decisions: Redeterminations andReconsiderations (Implementation Date October 1, 2005) |
| Workload Data Analysis Program | |
| Managing Appeals Workloads | |
| Standard Operating Procedures | |
| Execution of Workload Prioritization | |
| Workload Priorities | |
| 676 | 2006 Healthcare Common Procedure Coding System Annual Update Reminder |
| 677 | This Transmittal is rescinded and replaced by 687 |
| 678 | This Transmittal is rescinded and replaced by 688 |
| 679 | Medicare Redetermination Notice and Effect of the Redetermination Medicare Redetermination Notice (for partly or fully unfavorable redeterminations) |
| Medicare Redetermination Notice (for fully favorable redeterminations)Effect of the Redetermination | |
| 680 | Inpatient Rehabilitation Facility Annual Update: Prospective Payment SystemPricer Changes for FY 2006 |
| 681 | Guidelines For Payment of Vaccines (Pneumococcal Pneumonia Virus,Influenza Virus, And Hepatitis B Virus) and Their Administration Provided by Indian Health Services/Tribally-Owned and/or Operated Hospitals andHospital Based Facilities |
| Billing Requirements | |
| Bills Submitted to Fiscal Intermediaries | |
| Vaccines and Vaccine Administration | |
| 682 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 683 | October 2005 Outpatient Prospective Payment System Code Editor Specifications Version |
| 684 | Correction to Chapter 17, Section 80.2.3, MSN/ANSI X12 Denial Messages for Anti-Emetic Drugs |
| 685 | Discontinuation of the Skilled Nursing Facility Healthcare CommonProcedure Coding System Help File and Notification to Fiscal Intermediaries and Providers of the Redesigned Skilled Nursing Facility Consolidated BillingAnnual Update File Posted on CMS Web site |
| Services Included in Part A Prospective Payment System Payment Not Billable Separately by the Skilled Nursing Facility | |
| Services Beyond the Scope of the Part A Skilled Nursing Facility Benefit | |
| Billing for Medical and Other Health Services | |
| General Payment Rules and Application of Part B Deductible and Coinsurance | |
| 686 | Common Working File Unsolicited Response Adjustments for Certain ClaimsDenied Due to an Open Medicare Secondary Payer Group Health Plan RecordWhere the Group Health Plan Record Was Subsequently Deleted |
| 687 | Appeals of Claims Decisions: Redeterminations and Reconsiderations(Implementation Dates for Fiscal Intermediary Initial Determination IssuedOn or After May 1, 2005 and Carrier Initial Determinations Issued on or AfterJanuary 1, 2006) |
| Filing a Request for Redetermination | |
| Appeal Rights for Dismissals | |
| Dismissal Letters | |
| Model Dismissal Notices | |
| Reconsideration-The Second Level of Appeal | |
| Filing a Request for a Reconsideration | |
| Time Limit for Filing a Request for a Reconsideration | |
| Contractor Responsibilities-General | |
| Qualified Independent Contractor Case File Development | |
| Qualified Independent Contractor Case File Preparation | |
| Forwarding Qualified Independent Contractor Case Files | |
| Qualified Independent Contractor Jurisdictions | |
| Tracking Cases | |
| Effectuation of Reconsiderations | |
| 688 | Appeals of Claims Decisions: Redeterminations and Reconsiderations(Implementation Dates for All Requests for Redetermination Received by Fiscal Intermediary on or After May 1, 2005, and All Requests for Redetermination Received by Carriers on or After January 1, 2006) |
| Redetermination-The First Level of Appeal | |
| The Redetermination | |
| The Redetermination Decision | |
| Dismissals | |
| Vacating a Dismissal | |
| 689 | One Time Update to the National Council Prescription Drug Programs |
| Companion Document Regarding Crossover Claims to Medicaid | |
| 690 | Fiscal Year (FY) 2006 Payment for Services Furnished in Ambulatory Surgical Centers |
| 691 | October 2005 Update of the Hospital Outpatient Prospective Payment System |
| 692 | Fiscal Year 2006 Inpatient Prospective Payment System and Long Term Care Hospital Changes |
| 693 | Updates to the Inpatient Rehabilitation Facility and Skilled Nursing Facility |
| Provider Specific File and Changes in Inpatient Rehabilitation Facility | |
| Prospective Payment System for FY 2006 | |
| Provider-Specific File | |
| Case-Mix Groups | |
| Facility Level Adjustments | |
| Area Wage Adjustment | |
| Rural Adjustment | |
| Outlier | |
| Teaching Status Adjustment | |
| Full Time Equivalent Resident Cap | |
| Inpatient Rehabilitation Facility Prospective Payment System Pricer Software | |
| 694 | Update to the Healthcare Provider Taxonomy Codes Version 5.1 |
| Medicare Secondary Payer | |
| (CMS-Pub. 100-05) | |
| 31 | Full Replacement of Change Request 3770, Expanding the Number of Source Identifiers for Common Working File Medicare Secondary Payer Records |
| Change Request 3770 Is Rescinded | |
| Definition of Medicare Secondary Payer/Common Working File Terms | |
| Medicare Secondary Payer Delete Transaction | |
| Identification of Reimbursement Advisory Committee Created Group Health Plan Records | |
| 32 | Exception for Small Employers in Multi-Employer Group Health PlansOverview and General Responsibilities |
| Introduction to the Coordination of Benefits Contractor | |
| Scope of the Coordination of Benefit Contractor in Relation to Contractors | |
| Contractors Claim Referrals to the Coordination of Benefit ContractorsIRS/SSA/CMS Data Match | |
| Coordination of Benefit Contractors Discontinues Dissemination of the Right of Recovery Letters to Contractors | |
| Exception for Small Employers in Multi-Employer Group Health Plans | |
| Purpose | |
| Background | |
| Specific Information | |
| 33 | Working Aged Exception for Small Employers in Multi-Employer Group Health Plans |
| 34 | Manualization: Long-Standing Medicare Secondary Payer Policy in Chapter 1 of the Medicare Secondary Payer Internet Only Manual |
| General Provisions | |
| Working Aged | |
| End-Stage Renal Disease | |
| Workers' Compensation | |
| No-Fault Insurance | |
| Liability Insurance | |
| Conditional Primary Medicare Benefits | |
| When Conditional Primary Medicare Benefits May Be Paid When a Group Health Plan Is a Primary Payer to Medicare | |
| When Conditional Primary Medicare Benefits May Not Be Paid When a Group Health Plan Is a Primary Payer to Medicare | |
| When Medicare Secondary Payer Benefits Are Payable and Not Payable | |
| Multiple Insurers | |
| Definitions | |
| Crediting Deductible for Non-Inpatient Psychiatric Services | |
| Clarification of Current Employment Status for Specific Groups | |
| Actions Resulting From Group Health Plan or Large Group Health Plan | |
| Nonconformance | |
| Federal Government's Right to Sue and Collect Double Damages | |
| 35 | Updates to the Group Health Plan Identification and Recovery Processes |
| General | |
| IRS/SSA/CMS Data Match (Data Match) Group Health Plan Identified Cases | |
| Non-Data Match Group Health Plan Identified Cases | |
| Other Sources of Recovery Actions | |
| Group Health Plan Acknowledges Specific Debt (42 CFR 411.25) | |
| Recovery When a State Medicaid Agency Has Also Requested a Refund From the Group Health Plan | |
| Identification of Group Health Plan Mistaken Primary Payments Via the Recovery Management and Accounting System | |
| Progression of Recovery Management Accounting System Group Health Plan | |
| Lead Identification | |
| Progression of Recovery Management Accounting System History Search | |
| Contractor Recovery Case Files (Audit Trails) | |
| Group Health Plan Letters (Used for Recovery Management Accounting | |
| System/Healthcare Integrated General Ledger Accounting System (ReMAS/HIGLAS) When the Only Debtor Interfaced to Healthcare Integrated General Ledger Accounting System Is the Employer) | |
| Employer Group Health Plan Letter | |
| Important Information for Employers | |
| Insurer Group Health Plan Letter (Used for Recovery Management AccountingSystem/Healthcare Integrated General Ledger Accounting System When the Only Debtor Interfaced to Healthcare Integrated General Ledger AccountingSystem Is the Employer) | |
| Accountability Worksheet (Not Applicable to Recovery ManagementAccounting System/Healthcare Integrated General Ledger Accounting SystemUsers) | |
| Summary Data Sheet (Not Applicable to ReMAS/HIGLAS Users) | |
| Field Description on the Medicare Secondary Payer Summary Data SheetPayment Record Summary (Used with ReMAS/HIGLAS Users but in a Modified Format) | |
| Courtesy Copy of All Medicare Secondary Payer Group Health Plan-BasedRecovery Demand Packages to the Employer's Insurer/Third PartyAdministrator | |
| Insurer/Third Party Administrator Courtesy Copy Letter | |
| Recovery Management Accounting System Error Reports | |
| Mistaken Group Health Plan Primary Payments | |
| Mistaken Primary Payment Activities and Record Layouts | |
| Contractor Actions Upon Receipt of the Data Match Cycle Tape or Other Notice of Non-Data Match Group Health Plan Mistaken Payments (for Contractor Not on ReMAS/HIGLAS for GHP Recovery) and Actions to Take for ThoseContractors Using Recovery Management Accounting System/Health IntegratedGeneral Ledger Accounting System Group Health Plan Functions | |
| Coordination of Benefits Contractor Responsibility to Obtain MissingMedicare Secondary Payer Information | |
| Time Limitations for Group Health Plan Recoveries | |
| Actual Notice | |
| Contractor History Search | |
| Aggregate Claims for Recovery | |
| Documentation of Debt | |
| Recovery Attempt Audit Trails | |
| Summary of Medicare Reimbursement | |
| Claim Facsimiles for Each Claim Mistakenly Paid | |
| IRS/SSA/CMS Mistaken Payment Recovery Tracking System | |
| Inpatient, Skilled Nursing Facility, and Religious Non-Medicare Health Care | |
| Outpatient Mistaken Payment Report Record Layout | |
| Home Health Agency Mistaken Payment Record Layout | |
| Communication Receive in Response to Recovery Actions | |
| 36 | Update to the Healthcare Provider Taxonomy Codes Version 5.1 |
| Medicare Financial Management | |
| (CMS-Pub. 100-06) | |
| 71 | Notice of New Interest Rate for Medicare Overpayments and Underpayments |
| 72 | Claims Accounts Receivable Update |
| Intermediary Claims Accounts Receivable | |
| Financial Reporting for Intermediary Claims Accounts Receivable | |
| 73 | This Transmittal is rescinded and replaced by Transmittal 75 |
| 74 | Discovery Code Indication for Recovery Audit Contractor (RAC) Non-MSP Identified Overpayments |
| 75 | New Thresholds for 2nd Demand Letter for Physicians/Suppliers |
| Part B Overpayment Demand Letters to Physicians/Suppliers | |
| 76 | Development of New Report to Capture Benefits, Improvement and Protection Act and Medicare Prescription Drug, Improvement, and Modernization Act Appeals Data |
| Monthly Statistical Report on Intermediary and Carrier Part A and Part B | |
| Appeals Activity Form | |
| Redeterminations | |
| Qualified Independent Contractor Reconsiderations | |
| Administrative Law Judge Results | |
| Department Appeals Board Effectuations | |
| Clerical Error Reopenings | |
| Validation of Reports | |
| 77 | Non-Medicare Secondary Payer Debt Referral and Debt Collection Improvement Act of 1996 Activities |
| Background | |
| Cross Servicing | |
| Treasury Offset Program | |
| Definition of Delinquent Debt | |
| Referral Requirements | |
| Exemptions to Referral | |
| Debt to be Referred | |
| Delinquent Non-Medicare Secondary Payer Fiscal Intermediary Debt, Including Debt on the Provider Overpayment Reporting System | |
| Delinquent Non-Medicare Secondary Payer Medicare Carrier Debt, Including Debt on the Physician/Supplier Overpayment Reporting System | |
| Delinquent Non-Medicare Secondary Payer Debt Previously Ineligible for Referral | |
| Debt Collection Improvement Act Language/Intent to Refer Letter | |
| Response to "Intent to Refer" Letter | |
| Provider Overpayment Reporting System Updates | |
| Physician/Supplier Overpayment Reporting System Updates | |
| Cross Servicing Collection Efforts | |
| Actions Subsequent to Debt Collection System Input | |
| Transmission of Debt | |
| Update to Debt Collection System After Transmission | |
| Financial Reporting for Debt Referred | |
| Financial Reporting for Non-Medicare Secondary Payer Debt | |
| 78 | Coordination of Benefits Agreement Process for Contractor Financial Staff Notification |
| Medicare State Operations Manual | |
| (CMS-Pub. 100-07) | |
| 09 | Revision of Appendix P and Certain Exhibits of the State Operations Manual |
| 10 | Revisions-Appendix J-Interpretive Guidelines Intermediate Care Facilities With Mental Retardation |
| 11 | Revised Chapter 2-"The Certification Process," Sections 2180E thru 2200F, and Appendix B-"Interpretive Guidelines: Home Health Agencies" |
| Medicare Program Integrity | |
| (CMS-Pub. 100-08) | |
| 115 | Program Integrity Manual Revision |
| Affiliated Contractor/Full Program Safeguard Contractor CommunicationWith the Comprehensive Error Rate Testing Contractor | |
| Overview of the Comprehensive Error Rate Testing Process | |
| Providing Sample Information to the Comprehensive Error Rate Testing Contractor | |
| Providing Review Information to the Comprehensive Error Rate Testing Contractor | |
| Providing Feedback Information to the Comprehensive Error Rate Testing Contractor | |
| Disputing/Disagreeing With a Comprehensive Error Rate Testing DecisionHandling Overpayments and Underpayments Resulting From the ComprehensiveError Rate Testing Findings | |
| Handling Appeals Resulting From Comprehensive Error Rate Testing Initiated Denials | |
| Tracking Overpayments | |
| Tracking Appeals | |
| Potential Fraud | |
| Full Program Safeguard Contractor Requirements Involving ComprehensiveError Rate Testing Information Dissemination | |
| Full Program Safeguard Contractor Error Rate Reduction Plan | |
| Contacting Non-Responders | |
| Late Documentation Received by the Comprehensive Error Rate Testing Contractor | |
| Voluntary Refunds | |
| Local Coverage Determination/National Coverage Determination | |
| Comprehensive Error Rate Testing Review Contractor Review Guidelines | |
| 116 | Revise the Fiscal Intermediary Shared System to Allow Reporting of Data for the Comprehensive Error Rate Testing Program Resolution File at a Line Level |
| 117 | Revise the Medicare Contractor System and the VIPS Medicare System To Allow Update of the Comprehensive Error Rate Testing Program Resolution File Within Five Business Days of a Comprehensive Error Rate Testing Request |
| 118 | Various Benefit Integrity Clarifications |
| Goal of Medical Review Program | |
| Overpayment Procedures | |
| Disposition of the Suspension | |
| The Medicare Fraud Program | |
| Program Safeguard Contractor and Medicare Contractor Benefit Integrity Unit | |
| Organizational Requirements | |
| Training for Law Enforcement Organizations | |
| Procedural Requirements | |
| Requests for Information From Outside Organizations | |
| Sharing Fraud Referrals Between the Office of Inspector General and the Department of Justice | |
| Complaint Screening | |
| Investigations | |
| Conducting Investigations | |
| Disposition of Cases | |
| Reversed Denials by Administrative Law Judges on Open Cases | |
| Types of Fraud Alerts | |
| Coordination | |
| Investigation, Case, and Suspension Entries | |
| Update Requirements for Cases | |
| Closing Investigations | |
| Deleting Investigations, Cases, or Suspensions | |
| Access | |
| Harkin Grantees or Senior Medicare Patrol-Complaint Tracking System | |
| Harkin Grantees or Senior Medicare Patrol Project Description | |
| Harkin Grantees Tracking System Instructions | |
| System Access to Metaframe and Data Collection | |
| Data Dissemination/Aggregate Report | |
| Referral of Cases to the Office of the Inspector General/Office of Investigations | |
| Immediate Advisements to the Office of Inspector General/Office of Investigations | |
| Denial of Payments for Cases Referred to and Accepted by Office of Inspector General/Office of Investigations | |
| Take Administrative Action on Cases Referred to and Refused by Office of Inspector General /Office of Investigations | |
| Referral to State Agencies or Other Organizations | |
| Referral to Quality Improvement Organizations | |
| Referral Process to CMS | |
| Referrals to Office of Inspector General | |
| Breaches of Assignment Agreement by Physician or Other Supplier | |
| Annual Deceased-Beneficiary Postpayment Review | |
| Vulnerability Report | |
| 119 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 120 | Correction to Change Request (CR) 3222: Local Medical Review Policy/Local Coverage Determination Medicare Summary Notice Message RevisionDenials Notices |
| 121 | This Transmittal is rescinded and replaced by Transmittal 124 |
| 122 | Medical Review Collection Number Requirements |
| Overview of Prepayment and Postpayment Review for Medical Review Purposes | |
| 123 | Chapter 3, Medicare Modernization Act Section 935 |
| Verifying Potential Errors and Setting Priorities | |
| Determining Whether the Problem Is Widespread or Provider Specific | |
| Overpayment Procedures | |
| "Probe" Reviews | |
| 124 | Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle Claims |
| 125 | Medical Review Additional Documentation Requests |
| Additional Documentation Requests During Prepayment or Postpayment | |
| Medical Review | |
| Medicare Contractor Beneficiary and Provider Communications | |
| (CMS-Pub. 100-09) | |
| 12 | Next Generation Desktop Testing Requirements |
| 13 | Provider Contact Centers Training Program |
| Guidelines for Telephone Service | |
| Staff Development and Training | |
| Medicare Managed Care | |
| (CMS-Pub. 100-16) | |
| 66 | Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans |
| Changes in Requirements for Periodic Surveys of Current and Former Enrollees, and in the CMS Method for Calculating Interest on Overpayment and Underpayments to Health Maintenance Organizations, Comprehensive Medical Plans and Health Care Prepayment Plans | |
| 67 | Initial Publication of Chapter 1-General Provisions |
| Introduction | |
| Definitions | |
| Types of Medical Assistance Plans | |
| Cost Sharing in Enrollment-Related Costs | |
| 68 | Revisions to Chapter 12, "Effect of Change of Ownership," and Chapter 14, "Contract Determination and Appeals" |
| Effect of Change of Ownership | |
| What Constitutes a Change of Ownership | |
| Address for Sending Notifications to CMS | |
| When a Novation Agreement Is Required | |
| Acceptable Novation Agreements | |
| Contract Determination Notice | |
| Postponement of the Contract Determination's Effective Date | |
| Reconsiderations | |
| Time Frames for Filing a Reconsideration Request | |
| Parties to the Hearing | |
| Conduct and Record of a Hearing | |
| Reopening of Contract Reconsidered Determination or Decision of a Hearing Officer or the Administrator | |
| 69 | Beneficiary Enrollment and Disenrollment Requirements for MedicareAdvantage Plans |
| 70 | Deletion of MCM Chapter 19-The Enrollment and Payment User's Guide, andChapter 20-Managed Care and Medical Assistance Business Requirements |
| 71 | Changes in Manual Instructions for Benefits and Beneficiary Protections |
| Basic Rules | |
| Types of Benefits | |
| Availability and Structure of Plans | |
| CMS Review and Approval of M+C Benefit-rewritten and relocated to § 20 | |
| Requirements Relating to Medicare Conditions of Participation-renumbered as § 4.10.7 | |
| Provider Networks-renumbered as new § 10.8 and parts of the old § 20, "Original Medicare Covered Benefits" | |
| CMS Approval of Proposed Plan MA Benefits-old 10.7 revised and located here | |
| General Guidelines on Benefit Approval | |
| Screening Mammography, Influenza Vaccine, and Pneumococcal Vaccine | |
| Inpatient Hospital Rehabilitation Service | |
| Value-Added Items and Services | |
| Prescription Drug Discount Programs | |
| Waiting Periods and Exclusions That Are Not Present in Original Medicare | |
| Annual Beneficiary Out-of-Pocket Cap | |
| Drug Benefits | |
| Drugs That Are Covered Under Original Medicare | |
| Mid-Year Benefit Enhancements | |
| Multi-Year Benefits | |
| Return to Home Skilled Nursing Facility | |
| Guidance on Acceptable Cost-Sharing and Deductibles | |
| Homemaker Services | |
| Caregiver Resource Services | |
| Electronic Monitoring | |
| Dentures | |
| Chiropractic Services | |
| Cash | |
| Beauty Parlor | |
| Transportation | |
| Safety Items | |
| Travel for Transplants | |
| Meals | |
| Basic Benefits | |
| Cost-sharing Rules for Medical Assistance Regional Plans | |
| Supplemental Benefits and Mandatory Supplemental and Optional Supplemental | |
| Basic Versus Supplemental Benefits | |
| The Annual Deductible | |
| General Rule | |
| Accessing Plan Contracting Providers | |
| Enrollee Information and Disclosure | |
| Definitions | |
| Factors That Influence Service Area Approval | |
| The "County Integrity Rule" | |
| General Rule | |
| Employer Plans | |
| Basic Rule | |
| Medicare Benefits Secondary to Group Health Plans and Large Group Health Plans | |
| Medicare Secondary Payer Rules and State Laws | |
| Discrimination Against Beneficiaries Prohibited | |
| Disclosure Requirements at Enrollment (and Annually Thereafter) | |
| Information Pertaining to a Medical Assistance Organization Changing Their Rules or Provider Network | |
| Other Information That Is Disclosable Upon Request | |
| Access and Availability Rules for Coordinated Care Plans | |
| Emergency and Urgently Needed Services | |
| Post-Stabilization Care Services | |
| General Description | |
| Private Fee-for-Service Plan Terms and Conditions of Participation | |
| Provider Types-Direct Contracting, Deemed Contracting, Non-ContractingAccess to Services | |
| Payments and Balance Billing | |
| Advance Notice of Coverage | |
| Prompt Payment Requirements | |
| Original Medicare vs. Estimated Payment Amounts | |
| Table Summarizing Private Fee-for-Service Plan Provider Types and Rules | |
| 72 | Changes in Manual Instructions for Intermediate Sanctions |
| Types of Intermediate Sanctions | |
| General Basis for Imposing Intermediate Sanctions on Medical AssistanceOrganizations | |
| Imposing Sanctions for Specific Medical Assistance Contract Violations | |
| Civil Monetary Penalties for Medical Assistance Organizations That Improperly Terminate the Medical Assistance Contract | |
| CMS Process for Suspending Marketing, Enrollment, and Payment | |
| Contract Termination by CMS | |
| Medicare Business Partners Systems Security | |
| (CMS-Pub. 100-17) | |
| 00 | None |
| Demonstrations | |
| (CMS-Pub. 100-19) | |
| 26 | This Transmittal is rescinded and replaced by Transmittal 27 |
| 27 | The Medicare Chronic Care Improvement, "Medicare Health Support," Program |
| 28 | The Medicare Care Management for High Cost Beneficiaries Demonstration |
| One-Time Notification | |
| (CMS-Pub. 100-20) | |
| 161 | Kansas Blue Cross Blue Shield Carrier Numbering Issue |
| 162 | Instructions for Fiscal Intermediary Standard System and Multi-Carrier System |
| Healthcare Integrated General Ledger Accounting System Changes | |
| 163 | Qualified Independent Contractor Jurisdictions |
| 164 | Medicare HIPAA Electronic Claims Report-Third Reporting Timeframe Extension |
| 165 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 166 | This Transmittal is rescinded and replaced by Transmittal 173 |
| 167 | Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction |
| 168 | Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act Transaction January 2006 Release Testing |
| 169 | Analysis of Systems Improvements to Streamline POS Code Set Updates |
| 170 | Updates to the Coordination of Benefits Agreement Insurance File for Use in the National Claims Crossover Program |
| 171 | Preliminary system updates in preparation for ending the Medicare contingency plan in October 2005 |
| 172 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 173 | Overnight Oximetry Testing |
| 174 | Fiscal Intermediary Shared System Modification |
| 175 | Common Working File Calculation of Next Eligible Date for Preventive Services |
| 176 | Change of the CareFirst Part A Plan to Highmark in the State of Maryland and Washington, DC |
| 177 | Termination of Existing Crossover Agreements as Trading Partners |
| Transition to the National Coordination of Benefits Agreement Program | |
| 178 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 179 | Calculation of the Interim Payment of Indirect Medical Education Through the Inpatient Prospective Payment Pricer for Hospitals That Received an Increase to Their Full-Time Equivalent Resident Cap Under Section 422 of the Medicare Modernization Act, P.L. 108-173 |
| 180 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 181 | National Modifier and Condition Code To Be Used To Identify DisasterDisaster Related Claims |
| Publication date | FR Vol. 70 page number | CFR parts affected | File code | Title of regulation |
|---|---|---|---|---|
| July 6, 2005 | 39022 | 414 | CMS-3125-IFC | Medicare Program; Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B. |
| July 8, 2005 | 39514 | CMS-1288-N | Medicare Program; Meeting of the Advisory Panel on Ambulatory Payment Classification (APC) Groups-August 17, 18, and 19, 2005. | |
| July 12, 2005 | 40039 | CMS-2212-N | Medicaid Program; Meeting of the Medicaid Commission-July 27, 2005. | |
| July 14, 2005 | 40788 | 484 | CMS-1301-P | Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2006. |
| July 14, 2005 | 40709 | CMS-1288-CN | Medicare Program; Meeting of the Advisory Panel on Ambulatory Payment Classification (APC) Groups-August 17, 18, and 19, 2005; Correction. | |
| July 22, 2005 | 42331 | CMS-3142-FN | Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts. | |
| July 22, 2005 | 42330 | CMS-1315-N | Medicare Program; August 22, 2005, Meeting of Practicing Physicians Advisory Council and Request for Nominations. | |
| July 22, 2005 | 42329 | CMS-3153-N | Medicare Program; Meeting of the Medicare Coverage Advisory Committee-October 6, 2005. | |
| July 22, 2005 | 42328 | CMS-4093-N | Medicare Program; Request for Nominations for the Advisory Panel on Medicare Education. | |
| July 22, 2005 | 42327 | CMS-3158-N | Medicare Program; Request for Nominations for Members for the Medicare Coverage Advisory Committee. | |
| July 22, 2005 | 42276 | 146 | CMS-4094-F3 | Amendment to the Interim Final Regulation for Mental Health Parity. |
| July 25, 2005 | 42674 | 419 and 485 | CMS-1501-P | Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates. |
| August 4, 2005 | 45130 | 418 | CMS-1286-F | Medicare Program; Hospice Wage Index for Fiscal Year 2006. |
| August 4, 2005 | 45026 | 409, 411, 424, and 489 | CMS-1282-F | Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006. |
| August 4, 2005 | 44930 | CMS-2220-N | Medicare Program; Meeting of the Medicaid Commission-August 17-18, 2005. | |
| August 4, 2005 | 44879 | 402 | CMS-6019-P | Medicare Program; Revised Civil Money Penalties, Assessments, Exclusions, and Related Appeals Procedures. |
| August 8, 2005 | 45764 | 405, 410, 411, 413, 414, and 426 | CMS-1502-P | Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006. |
| August 12, 2005 | 47278 | 405, 412, 413, 415, 419, 422, and 485 | CMS-1500-F | Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates. |
| August 15, 2005 | 47880 | 412 | CMS-1290-F | Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for FY 2006. |
| August 15, 2005 | 47759 | 483 | CMS-3198-P | Medicare and Medicaid Programs; Condition of Participation: Immunization Standard for Long Term Care Facilities. |
| August 26, 2005 | 50940 | 410 | CMS-3017-IFC | Medicare Program; Conditions for Payment of Power Mobility Devices, including Power Wheelchairs and Power-Operated Vehicles. |
| August 26, 2005 | 50680 | 419 and 485 | CMS-1501-CN | Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction. |
| August 26, 2005 | 50375 | CMS-4111-N | Medicare Program; Meeting of the Advisory Panel on Medicare Education,September 27, 2005. | |
| August 26, 2005 | 50374 | CMS-1330-N | Medicare Program; Town Hall Meeting on the Medicare Provider Feedback Group (MPFG)-September 12, 2005. | |
| August 26, 2005 | 50373 | CMS-4106-PN | Medicare Program; Changes in Medicare Advantage Deeming Authority. | |
| August 26, 2005 | 50372 | CMS-1309-NC | Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver for Organ Procurement Service Area. | |
| August 26, 2005 | 50358 | CMS-2209-N | Medicaid Program; Fiscal Disproportionate Share Hospital Allotments and Disproportionate Share Hospital Institutions for Mental Disease Limits. | |
| August 26, 2005 | 50358 | CMS-1486-N | Medicare Program; Announcement of New Members of the Advisory Panel on Ambulatory Payment Classification (APC) Groups. | |
| August 26, 2005 | 50262 | 447 and 455 | CMS-2198-P | Medicaid Program; Disproportionate Share Hospital Payments. |
| August 26, 2005 | 50214 | 433 | CMS-2210-IFC | Medicaid Program; State Allotments for Payment of Medicare Part B Premiums for Qualifying Individuals: Federal Fiscal Year 2005. |
| August 26, 2005 | 50214 | 405 | CMS-4064-IFC3 | Medicare Program; Changes to the Medicare Claims Appeal Procedures: Correcting Amendment to a Correcting Amendment. |
| August 30, 2005 | 51321 | 410 | CMS-6024-P | Medicare Program; Prior Determination for Certain Items and Services. |
| September 1, 2005 | 52105 | CMS-1308-NC | Medicare Program; Withdrawal of Ambulance Fee Schedule Issued in Accordance With Federal District Court Order in Lifestar Ambulance v. United States, No. 4:02-CV-127-1 (M.D. Ga., Jan. 16, 2003)-Medicare Covered Ambulance Services. | |
| September 1, 2005 | 52056 | 405, 410, 411, 413, 414, and 426 | CMS-1502-CN | Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006; Correction. |
| September 1, 2005 | 52023 | 422 | CMS-4069-F3 | Medicare Program; Establishment of the Medicare Advantage Program; Correcting Amendment; Partial Stay of Effectiveness. |
| September 1, 2005 | 52019 | 403 | CMS-4063-F | Medicare Program; Medicare Prescription Drug Discount Card; Revision of Marketing Rules for Endorsed Drug Card Sponsors. |
| September 6, 2005 | 52930 | 414 | CMS-1325-IFC2 | Medicare Program; Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B: Interpretation and Correction. |
| September 16, 2005 | 54751 | CMS-5017-N | Medicare Program; Medicare Health Care Quality (MHCQ) Demonstration Programs. | |
| September 23, 2005 | 55905 | CMS-3159-N | Medicare Program; Meeting of the Medicare Coverage Advisory Committee-November 29, 2005. | |
| September 23, 2005 | 55903 | CMS-1269-N5 | Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG) Meeting-October 26, 2005 Through October 28, 2005. | |
| September 23, 2005 | 55897 | CMS-8027-N | Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible for Calendar Year 2006. | |
| September 23, 2005 | 55896 | CMS-8025-N | Medicare Program; Part A Premium for Calendar Year 2006 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement. | |
| September 23, 2005 | 55887 | CMS-1307-GNC | Medicare Program; Criteria and Standards for Evaluating Intermediary, Carrier, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Regional Carrier Performance During Fiscal Year 2006. | |
| September 23, 2005 | 55885 | CMS-8026-N | Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for Calendar Year 2006. | |
| September 23, 2005 | 55863 | CMS-9032-N | Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-April Through June 2005. | |
| September 23, 2005 | 55862 | CMS-2227-PN | Medicare and Medicaid Programs; Application by the Accreditation Commission of Healthcare for Deeming Authority for Home Health Agencies. | |
| September 23, 2005 | 55812 | 447 and 455 | CMS-2198-CN | Medicaid Program; Disproportionate Share Hospital Payments. |
| September 29, 2005 | 56901 | CMS-2230-FN | State Children's Health Insurance Program (SCHIP); Redistribution of Unexpended SCHIP Funds From the Appropriation for Fiscal Year 2002. | |
| September 30, 2005 | 57376 | 505 | CMS-1320-P | Medicare Program; Health care Infrastructure Improvement Program; Forgiveness of Indebtness. |
| September 30, 2005 | 57368 | 505 | CMS-1287-IFC | Medicare Program; Health Care Infrastructure Improvement Program; Selection Criteria of Loan Program for Qualifying Hospitals Engaged in Cancer-Related Health Care. |
| September 30, 2005 | 57300 | CMS-1307-CN | Medicare Program; Criteria and Standards for Evaluating Intermediary, Carrier, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Regional Carrier Performance During Fiscal Year 2006; Correction Notice. | |
| September 30, 2005 | 57297 | CMS-3144-NC | Medicare Program; Calendar Year 2005 Review of Appropriateness of Payment Amounts for New Technology Intraocular Lenses (NTIOLs) Furnished by Ambulatory Surgical Centers (ASCs). | |
| September 30, 2005 | 57296 | CMS-1269-N6 | Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG): Announcement of a New Member. | |
| September 30, 2005 | 57174 | 418 | CMS-1286-CN | Medicare Program; Hospice Wage Index for Fiscal Year 2006. |
| September 30, 2005 | 57166 | 412 | CMS-1290-CN | Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for FY 2006; Correction. |
| September 30, 2005 | 57164 | 411 and 424 | CMS-1282-CN | Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Correction. |
| September 30, 2005 | 57161 | 405, 412, 413, 415, 419, 422, and 485 | CMS-1500-CN | Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates; Correction. |
Addendum V-National Coverage Determinations
[July Through September 2005]
A national coverage determination (NCD) is a determination by the Secretary with respect to whether or not a particular item or service is covered nationally underTitle XVIII of the Social Security Act, but does not include a determination of what code, if any, is assigned to a particular item or service covered under this title, or determination with respect to the amount of payment made for a particular item or service so covered. We include below all of the NCDs that were issued during the quarter covered by this notice. The entries below include information concerning completed decisions as well as sections on program and decision memoranda, which also announce pending decisions or, in some cases, explain why it was not appropriate to issue an NCD. We identify completed decisions by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. Information on completed decisions as well as pending decisions has also been posted on the CMS Web site at http://cms.hhs.gov/coverage .
National Coverage Determinations
[July Through September 2005]
There were no new NCDs posted during this time period.
Addendum VI-FDA-Approved Category B IDEs
[July Through September 2005]
Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c) devices fall into one of three classes. To assist CMS under this categorization process, the FDA assigns one of two categories to each FDA-approved IDE. Category A refers to experimental IDEs, and Category B refers to non-experimental IDEs. To obtain more information about the classes or categories, please refer to the Federal Register notice published on April 21, 1997 (62 FR 19328).
The following list includes all Category B IDEs approved by FDA during the second quarter, July through September 2005.
IDE/Category
G040204
G050005
G050016
G050028
G050035
G050036
G050041
G050044
G050069
G050072
G050082
G050086
G050103
G050107
G050108
G050112
G050113
G050114
G050117
G050119
G050120
G050122
G050123
G050125
G050127
G050129
G050130
G050132
G050133
G050134
G050135
G050136
G050141
G050144
G050145
G050146
G050147
G050148
G050149
G050153
G050155
G050158
G050160
G050161
G050163
G050165
G050166
G050170
G050172
G050174
G050177
G050178
G050180
G050181
G050182
G050183
Addendum VII-Approval Numbers for Collections of Information
Below we list all approval numbers for collections of information in the referenced sections of CMS regulations in Title 42; Title 45, Subchapter C; and Title 20 of the Code of Federal Regulations, which have been approved by the Office of Management and Budget:
| OMB number | Approved CFR sections |
|---|---|
| 0938-0008 | 414.40, 424.32, 424.44 |
| 0938-0022 | 413.20, 413.24, 413.106 |
| 0938-0023 | 424.103 |
| 0938-0025 | 406.28, 407.27 |
| 0938-0027 | 486.100-486.110 |
| 0938-0033 | 405.807 |
| 0938-0035 | 407.40 |
| 0938-0037 | 413.20, 413.24 |
| 0938-0041 | 408.6, 408.22 |
| 0938-0042 | 410.40, 424.124 |
| 0938-0045 | 405.711 |
| 0938-0046 | 405.2133 |
| 0938-0050 | 413.20, 413.24 |
| 0938-0062 | 431.151, 435.1009, 440.220, 440.250, 442.1, 442.10-442.16, 442.30, 442.40, 442.42, 442.100-442.119, 483.400-483.480, 488.332, 488.400, 498.3-498.5 |
| 0938-0065 | 485.701-485.729 |
| 0938-0074 | 491.1-491.11 |
| 0938-0080 | 406.7, 406.13 |
| 0938-0086 | 420.200-420.206, 455.100-455.106 |
| 0938-0101 | 430.30 |
| 0938-0102 | 413.20, 413.24 |
| 0938-0107 | 413.20, 413.24 |
| 0938-0146 | 431.800-431.865 |
| 0938-0147 | 431.800-431.865 |
| 0938-0151 | 493.1357, 493.1363, 493.1405, 493.1406, 493.1411, 493.1417, 493.1423, 493.1443, 493.1449, 493.1455, 493.1461, 493.1462, 493.1469, 493.1483, 493.1489, 493.1491 |
| 0938-0155 | 405.2470 |
| 0938-0170 | 493.1269-493.1285 |
| 0938-0193 | 430.10-430.20, 440.167 |
| 0938-0202 | 413.17, 413.20 |
| 0938-0214 | 411.25, 489.2, 489.20 |
| 0938-0236 | 413.20, 413.24 |
| 0938-0242 | 442.30, 488.26 |
| 0938-0245 | 407.10, 407.11 |
| 0938-0246 | 431.800-431.865 |
| 0938-0251 | 406.7 |
| 0938-0266 | 416.41, 416.47, 416.48, 416.43 |
| 0938-0267 | 410.65, 485.56, 485.58, 485.60, 485.64, 485.66 |
| 0938-0269 | 412.116, 412.632, 413.64, 413.350, 484.245 |
| 0938-0270 | 405.376 |
| 0938-0272 | 440.180, 441.300-441.305 |
| 0938-0273 | 485.701-485.729 |
| 0938-0279 | 424.5 |
| 0938-0287 | 447.31 |
| 0938-0296 | 413.170, 413.184 |
| 0938-0301 | 413.20, 413.24 |
| 0938-0302 | 418.22, 418.24, 418.28, 418.56, 418.58, 418.70, 418.74, 418.83, 418.96, 418.100 |
| 0938-0313 | 489.11, 489.20 |
| 0938-0328 | 482.12, 482.13, 482.21, 482.22, 482.27, 482.30, 482.41, 482.43, 482.45, 482.53, 482.56, 482.57, 482.60, 482.61, 482.62, 485.618, 485.631 |
| 0938-0334 | 491.9, 491.10 |
| 0938-0338 | 486.104, 486.106, 486.110 |
| 0938-0354 | 441.60 |
| 0938-0355 | 442.30, 488.26 |
| 0938-0357 | 409.40-409.50, 410.36, 410.170, 411.4-411.15, 421.100, 424.22, 484.18, 489.21 |
| 0938-0358 | 412.20-412.30 |
| 0938-0359 | 412.40-412.52 |
| 0938-0360 | 488.60 |
| 0938-0365 | 484.10, 484.11, 484.12, 484.14, 484.16, 484.18, 484.20, 484.36, 484.48, 484.52 |
| 0938-0372 | 414.330 |
| 0938-0378 | 482.60-482.62 |
| 0938-0379 | 442.30, 488.26 |
| 0938-0382 | 442.30, 488.26 |
| 0938-0386 | 405.2100-405.2171 |
| 0938-0391 | 488.18, 488.26, 488.28 |
| 0938-0426 | 476.104, 476.105, 476.116, 476.134 |
| 0938-0429 | 447.53 |
| 0938-0443 | 473.18, 473.34, 473.36, 473.42 |
| 0938-0444 | 1004.40, 1004.50, 1004.60, 1004.70 |
| 0938-0445 | 412.44, 412.46, 431.630, 456.654, 466.71, 466.73, 466.74, 466.78 |
| 0938-0447 | 405.2133 |
| 0938-0448 | 405.2133, 45 CFR 5, 5b; 20 CFR Parts 401, 422 Subpart E 0938-0449 440.180, 441.300-441.310 |
| 0938-0454 | 424.20 |
| 0938-0456 | 412.105 |
| 0938-0463 | 413.20, 413.24, 413.106 |
| 0938-0467 | 431.17, 431.306, 435.910, 435.920, 435.940-435.960 |
| 0938-0469 | 417.126, 422.502, 422.516 |
| 0938-0470 | 417.143, 417.800-417.840, 422.6 |
| 0938-0477 | 412.92 |
| 0938-0484 | 424.123 |
| 0938-0501 | 406.15 |
| 0938-0502 | 433.138 |
| 0938-0512 | 486.304, 486.306, 486.307 |
| 0938-0526 | 475.102, 475.103, 475.104, 475.105, 475.106 |
| 0938-0534 | 410.38, 424.5 |
| 0938-0544 | 493.1-493.2001 |
| 0938-0564 | 411.32 |
| 0938-0565 | 411.20-411.206 |
| 0938-0566 | 411.404, 411.406, 411.408 |
| 0938-0573 | 412.230, 412.256 |
| 0938-0578 | 447.534 |
| 0938-0581 | 493.1-493.2001 |
| 0938-0599 | 493.1-493.2001 |
| 0938-0600 | 405.371, 405.378, 413.20 |
| 0938-0610 | 484.10, 489.102 |
| 0938-0612 | 493.801, 493.803, 493.1232, 493.1233, 493.1234, 493.1235, 493.1236, 493.1239, 493.1241, 493.1242, 493.1249, 493.1251, 493, 1252, 493.1253, 493.1254, 493.1255, 493.1256, 493.1261, 493.1262, 493.1263, 493.1269, 493.1273, 493.1274, 493.1278, 493.1283, 493.1289, 493.1291, 493.1299 |
| 0938-0618 | 433.68, 433.74, 447.272 |
| 0938-0653 | 493.1771, 493.1773, 493.1777 |
| 0938-0657 | 405.2110, 405.2112 |
| 0938-0658 | 405.2110, 405.2112 |
| 0938-0659 | 456.700, 456.705, 456.709, 456.711, 456.712 |
| 0938-0667 | 482.12, 488.18, 489.20, 489.24 |
| 0938-0679 | 410.38 |
| 0938-0685 | 410.32, 410.71, 413.17, 424.57, 424.73, 424.80, 440.30, 484.12 |
| 0938-0686 | 493.551-493.557 |
| 0938-0688 | 486.304, 486.306, 486.307, 486.310, 486.316, 486.318, 486.325 |
| 0938-0691 | 412.106 |
| 0938-0692 | 466.78, 489.20, 489.27 |
| 0938-0701 | 422.152 |
| 0938-0702 | 45 CFR 146.111, 146.115, 146.117, 146.150, 146.152, 146.160, 146.180 |
| 0938-0703 | 45 CFR 148.120, 148.124, 148.126, 148.128 |
| 0938-0713 | 441.16, 489.66, 489.67 |
| 0938-0714 | 411.370-411.389 |
| 0938-0717 | 424.57 |
| 0938-0721 | 410.33 |
| 0938-0723 | 421.300-421.318 |
| 0938-0730 | 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, 424.24 |
| 0938-0732 | 417.126, 417.470 |
| 0938-0734 | 45 CFR 5b |
| 0938-0739 | 413.337, 413.343, 424.32, 483.20 |
| 0938-0742 | 422.300-422.312 |
| 0938-0749 | 424.57 |
| 0938-0753 | 422.000-422.700 |
| 0938-0754 | 441.151, 441.152 |
| 0938-0758 | 413.20, 413.24 |
| 0938-0760 | 484 Subpart E, 484.55, 484.205, 484.245, 484.250 |
| 0938-0761 | 484.11, 484.20 |
| 0938-0763 | 422.1-422.10, 422.50-422.80, 422.100-422.132, 422.300-422.312, 422.400-422.404, 422.560-422.622 |
| 0938-0770 | 410.2 |
| 0938-0778 | 422.64, 422.111 |
| 0938-0779 | 417.126, 417.470, 422.64, 422.210 |
| 0938-0781 | 411.404-411.406, 484.10 |
| 0938-0786 | 438.352, 438.360, 438.362, 438.364 |
| 0938-0783 | 422.66, 422.562, 422.564, 422.568, 422.570, 422.572, 422.582, 422.584, 422.586, 422.590, 422.594, 422.602, 422.612, 422.618, 422.619, 422.620, 422.622 |
| 0938-0787 | 406.28, 407.27 |
| 0938-0790 | 460.12, 460.22, 460.26, 460.30, 460.32, 460.52, 460.60, 460.70, 460.71, 460.72, 460.74, 460.80, 460.82, 460.98, 460.100, 460.102, 460.104, 460.106, 460.110, 460.112, 460.116, 460.118, 460.120, 460.122, 460.124, 460.132, 460.152, 460.154, 460.156, 460.160, 460.164, 460.168, 460.172, 460.190, 460.196, 460.200, 460.202, 460.204, 460.208, 460.210 |
| 0938-0792 | 491.8, 491.11 |
| 0938-0798 | 413.24, 413.65, 419.42 |
| 0938-0802 | 419.43 |
| 0938-0818 | 410.141, 410.142, 410.143, 410.144, 410.145, 410.146, 414.63 |
| 0938-0829 | 422.568 |
| 0938-0832 | Parts 489 and 491 |
| 0938-0833 | 483.350-483.376 |
| 0938-0841 | 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 457.440, 457.525, 457.560, 457.570, 457.740, 457.750, 457.810, 457.940, 457.945, 457.965, 457.985, 457.1005, 457.1015, 457.1180 |
| 0938-0842 | 412.23, 412.604, 412.606, 412.608, 412.610, 412.614, 412.618, 412.626, 413.64 |
| 0938-0846 | 411.352-411.361 |
| 0938-0857 | Part 419 |
| 0938-0860 | 413.65, 419.42 |
| 0938-0866 | 45 CFR Part 162 |
| 0938-0872 | 413.337, 483.20, |
| 0938-0873 | 422.152 |
| 0938-0874 | 45 CFR Parts 160 and 162 |
| 0938-0878 | Part 422 Subpart F G |
| 0938-0883 | 45 CFR Parts 160 and 164 |
| 0938-0884 | 405.940 |
| 0938-0887 | 45 CFR 148.316, 148.318, 148.320 |
| 0938-0897 | 412.22, 412.533 |
| 0938-0907 | 412.230, 412.304, 413.65 |
| 0938-0910 | 422.620, 422.624, 422.626 |
| 0938-0911 | 426.400, 426.500 |
| 0938-0916 | 483.16 |
| 0938-0920 | 438.6, 438.8, 438.10, 438.12, 438.50, 438.56, 438.102, 438.114, 438.202, 438.206, 438.207, 438.240, 438.242, 438.402, 438.404, 438.406, 438.408, 438.410, 438.414, 438.416, 438.710, 438.722, 438.724, 438.810 |
| 0938-0921 | 414.804 |
| 0938-0931 | 45 CFR Part 142.408, 162.408, and 162.406 |
| 0938-0933 | 438.50 |
| 0938-0934 | 403.766 |
| 0938-0936 | 423 |
| 0938-0940 | 484 and 488 |
| 0938-0944 | 422.250, 422.252, 422.254, 422.256, 422.258, 422.262, 422.264, 422.266, 422.270, 422.300, 422.304, 422.306, 422.308, 422.310, 422.312, 422.314, 422.316, 422.318, 422.320, 422.322, 422.324, 423.251, 423.258, 423.265, 423.272, 423.279, 423.286, 423.293, 423.301, 423.308, 423.315, 423.322, 423.329, 423.336, 423.343, 423.346, 423.350 |
| 0938-0950 | 405.910 |
| 0938-0951 | 423.48 |
| 0938-0953 | 405.1200 and 405.1202 |
| 0938-0954 | 414.906, 414.908, 414.914, 414.916 |
| 0938-0957 | Part 423 Subpart R |
Addendum VIII-Medicare-Approved Carotid Stent Facilities[July Through September 2005]
On March 17, 2005, we issued our decision memorandum on carotid artery stenting. We determined that carotid artery stenting with embolic protection is reasonable and necessary only if performed in facilities that have been determined to be competent in performing the evaluation, procedure, and follow-up necessary to ensure optimal patient outcomes. We have created a list of minimum standards for facilities modeled in part on professional society statements on competency. All facilities must at least meet our standards in order to receive coverage for carotid artery stenting for high risk patients.
Effective Date-July 7, 2005
Antelope Valley Hospital, 1600 West Avenue J, Lancaster, CA 93534
Medicare Provider #050056
Baptist St. Anthony's Hospital, 1600 Wallace Boulevard, Amarillo, TX 79106
Medicare Provider #450231
Dayton Heart Hospital, 707 S. Edwin Moses Boulevard, Dayton, OH 45408
Medicare Provider #360253
Duke Health Raleigh Hospital, 3400 Wake Forest Road, Raleigh, NC 27609
Medicare Provider #340073
East Pasco Medical Center, 7050 Gall Boulevard, Zephyrhills, FL 33541-1399
Medicare Provider #100046
FirstHealth Moore Regional Hospital, 1555 Memorial Drive, P.O. Box 3000Pinehurst, NC 28374
Medicare Provider #340115
The George Washington University Hospital, 900 23rd Street, NW., Washington, DC 20037
Medicare Provider #090001
Heart Hospital of Lafayette, 1105 Kaliste Saloom Road, Lafayette, LA 70508
Medicare Provider #190263
Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287-1629
Medicare Provider #210009
Kingman Regional Medical Center, 3269 Stockton Hill Road, Kingman, AZ 86401
Medicare Provider #030055
Lafayette General Medical Center, 1214 Coolidge Street, P.O. Box 52009,Lafayette, LA 70505
Medicare Provider #190002
Manatee Memorial Hospital and Health Systems, 206 2nd Street East, Bradenton, FL 34208
Medicare Provider #100035
Mercy Health System, 1000 Mineral Point Avenue, P.O. Box 5003, Janesville, WI 53547-5003
Medicare Provider #520066
The Methodist Hospital, 6565 Fannin Street, Houston, TX 77030
Medicare Provider #450358
Mohawk Valley Vascular Center of Faxton, St. Luke's Healthcare, 1656 Champlain Avenue, Utica, NY 13502
Medicare Provider #330044
Northwest Medical Center, 2801 North State Road 7, Margate, FL 33063-9002
Medicare Provider #100189
Oakwood Hospital and Medical Center, 18101 Oakwood Boulevard, P.O. Box 2500, Dearborn, MI 48123-2500
Medicare Provider #230020
Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903
Medicare Provider #041007
Scripps Green Hospital, 10666 North Torrey Pines Road, La Jolla, CA 92037-9100
Medicare Provider #050424
St. Cloud Hospital, 1406 Sixth Avenue North, St. Cloud, MN 56303-1901
Medicare Provider #240036
St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07530
Medicare Provider #310019
St. Luke's Hospital, 5901 Monclova Road, Maumee, OH 43537-1899
Medicare Provider #360090
St. Vincent Hospital, 835 S. Van Buren Street, P.O. Box 13508, Green Bay, WI 54307-3508
Medicare Provider #520075
St. Vincent's Medical Center, 1800 Barrs Street, Jacksonville, FL 32204
Medicare Provider #100040
Stormont-Vail HealthCare, 1500 S.W. 10th Avenue, Topeka, KS 66604-1353
Medicare Provider #170086
Tomball Regional Hospital, 605 Holderrieth Street, Tomball, TX 77375
Medicare Provider #450670
Trinity Mother Frances Health System, 800 E. Dawson, Tyler, TX 75701
Medicare Provider #450102
Effective Date-July 15, 2005
Allen Memorial Hospital, 1825 Logan Avenue, Waterloo, IA 50703-1999
Medicare Provider #160110
Alta Bates Summit Medical Center, Alta Bates Campus, 2450 Ashby AvenueBerkley, CA 94705
Medicare Provider #050305
Alta Bates Summit Medical Center, Summit Campus, 350 Hawthorne Avenue, Oakland, CA 94609
Medicare Provider #050043
Banner Baywood Heart Hospital, 6750 East Baywood Avenue, Mesa, AZ 85206
Medicare Provider #030105
Battle Creek Health System, 300 North Avenue, Battle Creek, MI 49016
Medicare Provider #230075
Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
Medicare Provider #220086
BryanLGH Medical Center, 1600 South 48th Street, Lincoln, NE 68506-1299
Medicare Provider #280003
Deborah Heart Lung Center, 200 Trenton Road, Browns Mills, NJ 08015
Medicare Provider #310031
Erie County Medical Center Corporation, 462 Grinder Street, Buffalo, NY 14215
Medicare Provider #330219
Fairview Southdale Hospital, 6401 France Avenue, Edina, MN 55435
Medicare Provider #240078
Gratiot Medical Center, 300 East Warwick Drive, Alma, MI 48801-1096
Medicare Provider #230030
Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225-1290
Medicare Provider #210034
Holmes Regional Medical Center, 1350 South Hickory Street, Melbourne, FL 32901
Medicare Provider #100019
Holy Cross Hospital, 4725 North Federal Highway, Fort Lauderdale, FL 33308
Medicare Provider #100073
Marion General Hospital, 1000 McKinley Park Drive, Marion, OH 43301
Medicare Provider #360011
Mease Countryside Hospital, 3231 McMullen Booth Road, Safety Harbor, FL 34695
Medicare Provider #100265
Mercy General Hospital, 4001 J Street, P.O. Box 19245, Sacramento, CA 95819-9990
Medicare Provider #050017
OU Medical Center, 1200 Everett Drive, Oklahoma City, OK 73104
Medicare Provider #370093
Pennsylvania Hospital of the University of Pennsylvania Health System, 800 Spruce Street, Philadelphia, PA 19071-6192
Medicare Provider #390226
Provena Mercy Medical Center, 1325 North Highland Avenue, Aurora, IL 60506
Medicare Provider #140174
Reading Hospital and Medical Center, P.O. Box 16052, Reading, PA 19612-6052
Medicare Provider #390044
Regional Medical Center of Hopkins County, 900 Hospital Drive, Madisonville, KY 42431
Medicare Provider #180093
Sacred Heart Medical Center, 101 West 8th Avenue, P.O. Box 2555, Spokane, WA 99220-2555
Medicare Provider #500054
Scripps Mercy Hospital, 4077 Fifth Avenue, San Diego, CA 92103
Medicare Provider #050077
Sisters of Charity Providence Hospitals, 2435 Forest Drive, Columbia, SC 29204
Medicare Provider #420026
Tucson Medical Center, 5301 East Grant Road, Tucson, AZ 85712
Medicare Provider #030006
UCLA Medical Center, 10833 Le Conte Avenue, Los Angeles, CA 90095-1730
Medicare Provider #050262
University of Colorado Hospital, 4200 East 9th Avenue, Denver, CO 80262
Medicare Provider #060024
Effective Date-July 20, 2005
Christus St. Patrick Hospital, 524 South Ryan Street, Lake Charles, LA 70601
Medicare Provider #190027
Condell Medical Center, 801 South Milwaukee Avenue, Libertyville, IL 60048
Medicare Provider #140202
Florida Hospital Ormond Memorial, 875 Sterthaus Avenue, Ormond Beach, FL 32174
Medicare Provider #100169
Lakewood Hospital, 14519 Detroit Avenue,Lakewood, OH 44107
Medicare Provider #360212
Loma Linda University Medical Center, 11234 Anderson Street,P.O. Box 2000,Loma Linda, CA 92354
Medicare Provider #050327
Miami Valley Hospital,Medical Imaging,One Wyoming Street,Dayton, OH 45409-2793
Medicare Provider #360051
National Park Medical Center, 1910 Malvern Avenue,Hot Springs, AR 71901
Medicare Provider #040078
Newark Beth Israel Medical Center, 201 Lyons Avenue,Newark, NJ 07112
Medicare Provider #310002
Salina Regional Health Center,P.O. Box 5080,Salina, KS 67402-5080
Medicare Provider #170012
Scott and White Memorial Hospital andScott, Sherwood and Brindley Foundation, 2401 South 31st Street,Temple, TX 76508
Medicare Provider #450054
Sentra Norfolk General Hospital, 600 Gersham Drive,Norfolk, VA 23507
Medicare Provider #490007
Spartanburg Regional Medical Center, 101 East Wood Street,Spartanburg, SC 29303
Medicare Provider #420007
St. Francis Hospital, 3237 South 16th Street,Milwaukee, WI 53215-4592
Medicare Provider #520078
St. Vincent Indianapolis Hospital, 2001 West 86th Street,Indianapolis, IN 46260
Medicare Provider #150084
Tulsa Regional Medical Center, 744 West 9th,Tulsa, OK 74127
Medicare Provider #370078
University Hospital,SUNY Upstate Medical University, 750 East Adams Street,Syracuse, NY 13210
Medicare Provider #330241
UT Southwestern University Hospitals-Zale Lipshy, 5151 Harry Hines Boulevard,Dallas, TX 75390
Medicare Provider #450766
UT Southwestern University Hospitals-St. Paul, 5909 Harry Hines Boulevard,Dallas, TX 75390
Medicare Provider #450044
Effective Date-July 22, 2005
Forrest General Hospital, 6051 Highway 49,Hattiesburg, MS 39401-7243
Medicare Provider #250078
Hamilton Medical Center,P.O. Box 1168,Dalton, GA 30722-1168
Medicare Provider #110001
Heritage Valley Health System,The Medical Center, 100 Dutch Ridge Road,Beaver, PA 15009-9700
Medicare Provider #390036
Northeast Georgia Medical Center, 743 Spring Street,Gainesville, GA 30501
Medicare Provider #110029
Wishard Health Services, 1001 West Tenth Street,Indianapolis, IN 46202
Medicare Provider #150024
Effective Date-July 27, 2005
East Texas Medical Center Athens, 2000 South Palestine,Athens, TX 75751
Medicare Provider #450389
Glendale Adventist Medical Center, 1509 Wilson Terrace,Glendale, CA 91206
Medicare Provider #050239
Lahey Clinic Medical Center, Inc.,41 Mall Road,Burlington, MA 01805
Medicare Provider #220171
Saint Joseph Hospital,One Saint Joseph Drive,Lexington, KY 40504
Medicare Provider #180010
St. Mary's Medical Center, 2900 First Avenue,Huntington, WV 25702
Medicare Provider #510007
Yakima Regional Medical and Cardiac Center, 110 South 9th Avenue,Yakima, WA 98902
Medicare Provider #500012
Effective Date-August 1, 2005
Alegent Health Bergan Mercy Medical Center, 7500 Mercy Rd.,Omaha, NE 68124-9832
Medicare Provider #280060
Bon Secours DePaul Medical Center, 150 Kingsley Ln.,Norfolk, VA 23505
Medicare Provider #490011
Hendrick Medical Center, 1900 Pine St.,Abilene, TX 79601-2316
Medicare Provider #450229
Nebraska Heart Hospital, 7500 S. 91st St.,Lincoln, NE 68526
Medicare Provider #280128
Singing River Hospital System, 3109 Bienville Blvd.,Ocean Springs, MS 39564
Medicare Provider #250040
St. Peter's Hospital,315 South Manning Blvd.,Albany, NY 12208
Medicare Provider #330057
University of California San Francisco Medical Center, 500 Parnassus Ave.,San Francisco, CA 94143-0296
Medicare Provider #050454
Effective Date-August 4, 2005
Bowling Green Warren County Community Hospital Corp. d/b/a The Medical Center, 250 Park Street,P.O. Box 90010,Bowling Green, KY 42102-9010
Medicare Provider #180013
Carson-Tahoe Hospital, 775 Fleischmann Way,P.O. Box 2168,Carson City, NV 89702-2168
Medicare Provider #290010
Heart Hospital of Austin, 3801 N. Lamar Boulevard,Austin, TX 78756
Medicare Provider #450824
Indiana Heart Hospital, 8040 Clearvista Parkway, Suite 200,Indianapolis, IN 46256
Medicare Provider #150154
JFK Medical Center, 5301 South Congress Avenue,Atlantis, FL 33462
Medicare Provider #100080
Sierra Vista Regional Medical Center, 1010 Murray Avenue,San Luis Obispo, CA 93405
Medicare Provider #050506
St. Joseph Hospital, 1100 West Stewart Drive,P.O. Box 5600 Orange, CA 92863-5600
Medicare Provider #050069
St. Luke's Cornwall Hospital, 70 Dubois Street,Newburgh, NY 12550
Medicare Provider #330264
UCI Medical Center, 101 The City Drive South,Orange, CA 92868
Medicare Provider #050348
Effective Date-August 8, 2005
Lynchburg General Hospital, 1920 Atherholt Road,Lynchburg, VA 24501-1104
Medicare Provider #490021
Mercy Hospitals Bakersfield, 2215 Truxtun Avenue,P.O. Box 119,Bakersfield, CA 93302
Medicare Provider #050295
Virginia Regional Medical Center, 901 Ninth Street North,Virginia, MN 55792
Medicare Provider #240084
Effective Date-August 9, 2005
Columbia Hospital, 2201 45th Street,West Palm Beach, FL 33407
Medicare Provider #100234
Fairview Hospital, 14519 Detroit Avenue,Fairview, OH 44107
Medicare Provider #360077
Forum Health-Northside Medical Center,Cardiovascular Administration, 500 Gypsy Lane,Youngstown, OH 44501
Medicare Provider #360141
Mercy Hospital, 144 State Street,Portland, ME 04101
Medicare Provider #020008
New Hanover Regional Medical Center, 2131 South 17th Street,P.O. Box 9000,Wilmington, NC 28402-9000
Medicare Provider #340141
Sharp Grossmont Hospital,P.O. Box 158,La Mesa, CA 91944-0158
Medicare Provider #050026
Torrance Memorial Medical Center, 3330 Lomita Boulevard,Torrance, CA 90505-5073
Medicare Provider #050351
Effective Date-August 16, 2005
Englewood Hospital and Medical Center, 350 Engle Street,Englewood, NJ 07631
Medicare Provider #310045
Mobile Infirmary Medical Center,Five Mobile Infirmary Circle,Mobile, AL 36607
Medicare Provider #010113
Ocean Medical Center, 425 Jack Martin Boulevard,Brick, NJ 08724
Medicare Provider #310052
OSF St. Joseph Medical Center, 200 East Washington Street,Bloomington, IL 61701
Medicare Provider #140162
St. Luke's Medical Center, LP, 1800 East Van Buren Street,Phoenix, AZ 85006
Medicare Provider #030037
Effective Date-August 19, 2005
Inova Alexandria Hospital, 4320 Seminary Road,Alexandria, VA 22304
Medicare Provider #490040
Inova Fairfax Hospital,Inova Fairfax Hospital for Children andInova Heart and Vascular Institute, 3300 Gallows Road,Falls Church, VA 22042-3300
Medicare Provider #490063
Milford Hospital, 300 Seaside Avenue, P.O. Box 3015, Milford, CT 06460-0815
Medicare Provider #070019
Our Lady of the Lakes Regional Medical Center, 5000 Hennessy Boulevard, Baton Rouge, LA 70808
Medicare Provider #190064
Summit Hospital, 17000 Medical Center Drive, Baton Rouge, LA 70816
Medicare Provider #190202
University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0060
Medicare Provider #230046
Effective Date-August 22, 2005
Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176
Medicare Provider #100008
Camden-Clark Memorial Hospital, 800 Garfield Avenue, P.O. Box 718, Parkersburg, WV 26102
Medicare Provider #510058
HCA Dauterive Hospital, 600 North Lewis Avenue, New Iberia, LA 70563
Medicare Provider #190003
Kadlec Medical Center, 888 Swift Boulevard, Richland, WA 99352
Medicare Provider #500058
Lancaster Community Hospital, 43830 10th Street West, Lancaster, CA 93534
Medicare Provider #050204
Mercy Hospital, 4050 Coon Rapids Boulevard, Coon Rapids, MN 55433
Medicare Provider #240115
Montefiore Medical Center, 111 East 210th Street, New York, NY 10467
Medicare Provider #330059
Morristown Memorial Hospital, 100 Madison Avenue, Morristown, NJ 07962-1956
Medicare Provider #310015
Palmetto Health Richland, 5 Richland Medical Park Drive, Columbia, SC 29203-6897
Medicare Provider #420018
Saint Elizabeth Regional Medical Center, 555 South 70th Street, Lincoln, NE 68510
Medicare Provider #280020
Springhill Medical Center, 3710 Dauphine Street, Mobile, AL 36608
Medicare Provider #010144
Unity Hospital, 550 Osborne Road, Fridley, MN 55432
Medicare Provider #240132
Wilson Memorial Regional Medical Center, 33-57 Harrison Street, Johnson City, NY 13790
Medicare Provider #330394
Effective Date-August 23, 2005
Jackson Madison County General Hospital, 708 West Forest Avenue, Jackson, TN 38301-3956
Medicare Provider #044002
Leesburg Regional Medical Center, 600 E. Dixie Avenue, Leesburg, FL 34748
Medicare Provider #100084
Meriter Hospitals, Inc., 202 South Park Street, Madison, WI 53715
Medicare Provider #520089
Poplar Bluff Regional Medical Center, 2620 North Westwood Boulevard, Poplar Bluff, MO 63901
Medicare Provider #260119
Saint Francis Hospital, 241 North Road, Poughkeepsie, NY 12601-1399
Medicare Provider #330067
The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburg, PA 15224
Medicare Provider #390090
Effective Date-August 24, 2005
Halifax Medical Center, 303 N. Clyde Morris Boulevard, Daytona Beach, FL 32114
Medicare Provider #100017
Jackson Hospital, 1725 Pine Street, Montgomery, AL 36106-1117
Medicare Provider #010024
Marietta Memorial Hospital, 401 Matthew Street, Marietta, OH 45750
Medicare Provider #360147
Meadowcrest Hospital, 2500 Belle Chasse Highway, Gretna, LA 70056
Medicare Provider #190152
Medical Center Hospital, P.O. Box 7239, Odessa, TX 79760-7239
Medicare Provider #450132
REX Healthcare, 4420 Lake Boone Trail, Raleigh, NC 27607
Medicare Provider #340114
St. John's Mercy Medical Center, 615 South New Ballas Road, St. Louis, MO 63141
Medicare Provider #260020
Effective Date-August 26, 2005
Candler Hospital, 5353 Reynolds Street, Savannah, GA 31405
Medicare Provider #110024
CHRISTUS Santa Rosa, 333 North Santa Rosa Street, San Antonio, TX 78207-3198
Medicare Provider #450237
Durham Regional Hospital, 3643 North Roxboro Road, Durham, NC 27704
Medicare Provider #344155
Hillcrest Medical Center, 1120 South Utica Avenue, Tulsa, OK 74104
Medicare Provider #370001
Houston Northwest Medical Center, 710 FM 1960 West, Houston, TX 77090
Medicare Provider #450638
Mercy Hospital, 3663 South Miami Avenue, Miami, FL 33133
Medicare Provider #100061
Saint Barnabas Medical Center, Old Short Hills Road, Livingston, NJ 07039
Medicare Provider #310076
Effective Date-August 31, 2005
Columbia St. Mary's Hospital Milwaukee, Inc., 2323 North Lake Drive, Milwaukee, WI 53211
Medicare Provider #520051
Franklin Square Hospital Center, 9000 Franklin Square Drive, Baltimore, MD 21237-9986
Medicare Provider #210015
The Griffin Hospital, 130 Division Street, Derby, CT 06418
Medicare Provider #070031
Gwinnett Medical Center, 1000 Medical Center Boulevard, Lawrenceville, GA 30045
Medicare Provider #110087
Louis A. Weiss Memorial Hospital, 4646 North Marine Drive, Chicago, IL 60640
Medicare Provider #140082
The North Shore Medical Center, 81 Highland Avenue, Salem, MA 01970
Medicare Provider #220006
South Pointe Hospital, 20000 Harvard Road, Warrensville Hts., OH 44122
Medicare Provider #360144
Southwest Medical Center-Lafayette, 2810 Ambassador Caffery, Lafayette, LA 70506
Medicare Provider #190205
St. Mary's Hospital Ozaukee, Inc., 13111 North Port Washington Road, Mequon, WI 53097
Medicare Provider #520027
St. Tammany Parish Hospital, 1202 South Tyler Street, Covington, LA 70433
Medicare Provider #190045
Trinity Medical Center Terrace Park, 4500 Utica Ridge Road, Bettendorf, IA 52722
Medicare Provider #160104
UAMS Medical Center, 4301 West Markham, Little Rock, AK 72205-7199
Medicare Provider #040016
Valley Baptist Medical Center-Harlingen, P.O. Drawer 2588, 2101 Pease Street, Harlingen, TX 78551
Medicare Provider #450033
Effective Date-September 6, 2005
Carilion Roanoke Memorial Hospital, 1906 Belleview Avenue, Roanoke, VA 24014
Medicare Provider #490024
Midland Memorial Hospital, 2200 West Illinois Avenue, Midland, TX 79701-6499
Medicare Provider #450133
Provena Saint Joseph Medical Center, 333 North Madison Street, Joliet, IL 60435-6595
Medicare Provider #140007
Salinas Valley Memorial Healthcare System, 450 E. Romie Lane, Salinas, CA 93901
Medicare Provider #050334
UHHS Geauga Regional Hospital, 13207 Ravenna Road, Chardon, OH 44024
Medicare Provider #360192
Effective Date-September 8, 2005
Howard Regional Health System, 3500 South Lafountain Street, P.O. Box 9011, Kokomo, IN 46904-9011
Medicare Provider #150007
Luther Hospital, 1221 Whipple Street, P.O. Box 4105, Eau Claire, WI 54702-4105
Medicare Provider #520070
Our Lady of Fatima Hospital, 200 High Service Avenue, No. Providence, RI 02904
Medicare Provider #041005
Pitt County Memorial Hospital, Inc., P.O. Box 6028, Greenville, NC 27835-6028
Medicare Provider #340040
Effective Date-September 12, 2005
Baylor All Saints Medical Center, 1400 Eighth Avenue, Fort Worth, TX 76104
Medicare Provider #450137
St. Vincent's Hospital, Staten Island, 355 Bard Avenue, Staten Island, NY 10310
Medicare Provider #330028
SUNY Stony Brook University Hospital, Nicolls Road, Stony Brook, NY 11794
Medicare Provider #330393
The Washington Hospital, 155 Wilson Avenue, Washington, PA 15301
Medicare Provider #390042
Effective Date-September 15, 2005
Abilene Regional Medical Center, 6250 Highway 83/84, Abilene, TX 79606
Medicare Provider #450558
Bon Secours Cottage Health Services, 468 Cadieux Road, Grosse Pointe, MI 48230
Medicare Provider #230089
HealthOne/HCA Rose Medical Center, 4567 E. 9th Avenue, Denver, CO 80220
Medicare Provider #060032
Providence Health Center, 6901 Medical Parkway, Waco, TX 76712
Medicare Provider #450042
St. Edward Mercy Medical Center, 7301 Rogers Avenue, P.O. Box 17000, Fort Smith, AR 72917-7000
Medicare Provider #040062
St. Joseph's Hospital, 3001 W. Dr. M.L. King Jr. Boulevard, Tampa, FL 33607
Medicare Provider #100075
Effective Date-September 22, 2005
Baylor University Medical Center, Department of Radiology, 3500 Gaston Avenue, Dallas, TX 75246
Medicare Provider #450021
Delray Medical Center, 5352 Linton Boulevard, Delray Beach, FL 33484
Medicare Provider #100258
Desert Springs Hospital, 2075 East Flamingo Road, Las Vegas, NV 89119
Medicare Provider #290022
Ellis Hospital, 1101 Nott Street, Schenectady, NY 12308
Medicare Provider #330153
Ingham Regional Medical Center, 401 West Greenlawn Avenue, Lansing, MI 48910
Medicare Provider #230167
St. Joseph's Hospital, 11705 Mercy Boulevard, Savannah, GA 31419
Medicare Provider #110043
Mercy Hospital of Pittsburgh, 1400 Locust Street, Pittsburgh, PA 15219-5166
Medicare Provider #390028
The Pottsville Hospital and Warne Clinic, 420 South Jackson Street, Pottsville, PA 17901
Medicare Provider #390030
Southwest Mississippi Regional Medical Center, 215 Marion Avenue, McComb, MS 39648
Medicare Provider #250097
Sparks Regional Medical Center, 1311 South I Street, P.O. Box 17006, Fort Smith, AR 72917-7006
Medicare Provider #040055
Tampa General Hospital, 2 Columbia Drive, Tampa, FL 33606
Medicare Provider #100128
Wesley Medical Center, 550 N. Hillside, Wichita, KS 67214
Medicare Provider #170123
Effective Date-September 28, 2005
Advocate Illinois Masonic Medical Center, 836 W. Wellington Avenue, Chicago, IL 60657-5193
Medicare Provider #140182
East Texas Medical Center-Tyler, 1000 South Beckham, Tyler, TX 75701
Medicare Provider #450083
Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219
Medicare Provider #330914
Mesa General Hospital, 515 North Mesa Drive, Mesa, AZ 85201
Medicare Provider #030017
Opelousas General Health System, 539 E. Prudhomme Street, P.O. Box 1389, Opelousas, LA 70570
Medicare Provider #190017
Southern Ohio Medical Center, 1895 27th Street, Portsmouth, OH 45662
Medicare Provider #360008
St. Joseph Hospital, 2901 Squalicum Parkway, Bellingham, WA 98264
Medicare Provider #500030
St. Lukes Hospital, 801 Ostrum Street, Bethlehem, PA 18015
Medicare Provider #390049
WakeMed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610
Medicare Provider #340069
Yale-New Haven Hospital, 20 York Street, New Haven, CT 06504,
Medicare Provider #070022
[FR Doc. 05-24023 Filed 12-22-05; 8:45 am]
BILLING CODE 4120-01-U