[Federal Register Volume 83, Number 213 (Friday, November 2, 2018)]
[Rules and Regulations]
[Pages 55105-55106]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-23922]
[[Page 55105]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 482, 484, and 485
[CMS-3317-RCN]
RIN 0938-AS59
Medicare and Medicaid Programs; Revisions to Requirements for
Discharge Planning for Hospitals, Critical Access Hospitals, and Home
Health Agencies; Extension of Timeline for Publication of Final Rule
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Extension of timeline for publication of a final rule.
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SUMMARY: This document announces the extension of the timeline for
publication of the ``Medicare and Medicaid Program; Revisions to
Requirements for Discharge Planning for Hospitals, Critical Access
Hospitals, and Home Health Agencies'' final rule. We are issuing this
document in accordance with section 1871(a)(3)(B) of the Social
Security Act (the Act), which requires notice to be provided in the
Federal Register if there are exceptional circumstances that cause us
to publish a final rule more than 3 years after the publication date of
the proposed rule. In this case, the complexity of the rule and scope
of public comments warrants the extension of the timeline for
publication.
DATES: This extension is effective on November 2, 2018.
FOR FURTHER INFORMATION CONTACT: Alpha-Banu Wilson, (410) 786-8687.
SUPPLEMENTARY INFORMATION:
I. Background
Section 1871(a)(3)(A) of the Social Security Act (the Act) requires
the Secretary of the Department of Health and Human Services (the
Secretary), in consultation with the Director of the Office of
Management and Budget (OMB), to establish a regular timeline for the
publication of a final rule based on the previous publication of a
proposed rule or an interim final rule. Section 1871(a)(3)(B) of the
Act allows the timeline for publishing Medicare final regulations to
vary based on the complexity of the regulation, number and scope of
comments received, and other related factors. The timeline for
publishing the final regulation, however, cannot exceed 3 years from
the date of publishing the proposed regulation unless there are
exceptional circumstances. The Secretary may extend the initial
targeted publication date of the final regulation, if the Secretary
provides public notice including a brief explanation of the
justification for the variation no later than the regulation's
previously established proposed publication date.
After consultation with the Director of OMB, the Department,
through the Centers for Medicare & Medicaid Services (CMS), published a
notice in the Federal Register on December 30, 2004 (69 FR 78442)
establishing a general 3-year timeline for publishing Medicare final
rules after the publication of a proposed or interim final rule.
II. Notification of Continuation
Section 1861(e)(1) through (9), section 1861(m), section 1861(mm),
section 1861(o), section 1891, and section 1820(e) of the Act list the
requirements that hospitals, home health agencies (HHAs), and critical
access hospitals (CAHs) must meet to be eligible for Medicare and
Medicaid participation. The Medicare Conditions of Participation (CoPs)
and Conditions for Coverage (CfCs) set forth the federal health and
safety standards that providers and suppliers must meet to participate
in the Medicare and Medicaid programs. The purposes of these conditions
are to protect patient health and safety and to ensure that quality
care is furnished to all patients in Medicare and Medicaid-
participating facilities. The statute also specifies that the Secretary
may establish other requirements as necessary in the interest of the
health and safety of patients.
On November 3, 2015, we published a proposed rule in the Federal
Register titled, ``Medicare and Medicaid Program; Revisions to
Requirements for Discharge Planning for Hospitals, Critical Access
Hospitals, and Home Health Agencies'' (80 FR 68126) that would update
the discharge planning requirements for hospitals, CAHs, and HHAs. We
also proposed to implement the discharge planning requirements of the
Improving Medicare Post-Acute Care Transformation Act of 2014 (Pub. L.
113-185), that requires hospitals, including, but not limited to,
short-term acute care hospitals, CAHs and certain post-acute care (PAC)
providers, including long term care hospitals, inpatient rehabilitation
facilities, HHAs, and skilled nursing facilities, to take into account
quality measures and resource use measures to assist patients and their
families during the discharge planning process in order to encourage
patients and their families to become active participants in the
planning of their transition to the PAC setting (or between PAC
settings). In response to the proposed rule, we received 299 public
comments. Commenters included individuals, health care professionals
and corporations, national associations and coalitions, state health
departments, patient advocacy organizations, and individual facilities
that would be impacted by the rule. The commenters presented procedural
and cost information related to their specific circumstances, and the
information presented requires additional analysis.
This document announces an extension of the timeline for
publication of the final rule based on the following exceptional
circumstances, which we believe, justify such an extension. Based on
both public comments received and stakeholder feedback, we have
determined that there are significant policy issues that need to be
resolved in order to address all of the issues raised by public
comments to the proposed rule and to ensure appropriate coordination
with other government agencies. Specifically, the development of the
final rule requires collaboration with the Department of Health and
Human Services' Office of the National Coordinator for Health
Information Technology.
We, therefore, are not able to meet the 3-year timeline for
publication of the final rule and are instead extending the timeline
for publication of the final rule.
Our decision to extend the timeline for issuing a final rule that
would update the CoPs should not be viewed as a diminution of the
Department's commitment to timely and effective rulemaking in this
area. We are committed to publishing a final rule that provides clear
health and safety standards for hospitals, HHAs, and CAHs. At this
time, we believe we can best achieve this balance by issuing this
notification of continuation.
This document extends the timeline for publication of the final
rule until November 3, 2019.
III. Collection of Information
This document does not impose information collection requirements,
that is, reporting, recordkeeping or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 3501 et seq.).
[[Page 55106]]
Dated: October 24, 2018.
Ann C. Agnew,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2018-23922 Filed 10-30-18; 4:15 pm]
BILLING CODE 4120-01-P