[Federal Register Volume 70, Number 246 (Friday, December 23, 2005)]
[Notices]
[Pages 76290-76313]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-24023]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9033-N]
Medicare and Medicaid Programs; Quarterly Listing of Program
Issuances--July Through September 2005
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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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
[[Page 76291]]
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--
[cir] Date published;
[cir] Federal Register citation;
[cir] Parts of the Code of Federal Regulations (CFR) that have
changed (if applicable);
[cir] Agency file code number; and
[cir] 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); or National 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
[[Page 76292]]
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.
Addendum III.--Medicare and Medicaid Manual Instructions
[July through September 2005]
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Transmittal No. Manual/Subject/Publication No.
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Medicare General Information
(CMS--Pub. 100-01)
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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 Description Home
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
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Medicare Benefit Policy
(CMS--Pub. 100-02)
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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 Therapy Furnished by the
Skilled Nursing Facility or by Others Under
Arrangements With the Facility and Under Its
Supervision
Inpatient Physical Therapy, Occupational
Therapy, and Speech-Language Pathology
Services
Services Furnished Under Arrangements With
Providers
Supplementary Medical Insurance Provisions
Services Not Provided Within United States
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Medicare National Coverage Determinations
(CMS--Pub. 100-03)
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42 Cochlear Implantation
Cochlear Implantation (Effective April 4, 2005)
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[[Page 76293]]
Medicare Claims Processing
(CMS--Pub. 100-04)
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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 Outpatient Prospective 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
Intermediaries Carrier 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 Intermediary
Analysis of Internal Information
Systems Information
Review of Provider Profiles
Contact with New Providers
Production and Distribution of Material to
Increase Use of Electronic Data Interchange
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
Telecommunications System 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 Data Interchange
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
[[Page 76294]]
Shared System and Common Working File
Maintainers Internal Testing Requirements
Carrier, Durable Medical Equipment Regional
Carrier, and Intermediary Internal Testing
Requirements
Third-Party Certification Systems and Services
Electronic Data Interchange Submitter/Receiver
Testing by Carriers, Durable Medical 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 Intermediary Submitter/
Receiver Testing With Legacy Formats During
the Health Insurance Portability and
Accountability Act Contingency Period
Discontinuation of Use of Claim Legacy Formats
following Successful Health Insurance
Portability and Accountability Act Format
Testing
Electronic Data Interchange Receiver Testing by
Carriers, Durable Medical Equipment Regional
Carriers, and Intermediaries
Changes in Provider's System or Vendor's
Software, and Use of Additional Electronic
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 Direct Data Entry
Free Claim Submission Software
Remittance Advice Print Software
Medicare Remit Easy Print Software for Carrier
and Durable Medical Equipment Regional Carrier
Provider Use
Medicare Standard Fiscal Intermediary PC-Print
Software
Newsletters/Bulletin Board/Internet Publication
of Electronic Data Interchange 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 Intermediary X12 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-Specific Shared System
Implementation Guide Edit Requirements
Keyshop and Image Processing
Carrier, Durable Medical Equipment Regional
Carrier, or Fiscal Intermediary Data Security
and Confidentiality Requirements
Carrier, Durable Medical Equipment Regional
Carrier, and Fiscal Intermediary Electronic
Data Interchange Audit Trails
Security-Related Requirements for Carrier,
Durable Medical Equipment
Regional Carrier, or Fiscal Intermediary
Arrangements with Clearinghouses And 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 CMS Decision
Electronic and Paper Claims Implications of
Mandatory Electronic Submission Enforcement
Provider Education
616 Certified Registered Nurse Anesthetist Pass-
Through Payments
Anesthesia and Certified Registered Nurse
Anesthetist Services in a Critical Access
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 Inpatient Rehabilitation Facility
Prospective Payment System
Payment Adjustment for Late Transmission of
Patient Assessment Data
620 New Fiscal Intermediary (FI) Edit to Identify
Potentially Excessive Medicare Payments
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 Billing Indicator
Field for Adjusted Claims
624 This Transmittal is rescinded and replaced by
Transmittal 686
625 Competitive Acquisition Program for Part B
Drugs--Coding, Testing, and Implementation
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
[[Page 76295]]
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 Update Effective 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 Comprehensive Outpatient
Rehabilitation Facility Claims Subject to
Expedited Determinations
Scope of Issuance of Expedited Determination
Notices
General Responsibilities of Quality Improvement
Organizations and Fiscal Intermediaries
Related to Expedited Determinations
Billing and Claims Processing Requirements
Related to Expedited Determinations
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 Pricer Update 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
[[Page 76296]]
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, and Implementation
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 Pricing File, Effective
October 1, 2005 and Revisions to April 2005
and July 2005 Quarterly 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 States Source 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 States For 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 Ambulance Claims 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 From Durable 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
[[Page 76297]]
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 and Reconsiderations
(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 System Pricer
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 and Hospital 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 Common Procedure Coding System Help
File and Notification to Fiscal Intermediaries
and Providers of the Redesigned Skilled
Nursing Facility Consolidated Billing Annual
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 Claims Denied Due to
an Open Medicare Secondary Payer Group Health
Plan Record Where the Group Health Plan Record
Was Subsequently Deleted
687 Appeals of Claims Decisions: Redeterminations
and Reconsiderations (Implementation Dates for
Fiscal Intermediary Initial Determination
Issued On or After May 1, 2005 and Carrier
Initial Determinations Issued on or After
January 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
[[Page 76298]]
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 Plans Overview 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 Contractors IRS/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 Accounting System/
Healthcare Integrated General Ledger
Accounting System When the Only Debtor
Interfaced to Healthcare Integrated General
Ledger Accounting System Is the Employer)
Accountability Worksheet (Not Applicable to
Recovery Management Accounting System/
Healthcare Integrated General Ledger
Accounting System Users)
Summary Data Sheet (Not Applicable to ReMAS/
HIGLAS Users)
Field Description on the Medicare Secondary
Payer Summary Data Sheet Payment Record
Summary (Used with ReMAS/HIGLAS Users but in a
Modified Format)
[[Page 76299]]
Courtesy Copy of All Medicare Secondary Payer
Group Health Plan-Based Recovery Demand
Packages to the Employer's Insurer/Third Party
Administrator
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 Those
Contractors Using Recovery Management
Accounting System/Health Integrated General
Ledger Accounting System Group Health Plan
Functions
Coordination of Benefits Contractor
Responsibility to Obtain Missing Medicare
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
[[Page 76300]]
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 Communication With 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 Decision Handling
Overpayments and Underpayments Resulting From
the Comprehensive Error 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 Comprehensive Error 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
[[Page 76301]]
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
Revision Denials 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 Medicare Advantage Plans
70 Deletion of MCM Chapter 19--The Enrollment and
Payment User's Guide, and Chapter 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 Sec. 20
Requirements Relating to Medicare Conditions of
Participation--renumbered as Sec. 4.10.7
Provider Networks--renumbered as new Sec.
10.8 and parts of the old Sec. 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
[[Page 76302]]
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-Contracting Access 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 Assistance Organizations
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
------------------------
[[Page 76303]]
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 Disaster Disaster Related Claims
------------------------------------------------------------------------
Addendum IV.--Regulation Documents Published in the Federal Register
[July through September 2005]
----------------------------------------------------------------------------------------------------------------
FR Vol.
Publication date 70 page CFR parts affected File code Title of regulation
number
----------------------------------------------------------------------------------------------------------------
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.
[[Page 76304]]
August 4, 2005................... 45026 409, 411, 424, and CMS-1282-F Medicare Program;
489. 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, CMS-1502-P Medicare Program;
414, and 426. Revisions to Payment
Policies Under the
Physician Fee Schedule
for Calendar Year 2006.
August 12, 2005.................. 47278 405, 412, 413, 415, CMS-1500-F Medicare Program;
419, 422, and 485. 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, CMS-1502-CN Medicare Program;
414, and 426. 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.
[[Page 76305]]
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, CMS-1500-CN Medicare Program;
419, 422, and 485. 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 under Title 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
[[Page 76306]]
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 Control Numbers
[Approved CFR Sections in Title 42, Title 45, and Title 20 (Note:
Sections in Title 45 are preceded by ``45 CFR,'' and sections in Title
20 are preceded by ``20 CFR'')]
------------------------------------------------------------------------
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
[[Page 76307]]
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
[[Page 76308]]
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
[[Page 76309]]
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
3000 Pinehurst, 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
Avenue Berkley, 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
[[Page 76310]]
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 and Scott, 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
[[Page 76311]]
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 and
Inova 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
[[Page 76312]]
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
[[Page 76313]]
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