oversight

HCFA: Medicare Program--Prospective Payment System and Consolidated Billing for Skilled Nursing--Update

Published by the Government Accountability Office on 1999-08-05.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

United States General Accounting Office                               Office of the General Counsel
Washington, DC 20548



          B-283351



          August 5, 1999

          The Honorable William V. Roth
          Chairman
          The Honorable Daniel Patrick Moynihan
          Ranking Minority Member
          Committee on Finance
          United States Senate

          The Honorable Thomas J. Bliley, Jr.
          Chairman
          The Honorable John D. Dingell
          Ranking Minority Member
          Committee on Commerce
          House of Representatives

          The Honorable Bill Archer
          Chairman
          The Honorable Charles B. Rangel
          Ranking Minority Member
          Committee on Ways and Means
          House of Representatives

          Subject: Department of Health and Human Services, Health Care Financing
                   Administration: Medicare Program; Prospective Payment System and
                   Consolidated Billing for Skilled Nursing Facilities--Update

          Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a
          major rule promulgated by Department of Health and Human Services, Health Care
          Financing Administration (HCFA), entitled “Medicare Program; Prospective Payment
          System and Consolidated Billing for Skilled Nursing Facilities--Update” (RIN: 0938-
          AJ65). We received the notice on August 2, 1999. It was published in the Federal
          Register as a notice on July 30, 1999. 64 Fed. Reg. 41684.

          The notice sets forth the updates required in section 1888(e) of the Social Security
          Act, as added by section 4432 of the Balanced Budget Act of 1997 related to Medicare
          payments and consolidated billing for skilled nursing facilities.



                                                                                     GAO/OGC-99-57
Enclosed is our assessment of HCFA’s compliance with the procedural steps
required by section 801(a)(1)(B)(i) through (iv) of title 5 with respect to the notice.
Our review indicates that HCFA complied with the applicable requirements.

If you have any questions about this report, please contact James W. Vickers,
Assistant General Counsel, at (202) 512-8210. The official responsible for GAO
evaluation work relating to the subject matter of the notice is William Scanlon,
Director, Health Financing and Public Health Issues. Mr. Scanlon can be reached at
(202) 512-7114.

Sincerely yours,




Robert P. Murphy
General Counsel

Enclosure

cc: Ms. Jacquelyn Y. White
    Deputy Executive Secretary
     to the Department
    Department of Health and
     Human Services




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                                                                          ENCLOSURE

        ANALYSIS UNDER 5 U.S.C. § 801(a)(1)(B)(i)-(iv) OF A MAJOR RULE
                              ISSUED BY THE
             DEPARTMENT OF HEALTH AND HUMAN SERVICES,
                HEALTH CARE FINANCING ADMINISTRATION
                                 ENTITLED
           "MEDICARE PROGRAM; PROSPECTIVE PAYMENT SYSTEM
                     AND CONSOLIDATED BILLING FOR
                  SKILLED NURSING FACILITIES--UPDATE"
                             (RIN: 0938-AJ65)

(i) Cost-benefit analysis

HCFA has estimated the budgetary impact of the notice to result in an increase in
payments to skilled nursing facilities of approximately $120 million in fiscal year
2000.

(ii) Agency actions relevant to the Regulatory Flexibility Act, 5 U.S.C. §§ 603-605,
607, and 609

HCFA has determined that the notice will not have a significant economic impact on
a substantial number of small entities.

In addition, for the purposes of section 1102(b) of the Social Security Act, the
Secretary of Health and Human Services has certified that the notice will not have a
significant impact on the operations of a substantial number of small, rural hospitals.

(iii) Agency actions relevant to sections 202-205 of the Unfunded Mandates Reform
Act of 1995, 2 U.S.C. §§ 1532-1535

HCFA states that the notice does not impose a federal intergovernmental or private
sector mandate of $100 million or more, as defined in the Unfunded Mandates
Reform Act of 1995.

(iv) Other relevant information or requirements under acts and executive orders

Administrative Procedure Act, 5 U.S.C. §§ 551 et seq.

As HCFA issued this action as a notice and not a rulemaking, the procedures of
5 U.S.C. § 553(b) did not apply.




                                                                           GAO/OGC-99-57
Paperwork Reduction Act, 44 U.S.C. §§ 3501-3520

The notice does not contain any information collections subject to review by the
Office of Management and Budget under the Paperwork Reduction Act (PRA).

Statutory authorization for the rule

The notice is issued pursuant to the authority in sections 1888(e) of the Social
Security Act (42 U.S.C. § 1395yy(e)).

Executive Order No. 12866

The notice was reviewed and approved by the Office of Management and Budget
under Executive Order No. 12866.




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