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					                             Regulation                               Cite      Agency or Sponsor                                                                                                                                                                                                                                                                        Description
      Medicare and Medicaid Programs; Changes in Provider         75 FR 24437         CMS                             sn m n r e i
                                                                                                                    Thi i t er i f i al ul w hcom m ent per i di pl m ent s s ever al ovi i ns s et f or t hi t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( Af f or dabl Car eAct ) . I t i pl m ent s t hepr ovi i nw c hr equi es al ovi er s of m edi al ot her i em s or s er vi es ands uppl r s t hat qual y f or aNat i nal ovi er I dent i i r ( NPI ) t oi cl det hei NPI onal i at i ns t oenr ol t heM edi ar eandM edi ai pr ogr am s andonal ai s f or paym ent s ubm i t edunder t heM edi ar eandM edi ai pr ogr am s . Thi i t er i f i al ul w hcom m ent per i dal or equi es phys i i ns andel i l pr of es s i nal t oor der andr ef er cover edi em s ands er vi es f or M edi ar ebenef i i r i s t obeenr ol di M edi ar e. I naddi i n, i adds r equi em ent s f or pr ovi er s , phys i i ns , andot her s uppl r s par t i i at i gi t heM edi ar epr ogr am t opr ovi edocum ent at i nonr ef er r al t opr ogr am s at hi hr i k of w t eandabus e, t oi cl dedur abl m edi al pm ent , pr os t het i s , or t hot i s ands uppl s ( DM EPOS) , hom eheal hs er vi es , andot her i em s or s er vi es
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Medicaid Program; Review and Approval Process for Section 1115    75 FR 56946         CMS                                                                                                                                                          s              e oul m e
                                                                                                                                                                                                                                                 Thi pr opos edr ul w di pl m ent pr ovi i ns of s ect i n10201( i of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct of 2010( Af f or dabl Car eAct ) t hat s et f or t ht r ans par ency andpubl not i epr ocedur es f or exper i ent al pi t , anddem ons t r at i npr oj ct s appr ovedunder s ect i n1115of t heSoci l
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           aSecur i y Act r el t i gt oM edi ai andt heChi r en' Heal hI ns ur ancePr ogr am ( CHI P) . Thi pr opos edr ul w di cr eas et hedegr eet ow c hi f or m at i nabout M edi ai andCHI Pdem ons t r at i nappl at i ns andappr oveddem ons t r at i npr oj ct s ar epubl l avai bl andpr om ot egr eat er t r ans par ency i t her evi w appr oval dem ons t r at i ns . I t w dal ocodi y exi t i gs t at ut or y r equi em ent s per t ai i gt ot r i al
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Medicare; Home Health Prospective Payment System Rate Update      75 FR 70372         CMS                                                                                                                        This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy.




       Medicare and Medicaid Programs; Patient Notification        76 FR 5755         CMS                                                                                                                   Th i s p ro p o se d ru l e wo u l d se t fo rth n e w re q u i re me n ts fo r M e d i care ce rti fi e d p ro vi d e rs an d su p p l i e rs. Th i s p ro p o se d ru l e wo u l d re q u i re th at th e M e d i care ce rti fi e d p ro vi d e rs an d su p p l i e rs make avai l ab l e to th e i r M e d i care b e n e fi ci ari e s i n fo rmati o n ab o u t th e i r ri gh t to fi l e a wri tte n co mp l ai n t wi th th e Qu al i ty Imp ro ve me n t Organ i zati o n (QIO) i n th e State wh e re h e al th care se rvi ce s are b e i n g o r we re p ro vi d e d ab o u t th e q u al i ty o f care th e y are re ce i vi n g o r h ave re ce i ve d .




 Medicare, Medicaid, Screening Requirements, Application Fees      76 FR 5862         CMS                                                                                                                                                                                                      s n r e i
                                                                                                                                                                                                                                                                                             Thi f i al ul w hcom m ent per i dw pl m ent pr ovi i ns of t heACAt hat es t abl h: Pr ocedur es under w c hs cr eeni gi conduct edf or pr ovi er s of m edi al ot her s er vi es ands uppl r s i t heM edi ar epr ogr am , pr ovi er s i t heM edi ai pr ogr am , andpr ovi er s i t heChi r en' Heal hI ns ur ancePr ogr am ( CHI P) ; anappl at i nf eei pos edoni s t i ut i nal ovi er s ands uppl r s ; t em por ar y m or at or i t hat m ay bei pos edi neces s ar y t opr event or com bat f r aud, w t e, andabus eunder t heM edi ar eandM edi ai pr ogr am s , andCHI P; gui ancef or St at es r egar di gt er m i at i nof pr ovi er s f r om M edi ai andCHI Pi t er m i at edby M edi ar eor anot her M edi ai St at epl nor CHI P
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   Medicare and Medicaid; Requirements for Long-Term Care          76 FR 9503         CMS                                                                                                                                                                                           sn m n r e                            r                 o
                                                                                                                                                                                                                                                                                  Thi i t er i f i al ul am ends t her equi em ent s t hat al ng- t er m car e( LTC) f aci y m us t m eet i or der t oqual y t opar t i i at eas as ki dnur s i gf aci y ( SNF) i t heM edi ar epr ogr am , or anur s i gf aci y ( NF) i t heM edi ai pr ogr am . Thes er equi em ent s i pl m ent s ect i n6113of t heAf f or dabl Car eAct t oens ur et hat , am ongot her t hi gs , i t hecas eof aLTCf aci y cl s ur e, i di i ual s er vi gas adm i i t r at or s of aSNF or NF pr ovi ew i t ennot i i at i nof t hei pendi gcl s ur eandapl nf or t her el cat i nof r es i ent s at l as t 60days pr i r t ot hei pendi gcl s ur eor , i t heSecr et ar y t er m i at es t hef aci y' par t i i at i ni M edi ar eor M edi ai , not l t er t hant hedat et heSecr et ar y det er m i es appr opr i t e.
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        Medicaid Program; Community First Choice Option           76 FR 10736         CMS                                                                                                                                                         This proposed rule implements Section 2401 of the Affordable Care Act (ACA) which establishes a new State option to provide home and community-based attendant services and supports. These services and supports may be offered through the Community First Choice State plan option.




     Medicare and Medicaid Programs; Civil Money Penalties        76 FR 15106         CMS                                                                                                                                       This final rule will revise and expand current Medicare and Medicaid regulations regarding the imposition and collection of civil money penalties by CMS when nursing homes are not in compliance with Federal participation requirements in accordance with section 6111 of the Affordable Care Act of 2010.




       Medicare Program; Medicare Shared Savings Program          76 FR 19528         CMS                                                                                                                                                                                                                                                                                                                           Thi pr opos edr ul w di pl m ent s ect i n3022of t heAf f or dabl Car eAct w c hcont ai s pr ovi i ns r el t i gt oM edi ar epaym ent s t opr ovi er s of s er vi es ands uppl r s par t i i at i gi Account abl Car eOr gani at i ns ( ACOs ) . Under t hes epr ovi i ns , pr ovi er s of s er vi es ands uppl r s cancont i uet or ecei et r adi i nal edi ar ef ee- f or - s er vi epaym ent s under Par t s AandB, andbeel i l f or addi i nal
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               t o paym ent s bas edonm eet i gs peci i dqual y ands avi gs r equi em ent s .




     Medicare Program; Changes to the Medicare Advantage          76 FR 21432         CMS                                                                                                                                 Th i s fi n al ru l e make s re vi si o n s to th e M e d i care Ad van tage (M A) p ro gram (P art C ) an d P re scri p ti o n Dru g B e n e fi t P ro gram (P art D) to i mp l e me n t p ro vi si o n s sp e ci fi e d i n th e P ati e n t P ro te cti o n an d Affo rd ab l e C are Act an d th e He al th C are an d Ed u cati o n R e co n ci l i ati o n Act o f 2 0 1 0 (co l l e cti ve l y re fe rre d to as th e Affo rd ab l e C are Act) (AC A) an d make o th e r ch an ge s to th e re gu l ati o n s b ase d o n o u r e xp e ri e n ce i n th e ad mi n i strati o n o f th e P art C an d P art D p ro grams.




  Medicaid Program; Federal Funding, Medicaid Determination       76 FR 21950         CMS                                                                                                                                                                                                                                                                           s n r e i s
                                                                                                                                                                                                                                                                                                                                                                  Thi f i al ul w evi eM edi ai r egul t i ns f or M echani edCl i s Pr oces s i gandI nf or m at i nRet r i val t em s . W ear eal om odi yi gour r egul t i ns s ot hat t heenhancedFeder al i anci l t i i at i n( FFP) i avai bl f or des i n, devel pm ent andi s t al t i nor enhancem ent of el i i y det er m i at i ns ys t em s unt i
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Decem ber 31, 2015. Thi f i al ul al oi pos es cer t ai def i eds t andar ds andcondi i ns i t er m s of t i el es s , accur acy, ef f i i ncy, andi t egr i y f or m echani edcl i s pr oces s i gandi f or m at i nr et r i val ys t em s i or der t or ecei eenhancedFFP.
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  Medicare Program; Inpatient Rehabilitation Facility Payment     76 FR 24214         CMS                                                                                                                                                                                                                                                                      Thi pr opos edr ul w di pl m ent s ect i n3004of t heAf f or dabl Car eAct , w c hes t abl hes anew i y r epor t i gpr ogr am t hat pr ovi es f or a2per cent r educt i ni t heannual cr eas ef act or begi ni gi 2014f or f ai r et or epor t qual y dat at ot heSecr et ar y of Heal handHum anSer vi es . Thi pr opos edr ul w dal oupdat et hepr os pect i epaym ent r at es f or i pat i nt r ehabi at i nf aci i s ( I RFs ) f or Feder al i cal
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  aSecur i y Act ( t heAct ) .




  Medicare Program; Prospective Payment, Consolidated Billing     76 FR 26364         CMS                                                               s n r e                                                             v
                                                                                                                                                      Thi f i al ul updat es t hepaym ent r at es us edunder t hepr os pect i epaym ent s ys t em f or s ki dnur s i gf aci i s ( SNFs ) f or f i cal
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                                                                                                                                                                                                                                                                                                s year 2012. I naddi i n, i r ecal r at es t hecas e- m i i dexes s ot hat t hey m or eaccur at el r ef l ct par i y i expendi ur es bet w RUG- I Vandt hepr evi us cas e- m i cl s s i i at i ns ys t em . I t al oi cl des adi cus s i nof aNon- Ther apy Anci r y com ponent cur r ent l under devel pm ent w hi CM S. I naddi i n, t hi f i al ul di cus s es t hei pact of cer t ai pr ovi i ns of t heAf f or dabl Car eAct , andr educes t heSNF m ar ket bas ket per cent ageby t hem ul i f act or pr oduct i i y adj s t m ent . Thi r ul al oi pl m ent s cer t ai changes r el t i gt ot hepaym ent of gr oupt her apy s er vi es andi pl m ent s new es i ent as s es s m ent pol i s . Fi al , t hi r ul announces t hat t hepr opos edpr ovi i ns r egar di gt heow s hi di cl s ur er equi em ent s s et f or t hi s ect i n6101of t heAf f or dabl Car eAct w f i al edat al t er dat e.
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   Medicare Program; Inpatient Psychiatric Facilities Payment     76 FR 26432         CMS                                                                                                                                                                                                                 s n r e
                                                                                                                                                                                                                                                                                                        Thi f i al ul updat es t hepr os pect i epaym ent r at es f or M edi ar ei pat i nt hos pi al er vi es pr ovi edby i pat i nt ps ychi t r i f aci i s ( I PFs ) f or di char ges occur r i gdur i gt her at eyear ( RY) begi ni gJ ul 1, 2011t hr oughSept em ber 30, 2012. Thef i al ul al ochanges t heI PF pr os pect i epaym ent s ys t em ( PPS) paym ent r at eupdat eper i dt oaRYt hat coi ci es w haf i cal
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       s year ( FY) . I naddi i n, t her ul i pl m ent s pol y changes af f ect i gt heI PF PPS t eachi gadj s t m ent . I t al or ebas es andr evi es t heRehabi at i n, Ps ychi t r i , andLong- Ter m Car e( RPL) m ar ket bas ket , andm akes s om ecl r i i at i ns andcor r ect i ns t ot er m i ol gy andr egul t i ns t ext .
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   Medicare Program; Hospital Inpatient Value-Based Program       76 FR 26490         CMS                              s n r em e                     t I       e      u
                                                                                                                     Thi f i al ul i pl m ent s aHos pi al npat i nt Val e- Bas edPur chas i gpr ogr am ( Hos pi al pr ogr am or t hepr ogr am ) under s ect i n1886( o) of t heSoci l
                                                                                                                                                                                           n                   t VBP                                         o                            t                            hi    u          n
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    s year i vol ed. Thepr ogr am w y t opaym ent s f or di char ges occur r i gonor af t er Oct ober 1, 2012, i accor dancew hs ect i n1886( o) ( as addedby s ect i n3001( a) of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct , as am endedby t heHeal hCar eandEducat i nReconci t i nAct of 2010( col ct i el know as t heAf f or dabl Car eAct ) ) . Scor i gi t heHos pi al pr ogr am w bas edonw her ahos pi al eet s or exceeds t heper f or m ances t andar ds es t abl hedw hr es pect t ot hem eas ur es . By adopt i gt hi pr ogr am , w w ew dhos pi al bas edonact ual i y per f or m anceonm eas ur es , r at her t hans i pl r epor t i gdat af or t hos em eas ur es .
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 Medicaid Program; Payment Adjustment, Provider-Preventable       76 FR 32816         CMS                                                                                                                                                                                                                                                                                                s n r e i e
                                                                                                                                                                                                                                                                                                                                                                                       Thi f i al ul w pl m ent s ect i n2702of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct w c hdi ect s t heSecr et ar y of Heal handHum anSer vi es t oi s ueM edi ai r egul t i ns ef f ect i eas of J ul 1, 2011pr ohi i i gFeder al
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   aSecur i y Act f or any am ount s expendedf or pr ovi i gm edi al s i t ancef or heal hcar e- acqui edcondi i ns s peci i di t her egul t i n. I t w s oaut hor i eSt at es t oi ent i y ot her pr ovi er - pr event abl condi i ns f or w c hM edi ai paym ent w pr ohi i ed.
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 Medicare Program; Availability of Medicare Data, Measurement     76 FR 33566         CMS                                                                                                                               Th i s ru l e p ro p o se s to i mp l e me n t n e w statu to ry re q u i re me n ts re gard i n g th e re l e ase an d u se o f stan d ard i ze d e xtracts o f M e d i care cl ai ms d ata to me asu re th e p e rfo rman ce o f p ro vi d e rs an d su p p l i e rs i n ways th at p ro te ct p ati e n t p ri vacy. Th i s ru l e e xp l ai n s h o w e n ti ti e s can b e co me q u al i fi e d b y C M S to re ce i ve stan d ard i ze d e xtracts o f cl ai ms d ata u n d e r M e d i care P arts A, B , an d D fo r th e p u rp o se o f e val u ati o n o f th e p e rfo rman ce o f p ro vi d e rs o f se rvi ce s an d su p p l i e rs.




   Medicare Program; Changes to the End-Stage Renal Disease       76 FR 40498         CMS                                                                                                                                   s              e oul
                                                                                                                                                                                                                          Thi pr opos edr ul w dupdat eandm akecer t ai r evi i ns t ot heEnd- St ageRenal s eas e( ESRD) pr os pect i epaym ent s ys t em ( PPS) f or cal ndar year ( CY) 2012. Thi pr opos edr ul w dal os et f or t hpr opos edr equi em ent s f or t heESRDqual y i cent i epr ogr am ( QI P) f or paym ent year s ( PYs ) 2013and2014. I naddi i n, t hi pr opos edr ul w dr evi et heam bul ncef ees chedul r egul t i ns t oconf or m w hs t at ut or y changes . Fi al , t hi pr opos edr ul w dr evi et hedef i i i nof dur abl m edi al pm ent ( DM E) by addi ga3- year m i i um l et i ecr i er i nt hat m us t bem et by ani em or devi ei or der t obecons i er eddur abl f or t hepur pos eof cl s s i yi gt hei em under t heM edi ar ebenef i cat egor y f or DM E. ( Seet heTabl of Cont ent s f or al t i gof t hes peci i i s ues addr es s edi t hi pr opos edr ul . )
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 Medicaid Program; Face-to-Face Requirements for Home Health      76 FR 41032         CMS                                               s
                                                                                                                                      Thi pr opos edr ul w dr evi et heM edi ai hom eheal hs er vi edef i i i nas r equi edby s ect i n6407of t heAf f or dabl Car eAct t oaddar equi em ent t hat phys i i ns docum ent t heexi t enceof af ace- t o- f aceencount er ( i cl di gt hr ought heus eof t el heal h) w ht heM edi ai el i l i di i ual i hi r eas onabl t i ef r am es . Thi pr opos al oul al nt het i ef r am es w hs i i r r egul t or y r equi em ent s f or M edi ar ehom eheal hs er vi es i accor dancew hs ect i n6407of t heAf f or dabl Car eAct andr ef l ct s CM S'
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            com m i m ent t ot hegener al i ci l s of t hePr es i ent ' Execut i eOr der 13563r el as edJ anuar y 18, 2011, ent i l d“I m pr ovi gRegul t i nandRegul t or y Revi w ” I naddi i n, t hi r ul pr opos es t oam endhom eheal hs er vi es r egul t i ns t ocl r i y t hedef i i i ns of i cl dedm edi al uppl s , equi m ent andappl nces , andcl r i y t hat St at es m ay not l i hom eheal hs er vi es t os er vi es del er edi t hehom e, or t os er vi es f ur ni hedt oi di i ual w ar ehom ebound.
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Medicare and Medicaid: Hospital Outpatient Prospective Payment    76 FR 42170         CMS                                                                                                                                                                                                                                                                                                            s              e oul    s          c
                                                                                                                                                                                                                                                                                                                                                                                                   Thi pr opos edr ul w dr evi et heM edi ar ehos pi al pat i nt pr os pect i epaym ent s ys t em ( OPPS) t oi pl m ent appl abl s t at ut or y r equi em ent s andchanges ar i i gf r om our cont i ui gexper i ncew ht hi s ys t em . I nt hi pr opos edr ul , w des cr i et hepr opos edchanges t ot heam ount s andf act or s us edt odet er m i et hepaym ent r at es f or M edi ar ehos pi al pat i nt s er vi es pai under t heOPPS. Thes epr opos edchanges w dbeappl abl t os er vi es f ur ni hedonor af t er J anuar y 1, 2012.
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  Medicare Program; Payment Policies, Physician Fee Schedule      76 FR 42772         CMS         s              e                                  ca              e
                                                                                                Thi pr opos edr ul addr es s es changes t ot hephys i i nf ees chedul andot her M edi ar ePar t Bpaym ent pol i s t oens ur et hat our paym ent s ys t em s ar eupdat edt or ef l ct changes i m edi al act i eandt her el t i eval eof s er vi es . I t al oaddr es s es , i pl m ent s or di cus s es cer t ai pr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct , as am endedby t heHeal hCar eandEducat i nReconci t i nAct of 2010( col ct i el know as t heAf f or dabl Car eAct ) andt heM edi ar eI m pr ovem ent s f or Pat i nt s andPr ovi er s Act of 2008. I naddi i n, t hi pr opos edr ul di cus s es paym ent s f or Par t Bdr ugs ; Phys i i nQual y Repor t i gSys t em ; t heEl ct r oni Pr es cr i i g( eRx) I ncent i ePr ogr am ; t hePhys i i nRes our ce- Us eFeedback Pr ogr am andt heval em odi i r ; pr oduct i i y adj s t m ent f or am bul t or y s ur gi al
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       c cent er paym ent s ys t em andt heam bul nce, cl i al bor at or y, anddur abl m edi al pm ent pr os t het i s or t hot i s ands uppl s ( DM EPOS) f ees chedul s ; andot her Par t Br el t edi s ues . ( Seet heTabl of Cont ent s f or a
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Medicaid and Children's Health Insurance Programs; Disallowance   76 FR 46684         CMS             Thi pr opos edr ul r ef l ct s t heCent er s f or M edi ar eandM edi ai Ser vi es '
                                                                                                        s              e      e                             c            c d       c com m i m ent t ot hegener al i ci l s of t hePr es i ent ' Execut i eOr der 13563r el as edJ anuar y 18, 2011, ent i l d“I m pr ovi gRegul t i nandRegul t or y Revi w ” as t hi r ul w d: i pl m ent anew econs i er at i npr oces s f or adm i i t r at i edet er m i at i ns t odi al w ai s f or Feder al i anci l t i i at i n( FFP) under t i l XI Xof t heAct ( M edi ai ) ; l ngt hent het i eSt at es havet ocr edi t heFeder al
                                                                                                                                                                                           t                     pr n pe                 d s            v                 e                              te             n      a o           a           e ,         s e oul m e                r      d       o                     ns         v           n o              o
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Medicaid Program; Eligibility Changes Under Affordable Care Act   76 FR 51148         CMS                                                                                                                                                                                                                                 s
                                                                                                                                                                                                                                                                                                                        Thi pr opos edr ul w di pl m ent pr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct of 2010andt heHeal hCar eandEducat i nReconci t i nAct of 2010( col ct i el r ef er r edt oas t heAf f or dabl Car eAct ) . TheAf f or dabl Car eAct expands acces s t oheal hi s ur ancet hr oughi pr ovem ent s i M edi ai , t hees t abl hm ent of Af f or dabl I ns ur anceExchanges ( “Exchanges ”) , andcoor di at i nbet w M edi ai , t heChi r en' Heal hI ns ur ancePr ogr am ( CHI P) , andExchanges . Thi pr opos edr ul w di pl m ent s ect i ns of t heAf f or dabl Car eAct r el t edt oM edi ai andCHI Pel i i y, enr ol ent s i pl i at i n, andcoor di at i n.
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   Medicare; Hospital Inpatient Prospective Payment Systems       76 FR 51476         CMS                                                                                                                                                                                                                                           sn           c
                                                                                                                                                                                                                                                                                                                         W ear er evi i gt heM edi ar ehos pi al pat i nt pr os pect i epaym ent s ys t em s ( I PPS) f or oper at i gandcapi al r el t edcos t s of acut ecar ehos pi al t oi pl m ent changes ar i i gf r om our cont i ui gexper i ncew ht hes es ys t em s andt oi pl m ent cer t ai s t at ut or y pr ovi i ns cont ai edi t hePat i nt Pr ot ect i nandAf f or dabl Car eAct andt heHeal hCar eandEducat i nReconci t i nAct of 2010( col ct i el know as t heAf f or dabl Car eAct ) andot her l gi l t i n. W eal oar es et t i gf or t ht heupdat et ot her at e- of - i cr eas el i s f or cer t ai hos pi al excl dedf r om t heI PPS t hat ar epai onar eas onabl cos t bas i s ubj ct t ot hes el i s .
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           Medicaid Program; Recovery Audit Contractors           76 FR 57808         CMS                                                                                                                                                                                                         s n r em e
                                                                                                                                                                                                                                                                                                Thi f i al ul i pl m ent s s ect i n6411of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) , andpr ovi es gui ancet oSt at es r el t edt oFeder al St at ef undi gof St at es t ar t - up, oper at i nandm ai t enancecos t s of M edi ai Recover y Audi Cont r act or s ( M edi ai RACs ) andt hepaym ent m et hodol gy f or St at epaym ent s t oM edi ai RACs . Thi r ul al odi ect s St at es t oas s ur et hat adequat eappeal oces s es ar ei pl cef or pr ovi er s t odi put eadver s edet er m i at i ns m adeby M edi ai RACs . Las t l , t her ul di ect s St at es t ocoor di at ew hot her cont r act or s andent i i s audi i gM edi ai pr ovi er s andw hSt at eandFeder al w or cem ent agenci s .
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Medicare Program; Proposed Changes to the Medicare Advantage      76 FR 63018         CMS                                                                                                                                  Th e p ro p o se d ru l e wo u l d re vi se th e M e d i care Ad van tage (M A) p ro gram (P art C ) re gu l ati o n s an d p re scri p ti o n d ru g b e n e fi t p ro gram (P art D) re gu l ati o n s to i mp l e me n t n e w statu to ry re q u i re me n ts; stre n gth e n b e n e fi ci ary p ro te cti o n s; e xcl u d e p l an p arti ci p an ts th at p e rfo rm p o o rl y; i mp ro ve p ro gram e ffi ci e n ci e s; an d cl ari fy p ro gram re q u i re me n ts. W e are al so co n si d e ri n g ch an ge s to th e l o n g te rm care faci l i ty co n d i ti o n s o f p arti ci p ati o n p e rtai n i n g to p h armacy se rvi ce s.




 Medicare Program; Final Waivers With Shared Savings Program      76 FR 67992         CMS                                                                                                                                                                                                                                         Thi i t er i f i al ul w hcom m ent per i des t abl hes w v er s of t heappl at i nof t hePhys i i nSel - Ref er r al , t heFeder al i ki kback s t at ut e, andcer t ai ci i onet ar y penal i s ( CM P) l w ovi i ns t os peci i dar r angem ent s i vol i gaccount abl car eor gani at i ns ( ACOs ) under s ect i n1899of t heSoci l
                                                                                                                                                                                                                                                                                                                                    sn m n r e i          t               o         s
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                                                                                                                                                                                                                                                                                                                                                                                                             c                   ca     f             Law            ant - c                             n vl m               te            a pr s o             fe                    n vn               e            z o                            o                       t                                   n                  n u n
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       aSecur i y Act ( t heAct ) ( t heShar edSavi gs Pr ogr am ) , i cl di gACOs par t i i at i gi t heAdvancePaym ent I ni i t i e. Sect i n1899( f ) of t heAct , as addedby t heAf f or dabl Car eAct , aut hor i es t heSecr et ar y t ow v ecer t ai f r audandabus el w as neces s ar y t ocar r y out t hepr ovi i ns of s ect i n1899of t heAct .
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 Medicare Program; Home Health Payment System Rate Update         76 FR 68526         CMS              s n r e                                            t             v
                                                                                                     Thi f i al ul s et s f or t hupdat es t ot hehom eheal hpr os pect i epaym ent s ys t em ( HHPPS) r at es , i cl di g: t henat i nal t andar di ed60- day epi oder at es ; t henat i nal - vi i r at es ; andt hel w i at i npaym ent am ount ( LUPA) under t heM edi ar ePPS f or hom eheal hagenci s ef f ect i eJ anuar y 1, 2012. Thi r ul appl s a1. 4per cent updat ef act or t ot heepi oder at es , w c hr ef l ct s a1per cent r educt i nappl dt ot he2. 4per cent m ar ket bas ket updat ef act or , as m andat edby t heAf f or dabl Car eAct . Thi r ul al oupdat es t hew i dex us edunder t heHHPPS, andf ur t her r educes hom eheal hpaym ent s t oaccount f or cont i uednom i al ow hi cas e- m i w c hi unr el t edt ochanges i pat i nt heal hs t at us . Thi r ul r em oves t w hyper t ens i ncodes f r om t heHHPPS cas e- m i s ys t em , t her eby r equi i gr ecal r at i nof t hecas e- m i w ght s . I naddi i n, t her ul i pl m ent s t w s t r uct ur al
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  Medicare Program; Payment Policies, Physician Fee Schedule      76 FR 73026         CMS             s n r e i    t               o                                   ca
                                                                                                    Thi f i al ul w hcom m ent per i daddr es s es changes t ot hephys i i nf ees chedul andot her M edi ar ePar t Bpaym ent pol i s t oens ur et hat our paym ent s ys t em s ar eupdat edt or ef l ct changes i m edi al act i eandt her el t i eval eof s er vi es . I t al oaddr es s es , i pl m ent s or di cus s es cer t ai s t at ut or y pr ovi i ns i cl di gpr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct , as am endedby t heHeal hCar eandEducat i nReconci t i nAct of 2010( col ct i el know as t heAf f or dabl Car eAct ) andt heM edi ar eI m pr ovem ent s f or Pat i nt s andPr ovi er s Act ( M I PPA) of 2008. I naddi i n, t hi f i al ul w hcom m ent per i ddi cus s es paym ent s f or Par t Bdr ugs ; Cl i al
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   Filings Required of Multiple Employer Welfare Arrangements     76 FR 76222   Employee Benefits Thi docum ent cont ai s apr opos edr ul under t i l I of t heEm pl yeeRet i em ent I ncom eSecur i y Act ( ERI SA) t hat , uponadopt i n, w di pl m ent r epor t i gr equi em ent s f or m ul i l em pl yer w f ar ear r angem ent s ( M EW As ) andcer t ai ot her ent i i s t hat of f er or pr ovi eheal hbenef i s f or em pl yees of t w or m or eem pl yer s . Thepr opos al ends exi t i gr epor t i gr ul s t oi cor por at enew ovi i ns enact edas par t of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( Af f or dabl Car eAct ) t om or ecl ar l addr es s t her epor t i gobl at i ns of M EW As t hat ar eERI SApl ns . Thi r egul t i ni des i nedt oi pos et hem i i al ount of bur denonl gal com pl nt M EW As andent i i s cl i i gexcept i n( ECEs ) w l i pl m ent i gt heSecr et ar y' aut hor i y t ot akeenf or cem ent act i nagai s t f r audul nt or abus i eM EW As i cl dedi t heAf f or dabl Car eAct andw ki gt opr ot ect heal hbenef i s f or bus i es s es andt hei em pl yees . Thi pr opos edr ul i pl m ent s t henew ovi i ns w l pr es er vi gt hef i gs t r uct ur eandpr ovi i ns of
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       Ex Parte Cease and Desist and Summary Seizure Orders       76 FR 76235   Employee Benefits  s                 n o                  e                 o
                                                                                                 Thi docum ent cont ai s t w pr opos edr ul s under t heEm pl yeeRet i em ent I ncom eSecur i y Act of 1974( ERI SA) t of aci at ei pl m ent at i nof new or cem ent aut hor i y pr ovi edt ot heSecr et ar y of Labor by t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( Af f or dabl Car eAct ) . TheAf f or dabl Car eAct aut hor i es t heSecr et ar y t oi s ueaceas eanddes i t or der , ex par t e( i e. w hout pr i r not i eor hear i g) , w i appear s t hat t heal gedconduct of am ul i l em pl yer w f ar ear r angem ent ( M EW A) i f r audul nt , cr eat es ani m edi t edanger t ot hepubl s af et y or w f ar e, or i caus i gor canber eas onabl expect edt ocaus es i ni i ant , i m i ent , andi r epar abl publ i j r y. TheSecr et ar y m ay al oi s ueas um m ar y s ei ur eor der w i appear s t hat aM EW Ai i af i anci l haz ar dous condi i n. Thef i s t pr opos edr egul t i nes t abl hes t hepr ocedur es f or t heSecr et ar y t oi s ueex par t eceas eanddes i t or der s ands um m ar y s ei ur eor der s w hr es pect t of r audul nt or i s ol ent M EW As . Thes econdpr opos edr egul t i n
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    Food Labeling; Nutrition Labeling of Standard Menu Items      76 FR 19192         FDA                                                                                                                                                                                                                   To implement the menu labeling provis ions of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), the Food and Drug Adminis tration (FDA) is propos ing requirements for providing certain nutrition information for s tandard menu items in certain chain res taurants and s imilar retail food es tablis hments .




  Food Labeling; Calorie Labeling of Food in Vending Machines     76 FR 19238         FDA                                                                                                                                                  To implement the vending machine labeling provisions of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), the Food and Drug Administration (FDA) is proposing requirements for providing calorie information for certain articles of food sold from vending machines.
                  Early Retiree Reinsurance Program                   75 FR 24450   HHS     sn m n r e i          t               o          m e
                                                                                          Thi i t er i f i al ul w hcom m ent per i d( I FC) i pl m ent s t heEar l Ret i eeRei s ur ancePr ogr am , w c hw es t abl hedby s ect i n1102of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) . TheCongr es s appr opr i t edf undi gof $5bi nf or t het em por ar y pr ogr am . Sect i n1102( a) ( 1) r equi es t heSecr et ar y t oes t abl ht hi t em por ar y pr ogr am not l t er t han90days af t er enact m ent of t hes t at ut e, w c hi J une21, 2010. Thepr ogr am ends nol t er t hanJ anuar y 1, 2014. Thepr ogr am pr ovi es r ei bur s em ent t opar t i i at i gem pl ym ent - bas edpl ns f or apor t i nof t hecos t of heal hbenef i s f or ear l r et i ees andt hei s pous es , s ur vi i gs pous es anddependent s . TheSecr et ar y w ei bur s epl ns f or cer t ai cl i s bet w $15, 000and$90, 000( w ht hos eam ount s bei gi dexedf or pl nyear s s t ar t i gonor af t er Oct ober 1, 2011) . Thepur pos eof t her ei bur s em ent i t om akeheal hbenef i s m or eaf f or dabl f or pl npar t i i ant s ands pons or s s ot hat heal hbenef i s ar eacces s i l t om or eAm er i ans
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       Health Care Reform Insurance Web Portal Requirements           75 FR 24470   HHS                                                                                                                                                                                             e              o
                                                                                                                                                                                                                                                                             ThePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) w enact edonM ar ch23, 2010. I t r equi es t hees t abl hm ent of ani t er net W ebs i e( her ei af t er r ef er r edt oas aW ebpor t al t hr oughw c hi di i ual ands m al i es s es canobt ai i f or m at i nabout t hei s ur ancecover ageopt i ns t hat m ay beavai bl t ot hem i t hei St at e. TheDepar t m ent of Heal handHum anSer vi es ( HHS) i i s ui gt hi i t er i f i al ul i or der t oi pl m ent t hi m andat e. Thi i t er i f i al ul adopt s t hecat egor i s of i f or m at i nt hat w col ct edanddi pl yedas W ebpor t al
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    Interim Final Rules for Group Health Plans, Children to Age 26    75 FR 27122   HHS                                                                                                                                                                                                                       This document contains interim final regulations implementing the requirements for group health plans and health ins urance is s uers in the group and individual markets under provis ions of the Patient Protection and Affordable Care Act regarding dependent coverage of children who have not att ained age 26.




Interim Final Rules, Group Health Plans, Grandfathered Health Plans   75 FR 34538   HHS                                                                                                                                                                           This document contains interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan.




PPACA: Preexisting Condition Exclusions, Lifetime and Annual Limits   75 FR 37188   HHS                                                                                                                                                                              This document contains interim final regulations implementing the rules for group health plans and health ins urance coverage in the group and individual markets under provis ions of the Patient Protection and Affordable Care Act regarding preexis ting condition exclus ions , lifetime and annual dollar limits on benefits , res cis s ions , and patient protections .




     Interim Final Rules, Group Health Plans, Preventive Services     75 FR 41726   HHS                                                                                                                                                                                             This document contains interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.




            Pre-Existing Condition Insurance Plan Program             75 FR 45014   HHS                                                                                                                                 o          te               e              o
                                                                                                                                                                                                                   Sect i n1101of Ti l I of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct of 2010( Af f or dabl Car eAct ) r equi es t hat t heSecr et ar y es t abl h, ei her di ect l or t hr oughcont r act s w hSt at es or nonpr of i pr i at eent i i s , at em por ar y hi hr i k heal hi s ur ancepool ogr am t opr ovi eaf f or dabl heal hi s ur ancecover aget ouni s ur edi di i ual w hpr e- exi t i gcondi i ns . Thi pr ogr am w
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                                                                                                                                                                                                                                                                                                                                                                                                                       i                      t v            te                      g s         t n              pr               d             e    t n                         n        n vd s i    t         s n        to         s            cont i ueunt i anuar y 1, 2014, w Exchanges es t abl hedunder s ect i ns 1311and1321of t heAf f or dabl Car eAct w avai bl f or i di i ual t oobt ai heal hi s ur ancecover age. Thi i t er i f i al ul i pl m ent s r equi em ent s i s ect i n1101of t heAf f or dabl Car eAct . Key i s ues addr es s edi t hi i t er i f i al ul i cl deadm i i t r at i nof t hepr ogr am , el i i y andenr ol ent , benef i s , pr em i m s , f undi g, andappeal andover s i ht r ul s .
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 Amendment: Group Health, Insurance, Grandfathered Health Plan        75 FR 70114   HHS                                                                                                                                                                    Th i s d o cu me n t co n tai n s an ame n d me n t to i n te ri m fi n al re gu l ati o n s i mp l e me n ti n g th e ru l e s fo r gro u p h e al th p l an s an d h e al th i n su ran ce co ve rage i n th e gro u p an d i n d i vi d u al marke ts u n d e r p ro vi si o n s o f th e P ati e n t P ro te cti o n an d Affo rd ab l e C are Act re gard i n g statu s as a gran d fath e re d h e al th p l an ; th e ame n d me n t p e rmi ts ce rtai n ch an ge s i n p o l i ci e s, ce rti fi cate s, o r co n tracts o f i n su ran ce wi th o u t l o ss o f gran d fath e re d statu s.




   Health Issuers Implementing Medical Loss Ratio Requirements        75 FR 74864   HHS                                                                                                                                                                                                                  This document contains the interim final regulation implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act).




                  Student Health Insurance Coverage                   76 FR 7767    HHS                                                                                                                                                                                                                                                                                                                s                 n                   a o           oul
                                                                                                                                                                                                                                                                                                                                                                                                     Thi docum ent cont ai s apr opos edr egul t i nt hat w des t abl hr ul s f or s t udent heal hi s ur ancecover ageunder t hePubl Heal hSer vi eAct andt heAf f or dabl Car eAct . Thepr opos edr ul w ddef i e“s t udent heal hi s ur ancecover age” as at ypeof i di i ual t hi s ur ancecover age, and, pur s uant t os ect i n1560( c) of t heAf f or dabl Car eAct , s peci y cer t ai Publ Heal hSer vi eAct andAf f or dabl Car eAct r equi em ent s as i appl abl t ot hi t ypeof i di i ual t hi s ur ancecover age.
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   Application, Reporting Process for Waivers for State Innovation    76 FR 13553   HHS                                                                                                                                                          This propos ed rule s ets forth a procedural framework for s ubmis s ion and review of initial applications for a W aiver for State Innovation des cribed in s ection 1332 of the Patient Protection and the Affordable Care Act including proces s es to ens ure opportunities for public input in the development of s uch applications by States and in the Federal review of the applications .




        Exclusion of Orphan Drugs for Certain Covered Entities        76 FR 29183   HHS                                      t                                    o                i
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                                                                                                           The“Vet er ans Heal hCar eAct of 1992, ” enact eds ect i n340Bof t hePubl Heal hSer vi eAct ( PHSA) “Li i at i nonPr i es of Dr ugs Pur chas edby Cover edEnt i i s . ” Sect i n340Bi pl m ent edadr ugpr i i gpr ogr am by w c hm anuf act ur er s w par t i i at ei M edi ai ar er equi edt os el
                                                                                                                                                                                        t       c                mt o           c                                        te             o      m e                   cn                 hi                      ho     cp n          c d           r         cover edout pat i nt dr ugs t opar t i ul r cover edent i i s l t edi t hes t at ut eandm us t agr eet ochar geapr i et hat w exceedt heam ount det er m i edunder as t at ut or y f or m ul . Them anuf act ur er ' obl at i nt os el nogr eat er t hant hecei gpr i eext ends onl t ocover edout pat i nt dr ugs anddoes not appl t oi pat i nt dr ugs . Cover edent i i s ar er equi edt oens ur et hat dr ugs pur chas edunder 340Bar eus edonl f or out pat i nt s . ThePat i nt Pr ot ect i nandAf f or dabl Car eAct expandedt het ypes of cover edent i i s el i l t opar t i i at ei t he340BDr ugPr i i gPr ogr am ( 340BPr ogr am ) under t hePHSAt oi cl decer t ai f r ees t andi gcancer hos pi al , r ur al ef er r al
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                 Rate Increase Disclosure and Review                  76 FR 29964   HHS                                                                                                                           Th i s fi n al ru l e wi th co mme n t p e ri o d i mp l e me n ts re q u i re me n ts fo r h e al th i n su ran ce i ssu e rs re gard i n g d i scl o su re an d re vi e w o f u n re aso n ab l e p re mi u m i n cre ase s u n d e r se cti o n 2 7 9 4 o f th e P u b l i c He al th Se rvi ce Act. Th e fi n al ru l e e stab l i sh e s a rate re vi e w p ro gram to e n su re th at al l rate i n cre ase s th at me e t o r e xce e d a sp e ci fi e d th re sh o l d are re vi e we d b y a State o r C M S to d e te rmi n e wh e th e r th e y are u n re aso n ab l e an d th at ce rtai n rate i n fo rmati o n b e mad e p u b l i c.




           Group Health Plans and Health Insurance Issuers            76 FR 37208   HHS                                                                                                                                                                                                                                                                                        s
                                                                                                                                                                                                                                                                                                                                                                             Thi docum ent cont ai s am endm ent s t oi t er i f i al egul t i ns i pl m ent i gt her equi em ent s r egar di gi t er nal ai s andappeal andext er nal evi w oces s es f or gr oupheal hpl ns andheal hi s ur ancecover agei t hegr oupandi di i ual ar ket s under pr ovi i ns of t heAf f or dabl Car eAct . Thes er ul s ar ei t endedt or es pondt of eedback f r om aw er angeof s t akehol er s ont hei t er i f i al egul t i ns andt oas s i t pl ns andi s uer s i com i gi t of ul
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      Administrative Simplification: Adoption of Operating Rules      76 FR 40458   HHS                                                                                                                                                                                                         o                 ns
                                                                                                                                                                                                                                                                                           Sect i n1104of t heAdm i i t r at i eSi pl i at i npr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( her eaf t er r ef er r edt oas t heAf f or dabl Car eAct ) es t abl hes new equi em ent s f or adm i i t r at i et r ans act i ns t hat w pr ovet heut i y of t heexi t i gHI PAAt r ans act i ns andr educeadm i i t r at i ecos t s . Speci i al , i s ect i n1104( b) ( 2) of t heAf f or dabl Car eAct , Congr es s r equi edt headopt i nof oper at i gr ul s f or t heheal hcar ei dus t r y anddi ect edt heSecr et ar y of Heal handHum anSer vi es t o“adopt as i gl s et of oper at i gr ul s f or eacht r ans act i n***w ht hegoal cr eat i gas m uchuni or m i y i t hei pl m ent at i nof t heel ct r oni s t andar ds as pos s i l . ”
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           Affordable Care Act; Establishment of Exchanges            76 FR 41866   HHS                                                                                                                                                          s              e oul m e              Af
                                                                                                                                                                                                                                               Thi pr opos edr ul w di pl m ent t henew f or dabl I ns ur anceExchanges ( “Exchanges ”) , cons i t ent w ht i l I of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct of 2010( Pub. L. 111- 148) as am endedby t heHeal hCar eandEducat i nReconci t i nAct of 2010( Pub. L. 111- 152) , r ef er r edt ocol ct i el as t heAf f or dabl Car eAct . TheExchanges w ovi ecom pet i i em ar ket pl ces f or i di i ual ands m al pl yer s t odi ect l com par eavai bl pr i at eheal hi s ur anceopt i ns ont hebas i of pr i e, qual y, andot her f act or s . TheExchanges , w c hw
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        Affordable Care Act; Standards Related to Reinsurance         76 FR 41930   HHS             s              e oul m e                                     a           n
                                                                                                  Thi pr opos edr ul w di pl m ent s t andar ds f or St at es r el t edt or ei s ur anceandr i k adj s t m ent , andf or heal hi s ur ancei s uer s r el t edt or ei s ur ance, r i k cor r i or s , andr i k adj s t m ent cons i t ent w ht i l I of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct as am endedby t heHeal hCar eandEducat i nReconci t i nAct of 2010, r ef er r edt ocol ct i el as t heAf f or dabl Car eAct . Thes epr ogr am s w i i at et hei pact of pot ent i l
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          aadver s es el ct i nands t abi epr em i m s i t hei di i ual s m al oupm ar ket s as i s ur ancer ef or m s andt heAf f or dabl I ns ur anceExchanges ( “Exchanges ”) ar ei pl m ent ed, s t ar t i gi 2014. Thet r ans i i nal at e- bas edr ei s ur ancepr ogr am s er ves t or educet heuncer t ai t y of i s ur ancer i k i t hei di i ual ar ket by m aki gpaym ent s f or hi h- cos t cas es . Thet em por ar y Feder al - adm i i t er edr i k cor r i or pr ogr am s er ves t opr ot ect agai s t uncer t ai t y i t heExchangeby l i i gt heext ent of i s uer l s s es ( andgai s ) . Onanongoi gbas i , t heSt at e- bas edr i k adj s t m ent pr o
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  Patient Protection and Affordable Care Act; Establishment CO-OP     76 FR 43237   HHS                                                                                                                                                                                                                                                                                                                s              e oul m e                                      e
                                                                                                                                                                                                                                                                                                                                                                                                     Thi pr opos edr ul w di pl m ent t heCons um er Oper at edandOr i nt edPl n( CO- OP) pr ogr am , w c hpr ovi es l ans t of os t er t hecr eat i nof cons um er - gover ned, pr i at e, nonpr of i heal hi s ur ancei s uer s t oof f er qual i dheal hpl ns i t heAf f or dabl I ns ur anceExchanges ( Exchanges ) . Thepur pos eof t hi pr ogr am i t ocr eat eanew OPi ever y St at ei or der t oexpandt henum ber of heal hpl ns avai bl i t heExchanges w haf ocus oni t egr at edcar eandgr eat er pl naccount abi y.
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           Group Health Plans and Health Insurance Issuers            76 FR 46621   HHS                                                                                                                                                                This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.




    Summary of Benefits and Coverage and the Uniform Glossary         76 FR 52442   HHS                                                                                                                                                                                                                                                                         Thi docum ent cont ai s pr opos edr egul t i ns r egar di gdi cl s ur eof t hes um m ar y of benef i s andcover ageandt heuni or m gl s s ar y f or gr oupheal hpl ns andheal hi s ur ancecover agei t hegr oupandi di i ual ar ket s under t hePat i nt Pr ot ect i nandAf f or dabl Car eAct . Thi docum ent i pl m ent s t hedi cl s ur er equi em ent s t ohel pl ns andi di i ual bet t er under s t andt hei heal hcover age, as w l ot her cover ageopt i ns . Thet em pl t es andi s t r uct i ns t obeus edi m aki gt hes edi cl s ur es ar ebei gi s ueds epar at el i t oday' Feder al s t er .
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     Administrative Simplification: Adoption of Standards for EFTs    77 FR 1556    HHS                                                                                                                                                      This interim final rule with comment period implements parts of section 1104 of the Affordable Care Act which requires the adoption of a standard for electronic funds transfers (EFT). It defines EFT and explains how the adopted standards support and facilitate health care EFT transmissions.




           Group Health Plans and Health Insurance Issuers            75 FR 27141   IRS                                   ss n                         ai                     so
                                                                                                                     I RS i i s ui gt em por ar y r egul t ons under t hepr ovi i ns of t hePat ent Pr ot ect onandAf or dabl Car eAct ( t heAf or dabl Car eAct ) deal gw hcover ageof dependent chi r ent oage26. TheI RS i i s ui gt het em por ar y r egul t ons at t hes am et m et hat t heEm pl yeeBenef t s Secur i y Adm i i t r at onof t heU. S. Depar t m ent of Labor andt heOf i ceof Cons um er I nf or m at onandI ns ur anceOver s i ht of t heU. S. Depar t m ent of Heal handHum anSer vi es ar ei s ui gs ubs t ant al s i i r i t er i f nal egul t ons w hr es pect t ogr oupheal hpl ns andheal hi s ur ancecover ageof er edi connect onw hagr oupheal hpl nunder t heEm pl yeeRet r em ent I ncom eSecur i y Act of 1974andt hePubl Heal hSer vi eAct . Thet em por ar y r egul t ons pr ovi egui ancet oem pl yer s , gr oupheal hpl ns , andheal hi s ur ancei s uer s pr ovi i ggr oupheal hi s ur ancecover age. Thet ext of t hos et em por ar y r egul t ons al os er ves as t het ext of t hes epr opos edr egul t ons .
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       Indoor Tanning Services; Cosmetic Services; Excise Taxes       75 FR 33683   IRS                                                                                                                                                                                                                                                                                                         s                 n n and                       a o                 d d
                                                                                                                                                                                                                                                                                                                                                                                              Thi docum ent cont ai s f i al t em por ar y r egul t i ns t hat pr ovi egui anceont hei door t anni gs er vi es exci et ax i pos edby t hePat i nt Pr ot ect i nandAf f or dabl Car eAct . Thes ef i al t em por ar y r egul t i ns af f ect per s ons t hat us e, pr ovi e, or pay f or i door t anni gs er vi es . Thet ext of t hes et em por ar y r egul t i ns al os er ves as t het ext of t hepr opos edr egul t i ns s et f or t hi t henot i eof pr opos edr ul m aki gont hi s ubj ct i t hePr opos edRul s s ect i nof t hi i s ueof t heFeder al s t er .
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       Group Health Plans and Health Insurance Coverage Rules         75 FR 34571   IRS                 s her n s s                      Regi
                                                                                                       El ew ei t hi i s ueof t heFeder al s t er , t heI RS i i s ui gt em por ar y r egul t i ns under t hepr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) deal gw hr ul s r el t i gt os t at us as agr andf at her edheal hpl n. TheI RS i i s ui gt het em por ar y r egul t i ns at t hes am et i et hat t heEm pl yeeBenef i s Secur i y Adm i i t r at i nof t heU. S. Depar t m ent of Labor andt heOf f i eof Cons um er I nf or m at i nandI ns ur anceOver s i ht of t heU. S. Depar t m ent of Heal handHum anSer vi es ar ei s ui gs ubs t ant i l s i i r i t er i f i al egul t i ns w hr es pect t ogr oupheal hpl ns andheal hi s ur ancecover ageof f er edi connect i nw hagr oupheal hpl nunder t heEm pl yeeRet i em ent I ncom eSecur i y Act of 1974andt hePubl Heal hSer vi eAct . Thet em por ar y r egul t i ns pr ovi egui ancet oem pl yer s , gr oupheal hpl ns , andheal hi s ur ancei s uer s pr ovi i ggr oupheal hi s ur ancecover age. Thet ext of t hos et em por ar y r egul t i ns al os er ves as t het ext of t hes epr opos edr egul t i ns
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      Requirements for Group Health Plans, Affordable Care Act        76 FR 37037   IRS              s her n s s                      Regi                ss n
                                                                                                    El ew ei t hi i s ueof t heFeder al s t er , t heI RS i i s ui ganam endm ent t ot em por ar y r egul t i ns publ hedJ ul 23, 2010under t hepr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) r egar di gi t er nal ai s andappeal andext er nal evi w oces s es . TheI RS i i s ui gt het em por ar y r egul t i ns at t hes am et i et hat t heEm pl yeeBenef i s Secur i y Adm i i t r at i nof t heU. S. Depar t m ent of Labor andt heCent er f or Cons um er I nf or m at i n&I ns ur anceOver s i ht of t heU. S. Depar t m ent of Heal handHum anSer vi es ar ei s ui gas ubs t ant i l s i i r am endm ent t oi t er i f i al egul t i ns publ hedJ ul 23, 2010w hr es pect t ogr oupheal hpl ns andheal hi s ur ancecover ageof f er edi connect i nw hagr oupheal hpl nunder t heEm pl yeeRet i em ent I ncom eSecur i y Act of 1974andt hePubl Heal hSer vi eAct . Thet em por ar y r egul t i ns pr ovi egui ancet oem pl yer s , gr oupheal hpl ns , andheal hi s ur ancei s uer s pr ovi i ggr oupheal hi s ur ancecover age. Thet ext of t hos
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 Requirements for Group Health Plans and Health Insurance Issuers     75 FR 37242   IRS                                                                                                             s n                        a o
                                                                                                                                                          Tr eas ur y Depar t m ent andt heI RS ar ei s ui gt em por ar y r egul t i ns under t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) r el t i gt opr eexi t i gcondi i nexcl s i ns , l et i eandannual i s , r es ci s i ns , andpat i nt pr ot ect i ns . Thos et em por ar y r egul t i ns ar ebei gi s uedat t hes am et i et hat t heEm pl yeeBenef i s Secur i y Adm i i t r at i nof t heU. S. Depar t m ent of Labor andt heOf f i eof Cons um er I nf or m at i nandI ns ur anceOver s i ht of t heU. S. Depar t m ent of Heal handHum anSer vi es ar ei s ui gs ubs t ant i l s i i r i t er i f i al egul t i ns under t heEm pl yeeRet i em ent I ncom eSecur i y Act of 1974andt hePubl Heal hSer vi eAct . Thet em por ar y r egul t i ns pr ovi egui ancet oem pl yer s , gr oupheal hpl ns , andheal hi s ur ancei s uer s pr ovi i ggr oupheal hi s ur ancecover age. Thet ext of t hos et em por ar y r egul t i ns al os er ves as t het ext of t hes epr opos edr egul t i ns .
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 Requirements for Group Health Plans and Health Insurance Issuers     76 FR 46677   IRS                ss n                                          a o         s
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                                                                                                  I RS i i s ui ganam endm ent t ot em por ar y r egul t i ns publ hedJ ul 19, 2010, under t hepr ovi i ns of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct ( t heAf f or dabl Car eAct ) r el t i gt ocover ageof pr event i es er vi es w hout any par t i i ant cos t s har i g. TheI RS i i s ui gt het em por ar y r egul t i ns at t hes am et i et hat t heEm pl yeeBenef i s Secur i y Adm i i t r at i nof t heU. S. Depar t m ent of Labor andt heCent er f or Cons um er I nf or m at i n&I ns ur anceOver s i ht of t heU. S. Depar t m ent of Heal handHum anSer vi es ar ei s ui gas ubs t ant i l s i i r am endm ent t oi t er i f i al egul t i ns publ hedJ ul 19, 2010w hr es pect t ogr oupheal hpl ns andheal hi s ur ancecover ageof f er edi connect i nw hagr oupheal hpl nunder t heEm pl yeeRet i em ent I ncom eSecur i y Act of 1974andt hePubl Heal hSer vi eAct . Thet em por ar y r egul t i ns pr ovi egui ancet oem pl yer s , gr oupheal hpl ns , andheal hi s ur ancei s uer s pr ovi i ggr oupheal hi s ur ancecover age. Thet ext of t hos et em por ar y r egul t i ns al os er ves as
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                Health Insurance Premium Tax Credit                   76 FR 50931   IRS                                                                                                                                   s                 n
                                                                                                                                                                                                                        Thi docum ent cont ai s pr opos edr egul t i ns r el t i gt ot heheal hi s ur ancepr em i m t ax cr edi enact edby t hePat i nt Pr ot ect i nandAf f or dabl Car eAct andt heHeal hCar eandEducat i nReconci t i nAct of 2010, as am endedby t heM edi ar eandM edi ai Ext ender s Act of 2010, t heCom pr ehens i e1099Taxpayer Pr ot ect i nandRepaym ent of ExchangeSubs i y Over paym ent s Act of 2011, andt heDepar t m ent of Def ens eandFul Year Cont i ui gAppr opr i t i ns Act , 2011. Thes epr opos edr egul t i ns pr ovi egui ancet oi di i ual w enr ol qual i dheal hpl ns t hr oughAf f or dabl I ns ur anceExchanges andcl i t hepr em i m t ax cr edi , andt oExchanges t hat m akequal i dheal hpl ns avai bl t oi di i ual andem pl yer s . Thi docum ent al opr ovi es not i eof apubl hear i gont hes epr opos edr egul t i ns .
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                    Branded Prescription Drug Fee                     76 FR 51245   IRS                                                                                                                                                                                        s
                                                                                                                                                                                                                                                                             Thi docum ent cont ai s t em por ar y r egul t i ns t hat pr ovi egui anceont heannual eei pos edoncover edent i i s engagedi t hebus i es s of m anuf act ur i gor i por t i gbr andedpr es cr i t i ndr ugs . Thi f eew enact edby s ect i n9008of t hePat i nt Pr ot ect i nandAf f or dabl Car eAct , as am endedby s ect i n1404of t heHeal hCar eandEducat i nReconci t i nAct of 2010. Ther egul t i ns af f ect per s ons engagedi t hebus i es s of m anuf act ur i gor i por t i gcer t ai br andedpr es cr i t i ndr ugs . Thet ext of t het em por ar y r egul t i ns al os er ves as t het ext of t hepr opos edr egul t i ns s et f or t hi t henot i eof pr opos edr ul m aki gont hi s ubj ct i t hePr opos edRul s s ect i nof t hi i s ueof t heFeder al s t er .
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               Color Denotes Open Comment Period
Private Costs (Millions)          Affected Entity          State Costs (Millions)   Burden Hours   Cumulative         Link        Calculation
           0.0                       Providers                      0.0                   0                     http://federalregister.gov/a/2010-10505
           0.0                        States                        0.26                7,330          X                             0.263
                                                                                                                http://www.federalregister.gov/a/2010-2335
          12.81              Home Health Providers                   0                 429,046                                   12819894.5
                                                                                                                http://www.federalregister.gov/a/2010-2777
          68.7         Medicare Suppliers and Providers              0                1,920,575                 http://www.federalregister.gov/a/2011-2275
          358.9        Medicare Suppliers and Providers            40.95               366,000         X                             399.8
                                                                                                                http://www.federalregister.gov/a/2011-1686
          10.93             Long-Term Care Facilities                0                    0                                         10.931
                                                                                                                http://www.federalregister.gov/a/2011-3806
            0                     State Medicaid                   1,540                  0            X        http://www.federalregister.gov/a/2011-3946
          15.4                    Nursing Homes                      0                    0                     http://www.federalregister.gov/a/2011-6144
          451.0    Medicare Accountable Care Organizations           0                    0                     http://www.federalregister.gov/a/2011-7880
         102.49            MA, Part D Sponsors, FY 2011-16;         0.02               979,957         X                            102.49
                                                                                                                http://www.federalregister.gov/a/2011-8274
                                      States                       0.034                 840           X        http://www.federalregister.gov/a/2011-9340
          1.43          Inpatient Rehabilitation Facilities          0                 34,560                   http://www.federalregister.gov/a/2011-1951
          29.93                  Nursing Facilities                  0                 913,884                  http://www.federalregister.gov/a/2011-1954
            0                  Psychiatric Facilities                0                    0                     http://www.federalregister.gov/a/2011-1056
          0.190               Hospitals, Physicians                  0                  6,360                                      190036.8
                                                                                                                http://www.federalregister.gov/a/2011-1056
            0                     State Medicaid                   0.043                4,023                   http://federalregister.gov/a/2011-13819
           86          Medicare Suppliers and Providers              0                 24,250                   http://www.federalregister.gov/a/2011-1400
          87.1                 Medicare Providers                    0                1,180,450                                      87.13
                                                                                                                http://www.federalregister.gov/a/2011-2860
          5.69                      Physicians                       0                 190,574                                  5694351.12
                                                                                                                http://www.federalregister.gov/a/2011-1693
          2.55                       Hospitals                       0                 138,032         X        http://www.federalregister.gov/a/2011-2861
          0.181               Drug Manufacturers                     0                 34,775                   http://www.federalregister.gov/a/2011-1697
            0                         States                         0                    0                     http://federalregister.gov/a/2011-19528
            0                         States                       32.68             11,079,732                 http://www.federalregister.gov/a/2011-2075
            0                        Hospitals                       0                    0                     http://www.federalregister.gov/a/2011-1971
            0                         States                       0.376                8,008                   http://www.federalregister.gov/a/2011-2369
         530.41 Providers, Manufacturers, Part D Sponsors            0                 283,502         X                            530.41
                                                                                                                http://www.federalregister.gov/a/2011-2584
            0           Acccountable Care Organizations              0                    0                     http://federalregister.gov/a/2011-27460
            0                  Medicare Providers                    0                    0                     http://www.federalregister.gov/a/2011-2841
          0.63                 Medicare Providers                    0                 219,955                  http://www.federalregister.gov/a/2011-2859
          0.30                        MEWAs                          0                   272                                         0.30
                                                                                                                http://www.federalregister.gov/a/2011-3091
          0.18                        MEWAs                          0                   20                     http://www.federalregister.gov/a/2011-3092
          757.1                 Chain Restaurants                    0                 622,072         X                             757.1
                                                                                                                http://www.federalregister.gov/a/2011-7940
          64.9                  Vending Machines                     0                 842,048                                       64.9
                                                                                                                http://www.federalregister.gov/a/2011-8037
39.8       Employers, Plan Sponsors             0       854,675    X   http://www.federalregister.gov/a/2010-1065
6.18               Health Issuers               0       84,706     X   http://www.federalregister.gov/a/2010-1050
32.71         ERISA Covered Plans               0       822,000                             32.71
                                                                       http://www.gpo.gov/fdsys/pkg/FR-2010-05-1
71.8               Health Issuers               0       591,000    X                        71.8
                                                                       http://www.federalregister.gov/a/2010-1448
 4.9       Health Issuers, Employers            0       38,625         http://www.federalregister.gov/a/2010-1527
  0                   Issuers                   0          0           http://www.federalregister.gov/a/2010-1724
  0                    States                  1.93     103,244    X   http://www.federalregister.gov/a/2010-1869
0.26               Health Issuers               0        3,845         http://www.federalregister.gov/a/2010-2886
 228               Health Issuers               0      1,288,940   X                         228
                                                                       http://www.federalregister.gov/a/2010-2959
  6                Health Issuers               0       75,000                                6
                                                                       http://www.federalregister.gov/a/2011-3109
  0                    States                   0          0           http://www.federalregister.gov/a/2011-5583
  0           Drug Manufacturers                0          0           http://federalregister.gov/a/2011-12423
22.8              Issuers, States               0       11,902     X                        22.8
                                                                       http://www.federalregister.gov/a/2011-1263
  0               Issuers, States             161.54   2,789,844   X                       161.54
                                                                       http://www.federalregister.gov/a/2011-1589
5,958   Hospitals, Physicians, Health Plans     0          0                                5958
                                                                       http://www.federalregister.gov/a/2011-1683
57.2              Issuers, States             427.9    1,143,288   X                       485.10
                                                                       http://www.federalregister.gov/a/2011-1761
7.65              Issuers, States              0.91     144,281        http://www.federalregister.gov/a/2011-1760
 10                   Issuers                   0          0       X   http://www.federalregister.gov/a/2011-1834
  0               Issuers, States               0          0           http://federalregister.gov/a/2011-19684
 156       Third Party Administrators           0      3,140,000   X   http://www.federalregister.gov/a/2011-2119
 38                Health Issuers               0          0       X                   http://www.federalregister.g
                                                                       http://www.federalregister.gov/a/2012-132/p
  0            Group Health Plans               0          0           http://www.gpo.gov/fdsys/pkg/FR-2010-05-1
  0              Tanning Services               0       10,000         http://federalregister.gov/a/2010-14398
  0            Group Health Plans               0          0           http://federalregister.gov/a/2010-14487
  0        Employers, Plan Sponsors             0          0           http://federalregister.gov/a/2011-15891
  0                   Issuers                   0          0           http://federalregister.gov/a/2010-15277
  0                   Issuers                   0          0           http://federalregister.gov/a/2011-19685
  0           Insurance Exchanges               0          0           http://federalregister.gov/a/2011-20728
  0           Drug Manufacturers                0          0           http://www.federalregister.gov/a/2011-2101
ter.gov/a/2010-10505
             http://www.federalregister.gov/a/2010-23357/p-211
             http://www.federalregister.gov/a/2010-27778/p-1124
             http://www.federalregister.gov/a/2011-2275/p-121
                       http://www.federalregister.gov/a/2011-1686/p-1498
                                  http://www.federalregister.gov/a/2011-1686/p-1520
             http://www.federalregister.gov/a/2011-1686/p-1446
             http://www.federalregister.gov/a/2011-3806/p-105
alregister.gov/a/2011-3946/p-149
alregister.gov/a/2011-6144/p-233
alregister.gov/a/2011-7880/p-1108
             http://www.federalregister.gov/a/2011-8274/p-1386
alregister.gov/a/2011-9340/p-245
alregister.gov/a/2011-19516/p-688
             http://www.federalregister.gov/a/2011-10555/p-398
alregister.gov/a/2011-10562/p-443

             http://www.federalregister.gov/a/2011-13819/p-343
                       http://www.federalregister.gov/a/2011-31232/p-267
             http://www.federalregister.gov/a/2011-31232/p-252
                       http://www.federalregister.gov/a/2011-16874/p-615
             http://www.federalregister.gov/a/2011-16874/p-608
             http://www.federalregister.gov/a/2011-16937/p-70
alregister.gov/a/2011-28612/p-3670
alregister.gov/a/2011-16972/p-2139
ter.gov/a/2011-19528
alregister.gov/a/2011-20756/p-490
alregister.gov/a/2011-19719/p-4206
alregister.gov/a/2011-23695/p-512
             http://www.federalregister.gov/a/2011-25844/p-630
ter.gov/a/2011-27460
alregister.gov/a/2011-28416/p-740
alregister.gov/a/2011-28597/p-4090
                       http://www.federalregister.gov/a/2011-30918/p-88
             http://www.federalregister.gov/a/2011-30918/p-83
alregister.gov/a/2011-30921/p-99
                       http://www.regulations.gov/#!documentDetail;D=FDA-2011-F-0172-0032
             http://www.federalregister.gov/a/2011-7940/p-429
             http://www.federalregister.gov/a/2011-8037/p-127
             http://www.federalregister.gov/a/2010-10658/p-154
alregister.gov/a/2010-10504/p-134
             http://federalregister.gov/a/2010-11391
                        http://www.federalregister.gov/a/2010-14488/p-226
             http://www.federalregister.gov/a/2010-14488/p-205
alregister.gov/a/2010-15278/p-375
alregister.gov/a/2010-17242/p-65
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alregister.gov/a/2010-28861/p-63
                        http://www.federalregister.gov/a/2010-29596/p-520
                                     http://www.federalregister.gov/a/2011-31289/p-115
                                               http://federalregister.gov/a/2011-31291
             http://www.federalregister.gov/a/2010-29596/p-389
             http://www.federalregister.gov/a/2011-3109/p-99
             http://www.federalregister.gov/a/2011-5583/p-140
ter.gov/a/2011-12423
             http://www.federalregister.gov/a/2011-12631/p-162
ww.federalregister.gov/a/2011-15890/p-223
                        http://www.federalregister.gov/a/2011-16834/p-180
                                     http://www.federalregister.gov/a/2011-16834/p-180
             http://www.federalregister.gov/a/2011-16834/p-328
             http://www.federalregister.gov/a/2011-17610/p-536
             http://www.federalregister.gov/a/2011-17609/p-213
             http://www.federalregister.gov/a/2011-31864/p-303
ter.gov/a/2011-19684
alregister.gov/a/2011-21193/p-225
tp://www.federalregister.gov/a/2012-132/p-325
             http://federalregister.gov/a/2010-11393
             http://www.federalregister.gov/a/2010-14396/p-14
ter.gov/a/2010-14487
ter.gov/a/2011-15891
ter.gov/a/2010-15277
             http://federalregister.gov/a/2010-17243
ter.gov/a/2011-20728
alregister.gov/a/2011-21011/p-15

				
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