Administrative Rules May 8, 2009
The following final rules and notices were published in the May 6th edition of the Iowa Administrative Bulletin
Human Services Department Filed, Applicant’s/participant’s responsibility to provide information or verification to department, ARC 7740B (Notice ARC 7386B). Pursuant to the authority of Iowa Code sections 234.6, 239B.4(6), and 249A.4, the
Department of Human Services amends Chapter 40, “Application for Aid,” Chapter 76, “Application and Investigation,” and Chapter 170, “Child Care Services.” These amendments clarify that the applicant or participant for Family Investment Program assistance, medical assistance, or child care assistance has the primary responsibility for providing information and verification needed for the Department to establish eligibility and benefits. If the applicant or participant fails to supply the information or verification requested and does not request assistance and authorize the Department to obtain the specific information or verification, that failure is a basis for denial or cancellation of assistance. The Department has recently added a general release of information to applications and review documents used for these programs. If the applicant or participant signs the optional general release of information, the Department may be able to use the release to help obtain information from third parties to determine eligibility and benefits. In some instances, the use of a general release of information will allow the Department to assist the client in obtaining the necessary information more quickly. The reason for these amendments is to clarify that signing the optional general release does not absolve the applicant or participant from all responsibility for providing requested information or verification. Use of the general release is not appropriate in all instances, and, due to the general nature of the form, it will not always be honored by collateral contacts. When the Department needs specific information, the Department will notify the client. If the client is not able to provide the information, the client is responsible for asking the Department worker for help and for giving a specific authorization for the Department to obtain the requested information. These amendments shall become effective on June 10, 2009.
Iowa Public Employees’ Retirement System Notice, Additional employer contributions from employer-mandated reduction in hours, ARC 7760B.
Pursuant to the authority of Iowa Code sections 97B.4 and 97B.15, the Iowa Public Employees’ Retirement System (IPERS) hereby gives Notice of Intended Action to amend Chapter 4, “Employers,” Chapter 6, “Covered Wages,” and Chapter 15, “Dividends.” IPERS proposes the following amendments as a result of 2009 Iowa Acts, House File 414, section 51, which authorizes an IPERS program for restoring a member’s three-year average covered wages when that amount has been decreased by an employer-mandated reduction in hours. The amendments also remove citations to 2008 Iowa Acts now codified in the 2009 Code of Iowa. None of these amendments are subject to requests for waivers; however, the amendments are subject to IPERS’ normal appeal process. Written comments must be submitted by May 26, 2009.
Filed Emergency, Additional employer contributions from employer-mandated reduction in hours, ARC 7759B (Notice ARC 7760B). Pursuant to the authority of Iowa Code sections 97B.4 and 97B.15, the Iowa Public
Employees’ Retirement System (IPERS) hereby amends Chapter 4, “Employers,” Chapter 6, “Covered Wages,” and Chapter 15, “Dividends.” IPERS adopts the following amendments as a result of 2009 Iowa Acts, House File 414, section 51, which authorizes an IPERS program for restoring a member’s three-year average covered wages when that amount has been decreased by an employer-mandated reduction in hours. The amendments also remove citations to 2008 Iowa Acts now codified in the 2009 Code of Iowa. In compliance with legislative action pursuant to 2009 Iowa Acts, House File 414, section 51, IPERS adopts these rules as a double-barreled action with an Adopted and Filed Emergency filing at the same time as the Notice of Intended Action. IPERS finds that, pursuant to Iowa Code section 17A.4(3), because these amendments are beneficial to members and necessary to the current and ongoing administration of the system, additional notice and public participation prior to implementation are impracticable, unnecessary, and contrary to the public interest. IPERS also finds, pursuant to Iowa Code section 17A.5(2)“b”(1) and (2), that the normal effective date of these amendments should be waived and these amendments should be made effective upon filing with the Administrative Rules
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Coordinator on April 17, 2009, because these amendments confer benefits and are required to implement the system’s governing statutes. These amendments became effective April 17, 2009.
Medicine Boards Filed, Preliminary notice of denial—public record, ARC 7756B (Notice ARC 7607B). Pursuant to the
authority of Iowa Code sections 147.76 and 148.13, the Board of Medicine hereby amends Chapter 9, “Permanent Physician Licensure.” This amendment is intended to inform applicants that the preliminary notice of denial is a public record and that the applicant will be notified of the appeal process. This amendment will become effective June 10, 2009.
The following notices and rules appeared in the Federal Register
Agency for Healthcare Research & Quality Evaluation of AHRQ's Effective Health Care Program This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection under the project: ``Evaluation of AHRQ's Effective Health Care Program.'' In accordance with the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A)), AHRQ invites the public to comment on this proposed information collection. Comments on this notice must be received by June 23, 2009. (April 24, 2009).
Building an Implementation Toolset for E-Prescribing This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project: ``Building an Implementation Toolset for E-Prescribing.'' In accordance with the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A)), AHRQ invites the public to comment on this proposed information collection. Comments on this notice must be received by June 23, 2009. (April 24, 2009).
Centers for Medicare & Medicaid Services Medicare Program: Proposed Hospice Wage Index (Fiscal Year 2010). This proposed rule would set forth the
hospice wage index for fiscal year 2010. The proposed rule would adopt a MedPAC recommendation regarding a process for certification and recertification of terminal illness. This proposed rule would also continue the phase-out of the wage index budget neutrality adjustment factor (BNAF), which will conclude in 2011. In addition, we are requesting comments on a suggestion to require recertification visits by physicians or advanced practice nurses, and on issues of payment reform for use in possible future policy development. Finally, the proposed rule would make several technical and clarifying changes to the regulatory text. Comments must be received by June 22, 2009. (April 24, 2009).
Health & Human Services Department American Recovery and Reinvestment Act of 2009: Guidance Specifying Technologies and Methodologies that Render Protected Health Information Unusable, etc. This document is guidance and a request for comments under
section 13402 of the Health Information Technology for Economic and Clinical Health (HITECH) Act, Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5). ARRA was enacted on February 17, 2009. The HITECH Act (the Act) at section 13402 requires the Department of Health and Human Services (HHS) to issue interim final regulations within 180 days of enactment to require covered entities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and their business associates to provide for notification in the case of breaches of unsecured protected health information. For purposes of these requirements, section 13402(h) of the Act defines `unsecured protected health information'' to mean protected health information that is not secured through the use of a technology or methodology specified by the Secretary in guidance, and requires the Secretary to issue such guidance no later than 60 days after enactment and to specify within the technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals. Through this document, HHS is issuing the required guidance and seeking public comment both on the
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guidance as well as the breach notification provisions of the Act generally to inform the future rulemaking and updates to the guidance. Comments must be submitted by May 21, 2009. (April 27, 2009).
Centers for Medicare & Medicaid Services Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Request for Information. This document is a request for comments regarding issues under the Paul Wellstone and Pete Domenici
Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments) invite public comments in advance of future rulemaking. Comments must be submitted by May 28, 2009. (April 28, 2009).
Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System Payment Update for Rate Year Beginning July 1, 2009 (RY 2010). This notice updates the payment rates for the Medicare prospective payment
system (PPS) for inpatient psychiatric hospital services provided by inpatient psychiatric facilities (IPFs). These changes are applicable to IPF discharges occurring during the rate year beginning July 1, 2009 through June 30, 2010. We are also requesting comments on the IPF PPS teaching adjustment and the market basket. The updated IPF prospective payment rates are effective for discharges occurring on or after July 1, 2009 through June 30, 2010. Comments must be received by June 30, 2009. (May 1, 2009).
Health Resources & Services Administration /Bureau of Primary Health Care Capital Improvement Program Application National Environmental Policy Act (NEPA) Requirements (NEW) The American Recovery and Reinvestment Act (ARRA) provides $1.5 billion in grants
to support construction, renovation and equipment, and the acquisition of health information technology systems, for health centers, including health center controlled networks receiving operating grants under section 330 of the Public Health Service (PHS) Act, as amended (42 U.S.C. 254b). HRSA is requesting emergency processing procedures for the Environmental Information and Documentation portion of the application because this information is needed before the expiration of the normal time limits under regulations at 5 CFR part 1320 to ensure the timely availability of data to make award determinations for receipt of funds under ARRA. Of the $1.5 billion, HRSA will award approximately $850 million, through limited competition grants, for one-time Capital Improvement Program (CIP) grant funding in fiscal year (FY) 2009 to support existing section 330 funded health centers. Funding under this opportunity will address pressing capital improvement needs in health centers, such as construction, repair, renovation, and equipment purchases, including health information technology systems. Applicants must provide information and assurance of compliance with the National Environmental Policy Act of 1969 (NEPA) on the Environmental Information and Documentation (EID) checklist. (May 4, 2009).
HRSA/Bureau of Primary Health Care Capital Improvement Program Application Electronic Health Records (EHR) Readiness Checklist (NEW). HRSA/Bureau of Primary Health Care Capital Improvement Program
Application Electronic Health Records (EHR) Readiness Checklist (NEW). The American Recovery and Reinvestment Act (ARRA) provides $1.5 billion in grants to support construction, renovation and equipment, and the acquisition of health information technology systems, for health centers, including health center controlled networks receiving operating grants under section 330 of the Public Health Service (PHS) Act, as amended (42 U.S.C. 254b). HRSA is requesting emergency processing procedures for the Electronic Health Records (EHR) Readiness Checklist portion of the application because this information is needed before the expiration of the normal time limits under regulations at 5 CFR part 1320 to ensure the timely availability of data to make award determinations for receipt of funds under ARRA. Of the $1.5 billion, HRSA will award approximately $850 million, through limited competition grants, for one-time Capital Improvement Program (CIP) grant funding in fiscal year (FY) 2009 to support existing section 330 funded health centers. Funding under this opportunity will address pressing capital improvement needs in health centers, such as construction, repair, renovation, and equipment purchases, including health information technology systems. Applicants must provide information using the EHR Readiness Checklist that demonstrates comprehensive planning and readiness for implementing EHRs. (May 4, 4009).
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Administrative Rules May 8, 2009 Centers for Medicare & Medicaid Services Medicaid Program: Health Care-Related Taxes. This proposed rule would delay enforcement of certain portions of
the final rule entitled ``Medicaid Program; Health Care-Related Taxes'' from the expiration of a Congressional moratorium on enforcement on July 1, 2009 until June 30, 2010. That final rule revised the threshold levels under the regulatory indirect guarantee hold harmless arrangement test to reflect the provisions of the Tax Relief and Health Care Act of 2006, amended the definition of the ``class of managed care organization services,'' and removed obsolete transition period regulatory language. These changes would not be affected by this delay of enforcement. The final rule also clarified the standard for determining the existence of a hold harmless arrangement under the positive correlation test, Medicaid payment test, and the guarantee test. This proposed rule would delay enforcement of these latter provisions, concerning hold harmless arrangements, for 1 year. Comments must be received by June 1, 2009. (May 6, 2009).
Medicaid Program: Rescission of School-Based Services Final Rule, Outpatient Services Definition Final Rule, and Partial Rescission of Case Management Services Interim Final Rule. This rule proposes to rescind the
December 28, 2007 final rule entitled ``Elimination of Reimbursement Under Medicaid for School Administration Expenditures and Costs Related to Transportation of School-Age Children Between Home and School''; the November 7, 2008 final rule entitled ``Clarification of Outpatient Hospital Facility (Including Outpatient Hospital Clinic) Services Definition''; and certain provisions of the December 4, 2007 interim final rule with comment period entitled ``Optional State Plan Case Management Services.'' These regulations have been the subject of Congressional moratoria and have not yet been implemented (or, with respect to case management interim final rule, have only been partially implemented) by CMS. In light of concerns raised about the adverse effects that could result from these regulations, in particular the potential restrictions on services available to beneficiaries, potential deleterious effect on state partners in the economic downturn, and the lack of clear evidence demonstrating that the approaches taken in the regulations are warranted, CMS is proposing to rescind the two final rules in full, and to partially rescind the interim final rule. Rescinding these provisions will permit further opportunity to determine the best approach to further the objectives of the Medicaid program in providing necessary health benefits coverage to needy individuals. Comments must be received by June 1, 1009. (May 6, 2009).
Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2010.
This proposed rule would update the payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2010 (for discharges occurring on or after October 1, 2009 and on or before September 30, 2010) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each fiscal year, the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are proposing to revise existing policies regarding the IRF PPS within the authority granted under section 1886(j) of the Act. Comments must be received by June 29, 2009. (May 6, 2009).
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