Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Coverage and Payment of Ambulance Services; Inflation Update for CY 2006
GAO-06-307R: Dec 19, 2005
- Full Report:
GAO reviewed Department of Health and Human Services: Centers for Medicare and Medicaid Services' (CMS) new rule on coverage and payment of ambulance services. GAO found that (1) the rule discusses the annual review of the conversion factor used to calculate the Medicare program ambulance fee schedule and the annual ambulance inflation factor for calendar year 2006; and (2) CMS complied with applicable requirements in promulgating the rule.
Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Coverage and Payment of Ambulance Services; Inflation Update for CY 2006, GAO-06-307R, December 19, 2005
The Honorable William M. Thomas
The Honorable Charles B. Rangel
Ranking Minority Member
Committee on Ways and Means
House of Representatives
Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), entitled Medicare Program; Coverage and Payment of Ambulance Services; Inflation Update for CY 2006 (RIN: 0938-AN99). We received the rule on
The notice discusses the annual review of the conversion factor used to calculate the Medicare program ambulance fee schedule and the annual ambulance inflation factor for calendar year 2006.
Enclosed is our assessment of the CMS's compliance with the procedural steps required by section 801(a)(1)(B)(i) through (iv) of title 5 with respect to the rule. Our review indicates that CMS complied with the applicable requirements.
If you have any questions about this report, please contact James W. Vickers, Assistant General Counsel, at (202) 512-8210. The official responsible for GAO evaluation work relating to the subject matter of the rule is Marjorie Kanof, Managing Director, Health Care. Ms. Kanof can be reached at (202) 512-7101.
Kathleen E. Wannisky
Managing Associate General Counsel
ANALYSIS UNDER 5 U.S.C. sect. 801(a)(1)(B)(i)-(iv) OF A MAJOR RULE
ISSUED BY THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES,
CENTERS FOR MEDICARE AND MEDICAID SERVICES
"MEDICARE PROGRAM; COVERAGE AND PAYMENT OF
AMBULANCE SERVICES; INFLATION UPDATE FOR CY 2006"
(i) Cost-benefit analysis
CMS estimates that the total program expenditure for calendar year 2006 for ambulance services covered by Medicare is approximately $4.5 billion. The increases contained in the notice will result in an additional expenditure of approximately $112 million.
(ii) Agency actions relevant to the Regulatory Flexibility Act, 5 U.S.C. sections 603-605, 607, and 609
CMS has prepared a Final Regulatory Flexibility Analysis in connection with the notice and concludes that the notice will not have a significant economic impact since it will increase total revenues to the providers by 2.5 percent.
(iii) Agency actions relevant to sections 202-205 of the Unfunded Mandates Reform Act of 1995, 2 U.S.C. sections 1532-1535
The notice does not impose either an intergovernmental or private sector mandate, as defined in title II, of more than $110 million in any one year.
(iv) Other relevant information or requirements under acts and executive orders
Administrative Procedure Act, 5 U.S.C. sections 551 et seq.
CMS has found good cause under 5 U.S.C. 553 to waive the notice and comment procedures because the methods of computation of the annual updates are specified by statute, and there are no substantive policy changes.
Paperwork Reduction Act, 44 U.S.C. sections 3501-3520
The notice does not contain any information collections that are subject to review by the Office of Management (OMB) under the Paperwork Reduction Act.
Statutory authorization for the rule
The notice is promulgated under the authority found in sections 1834(l) and 1834(l)(3)(B) of the Social Security Act.
Executive Order No. 12866
The notice was reviewed by OMB and found to be an economically significant regulatory action under the order.
Executive Order No. 13132 (Federalism)
The notice does not have federalism implications according to CMS.