Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006
GAO-05-977R: Aug 18, 2005
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GAO reviewed the Department of Health and Human Services, Centers for Medicare and Medicaid Services' (CMS) new rule on consolidated billing for skilled nursing facilities for fiscal year 2006. GAO found that (1) the rule updates the payments rates used under the prospective payment system for skilled nursing facilities for fiscal year 2006, and (2) CMS, with the exception of the 60-day delay in effective date, complied with applicable requirements in promulgating the rule.
Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006, GAO-05-977R, August 18, 2005
The Honorable Charles E. Grassley
Chairman
The Honorable Max Baucus
Ranking Minority Member
Committee on Finance
The Honorable Joe Barton
Chairman
The Honorable John D. Dingell
Ranking Minority Member
Committee on Energy and Commerce
House of Representatives
The Honorable William M. Thomas
Chairman
The Honorable Charles B. Rangel
Ranking Minority Member
Committee on Ways and Means
House of Representatives
Subject: Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006
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; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006 (RIN: 0938-AN65). We received the rule on
The final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2006.
The final rule has an announced effective date of
Enclosed is our assessment of 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, with the exception of the 60-day delay in the effective date, 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 Ms. Marjorie Kanof, Managing Director, Health Care. Ms. Kanof can be reached at (202) 512-7101.
signed
Kathleen E. Wannisky
Managing Associate General Counsel
cc: Ann Stallion
Regulations Coordinator
Department of Health and
Human Services
ENCLOSURE
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
ENTITLED
"MEDICARE PROGRAM; PROSPECTIVE PAYMENT SYSTEM
AND CONSOLIDATED BILLING FOR
SKILLED NURSING FACILITIES FOR FY 2006"
(RIN: 0938-AN65)
(i) Cost-benefit analysis
CMS estimates that the impact of the standard update will increase payments to SNFs by approximately $20 million. This reflects a $1.02 billion reduction from the expiration of temporary payment increases, offset by a $510 million increase from the refined case-mix classification system and a $530 million increase from the update to the payment rates.
(ii) Agency actions relevant to the Regulatory Flexibility Act, 5 U.S.C. sections 603-605, 607, and 609
CMS prepared a Final Regulatory Flexibility Analysis in connection with the final rule that complies with the requirements of the Act, including a discussion of the alternatives considered to lessen the economic impact on small entities.
(iii) Agency actions relevant to sections 202-205 of the Unfunded Mandates Reform Act of 1995, 2 U.S.C. sections 1532-1535
The final rule does not contain 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.
The final rule was issued using the notice and comment procedures found at 5 U.S.C. 553. On
Paperwork Reduction Act, 44 U.S.C. sections 3501-3520
The final rule does not contain an information collection that requires review by the Office of Management and Budget (OMB) under the Paperwork Reduction Act.
Statutory authorization for the rule
The final rule is promulgated under the authority contained in sections 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).
Executive Order No. 12866
The final rule was reviewed by OMB and found to be an economically significant regulatory action under the order.
Executive Order No. 13132 (Federalism)
The final rule will not impact on the rights or responsibilities of state, local, or tribal governments.
Mar 4, 2021
Mar 3, 2021
Mar 2, 2021
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Gunnison Consulting Group, Inc.--Reconsideration
We deny the request for reconsideration.
B-418876.5 -
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Mar 1, 2021
Feb 26, 2021
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