Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-July Through September 2005

---
identifier: "/us/fr/05-24023"
source: "fr"
legal_status: "authoritative_unofficial"
title: "Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-July Through September 2005"
title_number: 0
title_name: "Federal Register"
section_number: "05-24023"
section_name: "Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-July Through September 2005"
positive_law: false
currency: "2005-12-23"
last_updated: "2005-12-23"
format_version: "1.1.0"
generator: "[email protected]"
agency: "Health and Human Services Department"
document_number: "05-24023"
document_type: "notice"
publication_date: "2005-12-23"
agencies:
  - "Health and Human Services Department"
  - "Centers for Medicare & Medicaid Services"
fr_citation: "70 FR 76290"
fr_volume: 70
docket_ids:
  - "CMS-9033-N"
fr_action: "Notice."
---


#  Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—July Through September 2005

**AGENCY:**

Centers for Medicare & Medicaid Services (CMS), HHS.

**ACTION:**

Notice.

**SUMMARY:**

This notice lists CMS manual instructions, substantive and interpretive regulations, and other *Federal Register* notices that were published from July 2005 through September 2005, relating to the Medicare and Medicaid programs. This notice provides information on national coverage determinations (NCDs) affecting specific medical and health care services under Medicare. Additionally, this notice identifies certain devices with investigational device exemption (IDE) numbers approved by the Food and Drug Administration (FDA) that potentially may be covered under Medicare. This notice also includes listings of all approval numbers from the Office of Management and Budget for collections of information in CMS regulations. Finally, this notice includes a list of Medicare-approved carotid stent facilities.

Section 1871(c) of the Social Security Act requires that we publish a list of Medicare issuances in the *Federal Register* at least every 3 months. Although we are not mandated to do so by statute, for the sake of completeness of the listing, and to foster more open and transparent collaboration efforts, we are also including all Medicaid issuances and Medicare and Medicaid substantive and interpretive regulations (proposed and final) published during this 3-month time frame.

**FOR FURTHER INFORMATION CONTACT:**

It is possible that an interested party may have a specific information need and not be able to determine from the listed information whether the issuance or regulation would fulfill that need. Consequently, we are providing information contact persons to answer general questions concerning these items. Copies are not available through the contact persons. (See Section III of this notice for how to obtain listed material.)

Questions concerning items in Addendum III may be addressed to Timothy Jennings, Office of Strategic Operations and Regulatory Affairs, Centers for Medicare & Medicaid Services, C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2134.

Questions concerning Medicare NCDs in Addendum V may be addressed to Patricia Brocato-Simons, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-0261.

Questions concerning FDA-approved Category B IDE numbers listed in Addendum VI may be addressed to John Manlove, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, C1-13-04, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-6877.

Questions concerning approval numbers for collections of information in Addendum VII may be addressed to Bonnie Harkless, Office of Strategic Operations and Regulatory Affairs, Regulations Development and Issuances Group, Centers for Medicare & Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-5666.

Questions concerning Medicare-approved carotid stent facilities may be addressed to Sarah J. McClain, Office of Clinical Standards and Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-2994.

Questions concerning all other information may be addressed to Gwendolyn Johnson, Office of Strategic Operations and Regulatory Affairs, Regulations Development Group, Centers for Medicare & Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-6954.

**SUPPLEMENTARY INFORMATION:**

**I. Program Issuances**

The Centers for Medicare & Medicaid Services (CMS) is responsible for administering the Medicare and Medicaid programs. These programs pay for health care and related services for 39 million Medicare beneficiaries and 35 million Medicaid recipients. Administration of the two programs involves (1) furnishing information to Medicare beneficiaries and Medicaid recipients, health care providers, and the public and (2) maintaining effective communications with regional offices, State governments, State Medicaid agencies, State survey agencies, various providers of health care, all Medicare contractors that process claims and pay bills, and others. To implement the various statutes on which the programs are based, we issue regulations under the authority granted to the Secretary of the Department of Health and Human Services under sections 1102, 1871, 1902, and related provisions of the Social Security Act (the Act). We also issue various manuals, memoranda, and statements necessary to administer the programs efficiently.

Section 1871(c)(1) of the Act requires that we publish a list of all Medicare manual instructions, interpretive rules, statements of policy, and guidelines of general applicability not issued as regulations at least every 3 months in the *Federal Register* . We published our first notice June 9, 1988 (53 FR 21730). Although we are not mandated to do so by statute, for the sake of completeness of the listing of operational and policy statements, and to foster more open and transparent collaboration, we are continuing our practice of including Medicare substantive and interpretive regulations (proposed and final) published during the respective 3-month time frame.

**II. How To Use the Addenda**

This notice is organized so that a reader may review the subjects of manual issuances, memoranda, substantive and interpretive regulations, NCDs, and FDA-approved IDEs published during the subject quarter to determine whether any are of particular interest. We expect this notice to be used in concert with previously published notices. Those unfamiliar with a description of our Medicare manuals may wish to review Table I of our first three notices (53 FR 21730, 53 FR 36891, and 53 FR 50577) published in 1988, and the notice published March 31, 1993 (58 FR 16837). Those desiring information on the Medicare NCD Manual (NCDM, formerly the Medicare  Coverage Issues Manual (CIM)) may wish to review the August 21, 1989, publication (54 FR 34555). Those interested in the revised process used in making NCDs under the Medicare program may review the September 26, 2003, publication (68 FR 55634).

To aid the reader, we have organized and divided this current listing into eight addenda:

• Addendum I lists the publication dates of the most recent quarterly listings of program issuances.

• Addendum II identifies previous *Federal Register* documents that contain a description of all previously published CMS Medicare and Medicaid manuals and memoranda.

• Addendum III lists a unique CMS transmittal number for each instruction in our manuals or Program Memoranda and its subject matter. A transmittal may consist of a single or multiple instruction(s). Often, it is necessary to use information in a transmittal in conjunction with information currently in the manuals.

• Addendum IV lists all substantive and interpretive Medicare and Medicaid regulations and general notices published in the *Federal Register* during the quarter covered by this notice. For each item, we list the—

○ Date published;

○ *Federal Register* citation;

○ Parts of the Code of Federal Regulations (CFR) that have changed (if applicable);

○ Agency file code number; and

○ Title of the regulation.

• Addendum V includes completed NCDs, or reconsiderations of completed NCDs, from the quarter covered by this notice. Completed decisions are identified by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision.

• Addendum VI includes listings of the FDA-approved IDE categorizations, using the IDE numbers the FDA assigns. The listings are organized according to the categories to which the device numbers are assigned (that is, Category A or Category B), and identified by the IDE number.

• Addendum VII includes listings of all approval numbers from the Office of Management and Budget (OMB) for collections of information in CMS regulations in title 42; title 45, subchapter C; and title 20 of the CFR.

• Addendum VIII includes listings of Medicare-approved carotid stent facilities. All facilities listed meet CMS standards for performing carotid artery stenting for high risk patients.

**III. How To Obtain Listed Material**

**A. Manuals**

Those wishing to subscribe to program manuals should contact either the Government Printing Office (GPO) or the National Technical Information Service (NTIS) at the following addresses: Superintendent of Documents, Government Printing Office, ATTN: New Orders, P.O. Box 371954, Pittsburgh, PA 15250-7954, Telephone (202) 512-1800, Fax number (202) 512-2250 (for credit card orders); or National Technical Information Service, Department of Commerce, 5825 Port Royal Road, Springfield, VA 22161, Telephone (703) 487-4630.

In addition, individual manual transmittals and Program Memoranda listed in this notice can be purchased from NTIS. Interested parties should identify the transmittal(s) they want. GPO or NTIS can give complete details on how to obtain the publications they sell. Additionally, most manuals are available at the following Internet address: *http://cms.hhs.gov/manuals/default.asp.*

**B. Regulations and Notices**

Regulations and notices are published in the daily *Federal Register* . Interested individuals may purchase individual copies or subscribe to the *Federal Register* by contacting the GPO at the address given above. When ordering individual copies, it is necessary to cite either the date of publication or the volume number and page number.

The *Federal Register* is also available on 24x microfiche and as an online database through *GPO Access.* The online database is updated by 6 a.m. each day the *Federal Register* is published. The database includes both text and graphics from Volume 59, Number 1 (January 2, 1994) forward. Free public access is available on a Wide Area Information Server (WAIS) through the Internet and via asynchronous dial-in. Internet users can access the database by using the World Wide Web; the Superintendent of Documents home page address is *http://www.gpoaccess.gov/fr/index.html* , by using local WAIS client software, or by telnet to *swais.gpoaccess.gov* , then log in as guest (no password required). Dial-in users should use communications software and modem to call (202) 512-1661; type swais, then log in as guest (no password required).

**C. Rulings**

We publish rulings on an infrequent basis. Interested individuals can obtain copies from the nearest CMS Regional Office or review them at the nearest regional depository library. We have, on occasion, published rulings in the *Federal Register* . Rulings, beginning with those released in 1995, are available online, through the CMS Home Page. The Internet address is *http://cms.hhs.gov/rulings.*

**D. CMS' Compact Disk-Read Only Memory (CD-ROM)**

Our laws, regulations, and manuals are also available on CD-ROM and may be purchased from GPO or NTIS on a subscription or single copy basis. The Superintendent of Documents list ID is HCLRM, and the stock number is 717-139-00000-3. The following material is on the CD-ROM disk:

• Titles XI, XVIII, and XIX of the Act.

• CMS-related regulations.

• CMS manuals and monthly revisions.

• CMS program memoranda.

The titles of the Compilation of the Social Security Laws are current as of January 1, 2003. (Updated titles of the Social Security Laws are available on the Internet at *http://www.ssa.gov/OP_Home/ssact/comp-toc.htm.* ) The remaining portions of CD-ROM are updated on a monthly basis.

Because of complaints about the unreadability of the Appendices (Interpretive Guidelines) in the State Operations Manual (SOM), as of March 1995, we deleted these appendices from CD-ROM. We intend to re-visit this issue in the near future and, with the aid of newer technology, we may again be able to include the appendices on CD-ROM.

Any cost report forms incorporated in the manuals are included on the CD-ROM disk as LOTUS files. LOTUS software is needed to view the reports once the files have been copied to a personal computer disk.

**IV. How To Review Listed Material**

Transmittals or Program Memoranda can be reviewed at a local Federal Depository Library (FDL). Under the FDL program, government publications are sent to approximately 1,400 designated libraries throughout the United States. Some FDLs may have arrangements to transfer material to a local library not designated as an FDL. Contact any library to locate the nearest FDL.

In addition, individuals may contact regional depository libraries that receive and retain at least one copy of most Federal Government publications, either in printed or microfilm form, for use by the general public. These libraries provide reference services and interlibrary loans; however, they are not  sales outlets. Individuals may obtain information about the location of the nearest regional depository library from any library. For each CMS publication listed in Addendum III, CMS publication and transmittal numbers are shown. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the Medicare NCD publication titled “Cochlear Implantation,” use CMS—Pub. 100-03, Transmittal No. 42.

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance, Program No. 93.774, Medicare—Supplementary Medical Insurance Program, and Program No. 93.714, Medical Assistance Program)

Dated: December 7, 2005.

Jacquelyn Y. White,

Director, Office of Strategic Operations and Regulatory Affairs.

**Addendum I**

This addendum lists the publication dates of the most recent quarterly listings of program issuances.

June 27, 2003 (68 FR 38359)

September 26, 2003 (68 FR 55618)

December 24, 2003 (68 FR 74590)

March 26, 2004 (69 FR 15837)

June 25, 2004 (69 FR 35634)

September 24, 2004 (69 FR 57312)

December 30, 2004 (69 FR 78428)

February 25, 2005 (70 FR 9338)

June 24, 2005 (70 FR 36620)

September 23, 2005 (70 FR 55863)

**Addendum II—Description of Manuals, Memoranda, and CMS Rulings**

An extensive descriptive listing of Medicare manuals and memoranda was published on June 9, 1988, at 53 FR 21730 and supplemented on September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR 50577. Also, a complete description of the former CIM (now the NCDM) was published on August 21, 1989, at 54 FR 34555. A brief description of the various Medicaid manuals and memoranda that we maintain was published on October 16, 1992, at 57 FR 47468.

| Transmittal No. | Manual/Subject/Publication No. |
| --- | --- |
|  |  |
|  |  |
| 25 | Next Generation Desktop Testing Requirements Definitions |
|  | Next Generation Desktop Maintainer Requirements |
| 26 | Implement New Medicare Plan ID and Carrier Number for the Single Testing Contractor |
|  | Shared System Testing Requirements for Maintainers, Beta Testers, and Contractors |
| 27 | Provider Extract File |
| 28 | Conforming Changes for Change Request 3648 to Pub. 100-01 |
|  | Hospital Insurance (Part A) for Inpatient Hospital, Hospice, and Skilled Nursing Facility Services—A Brief Description Home Health Services |
|  | Supplementary Medical Insurance (Part B)—A Brief Description |
|  | Discrimination Prohibited |
|  | Role of Part A Intermediaries |
|  | Limitation on Physical Therapy, Occupational Therapy and Speech-Language Pathology Services |
|  | Certification for Hospital Services Covered by the Supplementary Medical Insurance Program |
|  | Content of the Physician's Certification |
|  | Recertifications for Home Health Services |
|  | Physician's Certification and Recertification for Outpatient Physical Therapy Occupational Therapy and Speech-Language Pathology Recertification |
|  | Under Arrangements |
|  | Term of Agreements |
|  | Determining Payment for Services Furnished After Termination, Expiration, or Cancellation |
|  | Home Health Agency Defined |
| 29 | 2005 Scheduled Release for October Updates to Software Programs and Pricing/Coding Files |
|  |  |
|  |  |
| 37 | Conforming Changes for Change Request 3648 to Pub. 100-02 |
|  | Medical and Other Health Services Furnished to Inpatients of Participating Hospitals Outpatient Hospital Services |
|  | Distinguishing Outpatient Hospital Services Provided Outside the Hospital Coverage of Outpatient Therapeutic Services |
|  | Medical and Other Health Services Furnished by Home Health Agencies Skilled Services Defined |
|  | Speech-Language Pathology |
|  | Physical Therapy, Speech-Language Pathology, and Occupational Therapy Furnished by the Skilled Nursing Facility or by Others Under Arrangements With the Facility and Under Its Supervision |
|  | Inpatient Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services |
|  | Services Furnished Under Arrangements With Providers |
|  | Supplementary Medical Insurance Provisions |
|  | Services Not Provided Within United States |
|  |  |
|  |  |
| 42 | Cochlear Implantation |
|  | Cochlear Implantation (Effective April 4, 2005) |
|  |  |
|  |  |
|  |  |
| 601 | Cochlear Implantation |
|  | Billing Requirements for Expanded Coverage of Cochlear Implantation |
|  | Intermediary Billing Procedures |
|  | Applicable Bill Types |
|  | Special Billing Requirements for Intermediaries |
|  | Intermediary Payment Requirements |
|  | Carrier Billing Procedures |
|  | Healthcare Common Procedure Coding System |
| 602 | Expansion of Various Alpha and Numeric Fields Within the Outpatient Prospective Payment System Outpatient Code Editor |
| 603 | Modification to the Appeals Language on the Medicare Summary Notice; Full Replacement of Change Request 3808 |
|  | Appeals Section |
|  | Back of Medicare Summary Notice—Carriers and Intermediaries Carrier Spanish Medicare Summary Notices Back Intermediary Spanish Medicare Summary Notices Back |
| 604 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 605 | Frequency Instructions for Smoking and Tobacco-Use Cessation Counseling Services |
|  | Remittance Advice Notices |
|  | Medicare Summary Notices |
| 606 | Medicare Program-Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index, and the Hospice Pricer for FY 2005 |
|  | Payment Rates |
| 607 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 608 | New Health Professional Shortage Area Modifier |
|  | Zip Code Files |
|  | Provider Education |
|  | Claims Coding Requirements |
|  | Services Eligible for Health Professional Shortage Area and Physician Scarcity Bonus Payments |
|  | Post-payment Review |
|  | Health Professional Shortage Area Incentive Payments for Physician Services Rendered in a Critical Access Hospital |
| 609 | Remittance Advice Remark Code and Claim Adjustment Reason Code Update |
| 610 | This Transmittal is rescinded and replaced by Transmittal 634 |
| 611 | Payment Methodology for Rehabilitation Services in Indian Health Service/Tribally Owned and/or Operated Hospitals and Hospital Based Facilities |
|  | Services Paid Under the Physician Fee Schedule |
| 612 | Abarelix for Treatment of Prostate Cancer |
| 613 | New Healthcare Common Procedure Coding System Codes and Systems Edits for Supplies and Accessories for Ventricular Assist Devices—Full Replacement of CR 3761 |
| 614 | Medicare Physician Fee Schedule Database 2006 File Layout |
| 615 | Revision of Chapter 24, Electronic Data Interchange Support Requirements |
|  | Electronic Data Interchange General Outreach Activities Carrier, Durable Medical Equipment Regional Carrier, and Fiscal Intermediary Analysis of Internal Information |
|  | Systems Information |
|  | Review of Provider Profiles |
|  | Contact with New Providers |
|  | Production and Distribution of Material to Increase Use of Electronic Data Interchange |
|  | Electronic Data Interchange Enrollment |
|  | New Enrollments and Maintenance of Existing Enrollments |
|  | Submitter Number |
|  | Release of Medicare Eligibility Data |
|  | Network Service Vendor Agreement |
|  | Electronic Data Interchange User Guidelines |
|  | Directory of Billing Software Vendors and Clearinghouses |
|  | Technical Requirements—Data, Media, and Telecommunications System Availability |
|  | Media |
|  | Telecommunications and Transmission Protocols |
|  | Toll-Free Service |
|  | Initial Editing |
|  | Translators |
|  | Required Electronic Data Interchange Formats |
|  | General Health Insurance Portability and Accountability Act Electronic Data Interchange Requirements |
|  | Continued Support of Pre-Health Insurance Portability and Accountability Act |
|  | Electronic Data Interchange Formats |
|  | National Council for Prescription Drug Program Claim Requirements |
|  | Crossover Claim Requirements |
|  | Direct Data Entry Screens |
|  | Use of Imaging, External Key Shop, and In-House Keying for Entry of Transaction Data Submitted on Paper |
|  | Electronic Funds Transfer |
|  | Electronic Data Interchange Testing Requirements |
|  | Shared System and Common Working File Maintainers Internal Testing Requirements |
|  | Carrier, Durable Medical Equipment Regional Carrier, and Intermediary Internal Testing Requirements |
|  | Third-Party Certification Systems and Services |
|  | Electronic Data Interchange Submitter/Receiver Testing by Carriers, Durable Medical Equipment Regional Carriers, and Fiscal Intermediaries |
|  | Testing Accuracy |
|  | Limitation on Testing of Multiple Providers That Use the Same Clearinghouse, Billing Service, or Vendor Software |
|  | Carrier, Durable Medical Equipment Regional Carrier, and Fiscal Intermediary Submitter/Receiver Testing With Legacy Formats During the Health Insurance Portability and Accountability Act Contingency Period |
|  | Discontinuation of Use of Claim Legacy Formats following Successful Health Insurance Portability and Accountability Act Format Testing |
|  | Electronic Data Interchange Receiver Testing by Carriers, Durable Medical Equipment Regional Carriers, and Intermediaries |
|  | Changes in Provider's System or Vendor's Software, and Use of Additional Electronic Data Interchange Formats |
|  | Support of Electronic Data Interchange Trading Partners |
|  | User Guidelines |
|  | Technical Assistance to Electronic Data Interchange Trading Partners |
|  | Training Content and Frequency |
|  | Prohibition Against Requiring Use of Proprietary Software or Direct Data Entry |
|  | Free Claim Submission Software |
|  | Remittance Advice Print Software |
|  | Medicare Remit Easy Print Software for Carrier and Durable Medical Equipment Regional Carrier Provider Use |
|  | Medicare Standard Fiscal Intermediary PC-Print Software |
|  | Newsletters/Bulletin Board/Internet Publication of Electronic Data Interchange Information |
|  | Provider Guidelines for Choosing a Vendor |
|  | Determining Goals/Requirements |
|  | Vendor Selection |
|  | Negotiating With Vendors |
|  | Electronic Data Interchange Edit Requirements |
|  | Carrier, Durable Medical Equipment Regional Carrier, and Fiscal Intermediary X12 Edit Requirements |
|  | Supplemental Fiscal Intermediary-Specific Shared System Edit Requirements |
|  | Fiscal Intermediary Health Insurance and Portability Accountability Act Claim |
|  | Level Implementation Guide Edits |
|  | Supplemental Carrier/Durable Medical Equipment Regional Carrier-Specific Shared System Implementation Guide Edit Requirements |
|  | Keyshop and Image Processing |
|  | Carrier, Durable Medical Equipment Regional Carrier, or Fiscal Intermediary Data Security and Confidentiality Requirements |
|  | Carrier, Durable Medical Equipment Regional Carrier, and Fiscal Intermediary Electronic Data Interchange Audit Trails |
|  | Security-Related Requirements for Carrier, Durable Medical Equipment |
|  | Regional Carrier, or Fiscal Intermediary Arrangements with Clearinghouses And Billing Services |
|  | Mandatory Electronic Submission of Medicare Claims |
|  | Small Providers and Full-Time Equivalent Employee Self-Assessments |
|  | Exceptions |
|  | Unusual Circumstance Waivers |
|  | Unusual Circumstance Waivers Subject to Provider Self-Assessment |
|  | Unusual Circumstance Waivers Subject to Medicare Contractor Approval |
|  | Unusual Circumstance Waivers Subject to Contractor Evaluation and CMS Decision |
|  | Electronic and Paper Claims Implications of Mandatory Electronic Submission Enforcement |
|  | Provider Education |
| 616 | Certified Registered Nurse Anesthetist Pass-Through Payments |
|  | Anesthesia and Certified Registered Nurse Anesthetist Services in a Critical Access Hospitals |
|  | Payment for Certified Registered Nurse Anesthetist Pass-Through Services |
|  | Payment for Anesthesia Services by a Certified Registered Nurse Anesthetist (Method II Critical Access Hospital Only) |
| 617 | Administration of Drugs and Biologicals in a Method II Critical Access Hospital |
|  | Coding for Administering Drugs in a Method II Critical Access Hospital |
|  | Coding for Low Osmolar Contrast Material |
| 618 | Coding for the Administration of Other Drugs and Biologicals |
|  | Clarification for Carriers and Durable Medical Equipment Regional Carriers About Correction and Recoupment of Previously Processed Claims |
| 619 | Late IRF-PAI Data Submission Penalty Protocol Within the Inpatient Rehabilitation Facility Prospective Payment System |
|  | Payment Adjustment for Late Transmission of Patient Assessment Data |
| 620 | New Fiscal Intermediary (FI) Edit to Identify Potentially Excessive Medicare Payments |
|  | Fiscal Intermediary Edits Affecting Multiple Bill Types |
|  | Threshold Edit for Outpatient and Inpatient Part B Claims |
| 621 | Locality Codes for Purchased Diagnostic Tests |
| 622 | This Transmittal is rescinded and replaced by Transmittal 668 |
| 623 | Durable Medical Equipment Regional Carrier Only—Corrections to the Billing Indicator Field for Adjusted Claims |
| 624 | This Transmittal is rescinded and replaced by Transmittal 686 |
| 625 | Competitive Acquisition Program for Part B Drugs—Coding, Testing, and Implementation |
| 626 | Common Working File Expansion of Duplicate Claim Edit for Clinical Diagnostic Services |
| 627 | New Low Osmolar Contrast Material (LOCM) HCPCS Codes/Payment Criteria/Payment Level |
|  | Low Osmolar Contrast Media (HCPCS Codes Q9945-Q9951) |
|  | Payment Criteria/Payment Level |
| 628 | Radiopharmaceutical Diagnostic Imaging Agents Codes Applicable to Positron Emission Tomography Scan Services Performed on or After January 28, 2005 |
|  | Appropriate Common Procedure Terminology Codes Effective for Positron Emission Tomography Scan Services Performed on or After January 28, 2005 |
|  | Tracer Codes Required for Positron Emission Tomography Scans |
| 629 | Certificate of Medical Necessity Claim Edits Workload Reporting |
|  | Durable Medical Equipment Regional Carrier Systems |
| 630 | Medicare Part A Skilled Nursing Facility Prospective Payment System Pricer |
|  | Update and Health Insurance Prospective Payment System Coding Update Effective January 1, 2006 |
|  | Health Insurance Prospective Payment System Rate Code |
|  | Skilled Nursing Facility Prospective Payment System Rate Components |
|  | Decision Logic Used by the Pricer on Claims |
| 631 | Claim Status Category Code and Claim Status Code Update |
| 632 | Billing and Claims Processing Instructions for Claims Subject to Expedited Determinations |
|  | Limitation of Liability Notification and Coordination With Quality |
|  | Improvement Organizations |
|  | Limitation on Liability—Overview |
|  | Hospital Claims Subject to Hospital Issued Notices of Noncoverage |
|  | Scope of Issuance of Hospital Issued Notices of Noncoverage |
|  | General Responsibilities of Quality Improvement Organizations and Fiscal Intermediaries Related to Hospital Issued Notices of Noncoverage |
|  | Billing and Claims Processing Requirements Related to Hospital Issued Notices of Noncoverage |
|  | Skilled Nursing Facility, Home Health Agency, Hospice, and Comprehensive Outpatient Rehabilitation Facility Claims Subject to Expedited Determinations |
|  | Scope of Issuance of Expedited Determination Notices |
|  | General Responsibilities of Quality Improvement Organizations and Fiscal Intermediaries Related to Expedited Determinations |
|  | Billing and Claims Processing Requirements Related to Expedited Determinations |
|  | Coordination With the Quality Improvement Organization |
| 633 | Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus, Influenza Virus, and Hepatitis B Virus) and Their Administration Provided by Indian Health Service/Tribally-Owned and/or Operated Hospitals and Hospital Based Facilities |
|  | Billing Requirements |
|  | Bills Submitted to Fiscal Intermediaries |
|  | Vaccines and Vaccine Administration |
| 634 | Guidelines for Payment of Vaccines (Pneumococcal Pneumonia Virus, Influenza Virus, and Hepatitis B Virus) and Their Administration at Renal Dialysis Facilities |
|  | Vaccines Furnished to End-Stage Renal Disease Patients |
|  | Fiscal Intermediary Payment for Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccine |
|  | Bills Submitted by Hospices and Payment for Renal Dialysis Facilities |
| 635 | Financial Liability for Services Subject to Home Health Consolidated Billing |
|  | Home Health Prospective Payment System Consolidated Billing and Primary |
|  | Home Health Agencies |
|  | Home Health Prospective Payment System Consolidated Billing Beneficiary Notification and Payment Liability Under Home Health Consolidated Billing |
|  | Responsibilities of Home Health Agencies |
|  | Responsibilities of Providers/Suppliers of Services Subject to Consolidated Billing |
|  | Responsibilities of Hospitals Discharging Medicare Beneficiaries to Home Health Care |
|  | Home Health Consolidated Billing Edits in Medicare Systems |
|  | Non-routine Supply Editing |
|  | Therapy Editing |
|  | Other Editing Related to Home Health Consolidated Billing |
|  | Only Request for Anticipated Payment Received and Services Fall Within 60 Days After Request for Anticipated Payment Start Date |
|  | No Request for Anticipated Payment Received and Therapy Services Rendered in the Home |
|  | Health Insurance Eligibility Query to Determine Episode Status |
|  | Other Editing and Changes for Home Health Prospective Payment System Episodes |
|  | Coordination of Home Health Prospective Payment System Claims and Episodes With Inpatient Claim Types |
| 636 | Instructions for Implementation of CMS Ruling 05-01; Presbyopia-Correcting Intraocular Lens |
| 637 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 638 | New Medicare Summary Notice Messages |
|  | Adjustments |
|  | Ajustes |
| 639 | Cessation of Additional $50 Payment for New Technology Intraocular Lenses |
|  | Ambulatory Surgical Center Services on Ambulatory Surgical Center List |
|  | Payment for Intraocular Lens |
| 640 | Medicare Part A Skilled Nursing Facility Prospective Payment System Pricer Update FY 2006 |
| 641 | October 2005 Quarterly Update to Skilled Nursing Facility Consolidated Billing |
| 642 | New Waived Tests |
| 643 | Nature and Effect of Assignment on Carrier Claims |
| 644 | October 2005 Non-Outpatient Prospective Payment System Code Editor Specifications Version 21 |
| 645 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 646 | Update to the Inpatient Provider Specific File and the Outpatient Provider |
|  | Specific File to Retain Provider Information |
| 647 | The Supplemental Security Income/Medicare Beneficiary Data for Fiscal Year 2004 for Inpatient Prospective Payment System Hospitals |
| 648 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 649 | Competitive Acquisition Program for Part B Drugs—Coding, Testing, and Implementation |
| 650 | This Transmittal is rescinded and replaced by Transmittal 673 |
| 651 | Changes to the Laboratory National Coverage Determination Edit Software for October 2005 |
| 652 | This Transmittal is rescinded and replaced by Transmittal 661 |
| 653 | October 2005 Quarterly Average Sales Price Medicare Part B Drug Pricing File, Effective October 1, 2005 and Revisions to April 2005 and July 2005 Quarterly Average Sale Price Medicare Part B Drug Pricing File |
| 654 | Services Not Provided Within the United States |
|  | Services Received by Medicare Beneficiaries Outside the United States Source of Part B Claims |
|  | Appeals of Denied Charges for Physicians and Ambulance Services in Connection With Foreign Hospitalization |
|  | Services Rendered in Nonparticipating Providers |
|  | Coverage Requirements for Emergency Hospital Services in Foreign Countries |
|  | Services Furnished in a Foreign Hospital Nearest to Beneficiary's U.S. Residence |
|  | Coverage of Physician and Ambulance Services Furnished Outside U.S. |
|  | Payment by the Railroad Retirement Beneficiaries for Services Furnished in Canada to Qualified Railroad Retirement Beneficiaries |
|  | Foreign Religious Nonmedical Health Care Facility Claims |
|  | Elections to Bill for Services Rendered at Nonparticipating Hospitals |
|  | Processing Claims |
|  | Appeals on Claims for Emergency and Foreign Services |
|  | Payment for Services from Foreign Hospitals |
|  | Full Denial—Foreign Claim—Beneficiary Filed |
| 655 | This Transmittal is rescinded and replaced by Transmittal 663 |
| 656 | Full Replacement of Change Request 3607, Payment Edits in Applicable States For Durable Medical Equipment Prosthetics, Orthotics & Supplies |
|  | Provider Billing for Prosthetics and Orthotic Services |
| 657 | Quarterly Update to Correct Coding Initiative Edits, Version V11.3, Effective October 1, 2005 |
| 658 | Billing for Devices Under the Hospital Outpatient Prospective Payment System |
|  | Billing for Devices Under the Outpatient Prospective Payment System |
|  | Requirements that Hospitals Report Device Codes on Claims on Which They Report Specified Procedures |
|  | Edits for Claims on Which Specified Procedures Are To Be Reported With Device Codes |
| 659 | Instructions for Downloading the Medicare Zip Code File |
| 660 | This Transmittal is rescinded and replaced by Transmittal 664 |
| 661 | This Transmittal is rescinded and replaced by Transmittal 672 |
| 662 | This Transmittal is rescinded and replaced by Transmittal 691 |
| 663 | Update To The Hospice Payment Rates, Hospice Cap, Hospice Wage Index, and the Hospice Pricer for Fiscal Year 2006 |
| 664 | This Transmittal is rescinded and replaced by Transmittal 683 |
| 665 | October Quarterly Update for 2005 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Fees Schedule |
| 666 | Updates to the Coordination of Benefits Contractor Detailed Error |
|  | Report File Layout |
|  | Consolidation of the Claims Crossover Process |
|  | Coordination of Benefits Agreement Detailed Error Notification Process |
| 667 | Home Care and Domiciliary Care Visits (Codes 99321-99350) |
| 668 | Enforcement of Hospital Inpatient Bundling: Carrier Denial of Ambulance Claims During an Inpatient Stay |
|  | Hospital Inpatient Bundling |
|  | General Coverage and Payment Policies |
|  | Common Working File Editing of Ambulance Claims for Inpatients |
|  | Intermediary Guidelines |
|  | Provider/Intermediary Bill Processing Guidelines Effective April 1, 2002, as a Result of Fee Schedule Implementation |
| 669 | Schedule for Completing the Calendar Year 2006 Fee Updates and the Participating Physician Enrollment Procedures |
| 670 | Realignment of States and Medicare Claims Processing Workload From Durable Medical Equipment Regional Carrier Regions A, B, C, and D to the Durable Medical Equipment Major Ambulatory Jurisdictions A, B, C and D |
| 671 | Updated Manual Instructions for the Medicare Claims Processing Manual, Regarding Smoking and Tobacco-Use Cessation Counseling Services |
|  | Healthcare Common Procedure Coding System and Diagnosis Coding |
|  | Carrier Billing Requirements |
|  | Fiscal Intermediary Billing Requirements |
|  | Medicare Summary Notices |
| 672 | October Update to the 2005 Medicare Physician Fee Schedule Database |
| 673 | Manual Update on Medical Nutrition Therapy Services—Manualization |
|  | Medicare Nutrition Therapy Services |
|  | General Conditions and Limitations on Coverage |
|  | Referrals for Medicare Nutrition Therapy Services |
|  | Dietitians and Nutritionists Performing Medicare Nutrition Therapy Services |
|  | Payment for Medicare Nutrition Therapy Services |
|  | General Claims Processing Information |
|  | Common Working File Edits |
| 674 | This Transmittal is rescinded and replaced by Transmittal 692 |
| 675 | Changes to Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Date October 1, 2005) |
|  | Workload Data Analysis Program |
|  | Managing Appeals Workloads |
|  | Standard Operating Procedures |
|  | Execution of Workload Prioritization |
|  | Workload Priorities |
| 676 | 2006 Healthcare Common Procedure Coding System Annual Update Reminder |
| 677 | This Transmittal is rescinded and replaced by 687 |
| 678 | This Transmittal is rescinded and replaced by 688 |
| 679 | Medicare Redetermination Notice and Effect of the Redetermination Medicare Redetermination Notice (for partly or fully unfavorable redeterminations) |
|  | Medicare Redetermination Notice (for fully favorable redeterminations) Effect of the Redetermination |
| 680 | Inpatient Rehabilitation Facility Annual Update: Prospective Payment System Pricer Changes for FY 2006 |
| 681 | Guidelines For Payment of Vaccines (Pneumococcal Pneumonia Virus, Influenza Virus, And Hepatitis B Virus) and Their Administration Provided by Indian Health Services/Tribally-Owned and/or Operated Hospitals and Hospital Based Facilities |
|  | Billing Requirements |
|  | Bills Submitted to Fiscal Intermediaries |
|  | Vaccines and Vaccine Administration |
| 682 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 683 | October 2005 Outpatient Prospective Payment System Code Editor Specifications Version |
| 684 | Correction to Chapter 17, Section 80.2.3, MSN/ANSI X12 Denial Messages for Anti-Emetic Drugs |
| 685 | Discontinuation of the Skilled Nursing Facility Healthcare Common Procedure Coding System Help File and Notification to Fiscal Intermediaries and Providers of the Redesigned Skilled Nursing Facility Consolidated Billing Annual Update File Posted on CMS Web site |
|  | Services Included in Part A Prospective Payment System Payment Not Billable Separately by the Skilled Nursing Facility |
|  | Services Beyond the Scope of the Part A Skilled Nursing Facility Benefit |
|  | Billing for Medical and Other Health Services |
|  | General Payment Rules and Application of Part B Deductible and Coinsurance |
| 686 | Common Working File Unsolicited Response Adjustments for Certain Claims Denied Due to an Open Medicare Secondary Payer Group Health Plan Record Where the Group Health Plan Record Was Subsequently Deleted |
| 687 | Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for Fiscal Intermediary Initial Determination Issued On or After May 1, 2005 and Carrier Initial Determinations Issued on or After January 1, 2006) |
|  | Filing a Request for Redetermination |
|  | Appeal Rights for Dismissals |
|  | Dismissal Letters |
|  | Model Dismissal Notices |
|  | Reconsideration—The Second Level of Appeal |
|  | Filing a Request for a Reconsideration |
|  | Time Limit for Filing a Request for a Reconsideration |
|  | Contractor Responsibilities—General |
|  | Qualified Independent Contractor Case File Development |
|  | Qualified Independent Contractor Case File Preparation |
|  | Forwarding Qualified Independent Contractor Case Files |
|  | Qualified Independent Contractor Jurisdictions |
|  | Tracking Cases |
|  | Effectuation of Reconsiderations |
| 688 | Appeals of Claims Decisions: Redeterminations and Reconsiderations (Implementation Dates for All Requests for Redetermination Received by Fiscal Intermediary on or After May 1, 2005, and All Requests for Redetermination Received by Carriers on or After January 1, 2006) |
|  | Redetermination—The First Level of Appeal |
|  | The Redetermination |
|  | The Redetermination Decision |
|  | Dismissals |
|  | Vacating a Dismissal |
| 689 | One Time Update to the National Council Prescription Drug Programs |
|  | Companion Document Regarding Crossover Claims to Medicaid |
| 690 | Fiscal Year (FY) 2006 Payment for Services Furnished in Ambulatory Surgical Centers |
| 691 | October 2005 Update of the Hospital Outpatient Prospective Payment System |
| 692 | Fiscal Year 2006 Inpatient Prospective Payment System and Long Term Care Hospital Changes |
| 693 | Updates to the Inpatient Rehabilitation Facility and Skilled Nursing Facility |
|  | Provider Specific File and Changes in Inpatient Rehabilitation Facility |
|  | Prospective Payment System for FY 2006 |
|  | Provider-Specific File |
|  | Case-Mix Groups |
|  | Facility Level Adjustments |
|  | Area Wage Adjustment |
|  | Rural Adjustment |
|  | Outlier |
|  | Teaching Status Adjustment |
|  | Full Time Equivalent Resident Cap |
|  | Inpatient Rehabilitation Facility Prospective Payment System Pricer Software |
| 694 | Update to the Healthcare Provider Taxonomy Codes Version 5.1 |
|  |  |
|  |  |
| 31 | Full Replacement of Change Request 3770, Expanding the Number of Source Identifiers for Common Working File Medicare Secondary Payer Records |
|  | Change Request 3770 Is Rescinded |
|  | Definition of Medicare Secondary Payer/Common Working File Terms |
|  | Medicare Secondary Payer Delete Transaction |
|  | Identification of Reimbursement Advisory Committee Created Group Health Plan Records |
| 32 | Exception for Small Employers in Multi-Employer Group Health Plans Overview and General Responsibilities |
|  | Introduction to the Coordination of Benefits Contractor |
|  | Scope of the Coordination of Benefit Contractor in Relation to Contractors |
|  | Contractors Claim Referrals to the Coordination of Benefit Contractors IRS/SSA/CMS Data Match |
|  | Coordination of Benefit Contractors Discontinues Dissemination of the Right of Recovery Letters to Contractors |
|  | Exception for Small Employers in Multi-Employer Group Health Plans |
|  | Purpose |
|  | Background |
|  | Specific Information |
| 33 | Working Aged Exception for Small Employers in Multi-Employer Group Health Plans |
| 34 | Manualization: Long-Standing Medicare Secondary Payer Policy in Chapter 1 of the Medicare Secondary Payer Internet Only Manual |
|  | General Provisions |
|  | Working Aged |
|  | End-Stage Renal Disease |
|  | Workers' Compensation |
|  | No-Fault Insurance |
|  | Liability Insurance |
|  | Conditional Primary Medicare Benefits |
|  | When Conditional Primary Medicare Benefits May Be Paid When a Group Health Plan Is a Primary Payer to Medicare |
|  | When Conditional Primary Medicare Benefits May Not Be Paid When a Group Health Plan Is a Primary Payer to Medicare |
|  | When Medicare Secondary Payer Benefits Are Payable and Not Payable |
|  | Multiple Insurers |
|  | Definitions |
|  | Crediting Deductible for Non-Inpatient Psychiatric Services |
|  | Clarification of Current Employment Status for Specific Groups |
|  | Actions Resulting From Group Health Plan or Large Group Health Plan |
|  | Nonconformance |
|  | Federal Government's Right to Sue and Collect Double Damages |
| 35 | Updates to the Group Health Plan Identification and Recovery Processes |
|  | General |
|  | IRS/SSA/CMS Data Match (Data Match) Group Health Plan Identified Cases |
|  | Non-Data Match Group Health Plan Identified Cases |
|  | Other Sources of Recovery Actions |
|  | Group Health Plan Acknowledges Specific Debt (42 CFR 411.25) |
|  | Recovery When a State Medicaid Agency Has Also Requested a Refund From the Group Health Plan |
|  | Identification of Group Health Plan Mistaken Primary Payments Via the Recovery Management and Accounting System |
|  | Progression of Recovery Management Accounting System Group Health Plan |
|  | Lead Identification |
|  | Progression of Recovery Management Accounting System History Search |
|  | Contractor Recovery Case Files (Audit Trails) |
|  | Group Health Plan Letters (Used for Recovery Management Accounting |
|  | System/Healthcare Integrated General Ledger Accounting System (ReMAS/HIGLAS) When the Only Debtor Interfaced to Healthcare Integrated General Ledger Accounting System Is the Employer) |
|  | Employer Group Health Plan Letter |
|  | Important Information for Employers |
|  | Insurer Group Health Plan Letter (Used for Recovery Management Accounting System/Healthcare Integrated General Ledger Accounting System When the Only Debtor Interfaced to Healthcare Integrated General Ledger Accounting System Is the Employer) |
|  | Accountability Worksheet (Not Applicable to Recovery Management Accounting System/Healthcare Integrated General Ledger Accounting System Users) |
|  | Summary Data Sheet (Not Applicable to ReMAS/HIGLAS Users) |
|  | Field Description on the Medicare Secondary Payer Summary Data Sheet Payment Record Summary (Used with ReMAS/HIGLAS Users but in a Modified Format) |
|  | Courtesy Copy of All Medicare Secondary Payer Group Health Plan-Based Recovery Demand Packages to the Employer's Insurer/Third Party Administrator |
|  | Insurer/Third Party Administrator Courtesy Copy Letter |
|  | Recovery Management Accounting System Error Reports |
|  | Mistaken Group Health Plan Primary Payments |
|  | Mistaken Primary Payment Activities and Record Layouts |
|  | Contractor Actions Upon Receipt of the Data Match Cycle Tape or Other Notice of Non-Data Match Group Health Plan Mistaken Payments (for Contractor Not on ReMAS/HIGLAS for GHP Recovery) and Actions to Take for Those Contractors Using Recovery Management Accounting System/Health Integrated General Ledger Accounting System Group Health Plan Functions |
|  | Coordination of Benefits Contractor Responsibility to Obtain Missing Medicare Secondary Payer Information |
|  | Time Limitations for Group Health Plan Recoveries |
|  | Actual Notice |
|  | Contractor History Search |
|  | Aggregate Claims for Recovery |
|  | Documentation of Debt |
|  | Recovery Attempt Audit Trails |
|  | Summary of Medicare Reimbursement |
|  | Claim Facsimiles for Each Claim Mistakenly Paid |
|  | IRS/SSA/CMS Mistaken Payment Recovery Tracking System |
|  | Inpatient, Skilled Nursing Facility, and Religious Non-Medicare Health Care |
|  | Outpatient Mistaken Payment Report Record Layout |
|  | Home Health Agency Mistaken Payment Record Layout |
|  | Communication Receive in Response to Recovery Actions |
| 36 | Update to the Healthcare Provider Taxonomy Codes Version 5.1 |
|  |  |
|  |  |
| 71 | Notice of New Interest Rate for Medicare Overpayments and Underpayments |
| 72 | Claims Accounts Receivable Update |
|  | Intermediary Claims Accounts Receivable |
|  | Financial Reporting for Intermediary Claims Accounts Receivable |
| 73 | This Transmittal is rescinded and replaced by Transmittal 75 |
| 74 | Discovery Code Indication for Recovery Audit Contractor (RAC) Non-MSP Identified Overpayments |
| 75 | New Thresholds for 2nd Demand Letter for Physicians/Suppliers |
|  | Part B Overpayment Demand Letters to Physicians/Suppliers |
| 76 | Development of New Report to Capture Benefits, Improvement and Protection Act and Medicare Prescription Drug, Improvement, and Modernization Act Appeals Data |
|  | Monthly Statistical Report on Intermediary and Carrier Part A and Part B |
|  | Appeals Activity Form |
|  | Redeterminations |
|  | Qualified Independent Contractor Reconsiderations |
|  | Administrative Law Judge Results |
|  | Department Appeals Board Effectuations |
|  | Clerical Error Reopenings |
|  | Validation of Reports |
| 77 | Non-Medicare Secondary Payer Debt Referral and Debt Collection Improvement Act of 1996 Activities |
|  | Background |
|  | Cross Servicing |
|  | Treasury Offset Program |
|  | Definition of Delinquent Debt |
|  | Referral Requirements |
|  | Exemptions to Referral |
|  | Debt to be Referred |
|  | Delinquent Non-Medicare Secondary Payer Fiscal Intermediary Debt, Including Debt on the Provider Overpayment Reporting System |
|  | Delinquent Non-Medicare Secondary Payer Medicare Carrier Debt, Including Debt on the Physician/Supplier Overpayment Reporting System |
|  | Delinquent Non-Medicare Secondary Payer Debt Previously Ineligible for Referral |
|  | Debt Collection Improvement Act Language/Intent to Refer Letter |
|  | Response to “Intent to Refer” Letter |
|  | Provider Overpayment Reporting System Updates |
|  | Physician/Supplier Overpayment Reporting System Updates |
|  | Cross Servicing Collection Efforts |
|  | Actions Subsequent to Debt Collection System Input |
|  | Transmission of Debt |
|  | Update to Debt Collection System After Transmission |
|  | Financial Reporting for Debt Referred |
|  | Financial Reporting for Non-Medicare Secondary Payer Debt |
| 78 | Coordination of Benefits Agreement Process for Contractor Financial Staff Notification |
|  |  |
|  |  |
| 09 | Revision of Appendix P and Certain Exhibits of the State Operations Manual |
| 10 | Revisions—Appendix J—Interpretive Guidelines Intermediate Care Facilities With Mental Retardation |
| 11 | Revised Chapter 2—“The Certification Process,” Sections 2180E thru 2200F, and Appendix B—“Interpretive Guidelines: Home Health Agencies” |
|  |  |
|  |  |
| 115 | Program Integrity Manual Revision |
|  | Affiliated Contractor/Full Program Safeguard Contractor Communication With the Comprehensive Error Rate Testing Contractor |
|  | Overview of the Comprehensive Error Rate Testing Process |
|  | Providing Sample Information to the Comprehensive Error Rate Testing Contractor |
|  | Providing Review Information to the Comprehensive Error Rate Testing Contractor |
|  | Providing Feedback Information to the Comprehensive Error Rate Testing Contractor |
|  | Disputing/Disagreeing With a Comprehensive Error Rate Testing Decision Handling Overpayments and Underpayments Resulting From the Comprehensive Error Rate Testing Findings |
|  | Handling Appeals Resulting From Comprehensive Error Rate Testing Initiated Denials |
|  | Tracking Overpayments |
|  | Tracking Appeals |
|  | Potential Fraud |
|  | Full Program Safeguard Contractor Requirements Involving Comprehensive Error Rate Testing Information Dissemination |
|  | Full Program Safeguard Contractor Error Rate Reduction Plan |
|  | Contacting Non-Responders |
|  | Late Documentation Received by the Comprehensive Error Rate Testing Contractor |
|  | Voluntary Refunds |
|  | Local Coverage Determination/National Coverage Determination |
|  | Comprehensive Error Rate Testing Review Contractor Review Guidelines |
| 116 | Revise the Fiscal Intermediary Shared System to Allow Reporting of Data for the Comprehensive Error Rate Testing Program Resolution File at a Line Level |
| 117 | Revise the Medicare Contractor System and the VIPS Medicare System To Allow Update of the Comprehensive Error Rate Testing Program Resolution File Within Five Business Days of a Comprehensive Error Rate Testing Request |
| 118 | Various Benefit Integrity Clarifications |
|  | Goal of Medical Review Program |
|  | Overpayment Procedures |
|  | Disposition of the Suspension |
|  | The Medicare Fraud Program |
|  | Program Safeguard Contractor and Medicare Contractor Benefit Integrity Unit |
|  | Organizational Requirements |
|  | Training for Law Enforcement Organizations |
|  | Procedural Requirements |
|  | Requests for Information From Outside Organizations |
|  | Sharing Fraud Referrals Between the Office of Inspector General and the Department of Justice |
|  | Complaint Screening |
|  | Investigations |
|  | Conducting Investigations |
|  | Disposition of Cases |
|  | Reversed Denials by Administrative Law Judges on Open Cases |
|  | Types of Fraud Alerts |
|  | Coordination |
|  | Investigation, Case, and Suspension Entries |
|  | Update Requirements for Cases |
|  | Closing Investigations |
|  | Deleting Investigations, Cases, or Suspensions |
|  | Access |
|  | Harkin Grantees or Senior Medicare Patrol—Complaint Tracking System |
|  | Harkin Grantees or Senior Medicare Patrol Project Description |
|  | Harkin Grantees Tracking System Instructions |
|  | System Access to Metaframe and Data Collection |
|  | Data Dissemination/Aggregate Report |
|  | Referral of Cases to the Office of the Inspector General/Office of Investigations |
|  | Immediate Advisements to the Office of Inspector General/Office of Investigations |
|  | Denial of Payments for Cases Referred to and Accepted by Office of Inspector General/Office of Investigations |
|  | Take Administrative Action on Cases Referred to and Refused by Office of Inspector General /Office of Investigations |
|  | Referral to State Agencies or Other Organizations |
|  | Referral to Quality Improvement Organizations |
|  | Referral Process to CMS |
|  | Referrals to Office of Inspector General |
|  | Breaches of Assignment Agreement by Physician or Other Supplier |
|  | Annual Deceased-Beneficiary Postpayment Review |
|  | Vulnerability Report |
| 119 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 120 | Correction to Change Request (CR) 3222: Local Medical Review Policy/Local Coverage Determination Medicare Summary Notice Message Revision Denials Notices |
| 121 | This Transmittal is rescinded and replaced by Transmittal 124 |
| 122 | Medical Review Collection Number Requirements |
|  | Overview of Prepayment and Postpayment Review for Medical Review Purposes |
| 123 | Chapter 3, Medicare Modernization Act Section 935 |
|  | Verifying Potential Errors and Setting Priorities |
|  | Determining Whether the Problem Is Widespread or Provider Specific |
|  | Overpayment Procedures |
|  | “Probe” Reviews |
| 124 | Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle Claims |
| 125 | Medical Review Additional Documentation Requests |
|  | Additional Documentation Requests During Prepayment or Postpayment |
|  | Medical Review |
|  |  |
|  |  |
| 12 | Next Generation Desktop Testing Requirements |
| 13 | Provider Contact Centers Training Program |
|  | Guidelines for Telephone Service |
|  | Staff Development and Training |
|  |  |
|  |  |
| 66 | Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans |
|  | Changes in Requirements for Periodic Surveys of Current and Former Enrollees, and in the CMS Method for Calculating Interest on Overpayment and Underpayments to Health Maintenance Organizations, Comprehensive Medical Plans and Health Care Prepayment Plans |
| 67 | Initial Publication of Chapter 1—General Provisions |
|  | Introduction |
|  | Definitions |
|  | Types of Medical Assistance Plans |
|  | Cost Sharing in Enrollment—Related Costs |
| 68 | Revisions to Chapter 12, “Effect of Change of Ownership,” and Chapter 14, “Contract Determination and Appeals” |
|  | Effect of Change of Ownership |
|  | What Constitutes a Change of Ownership |
|  | Address for Sending Notifications to CMS |
|  | When a Novation Agreement Is Required |
|  | Acceptable Novation Agreements |
|  | Contract Determination Notice |
|  | Postponement of the Contract Determination's Effective Date |
|  | Reconsiderations |
|  | Time Frames for Filing a Reconsideration Request |
|  | Parties to the Hearing |
|  | Conduct and Record of a Hearing |
|  | Reopening of Contract Reconsidered Determination or Decision of a Hearing Officer or the Administrator |
| 69 | Beneficiary Enrollment and Disenrollment Requirements for Medicare Advantage Plans |
| 70 | Deletion of MCM Chapter 19—The Enrollment and Payment User's Guide, and Chapter 20—Managed Care and Medical Assistance Business Requirements |
| 71 | Changes in Manual Instructions for Benefits and Beneficiary Protections |
|  | Basic Rules |
|  | Types of Benefits |
|  | Availability and Structure of Plans |
|  | CMS Review and Approval of M+C Benefit—rewritten and relocated to § 20 |
|  | Requirements Relating to Medicare Conditions of Participation—renumbered as § 4.10.7 |
|  | Provider Networks—renumbered as new § 10.8 and parts of the old § 20, “Original Medicare Covered Benefits” |
|  | CMS Approval of Proposed Plan MA Benefits—old 10.7 revised and located here |
|  | General Guidelines on Benefit Approval |
|  | Screening Mammography, Influenza Vaccine, and Pneumococcal Vaccine |
|  | Inpatient Hospital Rehabilitation Service |
|  | Value-Added Items and Services |
|  | Prescription Drug Discount Programs |
|  | Waiting Periods and Exclusions That Are Not Present in Original Medicare |
|  | Annual Beneficiary Out-of-Pocket Cap |
|  | Drug Benefits |
|  | Drugs That Are Covered Under Original Medicare |
|  | Mid-Year Benefit Enhancements |
|  | Multi-Year Benefits |
|  | Return to Home Skilled Nursing Facility |
|  | Guidance on Acceptable Cost-Sharing and Deductibles |
|  | Homemaker Services |
|  | Caregiver Resource Services |
|  | Electronic Monitoring |
|  | Dentures |
|  | Chiropractic Services |
|  | Cash |
|  | Beauty Parlor |
|  | Transportation |
|  | Safety Items |
|  | Travel for Transplants |
|  | Meals |
|  | Basic Benefits |
|  | Cost-sharing Rules for Medical Assistance Regional Plans |
|  | Supplemental Benefits and Mandatory Supplemental and Optional Supplemental |
|  | Basic Versus Supplemental Benefits |
|  | The Annual Deductible |
|  | General Rule |
|  | Accessing Plan Contracting Providers |
|  | Enrollee Information and Disclosure |
|  | Definitions |
|  | Factors That Influence Service Area Approval |
|  | The “County Integrity Rule” |
|  | General Rule |
|  | Employer Plans |
|  | Basic Rule |
|  | Medicare Benefits Secondary to Group Health Plans and Large Group Health Plans |
|  | Medicare Secondary Payer Rules and State Laws |
|  | Discrimination Against Beneficiaries Prohibited |
|  | Disclosure Requirements at Enrollment (and Annually Thereafter) |
|  | Information Pertaining to a Medical Assistance Organization Changing Their Rules or Provider Network |
|  | Other Information That Is Disclosable Upon Request |
|  | Access and Availability Rules for Coordinated Care Plans |
|  | Emergency and Urgently Needed Services |
|  | Post-Stabilization Care Services |
|  | General Description |
|  | Private Fee-for-Service Plan Terms and Conditions of Participation |
|  | Provider Types—Direct Contracting, Deemed Contracting, Non-Contracting Access to Services |
|  | Payments and Balance Billing |
|  | Advance Notice of Coverage |
|  | Prompt Payment Requirements |
|  | Original Medicare vs. Estimated Payment Amounts |
|  | Table Summarizing Private Fee-for-Service Plan Provider Types and Rules |
| 72 | Changes in Manual Instructions for Intermediate Sanctions |
|  | Types of Intermediate Sanctions |
|  | General Basis for Imposing Intermediate Sanctions on Medical Assistance Organizations |
|  | Imposing Sanctions for Specific Medical Assistance Contract Violations |
|  | Civil Monetary Penalties for Medical Assistance Organizations That Improperly Terminate the Medical Assistance Contract |
|  | CMS Process for Suspending Marketing, Enrollment, and Payment |
|  | Contract Termination by CMS |
|  |  |
|  |  |
| 00 | None |
|  |  |
|  |  |
| 26 | This Transmittal is rescinded and replaced by Transmittal 27 |
| 27 | The Medicare Chronic Care Improvement, “Medicare Health Support,” Program |
| 28 | The Medicare Care Management for High Cost Beneficiaries Demonstration |
|  |  |
|  |  |
| 161 | Kansas Blue Cross Blue Shield Carrier Numbering Issue |
| 162 | Instructions for Fiscal Intermediary Standard System and Multi-Carrier System |
|  | Healthcare Integrated General Ledger Accounting System Changes |
| 163 | Qualified Independent Contractor Jurisdictions |
| 164 | Medicare HIPAA Electronic Claims Report—Third Reporting Timeframe Extension |
| 165 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 166 | This Transmittal is rescinded and replaced by Transmittal 173 |
| 167 | Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity of Instruction |
| 168 | Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act Transaction January 2006 Release Testing |
| 169 | Analysis of Systems Improvements to Streamline POS Code Set Updates |
| 170 | Updates to the Coordination of Benefits Agreement Insurance File for Use in the National Claims Crossover Program |
| 171 | Preliminary system updates in preparation for ending the Medicare contingency plan in October 2005 |
| 172 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 173 | Overnight Oximetry Testing |
| 174 | Fiscal Intermediary Shared System Modification |
| 175 | Common Working File Calculation of Next Eligible Date for Preventive Services |
| 176 | Change of the CareFirst Part A Plan to Highmark in the State of Maryland and Washington, DC |
| 177 | Termination of Existing Crossover Agreements as Trading Partners |
|  | Transition to the National Coordination of Benefits Agreement Program |
| 178 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 179 | Calculation of the Interim Payment of Indirect Medical Education Through the Inpatient Prospective Payment Pricer for Hospitals That Received an Increase to Their Full-Time Equivalent Resident Cap Under Section 422 of the Medicare Modernization Act, P.L. 108-173 |
| 180 | Issued to a specific audience, not posted to Internet/Intranet due to Confidentiality of Instruction |
| 181 | National Modifier and Condition Code To Be Used To Identify Disaster Disaster Related Claims |

| Publication date | FR Vol. 70 page number | CFR parts affected | File code | Title of regulation |
| --- | --- | --- | --- | --- |
| July 6, 2005 | 39022 | 414 | CMS-3125-IFC | Medicare Program; Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B. |
| July 8, 2005 | 39514 |  | CMS-1288-N | Medicare Program; Meeting of the Advisory Panel on Ambulatory Payment Classification (APC) Groups—August 17, 18, and 19, 2005. |
| July 12, 2005 | 40039 |  | CMS-2212-N | Medicaid Program; Meeting of the Medicaid Commission—July 27, 2005. |
| July 14, 2005 | 40788 | 484 | CMS-1301-P | Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2006. |
| July 14, 2005 | 40709 |  | CMS-1288-CN | Medicare Program; Meeting of the Advisory Panel on Ambulatory Payment Classification (APC) Groups—August 17, 18, and 19, 2005; Correction. |
| July 22, 2005 | 42331 |  | CMS-3142-FN | Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts. |
| July 22, 2005 | 42330 |  | CMS-1315-N | Medicare Program; August 22, 2005, Meeting of Practicing Physicians Advisory Council and Request for Nominations. |
| July 22, 2005 | 42329 |  | CMS-3153-N | Medicare Program; Meeting of the Medicare Coverage Advisory Committee—October 6, 2005. |
| July 22, 2005 | 42328 |  | CMS-4093-N | Medicare Program; Request for Nominations for the Advisory Panel on Medicare Education. |
| July 22, 2005 | 42327 |  | CMS-3158-N | Medicare Program; Request for Nominations for Members for the Medicare Coverage Advisory Committee. |
| July 22, 2005 | 42276 | 146 | CMS-4094-F3 | Amendment to the Interim Final Regulation for Mental Health Parity. |
| July 25, 2005 | 42674 | 419 and 485 | CMS-1501-P | Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates. |
| August 4, 2005 | 45130 | 418 | CMS-1286-F | Medicare Program; Hospice Wage Index for Fiscal Year 2006. |
| August 4, 2005 | 45026 | 409, 411, 424, and 489 | CMS-1282-F | Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006. |
| August 4, 2005 | 44930 |  | CMS-2220-N | Medicare Program; Meeting of the Medicaid Commission—August 17-18, 2005. |
| August 4, 2005 | 44879 | 402 | CMS-6019-P | Medicare Program; Revised Civil Money Penalties, Assessments, Exclusions, and Related Appeals Procedures. |
| August 8, 2005 | 45764 | 405, 410, 411, 413, 414, and 426 | CMS-1502-P | Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006. |
| August 12, 2005 | 47278 | 405, 412, 413, 415, 419, 422, and 485 | CMS-1500-F | Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates. |
| August 15, 2005 | 47880 | 412 | CMS-1290-F | Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for FY 2006. |
| August 15, 2005 | 47759 | 483 | CMS-3198-P | Medicare and Medicaid Programs; Condition of Participation: Immunization Standard for Long Term Care Facilities. |
| August 26, 2005 | 50940 | 410 | CMS-3017-IFC | Medicare Program; Conditions for Payment of Power Mobility Devices, including Power Wheelchairs and Power-Operated Vehicles. |
| August 26, 2005 | 50680 | 419 and 485 | CMS-1501-CN | Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction. |
| August 26, 2005 | 50375 |  | CMS-4111-N | Medicare Program; Meeting of the Advisory Panel on Medicare Education, September 27, 2005. |
| August 26, 2005 | 50374 |  | CMS-1330-N | Medicare Program; Town Hall Meeting on the Medicare Provider Feedback Group (MPFG)—September 12, 2005. |
| August 26, 2005 | 50373 |  | CMS-4106-PN | Medicare Program; Changes in Medicare Advantage Deeming Authority. |
| August 26, 2005 | 50372 |  | CMS-1309-NC | Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver for Organ Procurement Service Area. |
| August 26, 2005 | 50358 |  | CMS-2209-N | Medicaid Program; Fiscal Disproportionate Share Hospital Allotments and Disproportionate Share Hospital Institutions for Mental Disease Limits. |
| August 26, 2005 | 50358 |  | CMS-1486-N | Medicare Program; Announcement of New Members of the Advisory Panel on Ambulatory Payment Classification (APC) Groups. |
| August 26, 2005 | 50262 | 447 and 455 | CMS-2198-P | Medicaid Program; Disproportionate Share Hospital Payments. |
| August 26, 2005 | 50214 | 433 | CMS-2210-IFC | Medicaid Program; State Allotments for Payment of Medicare Part B Premiums for Qualifying Individuals: Federal Fiscal Year 2005. |
| August 26, 2005 | 50214 | 405 | CMS-4064-IFC3 | Medicare Program; Changes to the Medicare Claims Appeal Procedures: Correcting Amendment to a Correcting Amendment. |
| August 30, 2005 | 51321 | 410 | CMS-6024-P | Medicare Program; Prior Determination for Certain Items and Services. |
| September 1, 2005 | 52105 |  | CMS-1308-NC | Medicare Program; Withdrawal of Ambulance Fee Schedule Issued in Accordance With Federal District Court Order in Lifestar Ambulance v. United States, No. 4:02-CV-127-1 (M.D. Ga., Jan. 16, 2003)—Medicare Covered Ambulance Services. |
| September 1, 2005 | 52056 | 405, 410, 411, 413, 414, and 426 | CMS-1502-CN | Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006; Correction. |
| September 1, 2005 | 52023 | 422 | CMS-4069-F3 | Medicare Program; Establishment of the Medicare Advantage Program; Correcting Amendment; Partial Stay of Effectiveness. |
| September 1, 2005 | 52019 | 403 | CMS-4063-F | Medicare Program; Medicare Prescription Drug Discount Card; Revision of Marketing Rules for Endorsed Drug Card Sponsors. |
| September 6, 2005 | 52930 | 414 | CMS-1325-IFC2 | Medicare Program; Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B: Interpretation and Correction. |
| September 16, 2005 | 54751 |  | CMS-5017-N | Medicare Program; Medicare Health Care Quality (MHCQ) Demonstration Programs. |
| September 23, 2005 | 55905 |  | CMS-3159-N | Medicare Program; Meeting of the Medicare Coverage Advisory Committee—November 29, 2005. |
| September 23, 2005 | 55903 |  | CMS-1269-N5 | Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG) Meeting—October 26, 2005 Through October 28, 2005. |
| September 23, 2005 | 55897 |  | CMS-8027-N | Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible for Calendar Year 2006. |
| September 23, 2005 | 55896 |  | CMS-8025-N | Medicare Program; Part A Premium for Calendar Year 2006 for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement. |
| September 23, 2005 | 55887 |  | CMS-1307-GNC | Medicare Program; Criteria and Standards for Evaluating Intermediary, Carrier, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Regional Carrier Performance During Fiscal Year 2006. |
| September 23, 2005 | 55885 |  | CMS-8026-N | Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for Calendar Year 2006. |
| September 23, 2005 | 55863 |  | CMS-9032-N | Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-April Through June 2005. |
| September 23, 2005 | 55862 |  | CMS-2227-PN | Medicare and Medicaid Programs; Application by the Accreditation Commission of Healthcare for Deeming Authority for Home Health Agencies. |
| September 23, 2005 | 55812 | 447 and 455 | CMS-2198-CN | Medicaid Program; Disproportionate Share Hospital Payments. |
| September 29, 2005 | 56901 |  | CMS-2230-FN | State Children's Health Insurance Program (SCHIP); Redistribution of Unexpended SCHIP Funds From the Appropriation for Fiscal Year 2002. |
| September 30, 2005 | 57376 | 505 | CMS-1320-P | Medicare Program; Health care Infrastructure Improvement Program; Forgiveness of Indebtness. |
| September 30, 2005 | 57368 | 505 | CMS-1287-IFC | Medicare Program; Health Care Infrastructure Improvement Program; Selection Criteria of Loan Program for Qualifying Hospitals Engaged in Cancer-Related Health Care. |
| September 30, 2005 | 57300 |  | CMS-1307-CN | Medicare Program; Criteria and Standards for Evaluating Intermediary, Carrier, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Regional Carrier Performance During Fiscal Year 2006; Correction Notice. |
| September 30, 2005 | 57297 |  | CMS-3144-NC | Medicare Program; Calendar Year 2005 Review of Appropriateness of Payment Amounts for New Technology Intraocular Lenses (NTIOLs) Furnished by Ambulatory Surgical Centers (ASCs). |
| September 30, 2005 | 57296 |  | CMS-1269-N6 | Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG): Announcement of a New Member. |
| September 30, 2005 | 57174 | 418 | CMS-1286-CN | Medicare Program; Hospice Wage Index for Fiscal Year 2006. |
| September 30, 2005 | 57166 | 412 | CMS-1290-CN | Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for FY 2006; Correction. |
| September 30, 2005 | 57164 | 411 and 424 | CMS-1282-CN | Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Correction. |
| September 30, 2005 | 57161 | 405, 412, 413, 415, 419, 422, and 485 | CMS-1500-CN | Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates; Correction. |

**Addendum V—National Coverage Determinations**

**[July Through September 2005]**

A national coverage determination (NCD) is a determination by the Secretary with respect to whether or not a particular item or service is covered nationally under Title XVIII of the Social Security Act, but does not include a determination of what code, if any, is assigned to a particular item or service covered under this title, or determination with respect to the amount of payment made for a particular item or service so covered. We include below all of the NCDs that were issued during the quarter covered by this notice. The entries below include information concerning completed decisions  as well as sections on program and decision memoranda, which also announce pending decisions or, in some cases, explain why it was not appropriate to issue an NCD. We identify completed decisions by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. Information on completed decisions as well as pending decisions has also been posted on the CMS Web site at *http://cms.hhs.gov/coverage* .

**National Coverage Determinations**

**[July Through September 2005]**

There were no new NCDs posted during this time period.

**Addendum VI—FDA-Approved Category B IDEs**

**[July Through September 2005]**

Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c) devices fall into one of three classes. To assist CMS under this categorization process, the FDA assigns one of two categories to each FDA-approved IDE. Category A refers to experimental IDEs, and Category B refers to non-experimental IDEs. To obtain more information about the classes or categories, please refer to the *Federal Register* notice published on April 21, 1997 (62 FR 19328).

The following list includes all Category B IDEs approved by FDA during the second quarter, July through September 2005.

**IDE/Category**

G040204

G050005

G050016

G050028

G050035

G050036

G050041

G050044

G050069

G050072

G050082

G050086

G050103

G050107

G050108

G050112

G050113

G050114

G050117

G050119

G050120

G050122

G050123

G050125

G050127

G050129

G050130

G050132

G050133

G050134

G050135

G050136

G050141

G050144

G050145

G050146

G050147

G050148

G050149

G050153

G050155

G050158

G050160

G050161

G050163

G050165

G050166

G050170

G050172

G050174

G050177

G050178

G050180

G050181

G050182

G050183

**Addendum VII—Approval Numbers for Collections of Information**

Below we list all approval numbers for collections of information in the referenced sections of CMS regulations in Title 42; Title 45, Subchapter C; and Title 20 of the Code of Federal Regulations, which have been approved by the Office of Management and Budget:

| OMB number | Approved CFR sections |
| --- | --- |
| 0938-0008 | 414.40, 424.32, 424.44 |
| 0938-0022 | 413.20, 413.24, 413.106 |
| 0938-0023 | 424.103 |
| 0938-0025 | 406.28, 407.27 |
| 0938-0027 | 486.100-486.110 |
| 0938-0033 | 405.807 |
| 0938-0035 | 407.40 |
| 0938-0037 | 413.20, 413.24 |
| 0938-0041 | 408.6, 408.22 |
| 0938-0042 | 410.40, 424.124 |
| 0938-0045 | 405.711 |
| 0938-0046 | 405.2133 |
| 0938-0050 | 413.20, 413.24 |
| 0938-0062 | 431.151, 435.1009, 440.220, 440.250, 442.1, 442.10-442.16, 442.30, 442.40, 442.42, 442.100-442.119, 483.400-483.480, 488.332, 488.400, 498.3-498.5 |
| 0938-0065 | 485.701-485.729 |
| 0938-0074 | 491.1-491.11 |
| 0938-0080 | 406.7, 406.13 |
| 0938-0086 | 420.200-420.206, 455.100-455.106 |
| 0938-0101 | 430.30 |
| 0938-0102 | 413.20, 413.24 |
| 0938-0107 | 413.20, 413.24 |
| 0938-0146 | 431.800-431.865 |
| 0938-0147 | 431.800-431.865 |
| 0938-0151 | 493.1357, 493.1363, 493.1405, 493.1406, 493.1411, 493.1417, 493.1423, 493.1443, 493.1449, 493.1455, 493.1461, 493.1462, 493.1469, 493.1483, 493.1489, 493.1491 |
| 0938-0155 | 405.2470 |
| 0938-0170 | 493.1269-493.1285 |
| 0938-0193 | 430.10-430.20, 440.167 |
| 0938-0202 | 413.17, 413.20 |
| 0938-0214 | 411.25, 489.2, 489.20 |
| 0938-0236 | 413.20, 413.24 |
| 0938-0242 | 442.30, 488.26 |
| 0938-0245 | 407.10, 407.11 |
| 0938-0246 | 431.800-431.865 |
| 0938-0251 | 406.7 |
| 0938-0266 | 416.41, 416.47, 416.48, 416.43 |
| 0938-0267 | 410.65, 485.56, 485.58, 485.60, 485.64, 485.66 |
| 0938-0269 | 412.116, 412.632, 413.64, 413.350, 484.245 |
| 0938-0270 | 405.376 |
| 0938-0272 | 440.180, 441.300-441.305 |
| 0938-0273 | 485.701-485.729 |
| 0938-0279 | 424.5 |
| 0938-0287 | 447.31 |
| 0938-0296 | 413.170, 413.184 |
| 0938-0301 | 413.20, 413.24 |
| 0938-0302 | 418.22, 418.24, 418.28, 418.56, 418.58, 418.70, 418.74, 418.83, 418.96, 418.100 |
| 0938-0313 | 489.11, 489.20 |
| 0938-0328 | 482.12, 482.13, 482.21, 482.22, 482.27, 482.30, 482.41, 482.43, 482.45, 482.53, 482.56, 482.57, 482.60, 482.61, 482.62, 485.618, 485.631 |
| 0938-0334 | 491.9, 491.10 |
| 0938-0338 | 486.104, 486.106, 486.110 |
| 0938-0354 | 441.60 |
| 0938-0355 | 442.30, 488.26 |
| 0938-0357 | 409.40-409.50, 410.36, 410.170, 411.4-411.15, 421.100, 424.22, 484.18, 489.21 |
| 0938-0358 | 412.20-412.30 |
| 0938-0359 | 412.40-412.52 |
| 0938-0360 | 488.60 |
| 0938-0365 | 484.10, 484.11, 484.12, 484.14, 484.16, 484.18, 484.20, 484.36, 484.48, 484.52 |
| 0938-0372 | 414.330 |
| 0938-0378 | 482.60-482.62 |
| 0938-0379 | 442.30, 488.26 |
| 0938-0382 | 442.30, 488.26 |
| 0938-0386 | 405.2100-405.2171 |
| 0938-0391 | 488.18, 488.26, 488.28 |
| 0938-0426 | 476.104, 476.105, 476.116, 476.134 |
| 0938-0429 | 447.53 |
| 0938-0443 | 473.18, 473.34, 473.36, 473.42 |
| 0938-0444 | 1004.40, 1004.50, 1004.60, 1004.70 |
| 0938-0445 | 412.44, 412.46, 431.630, 456.654, 466.71, 466.73, 466.74, 466.78 |
| 0938-0447 | 405.2133 |
| 0938-0448 | 405.2133, 45 CFR 5, 5b; 20 CFR Parts 401, 422 Subpart E 0938-0449 440.180, 441.300-441.310 |
| 0938-0454 | 424.20 |
| 0938-0456 | 412.105 |
| 0938-0463 | 413.20, 413.24, 413.106 |
| 0938-0467 | 431.17, 431.306, 435.910, 435.920, 435.940-435.960 |
| 0938-0469 | 417.126, 422.502, 422.516 |
| 0938-0470 | 417.143, 417.800-417.840, 422.6 |
| 0938-0477 | 412.92 |
| 0938-0484 | 424.123 |
| 0938-0501 | 406.15 |
| 0938-0502 | 433.138 |
| 0938-0512 | 486.304, 486.306, 486.307 |
| 0938-0526 | 475.102, 475.103, 475.104, 475.105, 475.106 |
| 0938-0534 | 410.38, 424.5 |
| 0938-0544 | 493.1-493.2001 |
| 0938-0564 | 411.32 |
| 0938-0565 | 411.20-411.206 |
| 0938-0566 | 411.404, 411.406, 411.408 |
| 0938-0573 | 412.230, 412.256 |
| 0938-0578 | 447.534 |
| 0938-0581 | 493.1-493.2001 |
| 0938-0599 | 493.1-493.2001 |
| 0938-0600 | 405.371, 405.378, 413.20 |
| 0938-0610 | 484.10, 489.102 |
| 0938-0612 | 493.801, 493.803, 493.1232, 493.1233, 493.1234, 493.1235, 493.1236, 493.1239, 493.1241, 493.1242, 493.1249, 493.1251, 493, 1252, 493.1253, 493.1254, 493.1255, 493.1256, 493.1261, 493.1262, 493.1263, 493.1269, 493.1273, 493.1274, 493.1278, 493.1283, 493.1289, 493.1291, 493.1299 |
| 0938-0618 | 433.68, 433.74, 447.272 |
| 0938-0653 | 493.1771, 493.1773, 493.1777 |
| 0938-0657 | 405.2110, 405.2112 |
| 0938-0658 | 405.2110, 405.2112 |
| 0938-0659 | 456.700, 456.705, 456.709, 456.711, 456.712 |
| 0938-0667 | 482.12, 488.18, 489.20, 489.24 |
| 0938-0679 | 410.38 |
| 0938-0685 | 410.32, 410.71, 413.17, 424.57, 424.73, 424.80, 440.30, 484.12 |
| 0938-0686 | 493.551-493.557 |
| 0938-0688 | 486.304, 486.306, 486.307, 486.310, 486.316, 486.318, 486.325 |
| 0938-0691 | 412.106 |
| 0938-0692 | 466.78, 489.20, 489.27 |
| 0938-0701 | 422.152 |
| 0938-0702 | 45 CFR 146.111, 146.115, 146.117, 146.150, 146.152, 146.160, 146.180 |
| 0938-0703 | 45 CFR 148.120, 148.124, 148.126, 148.128 |
| 0938-0713 | 441.16, 489.66, 489.67 |
| 0938-0714 | 411.370-411.389 |
| 0938-0717 | 424.57 |
| 0938-0721 | 410.33 |
| 0938-0723 | 421.300-421.318 |
| 0938-0730 | 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, 424.24 |
| 0938-0732 | 417.126, 417.470 |
| 0938-0734 | 45 CFR 5b |
| 0938-0739 | 413.337, 413.343, 424.32, 483.20 |
| 0938-0742 | 422.300-422.312 |
| 0938-0749 | 424.57 |
| 0938-0753 | 422.000-422.700 |
| 0938-0754 | 441.151, 441.152 |
| 0938-0758 | 413.20, 413.24 |
| 0938-0760 | 484 Subpart E, 484.55, 484.205, 484.245, 484.250 |
| 0938-0761 | 484.11, 484.20 |
| 0938-0763 | 422.1-422.10, 422.50-422.80, 422.100-422.132, 422.300-422.312, 422.400-422.404, 422.560-422.622 |
| 0938-0770 | 410.2 |
| 0938-0778 | 422.64, 422.111 |
| 0938-0779 | 417.126, 417.470, 422.64, 422.210 |
| 0938-0781 | 411.404-411.406, 484.10 |
| 0938-0786 | 438.352, 438.360, 438.362, 438.364 |
| 0938-0783 | 422.66, 422.562, 422.564, 422.568, 422.570, 422.572, 422.582, 422.584, 422.586, 422.590, 422.594, 422.602, 422.612, 422.618, 422.619, 422.620, 422.622 |
| 0938-0787 | 406.28, 407.27 |
| 0938-0790 | 460.12, 460.22, 460.26, 460.30, 460.32, 460.52, 460.60, 460.70, 460.71, 460.72, 460.74, 460.80, 460.82, 460.98, 460.100, 460.102, 460.104, 460.106, 460.110, 460.112, 460.116, 460.118, 460.120, 460.122, 460.124, 460.132, 460.152, 460.154, 460.156, 460.160, 460.164, 460.168, 460.172, 460.190, 460.196, 460.200, 460.202, 460.204, 460.208, 460.210 |
| 0938-0792 | 491.8, 491.11 |
| 0938-0798 | 413.24, 413.65, 419.42 |
| 0938-0802 | 419.43 |
| 0938-0818 | 410.141, 410.142, 410.143, 410.144, 410.145, 410.146, 414.63 |
| 0938-0829 | 422.568 |
| 0938-0832 | Parts 489 and 491 |
| 0938-0833 | 483.350-483.376 |
| 0938-0841 | 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 457.440, 457.525, 457.560, 457.570, 457.740, 457.750, 457.810, 457.940, 457.945, 457.965, 457.985, 457.1005, 457.1015, 457.1180 |
| 0938-0842 | 412.23, 412.604, 412.606, 412.608, 412.610, 412.614, 412.618, 412.626, 413.64 |
| 0938-0846 | 411.352-411.361 |
| 0938-0857 | Part 419 |
| 0938-0860 | 413.65, 419.42 |
| 0938-0866 | 45 CFR Part 162 |
| 0938-0872 | 413.337, 483.20, |
| 0938-0873 | 422.152 |
| 0938-0874 | 45 CFR Parts 160 and 162 |
| 0938-0878 | Part 422 Subpart F & G |
| 0938-0883 | 45 CFR Parts 160 and 164 |
| 0938-0884 | 405.940 |
| 0938-0887 | 45 CFR 148.316, 148.318, 148.320 |
| 0938-0897 | 412.22, 412.533 |
| 0938-0907 | 412.230, 412.304, 413.65 |
| 0938-0910 | 422.620, 422.624, 422.626 |
| 0938-0911 | 426.400, 426.500 |
| 0938-0916 | 483.16 |
| 0938-0920 | 438.6, 438.8, 438.10, 438.12, 438.50, 438.56, 438.102, 438.114, 438.202, 438.206, 438.207, 438.240, 438.242, 438.402, 438.404, 438.406, 438.408, 438.410, 438.414, 438.416, 438.710, 438.722, 438.724, 438.810 |
| 0938-0921 | 414.804 |
| 0938-0931 | 45 CFR Part 142.408, 162.408, and 162.406 |
| 0938-0933 | 438.50 |
| 0938-0934 | 403.766 |
| 0938-0936 | 423 |
| 0938-0940 | 484 and 488 |
| 0938-0944 | 422.250, 422.252, 422.254, 422.256, 422.258, 422.262, 422.264, 422.266, 422.270, 422.300, 422.304, 422.306, 422.308, 422.310, 422.312, 422.314, 422.316, 422.318, 422.320, 422.322, 422.324, 423.251, 423.258, 423.265, 423.272, 423.279, 423.286, 423.293, 423.301, 423.308, 423.315, 423.322, 423.329, 423.336, 423.343, 423.346, 423.350 |
| 0938-0950 | 405.910 |
| 0938-0951 | 423.48 |
| 0938-0953 | 405.1200 and 405.1202 |
| 0938-0954 | 414.906, 414.908, 414.914, 414.916 |
| 0938-0957 | Part 423 Subpart R |

**Addendum VIII—Medicare-Approved Carotid Stent Facilities [July Through September 2005]**

On March 17, 2005, we issued our decision memorandum on carotid artery stenting. We determined that carotid artery stenting with embolic protection is reasonable and necessary only if performed in facilities that have been determined to be competent in performing the evaluation, procedure, and follow-up necessary to ensure optimal patient outcomes. We have created a list of minimum standards for facilities modeled in part on professional society statements on competency. All facilities must at least meet our standards in order to receive coverage for carotid artery stenting for high risk patients.

**Effective Date—July 7, 2005**

Antelope Valley Hospital, 1600 West Avenue J, Lancaster, CA 93534

Medicare Provider #050056

Baptist St. Anthony's Hospital, 1600 Wallace Boulevard, Amarillo, TX 79106

**Medicare Provider #450231**

Dayton Heart Hospital, 707 S. Edwin Moses Boulevard, Dayton, OH 45408

**Medicare Provider #360253**

Duke Health Raleigh Hospital, 3400 Wake Forest Road, Raleigh, NC 27609

**Medicare Provider #340073**

East Pasco Medical Center, 7050 Gall Boulevard, Zephyrhills, FL 33541-1399

**Medicare Provider #100046**

FirstHealth Moore Regional Hospital, 1555 Memorial Drive, P.O. Box 3000 Pinehurst, NC 28374

**Medicare Provider #340115**

The George Washington University Hospital, 900 23rd Street, NW., Washington, DC 20037

**Medicare Provider #090001**

Heart Hospital of Lafayette, 1105 Kaliste Saloom Road, Lafayette, LA 70508

**Medicare Provider #190263**

Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287-1629

**Medicare Provider #210009**

Kingman Regional Medical Center, 3269 Stockton Hill Road, Kingman, AZ 86401

**Medicare Provider #030055**

Lafayette General Medical Center, 1214 Coolidge Street, P.O. Box 52009, Lafayette, LA 70505

**Medicare Provider #190002**

Manatee Memorial Hospital and Health Systems, 206 2nd Street East, Bradenton, FL 34208

**Medicare Provider #100035**

Mercy Health System, 1000 Mineral Point Avenue, P.O. Box 5003, Janesville, WI 53547-5003

**Medicare Provider #520066**

The Methodist Hospital, 6565 Fannin Street, Houston, TX 77030

**Medicare Provider #450358**

Mohawk Valley Vascular Center of Faxton, St. Luke's Healthcare, 1656 Champlain Avenue, Utica, NY 13502

**Medicare Provider #330044**

Northwest Medical Center, 2801 North State Road 7, Margate, FL 33063-9002

**Medicare Provider #100189**

Oakwood Hospital and Medical Center, 18101 Oakwood Boulevard, P.O. Box 2500, Dearborn, MI 48123-2500

**Medicare Provider #230020**

Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903

**Medicare Provider #041007**

Scripps Green Hospital, 10666 North Torrey Pines Road, La Jolla, CA 92037-9100

**Medicare Provider #050424**

St. Cloud Hospital, 1406 Sixth Avenue North, St. Cloud, MN 56303-1901

**Medicare Provider #240036**

St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07530

**Medicare Provider #310019**

St. Luke's Hospital, 5901 Monclova Road, Maumee, OH 43537-1899

**Medicare Provider #360090**

St. Vincent Hospital, 835 S. Van Buren Street, P.O. Box 13508, Green Bay, WI 54307-3508

**Medicare Provider #520075**

St. Vincent's Medical Center, 1800 Barrs Street, Jacksonville, FL 32204

**Medicare Provider #100040**

Stormont-Vail HealthCare, 1500 S.W. 10th Avenue, Topeka, KS 66604-1353

**Medicare Provider #170086**

Tomball Regional Hospital, 605 Holderrieth Street, Tomball, TX 77375

**Medicare Provider #450670**

Trinity Mother Frances Health System, 800 E. Dawson, Tyler, TX 75701

**Medicare Provider #450102**

**Effective Date—July 15, 2005**

Allen Memorial Hospital, 1825 Logan Avenue, Waterloo, IA 50703-1999

**Medicare Provider #160110**

Alta Bates Summit Medical Center, Alta Bates Campus, 2450 Ashby Avenue Berkley, CA 94705

**Medicare Provider #050305**

Alta Bates Summit Medical Center, Summit Campus, 350 Hawthorne Avenue, Oakland, CA 94609

**Medicare Provider #050043**

Banner Baywood Heart Hospital, 6750 East Baywood Avenue, Mesa, AZ 85206

**Medicare Provider #030105**

Battle Creek Health System, 300 North Avenue, Battle Creek, MI 49016

**Medicare Provider #230075**

Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215

**Medicare Provider #220086**

BryanLGH Medical Center, 1600 South 48th Street, Lincoln, NE 68506-1299

**Medicare Provider #280003**

Deborah Heart & Lung Center, 200 Trenton Road, Browns Mills, NJ 08015

**Medicare Provider #310031**

Erie County Medical Center Corporation, 462 Grinder Street, Buffalo, NY 14215

**Medicare Provider #330219**

Fairview Southdale Hospital, 6401 France Avenue, Edina, MN 55435

**Medicare Provider #240078**

Gratiot Medical Center, 300 East Warwick Drive, Alma, MI 48801-1096

**Medicare Provider #230030**

Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225-1290

**Medicare Provider #210034**

Holmes Regional Medical Center, 1350 South Hickory Street, Melbourne, FL 32901

**Medicare Provider #100019**

Holy Cross Hospital, 4725 North Federal Highway, Fort Lauderdale, FL 33308

**Medicare Provider #100073**

Marion General Hospital, 1000 McKinley Park Drive, Marion, OH 43301

**Medicare Provider #360011**

Mease Countryside Hospital, 3231 McMullen Booth Road, Safety Harbor, FL 34695

**Medicare Provider #100265**

Mercy General Hospital, 4001 J Street, P.O. Box 19245, Sacramento, CA 95819-9990

**Medicare Provider #050017**

OU Medical Center, 1200 Everett Drive, Oklahoma City, OK 73104

**Medicare Provider #370093**

Pennsylvania Hospital of the University of Pennsylvania Health System, 800 Spruce Street, Philadelphia, PA 19071-6192

**Medicare Provider #390226**

Provena Mercy Medical Center, 1325 North Highland Avenue, Aurora, IL 60506

**Medicare Provider #140174**

Reading Hospital and Medical Center, P.O. Box 16052, Reading, PA 19612-6052

**Medicare Provider #390044**

Regional Medical Center of Hopkins County, 900 Hospital Drive, Madisonville, KY 42431

**Medicare Provider #180093**

Sacred Heart Medical Center, 101 West 8th Avenue, P.O. Box 2555, Spokane, WA 99220-2555

**Medicare Provider #500054**

Scripps Mercy Hospital, 4077 Fifth Avenue, San Diego, CA 92103

**Medicare Provider #050077**

Sisters of Charity Providence Hospitals, 2435 Forest Drive, Columbia, SC 29204

**Medicare Provider #420026**

Tucson Medical Center, 5301 East Grant Road, Tucson, AZ 85712

**Medicare Provider #030006**

UCLA Medical Center, 10833 Le Conte Avenue, Los Angeles, CA 90095-1730

**Medicare Provider #050262**

University of Colorado Hospital, 4200 East 9th Avenue, Denver, CO 80262

**Medicare Provider #060024**

**Effective Date—July 20, 2005**

Christus St. Patrick Hospital, 524 South Ryan Street, Lake Charles, LA 70601

**Medicare Provider #190027**

Condell Medical Center, 801 South Milwaukee Avenue, Libertyville, IL 60048

**Medicare Provider #140202**

Florida Hospital Ormond Memorial, 875 Sterthaus Avenue, Ormond Beach, FL 32174

**Medicare Provider #100169**

Lakewood Hospital, 14519 Detroit Avenue, Lakewood, OH 44107

**Medicare Provider #360212**

Loma Linda University Medical Center, 11234 Anderson Street, P.O. Box 2000, Loma Linda, CA 92354

**Medicare Provider #050327**

Miami Valley Hospital, Medical Imaging, One Wyoming Street, Dayton, OH 45409-2793

**Medicare Provider #360051**

National Park Medical Center, 1910 Malvern Avenue, Hot Springs, AR 71901

**Medicare Provider #040078**

Newark Beth Israel Medical Center, 201 Lyons Avenue, Newark, NJ 07112

**Medicare Provider #310002**

Salina Regional Health Center, P.O. Box 5080, Salina, KS 67402-5080

**Medicare Provider #170012**

Scott and White Memorial Hospital and Scott, Sherwood and Brindley Foundation, 2401 South 31st Street, Temple, TX 76508

**Medicare Provider #450054**

Sentra Norfolk General Hospital, 600 Gersham Drive, Norfolk, VA 23507

**Medicare Provider #490007**

Spartanburg Regional Medical Center, 101 East Wood Street, Spartanburg, SC 29303

**Medicare Provider #420007**

St. Francis Hospital, 3237 South 16th Street, Milwaukee, WI 53215-4592

**Medicare Provider #520078**

St. Vincent Indianapolis Hospital, 2001 West 86th Street, Indianapolis, IN 46260

**Medicare Provider #150084**

Tulsa Regional Medical Center, 744 West 9th, Tulsa, OK 74127

**Medicare Provider #370078**

University Hospital, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210

**Medicare Provider #330241**

UT Southwestern University Hospitals—Zale Lipshy, 5151 Harry Hines Boulevard, Dallas, TX 75390

**Medicare Provider #450766**

UT Southwestern University Hospitals—St. Paul, 5909 Harry Hines Boulevard, Dallas, TX 75390

**Medicare Provider #450044**

**Effective Date—July 22, 2005**

Forrest General Hospital, 6051 Highway 49, Hattiesburg, MS 39401-7243

**Medicare Provider #250078**

Hamilton Medical Center, P.O. Box 1168, Dalton, GA 30722-1168

**Medicare Provider #110001**

Heritage Valley Health System, The Medical Center, 100 Dutch Ridge Road, Beaver, PA 15009-9700

**Medicare Provider #390036**

Northeast Georgia Medical Center, 743 Spring Street, Gainesville, GA 30501

**Medicare Provider #110029**

Wishard Health Services, 1001 West Tenth Street, Indianapolis, IN 46202

**Medicare Provider #150024**

**Effective Date—July 27, 2005**

East Texas Medical Center Athens, 2000 South Palestine, Athens, TX 75751

**Medicare Provider #450389**

Glendale Adventist Medical Center, 1509 Wilson Terrace, Glendale, CA 91206

**Medicare Provider #050239**

Lahey Clinic Medical Center, Inc., 41 Mall Road, Burlington, MA 01805

**Medicare Provider #220171**

Saint Joseph Hospital, One Saint Joseph Drive, Lexington, KY 40504

**Medicare Provider #180010**

St. Mary's Medical Center, 2900 First Avenue, Huntington, WV 25702

**Medicare Provider #510007**

Yakima Regional Medical and Cardiac Center, 110 South 9th Avenue, Yakima, WA 98902

**Medicare Provider #500012**

**Effective Date—August 1, 2005**

Alegent Health Bergan Mercy Medical Center, 7500 Mercy Rd., Omaha, NE 68124-9832

**Medicare Provider #280060**

Bon Secours DePaul Medical Center, 150 Kingsley Ln., Norfolk, VA 23505

**Medicare Provider #490011**

Hendrick Medical Center, 1900 Pine St., Abilene, TX 79601-2316

**Medicare Provider #450229**

Nebraska Heart Hospital, 7500 S. 91st St., Lincoln, NE 68526

**Medicare Provider #280128**

Singing River Hospital System, 3109 Bienville Blvd., Ocean Springs, MS 39564

**Medicare Provider #250040**

St. Peter's Hospital,315 South Manning Blvd., Albany, NY 12208

**Medicare Provider #330057**

University of California San Francisco Medical Center, 500 Parnassus Ave., San Francisco, CA 94143-0296

**Medicare Provider #050454**

**Effective Date—August 4, 2005**

Bowling Green Warren County Community Hospital Corp. d/b/a The Medical Center, 250 Park Street, P.O. Box 90010, Bowling Green, KY 42102-9010

**Medicare Provider #180013**

Carson-Tahoe Hospital, 775 Fleischmann Way, P.O. Box 2168, Carson City, NV 89702-2168

**Medicare Provider #290010**

Heart Hospital of Austin, 3801 N. Lamar Boulevard, Austin, TX 78756

**Medicare Provider #450824**

Indiana Heart Hospital, 8040 Clearvista Parkway, Suite 200, Indianapolis, IN 46256

**Medicare Provider #150154**

JFK Medical Center, 5301 South Congress Avenue, Atlantis, FL 33462

**Medicare Provider #100080**

Sierra Vista Regional Medical Center, 1010 Murray Avenue, San Luis Obispo, CA 93405

**Medicare Provider #050506**

St. Joseph Hospital, 1100 West Stewart Drive, P.O. Box 5600 Orange, CA 92863-5600

**Medicare Provider #050069**

St. Luke's Cornwall Hospital, 70 Dubois Street, Newburgh, NY 12550

**Medicare Provider #330264**

UCI Medical Center, 101 The City Drive South, Orange, CA 92868

**Medicare Provider #050348**

**Effective Date—August 8, 2005**

Lynchburg General Hospital, 1920 Atherholt Road, Lynchburg, VA 24501-1104

**Medicare Provider #490021**

Mercy Hospitals Bakersfield, 2215 Truxtun Avenue, P.O. Box 119, Bakersfield, CA 93302

**Medicare Provider #050295**

Virginia Regional Medical Center, 901 Ninth Street North, Virginia, MN 55792

**Medicare Provider #240084**

**Effective Date—August 9, 2005**

Columbia Hospital, 2201 45th Street, West Palm Beach, FL 33407

**Medicare Provider #100234**

Fairview Hospital, 14519 Detroit Avenue, Fairview, OH 44107

**Medicare Provider #360077**

Forum Health-Northside Medical Center, Cardiovascular Administration, 500 Gypsy Lane, Youngstown, OH 44501

**Medicare Provider #360141**

Mercy Hospital, 144 State Street, Portland, ME 04101

**Medicare Provider #020008**

New Hanover Regional Medical Center, 2131 South 17th Street, P.O. Box 9000, Wilmington, NC 28402-9000

**Medicare Provider #340141**

Sharp Grossmont Hospital, P.O. Box 158, La Mesa, CA 91944-0158

**Medicare Provider #050026**

Torrance Memorial Medical Center, 3330 Lomita Boulevard, Torrance, CA 90505-5073

**Medicare Provider #050351**

**Effective Date—August 16, 2005**

Englewood Hospital and Medical Center, 350 Engle Street, Englewood, NJ 07631

**Medicare Provider #310045**

Mobile Infirmary Medical Center, Five Mobile Infirmary Circle, Mobile, AL 36607

**Medicare Provider #010113**

Ocean Medical Center, 425 Jack Martin Boulevard, Brick, NJ 08724

**Medicare Provider #310052**

OSF St. Joseph Medical Center, 200 East Washington Street, Bloomington, IL 61701

**Medicare Provider #140162**

St. Luke's Medical Center, LP, 1800 East Van Buren Street, Phoenix, AZ 85006

**Medicare Provider #030037**

**Effective Date—August 19, 2005**

Inova Alexandria Hospital, 4320 Seminary Road, Alexandria, VA 22304

**Medicare Provider #490040**

Inova Fairfax Hospital, Inova Fairfax Hospital for Children and Inova Heart and Vascular Institute, 3300 Gallows Road, Falls Church, VA 22042-3300

**Medicare Provider #490063**

Milford Hospital, 300 Seaside Avenue, P.O. Box 3015, Milford, CT 06460-0815

**Medicare Provider #070019**

Our Lady of the Lakes Regional Medical Center, 5000 Hennessy Boulevard, Baton Rouge, LA 70808

**Medicare Provider #190064**

Summit Hospital, 17000 Medical Center Drive, Baton Rouge, LA 70816

**Medicare Provider #190202**

University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0060

**Medicare Provider #230046**

**Effective Date—August 22, 2005**

Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176

**Medicare Provider #100008**

Camden-Clark Memorial Hospital, 800 Garfield Avenue, P.O. Box 718, Parkersburg, WV 26102

**Medicare Provider #510058**

HCA Dauterive Hospital, 600 North Lewis Avenue, New Iberia, LA 70563

**Medicare Provider #190003**

Kadlec Medical Center, 888 Swift Boulevard, Richland, WA 99352

**Medicare Provider #500058**

Lancaster Community Hospital, 43830 10th Street West, Lancaster, CA 93534

**Medicare Provider #050204**

Mercy Hospital, 4050 Coon Rapids Boulevard, Coon Rapids, MN 55433

**Medicare Provider #240115**

Montefiore Medical Center, 111 East 210th Street, New York, NY 10467

**Medicare Provider #330059**

Morristown Memorial Hospital, 100 Madison Avenue, Morristown, NJ 07962-1956

**Medicare Provider #310015**

Palmetto Health Richland, 5 Richland Medical Park Drive, Columbia, SC 29203-6897

**Medicare Provider #420018**

Saint Elizabeth Regional Medical Center, 555 South 70th Street, Lincoln, NE 68510

**Medicare Provider #280020**

Springhill Medical Center, 3710 Dauphine Street, Mobile, AL 36608

**Medicare Provider #010144**

Unity Hospital, 550 Osborne Road, Fridley, MN 55432

**Medicare Provider #240132**

Wilson Memorial Regional Medical Center, 33-57 Harrison Street, Johnson City, NY 13790

**Medicare Provider #330394**

**Effective Date—August 23, 2005**

Jackson Madison County General Hospital, 708 West Forest Avenue, Jackson, TN 38301-3956

**Medicare Provider #044002**

Leesburg Regional Medical Center, 600 E. Dixie Avenue, Leesburg, FL 34748

**Medicare Provider #100084**

Meriter Hospitals, Inc., 202 South Park Street, Madison, WI 53715

**Medicare Provider #520089**

Poplar Bluff Regional Medical Center, 2620 North Westwood Boulevard, Poplar Bluff, MO 63901

**Medicare Provider #260119**

Saint Francis Hospital, 241 North Road, Poughkeepsie, NY 12601-1399

**Medicare Provider #330067**

The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburg, PA 15224

**Medicare Provider #390090**

*Effective Date—August 24, 2005*

Halifax Medical Center, 303 N. Clyde Morris  Boulevard, Daytona Beach, FL 32114

**Medicare Provider #100017**

Jackson Hospital, 1725 Pine Street, Montgomery, AL 36106-1117

**Medicare Provider #010024**

Marietta Memorial Hospital, 401 Matthew Street, Marietta, OH 45750

**Medicare Provider #360147**

Meadowcrest Hospital, 2500 Belle Chasse Highway, Gretna, LA 70056

**Medicare Provider #190152**

Medical Center Hospital, P.O. Box 7239, Odessa, TX 79760-7239

**Medicare Provider #450132**

REX Healthcare, 4420 Lake Boone Trail, Raleigh, NC 27607

**Medicare Provider #340114**

St. John's Mercy Medical Center, 615 South New Ballas Road, St. Louis, MO 63141

**Medicare Provider #260020**

**Effective Date—August 26, 2005**

Candler Hospital, 5353 Reynolds Street, Savannah, GA 31405

**Medicare Provider #110024**

CHRISTUS Santa Rosa, 333 North Santa Rosa Street, San Antonio, TX 78207-3198

**Medicare Provider #450237**

Durham Regional Hospital, 3643 North Roxboro Road, Durham, NC 27704

**Medicare Provider #344155**

Hillcrest Medical Center, 1120 South Utica Avenue, Tulsa, OK 74104

**Medicare Provider #370001**

Houston Northwest Medical Center, 710 FM 1960 West, Houston, TX 77090

**Medicare Provider #450638**

Mercy Hospital, 3663 South Miami Avenue, Miami, FL 33133

**Medicare Provider #100061**

Saint Barnabas Medical Center, Old Short Hills Road, Livingston, NJ 07039

**Medicare Provider #310076**

**Effective Date—August 31, 2005**

Columbia St. Mary's Hospital Milwaukee, Inc., 2323 North Lake Drive, Milwaukee, WI 53211

**Medicare Provider #520051**

Franklin Square Hospital Center, 9000 Franklin Square Drive, Baltimore, MD 21237-9986

**Medicare Provider #210015**

The Griffin Hospital, 130 Division Street, Derby, CT 06418

**Medicare Provider #070031**

Gwinnett Medical Center, 1000 Medical Center Boulevard, Lawrenceville, GA 30045

**Medicare Provider #110087**

Louis A. Weiss Memorial Hospital, 4646 North Marine Drive, Chicago, IL 60640

**Medicare Provider #140082**

The North Shore Medical Center, 81 Highland Avenue, Salem, MA 01970

**Medicare Provider #220006**

South Pointe Hospital, 20000 Harvard Road, Warrensville Hts., OH 44122

**Medicare Provider #360144**

Southwest Medical Center—Lafayette, 2810 Ambassador Caffery, Lafayette, LA 70506

**Medicare Provider #190205**

St. Mary's Hospital Ozaukee, Inc., 13111 North Port Washington Road, Mequon, WI 53097

**Medicare Provider #520027**

St. Tammany Parish Hospital, 1202 South Tyler Street, Covington, LA 70433

**Medicare Provider #190045**

Trinity Medical Center Terrace Park, 4500 Utica Ridge Road, Bettendorf, IA 52722

**Medicare Provider #160104**

UAMS Medical Center, 4301 West Markham, Little Rock, AK 72205-7199

**Medicare Provider #040016**

Valley Baptist Medical Center—Harlingen, P.O. Drawer 2588, 2101 Pease Street, Harlingen, TX 78551

**Medicare Provider #450033**

**Effective Date—September 6, 2005**

Carilion Roanoke Memorial Hospital, 1906 Belleview Avenue, Roanoke, VA 24014

**Medicare Provider #490024**

Midland Memorial Hospital, 2200 West Illinois Avenue, Midland, TX 79701-6499

**Medicare Provider #450133**

Provena Saint Joseph Medical Center, 333 North Madison Street, Joliet, IL 60435-6595

**Medicare Provider #140007**

Salinas Valley Memorial Healthcare System, 450 E. Romie Lane, Salinas, CA 93901

**Medicare Provider #050334**

UHHS Geauga Regional Hospital, 13207 Ravenna Road, Chardon, OH 44024

**Medicare Provider #360192**

**Effective Date—September 8, 2005**

Howard Regional Health System, 3500 South Lafountain Street, P.O. Box 9011, Kokomo, IN 46904-9011

**Medicare Provider #150007**

Luther Hospital, 1221 Whipple Street, P.O. Box 4105, Eau Claire, WI 54702-4105

**Medicare Provider #520070**

Our Lady of Fatima Hospital, 200 High Service Avenue, No. Providence, RI 02904

**Medicare Provider #041005**

Pitt County Memorial Hospital, Inc., P.O. Box 6028, Greenville, NC 27835-6028

**Medicare Provider #340040**

**Effective Date—September 12, 2005**

Baylor All Saints Medical Center, 1400 Eighth Avenue, Fort Worth, TX 76104

**Medicare Provider #450137**

St. Vincent's Hospital, Staten Island, 355 Bard Avenue, Staten Island, NY 10310

**Medicare Provider #330028**

SUNY Stony Brook University Hospital, Nicolls Road, Stony Brook, NY 11794

**Medicare Provider #330393**

The Washington Hospital, 155 Wilson Avenue, Washington, PA 15301

**Medicare Provider #390042**

**Effective Date—September 15, 2005**

Abilene Regional Medical Center, 6250 Highway 83/84, Abilene, TX 79606

**Medicare Provider #450558**

Bon Secours Cottage Health Services, 468 Cadieux Road, Grosse Pointe, MI 48230

**Medicare Provider #230089**

HealthOne/HCA Rose Medical Center, 4567 E. 9th Avenue, Denver, CO 80220

**Medicare Provider #060032**

Providence Health Center, 6901 Medical Parkway, Waco, TX 76712

**Medicare Provider #450042**

St. Edward Mercy Medical Center, 7301 Rogers Avenue, P.O. Box 17000, Fort Smith, AR 72917-7000

**Medicare Provider #040062**

St. Joseph's Hospital, 3001 W. Dr. M.L. King Jr. Boulevard, Tampa, FL 33607

**Medicare Provider #100075**

**Effective Date—September 22, 2005**

Baylor University Medical Center, Department of Radiology, 3500 Gaston Avenue, Dallas, TX 75246

**Medicare Provider #450021**

Delray Medical Center, 5352 Linton Boulevard, Delray Beach, FL 33484

**Medicare Provider #100258**

Desert Springs Hospital, 2075 East Flamingo Road, Las Vegas, NV 89119

**Medicare Provider #290022**

Ellis Hospital, 1101 Nott Street, Schenectady, NY 12308

**Medicare Provider #330153**

Ingham Regional Medical Center, 401 West Greenlawn Avenue, Lansing, MI 48910

**Medicare Provider #230167**

St. Joseph's Hospital, 11705 Mercy Boulevard, Savannah, GA 31419

**Medicare Provider #110043**

Mercy Hospital of Pittsburgh, 1400 Locust Street, Pittsburgh, PA 15219-5166

**Medicare Provider #390028**

The Pottsville Hospital and Warne Clinic, 420 South Jackson Street, Pottsville, PA 17901

**Medicare Provider #390030**

Southwest Mississippi Regional Medical Center, 215 Marion Avenue, McComb, MS 39648

**Medicare Provider #250097**

Sparks Regional Medical Center, 1311 South  I Street, P.O. Box 17006, Fort Smith, AR 72917-7006

**Medicare Provider #040055**

Tampa General Hospital, 2 Columbia Drive, Tampa, FL 33606

**Medicare Provider #100128**

Wesley Medical Center, 550 N. Hillside, Wichita, KS 67214

**Medicare Provider #170123**

**Effective Date—September 28, 2005**

Advocate Illinois Masonic Medical Center, 836 W. Wellington Avenue, Chicago, IL 60657-5193

**Medicare Provider #140182**

East Texas Medical Center-Tyler, 1000 South Beckham, Tyler, TX 75701

**Medicare Provider #450083**

Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219

**Medicare Provider #330914**

Mesa General Hospital, 515 North Mesa Drive, Mesa, AZ 85201

**Medicare Provider #030017**

Opelousas General Health System, 539 E. Prudhomme Street, P.O. Box 1389, Opelousas, LA 70570

**Medicare Provider #190017**

Southern Ohio Medical Center, 1895 27th Street, Portsmouth, OH 45662

**Medicare Provider #360008**

St. Joseph Hospital, 2901 Squalicum Parkway, Bellingham, WA 98264

**Medicare Provider #500030**

St. Lukes Hospital, 801 Ostrum Street, Bethlehem, PA 18015

**Medicare Provider #390049**

WakeMed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610

**Medicare Provider #340069**

Yale-New Haven Hospital, 20 York Street, New Haven, CT 06504,

**Medicare Provider #070022**