Free Webinar: How To Comment on Regulations

SAMHSA's Partners for Recovery Initiative invites you to a free webinar on the public comment process for Federal regulations.

How To Comment on Regulations

May 26, 2011
1 p.m. Eastern Time

This webinar, designed for consumers and members of the recovery community, will provide guidance on the Federal regulatory process and the proper procedure and best practices for submitting comments on proposed regulations, including those governing the implementation of the Affordable Care Act.

Register for How To Comment on Regulations Webinar

HHS to Insurers: Double-Digit Rate Hikes Will Prompt Review

The Department of Health and Human Services (HHS) has released a final rule that will allow states to scrutinize insurance companies if they propose excessive increases in insurance premiums.

The final rule, published Thursday, would give states the authority beginning in September to issue a review of any insurer that raises premiums for small or individual health insurance plans by more than 10% in a given year. The law does not, however, give states or the federal government the power to tell an insurance company that it can't enact a high rate hike.

Public comment on Home and Community Based Services

The Centers for Medicare & Medicaid Services have issued a Notice of Proposed Rulemaking that would revise the regulations implementing Medicaid Home and Community Based Services (HCBS) under section 1915(c) of the Social Security Act. There are several proposed changes including the following:

· Requirement for person-centered planning

· Characteristics of home and community based settings

· Options for States to combine target groups into a single waiver

· Clarification of timing and public input requirements for amendments.

Please take a few minutes and comment on this important proposed rule.

Click the following link to view the proposed rule and make a comments:

http://www.hhs.gov/od/community/public/index.html

COMMENTS ARE DUE 5:00 PM EST JUNE 14, 2011



Supplemental Nutrition Assistance Program (SNAP): Eligibility,

This proposed rule would implement provisions of the Food, Conservation and Energy Act of 2008 (FCEA) affecting the eligibility, benefits, certification, and employment and training (E&T) requirements for applicant or participant households in the Supplemental Nutrition Assistance Program (SNAP). The rule would amend the SNAP regulations to:

• Exclude military combat pay from the income of SNAP households;
• raise the minimum standard deduction and the minimum benefit for small households;
• eliminate the cap on the deduction for dependent care expenses;
• index resource limits to inflation;
• exclude retirement and education accounts from countable resources;
• permit States to expand the use of simplified reporting; permit States to provide transitional benefits to households leaving State-funded cash assistance programs;
• allow States to establish telephonic signature systems;
• permit States to use E&T funds to provide post-employment job retention services; and
• limit the E&T funding cycle to 15 months.

These provisions are intended to increase SNAP benefit levels for certain participants, reduce barriers to participation, and promote efficiency in the administration of the program.

DATES: Comments must be received on or before July 5, 2011.

Full Federal Register Notice

Assisted Living Settings/Facilities and the ADA. Information Bulletin # 331 (4/2011)

by Steve Gold

CMS issued proposed rules regarding Medicaid’s Home and Community-Based waivers. 76 Federal Register 21311 (4/15/11). One part of the proposed rules focused on Assisted Living Settings and whether these qualify under Olmstead’s “the most integrated setting” mandate. CMS stated that “a State’s obligations under the ADA and Section 504 are not defined by, or limited to, the cope or requirements of the Medicaid program; however, the Medicaid program provides an opportunity to obtain partial Federal funding to assist in compliance with the ADA and 504 through the provision of Medicaid services.”

CMS noted that older Americans “ with and without disabilities” may wish to live together. Because so many nursing homes have “converted” to ALS by changing their names and repainting the facility, it is important that advocates for older Americans “with and without disabilities” hold your State Medicaid agency accountable to make sure that the following CMS criteria are really being applied. CMS will permit Medicaid waiver funding only if the ALS were really community-based settings. Advocates can make sure the following criteria are implemented.

Here are the CMS criteria. Unless they are complied with, a Medicaid funded ALS waiver does not comply with the ADA and 504.

1. “The individual has a lease.” Leases trigger tenant rights and the proprietors of the ALS take on landlord duties. They are written and enforceable. State tenant rights statutes provide legal requirements and recourse that residents in an ALS could use if the landlord, aka provider, tries illegally to evict the tenant or act contrary to the lease.

2. The “Setting is an apartment with individual living, sleeping, bathing and cooking areas.” These rights will prevent nursing home providers from just changing the name of their facilities. Each apartment must have an individual cooking area - like a kitchen or kitchenette. Individual bathing is more than a toilet, but includes a shower and/or bathtub. Wow, this is beginning to sound like a real apartment.

3. “Individuals can choose whether to share a living arrangement and with whom.” Hey, isn’t that like what nondisabled tenants do?

4. “Individuals have lockable access to and egress from their own apartments.” That’s fancy talk for a key and a lock. Yes, the person in an ALS has the right to lock the door to her/his own apartment. What next? Invite whomever they wish into thei apartment?

5. Yes. “Individuals are free to receive visitors.” Providers cannot screen of guests.

6. Individuals can also “leave the setting at times and for durations of their own choosing.” They can go out whenever they want. No night curfews.

7. “Aging in place, or allowing individuals to remain where they live as they age and/or support needs change.” Advocates better make sure this is explicitly spelled out in the lease!

8. “Leases may not reserve the right to assign apartments or change apartment assignments.” Make sure it’s explicitly in the lease so there is no doubt about this right.

9. “Access to the greater community is easily facilitated based on the individual’s needs and preferences.” This means that the ALS provider, i.e., landlord, cannot arbitrarily deny a person the right to leave the ALS. More affirmatively, does it suggest providing some assistance in gaining such access - i.e., “easily facilitated”?

10. If there is a “person-centered plan,” compliance with it is “not in and of itself a condition of the lease.” Although the intent of this one is good, we’re not sure why compliance should ever be a condition of a lease. People in ALS should be treated like adults.

If these points are not provided for, then the ALS are “not home and community-based because they are not integrated in the community. A setting that is integrated in the community is a setting that enables individuals with disabilities to interact with individuals without disabilities to the fullest extent possible.”

CMS wrote that “we are particularly interested in gaining comments on these aspects of the proposed rule.” Anyone want to wager that the ALS industry will be against these basic rights?

Advocates for the elderly and disabled Americans should let CMS know these rights are long, long overdue. If advocates do not respond, CMS will be swamped with ALS providers opposing the changes.

Please let CMS know what you think about ALS. You have only until June 14 to respond. If you do, refer to the file code CMS-2296-P.

Electronically - http://www.regualtions.gov and follow the instructions under the “more search options” tab.

Regular Mail: CMS, Dept of HHS, Attention: CMS-2296-P [yes, I know that is different but I do not know which is correct.], P.O Box 8016, Baltimore, MD 21244-1850.

U.S. Senate Aging Committee Considers Assisted Living Issues

The federal government should take a more active role in oversight of assisted living facilities in light of current common practice that allows facilities to kick out or refuse to admit Medicaid-eligible residents even though the facilities themselves are approved to participate in Medicaid.

"Assisted living facilities are glad to accept money from Medicaid, but currently they don't live by the same rules as other Medicaid-certified providers," said National Senior Citizens Law Center Directing Attorney Eric Carlson during a roundtable discussion about assisted living issues today on Capitol Hill.

"If they agree to accept Medicaid, assisted living facilities should be held as accountable as other health care providers at both the federal and state levels," Carlson added. He also explained how, in the absence of consistent federal oversight, states have developed widely varying rules that do not protect consumers adequately.

When assisted living facilities stop accepting Medicaid, Carlson said the results can be devastating to residents. For example, after one 89-year-old Washington woman received an eviction notice when her facility stopped accepting Medicaid, she grew depressed, stopped eating and died within the month.

Carlson recommended that federal law be enforced to protect residents when a facility refuses Medicaid as in the tragic case above. It also calls on states to write rules to require Medicaid-certified facilities to accept residents regardless of their Medicaid status and prohibit facilities from penalizing current residents when a facility chooses to decertify.

In his remarks, Carlson also pointed to other problems and challenges related to the oversight of assisted living, basing his comments on a series of policy issue briefs and white papers that related to this and other legal issues developed with support from the Commonwealth Fund.

The roundtable is convened by the U.S. Senate Special Committee on Aging, and is entitled "Assisted Living at the Dawn of America's 'Age Wave': What Have States Achieved and How Is the Federal Role Evolving?" The hearing starts at 1 p.m., March 15, in room 216 of the Hart Senate Office Building.

Source: National Senior Citizens Law Center
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After Two Decades, Change Coming To ADA - Disability Scoop

Image via WikipediaBy Michelle Diament

For the first time in more than 20 years, regulations governing the Americans with Disabilities Act are getting a major overhaul.

Starting Tuesday, new rules go into effect covering everything from building design to what qualifies as a service animal.

Notably, the new ADA regulations will include first-ever accessibility requirements for swimming pools, parks, golf courses, boating facilities, exercise clubs and other recreational facilities.

What’s more, going forward, only trained dogs will be eligible for use as service animals.
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Improvements to Medicare Health and Drug Plans

AARP Press Release

WASHINGTON—AARP today submitted comments on regulations proposed by the Centers for Medicare and Medicaid Services (CMS). Many of the proposed regulations for Medicare health and prescription drug plans could improve care, lower costs and simplify enrollment for people in Medicare.

AARP Legislative Policy Director David Certner, the author of the comments, said: “We applaud CMS for working to continually improve the Medicare plans that millions of seniors rely on. While we recommend several areas to strengthen these regulations, on the whole, they will simplify and improve the plans available to people in Medicare.”

Excerpts from AARP’s letter to CMS follow:

On simplifying election periods for Medicare health and drug plans: “AARP strongly supports efforts to simplify beneficiary enrollment for Parts C and D. However, AARP is concerned that this change could result in beneficiary confusion and/or missed enrollment opportunities unless it is widely and effectively promoted. Therefore, AARP urges CMS to work with plan sponsors and beneficiary advocates to develop a public education campaign that will help ensure that all beneficiaries are aware of the new dates for the annual coordinated election period. AARP further believes that Congress should put Medicare fee-for-service and MA on a level playing field by creating an open enrollment period that makes all Medigap products available without regard to health status or pre-existing conditions.”

On income-related Part D premiums: “AARP did not support imposing an income-related premium in the Medicare Part D program. AARP has concerns about the potentially adverse effect of the income related Part D premium on the Part D program and its enrollees…. Nevertheless, we commend CMS for its efforts to develop timely regulations to implement the ACA provision. We are particularly supportive of the proposal in the NPRM to give Medicare beneficiaries a 3-month grace period, and an extension of the grace period for good cause, to pay the Part D Income-Related Monthly Adjustment Amount before their coverage could be terminated.”

On eliminating Part D cost-sharing for “dual eligibles” receiving care at home: “AARP supports the promulgation of this provision, which will create equity in Part D cost-sharing between institutionalized full-benefit dual eligibles and full-benefit dual eligibles receiving substantially the same services in the community.”

On Medicare Advantage cost-sharing for covered preventive care: “AARP strongly supports requiring [MA plans], including section 1876 cost plans, to provide preventive benefits at zero cost-sharing. This measure would align policy for the MA program with the FFS Medicare requirements. It makes sense in terms of providing appropriate incentives to MA enrollees to obtain preventive services and should have the longer term effect of improving health outcomes for the Medicare population.”

To obtain a complete copy of AARP’s letter to CMS, please contact AARP Media Relations at 202-434-2560 or media@aarp.org.

ONC Issues Final Rule for Permanent Certification Program for Health Information Technology

ONC Issues Final Rule for Permanent Certification Program for Health Information Technology

Steps to create permanent health IT certification program underway

The Office of the National Coordinator for Health Information Technology (ONC) today issued a final rule to establish the permanent certification program for health information technology.  The permanent certification program provides new features that will enhance the certification of health information technology, including increasing the comprehensiveness, transparency, reliability, and efficiency of the current processes used for the certification of electronic health record (EHR) technology.  Meaningful use of "Certified EHR Technology" is a core requirement for eligible health care providers who seek to qualify to receive incentive payments under the Medicare and Medicaid Electronic Health Record Incentive Programs as authorized by the Health Information Technology for Economic and Clinical Health (HITECH) Act.

"This final rule completes the two-phased approach ONC began with the proposed rule issued in Spring 2010 and includes several important improvements to our certification processes," said David Blumenthal, M.D., M.P.P., national coordinator for health information technology.  "Our goal is to make the transition to the permanent certification program as seamless as possible."

The temporary certification program, established through a final rule published on June 24, 2010, will continue to be in effect until it sunsets on December 31, 2011, or at a later date when the processes necessary for the permanent certification program to operate are completed.  ONC expects to stand-up the programmatic activities necessary to implement the permanent certification program throughout 2011. 

Features of the permanent certification program include:
Organizations must first be accredited in order to test and/or certify health information technology;
Certification bodies authorized by the National Coordinator (ONC-Authorized Certification Bodies or ONC-ACBs) are required to conduct post-certification surveillance; and
ONC-ACBs are permitted to perform "gap certification." 

As proposed, ONC will request that the National Institute of Standards and Technology (NIST) through its National Voluntary Laboratory Accreditation Program (NVLAP) develop a laboratory accreditation program for organizations to be accredited to test health information technology for purposes of the permanent certification program.  Based on NIST's technical expertise and the strong relationship formed between ONC and NIST during the successful implementation of the temporary certification program, the use of NVLAP is expected to enhance testing under the permanent certification program and its objectivity overall.     

This final rule is issued under the authority provided to the National Coordinator for Health Information Technology in section 3001(c)(5) of the Public Health Service Act, as added by the Health Information Technology for Economic and Clinical Health Act.

For more information about the permanent certification program and the final rule, please visit http://healthit.hhs.gov/certification.

For more information about the Office of the National Coordinator for Health Information Technology, please visit http://healthit.hhs.gov.

HHS PRESS RELEASE: New Affordable Care Act rules shed light on high health insurance rate hikes

Image via WikipediaNew Affordable Care Act rules shed light on high health insurance rate hikes

New proposed Affordable Care Act regulations announced today by the U.S. Department of Health and Human Services (HHS) will bring new transparency and scrutiny to proposed health insurance rate increases.  These proposed rules allow HHS to work with states to require insurers to publicly disclose and justify unreasonable rate increases.

“Year after year, insurance company profits soar, while Americans pay more for less health care coverage,” said Secretary Sebelius. “The Affordable Care Act is bringing unprecedented transparency and oversight to insurance premiums to help reign in the kind of excessive and unreasonable rate increases that have made insurance unaffordable for so many families.”

Health insurance premiums have risen rapidly over the past decade, straining pocketbooks for American families and businesses.  Since 1999, average premiums for family coverage have risen 131 percent. 

The Affordable Care Act has already begun to help states strengthen or create rate review processes.  On August 16, HHS awarded $46 million to 45 states and the District of Columbia to help them improve their oversight of proposed health insurance rate increases. This is part of $250 million that the health reform law makes available to states to take action against insurers seeking unreasonable rate hikes.

Today’s proposed regulations will build on these efforts by requiring insurers in all states to publicly justify any unreasonable rate increases beginning in 2011. In 2011, proposed rate increases of 10 percent or higher will be publicly disclosed and thoroughly reviewed to determine if the rate increase is unreasonable.  After 2011, state-specific thresholds would be set using data and trends that better reflect cost trends particular to each state.  Insurance company’s justifications for unreasonable increases will be posted on HealthCare.gov and the insurance plan’s website.

“The proposed rate review policy will empower consumers, promote competition, encourage insurers to do more to control health care costs and discourage insurers from charging premiums which are unjustified,” said Jay Angoff, director of HHS’ Office of Consumer Information and Insurance Oversight.

Under the proposed regulation, states with effective rate review systems would conduct the reviews. If a state lacks the resources or authority to do thorough actuarial reviews, HHS would conduct them.  Meanwhile, HHS will continue to make resources available to states to strengthen their rate review processes. 

In 2014, the Affordable Care Act empowers states to exclude health plans that show a pattern of excessive or unjustified premium increases from the new health insurance exchanges.

For more information on the regulation, go to: http://www.healthcare.gov/news/factsheets/ratereview.html.  For links to the regulation or other premium review information, go to: www.hhs.gov/ociio/initiative/index.html.

###

Medicaid Program-Review and Approval Process for Section 1115 Demonstrations

This proposed rule would implement provisions of section 10201(i) of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act) that set forth transparency and public notice procedures for experimental, pilot, and demonstration projects approved under section 1115 of the Social Security Act relating to Medicaid and the Children's Health Insurance Program (CHIP). This proposed rule would increase the degree to which information about Medicaid and CHIP demonstration applications and approved demonstration projects are publicly available and promote greater transparency in the review and approval of demonstrations. It would also codify existing statutory requirements pertaining to tribal consultation for section 1115 demonstration projects.

DATES: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on November 16, 2010.
Full Notice

U.S. Department of Veterans Affairs (VA) Publishes Final Rule to Help Veterans Exposed to Agent Orange - Disability.gov

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Veterans exposed to herbicides while serving in Vietnam and other areas will find it easier to access quality health care and qualify for disability compensation under a final rule published in the Federal Register. The new rule expands the list of health problems VA will presume to be related to Agent Orange and other herbicide exposures, which will speed up the application process. VA is adding Parkinson’s disease and ischemic heart disease and expanding chronic lymphocytic leukemia to include all chronic B cell leukemias, such as hairy cell leukemia.

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Government Auditing Standards: 2010 Exposure Draft

Image via WikipediaAugust 2010

TO AUDIT OFFICIALS AND OTHERS INTERESTED IN GOVERNMENT AUDITING STANDARDS

GAO invites your comments on the accompanying proposed changes to Government Auditing Standards (GAGAS), commonly known as the “Yellow Book.” This letter describes the process used by GAO for revising GAGAS, summarizes the proposed major changes, discusses proposed effective dates, and provides instructions for submitting comments on the proposed standards.

Process for Revising GAGAS

To help ensure that the standards continue to meet the needs of the audit community and the public it serves, the Comptroller General of the United States appointed the Advisory Council on Government Auditing Standards to review the standards and recommend necessary changes.
The Advisory Council includes experts in financial and performance auditing drawn from federal, state, and local government, the private sector, public accounting, and academia. This exposure draft includes the Advisory Council’s input regarding the proposed changes. We are currently requesting public comments on the proposed revisions in the exposure draft.

Summary of Major Changes

The proposed revision to GAGAS will be the sixth since GAO first issued the standards in 1972. The proposed changes contained in the 2010 Exposure Draft update GAGAS to reflect major developments in the accountability and audit profession and emphasize specific considerations applicable to the government environment.

The major changes in the proposed revision were made to:
•  consolidate and reorganize the foundation and ethical principles for government audits and the standards for use and application of GAGAS (chapters 1 and 2);
•  add a conceptual framework approach for independence (chapter 3);
•  update the financial audit standards to  (1) reflect recent updates to the auditing standards issued by the American Institute of Certified Public Accountants (AICPA), where applicable, (2) more clearly identify the GAGAS requirements and guidance that supplement AICPA requirements for financial audits, and (3) consolidate the financial audit standards into a single chapter (chapter 4);

Enclosure 1 to this letter contains a more comprehensive listing of the major changes.

 Effective Dates

When issued in final form, the 2011 revision will supersede the July 2007 revision of the standards and the guidance provided in Government Auditing Standards: Answers to Independence Standard Questions (GAO-02-870G). The effective date for the 2011 revision of GAGAS will be established when the standards are issued in final form.

 Instructions for Commenting

The draft of the proposed changes to Government Auditing Standards, 2010 Exposure Draft, is only available in electronic format and can be downloaded from GAO’s Yellow Book Web Page at http://www.gao.gov/govaud/ybk01.htm.

We are requesting comments on this draft from audit officials and financial management at all levels of government, the public accounting profession, academia, professional organizations, public interest groups, and other interested parties. To assist you in developing your comments, specific issues are presented in enclosure 2 to this letter.

We encourage you to comment on these issues and any additional issues that you note. Please associate your comments with specific references to question numbers in the enclosure and/or paragraph numbers in the proposed standards and provide your rationale for any suggested changes, along with suggested revised language. Please send your comments electronically to yellowbook@gao.gov no later than November 22, 2010.

If you need additional information please call Michael Hrapsky, Specialist, Auditing Standards, at (202) 512-9535, or Jim Dalkin, Director, at (202) 512-3133.

Sincerely yours,

Jeanette M. Franzel
Managing Director
Financial Management and Assurance
Read Full Report

Administration Announces Regulations Requiring New Health Insurance Plans to Provide Free Preventive Care

The Departments of Health and Human Services (HHS), Labor, and the Treasury issued new regulations today, requiring new private health plans to cover evidence-based preventive services and eliminate cost sharing requirements for such services.  The new rules will help Americans gain easier access to services such as blood pressure, diabetes, and cholesterol tests; many cancer screenings; routine vaccinations; pre-natal care; and regular wellness visits for infants and children.

"Today, too many Americans do not get the high-quality preventive care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs," said HHS Secretary Sebelius.  "From the Recovery Act to the First Lady's Let's Move Campaign to the Affordable Care Act, the Administration is laying the foundation to help transform the health care system from a system that focuses on treating the sick to a system that focuses on keeping every American healthy."

Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of 10 deaths among Americans each year and account for 75 percent of the nation's health spending - and often are preventable.  Nationally, Americans use preventive services at about half the recommended rate.  An estimated 11 million children and 59 million adults have private insurance that does not adequately cover immunization, for instance.  Cost sharing, including deductibles, coinsurance, or copayments, has been found to reduce the likelihood that preventive services will be used. 

"Getting access to early care and screenings will go a long way in preventing chronic illnesses like diabetes, heart disease, and high-blood pressure," said First Lady Michelle Obama.  "And good preventative care will also help tackle an issue that is particularly important to me as First Lady and as a mother - and that is the epidemic of childhood obesity in America today.  These are important tools, and now it's up to us to use them."

"One of the best ways to improve the quality of your life - and control health care costs - is to prevent illness in the first place," said Dr. Jill Biden. "Focusing on prevention and early treatment makes more sense than trying to play catch-up with a potentially deadly disease. Quite simply, these preventative services will save lives."

Under the regulations issued today, new health plans beginning on or after September 23, 2010, must cover preventive services that have strong scientific evidence of their health benefits, and these plans may no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.  Specifically, these recommendations include:

* Evidence-based preventive services: The U.S. Preventive Services Task Force, an independent panel of scientific experts, rates preventive services based on the strength of the scientific evidence documenting their benefits.  Preventive services with a "grade" of A or B, like breast and colon cancer screenings, screening for vitamin deficiencies during pregnancy, screenings for diabetes, high cholesterol and high blood pressure, and tobacco cessation counseling will be covered under these rules. 

* Routine vaccines: Health plans will cover a set of standard vaccines recommended by the Advisory Committee on Immunization Practices ranging from routine childhood immunizations to periodic tetanus shots for adults.

* Prevention for children: Health plans will cover preventive care for children recommended under the Bright Futures guidelines, developed by the Health Resources and Services Administration with the American Academy of Pediatrics.  These guidelines provide pediatricians and other health care professionals with recommendations on the services they should provide to children from birth to age 21 to keep them healthy and improve their chances of becoming healthy adults.  The types of services that will be covered include regular pediatrician visits, vision and hearing screening, developmental assessments, immunizations, and screening and counseling to address obesity and help children maintain a healthy weight. 

* Prevention for women: Health plans will cover preventive care provided to women under both the Task Force recommendations and new guidelines being developed by an independent group of experts, including doctors, nurses, and scientists, which are expected to be issued by August 1, 2011.

Today's announcement builds on other provisions in the Affordable Care Act that support prevention, including the creation of a first-ever National Prevention, Health Promotion and public Health Council tasked with developing a national strategy and a Prevention and Public Health Fund to invest in prevention initiatives and, this year, policies to increase the number of primary care professionals to help ensure access to these services.  The Affordable Care Act also helps make it easier and more affordable for Americans enrolled in Medicare or Medicaid to access critical preventive screenings and services.

More information on the Affordable Care Act's new rules on preventive care can be found at: http://www.healthcare.gov/law/about/provisions/services/index.html.

The regulations can be found at: http://www.healthcare.gov/center/regulations/prevention/regs.html.

Life-Changing Events Affecting Income-Related Monthly Adjustment Amounts to Medicare Part B Premiums

Amendments to Regulations Regarding Major Life-Changing Events Affecting Income-Related Monthly Adjustment Amounts to Medicare Part B Premiums

AGENCY: Social Security Administration.

ACTION: Interim rule with request for comments.

SUMMARY: SSA is modifying its regulations to clarify and revise what it considers major life-changing events for the Medicare Part B income- related monthly adjustment amount (IRMAA) and what evidence is required to support a claim of a major life-changing event. Recent changes in the economy and other unforeseen events have had a significant effect on many Medicare Part B beneficiaries. The changes we are making in this interim final rule will allow SSA to respond appropriately to circumstances brought about by the current economic climate and other unforeseen events, as described below.

DATES:
Effective Date: This interim rule will be effective July 15, 2010.
Comment Date: To ensure that your comments are considered, we must receive them no later than September 13, 2010.

ADDRESSES:
You may submit comments by any one of three methods-- Internet, fax, or mail. Do not submit the same comments multiple times or by more than one method. Regardless of which method you choose, please state that your comments refer to Docket No. SSA-2009-0078 so that we may associate your comments with the correct regulation. Caution: You should be careful to include in your comments only information that you wish to make publicly available. We strongly urge you not to include in your comments any personal information such as Social Security numbers or medical information.

1. Internet: We strongly recommend that you submit your comments via the Internet. Please visit the Federal eRulemaking portal at http:/ /www.regulations.gov. Use the Search function to find docket number SSA-2009-0078. The system will issue a tracking number to confirm your submission. You will not be able to view your comment immediately because we must post each comment manually. It may take up to a week for your comment to be viewable.

2. Fax: Fax comments to (410) 966-2830.

3. Mail: Mail your comments to the Office of Regulations, Social Security Administration, 107 Altmeyer Building, 6401 Security Boulevard, Baltimore, Maryland 21235-6401.
Read Complete Notice

Proposed Rule: Civil Money Penalties for Nursing Homes

This proposed rule would revise and expand current Medicare and Medicaid regulations regarding the imposition and collection of civil money penalties by CMS when nursing homes are not in compliance with Federal participation requirements in accordance with the Patient Protection and Affordable Care Act of 2010.

DATES: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. EST on August 11,2010.

Read/Download Complete Notice

Draft 2010 Report to Congress on the Benefits and Costs of Federal Regulations

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The Office of Management and Budget (OMB) requests comments on its Draft 2010 Report to Congress on the Benefits and Costs of Federal Regulations, available at: http://www.whitehouse.gov/omb/inforeg_ regpol_reports_congress/.

The Draft Report is divided into four chapters. Chapter I examines the benefits and costs of major Federal regulations issued in fiscal year 2009 and summarizes the benefits and costs of major regulations issued between October 1999 and September 2009. It also discusses regulatory impacts on State, local, and Tribal governments, small business, wages, and economic growth. Chapter II offers recommendations for regulatory reform. Chapter III provides an update on implementation of the Information Quality Act. Chapter IV summarizes agency compliance with the Unfunded Mandates Reform Act.

Department of Transportation Semi-Annual Regulatory Agenda

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The regulatory agenda is a semiannual summary of all current and projected rulemakings, reviews of existing regulations, and completed actions of the Department. The agenda provides the public with information about the Department of Transportation's regulatory activity. It is expected that this information will enable the public to be more aware of and allow it to more effectively participate in the Department's regulatory activity. The public is also invited to submit comments on any aspect of this agenda.

Improvement of our regulations is a prime goal of the Department of Transportation (Department or DOT). There should be no more regulations than necessary, and those that are issued should be simpler, more comprehensible, and less burdensome. Regulations should not be issued without appropriate involvement of the public; once issued, they should be periodically reviewed and revised, as needed, to assure that they continue to meet the needs for which they originally were designed. To view additional information about the Department of Transportation's regulatory activities online, go to http://regs.dot.gov.

Department of Labor Semi-Annual Regulatory Agenda

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This document sets forth the Department's semiannual agenda of regulations that have been selected for review or development during the coming year. The Department's agencies have carefully assessed their available resources and what they can accomplish in the next 12 months and have adjusted their agendas accordingly.

The agenda complies with the requirements of both Executive Order 12866 and the Regulatory Flexibility Act. The agenda lists all regulations that are expected to be under review or development between April 2010 and April 2011, as well as those completed during the past 6 months.

Department of Homeland Security Semi-Annual Regulatory Agenda

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This regulatory agenda is a semiannual summary of all current and projected rulemakings, existing regulations, and completed actions of the Department of Homeland Security (DHS) and its components. This agenda provides the public with information about DHS' regulatory activity. DHS expects that this information will enable the public to be more aware of, and effectively participate in, the Department's regulatory activity. DHS invites the public to submit comments on any aspect of this agenda.

Note: Item 199 is UPDATE OF FEMA'S PUBLIC ASSISTANCE REGULATIONS