Benefits Payable in Terminated Single-Employer Plans; Limitations on Guaranteed Benefits

Image via WikipediSUMMARY: This is a proposed rule to
amend PBGC’s regulation on Benefits
Payable in Terminated Single-Employer Plans. That regulation sets forth rules on PBGC’s guarantee of pension plan benefits, including rules on the phasein of the guarantee. The amendments implement section 403 of the Pension Protection Act of 2006, which provides that the phase-in period for the guarantee of  benefits that are contingent upon the occurrence of an ‘‘unpredictable contingent event,’’ such as a plant shutdown, starts no earlier than the date of the shutdown or other unpredictable contingent event.

DATES: Comments must be received on or before May 10, 2011.

ADDRESSES: Comments should be identified by Regulation Information Number (RIN 1212–AB18), and may be submitted by any of the following methods:

• Federal eRulemaking Portal: http://www.regulations.gov.
• Follow the Web site instructions for submitting comments.
• E-mail: reg.comments@pbgc.gov.
• Fax: 202–326–4224.
• Mail or Hand Delivery: Legislative and Regulatory Department, Pension Benefit Guaranty Corporation, 1200 K Street, NW., Washington, DC 20005–4026.

PBGC will make all comments available on its Web site, http://www.pbgc.gov.

Copies of comments also may be obtained by writing PBGC’s Communications and Public Affairs
Department (CPAD) at Suite 240 at the above address or by visiting or calling CPAD during normal business hours (202–326–4040).

FOR FURTHER INFORMATION CONTACT: John
H. Hanley, Director; Gail A. Sevin, Manager; or Bernard Klein, Attorney;
Legislative & Regulatory Department,
Pension Benefit Guaranty Corporation,
1200 K Street, NW., Washington, DC
20005, 202–326–4224. (TTY/TDD users may call the Federal relay service tollfree at 1–800–877–8339 and ask to be connected to 202–326–4224.)
Complete Federal Register Notice with Full Details

CMS Proposed Community First Choice Rule

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On February 25th, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule in the Federal Register to implement a new Community First Choice Option.  Under Section 2401 of the Affordable Care Act, this proposed rule establishes a new State option to provide home and community-based attendant services and supports through a new section of 1915 (k) to the Social Security Act.  The goal of this new option is to give States additional resources to make community living a first choice.

Starting in October, this option will allow States to receive a six percent increase in federal matching funds for providing community-based attendant services and supports to people with Medicaid.  Over the next three years—through 2014—States could see a total of $3.7 billion in new funds to provide these services.  Under this new option, States will provide consumer controlled, person-centered home and community-based attendant supports to individuals on a statewide basis.  The person-directed plans and services will be developed in a manner that is most integrated and appropriate to the individual’s needs, without regard to age, type or nature of disability, severity of disability, or form of home and community-based attendant services and supports the individual requires in order to lead an independent life. 

To find out more about the Community First Choice option and to review the proposed rule implementing this section, please visit: http://www.gpo.gov/fdsys/pkg/FR-2011-02-25/pdf/2011-3946.pdf

Comments for this proposed rule are due to CMS by April 26, 2011. 

Legal Services Corporation Eligibility Rule Change

The Legal Services Corporation (‘‘Corporation’’) is required by law to establish maximum income levels for individuals eligible for legal assistance. This document updates the specified income levels to reflect the annual amendments to the Federal Poverty Guidelines as issued by the Department of Health and Human Services.

Effective Date: This rule is effective as of January 31, 2011.
Complete Federal Register Notice

Loan Guaranty: Assistance to Eligible Individuals in Acquiring Specially Adapted Housing

Image via WikipediaVeterans and servicemembers with severe disabilities may be eligible under 38 U.S.C. chapter 21 for specially adapted housing (SAH) grants. In administering the SAH program, VA helps these eligible individuals to purchase, construct, or adapt a home that suits the individual's living needs. In a document published in the Federal Register on October 5, 2009 (74 FR 51103), VA proposed to amend regulations in 38 CFR part 36, subpart C, regarding assistance to certain disabled veterans in acquiring SAH, specifically Sec. Sec. 36.4400 through 36.4410, which implement the SAH grant program.

As explained in the proposed rule, VA is amending these regulations for three reasons.

• First, VA believes the regulations should be written in a reader-focused style. 
• Second, detailed guidance about program policies and a regulation written with an easy-to-follow organizational structure will help applicants and eligible individuals (and those acting on their behalf) understand program requirements.
• Third, substantive changes are necessary to implement recent legislation, policy decisions, and a VA General Counsel legal opinion. 

Pursuant to 38 U.S.C. 2101(d), the Secretary may prescribe regulations applicable to the SAH program. In revising these regulations, VA intends that applicants, eligible individuals, program participants, and other interested parties will be better informed about the legal requirements and Department policies that guide the administration of SAH grants.

Final Rule

Income Level for Individuals Eligible for Legal Services Corporation Assistance

The Legal Services Corporation (``Corporation'') is required by law to establish maximum income levels for individuals eligible for legal assistance. This document updates the specified income levels to reflect the annual amendments to the Federal Poverty Guidelines as issued by the Department of Health and Human Services.

Effective Date: This rule is effective as of August 6, 2010.

Final Rule

Telecommunications Relay Services and Speech-to-Speech Services

Final rule; extension of waiver.

In this document, the Consumer and Governmental Affairs Bureau (Bureau) extends for an additional year waivers of certain Telecommunications Relay Services (TRS) mandatory minimum standards for Video Relay Service (VRS) and Internet Protocol Relay (IP Relay). The waived TRS mandatory minimum standards are: One-line voice carry over(VCO); VCO-to-teletypewriter (TTY); VCO-to-VCO; one-line hearing carry over (HCO); HCO-to-TTY; HCO-to-HCO; call release; pay-per-call (900)calls; types of calls; equal access to interexchange carriers; and speech-to-speech (STS). Also, in this document, the Bureau grants a limited extension of the waiver of the speed dialing requirement for IP Relay. The Bureau extends the waivers for one year (four months in the case of speed dialing for IP Relay) because the record demonstrates that it is technologically infeasible for VRS and IP Relay providers to offer these services at this time.

DATES: The waivers of certain TRS mandatory minimum standards for VRS and IP Relay will expire on January 1, 2010, except the limited extension of the wavier of the speed dialing requirement for IP Relay, which expired on May 1, 2009.

ADDRESSES: Parties may submit documentation related to the waivers, identified by [CG Docket No. 03-123 and/or DA 08-2808], by mail, to:
Dana Wilson, Consumer and Governmental Affairs Bureau, Disability Rights Office, 445 12th Street, SW., Room 3-C418, Washington, DC 20554.

Authorized Number of Beds for Veterans Administration State Homes

Grants to States for Construction or Acquisition of State Home Facilities--Update of Authorized Beds This proposed rule updates the number of authorized beds for Veterans Administration State Homes grant program. There is a 30 day comment period. Congress has authorized VA to provide grants to States for the construction or acquisition of State home facilities for the provision of care to veterans. The term ``State home'' means ``a home established by a State (other than a possession) for veterans disabled by age, disease, or otherwise who by reason of such disability are incapable of earning a living'' and ``includes such a home which furnishes nursing home care for veterans.'' Section 8134(a)(2) of title 38, U.S.C., mandates that VA prescribe for each State the number of nursing home and domiciliary beds for which grants may be furnished, which the proposed note to 38 CFR 59.40(a) would refer to as a State's ``unmet need'' number. To compute this number, VA estimates for each State the maximum number of nursing home and domiciliary beds needed by veterans in that State (which is the maximum number of such beds designated for each State, as shown on the chart in proposed Sec. 59.40(a)), and then subtracts the number of existing State home beds plus the number of those beds under construction or that would be constructed in accordance with the State's grant applications. Click the link below to see each state's authorized number of beds. FR Doc E9-16341

Medicare and Medicaid Programs: Quarterly Listing of Program Issuances

This notice lists CMS Medicare and Medicaid programs:

• manual instructions,
• substantive and interpretive regulations, and
• other Federal Register notices that were published from July 2008 through September 2008.

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 and
• a list of Medicare-approved carotid stent facilities.

Included in this notice is:

• a list of the American College of Cardiology's National Cardiovascular Data registry sites,
• active CMS coverage-related guidance documents, and
• special one-time notices regarding national coverage provisions.

Also included in this notice is a list of:

• National Oncologic Positron Emissions Tomography Registry sites,
• Medicare-approved ventricular assist device (destination therapy) facilities,
• Medicare-approved lung volume reduction surgery facilities,
• Medicare-approved clinical trials for fluorodeoxyglucose positron emissions tomography for dementia, and
• Medicare-approved bariatric surgery 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.

Proposed Rule: Weatherization Assistance Program for Low-Income Persons

SUMMARY: The U.S. Department of Energy (DOE) is proposing to expand the definition of ``State'' under the Weatherization Assistance Program for Low-Income Persons (Weatherization Assistance Program) and to amend the financial assistance allocation procedure to reflect the expanded definition. The Energy Independence and Security Act of 2007 amended the Weatherization Assistance Program definition of ``State'' to include the Commonwealth of Puerto Rico and the other territories and possessions of the United States. Consistent with the statutory amendment, DOE is proposing to amend the regulatory definition of ``State,'' and to amend the allocation procedure relied on to calculate the amount of financial assistance received by each State so as to include American Samoa, Guam, Commonwealth of the Northern Mariana Islands, Commonwealth of Puerto Rico, and the Virgin Islands. DATES: Public comments on this proposed rule and the proposed information collection request will be accepted until February 27, 2009. DOE will hold a public meeting on Tuesday, January 27, 2009, from 9 a.m. to 12 p.m., in Conference Room 5E-081, at 1000 Independence Avenue, SW., Washington, DC.

State Option To Establish Non-Emergency Medical Transportation Program

This final rule implements section 6083 of the Deficit Reduction Act of 2005, which provides States with additional State plan flexibility to establish a non-emergency medical transportation (NEMT) brokerage program, and to receive the Federal medical assistance percentage matching rate. This authority supplements the current authority that States have to provide NEMT to Medicaid beneficiaries who need access to medical care, but have no other means of transportation. Effective date: These regulations are effective January 20, 2009.

Medicaid Program; Disproportionate Share Hospital Payments; Final Rule

This final rule sets forth the data elements necessary to comply with the requirements of Section 1923(j) of the Social Security Act (Act) related to auditing and reporting of disproportionate share hospital payments under State Medicaid programs. These requirements were added by Section 1001(d) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). Effective Date: This rule is effective on January 19, 2009.

SSA: Clarification of Evidentiary Standard for Determinations and Decisions

Final Rule We (Social Security Administration) are amending our rules to clarify that we apply the preponderance of the evidence standard when we make determinations and decisions at all levels of our administrative review process. These rules do not change our policy that the Appeals Council applies the substantial evidence standard when it reviews a decision by an administrative law judge (ALJ) to determine whether to grant a request for review. We are also adding definitions of the terms ``substantial evidence'' and ``preponderance of the evidence'' for use in applying these rules. DATES: These final rules are effective on January 20, 2009.

State Long-Term Care Partnership Program: Reporting Requirements for Insurers

This final rule sets forth reporting requirements for private insurers that issue qualified long-term care insurance policies in States participating in the State Long-Term Care Partnership Program established under the Deficit Reduction Act of 2005 (DRA) (Pub. L. 109-171). Section 6021 of the DRA requires that the Secretary of Health and Human Services (the Secretary) specify a set of reporting requirements and collect data from insurers on qualified long-term care insurance policies issued under the program and the subsequent use of the benefits under these policies. Under a State Long-Term Care Partnership Program, an amount equal to the benefits received under the long-term care insurance policy is disregarded in determining the assets of an individual for purposes of Medicaid eligibility and estate recovery. Effective Date: This final rule is effective on April 17, 2009.

Final Rule: Patient Safety and Quality Improvement

The Secretary of Health and Human Services is adopting rules to implement certain aspects of the Patient Safety and Quality Improvement Act of 2005, Pub. L. 109-41, 42 U.S.C. 299b-21--b-26 (Patient Safety Act). The final rule establishes a framework by which hospitals, doctors, and other health care providers may voluntarily report information to Patient Safety Organizations (PSOs), on a privileged and confidential basis, for the aggregation and analysis of patient safety events. The final rule outlines the requirements that entities must meet to become PSOs and the processes by which the Secretary will review and accept certifications and list PSOs. It also describes the privilege and confidentiality protections for the information that is assembled and developed by providers and PSOs, the exceptions to these privilege and confidentiality protections, and the procedures for the imposition of civil money penalties for the knowing or reckless impermissible disclosure of patient safety work product. DATES: The final rule is effective on January 19, 2009.

Medicare Program Final Rule

This final rule with comment period implements changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also finalizes the calendar year (CY) 2008 interim relative value units (RVUs) and issues interim RVUs for new and revised codes for CY 2009. In addition, as required by the statute, it announces that the physician fee schedule update is 1.1 percent for CY 2009, the preliminary estimate for the sustainable growth rate for CY 2009 is 7.4 percent, and the conversion factor (CF) for CY 2009 is $36.0666. This final rule with comment period also implements or discusses certain provisions of the
Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

DATES:
Effective Date: This final rule with comment period is effective on January 1, 2009 except for amendments to Sec. 410.62 and Sec. 411.351 which are effective July 1, 2009.

Comment Date: Comments will be considered if we receive them at one of the addresses provided below, no later than 5 p.m. e.s.t. on December 29, 2008.

Medicare Final Rules

1. Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates
2. Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates
3. Hospital Conditions of Participation:
1. Requirements for Approval and Re-Approval of Transplant Centers To Perform Organ Transplants
2. Clarification of  Provider and Supplier Termination Policy
4. Changes to the Ambulatory Surgical Center Conditions for Coverage

The Family and Medical Leave Act of 1993; Final Rule

This document provides the text of final regulations implementing the Family and Medical Leave Act of 1993 (``FMLA''), the law that provides eligible employees who work for covered employers the right to take job-protected, unpaid leave for absences due to the birth of the employee's son or daughter and to care for the newborn child; because of the placement of a son or daughter with the employee for adoption or foster care; in order to care for a son, daughter, spouse, or parent with a serious health condition; or because of the employee's own serious health condition that makes the employee unable to perform the functions of his or her job. The final regulations also address new military family leave entitlements included in amendments to the FMLA enacted as part of the National Defense Authorization Act for FY 2008, which provide additional job-protected leave rights to eligible employees of covered employers who provide care for covered servicemembers with a serious injury or illness and because of qualifying exigencies arising out of the fact that a covered military member is on active duty or has been notified of an impending call or order to active duty in support of a contingency operation. EFFECTIVE DATE: These rules are effective on January 16, 2009.

SSA: Administrative Law Judge Hearings Proposed Rule

Setting the Time and Place for a Hearing before an Administrative Law Judge SUMMARY: We propose to amend our rules to clarify that the agency is responsible for setting the time and place for a hearing before an administrative law judge (ALJ). Consistent with our regulations at lower levels of the administrative process, we propose to use ``we'' or ``us'' in the rules setting the time and place for a hearing. These changes will ensure greater flexibility in scheduling hearings both in person and via video teleconferencing and will aid us in our effort to increase efficiency in the hearing process and reduce the number of pending hearings. The number of cases awaiting a hearing has reached historic proportions, and efforts toward greater efficiency are critical to addressing this problem. DATES: To be sure that we consider your comments, we must receive them no later than January 9, 2009.

VA: Schedule for Rating Eye Disabilities

Final rule This document amends the Department of Veterans Affairs (VA) Schedule for Rating Disabilities (Rating Schedule) by updating the portion of the schedule that addresses disabilities of the eye. These amendments ensure that the schedule uses current medical terminology, provides unambiguous criteria for evaluating disabilities, and incorporates pertinent medical advances. DATES: Effective Date: This amendment is effective December 10, 2008. Applicability Date: These amendments shall apply to all applications for benefits received by VA on or after December 10, 2008.

Final rule - Clarification of Outpatient Hospital Facility Services Definition

SUMMARY: Outpatient hospital services are a mandatory part of the standard Medicaid benefit package. This final rule aligns the Medicaid definition of outpatient hospital services more closely to the Medicare definition in order to: Improve the functionality of the applicable upper payment limits (which are based on a comparison to Medicare payments for the same services), provide more transparency in determining available hospital coverage in any State, and generally clarify the scope of services for which Federal financial participation (FFP) is available under the outpatient hospital services benefit category.

Effective Date: These regulations are effective December 8, 2008.