{"description":"Documents matching 'lender direct guarantee lenders non-direct'","count":22,"total_pages":2,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=lender+direct+guarantee+lenders+non-direct&format=json&page=2","results":[{"title":"Strengthening the Section 184 Indian Housing Loan Guarantee Program; Extension of Compliance Date","type":"Rule","abstract":"This document extends the compliance date for HUD's final rule entitled \"Strengthening the Section 184 Indian Housing Loan Guarantee Program\" (the final rule). HUD is extending the compliance date from March 1, 2025, to December 31, 2025 to provide additional time for HUD to develop and implement a comprehensive handbook, to prepare new forms, and to allow Tribes, lenders, servicers, and other participants time to conform their policies, procedures, and systems to comply with the final rule.","document_number":"2025-01300","html_url":"https://www.federalregister.gov/documents/2025/01/17/2025-01300/strengthening-the-section-184-indian-housing-loan-guarantee-program-extension-of-compliance-date","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-17/pdf/2025-01300.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-01300.pdf?1737035141","publication_date":"2025-01-17","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"20032), which amended the regulations to the Section 184 Indian Housing Loan Guarantee Program (Section 184 Program). Since its inception, the Section 184 Program has experienced an increase in demand. As a result, the final rule updated program regulations to minimize potential risk and increase program participation by financial institutions, and added eligibility and participation requirements for Lender Applicants, Direct Guarantee Lenders, Non-Direct Guarantee Lenders, Holders and Servicers and other Section 184 Program participants. The final"},{"title":"Strengthening the Section 184 Indian Housing Loan Guarantee Program; Extension of Compliance Date","type":"Rule","abstract":"This document indefinitely delays the compliance date for HUD's final rule entitled \"Strengthening the Section 184 Indian Housing Loan Guarantee Program\" published on March 20, 2024 until HUD completes necessary updates to the handbook, which will provide necessary guidance for implementing the final rule.","document_number":"2025-23884","html_url":"https://www.federalregister.gov/documents/2025/12/29/2025-23884/strengthening-the-section-184-indian-housing-loan-guarantee-program-extension-of-compliance-date","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-29/pdf/2025-23884.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-23884.pdf?1766497520","publication_date":"2025-12-29","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"20032), which amended the regulations to the Section 184 Indian Housing Loan Guarantee Program (Section 184 Program). Since its inception, the Section 184 Program has experienced an increase in demand. As a result, the final rule updated program regulations to minimize potential risk and increase program participation by financial institutions, and added eligibility and participation requirements for Lender Applicants, \n \n Direct Guarantee Lenders, Non-Direct Guarantee Lenders, Holders and Servicers and other Section 184 Program participants. The final"},{"title":"Strengthening the Section 184 Indian Housing Loan Guarantee Program","type":"Rule","abstract":"This final rule amends the regulations governing the Section 184 Indian Housing Loan Guarantee Program (\"Section 184 Program\") to strengthen the program by clarifying rules for stakeholders. As the program has experienced an increase in demand, it is necessary that HUD update the Section 184 Program implementing regulations to minimize potential risk and increase program participation by financial institutions. This final rule adds participation and eligibility requirements for Lender Applicants, Direct Guarantee Lenders, Non- Direct Guarantee Lenders, Holders and Servicers and other financial institutions. This final rule clarifies the rules governing Tribal participation in the program, establishes underwriting requirements, specifies rules on the closing and endorsement process, establishes stronger and clearer servicing requirements, establishes program rules governing claims submitted by Servicers and paid by HUD, and adds standards governing monitoring, reporting, sanctions, and appeals. This final rule adds new definitions and makes statutory conforming amendments, including the categorical exclusion of the Section 184 Program in HUD's environmental review regulations. Ultimately, the changes made by this final rule promote program sustainability, increase Borrower protections, and provide clarity for new and existing Lenders who participate in the program. This final rule follows the publication of a proposed rule on December 21, 2022, and takes into consideration the comments received in response to that proposed rule and during the Tribal consultations.","document_number":"2024-05515","html_url":"https://www.federalregister.gov/documents/2024/03/20/2024-05515/strengthening-the-section-184-indian-housing-loan-guarantee-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-03-20/pdf/2024-05515.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-05515.pdf?1710852313","publication_date":"2024-03-20","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"HUD will use to detect issues or anomalies in Lender Applicants, Direct Guarantee and Non-Direct Guarantee Lenders' Section 184 lending is by reviewing a random statistical sampling of the Lender Applicants, Direct Guarantee and Non-Direct Guarantee Lenders' rejected Section 184 loans. Having this data is essential to HUD maintaining Section 184 Program integrity.\n \n § 1005.219 Other Requirements \n Several commenters supported establishing HUD's ability to set a trust land lending requirement for lenders as proposed in this section. One commenter recommended"},{"title":"Revising Residency Requirements for the Section 184 Indian Housing Loan Guarantee Program","type":"Rule","abstract":"This interim final rule revises the Department of Housing and Urban Development's (HUD) regulations governing the Section 184 Indian Housing Loan Guarantee Program (the \"Section 184 Program\") by modifying the residency requirements for Borrower eligibility for Section 184 Program insured mortgages. This revision aligns HUD's requirements with recent executive actions that emphasize the prioritization of federal resources to protect the financial interests of American citizens and ensure the integrity of government-insured loan programs.","document_number":"2025-16979","html_url":"https://www.federalregister.gov/documents/2025/09/04/2025-16979/revising-residency-requirements-for-the-section-184-indian-housing-loan-guarantee-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-09-04/pdf/2025-16979.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-16979.pdf?1756903514","publication_date":"2025-09-04","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"“Strengthening the Section 184 Indian Housing Loan Guarantee Program” (the final rule) in the \n Federal Register \n , \n at 89 FR 20032. The final rule amended the regulations to the Section 184 Indian Housing Loan Guarantee Program (Section 184 Program) to minimize potential risk and increase program participation by financial institutions. Among the various amendments, the final rule added eligibility and participation requirements for Lender Applicants, Direct Guarantee Lenders, Non-Direct Guarantee Lenders, Holders and Servicers and other Section 184"},{"title":"Strengthening the Section 184 Indian Housing Loan Guarantee Program; Delay of Effective and Compliance Dates","type":"Rule","abstract":"The Department of Housing and Urban Development (HUD) published in the Federal Register on March 20, 2024, a final rule to strengthen its Section 184 Indian Loan Guarantee Program by, among other things, clarifying rules for Tribes, lenders, servicers, and other participants. The final rule established an effective date of June 18, 2024. To provide time for HUD to develop and implement a comprehensive handbook for the Section 184 Program and to allow Tribes, lenders, servicers, and other participants time to conform their policies, procedures, and systems to comply with HUD's March 20, 2024, final rule, this rulemaking delays that effective date to December 31, 2024, and establishes a compliance date of March 1, 2025.","document_number":"2024-13124","html_url":"https://www.federalregister.gov/documents/2024/06/14/2024-13124/strengthening-the-section-184-indian-housing-loan-guarantee-program-delay-of-effective-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-06-14/pdf/2024-13124.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-13124.pdf?1718282733","publication_date":"2024-06-14","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"Loan Guarantee Program” (the Final Rule). The Final Rule amended the regulations to the Section 184 Indian Housing Loan Guarantee Program (Section 184 Program). Since its inception, the Section 184 Program has experienced an increase in demand. As a result, HUD's March 20, 2024, final rule updated program regulations to minimize potential risk and increase program participation by financial institutions. The final rule added eligibility and participation requirements for Lender Applicants, Direct Guarantee Lenders, Non-Direct Guarantee Lenders, Holders"},{"title":"Strengthening the Section 184 Indian Home Loan Guarantee Program","type":"Proposed Rule","abstract":"This proposed rule would revise the regulations governing the Section 184 Indian Home Loan Guarantee Program (\"Section 184 Program\") to fiscally strengthen the program by clarifying rules for Lenders, Tribes, and Borrowers. As the program has experienced an increase in demand, it now requires an update to the implementing regulations to minimize potential risk and increase program participation by financial institutions. This proposed rule strives to modernize and enhance the Section 184 Program by adding participation and eligibility requirements for Lenders and other financial institutions. This proposed rule would also clarify the rules governing Tribal participation in the program, establish underwriting requirements, specify rules on the closing and endorsement process, establish stronger and clearer servicing requirements, establish program rules governing claims submitted by Servicers and paid by HUD, and add standards governing monitoring, reporting, sanctions and appeals. This rule would add new definitions and make statutory conforming amendments, including the categorical exclusion of the Section 184 program in HUD's environmental review regulations. Ultimately, the changes made by this proposed rule would promote program sustainability, increase Borrower protections, and provide clarity for new and existing Lenders who participate in the program.","document_number":"2022-26097","html_url":"https://www.federalregister.gov/documents/2022/12/21/2022-26097/strengthening-the-section-184-indian-home-loan-guarantee-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-12-21/pdf/2022-26097.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-26097.pdf?1671543938","publication_date":"2022-12-21","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"ensure that Direct Guarantee and Non-Direct Guarantee Lenders continue to meet program eligibility requirements and to reduce the risk to HUD and the Fund. This section also would require the Direct Guarantee Lender and Non-Direct Guarantee Lender to submit Financial Reports and updated contact information. This section is consistent with HUD's current practice.\n \n \n Program ineligibility § 1005.225. \n This section describes the circumstances under which HUD would determine that a Direct Guarantee Lender or Non-Direct Guarantee Lender is ineligible"},{"title":"Standards for Covered Clearing Agencies for U.S. Treasury Securities and Application of the Broker-Dealer Customer Protection Rule With Respect to U.S. Treasury Securities","type":"Rule","abstract":"The Securities and Exchange Commission (\"Commission\") is adopting rules under the Securities Exchange Act of 1934 (\"Exchange Act\") to amend the standards applicable to covered clearing agencies for U.S. Treasury securities to require that such covered clearing agencies have written policies and procedures reasonably designed to require that every direct participant of the covered clearing agency submit for clearance and settlement all eligible secondary market transactions in U.S. Treasury securities to which it is a counterparty. In addition, the Commission is adopting additional amendments to the Covered Clearing Agency Standards with respect to risk management. These requirements are designed to protect investors, reduce risk, and increase operational efficiency. Finally, the Commission is amending the broker-dealer customer protection rule to permit margin required and on deposit with covered clearing agencies for U.S. Treasury securities to be included as a debit in the reserve formulas for accounts of customers and proprietary accounts of broker-dealers (\"PAB\"), subject to certain conditions.","document_number":"2023-27860","html_url":"https://www.federalregister.gov/documents/2024/01/16/2023-27860/standards-for-covered-clearing-agencies-for-us-treasury-securities-and-application-of-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-01-16/pdf/2023-27860.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-27860.pdf?1705067114","publication_date":"2024-01-16","agencies":[{"raw_name":"SECURITIES AND EXCHANGE COMMISSION","name":"Securities and Exchange Commission","id":466,"url":"https://www.federalregister.gov/agencies/securities-and-exchange-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/466","parent_id":null,"slug":"securities-and-exchange-commission"}],"excerpts":"funds and direct participants of the CCA could cause risks to the CCA in the event that the hedge fund is not able to meet its obligations to the direct participant, which could, in turn, create stress to the direct participant and through to the CCA. Therefore, the Commission stated that including the direct participant's purchase and sale transactions with hedge funds within the definition of an eligible secondary market transaction should reduce the potential for financial distress arising from the transactions that could affect the direct participant"},{"title":"Federal Student Aid Programs (Student Assistance General Provisions, Federal Perkins Loan Program, Federal Family Education Loan Program, and William D. Ford Federal Direct Loan Program)","type":"Rule","abstract":"The Secretary is issuing updated waivers and modifications of statutory and regulatory provisions governing the Federal student financial aid programs under the authority of the Higher Education Relief Opportunities for Students Act of 2003 (HEROES Act). The waivers and modifications in this document apply only to the national emergency declared in regard to the coronavirus disease 2019 (COVID-19) pandemic. With the termination of the COVID-19 national emergency, effective April 10, 2023, each waiver and modification identified in this document expires at the end of the award year that ends on June 30, 2023, unless otherwise noted in this document or unless it is otherwise extended by the Secretary in a document published in the Federal Register. HEROES Act waivers and modifications included in earlier documents sunset in accordance with the timeframes provided in those documents.","document_number":"2023-12977","html_url":"https://www.federalregister.gov/documents/2023/06/16/2023-12977/federal-student-aid-programs-student-assistance-general-provisions-federal-perkins-loan-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-06-16/pdf/2023-12977.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-12977.pdf?1686833145","publication_date":"2023-06-16","agencies":[{"raw_name":"DEPARTMENT OF EDUCATION","name":"Education Department","id":126,"url":"https://www.federalregister.gov/agencies/education-department","json_url":"https://www.federalregister.gov/api/v1/agencies/126","parent_id":null,"slug":"education-department"}],"excerpts":"borrowers with Direct Loans, those who have already consolidated into the Direct Loan Program, and those with other types of Federal student loans who submitted a Direct Consolidation Loan application between October 6, 2021, and October 30, 2022. \n Borrower Defense (34 CFR 685.206) \n \n On December 11, 2020, the Department announced that borrowers who had applied prior to July 1, 2020, for a borrower defense discharge of \n \n FFEL, Perkins, and other loans that were not Direct Loans (non-Direct Loans), but who had not consolidated their non-Direct Loans prior"},{"title":"Institutional Eligibility Under the Higher Education Act of 1965, as Amended; Student Assistance General Provisions; Federal Perkins Loan Program; Federal Family Education Loan Program; and William D. Ford Federal Direct Loan Program","type":"Rule","abstract":"The Secretary establishes new regulations governing the William D. Ford Federal Direct Loan (Direct Loan) Program to establish a new Federal standard and a process for determining whether a borrower has a defense to repayment on a loan based on an act or omission of their school. We also are amending the Direct Loan Program regulations to prohibit participating schools from using certain contractual provisions regarding dispute resolution processes and to require certain notifications and disclosures by institutions (institutions or schools) regarding their use of mandatory arbitration. Additionally, we are amending the Direct Loan regulations to eliminate interest capitalization in instances where it is not required by statute. We are also amending the regulations governing closed school discharges and total and permanent disability (TPD) discharges in the Federal Perkins Loan (Perkins), Direct Loan, and Federal Family Education Loan (FFEL) programs. We are also amending the regulations governing false certification discharges in the Direct Loan and FFEL programs. Finally, we are amending the regulations governing Public Service Loan Forgiveness (PSLF) in the Direct Loan program to improve the application process, and to clarify and expand definitions for full- time employment, qualifying employers, and qualifying monthly payments. The changes would bring greater transparency and clarity and improve the administration of Federal student financial aid programs to assist and protect students, participating institutions, and taxpayers.","document_number":"2022-23447","html_url":"https://www.federalregister.gov/documents/2022/11/01/2022-23447/institutional-eligibility-under-the-higher-education-act-of-1965-as-amended-student-assistance","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-11-01/pdf/2022-23447.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-23447.pdf?1667220318","publication_date":"2022-11-01","agencies":[{"raw_name":"DEPARTMENT OF EDUCATION","name":"Education Department","id":126,"url":"https://www.federalregister.gov/agencies/education-department","json_url":"https://www.federalregister.gov/api/v1/agencies/126","parent_id":null,"slug":"education-department"}],"excerpts":"statutory definition of “Direct Loan” (see Part D of title IV of the HEA). These regulations make clear, however, that FFEL borrowers may access the BD process through a Direct Consolidation Loan. A covered loan remains a Direct Loan or other Federal student loan that is or could be consolidated into a Federal Direct Consolidation Loan.\n \n \n Changes: \n We added a new definition of “covered loan” in § 685.401(a), which includes a Direct Loan or other Federal student loan that is or could be consolidated into a Federal Direct Consolidation loan.\n \n"},{"title":"Introduction to the Unified Agenda of Federal Regulatory and Deregulatory Actions-Fall 2023","type":"Proposed Rule","abstract":"Publication of the Fall 2023 Unified Agenda of Federal Regulatory and Deregulatory Actions represents a key component of the regulatory planning mechanism prescribed in Executive Order (\"E.O.\") 12866, \"Regulatory Planning and Review,\" (58 FR 51735, as amended) and reaffirmed in E.O. 13563, \"Improving Regulation and Regulatory Review,\" (76 FR 3821) and E.O. 14094, \"Modernizing Regulatory Review,\" (88 FR 21879). The Regulatory Flexibility Act requires that agencies publish semiannual regulatory agendas in the Federal Register describing regulatory actions they are developing that may have a significant economic impact on a substantial number of small entities (5 U.S.C. 602). The Unified Agenda of Federal Regulatory and Deregulatory Actions (Unified Agenda), published in the fall and spring, helps agencies fulfill all of these requirements. All Federal regulatory agencies have chosen to publish their regulatory agendas as part of this publication. The complete publication of the Fall 2023 Unified Agenda contains the Regulatory Plans of 29 Federal agencies and 69 Federal agency regulatory agendas available to the public at www.reginfo.gov. The Fall 2023 Unified Agenda publication appearing in the Federal Register includes the Regulatory Plan and agency Regulatory Flexibility Agendas, in accordance with the publication requirements of the Regulatory Flexibility Act. Agency Regulatory Flexibility Agendas contain only those Agenda entries for rules that are likely to have a significant economic impact on a substantial number of small entities and entries that have been selected for periodic review under section 610 of the Regulatory Flexibility Act.","document_number":"2024-00476","html_url":"https://www.federalregister.gov/documents/2024/02/09/2024-00476/introduction-to-the-unified-agenda-of-federal-regulatory-and-deregulatory-actions-fall-2023","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-02-09/pdf/2024-00476.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-00476.pdf?1707399919","publication_date":"2024-02-09","agencies":[{"raw_name":"REGULATORY INFORMATION SERVICE CENTER","name":"Regulatory Information Service Center","id":449,"url":"https://www.federalregister.gov/agencies/regulatory-information-service-center","json_url":"https://www.federalregister.gov/api/v1/agencies/449","parent_id":null,"slug":"regulatory-information-service-center"}],"excerpts":"address weaknesses identified by OIG, provide clarity for new and existing Direct Guarantee and Non-Direct Guarantee Lenders, and reduce unreasonable claim payment requests from Servicers Many of the procedures and policy proposed by the proposed rule adopt industry standards and best practices and do not differ from existing HUD guidance or current practice within the Section 184 Program, which are often documented in HUD guidance such as “PIH Notices” and “Dear Lender Letters”. \n Aggregate Costs and Benefits \n \n Executive Order 12866, as amended"},{"title":"Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment Requirements","type":"Rule","abstract":"This final rule sets forth routine updates to the Medicare home health payment rates for calendar year (CY) 2024 in accordance with existing statutory and regulatory requirements. This rule-- discusses comments received regarding access to home health aide services; implements home health payment-related changes; rebases and revises the home health market basket and revises the labor-related share; codifies statutory requirements for disposable negative pressure wound therapy (dNPWT); and implements the new items and services payment for the home intravenous immune globulin (IVIG) benefit. In addition, it--finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements and the expanded Home Health Value-Based Purchasing (HHVBP) Model; implements the new Part B benefit for lymphedema compression treatment items, codifies the Medicare definition of brace, and makes other codification changes based on recent legislation; adds an informal dispute resolution (IDR) and special focus program (SFP) for hospice programs; codifies DMEPOS refill policy; and finalizes proposed revisions for Medicare provider and supplier enrollment requirements.","document_number":"2023-24455","html_url":"https://www.federalregister.gov/documents/2023/11/13/2023-24455/medicare-program-calendar-year-cy-2024-home-health-hh-prospective-payment-system-rate-update-hh","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-11-13/pdf/2023-24455.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-24455.pdf?1698869908","publication_date":"2023-11-13","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"3 through 9. \n (iii) Wages and Salaries Portion of Direct Patient Care Contract Labor \n Contract labor costs allocated to wages and salaries costs reflect a portion of the direct patient care contract labor costs. Specifically, we proposed to calculate direct patient care contract labor costs by first summing costs from Worksheet A, column 4, lines 16 through 25. These contract labor costs are then multiplied by each provider's ratio of direct patient care wages and salaries costs to total direct patient care wages and salaries and benefits costs"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2023 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Costs Incurred for Qualified and Non-Qualified DeferredCompensation Plans; and Changes to Hospital and Critical Access Hospital Conditions of Participation","type":"Rule","abstract":"This final rule will: revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs). In addition it will establish new requirements and revise existing requirements for eligible hospitals and critical access hospitals (CAHs) participating in the Medicare Promoting Interoperability Program; and update policies for the Hospital Readmissions Reduction Program, Hospital Inpatient Quality Reporting (IQR) Program, Hospital VBP Program, Hospital- Acquired Condition (HAC) Reduction Program, PPS-Exempt Cancer Hospital Reporting (PCHQR) Program, and the Long-Term Care Hospital Quality Reporting Program (LTCH QRP). It will also revise the hospital and critical access hospital (CAH) conditions of participation (CoPs) for infection prevention and control and antibiotic stewardship programs; and codify and clarify policies related to the costs incurred for qualified and non-qualified deferred compensation plans. Lastly, this final rule will provide updates on the Rural Community Hospital Demonstration Program and the Frontier Community Health Integration Project.","document_number":"2022-16472","html_url":"https://www.federalregister.gov/documents/2022/08/10/2022-16472/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-08-10/pdf/2022-16472.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-16472.pdf?1659384921","publication_date":"2022-08-10","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"calendar year for MA direct GME, and the Consumer Price Index-Urban (CPI-U) increases for Part A direct GME. For CY 2020, the direct GME projections are based on FY 2019 HCRIS. For CY 2021, the direct GME projections are based on FY 2019 HCRIS. For CYs 2020 and 2021, the final national rates and percentages, and their data sources are set forth in this table. \n \n \n ER10AU22.131 \n \n In summary, after consideration of the public comments received, we are finalizing our proposal to use NAH MA add-on rates as well as the direct GME MA percent reductions"},{"title":"Executive Office for Immigration Review; Fee Review","type":"Rule","abstract":"On February 28, 2020, the Department of Justice (\"the Department\" or \"DOJ\") published a notice of proposed rulemaking (\"NPRM\" or \"proposed rule\") that would increase the fees for those Executive Office for Immigration Review (\"EOIR\") applications, appeals, and motions that are subject to an EOIR-determined fee, based on a fee review conducted by EOIR. The proposed rule would not affect fees established by the Department of Homeland Security (\"DHS\") with respect to DHS forms for applications that are filed or submitted in EOIR proceedings. The proposal would not affect the ability of aliens to submit fee waiver requests, nor would it add new fees. The proposed rule would also update cross-references to DHS regulations regarding fees and make a technical change regarding requests under the Freedom of Information Act (\"FOIA\"). This final rule responds to comments received in response to the NPRM and adopts the fee amounts proposed in the NPRM without change.","document_number":"2020-27506","html_url":"https://www.federalregister.gov/documents/2020/12/18/2020-27506/executive-office-for-immigration-review-fee-review","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2020-12-18/pdf/2020-27506.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2020-27506.pdf?1608048916","publication_date":"2020-12-18","agencies":[{"raw_name":"DEPARTMENT OF JUSTICE","name":"Justice Department","id":268,"url":"https://www.federalregister.gov/agencies/justice-department","json_url":"https://www.federalregister.gov/api/v1/agencies/268","parent_id":null,"slug":"justice-department"},{"raw_name":"Executive Office for Immigration Review","name":"Executive Office for Immigration Review","id":149,"url":"https://www.federalregister.gov/agencies/executive-office-for-immigration-review","json_url":"https://www.federalregister.gov/api/v1/agencies/149","parent_id":268,"slug":"executive-office-for-immigration-review"}],"excerpts":"help DHS when determining the new fee. As stated in the NPRM, EOIR conducted a cost study that considered the direct salary costs required for each step in the processing and adjudications of those applications, appeals, and motions for which EOIR levies a fee. 85 FR at 11869. The Department did not include any other costs, such as the cost of network access, maintenance of EOIR databases, EOIR adjudicator training, or other non-direct salary costs, although those costs could have been included in accordance with the law. \n Id. \n \n \n In response"},{"title":"Program Integrity: Gainful Employment","type":"Rule","abstract":"The Secretary of the Department of Education (Department) amends the regulations on institutional eligibility under the Higher Education Act of 1965, as amended (HEA), and the Student Assistance General Provisions to rescind the Department's gainful employment (GE) regulations (2014 Rule).","document_number":"2019-13703","html_url":"https://www.federalregister.gov/documents/2019/07/01/2019-13703/program-integrity-gainful-employment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2019-07-01/pdf/2019-13703.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2019-13703.pdf?1561752919","publication_date":"2019-07-01","agencies":[{"raw_name":"DEPARTMENT OF EDUCATION","name":"Education Department","id":126,"url":"https://www.federalregister.gov/agencies/education-department","json_url":"https://www.federalregister.gov/api/v1/agencies/126","parent_id":null,"slug":"education-department"}],"excerpts":"point out that the amount of debt utilized for calculating the debt portion of the D/E rates is the lower of mean/median debt or total direct educational costs—tuition, fees, books, supplies, and equipment—so that loans taken for non-direct expenses may be excluded from the calculation. Still, adults with higher borrowing limits who borrow to generate a credit balance must first borrow enough to pay all of the direct costs of education since the credit balance is generated only after those other expenses are paid. \n \n As described earlier, independent"},{"title":"Regulation of NMS Stock Alternative Trading Systems","type":"Rule","abstract":"The Securities and Exchange Commission is adopting amendments to regulatory requirements in Regulation ATS under the Securities Exchange Act of 1934 (\"Exchange Act\") applicable to alternative trading systems (\"ATSs\") that trade National Market System (\"NMS\") stocks (hereinafter referred to as \"NMS Stock ATSs\"), including so called \"dark pools.\" First, we are adopting new Form ATS-N, which will require NMS Stock ATSs to disclose information about their manner of operations, the broker-dealer that operates the ATS (\"broker-dealer operator\"), and the ATS-related activities of the broker-dealer operator and its affiliates. Second, as amended, the regulations will require public posting of certain Form ATS-N filings on the Commission's website, which will be accomplished through the Commission's Electronic Data Gathering, Analysis, and Retrieval system (\"EDGAR\") and require each NMS Stock ATS that has a website to post on its website a direct URL hyperlink to the Commission's website. Third, the amendments that we are adopting today provide a process for the Commission to review Form ATS-N filings and, after notice and opportunity for hearing, declare an NMS Stock ATS's Form ATS-N ineffective. Fourth, the regulations, as amended, will require all ATSs subject to the regulations to place in writing its safeguards and procedures to protect subscribers' confidential trading information. We are also adopting conforming amendments.","document_number":"2018-15896","html_url":"https://www.federalregister.gov/documents/2018/08/07/2018-15896/regulation-of-nms-stock-alternative-trading-systems","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2018-08-07/pdf/2018-15896.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2018-15896.pdf?1533559519","publication_date":"2018-08-07","agencies":[{"raw_name":"SECURITIES AND EXCHANGE COMMISSION","name":"Securities and Exchange Commission","id":466,"url":"https://www.federalregister.gov/agencies/securities-and-exchange-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/466","parent_id":null,"slug":"securities-and-exchange-commission"}],"excerpts":"used for direct entry into the ATS, which could include SORs or algorithms offered by the broker-dealer operator. Furthermore, the adopted disclosure requirements only require the NMS Stock ATS to “list and provide a summary description of the terms and conditions for entering orders or trading interest into the ATS” through these sources. This revised language is intended to clarify that the NMS Stock ATS need not provide a detailed description of the programming for its SOR (or other similar functionality), algorithms, or other non-direct means for"},{"title":"Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) and Fee Schedule Amounts, and Technical Amendments To Correct Existing Regulations Related to the CBP for Certain DMEPOS","type":"Rule","abstract":"This final rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year (CY) 2019. This rule also updates the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). In addition, it updates and rebases the ESRD market basket for CY 2019. This rule also updates requirements for the ESRD Quality Incentive Program (QIP), and makes technical amendments to correct existing regulations related to the Competitive Bidding Program (CBP) for certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS). Finally, this rule finalizes changes to bidding and pricing methodologies under the DMEPOS competitive bidding program; adjustments to DMEPOS fee schedule amounts using information from competitive bidding for items furnished from January 1, 2019 through December 31, 2020; new payment classes for oxygen and oxygen equipment and a new methodology for ensuring that new payment classes for oxygen and oxygen equipment are budget neutral; payment rules for multi- function ventilators or ventilators that perform functions of other durable medical equipment (DME); and revises the payment methodology for mail order items furnished in the Northern Mariana Islands. This rule also includes a summary of the feedback received for the request for information related to establishing fee schedule amounts for new DMEPOS items and services.","document_number":"2018-24238","html_url":"https://www.federalregister.gov/documents/2018/11/14/2018-24238/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2018-11-14/pdf/2018-24238.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2018-24238.pdf?1541103342","publication_date":"2018-11-14","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"is comprised of direct patient care wages and salaries and non-direct patient care wages and salaries. Direct patient care wages and salaries for 2016 were derived from Worksheet B, column 5, lines 8 through 17 of the MCR. Non-direct patient care wages and salaries includes all other wages and salaries costs for non-health workers and physicians, which we derive using the following steps: \n \n Step 1: \n To capture the salary costs associated with non-direct patient care cost centers, we calculated salary percentages for non-direct patient care from"},{"title":"Program Integrity and Improvement","type":"Rule","abstract":"The Secretary amends the cash management regulations and other sections of the Student Assistance General Provisions regulations issued under the Higher Education Act of 1965, as amended (HEA). These final regulations are intended to ensure that students have convenient access to their title IV, HEA program funds, do not incur unreasonable and uncommon financial account fees on their title IV funds, and are not led to believe they must open a particular financial account to receive their Federal student aid. In addition, the final regulations update other provisions in the cash management regulations and otherwise amend the Student Assistance General Provisions. The final regulations also clarify how previously passed coursework is treated for title IV eligibility purposes and streamline the requirements for converting clock hours to credit hours.","document_number":"2015-27145","html_url":"https://www.federalregister.gov/documents/2015/10/30/2015-27145/program-integrity-and-improvement","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2015-10-30/pdf/2015-27145.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2015-27145.pdf?1446122720","publication_date":"2015-10-30","agencies":[{"raw_name":"DEPARTMENT OF EDUCATION","name":"Education Department","id":126,"url":"https://www.federalregister.gov/agencies/education-department","json_url":"https://www.federalregister.gov/api/v1/agencies/126","parent_id":null,"slug":"education-department"}],"excerpts":"non-institutional educational expenses. \n \n Changes: \n We have revised § 668.164(c)(3)(ii) to state the following rules. If a student's title IV aid package includes only a Direct Loan, the current year is the current loan period. If a student's title IV aid package includes only non-Direct Loan aid, the current year is the award year. If a student's title IV aid package includes both a Direct Loan and other aid, the institution may choose to use either the loan period or the award year as the current year. And, we have clarified that a prior year is any"},{"title":"Regulation of Fuels and Fuel Additives: Changes to Renewable Fuel Standard Program","type":"Rule","abstract":"Under the Clean Air Act Section 211(o), as amended by the Energy Independence and Security Act of 2007 (EISA), the Environmental Protection Agency is required to promulgate regulations implementing changes to the Renewable Fuel Standard program. The revised statutory requirements specify the volumes of cellulosic biofuel, biomass-based diesel, advanced biofuel, and total renewable fuel that must be used in transportation fuel. This action finalizes the regulations that implement the requirements of EISA, including the cellulosic, biomass- based diesel, advanced biofuel, and renewable fuel standards that will apply to all gasoline and diesel produced or imported in 2010. The final regulations make a number of changes to the current Renewable Fuel Standard program while retaining many elements of the compliance and trading system already in place. This final rule also implements the revised statutory definitions and criteria, most notably the new greenhouse gas emission thresholds for renewable fuels and new limits on renewable biomass feedstocks. This rulemaking marks the first time that greenhouse gas emission performance is being applied in a regulatory context for a nationwide program. As mandated by the statute, our greenhouse gas emission assessments consider the full lifecycle emission impacts of fuel production from both direct and indirect emissions, including significant emissions from land use changes. In carrying out our lifecycle analysis we have taken steps to ensure that the lifecycle estimates are based on the latest and most up-to-date science. The lifecycle greenhouse gas assessments reflected in this rulemaking represent significant improvements in analysis based on information and data received since the proposal. However, we also recognize that lifecycle GHG assessment of biofuels is an evolving discipline and will continue to revisit our lifecycle analyses in the future as new information becomes available. EPA plans to ask the National Academy of Sciences for assistance as we move forward. Based on current analyses we have determined that ethanol from corn starch will be able to comply with the required greenhouse gas (GHG) threshold for renewable fuel. Similarly, biodiesel can be produced to comply with the 50% threshold for biomass-based diesel, sugarcane with the 50% threshold for advanced biofuel and multiple cellulosic-based fuels with their 60% threshold. Additional fuel pathways have also been determined to comply with their thresholds. The assessment for this rulemaking also indicates the increased use of renewable fuels will have important environmental, energy and economic impacts for our Nation.","document_number":"2010-3851","html_url":"https://www.federalregister.gov/documents/2010/03/26/2010-3851/regulation-of-fuels-and-fuel-additives-changes-to-renewable-fuel-standard-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2010-03-26/pdf/2010-3851.pdf","public_inspection_pdf_url":null,"publication_date":"2010-03-26","agencies":[{"raw_name":"ENVIRONMENTAL PROTECTION AGENCY","name":"Environmental Protection Agency","id":145,"url":"https://www.federalregister.gov/agencies/environmental-protection-agency","json_url":"https://www.federalregister.gov/api/v1/agencies/145","parent_id":null,"slug":"environmental-protection-agency"}],"excerpts":"factors like we do in the US from the DAYCENT model. The IPCC guidance has emission factors for four sources of N\n 2 \n O emissions from crops, Direct N\n 2 \n O Emissions from Synthetic Fertilizer Application, Indirect N\n 2 \n O Emissions from Synthetic Fertilizer Application, Direct Emissions from Crop Residues, and Indirect Emissions from Crop Residues. The proposal did not include N\n 2 \n O emissions from the Direct and Indirect Emissions from Crop Residues for cotton, palm oil, rapeseed, sugar beet, sugarcane, or sunflower. These were not included for"},{"title":"Regulation of Fuels and Fuel Additives: Changes to Renewable Fuel Standard Program","type":"Proposed Rule","abstract":"Under the Clean Air Act, as amended by Sections 201, 202, and 210 of the Energy Independence and Security Act of 2007, the Environmental Protection Agency is required to promulgate regulations implementing changes to the Renewable Fuel Standard program. The revised statutory requirements specify the volumes of cellulosic biofuel, biomass-based diesel, advanced biofuel, and total renewable fuel that must be used in transportation fuel each year, with the volumes increasing over time. The revised statutory requirements also include new definitions and criteria for both renewable fuels and the feedstocks used to produce them, including new greenhouse gas emission thresholds for renewable fuels. For the first time in a regulatory program, an assessment of greenhouse gas emission performance is being utilized to establish those fuels that qualify for the four different renewable fuel standards. As mandated by the revised statutory requirements, the greenhouse gas emission assessments must evaluate the full lifecycle emission impacts of fuel production including both direct and indirect emissions, including significant emissions from land use changes. The proposed program is expected to reduce U.S. dependence on foreign sources of petroleum by increasing domestic sources of energy. Based on our lifecycle analysis, we believe that the expanded use of renewable fuels would provide significant reductions in greenhouse gas emissions such as carbon dioxide that affect climate change. We recognize the significance of using lifecycle greenhouse gas emission assessments that include indirect impacts such as emission impacts of indirect land use changes. Therefore, in this preamble we have been transparent in breaking out the various sources of greenhouse gas emissions included in the analysis and are seeking comments on our methodology as well as various options for determining the lifecycle greenhouse gas emissions (GHG) for each fuel. In addition to seeking comments on the information in this document and its supporting materials, the Agency is conducting peer reviews of critical aspects of the lifecycle methodology. The increased use of renewable fuels would also impact criteria pollutant emissions, with some pollutants such as volatile organic compounds (VOC) and nitrogen oxides (NOX) expected to increase and other pollutants such as carbon monoxide (CO) and benzene expected to decrease. The production of feedstocks used to produce renewable fuels is also expected to impact water quality. This action proposes regulations designed to ensure that refiners, blenders, and importers of gasoline and diesel would use enough renewable fuel each year so that the four volume requirements of the Energy Independence and Security Act would be met with renewable fuels that also meet the required lifecycle greenhouse gas emissions performance standards. Our proposed rule describes the standards that would apply to these parties and the renewable fuels that would qualify for compliance. The proposed regulations make a number of changes to the current Renewable Fuel Standard program while retaining many elements of the compliance and trading system already in place.","document_number":"E9-10978","html_url":"https://www.federalregister.gov/documents/2009/05/26/E9-10978/regulation-of-fuels-and-fuel-additives-changes-to-renewable-fuel-standard-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2009-05-26/pdf/E9-10978.pdf","public_inspection_pdf_url":null,"publication_date":"2009-05-26","agencies":[{"raw_name":"ENVIRONMENTAL PROTECTION AGENCY","name":"Environmental Protection Agency","id":145,"url":"https://www.federalregister.gov/agencies/environmental-protection-agency","json_url":"https://www.federalregister.gov/api/v1/agencies/145","parent_id":null,"slug":"environmental-protection-agency"}],"excerpts":"through distribution and delivery and use of the finished fuel. As mandated by EISA, it includes direct emissions and significant indirect emissions such as significant emissions from land use changes. EPA believes that compliance with the EISA mandate—determining the aggregate GHG emissions related to the full fuel lifecycle, including both direct emissions and significant indirect emissions such as land use changes—make it necessary to assess those direct and indirect impacts that occur not just within the United States but also those that occur in"},{"title":"Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, and Other Part B Payment Policies for CY 2008; Revisions to the Payment Policies of Ambulance Services Under the Ambulance Fee Schedule for CY 2008; and the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions","type":"Rule","abstract":"This final rule with comment period addresses certain provisions of the Tax Relief and Health Care Act of 2006, as well as making other proposed changes to Medicare Part B payment policy. We are making these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also discusses refinements to resource-based practice expense (PE) relative value units (RVUs); geographic practice cost indices (GPCI) changes; malpractice RVUs; requests for additions to the list of telehealth services; several coding issues including additional codes from the 5-Year Review; payment for covered outpatient drugs and biologicals; the competitive acquisition program (CAP); clinical lab fee schedule issues; payment for renal dialysis services; performance standards for independent diagnostic testing facilities; expiration of the physician scarcity area (PSA) bonus payment; conforming and clarifying changes for comprehensive outpatient rehabilitation facilities (CORFs); a process for updating the drug compendia; physician self referral issues; beneficiary signature for ambulance transport services; durable medical equipment (DME) update; the chiropractic services demonstration; a Medicare economic index (MEI) data change; technical corrections; standards and requirements related to therapy services under Medicare Parts A and B; revisions to the ambulance fee schedule; the ambulance inflation factor for CY 2008; and amending the e-prescribing exemption for computer-generated facsimile transmissions. We are also finalizing the calendar year (CY) 2007 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2008. As required by the statute, we are announcing that the physician fee schedule update for CY 2008 is -10.1 percent, the initial estimate for the sustainable growth rate for CY 2008 is -0.1 percent, and the conversion factor (CF) for CY 2008 is $34.0682.","document_number":"07-5506","html_url":"https://www.federalregister.gov/documents/2007/11/27/07-5506/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-part-b","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2007-11-27/pdf/07-5506.pdf","public_inspection_pdf_url":null,"publication_date":"2007-11-27","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"percent of total direct costs, all supply costs be passed through and exempt from the direct adjustment factor.\n \n \n Response: \n The resource-based PE methodology converts the direct costs for a service, obtained from the direct cost database, into PE RVUs by comparing the service specific aggregate costs to the aggregate pool of costs available for expenditure on direct costs. Because the aggregate direct costs for all services contained in the direct cost database exceed the aggregate pool of available direct dollars, a direct cost adjustment must"}]}