{"description":"Documents matching 'state infant formula containment contracts'","count":132,"total_pages":7,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=state+infant+formula+containment+contracts&format=json&page=2","results":[{"title":"Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Implementation of the Access to Baby Formula Act of 2022 and Related Provisions; Correcting Amendments","type":"Rule","abstract":"On December 14, 2023, the U.S. Department of Agriculture's Food and Nutrition Service (FNS) published a final rule that went into effect on February 12, 2024. The rule amended the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) regulations to implement the provisions of the Access to Baby Formula Act of 2022 (ABFA) and make related amendments. In reviewing the resulting changes to the Code of Federal Regulations (CFR), FNS found that the final rule inadvertently omitted provisions from the CFR and contained several non-substantive errors. This document corrects those errors in the WIC regulations.","document_number":"2025-23089","html_url":"https://www.federalregister.gov/documents/2025/12/17/2025-23089/special-supplemental-nutrition-program-for-women-infants-and-children-wic-implementation-of-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-17/pdf/2025-23089.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-23089.pdf?1765892721","publication_date":"2025-12-17","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"},{"raw_name":"Food and Nutrition Service","name":"Food and Nutrition Service","id":200,"url":"https://www.federalregister.gov/agencies/food-and-nutrition-service","json_url":"https://www.federalregister.gov/api/v1/agencies/200","parent_id":12,"slug":"food-and-nutrition-service"}],"excerpts":"the weighted average retail prices for different brands of <span class=\"match\">infant</span> <span class=\"match\">formula</span> in the <span class=\"match\">State</span> vary by 5 percent or less. The weighted average retail price must take into account the prices charged for each type and physical form of <span class=\"match\">infant</span> <span class=\"match\">formula</span> by authorized vendors or, if a <span class=\"match\">State</span> agency elects, it may include stores that do not participate in the WIC program in the <span class=\"match\">State</span>. The <span class=\"match\">State</span> agency must also base calculations on the proportion of each type and physical form of <span class=\"match\">infant</span> <span class=\"match\">formula</span> the <span class=\"match\">State</span> agency issues based on the data provided to bidders pursuant"},{"title":"Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Implementation of the Access to Baby Formula Act of 2022 and Related Provisions","type":"Rule","abstract":"This rulemaking serves to amend the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program regulations by incorporating provisions of the Access to Baby Formula Act of 2022 and making related amendments. ABFA establishes waiver authority for the Secretary of Agriculture to address certain emergencies, disasters, and supply chain disruptions impacting WIC, and adds requirements to State agency infant formula cost containment contracts to protect against disruptions to the Program in the event of a recall. The provisions focus on improving State agencies' ability to ensure continuity of Program operations during emergency periods (i.e., emergencies, disasters, and public health emergencies) and supply chain disruptions, while ensuring access to Program benefits among low-income pregnant and postpartum participants, infants, and children up to 5 years of age who are at nutritional risk.","document_number":"2023-26641","html_url":"https://www.federalregister.gov/documents/2023/12/14/2023-26641/special-supplemental-nutrition-program-for-women-infants-and-children-wic-implementation-of-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-12-14/pdf/2023-26641.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-26641.pdf?1702475114","publication_date":"2023-12-14","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"},{"raw_name":"Food and Nutrition Service","name":"Food and Nutrition Service","id":200,"url":"https://www.federalregister.gov/agencies/food-and-nutrition-service","json_url":"https://www.federalregister.gov/api/v1/agencies/200","parent_id":12,"slug":"food-and-nutrition-service"}],"excerpts":"competitive, non-<span class=\"match\">contract</span> brand <span class=\"match\">infant</span> <span class=\"match\">formula</span> in WIC <span class=\"match\">State</span> agencies where they held the <span class=\"match\">contract</span>. \n E. <span class=\"match\">Infant</span> <span class=\"match\">Formula</span> Cost <span class=\"match\">Containment</span> <span class=\"match\">Contracts</span> \n The Child Nutrition Act of 1966, (CNA, 42 U.S.C. 1786(h)(8)(A)(i)(I)) and WIC Program regulations at 7 CFR 246.16a require most WIC <span class=\"match\">State</span> agencies to continuously operate a cost <span class=\"match\">containment</span> system for <span class=\"match\">infant</span> <span class=\"match\">formula</span>. WIC <span class=\"match\">State</span> agencies have historically met this requirement through a competitive bidding process that requires sealed bids, for single-supplier rebate <span class=\"match\">contracts</span>. WIC <span class=\"match\">State</span> agencies solicit"},{"title":"Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Revisions in the WIC Food Packages","type":"Rule","abstract":"This final rule considers public comments submitted in response to the proposed rule revising the WIC food packages published on November 21, 2022. It revises regulations to align the WIC food packages with the current Dietary Guidelines for Americans and to reflect recommendations from the National Academies of Science, Engineering, and Medicine while promoting nutrition security and equity and considering program administration. The changes are intended to provide WIC participants with a wider variety of foods that align with the latest nutritional science; provide WIC State agencies with greater flexibility to prescribe and tailor food packages that accommodate participants' special dietary needs and personal and cultural food preferences; and address key nutritional needs to support healthy dietary patterns. This rule provides foods in amounts that are more consistent with the supplemental nature of the Program; encourages fruit and vegetable consumption; and strengthens support for individual breastfeeding goals to help establish long-term breastfeeding.","document_number":"2024-07437","html_url":"https://www.federalregister.gov/documents/2024/04/18/2024-07437/special-supplemental-nutrition-program-for-women-infants-and-children-wic-revisions-in-the-wic-food","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-18/pdf/2024-07437.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-07437.pdf?1713357917","publication_date":"2024-04-18","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"},{"raw_name":"Food and Nutrition Service","name":"Food and Nutrition Service","id":200,"url":"https://www.federalregister.gov/agencies/food-and-nutrition-service","json_url":"https://www.federalregister.gov/api/v1/agencies/200","parent_id":12,"slug":"food-and-nutrition-service"}],"excerpts":"\n \n \n D. <span class=\"match\">Infant</span> Foods \n 1. Reduce <span class=\"match\">infant</span> cereal, <span class=\"match\">infant</span> fruits and vegetables, and <span class=\"match\">infant</span> meat \n Finalize as proposed. \n \n \n   \n 2. Increase CVV substitution amounts for <span class=\"match\">infant</span> fruits and vegetables, allow forms other than fresh, and lower the minimum age for <span class=\"match\">infants</span> to receive a CVV \n Finalize as proposed. \n \n \n   \n 3. Prohibit added fats in <span class=\"match\">infant</span> foods \n No change to current provision. \n \n \n E. Add <span class=\"match\">Infant</span> <span class=\"match\">Formula</span> Flexibilities and Create a Separate Food Package for Partially (Mostly) Breastfeeding Participants \n 1. Increase <span class=\"match\">formula</span> amounts in"},{"title":"Submission for OMB Review; Comment Request","type":"Notice","abstract":null,"document_number":"2024-10421","html_url":"https://www.federalregister.gov/documents/2024/05/13/2024-10421/submission-for-omb-review-comment-request","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-13/pdf/2024-10421.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-10421.pdf?1715345141","publication_date":"2024-05-13","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"}],"excerpts":"1966, as amended.\n \n Access to Baby <span class=\"match\">Formula</span> Act (ABFA) of 2022 Implementation (RIN 0584-AE94) and amends the Special Supplemental Nutrition Program for Women, <span class=\"match\">Infants</span>, and Children (WIC) program regulations by incorporating provisions of the Access to Baby <span class=\"match\">Formula</span> Act of 2022. \n ABFA established waiver authority for the Secretary of Agriculture to address certain emergencies, disasters, and supply chain disruptions impacting WIC, and adds requirements to <span class=\"match\">State</span> agency <span class=\"match\">infant</span> <span class=\"match\">formula</span> cost <span class=\"match\">containment</span> <span class=\"match\">contracts</span> to protect against disruptions to the"},{"title":"Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Online Ordering and Transactions and Food Delivery Revisions To Meet the Needs of a Modern, Data-Driven Program","type":"Proposed Rule","abstract":"The Food and Nutrition Service, USDA (the Department), proposes to remove barriers to online ordering and internet-based transactions in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) through this rulemaking. This is expected to improve the WIC shopping experience while increasing equity and access to nutritious foods for WIC participants, thus positively impacting nutrition security. The proposed rule also complements the Program's near-complete transition to electronic benefit transfer (EBT) by streamlining and modernizing certain WIC food delivery regulations to support current technology and future innovation, and by introducing measures intended to meet the needs of a modern, data-driven program that uses these technologies for food delivery.","document_number":"2023-02484","html_url":"https://www.federalregister.gov/documents/2023/02/23/2023-02484/special-supplemental-nutrition-program-for-women-infants-and-children-wic-online-ordering-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-02-23/pdf/2023-02484.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-02484.pdf?1676987124","publication_date":"2023-02-23","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"},{"raw_name":"Food and Nutrition Service","name":"Food and Nutrition Service","id":200,"url":"https://www.federalregister.gov/agencies/food-and-nutrition-service","json_url":"https://www.federalregister.gov/api/v1/agencies/200","parent_id":12,"slug":"food-and-nutrition-service"}],"excerpts":"adjustments to the information that <span class=\"match\">State</span> agencies are required to submit annually to FNS in their <span class=\"match\">State</span> Plans. FNS estimates that one <span class=\"match\">State</span> agency currently provides justification to authorize a mobile vendor in their <span class=\"match\">State</span> Plan which requires approximately one hour to complete. Therefore, across all <span class=\"match\">State</span> agencies, the removal of the requirement to justify authorization of mobile vendors would result in less than a one-minute decrease in the number of hours that an average WIC <span class=\"match\">State</span> agency spends preparing their <span class=\"match\">State</span> Plan each year (from 134.62 to"},{"title":"Coronavirus State and Local Fiscal Recovery Funds","type":"Rule","abstract":"The Secretary of the Treasury is issuing an interim final rule to implement the amendments made by the Consolidated Appropriations Act, 2023 with respect to the Coronavirus State Fiscal Recovery Fund and the Coronavirus Local Fiscal Recovery Fund established under the American Rescue Plan Act.","document_number":"2023-17446","html_url":"https://www.federalregister.gov/documents/2023/09/20/2023-17446/coronavirus-state-and-local-fiscal-recovery-funds","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-09-20/pdf/2023-17446.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-17446.pdf?1695127514","publication_date":"2023-09-20","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"}],"excerpts":"direct compliance costs on <span class=\"match\">state</span>, local, and Tribal governments, and is not required by statute, or preempts <span class=\"match\">state</span> law, unless the agency meets the consultation and funding requirements of section 6 of the Executive order. This interim final rule does not have Federalism implications within the meaning of the Executive order and does not impose substantial, direct compliance costs on <span class=\"match\">state</span>, local, and Tribal governments or preempt <span class=\"match\">state</span> law within the meaning of the Executive Order. The compliance costs are imposed on <span class=\"match\">state</span>, local, and Tribal governments"},{"title":"Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Revisions in the WIC Food Packages","type":"Proposed Rule","abstract":"This rulemaking proposes to revise regulations governing the WIC food packages to align them with the current Dietary Guidelines for Americans and reflect recommendations made by the National Academies of Sciences, Engineering and Medicine (NASEM) in its 2017 report, \"Review of WIC Food Packages: Improving Balance and Choice,\" while promoting nutrition security and equity and taking into account program administration considerations. The proposed changes are intended to provide WIC participants with a wider variety of foods that align with the latest nutritional science; provide WIC State agencies with greater flexibility to prescribe and tailor food packages that accommodate participants' special dietary needs and personal and cultural food preferences; provide more equitable access to supplemental foods; and better promote and support individual breastfeeding goals of participants to help establish successful long-term breastfeeding.","document_number":"2022-24705","html_url":"https://www.federalregister.gov/documents/2022/11/21/2022-24705/special-supplemental-nutrition-program-for-women-infants-and-children-wic-revisions-in-the-wic-food","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-11-21/pdf/2022-24705.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-24705.pdf?1668779117","publication_date":"2022-11-21","agencies":[{"raw_name":"DEPARTMENT OF AGRICULTURE","name":"Agriculture Department","id":12,"url":"https://www.federalregister.gov/agencies/agriculture-department","json_url":"https://www.federalregister.gov/api/v1/agencies/12","parent_id":null,"slug":"agriculture-department"},{"raw_name":"Food and Nutrition Service","name":"Food and Nutrition Service","id":200,"url":"https://www.federalregister.gov/agencies/food-and-nutrition-service","json_url":"https://www.federalregister.gov/api/v1/agencies/200","parent_id":12,"slug":"food-and-nutrition-service"}],"excerpts":"following maximum monthly amounts of <span class=\"match\">infant</span> cereal, <span class=\"match\">infant</span> fruits and vegetables, and <span class=\"match\">infant</span> meat: \n • Fully breastfed <span class=\"match\">infants</span>: \n ○ 16 ounces <span class=\"match\">infant</span> cereal \n ○ 128 ounces <span class=\"match\">infant</span> fruits and vegetables \n ○ 40 ounces <span class=\"match\">infant</span> meat \n • Partially (mostly) breastfed and fully <span class=\"match\">formula</span> fed <span class=\"match\">infants</span>: \n ○ 8 ounces <span class=\"match\">infant</span> cereal \n ○ 128 ounces <span class=\"match\">infant</span> fruits and vegetables (no change) \n ○ No <span class=\"match\">infant</span> meat (no change) \n Due to the low redemption of <span class=\"match\">infant</span> meat and importance of this food as an iron source for fully breastfed <span class=\"match\">infants</span>, the Department requests public comment"},{"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":"and information meetings with <span class=\"match\">State</span> agencies, advocacy groups, program operators, and industry partners. For more information about this rule, see RIN 0584-AE96.\n \n \n In December 2023, FNS also plans to publish a final rule codifying the provisions of the \n Access to Baby <span class=\"match\">Formula</span> Act of 2022. \n Amongst other things, the rule codifies requirements for <span class=\"match\">State</span> agencies to include language in their Women, <span class=\"match\">Infants</span> and Children (WIC) <span class=\"match\">infant</span> <span class=\"match\">formula</span> rebate <span class=\"match\">contracts</span> that describes remedies in the event of an <span class=\"match\">infant</span> <span class=\"match\">formula</span> recall. This rule was informed"},{"title":"Nondiscrimination in Health Programs and Activities","type":"Rule","abstract":"The Department of Health and Human Services (HHS or the Department) is issuing this final rule regarding section 1557 of the Affordable Care Act (ACA) (section 1557). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 1557(c) of the ACA authorizes the Secretary of the Department to promulgate regulations to implement the nondiscrimination requirements of section 1557. The Department is also revising its interpretation regarding whether Medicare Part B constitutes Federal financial assistance for purposes of civil rights enforcement. Additionally, the Department is revising provisions prohibiting discrimination on the basis of sex in regulations issued by the Centers for Medicare & Medicaid Services (CMS) governing Medicaid and the Children's Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; States and the Exchanges carrying out Exchange requirements; agents, brokers, or web-brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; issuers providing essential health benefits (EHB); and qualified health plan issuers.","document_number":"2024-08711","html_url":"https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-06/pdf/2024-08711.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08711.pdf?1714162519","publication_date":"2024-05-06","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"},{"raw_name":"Office of the Secretary"}],"excerpts":"consideration applicable <span class=\"match\">State</span> law governing licensure of interpreters if any are available in the <span class=\"match\">State</span> where the covered entity provides services. These commenters noted that the process of who can serve as a qualified interpreter differs from <span class=\"match\">State</span> to <span class=\"match\">State</span>, and OCR should adopt language that reflects the minimum standards of <span class=\"match\">State</span> laws governing qualifications of sign language interpreters, if any.\n \n \n Response: \n OCR understands and appreciates commenters raised concerns. Covered entities may use adherence to <span class=\"match\">State</span> law governing licensure as"},{"title":"PFAS National Primary Drinking Water Regulation Rulemaking","type":"Proposed Rule","abstract":"The Environmental Protection Agency (EPA) is committed to using and advancing the best available science to tackle per- and polyfluoroalkyl substances (PFAS) pollution, protect public health, and harmonize policies that strengthen public health protections with infrastructure funding to help communities, especially disadvantaged communities, deliver safe drinking water. In March 2021, EPA issued a final regulatory determination to regulate perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) as contaminants under Safe Drinking Water Act (SDWA). In this notice, EPA is issuing a preliminary regulatory determination to regulate perfluorohexane sulfonic acid (PFHxS), hexafluoropropylene oxide dimer acid (HFPO-DA) and its ammonium salt (also known as a GenX chemicals), perfluorononanoic acid (PFNA), and perfluorobutane sulfonic acid (PFBS), and mixtures of these PFAS as contaminants under SDWA. Through this action, EPA is also proposing a National Primary Drinking Water Regulation (NPDWR) and health-based Maximum Contaminant Level Goals (MCLG) for these four PFAS and their mixtures as well as for PFOA and PFOS. EPA is proposing to set the health-based value, the MCLG, for PFOA and PFOS at zero. Considering feasibility, including currently available analytical methods to measure and treat these chemicals in drinking water, EPA is proposing individual MCLs of 4.0 nanograms per liter (ng/L) or parts per trillion (ppt) for PFOA and PFOS. EPA is proposing to use a Hazard Index (HI) approach to protecting public health from mixtures of PFHxS, HFPO-DA and its ammonium salt, PFNA, and PFBS because of their known and additive toxic effects and occurrence and likely co-occurrence in drinking water. EPA is proposing an HI of 1.0 as the MCLGs for these four PFAS and any mixture containing one or more of them because it represents a level at which no known or anticipated adverse effects on the health of persons is expected to occur and which allows for an adequate margin of safety. EPA has determined it is also feasible to set the MCLs for these four PFAS and for a mixture containing one or more of PFHxS, HFPO-DA and its ammonium salt, PFNA, PFBS as an HI of unitless 1.0. The Agency is requesting comment on this action, including this proposed NPDWR and MCLGs, and have identified specific areas where public input will be helpful for EPA in developing the final rule. In addition to seeking written input, the EPA will be holding a public hearing on May 4, 2023.","document_number":"2023-05471","html_url":"https://www.federalregister.gov/documents/2023/03/29/2023-05471/pfas-national-primary-drinking-water-regulation-rulemaking","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-03-29/pdf/2023-05471.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-05471.pdf?1679584516","publication_date":"2023-03-29","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":"conducting data analyses, EPA incorporated individual <span class=\"match\">state</span>-specific reporting limits where possible. Specific details on <span class=\"match\">state</span> data reporting thresholds are available in USEPA (2023e). \n \n \n Table 5—Non-Targeted <span class=\"match\">State</span> PFOS and PFOA Finished Water Data—Summary of Samples With <span class=\"match\">State</span> Reported Detections \n 1 \n \n \n <span class=\"match\">State</span> \n \n PFOS samples with <span class=\"match\">state</span> \n reported \n detections \n \n \n PFOS <span class=\"match\">state</span> \n reported \n sample percent \n detection \n \n \n PFOA samples with <span class=\"match\">state</span> \n reported \n detections \n \n \n PFOA <span class=\"match\">state</span> \n reported \n sample percent \n detections \n \n \n \n \n Alabama "},{"title":"Discrimination on the Basis of Disability in Health and Human Service Programs or Activities","type":"Proposed Rule","abstract":"The Department of Health and Human Services (HHS or the Department) is committed to protecting the civil rights of individuals with disabilities under section 504 of the Rehabilitation Act of 1973 (section 504). To implement the prohibition of discrimination on the basis of disability, the Department proposes to update and amend its section 504 regulation. The proposed rule would add new provisions that clarify existing requirements under section 504 prohibiting recipients of financial assistance from the Department (recipients) from discriminating on the basis of disability in their programs and activities, including in health care, child welfare, and other human services. The proposed rule includes new requirements prohibiting discrimination in the areas of medical treatment; the use of value assessments; web, mobile, and kiosk accessibility; and requirements for accessible medical equipment, so that persons with disabilities have an opportunity to participate in or benefit from health care programs and activities that is equal to the opportunity afforded others. It also adds a section on child welfare to expand on and clarify the obligation to provide nondiscriminatory child welfare services. The proposed rule would also update the definition of disability and other provisions to ensure consistency with statutory amendments to the Rehabilitation Act, enactment of the Americans with Disabilities Act and the Americans with Disabilities Amendments Act of 2008, the Affordable Care Act, as well as Supreme Court and other significant court cases. It also further clarifies the obligation to provide services in the most integrated setting. Finally, the proposed rule would make other clarifying edits, including updating outdated terminology and references.","document_number":"2023-19149","html_url":"https://www.federalregister.gov/documents/2023/09/14/2023-19149/discrimination-on-the-basis-of-disability-in-health-and-human-service-programs-or-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-09-14/pdf/2023-19149.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-19149.pdf?1694440872","publication_date":"2023-09-14","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"}],"excerpts":"504.” \n The definition of “Federal financial assistance” in the existing rule states that Federal financial assistance means “any grant, cooperative agreement, loan, <span class=\"match\">contract</span> (other than a procurement <span class=\"match\">contract</span> or a <span class=\"match\">contract</span> of insurance or guaranty) . . . .” The proposed revision adds “direct Federal” so that it reads “(other than a direct Federal procurement <span class=\"match\">contract</span> or a <span class=\"match\">contract</span> of insurance or guaranty”). No substantive change is intended. \n Finally, the Department proposes to retain with no revisions the terms “Recipient,” “Director,” and “Department"},{"title":"Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies","type":"Proposed Rule","abstract":"This proposed rule would set forth routine updates to the Medicare home health payment rates; the payment rate for the disposable negative pressure wound therapy (dNPWT) devices; and the intravenous immune globulin (IVIG) items and services payment rate for CY 2025 in accordance with existing statutory and regulatory requirements. In addition, it proposes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value Based Purchasing (HHVBP) Model. It also proposes a new standard for acceptance to service policy in the HH conditions of participation (CoPs) and includes requests for information (RFIs) soliciting input on permitting rehabilitative therapists to conduct the initial and comprehensive assessment and the factors that may influence the patient referral and intake processes. Lastly, it proposes updates to provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses.","document_number":"2024-14254","html_url":"https://www.federalregister.gov/documents/2024/07/03/2024-14254/medicare-program-calendar-year-cy-2025-home-health-prospective-payment-system-hh-pps-rate-update-hh","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-07-03/pdf/2024-14254.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-14254.pdf?1719432920","publication_date":"2024-07-03","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":"furnish services directly, under an individual <span class=\"match\">contract</span>, or under arrangement with a DMEPOS supplier to furnish services related to the administration of IVIG in the home, must be legally authorized (licensed, certified, or registered) in accordance with applicable Federal, <span class=\"match\">State</span>, and local laws, and must act only within the scope of their <span class=\"match\">State</span> license or <span class=\"match\">State</span> certification, or registration. A supplier may not <span class=\"match\">contract</span> with any entity that is currently excluded from the Medicare program, any <span class=\"match\">State</span> health care programs or from any other Federal"},{"title":"Introduction to the Unified Agenda of Federal Regulatory and Deregulatory Actions-Fall 2022","type":"Proposed Rule","abstract":"Publication of the Fall 2022 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) and reaffirmed in E.O. 13563, \"Improving Regulation and Regulatory Review,\" (76 FR 3821). 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 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 Unified Agenda and Regulatory Plan can be found online at www.reginfo.gov and a reduced print version can be found in the Federal Register. Information regarding obtaining printed copies can also be found on the Reginfo.gov website (or below, VI. How Can Users Get Copies of the Plan and the Agenda?). The Fall 2022 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. The complete Fall 2022 Unified Agenda contains the Regulatory Plans of 29 Federal agencies and 67 Federal agency regulatory agendas.","document_number":"2023-02113","html_url":"https://www.federalregister.gov/documents/2023/02/22/2023-02113/introduction-to-the-unified-agenda-of-federal-regulatory-and-deregulatory-actions-fall-2022","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-02-22/pdf/2023-02113.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-02113.pdf?1676987125","publication_date":"2023-02-22","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":"to modernize applicable WIC Program regulations.\n \n \n Statement of Need: \n This rule would codify requirements for <span class=\"match\">State</span> agencies to include language in their WIC <span class=\"match\">infant</span> <span class=\"match\">formula</span> rebate <span class=\"match\">contracts</span> that describes remedies in the event of an <span class=\"match\">infant</span> <span class=\"match\">formula</span> recall, including how an <span class=\"match\">infant</span> <span class=\"match\">formula</span> manufacturer would protect against disruption to program participants in the <span class=\"match\">State</span> (\n i.e., \n ensure that WIC participants can purchase <span class=\"match\">formula</span> using WIC benefits). The rule would also codify permanent expanded waiver authority to aid participants in obtaining"},{"title":"Coronavirus State and Local Fiscal Recovery Funds","type":"Rule","abstract":"The Secretary of the Treasury (Treasury) is adopting as final the interim final rule published on May 17, 2021, with amendments. This rule implements the Coronavirus State Fiscal Recovery Fund and the Coronavirus Local Fiscal Recovery Fund established under the American Rescue Plan Act.","document_number":"2022-00292","html_url":"https://www.federalregister.gov/documents/2022/01/27/2022-00292/coronavirus-state-and-local-fiscal-recovery-funds","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-01-27/pdf/2022-00292.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-00292.pdf?1643204721","publication_date":"2022-01-27","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"}],"excerpts":"defining a constituent industry with greater geographic precision than <span class=\"match\">state</span> or territory-wide.\n \n \n <span class=\"match\">State</span> or territory recipients may also define a constituent industry with greater geographic precision than <span class=\"match\">state</span> or territory-wide. For example, a <span class=\"match\">state</span> may identify a particular industry in a certain region of the <span class=\"match\">state</span> that was negatively impacted by the pandemic, even if the same industry in the rest of the <span class=\"match\">state</span> did not see a meaningful negative economic impact from the pandemic. <span class=\"match\">State</span> recipients oversee large and diverse industries, sometimes with"},{"title":"Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2023","type":"Rule","abstract":"This final rule includes payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs, as well as 2023 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes requirements related to guaranteed availability; the offering of QHP standardized plan options through Exchanges on the Federal platform; requirements for agents, brokers, and web-brokers; verification standards related to employer sponsored coverage; Exchange eligibility determinations during a benefit year; special enrollment period verification; cost-sharing requirements; Essential Health Benefits (EHBs); Actuarial Value (AV); QHP issuer quality improvement strategies; accounting for quality improvement activity (QIA) expenses and provider incentives for medical loss ratio (MLR) reporting and rebate calculation purposes; and re-enrollment. This final rule also responds to comments on how the Department of Health and Human Services (HHS) can advance health equity through QHP certification standards and otherwise in the individual and group health insurance markets, and how HHS might address plan choice overload in the Exchanges.","document_number":"2022-09438","html_url":"https://www.federalregister.gov/documents/2022/05/06/2022-09438/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2023","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-05-06/pdf/2022-09438.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-09438.pdf?1651522516","publication_date":"2022-05-06","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"}],"excerpts":"a particular <span class=\"match\">State</span>, risk selection can be significantly less in a <span class=\"match\">State's</span> small group market compared to the individual market.\n \n \n b. Repeal of Risk Adjustment <span class=\"match\">State</span> Flexibility To Request a Reduction in Risk Adjustment <span class=\"match\">State</span> Transfers (§ 153.320(d)) \n In the HHS Notice of Benefit and Payment Parameters for 2023 proposed rule (87 FR 584, 625), we proposed numerous amendments to § 153.320(d) to repeal the flexibility for States to request reductions of transfers calculated by HHS under the <span class=\"match\">State</span> payment transfer <span class=\"match\">formula</span> in all <span class=\"match\">State</span> market risk"},{"title":"Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2023","type":"Proposed Rule","abstract":"This proposed rule includes proposed payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs, as well as proposed 2023 user fee rates for issuers offering qualified health plans (QHPs) through federally- facilitated Exchanges and State-based Exchanges on the Federal platform. This proposed rule also proposes requirements related to prohibiting discrimination based on sexual orientation and gender identity; guaranteed availability; the offering of QHP standardized options through Exchanges on the Federal platform; requirements for agents, brokers, web-brokers, and issuers assisting consumers with enrollment through Exchanges that use the Federal platform; verification standards related to employer sponsored coverage; Exchange eligibility determinations during a benefit year; special enrollment period verification; cost-sharing requirements; Essential Health Benefits (EHBs); Actuarial Value (AV); QHP issuer quality improvement strategies; accounting for quality improvement activity (QIA) expenses and provider incentives for medical loss ratio (MLR) reporting and rebate calculation purposes; re-enrollment, and requirements related to a new State Exchange improper payment measurement program. This proposed rule also seeks comment on how HHS can advance health equity through QHP certification standards and otherwise in the individual and group health insurance markets, and how HHS might address plan choice overload in the Exchanges.","document_number":"2021-28317","html_url":"https://www.federalregister.gov/documents/2022/01/05/2021-28317/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2023","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-01-05/pdf/2021-28317.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2021-28317.pdf?1640726125","publication_date":"2022-01-05","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"}],"excerpts":"continue to use the <span class=\"match\">state</span> payment transfer <span class=\"match\">formula</span> finalized in the 2021 Payment Notice for the 2022 benefit year and beyond, unless changed through notice-and-comment rulemaking.\n 141 \n \n We explained that under this approach, we will no longer republish these <span class=\"match\">formulas</span> in future annual HHS notice of benefit and payment parameter rules unless changes are being proposed. We are not proposing any changes to the <span class=\"match\">formula</span> in this rule and therefore are not republishing the <span class=\"match\">formulas</span> in this rule. We would continue to apply the <span class=\"match\">formula</span> as finalized in the"},{"title":"Introduction to the Unified Agenda of Federal Regulatory and Deregulatory Actions-Fall 2021","type":"Proposed Rule","abstract":"Publication of the Fall 2021 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) and reaffirmed in E.O. 13563, \"Improving Regulation and Regulatory Review,\" (76 FR 3821). 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 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 Unified Agenda and Regulatory Plan can be found online at www.reginfo.gov and a reduced print version can be found in the Federal Register. Information regarding obtaining printed copies can also be found on the Reginfo.gov website (or below, VI. How Can Users Get Copies of the Plan and the Agenda?). The Fall 2021 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. The complete Fall 2021 Unified Agenda contains the Regulatory Plans of 27 Federal agencies and 67 Federal agency regulatory agendas.","document_number":"2022-00702","html_url":"https://www.federalregister.gov/documents/2022/01/31/2022-00702/introduction-to-the-unified-agenda-of-federal-regulatory-and-deregulatory-actions-fall-2021","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-01-31/pdf/2022-00702.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-00702.pdf?1643377519","publication_date":"2022-01-31","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":"directs agencies to have an accountable process to ensure meaningful and timely input by <span class=\"match\">State</span> and local officials in the development of regulatory policies that have “federalism implications” as defined in the Order. Under the Order, an agency that is proposing a regulation with federalism implications, which either preempt <span class=\"match\">State</span> law or impose non-statutory unfunded substantial direct compliance costs on <span class=\"match\">State</span> and local governments, must consult with <span class=\"match\">State</span> and local officials early in the process of developing the regulation. In addition, the agency"},{"title":"Requirements Related to Surprise Billing; Part I","type":"Rule","abstract":"This document sets forth interim final rules implementing certain provisions of the No Surprises Act, which was enacted as part of the Consolidated Appropriations Act, 2021. These interim final rules amend and add provisions to existing rules under the Internal Revenue Code, the Employee Retirement Income Security Act, the Public Health Service Act, and the Federal Employees Health Benefits Act. These interim final rules implement provisions of the No Surprises Act that protect participants, beneficiaries, and enrollees in group health plans and group and individual health insurance coverage from surprise medical bills when they receive emergency services, non-emergency services from nonparticipating providers at participating facilities, and air ambulance services from nonparticipating providers of air ambulance services, under certain circumstances. In this rulemaking, the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury (collectively, the Departments) are issuing interim final rules with largely parallel provisions that apply to group health plans and health insurance issuers offering group or individual health insurance coverage. HHS is also issuing in this rulemaking additional interim final rules that apply to emergency departments of hospitals and independent freestanding emergency departments, health care providers and facilities, and providers of air ambulance services related to the protections against surprise billing. The Office of Personnel Management (OPM) is issuing in this rulemaking interim final rules that specify how certain provisions of the No Surprises Act apply to health benefits plans offered by carriers under the Federal Employees Health Benefits Act (FEHBA).","document_number":"2021-14379","html_url":"https://www.federalregister.gov/documents/2021/07/13/2021-14379/requirements-related-to-surprise-billing-part-i","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2021-07-13/pdf/2021-14379.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2021-14379.pdf?1625602526","publication_date":"2021-07-13","agencies":[{"raw_name":"OFFICE OF PERSONNEL MANAGEMENT","name":"Personnel Management Office","id":406,"url":"https://www.federalregister.gov/agencies/personnel-management-office","json_url":"https://www.federalregister.gov/api/v1/agencies/406","parent_id":null,"slug":"personnel-management-office"},{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"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"}],"excerpts":"that <span class=\"match\">contracted</span> rate. However, if a plan or issuer has a <span class=\"match\">contract</span> with multiple providers, with separate negotiated rates with each particular provider for a given item or service, each unique <span class=\"match\">contracted</span> rate constitutes a single <span class=\"match\">contracted</span> rate for purposes of determining the median <span class=\"match\">contracted</span> rate. 47 \n Further, if a plan or issuer has separate <span class=\"match\">contracts</span> with individual providers, the <span class=\"match\">contracted</span> rate under each such <span class=\"match\">contract</span> constitutes a single <span class=\"match\">contracted</span> rate (even if the same amount is paid to other providers under separate <span class=\"match\">contracts</span>). \n \n"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Proposed Changes to Medicaid Provider Enrollment; and Proposed Changes to the Medicare Shared Savings Program","type":"Proposed Rule","abstract":"We are proposing to revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2022 and to implement certain recent legislation. In addition, we are proposing to rebase and revise the hospital market baskets for acute care hospitals, update the labor-related share, and provide the market basket update that would apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis, subject to these limits for FY 2022. We are also proposing policies relating to Medicare graduate medical education (GME) for teaching hospitals to implement certain recent legislation. The proposed rule would also 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) for FY 2022. In this FY 2022 IPPS/LTCH PPS proposed rule, we are proposing to extend New COVID-19 Treatments Add-on Payment (NCTAP) for certain eligible products through the end of the fiscal year in which the PHE ends and to discontinue the NCTAP for discharges on or after October 1, 2021 for a product that is approved for new technology add-on payments beginning FY 2022. We are also proposing to repeal the collection of market-based rate information on the Medicare cost report and the market-based MS- DRG relative weight methodology, as finalized in the FY 2021 IPPS/LTCH PPS final rule. We are proposing to establish new requirements and revise existing requirements for eligible hospitals and critical access hospitals (CAHs) participating in the Medicare Promoting Interoperability Program. We are also providing estimated and newly established performance standards for the Hospital Value-Based Purchasing (VBP) Program, and proposing updated policies for the Hospital Readmissions Reduction Program, Hospital Inpatient Quality Reporting (IQR) Program, Hospital VBP Program, Hospital-Acquired Condition (HAC) Reduction Program, and the PPS-Exempt Cancer Hospital Reporting (PCHQR) Program, and the Long-Term Care Hospital Quality Reporting Program (LTCH QRP). Additionally, due to the impact of the COVID-19 PHE on measure data used in our value-based purchasing programs, we are proposing to suppress several measures in the Hospital VBP, HAC Reduction, and Hospital Readmissions Reduction Programs. In connection with our measure suppression proposals for the FY 2022 Hospital VBP Program, we are also proposing to revise the scoring and payment methodology for the FY 2022 program year such that hospitals will not be scored using quality measure data that are distorted by the effects of the COVID-19 public health emergency (PHE) and will not receive Total Performance Scores or adjustments to their payments as a result. Similarly, we are proposing to suppress affected measures for the FY 2022 HAC Reduction Program such that hospitals will not be scored using distorted quality measure data and will not receive Total HAC Scores based on those data. For the Hospital Readmissions Reduction Program, we are proposing to suppress one affected measure under the proposed measure suppression policy for the FY 2023 applicable period such that hospitals will not be assessed using distorted quality measure data and will not receive payment reductions based on those data. In addition, we are proposing to change, clarify, and codify Medicare organ acquisition payment policies relative to organ procurement organizations (OPOs), transplant hospitals, and donor community hospitals. Also, we are proposing to add regulation requiring that state Medicaid agencies accept valid enrollments from all Medicare-enrolled providers and suppliers for purposes of processing claims for Medicare cost-sharing liability for services furnished to Medicare-Medicaid dually eligible individuals in order to alleviate a long-standing problem related to claiming Medicare bad debt. Additionally, we are proposing to amend the Medicare Shared Savings Program regulations to allow eligible accountable care organizations (ACOs) participating in the BASIC track's glide path the opportunity to maintain their current level of participation for performance year (PY) 2022.","document_number":"2021-08888","html_url":"https://www.federalregister.gov/documents/2021/05/10/2021-08888/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2021-05-10/pdf/2021-08888.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2021-08888.pdf?1619556476","publication_date":"2021-05-10","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":"requestor <span class=\"match\">stated</span> are currently not recognized as O.R. procedures for purposes of MS-DRG assignment. The four procedure codes are listed in the following table. \n \n EP10MY21.093 \n \n The requestor <span class=\"match\">stated</span> that the procedure codes that describe the extirpation of matter from the upper or lower jaw by an open or percutaneous endoscopic approach should be designated as O.R. procedures. The requestor <span class=\"match\">stated</span> these procedures would commonly be performed under general anesthesia and require the resources of an operating room. The requestor also <span class=\"match\">stated</span> that these"},{"title":"Medicare Program; CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19","type":"Rule","abstract":"This major final rule addresses: Changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; Medicare Shared Savings Program requirements; Medicaid Promoting Interoperability Program requirements for Eligible Professionals; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; Medicare enrollment of Opioid Treatment Programs; payment for office/outpatient evaluation and management services; Requirement for Electronic Prescribing for Controlled Substances for a Covered Part D drug under a prescription drug plan or an MA-PD plan and Medicare Diabetes Prevention Program (MDPP) expanded model Emergency Policy. This final rule also finalizes certain provisions of the interim final rules with comment period that CMS issued on March 31, 2020, May 8, 2020\\,\\ and September 2, 2020 in response to the Public Health Emergency (PHE) for the Coronavirus Disease 2019 (COVID-19). This rule also establishes coding and payment for virtual check-in services and for personal protective equipment (PPE) on an interim final basis.","document_number":"2020-26815","html_url":"https://www.federalregister.gov/documents/2020/12/28/2020-26815/medicare-program-cy-2021-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2020-12-28/pdf/2020-26815.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2020-26815.pdf?1606943727","publication_date":"2020-12-28","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":"The following is a summary of the comments we received and our responses. \n \n Comment: \n Several commenters <span class=\"match\">stated</span> that they agreed with and supported all four of the CMS proposals associated with Myocardial PET equipment inputs. Commenters also <span class=\"match\">stated</span> that they supported the decision to maintain contractor pricing for the technical components for all the new and revised Myocardial PET codes. Commenters <span class=\"match\">stated</span> that the standard CMS <span class=\"match\">formula</span> and RUC PE inputs do not allow for certain high-cost expenses that are generally part of overhead to be factored"}]}