SUPPORTING INFORMATION Item Disease State Management Programs--The conferees do not concur with the Senate report language regarding the extension of Disease State Management Programs to Medicare demonstration projects. Action Taken or to be Taken CMS concurs with the above recommendation. Item Lifestyle Changes to Treat Heart Disease-The conferees have included sufficient funds to continue a Medicare demonstration project to test the effectiveness of using lifestyle changes to treat heart disease. Action Taken or to be Taken CMS has agreed to broaden the clinical eligibility criteria for the demonstration and is working to refine the criteria definition, design protocol, and payment, oversight and evaluation systems in order to accommodate the treatment and evaluation of Medicare beneficiaries meeting the new eligibility requirements. CMS is committed to reaching agreement on the protocol revisions and working to secure the necessary administrative approvals as quickly as possible. Item Regional Nursing Centers Consortium-The agreement includes bill language for the following projects and activities for fiscal year 2002...$100,000 is for the Regional Nursing Centers Consortium in Philadelphia to initiate a demonstration project to evaluate 15 nurse-managed health centers in urban and rural areas across Pennsylvania. Action Taken or to be Taken CMS has contacted the consortium and informed them how to submit an application for funding. We will award grant funds after an application is received and approved. Item Madonna Rehabilitation Center--The agreement includes bill language for the following projects and activities for fiscal year 2002...$200,000 is for the Madonna Rehabilitation Center in Lincoln, Nebraska to create a new standard of rehabilitation practice and program design for children and adults with disabilities. Action Taken or to be Taken CMS has contacted the Rehabilitation Center and informed them how to submit an application for funding. We will award grant funds after an application is received and approved. Item Asthma Champion Initiative--The agreement includes bill language for the following projects and activities for fiscal year 2002...$250,000 if for the Cook County, Illinois Bureau of Health for the Asthma Champion Initiative to reduce the morbidity and mortality from asthma in high prevalence areas. SUPPORTING INFORMATION Action Taken or to be Taken Congress appropriated $350,000 for this project in the FY 2001 budget. Cook County submitted a proposal, which was reviewed and approved by a CMS panel. The grant project is underway and CMS will work with the grantee to award these additional funds in FY 2002. Item Shared Integrated Management Information System--The agreement includes bill language for the following projects and activities for fiscal year 2002...$250,000 is for the Illinois Primary Health Care Association to implement the Shared Integrated Management Information System providing centralized case management, reimbursement and administrative support services. Action Taken or to be Taken We will contact the Illinois Primary Health Care Association and inform them how to submit an application for funding. We will award grant funds after an application is received and approved. Item Project Access--The agreement includes bill language for the following projects and activities for fiscal year 2002...$500,000 is for Project Access in Muskegon, Michigan to offer affordable insurance to uninsured workers, primarily in small business, and low-income individuals. Action Taken or to be Taken CMS has contacted the Muskegon Community Health Project and informed them how to submit an application for funding. We will award grant funds after an application is received and approved. Item Children's Health Initiative--The agreement includes bill language for the following projects and activities for fiscal year 2002...$590,000 is for Santa Clara County, California for the outreach and application assistance aspects of its Children's Health Initiative, to demonstrate means of expanding enrollment of eligible children in Medicaid, SCHIP and other available health care programs. Action Taken or to be Taken CMS will contact Santa Clara County and inform them how to submit an application for funding. We will award grant funds after an application is received and approved. Item Fishing Partnership Health Plan-The agreement includes bill language for the following projects and activities for fiscal year 2002...$800,000 is for the Fishing Partnership Health Plan, based in Boston, Massachusetts for a demonstration project on the efficacy of using a community-based health benefit program to provide health care coverage for lower-income independently employed workers and their families. SUPPORTING INFORMATION Action Taken or to be Taken CMS has contacted the Fishing Partnership Health Plan and informed them how to submit an application for funding. We will award grant funds after an application is received and approved. Item Mind-Body Institute--The agreement includes bill language for the following projects and activities for fiscal year 2002...$800,000 is to continue a demonstration project being conducted at the Mind-Body Institute of Boston, Massachusetts, and expand the demonstration project so that eligible patients shall also include those who have undergone coronary bypass surgery or angioplasty and do not have reduced blood flow to the heart, and/or angina. Action Taken or to be Taken CMS has agreed to broaden the clinical eligibility criteria for the demonstration and is working to refine the criteria definition, design protocol, and payment, oversight and evaluation systems in order to accommodate the treatment and evaluation of Medicare beneficiaries meeting the new eligibility requirements. CMS is committed to reaching agreement on the protocol revisions and working to secure the necessary administrative approvals as quickly as possible. Item Children's Hospice International-The agreement includes bill language for the following projects and activities for fiscal year 2002...$900,000 is for the Children's Hospice International demonstration program to provide a continuum of care for children with life-threatening conditions and their families. Action Taken or to be Taken CMS will make grant awards to continue Federal financial support for this demonstration program. Item Prescription Drug Cooperative Demonstration--The agreement includes bill language for the following projects and activities for fiscal year 2002...$1,500,000 is for the lowa Department of Public Health for the continuation of a prescription drug cooperative demonstration. Action Taken or to be Taken We have an existing grant with the Iowa Department of Public Health for this project. We will inform them on how to request additional funding for FY 2002. Item AIDS Healthcare Foundation-The agreement includes bill language for the following projects and activities for fiscal year 2002...$2,000,000 is for the AIDS Healthcare Foundation in Los Angeles for a demonstration of residential and outpatient treatment facilities. SUPPORTING INFORMATION Action Taken or to be Taken The Foundation will submit an application for Federal funding to CMS, and the grant award will be made by early April, 2002. Item Fee Schedule for Ambulance Payments-The conferees understand that CMS is developing a comprehensive regulation establishing a new fee schedule for ambulance payments as required by the Balanced Budget Act of 1997. The conferees believe it is equally important to implement condition codes and urge CMS to do so simultaneously with the new fee schedule. Action Taken or to be Taken CMS understands and appreciates both the Committee's and the conferee's concerns and is presently working on a regulation as required by the Balanced Budget Act of 1997, that will be issued shortly. Item Inhaled Nitric Oxide Treatment--The conferees are aware of underpayment to certain hospitals that treat newborns with life threatening respiratory diseases and encourage CMS to implement a methodology to reimburse hospitals for inhaled nitric oxide treatment for neonatal hypoxic respiratory failure. Action Taken or to be Taken CMS does not have the authority to change or adjust hospital payments for specific conditions under the Medicaid program. State Medicaid agencies make such decisions. Item Medicaid Upper Payment Limit--The conferees strongly concur with Senate report language regarding the Medicaid upper payment limit agreement that was included in the Omnibus Consolidated and Emergency Supplemental Appropriations Act for Fiscal Year 2001. Action Taken or to be Taken CMS, in publishing a final rule in January 2001, fulfilled the requirements of the Medicare, Medicaid, and SCHIP Benefits improvement and Protection Act of (BIPA) 2000. Thus, we were allowed to issue a final rule on January 18, 2002 that reduced upper payment limit (UPL) payment for non-State public hospitals from 150 percent to 100 percent of a reasonable estimate of what Medicare would have paid for the same services. We carefully considered every public comment received on the rule and concluded that the rule was necessary to promote fiscal integrity and restore an appropriate balance between States and the federal government with respect to funding the Medicaid program. We estimate that the rule will reduce potential federal costs by about $9 billion over the next five years. |