ࡱ> b  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`acdefghijklmnopqrstuvwxyz{|}~Root Entry FWWorkbookSummaryInformation(DocumentSummaryInformation8< \p Ba==KxK458@"1Verdana1Verdana1Verdana1Verdana1Verdana1Verdana1Tahoma1Tahoma1Tahoma1Tahoma1Tahoma1 Verdana1=Verdana1<Hoefler Text Ornaments1h>RCambria1,>RCalibri1>RCalibri1>RCalibri1RCalibri1RCalibri1<RCalibri1>RCalibri1?RCalibri14RCalibri14RCalibri1 RCalibri1 RCalibri1RCalibri1RCalibri1 RCalibri1RCalibri"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)mmmm\ d\,\ yyyym/d                                                                      ff + ) , *      P  P         `            a   1<@ @  <@ @  8@ @   <@ @  x@ @  |@ @  x@ @  |@ @  <@ @    |@ @ ,  |@ @ , x@ @   8@@  8@  8 @   (@ @   (@ @  (8@ @  8@ @  8@ @   ,@ @   h@ @ ,   H,  8@ @        8@ @  x@ @ ,  8@ @  x@ @ ,  8@ @  x@ @  <@ @   h@ @   h@ @ 8@ @ 8@ @ <@ @  )8@ @  !8@ @  !8@ @  (8@ @   8@ @   x@@ ,   8@   8 @   x@ ,   x @ ,   8@ @  8@ @   x@ @ ,  8@ @  x@ @ ,  8@ @  x@ @  x@ @  x@ @ ,  8@ @  8@ @  x@@ ,  x@ ,  x @ ,  0@  0 @ 0@ 0 @ || }A} 00\);_(*ef;_(@_) }A} 00\);_(*ef;_(@_) }A} 00\);_(*ef;_(@_) }A} 00\);_(*ef;_(@_) }A} 00\);_(*ef;_(@_) }A} 00\);_(*ef ;_(@_) }A} 00\);_(*L;_(@_) }A} 00\);_(*L;_(@_) }A} 00\);_(*L;_(@_) }A} 00\);_(*L;_(@_) }A} 00\);_(*L;_(@_) }A} 00\);_(*L ;_(@_) }A} 00\);_(*23;_(@_) }A} 00\);_(*23;_(@_) }A} 00\);_(*23;_(@_) }A} 00\);_(*23;_(@_) }A}  00\);_(*23;_(@_) }A}! 00\);_(*23 ;_(@_) }A}" 00\);_(*;_(@_) }A}# 00\);_(*;_(@_) }A}$ 00\);_(*;_(@_) }A}% 00\);_(*;_(@_) }A}& 00\);_(*;_(@_) }A}' 00\);_(* ;_(@_) }A}( 00\);_(*;_(@_) }}) }00\);_(*;_(@_)    }}* 00\);_(*;_(@_) ??? ??? ??? ???}-}/ 00\);_(*}A}1 a00\);_(*;_(@_) }A}2 00\);_(*;_(@_) }A}3 00\);_(*?;_(@_) }A}4 00\);_(*23;_(@_) }-}5 00\);_(*}}7 ??v00\);_(*̙;_(@_)    }A}8 }00\);_(*;_(@_) }A}9 e00\);_(*;_(@_) }x}:00\);_(*;_(  }}; ???00\);_(*;_(??? ???  ??? ???}-}= 00\);_(*}U}> 00\);_(*;_( }-}? 00\);_(* 20% - Accent1M 20% - Accent1 ef % 20% - Accent2M" 20% - Accent2 ef % 20% - Accent3M& 20% - Accent3 ef % 20% - Accent4M* 20% - Accent4 ef % 20% - Accent5M. 20% - Accent5 ef % 20% - Accent6M2 20% - Accent6  ef % 40% - Accent1M 40% - Accent1 L % 40% - Accent2M# 40% - Accent2 L湸 % 40% - Accent3M' 40% - Accent3 L % 40% - Accent4M+ 40% - Accent4 L % 40% - Accent5M/ 40% - Accent5 L % 40% - Accent6M3 40% - Accent6  Lմ % 60% - Accent1M 60% - Accent1 23 % 60% - Accent2M$ 60% - Accent2 23ٗ % 60% - Accent3M( 60% - Accent3 23֚ % 60% - Accent4M, 60% - Accent4 23 % 60% - Accent5M0 60% - Accent5 23 %! 60% - Accent6M4 60% - Accent6  23 % "Accent1AAccent1 O % #Accent2A!Accent2 PM % $Accent3A%Accent3 Y % %Accent4A)Accent4 d % &Accent5A-Accent5 K % 'Accent6A1Accent6  F %(Bad9Bad  %) Calculation Calculation  }% * Check Cell Check Cell  %????????? ???+ Comma,( Comma [0]-&Currency.. Currency [0]/Explanatory TextG5Explanatory Text %0 : Followed Hyperlink 1Good;Good  a%2 Heading 1G Heading 1 I}%O3 Heading 2G Heading 2 I}%?4 Heading 3G Heading 3 I}%235 Heading 49 Heading 4 I}%6( Hyperlink 7InputuInput ̙ ??v% 8 Linked CellK Linked Cell }% 9NeutralANeutral  e%"Normal :Noteb Note   ;OutputwOutput  ???%????????? ???<$Percent =Title1Title I}% >TotalMTotal %OO? Warning Text? Warning Text %XTableStyleMedium9PivotStyleLight168dq:Fc-2NWgFSWc-2NWgFSW̙̙3f3fff3f3f33333f33333\`k@Sheet1!  ;j  ; SDU_50932: [Sent summary to senior management; Melissa to reach out to internal subject matter experts. %No action necessary per AHIP and MMS. +Reviewed by G. Figueroa; no further action. Comments submitted 10/31 -Sent to senior management; no further action. 5Working with AHIP on comments; letter submitted 10/31 Interim final rule last week that would require health plans, health care clearinghouses, and certain health care providers to implement operating rules for two electronic health care transactions as part of an effort to simplify administrative transactions by January 1, 2013. These proposed regulations provide guidance to individuals who enroll in qualified health plans through Affordable Insurance Exchanges and claim the premium tax credit, and to Exchanges that make qualified health plans available to individuals and employers.  Comment letter submitted 9/16/11 VTopic: Metadata Standards to Support Nationwide Electronic Health Information Exchange  Proposed Rule This proposed rule would implement sections of the Affordable Care Act related to Medicaid and CHIP eligibility, enrollment simplification, and coordination. Proposed Rulemaking <Topic: Summary of Benefits and Coverage and Uniform Glossary |Topic: Request for Information Regarding State Flexibility to Establish a Basic Health Program Under the Affordable Care Act wTopic: PPACA; Exchange Functions in the Individual Market: Eligibility Determinations; Exchange Standards for Employers April 1, 2011 effective date has been postponed; a new implementation deadline will be indicated when the final rule is published later this year. FINAL RULE PUBLISHED 9/16/11. EFFECTIVE JANUARY 1, 2012 SSent summary to senior management; Melissa, Liz and Berenice to discuss next steps. :Sent summary to Medicare team. Berenice working on draft.  This proposed rule would revise the Medicaid home health service definition as required by section 6407 of the Affordable Care Act to add a requirement that physicians document the existence of a face-to-face encounter (including through the use of telehealth) with the Medicaid eligible individual within reasonable timeframes. This proposal would align the timeframes with similar regulatory requirements for Medicare home health services in accordance with section 6407 of the ACA.  UThis proposed rule would update payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning Jan. 1, 2012. The proposed rule also contains proposals that would strengthen the Hospital Value-Based Purchasing (HVBP) Program.CMS is also proposing changes to the Medicare Electronic Health Record Incentive Program that would allow eligible hospitals and critical access hospitals (CAHs) to report clinical quality measures for 2012 by participating in an electronic reporting pilot.  bTopic: Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012  Proposed Rule VThis rule would implement new Affordable Insurance Exchanges consistent with the ACA.  RTopic: PPACA; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment  Proposed Rule eSent to senior management; Jason to review and follow up with Medicare team. Molina will not comment. Topic: Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy Changes and Clarifications Related to Home Health   Proposed Rule  Proposed Rule JTopic: PPACA; Establishment of Consumer Operated and Oriented Plan Program  Proposed Rule Proposed rule establishing the basic framework for the Consumer Operated and Oriented Plan (Co-Op) Program that was enacted as part of the ACA and designed to fund the establishment of nonprofit, consumer oriented health plan issuers. RTopic: Medicaid Program; Eligibility Changes Under the Affordable Care Act of 2010 *Topic: Health Insurance Premium Tax Credit This proposed rule addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain provisions of the Patient Protection and Affordable Care Act and the Medicare Improvements for Patients and Providers Act of 2008.  $Molina submitted comments on 8/1/11. )Submitted response to HHS on May 18, 2010 7Topic: Internet Portal (PPACA) 7&Interim Final Rule with Comment Period 7*Submitted comments to HHS on June 18, 2010 7 No Action 7Proposed to set up a hospital value-based purchasing program that would give higher payments to hospitals that perform well on quality measures as a method to improve clinical outcomes for hospital patients and improve the patient experience of inpatient care. The total amount available for value-based incentive payments for all hospitals for a fiscal year must be equal to the total amount of reduced payments for all hospitals. -Sent to senior management; no further action. ZThis proposed rule would update the Home Health Prospective Payment System (HH PPS) rates. oTopic: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions  Interim Final Rule CTopic: PPACA; Establishment of Exchanges and Qualified Health Plans %Advance notice of proposed rulemaking Topic: Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical Center Payment; Hospital Value-Based Purchasing Program; Physician Self-Referral; and Provider Agreement Regulations on Patient Notification Requirements -Sent to senior management. No further action. This proposed rule would implement provisions of the ACA that establish: procedures under which screening is conducted for providers of medical or other services and suppliers in the Medicare program, providers in the Medicaid program, and providers in the Children's Health Insurance Program (CHIP); an application fee to be imposed on providers and suppliers; temporary moratoria that may be imposed if necessary to prevent or combat fraud, waste, and abuse under the Medicare and Medicaid programs, and CHIP; guidance for States regarding termination of providers from Medicaid and CHIP if terminated by Medicare or another Medicaid State plan or CHIP; guidance regarding the termination of providers and suppliers from Medicare if terminated by a Medicaid State agency; and requirements for suspension of payments pending credible allegations of fraud in the Medicare and Medicaid programs. This proposed rule would also present an approach and request comments on the provisions of the Affordable Care Act that require providers of medical or other items or services or suppliers within a particular industry sector or category to establish compliance programs.  JTopic: Medicare and Medicaid Programs - Electronic Health Records (HITECH) 7KNotice of Proposed Rule Making (Centers for Medicaid and Medicare Services) 7January 13, 2010 7March 15, 2010 7DFINAL RU< LE and EFFECTIVE DATE: July 28, 2010 (see final rule below) 7RFI 7RFI 7April 14, 2010 7 May 14, 2010 7 May 3, 2010 7 May 18, 2010 7Topic: State Innovation Waivers !Topic: Dependent Coverage (PPACA) 7IRS - Request for Comments 7Notice of Proposed Rule Making 7N/A 7 No Action Topic: Home Health (PPACA) 7&Comments submitted by Vicky on Nov 19. N/A !Topic: Health Insurance Exchanges Guidance  No action Request for Comments Dr. Siegel participated on AHIP call. Our positions are consistent with those of other plans on the call and will be expressed in AHIP comment letter.  Proposed Rule Beginning in 2012  No action $Working with AHIP on comment letter. PTopic: Value-Based Insurance Design in Connection with Preventive Care Benefits  Provides the adjusted FMAP rate for Q4 FY10 as required under Section 5001 of the ARRA. Section 5001 provides for temporary increases in the FMAP rates to provide fiscal relief to States and to protect and maintain State Medicaid and other assistance programs in a period of economic downturn. The increased FMAP rates apply during a recession adjustment period that was originally defined in ARRA as the period beginning October 1, 2008 and ending December 31, 2010. Topic: NCQA Draft ACO Criteria Draft Criteria *October 19, 2010 (not in Federal Register) Notice xInterim Final Rule with Comment Period (Office of the National Coordinator for Health IT) 7January 13, 2010 7March 15, 2010 7February 12, 2010 7Request for Comments 7 Final Rule 7Notice of Interim Procedure 7N/A 7Sub-Regulatory Guidance (HHS) 7 No Action September 13 ,2010 7)Web Portal to be released October 1, 2010 7Proposes to create a standardized, transparent process for States to follow as part of their broader efforts to  assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area as required by the Social Security Act (the Act).  <Engaged through CAHP. Molina will not submit comment letter. ?Topic: Opportunities for Alignment under Medicaid and Medicare  Request for Information +The RFI invites comments on a list of specific opportunities for alignment between Medicare and Medicaid (for dual eligibles) that fall into the following broad categories: (1) Coordinated Care, (2) Fee-for-service benefits, (3) Prescription Drugs, (4) Cost Sharing, (5) Enrollment, and (6) Appeals. Comments submitted 7/1/11. STopic: Medicare Program; Availability of Medicare Data for Performance Measurement  This rule proposes to implement new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers in ways that protect patient privacy. This rule explains how entities can become qualified by CMS to receive standardized extracts of claims data under Medicare Parts A, B, and D for the purpose of evaluation of the performance of providers of services and suppliers. ^Sent to senior management; reviewed and discussed with Medicare team. Molina will not comment. 'Topic: Multi-State Plans and Exchanges  RFI Notice &Criteria will be finalized in mid-2011  Proposed Rule -Sent to senior management; no further action.  Proposed Rule NCQA is seeking comments on the structure, standards and elements of the 2011 Draft Accountable Care Organizations (ACO) Criteria. General questions and comment are to be received by June 30, 2011 - and potential offerors are to provide responses to the RFI by August 2, 2011. CMS is collecting four types of information; of note is the Medicaid Management Information System (MMIS) Advanced Planning Document (APD) Template for Use by States When Implementing the Mandatory National Correct Coding Initiative (NCCI) in Medicaid.   No action Notice 5Topic: Waivers of Annual Limit Requirements (PHS Act) 7'Topic: CEO/CFO Attestation Requirements 7Guidance (HHS) 7Submitted comments on 9/27/10 April 14, 2010 7 May 14, 2010 7 Proposed Rule CMS is requesting applications for a new Pioneer ACO Model which provides a faster path for mature ACOs that have already begun coordinating care for patients and are ready to move forward. -Sent to senior management; no further action  hTopic: Payment Adjustment for Provider-Preventable Conditions Including Health Care-Acquired Conditions  @Topic: Accounting for Disclosures and Access Report Requirements .Topic: Home-and-Community Based (HCBS) Waiver   Proposed Rule  Final Rule This final rule implements Section 2702 of the Affordable Care Act which directs the Secretary of Health and Human Services to issue Medicaid regulations effective as of July 1, 2011 prohibiting Federal payments to States under section 1903 of the Social Security Act for any amounts expended for providing medical assistance for health care-acquired conditions specified in the regulation. ?Topic: Proposed Changes to the Electronic eRx Incentive Program  Proposed Rule -Sent to senior management; no further action. IThis memo describes in detail the process for attestation by the CEO/CFO. 7 No Action This proposed rule amends a provision in HHS regulations that prohibits State Medicaid Fraud Control Units (MFCU) from using Federal matching funds to identify fraud through screening and analyzing State Medicaid claims data, known as data mining.  !Comment letter submitted 5/13/11. 2Topic: Federal Health IT Strategic Plan 2011-2015  Request for comment The Federal Health IT Strategic Plan: 2011-2015 ("the Plan") reflects ONC's strategy for coordinating with the public and private sector to realize Congress and the Administration's health IT agenda: improving the quality, efficiency, safety and patient-centeredness of health care. The Plan serves as an im< portant tool for guiding federal efforts and investments in health IT over the next five years. LSent summary and copy of regulation to senior management; no further action. JTopic: IRS Guidance to Employers on Health Benefit Reporting Requirements   Guidance/RFC Section 1334 of the Affordable Care Act directs the Office of Personnel Management (OPM) to contract with health insurance issuers to offer Multi-State qualified health plans through Exchanges. The OPM is issuing this RFI to gather information related to section 1334 of the Affordable Care Act. The goal of the RFI is to better understand potential offerors interests and capabilities. The RFI also provides background information on the statutory requirements for Multi-State Plans. -Sent to senior management; no further action. tTopic: Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2012 9Topic: Pioneer Accountable Care Organization (ACO) Model  Request for Application %Letter of intent due by June 10, 2011 KThis final rule with comment period includes a total reduction in the MPFS rates of 24.9 percent that includes the scheduled reductions on December 1, 2010 and again on January 1, 2011 under the sustainable growth rate (SGR) formula. In addition, CMS indicates that the rule will implement key provisions of the Affordable Care Act (ACA) of 2010, including elimination of out-of-pocket costs for most preventive services for Medicare beneficiaries, incentive payments for primary care services, and incentive payments for major surgical procedures in health professional shortage areas. bTopic: Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults  Topic: Meaningful Use Stage 2 9Request for Comment on Preliminary Set of Recommendations  Comment letter submitted 4/25/11 &Interim Final Rule with Comment Period 7rTopic: Preexisting Conditions, Exclusions, Lifetime and Annual Limits, Recissions, and Patient Protections (PPACA) 7FMust be implemented in the states between July 1 2011 and July 1 2012. CMS has worked to delete or synthesize any dated or repetitive language and ensure that the new template reflects the changes in CHIPRA and aligns with current policy guidance; they are not proposing any new policy in the revised template.  No action. S Topic: Medicaid Program; Methods for Assuring Access to Covered Medicaid Services   jThe proposed regulations: (1) modify the requirements for individuals to request and receive an accounting of disclosures of their health information; and (2) include a new right for individuals to request and receive an access report that lists the persons and entities that accessed information contained in the individual s electronic  designated record set.   Proposed Rule  Proposed Rule 8Sets forth a procedural framework for submission and review of initial applications for a Waiver for State Innovation described in section 1332 in the ACA including processes to ensure opportunities for public input in the development of such applications by States and in the Federal review of the applications. !Comment letter submitted 5/13/11. 6Topic: State Medicaid Fraud Control Units; Data Mining CMS is requesting legislative changes on how to improve the quality of care provided to children under Medicaid and CHIP, including requirements for the process and content of quality reporting by the states. The Secretary will report to Congress on 1/1/11. 7,Submitted response to CMS on August 30, 2010 7 Proposed Rule 8Topic: Revised CHIP State Plan Amendment (SPA) Template  Notice LSent summary and copy of regulation to senior management; no further action. %Topic: Accountable Care Organizations Request for Comment Comments submitted 6/3/11. Proposed rule would implement section 3022 of the Affordable Care Act (ACA), which contains provisions relating to Medicare payments to providers of services and suppliers participating in Accountable Care Organizations (ACOs). Under the ACA, the shared savings program will reward ACOs that lower costs while meeting quality standards. The program must be established by January 1, 2012. Proposes that Medicaid eligibility determination systems will be potentially eligible for an enhanced Federal matching rate of 90 and 75 percent for development and maintenance respectively, under Section 1903 of the Social Security Act. Comment letter submitted 1/7/11  No Action .Topic: Coverage of Preventive Services (PPACA) 7=Topic: Internal Review and External Appeals Processes (PPACA) 7Interim Final Rule 7MListened to CMS call on February 22. Molina will not submit a comment letter. This notice presents an approach and requests comments on the provision of the PPACA that requires the expansion of the Recovery Audit Contractor (RAC) Program to the Medicare Part C and D programs. Request for Information This document contains a request for information on how group health plans and health insurance issuers can employ value-based insurance design in the coverage of recommended preventive services.  LSent summary and copy of regulation to senior management; no further action. ,Interim guidance on informational reporting to employees of the cost of their employer-sponsored group health plan coverage. This reporting requirement is required under the Affordable Care Act (ACA) and is for information only and intended to inform employees of the cost of their health coverage.  XTopic: Federal Funding for Medicaid Eligibility Determination and Enrollment Activities   Proposed Rule $Topic: Community First Choice Option JProposed rule would implement Section 2401 of the ACA. Section 2401, entitled  Community First Choice Option, makes a new service available to the Medicaid long-term services and support population and offers states an incentive to provide coverage for it. The goal of the  Community First Ch< oice Option program is to give states additional resources to make community living a first choice, not nursing homes and institutions. This option will be available starting October 1, 2011 and allows States to receive a 6% increase in Federal matching payments for related expenditures. CHIPRA directs the Secretary to establish a pediatric quality measures program to: improve and strengthen the initial core child health care quality measures; expand on existing pediatric quality measures used by public and private health care purchasers and advance the development of new quality measures; and increase the portfolio of evidence-based, consensus pediatric quality measures available to public and private purchasers of children's healthcare services, providers, and consumers. It also requires the Secretary to consult with a broad range of stakeholders to set these priorities, therefore AHRQ/HHS is seeking public comment on these draft priorities. Dr. Siegel sits on NCQA advisory board that is commenting on these measures. Our comments will be incorporated into that letter. The proposed rule would implement section 2702 of the Patient Protection and Affordable Care Act (ACA) which directs the Secretary of HHS to issue Medicaid regulations effective July 1, 2011 prohibiting Federal payments to States for any amounts expended for providing medical assistance for health care-acquired conditions (HCACs). It would also authorize States to identify other provider-preventable conditions (PPC) for which Medicaid payment would be prohibited.  #Letter submitted to CMS on 3/18/11. /Topic: Semiannual Regulatory Agenda - Fall 2010 yThe information provided in the Agenda presents a forecast of the rulemaking activities that the Department of Health and Human Services (HHS) expects to undertake in the foreseeable future. Rulemakings are grouped according to pre-rulemaking actions, proposed rules, final rules, long-term actions, and rulemaking actions completed since the Spring 2009 Agenda was published. N/A &Interim Final Rule with Comment Period 7)Topic: Health Insurance Exchanges (PPACA) 7Request for Comments 7KTopic: High-Risk Pool Coverage/Pre-Existing Condition Insurance Plan (PCIP) 7Interim Final Rule 7 No Action @Topic: Quality of Care to Children in Medicaid and CHIP (CHIPRA) 7Request for Comments 7Request for Information  Topic: MLR Interim Final Regulation This document contains the interim final regulation implementing MLR requirements for health insurance issuers under the Public Health Service Act, as added by the PPACA  Comment letter submitted 1/31/11 6Topic: CY 2011 Medicare Physician Fee Schedule (MPFS)  $Final Regulation with Comment Period +Topic: Encounter Data from MA Organizations Request for Information cThis notice provides an opportunity to comment under the Paperwork Reduction Act (PRA) on revisions to the CMS Medicare Part D Reporting Requirements for CY 2012. To help facilitate review of the document, CMS has provided a crosswalk table that outlines the changes between the currently approved CY 2011 and draft CY 2012 Part D Reporting Requirements. BSent summary to Lisa Rubino and Rick Slaughter; no further action.  Proposed Rule <Topic: Internal Review and External Appeal Processes (PPACA) 7Technical Release 7=Topic: Internal Review and External Appeals Processes (PPACA) 7Guidance (CMS) 7"Comment letter submitted 11/16/10. No Action needed per Dr. Siegel :Topic: Consumer Operated and Oriented Plan Program (Co-Op) .Topic: Health Care-Acquired Conditions (HCACs)  Section 340B implements a drug pricing program by which manufacturers enter into an agreement to sell covered outpatient drugs to particular covered entities at a price not exceeding the amount determined under a statutory formula. Manufacturers are required to enter in agreements with the Secretary if they participate in the Medicaid Drug Rebate Program. Section 7102(a) of the PPACA requires the Secretary of HHS to develop and issue regulations for the 340B Drug Pricing Program establishing standards for the imposition of sanctions in the form of civil monetary penalties for manufacturers that knowingly and intentionally overcharge a covered entity for a 340B drug. HHS is issuing this notice to solicit public comment on multiple issues regarding the implementation of this requirement.   No Action Request for Comments 9Dr. Siegel and Vicky Cuevas-Sobschak to develop comments. Topic: Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality Measures Program  Request for Comments LTopic: Medicare Program; Hospital Inpatient Value-Based Purchasing Program  The HITECH legislation mandated that incentives should be given to Medicare and Medicaid providers for "meaningful use" of EHRs. This request for comments is in response to the preliminary set of Stage 2 meaningful use recommendations.  $Topic: 45 Day Notice and Call Letter #Advanced Notice/Request for Comment Regulatory Agenda  Topic: President s Council of Advisors on Science and Technology Report -  Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward.  ,Topic: Medicaid - Recovery Audit Contractors Notice N/A Topic: Rate Review  Proposed Rule This proposed rule will: (1) Establish the requirements for suspending payments to providers and suppliers based on credible allegations of fraud in Medicaid and Medicare; (2) Establish the authority for imposing a temporary moratorium on Medicare, Medicaid and CHIP enrollment on providers and suppliers when necessary to help prevent fraud without impeding beneficiaries access to care; (3) Strengthen and build on current provider enrollment and screening procedures to more accurately assure that fraudulent providers are not gaming the system and that only qualified health care providers are allowed to enroll in and bill Medicare, Medicaid and CHIP; (4) Outline requirements for States to terminate providers from Medicaid and CHIP when they have been terminated by Medicare or by another state Medicaid or CHIP program; (5) Solicit input on how to best structure and develop provider compliance programs now required under the ACA.  Proposed Rule This final rule implements provisions from CHIPRA with regard to the MEQC and PERM. It also codifies several aspects of the process for estimating improper payments in Medicaid and CHIP. 7=Topic: Hospice Care for Children in Medicaid and CHIP (PPACA) 7fTopic: Program Changes to MA a< nd the Medicare Prescription Drug Benefit Program for Contract Year 2012  Proposed Rule PTopic: Clinical Quality Measures Concepts for Stage 2 and Stage 3 Meaningful Use  No Action cProposes revisions to Medicare Advantage and Part D to implement provisions of the ACA. Proposed revisions also include clarifying various program participation requirements, changes to strengthen beneficiary protections, strengthen our ability to identify strong applicants for Part C and D program participation and remove consistently poor performers. =This notice identifies an initial core set of health quality measures recommended for Medicaid-eligible adults, as required by the ACA, for voluntary use by State programs administered under title XIX of the Social Security Act (the Act), health insurance issuers and managed care entities that enter into contracts with Medicaid, and providers of items and services under these programs. This notice solicits comments on these initial measures, on facilitating the use of these measures by States and on identifying priority areas for measure enhancement and development.=Topic: National Health Care Quality Strategy and Plan (PPACA) Proposed Strategy "Due to Congress on January 1, 2011 "Topic: Medical Loss Ratios (PPACA) Draft Regulation The NAIC released draft regulations on MLRs establishing uniform definitions and standardized methodologies for calculating the required information. "Submitted comments October 4, 2010  Proposed Rule (Comments submitted on November 15, 2010. Technical Release  No Action DTopic: Fraud, Waste and Abuse in Medicare, Medicaid and CHIP (PPACA)  Proposed Rule $Comments submitted on Feb. 25, 2011. mCMS issued a NPRM that outlines provisions governing the Medicare and Medicaid EHR incentive programs, including a proposed definition for the central concept of  meaningful use of EHR technology. The proposed standards and certification criteria in the ONC s interim final rule are linked to and specifically designed to support the 2011 meaningful use criteria.CTopic: Recovery Audit Contractors (RACs) for Medicare Parts C and D Request for Information  No Action 1The final rules specify the objectives that providers must achieve in payment years 2011 and 2012 to qualify for incentive payments. The ONC regulations specify the technical capabilities that EHR technology must have to be certified and to support providers in achieving the  meaningful use objectives.xApplies to group health plans and group health insurance issuers for plan years beginning on or after September 23, 2010Effective Date 7Guidance (HHS) 7+Submitted response to ONC on March 15, 2010 7!Topic: Medical Loss Ratio (PPACA) 7 Molina Action 7EThe reinsurance program will reimburse sponsors of employment-based plans for a portion of the costs of providing health coverage to early retirees (including eligible spouses, surviving spouses, and dependents). An  early retiree is defined as a plan participant age 55 or older who is not eligible for Medicare coverage.This proposed rule would modify the 2011 eRx quality measure, provide additional significant hardship exemption categories for eligible professionals and group practices to request an exemption during 2011 for the 2012 eRx payment adjustment due to a significant hardship, and extend the deadline for submitting requests for consideration for the two significant hardship exemption categories for the 2012 eRx payment adjustment that were finalized in the CY 2011 Medicare Physician Fee schedule.2Topic: Internal Claims and Appeals under the PPACA  Comment letter submitted 1/11/11 Topic: Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program Topic: Rate Review (PPACA) 7The Social Security Act requires that CMS publish a list of Medicare issuances in the Federal Register at least every 3 months. Although not mandated to do so, for the sake of completeness, and to foster more open and transparent collaboration, Medicaid issuances and Medicare and Medicaid substantive and interpretive regulations published from April-June 2010 are also included in this notice. Comment letter submitted 12/3/10This document contains proposed regulations implementing the rule for health insurance issuers regarding the disclosure and review of unreasonable premium increases under the PHSA. The proposed rule would establish a rate review program to ensure that all rate increases that meet or exceed an established threshold are reviewed by a State or HHS to determine whether the rate increases are unreasonable.JTopic: Medicare and Medicaid Programs - Electronic Health Records (HITECH) 7{The HIT Policy Committee (a federal advisory committee that advises the U.S. Department of Health and Human Services) formed the Quality Measures Workgroup to recommend new clinical quality measures to leverage the evolving health IT infrastructure. The Quality Measures Workgroup is developing recommendations on clinical quality measures for Stage 2 and Stage 3 Meaningful Use.PPACA requires that the Secretary establish, either directly or through contracts with States or nonprofit private entities, a temporary high risk health insurance pool program. This program will continue until January 1, 2014, when Exchanges will be available for individuals to obtain health insurance coverage. Key issues addressed in this IFR include administration of the program, eligibility and enrollment, benefits, premiums, funding, and appeals and oversight rules.FTopic: Internal Claims and Appeals and External Review Process (PPACA) 7jTopic: Internal Claims and Appeals and External Review Process - Cultural and Linguistic Standards (PPACA) 7This proposed rule would provide guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid RACs in accordance with section 6411 of the ACA. This rule propose requirements for States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by RACs. The rule proposes that States and Medicaid RACs coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies.Summary 7PPACA requires HHS to work with States to establish an annual review of unreasonable rate increases, to monitor premium increases and to award grants to States to carry out their rate review process. HHS invites< public comments in advance of future rulemaking.This regulation provides for the implementation of legislative provisions addressing preexisting condition exclusions, restrictions on rescissions, application of lifetime and annual limits, and patient protections relating to emergency services and choice of health care professionals.HThe RFI is to help HHS better understand the interests of individuals with respect to learning of disclosures of protected health information, the administrative burden on covered entities and business associates of accounting for such disclosures, and other information that may inform the Department s rulemaking in this area.The 45 Day Notice must be released annually 45 days prior to the issuance of the final Medicare Advantage (MA) rates and Medicare Part D payment-related information for the upcoming contract year to provide preliminary information related to the rates and notice of any methodological changes. The Call Letter is intended to provide information relevant to MA and Part D plan bidding for the upcoming contract year. Applies to group health plans or group or individual health insurance for plan or policy years beginning on/after Sept. 23, 2010. PPACA requires health insurance issuers offering individual or group coverage to submit annual reports to HHS on the percentages of premiums that the coverage spends on reimbursement for clinical services and activities that improve health care quality, and to provide rebates to enrollees if this spending does not meet minimum standards for a given plan year. HHS invites public comments in advance of future rulemaking.The regulations require coverage of such preventive services as mammograms, colonoscopies, cancer screenings, blood pressure and cholesterol tests, counseling to lose weight or quit smoking, healthy check-ups, and immunizations for children. The services, recommended by the U.S. Preventive Services Task Force, the Advisory Committee on Immunization Practices, and the American Academy of Pediatrics, must be covered without requiring patients to pay deductibles, copayments, or coinsurance. 3Topic: Electronic Health Record Technology (HITECH) 7`Topic: Medicaid Eligibility Quality Control and payment Error Rate Measurement Programs (CHIPRA)Proposes to withdraw two provisions from the AMP Final Rule published July 17, 2007: (1) The determination of AMP and the FULs for multiple source drugs withdrawn in its entirety; (2) The definition of "multiple source drug" as it was amended in the Multiple Source Drug definition rule on October 7, 2008. These provisions were challenged in a lawsuit and have also been superseded by the PPACA. PPACA requires the establishment of an internet Website through which individuals and small businesses can obtain information about the insurance coverage options that may be available to them in their State. HHS is issuing an IRF in order to implement this mandate. This interim final rule adopts the categories of information that will be collected and displayed as Web portal content, and the data we will require from issuers and request from States, associations, and high risk pools in order to create the content.@Comments are requested regarding the need for any guidance on the PPACA tax-exempt hospital requirements; the appropriate requirements for a community health needs assessment; what constitutes "reasonable efforts" to determine eligibility for assistance under the requirement for a written financial assistance policy; and the requirement that each hospital in an organization separately meet the section's provisions. The new requirements relate to community health needs assessments, financial assistance policies, limitations on charges, and billing and collection actions.The key function of the proposed new rule is to extend requirements for protecting the privacy and security of patients' PHI to business associates of health care entities already covered by HIPAA. Business associates would be subject to the same enforcement actions as covered entities. The rule also defines subcontractors of business associates as being obligated with complying with HIPAA rules. The expansion of HIPAA privacy and security requirements to subcontractors was not widely expected and will have a significant impact. September 14, 2010 at 11:59p EST 7 Proposed Rule The interim final rules implement the PPACA provisions requiring group health plans and health insurance issuers providing coverage in the individual and group markets that provide dependent coverage to children to extend such coverage up to age 26.Applies to group health plans and health insurance coverage issued in the group and individual markets, effective for plan or policy years beginning on or after September 23, 2010The IFR implements the rules for group health plans and health insurance coverage in the group and individual markets under PPACA regarding status as a grandfathered health plan. The IFR establishes new requirements to handle internal review of claim denials and rescissions and for external appeals. Plans and insurers are required to notify individuals of an adverse benefit determination within the time frames established by state or federal law. However, a denial of an  urgent care claim must be provided as soon as possible, but no later than 24 hours after the receipt of the claim. Plans and insurers must ensure the internal review process is fair and impartial and provide claimants with the opportunity to review the claim file and present evidence and testimony. If a patient s internal appeal is denied, patients in new plans will have the right to appeal all denied claims to an independent reviewer not employed by their health plan. A state external appeal process must include the consumer protections in the NAIC Uniform Health Carrier External Review Model Act in effect as of July 23, 2010. The IFR establishes new federal minimum consumer protections for external appeals. Date Issued in Federal RegisterSets forth an enforcement grace period until July 1, 2011 with respect to some of the additional standards set forth in interim regulations in order to give plans and issuers more time to implement procedures and make changes to computer systems in order to fully comply. HHS is encouraging States to provide similar grace periods with respect to issuers and HHS will not cite a State for failing to substantially enforce the provisions. ?Restricted annual limits may be waived by the Secretary of HHS if compliance with the interim final regulations (June 28, 2010) would result in a significant decrease in access to benefits or a significant increase in premiums. This memorandum provides guidance and the scope and process for applying for< such a waiver.Applies to group health plans and health insurance coverage issued in the group and individual markets for plan (or policy years) on or after September 23, 2010.=This proposed rule provides that information about Medicaid and CHIP demonstration applications and approved projects will be publicly available at the State and Federal level and that there will be an opportunity for the public to comment on the proposals as they move through the process. The rule also seeks to assure that the development and review of demonstration proposals proceed in a timely and responsive manner. This rule proposes that State and Federal public notices processes, identifies the information that must be provided in such notices, and proposed minimum 30 day public comment period at both the State and Federal level. The rule also proposes a good cause exception under which CMS and States could bypass transparency requirements in the event of an emergency, such as a flood or other natural disaster. Submitted comments on 9/13/10The IFR provides details on requirements for "certified" electronic health record (HER) systems, and the technical specifications needed to support, secure, interoperable, nationwide exchange and meaningful use of health information.&Interim Final Rule with Comment Period 7Type of Document 7Comment Period Due Date 7This final rule establishes a temporary certification program for the purposes of testing and certifying health information technology. The ONC will utilize the program to authorize organizations to test and certify Complete Electronic Health Records (EHRs) and/or EHR Modules. The temporary certification program is scheduled to sunset on December 31, 2011 or when the National Coordinator determines that the permanent certification program is fully constituted.June 14, 2010 Applies to group health plans or group or individual health insurance with individuals enrolled on March 23, 2010.  7HHS is inviting comments from all interested parties and poses questions in several key areas including: (1) state exchange planning and establishment grants; (2) implementation timeframes and considerations; (3) selection of qualified health plans; (4) standards for a quality rating system; (5) establishing an exchange for non-electing states; (6) eligibility and enrollment functions; (7) outreach by exchange navigators; (8) state established rating areas; (9) design features and information most useful to help consumers obtain coverage; (10) design features that impact employer participation; and (11) transitional reinsurance programs, risk corridors, and risk adjustment. Of particular interest to health plans are questions regarding consistent operational and administrative rules across the states, interaction of the exchanges with rate review work funded by federal grants, certification of plans as qualified health plans, and issues surrounding participation in the exchange and bidding processes and standards.+Submitted response to CMS on March 15, 2010 7YThis memo identifies the types of submission errors that must be corrected immediately: (1) alteration of the benefits and/or rate templates; (2) submission of multiple benefits and/or rate templates for a single plan; and (3) missing benefits and/or rate templates for a plan. Submissions for other errors will be processed on a rolling basis. Group health plans and group insurance issuers offering group or individual coverage must provide notice to enrollees in a culturally and linguistically appropriate manner, of available internal and external appeals processes. The determination of whether issuers are providing notices in an appropriate manner is made at the county level. The IFR published July 23, 2010 states that DHHS would provide guidance as to how county level estimates should be established in the individual market, this is that guidance. 7 No Action Technical Guidance 7The PHS Act implemented by the IFR on July 23, 2010, requires that health insurance issuers comply with State external review processes in their states if that process includes, at a minimum, the consumer protections set forth in the NAIC Uniform Model Act. If the state process does not meet this standard, the issuer must implement an effective external review process. This guidance establishes the interim external review processes that apply during the transition period in which HHS will work with states to assist them in making any necessary changes so that the state process provides the consumer protection under the NAIC Uniform Model Act. 7 No Action ETopic: AMP, Multiple Source Drug Definition, and Federal Upper Limits 7:Proposed Rule (Centers for Medicare and Medicaid Services) 7$No Action Required per Dr. Schatzman 7 No Action pTopic: Financial Accounting Standards Board (FASB) Seeks Comments on How Health Insurers Should Account for Fees Request for Comments The Affordable Care Act (ACA) calls on the Secretary of HHS to establish a National Health Care Quality Strategy and Plan including a comprehensive strategic plan and the identification of priorities to improve the delivery of health care services, patient health outcomes, and population health. It's intended to be a living and changing guide for the Federal government, as well as for States and the private sector. HHS is requesting comments on whether the principles outlined are appropriate, whether the goals of the plan are easily understood, what national priorities should be addressed, what measurements should be used for assessing progress, how to engage  stakeholders in the process, and what priorities should be considered to address state needs. )Submitted response to HHS on May 14, 2010 7 No Action 7<Topic: HIPAA Privacy Rule Accounting of Disclosures (HITECH) 7Proposed Rule to incorporate new legislative requirements in the Affordable Care Act which mandate that, prior to certifying a patient s eligibility for the Medicare home health benefit, the physician must document that the physician or a non-physician practitioner has had a face-to-face encounter with the patient. Section 6407 is largely a Medicare provision but it applies to Medicaid in the same manner and to the same extent in the case of physicians authorizing home health services.This technical release sets forth an interim enforcement safe harbor for non-grandfathered self-insured group health plans that are not subject to a state external review process. 7 No Action  No Action < Request for Comments  Final Rule 7N/A 7-Comment letter submitted on October 18, 2010. cTopic: Federal Medical Assistance Percentage (FMAP) rate for the fourth quarter of Fiscal Year 2010 Request for Information New provision requires States make hospice services available to children eligible for Medicaid and children eligible for Medicaid expansion CHIP programs without forgoing any other service to which the child is entitled under Medicaid for treatment of the terminal condition. 7)Topic: Incomplete and Erroneous Plan Data 76The regulation would, for the first time, allow states to target multiple groups in a single home-and-community based (HCBS) waiver demonstration. Under current rules, states must serve one target group per waiver. This creates administrative difficulties for states that can delay opportunities for persons with disabilities to either remain in or transition to community living situations. The three target groups whose services could be combined into one demonstration are aged or disabled, persons with developmental disabilities and those with mental illness.Request for Comments :Topic: FMAP for October 1, 2011 through September 30, 2012  Final Rule 7N/A 7 No Action 7uThis requirement for insured group health plans are effective for plan years beginning on or after September 23, 2010 )Web Portal to be released October 1, 2010 7 Comment letter submitted 1/10/11 2Topic: Section 1115 Medicaid Demonstration Project  Proposed Rule (Topic: Early Retiree Reinsurance (PPACA) 7#Topic: Tax-Exempt Hospitals (PPACA) 7 No Action fTopic: Establishment of the Temporary Certification Program for Health Information Technology (HITECH) 7>Topic: HIPAA Privacy, Security, and Enforcement Rules (HITECH) 7N/A 7)Topic: Grandfathered Health Plans (PPACA) 7 Proposed Rule The Office of the National Coordinator for Health Information Technology is seeking public comments on issues related to personal health records, including: privacy and security emerging technologies; consumer expectations; and privacy and security requirements for non-covered entities. -Sent to senior management; no further action. }OCIIO is requesting comments on creating Co-Ops under the ACA. HHS seeks comments on assessments of the types of groups that would meet the criteria of the program; what issues a nonprofit insurer may face in developing provider networks in areas with medical shortages; how much funding is necessary; and whether these plans should participate in Medicaid, CHIP, or other markets. LSent summary and copy of regulation to senior management; no further action. $Topic: Personal Health Records (PHR) This guidance document is the first in a series of documents that the Department of Health and Human Services (HHS) intends to publish over the next three years to provide information to States and the Territories seeking to establish a Health Insurance Exchange (Exchange) under Section 1311(b) of the Affordable Care Act. This guidance focuses on four main issues: principles and priorities, outline of statutory requirements, clarifications and policy guidance, and federal support for the establishment of state-based exchanges.CTopic: Highly Compensated Individuals in Insured Group Health Plans Announces the availability of EBSA Technical Release (see above) and Model notices that can be used to satisfy the disclosure requirements of the interim final regulations. 7 No Action Technical Guidance 7N/A 7The proposed rule would amend the CLIA regulations to specify that, upon a patient's request, the laboratory may provide access to completed test reports that, using the laboratory's authentication process, can be identified as belonging to that patient. The proposed rule would retain the existing provisions that provide for release of test reports to authorized persons and, if applicable, Request for comments on potential approaches for determining the  affordability of employer-sponsored coverage for purposes of implementing the employer responsibility provisions of the Affordable Care Act (ACA).  NPRM "Notice and Opportunity for Comment This notice seeks comment on an OIG proposal to revise standards for assessing the performance of Medicaid Fraud Control Units. This proposal would replace and supersede standards published in September 1994. RFI regarding the recently released PCAST report and its implications for the nation's health information technology agenda and ONC's implementation of the HITECH Act. N/A Non-grandfathered insured group health plans that discriminate in favor of highly compensated employees face significant liability under new rules enacted as part of the PPACA, as amended by the Health Care and Education Reconciliation Act. The Department of Treasury and the IRS request comments on what additional guidance would be helpful with respect to insured group health plans.   No Action .Topic: MMIS APD Template - NCCI Implementation Requests comments regarding certain aspects of the policies and standards that will apply to ACOs participating in the Medicare program under Section 3021 or 3022 of the ACA. -Topic: Medicare Advantage/Special Needs Plans (This proposed rule would revise the MA program regulations and prescription drug benefit program regulations to implement new statutory requirements; strengthen beneficiary protections, exclude plan participants that perform poorly; improve program efficiencies; and clarify program requirements.7Health Coverage Affordability Safe Harbor for Employers LTopic: CLIA Program and HIPAA Privacy Rule; Patients' Access to Test Reports XTopic: Proposed Revision of Performance Standards for State Medicaid Fraud Control Units Topic: Medicare Program; Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract year 2013 and Other Proposed Changes ;Reviewed by George Figueroa. No further action recommended. The specific Exchange functions proposed in this rule include: Eligibility determinations for Exchange participation and insurance affordability programs and standards for employer participation in SHOP.HHS published the FY 2012 FMAP rates in the Federal Register. FY 2012 covers the period October 1, 2011, through September 30, 2012. The notice also includes Enhanced FMAP rates for CHIP programs. The FMAP formula is based on the three-year rolling average per-capita income in each state in relation to the United States for the three to six years prior, in this case income data from calendar years 2007-2009 compiled by the Bureau of Economic Analysis.The Financial Accounting Standards Board is seeking comments on narrow-scoped accounting provisions aimed at addressing questions on how health insurers should recognize and classify fees under regulatory provisions related to the Health Care and Education Reconciliation Act.   No action < This proposed rule would implement standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors and risk adjustment consistent with the ACA. These programs will mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and Exchanges are implemented..ONC is seeking comments on the following categories of metadata recommended by both the HIT Policy Committee and HIT Standards Committee: patient identity, provenance, and privacy. ONC also requests comments on any additional metdata categories, metadata elements, or syntax that should be considered. RFC FTopic: 340B Drug Pricing Program Manufacturer Civil Monetary Penalties N/A 7-Topic: Quarterly Listing of Program Issuances This proposed rule identifies and proposes reforms in Medicare and Medicaid regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on health care providers and beneficiaries. This is one of several rules CMS is proposing to achieve regulatory reforms under Executive Order 13563, "Improving Regulation and Regulatory Review" and HHS's Plan for Retrospective Review of Existing Rules. Proposed Rule _Topic: Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction   Proposed Rule QThis proposed regulation implements the disclosure for group health plans and health insurance issuers of the summary of benefits and coverage (SBC) and the uniform glossary. This document proposes a template for an SBC; instructions, sample language, and a guide for coverage examples calculations to be used in completing the template. Request for Information This notice is a request for information regarding section 1331 of the Affordable Care Act, which provides States with the option to establish a Basic Health Program. Comments submitted 10/31 Letter submitted 10/31 Letter submitted 10/31 ;Blair is the lead. Summary sent to John. No further action. CSent to senior management; engaged through AHIP. No further action. Solicitation of Comments w3 l7:A*DQH6LS TH7VWc[6]v Zcfoj@loHyrz[K~ R^Mph ˣĥīѹhn6<[=V8h'_O ic ! h&+U0s7;yccB  80AJ Sa[c9lEtm|˄ߌ7  dMbP?_*+%541&C&14 2010 Federal Regulatory Tracking Worksheet &R&D&?'?(?)?"d??&U} } }  } +} }  Column G0 @      @@  MG M? MH M M+ Mtttttt u3wwwww ^W @X @Y @Z @E ^zzzzzz u4uuuuu ^5 @6 @7 @8 ^ ^Lz{{{{{ uuuuuu ^9 @| @} @ ^1 ^Z z{{{{{ u! uuuuu ^: @; @< @ ^, ^n z{{{{{ |\||||| ^9 @= @>@ ^. ^%zzzzzz |&||||| ^'D @D@D@ ^6 ^(z{{{{{ |t||||| ^D @D@D@ ^ ^)z{{{{{ |@||||| ^FD @D`@ ^ ^; ^vvwwwww |u||||| ^AA@D@^ B7 ^[zzzzzz uzuuuuu ^FD@D@ AJ ^= ^vvwwwwwD$lT"T"T"P"P"P"F"F"N"J"N !"#$%&' ()* +,-./0123456789:;<=>? uw wwww` !`l~ !b@ !`m~ !b`@ !^I !`n"vvvvvv #|#||||| $^$D@D`@ $^0 $^- $^%zzzzzz &yx&yyyyy 'EB'H@H@ 'EC 'E8 'ED(vvvvvv )x)xxxxx *G*F@F@ *E< *E2 *G+vvvvvv ,x,xxxxx -G-F@F@ -EB -E> -GD._KK___ /aE/FFGGG 0G[0F@F@0G 0E] 0G1vvvvvv 2u%2uuuuu 3`\~ 3b@ 3`y~ 3b@ 3^ 3`y4vvvvvv 5x5xxxxx 6G6H@H @H@@ 6EK 6E{7vwwwww 8x8xxxxx 9G9F@F` @9G 9E' 9G:____]_ ;u;uuuuu <`<b@b@<` <^ <^=vwwwww >u4>uuuuu ?`b~ ?b`@ ?`c~ ?b @ ?^ ?`D*l"T"N"N"N"N"J"T"F"J"J"@ABCDEFGH IJK LMNOPQRSTUVWXYZ[\]^_@vwwwww AuAuuuuu B`~ BD@ B`~ Bb@ B^^ B`_Cvvvvvv DuDuuuuu E`]~ Eb@@ E`^E` E^ E`Fvvvvvv Gu)Guuuuu H`~ Hb@ H`H` H^N H`OIvvvvvv Ju(Juuuuu K`P~ Kb@Kb~ Kb+@ K^Q K`RLvvvvvv MxSMxxxxx NETNF@@F @NF NE5 NEUOvvvvvv PuxPuuuuu Q^_~ Qb@@ Q`` Q^A Q``R______ SuSuuuuu T`~ Tb@Tb~ Tb@ T^g T``Uvvvvvv VuyVuuuuu W^z W^aW^ W^b W^ W`Xvvvvvv YNhYOOOOP Z^~ ZD@ Z^9 Z^p ZEM Z^V[______C \\r\`````C ]` ]b@b@]` ]^C ]^ ]C^______C _\_`````CD l"T"P"P"P"J"F"P"P"T$T`abcdefghijkl mnopqrstuvwxyz{|}~ ``a`b`@b@ `^o `^ ```Ca_KK_]_C b\b`````C c` ~ cb`@ cbb c^@ c` cCd_KKK]_C e|euuuuuC f`fb`@b@fI f^ f^fCg_KKL]_C h\h`````C i`ib`@b@i` i^ i`iCjmppppqC kQkRRRRRC l`lb`@b @ l^ lSY lTlCm}nnnnoC n\nbb^STC o`{ob@b @D`@ oS3 oTdoCptttttt qQqRRRRR r`rb@b @b@@ rS rS stttttt tQtRRRRR u`n~ ub@ @ u`` uS" uRJvttttttJ wQSwRRRRRJ xUT x^U~ xD@ x^o xSs xSFxJymppppq zQzRRRRR {`V{b` @b@{V {Su {Uv|mppppq }Qe}RRRRR ~`w~ ~b@ @ ~RR ~SR ~UGmppppqDPlX$P$T$T$X$P"F"F$^"J"F     QRRRRR `ab @b@` S| Umppppq QRRRRR `b @b@` S Tmnnnno QVVRRS `sb@b`@ S S* Tqmnnnno QkRRRRS `~ b@ VR S Tmnnnno QVVRRS `b@b@R S Tmnnnno Q RRRRS Ub@b@U S ^#mnnnno QHRRRRS `I~ b@ bb S Tmnnnno QbbbRS `b@@b@b@@ ^ Tmnnnno QRRRRS ^b @b@` ^ Tmppppq QRRRRR `b@@b @` S& Tmppppq llllll `b@b@@` ^ ^Dl"J"J"N"F"J"J"F"F"J"J"h@ }~~~~ rsssss `fb@b@` ^ `tttttt QRRRRR `~ b@ `R S Umppppq QRRRRR `b@b@R S$ UJmppppq QRRRRR `b @b @R S TPmppppq kQlllll `b@b`@R S Tm QWRRRRT `Xb`@b"@` S T} QRRRRS `b`@b@bB@ S Tmppppq klllll `Kb@b@` S TLWWWWWW klllll `b@b@` S* TOm QRRRRR Tb@b @R S Tmppppq QRRRRRDl"J"F"J"J"J"J"F"J"J"J @  `jb@@b@R S~ Tm QRRRRR Ub @b@b+@ S Tmppppq QRRRRR Tb@@b@bB@ S/ Tmppppq QRRRRR `b @b#@b`7@ S Tmppppq Q?RRRRR `~b@@b%@R T Tmppppq QRRRRR Ub@b &@R S Tmppppq QRRRRR `b@b #@R S TXXXXXX QRRRRR `b@ @b+@`p@ Y Tmppppq QRRRRR Ub@!@b(@bB@ S Tmppppq QRRRRR `pb@"@b)@` ^i ^q}~~~~ \````` `b@b@%@` ^ ^}DlJ"F"F"F"J"J"J"F"F"J"J n@@X@ @@ QRQRRR `rb$@b`,@` ^c ^d} \ebb``` `fb &@b -@` ^g ^hmppppq QRRRRR `~ b@&@ ^` ^ ^mppppq QRRRRR `~ b (@b~ b+@ S TXXXXXX Z[[[[[ `Mb(@b/@R S ^$} \bbRR` `b (@b.@R S ^} \ibbRR` `b`(@b0@ UN Tj ^kmppppq QlRRRRR `m~ b*@ ^t` ^ ^mppppq QRRRRR `b+@b`3@` ^# ^}mppppq h1jjjjj `b+@b`3@` ^ ^+mppppq QRRRRR `b,@b@4@` ^, ^Dl"J"J"P"P"J"J"N"P"J"J" @@     mppppq QRRRRR `b,@b@4@` ^ ^2}~~~~ \-````` `.b,@b4@` ^ ^}~~~~ \/\```` `b -@b ;@` ^ ^ }~~~~ \ ````` `: b -@b ;@ ` ^ ^ }~~~~ \ ````` `b.@b5@` ^ ^WWWWWW Q RRRRR ^0b0@b`6@` ^ ^______ \````` ` b1@b ;@` ^ ^W__WWW Q!``RRR U:b1@b ;@R S ^W__WWW Q"``RRR ` b1@b ;@R S ^WWWWWW Q RRRRR `b`2@b9@` ^ ^WWWWWW klllllDl"J"J"J"J"J"J"J"J"J"J !"#$%&'()*+,-./ ` b4@b ;@ ` ^ `!WWWWWW "c"ddddd #`#b3@b@@#` #^ #^$WWWWWW %Q%RRRRR &`&b5@b<@&` &^ &^'WWWWWW (h(iiiii )^)b8@b?@)` )^ )^*______ +\+````` ,`,b8@b`@@,` ,^ ,^-WWWWWW .Q.RRRRR /e~ /g9@ /ee /f /f$,J"J"J"J"J">@A  t    eejjvvppmm778855%%(( ##""   ==++1144,,22))&&OOMMJJ;;>>AADDGGVV@@UUXXPPCCFFIILLSSyyss||((ggD@  Oh+'0HPht Melissa Johnson Microsoft Macintosh Excel@@; .T@ByP@!՜.+,0  PXd lt|  Sheet1Sheet1!Print_TitlesSheet1!SDU_50932  Worksheets Named Ranges F&Microsoft Office Excel 2003 WorksheetBiff8Excel.Sheet.89qCompObj r