[Federal Register Volume 69, Number 194 (Thursday, October 7, 2004)]
[Notices]
[Pages 60157-60158]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-22400]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1360-CN]
RIN 0938-AM82


Medicare Program; Inpatient Rehabilitation Facility Prospective 
Payment System for Fiscal Year 2005; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice; correction.

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SUMMARY: This document corrects technical errors that appeared in the 
Federal Register notice on July 30, 2004, entitled ``Medicare Program; 
Inpatient Rehabilitation Facility Prospective Payment System for Fiscal 
Year 2005.'' That notice updated prospective payment rates for 
inpatient rehabilitation facilities for Federal fiscal year 2005 as 
authorized under section 1886(j)(3)(C) of the Social Security Act (the 
Act). In addition, section 1886(j)(5) of the Act requires the Secretary 
to publish in the Federal Register, on or before August 1 before each 
fiscal year, the classifications and weighting factors for the 
inpatient rehabilitation facility case mix groups and a description of 
the methodology and data used in computing the prospective payment 
rates for that fiscal year.

DATES: Effective for discharges occurring on or after October 1, 2004, 
and on or before September 30, 2005.

[[Page 60158]]


FOR FURTHER INFORMATION CONTACT: August Nemec, (410) 786-0612; or 
Jeannette Kranacs, (410) 786-9385.

SUPPLEMENTARY INFORMATION:

I. Background

    In CMS-1360-N, FR Doc. 04-17444 of July 30, 2004 (69 FR 45721), 
there were three technical errors that are identified and corrected in 
the Correction of Errors section below. The provisions in this 
correction notice are effective as if they had been included in the 
document published July 30, 2004. Accordingly, the corrections are 
effective for discharges occurring on or after October 1, 2004, and on 
or before September 30, 2005.
    We recently determined that several technical errors occurred in 
the publication of the wage index values for a number of specific 
Metropolitan Statistical Areas (MSAs). A description of those technical 
errors is included in the ``Correction of Errors'' section below. We 
note that correcting these technical errors is a purely administrative 
function that does not result in any change of policy or payment 
methodology.

II. Correction of Errors

    In CMS-1360-N, FR Doc. 04-17444 of July 30, 2004 (69 FR 45721), 
make the following corrections:
    A. On page 45734, remove Stanly, NC from Urban Area 1520 Charlotte-
Gastonia-Rock Hill, NC-SC, because it has a rural designation instead 
of an urban designation. We note an error in the labeling of the wage 
index tables within the Inpatient Rehabilitation Facility Prospective 
Payment System (IRF PPS). That labeling error is the listing of Stanly 
County, NC as one of the urban areas under MSA 1520 when, in fact, we 
consider Stanly County, NC to be a rural area in North Carolina. Stanly 
County wage data have always been correctly treated as rural in the 
actual creation of the IRF wage index values, and it has only been the 
listing of Stanly County under MSA 1520 that was in error. 
Consequently, we are correcting our labeling error in the IRF PPS 
notice (CMS-1360-N), and have removed Stanly County from the list of 
areas that fall under the MSA 1520 wage index. Since this is strictly a 
labeling correction that does not affect the actual computation of the 
wage index values, IRFs in Stanly County, NC will continue to fall 
under, and use, the wage index for rural North Carolina.
    B. On page 45746, remove the wage index of 0.0000 for Urban Area 
4150 and in its place, add a wage index of 0.8677. This change is made 
due the inadvertent insertion of 0.0000 for MSA 4150 when it should 
have been 0.8677.
    C. On page 45757, remove the wage index of 0.0000 for Urban Area 
7000 and in its place, add a wage index of 0.9757. This change is made 
due to the inadvertent insertion of 0.0000 for MSA 7000 when it should 
have been 0.9757.

III. Waiver of Proposed Rulemaking and Delayed Effective Date

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a regulation take effect. We can waive this procedure, 
however, if we find good cause that notice-and-comment procedure is 
impracticable, unnecessary, or contrary to the public interest and 
incorporate a statement of the finding and the reasons for it into the 
notice issued. 5 U.S.C. 553(b)(B). We can also waive the 30-day delayed 
effective date of the Administrative Procedure Act (5 U.S.C. 553(d)) 
when there is good cause to do so and we publish in the rule an 
explanation of our good cause.
    We find it unnecessary to undertake notice-and-comment rulemaking 
because this correction notice merely provides technical corrections to 
the July 30, 2004 notice. This correction notice corrects inadvertent 
drafting errors (that is, a labeling error with respect to Stanley 
County and the insertion of incorrect wage indexes for MSA 4150 and MSA 
7000). We are not making substantive changes in policy, but rather, are 
simply implementing correctly the payment methodology that we long ago 
proposed, received comment on, and subsequently finalized. Thus, 
because the public has already had the opportunity to comment on the 
payment methodology used to calculate the wage indexes, additional 
comment would be unnecessary.
    In addition, publication of a substantive rule shall be made not 
less than 30 days before its effective date. We can waive this 
procedure, however, if we find good cause that a delayed effective date 
is impracticable, unnecessary, or contrary to the public interest. 5 
U.S.C. 553(d)(3). We believe a delayed effective date is unnecessary 
because this correction notice merely corrects inadvertent technical 
mistakes (that is, a labeling error with respect to Stanley County and 
the insertion of incorrect numbers in the wage indexes for MSA 4150 and 
MSA 7000). Further, we believe imposing a 30-day delay in the effective 
date would be contrary to the public interest with respect to IRF 
providers in MSA 4150 and MSA 7000. As a matter of good public policy, 
the rates used in the IRF PPS should not be based on wage indexes that 
contain inadvertent errors that, if not corrected, would have very real 
impacts on the payments received by providers in MSA 4150 and MSA 7000. 
We believe that it is imperative that these providers receive 
appropriate IRF PPS payments and that failure to do so would be 
contrary to the public interest. Furthermore, the changes noted above 
do not make any substantive changes to the IRF PPS payment methodology 
or underlying payment policies. Therefore, we find good cause to waive 
the 30-day delayed effective date.


(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program.)

    Dated: September 30, 2004.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 04-22400 Filed 10-1-04; 11:46 am]
BILLING CODE 4120-01-P