Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78315

EPA APPROVED ALBUQUERQUE/BERNALILLO COUNTY, NN REGULATIONS—Continued

State citation Title/subject State approval/

effective date EPA approval date Explanation 

Part 61 (20.11.61 NMAC) ..................... Prevention of Significant Deterioration.10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 63 (20.11.63 NMAC) ..................... New Source Performance Standards for 

Stationary Sources.

10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 64 (20.11.64 NMAC) ..................... Emission Standards 

for Hazardous Air 

Pollutants for Stationary Sources.

10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 65 (20.11.65 NMAC) ..................... Volatile Organic Compounds.10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 66 (20.11.66 NMAC) ..................... Process Equipment ... 10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 67 (20.11.67 NMAC) ..................... Equipment, Emissions, Limitations.10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 68 (20.11.68 NMAC) ..................... Incinerators and 

Crematories.

04/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 90 (20.11.90 NMAC) ..................... Administration, Enforcement, and Inspection.10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 100 (20.11.100 NMAC) ................. Motor Vehicle Inspection—Decentralized.10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 102 (20.11.102 NMAC) ................. Oxygenated Fuels ..... 10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

Part 103 (20.11.103 NMAC) ................. Motor Vehicle Visible 

Emissions.

10/01/02 ........... 12/30/04 [Insert FR page 

where document begins].

* * * * *

[FR Doc. 04–28501 Filed 12–29–04; 8:45 am] 

BILLING CODE 6560–50–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 419 

[CMS–1427–CN] 

RIN 0938–AM75 

Medicare Program; Changes to the 

Hospital Outpatient Prospective 

Payment System and Calendar Year 

2005 Payment Rates; Wage Index 

Tables and Corrections

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS.

ACTION: Correction of final rule with 

comment period. 

SUMMARY: This document corrects 

technical errors that appear in the final 

rule with comment period published in 

the Federal Register on November 15, 

2004 entitled ‘‘Changes to the Hospital 

Outpatient Prospective Payment System 

and Calendar Year 2005 Payment 

Rates.’’ In addition, it provides 

additional information about the 

calendar year 2005 wage indices for this 

payment system that was not published 

in that final rule with comment period.

DATES: Effective Date: This document is 

effective on January 1, 2005.

FOR FURTHER INFORMATION CONTACT:

Dana Burley, (410) 786–0378.

SUPPLEMENTARY INFORMATION:

I. Background 

A. Corrections 

In FR Doc. 04–24759 of November 15, 

2004 (69 FR 65681), there were a few 

inadvertent technical and typographical 

errors that we are correcting and 

identifying in the ‘‘Correction of Errors’’

section below. The provisions in this 

correction are effective as if they had 

been included in the document 

published in the Federal Register on 

November 15, 2004, that is, as of 

January 1, 2005. 

B. Wage Index 

Section 1833(t)(2)(D) of the Social 

Security Act (the Act) requires the 

Secretary to determine a wage 

adjustment factor to adjust, for 

geographic wage differences, the portion 

of the Hospital Outpatient Prospective 

Payment System (OPPS) payment rate 

and the copayment standardized 

amount attributable to labor and laborrelated cost. This adjustment must be 

made in a budget neutral manner. As we 

have done in prior years, we adopted 

the Hospital Inpatient Prospective 

Payment System (IPPS) wage indices 

and applied them to Tax Equality and 

Fiscal Responsibility Act (TEFRA) 

hospitals that participate in the OPPS 

but not the IPPS. 

In determining the OPPS payment 

rate and the copayment standardized 

amount, we standardize 60 percent of 

estimated costs (the labor-related 

portion of costs) for geographic area 

wage variation using the IPPS wage 

indices that are calculated prior to 

adjustments for reclassification to 

remove the effects of differences in area 

wage levels. 

As published in the original OPPS 

April 7, 2000 final rule (65 FR 18545), 

the OPPS has consistently adopted the 

final IPPS wage indices for adjusting the 

OPPS standard payment amounts for 

labor market differences. In accordance 

with section 1886(d)(3)(E) of the Act, 

the IPPS wage index is updated 

annually. In the August 16, 2004 OPPS 

proposed rule (69 FR 50541), we 

proposed to use the corrected proposed 

fiscal year (FY) 2005 hospital IPPS wage 

index for urban areas published in the 

Federal Register on June 25, 2004 (69 

FR 35919) and the proposed FY 2005 

hospital IPPS wage index for rural areas 

published in the Federal Register on 

May 18, 2004 (69 FR 28580) to 

determine the wage adjustments for the 

OPPS payment rates and the copayment 

standardized amount for calendar year 

(CY) 2005. 

On November 15, 2004, we published 

the final rule with comment period for 

the OPPS and CY 2005 payment rates 

(69 FR 65681). In that final rule (69 FR 

78316 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 

65842), we specified that, while we 

customarily publish the wage index 

tables in the final rule for the OPPS 

update, we were not including them as 

we were in the process of reviewing the 

wage indices for IPPS. We added that 

we would publish the finalized tables in 

a later Federal Register document. 

II. Correction of Errors 

In FR Doc. 04–24759 (69 FR 65681) 

make the following corrections: 

1. On page 65697, line 38 of the center 

column, the code ‘‘73428’’ is corrected 

to read ‘‘74328.’’

2. On page 65771, line 39 of the first 

column ‘‘January 1, 2006’’ is corrected 

to read, ‘‘January 1, 2007.’’

3. On page 65778, Table 23 

incorrectly lists C9218. Table 23 is 

corrected to exclude C9218. 

4. On page 65841, line 22 of the third 

column, the payment rate for APC 375 

is incorrectly identified as ‘‘$3,214.22.’’

The payment rate is corrected to read 

‘‘$3,217.47.’’

5. On page 65848, line 13 of the center 

column, the coinsurance amount for the 

partial hospitalization APC is 

incorrectly identified as ‘‘$56.33.’’ The 

coinsurance amount is corrected to read 

‘‘$56.27.’’

6. On page 65885, APC 9218 

incorrectly notes status indicator ‘‘G.’’

The status indicator for APC 9218 is 

corrected to read ‘‘K.’’

7. On page 66104, C9218 incorrectly 

notes status indicator ‘‘G.’’ The status 

indicator for C9218 is corrected to read 

‘‘K.’’

III. Wage Index Tables and Additional 

Information 

As stated above, we adopted the final 

IPPS wage indices for adjusting the 

OPPS standard payment amounts for 

labor market differences. Accordingly, 

the final wage index tables for the IPPS 

and OPPS are included in the IPPS 

correction notice (CMS–1428–F2) 

published elsewhere in this issue. The 

applicable wage index tables published 

in the IPPS correction notice that we 

will adopt for OPPS calculations are 

referenced in the following chart: 

BILLING CODE 4120–01–P

Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78317


ER30DE04.015</GPH>
78318 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 

In addition, as also noted above, we 

adopted the IPPS wage indices and 

applied them to TEFRA hospitals that 

participate in the OPPS but not the 

IPPS. For CY 2005, we will also 

implement an adjustment to the wage 

index to reflect the ’’out-migration’’ of 

hospital employees who reside in one 

county but commute to work in a 

different county with a higher wage 

index, in accordance with section 505 of 

the Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003, Pub. L. 108–173 (August 11, 2004 

IPPS final rule (69 FR 49061 through 

49067), as revised and corrected on 

October 7, 2004 (69 FR 60242)). 

Hospitals paid under the IPPS located in 

the qualifying section 505 ‘‘outmigration’’ counties received a wage 

index increase. We are applying the 

same criterion to TEFRA hospitals paid 

under the OPPS but not paid under the 

IPPS. Therefore, TEFRA hospitals 

located in qualifying section 505 

counties will also receive increases to 

their wage indices under OPPS. In the 

OPPS proposed rule (69 FR 50916), 

those TEFRA hospitals were included in 

Addendum K. Accordingly, in this 

notice, we are providing the finalized 

Addendum K below. This addendum 

includes the wage index adjustment for 

commuting hospital employees (outmigration) in qualifying counties under 

IPPS (Table 4J under IPPS) as well as 

information regarding TEFRA hospitals 

that are paid under the OPPS and that 

are located in qualifying section 505 

counties and for which an adjustment 

will be made to their wage indices for 

CY 2005. Column 4 identifies the 

TEFRA hospitals by triple asterisks 

(* * *).

Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78319


ER30DE04.016</GPH>
78320 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.017</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78321


ER30DE04.018</GPH>
78322 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.019</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78323


ER30DE04.020</GPH>
78324 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.021</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78325


ER30DE04.022</GPH>
78326 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.023</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78327


ER30DE04.024</GPH>
78328 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.025</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78329


ER30DE04.026</GPH>
78330 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.027</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78331


ER30DE04.028</GPH>
78332 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.029</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78333


ER30DE04.030</GPH>
78334 Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 


ER30DE04.031</GPH>
Federal Register / Vol. 69, No. 250 / Thursday, December 30, 2004 / Rules and Regulations 78335

BILLING CODE 4210–01–C 

IV. 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 

notice such as this are effective in 

accordance with section 553(b) of the 

Administrative Procedure Act (APA) (5 

U.S.C. 553(b)). We also ordinarily 

provide a 30-day delay in the effective 

date of the provisions of a notice in 

accordance with section 553(d) of the 

APA (5 U.S.C. 553(d)). However, we can 

waive both the notice-and-comment 

procedure and the 30-day delay in 

effective date if the Secretary finds, for 

good cause, that it is impracticable, 

unnecessary, or contrary to the public 

interest, and incorporates a statement of 

the finding and the reasons in the 

notice.

We find it unnecessary to undertake 

notice-and-comment rulemaking 

because this correction notice merely 

provides minor technical and 

typographical corrections and does not 

make any substantive changes to the 

regulations. In addition, while we are 

presenting information regarding the 

wage index tables, we are not changing 

our payment methodology. We are 

adopting the IPPS wage indices and 

applying the methodology that has 

already been subject to public comment 

and subsequently finalized. As we 

stated in the OPPS final rule, we are 

now presenting the information 

regarding the wage index tables that was 

not available when the final rule was 

published. Thus, because the 

corrections are technical and 

typographical in nature, and the public 

has already been given the opportunity 

to comment on our method for 

calculating the wage adjustment factor 

and was informed earlier that the 

finalized wage index tables would be 

provided in a subsequent Federal 

Register document, we believe 

additional comment would be 

unnecessary. 

Further, we believe a delayed 

effective date is unnecessary because 

this notice merely corrects inadvertent 

technical errors and provides the tables 

that display the wage index values 

applicable for the OPPS as explained in 

the OPPS final rule (69 FR 65842). 

There is no significant effect on the 

payment rates for any provider. Further, 

we believe imposing a 30-day delay in 

the effective date would be contrary to 

the public interest for outpatient 

providers. To the extent that any 

provider’s rates are affected, we believe 

that it is imperative that appropriate 

wage index values are applied in as 

timely a manner as possible, and that 

any delay in applying the appropriate 

wage index values would be contrary to 

the public interest. Therefore, we find 

good cause to waive notice-andcomment procedures, as well as the 30-

day delay in effective date.

Authority: Section 1833(t) of the Social 

Security Act (42 U.S.C. 1395l(t)).

(Catalog of Federal Domestic Assistance 

Program No. 93.773 Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program)

Dated: December 21, 2004. 

Ann C. Agnew, 

Executive Secretary to the Department.

[FR Doc. 04–28253 Filed 12–22–04; 1:00 pm] 

BILLING CODE 4120–01–P


ER30DE04.032</GPH>