50712 Federal Register / Vol. 74, No. 189 / Thursday, October 1, 2009 / Rules and Regulations 

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[FR Doc. E9–23687 Filed 9–30–09; 8:45 am] 

BILLING CODE 7710–FW–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 412 

[CMS–1538–CN] 

RIN 0938–AP56 

Medicare Program; Inpatient 

Rehabilitation Facility Prospective 

Payment System for Federal Fiscal 

Year 2010; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of final rule. 

SUMMARY: This document corrects 

technical errors that appeared in the 

final rule published in the Federal 

Register on August 7, 2009 entitled 

‘‘Inpatient Rehabilitation Facility 

Prospective Payment System for Federal 

Fiscal Year 2010’’ (74 FR 39762). 

DATES: Effective Date. The correction to 

the average length of stay value for CMG 

0501, tier 2, in Table 1 on page 39768 

of the final rule (74 FR 39762) is 

effective October 1, 2009. The correction 

to the preamble text at the top of the 

middle column of page 39791 of the 

final rule (74 FR 39762) is effective 

January 1, 2010. 

FOR FURTHER INFORMATION CONTACT: 

Susanne Seagrave, (410) 786–0044. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. E9–18616 of August 7, 

2009 (74 FR 39762), there are technical 

errors that we are identifying and 

correcting in the Correction of Errors 

section below. The corrections in this 

notice are effective as if they were 

included in the final rule published on 

August 7, 2009. Accordingly, the 

correction to the average length of stay 

value for CMG 0501, tier 2, in Table 1 

on page 39768 of the final rule (74 FR 

39762) is effective October 1, 2009. This 

change is applicable for IRF discharges 

occurring on or after October 1, 2009 

and on or before September 30, 2010 

(FY 2010). The correction to the 

preamble text at the top of the middle 

column of page 39791 of the final rule 

is effective January 1, 2010. 

II. Summary of Errors 

In the August 7, 2009 final rule (74 FR 

39762), the average length of stay value 

for CMG 0501, tier 2, in Table 1 on page 

39768 should have been listed as 10, but 

was inadvertently listed as 0. In the FY 

2010 IRF PPS proposed rule (74 FR 

21052 at 21057), we proposed the 

average length of stay value for CMG 

0501, tier 2, as 10. The proposal was 

based on FY 2007 IRF claims data, 

which was the most recent available 

data we had at the time. The updated 

FY 2008 data that we used for the final 

rule contained no IRF cases for CMG 

0501, tier 2. When there are not enough 

cases in a particular CMG and tier 

(referred to herein as a ‘‘payment 

group’’) to calculate an average length of 

stay, we combine the cases in that 

payment group with the next highestpaying payment group to calculate an 

average length of stay value. 

Accordingly, for the final rule, we used 

the average length of stay value of 10 

from CMG 0501, tier 1 for CMG 0501, 

tier 2, but in Table 1 we inadvertently 

indicated a value of 0 instead of 10. 

Thus, we are correcting Table 1 to show 

the average length of stay value for CMG 

0501, tier 2, is 10. 

In addition, we are correcting certain 

language in the preamble that could be 

misread, resulting in confusion with the 

regulatory requirements that must be 

met with respect to the preadmission 

screening required under 

§ 412.622(a)(4)(A). Section 

412.622(a)(4)(A) requires that the 

comprehensive preadmission screening 

be conducted by a licensed or certified 

clinician(s) designated by the 

rehabilitation physician described in 

§ 412.622(a)(3(iv) within 48 hours 

immediately preceding the IRF 

admission. Our policy is that the IRF 

personnel conducting the screening 

must be a clinician or group of 

clinicians who are appropriately trained 

and qualified to assess the patient’s 

medical and functional status, assess the 

risk for clinical and rehabilitation 

complications, and assess other aspects 

of the patient’s condition both 

medically and functionally. As we 

stated in the final rule, we do not 

believe that non-clinical personnel can 

adequately perform these assessments. 

In the final rule (74 FR 39791), we 

stated that, ‘‘* * * we believe that the 

IRF personnel involved in collecting the 

information for the preadmission 

screening must be appropriately trained 

and qualified to assess the patient’s 

medical and functional status, assess the 

risk for clinical and rehabilitation 

complications, and assess other aspects 

of the patient’s condition both 

medically and functionally’’ (emphasis 

added). As the discussion in which this 

sentence was embedded only pertained 

to clinical staff assessments under 

§ 412.622(a)(4)(A), we should have 

utilized terminology that referenced 

‘‘clinical staff’’ and ‘‘assessment,’’ not 

‘‘IRF personnel’’ and ‘‘collecting.’’ 

Consistent with the discussion in which 

the statement appears, we meant to 

convey that the IRF clinical staff 

conducting the preadmission screening 

must be trained and qualified to make 

the appropriate assessments. The 

appropriate use of non-clinical staff in 

the collection of the information that is 

used in the § 412.622(a)(4)(A) 

assessment is beyond the scope of the 

preamble discussion. Therefore, to 

eliminate any confusion, we are revising 

the sentence in the middle column at 

the top of page 39791 of the final rule 

to read, ‘‘* * * we believe that the 

clinician(s) conducting the 

preadmission screening must be 

appropriately trained and qualified to 

assess the patient’s medical and 

functional status, assess the risk for 

clinical and rehabilitation 

mstockstill on DSKH9S0YB1PROD with RULES

Federal Register / Vol. 74, No. 189 / Thursday, October 1, 2009 / Rules and Regulations 50713 

complications, and assess other aspects 

of the patient’s condition both 

medically and functionally.’’ 

III. Correction of Errors 

In FR Doc. E9–18616 of August 7, 

2009 (74 FR 39762), make the following 

corrections: 

■ 1. On page 39768, in Table 1, in CMG 

0501, under ‘‘Average length of stay,’’ 

tier 2, the value ‘‘0’’ is corrected to read 

‘‘10.’’ 

■ 2. On page 39791, in column 2, in line 

7 from the top, the phrase ‘‘IRF 

personnel involved in collecting the 

information for,’’ is corrected to read, 

‘‘clinician(s) conducting.’’ 

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 rule 

take effect 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 rule 

in accordance with section 553(d) of the 

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

waive both notice and comment 

procedures and the 30-day delay in 

effective date if the Secretary finds, for 

good cause, that such procedures are 

impracticable, unnecessary, or contrary 

to the public interest, and incorporates 

a statement of the finding and the 

reasons into the notice. 

The policies and payment 

methodology expressed in the FY 2010 

IRF PPS final rule (74 FR 39762) have 

previously been subjected to notice and 

comment procedures. This correction 

notice provides technical corrections to 

the FY 2010 final rule that was 

promulgated through notice and 

comment rulemaking, and does not 

make substantive changes to the policies 

or payment methodologies that were 

expressed in the final rule. Therefore, 

we find it unnecessary to undertake 

further notice and comment procedures 

with respect to this correction notice. 

We also believe that it is in the public 

interest (and would be contrary to the 

public interest to do otherwise) to waive 

notice and comment procedures and the 

30-day delay in effective date for this 

notice. This correction notice is 

intended to ensure that the FY 2010 

final rule accurately reflects the policies 

expressed in the final rule, and that the 

correct information is made available to 

the public prior to the effective dates of 

the final rule. Therefore, we find good 

cause to waive notice and comment 

procedures and the 30-day delay in the 

effective date for this correction notice. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: September 25, 2009. 

Dawn L. Smalls, 

Executive Secretary to the Department. 

[FR Doc. E9–23708 Filed 9–30–09; 8:45 am] 

BILLING CODE 4120–01–P 

FEDERAL MARITIME COMMISSION 

46 CFR Parts 501, 502, 503, 504, 506, 

508, 515, 520, 525, 530, 531, 535, 540, 

545, 550, 551, 555, 560, and 565. 

[Docket No. 09–06] 

RIN 3072–AC37 

Recodification of the Shipping Act as 

Positive Law 

September 16, 2009. 

AGENCY: Federal Maritime Commission. 

ACTION: Final rule. 

SUMMARY: This rule amends 

Commission regulations to reflect the 

codification of the Shipping Act as 

positive law. No substantive change is 

involved. 

DATES: Effective Date: October 1, 2009. 

FOR FURTHER INFORMATION CONTACT: 

Karen V. Gregory, Secretary, Federal 

Maritime Commission, 800 North 

Capitol Street, NW., Washington, DC 

20573–0001. (202) 523–5725. E-mail: 

secretary@fmc.gov. 

SUPPLEMENTARY INFORMATION: The House 

of Representatives introduced H.R. 1442 

to complete the codification of title 46, 

United States Code, ‘‘Shipping,’’ as 

positive law, by reorganizing and 

restating the laws previously set forth in 

the appendix to title 46. On October 6, 

2006, H.R. 1442 was enacted as Public 

Law 109–304. This rule changes prior 

references in the Commission 

regulations to reflect the codification 

and involves no substantive changes. 

This rule also corrects typographical 

errors in the Commission regulations. 

Because this rule involves no 

substantive changes, the Commission 

finds, pursuant to 5 U.S.C. 553(b)(B), 

that notice and public procedure on this 

rule is unnecessary. The Chairman of 

the Commission certifies, pursuant to 

section 605(b) of the Regulatory 

Flexibility Act, 5 U.S.C. et seq., that the 

rule will not, if promulgated, have a 

significant economic impact on a 

substantial number of small entities. 

This rule is not a ‘‘major rule’’ under 

5 U.S.C. 804(2). 

List of Subjects 

46 CFR Part 501 

Administrative practice and 

procedure, Authority delegations, 

Organization and functions, Seals and 

insignia. 

46 CFR Part 502 

Administrative practice and 

procedure, Claims, Investigations, 

Lawyers, Penalties, Reporting and 

recordkeeping requirements. 

46 CFR Part 503 

Freedom of information, Sunshine 

Act. 

46 CFR Part 504 

Environmental impact statements, 

Reporting and recordkeeping 

requirements. 

46 CFR Part 506 

Administrative practice and 

procedure, Penalties. 

46 CFR Part 508 

Conflict of interests. 

46 CFR Part 515 

Freight forwarders, Maritime carriers, 

Reporting and recordkeeping 

requirements. 

46 CFR Part 520 

Freight, Intermodal transportation, 

Maritime carriers, Reporting and 

recordkeeping requirements. 

46 CFR Part 525 

Freight, Harbors, Reporting and 

recordkeeping requirements, 

Warehouses. 

46 CFR Part 530 

Freight, Maritime carriers, Reporting 

and recordkeeping requirements. 

46 CFR Part 531 

Freight, Non-vessel-operating 

common carriers, Reporting and 

recordkeeping requirements. 

46 CFR Part 535 

Administrative practice and 

procedure, Maritime carriers, Terminal 

operators, Reporting and recordkeeping 

requirements. 

46 CFR Part 540 

Insurance, Maritime carriers, 

Reporting and recordkeeping 

requirements, Surety bonds. 

46 CFR Part 545 

Antitrust, Maritime carriers. 

46 CFR Part 550 

Administrative practice and 

procedure, Maritime carriers, Penalties. 

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