Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 59675 

PART 81—DESIGNATION OF AREAS 

FOR AIR QUALITY PLANNING 

PURPOSES 

■ 1. The authority citation for part 81 

continues to read as follows: 

Authority: 42 U.S.C. 7401 et seq. 

■ 2. Section 81.350 is amended by 

revising the entry for MilwaukeeRacine, WI in the table entitled 

‘‘Wisconsin—PM2.5 (24-Hour NAAQS)’’ 

to read as follows: 

§ 81.350 Wisconsin. 

* * * * * 

WISCONSIN–2006—24-HOUR PM2.5 NAAQS 

[Primary and Secondary] 

Designated area 

Designationa Classification 

Date1 Type Date 2 Type 

Milwaukee-Racine, WI: 

Milwaukee County .................................. April 22, 2014 ............................. Attainment .................................. .................... ....................

Racine County ........................................ April 22, 2014 ............................. Attainment .................................. .................... ....................

Waukesha County .................................. April 22, 2014 ............................. Attainment .................................. .................... ....................

*******

a Includes Indian Country located in each county or area, except as otherwise specified. 

1This date is 30 days after November 13, 2009, unless otherwise noted. 

2This date is July 2, 2014, unless otherwise noted. 

[FR Doc. 2014–23634 Filed 10–2–14; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 405, 412, 413, 415, 422, 

424, 485, and 488 

[CMS–1607–CN] 

RINs 0938–AS11; 0938–AR12; and 0938– 

AR53 

Medicare Program; Hospital Inpatient 

Prospective Payment Systems for 

Acute Care Hospitals and the LongTerm Care Hospital Prospective 

Payment System and Fiscal Year 2015 

Rates; Quality Reporting Requirements 

for Specific Providers; Reasonable 

Compensation Equivalents for 

Physician Services in Excluded 

Hospitals and Certain Teaching 

Hospitals; Provider Administrative 

Appeals and Judicial Review; 

Enforcement Provisions for Organ 

Transplant Centers; and Electronic 

Health Record (EHR) Incentive 

Program; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical and typographical errors in 

the final rule that appeared in the 

August 22, 2014 Federal Register titled 

‘‘Medicare Program; Hospital Inpatient 

Prospective Payment Systems for Acute 

Care Hospitals and the Long-Term Care 

Hospital Prospective Payment System 

and Fiscal Year 2015 Rates; Quality 

Reporting Requirements for Specific 

Providers; Reasonable Compensation 

Equivalents for Physician Services in 

Excluded Hospitals and Certain 

Teaching Hospitals; Provider 

Administrative Appeals and Judicial 

Review; Enforcement Provisions for 

Organ Transplant Centers; and 

Electronic Health Record (EHR) 

Incentive Program.’’ 

DATES: Effective date: This document is 

effective October 1, 2014. 

FOR FURTHER INFORMATION CONTACT: Ing 

Jye Cheng, (410) 786–4487, Operating 

Prospective Payment, Capital 

Prospective Payment, and New Medical 

Service and Technology Add-On 

Payment Corrections. 

Donald Thompson, (410) 786–6504, 

Operating Prospective Payment, Wage 

Index, and Capital Prospective Payment 

Corrections. 

James Poyer, (410) 786–2261, PPSExempt Cancer Hospital Quality 

Reporting and Hospital Inpatient 

Quality Reporting Corrections. 

Mary Pratt, (410) 786–2261, Longterm Care Hospital Quality Data 

Reporting Corrections. 

Kellie Shannon, (410) 786–0416, 

Administrative Appeals by Providers 

and Judicial Review Corrections. 

Thomas Hamilton, (410) 786–6763, 

Organ Transplant Center Corrections. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2014–18545 which 

appeared in the August 22, 2014 

Federal Register (79 FR 49853), titled 

‘‘Medicare Program; Hospital Inpatient 

Prospective Payment Systems for Acute 

Care Hospitals and the Long-Term Care 

Hospital Prospective Payment System 

and Fiscal Year 2015 Rates; Quality 

Reporting Requirements for Specific 

Providers; Reasonable Compensation 

Equivalents for Physician Services in 

Excluded Hospitals and Certain 

Teaching Hospitals; Provider 

Administrative Appeals and Judicial 

Review; Enforcement Provisions for 

Organ Transplant Centers; and 

Electronic Health Record (EHR) 

Incentive Program’’ (hereinafter referred 

to as the FY 2015 IPPS/LTCH PPS final 

rule), there were a number of technical 

errors that are identified and corrected 

in section IV. of this correcting 

document. The provisions in this 

correction document are effective as if 

they had been included in the FY 2015 

IPPS/LTCH PPS final rule that appeared 

in the August 22, 2014 Federal Register. 

Accordingly, the corrections are 

effective October 1, 2014. 

II. Summary of Errors and Corrections 

to Tables Posted on the CMS Web Site 

A. Summary of Errors in the Preamble 

On page 49865, in our discussion of 

the summary of costs and benefits of the 

payment adjustment of the HospitalAcquired Condition (HAC) Reduction 

Program for FY 2015, we made a 

technical error in the amount by which 

overall payments would decrease. 

On page 49918, in our discussion of 

new technology add-on payments, we 

made an error in the amount of the 

maximum add-on payment for 

Voraxaze®. 

On page 49940, we made an error in 

our discussion of the FY 2015 new 

technology add-on payment for the 


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CardioMEMSTM HF (Heart Failure) 

Monitoring System. 

On pages 50246 through 50249, in the 

table titled ‘‘Previously Adopted 

Hospital IQR Program Measures And 

Measures Newly Finalized in this Final 

Rule for the FY 2017 Payment 

Determination and Subsequent Years,’’ 

we inadvertently listed VTE–3 as a 

‘‘voluntary electronic clinical quality 

measure’’ only and inadvertently 

omitted PN–6 from the table, which 

should have been listed as a voluntary 

electronic clinical quality measure. 

On pages 50279 and 52084, in our 

discussion of the PPS-exempt Cancer 

Hospital Quality Reporting Program 

(PCHQR), we provided a Web site link 

that is not functional due to a 

typographical error, and made other 

typographical and technical errors. 

On pages 50298, 50302, and 50306, 

we made typographical and technical 

errors in our discussion of the LongTerm Care Hospital Quality Reporting 

(LTCHQR) Program. 

On page 50335, we made 

typographical and technical errors in 

our discussion of organ transplant 

centers. 

B. Summary of Errors in the Regulations 

Text 

On page 50350, in the regulations text 

at § 405.1811(c) and § 405.1835(c), we 

made technical errors in specifying the 

requirements regarding a provider’s 

right to contractor or Board hearings 

resulting from untimely contractor 

determinations. 

C. Summary of Errors in the Addendum 

In calculating the final FY 2015 IPPS 

operating and capital rates and impacts, 

we made two technical errors. 

First, there was a technical error in 

our determination of payments under 

the postacute care transfer policy for 

certain MS–DRGs within the ratesetting 

process. Specifically, we inadvertently 

did not treat those MS–DRGs that 

qualified for a special payment under 

the postacute care transfer policy (see 

§ 412.4(f)(6)) in FY 2015 as MS–DRGs 

subject to the postacute care transfer 

policy. Consequently, the FY 2015 

transfer-adjusted case-mix indexes and 

cases used to model IPPS payments in 

the ratesetting process were incorrect, 

and resulted in a miscalculation of the 

operating and capital IPPS budget 

neutrality factors, outlier threshold, 

operating standardized amounts, capital 

Federal rates, and impacts for the FY 

2015 IPPS/LTCH PPS final rule. To 

conform with our established 

methodology, we are recalculating the 

FY 2015 transfer-adjusted case-mix 

indexes and cases used to model IPPS 

payments in the ratesetting process after 

properly treating those MS–DRGs that 

qualified for a special payment under 

the postacute care transfer policy in FY 

2015 as MS–DRGs subject to the 

postacute care transfer policy. 

Therefore, we are recalculating the 

operating and capital IPPS budget 

neutrality factors, outlier threshold, 

operating standardized amounts, capital 

Federal rates, and impacts for FY 2015 

using our established methodology. 

The second error was the inadvertent 

error in identifying claims for indirect 

medical education (IME) payments for 

Medicare Advantage (MA) beneficiaries 

(MA IME claims) in the ratesetting 

process for the FY 2015 IPPS/LTCH PPS 

final rule. Per the methodology 

established in the FY 2011 IPPS/LTCH 

PPS final rule (75 FR 50422 through 

50433), in order to identify IME MA 

claims, we first search the MedPAR file 

for all claims with an IME payment 

greater than zero. Then, we filter these 

claims for a subset of claims with a 

group health organization (GHO) paid 

indicator with a value of ‘‘1’’ or with the 

IME payment field equal to the DRG 

payment field. For the reasons described 

later in this section, in applying this 

methodology for the FY 2015 IPPS/

LTCH PPS final rule, we did not 

identify certain MA IME claims using 

the filter for claims where the IME 

payment field is equal to the DRG 

payment field. 

The Budget Control Act of 2011 

requires mandatory across-the-board 

reductions in Federal spending, also 

known as sequestration. The American 

Taxpayer Relief Act of 2012 postponed 

sequestration for 2 months. As required 

by law, President Obama issued a 

sequestration order on March 1, 2013. 

For FY 2015, we used claims from the 

FY 2013 MedPAR in our ratesetting 

process to determine the operating and 

capital IPPS budget neutrality factors, 

outlier threshold, operating 

standardized amounts, capital Federal 

rates, and the IPPS impact analyses 

presented in the FY 2015 IPPS/LTCH 

PPS final rule. Claims for discharges 

occurring on or after April 1, 2013 had 

the 2-percent reduction for 

sequestration applied to the DRG 

payment field. As a result, in applying 

the methodology described previously 

for the FY 2015 IPPS/LTCH PPS final 

rule, we inadvertently did not properly 

identify certain claims for IME MA 

payments because the DRG payment 

field reflected the 2-percent reduction 

for sequestration (and therefore, the IME 

payment field did not equal the DRG 

payment field for those claims). As 

discussed in the FY 2015 IPPS/LTCH 

PPS final rule (79 FR 50364 and 50365), 

under our established methodology, 

payments for MA IME claims are used 

in our operating IPPS budget neutrality 

calculations. Therefore, the inadvertent 

omission of these MA IME claims 

resulted in a miscalculation of the 

operating budget neutrality calculations. 

(We note this error did not affect the 

calculation of the outlier threshold or 

the MS–DRG relative weights because, 

under our established methodology for 

the respective calculations of these IPPS 

payment factors, we only include claims 

with a ‘‘Claim Type’’ of 60, and the 

claims that were not properly identified 

as MA IME claims did not have a 

‘‘Claim Type’’ of 60.) We are 

recalculating the operating budget 

neutrality factors that are used to 

determine the standardized amounts for 

FY 2015 to conform with our 

established methodology as stated in the 

FY 2015 IPPS/LTCH PPS final rule. 

Specifically, for this correcting 

document, we are restoring the 2- 

percent reduction for sequestration to 

the DRG payment field in order to 

ensure that we properly identify all 

claims where the IME payment field is 

equal to the DRG payment field 

consistent with our established 

methodology. 

As described previously, one or both 

of these two technical errors resulted in 

errors to our calculation of the operating 

and capital IPPS budget neutrality 

factors, outlier threshold, operating 

standardized amounts, capital Federal 

rates, and impacts. As a result of these 

technical errors we are correcting the 

following errors: 

• In the operating and capital budget 

neutrality factors, outlier threshold, 

operating standardized amounts, capital 

Federal rates, and capital IPPS payment 

estimates that appear on the following 

pages of the Addendum of the FY 2015 

IPPS/LTCH PPS final rule: 50367 

through 50370, 50373 and 50374, 50380 

through 50383, 50385 and 50386, 50388 

through 50390, and 50404 (Tables 1A 

through 1D). 

• In the data presented in the tables 

referred to in the FY 2015 IPPS/LTCH 

PPS final rule and available via the 

Internet on the CMS Web site (see 

section II.D. of this correcting 

document). 

• In the operating and capital impacts 

that appear in the following pages of the 

Appendices of the FY 2015 IPPS/LTCH 

PPS final rule: 50405, 50407, 50409 

through 50418, 50420 through 50429, 

50435 and 50436, and 50446. 

The errors described previously also 

affect the calculation of the Hospital 

Readmissions Reduction Program 

payment adjustment factors and the 

Hospital Value-Based Purchasing (VBP) 


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Program payment adjustment factors for 

FY 2015. The readmissions payment 

adjustment factor is based in part on a 

ratio of a hospital’s ‘‘aggregate payment 

for excess readmissions’’ and its 

‘‘aggregate payments for all discharges.’’ 

We use Medicare Part A inpatient 

claims from the MedPAR file as our data 

source for determining aggregate 

payments for excess readmissions and 

aggregate payments for all discharges. 

For FY 2015, we use MedPAR claims 

with discharge dates on or after July 1, 

2010 and no later than June 30, 2013 to 

calculate the ratio used in determining 

the readmissions payment adjustment 

factors. Under the Hospital VBP 

Program, the Secretary reduces the base 

operating DRG payment amount for an 

eligible hospital for each discharge in a 

fiscal year by an applicable percent. The 

sum total of these reductions in a fiscal 

year must equal the total amount 

available for value-based incentive 

payments for all eligible hospitals for 

the fiscal year, as estimated by the 

Secretary. We use a linear exchange 

function to translate this estimated 

amount available into a value-based 

incentive payment percentage for each 

hospital, based on its total performance 

score (TPS). We then calculate the 

value-based incentive payment 

adjustment factor for each hospital and 

apply that factor to the base-operating 

DRG payment amount for each 

discharge occurring at that hospital in 

FY 2015 on a per claim basis. We 

finalized the methodology for using base 

operating DRG payment amounts 

derived from the MedPAR file in the 

calculation of the value-based incentive 

payment adjustment factors in the FY 

2013 IPPS/LTCH PPS final rule (77 FR 

53574 and 53575). In the FY 2015 IPPS/ 

LTCH PPS final rule (79 FR 50049), 

based on the March 2014 update of the 

FY 2013 MedPAR file (that is, MedPAR 

Part A claims with discharge dates on or 

after October 1, 2012 and on or before 

September 30, 2013), we estimated that 

the amount available for value-based 

incentive payments for FY 2015 is $1.4 

billion (the applicable percent for the 

FY 2015 Hospital VBP Program is 1.50 

percent). 

We use the same methodology 

described previously to identify only 

Medicare Part A claims in the MedPAR 

file and to remove IME MA claims when 

calculating the Hospital Readmissions 

Reduction Program and the Hospital 

VBP Program payment adjustment 

factors. In addition, we use the claims 

in the MedPAR file to determine the 

base operating DRG payment amounts 

used in the calculation of these payment 

adjustment factors. Consequently, in 

determining the base-operating DRG 

payment amounts used in our 

calculation of the proxy readmissions 

adjustment factors (Table 15A) and the 

updated proxy Hospital VBP payment 

adjustment factors (Table 16A) for the 

FY 2015 IPPS/LTCH PPS final rule, we 

inadvertently failed to properly exclude 

all of the IME MA claims, and also 

inadvertently included the 2-percent 

sequestration reduction for claims in the 

FY 2013 MedPAR with a discharge date 

after April 1, 2013. Therefore, to 

properly account for how sequestration 

is reflected in the FY 2013 MedPAR 

data in the calculation of these payment 

adjustment factors, we restored the 2- 

percent sequestration reduction to the 

DRG payment field on the MedPAR 

claim (as described previously). This 

correction ensures that we identify and 

remove all IME MA claims when the 

IME payment field is equal to the DRG 

payment field and correctly determine 

the base-operating DRG payment 

amount used in the calculation of the 

readmission and Hospital VBP payment 

adjustment factors for FY 2015. 

At the time of the issuance of the FY 

2015 IPPS/LTCH PPS final rule, under 

the Hospital Readmissions Reduction 

Program, applicable hospitals had not 

yet had the opportunity to review and 

correct data from the FY 2015 

applicable period before they were 

made public under our policy regarding 

the reporting of hospital-specific 

information. Therefore, in Table 15A 

listed in the Addendum of the FY 2015 

IPPS/LTCH PPS final rule, we provided 

proxy FY 2015 readmission payment 

adjustment factors, and stated that we 

expected to publish the final FY 2015 

readmissions payment adjustment 

factors in Table 15B on the CMS IPPS 

Web site by October 2014, and would 

use those final factors for determining 

payments for discharges occurring on or 

after October 1, 2014 (79 FR 50048). 

Similarly, in the final rule, we provided 

updated proxy value-based incentive 

payment adjustment factors for FY 2015 

in Table 16A listed in the Addendum of 

that final rule to reflect changes based 

on the March 2014 update to the FY 

2013 MedPAR file. These updated proxy 

value-based incentive payment 

adjustment factors for FY 2015 were 

based on historic FY 2014 Program TPSs 

because hospitals had not been given 

the opportunity to review and correct 

their actual TPSs for the FY 2015 

Hospital VBP Program at the time we 

issued that final rule. We stated that 

after hospitals had been given an 

opportunity to review and correct their 

actual TPSs for FY 2015, we would 

publish Table 16B to display the actual 

value-based incentive payment 

adjustment factors, and that we 

expected Table 16B to be posted on the 

CMS Web site in October 2014 (79 FR 

50049). 

The review and corrections period for 

the data from the FY 2015 applicable 

period under the Hospital Readmissions 

Reduction Program resulted in no 

changes to the proxy adjustment factors 

shown in Table 15A. However, the 

calculation of the FY 2015 readmissions 

payment adjustment factors was affected 

by the inadvertent errors resulting from 

our use of claims in the FY 2013 

MedPAR with a discharge date after 

April 1, 2013 without properly 

accounting for how sequestration was 

reflected in those data. Because we use 

claims data from July 1, 2010 to June 30, 

2013 to calculate the FY 2015 

readmissions payment adjustment 

factors, only a portion of that data (that 

is, the claims between April 1, 2013 and 

June 30, 2013) was impacted by the 

errors described previously. As a result 

of the correction of those errors, the FY 

2015 readmissions payment adjustment 

factors have changed for 60 hospitals. 

The final FY 2015 readmissions 

payment adjustment factors, which were 

calculated after correcting the errors 

discussed previously, are posted in 

Table 15B on the CMS Web site at: 

http://www.cms.gov/Medicare/ 

Medicare-Fee-for-Service-Payment/ 

AcuteInpatientPPS/index.html. (Click 

on the link on the left side of the screen 

titled, ’’FY 2015 IPPS Final Rule Home 

Page’’ or ’’Acute Inpatient—Files for 

Download’’.) As noted previously, the 

final FY 2015 readmissions payment 

adjustment factors in Table 15B will be 

used for determining payments for 

discharges occurring on or after October 

1, 2014. After accounting for these 

corrections in determination of the FY 

2015 readmissions payment adjustment 

factors, we are revising the estimated 

savings under the Hospital 

Readmissions Reduction Program to 

$428 million, from $424 million in the 

FY 2015 IPPS/LTCH PPS final rule (79 

FR 50425). 

We note that we are not correcting the 

proxy FY 2015 readmissions payment 

adjustment factors for FY 2015 shown in 

Table 15A or the updated proxy valuebased incentive payment adjustment 

factors for FY 2015 shown in Table 16A. 

However, consistent with the 

methodology for calculating the 

operating budget neutrality factors for 

the FY 2015 IPPS/LTCH PPS final rule 

(79 FR 50366), we used corrected proxy 

payment adjustment factors in the 

recalculation of the IPPS rates for this 

correcting document. These factors can 

be found in the IPPS Impact File that 


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corresponds to this correcting document 

which is available on the CMS Web site. 

(We note that the description of the 

methodology for calculating the 

operating budget neutrality factors 

contained errors that are summarized 

later in the section and corrected in 

section IV.C.1. of this correcting 

document). The proxy factors in Table 

15A were provided for informational 

purposes and they are not used for 

payment adjustment purposes and the 

final FY 2015 readmissions payment 

adjustment factors in Table 15B will be 

used for determining payments for 

discharges occurring on or after October 

1, 2014 (79 FR 50048). Similarly, the 

proxy factors in Table 16A were 

provided for informational purposes, 

according to the methodology finalized 

in the FY 2013 IPPS/LTCH final rule (77 

FR 53576), and they are not used for 

payment adjustment purposes. As stated 

in the FY 2015 IPPS/LTCH PPS final 

rule, we intend to post the actual 

Hospital VBP Program payment 

adjustment factors, as Table 16B, in 

October of 2014, after hospitals have 

had an opportunity to review and 

correct their TPSs. 

On page 50366, we made an error in 

the description of our budget neutrality 

methodology with respect to the 

readmissions payment adjustment 

factors that we used for the purpose of 

modeling aggregate payments when 

determining all budget neutrality 

factors. As we discussed in the FY 2015 

IPPS/LTCH PPS final rule (79 FR 

50048), for that final rule we determined 

proxy FY 2015 readmission payment 

adjustment factors (shown in Table 

15A), which were calculated based on 

data from the FY 2015 applicable period 

of July 1, 2010 to June 30, 2013. 

In addition, we made a typographical 

error in the March 2013 and 2014 

operating national average case 

weighted cost-to charge ratios (CCRs) set 

forth in the FY 2015 IPPS/LTCH PPS 

final rule. Also, we made a technical 

error in the calculation of the capital 

CCR adjustment factor that is applied to 

determine the capital CCRs used in our 

ratesetting process. This inadvertent 

technical error caused a miscalculation 

of the capital CCRs used in the 

determination of the operating and 

capital budget neutrality factors and the 

calculation of the outlier threshold for 

the FY 2015 IPPS/LTCH PPS final rule. 

Therefore, we are correcting the capital 

CCR adjustment factor and the capital 

CCRs used in our determination of the 

operating and capital budget neutrality 

factors as well as our calculation of the 

outlier threshold. 

Lastly, we made technical and 

typographical errors in the table heading 

for Table 2–2 which is listed in the 

Addendum of the FY 2015 IPPS/LTCH 

PPS final rule as one of the tables that 

are only available through the Internet 

on the CMS Web site (page 50403). 

D. Corrections to Tables Posted on the 

CMS Web Site 

The following corrections are being 

made to the tables listed on pages 50402 

and 50403 of the FY 2015 IPPS/LTCH 

PPS final rule that are only available 

through the Internet on the CMS Web 

site at http://www.cms.gov/Medicare/ 

Medicare-Fee-for-Service-Payment/ 

AcuteInpatientPPS/index.html. 

In Table 2–2.—Acute Care Hospitals 

Case-Mix Indexes for Discharges 

Occurring in Federal Fiscal Year 2012; 

Hospital Wage Indexes for Federal 

Fiscal Year 2015; Hospital Average 

Hourly Wages for Federal Fiscal Years 

2013 (2009 Wage Data), 2014 (2010 

Wage Data), and 2015 (2011 Wage Data; 

Based on FY 2015 CBSA Delineations); 

and 3-Year Average of Hospital Average 

Hourly Wages, we are correcting the 

table heading as noted in section II.C. of 

this correcting document. We are also 

correcting the entries in column ‘‘FY 

2015 Wage Index’’ as a result of the 

technical errors discussed in section 

II.C. of this correcting document. 

We are correcting the following tables 

in the entirety as a result of the 

technical errors discussed in section 

II.C. of this correcting document: 

• Table 4A–1.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Acute Care Hospitals in Urban 

Areas by CBSA and by State—FY 2015; 

Based on CBSA Delineations Used in FY 

2014. 

• Table 4A–2.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Acute Care Hospitals in Urban 

Areas by CBSA and by State—FY 2015; 

Based on CBSA Delineations Used in FY 

2015. 

• Table 4B–1.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Acute Care Hospitals in Rural 

Areas by CBSA and by State—FY 2015; 

Based on CBSA Delineations Used in FY 

2014. 

• Table 4B–2.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Acute Care Hospitals in Rural 

Areas by CBSA and by State—FY 2015; 

Based on FY 2015 CBSA Delineations. 

• Table 4C–1.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Acute Care Hospitals That Are 

Reclassified by CBSA and by State—FY 

2015; Based on CBSA Delineations Used 

in FY 2014. 

• Table 4C–2.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Acute Care Hospitals That Are 

Reclassified by CBSA and by State—FY 

2015; Based on CBSA Delineations Used 

in FY 2015. 

• Table 4D–1.—States Designated as 

Frontier, with Acute Care Hospitals 

Receiving at a Minimum the Frontier 

State Floor Wage Index; Urban Areas 

with Acute Care Hospitals Receiving the 

Statewide Rural Floor or Imputed Floor 

Wage Index—FY 2015; Based on CBSA 

Delineations Used in FY 2014. 

• Table 4D–2.—States Designated as 

Frontier, with Acute Care Hospitals 

Receiving at a Minimum the Frontier 

State Floor Wage Index; Urban Areas 

with Acute Care Hospitals Receiving the 

Statewide Rural Floor or Imputed Floor 

Wage Index—FY 2015; Based on CBSA 

Delineations Used in FY 2015. 

• Table 4J.—Out-Migration 

Adjustment for Acute Care Hospitals— 

FY 2015 

• Table 10.—New Technology AddOn Payment Thresholds 1,2 for 

Applications for FY 2016. 

Table 5.—List of Medicare Severity 

Diagnosis-Related Groups (MS–DRGs), 

Relative Weighting Factors, and 

Geometric and Arithmetic Mean Length 

of Stay—FY 2015. We are correcting this 

table by correcting typographical and 

technical errors in the columns titled 

‘‘Geometric Mean LOS’’ and 

‘‘Arithmetic Mean LOS’’. 

Table 8B.—FY 2015 Statewide 

Average Capital Cost-to-Charge Ratios 

(CCRs) for Acute Care Hospitals. We are 

correcting typographical and technical 

errors in this table. 

Table 18.—FY 2015 Medicare DSH 

Uncompensated Care Payment Factor 3 

and Supplemental Medicare DSH File— 

FY 2015 Uncompensated Care Payment 

Factors. For the FY 2015 IPPS/LTCH 

PPS final rule, we published a list of 

hospitals that we identified to be 

subsection (d) hospitals and subsection 

(d) Puerto Rico hospitals eligible to 

receive empirically justified Medicare 

DSH payment adjustments and 

uncompensated care payments for FY 

2015. As stated in the FY 2015 IPPS/

LTCH PPS final rule (79 FR 50022), we 

allowed the public an additional period 

after the issuance of the final rule to 

review and submit comments on the 

accuracy of the list of mergers that we 

identified in the final rule. Based on the 

comments received during this 

additional period, we are updating 

Table 18 and the Supplemental 

Medicare DSH File to reflect the merger 

information received in response to the 

final rule and are also making one other 

correction to Table 18 and the 

Supplemental Medicare DSH File. We 

have discovered that in calculating 

Factor 3 of the uncompensated care 

payment methodology, we inadvertently 


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excluded the Medicaid days from the 

most recently available 2012 or 2011 

cost report for a certain provider that 

was projected to receive Medicare DSH 

in FY 2015. This provider submitted its 

Medicare hospital cost reports to its 

Medicare contractor prior to the March 

2014 update of HCRIS but due to 

technical errors the Medicare hospital 

cost reports were not included in the 

March 2014 update of HCRIS. As a 

result, this provider had no Medicaid 

days included in the calculation of 

Factor 3. In order to correct this error, 

we have revised Factor 3 for all 

hospitals to incorporate the changes to 

the data for this provider whose 

Medicare hospital cost report data were 

inadvertently excluded from the March 

2014 update of HCRIS. 

E. Summary of Errors in the Appendices 

On page 50428, in our discussion of 

the effects of the new technology addon payment policy, we made an error in 

the costs of the add-on payments for 

Voraxaze® for FY 2015. 

On pages 50405, 50407, and 50409 

through 50429; we made errors in the 

operating impacts as described in 

section II.C. of this correcting document. 

On pages 50435 through 50437, we 

made errors in the capital impacts as 

described in section II.C. of this 

correcting document. 

On page 50446, we made an error in 

the estimated expenditures under the 

IPPS as a result of the errors described 

in section II.C. of this correcting 

document. 

III. Waiver of Proposed Rulemaking 

and Delay in 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)). However, 

we can waive this notice and comment 

procedure if the Secretary finds, for 

good cause, that the notice and 

comment process is impracticable, 

unnecessary, or contrary to the public 

interest, and incorporates a statement of 

the finding and the reasons therefore in 

the notice. 

Section 553(d) of the APA ordinarily 

requires a 30-day delay in effective date 

of final rules after the date of their 

publication in the Federal Register. 

This 30-day delay in effective date can 

be waived, however, if an agency finds 

for good cause that the delay is 

impracticable, unnecessary, or contrary 

to the public interest, and the agency 

incorporates a statement of the findings 

and its reasons in the rule issued. 

In our view, this correcting document 

does not constitute a rule that would be 

subject to the APA notice and comment 

or delayed effective date requirements. 

This correcting document corrects 

technical and typographic errors in the 

preamble, regulation text, addendum, 

payment rates, tables, and appendices 

included or referenced in the FY 2015 

IPPS/LTCH PPS final rule but does not 

make substantive changes to the policies 

or payment methodologies that were 

adopted in the final rule. As a result, 

this correcting document is intended to 

ensure that the information in the FY 

2015 IPPS/LTCH PPS final rule 

accurately reflects the policies adopted 

in that final rule. 

In addition, even if this were a rule to 

which the notice and comment 

procedures and delayed effective date 

requirements applied, we find that there 

is good cause to waive such 

requirements. Undertaking further 

notice and comment procedures to 

incorporate the corrections in this 

document into the final rule or delaying 

the effective date would be contrary to 

the public interest because it is in the 

public’s interest for providers to receive 

appropriate payments in as timely a 

manner as possible, and to ensure that 

the FY 2015 IPPS/LTCH PPS final rule 

accurately reflects our policies. 

Furthermore, such procedures would be 

unnecessary, as we are not altering our 

payment methodologies or policies, but 

rather, we are simply implementing 

correctly the policies that we previously 

proposed, received comment on, and 

subsequently finalized. This correcting 

document is intended solely to ensure 

that the FY 2015 IPPS/LTCH PPS final 

rule accurately reflects these payment 

methodologies and policies. Therefore, 

we believe we have good cause to waive 

the notice and comment and effective 

date requirements. 

IV. Correction of Errors 

In FR Doc. 2014–18545 of August 22, 

2014 (79 FR 49853), make the following 

corrections: 

A. Corrections of Errors in the Preamble 

1. On page 49865, third column, third 

bulleted paragraph, line 12, the figure 

‘‘$369’’ is corrected to read ‘‘$373’’. 

2. On page 49918, second column, 

first partial paragraph: 

a. Lines 7 through 12, the sentences 

‘‘The cost of Voraxaze® is $22,500 per 

vial. The applicant stated that an 

average of four vials is used per 

Medicare beneficiary. Therefore, the 

average cost per case for Voraxaze® is 

$90,000 ($22,500 × 4).’’ are corrected to 

read ‘‘Based on the latest data from the 

manufacturer, the cost of Voraxaze® is 

$23,625 per vial. The applicant stated 

that an average of four vials is used per 

Medicare beneficiary. Therefore, the 

average cost per case for Voraxaze® is 

$94,500 ($23,625 × 4).’’ 

b. Lines 18 through 20, the sentence 

‘‘As a result, the maximum new 

technology add-on payment for 

Voraxaze® is $45,000 per case.’’ is 

corrected to read ‘‘As a result, based on 

the latest data from the manufacturer, 

the maximum new technology add-on 

payment for Voraxaze® for FY 2015 is 

$47,250 per case.’’ 

3. On page 49940, third column, last 

paragraph, fourth line from the bottom, 

the phrase ‘‘the maximum payment’’ is 

corrected to read ‘‘the maximum add-on 

payment’’. 

4. On pages 50246 through 50249, the 

table titled ‘‘Previously Adopted 

Hospital IQR Program Measures and 

Measures Newly Finalized in this Final 

Rule for the FY 2017 Payment 

Determination and Subsequent Years’’ is 

corrected as follows: 

a. Adding the following entry (short 

name VTE–3) immediately preceding 

the entry VTE–5: 

Short 

name Measure name NQF No. Submission methods for FY 2017 New for FY 2017 

VTE–3 Venous thromboembolism patients with anticoagulation 

overlap therapy.

NQF #0373 Electronic clinical quality 

measure or chart-abstracted REQUIRED.

b. Removing the entry for VTE–3 that 

follows the entry for Stroke-10. 

c. Adding the following entry for PN– 

6 immediately preceding the entry for 

VTE–4: 


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59680 Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 

Short 

name Measure name NQF No. Submission methods for FY 2017 New for FY 2017 

PN–6 ... Initial Antibiotic Selection for community-acquired pneumonia (CAP) in Immunocompetent Patients.NQF #0147 Electronic clinical quality 

measure.

Voluntary electronic clinical 

quality measure. 

5. On 50279, second column, second 

full paragraph, lines 10 through 13, the 

hyperlink, ‘‘http://www.Fqualityforum.

Forg/WorkArea/linkit.aspx

?LinkIdentifier=id&ItemID=70374’’ is 

corrected to read ‘‘http://www.quality

forum.org/WorkArea/linkit.aspx

?LinkIdentifier=id&ItemID=70374.’’ 

6. On page 50284: 

a. Second column, first partial 

paragraph: 

(1) Line 7, the phrase ‘‘However the 

six’’ is corrected to read ‘‘However for 

the six’’. 

(2) Line 12, the phrase ‘‘four quarters 

data’’ is corrected to read ‘‘four quarters 

of data’’. 

b. Third column, third full paragraph, 

lines 14 and 15, the parenthetical phase 

‘‘(and not limited to orthopedic 

surgeries)’’ is corrected to read ‘‘(and are 

not limited to orthopedic surgeries)’’. 

7. On page 50298, second column, 

first partial paragraph, line 6, the phrase 

‘‘the CAM® Instrument’’ is corrected to 

read ‘‘the short CAM® instrument’’. 

8. On page 50302, third column, 

second full paragraph, lines 3 and 4, the 

phrase ‘‘of long-term mechanical 

ventilation’’ is corrected to read ‘‘with 

patients on prolonged mechanical 

ventilation’’. 

9. On page 50306, lower two-thirds of 

the page, third column, partial 

paragraph, lines 18 and 19, the phrase 

‘‘tobacco performance measure set’’ is 

corrected to read ‘‘tobacco treatment 

performance measure set’’. 

10. On page 50335, first column, first 

full paragraph: 

a. Line 34, the phrase ‘‘that because 

available’’ is corrected to read ‘‘that 

became available’’. 

b. Lines 38 and 39, the phrase ‘‘not 

enter into an SIA’’ is corrected to read 

‘‘not entered into an SIA’’. 

B. Corrections of Errors in the 

Regulation Text 

§ 405.1811 [Corrected] 

1. On page 50350, in the first column, 

in § 405.1811(c) introductory text, lines 

7 and 8, the phrase ‘‘for a cost reporting 

period if—’’ is corrected to read ‘‘for 

specific items for a cost reporting period 

if—’’. 

§ 405.1835 [Corrected] 

2. On page 50350, in the third 

column, in § 405.1835(c), in lines 7 

through 9, the phrase ‘‘for specific items 

claimed for a cost reporting period 

if—’’ is corrected to read ‘‘for specific 

items for a cost reporting period if—’’. 

C. Corrections of Errors in the 

Addendum 

1. On page 50366, first column, first 

full paragraph the paragraph beginning 

with the phrase ‘‘For the purpose of 

calculating the FY’’ and ending with the 

phrase ‘‘to the FY 2013 IPPS/LTCH PPS 

final rule (77 FR 53399 through 

53400).)’’ is corrected to read as follows: 

‘‘For the purpose of calculating the 

proposed FY 2015 readmissions 

payment adjustment factors in the 

proposed rule, we used excess 

readmission ratios and aggregate 

payments for excess readmissions based 

on admissions from the prior fiscal 

year’s applicable period because 

hospitals have had the opportunity to 

review and correct these data before the 

data were made public under the policy 

we adopted regarding the reporting of 

hospital-specific readmission rates, 

consistent with section 1886(q)(6) of the 

Act. As discussed in section IV.H.11. of 

this preamble, because the review and 

corrections period will still be ongoing 

through August 19, 2014, which extends 

beyond the issuance of this FY 2015 

IPPS/LTCH PPS final rule, we are 

calculating proxy FY 2015 readmissions 

payment adjustment factors using 

excess readmission ratios and aggregate 

payments for excess readmissions based 

on admissions from the finalized 

applicable period for FY 2015. We will 

determine the final readmissions 

payment adjustment factors that will be 

used for payments in FY 2015 after the 

completion of the review and correct 

process. (For additional information on 

our general policy for the reporting of 

hospital-specific readmission rates, 

consistent with section 1886(q)(6) of the 

Act, we refer readers to the FY 2013 

IPPS/LTCH PPS final rule (77 FR 53399 

through 53400).)’’ 

2. On page 50367, third column, first 

full paragraph: 

a. Line 3, the figure ‘‘0.997543’’ is 

corrected to read ‘‘0.998761’’. 

b. Line 8, the figure ‘‘0.997543’’ is 

corrected to read ‘‘0.998761’’. 

3. On page 50368: 

a. First column, first partial 

paragraph, line 19, the figure 

‘‘0.997543’’ is corrected to read 

‘‘0.998761’’. 

b. Third column: 

(1) First partial paragraph, line 11, the 

figure ‘‘0.997543’’ is corrected to read 

‘‘0.998761’’. 

(2) Last paragraph: 

(a) Line 9, the figure ‘‘1.001443’’ is 

corrected to read ‘‘1.001421’’. 

(b) Line 13, the figure ‘‘0.997543’’ is 

corrected to read ‘‘0.998761’’. 

(c) Line 15, the figure ‘‘1.001443’’ is 

corrected to read ‘‘1.001421’’. 

(d) Line 21, the figure ‘‘0.998982’’ is 

corrected to read ‘‘1.000180’’. 

4. On page 50369, first column, last 

partial paragraph, line 13, the figure 

‘‘0.990406’’ is corrected to read 

‘‘0.990429’’. 

5. On page 50370, first column, 

second full paragraph: 

a. Line 3, the figure ‘‘0.989507’’ is 

corrected to read ‘‘0.989525’’. 

b. Line 5, the figure ‘‘0.991291’’ is 

corrected to read ‘‘0.991293’’. 

6. On page 50373: 

a. First column, last paragraph, line 3, 

the figure ‘‘0.998859’’ is corrected to 

read ‘‘0.998854’’. 

b. Second column, first partial 

paragraph, line 1, the figure ‘‘0.998859’’ 

is corrected to read ‘‘0.998854’’. 

7. On page 50374, second column, 

second full paragraph, line 5, the figure 

‘‘0.99931’’ is corrected to read 

‘‘0.999313’’. 

8. On page 50380: 

a. First column: 

(1) First paragraph: 

(a) Line 4, the figure ‘‘0.292377’’ is 

corrected to read ‘‘0.292376’’. 

(b) Line 6, the figure ‘‘0.28714’’ is 

corrected to read ‘‘0.287139’’. 

(2) Second paragraph: 

(a) Line 7, the figure ‘‘0.024849’’ is 

corrected to read ‘‘0.024649’’. 

(b) Line 18, the figure ‘‘0.988307’’ is 

corrected to read ‘‘0.980352’’. 

c. Third column, second full 

paragraph, line 9, the figure ‘‘$24,758’’ 

is corrected to read ‘‘$24,626’’. 

9. On page 50381: 

a. First column: 

(1) First full paragraph, line 15, the 

figure ‘‘6.27’’ is corrected to read ‘‘6.18’’. 

(2) Third full paragraph, the table is 

corrected to read as follows: 


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Operating 

standardized 

amounts 

Capital federal 

rate 

National ............................................................................................................................................................ 0.948999 0.938237 

Puerto Rico ...................................................................................................................................................... 0.926334 0.916334 

b. Third column, third full paragraph: 

(1) Line 4, the figure ‘‘5.71’’ is 

corrected to read ‘‘5.68’’. 

(2) Line 6, the figure ‘‘0.61’’ is 

corrected to read ‘‘0.58’’. 

(3) Line 10, the figure ‘‘5.71’’ is 

corrected to read ‘‘5.68’’. 

10. On pages 50382 and 50383, the 

table titled, ‘‘Comparison of FY 2014 

Standardized Amounts to the FY 2015 

Standardized Amounts’’ is corrected to 

read as follows: 

COMPARISON OF FY 2014 STANDARDIZED AMOUNTS TO THE FY 2015 STANDARDIZED AMOUNTS

Hospital submitted 

quality data 

and is a meaningful 

EHR user 

Hospital submitted 

quality data 

and is NOT a meaningful EHR user 

Hospital did NOT submit quality data 

and is a meaningful 

EHR user 

Hospital did NOT submit quality data 

and is NOT a meaningful EHR user 

FY 2014 Base Rate after removing: 

1. FY 2014 Geographic Reclassification 

Budget Neutrality (0.990718).

2. FY 2014 Rural Community Hospital 

Demonstration Program Budget Neutrality (0.999415).

3. Cumulative Factor: FY 2008, FY 

2009, FY 2012, FY 2013, and FY 

2014 Documentation and Coding Adjustment as Required under Sections 

7(b)(1)(A) and 7(b)(1)(B) of Pub. L. 

110–90 and Documentation and Coding Recoupment Adjustment as required under Section 631 of the American Taxpayer Relief Act of 2012 

(0.9403).

4. FY 2014 Operating Outlier Offset 

(0.948995).

If Wage Index is 

Greater Than 

1.0000: Labor 

(69.6%): $4,230.38 

Nonlabor (30.4%): 

$1,847.75.

If Wage Index is less 

Than or Equal to 

1.0000: Labor 

(62%): $3,768.45 

Nonlabor (38%): 

$2,309.70.

If Wage Index is 

Greater Than 

1.0000: Labor 

(69.6%): $4,230.38 

Nonlabor (30.4%): 

$1,847.75.

If Wage Index is less 

Than or Equal to 

1.0000: Labor 

(62%): $3,768.45 

Nonlabor (38%): 

$2,309.70.

If Wage Index is 

Greater Than 

1.0000: Labor 

(69.6%): $4,230.38 

Nonlabor (30.4%): 

$1,847.75.

If Wage Index is less 

Than or Equal to 

1.0000: Labor 

(62%): $3,768.45 

Nonlabor (38%): 

$2,309.70.

If Wage Index is 

Greater Than 

1.0000: Labor 

(69.6%): $4,230.38 

Nonlabor (30.4%): 

$1,847.75. 

If Wage Index is less 

Than or Equal to 

1.0000: Labor 

(62%): $3,768.45 

Nonlabor (38%): 

$2,309.70. 

FY 2015 Update Factor ................................. 1.022 .......................... 1.01475 ...................... 1.01475 ...................... 1.0075. 

FY 2015 MS-DRG Recalibration and Wage 

Index Budget Neutrality Factor.

1.000180 .................... 1.000180 .................... 1.000180 .................... 1.000180. 

FY 2015 Reclassification Budget Neutrality 

Factor.

0.990429 .................... 0.990429 .................... 0.990429 .................... 0.990429. 

FY 2015 Rural Community Demonstration 

Program Budget Neutrality Factor.

0.999313 .................... 0.999313 .................... 0.999313 .................... 0.999313. 

FY 2015 Operating Outlier Factor ................. 0.948999 .................... 0.948999 .................... 0.948999 .................... 0.948999. 

Cumulative Factor: FY 2008, FY 2009, FY 

2012, FY 2013, FY 2014 and FY 2015 

Documentation and Coding Adjustment as 

Required under Sections 7(b)(1)(A) and 

7(b)(1)(B) of Pub. L. 110–90 and Documentation and Coding Recoupment Adjustment as required under Section 631 of 

the American Taxpayer Relief Act of 2012.

0.9329 ........................ 0.9329 ........................ 0.9329 ........................ 0.9329. 

FY 2015 New Labor Market Delineation 

Wage Index Transition Budget Neutrality 

Factor.

0.998854 .................... 0.998854 .................... 0.998854 .................... 0.998854. 

National Standardized Amount for FY 2015 if 

Wage Index is Greater Than 1.0000; 

Labor/Non-Labor Share Percentage (69.6/

30.4).

Labor: $3,784.75 

Nonlabor: $1,653.10.

Labor: $3,757.90 

Nonlabor: $1,641.37.

Labor: $3,757.90 

Nonlabor: $1,641.37.

Labor: $3,731.05 

Nonlabor: 

$1,629.65. 

National Standardized Amount for FY 2015 if 

Wage Index is less Than or Equal to 

1.0000; Labor/Non-Labor Share Percentage (62/38).

Labor: $3,371.47 

Nonlabor: $2,066.38.

Labor: $3,347.55 

Nonlabor: $2,051.72.

Labor: $3,347.55 

Nonlabor: $2,051.72.

Labor: $3,323.63 

Nonlabor: 

$2,037.07. 

11. On page 50383, the table titled, 

‘‘Comparison of FY 2014 Puerto RicoSpecific Payment Rate to the FY 2015 

Puerto Rico-Specific Payment Rate’’ is 

corrected to read as follows: 


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COMPARISON OF FY 2014 PUERTO RICO-SPECIFIC PAYMENT RATE TO THE FY 2015 PUERTO RICO-SPECIFIC PAYMENT

RATE

Update (2.2 percent); wage index is greater 

than 1.0000; labor/non-labor share 

percentage (63.2/36.8) 

Update (2.2 percent); Wage index is less than 

or equal to 1.0000; labor/non-labor share percentage (62/38) 

FY 2014 Puerto Rico Base Rate, after removing: 

1. FY 2014 Geographic Reclassification 

Budget Neutrality (0.990718).

2. FY 2014 Rural Community Hospital 

Demonstration Program Budget Neutrality (0.999415).

3. FY 2014 Puerto Rico Operating Outlier 

Offset (0.943455).

Labor: $1,722.31 Nonlabor: $1,002.86 ............ Labor: $1,689.61 Nonlabor: $1,035.56. 

FY 2015 Update Factor ...................................... 1.022 ................................................................ 1.022. 

FY 2015 MS-DRG Recalibration Budget Neutrality Factor.0.998761 .......................................................... 0.998761. 

FY 2015 Reclassification Budget Neutrality Factor.0.990429 .......................................................... 0.990429. 

FY 2015 Rural Community Hospital Demonstration Program Budget Neutrality Factor.0.999313 .......................................................... 0.999313. 

FY 2015 New Labor Market Delineation Wage 

Index Transition Budget Neutrality Factor.

0.998854 .......................................................... 0.998854. 

FY 2015 Puerto Rico Operating Outlier Factor .. 0.926334 .......................................................... 0.926334. 

Puerto Rico-Specific Payment Rate for FY 2015 Labor: $1,609.97 Nonlabor: $937.45 ............... Labor: $1,579.40 Nonlabor: $968.02. 

12. On page 50385, lower half of the 

page, first column, second paragraph, 

line 15, the figure ‘‘0.997543’’ is 

corrected to read ‘‘0.998761’’. 

13. On page 50386, second column, 

last partial paragraph, line 6, the figure 

‘‘1.2’’ is corrected to read ‘‘1.3’’. 

14. On page 50388: 

a. First column: 

(1) Second full paragraph: 

(a) Line 9, the figure ‘‘6.27’’ is 

corrected to read ‘‘6.18’’. 

(b) Line 13, the figure ‘‘0.9373’’ is 

corrected to read ‘‘0.9382’’ 

(2) Third full paragraph: 

(a) Line 6, the phrase ‘‘0.9373 is a 

¥0.21 percent’’ is corrected to read 

‘‘0.9382 is a ¥0.12 percent’’. 

(b) Line 11, the mathematical 

expression ‘‘0.9979 (0.9373/0.9393)’’ is 

corrected to read ‘‘0.9988 (0.9382/

0.9393)’’. 

(c) Line 13, the figure ‘‘0.21 percent’’ 

is corrected to read ‘‘0.12 percent’’ 

b. Second column, second full 

paragraph: 

(1) Line 12, the figure ‘‘0.9987’’ is 

corrected to read’’0.9994’’. 

(2) Line 17, the figure ‘‘0.9877’’ is 

corrected to read ‘‘0.9884’’. 

(3) Line 18, the figure ‘‘1.0075’’ is 

corrected to read ‘‘1.0082’’. 

c. Third column: 

(1) Third full paragraph, line 9, the 

figure ‘‘$434.26’’ is corrected to read 

‘‘$434.97’’. 

(2) Fifth full paragraph (second 

bulleted paragraph), last line, the figure 

‘‘0.9986’’ is corrected to read ‘‘0.9993’’. 

(3) Sixth full paragraph (third bulleted 

paragraph), last line, the figure ‘‘0.9373’’ 

is corrected to read ‘‘0.9382’’. 

15. On page 50389: 

a. Top of page, third column, partial 

paragraph: 

(1) Line 1, the figure ‘‘0.14’’ is 

corrected to read ‘‘0.07’’. 

(2) Line 4, the figure ‘‘0.21’’is 

corrected to read ‘‘0.11’’. 

(3) Line 7, the figure ‘‘1.15’’ is 

corrected to read ‘‘1.32’’. 

b. Top half of the page, first table 

titled, ‘‘Comparison of Factors and 

Adjustments: FY 2014 Capital Federal 

Rate and FY 2015 Capital Federal Rate’’ 

the table and table footnotes are 

corrected to read as follows: 

COMPARISON OF FACTORS AND ADJUSTMENTS: FY 2014 CAPITAL FEDERAL RATE AND FY 2015 CAPITAL FEDERAL RATE

FY 2014 FY 2015 Change Percent 

change 

Update Factor 1 ............................................................................................ 1 .0090 1 .0150 1.0150 1.50 

GAF/DRG Adjustment Factor 1 .................................................................... 0 .9987 0 .9993 0.9993 ¥0.07 

Outlier Adjustment Factor 2 .......................................................................... 0 .9393 0 .9382 0.9989 ¥0.11 

Capital Federal Rate .................................................................................... 429 .31 434 .97 1.0132 1.32 

1The update factor and the GAF/DRG budget neutrality adjustment factors are built permanently into the capital Federal rates. Thus, for example, the incremental change from FY 2014 to FY 2015 resulting from the application of the 0.9993 GAF/DRG budget neutrality adjustment factor 

for FY 2015 is a net change of 0.9993 (or ¥0.07 percent). 2The outlier reduction factor is not built permanently into the capital Federal rate; that is, the factor is not applied cumulatively in determining 

the capital Federal rate. Thus, for example, the net change resulting from the application of the FY 2015 outlier adjustment factor is 0.9382/

0.9393, or 0.9989 (or ¥0.11 percent). 

c. Middle of the page, second table 

titled, ‘‘Comparison of Factors and 

Adjustments: Proposed FY 2015 Capital 

Federal Rate and Final FY 2015 Capital 

Federal Rate’’ is corrected to read as 

follows: 


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COMPARISON OF FACTORS AND ADJUSTMENTS: PROPOSED FY 2015 CAPITAL FEDERAL RATE AND FINAL FY 2015 

CAPITAL FEDERAL RATE

Proposed Final Change Percent 

change 

Update Factor .............................................................................................. 1 .0150 1 .0150 1.0000 0.00 

GAF/DRG Adjustment Factor ...................................................................... 0 .9957 0 .9993 1.0037 0.37 

Outlier Adjustment Factor ............................................................................ 0 .9374 0 .9382 1.0009 0.09 

Capital Federal Rate .................................................................................... 433 .01 434 .97 1.0045 0.45 

d. Bottom half of the page, third 

column, second full paragraph, last line, 

the figure ‘‘$209.10.’’ is corrected to 

read ‘‘$209.45.’’ 

16. On page 50390, second column, 

first partial paragraph, last line, the 

figure ‘‘$24,758’’ is corrected to read 

‘‘$24,626’’. 

17. On page 50403, first column, first 

paragraph (table heading for Table 2–2), 

the heading, ‘‘Table 2–2.—Acute Care 

Hospitals Case-Mix Indexes for 

Discharges Occurring in Federal Fiscal 

Year 2012; Hospital Wage Indexes for 

Federal Fiscal Year 2015; Hospital 

Average Hourly Wages for Federal 

Fiscal Years 2013 (2009 Wage Data), 

2014 (2010 Wage Data), and 2015 (2011 

Wage Data; Based on FY 2015 CBSA 

Delineations); and 3-Year Average of 

Hospital Average Hourly Wages’’ is 

corrected to read ‘‘Table 2–2.—Acute 

Care Hospitals Case-Mix Indexes for 

Discharges Occurring in Federal Fiscal 

Year 2013; Hospital Wage Indexes for 

Federal Fiscal Year 2015; Hospital 

Average Hourly Wages for Federal 

Fiscal Years 2013 (2009 Wage Data; 

Based on FY 2014 CBSA Delineations), 

2014 (2010 Wage Data; Based on FY 

2014 CBSA Delineations), and 2015 

(2011 Wage Data; Based on FY 2015 

CBSA Delineations); and 3-Year Average 

of Hospital Average Hourly Wages 

(Based on FY 2014 and FY 2015 CBSA 

Delineations)’’. 

18. On page 50404: 

a. Top one-sixth of the page, the first 

table titled ‘‘Table 1A.—National 

Adjusted Operating Standardized 

Amounts, Labor/Nonlabor (69.6 Percent 

Labor Share/30.4 Percent Nonlabor 

Share If Wage Index Is Greater Than 

1)—FY 2015’’ is corrected to read as 

follows: 

TABLE 1A—NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, LABOR/NONLABOR (69.6 PERCENT LABOR

SHARE/30.4 PERCENT NONLABOR SHARE IF WAGE INDEX IS GREATER THAN 1)—FY 2015 

Hospital submitted quality data 

and is a meaningful 

EHR user 

(update = 2.2 percent) 

Hospital did NOT submit quality 

data and is a meaningful 

EHR user 

(update = 1.475 percent) 

Hospital submitted quality data 

and is NOT a meaningful 

EHR user 

(update = 1.475 percent) 

Hospital did NOT submit quality 

data and is NOT a meaningful 

EHR user 

(Update = 0.75 percent) 

Labor Nonlabor Labor Nonlabor Labor Nonlabor Labor Nonlabor 

$3,784.75 $1,653.10 $3,757.90 $1,641.37 $3,757.90 $1,641.37 $3,731.05 $1,629.65 

b. Top third of the page, the second 

table titled ‘‘Table 1B.—National 

Adjusted Operating Standardized 

Amounts, Labor/Nonlabor (62 Percent 

Labor Share/38 Percent Nonlabor Share 

If Wage Index Is Less Than Or Equal To 

1)—FY 2015’’ is corrected to read as 

follows: 

TABLE 1B—NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, LABOR/NONLABOR (62 PERCENT LABOR SHARE/

38 PERCENT NONLABOR SHARE IF WAGE INDEX IS LESS THAN OR EQUAL TO 1)—FY 2015 

Hospital submitted quality data 

and is a meaningful 

EHR user 

(update = 2.2 percent) 

Hospital did NOT submit quality 

data and is a meaningful 

EHR user 

(update = 1.475 percent) 

Hospital submitted quality data 

and is NOT a meaningful 

EHR user 

(update = 1.475 percent) 

Hospital did NOT submit quality 

data and is NOT a meaningful 

EHR user 

(update = 0.75 percent) 

Labor Nonlabor Labor Nonlabor Labor Nonlabor Labor Nonlabor 

$3,371.47 $2,066.38 $3,347.55 $2,051.72 $3,347.55 $2,051.72 $3,323.63 $2,037.07 

c. Middle of the page, the third table 

titled ‘‘Table 1C.—Adjusted Operating 

Standardized Amounts For Puerto Rico, 

Labor/Nonlabor (National: 62 Percent 

Labor Share/38 Percent Nonlabor Share 

Because Wage Index Is Less Than Or 

Equal To 1; Puerto Rico: 63.2 Percent 

Labor Share/36.8 Percent Nonlabor 

Share If Wage Index Is Greater Than 1 

Or 62 Percent Labor Share/38 Percent 

Nonlabor Share If Wage Index Is Less 

Than Or Equal To 1—FY 2015’’ is 

corrected to read as follows: 


rmajette on DSK2TPTVN1PROD with RULES
59684 Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 

TABLE 1C—ADJUSTED OPERATING STANDARDIZED AMOUNTS FOR PUERTO RICO, LABOR/NONLABOR (NATIONAL: 62 PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE BECAUSE WAGE INDEX IS LESS THAN OR EQUAL TO 1; PUERTO

RICO: 63.2 PERCENT LABOR SHARE/36.8 PERCENT NONLABOR SHARE IF WAGE INDEX IS GREATER THAN 1 OR 62 

PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE IF WAGE INDEX IS LESS THAN OR EQUAL TO 1—FY 2015 

Standardized amount 

Rates if wage index is 

greater than 1 

Rates if wage index is 

less than or equal to 1 

Labor Nonlabor Labor Nonlabor 

.

National 1 ........................................ Not Applicable ................................ Not Applicable ................................ $3,371.47 $2,066.38 

Puerto Rico ..................................... $1,609.97 ....................................... $937.45 .......................................... 1,579.40 968.02 

1For FY 2015, there are no CBSAs in Puerto Rico with a national wage index greater than 1. 

d. Lower third of the page, the fourth 

table titled ‘‘Table 1D.—Capital 

Standard Federal Payment Rate—FY 

2015’’ is corrected to read as follows: 

TABLE 1D—CAPITAL STANDARD

FEDERAL PAYMENT RATE—FY 2015 

Rate 

National ................................. $434.97 

Puerto Rico ........................... 209.45 

D. Corrections of Errors in the 

Appendices 

1. On page 50405, first column, first 

paragraph: 

a. Line 10, the figure ‘‘$654’’ is 

corrected to read ‘‘$623’’. 

b. Line 12, the figure ‘‘$132’’ is 

corrected to read ‘‘$128’’. 

c. Line 14, the figure ‘‘1.6’’ is 

corrected to read ‘‘1.5’’. 

2. On page 50407, second column, last 

partial paragraph, line 3, the figure 

‘‘5.71’’ is corrected to read ‘‘5.68’’. 

3. On pages 50409 through 50419, 

table titled ‘‘Table I.—Impact Analysis 

of Changes to the IPPS For Operating 

Costs for FY 2015’’ the table and table 

footnotes are corrected as follows: 

BILLING CODE 4120–01–P 


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Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 59685 


rmajette on DSK2TPTVN1PROD with RULESER03OC14.006</GPH>

All Hospitals 

By Geographic Location: 

Urban hospitals 

Large urban areas 

Other urban areas 

Rural hospitals 

Bed Size (Urban): 

0-99 beds 

1 00-199 beds 

200-299 beds 

300-499 beds 

500 or more beds 

Bed Size (Rural): 

0-49 beds 

50-99 beds 

1 00-149 beds 

150-199 beds 

200 or more beds 

Urban by Region: 

New England 

Middle Atlantic 

South Atlantic 

East North Central 

East South Central 

West North Central 

West South Central 

Mountain 

Pacific 

Puerto Rico 

Rural by Re!lion: 

New En!lland 

Middle Atlantic 

South Atlantic 

East North Central 

East South Central 

West North Central 

West South Central 

Mountain 

Pacific 

By Payment Classification: 

Urban areas 

Large urban areas 

Other urban areas 

Rural areas 

TABLE I.-IMPACT ANALYSIS OF CHANGES TO THE IPPS FOR 

OPERATING COSTS FOR FY 2015 

Appli . 

catio 

FY n of 

2015 the 

Weight FY 2015 Front 

sand DRG, ier 

Hospit DRG Rei. Rural Applic Wag 

al Rate Chang wts., Floor and a-tion e 

Updat es Wage Imputed of the lnde 

e and with FY2015 Index Floor CBSA X 

Docu- Appli- Wage Change with Transi- and 

menta- cation Data swith FY201 Applica- Impact tion Outtion of with Wage 5 tion of of the Wage Migr 

and Recall- Appli- and MGCR National New Index aCod in bratio cation Recall- B Rural OMB with tion 

g n of Wage bration Reclas Floor CBSA Budge Adju 

No. of Adjust Budge Budget Budget si- Budget Design t stHospi· -ment t Neu- Neu- Neutrali ficatio Neu- a-tions Neutra ment 

tals1 2 tralityl trality4 ty5 ns6 trality7 8 -lity 9 10 

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 

3,396 1.5 0 0 0 0 0 0 0 0.1 

2,549 1.4 0 0 0 -0.1 0 0 0 0.1 

1,401 1.4 0.1 0.1 0.2 -0.3 0 0 0 0 

1,148 1.5 0 -0.2 -0.2 0.1 0 0 0 0.2 

847 1.8 -0.2 0.1 -0.2 1.6 -0.3 0 0 0.1 

666 1.5 -0.2 0.1 -0.1 -0.4 0.1 0.1 0 0.4 

787 1.4 -0.1 -0.1 -0.1 0 0.3 0 0 0.2 

455 1.5 -0.1 0 0 0.1 0 0.1 0 0.1 

429 1.4 0 0 0.1 -0.3 0.1 0.1 0 0.2 

212 1.4 0.2 0 0.2 -0.2 -0.2 -0.1 0 0 

328 1.8 -0.2 -0.1 -0.3 0.4 -0.2 -0.1 0.1 0.2 

305 1.9 -0.3 0.1 -0.3 0.9 -0.2 0 0 0.1 

125 1.8 -0.2 0.1 -0.2 1.8 -0.3 0 0 0.2 

50 1.7 -0.1 0.1 0 1.8 -0.3 0 0 0.2 

39 1.7 -0.1 0.1 0 2.8 -0.4 0.1 -0.1 0 

120 1.4 0 0.8 0.8 1.3 2.8 -0.5 0.2 0.1 

324 1.4 0.1 0.1 0.2 0.1 -0.4 0 0.3 0.2 

407 1.4 0 -0.3 -0.2 -0.3 -0.4 0.1 -0.1 0 

397 1.4 0 0 0 -0.2 -0.6 0.1 -0.1 0 

153 1.4 0 -0.5 -0.4 -0.4 -0.4 0 -0.1 0 

162 1.4 0 -0.1 0 -0.7 -0.5 0.1 -0.1 0.8 

387 1.4 0 -0.6 -0.5 -0.5 -0.5 0.1 -0.1 0 

162 1.5 -0.1 0 0 -0.1 0 0.1 -0.1 0.2 

385 1.4 0 0.6 0.5 -0.2 1.4 0.1 -0.1 0 

52 1.5 0.2 0.1 0.3 -0.8 0 -0.1 0 0 

22 1.7 -0.1 0.6 0.4 2.2 -0.3 0 0 0 

57 1.9 -0.3 0.7 0.3 1.1 -0.2 -0.2 0.2 0.2 

132 1.8 -0.2 -0.1 -0.3 2.2 -0.4 0 0 0.1 

116 1.9 -0.2 0 -0.2 1.1 -0.2 0.1 0 0 

165 1.6 -0.1 -0.3 -0.3 2.6 -0.5 0 -0.1 0.1 

102 2.1 -0.3 0 -0.3 0.4 -0.1 0.1 0 0.3 

168 1.7 -0.1 0 0 1.6 -0.4 -0.1 0 0.1 

61 2 -0.3 -0.1 -0.4 0.2 -0.1 0 0 0.6 

24 2.3 -0.6 0.8 -0.4 0.9 -0.1 -0.2 0 0 

2,563 1.4 0 0 0.1 -0.1 0 0 0 0.1 

1,413 1.4 0.1 0.1 0.2 -0.3 0 0 0 0 

1,150 1.5 0 -0.2 -0.1 0.1 0 0 0 0.2 

833 1.8 -0.2 0 -0.2 1.2 -0.3 -0.1 0 0.3 

Hos 

pita I 

Rea 

dmis 

sion Cha 

s nge All 

Red s to FY 

UC· Med 201 

tion lear 5 

Pro- e Cha 

gra DSH nqe 

m" 12 s 3 

(11) (12) (13) 

-0.2 -1.3 -0.6 

-0.2 -1.4 -0.6 

-0.2 -1.4 -0.6 

-0.2 -1.3 -0.6 

0 -0.9 -0.6 

-0.2 -0.7 -0.3 

-0.3 -1.4 -0.7 

-0.2 -1.1 -0.2 

-0.1 -1.5 -0.6 

-0.1 -1.4 -0.8 

0 -0.7 -1.1 

0 -0.9 -1.4 

-0.1 -0.9 0 

-0.1 -1.2 -0.4 

0.1 -0.7 0.4 

-0.2 -1 0 

-0.2 -1.2 -0.1 

-0.2 -1.3 -0.9 

-0.3 -1.1 -0.5 

-0.2 -1.6 -1.3 

-0.1 -1 -0.4 

-0.2 -2 -1.7 

-0.2 -1.6 -0.8 

-0.1 -1.5 0.1 

0 -7.6 -7.3 

0 -0.5 -0.9 

-0.1 -0.7 -0.7 

0.1 -1 -0.8 

-0.1 -0.5 0.2 

-0.1 -1.5 -1.4 

0 -0.3 0.3 

-0.2 -1.6 -1.8 

0 -0.4 0.6 

0.2 -0.3 1.3 

-0.2 -1.4 -0.6 

-0.2 -1.4 -0.6 

-0.2 -1.3 -0.6 

0 -0.8 -0.5 
59686 Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 


rmajette on DSK2TPTVN1PROD with RULESER03OC14.007</GPH>

Appli 

-

catio 

FY n of 

2015 the 

Weight FY 2015 Front 

sand DRG, ier 

Hospit DRG Rei. Rural Applic Wag Hos 

al Rate Chang wts., Floor and a-tion e pital 

Updat es Wage Imputed of the lnde Rea 

e and with FY2015 Index Floor CBSA X dDocu- Appli- Wage Change with Transi- and mis 

menta- cation Data swith FY201 Applica- Impact lion Out- sion Cha 

lion of with Wage 5 tion of of the Wage Migr s nge All 

and Recali- Appli- and MGCR National New Index a- Red s to FY 

Cod in bratio cation Recali- B Rural OMB with lion uc- Med 201 

g n of Wage bration Reclas Floor CBSA Budge Adju tion icar 5 

No. of Adjust Budge Budget Budget si- Budget Design t st- Pro- e Cha 

Hospi- -ment t Neu- Neu- Neutrali ficatio Neu- a-lions Neutra ment gra DSH n~e 

tals1 2 tralityl trality" 

~~ ns6 trality7 8 -lily 9 10 m11 12 53 

(1) (2) (3). (4). (6) m· (8) (9) (10) (11) (12) (13) 

Teaching Status: 

Nonteaching 2,357 1.5 -0.1 -0.1 -0.1 0.2 0.2 0.1 0 0.1 -0.2 -1.1 -0.5 

Fewer than 1 00 residents 795 1.5 0 0 0 -0.1 -0.1 0.1 0 0.2 -0.2 -1.4 -0.5 

1 DO or more residents 244 1.4 0.2 0.1 0.3 -0.1 -0.2 -0.1 0.1 0 -0.1 -1.6 -0.8 

Urban DSH: 

Non-DSH 679 1.5 -0.1 -0.1 -0.1 0 0 0.2 0 0.2 -0.2 -0.3 0.6 

1 00 or more beds 1,588 1.4 0 0 0.1 -0.1 0 0 0 0.1 -0.2 -1.5 -0.8 

Less than 1 00 beds 383 1.5 -0.2 0.2 0 0 0 0.1 0 0.3 -0.2 -1 -0.7 

Rural DSH: 

SCH 373 2.1 -0.3 0 -0.4 0.3 -0.1 0 0 0 0 -0.6 -0.5 

RRC 212 1.8 -0.2 0 -0.1 1.8 -0.3 0 0 0.5 0 -0.9 -0.2 

1 00 or more beds 24 1.4 -0.1 -0.2 -0.3 2.4 -0.6 0.1 0 0.2 -0.2 -1.7 -1.2 

Less than 1 DO beds 137 1.4 -0.1 -0.1 -0.2 1 -0.6 -0.3 0.2 0.6 -0.2 -1.8 -1.2 

Urban teaching and DSH: 

Both teaching and DSH 842 1.4 0.1 0 0.2 -0.2 -0.1 0 0 0.1 -0.1 -1.6 -0.8 

Teaching and no DSH 133 1.4 0 0 0 0.3 0.1 0.1 0 0.1 -0.3 -0.3 0.9 

No teaching and DSH 1,129 1.5 -0.1 -0.1 -0.1 0 0.3 0.1 0 0.1 -0.2 -1.4 -0.7 

No teaching and no DSH 459 1.4 -0.1 -0.2 -0.2 -0.2 0 0.2 0 0.2 -0.2 -0.3 0.7 

Special Hospital Types: 

RRC 193 1.4 0 0 -0.1 2.5 -0.5 0 0 0.6 -0.2 -1.2 -0.6 

SCH 325 2 -0.2 -0.1 -0.3 0 -0.1 0 0 0 0 -0.4 0.8 

MDH 162 2 -0.3 0 -0.3 0.3 -0.2 0 0 0.1 -0.1 -0.8 -5.2 

SCH and RRC 124 2.1 -0.3 0 -0.2 0.3 0 0 0 0.1 0.1 -0.3 1.1 

MDH and RRC 15 2 -0.3 -0.1 -0.3 0.5 -0.1 -0.1 0 0 0 -0.3 -8 

Type of Ownership: 

Voluntary 1,935 1.5 0 0.1 0.1 0 0 0 0 0.1 -0.2 -1.2 -0.4 

Proprietary 892 1.4 0 -0.2 -0.1 0.2 0.1 0.1 -0.1 0.1 -0.2 -1.5 -0.8 

Government 542 1.5 0 -0.1 0 -0.1 0 0 0 0 -0.1 -2 -1.4 

Medicare Utilization as a 

Percent of Inpatient Days: 

0-25 501 1.4 0 0.1 0.2 -0.3 0 0 0 0 -0.1 -3 -2.3 

25-50 2,081 1.4 0 0 0 -0.1 0 0 0 0.1 -0.2 -1.2 -0.4 

50-65 601 1.6 -0.1 -0.1 -0.1 0.8 0.1 0.2 0 0.1 -0.2 -0.6 0 

Over65 93 1.6 -0.2 -0.2 -0.3 0.2 0.5 -0.1 0 0.2 -0.2 -0.6 -0.6 

FY 2015 Reclassifications 

by the Medicare Geographic 

Classification Review 

Board: 

All Reclassified Hospitals 719 1.5 0 0 0 2.4 0.1 0 -0.1 0 -0.2 -1.1 -0.1 

Non-Reclassified Hospitals 2,677 1.4 0 0 0 -0.7 0 0 0 0.1 -0.2 -1.4 -0.7 

Urban Hospitals Reclassified 450 1.4 0 0 0.1 2.4 0.2 0 -0.1 0 -0.2 -1.2 -0.1 

Urban Nonreclassified 

Hospitals, FY 2015 2,054 1.4 0 0 0 -0.8 0 0 0 0.1 -0.2 -1.4 -0.7 

All Rural Hospitals 

Reclassified FY 2015 269 1.8 -0.2 0 -0.1 2.5 -0.3 0.1 0 0 -0.1 -0.9 -0.2 

Rural Nonreclassified 

Hospitals FY 2015 514 1.9 -0.3 0 -0.3 -0.1 -0.2 -0.1 0 0.3 0.1 -0.9 -0.8 

All Section 401 Reclassified 

Hospitals 50 1.9 -0.2 -0.1 -0.4 -0.4 -0.1 -0.4 0.2 2 0 -0.6 -1.1 
Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 59687 

BILLING CODE 4120–01–C 

4. On page 50420: 

a. First column, last partial paragraph, 

last line, the figure ‘‘0.997543’’ is 

corrected to read ‘‘0.998761’’. 

b. Second column, first partial 

paragraph, line 6, the figure ‘‘0.3’’ is 

corrected to read ‘‘0.2’’. 

c. Third column: 

(1) First full paragraph, line 26, the 

figure ‘‘1.001443’’ is corrected to read 

‘‘1.001421’’. 


rmajette on DSK2TPTVN1PROD with RULESER03OC14.008</GPH>

Appll 

. 

catlo 

FY n of 

2015 the 

Weight FY 2015 Front 

sand DRG, ier 

Hospit DRG Rei. Rural Applic Wag Hos 

al Rate Chang Wts., Floor and a-tion e pita I 

Updat es Wage Imputed of the lnde Rea 

eand with FY2015 Index Floor CBSA X dDocu- Appll- Wage Change with Transl- and mls 

menta- cation Data swith FY201 Applica- Impact tion Out- sion 

tion of with Wage 5 tion of of the Wage Migr s 

and Recall- Appli- and MGCR National New Index a- Red 

Codin bratio cation Recall- B Rural OMB with tion UC• 

g n of Wage brat ion Reel as Floor CBSA Budge Adju tion 

No. of Adjust Budge Budget Budget si- Budget Design t st- ProHospi· -ment tNeu- Neu- Neutrali ficatio Neu· a-tions Neutra ment g~ tals1 2 trallty'l trallty' t/ ns6 trallty7 8 -llty9 10 m 

{1) {2) {3) {4) {lj} {6) m {8) nil {10) {11) 

Other Reclassified Hospitals 

(Section 1886(d){8)(B)l. 64 1.6 -0.2 0.3 0 3.1 -0.5 0.2 0.1 0.1 -0.1 

Specialty Hospitals 

Cardiac specialty Hospitals 15 1.4 0.9 0.1 1.1 -0.9 -0.1 0.1 -0.1 0.7 

1 Because data necessary to classify some hospitals by category were missing, the total number of hospitals in each category may not equal 

the national total. Discharge data are from FY 2013, and hospital cost report data are from reporting periods beginning in FY 2012 and FY 

2011. 

2 This column displays the payment impact of the hospital rate update and the documentation and coding adjustment including the 2.2 percent 

adjustment to the national standardized amount and hospital-specific rate (the estimated 2.9 percent market basket update reduced by the 0.5 

percentage point for the multifactor productivity adjustment and the 0.2 percentage point reduction under the Affordable Care Act) and the 0.8 

percent documentation and coding adjustment to the national standardized amount. 

This column displays the payment impact of the changes to the Version 32.0 GROUPER, the changes to the relative weights and the 

recalibration of the MS-DRG weights based on the corrected FY 2013 MedPAR data in accordance with section 1886(d)(4)(C)(iii) of the Act. 

This column displays the application of the recalibration budget neutrality factor of 0.998761 in accordance with section 1886(d)(4)(C)(iii) of the 

Act. 

4 This column displays the payment impact of the update to wage index data using FY 2011 cost report data and the new OMB labor market 

area delineations. This column displays the payment impact of the application of the wage budget neutrality factor, which is calculated 

separately from the recalibration budget neutrality factor, and is calculated in accordance with section 1886( d)(3)(E)(i) of the Act. The wage 

budget neutrality factor is 1.001421. 5 This column displays the combined payment impact of the changes in Columns 3 through 4 and the cumulative budget neutrality factor for 

MS-DRG and wage changes in accordance with section 1886(d)(4)(C)(iii) of the Act and section 1886(d)(3)(E) of the Act. The cumulative 

wage and recalibration budget neutrality factor of 1.000180 is the product of the wage budget neutrality factor and the recalibration budget 

neutrality factor. 6 Shown here are the effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB) along with the 

effects of the adoption of the new OMB labor market area delineations on these reclassifications. The effects demonstrate the FY 2015 

payment impact of going from no reclassifications to the reclassifications scheduled to be in effect for FY 2015. Reclassification for prior years 

has no bearing on the payment impacts shown here. This column reflects the geographic budget neutrality factor of 0.990429. 7 This column displays the effects of the rural floor and imputed floor based on the adoption of new OMB labor market area delineations. The 

Affordable Care Act requires the rural floor budget neutrality adjustment to be 100 percent national level adjustment. The rural floor budget 

neutrality factor (which includes the imputed floor) applied to the wage index is 0.989525. 8 This column displays the effects of the adoption of the new OMB labor market area delineations. It does not reflect the 3-year transition for 

hospitals that are currently located in urban counties that would become rural under the new OMB delineations and the 1-year transition to the 

new OMB delineations where the wage indexes are blended such that hospitals receive 50 percent of their wage index based on the new OMB 

delineations, and 50 percent of their wage index based on their current labor market area. Rather, it shows the impact of the new OMB 

delineations fully implemented in FY 2015. 

~his column shows the effects of both the 3-year transition for hospitals that are currently located in urban counties that become rural under 

the new OMB delineations, and the 50150 blended wage index adjustments in a budget neutral manner. For FY 2015, we are applying both 

the 3-year transition and 50150 blended wage index adjustments in a budget neutral manner, with a budget neutrality factor of 0.998854 

applied to the standardized amount. 1 This column shows the combined impact of the policy required under section 10324 of the Affordable Care Act that hospitals located in 

frontier States have a wage index no less than 1.0 and of section 1886(d)(13) of the Act, as added by section 505 of Pub. L. 108-173, which 

provides for an increase in a hospital's wage index if a threshold percentage of residents of the county where the hospital Is located commute 

to work at hospitals in counties with higher wage indexes. These are non budget neutral policies. 11 This column displays the impact of the implementation of the Hospital Readmissions Reduction Program, section 3025 of the Affordable 

Care Act, a nonbudget neutral provision that adjusts a hospital's payment for excess readmissions. 12 This column displays the impact of the implementation of section 3133 of the Affordable Care Act that reduces Medicare DSH payments by 

75 percent and establishes an additional uncompensated care payment. 13 This column shows the changes in payments from FY 2014 to FY 2015. It reflects the impact of the FY 2015 hospital update and the 

adjustment for documentation and coding. It also reflects changes in hospitals' reclassification status in FY 2015 compared to FY 2014, and 

the extension of MDH payment status for the first half of FY 2015, under Pub. L. 113-93 enacted on April1, 2014. It incorporates all of the 

changes displayed in Columns 2, 5, 6, 7, 8, 9, 10, 11, and 12 (the changes displayed in Columns 3 and 4 are included in Column 5). The sum 

of these impacts may be different from the percentage changes shown here due to rounding and interactive effects. 

0 

Cha 

nge All 

sto FY 

Med 201 

icar 5 

e Cha 

DSH n~e 12 s 3 

{12) {13) 

-1.2 -1.9 

-0.1 1.9 
59688 Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 

(2) Last partial paragraph, line 6, the 

phrase ‘‘2 urban hospital’’ is corrected 

to read ‘‘2 urban hospitals’’. 

5. On page 50421, bottom half of the 

page: 

a. First column, first full paragraph: 

(1) Line 9, the figure ‘‘1.001443’’ is 

corrected to read ‘‘1.001421’’. 

(2) Line 11, the figure ‘‘0.997543’’ is 

corrected to read ‘‘0.998761’’. 

(3) Line 18, the figures ‘‘0.998982’’ 

and ‘‘0.10’’ are corrected to read 

‘‘1.000180’’ and ‘‘0.018’’, respectively. 

b. Second column, second full 

paragraph: 

(1) Line 6, the figure ‘‘0.990406’’ is 

corrected to read ‘‘0.990429’’. 

(2) Line 13, the figure ‘‘1.5’’ is 

corrected to read ‘‘1.6’’. 

c. Third column, first full paragraph, 

line 8, the figure ‘‘0.989507’’ is 

corrected to read ‘‘0.989525’’. 

6. On page 50422: 

a. First column, second partial 

paragraph: 

(1) Line 1, the figure ‘‘422’’ is 

corrected to read ‘‘423’’. 

(2) Line 3, the figure ‘‘2,974’’ is 

corrected to read ‘‘2,973’’. 

(3) Line 6, the figure ‘‘0.989507’’ is 

corrected to read ‘‘0.989525’’. 

b. Second column: 

(1) First paragraph, line 23, the 

phrase, ‘‘this final rule for a complere’’ 

is corrected to read ‘‘this final rule for 

a complete’’. 

(2) Second paragraph, line 8, the 

figure ‘‘0.991291’’ is corrected to read 

‘‘0.991293’’. 

(3) Last paragraph, line 7, the figure 

‘‘1.121’’ is corrected to read ‘‘1.1093’’. 

(4) Last paragraph, last line, the figure 

‘‘$1.9’’ is corrected to read ‘‘$1.8’’. 

7. On page 50423, the table titled ‘‘FY 

2015 IPPS Estimated Payments Due to 

Rural Floor and Imputed Floor with 

National Budget Neutrality’’ is corrected 

to read as follows: 

FY 2015 IPPS ESTIMATED PAYMENTS DUE TO RURAL FLOOR AND IMPUTED FLOOR WITH NATIONAL BUDGET NEUTRALITY

State Number of 

hospitals 

Number of 

hospitals that 

will receive the 

rural floor or 

imputed floor 

Percent 

change in payments due to 

application of 

rural floor and 

imputed floor 

with budget 

neutrality 

Difference 

(in millions) 

(1) (2) (3) (4) 

Alabama ........................................................................................................... 91 2 ¥0.5 ¥8.4 

Alaska .............................................................................................................. 6 4 1.5 2.2

Arizona ............................................................................................................. 57 9 ¥0.1 ¥1.9 

Arkansas .......................................................................................................... 45 0 ¥0.5 ¥5.3 

California .......................................................................................................... 309 200 1.9 190.2 

Colorado .......................................................................................................... 47 6 0.2 2.3 

Connecticut ...................................................................................................... 31 8 ¥0.4 ¥6.6 

Delaware .......................................................................................................... 6 0 ¥0.6 ¥2.4 

Washington, D.C .............................................................................................. 7 0 ¥0.6 ¥2.6 

Florida .............................................................................................................. 169 25 ¥0.3 ¥18.7 

Georgia ............................................................................................................ 106 0 ¥0.5 ¥13.2 

Hawaii .............................................................................................................. 12 0 ¥0.4 ¥1.3 

Idaho ................................................................................................................ 14 0 ¥0.4 ¥1.2 

Illinois ............................................................................................................... 127 0 ¥0.6 ¥28.0 

Indiana ............................................................................................................. 91 0 ¥0.6 ¥13.2 

Iowa ................................................................................................................. 34 0 ¥0.5 ¥4.5 

Kansas ............................................................................................................. 53 0 ¥0.4 ¥3.8 

Kentucky .......................................................................................................... 65 1 ¥0.5 ¥7.9 

Louisiana .......................................................................................................... 100 0 ¥0.5 ¥7.0 

Maine ............................................................................................................... 20 0 ¥0.5 ¥2.5 

Massachusetts ................................................................................................. 61 51 4.9 156.4 

Michigan ........................................................................................................... 95 0 ¥0.5 ¥23.2 

Minnesota ........................................................................................................ 51 0 ¥0.5 ¥10.1 

Mississippi ........................................................................................................ 64 0 ¥0.5 ¥5.3 

Missouri ............................................................................................................ 78 0 ¥0.5 ¥11.2 

Montana ........................................................................................................... 12 4 ¥0.3 ¥0.8 

Nebraska .......................................................................................................... 23 0 ¥0.4 ¥2.6 

Nevada ............................................................................................................. 24 6 0.7 4.7

New Hampshire ............................................................................................... 13 9 2.2 10.5 

New Jersey ...................................................................................................... 64 15 0.1 2.7 

New Mexico ..................................................................................................... 25 2 ¥0.3 ¥1.1 

New York ......................................................................................................... 163 0 ¥0.6 ¥48.9 

North Carolina .................................................................................................. 87 0 ¥0.5 ¥15.9 

North Dakota .................................................................................................... 6 1 ¥0.3 ¥0.8 

Ohio ................................................................................................................. 135 10 ¥0.4 ¥16.9 

Oklahoma ......................................................................................................... 86 2 ¥0.5 ¥5.7 

Oregon ............................................................................................................. 33 0 ¥0.5 ¥4.8 

Pennsylvania .................................................................................................... 154 10 ¥0.5 ¥23.3 

Puerto Rico ...................................................................................................... 52 11 0 ¥0.1 

Rhode Island .................................................................................................... 11 4 0.5 1.8 

South Carolina ................................................................................................. 55 7 ¥0.3 ¥5.1 

South Dakota ................................................................................................... 19 0 ¥0.3 ¥1.1 

Tennessee ....................................................................................................... 98 16 ¥0.2 ¥5.6 

Texas ............................................................................................................... 324 6 ¥0.5 ¥30.1 

Utah ................................................................................................................. 33 2 ¥0.4 ¥2.2 


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Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 59689 

FY 2015 IPPS ESTIMATED PAYMENTS DUE TO RURAL FLOOR AND IMPUTED FLOOR WITH NATIONAL BUDGET

NEUTRALITY—Continued 

State Number of 

hospitals 

Number of 

hospitals that 

will receive the 

rural floor or 

imputed floor 

Percent 

change in payments due to 

application of 

rural floor and 

imputed floor 

with budget 

neutrality 

Difference 

(in millions) 

(1) (2) (3) (4) 

Vermont ........................................................................................................... 6 0 ¥0.3 ¥0.7 

Virginia ............................................................................................................. 79 1 ¥0.5 ¥12.0 

Washington ...................................................................................................... 49 8 ¥0.2 ¥3.1 

West Virginia .................................................................................................... 30 0 ¥0.4 ¥3.2 

Wisconsin ......................................................................................................... 65 2 ¥0.5 ¥8.6 

Wyoming .......................................................................................................... 11 1 ¥0.2 ¥0.3 

8. On page 50424: 

a. Second column, first partial 

paragraph, line 9, the figure ‘‘0.998859’’ 

is corrected to read ‘‘0.998854’’. 

b. Third column, first full paragraph, 

line 18, the figure ‘‘273’’ is corrected to 

read ‘‘279’’. 

9. On page 50425: 

a. First column, first partial 

paragraph, last line, the figure ‘‘$424’’ is 

corrected to read ‘‘$428’’. 

b. Second column, first full 

paragraph, line 1, the phrase ‘‘Rural 

West South’’ is corrected to read ‘‘Rural 

West North’’. 

c. Third column: 

(1) First partial paragraph, line 6, the 

figure ‘‘5.71’’ is corrected to read ‘‘5.68’’. 

(2) First full paragraph, line 14, the 

figure ‘‘0.7’’ is corrected to read ‘‘0.6’’. 

10. On pages 50426 and 50427, the 

table titled ‘‘Table II.—Impact Analysis 

of Changes for FY 2015 Acute Care 

Hospital Operating Prospective Payment 

System (Payments Per Discharge)’’ is 

corrected to read as follows: 

TABLE II—IMPACT ANALYSIS OF CHANGES FOR FY 2015 ACUTE CARE HOSPITAL OPERATING PROSPECTIVE PAYMENT

SYSTEM

[Payments per discharge] 

Number of 

hospitals 

Estimated average FY 2014 

payment per 

discharge 

Estimated average FY 2015 

payment per 

discharge 

All FY 2015 

changes 

(1) (2) (3) (4) 

All Hospitals ..................................................................................................... 3,396 11,249 11,184 ¥0.6 

By Geographic Location: 

Urban hospitals ......................................................................................... 2,549 11,625 11,557 ¥0.6 

Large urban areas .................................................................................... 1,401 12,377 12,308 ¥0.6 

Other urban areas .................................................................................... 1,148 10,709 10,643 ¥0.6 

Rural hospitals .......................................................................................... 847 8,240 8,194 ¥0.6 

Bed Size (Urban): 

0–99 beds ................................................................................................. 666 9,088 9,061 ¥0.3 

100–199 beds ........................................................................................... 787 9,747 9,682 ¥0.7 

200–299 beds ........................................................................................... 455 10,507 10,489 ¥0.2 

300–499 beds ........................................................................................... 429 11,951 11,875 ¥0.6 

500 or more beds ..................................................................................... 212 14,309 14,198 ¥0.8 

Bed Size (Rural): 

0–49 beds ................................................................................................. 328 6,778 6,701 ¥1.1 

50–99 beds ............................................................................................... 305 7,803 7,692 ¥1.4 

100–149 beds ........................................................................................... 125 8,113 8,109 0 

150–199 beds ........................................................................................... 50 8,857 8,819 ¥0.4 

200 or more beds ..................................................................................... 39 9,988 10,027 0.4 

Urban by Region: 

New England ............................................................................................ 120 12,806 12,802 0 

Middle Atlantic .......................................................................................... 324 12,914 12,905 ¥0.1 

South Atlantic ........................................................................................... 407 10,453 10,359 ¥0.9 

East North Central .................................................................................... 397 10,849 10,790 ¥0.5 

East South Central ................................................................................... 153 10,052 9,922 ¥1.3 

West North Central ................................................................................... 162 11,355 11,314 ¥0.4 

West South Central .................................................................................. 387 10,677 10,500 ¥1.7 

Mountain ................................................................................................... 162 11,935 11,835 ¥0.8 

Pacific ....................................................................................................... 385 14,691 14,708 0.1 

Puerto Rico ............................................................................................... 52 8,218 7,620 ¥7.3 

Rural by Region: 

New England ............................................................................................ 22 11,207 11,110 ¥0.9 


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59690 Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 

TABLE II—IMPACT ANALYSIS OF CHANGES FOR FY 2015 ACUTE CARE HOSPITAL OPERATING PROSPECTIVE PAYMENT

SYSTEM—Continued 

[Payments per discharge] 

Number of 

hospitals 

Estimated average FY 2014 

payment per 

discharge 

Estimated average FY 2015 

payment per 

discharge 

All FY 2015 

changes 

(1) (2) (3) (4) 

Middle Atlantic .......................................................................................... 57 8,292 8,231 ¥0.7 

South Atlantic ........................................................................................... 132 7,836 7,772 ¥0.8 

East North Central .................................................................................... 116 8,475 8,496 0.2 

East South Central ................................................................................... 165 7,513 7,409 ¥1.4 

West North Central ................................................................................... 102 8,914 8,941 0.3 

West South Central .................................................................................. 168 7,108 6,978 ¥1.8 

Mountain ................................................................................................... 61 9,454 9,509 0.6 

Pacific ....................................................................................................... 24 11,083 11,221 1.3 

By Payment Classification: 

Urban hospitals ......................................................................................... 2,563 11,609 11,541 ¥0.6 

Large urban areas .................................................................................... 1,413 12,366 12,296 ¥0.6 

Other urban areas .................................................................................... 1,150 10,677 10,611 ¥0.6 

Rural areas ............................................................................................... 833 8,457 8,411 ¥0.5 

Teaching Status: 

Nonteaching .............................................................................................. 2,357 9,343 9,300 ¥0.5 

Fewer than 100 residents ......................................................................... 795 10,978 10,920 ¥0.5 

100 or more residents .............................................................................. 244 16,533 16,399 ¥0.8 

Urban DSH: 

Non-DSH .................................................................................................. 679 9,836 9,899 0.6 

100 or more beds ..................................................................................... 1,588 12,055 11,960 ¥0.8 

Less than 100 beds .................................................................................. 383 8,434 8,375 ¥0.7 

Rural DSH: 

SCH .......................................................................................................... 373 7,907 7,867 ¥0.5 

RRC .......................................................................................................... 212 9,194 9,175 ¥0.2 

100 or more beds ..................................................................................... 24 7,395 7,305 ¥1.2 

Less than 100 beds .................................................................................. 137 6,329 6,253 ¥1.2 

Urban teaching and DSH: 

Both teaching and DSH ............................................................................ 842 13,277 13,167 ¥0.8 

Teaching and no DSH .............................................................................. 133 11,130 11,230 0.9 

No teaching and DSH .............................................................................. 1,129 9,781 9,713 ¥0.7 

No teaching and no DSH ......................................................................... 459 9,223 9,289 0.7 

Special Hospital Types: 

RRC .......................................................................................................... 193 9,403 9,350 ¥0.6 

SCH .......................................................................................................... 325 9,577 9,654 0.8 

MDH .......................................................................................................... 162 7,072 6,706 ¥5.2 

SCH and RRC .......................................................................................... 124 10,293 10,410 1.1 

MDH and RRC .......................................................................................... 15 9,195 8,458 ¥8 

Type of Ownership: 

Voluntary ................................................................................................... 1,935 11,377 11,334 ¥0.4 

Proprietary ................................................................................................ 892 10,001 9,919 ¥0.8 

Government .............................................................................................. 542 12,283 12,113 ¥1.4 

Medicare Utilization as a Percent of Inpatient Days: 

0–25 .......................................................................................................... 501 14,885 14,544 ¥2.3 

25–50 ........................................................................................................ 2,081 11,359 11,311 ¥0.4 

50–65 ........................................................................................................ 601 9,146 9,145 0 

Over 65 ..................................................................................................... 93 8,408 8,353 ¥0.6 

FY 2015 Reclassifications by the Medicare Geographic Classification Review Board: 

All Reclassified Hospitals ......................................................................... 719 10,843 10,829 ¥0.1 

Non-Reclassified Hospitals ....................................................................... 2,677 11,379 11,298 ¥0.7 

Urban Hospitals Reclassified .................................................................... 450 11,514 11,502 ¥0.1 

Urban Nonreclassified Hospitals, FY 2015: ............................................. 2,054 11,675 11,593 ¥0.7 

All Rural Hospitals Reclassified FY 2015: ................................................ 269 8,734 8,713 ¥0.2 

Rural Nonreclassified Hospitals FY 2015: ................................................ 514 7,667 7,606 ¥0.8 

All Section 401 Reclassified Hospitals: .................................................... 50 10,137 10,025 ¥1.1 

Other Reclassified Hospitals (Section 1886(d)(8)(B)) .............................. 64 7,814 7,665 ¥1.9 

Specialty Hospitals: 

Cardiac specialty Hospitals ...................................................................... 15 12,303 12,538 1.9 

11. On page 50428, first column, first 

paragraph, lines 31 through 35, the 

sentence ‘‘Based on the applicant’s 

estimate from FY 2013, we currently 

estimate that new technology add-on 

payments for Voraxaze® will increase 

overall FY 2015 payments by 

$6,300,000.’’ is corrected to read ‘‘Based 

on the latest data from the 


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Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 59691 

manufacturer, we currently estimate 

that new technology add-on payments 

for Voraxaze® will increase overall FY 

2015 payments by $6,615,000.’’ 

12. On page 50429: 

a. First column, second paragraph, 

line 6, the figure ‘‘$5.3’’ is corrected to 

read ‘‘$8.8’’. 

b. First column, third paragraph, line 

16, the figure ‘‘166’’ is corrected to read 

‘‘116’’. 

c. Second column, first partial 

paragraph, line 4, the figure ‘‘$70.7’’ is 

corrected to read ‘‘$71’’. 

13. On page 50435, upper threefourths of the page: 

a. First column, fourth bulleted 

paragraph: 

(1) Line 4, the figure ‘‘0.9986’’ is 

corrected to read ‘‘0.9993’’. 

(2) Line 5, the figure ‘‘0.9373’’ is 

corrected to read ‘‘0.9382’’. 

b. Second column, first partial 

paragraph, line 2, the figure’’1.2’’ is 

corrected to read ‘‘1.3’’. 

c. Third column: 

(1) Second full paragraph, second 

sentence, is corrected to read, ‘‘The 

increase in capital payments for 

voluntary and proprietary hospitals is 

estimated at 1.5 percent, and for 

government hospitals the increase is 

estimated to be 1.3 percent.’’ 

(2) Third full paragraph: 

(a) Line 20, the figure ‘‘0.7’’ is 

corrected to read ‘‘0.8’’. 

(b) Line 24, the figure ‘‘(2.2 percent)’’ 

is corrected to read ‘‘(2.3 percent)’’. 

14. On pages 50435 through 50437, 

the table titled, ‘‘Table III. Comparison 

of Total Payments Per Case’’ is corrected 

to read as follows: 

TABLE III—COMPARISON OF TOTAL PAYMENTS PER CASE

[FY 2014 payments compared to FY 2015 payments] 

Number of 

hospitals 

Average FY 

2014 

payments/ 

case 

Average FY 

2015 

payments/ 

case 

Change 

By Geographic Location: 

All hospitals .............................................................................................. 3,396 856 869 1.5 

Large urban areas (populations over 1 million) ....................................... 1,401 944 959 1.7 

Other urban areas (populations of 1 million or fewer) ............................. 1,148 824 835 1.4 

Rural areas ............................................................................................... 847 583 589 1.0 

Urban hospitals ......................................................................................... 2,549 890 903 1.5 

0–99 beds .......................................................................................... 666 733 740 0.9 

100–199 beds .................................................................................... 787 772 783 1.5 

200–299 beds .................................................................................... 455 812 826 1.8 

300–499 beds .................................................................................... 429 907 922 1.6 

500 or more beds .............................................................................. 212 1,066 1,081 1.5 

Rural hospitals .......................................................................................... 847 583 589 1.0 

0–49 beds .......................................................................................... 328 474 480 1.2 

50–99 beds ........................................................................................ 305 542 546 0.8 

100–149 beds .................................................................................... 125 582 588 1.1 

150–199 beds .................................................................................... 50 636 643 1.1 

200 or more beds .............................................................................. 39 709 717 1.1 

By Region: 

Urban by Region ...................................................................................... 2,549 890 903 1.5 

New England ..................................................................................... 120 984 1,001 1.7 

Middle Atlantic ................................................................................... 324 958 977 1.9 

South Atlantic .................................................................................... 407 802 812 1.3 

East North Central ............................................................................. 397 856 867 1.3 

East South Central ............................................................................ 153 764 772 1.0 

West North Central ............................................................................ 162 880 892 1.4 

West South Central ........................................................................... 387 823 831 0.9 

Mountain ............................................................................................ 162 907 918 1.2 

Pacific ................................................................................................ 385 1,120 1,148 2.4 

Puerto Rico ........................................................................................ 52 408 412 1.2 

Rural by Region ........................................................................................ 847 583 589 1.0 

New England ..................................................................................... 22 812 823 1.4 

Middle Atlantic ................................................................................... 57 566 575 1.7 

South Atlantic .................................................................................... 132 555 559 0.7 

East North Central ............................................................................. 116 607 613 1.1 

East South Central ............................................................................ 165 534 539 0.9 

West North Central ............................................................................ 102 619 624 0.9 

West South Central ........................................................................... 168 515 519 0.8 

Mountain ............................................................................................ 61 653 657 0.5 

Pacific ................................................................................................ 24 749 767 2.4 

Puerto Rico ........................................................................................ 0 0 0 0.0 

By Payment Classification: 

All hospitals .............................................................................................. 3,396 856 869 1.5 

Large urban areas (populations over 1 million) ....................................... 1,413 943 959 1.7 

Other urban areas (populations of 1 million or fewer) ............................. 1,150 823 835 1.4 

Rural areas ............................................................................................... 833 594 599 0.8 

Teaching Status: 

Non-teaching ..................................................................................... 2,357 728 738 1.5 

Fewer than 100 Residents ................................................................ 795 837 850 1.5 

100 or more Residents ...................................................................... 244 1,210 1,229 1.6 

Urban DSH: 

100 or more beds ....................................................................... 1,588 911 925 1.6 

Less than 100 beds ................................................................... 383 649 657 1.1 


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59692 Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Rules and Regulations 

TABLE III—COMPARISON OF TOTAL PAYMENTS PER CASE—Continued 

[FY 2014 payments compared to FY 2015 payments] 

Number of 

hospitals 

Average FY 

2014 

payments/ 

case 

Average FY 

2015 

payments/ 

case 

Change 

Rural DSH: 

Sole Community (SCH/EACH) ................................................... 373 530 535 1.1 

Referral Center (RRC/EACH) .................................................... 212 656 661 0.8 

Other Rural: 

100 or more beds ................................................................ 24 552 552 0.0 

Less than 100 beds ............................................................ 137 465 469 1.0 

Urban teaching and DSH: 

Both teaching and DSH .................................................................... 842 990 1,005 1.5 

Teaching and no DSH ....................................................................... 133 891 907 1.8 

No teaching and DSH ....................................................................... 1,129 762 774 1.6 

No teaching and no DSH .................................................................. 459 788 799 1.4 

Rural Hospital Types: 

Non special status hospitals .............................................................. 2,575 890 903 1.5 

RRC/EACH ........................................................................................ 193 717 730 1.8 

SCH/EACH ........................................................................................ 325 652 659 1.1 

SCH, RRC and EACH ....................................................................... 124 711 720 1.3 

Hospitals Reclassified by the Medicare Geographic Classification Review 

Board: 

FY2015 Reclassifications: 

All Urban Reclassified ....................................................................... 450 886 904 2.1 

All Urban Non-Reclassified ............................................................... 2,054 893 906 1.4 

All Rural Reclassified ........................................................................ 269 621 628 1.0 

All Rural Non-Reclassified ................................................................. 514 533 537 0.8 

Other Reclassified Hospitals (Section 1886(d)(8)(B)) ....................... 59 581 595 2.3 

Type of Ownership: 

Voluntary ........................................................................................... 1,935 868 882 1.5 

Proprietary ......................................................................................... 892 776 787 1.5 

Government ....................................................................................... 542 895 907 1.3 

Medicare Utilization as a Percent of Inpatient Days: 

0–25 ................................................................................................... 501 1,022 1,037 1.4 

25–50 ................................................................................................. 2,081 871 884 1.5 

50–65 ................................................................................................. 601 717 728 1.6 

Over 65 .............................................................................................. 93 648 654 1.0 

a. Upper three-fourths of the page: 

(1) Second column, first paragraph: 

(a) Line 2, the figure ‘‘$654’’ is 

corrected to read ‘‘$623’’. 

(b) Line 14, the figure ‘‘$457’’ is 

corrected to read ‘‘$428’’. 

(c) Line 22, the figure ‘‘$369’’ is 

corrected to read ‘‘$373’’. 

(d) Line 44, the figure ‘‘$457’’ is 

corrected to read ‘‘$428’’. 

(e) Line 45, the figure ‘‘$888’’ is 

corrected to read ‘‘$862’’. 

(f) Line 51, the figure ‘‘$132’’ is 

corrected to read ‘‘$128’’. 

(g) Line 55, the figure ‘‘$756’’ is 

corrected to read ‘‘$734’’. 

(2) Third column, last paragraph, last 

line, the figure ‘‘$756’’ is corrected to 

read ‘‘$734’’. 

b. Lower quarter of the page, the table 

titled ‘‘Table V.—Accounting Statement: 

Classification of Estimated Expenditures 

under the IPPS from FY 2014 to FY 

2015’’ is corrected to read as follows: 

TABLE V—ACCOUNTING STATEMENT: 

CLASSIFICATION OF ESTIMATED EXPENDITURES UNDER THE IPPS 

FROM FY 2014 TO FY 2015 

Category Transfers 

Annualized Monetized 

Transfers.

¥$734 million. 

From Whom to Whom Federal Government 

to IPPS Medicare 

Providers. 

Dated: September 30, 2014. 

Oliver Potts, 

Deputy Executive Secretary to the 

Department, Department of Health and 

Human Services. 

[FR Doc. 2014–23630 Filed 10–1–14; 11:15 am] 

BILLING CODE 4120–01–P 


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