Federal Register / Vol. 72, No. 3 / Friday, January 5, 2007 / Notices 569 

Dated: December 27, 2006. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E6–22570 Filed 1–4–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–301] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS), Department of Health 

and Human Services, is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this burden 

estimate or any other aspect of this 

collection of information, including any 

of the following subjects: (1) The 

necessity and utility of the proposed 

information collection for the proper 

performance of the Agency’s function; 

(2) the accuracy of the estimated 

burden; (3) ways to enhance the quality, 

utility, and clarity of the information to 

be collected; and (4) the use of 

automated collection techniques or 

other forms of information technology to 

minimize the information collection 

burden. 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Certification of 

Medicaid Eligibility Control (MEQC) 

Payment Error Rates and Supporting 

Regulations at 42 CFR 431.800–431.865; 

Use: Medicaid Eligibility Quality 

Control (MEQC) is operated by Title XIX 

agencies to monitor and improve the 

administration of its Medicaid program. 

The traditional MEQC program is based 

on State reviews of Medicaid 

beneficiaries identified through a 

statistically reliable statewide sample of 

cases selected from the eligibility files. 

These reviews are conducted to 

determine whether the sampled cases 

meet applicable Title XIX eligibility 

requirements. State agencies are 

required to submit the Payment Error 

Rate form to their respective CMS 

Regional Office. Regional Office staff 

will review these forms for 

completeness and will forward these 

forms to central office for compilation of 

error rate charts for projected quarterly 

withholdings and/or fiscal 

disallowances. Form Number: CMS–301 

(OMB#: 0938–0246); Frequency: 

Recordkeeping and Reporting—Semiannually; Affected Public: State, Local 

or Tribal Governments; Number of 

Respondents: 51; Total Annual 

Responses: 102; Total Annual Hours: 

22,515. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS Web site 

address at http://www.cms.hhs.gov/ 

PaperworkReductionActof1995, or email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786–

1326. 

Written comments and 

recommendations for the proposed 

information collections must be mailed 

or faxed within 30 days of this notice 

directly to the OMB desk officer: OMB 

Human Resources and Housing Branch, 

Attention: Carolyn Lovett, New 

Executive Office Building, Room 10235, 

Washington, DC 20503. Fax Number: 

(202) 395–6974. 

Dated: December 27, 2006. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E6–22571 Filed 1–4–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1488–CN2] 

RIN 0938–A012 

Medicare Program; Changes to the 

Hospital Inpatient Prospective 

Payment Systems and Fiscal Year 2007 

Rates; Final Fiscal Year 2007 Wage 

Indices and Payment Rates After 

Application of Revised Occupational 

Mix Adjustment to the Wage Index; 

Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of notice. 

SUMMARY: This document corrects wage 

index and technical errors that appeared 

in the notice published in the Federal 

Register on October 11, 2006 entitled 

‘‘Medicare Program; Hospital Inpatient 

Prospective Payment Systems and Fiscal 

Year 2007 Rates. 

DATES: Effective Date: Corrections listed 

in items 10 through 12 of section III. of 

this notice are effective as of October 1, 

2006. The corrections to the wage index 

listed in items 2a, 3 through 8a, and 9a 

of section III. of this notice are effective 

as of November 3, 2006. The corrections 

to the wage index listed in items 1, 2b, 

8b, and 9b of section III. of this notice 

are effective as of November 21, 2006. 

FOR FURTHER INFORMATION CONTACT: 

Marc Hartstein, (410) 786–4548. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 06–8471 of October 11, 

2006 (71 FR 59886), the notice entitled 

‘‘Hospital Inpatient Prospective 

Payment Systems and Fiscal Year 2007 

Rates: Final Fiscal Year 2007 Wage 

Indices and Payment Rates After 

Application of Revised Occupational 

Mix Adjustment to Wage Index’’

(hereinafter referred to as the ‘‘FY 2007 

IPPS notice’’), there were a number of 

technical errors that are identified and 

corrected in the Correction of Errors 

section (items 10 through 12 of section 

III. of this notice). These technical 

corrections are effective October 1, 

2006. 

In addition, in October 2006, we 

became aware of an error in the 

calculation of the FY 2007 wage index 

for a number of rural areas and several 

hospitals that are reclassified to those 

areas. The error also affected some 

hospitals in urban areas that are 

assigned the statewide rural wage index 

floor. Section 412.64(k)(1) of the 

regulations requires that wage index 

corrections made after October 1 are 

effective prospectively for the remainder 

of the fiscal year from the date the fiscal 

intermediaries are informed of the 

correction. We recalculated the wage 

indices for the affected hospitals, and on 

November 3, 2006, sent a Joint Signature 

Memorandum to the fiscal 

intermediaries informing them to pay 

hospitals using the corrected wage 

indices. Subsequent to the November 3, 

2006 Joint Signature Memorandum, 

additional errors in the wage indices 

were brought to our attention and were 

corrected through a November 21, 2006 

Joint Signature Memorandum. 

Therefore, the corrected FY 2007 wage 

indices are effective beginning 

November 3, 2006 or November 21, 

2006. Accordingly, the wage index 

provisions of this correction notice are 

corrections to the tabulation of the rates 

paid to hospitals. We note that the 


sroberts on PROD1PC70 with NOTICES
570 Federal Register / Vol. 72, No. 3 / Friday, January 5, 2007 / Notices 

corrections to the impact analysis (item 

1 of section III. of this notice) are 

effective as of November 3, 2006 since 

the additional corrections made based 

on the November 21, 2006 Joint 

Signature Memorandum had no 

significant effect on the impact analysis. 

II. Summary of the Corrections to the 

FY 2007 IPPS Notice 

We made corrections to wage index 

values and geographic adjustment 

factors (GAFs) that were published in 

Tables 2, 4A–1, 4A–2, 4B–1, 4B–2, 4C–

1, and 4C–2. In addition, we are making 

technical corrections to— (1) the outmigration adjustments and qualifying 

counties that were published in Table 

4J; and (2) the list of diagnosis-related 

groups (DRGs), relative weighting 

factors, and geometric and arithmetic 

mean length of stay (LOS) that were 

published in Table 5. 

III. Correction of Errors 

In FR Doc. 06–8471 of October 11, 

2006 (71 FR 59886), make the following 

corrections: 

1. On pages 59893 and 59894, in 

Table I.—Impact Analysis of Changes 

for FY 2007, the figures in the last 

column (All FY 2007 changes 8) are 

corrected to read as follows: 

IMPACT ANALYSIS OF FINAL CHANGES

FOR FY 2007 OPERATING PROSPECTIVE PAYMENT SYSTEM

[Percent changes in payments per case] 

All FY 2007 

changes 

(4) 

All Hospitals .......................... 3.5 

By Geographic Location: 

Urban hospitals ................. 3.5 

Large urban areas (populations over 1 million) .... 3.5 

Other urban areas (populations of 1 million or 

fewer) ............................. 3.4 

Rural hospitals .................. 4 

Bed Size (Urban): 

0–99 beds ......................... 3.5 

100–199 beds ................... 3.8 

200–299 beds ................... 3.6 

300–499 beds ................... 3.4 

500 or more beds ............. 3.2 

Bed Size (Rural): 

0–49 beds ......................... 4.7 

50–99 beds ....................... 4.9 

100–149 beds ................... 3.7 

150–199 beds ................... 3.3 

200 or more beds ............. 3.0 

Urban by Region: 

New England ..................... 3.9 

Middle Atlantic ................... 3.9 

South Atlantic .................... 3.2 

East North Central ............ 3.4 

East South Central ............ 2.7 

West North Central ........... 2.8 

West South Central ........... 3.4 

IMPACT ANALYSIS OF FINAL CHANGES

FOR FY 2007 OPERATING PROSPECTIVE PAYMENT SYSTEM—Continued 

[Percent changes in payments per case] 

All FY 2007 

changes 

(4) 

Mountain ........................... 3.7 

Pacific ................................ 3.7 

Puerto Rico ....................... 2.0 

Rural by Region: 

New England ..................... 6.3 

Middle Atlantic ................... 5.2 

South Atlantic .................... 3.9 

East North Central ............ 3.8 

East South Central ............ 3.5 

West North Central ........... 4.3 

West South Central ........... 4.1 

Mountain ........................... 2.7 

Pacific ................................ 3.3 

By Payment Classification: 

Urban hospitals ................. 3.4 

Large urban areas (populations over 1 million) .... 3.5 

Other urban areas (populations of 1 million or 

fewer) ............................. 3.4 

Rural areas ....................... 4.0 

Teaching Status: 

Non-teaching ..................... 3.8 

Fewer than 100 Residents 3.4 

100 or more Residents ..... 3.2 

Urban DSH: 

Non-DSH ........................... 3.6 

100 or more beds ............. 3.4 

Less than 100 beds .......... 3.6 

Rural DSH: 

SCH ................................... 4.6 

RRC .................................. 3.5 

Other Rural: 

100 or more beds ............. 3.5 

Less than 100 beds .......... 3.9 

Urban teaching and DSH: 

Both teaching and DSH .... 3.3 

Teaching and no DSH ...... 3.3 

No teaching and DSH ....... 3.7 

No teaching and no DSH .. 3.6 

Rural Hospital Types: 

RRC .................................. 3.5 

SCH ................................... 3.6 

MDH .................................. 9.0 

SCH and RRC .................. 3.1 

MDH and RRC .................. 14.1 

Unknown.

Type of Ownership: 

Voluntary ........................... 3.5 

Proprietary ......................... 3.5 

Government ...................... 3.4 

Unknown ............................... 7.6 

Medicare Utilization as a 

Percent of Inpatient Days: 

0–25 .................................. 3.6 

25–50 ................................ 3.3 

50–65 ................................ 3.7 

Over 65 ............................. 3.8 

Unknown ........................... 4.4 

Hospitals Reclassified by the 

Medicare Geographic 

Classification Review 

Board: 

FY 2005 Reclassifications.

IMPACT ANALYSIS OF FINAL CHANGES

FOR FY 2007 OPERATING PROSPECTIVE PAYMENT SYSTEM—Continued 

[Percent changes in payments per case] 

All FY 2007 

changes 

(4) 

Urban Hospitals Reclassified by the Medicare Geographic Classification 

Review Board: First Half 

FY 2007 Reclassifications ............................... 3.7 

Urban Nonreclassified, 

First Half FY 2007 ......... 3.4 

All Urban Hospitals Reclassified Second Half 

FY 2007 ......................... 3.5 

Urban Nonreclassified 

Hospitals Second Half 

FY 2007 ......................... 3.4 

All Rural Hospitals Reclassified Second Half FY 

2007 ............................... 3.6 

Rural Nonreclassified Hospitals Second Half FY 

2007 ............................... 4.5 

All Section 401 Reclassified Hospitals ................. 5.4 

Other Reclassified Hospitals (Section 

1886(d)(8)(B)) ................ 4.5 

Section 508 Hospitals ....... 2 

Specialty Hospitals ............ —

Cardiac Specialty Hospitals .............................. 1.2 

2. On pages 59903 through to 59968, 

in Table 2.—Hospital Case-Mix Indexes 

for Discharges Occurring in Federal 

Fiscal Year 2005; Hospital Wage Indexes 

for Federal Fiscal Year 2007; Hospital 

Average Hourly Wages for Federal 

Fiscal Years 2005 (2001 Wage Data), 

2006 (2002 Wage Data), and 2007 (2003 

Wage Data); Wage Indexes and 3–Year 

Average of Hospital Average Hourly 

Wages, for the listed providers, the wage 

indexes are corrected to read as follows: 

a. Effective November 3, 2006 

Provider No. FY 2007 wage 

index 

040039 .................................. 0.8341 

040047 .................................. 0.8431 

070002 .................................. 1.2452 

070003 .................................. 1.2461 

070004 .................................. 1.2452 

070007 .................................. 1.2452 

070008 .................................. 1.2452 

070009 .................................. 1.2452 

070011 .................................. 1.2452 

070012 .................................. 1.2452 

070015 .................................. 1.2452 

070020 .................................. 1.2525 

070021 .................................. 1.2461 

070024 .................................. 1.2452 

070025 .................................. 1.2452 

070027 .................................. 1.2452 

070029 .................................. 1.2452 

070035 .................................. 1.2452 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 3 / Friday, January 5, 2007 / Notices 571 

Provider No. FY 2007 wage 

index 

070038 .................................. 1.2452 

100025 .................................. 0.8847 

100026 .................................. 0.8847 

100027 .................................. 0.8847 

100048 .................................. 0.8847 

100054 .................................. 0.8847 

100062 .................................. 0.8907 

100081 .................................. 0.8847 

100093 .................................. 0.8847 

100102 .................................. 0.8972 

100106 .................................. 0.8847 

100108 .................................. 0.8847 

100118 .................................. 0.9245 

100122 .................................. 0.8847 

100124 .................................. 0.8847 

100134 .................................. 0.8847 

100142 .................................. 0.8847 

100156 .................................. 0.8972 

100160 .................................. 0.8847 

100175 .................................. 0.9078 

100212 .................................. 0.8907 

100223 .................................. 0.8847 

100231 .................................. 0.8847 

100242 .................................. 0.8847 

100266 .................................. 0.8847 

100290 .................................. 0.9429 

100292 .................................. 0.8847 

230254 .................................. 1.0381 

230257 .................................. 1.0381 

230264 .................................. 1.0381 

230269 .................................. 1.0381 

230277 .................................. 1.0381 

260004 .................................. 0.8341 

260006 .................................. 0.8341 

260015 .................................. 0.8345 

260022 .................................. 0.8615 

260024 .................................. 0.8341 

260047 .................................. 0.8348 

260059 .................................. 0.8341 

260061 .................................. 0.8341 

260070 .................................. 0.8341 

260074 .................................. 0.8499 

260078 .................................. 0.8341 

260080 .................................. 0.8341 

260097 .................................. 0.8766 

260113 .................................. 0.8341 

260116 .................................. 0.8341 

260119 .................................. 0.8345 

260142 .................................. 0.8341 

260147 .................................. 0.8341 

260160 .................................. 0.8341 

Provider No. FY 2007 wage 

index 

260163 .................................. 0.8341 

260195 .................................. 0.8341 

280061 .................................. 0.9048 

340073 .................................. 0.9828 

380002 .................................. 1.0282 

380040 .................................. 1.0152 

380052 .................................. 1.0152 

380081 .................................. 1.0152 

390044 .................................. 1.1196 

390096 .................................. 1.1196 

430094 .................................. 0.9048 

470001 .................................. 1.0770 

470005 .................................. 1.0383 

470012 .................................. 1.0383 

470024 .................................. 1.0383 

500002 .................................. 1.0390 

500007 .................................. 1.0598 

500012 .................................. 1.0390 

500019 .................................. 1.0603 

500031 .................................. 1.0390 

500033 .................................. 1.0390 

500036 .................................. 1.0390 

500037 .................................. 1.0390 

500049 .................................. 1.0390 

500053 .................................. 1.0390 

500058 .................................. 1.0390 

500148 .................................. 1.0390 

530002 .................................. 0.9128 

530006 .................................. 0.9128 

530008 .................................. 0.9128 

530009 .................................. 0.9128 

530010 .................................. 0.9128 

530011 .................................. 0.9128 

530014 .................................. 0.9128 

530017 .................................. 0.9128 

530032 .................................. 0.9128 

530008 .................................. 0.9057 

530009 .................................. 0.9057 

530010 .................................. 0.9057 

530011 .................................. 0.9057 

530014 .................................. 0.9057 

530017 .................................. 0.9057 

530032 .................................. 0.9057 

b. Effective November 21, 2006. 

Provider No. FY 2007 wage 

index 

230013 .................................. 1.0381 

230019 .................................. 1.0381 

Provider No. FY 2007 wage 

index 

230029 .................................. 1.0381 

230047 .................................. 1.0381 

230071 .................................. 1.0381 

230130 .................................. 1.0381 

230151 .................................. 1.0381 

230195 .................................. 1.0381 

230204 .................................. 1.0381 

230207 .................................. 1.0381 

230223 .................................. 1.0381 

230227 .................................. 1.0381 

230254 .................................. 1.0381 

230257 .................................. 1.0381 

230264 .................................. 1.0381 

230269 .................................. 1.0381 

230277 .................................. 1.0381 

390065 .................................. 1.0977 

390138 .................................. 1.0977 

490005 .................................. 1.0977 

3. On page 59968 in Table 2.—

Hospital Case-Mix Indexes for 

Discharges Occurring in Federal Fiscal 

Year 2005; Hospital Wage Indexes for 

Federal Fiscal Year 2007; Hospital 

Average Hourly Wages for Federal 

Fiscal Years 2005 (2001 Wage Data), 

2006 (2002 Wage Data), and 2007 (2003 

Wage Data); Wage Indexes and 3-Year 

Average of Hospital Average Hourly 

Wages, the table is corrected by adding 

a note to the end of the table to read as 

follows: 

Note: Due to the expiration of section 508 

of the MMA, the wage index values for some 

hospitals will change in the second half of 

the fiscal year. The wage index values in this 

table reflect an average of the first half of FY 

2007 (October 1, 2006–March 31, 2007) and 

second half of FY 2007 (April 1–September 

30, 2007). 

4. On pages 59975 through to 59998, 

in Table 4A–1.—Wage Index and 

Capital Geographic Adjustment Factor 

(GAF) for Urban Areas by CBSA, for the 

listed CBSAs, the wage indexes and 

GAFs are corrected to read as follows: 

CBSA code Urban area (constituent counties) Wage 

index GAF 

15540 ..................................... Burlington-South Burlington, VT .........................................................................................

Chittenden County, VT 2 .....................................................................................................

Franklin County, VT ............................................................................................................

Grand Isle County, VT ........................................................................................................

1.0383 1.0261 

23020 ..................................... Fort Walton Beach-Crestview-Destin, FL2 ..........................................................................

Okaloosa County, FL ..........................................................................................................

0.8847 0.9195 

25540 ..................................... Hartford-West Hartford-East Hartford, CT 1 2 ......................................................................

Hartford County, CT ............................................................................................................

Litchfield County, CT ..........................................................................................................

Middlesex County, CT ........................................................................................................

Tolland County, CT .............................................................................................................

1.2452 1.1620 

28420 ..................................... Kennewick-Richland-Pasco, WA2 .......................................................................................

Benton County, WA ............................................................................................................

Franklin County, WA ...........................................................................................................

1.0390 1.0265 

30300 ..................................... Lewiston, ID–WA (WA Hospitals) 2 .....................................................................................

Nez Perce County, ID .........................................................................................................

Asotin County, WA ..............................................................................................................

1.0390 1.0265 


sroberts on PROD1PC70 with NOTICES
572 Federal Register / Vol. 72, No. 3 / Friday, January 5, 2007 / Notices 

CBSA code Urban area (constituent counties) Wage 

index GAF 

31020 ..................................... Longview, WA .....................................................................................................................

Cowlitz County, WA ............................................................................................................

1.0390 1.0265 

34580 ..................................... Mount Vernon-Anacortes, WA ............................................................................................

Skagit County, WA ..............................................................................................................

1.0390 1.0265 

35300 ..................................... New Haven-Milford, CT 3 ....................................................................................................

New Haven County, CT ......................................................................................................

1.2452 1.1620 

35980 ..................................... Norwich-New London, CT ...................................................................................................

New London County, CT ....................................................................................................

1.2452 1.1620 

36100 ..................................... Ocala, FL2 ...........................................................................................................................

Marion County, FL ..............................................................................................................

0.8847 0.9195 

37460 ..................................... Panama City-Lynn Haven, FL ............................................................................................

Bay County, Fl ....................................................................................................................

0.8847 0.9195 

37860 ..................................... Pensacola-Ferry Pass-Brent, FL ........................................................................................

Escambia County, FL .........................................................................................................

Santa Rosa County, FL ......................................................................................................

0.8847 0.9195 

48300 ..................................... Wenatchee, WA ..................................................................................................................

Chelan County, WA ............................................................................................................

Douglas County, WA ..........................................................................................................

1.0390 1.0265 

49420 ..................................... Yakima, WA ........................................................................................................................

Yakima County, WA ............................................................................................................

1.0390 1.0265 

1 Large urban area. 

2 Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2007. 

3For this area, the wage index and GAF on this table are only effective from October 1, 2006 through March 31, 2007. See Table 4A–2 for the 

values that are effective from April 1 through September 30, 2007. 

5. On page 59998, in Table 4A–2.—

Wage Index and Capital Geographic 

Adjustment Factor (GAF) for Certain 

Urban Areas by CBSA for the Period 

April 1 Through September 30, 2007, for 

the listed CBSAs, the wage indexes and 

GAFs are corrected to read as follows: 

CBSA code Urban area (constituent counties) Wage index GAF 

16940 .................................................. Cheyenne, WY ................................................................................................ 0.9057 0.9344 

35300 .................................................. New Haven-Milford, CT .................................................................................. 1.2452 1.1620 

6. On pages 59998 and 59999, in 

Table 4B–1.—Wage Index and Capital 

Geographic Adjustment Factor (GAF) for 

Rural Areas by CBSA—FY 2007, for the 

listed CBSAs, the wage indexes and 

GAFs are corrected to read as follows: 

CBSA code Nonurban area Wage index GAF 

07 ...................................................................................... Connecticut ...................................................................... 1.2452 1.1620 

10 ...................................................................................... Florida .............................................................................. 0.8847 0.9195 

26 ...................................................................................... Missouri ............................................................................ 0.8341 0.8832 

38 ...................................................................................... Oregon 2 ........................................................................... 1.0152 1.0104 

47 ...................................................................................... Vermont ............................................................................ 1.0383 1.0261 

50 ...................................................................................... Washington ...................................................................... 1.0390 1.0265 

7. On page 59999, in Table 4B–2.—

Wage Index and Capital Geographic 

Adjustment Factor (GAF) for Certain 

Rural Areas by CBSA for the Period 

April 1 Through September 30, 2007, for 

the listed CBSA, the wage index and 

GAF is corrected to read as follows: 

CBSA code Nonurban area Wage index GAF 

53 ...................................................................................... Wyoming .......................................................................... 0.9057 0.9344 

8. On pages 59999 through to 60003, 

in Table 4C–1.—Wage Index and Capital 

Geographic Adjustment Factor (GAF) for 

Hospitals That Are Reclassified by 

CBSA, for the listed CBSAs, the wage 

indexes and GAFs are corrected to read 

as follows: 

a. Effective November 3, 2006. 

CBSA code Area Wage index GAF 

23020 ................................... Fort Walton Beach-Crestview-Destin, FL ...................................................................... 0.8847 0.9195 

25540 ................................... Hartford-West Hartford-East Hartford, CT (CT Hospitals) ............................................ 1.2452 1.1620 

27860 ................................... Jonesboro, AR (MO Hospitals) ..................................................................................... 0.8345 0.8835 

28420 ................................... Kennewick-Richland-Pasco, WA ................................................................................... 1.0390 1.0265 

38340 ................................... Pittsfield, MA .................................................................................................................. 1.0383 1.0261 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 3 / Friday, January 5, 2007 / Notices 573 

CBSA code Area Wage index GAF 

07 ......................................... Connecticut .................................................................................................................... 1.2452 1.1620 

10 ......................................... Florida (FL Hospitals) .................................................................................................... 0.8847 0.9195 

14 ......................................... Illinois (MO Hospitals) ................................................................................................... 0.8341 0.8832 

16 ......................................... Iowa ............................................................................................................................... 0.8615 0.9029 

26 ......................................... Missouri ......................................................................................................................... 0.8341 0.8832 

30 ......................................... New Hampshire ............................................................................................................. 1.0770 1.0521 

38 ......................................... Oregon ........................................................................................................................... 1.0152 1.0104 

50 ......................................... Washington (WA Hospitals) .......................................................................................... 1.0390 1.0265 

53 ......................................... Wyoming ........................................................................................................................ 0.9048 0.9338 

b. Effective November 21, 2006. 

CBSA code Area Wage index GAF 

47894 ................................... Washington-Arlington-Alexandria, DC–VA–MD–WV ..................................................... 1.0977 1.0659 

9. On page 60003, in Table 4C–2.—

Wage Index and Capital Geographic 

Adjustment Factor (GAF) for Certain 

Hospitals That Are Reclassified by 

CBSA for the Period April 1 Through 

September 30, 2007*, CBSAs 35300 and 

19804 are corrected and CBSA 47894 is 

added. The wage indexes and GAFs are 

corrected to read as follows: 

a. Effective November 3, 2006. 

CBSA code Area Wage index GAF 

19804 .................................................. Detroit-Livonia-Dearborn, MI .......................................................................... 1.0381 1.0192 

35300 .................................................. New Haven-Milford, CT .................................................................................. 1.2452 1.1620 

b. Effective November 21, 2006. 

CBSA code Area Wage index GAF 

47894 .................................................. Washington–Arlington–Alexandria, DC–VA–MD–WV .................................... 1.0977 1.0659 

10. On pages 60004 through to 60012, 

in Table 4J.—Out-Migration 

Adjustment—FY 2007, provider number 

010009 is corrected and provider 

number 010010 is added to read as 

follows: 

a. Effective October 1, 2006. 

Provider No. 

Reclassified 

between 10/1/06 

and 3/31/07 

Reclassified 

between 4/1/07 

and 9/30/07 

Out-migration 

adjustment 

Qualifying 

county name 

010009 ............................................................................................. * * 0.0092 MORGAN. 

010010 ............................................................................................. * * 0.0259 MARSHALL. 

11. On pages 60013 through to 60025, 

in Table 5.—List of Diagnosis-Related 

Groups (DRGS), Relative Weighting 

Factors, and Geometric and Arithmetic 

Mean Length of Stay (LOS), DRGs 525, 

544, and 572 are corrected to read as 

follows: 

a. Effective October 1, 2006. 

DRG 

FY 07 final 

rule postacute care 

DRG 

FY 07 final 

rule special 

pay DRG 

MDC Type DRG title Weights Geometric 

mean LOS 

Arithmetic 

mean LOS 

525 ........ No ................. No ................. 05 SURG Other Heart Assist System Implant 2.2268 7.7 14.3 

544 ........ Yes ............... Yes ............... 08 SURG Major Joint Replacement or Reattachment of Lower Extremity.1.9878 4.0 4.4 

572 ........ Yes ............... No ................. 06 MED .. Major Gastrointestinal Disorders 

and Peritoneal Infections.

1.3378 5.6 7.1 

12. On page 60025 in Table 5.—List 

of Diagnosis-Related Groups (DRGs), 

Relative Weighting Factors, and 

Geometric and Arithmetic Mean Length 

of Stay (LOS), the table is corrected by 

adding the following notes to the end of 

the table: 

a. Effective October 1, 2006. 

Note: If there is an asterisk in the ‘‘Type’’

column this means that data is unavailable to 

calculate weights for these low volume DRGs. 

Therefore, last year’s weights have been 

updated based on the percent change in 


sroberts on PROD1PC70 with NOTICES
574 Federal Register / Vol. 72, No. 3 / Friday, January 5, 2007 / Notices 

1Section 116 of FDAMA (Public Law 105–115) 

amended the Federal Food, Drug, and Cosmetic Act 

(FDCA) by adding section 506A (21 U.S.C. 356a), 

which describes requirements and procedures for 

making and reporting manufacturing changes to 

certain approved marketing applications, including 

new drug applications (NDAs) and abbreviated new 

drug applications (ANDAs). 

normalization factors between FY 2006 and 

FY 2007. 

Note: If there is no value or dashes (that 

is, ‘‘----’’) in either the geometric mean LOS 

or the arithmetic mean LOS columns, the 

volume of cases is insufficient to determine 

a meaningful computation of these statistics. 

IV. Discussion of Effective Date and 

Notice and Comment Rulemaking 

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)). In addition, 

a final rule would ordinarily require a 

30-day delay in effective date after the 

date of publication in the Federal 

Register. This correction of the rates 

published in the FY 2007 IPPS notice 

does not constitute a rule under the 

Administrative Procedure Act, because, 

in our FY 2007 IPPS final rule (71 FR 

47870, August 18, 2006), we already 

published the methodologies and 

formulas we use for determining the 

wage index, geographic adjustment 

factors, and other rates. This notice does 

not change our methodology or 

formulas, but merely ensures that our 

rules are implemented correctly. As this 

notice is not a rule under the 

Administrative Procedure Act, no notice 

of proposed rulemaking or delay in 

effective date is necessary. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program.) 

Dated: December 28, 2006. 

Ashley Files Flory, 

Deputy Executive Secretary to the 

Department. 

[FR Doc. 06–9976 Filed 12–29–06; 1:29 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Food and Drug Administration 

[Docket No. 2006N–0525] 

Supplements and Other Changes to an 

Approved Application; Public Meeting 

AGENCY: Food and Drug Administration, 

HHS. 

ACTION: Notice of public meeting. 

SUMMARY: The Food and Drug 

Administration (FDA) is announcing a 

public meeting to solicit comments on 

issues that FDA should consider when 

developing revisions to its regulations 

regarding chemistry, manufacturing, 

and controls (CMC) supplements and 

other changes to approved marketing 

applications for human drugs. FDA is 

evaluating how it could revise its 

regulations to allow for consideration of 

risk-based approaches based on 

manufacturing process understanding, 

including prior knowledge of similar 

products, and overall quality systems to 

provide an enhanced risk-based 

approach to the CMC regulatory process, 

which would reduce the number of 

supplements. We will consider the 

input from the public meeting and 

comments on the issues presented in 

this document as we consider whether 

to revise our regulations. 

DATES: The public meeting will be held 

on February 7, 2007, from 8:30 a.m. to 

3:30 p.m. Anyone who wishes to speak 

at the meeting must register and submit 

a summary of the presentation by 

January 24, 2007, and submit an 

electronic copy of the presentation by 

January 31, 2007. See section III of the 

SUPPLEMENTARY INFORMATION section of 

this document for details on how to 

register. Submit written or electronic 

comments by March 7, 2007. 

ADDRESSES: The public meeting will be 

held at the Food and Drug 

Administration, Center for Drug 

Evaluation and Research Conference 

Room, 7519 Standish Pl., third floor, rm. 

A, Rockville, MD 20855. There is 

parking near the building. Photo 

identification is required to clear 

building security. 

Submit written comments to the 

Division of Dockets Management (HFA–

305), Food and Drug Administration, 

5630 Fishers Lane, rm. 1061, Rockville, 

MD 20852. Submit electronic comments 

to http://www.fda.gov/dockets/ 

ecomments. 

FOR FURTHER INFORMATION CONTACT: 

David J. Cummings, Center for Drug 

Evaluation and Research, Food and 

Drug Administration, 10903 New 

Hampshire Ave., Bldg. 21, rm. 3525, 

Rockville, MD 20993–0002, 301–796–

2400, e-mail: 

David.Cummings@fda.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In the Federal Register of June 28, 

1999 (64 FR 34608), FDA published a 

proposed rule to implement section 116 

of the Food and Drug Administration 

Modernization Act (FDAMA)1 by 

amending certain regulations including 

§ 314.70 (21 CFR 314.70) regarding 

supplements and other changes to 

approved human new drug and 

abbreviated new drug marketing 

applications. In the Federal Register of 

April 8, 2004 (69 FR 18728), FDA 

published the final rule (final rule) 

implementing these changes. Section 

314.70, as amended, requires 

manufacturers to assess the effects of 

manufacturing changes on the identity, 

strength, quality, purity, and potency of 

a drug as those factors relate to the 

safety or effectiveness of the product, 

and categorizes all changes beyond the 

established variations in an approved 

NDA or ANDA into one of three 

groups—major, moderate, or minor. 

Major changes require an applicant to 

submit and receive FDA approval of a 

supplement before distribution of the 

product made with the manufacturing 

change. Moderate changes require an 

applicant to submit a supplement at 

least 30 days before distribution of the 

product or, in some cases, submit a 

supplement at the time of distribution. 

Minor changes require an applicant to 

notify FDA of the changes in an annual 

report. 

In August 2002, FDA introduced the 

Pharmaceutical Current Good 

Manufacturing Practices (CGMPs) for 

the 21st Century Initiative (CGMP 

Initiative, available on the Internet at 

http://www.fda.gov/cder/gmp/ 

index.htm) to enhance and modernize 

the regulation of pharmaceutical 

manufacturing and product quality. In 

September 2004 (after publication of the 

final rule), FDA published a final report 

on ‘‘Pharmaceutical CGMPs for the 21st 

Century—A Risk-Based Approach’’

(http://www.fda.gov/cder/gmp/ 

gmp2004/GMP_finalreport2004.htm). 

As explained in the report, FDA 

regulates pharmaceutical manufacturing 

to ensure that the drug supply in the 

United States is of consistently high 

quality. Because of critical public health 

implications of drug manufacturing, 

FDA traditionally has exercised 

extensive control over virtually every 

aspect of the manufacturing process. 

This regulatory approach has 

contributed to pharmaceutical 

companies being reluctant to change 

their manufacturing processes and 

equipment. In recent years, significant 

advances in pharmaceutical 

manufacturing science, modern quality 

management systems, and risk 

management approaches have taken 

place. This has yielded new tools that 


sroberts on PROD1PC70 with NOTICES