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 Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 411, 412, 413, and 489
[CMS-1533-CN]
RIN 0938-A070
 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
 ACTION: Correction of proposed rule.
 SUMMARY: This document corrects technical errors that appeared in the proposed rule entitled “Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates” that appeared in the May 3, 2007 
                        **Federal Register**
                        .
 FOR FURTHER INFORMATION CONTACT: Marc Hartstein, (410) 786-4548.


SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), there were a number of technical errors that are identified and corrected in the Correction of Errors section of this notice. We issued the fiscal year (FY) 2008 hospital inpatient prospective payment systems (IPPS) proposed rule on April 13, 2007. The FY 2008 IPPS proposed rule appeared in the May 3, 2007 
                    **Federal Register**
                    . II. Summary of Errors We recently discovered that an error was made in the calculation of the DRG relative weights presented in the FY 2008 IPPS proposed rule. We have revised the relative weights to correct the error and have recalculated the standardized amounts. These changes increase the standardized amounts slightly and reduce the proposed FY 2008 outlier threshold by $85. Further, these revisions affect the DRG-specific costs thresholds for new technology add-on payments. Therefore, in this notice we are correcting the following: Preamble language regarding the methodology used to calculate charge-based and cost-based relative weights.
                Outlier threshold.
                Recalibration, wage and recalibration, geographic reclassification, and rural floor budget neutrality factors.
                Tables 1A through 1D, 2, 4A, 4C, 4J, 5, 10.
                Impact analysis tables (Tables I and II). In addition, we have posted these corrected tables on our Web site at 
                    *http://www.cms.hhs.gov/​AcuteInpatientPPS/​WIFN/​list.asp.* III. Correction of Errors In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), make the following corrections: A. Corrections to the Preamble 1. On page 24711, second column, last paragraph, sixth line from the bottom, the figure “$23,015” is corrected to read “$22,930.” 2. On page 24746, second column, a. Third full paragraph, line 9, the phrase, “in the FY 2005 MedPAR” is corrected to read “in the FY 2006 MedPAR.” b. Fifth full paragraph, last line, after the phrase “cost of living adjustment.”, the following sentence is added to read as follows: “Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well.” 3. On page 24747, first column, third full paragraph, last line, after the phrase “cost of living adjustment.” and before the phrase “Charges were then”, the following sentence is added to read as follows: “Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well.” B. Corrections to the Addendum 1. On page 24836, a. First column, second full paragraph, (1) Line 14, the figure “0.999317” is corrected to read “0.999367.” (2) Lines 19 and 29, the figure “0.998557” is corrected to read “0.998573.” b. Second column, first partial paragraph, line 17, the figure “0.991938” is corrected to read “0.991925.” 2. On page 24837, second column, second full paragraph, line 6, the figure “$23,015” is corrected to read “$22,930”. 3. On page 24839, top half of the page, in the table Comparison of FY 2007 Standardized Amounts to Proposed FY 2008 Single Standardized Amount with Full Update and Reduced Update, the figures in the listed entries are corrected to read as follows: Full update
                             (3.3 percent)
Reduced 
                             update 
                             (1.3 percent)FY 2008 DRG Recalibrations and Wage Index Budget Neutrality Factor
0.999367
0.999367FY 2008 Reclassification Budget Neutrality Factor
0.991925
0.991925
 
 
 4. On page 24846, third column, first full paragraph, a. Line 38, the figure “$417.26” is corrected to read “$417.12.” b. Line 40, the figure “$413.87” is corrected to read “$413.73.” 5. On page 24847, a. Middle of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Urban Hospitals, third column, last row, the figure, “$413.87” is corrected to read “$413.73.” b. Lower third of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Rural Hospitals, third column, last row, the figure “$417.26” is corrected to read “$417.12.” 6. On page 24848, a. First column, fourth full paragraph, (1) Line 10, the phrase “is $197.21” is corrected to read “is $197.11.”. (2) Line 12, the figure “$195.60” is corrected to read “$195.51.” b. Second column, third paragraph, last line, the figure “$23,015” is corrected to read “$22,930”. 7. On page 24850, in Table 1A.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1), the table is corrected to read as follows: Table 1A.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1)
Full update
                             (3.3 percent)
Reduced update
                             (1.3 Percent)Labor-related
Nonlabor-related
Labor-related
Nonlabor-related$3,430.41
$1,491.27
$3,363.99
$1,462.40
 8. On page 24850, in Table 1B.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than Or Equal To 1), the table 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 Less Than or Equal to 1)
Full update
                             (3.3 percent)
Reduced update
                             (1.3 Percent)Labor-related
Nonlabor-related
Labor-related
Nonlabor-related$3,051.44
$1,870.24
$2,992.36
$1,834.03
 9. On page 24850, in Table 1C.—Adjusted Operating Standardized Amounts For Puerto Rico Labor, Labor/Nonlabor, the table is corrected to read as follows: Table 1C.—Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor
Rates if wage index greater than 1
Rates if wage index less than or equal to 1Labor
Nonlabor
Labor
NonlaborNational
$3,430.41
$1,491.27
$3,363.99
$1,462.40Puerto Rico
1,442.16
883.90
1,365.40
960.66
 10. On page 24850, in Table 1D.—Capital Standard Federal Payment Rate, the table is corrected to read as follows: Table 1D.—Capital Standard Federal Payment Rate
Urban rate
Rural rateNational
$413.73
$417.12Puerto Rico
195.51
197.11
 11. On pages 24851 through 24917, in Table 2.—Hospital Case-Mix Indexes For Discharges Occurring in Federal Fiscal Year 2006; Hospital Wage Indexes For Federal Fiscal Year 2008; Hospital Average Hourly Wages For Federal Fiscal Years 2006 (2002 Wage Data), 2007 (2003 Wage Data), And 2008 (2004 Wage Data); And 3-Year Average Of Hospital Average Hourly Wages, the wage index for the listed provider numbers are corrected to read as follows: 
                    ( print page 31509) Provider No.
FY 2008 
                             wage index010012
0.9390010047
0.7776010052
0.7701010109
0.8049010110
0.7900010164
0.8042040014
0.8720040017
0.8718040041
0.8720040071
0.8720040076
0.8720040078
0.8720040100
0.8720040119
0.8720050007
1.4907050008
1.4792050009
1.4200050013
1.4200050016
1.2015050047
1.4792050055
1.4792050070
1.4907050113
1.4907050152
1.4792050228
1.4792050232
1.2015050280
1.2826050289
1.4907050407
1.4792050454
1.4792050457
1.4792050506
1.2015050633
1.2015050667
1.4200050668
1.4792050697
1.2826050707
1.4907050733
1.2826050754
1.4907060010
0.9730060030
0.9730080001
1.0777080003
1.0777100102
0.8874100290
0.9331110107
0.9752110164
0.9752110201
0.9752130066
0.9680130068
0.9680150015
0.8904160030
1.0022180013
0.9407180064
0.8131180066
0.9407180079
0.8075180080
0.8042180124
0.9407190044
0.7849190190
0.7752190246
0.7752200032
0.8878210028
0.9429230036
0.9398230041
0.9398230047
1.0091230080
0.9398230105
0.9398230195
1.0091230204
1.0091230222
0.9398230227
1.0091230257
1.0091230264
1.0091230297
1.0091230299
1.0091230300
1.0091240006
1.0760240010
1.0760240018
1.0084240061
1.0760240069
1.0760240071
1.0760270081
0.8574280065
0.9746310010
1.0812310011
1.0864310014
1.0777310044
1.0812310081
1.0777310092
1.0812310110
1.0812320001
0.9739320005
0.9739320006
0.9739320009
0.9739320011
0.9407320017
0.9739320019
0.9739320021
0.9739320037
0.9739320074
0.9739320079
0.9739320083
0.9739330135
1.1528330205
1.1528330264
1.1528340133
0.8916360044
0.8825370113
0.8718380029
1.0479380051
1.0479380056
1.0479390044
1.0777390096
1.0777390133
1.0777410013
1.1793430012
0.9394430013
0.9394430048
0.8398440011
0.8042440015
0.8042440019
0.8042440030
0.7972440034
0.8042440035
0.9407440056
0.8042440073
0.9407440084
0.7949440110
0.8042440120
0.8042440125
0.8042440144
0.9407440148
0.9407440151
0.9407440153
0.7923440173
0.8042440175
0.9407440192
0.9407440225
0.8042440226
0.8042450370
0.8444450565
0.8690450755
0.8498
 12. On pages 24924, 29426, and 24941, in Table 4A.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA—FY 2008, the wage index and GAF for the listed CBSAs are corrected to read as follows: CBSA code
Urban area
Wage index
GAF10740
Albuquerque, NM
0.9739
0.9821Bernalillo County, NMSandoval County, NMTorrance County, NMValencia County, NM13020
Bay City MI
0.9398
0.9584Bay County, MI40340
Rochester, MN
1.0760
1.0514Dodge County, MNOlmsted County, MNWabasha County, MN
 13. On pages 24948 through 24951, in Table 4C.—Wage Index And Capital Geographic Adjustment Factor (GAF) For Hospitals That Are Reclassified By CBSA FY 2008, the wage indices and GAFs for the listed areas are corrected to read as follows:
                    ( print page 31510) CBSA code
Area
Wage index
GAF10740
Albuquerque, NM
0.9739
0.982113020
Bay City, MI
0.9398
0.958422220
Fayetteville-Springdale-Rogers, AR-MO
0.8718
0.910335980
Norwich-New London, CT
1.1793
1.119640340
Rochester, MN
1.0760
1.051440660
Rome, GA
0.9390
0.957843620
Sioux Falls, SD
0.9394
0.9581
 14. On pages 24952 through 24960, in Table 4J.—Out-Migration Adjustment—FY 2008, the entries for the listed providers are corrected to read as follows: Provider No.
Reclassified for FY 2008
Out-migration 
                             adjustment
Qualifying county name
County code010009
*
0.0092
MORGAN
01510010025
*
0.0235
CHAMBERS
01080010038

0.0039
CALHOUN
01070010047

0.0178
BUTLER
01060010052

0.0103
TALLAPOOSA
01610010054
*
0.0092
MORGAN
01510010065
*
0.0103
TALLAPOOSA
01610010078

0.0039
CALHOUN
01070010085
*
0.0092
MORGAN
01510010109

0.0451
PICKENS
01530010110

0.0302
BULLOCK
01050010146

0.0039
CALHOUN
01070010150
*
0.0178
BUTLER
01060050007

0.0141
SAN MATEO
05510050008

0.0026
SAN FRANCISCO
05480050016

0.0103
SAN LUIS OBISPO
05500050047

0.0026
SAN FRANCISCO
05480050055

0.0026
SAN FRANCISCO
05480050070

0.0141
SAN MATEO
05510050076
*
0.0026
SAN FRANCISCO
05480050113

0.0141
SAN MATEO
05510050152

0.0026
SAN FRANCISCO
05480050194
*
0.0052
SANTA CRUZ
05540050197
*
0.0141
SAN MATEO
05510050228

0.0026
SAN FRANCISCO
05480050232

0.0103
SAN LUIS OBISPO
05500050242
*
0.0052
SANTA CRUZ
05540050289

0.0141
SAN MATEO
05510050407

0.0026
SAN FRANCISCO
05480050454

0.0026
SAN FRANCISCO
05480050457

0.0026
SAN FRANCISCO
05480050506

0.0103
SAN LUIS OBISPO
05500050541
*
0.0141
SAN MATEO
05510050633

0.0103
SAN LUIS OBISPO
05500050668

0.0026
SAN FRANCISCO
05480050707

0.0141
SAN MATEO
05510050714
*
0.0052
SANTA CRUZ
05540050754

0.0141
SAN MATEO
05510060010

0.0153
LARIMER
06340060030

0.0153
LARIMER
06340080001
*
0.0063
NEW CASTLE
08010080003
*
0.0063
NEW CASTLE
08010100102

0.0125
COLUMBIA
10110100156
*
0.0125
COLUMBIA
10110100290

0.0582
SUMTER
10590110146
*
0.0805
CAMDEN
11170130049
*
0.032
KOOTENAI
13270130066

0.032
KOOTENAI
13270130067
*
0.0696
BINGHAM
13050130068

0.032
KOOTENAI
13270140167
*
0.1055
IROQUOIS
14460150006
*
0.0113
LA PORTE
15450150015

0.0113
LA PORTE
15450150146
*
0.0319
NOBLE
15560160030

0.004
STORY
16840170137
*
0.0336
DOUGLAS
17220( print page 31511)180064

0.0319
MONTGOMERY
18860180066
*
0.0449
LOGAN
18700180079

0.0263
HARRISON
18480190044

0.0258
ACADIA
19000190099
*
0.0188
AVOYELLES
19040190184
*
0.0161
CALDWELL
19100190190

0.0161
CALDWELL
19100190246

0.0161
CALDWELL
19100200032

0.0466
OXFORD
20080210028

0.0512
ST. MARY'S
21180230069
*
0.0209
LIVINGSTON
23460230279
*
0.0209
LIVINGSTON
23460240018

0.0872
GOODHUE
24240270081

0.0237
MUSSELSHELL
27320300011
*
0.0069
HILLSBOROUGH
30050300012
*
0.0069
HILLSBOROUGH
30050300020
*
0.0069
HILLSBOROUGH
30050300034
*
0.0069
HILLSBOROUGH
30050310010

0.0092
MERCER
31260310011

0.0115
CAPE MAY
31180310021
*
0.0092
MERCER
31260310044

0.0092
MERCER
31260310092

0.0092
MERCER
31260310110

0.0092
MERCER
31260320003
*
0.0629
SAN MIGUEL
32230320011

0.0442
RIO ARRIBA
32190330027
*
0.0149
NASSAU
33400330106
*
0.0149
NASSAU
33400330167
*
0.0149
NASSAU
33400330181
*
0.0149
NASSAU
33400330182
*
0.0149
NASSAU
33400330198
*
0.0149
NASSAU
33400330225
*
0.0149
NASSAU
33400330259
*
0.0149
NASSAU
33400330331
*
0.0149
NASSAU
33400330332
*
0.0149
NASSAU
33400330372
*
0.0149
NASSAU
33400340133

0.0308
MARTIN
34580360010
*
0.0076
TUSCARAWAS
36800360013
*
0.0136
SHELBY
36760360025
*
0.0072
ERIE
36220360044

0.0124
DARKE
36190360096
*
0.0072
COLUMBIANA
36140360175
*
0.0176
CLINTON
36130360185
*
0.0072
COLUMBIANA
36140380022
*
0.0068
LINN
38210380029

0.0075
MARION
38230380051

0.0075
MARION
38230380056

0.0075
MARION
38230390030
*
0.0284
SCHUYLKILL
39650390031
*
0.0284
SCHUYLKILL
39650390065
*
0.049
ADAMS
39000390138
*
0.0213
FRANKLIN
39350390151
*
0.0213
FRANKLIN
39350390162
*
0.02
NORTHAMPTON
39590390181
*
0.0284
SCHUYLKILL
39650390183
*
0.0284
SCHUYLKILL
39650390313
*
0.0284
SCHUYLKILL
39650420009
*
0.0113
OCONEE
42360420039
*
0.0153
UNION
42430420062
*
0.0109
CHESTERFIELD
42120440030

0.0056
HAMBLEN
44310440067
*
0.0056
HAMBLEN
44310440084

0.0033
MONROE
44610440153

0.0007
COCKE
44140450324
*
0.0132
GRAYSON
45564450370

0.024
COLORADO
45312450393
*
0.0132
GRAYSON
45564450395
*
0.0451
POLK
45850450438
*
0.024
COLORADO
45312450469
*
0.0132
GRAYSON
45564450565

0.0486
PALO PINTO
45841450755

0.0294
HOCKLEY
45652( print page 31512)510077
*
0.0021
MINGO
51290
 15. On pages 24960 through 24977, in Table 5.—List of Proposed Medicare Severity-Diagnosis Related Groups (MS-DRGs), Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay, the table is corrected to read as follows: 
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  
 
  16. On pages 25095 through 25099, in Table 10.—Geometric Mean Plus The Lesser of .75 Of The National Adjusted Operating Standardized Payment 
                    ( print page 31532)
                    Amount (Increased To Reflect The Difference Between Costs And Charges) Or .75 Of One Standard Deviation Of Mean Charges By Proposed Medicare Severity Diagnosis Related Group (MS-DRG) April 2007,[1]
                    
                     the table is corrected to read as follows: Proposed  MS-DRG
Number of cases
Threshold1
629
$337,7762
328
177,4593
23,999
266,1994
21,742
162,4485
842
159,5066
495
90,8777
413
130,2768
560
92,4829
1,358
96,14810
177
72,49811
1,289
71,56912
1,923
51,37713
1,484
36,89020
901
138,45121
558
107,62522
251
74,54723
3,112
81,76224
2,576
60,74025
8,417
79,52226
11,626
52,97027
14,454
41,14128
1,609
73,99429
2,862
45,28030
3,751
30,57831
1,057
59,86232
2,987
35,34133
4,263
30,56234
813
58,04535
2,506
42,02036
7,710
36,36537
4,777
51,68838
14,602
33,10739
55,357
25,68740
4,549
58,68241
7,720
39,54742
5,430
34,18652
1,156
29,43353
593
22,83654
4,664
30,61055
16,896
24,93456
7,716
29,07257
48,432
19,65758
789
28,52559
2,639
22,93960
4,201
17,67961
1,340
53,31862
2,288
41,97963
1,185
36,18664
55,552
34,35865
112,189
27,00466
94,547
21,58667
1,383
30,61668
12,393
23,50669
103,747
18,93670
7,092
34,03171
10,001
26,44472
6,056
20,62873
8,655
26,84474
32,523
21,42775
1,197
33,93176
874
24,31877
1,101
32,85478
1,307
24,93379
957
20,52380
2,077
24,13581
8,190
17,50282
1,646
33,91083
1,940
28,38384
2,591
22,65485
5,328
35,67986
10,382
26,40487
12,152
20,14488
717
30,10789
2,641
23,70690
3,319
17,87491
6,676
29,69092
14,890
22,31393
15,484
17,17294
1,521
56,93895
1,088
42,96496
755
36,33897
1,252
51,31498
1,048
35,97799
642
30,167100
15,837
28,714101
56,905
19,341102
1,352
24,321103
15,023
17,133113
568
31,544114
601
21,640115
1,098
25,563116
665
23,828117
1,400
16,827121
587
22,514122
674
13,518123
2,843
19,108124
679
24,153125
4,705
16,568129
1,374
37,663130
1,072
28,539131
655
35,824132
728
27,050133
1,352
31,142134
2,661
20,306135
781
35,301136
1,113
24,451137
1,108
28,410138
1,370
20,587139
2,145
22,300146
687
35,060147
1,422
25,142148
935
18,944149
39,248
15,883150
939
25,105151
6,801
13,607152
2,352
22,958153
16,028
15,145154
1,843
27,851155
4,207
22,020156
5,140
16,103157
1,145
28,232158
3,039
21,662159
2,418
15,345163
13,431
79,829164
18,047
47,971165
14,553
37,942166
20,290
58,779167
20,772
40,117168
5,758
30,294175
11,954
33,475176
40,173
26,670177
57,179
36,617178
71,192
30,381179
27,454
24,673180
22,474
32,948181
32,156
26,822182
6,163
22,468183
1,654
29,694184
4,141
22,561185
2,593
15,740186
8,533
31,857187
9,968
25,761188
5,148
20,974189
104,531
28,757190
57,041
27,770191
121,659
24,280192
196,903
18,419193
88,053
29,668194
266,599
24,679195
147,744
18,274196
5,143
30,999197
6,894
25,721198
4,943
21,129199
3,257
33,231200
8,185
23,984201
3,523
17,676202
31,587
20,635203
41,587
15,003204
26,039
17,394205
5,775
26,368206
22,415
18,854207
46,165
83,212208
79,432
41,398215
150
151,502216
8,411
165,422217
7,609
118,088218
3,256
98,470219
10,062
132,460220
13,481
94,478221
8,383
81,144222
2,865
149,784223
5,770
116,219224
1,919
138,213225
5,871
109,030226
7,048
112,464227
50,536
88,444228
3,084
126,976229
4,128
89,139230
1,989
73,311231
1,478
138,287232
1,795
107,403233
16,911
119,988234
39,167
86,734235
9,628
97,022236
32,871
68,172237
21,789
85,211238
44,929
53,794239
13,814
64,168240
13,349
43,051241
3,350
31,297242
17,179
64,273243
37,856
50,218244
68,201
42,102245
6,241
54,054246
32,661
64,613247
279,972
46,787248
5,013
58,218249
29,657
41,876250
5,739
53,408251
39,905
38,200252
44,602
48,168253
46,864
43,475254
59,029
34,550255
2,609
39,961256
3,833
30,250257
774
23,818258
598
49,682( print page 31533)259
7,328
35,034260
867
47,446261
2,804
28,303262
3,378
23,301263
788
29,053264
30,137
39,708280
60,735
36,717281
57,734
28,584282
60,951
23,031283
15,852
30,928284
4,911
23,409285
3,254
17,351286
23,282
40,266287
172,488
28,923288
3,245
50,617289
1,423
36,464290
484
28,249291
183,774
29,157292
217,052
24,421293
226,688
17,810294
1,704
21,989295
1,658
13,805296
1,730
26,654297
943
20,306298
554
12,889299
17,443
28,063300
46,820
21,997301
39,910
15,712302
7,873
23,741303
81,458
15,192304
2,084
24,110305
35,646
15,139306
1,379
27,644307
6,447
18,857308
33,528
27,255309
79,751
20,827310
160,738
14,816311
24,867
13,364312
169,247
18,273313
220,769
14,894314
60,053
30,750315
30,730
23,629316
20,101
16,823326
11,567
88,786327
10,901
49,818328
9,333
32,074329
48,135
80,371330
66,303
47,127331
31,391
35,021332
1,890
74,102333
6,196
46,130334
4,023
34,266335
7,161
68,407336
12,516
43,200337
8,835
32,563338
1,499
58,047339
3,192
39,795340
3,607
30,753341
874
42,806342
2,536
31,921343
6,875
24,258344
898
51,426345
2,915
33,636346
2,909
27,779347
1,568
36,443348
3,985
27,800349
5,787
19,265350
1,669
41,035351
3,997
28,329352
8,419
19,894353
3,182
44,303354
9,118
30,612355
17,451
23,281356
8,366
58,953357
8,046
40,130358
2,714
31,167368
3,052
31,502369
4,005
25,728370
3,914
20,084371
16,843
32,446372
22,903
26,907373
14,897
20,598374
9,414
34,760375
19,730
26,563376
4,816
22,403377
50,503
30,943378
84,806
24,936379
128,748
19,140380
2,917
32,583381
4,894
26,915382
5,445
20,581383
1,303
28,065384
8,664
21,556385
2,107
33,476386
7,221
25,067387
5,230
20,543388
18,267
29,699389
46,328
23,347390
48,052
16,336391
47,511
24,761392
306,515
17,829393
23,917
28,925394
45,952
23,434395
26,460
17,594405
3,903
83,940406
5,241
49,125407
2,310
36,497408
1,644
67,203409
1,713
46,400410
722
35,648411
978
65,359412
1,063
47,834413
881
37,325414
5,596
59,660415
6,847
40,610416
6,222
30,251417
16,671
46,291418
27,563
36,466419
38,264
28,533420
714
61,258421
1,091
36,437422
364
28,520423
1,500
63,840424
912
44,260425
157
35,667432
16,259
30,416433
9,022
22,852434
945
17,210435
11,908
32,613436
13,987
26,367437
4,357
23,539438
14,426
31,691439
24,816
25,250440
27,346
18,913441
13,912
29,122442
12,756
23,365443
6,698
18,374444
12,447
31,276445
16,757
25,851446
16,849
20,274453
846
162,178454
1,496
110,006455
1,875
85,089456
764
132,358457
1,763
93,955458
1,534
78,607459
3,180
93,067460
50,317
61,555461
1,062
78,144462
14,234
58,820463
5,283
64,018464
6,322
42,171465
2,942
31,102466
4,152
70,822467
10,818
52,840468
28,701
44,445469
29,730
57,143470
410,173
41,440471
2,227
71,285472
6,218
48,040473
22,546
39,667474
2,829
51,053475
3,530
35,636476
1,698
26,070477
2,257
57,109478
7,144
41,570479
10,267
33,395480
25,866
50,686481
59,136
38,146482
64,739
33,332483
5,729
44,536484
17,949
37,665485
967
55,459486
1,535
40,900487
1,214
33,214488
1,551
33,205489
3,866
26,495490
19,803
34,057491
58,396
24,028492
4,700
48,148493
15,248
36,196494
30,563
28,910495
1,867
51,435496
5,049
34,292497
7,519
27,156498
1,177
36,767499
1,245
22,858500
1,349
47,836501
3,679
30,766502
6,825
23,032503
736
38,112504
2,155
30,857505
3,214
24,352506
909
25,023507
779
33,035508
2,722
26,249509
465
25,608510
957
38,420511
4,008
30,072512
11,961
23,087513
1,287
29,502514
1,339
20,718515
3,577
51,402516
10,963
37,292517
18,263
30,388533
828
27,486534
3,634
15,819535
6,844
27,022536
34,321
15,408537
654
20,405538
1,164
12,954539
3,379
34,667540
4,187
27,375541
1,858
22,002542
6,158
33,306543
18,413
25,124544
12,644
18,008545
4,016
34,451546
5,881
24,102( print page 31534)547
4,880
18,469548
591
33,006549
1,077
25,270550
904
18,381551
9,502
29,646552
87,859
18,492553
2,790
24,265554
20,253
14,944555
1,995
22,555556
19,168
14,428557
3,184
29,321558
14,178
19,372559
1,635
28,972560
3,979
20,901561
7,617
13,636562
4,996
26,929563
36,056
15,451564
1,606
27,237565
3,237
21,478566
2,779
15,695573
5,687
46,949574
12,100
33,325575
6,468
25,393576
558
44,896577
2,179
31,142578
3,299
23,686579
3,088
44,811580
6,766
31,460581
5,288
23,941582
8,972
24,930583
15,549
19,001584
1,431
27,897585
2,818
20,786592
3,982
30,226593
12,832
23,538594
2,955
16,562595
1,082
29,610596
5,755
19,571597
548
29,514598
1,483
23,497599
350
15,943600
572
21,988601
865
15,125602
21,307
26,948603
130,923
18,145604
2,627
25,150605
22,672
16,152606
1,363
22,966607
7,169
14,791614
1,376
44,346615
1,626
32,541616
1,132
61,354617
6,822
37,382618
343
28,522619
663
60,076620
1,877
41,119621
6,556
35,242622
1,234
45,937623
3,268
33,291624
487
24,889625
1,098
40,232626
2,522
27,537627
14,305
19,134628
3,267
51,514629
3,958
40,808630
684
31,392637
16,283
26,892638
40,811
20,070639
41,135
14,010640
55,690
23,971641
188,104
16,575642
1,542
23,138643
5,014
31,125644
11,845
24,210645
8,402
18,520652
10,437
57,281653
1,585
86,150654
3,231
54,167655
1,650
40,670656
3,721
56,568657
7,359
38,736658
8,479
32,186659
4,442
51,032660
7,444
36,348661
4,745
29,748662
988
41,594663
2,131
29,231664
4,676
23,754665
690
46,858666
2,213
30,439667
3,948
19,910668
3,757
39,537669
12,491
27,870670
13,411
19,410671
884
28,518672
965
19,128673
12,577
43,111674
10,503
40,270675
11,704
31,229682
75,827
30,254683
112,129
25,615684
43,451
19,020685
2,493
19,996686
1,581
31,234687
3,322
24,255688
1,198
18,441689
55,398
25,904690
200,059
18,352691
898
31,887692
654
25,534693
2,235
27,712694
19,213
17,667695
974
24,032696
10,565
14,808697
575
17,475698
21,061
27,909699
22,820
23,309700
15,089
17,723707
4,874
35,532708
17,015
29,281709
755
34,020710
2,037
27,689711
921
34,145712
819
20,449713
11,755
25,154714
32,745
15,644715
638
34,191716
1,382
26,921717
634
31,538718
633
19,455722
871
28,980723
2,037
23,777724
666
15,999725
802
23,413726
3,940
16,420727
1,098
26,180728
6,176
16,848729
578
22,426730
552
14,387734
1,470
39,650735
1,328
26,263736
840
68,822737
3,429
39,321738
954
28,973739
975
48,200740
4,366
31,584741
6,554
24,119742
10,705
29,966743
35,310
21,122744
1,498
28,762745
2,189
20,066746
2,486
27,713747
11,218
20,664748
21,171
19,841749
1,037
42,792750
484
24,671754
1,083
31,715755
3,152
24,245756
831
16,790757
1,322
31,004758
1,597
24,623759
1,186
19,161760
1,703
19,848761
1,918
13,557765
2,497
22,146766
2,634
14,889767
119
15,750768
10
28,201769
86
29,901770
181
18,191774
1,442
12,637775
5,224
9,066776
491
15,413777
177
19,480778
489
8,798779
107
14,082780
47
5,638781
3,004
13,343782
125
8,369794
7
2,880799
623
76,151800
699
45,583801
602
35,355802
691
51,739803
1,003
33,630804
996
25,527808
8,315
34,115809
15,527
24,895810
3,818
21,504811
18,344
24,532812
83,082
18,156813
15,031
25,132814
1,631
29,730815
3,337
23,820816
2,355
18,234820
1,481
83,993821
2,529
40,735822
2,139
28,780823
2,436
64,907824
3,039
40,522825
2,009
29,739826
562
77,350827
1,318
40,156828
872
29,232829
1,374
44,261830
531
25,785834
5,257
51,445835
1,469
30,879836
1,526
23,524837
1,623
85,432838
900
41,508839
1,385
26,968840
15,152
38,374841
11,012
29,060842
7,678
22,849843
1,477
32,639844
2,854
25,034845
1,008
21,623846
2,480
37,292( print page 31535)847
23,667
25,136848
1,699
20,748849
1,498
26,843853
31,444
77,914854
6,881
50,010855
467
36,089856
6,187
69,506857
10,059
36,989858
3,500
28,786862
7,425
33,012863
21,807
21,882864
19,826
20,564865
2,019
27,840866
9,406
16,786867
5,306
38,488868
2,369
24,746869
1,100
20,520870
13,710
90,935871
203,702
33,685872
92,118
25,456876
968
40,268880
10,494
15,328881
4,576
11,727882
1,656
12,481883
786
17,701884
21,619
19,048885
77,763
16,598886
376
14,393887
423
18,850894
4,480
8,389895
6,474
16,201896
5,369
25,303897
35,835
13,689901
917
48,598902
2,135
31,632903
1,739
24,530904
941
39,574905
798
25,597906
745
23,573907
8,098
53,982908
7,884
35,453909
5,971
26,248913
813
26,149914
6,958
16,346915
915
24,023916
5,369
10,725917
14,155
28,466918
34,847
14,539919
10,569
27,881920
12,135
22,284921
11,659
15,316922
1,005
26,606923
4,211
16,053927
182
181,306928
794
60,107929
459
32,721933
155
31,143934
694
23,842935
2,179
21,397939
423
43,099940
690
32,755941
1,077
26,227945
5,053
21,694946
3,199
17,198947
6,544
23,445948
34,325
15,485949
742
18,955950
476
12,079951
990
14,489955
446
82,175956
3,718
55,062957
1,157
102,443958
737
70,330959
816
53,566963
1,395
46,322964
1,578
32,525965
2,016
27,560969
598
75,122970
231
47,821974
7,276
34,615975
3,463
29,344976
2,728
23,762977
4,871
23,005981
26,280
77,452982
18,594
53,442983
6,766
38,481984
669
55,818985
1,048
38,813986
890
27,837987
8,036
54,475988
11,880
36,064989
6,537
26,243999
18
16,006
 17. On pages 25118 through 25123, in Table I.—Impact Analysis of Proposed Changes For FY 2008, the listed entries and footnotes are corrected to read as follows: 
 
  
 
  
 
  18. On page 
                    
                     25124, 
 
 a. First column, second full paragraph, line 25, the figure “0.999317” is corrected to read “0.999367.” b. Second column, last paragraph, line 3, the figure “0.999317” is corrected to read “0.999367.” 19. On page 25125, a. First column, last paragraph, line 5, the figure “0.991938” is corrected to read “0.991925.” b. Second column, first full paragraph, line 17, the figure “0.997084” is corrected to read “0.997080.” 20. On pages 25126 through 25128, in Table II.—Impact Analysis of Proposed Changes For FY 2008 Operating Prospective Payment System, the listed entries are corrected to read as follows: Table II.—Impact Analysis of Proposed Changes for FY 2008 Operating Prospective Payment System (Payments per Case)
[Percent changes in payments per case]
Number of hospitals
Published  average  proposed  FY 2008  payment per case 1
Corrected  average  proposed  FY 2008  payment per case 1
Published  all  proposed  FY 2008  changes
Corrected all proposed FY 2008 changes(1)
(3)
(3)
(4)
(4)All hospitals
3535
9299
9299
3.3
3.3By Geographic Location:Urban hospitals
2540
9678
9680
3.6
3.6Large urban areas (populations over 1 million)
1409
10156
10157
4.2
4.2Other urban areas (populations of 1 million or fewer)
1131
9103
9107
2.8
2.9Rural hospitals
995
7123
7110
0.9
0.7Bed Size (Urban):0-99 beds
632
7263
7261
0.4
0.3100-199 beds
849
8170
8159
3.4
3.2200-299 beds
480
9120
9117
3.5
3.4300-499 beds
412
10136
10143
4.0
4.0500 or more beds
167
12234
12254
4.0
4.2Bed Size (Rural):0-49 beds
342
6065
6045
−1.6
−1.950-99 beds
369
6588
6572
0.5
0.2100-149 beds
172
6960
6945
1.3
1.1150-199 beds
67
7735
7727
1.4
1.3200 or more beds
45
8938
8937
2.0
2.0Urban by Region:New England
126
10001
10004
2.6
2.6Middle Atlantic
350
10529
10532
2.8
2.8South Atlantic
388
9175
9176
4.2
4.3East North Central
395
9197
9199
3.4
3.5East South Central
166
8784
8786
3.2
3.2West North Central
156
9321
9334
2.8
3.0West South Central
358
9174
9175
4.0
4.0Mountain
153
9826
9836
3.3
3.5Pacific
395
11657
11656
4.7
4.7Puerto Rico
53
4525
4511
3.6
3.3Rural by Region:New England
19
9714
9716
0.4
0.4Middle Atlantic
72
7525
7514
0.8
0.6South Atlantic
173
6700
6683
1.8
1.6East North Central
124
7574
7567
0.7
0.6East South Central
177
6479
6462
1.2
1.0West North Central
115
7792
7786
0.6
0.6West South Central
194
6339
6322
−0.7
−0.9Mountain
80
7834
7822
0.9
0.7Pacific
41
8896
8881
2.0
1.8By Payment Classification:Urban hospitals
2619
9629
9631
3.6
3.6Large urban areas (populations over 1 million)
1436
10127
10128
4.1
4.1Other urban areas (populations of 1 million or fewer)
1183
9034
9038
2.8
2.8Rural areas
916
7242
7230
0.9
0.8Teaching Status:Non-teaching
2479
7851
7844
2.7
2.6Fewer than 100 Residents
816
9384
9385
3.5
3.5100 or more Residents
240
13533
13555
4.1
4.2Urban DSH:Non-DSH
879
8307
8314
2.0
2.1100 or more beds
1527
10182
10183
4.0
4.0( print page 31540)Less than 100 beds
359
6697
6682
1.9
1.6Rural DSH:SCH
391
7013
6994
0.3
0.0RRC
189
7818
7809
1.7
1.6100 or more beds
36
6028
6010
2.1
1.8Less than 100 beds
154
5353
5335
0.4
0.0Urban teaching and DSH:Both teaching and DSH
805
11185
11192
4.0
4.1Teaching and no DSH
192
9078
9089
2.5
2.6No teaching and DSH
1081
8283
8273
3.7
3.5No teaching and no DSH
541
7812
7817
1.9
2.0Rural Hospital Types:RRC
59
8358
8359
2.5
2.5SCH
45
9301
9296
0.8
0.8MDH
21
6339
6319
0.3
0.0SCH and RRC
17
10239
10236
2.7
2.7MDH and RRC
1
9674
9677
−0.8
−0.8Type of Ownership:Voluntary
2069
9424
9427
3.2
3.2Proprietary
823
8478
8471
3.7
3.6Government
598
9593
9589
3.5
3.4Medicare Utilization as a Percent of Inpatient Days:0-25
230
13443
13434
5.6
5.525-50
1292
10570
10576
4.0
4.150-65
1453
8116
8113
2.6
2.5Over 65
441
7331
7325
1.2
1.2Hospitals Reclassified by the Medicare Geographic Classification Review Board:  FY 2008 Reclassifications:All Reclassified Hospitals FY 2008
801
8938
8937
2.8
2.8All Non-Reclassified Hospitals FY 2008
2734
9417
9416
3.4
3.4Urban Reclassified Hospitals FY 2008
434
9581
9595
3.3
3.4Urban Non-reclassified Hospitals FY 2008
2105
9701
9705
3.6
3.7Rural Reclassified Hospitals FY 2008
367
7669
7663
1.5
1.4Rural Nonreclassified Hospitals FY 2008
568
6392
6374
−0.3
−0.6All Section 401 Reclassified Hospitals
31
8799
8787
1.8
1.6Other Reclassified Hospitals (Section 1886(d)(8)(B))
61
6729
6710
1.4
1.1Former Section 508 Hospitals
107
9814
9823
0.5
0.6Specialty HospitalsCardiac Specialty Hospitals
22
10676
10727
−0.6
−0.11
                         These payment amounts per case do not reflect any estimates of annual case-mix increase.
 (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: June 1, 2007. Ann C. Agnew, Executive Secretary to the Department.


# Footnotes

1.
    
                         Cases taken from the FY 2006 MedPAR file; proposed MS-DRGs are from GROUPER Version 25.0. Back to Citation
 6.
    
                         Shown here are the tentative effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB). The effects demonstrate the FY 2008 payment impact of going from no reclassifications to the reclassifications scheduled to be in effect for FY 2008. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflect the geographic budget neutrality factor of 0.991925. 7.
    
                         This column displays the effects of the proposed changes in the rural floor budget neutrality adjustment applied on the wage index instead of on the standardized amount. The column reflects a proposed rural floor budget neutrality factor of 0.997080. 11.
    
                         This column shows tentative changes in payments from FY 2007 to FY 2008 including a 0.976 case mix index adjustment for coding and documentation improvements that are anticipated with the adoption of the MS-DRGs prior to the assumed growth occurring. In incorporates all of the changes displayed in Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4). 12.
    
                         This column shows tentative changes in payments from FY 2007 to FY 2008 with a case mix index adjustment and the assumed growth for improvements in documentation and coding. It incorporates all of the changes displayed in 
                        
                        Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4). It also reflects the impact of the proposed FY 2008 update, and changes in hospitals' reclassification status in FY 2008 compared to FY 2007. The sum of these impacts may be different from the percentage changes shown here due to rounding and interactive effects. Back to Citation


BILLING CODE 4120-01-P BILLING CODE 4120-01-C [FR Doc. 07-2806 Filed 6-1-07; 2:04 pm] BILLING CODE 4120-01-P