Federal Register / Vol. 72, No. 116 / Monday, June 18, 2007 / Proposed Rules 33425 

figure 2–1, paragraph (32)(e), an 

‘‘Environmental Analysis Check List’’ or 

‘‘Categorical Exclusion Determination’’

is not required for this rule. Comments 

on this section will be considered before 

we make the final decision on whether 

to categorically exclude this rule from 

further environmental review. 

List of Subjects in 33 CFR Part 117 

Bridges 

For the reasons discussed in the 

preamble, the Coast Guard proposes to 

amend 33 CFR part 117 as follows: 

PART 117—DRAWBRIDGE 

OPERATION REGULATIONS 

1. The authority citation for part 117 

continues to read as follows: 

Authority: 33 U.S.C. 499; 33 CFR 1.05–1(g); 

Department of Homeland Security Delegation 

No. 0170.1. 

2. Revise § 117.287(i) to read as 

follows: 

§ 117.287 Gulf Intracoastal Waterway. 

* * * * * 

(i) The draw of the Belleair Beach 

Drawbridge, mile 131.8, Belleair Beach, 

FL shall open on signal, except that 

from 7 a.m. to 7 p.m., the bridge shall 

open on the hour and half-hour. 

Dated: May 30, 2007. 

D.W. Kunkel, 

Rear Admiral, U.S. Coast Guard, Commander, 

Seventh Coast Guard District. 

[FR Doc. E7–11661 Filed 6–15–07; 8:45 am] 

BILLING CODE 4910–15–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 52 

[EPA–R09–OAR–2006–0619; FRL–8327–2] 

Revisions to the Nevada State 

Implementation Plan, Washoe County 

District Health Department 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Proposed rule. 

SUMMARY: EPA is proposing to approve 

revisions to the Washoe County District 

Health Department (WCDHD) portion of 

the Nevada State Implementation Plan 

(SIP). These revisions concern opacity, 

emissions of carbon monoxide (CO) and 

particulate matter (PM) from wood 

stoves and fireplaces, and air emergency 

episode plans. We are proposing 

approval of local rules that help regulate 

emission sources under the Clean Air 

Act as amended in 1990 (CAA or the 

Act). 

DATES: Any comments on this proposal 

must arrive by July 18, 2007. 

ADDRESSES: Submit comments, 

identified by docket number EPA–R09–

OAR–2006–0619, by one of the 

following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the on-line 

instructions. 

• E-mail: steckel.andrew@epa.gov. 

• Mail or deliver: Andrew Steckel 

(Air–4), U.S. Environmental Protection 

Agency Region IX, 75 Hawthorne Street, 

San Francisco, CA 94105. 

Instructions: All comments will be 

included in the public docket without 

change and may be made available 

online at http://www.regulations.gov, 

including any personal information 

provided, unless the comment includes 

Confidential Business Information (CBI) 

or other information whose disclosure is 

restricted by statute. Information that 

you consider CBI or otherwise protected 

should be clearly identified as such and 

should not be submitted through 

www.regulations.gov or e-mail. 

www.regulations.gov is an ‘‘anonymous 

access’’ system, and EPA will not know 

your identity or contact information 

unless you provide it in the body of 

your comment. If you send e-mail 

directly to EPA, your e-mail address 

will be automatically captured and 

included as part of the public comment. 

If EPA cannot read your comment due 

to technical difficulties and cannot 

contact you for clarification, EPA may 

not be able to consider your comment. 

Docket: The index to the docket for 

this action is available electronically at 

http://www.regulations.gov and in hard 

copy at EPA Region IX, 75 Hawthorne 

Street, San Francisco, California. While 

all documents in the docket are listed in 

the index, some information may be 

publicly available only at the hard copy 

location (e.g., copyrighted material), and 

some may not be publicly available in 

either location (e.g., CBI). To inspect the 

hard copy materials, please schedule an 

appointment during normal business 

hours with the contact listed in the FOR

FURTHER INFORMATION CONTACT section. 

FOR FURTHER INFORMATION CONTACT: Al 

Petersen, Rulemaking Office (AIR–4), 

U.S. Environmental Protection Agency, 

Region IX, (415) 947–4118, 

petersen.alfred@epa.gov. 

SUPPLEMENTARY INFORMATION: This 

proposal addresses the following local 

rules: WCDHD Rules 010.117, 040.005, 

040.051, and 050.001. In the Rules and 

Regulations section of this Federal 

Register, we are approving these local 

rules in a direct final action without 

prior proposal because we believe these 

SIP revisions are not controversial. If we 

receive adverse comments, however, we 

will publish a timely withdrawal of the 

direct final rule and address the 

comments in subsequent action based 

on this proposed rule. We do not plan 

to open a second comment period, so 

anyone interested in commenting 

should do so at this time. If we do not 

receive adverse comments, no further 

activity is planned. For further 

information, please see the direct final 

action. 

Please note that if we receive adverse 

comment on an amendment, paragraph, 

or section of this rule and if that 

provision may be severed from the 

remainder of the rule, we may adopt as 

final those provisions of the rule that are 

not the subject of an adverse comment. 

Dated: May 9, 2007. 

Laura Yoshii, 

Acting Regional Administrator, Region IX. 

[FR Doc. E7–11581 Filed 6–15–07; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 484 

[CMS–1541–CN] 

RIN 0938–AO32 

Medicare Program; Home Health 

Prospective Payment System 

Refinement and Rate Update for 

Calendar Year 2008; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Proposed rule; correction notice. 

SUMMARY: This document corrects 

technical errors that appeared in the 

proposed rule published in the Federal 

Register on May 4, 2007, entitled 

‘‘Medicare Program; Home Health 

Prospective Payment System 

Refinement and Rate Update for 

Calendar Year 2008’’ (72 FR 25356). 

FOR FURTHER INFORMATION CONTACT: 

Randy Throndset, (410) 786–0131. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 07–2167 of May 4, 2007 

(72 FR 25356), there were a number of 

technical errors that we identified and 

corrected in the Correction of Errors 

section below. 

II. Summary of Errors 

In the May 4, 2007 published 

proposed rule, on page 25388, we 


jlentini on PROD1PC65 with PROPOSALS
33426 Federal Register / Vol. 72, No. 116 / Monday, June 18, 2007 / Proposed Rules 

provided a Table 4 ‘‘Regression 

Coefficients for Calculating Case-Mix 

Relative Weights’’ that illustrated 

payment regression coefficients, which 

represent the average addition to 

resource cost due to each severity level. 

We inadvertently miscalculated the 

payment for the case-mix groups in the 

second column of Table 4 and have 

corrected these errors. 

We are republishing Table 4 in its 

entirety with the corrected information. 

The text on page 25388 describing Table 

4 has also been changed to reflect the 

corrected data in the table as well as a 

typographical error. We are also 

correcting the language on page 25388 

which describes how coefficients are 

scaled. A phrase was inadvertently 

omitted which notes that the calculation 

also adjusts for budget neutrality in the 

weights. 

We are correcting text on page 25389, 

which incorrectly stated that we are 

proposing to adjust for nominal change 

in case-mix through a reduction in the 

weights. The adjustment for nominal 

change in case-mix is made through a 

rate reduction in the national 

standardized 60-day episode payment. 

We are also correcting some typographic 

errors. On pages 25389–25392, Table 5 

‘‘Case-Mix Groups, Average Cost, and 

Case-Mix Weight’’ includes the 

predicted average resource cost for the 

153 case-mix groups of the proposed 

model. We inadvertently miscalculated 

the ‘‘Average Cost’’ in the fourth 

column. We are republishing Table 5 in 

its entirety with the corrected 

information. 

On pages 25430–25431, Table 12a 

‘‘NRS Case-Mix Adjustment Variables 

and Scores’’ sets forth the NRS scores 

for the five-group model. We 

inadvertently included incorrect scores 

in the third column and have corrected 

these errors. The table also corrects how 

the scoring is broken out for Outcome 

and Assessment Information Set 

(OASIS) item M0450, giving separate 

scores for stage 3 and stage 4 pressure 

ulcers, separating 1 pressure ulcer and 

2 pressure ulcers within both stages 3 

and 4, changing 3 pressure ulcers for 

stage 3 or 4 to 3+ pressure ulcers for 

stage 3, changing the 4+ pressure ulcers 

for stage 3 and 4 to 3+ pressure ulcers 

for stage 4, and deleting the score for 5 

or more pressure ulcers. We are 

republishing Table 12a in its entirety 

with the corrected information. 

We are also correcting text on page 

25444 describing the calculation of the 

case-mix and wage-adjusted national 

standardized 60-day episode payment 

rate including non-routine supplies to 

correct an error in the order of the 

calculation. We are correcting 

typographical errors in the LUPA 

calculation example on page 25447. 

Finally, we are correcting 

typographical errors in Addendum A on 

page 25459, in the rural Massachusetts 

and New Jersey wage indices. The text 

of the first footnote to Addendum A also 

incorrectly states that all counties 

within the State are classified as rural. 

The first footnote has been corrected. 

III. Correction of Errors 

In FR Doc. 07–2167 of May 4, 2007 

(72 FR 25356), make the following 

corrections: 

1. On page 25388, in the first column, 

the first full paragraph, 

a. In line 1, the word ‘‘PSS’’ is 

corrected to read ‘‘PPS’’. 

b. In lines 5 through 10, the sentence 

‘‘(To show the coefficients in actual, as 

opposed to resource cost, dollars, the 

coefficients were scaled by a multiplier 

representing the ratio of the HH PPS 

average payment level to the Abt 

Associates average resource cost level)’’

is corrected to read as follows: ‘‘(To 

show the coefficients in actual, as 

opposed to resource cost, dollars, the 

coefficients were scaled by a multiplier 

representing the ratio of the HH PPS 

average payment level to the Abt 

Associates average resource cost level 

after adjusting for budget neutrality in 

the weights (see section II.A.2.c. for an 

explanation of budget neutrality 

adjustment to the weights.))’’. 

c. In line 17, the figure ‘‘$861.74’’ is 

corrected to read ‘‘$869.55’’. 

d. In line 18, the figure ‘‘$219.44’’ is 

corrected to read ‘‘$221.43’’. 

2. On page 25388, in the first column, 

second full paragraph, line 4, the figure 

‘‘$1,265.18’’ is corrected to read 

‘‘$1,276.66’’. 

3. On page 25388, in the second 

column, first partial paragraph, 

a. In line 5, the figure ‘‘$1,265.18’’ is 

corrected to read ‘‘$1,276.66’’. 

b. In line 6, the figure ‘‘$139.26’’ is 

corrected to read ‘‘$140.52’’. 

c. In line 7, the figure ‘‘$645.90’’ is 

corrected to read ‘‘$651.76’’. 

d. In line 9, the figure ‘‘$210.94’’ is 

corrected to read ‘‘$212.85’’. 

e. In line 15, the figure ‘‘$2,261.28’’ is 

corrected to read ‘‘$2,281.79’’. 

4. On page 25388, in Table 4: 

Regression Coefficients for Calculating 

Case-Mix Relative Weights, the table is 

corrected as follows: 

TABLE 4.—REGRESSION COEFFICIENTS

FOR CALCULATING CASE-MIX RELATIVE WEIGHTS

Intercept (constant for all case 

mix groups) ........................... $1,276.66 

TABLE 4.—REGRESSION COEFFICIENTS

FOR CALCULATING CASE-MIX RELATIVE WEIGHTS—Continued 

1st and 2nd Episodes, 0 to 13 Therapy 

Visits 

C2 ............................................. 384.11 

C3 ............................................. 869.55 

F2 .............................................. 221.43 

F3 .............................................. 382.50 

S2 (6 therapy visits) ................. 504.49 

S3 (7–9 therapy visits) ............. 943.50 

S4 (10 therapy visits) ............... 1,387.86 

S5 (11–13 therapy visits) ......... 1,771.84 

1st and 2nd Episodes, 14 to 19 Therapy 

Visits 

Constant ................................... 2,191.26 

C2 ............................................. 539.55 

C3 ............................................. 1,257.78 

F2 .............................................. 270.79 

F3 .............................................. 429.54 

S2 (16–17 therapy visits) ......... 429.35 

S3 (18–19 therapy visits) ......... 705.26 

3rd+ Episodes, 0 to 13 Therapy Visits 

Constant ................................... 212.85 

C2 ............................................. 140.52 

C3 ............................................. 619.33 

F2 .............................................. 418.51 

F3 .............................................. 825.67 

S2 (6 therapy visits) ................. 651.76 

S3 (7–9 therapy visits) ............. 1,093.13 

S4 (10 therapy visits) ............... 1,521.27 

S5 (11–13 therapy visits) ......... 1,907.93 

3rd+ Episodes, 14 to 19 Therapy Visits 

Constant ................................... 2,198.69 

C2 ............................................. 678.75 

C3 ............................................. 1,405.22 

F2 .............................................. 394.26 

F3 .............................................. 693.30 

S2 (16–17 therapy visits) ......... 294.71 

S3 (18–19 therapy visits) ......... 719.09 

All Episodes, 20+ Therapy Visits 

Constant ................................... 4,033.07 

C2 ............................................. 583.74 

C3 ............................................. 1,396.22 

F2 .............................................. 490.14 

F3 .............................................. 1,052.59 

5. On page 25389, in the first column, 

a. In line 3, the word ‘‘two’’ is deleted. 

b. In line 3, the word ‘‘adjustments’’

is corrected to read ‘‘adjustment’’. 

6. On page 25389, in the second 

column, 

a. In line 1, the words ‘‘and the’’ is 

deleted. 

b. In line 2, the phrase ‘‘adjustment 

for nominal changes in case-’’ is deleted. 

7. On page 25389, in the third 

column, 

a. In line 1, the words ‘‘mix coding’’

is deleted. 

b. In line 1, the word ‘‘are’’ is 

corrected to read ‘‘is’’. 

8. On pages 25389–25392, in Table 5: 

Case Mix Groups, Average Cost, and 


jlentini on PROD1PC65 with PROPOSALS
Federal Register / Vol. 72, No. 116 / Monday, June 18, 2007 / Proposed Rules 33427 

Case Mix Weight, the table is corrected 

to read as follows: 

TABLE 5.—CASE-MIX GROUPS, AVERAGE COST, AND CASE-MIX WEIGHT

Severity level for each dimension 

Clinical Functional Services utilization Average 

cost 

Case-mix 

weight 

1st and 2nd Episodes, 0 to 13 Therapy Visits+C47 

C1 ...................................................... F1 ...................................................... S1 ..................................................... $1,276.66 0.5549 

C1 ...................................................... F1 ...................................................... S2 ..................................................... 1,781.15 0.7742 

C1 ...................................................... F1 ...................................................... S3 ..................................................... 2,220.16 0.9650 

C1 ...................................................... F1 ...................................................... S4 ..................................................... 2,664.52 1.1582 

C1 ...................................................... F1 ...................................................... S5 ..................................................... 3,048.51 1.3251 

C1 ...................................................... F2 ...................................................... S1 ..................................................... 1,498.09 0.6512 

C1 ...................................................... F2 ...................................................... S2 ..................................................... 2,002.59 0.8705 

C1 ...................................................... F2 ...................................................... S3 ..................................................... 2,441.60 1.0613 

C1 ...................................................... F2 ...................................................... S4 ..................................................... 2,885.95 1.2544 

C1 ...................................................... F2 ...................................................... S5 ..................................................... 3,269.94 1.4213 

C1 ...................................................... F3 ...................................................... S1 ..................................................... 1,659.16 0.7212 

C1 ...................................................... F3 ...................................................... S2 ..................................................... 2,163.65 0.9405 

C1 ...................................................... F3 ...................................................... S3 ..................................................... 2,602.66 1.1313 

C1 ...................................................... F3 ...................................................... S4 ..................................................... 3,047.02 1.3244 

C1 ...................................................... F3 ...................................................... S5 ..................................................... 3,431.00 1.4914 

C2 ...................................................... F1 ...................................................... S1 ..................................................... 1,660.77 0.7219 

C2 ...................................................... F1 ...................................................... S2 ..................................................... 2,165.26 0.9412 

C2 ...................................................... F1 ...................................................... S3 ..................................................... 2,604.27 1.1320 

C2 ...................................................... F1 ...................................................... S4 ..................................................... 3,048.63 1.3251 

C2 ...................................................... F1 ...................................................... S5 ..................................................... 3,432.61 1.4921 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 1,882.20 0.8181 

C2 ...................................................... F2 ...................................................... S2 ..................................................... 2,386.69 1.0374 

C2 ...................................................... F2 ...................................................... S3 ..................................................... 2,825.70 1.2282 

C2 ...................................................... F2 ...................................................... S4 ..................................................... 3,270.06 1.4214 

C2 ...................................................... F2 ...................................................... S5 ..................................................... 3,654.04 1.5883 

C2 ...................................................... F3 ...................................................... S1 ..................................................... 2,043.27 0.8881 

C2 ...................................................... F3 ...................................................... S2 ..................................................... 2,547.76 1.1074 

C2 ...................................................... F3 ...................................................... S3 ..................................................... 2,986.77 1.2983 

C2 ...................................................... F3 ...................................................... S4 ..................................................... 3,431.12 1.4914 

C2 ...................................................... F3 ...................................................... S5 ..................................................... 3,815.11 1.6583 

C3 ...................................................... F1 ...................................................... S1 ..................................................... 2,146.21 0.9329 

C3 ...................................................... F1 ...................................................... S2 ..................................................... 2,650.71 1.1522 

C3 ...................................................... F1 ...................................................... S3 ..................................................... 3,089.72 1.3430 

C3 ...................................................... F1 ...................................................... S4 ..................................................... 3,534.07 1.5362 

C3 ...................................................... F1 ...................................................... S5 ..................................................... 3,918.06 1.7031 

C3 ...................................................... F2 ...................................................... S1 ..................................................... 2,367.65 1.0291 

C3 ...................................................... F2 ...................................................... S2 ..................................................... 2,872.14 1.2484 

C3 ...................................................... F2 ...................................................... S3 ..................................................... 3,311.15 1.4393 

C3 ...................................................... F2 ...................................................... S4 ..................................................... 3,755.50 1.6324 

C3 ...................................................... F2 ...................................................... S5 ..................................................... 4,139.49 1.7993 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 2,528.71 1.0992 

C3 ...................................................... F3 ...................................................... S2 ..................................................... 3,033.21 1.3184 

C3 ...................................................... F3 ...................................................... S3 ..................................................... 3,472.22 1.5093 

C3 ...................................................... F3 ...................................................... S4 ..................................................... 3,916.57 1.7024 

C3 ...................................................... F3 ...................................................... S5 ..................................................... 4,300.56 1.8693 

1st and 2nd Episodes, 14 to 19 Therapy Visits 

C1 ...................................................... F1 ...................................................... S1 ..................................................... 3,467.92 1.5074 

C1 ...................................................... F1 ...................................................... S2 ..................................................... 3,897.27 1.6940 

C1 ...................................................... F1 ...................................................... S3 ..................................................... 4,173.18 1.8140 

C1 ...................................................... F2 ...................................................... S1 ..................................................... 3,738.71 1.6251 

C1 ...................................................... F2 ...................................................... S2 ..................................................... 4,168.06 1.8117 

C1 ...................................................... F2 ...................................................... S3 ..................................................... 4,443.97 1.9317 

C1 ...................................................... F3 ...................................................... S1 ..................................................... 3,897.46 1.6941 

C1 ...................................................... F3 ...................................................... S2 ..................................................... 4,326.81 1.8807 

C1 ...................................................... F3 ...................................................... S3 ..................................................... 4,602.72 2.0007 

C2 ...................................................... F1 ...................................................... S1 ..................................................... 4,007.46 1.7419 

C2 ...................................................... F1 ...................................................... S2 ..................................................... 4,436.82 1.9285 

C2 ...................................................... F1 ...................................................... S3 ..................................................... 4,712.73 2.0485 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 4,278.26 1.8596 

C2 ...................................................... F2 ...................................................... S2 ..................................................... 4,707.61 2.0463 

C2 ...................................................... F2 ...................................................... S3 ..................................................... 4,983.52 2.1662 

C2 ...................................................... F3 ...................................................... S1 ..................................................... 4,437.00 1.9286 


jlentini on PROD1PC65 with PROPOSALS
33428 Federal Register / Vol. 72, No. 116 / Monday, June 18, 2007 / Proposed Rules 

TABLE 5.—CASE-MIX GROUPS, AVERAGE COST, AND CASE-MIX WEIGHT—Continued 

Severity level for each dimension 

Clinical Functional Services utilization Average 

cost 

Case-mix 

weight 

C2 ...................................................... F3 ...................................................... S2 ..................................................... 4,866.36 2.1153 

C2 ...................................................... F3 ...................................................... S3 ..................................................... 5,142.26 2.2352 

C3 ...................................................... F1 ...................................................... S1 ..................................................... 4,725.69 2.0541 

C3 ...................................................... F1 ...................................................... S2 ..................................................... 5,155.05 2.2407 

C3 ...................................................... F1 ...................................................... S3 ..................................................... 5,430.95 2.3607 

C3 ...................................................... F2 ...................................................... S1 ..................................................... 4,996.48 2.1718 

C3 ...................................................... F2 ...................................................... S2 ..................................................... 5,425.84 2.3584 

C3 ...................................................... F2 ...................................................... S3 ..................................................... 5,701.75 2.4784 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 5,155.23 2.2408 

C3 ...................................................... F3 ...................................................... S2 ..................................................... 5,584.59 2.4274 

C3 ...................................................... F3 ...................................................... S3 ..................................................... 5,860.49 2.5474 

3rd+ Episodes, 0 to 13 Therapy Visits 

C1 ...................................................... F1 ...................................................... S1 ..................................................... 1,489.51 0.6474 

C1 ...................................................... F1 ...................................................... S2 ..................................................... 2,141.27 0.9307 

C1 ...................................................... F1 ...................................................... S3 ..................................................... 2,582.64 1.1226 

C1 ...................................................... F1 ...................................................... S4 ..................................................... 3,010.78 1.3087 

C1 ...................................................... F1 ...................................................... S5 ..................................................... 3,397.44 1.4768 

C1 ...................................................... F2 ...................................................... S1 ..................................................... 1,908.02 0.8294 

C1 ...................................................... F2 ...................................................... S2 ..................................................... 2,559.78 1.1127 

C1 ...................................................... F2 ...................................................... S3 ..................................................... 3,001.15 1.3045 

C1 ...................................................... F2 ...................................................... S4 ..................................................... 3,429.29 1.4906 

C1 ...................................................... F2 ...................................................... S5 ..................................................... 3,815.95 1.6587 

C1 ...................................................... F3 ...................................................... S1 ..................................................... 2,315.18 1.0063 

C1 ...................................................... F3 ...................................................... S2 ..................................................... 2,966.94 1.2896 

C1 ...................................................... F3 ...................................................... S3 ..................................................... 3,408.31 1.4815 

C1 ...................................................... F3 ...................................................... S4 ..................................................... 3,836.46 1.6676 

C1 ...................................................... F3 ...................................................... S5 ..................................................... 4,223.12 1.8357 

C2 ...................................................... F1 ...................................................... S1 ..................................................... 1,630.03 0.7085 

C2 ...................................................... F1 ...................................................... S2 ..................................................... 2,281.79 0.9918 

C2 ...................................................... F1 ...................................................... S3 ..................................................... 2,723.16 1.1837 

C2 ...................................................... F1 ...................................................... S4 ..................................................... 3,151.31 1.3698 

C2 ...................................................... F1 ...................................................... S5 ..................................................... 3,537.97 1.5378 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 2,048.54 0.8904 

C2 ...................................................... F2 ...................................................... S2 ..................................................... 2,700.30 1.1737 

C2 ...................................................... F2 ...................................................... S3 ..................................................... 3,141.67 1.3656 

C2 ...................................................... F2 ...................................................... S4 ..................................................... 3,569.81 1.5517 

C2 ...................................................... F2 ...................................................... S5 ..................................................... 3,956.47 1.7198 

C2 ...................................................... F3 ...................................................... S1 ..................................................... 2,455.71 1.0674 

C2 ...................................................... F3 ...................................................... S2 ..................................................... 3,107.47 1.3507 

C2 ...................................................... F3 ...................................................... S3 ..................................................... 3,548.84 1.5426 

C2 ...................................................... F3 ...................................................... S4 ..................................................... 3,976.98 1.7287 

C2 ...................................................... F3 ...................................................... S5 ..................................................... 4,363.64 1.8967 

C3 ...................................................... F1 ...................................................... S1 ..................................................... 2,108.84 0.9166 

C3 ...................................................... F1 ...................................................... S2 ..................................................... 2,760.60 1.1999 

C3 ...................................................... F1 ...................................................... S3 ..................................................... 3,201.97 1.3918 

C3 ...................................................... F1 ...................................................... S4 ..................................................... 3,630.11 1.5779 

C3 ...................................................... F1 ...................................................... S5 ..................................................... 4,016.77 1.7460 

C3 ...................................................... F2 ...................................................... S1 ..................................................... 2,527.34 1.0986 

C3 ...................................................... F2 ...................................................... S2 ..................................................... 3,179.10 1.3819 

C3 ...................................................... F2 ...................................................... S3 ..................................................... 3,620.47 1.5737 

C3 ...................................................... F2 ...................................................... S4 ..................................................... 4,048.62 1.7598 

C3 ...................................................... F2 ...................................................... S5 ..................................................... 4,435.28 1.9279 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 2,934.51 1.2755 

C3 ...................................................... F3 ...................................................... S2 ..................................................... 3,586.27 1.5588 

C3 ...................................................... F3 ...................................................... S3 ..................................................... 4,027.64 1.7507 

C3 ...................................................... F3 ...................................................... S4 ..................................................... 4,455.78 1.9368 

C3 ...................................................... F3 ...................................................... S5 ..................................................... 4,842.44 2.1049 

3rd+ Episodes, 14 to 19 Therapy Visits 

C1 ...................................................... F1 ...................................................... S1 ..................................................... 3,475.35 1.5106 

C1 ...................................................... F1 ...................................................... S2 ..................................................... 3,770.07 1.6387 

C1 ...................................................... F1 ...................................................... S3 ..................................................... 4,194.44 1.8232 

C1 ...................................................... F2 ...................................................... S1 ..................................................... 3,869.61 1.6820 

C1 ...................................................... F2 ...................................................... S2 ..................................................... 4,164.33 1.8101 

C1 ...................................................... F2 ...................................................... S3 ..................................................... 4,588.70 1.9946 

C1 ...................................................... F3 ...................................................... S1 ..................................................... 4,168.65 1.8120 

C1 ...................................................... F3 ...................................................... S2 ..................................................... 4,463.37 1.9401 


jlentini on PROD1PC65 with PROPOSALS
Federal Register / Vol. 72, No. 116 / Monday, June 18, 2007 / Proposed Rules 33429 

TABLE 5.—CASE-MIX GROUPS, AVERAGE COST, AND CASE-MIX WEIGHT—Continued 

Severity level for each dimension 

Clinical Functional Services utilization Average 

cost 

Case-mix 

weight 

C1 ...................................................... F3 ...................................................... S3 ..................................................... 4,887.74 2.1246 

C2 ...................................................... F1 ...................................................... S1 ..................................................... 4,154.10 1.8057 

C2 ...................................................... F1 ...................................................... S2 ..................................................... 4,448.82 1.9338 

C2 ...................................................... F1 ...................................................... S3 ..................................................... 4,873.19 2.1182 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 4,548.37 1.9770 

C2 ...................................................... F2 ...................................................... S2 ..................................................... 4,843.08 2.1051 

C2 ...................................................... F2 ...................................................... S3 ..................................................... 5,267.45 2.2896 

C2 ...................................................... F3 ...................................................... S1 ..................................................... 4,847.40 2.1070 

C2 ...................................................... F3 ...................................................... S2 ..................................................... 5,142.12 2.2351 

C2 ...................................................... F3 ...................................................... S3 ..................................................... 5,566.49 2.4196 

C3 ...................................................... F1 ...................................................... S1 ..................................................... 4,880.57 2.1214 

C3 ...................................................... F1 ...................................................... S2 ..................................................... 5,175.29 2.2495 

C3 ...................................................... F1 ...................................................... S3 ..................................................... 5,599.66 2.4340 

C3 ...................................................... F2 ...................................................... S1 ..................................................... 5,274.84 2.2928 

C3 ...................................................... F2 ...................................................... S2 ..................................................... 5,569.55 2.4209 

C3 ...................................................... F2 ...................................................... S3 ..................................................... 5,993.92 2.6054 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 5,573.87 2.4228 

C3 ...................................................... F3 ...................................................... S2 ..................................................... 5,868.59 2.5509 

C3 ...................................................... F3 ...................................................... S3 ..................................................... 6,292.96 2.7354 

All Episodes, 20+ Therapy Visits 

C1 ...................................................... F1 ...................................................... S1 ..................................................... 5,309.73 2.3080 

C1 ...................................................... F1 ...................................................... S1 ..................................................... 5,799.87 2.5210 

C1 ...................................................... F1 ...................................................... S1 ..................................................... 6,362.32 2.7655 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 5,893.47 2.5617 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 6,383.61 2.7748 

C2 ...................................................... F2 ...................................................... S1 ..................................................... 6,946.06 3.0192 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 6,705.95 2.9149 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 7,196.09 3.1279 

C3 ...................................................... F3 ...................................................... S1 ..................................................... 7,758.55 3.3724 

9. On pages 25430–25431, in Table 

12a: NRS Case-Mix Adjustment 

Variables and Scores, the table is 

corrected to read as follows: 

TABLE 12a.—NRS CASE-MIX ADJUSTMENT VARIABLES AND SCORES

Description Score 

Selected Skin Conditions: 

1 ................................... Primary diagnosis = Anal fissure, fistula and abscess .............................................................................. 19 

2 ................................... Primary diagnosis = Cellulitis and abscess ................................................................................................ 13 

3 ................................... Primary diagnosis = Gangrene .................................................................................................................. 10 

4 ................................... Primary diagnosis = Malignant neoplasms of skin ..................................................................................... 16 

5 ................................... Primary diagnosis = Non-pressure and non-stasis ulcers ......................................................................... 10 

6 ................................... Primary diagnosis = Other infections of skin and subcutaneous tissue .................................................... 19 

7 ................................... Primary diagnosis = Post-operative Complications 1 ................................................................................ 32 

8 ................................... Primary diagnosis = Post-operative Complications 2 ................................................................................ 23 

9 ................................... Primary diagnosis = Traumatic Wounds and Burns .................................................................................. 16 

10 ................................. Other diagnosis = Anal fissure, fistula and abscess .................................................................................. 8 

11 ................................. Other diagnosis = Cellulitis and abscess ................................................................................................... 6 

12 ................................. Other diagnosis = Gangrene ...................................................................................................................... 11 

13 ................................. Other diagnosis = Non-pressure and non-stasis ulcers ............................................................................ 8 

14 ................................. Other diagnosis = Other infections of skin and subcutaneous tissue ....................................................... 7 

15 ................................. Other diagnosis = Post-operative Complications 1 .................................................................................... 15 

16 ................................. Other diagnosis = Post-operative Complications 2 .................................................................................... 15 

17 ................................. Other diagnosis = Traumatic Wounds and Burns ...................................................................................... 7 

18 ................................. M0450 = 1 pressure ulcer, stage 1 or 2 .................................................................................................... 12 

19 ................................. M0450 = 2 or 3 pressure ulcers, stage 1 or 2 ........................................................................................... 20 

20 ................................. M0450 = 4+ pressure ulcers, stage 1 or 2 ................................................................................................ 30 

21 ................................. M0450 = 1 pressure ulcer, stage 3 ............................................................................................................ 31 

22 ................................. M0450 = 2 pressure ulcers, stage 3 .......................................................................................................... 41 

23 ................................. M0450 = 3+ pressure ulcers, stage 3 ........................................................................................................ 57 

24 ................................. M0450 = 1 pressure ulcer, stage 4 ............................................................................................................ 52 

25 ................................. M0450 = 2 pressure ulcers, stage 4 .......................................................................................................... 80 

26 ................................. M0450 = 3+ pressure ulcers, stage 4 ........................................................................................................ 104 

27 ................................. M0450e = 1(unobserved pressure ulcer(s)) ............................................................................................... 16 


jlentini on PROD1PC65 with PROPOSALS
33430 Federal Register / Vol. 72, No. 116 / Monday, June 18, 2007 / Proposed Rules 

TABLE 12a.—NRS CASE-MIX ADJUSTMENT VARIABLES AND SCORES—Continued 

Description Score 

28 ................................. M0476 = 2 (status of most problematic stasis ulcer: early/partial granulation) ......................................... 18 

29 ................................. M0476 = 3 (status of most problematic stasis ulcer: not healing) ............................................................. 28 

30 ................................. M0488 = 3 (status of most problematic surgical wound: not healing) ....................................................... 18 

31 ................................. M0488 = 2 (status of most problematic surgical wound: early/partial granulation) ................................... 5 

Other Clinical Factors: 

32 ................................. M0550 = 1 (ostomy not related to inpt stay/no regimen change) .............................................................. 21 

33 ................................. M0550 = 2 (ostomy related to inpt stay/regimen change) ......................................................................... 35 

34 ................................. Any ‘‘Selected Skin Conditions’’ AND M0550 = 1 (ostomy not related to inpt stay/no regimen change) 22 

35 ................................. Any ‘‘Selected Skin Conditions’’ AND M0550 = 2 (ostomy related to inpt stay/regimen change) ............ 7 

36 ................................. M0250 (Therapy at home) = 1 (IV/Infusion) .............................................................................................. 11 

37 ................................. M0470 = 2 or 3 (2 or 3 stasis ulcers) ........................................................................................................ 17 

38 ................................. M0470 = 4 (4 stasis ulcers) ....................................................................................................................... 34 

39 ................................. M0520 = 2 (patient requires urinary catheter) ........................................................................................... 17 

10. On page 25444, after Table 23b 

entitled ‘‘Proposed National 60–Day 

Episode Amounts Updated by the 

Estimated Home Health Market Basket 

Update for CY 2008, Before Case-Mix 

Adjustment, Wage Index Adjustment 

Based on the Site of Service for the 

Beneficiary or Applicable Payment 

Adjustment for Episodes Beginning and 

Ending in CY 2008,’’ in the first column, 

in the first full paragraph, in lines 14 

through 43, the sentence ‘‘Therefore, to 

calculate an episode’s prospective 

payment amount * * *’’ and ending 

with the sentence ‘‘The resulting 

amount is the national case-mix and 

wage adjusted national standardized 60- 

day episode payment rate for that 

particular episode’’ is corrected to read 

as follows: ‘‘To calculate an episode’s 

prospective payment amount, take the 

non-adjusted national standardized 60- 

day episode payment rate and multiply 

it by the appropriate case-mix weight 

from Table 5 of this rule. Next, multiply 

the case-mix adjusted national 

standardized 60-day episode payment 

by the labor portion (77.082 percent); 

multiply this result by the appropriate 

wage index factor listed in Addendum 

A or B to wage-adjust the 60-day 

episode payment. Next multiply the 

case-mix adjusted national standardized 

60-day episode payment by 22.918 

percent to compute the non-labor 

portion. Add this result to the wageadjusted labor portion to get the casemix and wage adjusted national 60-day 

episode payment without NRS. 

Calculate the NRS amount by 

multiplying the episode’s NRS weight 

(taken from Table 11 of this proposed 

rule) by the NRS conversion factor. This 

adjusted NRS payment is added to the 

case-mix and wage-adjusted national 

standardized 60-day episode payment. 

The resulting amount is the case-mix 

and wage-adjusted national 

standardized 60-day episode payment 

rate including NRS for that particular 

episode.’’

11. On page 25447, in the 12th line, 

the figure ‘‘0.22198’’ is corrected to read 

‘‘0.22918’’. 

12. On page 25459, in Addendum A, 

a. In the first column, in line 29, the 

Wage Index for ‘‘Massachusetts’’ the 

figure ‘‘1.0661’’ is corrected to read 

‘‘1.1662’’. 

b. In the second column, in line 15, 

the superscript ‘‘1’’ which appears after 

‘‘New Jersey’’ is deleted. 

c. In the third column, in lines 17 

through 22, the footnote ‘‘1’’ at the end 

of Addendum A, the sentence ‘‘All 

counties within the State are classified 

as rural. No short-term acute care 

hospitals are located in the area(s)’’ is 

corrected to read as follows: ‘‘There are 

no short-term, acute care hospitals 

located in rural area(s) in Massachusetts 

from which to calculate a wage index 

for CY 2008.’’

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: June 12, 2007. 

Ann C. Agnew, 

Executive Secretary to the Department. 

[FR Doc. 07–2987 Filed 6–13–07; 11:55 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Office of Inspector General 

42 CFR Part 1001 

RIN 0991–AB23 

Medicare and State Health Care 

Programs: Fraud and Abuse; 

Clarification of Terms and Application 

of Program Exclusion Authority for 

Submitting Claims Containing 

Excessive Charges 

AGENCY: Office of Inspector General 

(OIG), HHS. 

ACTION: Notice of withdrawal of 

proposed rulemaking. 

SUMMARY: On September 15, 2003, we 

published a notice of proposed 

rulemaking (68 FR 53939) soliciting 

public comments regarding further 

guidance on OIG’s exclusion authority 

under section 1128(b)(6)(A) of the Social 

Security Act and 42 CFR 1001.701 of 

our regulations. Having considered the 

public comments and for the reasons 

explained below, we are not 

promulgating a final rule. 

DATES: The notice of proposed 

rulemaking published on September 15, 

2003 at 68 FR 53939 is withdrawn as of 

June 18, 2007. 

FOR FURTHER INFORMATION CONTACT: Joel 

Schaer, Office of External Affairs, (202) 

619–0089. 

SUPPLEMENTARY INFORMATION: 

I. Background 

A. Current Legal Framework 

Section 1128(b)(6)(A) of the Social 

Security Act (the Act) provides that the 

Secretary may exclude any individual or 

entity from participation in any Federal 

health care program if the Secretary 

determines that the individual or entity: 

‘‘has submitted or caused to be submitted 

bills or requests for payment (where such 


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