36612 Federal Register / Vol. 72, No. 128 / Thursday, July 5, 2007 / Rules and Regulations 

Order 13132 regarding federalism, and 

has determined that it does not have 

‘‘federalism implications.’’ The Final 

Rule would not ‘‘have substantial direct 

effects on the States, or on the 

relationship between the national 

government and the States, or on the 

distribution of power and 

responsibilities among the various 

levels of government.’’

Impact on Family Well-Being 

This Final Rule will not adversely 

affect the following elements of family 

well-being: family safety, family 

stability, marital commitment; parental 

rights in the education, nurture and 

supervision of their children; family 

functioning, disposable income or 

poverty; or the behavior and personal 

responsibility of youth, as determined 

under section 654(c) of the Treasury and 

General Government Appropriations 

Act of 1999. 

Impact of the New Rule 

This Final Rule revises § 100.2 to 

incorporate a new methodology for 

calculating the average cost of a health 

insurance policy. This new 

methodology will result in a more 

accurate reflection of the actual average 

cost of a health insurance policy as 

compared to the old methodology which 

resulted in a number that was too high. 

Paperwork Reduction Act of 1980 

This Final Rule has no information 

collection requirements. 

List of Subjects in 42 CFR Part 100 

Biologics, Compensation, Health 

insurance, Immunizations. 

Dated: January 28, 2007. 

Elizabeth M. Duke, 

Administrator, HRSA. 

Approved: March 29, 2007. 

Michael O. Leavitt, 

Secretary. 

Editorial Note: This document was 

received at the Office of the Federal Register 

on June 29, 2007. 

■ For the reasons stated above, HHS 

amends part 100 of 42 CFR as follows: 

PART 100—VACCINE INJURY 

COMPENSATION 

■ 1. The authority section for 42 CFR 

part 100 is revised to read as follows: 

Authority: Secs. 312 and 313 of Pub. L. 99–

660, 100 Stat. 3779–3782 (42 U.S.C. 300aa–

1 note); sec. 2114(c) and (e) of the PHS Act 

(42 U.S.C. 300aa–14(c) and (e)); sec. 

2115(a)(3)(B) of the PHS Act (42 U.S.C. 

300aa–15(a)(3)(B)); sec. 904(b) of Pub. L. 105–

34, 111 Stat. 873; sec. 1503 of Pub. L. 105–

277, 112 Stat. 2681–741; and sec. 523(a) of 

Pub. L. 106–170, 113 Stat. 1927–1928. 

■ 2. Section 100.2 is revised to read as 

follows: 

§ 100.2 Average cost of a health insurance 

policy. 

For purposes of determining the 

amount of compensation under the 

VICP, section 2115(a)(3)(B) of the PHS 

Act, 42 U.S.C. 300aa–15(a)(3)(B), 

provides that certain individuals are 

entitled to receive an amount reflecting 

lost earnings, less certain deductions. 

One of the deductions is the average 

cost of a health insurance policy, as 

determined by the Secretary. The 

Secretary has determined that the 

average cost of a health insurance policy 

is $363.12 for 2006. This figure is 

calculated periodically (generally on an 

annual basis) using the most recent 

Medical Expenditure Panel SurveyInsurance Component (MEPS–IC) data 

available as the baseline for the average 

monthly cost of a health insurance 

policy. This baseline is adjusted by the 

annual percentage increase/decrease 

obtained from the most recent annual 

Kaiser Family Foundation and Health 

Research and Educational Trust (KFF/ 

HRET) Employer Health Benefits survey 

or other authoritative source that may be 

more accurate or appropriate in the 

future. The revised amount will be 

effective upon its delivery by the 

Secretary to the United States Court of 

Federal Claims, and the amount will be 

published as a notice in the Federal 

Register periodically (generally on an 

annual basis). 

[FR Doc. E7–13039 Filed 7–3–07; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 412 and 413 

[CMS–1529–N] 

RIN 0938–AO30 

Medicare Program; Hospital Direct and 

Indirect Graduate Medical Education 

Policy Changes; Notice 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule; clarification. 

SUMMARY: This notice clarifies the 

availability of certain physician salary 

proxy data for purposes of the hospital 

direct and indirect graduate medical 

education policy adopted in the 

‘‘Medicare Program; Prospective 

Payment System for Long-Term Care 

Hospitals RY 2008: Annual Payment 

Rate Updates, and Policy Changes; and 

Hospital Direct and Indirect Graduate 

Medical Education Policy Changes’’

final rule that appeared in the May 11, 

2007 Federal Register. 

EFFECTIVE DATE: This notice is effective 

on July 1, 2007. 

FOR FURTHER INFORMATION CONTACT: Tzvi 

Hefter, (410) 786–4487 (General 

information). Miechal Lefkowitz, (410) 

786–5316 (Graduate Medical Education 

payments). Renate Rockwell, (410) 786–

4645 (Graduate Medical Education 

payments). 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 07–2206 (72 FR 26870), 

there was an erroneous statement of fact 

relating to the GME policy adopted in 

the final rule. In light of the error, this 

notice serves to clarify the availability of 

certain salary proxy data that can be 

used for purposes of the hospital direct 

and indirect graduate medical education 

policy adopted in the final rule. 

II. Provisions of the Notice 

In the final rule that appeared in the 

May 11, 2007 Federal Register (72 FR 

26958), we responded erroneously to 

the following comment, ‘‘One 

commenter stated that CMS should use 

average compensation figures for dental 

faculty based on specialty and regional 

variation. The commenter stated that the 

commenter would be happy to work 

with CMS to develop compensation 

figures for dental programs.’’ We 

responded, ‘‘The AMGA [American 

Medical Group Association] data does 

not apply to dental faculty, at this point 

we are unaware of a comparable data 

source for dental faculty salaries. We 

will work with the commenter to 

determine whether we can develop 

proxy salary amounts for supervisory 

dentists.’’ After the final rule was 

issued, we were made aware that the 

AMGA data, in fact, do apply to dentists 

and podiatrists. Because AMGA data are 

available for the dental and podiatry 

specialties, the AMGA 2006 Medical 

Group Compensation and Financial 

Survey data can be used as the salary 

proxy for both dentistry and podiatry in 

accordance with the policies adopted in 

the final rule. We will also correct our 

posting of 2006 AMGA salary data at the 

following Web site address to include 

the median salary data for both dentistry 

and podiatry: http://www.cms.hhs.gov/

AcuteInpatientPPS/Downloads/

Specialty_Table_050107.pdf. 


jlentini on PROD1PC65 with RULES
Federal Register / Vol. 72, No. 128 / Thursday, July 5, 2007 / Rules and Regulations 36613 

Authority 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program). 

Dated: June 29, 2007. 

Leslie V. Norwalk, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 07–3260 Filed 6–29–07; 3:21 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 412 and 413 

[CMS–1529–CN] 

RIN 0938–AO30 

Medicare Program; Prospective 

Payment System for Long-Term Care 

Hospitals RY 2008: Annual Payment 

Rate Updates, and Policy Changes; 

Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of final rule. 

SUMMARY: This document corrects 

technical errors in the ‘‘Medicare 

Program; Prospective Payment System 

for Long-Term Care Hospitals RY 2008: 

Annual Payment Rate Updates, and 

Policy Changes; and Hospital Direct and 

Indirect Graduate Medical Education 

Policy Changes; Final Rule’’ (hereinafter 

referred to as the RY 2008 LTCH PPS 

final rule) that appeared in the May 11, 

2007 Federal Register. We are 

correcting the high cost outlier (HCO) 

fixed-loss amount that is effective for 

long-term care hospital (LTCH) 

prospective payment system (PPS) 

payments beginning on or after July 1, 

2007 from $22,954 to $20,738. The 

incorrect fixed-loss amount was 

determined due to a typographical error 

in the computer programming. We are 

also correcting figures in Table 9 and 

Table 11 since the incorrect figures 

originally published originated from the 

same typographical error. We are 

making additional conforming changes 

to the preamble of the final rule which 

were necessary as a result of the 

correction of the fixed-loss amount and 

the figures in Tables 9 and 11. 

EFFECTIVE DATE: July 1, 2007. 

FOR FURTHER INFORMATION CONTACT: Tzvi 

Hefter, (410) 786–4487 (General 

information). Elizabeth Truong, (410) 

786–6005 (Federal rate update, budget 

neutrality, other adjustments, and 

calculation of the payment rates). 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 07–2206 (72 FR 26870), 

there were technical errors stemming 

from a typographical error in the 

computer programming of the payment 

simulation program that are identified 

and corrected in the Correction of Errors 

section below. The provisions in this 

correction notice are effective as if they 

had been included in the RY 2008 LTCH 

PPS final rule. Accordingly, the 

corrections are effective July 1, 2007. 

II. Summary of Errors 

In the RY 2008 LTCH PPS final rule, 

we incorrectly calculated the HCO 

fixed-loss amount. Specifically, we 

discovered that there was a 

typographical error in one of the 

numeric inputs used in the payment 

simulation program and this resulted in 

an understating of the nonlabor share of 

payments to LTCHs. Since the nonlabor 

related share is used in the calculation 

of the fixed-loss amount, this error 

caused the fixed-loss amount to be 

inaccurate. We corrected the 

typographical error in the payment 

simulation program and computed the 

payment using the same payment 

methodology that was discussed and 

used in the final rule. Consequently, the 

corrected final fixed-loss amount for RY 

2008 is $20,738. This document 

replaces all incorrect HCO fixed-loss 

amounts references in the RY 2008 

LTCH PPS final rule with the corrected 

fixed-loss amount of $20,738. 

Furthermore, the payment simulation 

program was used in the analysis of 

payment changes for the impact section 

of the RY 2008 LTCH PPS final rule. 

Specifically, Tables 9 and 11 of the final 

rule address the projected impact of 

payment rate policy changes by 

comparing payments based on the 

policies that were in effect for RY 2007 

to LTCH PPS payments based on 

policies to be in effect for RY 2008, 

including the RY 2008 HCO fixed-loss 

amount (72 FR 26870, 26977 through 

26978, and 26985 through 26986). In 

this correction notice, we are providing 

the revised Tables 9 and 11 to reflect the 

changes resulting from correcting the 

typographical error in the payment 

simulation program. We note that it was 

necessary to revise only two columns in 

Table 11. Correcting the typographical 

error for the nonlabor share generally 

reduced the estimated impact on 

estimated payments per discharge from 

RY 2007 to RY 2008 due to finalized 

changes to the area wage adjustment 

(column 7). In addition, applying the 

revised fixed-loss amount, which is 

$2,216 lower than the incorrect fixedloss amount applied in the RY 2008 

LTCH PPS final rule, generally reduced 

the estimated impact on estimated 

payments per discharge from RY 2007 to 

RY 2008 (column 9). In addition, we are 

making conforming changes to the 

preamble of the final rule (as indicated 

in Section III. of this correction notice) 

that are necessary as a result of the 

correction of the fixed-loss amount and 

Tables 9 and 11. 

III. Correction of Errors 

In FR Doc. 07–2206 (72 FR 26870), 

make the following corrections: 

1. On page 26898, 

a. In the 2nd column, 1st full 

paragraph, lines 25 and 30, the figure 

‘‘$22,954’’ is corrected to read 

‘‘$20,738’’. 

b. In the 3rd column, 2nd full 

paragraph, lines 4 and 11, the figure 

‘‘$22,954’’ is corrected to read 

‘‘$20,738’’. 

2. On page 26899, 

a. In the 1st column, 

(1) In the 1st partial paragraph, 

(a) Line 26, the figure ‘‘3.8’’ is 

corrected to read ‘‘1.2’’. 

(b) Line 42, the figure ‘‘1.0’’ is 

corrected to read ‘‘0.5’’. 

(c) Lines 46 through 48, the sentence 

‘‘We also project an estimated 2.5 

percent decrease in estimated payments 

per discharge from RY 2007 to RY 2008 

due’’ is corrected to read, ‘‘We also 

project an estimated 0.4 percent 

decrease in estimated payments per 

discharge from RY 2007 to RY 2008 

primarily due’’. 

(2) In the 1st full paragraph, line 2, 

the figure ‘‘$22,954’’ is corrected to read 

‘‘$20,738’’. 

b. In the 2nd column, 

(1) In the 1st partial paragraph, line 

14, the figure ‘‘10’’ is corrected to read 

‘‘8’’. 

(2) In the 1st partial paragraph, line 

31, the figure ‘‘10’’ is corrected to read 

‘‘8.5’’. 

3. On page 26900, in the 1st column, 

in the 3rd full paragraph, in the 2nd line 

from the bottom, the figure ‘‘$22,954’’ is 

corrected to read ‘‘$20,738’’. 

4. On page 26977, in the 3rd column, 

in the 1st partial paragraph, lines 27 and 

28, the phrase ‘‘approximately $156 

million (or about 3.8 percent).’’ is 

corrected to read, ‘‘approximately $50 

million (or about 1.2 percent). In 

addition, applying the case-mix 

adjustment (2.49 percent) to account for 

the increase in payments in FY 2005, 

the result is estimated to be an impact 

of approximately $100 million.’’

5. On pages 26977 through 26978, 

Table 9: Estimated Impact of the 


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