13798 Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices 

from the Secretary, a waiver of the 

above requirements under certain 

specified conditions. A waiver allows 

the hospital to have an agreement with 

an OPO other than the one initially 

designated by CMS, if the hospital 

meets certain conditions specified in 

section 1138(a)(2)(A) of the Act. In 

addition, the Secretary may review 

additional criteria described in section 

1138(a)(2)(B) of the Act to evaluate the 

hospital’s request for a waiver. 

Section 1138(a)(2)(A) of the Act states 

that in granting a waiver, the Secretary 

must determine that the waiver—(1) is 

expected to increase organ donations; 

and (2) will ensure equitable treatment 

of patients referred for transplants 

within the service area served by the 

designated OPO and within the service 

area served by the OPO with which the 

hospital seeks to enter into an 

agreement under the waiver. In making 

a waiver determination, section 

1138(a)(2)(B) of the Act provides that 

the Secretary may consider, among 

other factors: (1) Cost-effectiveness; (2) 

improvements in quality; (3) whether 

there has been any change in a 

hospital’s designated OPO due to the 

changes made in definitions for 

metropolitan statistical areas; and (4) 

the length and continuity of a hospital’s 

relationship with an OPO other than the 

hospital’s designated OPO. Under 

section 1138(a)(2)(D) of the Act, the 

Secretary is required to publish a notice 

of any waiver application received from 

a hospital within 30 days of receiving 

the application, and to offer interested 

parties an opportunity to comment in 

writing during the 60-day period 

beginning on the publication date in the 

Federal Register. 

The criteria that the Secretary uses to 

evaluate the waiver in these cases are 

the same as those described above under 

sections 1138(a)(2)(A) and (B) of the Act 

and have been incorporated into the 

regulations at 42 CFR 486.308(e) and (f). 

II. Waiver Request Procedures 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘Waiver Request Procedures’’ at 

the beginning of your comments.] 

In October 1995, we issued a Program 

Memorandum (Transmittal No. A–95–

11) detailing the waiver process and 

discussing the information that 

hospitals must provide in requesting a 

waiver. We indicated that upon receipt 

of a waiver request, we would publish 

a Federal Register notice to solicit 

public comments, as required by section 

1138(a)(2)(D) of the Act. 

According to these requirements, we 

will review the request and comments 

received. During the review process, we 

may consult on an as-needed basis with 

the Public Health Service’s Division of 

Transplantation, the United Network for 

Organ Sharing, and our regional offices. 

If necessary, we may request additional 

clarifying information from the applying 

hospital or others. We will then make a 

final determination on the waiver 

request and notify the hospital and the 

designated and requested OPOs. 

III. Hospital Waiver Request 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘Hospital Waiver Request’’ at 

the beginning of your comments.] 

As permitted by 42 CFR 486.308(e), 

Select Specialty Hospital-Quad Cities, of 

Davenport, Iowa has requested a waiver 

in order to enter into an agreement with 

a designated OPO other than the OPO 

designated for the service area in which 

the hospital is located. Select Specialty 

Hospital-Quad Cities is requesting a 

waiver to work with: 

Iowa Donor Network, 550 Madison 

Avenue, North Liberty, Iowa 52317. 

Select Specialty Hospital’s Designated 

OPO is: 

Gift of Hope Organ and Tissue Donor 

Network, 660 North Industrial Drive, 

Elmhurst, IL 60126–1520. 

Authority: Section 1138 of the Social 

Security Act (42 U.S.C. 1320b–8). 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; Program No. 93.774, Medicare—

Supplementary Medical Insurance, and 

Program No. 93.778, Medical Assistance 

Program.) 

Dated: March 16, 2007. 

Leslie V. Norwalk, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. E7–5328 Filed 3–22–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1488–CN3] 

RIN 0938–A012 

Medicare Program; Changes to the 

Hospital Inpatient Prospective 

Payment Systems and Fiscal Year 2007 

Rates; Final Fiscal Year 2007 Wage 

Indices and Payment Rates After 

Application of Revised Occupational 

Mix Adjustment to the Wage Index; 

Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of notice. 

SUMMARY: This document corrects wage 

index values and a relative weighting 

factor error that appeared in the 

correction notice published in the 

Federal Register on January 5, 2007 

entitled ‘‘Medicare Program; Changes to 

the Hospital Inpatient Prospective 

Payment Systems and Fiscal Year 2007 

Rates; Final Fiscal Year 2007 Wage 

Indices and Payment Rates After 

Application of Revised Occupational 

Mix Adjustment to Wage Index; 

Corrections’’. 

DATES: Effective Dates. The corrections 

to the wage index values listed in items 

1a, 1b, and 2 of section III. of this notice 

are effective as of November 3, 2006. 

The corrections to the wage index 

values listed in item 1c of section III. of 

this notice are effective November 21, 

2006. The correction to the relative 

weighting factor listed in item 3 of 

section III. of this notice is effective 

October 1, 2006. 

FOR FURTHER INFORMATION CONTACT: 

Brian Slater, (410) 786–5229. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In the October 11, 2006 Federal 

Register (71 FR 59886), we published a 

notice entitled ‘‘Hospital Inpatient 

Prospective Payment Systems and Fiscal 

Year 2007 Rates; Final Fiscal Year 2007 

Wage Indices and Payment Rates After 

Application of Revised Occupational 

Mix Adjustment to Wage Index’’

(hereinafter referred to as the ‘‘FY 2007 

IPPS notice’’). After publication of the 

October 11, 2006 notice, we became 

aware of errors in the wage indices. 

Section 412.64(k)(1) of the regulations 

requires that wage index corrections 

made after October 1 are effective 

prospectively for the remainder of the 

fiscal year from the date the fiscal 

intermediaries are informed of the 

correction. We recalculated the wage 

indices for the affected hospitals, and on 

November 3, 2006, sent a Joint Signature 

Memorandum to the fiscal 

intermediaries informing them to pay 

hospitals using the corrected wage 

indices. Subsequent to the November 3, 

2006 Joint Signature Memorandum, 

additional errors in the wage indices 

were brought to our attention and were 

corrected through a November 21, 2006 

Joint Signature Memorandum. In the 

January 5, 2007 Federal Register (FR 

Doc. 06–9976, 72 FR 569), we then 

published a correction notice entitled 

‘‘Changes to the Hospital Inpatient 

Prospective Payment Systems and Fiscal 

Year 2007 Rates; Final Fiscal Year 2007 

Wage Indices and Payment Rates After 

Application of Revised Occupational 

Mix Adjustment to Wage Index; 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices 13799 

Corrections’’ (hereinafter referred to as 

the ‘‘FY 2007 IPPS correction notice’’) 

in order to reflect the recalculations 

included in the two Joint Signature 

Memoranda. Since the publication of 

the January 5, 2007 correction notice, 

we have become aware of several 

technical errors included in the January 

5, 2007 correction notice. The Joint 

Signature Memoranda used to inform 

fiscal intermediaries of hospital 

payment rates did not contain such 

errors, in part because those Memoranda 

use a slightly different format for 

presenting wage index data. Thus, the 

corrections in this notice do not alter 

the rates already being used by fiscal 

intermediaries to pay hospitals. Rather, 

the corrections ensure that the Federal 

Register accurately reflects the rates 

actually in place. 

In sections II. and III. of this 

correction notice, we summarize, 

identify, and correct the errors in the 

January 5, 2007 correction notice. We 

note that the corrections to items 1a, 1b 

and 2 of section III. of this notice are 

effective November 3, 2006; the 

correction to item 1c of section III of this 

notice is effective November 21, 2006, 

and the correction to item 3 of section 

III of this notice is effective October 1, 

2006. 

II. Summary of the Corrections to the 

FY 2007 IPPS Correction Notice 

We made corrections to several of the 

wage index values that were published 

in Table 2 in order to ensure that the 

published tables accurately reflect the 

rates actually being used by fiscal 

intermediaries. We also added a 

sentence to the note that appears at the 

end of Table 2. In addition, we are 

making a technical correction in Table 

5 to the relative weighting factor listed 

for DRG 525. 

III. Correction of Errors 

In FR Doc. 06–9976 of January 5, 2007 

(72 FR 569), make the following 

corrections: 

1. On pages 570 through 571, in Table 

2.—Hospital Case-Mix Indexes for 

Discharges Occurring in Federal Fiscal 

Year 2005; Hospital Wage Indexes for 

Federal Fiscal Year 2007; Hospital 

Average Hourly Wages for Federal 

Fiscal Years 2005 (2001 Wage Data), 

2006 (2002 Wage Data), and 2007 (2003 

Wage Data); Wage Indexes and 3-Year 

Average of Hospital Average Hourly 

Wages, is corrected by—

a. Correcting the following entries 

effective November 3, 2006: 

Provider No. FY 2007 

wage index 

070003 ...................................... 1.2452 

070038 ...................................... 1.2591 

260015 ...................................... 0.8353 

260047 ...................................... 0.8341 

340073 ...................................... 0.9775 

390044 ...................................... 1.0996 

390096 ...................................... 1.0996 

b. Deleting the following entries 

effective November 3, 2006: 

Provider No. FY 2007 

wage index 

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

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

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

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

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

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

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

c. Correcting the following entries 

effective November 21, 2006: 

Provider No. FY 2007 

wage index 

230013 ...................................... 1.0492 

230019 ...................................... 1.0492 

230029 ...................................... 1.0492 

230071 ...................................... 1.0492 

230130 ...................................... 1.0492 

230151 ...................................... 1.0492 

230207 ...................................... 1.0492 

230223 ...................................... 1.0492 

230254 ...................................... 1.0492 

230269 ...................................... 1.0492 

230277 ...................................... 1.0492 

2. On page 571, third column, second 

full paragraph, that ends with the 

parenthetical phrase ‘‘(April 1–

September 30, 2007),’’ the paragraph is 

corrected by adding a sentence to read 

as follows: 

The separate wage index values for the first 

and second halves of FY 2007 can be viewed 

in Supplemental Table 2 on the CMS Web 

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

AcuteInpatientPPS/WIFN/ 

list.asp#TopOfPage. 

3. On page 573 in Table 5.—List of 

Diagnosis-Related Groups (DRGs), 

Relative Weighting Factors, and 

Geometric and Arithmetic Mean Length 

of Stay (LOS), first line (DRG 525), 

seventh column (weights), the figure 

‘‘2.2268’’ is corrected to read ‘‘12.2268’’. 

IV. Discussion of Effective Date and 

Notice and Comment Rulemaking 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register to provide a period for public 

comment before the provisions of a rule 

take effect in accordance with section 

553(b) of the Administrative Procedure 

Act (APA) (5 U.S.C. 553(b). In addition, 

a final rule would ordinarily require a 

30-day delay in effective date after the 

date of publication in the Federal 

Register. This correction of the rates 

published in the FY 2007 IPPS notice 

and subsequent FY 2007 IPPS correction 

notice does constitute a rule under the 

Administrative Procedure Act, because 

in our FY 2007 IPPS final rule (71 FR 

47870, August 18, 2006), we already 

published the methodologies and 

formulas we use for determining the 

wage index, geographic adjustment 

factors, and other rates. This notice does 

not change our methodology or 

formulas, but merely ensures that our 

notice accurately reflects the rates that 

are already being used to pay hospitals. 

As this notice is not a rule under the 

Administrative Procedure Act, no notice 

of proposed rulemaking or delay in 

effective date is necessary. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: March 16, 2007. 

Ann C. Agnew, 

Executive Secretary to the Department. 

[FR Doc. E7–5290 Filed 3–22–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1384–N] 

Medicare Program; Extension of 

Certain Hospital Wage Index 

Reclassifications 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS) HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

extension of the expiration date for 

certain geographic reclassifications as 

implemented by Division B, Title I, 

section 106 of the Tax Relief and Health 

Care Act of 2006. These geographic 

classifications, which affected hospitals’

wage indices, were previously set to 

expire on March 31, 2007 and are now 

extended to September 30, 2007. 

DATES: Effective Date: April 1, 2007. 

FOR FURTHER INFORMATION CONTACT: 

Brian Slater, for hospital inpatient 

prospective payment systems questions, 

(410) 786–5229. Chris Smith-Ritter, for 

hospital outpatient prospective payment 

systems questions, (410) 786–4636. 

SUPPLEMENTARY INFORMATION: 


sroberts on PROD1PC70 with NOTICES