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
13800 Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices 

I. Background 

Section 508 of Pub. L. 108–173 

(hereinafter referred to as ‘‘section 508’’) 

permitted a qualifying hospital to 

appeal the wage index classification 

otherwise applicable to the hospital and 

apply for reclassification to another area 

of the State in which the hospital was 

located (or, at the discretion of the 

Secretary, to an area within a 

contiguous State). Hospitals were 

required to submit their applications by 

February 15, 2004. In the February 13, 

2004 Federal Register (69 FR 7340), we 

published a notice that described our 

implementation of section 508. The 

Congress limited the reclassifications 

under section 508 to a 3-year period 

beginning April 1, 2004 and ending 

March 31, 2007. 

Generally, geographic reclassifications 

are in effect for at least one entire 

Federal fiscal year (October 1 to 

September 30). However, in the FY 2006 

IPPS final rule, to coincide with the end 

of section 508 reclassifications on 

March 31, 2007, we established special 

procedural rules under which 

individual and group reclassifications 

could take effect for only the second 

half of the fiscal year, from April 1 

through September 30, 2007 (70 FR 

47382, August 12, 2005). Consistent 

with those procedural rules, for FY 

2007, some hospitals or geographic 

areas were assigned different geographic 

reclassifications and wage indices for 

the 1st half of FY 2007 than were 

assigned for the 2nd half of FY 2007 (71 

FR 59886). Further, in accordance to 

section 1886(d)(8)(D) of the Act, we 

apply an adjustment to the IPPS 

standardized amounts to ensure that the 

effects of geographic reclassification are 

budget neutral. For FY 2008, we 

calculated one budget neutrality 

adjustment that reflects the average of 

the adjustments required for 1st and 2nd 

half fiscal year reclassifications, 

respectively. We received only favorable 

comments on our policy of providing for 

half-year reclassifications in FY 2007. 

II. Provisions of the Notice 

Division B, Title I, section 106 of the 

Tax Relief and Health Care Act of 2006 

(Pub. L. 109–432) extends any 

geographic reclassification that was set 

to expire on March 31, 2007 by 6 

months until September 30, 2007. 

Consistent with the mid-year manner in 

which we originally implemented 

section 508 (Pub. L. 108–173) in FY 

2005, we will not alter previously 

announced wage indices or geographic 

reclassifications for hospitals whose 

reclassifications are not extended by 

section 106. Such hospitals will 

continue to receive the wage indices 

and reclassifications previously 

announced in the October 11, 2006 IPPS 

Federal Register notice (71 FR 59885) 

(or any corrections to such notice). Also, 

consistent with the mid-year 

implementation of section 508, we have 

made no changes to the budget 

neutrality adjustments applied to the 

standardized amounts previously 

announced. 

Also, as with the section 508 

reclassifications, the 6-month extension 

applies to both hospital inpatient and 

outpatient department services. 

However, because the Congress limited 

the extensions available under section 

106 to a 6-month period, for hospital 

outpatient department services and 

payment under OPPS, a hospital that 

has a geographic reclassification 

extended from March 31, 2007 to 

September 30, 2007 will revert to its 

previously scheduled April 1st 

reclassification or its home area wage 

index from October 1, 2007 to December 

31, 2007. As discussed in the previous 

paragraph, the OPPS wage index 

received for October 1 through 

December 31, 2007 will not be affected 

by the section 106 extension. 

We have instructed the Medicare 

Administrative Contractors (MAC) for 

the affected providers to continue any 

geographic reclassifications that were 

set to expire on March 31, 2007 through 

September 30, 2007. 

As described in section I of this 

Notice, for FY 2007, we allowed some 

reclassifications to take effect for only 

half of the fiscal year, and we calculated 

separate wage indices for the first and 

second halves of the year for the areas 

affected by such reclassifications. 

Hospitals receiving a section 508 

reclassification receive the wage index 

for reclassified hospitals, when such a 

wage index applies. Because there may 

be two separate wage indices for 

hospitals for the first and second halves 

of the year, a small number of hospitals 

whose reclassifications are being 

extended under section 106 will receive 

the April 1–September 30, 2007 wage 

index (that is, the wage index value for 

the second half of the year). Thus, even 

if these hospitals are reclassified to the 

same area as in the first half of the year, 

the hospitals may see a change in their 

wage indices (see Tables 4A–2, 4B–2, 

and 4C–2 further corrected on January 5, 

2007 (72 FR 569) and March xx, 2007 

(72 FR XXX) for a listing of areas where 

the wage index is changing between the 

1st and 2nd half of the fiscal year). We 

believe such a change is appropriate 

given section 106’s focus on extending 

the actual geographic reclassification, 

and not the specific wage index 

assignment, for the additional 6 months. 

When applying section 508, we 

required each hospital to submit a 

request in writing by February 15, 2004, 

to the Medicare Geographic 

Classification Review Board (MGCRB), 

with a copy to CMS. CMS will neither 

require nor accept written requests for 

the extension required by section 106, 

since that section simply provides a 6- 

month continuation for any 

reclassification set to expire March 31, 

2007. Thus, for example, hospitals that 

were not reclassified under section 508 

should not send written requests to the 

MGCRB requesting section 106 

extensions. 

Providers affected by section 106 are 

listed below: 

Provider No. 

Wage index 

4/1/2007–

9/30/2007 

010150 .................................. 0.8371 

020008 .................................. 1.2183 

050494 .................................. 1.4116 

050549 .................................. 1.4116 

060075 .................................. 1.0877 

070001 .................................. 1.2730 

070005 .................................. 1.2730 

070010 .................................. 1.3113 

070016 .................................. 1.2730 

070017 .................................. 1.2730 

070019 .................................. 1.2730 

070022 .................................. 1.2730 

070028 .................................. 1.3113 

070031 .................................. 1.2730 

070036 .................................. 1.2930 

070039 .................................. 1.2730 

160040 .................................. 0.8708 

160064 .................................. 0.9701 

160067 .................................. 0.8708 

160110 .................................. 0.8708 

220046 .................................. 1.1343 

230003 .................................. 1.0797 

230004 .................................. 1.0797 

230013 .................................. 1.0602 

230019 .................................. 1.0602 

230020 .................................. 1.0440 

230024 .................................. 1.0440 

230029 .................................. 1.0602 

230036 .................................. 1.0602 

230038 .................................. 1.0797 

230053 .................................. 1.0440 

230059 .................................. 1.0797 

230066 .................................. 1.0797 

230071 .................................. 1.0602 

230072 .................................. 1.0797 

230089 .................................. 1.0440 

230097 .................................. 1.0797 

230104 .................................. 1.0440 

230106 .................................. 1.0797 

230119 .................................. 1.0440 

230130 .................................. 1.0602 

230135 .................................. 1.0440 

230146 .................................. 1.0440 

230151 .................................. 1.0602 

230165 .................................. 1.0440 

230174 .................................. 1.0797 

230176 .................................. 1.0440 

230207 .................................. 1.0602 

230223 .................................. 1.0602 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices 13801 

Provider No. 

Wage index 

4/1/2007–

9/30/2007 

230236 .................................. 1.0797 

230254 .................................. 1.0602 

230269 .................................. 1.0602 

230270 .................................. 1.0440 

230273 .................................. 1.0440 

230277 .................................. 1.0602 

250002 .................................. 0.8461 

250122 .................................. 0.8461 

270023 .................................. 0.8956 

270032 .................................. 0.8956 

270057 .................................. 0.8956 

310021 .................................. 1.3113 

310028 .................................. 1.3113 

310051 .................................. 1.3113 

310060 .................................. 1.3113 

310115 .................................. 1.3113 

310120 .................................. 1.3113 

330049 .................................. 1.3113 

330106 .................................. 1.4779 

330126 .................................. 1.3113 

330135 .................................. 1.3113 

330205 .................................. 1.3113 

330209 .................................. 1.2730 

330264 .................................. 1.2730 

340002 .................................. 0.9413 

350002 .................................. 0.8367 

350003 .................................. 0.8367 

350006 .................................. 0.8367 

350010 .................................. 0.8367 

350014 .................................. 0.8367 

350015 .................................. 0.8367 

350017 .................................. 0.8367 

350030 .................................. 0.8367 

380090 .................................. 1.1162 

390001 .................................. 0.9990 

390003 .................................. 0.9990 

390045* ................................ 0.9990 

390054 .................................. 0.9942 

390072 .................................. 0.9990 

390095 .................................. 0.9990 

390119 .................................. 0.9990 

390137 .................................. 0.9990 

390169 .................................. 0.9990 

390185 .................................. 0.9942 

390192 .................................. 0.9990 

390237 .................................. 0.9990 

390270 .................................. 0.9942 

430005 .................................. 0.8708 

430015 .................................. 0.9238 

430048 .................................. 0.9238 

430060 .................................. 0.9238 

430064 .................................. 0.9238 

430077 .................................. 0.9238 

430091 .................................. 0.9238 

450010 .................................. 0.8794 

450072 .................................. 1.0094 

450591 .................................. 1.0094 

470003 .................................. 1.1343 

490001 .................................. 0.8600 

530015 .................................. 1.0060 

* This hospital is assigned a wage index 

value under a special exceptions policy (69 

FR 49105). 

III. Regulatory Impact Statement 

We have examined the impact of this 

notice using the requirements of 

Executive Order 12866 (September 

1993, Regulatory Planning and Review), 

and Executive Order 13132. 

Executive Order 12866 directs 

agencies to assess all costs and benefits 

of available regulatory alternatives and, 

if regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety effects, distributive impacts, 

and equity). A regulatory impact 

analysis (RIA) must be prepared for 

major rules with economically 

significant effects ($100 million or more 

in any 1 year). This notice implements 

a statutory provision that would 

increase payments to hospitals by less 

than $100 million and is therefore not 

a major rule. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates a 

proposed rule (and subsequent final 

rule) that imposes substantial direct 

requirement costs on State and local 

governments, preempts State law, or 

otherwise has Federalism implications. 

Again, although we do not consider this 

notice to be a rule subject to notice and 

comment rulemaking, we note that this 

notice does not impose any costs on 

State or local governments. Therefore, 

the requirements of Executive Order 

13132 would not be applicable. 

Section 106 of the Tax Relief and 

Health Care Act of 2006 extends any 

geographic reclassification that was set 

to expire on March 31, 2007 by six 

months until September 30, 2007. We 

estimate the impact of this provision 

will be to increase payments to 

hospitals by $80 million. 

In accordance with the provisions of 

Executive Order 12866, this notice was 

reviewed by the Office of Management 

and Budget. 

Authority: Section 106 of Public Law 109–

432. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: March 8, 2007. 

Leslie V. Norwalk, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. E7–5298 Filed 3–22–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4083–NR] 

Medicare Program; Applicability of 

Part 405 Medicare Appeals Council 

Own Motion Review Provisions to the 

Part 423 Medicare Prescription Drug 

(Part D) Appeals Process 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice of CMS Ruling. 

SUMMARY: This notice announces a CMS 

Ruling that establishes a process for 

own motion review of Medicare 

Prescription Drug Program (Part D) cases 

by the Medicare Appeals Council. 

FOR FURTHER INFORMATION CONTACT: 

Arrah Tabe-Bedward, (410) 786–7129 or 

Kathryn McCann Smith, (410) 786–

7623. 

SUPPLEMENTARY INFORMATION: The CMS 

Acting Administrator signed Ruling 

CMS–4083–NR on March 15, 2007. The 

text of the CMS Ruling is as follows: 

Implementation of a Process for Own 

Motion Review of Part D Cases by the 

Medicare Appeals Council 

Summary: This Ruling establishes a 

process, consistent with the current 

Medicare fee-for-service (FFS) appeals 

rules in title 42 of the Code of Federal 

Regulations, part 405, subpart I, for own 

motion review of Part D cases by the 

Medicare Appeals Council. This Ruling 

is effective on the date the Acting 

Administrator signs the Ruling. 

Citations: Sections 1852(g), 1860D–

4(g)–(h), and 1869 of the Social Security 

Act (42 U.S.C. 1395w–22, 1395w–104 

and 1395ff). 

I. Background on Part D Appeals 

Sections 1860D–4(g) and (h) of the 

Social Security Act (the Act) and the 

implementing regulations at 42 CFR part 

423, subpart M, establish a Part D 

enrollee’s right to appeal an adverse 

coverage determination made by a Part 

D plan sponsor (‘‘plan sponsor’’), as 

defined at 42 CFR 423.4, that results in 

the denial of prescription drug coverage 

the enrollee believes he or she is 

entitled to receive under the Part D 

program. This includes a plan sponsor’s 

decision not to provide or pay for a Part 

D drug, failure to provide a coverage 

determination in a timely manner when 

a delay would adversely affect the 

enrollee’s health, a decision concerning 

a tiering or non-formulary exceptions 

request, and a decision on the amount 


sroberts on PROD1PC70 with NOTICES