This document is scheduled to be published in the

Federal Register on 01/02/2014 and available online at

DEPARTMENT OF HEALTH AND HUMAN SERVICES http://federalregister.gov/a/2013-31432, and on FDsys.gov

Centers for Medicare & Medicaid Services 

42 CFR Parts 412, 482, 485, and 489 

CMS-1599 & 1455-CN3 

RINs 0938-AR53 and 0938-AR73 

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute 

Care Hospitals and the Long-Term Care Hospital Prospective Payment System and 

Fiscal Year 2014 Rates; Quality Reporting Requirements for Specific Providers; 

Hospital Conditions of Participation; Payment Policies Related to Patient Status; 

Corrections 

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notification of correction to tables. 

SUMMARY: This document corrects technical errors in the final rules that appeared in 

the August 19, 2013 Federal Register titled "Medicare Program; Hospital Inpatient 

Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care 

Hospital Prospective Payment System and Fiscal Year 2014 Rates; Quality Reporting 

Requirements for Specific Providers; Hospital Conditions of Participation; Payment 

Policies Related to Patient Status." 

EFFECTIVE DATE: This correcting document is effective on [OFR: Insert date of 

publication in the Federal Register.]

FOR FURTHER INFORMATION CONTACT: 

Tzvi Hefter (410) 786-4487. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2013-18956, which appeared in the August 19, 2013 Federal 
CMS-1599 & 1455-CN3 2 

Register (78 FR 50496) entitled "Medicare Program; Hospital Inpatient Prospective 

Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective 

Payment System and Fiscal Year 2014 Rates; Quality Reporting Requirements for 

Specific Providers; Hospital Conditions of Participation; Payment Policies Related to 

Patient Status" (hereinafter referred to as the FY 2014 IPPS/LTCH PPS final rule), there 

were a number of technical and typographical errors. Therefore, in the October 3, 2013 

Federal Register (78 FR 61197), we published a correcting document to correct those 

errors. The provisions of the correcting document were effective as if they had been 

included in the FY 2014 IPPS/LTCH PPS final rule that appeared in the August 19, 2013 

Federal Register. Accordingly, those corrections were effective October 1, 2013. 

We have learned of an additional technical error that appeared in FY 2014 

IPPS/LTCH PPS final rule. Specifically, the wage data of provider 220153 in core-based 

statistical area (CBSA) 44140, Springfield, MA should not have been included in the 

wage index data. The inclusion of this data resulted in an error in the pre-reclassified, 

unadjusted wage index, which is used in the IPPS, for CBSA 44140 as well as to 

determine the LTCH PPS wage index, which is computed using wage data from inpatient 

acute care hospitals without regard to reclassification under section 1886(d)(8) or section 

1886(d)(10) of the Act. Section 412.64(k) of the regulations provides for making 

midyear corrections to the wage index. Under this provision, we make a midyear 

correction to the wage index for an area only if a hospital can show that the--(1) 

intermediary or CMS made an error in tabulating its data; and (2) hospital could not have 

known about the error or did not have the opportunity to correct the error before the 

beginning of the Federal fiscal year (that is, October 1). A midyear correction to the 
CMS-1599 & 1455-CN3 3 

wage index is effective prospectively from the date the change is made to the wage index 

rather than retroactively to the beginning of the Federal fiscal year, unless several 

conditions are met, including the requirement, under §412.64(k)(2)(ii)(C), that CMS 

agreed before October 1st that the fiscal intermediary or CMS made an error in tabulating 

the hospital’s wage data and the wage index should be corrected. CMS did not agree that 

there was an error in the IPPS wage index until after October 1, 2013; therefore, under 

the authority of §412.64(k), the effective date of this correction is prospective, [OFR: 

Insert date of publication in the Federal Register]. Furthermore, as the IPPS wage data 

is also used to compute the LTCH PPS wage index, these corrections will also apply 

prospectively to the LTCH PPS wage index as of [insert date of publication in the 

Federal Register]. 

II. Summary of Errors and Corrections to Tables Posted on the CMS Website 

A. Errors in and Corrections to the IPPS Tables

We are correcting the errors in the following IPPS tables that are listed on 78 FR 

51002 of FY 2014 IPPS/LTCH PPS final rule and are available on the Internet on the 

CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/AcuteInpatientPPS/FY2014-IPPS-Final-Rule-Home-Page.html . 

In Table 2.--Acute Care Hospitals Case-Mix Indexes for Discharges Occurring in 

Federal Fiscal Year 2012; Hospital Wage Indexes for Federal Fiscal Year 2014; Hospital 

Average Hourly Wages for Federal Fiscal Years 2012 (2008 Wage Data), 2013 (2009 

Wage Data), and 2014 (2010 Wage Data); and 3-Year Average of Hospital Average 

Hourly Wages. We inadvertently included the wage data of provider 220153 in CBSA 
CMS-1599 & 1455-CN3 4 

44140, Springfield, MA in the FY 2014 wage index. Therefore, we are correcting Table 

2 by removing the wage data for provider 220153. 

In Table 3A.--FY 2014 and 3-Year Average Hourly Wage for Acute Care 

Hospitals in Urban Areas by CBSA. We inadvertently included provider 220153 in the 

wage index of CBSA 44140. Therefore, we are correcting the FY 2014 average hourly 

wage and the 3-year average hourly wage for CBSA 44140, Springfield, MA by 

removing the wage data for provider 220153, and recomputing the FY 2014 average 

hourly wage and the 3-year average hourly wage for CBSA 44140. 

B. Error in and Correction to a LTCH PPS Table

We are also correcting the error in the following LTCH PPS table that is listed on 

78 FR 51002 of the FY 2014 IPPS/LTCH PPS final rule and is available on the Internet 

on the CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/LongTermCare HospitalPPS/index.html . 

Table 12A.—LTCH PPS Wage Index for Urban Areas for Discharges Occurring 

from October 1, 2013 through September 30, 2014. Due to a technical error found in the 

data of a provider in CBSA 44140, we are correcting the LTCH PPS wage index value 

for that CBSA. 

III. Waiver of Proposed Rulemaking and Delay of Effective Date 

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)). However, we can waive this notice and comment procedure if the Secretary 

finds, for good cause, that the notice and comment process is impracticable, unnecessary, 
CMS-1599 & 1455-CN3 5 

or contrary to the public interest, and incorporates a statement of the finding and the 

reasons therefore in the notice. 

Section 553(d) of the APA ordinarily requires a 30-day delay in effective date of 

final rules after the date of their publication in the Federal Register. This 30-day delay 

in effective date can be waived, however, if an agency finds for good cause that the delay 

is impracticable, unnecessary, or contrary to the public interest, and the agency 

incorporates a statement of the findings and its reasons in the rule issued. 

In our view, this correcting document does not constitute a rule that would be 

subject to the APA notice and comment or delayed effective date requirements. This 

correcting document corrects technical errors in tables posted on the CMS website but 

does not make substantive changes to the policies or payment methodologies that were 

adopted in the final rule. As a result, this correcting document is intended to ensure that 

the tables posted on the CMS website accurately reflect the policies adopted in that final 

rule. 

 In addition, even if this were a rule to which the notice and comment procedures 

and delayed effective date requirements applied, we find that there is good cause to 

waive such requirements. Undertaking further notice and comment procedures to 

incorporate the corrections in this document into the final rule or delaying the effective 

date would be contrary to the public interest because it is in the public's interest for 

providers to receive appropriate payments in as timely a manner as possible, and to 

ensure that the FY 2014 IPPS/LTCH PPS final rule accurately reflects our payment 

methodologies, payment rates, and policies. Furthermore, such procedures would be 

unnecessary, as we are not altering our payment methodologies or policies, but rather, we 
CMS-1599 & 1455-CN3 6 

are simply implementing correctly the payment methodologies and policies that we 

previously proposed, received comment on, and subsequently finalized. This correcting 

document is intended solely to ensure that the FY 2014 IPPS/LTCH PPS final rule 

accurately reflects these payment methodologies and policies. Therefore, we believe we 

have good cause to waive the notice and comment and effective date requirements. 
CMS-1599 & 1455-CN3 

(Catalog of Federal Domestic Assistance Program No. 93.778, Medical Assistance 

Program) 

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare--Hospital 

Insurance; and Program No. 93.774, Medicare--Supplementary Medical Insurance 

Program) 

Dated: December 26, 2013

______________________________ 

Oliver Potts,

Deputy Executive Secretary to the 

 Department,

Department of Health and Human Services. 
CMS-1599 & 1455-CN3 8 

BILLING CODE 4120-01-P 

[FR Doc. 2013-31432 Filed 12/31/2013 at 8:45 am; Publication Date: 01/02/2014]