Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80131 

E. Corrections of Errors in the 

Regulations Text 

§ 495.24 [Corrected] 

■ 70. On page 69914, in the first 

column, § 495.24(f)(1)(i)(C) is corrected 

to read: ‘‘(C) In 2025 earn a total score 

of at least 70 points’’. 

Elizabeth J. Gramling, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2024–22501 Filed 9–27–24; 4:15 pm] 

BILLING CODE 4120–01–C 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 412 

[CMS–1804–CN] 

RIN 0938–AV31 

Medicare Program; Inpatient 

Rehabilitation Facility Prospective 

Payment System for Federal Fiscal 

Year 2025 and Updates to the IRF 

Quality Reporting Program; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical and typographical errors in 

the final rule that appeared in the 

August 6, 2024 Federal Register entitled 

‘‘Medicare Program; Inpatient 

Rehabilitation Facility Prospective 

Payment System for Federal Fiscal Year 

2025 and Updates to the IRF Quality 

Reporting Program’’ (referred to 

hereafter as the ‘‘FY 2025 IRF final 

rule’’). The effective date of the FY 2025 

IRF final rule is October 1, 2024. 

DATES: This correction is effective 

October 1, 2024. 

FOR FURTHER INFORMATION CONTACT: Kia 

Burwell, (410) 786–7816. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2024–16911 of August 6, 

2024, the FY 2025 IRF final rule (89 FR 

64276), there were technical and 

typographical errors that are identified 

and corrected in this correcting 

document. These corrections are 

effective as if they had been included in 

the FY 2025 IRF final rule. Accordingly, 

the corrections are effective October 1, 

2024. 

II. Summary of Errors 

A. Summary of Errors in the Preamble 

On page 64304, we made a 

typographical error in the standard 

payment amount calculated following 

the application of the budget neutrality 

factor for the FY 2025 wage index due 

to the number being transposed in the 

original text. 

A technical error in the calculation of 

the final FY 2025 IRF PPS wage indexes 

require us to recalculate the impact 

analysis provided on pages 64335 and 

64336 in Table 17. Discussions of these 

errors are found in section IV. of this 

document. 

B. Summary of Errors and Corrections 

Posted on the CMS Website for the IRF 

Wage Index 

As discussed in the FY 2025 IRF PPS 

final rule (89 FR 64289 through 64291), 

in developing the wage index to be 

applied to IRFs under the IRF PPS, we 

use the updated, pre-reclassified, prerural floor hospital inpatient PPS (IPPS) 

wage data, exclusive of the occupational 

mix adjustment. For FY 2025, the 

updated, unadjusted, pre-reclassified, 

pre-rural floor IPPS wage data used 

under the IRF PPS are for cost reporting 

periods beginning on or after October 1, 

2020, and before October 1, 2021 (FY 

2021 cost report data), as discussed in 

the final rule entitled ‘‘Medicare and 

Medicaid Programs and the Children’s 

Health Insurance Program; Hospital 

Inpatient Prospective Payment Systems 

for Acute Care Hospitals and the LongTerm Care Hospital Prospective 

Payment System and Policy Changes 

and Fiscal Year 2025 Rates; Quality 

Programs Requirements; and Other 

Policy Changes’’ (89 FR 69896) 

(hereinafter referred to as the FY 2025 

IPPS final rule). In calculating the wage 

index under the FY 2025 IPPS final rule, 

we made an inadvertent error related to 

the calculation of the wage index. This 

error is identified, discussed, and 

corrected in the document entitled 

‘‘Medicare and Medicaid Programs and 

the Children’s Health Insurance 

Program; Hospital Inpatient Prospective 

Payment Systems for Acute Care 

Hospitals and the Long-Term Care 

Hospital Prospective Payment System 

and Policy Changes and Fiscal Year 

2025 Rates; Quality Programs 


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Average Average 

Number of FY2024 FY2025 

[FY 2024 PAYMENTS COMPARED TO FY 2025 PAYMENTS] Hospitals Payments/Case Payments/Case Cban2e 

Voluntary 1,907 1,158 1,189 2.7 

Proprietary 755 1,060 1,094 3.2 

Government 420 1,265 1,294 2.3 

Medicare Utilization as a Percent oflnpatient Davs: 

0-25 1,362 1,243 1,277 2.7 

25-50 1,616 1,091 1,122 2.8 

50-65 65 1,055 1,068 1.2 

Over65 16 719 725 0.8 

Medicaid Utilization as a Percent oflnpatient Davs: 

0-25 1,911 1,056 1,087 2.9 

25-50 1,044 1,289 1,323 2.6 

50-65 99 1,571 1,585 0.9 

Over65 29 1,348 1,353 0.4 

FY 2025 Reclassifications: 

All Reclassified Hospitals 1,061 1,210 1,248 3.1 

Non-Reclassified Hospitals 2,022 1,099 1,125 2.4 

Urban Hospitals Reclassified 902 1,256 1,294 3.0 

Urban Non-Reclassified Hospitals 1,501 1,108 1,133 2.3 

Rural Hospitals Reclassified Full Year 281 811 844 4.1 

Rural Non-Reclassified Hospitals Full Year 399 766 791 3.3 

All Section 401 Rural Reclassified Hospitals 729 1,281 1,320 3.0 

Other Reclassified Hospitals (Section 1886(d)(8)(B)) 51 808 842 4.2 
80132 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

Requirements; and Other Policy 

Changes; Correction,’’ published 

elsewhere in this issue of the Federal 

Register. The error that affects the 

unadjusted, pre-reclassified, pre-rural 

floor IPPS wage data and thereby affects 

the IRF PPS wage data was an error 

resulting from excluding the Medicare 

cost report wage data for CMS 

Certification Number (CCN) 260163, 

which caused a change in the wage 

index for rural Missouri. The wage data 

for this hospital has been restored and 

included in the wage index. 

Thus, the use of the corrected wage 

data for the rural Missouri CBSA 26 

required the recalculation of the final 

FY 2025 IRF PPS wage indexes. 

Additionally, as discussed in the FY 

2025 IRF PPS final rule, adjustments or 

updates to the IRF wage index made 

under section 1886(j)(6) of the Social 

Security Act (the Act) must be made in 

a budget-neutral manner. Due to the 

recalculation and subsequent revision of 

the final FY 2025 IRF PPS wage indexes, 

it was necessary to recalculate the FY 

2025 IRF PPS wage index budget 

neutrality factor as well, with no 

subsequent changes noted. Due to the 

recalculated wage indexes, we 

recalculated the impact analysis 

provided in Table 17 of the FY 2025 IRF 

PPS final rule (89 FR 64335 through 

64337). The correction to this error is 

found in section IV. of this document. 

We are correcting the wage index in 

Table B setting forth the wage indexes 

for rural areas based on CBSA labor 

market areas (Table B), which is 

available exclusively on the CMS 

website at https://www.cms.gov/ 

medicare/payment/prospectivepayment-systems/inpatientrehabilitation. Table B has been updated 

to reflect the error in the wage index for 

the State of Missouri discussed in this 

correcting document, and we are 

republishing the wage indexes in Tables 

A and B accordingly on the CMS 

website at https://www.cms.gov/ 

medicare/payment/prospectivepayment-systems/inpatientrehabilitation. 

III. Waiver of Proposed Rulemaking 

Under section 553(b) of the 

Administrative Procedure Act (the APA) 

(5 U.S.C. 553(b)), the agency is required 

to publish a notice of proposed 

rulemaking in the Federal Register 

before the provisions of a rule take 

effect. Similarly, section 1871(b)(1) of 

the Act requires the Secretary to provide 

for notice of the proposed rule in the 

Federal Register and provide a period of 

not less than 60 days for public 

comment. In addition, section 553(d) of 

the APA and section 1871(e)(1)(B)(i) of 

the Act mandate a 30-day delay in 

effective date after issuance or 

publication of a rule. Sections 553(b)(B) 

and 553(d)(3) of the APA provide for 

exceptions from the APA notice and 

comment, and delay in effective date 

requirements; in cases in which these 

exceptions apply, sections 1871(b)(2)(C) 

and 1871(e)(1)(B)(ii) of the Act provide 

exceptions from the notice and 60-day 

comment period and delay in effective 

date requirements of the Act as well. 

Section 553(b)(B) of the APA and 

section 1871(b)(2)(C) of the Act 

authorize an agency to dispense with 

normal notice and comment rulemaking 

procedures for good cause if the agency 

makes a finding that the notice and 

comment process is impracticable, 

unnecessary, or contrary to the public 

interest, and includes a statement of the 

finding and the reasons for it in the rule. 

In addition, section 553(d)(3) of the 

APA and section 1871(e)(1)(B)(ii) of the 

Act allow the agency to avoid the 30- 

day delay in effective date where the 

agency finds that such delay is contrary 

to the public interest and the agency 

includes in the rule a statement of the 

finding and the reasons for it. 

In our view, this correcting document 

does not constitute a rulemaking that 

would be subject to these requirements. 

This document merely corrects 

technical errors in the FY 2025 IRF final 

rule. The corrections contained in this 

document are consistent with, and do 

not make substantive changes to, the 

policies and payment methodologies 

that were proposed, subject to notice 

and comment procedures, and adopted 

in the FY 2025 IRF final rule. As a 

result, the corrections made through this 

correcting document are intended to 

resolve inadvertent errors so that the 

rule accurately reflects the policies 

adopted in the final rule. Even if this 

were a rulemaking to which the notice 

and comment 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 FY 2025 IRF final 

rule or delaying the effective date of the 

corrections would be contrary to the 

public interest because it is in the 

public interest to ensure that the rule 

accurately reflects our policies as of the 

date they take effect. Further, such 

procedures would be unnecessary 

because we are not making any 

substantive revisions to the final rule, 

but rather, we are simply correcting the 

Federal Register document to reflect the 

policies that we previously proposed, 

received public comment on, and 

subsequently finalized in the final rule. 

For these reasons, we believe there is 

good cause to waive the requirements 

for notice and comment and delay in 

effective date. 

IV. Correction of Errors 

In FR Doc. 2024–16911 of August 6, 

2024 (89 FR 64276), make the following 

corrections: 

1. On page 64304, third column; third 

full paragraph, line 20, the Standard 

Payment Amount that reads ‘‘$18,592’’ 

is corrected to read ‘‘$18,952’’. 

2. On page 64335, Table 17 titled ‘‘IRF 

Impact for FY 2025 (Columns 4 through 

7 in percentage)’’, row 13, column 5, the 

FY 2025 Wage Index (5% cap), FY 2024 

CBSA delineations, and Labor-Related 

Share the value that reads ‘‘0.5’’ is 

corrected to read ‘‘0.6’’. 

3. On page 64336, Table 17 titled ‘‘IRF 

Impact for FY 2025 (Columns 4 through 

7 in percentage)’’, row 13, 

a. Column 5, the FY 2025 Wage Index 

(5% cap), FY 2024 CBSA delineations, 

and Labor-Related Share value that 

reads ‘‘1.1’’ is corrected to read ’’1.2’’. 

b. Column 9, the Total Percent Change 

that reads ‘‘3.6’’ is corrected to read 

‘‘3.8.’’ 

Elizabeth J. Gramling, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2024–22497 Filed 9–27–24; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 413 and 488 

[CMS–1802–CN] 

RIN 0938–AV30 

Medicare Program; Prospective 

Payment System and Consolidated 

Billing for Skilled Nursing Facilities; 

Updates to the Quality Reporting 

Program and Value-Based Purchasing 

Program for Federal Fiscal Year 2025; 

Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical errors in the final rule that 

appeared in the August 6, 2024 Federal 

Register, titled ‘‘Medicare Program; 

Prospective Payment System and 

Consolidated Billing for Skilled Nursing 

Facilities (SNF); Updates to the Quality 


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