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 


lotter on DSK11XQN23PROD with RULES1
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80133 

Reporting Program and Value-Based 

Purchasing Program for Federal Fiscal 

Year 2025’’ (referred to hereafter as the 

‘‘FY 2025 SNF final rule’’). The effective 

date of the FY 2025 SNF final rule is 

October 1, 2024. 

DATES: The corrections in this document 

are effective October 1, 2024. 

FOR FURTHER INFORMATION CONTACT: Kia 

Burwell, (410) 786–7816. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2024–16907 of August 6, 

2024 (89 FR 64048), there were a 

number of technical errors that are 

identified and corrected in this 

correcting document. These corrections 

are effective as if they had been 

included in the FY 2025 SNF final rule. 

Accordingly, the corrections are 

effective October 1, 2024. 

II. Summary of Errors 

A. Summary of Errors in the Preamble 

On page 64120, we inadvertently 

omitted language in regard to when we 

would apply the 2 percentage point 

penalty if the SNF fails to submit 

medical records within 45 days of the 

date on the initial request. 

Additionally, a technical error in the 

calculation of the final FY 2025 SNF 

prospective payment system (PPS) wage 

indexes required us to recalculate the 

impact analysis provided on page 64152 

in Table 39. Further discussions of these 

errors are found in section IV. of this 

document. 

B. Summary of Errors and Corrections 

Posted on the CMS Website 

As discussed in the FY 2025 SNF 

final rule (89 FR 64058 through 64061), 

in developing the wage index to be 

applied to SNFs under the SNF 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 SNF 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 titled ‘‘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 68986) 

(hereinafter referred to as the FY 2025 

IPPS final rule). In calculating the wage 

index in 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 titled ‘‘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; 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 SNF PPS wage data, was an error 

resulting from the inadvertent exclusion 

of the Medicare cost report wage data 

for a hospital (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. 

As discussed previously in this 

section, we use the updated, prereclassified, unadjusted IPPS wage data 

in developing the wage index used 

under the SNF PPS. Due to the technical 

error described previously in this 

section, the published FY 2025 SNF PPS 

wage indexes were incorrect. Thus, the 

use of the corrected wage data for rural 

Missouri required us to recalculate the 

final FY 2025 SNF PPS wage indexes. 

While correcting this wage data had no 

impact on the FY 2025 SNF PPS Federal 

per diem rates published in the FY 2025 

SNF final rule, it did cause a slight 

change in certain results found in the 

impact analysis provided in Table 39 of 

the FY 2025 SNF final rule (89 FR 

64152). The corrections to these errors 

are found in section IV. of this 

document. We are also 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/skilled-nursingfacility-snf/wage-index. Table B has 

been updated to reflect the error 

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/ 

prospective-payment-systems/skillednursing-facility-snf/wage-index. 

III. Waiver of Proposed Rulemaking 

and Delay in Effective Date 

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 Social Security Act (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) allow 

the agency to avoid the 30-day delay in 

effective date where 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 SNF 

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 SNF 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 SNF final 

rule or delaying the effective date of the 

corrections would be contrary to the 


lotter on DSK11XQN23PROD with RULES1
80134 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

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. 2024–16907 of August 6, 

2024 (89 FR 64048), make the following 

corrections: 

1. On page 64120, third column, 

second full paragraph, lines 9 and 10, 

the sentence ‘‘If the SNF fails to submit 

those medical records within 45 days of 

the date on the initial request, then we 

would apply the 2 percentage point 

penalty to FY 2027 SNF payments.’’ is 

corrected to read ‘‘If the SNF fails to 

submit those medical records within 45 

days of the date on the initial request, 

then we would apply the 2 percentage 

point penalty to the SNF’s PPS 

payments for the applicable program 

determination year.’’ 

2. On page 64152, TABLE 39: Impact 

to the SNF PPS for FY 2025 is corrected 

to read as follows: 

TABLE 39—IMPACT TO THE SNF PPS FOR FY 2025 

Impact categories Number of 

facilities 

Census data 

update 

(percent) 

Update wage 

data 

(percent) 

Total change 

(percent) 

Group 

Total ................................................................................................................. 15,477 0.0 0.0 4.2 

Urban ............................................................................................................... 11,202 0.0 ¥0.2 4.1 

Rural ................................................................................................................ 4,275 ¥0.1 1.0 5.1 

Hospital-based urban ....................................................................................... 364 0.1 ¥1.0 3.2 

Freestanding urban .......................................................................................... 10,838 0.0 ¥0.1 4.1 

Hospital-based rural ......................................................................................... 376 ¥0.1 0.8 4.9 

Freestanding rural ............................................................................................ 3,899 ¥0.1 1.0 5.1 

Urban by region 

New England ................................................................................................... 715 ¥0.3 ¥1.1 2.7 

Middle Atlantic ................................................................................................. 1,469 ¥1.0 ¥0.9 2.3 

South Atlantic ................................................................................................... 1,906 0.6 1.0 5.8 

East North Central ........................................................................................... 2,174 1.0 ¥0.6 4.6 

East South Central .......................................................................................... 568 0.4 2.3 7.0 

West North Central .......................................................................................... 950 0.0 0.4 4.6 

West South Central ......................................................................................... 1,473 0.2 0.9 5.4 

Mountain .......................................................................................................... 541 0.1 1.5 5.8 

Pacific .............................................................................................................. 1,401 ¥0.1 ¥1.4 2.6 

Outlying ............................................................................................................ 5 0.0 ¥2.5 1.5 

Rural by region 

New England ................................................................................................... 120 0.6 ¥1.4 3.4 

Middle Atlantic ................................................................................................. 226 ¥0.7 3.8 7.4 

South Atlantic ................................................................................................... 532 ¥0.1 0.4 4.5 

East North Central ........................................................................................... 897 ¥0.1 0.5 4.6 

East South Central .......................................................................................... 475 ¥0.1 1.6 5.8 

West North Central .......................................................................................... 990 0.0 1.2 5.4 

West South Central ......................................................................................... 752 ¥0.1 1.0 5.1 

Mountain .......................................................................................................... 195 0.0 1.8 6.0 

Pacific .............................................................................................................. 87 0.0 ¥0.7 3.5 

Outlying ............................................................................................................ 1 0.0 0.0 4.2 

Ownership 

For profit .......................................................................................................... 10,937 0.0 0.0 4.1 

Non-profit ......................................................................................................... 3,513 0.1 0.1 4.3 

Government ..................................................................................................... 1,027 ¥0.1 0.6 4.8 

Note: The Total column includes FY 2025 SNF market basket update of 4.2 percent. The values in Table 39 may not sum due to rounding. 

Elizabeth J. Gramling, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2024–22504 Filed 9–27–24; 4:15 pm] 

BILLING CODE 4120–01–P 


lotter on DSK11XQN23PROD with RULES1