[Federal Register Volume 89, Number 191 (Wednesday, October 2, 2024)]
[Rules and Regulations]
[Pages 80098-80131]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-22501]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 412, 413, 431, 482, 485, 495, and 512

[CMS-1808-CN2]
RIN 0938-AV34


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 Requirements; and Other Policy Changes; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services HHS.

ACTION: Final rule; correction

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SUMMARY: This document corrects technical and typographical errors in 
the final rule that appeared in the August 28, 2024 Federal Register 
titled ``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 Requirements; and Other Policy Changes'' (referred to 
hereafter as the ``FY 2025 IPPS/LTCH PPS final rule'').

DATES: The corrections in this document are effective October 1, 2024.

FOR FURTHER INFORMATION CONTACT: 
    Donald Thompson and Michele Hudson, <a href="/cdn-cgi/l/email-protection#6b2f2a282b08061845030318450c041d"><span class="__cf_email__" data-cfemail="9fdbdedcdffcf2ecb1f7f7ecb1f8f0e9">[email protected]</span></a>, (410) 786-
4487, IPPS Payment Rate Issues.
    Lily Yuan, <a href="/cdn-cgi/l/email-protection#a6e8c3d1f2c3c5cee6c5cbd588ceced588c1c9d0"><span class="__cf_email__" data-cfemail="df91baa88bbabcb79fbcb2acf1b7b7acf1b8b0a9">[email protected]</span></a>, New Technology Add-On Payments 
Issues.
    Benjamin Cohen, <a href="/cdn-cgi/l/email-protection#5f3d3a31353e323631713c30373a311f3c322c7137372c71383029"><span class="__cf_email__" data-cfemail="4321262d29222e2a2d6d202c2b262d03202e306d2b2b306d242c35">[email protected]</span></a>, Provider Reimbursement 
Review Board.
    Mady Hue, <a href="/cdn-cgi/l/email-protection#99f4f8ebf0f5ecb7f1ecfcd9faf4eab7f1f1eab7fef6ef"><span class="__cf_email__" data-cfemail="91fcf0e3f8fde4bff9e4f4d1f2fce2bff9f9e2bff6fee7">[email protected]</span></a>, and Andrea Hazeley, 
<a href="/cdn-cgi/l/email-protection#2f4e414b5d4a4e01474e554a434a566f4c425c0147475c01484059"><span class="__cf_email__" data-cfemail="4a2b242e382f2b64222b302f262f330a29273964222239642d253c">[email protected]</span></a>, MS-DRG Classifications Issues.
    Jennifer Tate, <a href="/cdn-cgi/l/email-protection#761c1318181f101304580217021336151b05581e1e0558111900"><span class="__cf_email__" data-cfemail="5d37383333343b382f73293c29381d3e302e7335352e733a322b">[email protected]</span></a>, Hospital-Acquired 
Condition Reduction Program--Administration Issues.
    Julia Venanzi, <a href="/cdn-cgi/l/email-protection#caa0bfa6a3abe4bcafa4aba4b0a38aa9a7b9e4a2a2b9e4ada5bc"><span class="__cf_email__" data-cfemail="e288978e8b83cc94878c838c988ba2818f91cc8a8a91cc858d94">[email protected]</span></a>, Hospital Inpatient 
Quality Reporting Program and Hospital Value-Based Purchasing Program--
Administration Issues.
    Jennifer Tate, <a href="/cdn-cgi/l/email-protection#98f2fdf6f6f1fefdeab6ecf9ecfdd8fbf5ebb6f0f0ebb6fff7ee"><span class="__cf_email__" data-cfemail="751f101b1b1c1310075b01140110351618065b1d1d065b121a03">[email protected]</span></a>, PPS-Exempt Cancer 
Hospital Quality Reporting--Administration Issues.
    Ariel Cress, <a href="/cdn-cgi/l/email-protection#5637243f333a78352433252516353b25783e3e2578313920"><span class="__cf_email__" data-cfemail="f8998a919d94d69b8a9d8b8bb89b958bd690908bd69f978e">[email protected]</span></a> or Lorraine Wickiser, 
<a href="/cdn-cgi/l/email-protection#2844475a5a4941464d065f414b43415b4d5a684b455b0640405b064f475e"><span class="__cf_email__" data-cfemail="117d7e636370787f743f6678727a7862746351727c623f7979623f767e67">[email protected]</span></a>, Long-Term Care Hospital Quality 
Reporting Program--Administration Issues.
    Jessica Warren, <a href="/cdn-cgi/l/email-protection#5d37382e2e343e3c732a3c2f2f38331d3e302e7335352e733a322b"><span class="__cf_email__" data-cfemail="402a2533332923216e37213232252e00232d336e2828336e272f36">[email protected]</span></a> and Elizabeth Holland, 
<a href="/cdn-cgi/l/email-protection#6a0f0603100b080f1e0244020506060b040e2a09071944020219440d051c"><span class="__cf_email__" data-cfemail="89ece5e0f3e8ebecfde1a7e1e6e5e5e8e7edc9eae4faa7e1e1faa7eee6ff">[email protected]</span></a>, Medicare Promoting Interoperability 
Program.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2024-07567 of August 28, 2024 (89 FR 68986), there were 
a number of typographical and technical errors that are identified and 
corrected in this correcting document. The corrections in this 
correcting document are applicable to discharges occurring on or after 
October 1, 2024, as if they had been included in the document that 
appeared in the August 28, 2024 Federal Register.

II. Summary of Errors

A. Summary of Error in the Dates Section

    On page 68986, we are correcting technical errors in our discussion 
of the regulatory provisions that are effective November 1, 2024.

B. Summary of Errors in the Preamble

    On pages 69060 and 69095, in our discussion of the Change to 
Specific Medicare Severity Diagnosis-Related Group (MS-DRG) 
Classifications, we are correcting several inadvertent typographical 
errors.
    Under our methodologies as finalized in the FY 2025 IPPS/LTCH PPS 
final rule, we exclude hospitals that have subsequently converted to 
rural emergency hospitals (REHs) from certain data and calculations 
used in the IPPS ratesetting. Specifically, we stated that we exclude 
REHs, including hospitals that subsequently became REHs after the 
period from which the data were taken for purposes of developing the 
MS-DRG relative weights for FY 2025 (89 FR 69109) and from the 
calculation of the standardized amount (89 FR 69942). In addition, we 
stated that any hospital that is designated as a REH by 7 days prior to 
the publication of the preliminary wage index public use file (PUF) is 
excluded from the calculation of the wage index. We inadvertently 
treated a current IPPS hospital as a hospital that had converted to REH 
status, thereby erroneously excluding its data from the MS-DRG relative 
weight calculation and the wage index (CMS Certification Number (CCN) 
260163). Therefore, we restored the applicable data for this hospital 
for these and other ratesetting calculations, as discussed further in 
section II.D. of this correcting document.
    We are correcting an error in the version 42 MS-DRG assignment for 
some cases in the historical claims data in the FY 2023 MedPAR files 
used in the ratesetting for the FY 2025 IPPS/LTCH PPS final rule, which 
resulted in inadvertent errors in the MS-DRG relative weights. (We note 
this error did not change the associated average length-of-stay (LOS) 
for the impacted DRGs.) Additionally, the version 42 MS-DRG assignment 
and relative weights are used when determining total payments for 
purposes of all of the budget neutrality factors and the final outlier 
threshold. Therefore, the corrections to the MS-DRG assignment under 
the version 42 GROUPER for some cases in the historical claims data in 
the FY 2023 MedPAR files (along with the restoration of the data for 
CCN 260163 as discussed previously) and the conforming recalculation of 
the relative weights directly affected the calculation of total 
payments and required the recalculation of all the budget neutrality 
factors and the final outlier threshold.
    On page 69109, we are correcting the number of Medicare discharges 
from IPPS providers in the FY 2023 MedPAR file used in calculating the 
relative weights for FY 2025 due to the correction of the number of 
hospitals with REH status.
    On page 69113, we are correcting the normalization adjustment 
factor used in calculating the relative weights for FY 2025 due to the 
correction of the number of hospitals with REH status, the error in the 
version 42 MS-DRG assignment for some cases in the historical claims 
data, and the conforming changes to the relative weights.
    On page 69268, we are correcting the total number of hospitals that 
were removed from the FY 2025 IPPS wage index due to conversion to REH 
status and making a corresponding correction to the number of 
hospitals' wage data used to calculate the FY 2025 wage index.

[[Page 80099]]

    On page 69277, we are correcting the occupational mix adjusted 
national average hourly wage due to the inadvertent omission of one 
hospital's wage data (CCN 260163). (We note, there was no change to the 
unadjusted national average hourly wage value rounded to 2-digits.)
    On page 69282 in the discussion of the FY 2025 reclassification 
application requirements and approvals, due to reclassification errors 
described in section II.D. of this correcting document, we are 
correcting the number of hospitals approved for reclassification in FY 
2025, the total number of hospitals in reclassification status, and the 
number of hospitals reclassified back to their geographic urban area.
    On page 69282, in the discussion of the FY 2025 reclassification 
application requirements and approvals, we are correcting a 
typographical error in the date applications for FY 2026 
reclassifications are due to the Medicare Geographic Classification 
Review Board (MGCRB).
    On page 69291, we inadvertently omitted a hospital from the list of 
all hospitals subject to our reclassification assignment and 
reassignment policy for core-based statistical areas (CBSAs) 
reconfigured due to the migration to Connecticut planning regions and 
the CBSA assigned or reassigned for FY 2025 under this policy. We are 
correcting this error by adding a hospital, CCN 220015 to Table Y 
``HOSPITALS SUBJECT TO RECLASSIFICATION ASSIGNMENT POLICY''. The 
assignment of the hospital's MGCRB reclassification is discussed 
further in section II.D. of this correcting document.
    On page 69308, because we restored the wage data for a IPPS 
hospital that we inadvertently treated as a REH and recalculated the 
wage index (as discussed earlier in this section) and made corrections 
to the MGCRB reclassification status of three hospitals (as discussed 
in section II.D. of this correcting document), we recalculated budget 
neutrality factors, including the rural floor budget neutrality factor, 
which is the only budget neutrality factor applied to the FY 2025 wage 
indexes (as discussed in section II.D. of this correcting document), 
made conforming changes to the out-migration adjustment discussed in 
section II.E. of this correcting document (as discussed with regard to 
Table 4A in section II.E. of this correcting document) and made a 
conforming change to the 25th percentile wage index value across all 
hospitals.
    On pages 69313 and 69315, we are correcting typographical errors in 
the number of hospitals that may participate in the Rural Community 
Hospital Demonstration Program at the start of FY 2025.
    On page 69369, we inadvertently omitted a reference to population 
health professional shortage areas (HPSAs) when summarizing the 
prioritization methodology for the distribution any remaining slots 
after awarding up to 1.00 FTE to each qualifying hospital under section 
4122 of the Consolidated Appropriations Act, 2023.
    On page 69400, in our discussion of the Hospital Readmissions 
Reduction Program, we are correcting a typographical error.
    On pages 69455, 69458, 69463, 69476, 69481, 69489, 69529, 69533, 
69534, 69538, 69540, 69544, 69545, 69549, 69572, 69573, and 69575 in 
our discussion of the Hospital Inpatient Quality Reporting Program, we 
are correcting several typographical and technical errors.
    On page 69503, in our discussion of the Modifications to the 
Hospital Consumer Assessment of Healthcare Providers and Systems 
(HCAHPS) Survey measure, we are correcting a typographical error.
    On page 69512, in our discussion of the Advancing Patient Safety 
and Outcomes Across the Hospital Quality Programs--Request for Comment, 
we are correcting a technical error.
    On pages 69577 and 69578, in our discussion of the PPS-Exempt 
Cancer Hospital Quality Reporting (PCHQR) Program, we are correcting 
typographical errors.
    On pages 69590, in our discussion of the Long-term Care Quality 
Reporting Program (LTCH QRP), we are correcting a typographical error.
    On pages 69605 through 69613, 69621, and 69622 in our discussion of 
the Medicare Promoting Interoperability Program, we are correcting 
several typographical and technical errors.
    On page 69880, in our discussion of the Provider Reimbursement 
Review Board, we are correcting an inadvertent grammatical error.
    On pages 69901 and 66902, in our discussion of the information 
collection requirements for the LTCH QRP, we are correcting 
typographical errors.

C. Summary of Errors in the Regulations Text

    On page 69914, in the regulations text for the Medicare Promoting 
Interoperability Program at Sec.  495.24(f)(1)(i)(C), we are correcting 
a technical error.

D. Summary of Errors in the Addendum

    We made inadvertent errors in the Medicare Geographic 
Classification Review Board (MGCRB) reclassification status of 3 
hospitals in the FY 2025 IPPS/LTCH PPS final rule. Specifically, we are 
correcting the MGCRB reclassification for CCNs 170040 and 220015. The 
correct reclassified CBSA for CCN 170040 is 41440, and the correct 
reclassified CBSA for CCN 220015 is 49340. We are also adding an MGCRB 
reclassification for CCN 520034 to CBSA 43100. The final FY 2025 IPPS 
wage index with reclassification is used when determining total 
payments for purposes of all budget neutrality factors (except for the 
MS-DRG reclassification and recalibration budget neutrality factor 
before the cap, MS-DRG reclassification and recalibration budget 
neutrality factor with the cap and the wage index budget neutrality 
adjustment factor) and the final outlier threshold.
    In addition, as discussed in section II.B. of this correcting 
document, we inadvertently treated a current IPPS hospital as a 
hospital that had converted to REH status, thereby erroneously 
excluding its data from the IPPS ratesetting calculations for FY 2025, 
including the standardized amount calculations. After restoring the 
hospital's data (CCN 260163) and correcting the version 42 MS-DRG 
assignment for some cases in the historical claims data (as also 
discussed in section II.B. of this correcting document, we recalculated 
the MS-DRG relative weights, all wage indexes (and geographic 
adjustment factors (GAFs)), all budget neutrality factors, the fixed-
loss cost threshold, and the national operating standardized amounts 
and capital Federal rate. The MGCRB reclassification changes described 
previously were included in these recalculations as applicable.
    Due to the errors described previously, we made updates to the 
calculation of Factor 3 of the uncompensated care payment methodology 
to reflect the updated information for the IPPS hospital that had 
inadvertently been treated as a hospital that had converted to an REH. 
This hospital is projected to be DSH-eligible for purposes of interim 
uncompensated care payments during FY 2025. We recalculated the total 
uncompensated care amount for all DSH-eligible hospitals to reflect 
these updates. In addition, because the Factor 3 for each hospital 
reflects that hospital's uncompensated care amount relative to the 
uncompensated care amount for all subsection (d) hospitals

[[Page 80100]]

that receive a DSH payment for the fiscal year, we also recalculated 
Factor 3 for all DSH-eligible hospitals. The hospital-specific Factor 3 
determines the total amount of the uncompensated care payment a 
hospital is eligible to receive for a fiscal year. This hospital-
specific payment amount is then used to calculate the amount of the 
interim uncompensated care payments a hospital receives per discharge. 
Given the very narrowly targeted update to the information used in the 
calculation of Factor 3, the change to the previously calculated Factor 
3 for the majority of hospitals is of limited magnitude. We 
incorporated the revised uncompensated care payment amounts for all 
DSH-eligible hospitals into our recalculation of the FY 2025 fixed-loss 
threshold and related budget neutrality figures.
    On page 69960, we made conforming changes to the operating national 
average case-weighted cost-to-charge ratios (CCRs) for March 2023 and 
March 2024, the 1-year national operating CCR adjustment factor, the 
capital national average case-weighted CCRs for March 2023 and March 
2024, and the 1-year national capital CCR adjustment factor to reflect 
the inclusion of applicable data for the IPPS hospital that had 
inadvertently been treated as a hospital that converted to an REH.
    Due to the correction of the combination of errors that are 
discussed previously, we made changes to the following:
    <bullet> On page 69948, the table titled ``Summary of FY 2025 
Budget Neutrality Factors''.
    <bullet> On page 69955, estimated capital outlier payments and 
estimated total capital Federal payments.
    <bullet> On page 69961, the outlier fixed-loss cost threshold, 
total operating Federal payments, total operating outlier payments, and 
the outlier adjustment to the capital Federal rate.
    <bullet> On page 69963, the table titled ``Changes from FY 2024 
Standardized Amounts to the FY 2025 Standardized Amounts''.
    In determining the capital budget neutrality adjustment factor for 
changes in DRG classifications and weights and the GAF, under our 2-
step calculation of the GAF budget neutrality factor, we inadvertently 
assigned one hospital the incorrect FY 2024 GAF without incorporating 
the lowest quartile hospital wage index adjustment and the 5 percent 
cap on wage index decreases. We recalculated the capital outlier 
adjustment factor, the GAF/DRG budget neutrality factor, and the 
Quartile/Cap budget neutrality factor to reflect the correction of one 
hospital's FY 2024 GAF. We note that these recalculations also reflect 
the correction of the error in the REH status, the correction of the 
error in the version 42 MS DRG assignment for some cases in the 
historical claims data, the recalculation of the relative weights, and 
the correction of the MGCRB reclassification status for certain 
hospitals described previously. As we noted in the final rule, the 
capital Federal rate is calculated using unrounded budget neutrality 
and outlier adjustment factors. The unrounded Quartile/Cap budget 
neutrality factor and the unrounded outlier adjustment to the capital 
Federal rate were revised because of these errors. However, after 
rounding these factors to 4 decimal places as displayed in the final 
rule, the rounded factors were unchanged from the final rule.
    On pages 69966 through 69971, in the discussion of the 
determination of the Federal hospital inpatient capital related 
prospective payment rate update, due to the correction of these errors 
as discussed previously, we made conforming corrections to the GAF/DRG 
budget neutrality factor, the capital Federal rate, and related 
figures. As a result of these changes, we also made conforming 
corrections in the table showing the comparison of factors and 
adjustments for the FY 2024 capital Federal rate and FY 2025 capital 
Federal rate.
    On page 69987, we are making conforming changes to the applicable 
HCO threshold for site neutral payment rate cases under the LTCH PPS 
for FY 2025 since it is calculated as the sum of the site neutral 
payment rate for the case and the IPPS fixed-loss amount.
    On page 69990, we are making conforming corrections to the national 
adjusted operating standardized amounts and capital standard Federal 
payment rate (which also include the rates payable to hospitals located 
in Puerto Rico) in Tables 1A, 1B, 1C, and 1D as a result of the 
conforming corrections to certain budget neutrality factors, as 
previously described.

E. Summary of Errors in the Appendices

    On pages 69994, 69996 through 70001, 70003 through 70004, 70006 
through 70008, and 70030 through 70032, in the regulatory impact 
analyses, we have made conforming corrections to the factors, values, 
and tables, and the accompanying discussion of the changes to operating 
and capital IPPS payments for FY 2025 as a result of the technical 
errors that lead to changes in our calculation of certain IPPS budget 
neutrality factors, MS-DRG relative weights, wage indexes, and other 
figures as described in sections II.B. and D. of this correcting 
document. These conforming corrections include changes to the 
following:
    <bullet> On pages 69998 through 70000, the table titled ``Table I--
Impact Analysis of Changes to the IPPS for Operating Costs for FY 
2025''.
    <bullet> On pages 70003 and 70004, the table titled ``Table II--
Impact Analysis of Changes for FY 2025 Acute Care Hospital Operating 
Prospective Payment System (Payments per Discharge)''.
    <bullet> On pages 70007 and 70008, the table titled ``Table III--
Provider Deciles by Beneficiary Characteristics''.
    <bullet> On pages 70031 through 70032, the table titled ``Table 
III--Comparison of Total Payments per Case''.
    On page 70011, in our discussion of the effects of the changes to 
new technology add-on payments, we are correcting inadvertent 
typographical errors made in the numbers of traditional pathway 
technologies and new technology add-on payments provided for those 
technologies in FY 2025.
    On pages 70012 through 70015, we are correcting the discussion of 
the ``Medicare DSH Uncompensated Care Payments and Supplemental Payment 
for Indian Health Service Hospitals and Tribal Hospitals and Hospitals 
Located in Puerto Rico'' for purposes of the Regulatory Impact Analysis 
in Appendix A of the FY 2025 IPPS/LTCH PPS final rule, including the 
table titled ``Modeled Uncompensated Care Payments* and Supplemental 
Payments for Estimated FY 2025 DSHs by Hospital Type,'' in light of the 
corrections discussed in section II.D. of this correcting document.
    On page 70022, in our discussion of the effects of the changes to 
the Hospital VBP Program, we are correcting technical errors the 
entries for ``By MCR Percent'', ``By DSH Percent'', and By Teaching 
Status'' in Table I.8-01.

F. Summary of Errors in and Corrections to Files and Tables Posted on 
the CMS Website

    We are correcting the errors in the following IPPS tables that are 
listed on page 69989 of the FY 2025 IPPS/LTCH PPS final rule and are 
available on the internet on the CMS website at https://www.cms.gov/Medicare/Medicare-Feefor-ServicePayment/AcuteInpatientPPS/index.html. 
The tables that are available on the internet have been updated to 
reflect the revisions discussed in this final rule correction.
    Table 2.--Final Case-Mix Index and Wage Index Table by CCN--FY 2025 
Final Rule. As discussed in the previous

[[Page 80101]]

section, we inadvertently treated a current IPPS hospital as a hospital 
that had converted to REH status, thereby erroneously excluding its 
data from the wage index (CCN 260163). Therefore, we restored this 
provider to Table 2, which includes all relevant values for this 
provider for each column in the table. (We note, CCN 260163 has a MGCRB 
reclassification to CBSA 14.)
    Because of the inadvertent errors in the MGCRB reclassification 
status of 3 hospitals (as discussed in section II.D. of this correcting 
document) we are making the following corrections in Table 2: We are 
correcting the values in the columns titled ``Wage Index Payment CBSA'' 
and ``MGCRB Reclass'' for CCNs 170040, 220015 and 520034. As mentioned 
earlier, the correct reclassified CBSA for CCN 170040 is 41440, and the 
correct reclassified CBSA for CCN 220015 is 49340. The ``Y'' value in 
the column titled ``MGCRB Reclass to Home'' for both CCNs has also been 
removed, as the correct MGCRB reclassification CBSA is not the 
hospitals' geographic urban CBSA. We are also adding an MGCRB 
reclassification for CCN 520034 by inserting CBSA 43100 to the columns 
``Wage Index Payment CBSA'' and ``MGCRB Reclass''.
    Due to the inadvertent omission of one hospital's wage data (CCN 
260163), we are correcting the occupational mix adjusted national 
average hourly wage (as discussed in section II.B. of this correcting 
document), and we recalculated all of the budget neutrality adjustments 
(as discussed in section II.D. of this correcting document) including 
the recalculation of the rural floor budget neutrality factor, which is 
the only budget neutrality factor applied to the FY 2025 wage indexes. 
As discussed in section II.D. of this correcting document we are making 
corrections to the MGCRB reclassification status of three hospitals. 
Because all these changes affect the calculation of various area wage 
indexes used to determine certain budget neutrality factors and 
hospitals' final wage index value for FY 2025, we are also making 
conforming changes to the other impacted wage indexes, including the 
imputed floor, outmigration adjustment (as discussed later in this 
section) and the 25th percentile wage index value across all hospitals 
(as discussed in section II.D. of this correcting document). Therefore, 
based on all these changes described previously, we are correcting the 
values in the columns titled ``FY 2025 Wage Index Prior to Quartile and 
Cap'', ``FY 2025 Wage Index With Quartile'', ``FY 2025 Wage Index With 
Quartile and Cap'', and ``Out-Migration Adjustment''. We also updated 
footnote number 6 to reflect the conforming change to the 25th 
percentile wage index value across all hospitals.
    Table 3.--Final Wage Index Table by CBSA--FY 2025 Final Rule. As 
discussed previously, we inadvertently treated a current IPPS hospital 
as a hospital that had converted to REH status, thereby erroneously 
excluding its data from the wage index (CCN 260163). Therefore, we 
restored CCN 260163 to the wage data and recalculated the FY 2025 wage 
index for CBSA 26 as well as the reclassified wage index for CBSA 14 
(see discussion earlier in this section regarding the MGCRB 
reclassification for CCN 260163). We also revised the values in the 
columns titled ``FY 2025 Average Hourly Wage'' and ``3-Year Average 
Hourly Wage (2023, 2024, 2025)'' for CBSA 26.
    Because of the inadvertent errors in the MGCRB reclassification 
status of CCNs 170040, 220015 and 520034 (as discussed earlier in this 
section), we recalculated the wage index for CBSAs 41440, 49340, 43100, 
and the rural wage index for Wisconsin (CBSA 52).
    Due to the inadvertent omission of one hospital's wage data (CCN 
260163), we are correcting the occupational mix adjusted national 
average hourly wage (as discussed in section II.B. of this correcting 
document), and we recalculated all of the budget neutrality adjustments 
(as discussed in section II.D. of this correcting document), including 
the recalculation of the rural floor budget neutrality factor, which is 
the only budget neutrality factor applied to the FY 2025 wage indexes. 
As discussed earlier in this section we made corrections to the MGCRB 
reclassification status of three hospitals. Because these changes 
described earlier (restoring provider 2060163 to the wage data, the 
inadvertent errors in the MGCRB reclassification status of CCNs 170040, 
220015 and 520034, the recalculation of the rural floor budget 
neutrality factor) affect the area pre and post reclassified wage 
indexes, we are also making conforming changes to the other impacted 
wage indexes, including the imputed floor. We also are making 
corresponding changes to the GAFs for any CBSAs with a wage index that 
changed. Based on all these changes described previously, we are 
correcting the values and flags in the columns titled ``Wage Index'', 
``GAF'', ``Reclassified Wage Index'', ``Reclassified GAF'', ``State 
Rural Floor'', ``Eligible for Rural Floor Wage Index'', ``Pre-Frontier 
and/or Pre-Rural Floor Wage Index'', ``Reclassified Wage Index Eligible 
for Frontier Wage Index'', ``Reclassified Wage Index Eligible for Rural 
Floor Wage Index'', and ``Reclassified Wage Index Pre-Frontier and/or 
Pre-Rural Floor''.
    Table 4A.--Final List of Counties Eligible for the Out-Migration 
Adjustment under Section 1886(d)(13) of the Act--FY 2025 Final Rule. 
Due to the inadvertent omission of one hospital's wage data (CCN 
260163), we are correcting the occupational mix adjusted national 
average hourly wage (as discussed in section II.B. of this correcting 
document), and we recalculated all of the budget neutrality adjustments 
(as discussed in section II.D. of this correcting document) including 
the recalculation of the rural floor budget neutrality factor, which is 
the only budget neutrality factor applied to the FY 2025 wage indexes. 
As also discussed in section II.D. of this correcting document and 
earlier in this section, we made corrections to the MGCRB 
reclassification status of three hospitals. Because all these changes 
affect various area wage indexes (including the post reclassified wage 
indexes), we are also making conforming changes to the other impacted 
wage indexes, including the imputed floor. As discussed in the FY 2012 
IPPS final rule (76 FR 51601 through 51602), we calculate the out-
migration adjustment using the post-reclassified wage indexes. Because 
the wage indexes are one of the inputs used to determine the out-
migration adjustment, the out-migration adjustments for some counties/
hospitals changed. Therefore, we are making corresponding changes to 
certain out-migration adjustments listed in Table 4A. Specifically, we 
are correcting the values in the column titled ``FY 2025 Out-Migration 
Adjustment''.
    Table 5.--Final List of Medicare Severity Diagnosis-Related Groups 
(MS-DRGs), Relative Weighting Factors, and Geometric and Arithmetic 
Mean Length of Stay--FY 2025 Final Rule. We are correcting this table 
to reflect the recalculation of the relative weights, geometric average 
length-of-stay (LOS), and arithmetic mean LOS as a result of the 
correction of the number of hospitals with REH status and the 
correction in the version 42 MS-DRG assignment for some cases in the 
historical claims data (as discussed in section II.B. of this 
correcting document).
    Table 12B.--Final LTCH PPS Wage Index for Rural Areas for 
Discharges Occurring from October 1, 2024, through September 30, 2025. 
As discussed in the previous section, we inadvertently excluded a 
hospital (CCN 260163) from the IPPS wage data used

[[Page 80102]]

to calculate the FY 2025 LTCH PPS wage index. This resulted in a 
correction to the wage index value for rural Missouri (CBSA 26) in 
Table 12B. (We note, there are no LTCHs located in rural Missouri in 
the data used to develop the FY 2025 LTCH PPS rates in the FY 2025 
IPPS/LTCH PPS final. Therefore, this correction to the LTCH PPS wage 
index value for rural Missouri did not necessitate the recalculation of 
the FY 2025 LTCH PPS rates.)
    Table 18.--Final FY 2025 Medicare DSH Uncompensated Care Payment 
Factor 3. We further note that we also made updates to the calculation 
of Factor 3 of the uncompensated care payment methodology to reflect 
the updated information for the IPPS hospital that had inadvertently 
been treated as a hospital that had converted to an REH. This hospital 
is projected to be DSH-eligible for purposes of the interim 
uncompensated care payments during FY 2025, but its data was 
erroneously excluded from the Factor 3 calculations for FY 2025. We 
recalculated the total uncompensated care amount for all DSH-eligible 
hospitals to reflect this update. In addition, because the Factor 3 
calculated for each hospital reflects that hospital's uncompensated 
care amount relative to the uncompensated care amount for all 
subsection (d) hospitals that receive a DSH payment for the fiscal 
year, we also recalculated Factor 3 for all DSH-eligible hospitals. The 
hospital-specific Factor 3 determines the total amount of the 
uncompensated care payment a hospital is eligible to receive for the 
fiscal year. This hospital-specific payment amount is then used to 
calculate the amount of the interim uncompensated care payments a 
hospital receives per discharge. Given the very narrowly targeted 
update to the information used in the calculation of Factor 3, the 
change to the previously calculated Factor 3 is of limited magnitude 
for the majority of hospitals.
    For the FY 2025 IPPS/LTCH PPS final rule, we published a list of 
hospitals that we identified to be subsection (d) hospitals and 
subsection (d) Puerto Rico hospitals projected to be eligible to 
receive interim uncompensated care payments for FY 2025. We are 
updating this list and the calculation of Factor 3 of the uncompensated 
care payment methodology to reflect the updated information for the 
IPPS hospital that was inadvertently treated as a hospital that had 
converted to an REH. We are revising Factor 3 for all hospitals to 
reflect this correction. We are also revising the amount of the total 
uncompensated care payment calculated for each DSH-eligible hospital. 
The total uncompensated care payment that a hospital receives is used 
to calculate the amount of the interim uncompensated care payments the 
hospital receives per discharge.

III. Waiver of Proposed Rulemaking and Delay in Effective Date

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), 
the agency is required to publish a notice of the 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 rulemaking 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 notice and comment and delay in 
effective date APA 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 rulemaking requirements for good cause if the 
agency makes a finding that the notice and comment process are 
impracticable, unnecessary, or contrary to the public interest. In 
addition, both 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 such delay is contrary to the public interest 
and an agency includes a statement of support.
    We believe that this final rule correction does not constitute a 
rule that would be subject to the notice and comment or delayed 
effective date requirements. This document corrects technical and 
typographical errors in the preamble, regulations text, addendum, 
tables, and appendices included or referenced in the FY 2025 IPPS/LTCH 
PPS final rule but does not make substantive changes to the policies or 
payment methodologies that were adopted in the final rule. As a result, 
this final rule correction is intended to ensure that the information 
in the FY 2025 IPPS/LTCH PPS final rule accurately reflects the 
policies adopted in that document.
    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 2025 IPPS/LTCH PPS final 
rule accurately reflects our policies. Furthermore, such procedures 
would be unnecessary, as we are not altering our payment methodologies 
or policies, but rather, we are simply implementing correctly the 
methodologies and policies that we previously proposed, requested 
comment on, and subsequently finalized. This final rule correction is 
intended solely to ensure that the FY 2025 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.

IV. Correction of Errors

    In FR Doc. 2024-07567 of August 28, 2024 (89 FR 68986), we are 
making the following corrections:

A. Correction of Errors in the Dates Section

    1. On page 68986, first column, DATES section, lines 7 and 8, the 
phrase ``The regulations at Sec. Sec.  482.42(e) and 485.640(d)'' is 
corrected to read ``The regulations at Sec. Sec.  482.42(e) and (f) and 
485.640(d) and (e)''.

B. Corrections of Errors in the Preamble

    2. On page 69060, third column, first partial paragraph:
    a. Lines 22 through 26, the phrase ``MS-DRG 447 `Multiple Level 
Anterior and Posterior Spinal Fusion Except Cervical with MCC or 
Custom-Made Anatomically Designed Interbody Fusion Device' '' is 
corrected to read ``MS-DRG 447 `Multiple Level Spinal Fusion Except 
Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion 
Device' ''.
    b. Lines 26 through 29, the phrase ``MS-DRG 448 `Multiple Level 
Anterior and Posterior Spinal Fusion Except Cervical without MCC' '' is 
corrected to read, ``MS-DRG 448 `Multiple Level Spinal Fusion Except 
Cervical without MCC' ''.
    3. On page 69095, bottom of page, second column, first partial 
paragraph, line 7, the date ``June 5, 2025'' is corrected to read 
``June 5, 2024''.

[[Page 80103]]

    4. On page 69109, first column, last paragraph, line 3, the figure 
``6,916,571'' is corrected to read ``6,916,748''.
    5. On page 69113, third column, first full paragraph, line 17, the 
figure ``1.92336'' is corrected to read as ``1.92331''.
    6. On page 69268, third column, first partial paragraph:
    a. Line 14, the figure ``4'' is corrected to read ``3'',
    b. Line 20, the figure ``19'' is corrected to read ``18'',
    b. Line 25, the figure ``3,074'' is corrected to read ``3,075''.
    7. On page 69277, at the bottom of the page, in the untitled table, 
the figure ``$54.97'' is corrected to read ``$54.96''.
    8. On page 69282:
    a. Second column, third paragraph:
    i. Line 9, the figure ``470'' is corrected to read ``471'',
    ii. Line 29, the figure ``1,078'' is corrected to read ``1,079'', 
and
    iii. Line 32, the figure ``237'' is corrected to read ``235''.
    b. Third column, second full paragraph, line 3, the phrase ``by 
September 1, 2024.'' is corrected to read, ``by September 3, 2024 
(while applications are due not later than 13 months prior to the start 
of the fiscal year for which reclassification is sought, usually by 
September 1, it has been the MGCRB's practice to allow submission up to 
the first business day in September).''
    9. On page 69291, the Table Y ``HOSPITALS SUBJECT TO 
RECLASSIFICATION ASSIGNMENT POLICY'' is corrected by adding the 
following entry after row 8 (CCN 070036) and before row 9 (CCN 220020):

----------------------------------------------------------------------------------------------------------------
                         CCN                            MGCRB case No.       Approved CBSA      Final rule CBSA
----------------------------------------------------------------------------------------------------------------
220015..............................................                 25C0368          49340               49340
----------------------------------------------------------------------------------------------------------------

    10. On page 69308, third column, middle of the page, the untitled 
table is corrected to read as follows:

------------------------------------------------------------------------
 
------------------------------------------------------------------------
FY 2025 25th Percentile Wage Index Value................          0.9009
------------------------------------------------------------------------

    11. On page 69313, second column, first partial paragraph, line 13, 
the figure ``23'' is corrected to read ``22''.
    12. On page 69315, third column, first full paragraph, line 1, the 
figure ``23'' is corrected to read ``22''.
    13. On page 69369, second column, fourth full paragraph, line 14, 
the phrase ``mental-health-only geographic'' is corrected to read 
``mental-health-only population and geographic''.
    14. On page 69400, second column, last partial paragraph, line 9, 
the phrase ``beneficiaries, ERRs, and aggregate'' is corrected to read 
``beneficiaries, excess readmission ratios (ERRs), and aggregate''.
    15. On page 69455, third column, third footnote paragraph (footnote 
266), lines 4 and 5, the web address ``https://www.cdc.gov/hai/data/
archive/2021-HAI-progress-report.html#2018'' is corrected to read 
``https://archive.cdc.gov/#/details?url=https://www.cdc.gov/hai/data/
archive/2021-HAI-progress-report.html''.
    16. On page 69458, second column, second footnote paragraph 
(footnote 297), lines 4 through 6, the web address ``https://
qualitynet.gov/inpatient/iqr/proposedmeasures'' is corrected to 
``https://qualitynet.cms.gov/inpatient/iqr/proposedmeasures''.
    17. On page 69463, lower half of the page, first column, first 
footnote paragraph (footnote 304), lines 3 through 5, the web address 
``https://qualitynet.gov/inpatient/iqr/proposedmeasures'' is corrected 
to ``https://qualitynet.cms.gov/inpatient/iqr/proposedmeasures.''
    18. On page 69476, first column, third footnote paragraph (footnote 
341), lines 4 through 8, the web address https://www.cdc.gov/healthcare-associated-infections/?CDC_AAref_Val=https://www.cdc.gov/hai/prevent/infection%25C2%25ADcontrol%25C2%25AD.assessment%25C2%25ADtools.html is 
corrected to ``https://www.cdc.gov/infection-control/media/pdfs/IPC-
Instructions-508.pdf.''
    19. On page 69481, first and second columns, footnote paragraph 
(footnote 366), last line and lines 1 and 2, the web address ``https://
mmshub.cms.gov/sites/default/files/PSSMTEP-Summary-Report-202306.pdf'' 
is corrected to ``https://mmshub.cms.gov/sites/default/files/PSSM-TEP-
Summary-Report-202306.pdf.''
    20. On page 69489, in the first column; first footnote paragraph 
(footnote 394), lines 3 through 5, the web address ``https://
qualitynet.gov/inpatient/iqr/proposedmeasures'' is corrected to 
``https://qualitynet.cms.gov/inpatient/iqr/proposedmeasures.''
    21. On page 69503, third column, second full paragraph, lines 15 
through 17, the web address, ``https://hcahpsonline.org/en/mode-
patient-mix-adj/#jan2023publiclyreported'' is corrected to read, 
``https://hcahpsonline.org/en/mode--patient-mix-adj/
#jan2023publiclyreported.''
    22. On page 69512, second column, first footnote paragraph 
(footnote 437), lines 1 through 4, ``Medicare Hospital Quality 
Chartbook. National Rates over Time. Available at: https://www.cmshospitalchartbook.com/visualization/national-rates-over-time. 
Accessed March 12, 2024.'' is corrected to read ``MedPAC. (2019). 
Update: MedPAC's evaluation of Medicare's Hospital Readmission 
Reduction Program. Available at: https://www.medpac.gov/update-medpac-
s-evaluation-of-medicare-s-hospital-readmission-reduction-program/.''
    23. On page 69529, first column, second footnote paragraph 
(footnote 531), lines 2 through 4, the footnote ``CDC. (2024). National 
and State Healthcare-associated Infections Progress Report. Available 
at: https://www.cdc.gov/healthcare-associated-infections/php/data/
progress-report.html.'' is corrected to read ``CDC. (2022). Antibiotic 
Resistance & Patient Safety Portal: Catheter-Associated Urinary Tract 
Infections. Available at: https://arpsp.cdc.gov/profile/nhsn/cauti.''.
    24. On page 69533, first column, second full paragraph, lines 9 
through 17, the sentences ``In CAUTI and CLABSI SIRs, risk adjustment 
is applied at the individual location level, resulting in a count of 
infection events (SIR numerator) and predicted number of infections 
(SIR denominator). The NHSN then aggregates location-specific results 
for all of a facility's locations prior to calculating the SIR.'' are 
corrected to read ``The NHSN then aggregates location-specific results 
for all of a facility's locations prior to calculating the SIR.''
    25. On page 69534, first column, second full paragraph, lines 18-
21, the

[[Page 80104]]

sentence ``This would also allow more direct comparison with the CAUTI-
Onc and CLABSI-Onc measures used in the PCHQR Program.'' is corrected 
to read ``The oncology-specific measures would also allow more direct 
comparison with the CAUTI and CLABSI measures used in the PCHQR 
Program.''.
    26. On page 69538, first column, last paragraph, lines 6 through 
12, the sentence ``Hospitals must report on the following three eCQMs: 
(1) Hospital Harm--Severe Hypoglycemia eCQM; (2) Hospital Harm--Severe 
Hyperglycemia eCQM; and (3) Hospital Harm--Opioid-Related Adverse 
Events eCQM.'' is corrected to read ``Hospitals must report on the 
following three eCQMs: (1) the Safe Use of Opioids--Concurrent 
Prescribing eCQM; (2) the Cesarean Birth eCQM; and (3) the Severe 
Obstetric Complications eCQM.''.
    27. On page 69540, first column, last paragraph, line 11, the 
reference ``section XXXX'' is corrected to read ``section X.A.''.
    28. On page 69544, third column, last paragraph, lines 6 through 
12, the sentence ``Hospitals must report the following three eCQMs: (1) 
Hospital Harm--Severe Hypoglycemia eCQM; (2) Hospital Harm--Severe 
Hyperglycemia eCQM; and (3) Hospital Harm--Opioid-Related Adverse 
Events eCQM.'' is corrected to read ``Hospitals must report the 
following three eCQMs: (1) the Safe Use of Opioids--Concurrent 
Prescribing eCQM; (2) the Cesarean Birth eCQM; and (3) the Severe 
Obstetric Complications eCQM.''.
    29. On page 69545, third column, first partial paragraph, line 3, 
the reference ``section XXXX'' is corrected to read ``section X.A.''.
    30. On page 69549, first column, fourth full paragraph, lines 5 
through 7, the web address ``https://qualitynet.cms.gov/inpatient/iqr/
measures'' is corrected to read ``https://qualitynet.cms.gov/inpatient/
measures.''
    31. On page 69572, third column, last paragraph, line 25, the table 
reference ``Table IX.C.XXXX'' is corrected to read ``Table IX.C.10.''.
    32. On page 69573, top of the page:
    a. First column, first paragraph, line 1, the table reference 
``Table IX.C.XXXX'' is corrected to read ``Table IX.C.10.''
    b. In the table titled, ``TABLE IX.C.X:XXX. NEWLY FINALIZED eCQM 
REPORTING AND SUBMISSION REQUIREMENTS FOR THE CY 2026 REPORTING PERIOD/
FY 2028 PAYMENT DETERMINATION AND SUBSEQUENT YEARS'', line 1, the table 
number ``TABLE IX.C.XXXX'' is corrected to read ``TABLE IX.C.10.''.
    33. On page 69575:
    a. Top third of the page, third column, first full paragraph, line 
3, the reference ``Table IX.C.10.'' is corrected to read ``Table 
IX.C.11.''.
    b. Middle of the page, in the table titled, ``TABLE IX.C.10. 
SUMMARY OF THE CURRENT AND NEWLY MODIFIED VALIDATION SCORING 
POLICIES'', line 1, the table number ``TABLE IX.C.10'' is corrected to 
read ``TABLE IX.C.11.''.
    34. On page 69577, third column, last partial paragraph, the 
parenthetical reference ``(86 FR 36341)'' is corrected to read ``(89 FR 
36341)''.
    35. On page 69578, first column, first partial paragraph, line 2, 
the parenthetical reference ``(86 FR 36341)'' is corrected to read 
``(89 FR 36341)''.
    36. On page 69590, first column, first partial paragraph, line 6, 
the word ``effect'' is corrected to read ``effective''.
    37. On pages 69605 and 69606 remove the undesignated table.
    38. On pages 69606 through 69613 correct ``TABLE IX.F.-01.: SUMMARY 
OF OBJECTIVES AND MEASURES FOR THE MEDICARE PROMOTING INTEROPERABILITY 
PROGRAM FOR THE EHR REPORTING PERIOD IN CY 2025'' to read as follows:
BILLING CODE 4120-01-P

[[Page 80105]]

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[[Page 80106]]


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[[Page 80107]]


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[[Page 80108]]


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[[Page 80109]]


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[[Page 80110]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.005


[[Page 80111]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.006

BILLING CODE 4120-01-C
    39. On page 69621, top of the page, lines 1 and 2, the table title 
``TABLE IX.F.-05: PREVIOUSLY FINALIZED ECQMS FOR ELIGIBLE HOSPITALS

[[Page 80112]]

AND CAHS FOR THE CY 2024 THE REPORTING PERIOD'' is corrected to read 
``TABLE IX.F.-05: PREVIOUSLY FINALIZED ECQMS FOR ELIGIBLE HOSPITALS AND 
CAHS FOR THE CY 2024 REPORTING PERIOD''.
    40. On page 69622, third column, last paragraph, line 19, the 
phrase ``CY 206'' is corrected to read ``CY 2026''.
    41. On page 69880, third column, second full paragraph, line 2, the 
phrase, ``supporting our CMS's proposal'' is corrected to read 
``supported CMS's proposal''.
    42. On page 69901, lower half of the page, second column, partial 
paragraph, line 16, the phrase ``section . and IX.E.7.b.'' is corrected 
to read ``section IX.E.7.b.''.
    43. On page 69902, top of the page, in the table title ``TABLE 
XII.B-08: U.S. BUREAU OF LABOR AND STATISTICS' MAY 2021 NATIONAL 
OCCUPATIONAL EMPLOYMENT AND WAGE ESTIMATES, line 1, the date ``MAY 
2021'' is corrected to read ``MAY 2022''.

C. Corrections of Errors in the Addendum

    44. On page 69948, the table titled ``Summary of FY 2025 Budget 
Neutrality Factors'' is corrected to read:
[GRAPHIC] [TIFF OMITTED] TR02OC24.007

    45. On page 69955, third column, first full paragraph, line 6 
through 11, the phrase ``(estimated capital outlier payments of 
$292,195,135 divided by (estimated capital outlier payments of 
$292,195,135 plus the estimated total capital Federal payment of 
$6,564,012,091))'' is corrected to read: ``(estimated capital outlier 
payments of $292,277,686 divided by (estimated capital outlier payments 
of $292,277,686 plus the estimated total capital Federal payment of 
$6,564,098,157))''.
    46. On page 69960, third column:
    a. First full paragraph:
    i. Line 4, the figure ``0.24849'' is corrected to ``0.248486'',
    ii. Line 6, the figure ``0.252248'' is corrected to ``0.252261'', 
and
    iii. Line 17, the figure ``1.015123'' is corrected to ``1.015192''.
    b. Second full paragraph:
    i. Line 5, the figure ``0.017716'' is corrected to ``0.017718'',
    ii. Line 7, the figure ``0.017666'' is corrected to ``0.017669'', 
and
    iii. Line 18, the figure ``0.997178'' is corrected to ``0.997234''.
    47. On page 69961, second column:
    a. First full paragraph:
    i. Line 22, the figure ``$46,152'' is corrected to ``$46,147'',
    ii. Line 24, the figure ``$4,349,520,041'' is corrected to 
``$4,350,072,899'',
    iii. Line 25, the figure ``$80,269,760,637'' is corrected to 
``$80,279,536,469'',
    iv. Line 40, the figure ``$46,502'' is corrected to ``$46,498'', 
and
    v. Line 51, the figure ``$46,152'' is corrected to ``$46,147''.
    b. the untitled table, the figure ``0.957682'' is corrected to 
``0.957678.
    48. On page 69963, the table titled ``CHANGES FROM FY 2024 
STANDARDIZED AMOUNTS TO THE FY 2025 STANDARDIZED AMOUNTS'' is corrected 
to read as follows:

[[Page 80113]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.008

    49. On page 69966, third column, first full paragraph, line 6, the 
figure ``1.33 percent'' is corrected to read ``1.30 percent''.
    50. On page 69969, second column, second partial paragraph, line 
17, the figure ``0.9887'' is corrected to read ``0.9884''.
    51. On page 69970:
    a. First column, first full paragraph, line 8, the mathematical 
phrase, ``(0.9887) is 0.9856 (0.9969 x 0.9887)'' is corrected to read 
``(0.9884) is 0.9854 (0.9969 x 0.9884)''.
    b. Second column, second full paragraph, line 2, the figure 
``0.9856'' is corrected to read ``0.9854''.
    c. Third column:
    i. First partial paragraph, line 5, the figure ``$510.51'' is 
corrected to read ``$510.39''.
    ii. Second bulleted paragraph, line 12, the figure ``0.9856'' is 
corrected to read ``0.9854''.
    iii. Last paragraph:
    A. Line 13, the figure ``1.44'' is corrected to read ``1.46''.
    B. Line 25, the figure ``1.33'' is corrected to read ``1.30''.
    52. On page 69971:
    a. Top of the page, the table titled ``COMPARISON OF FACTORS AND 
ADJUSTMENTS: FY 2024 CAPITAL FEDERAL RATE AND THE FY 2025 CAPITAL 
FEDERAL RATE'' is corrected to read as follows:

[[Page 80114]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.009

    b. Lower three-fourths of the page, first column, second paragraph, 
last line, the figure ``$46,152'' is corrected to read ``$46,147''.
    53. On page 69987, first column, first full paragraph,
    a. Line 13, the figure ``$46,152'' is corrected to read 
``$46,147''.
    b. Last line, the figure ``$46,152'' is corrected to read 
``$46,147''.
    54. On page 69990:
    a. The table titled ``TABLE 1A--NATIONAL ADJUSTED OPERATING 
STANDARDIZED AMOUNTS, LABOR/NONLABOR (67.6 PERCENT LABOR SHARE/32.4 
PERCENT NONLABOR SHARE IF WAGE INDEX IS GREATER THAN 11)--FY 2025'' is 
corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR02OC24.010

    b. The table titled ``TABLE 1B.--NATIONAL ADJUSTED OPERATING 
STANDARDIZED AMOUNTS, LABOR/NONLABOR (62 PERCENT LABOR SHARE/38 PERCENT 
NONLABOR SHARE IF WAGE INDEX IS LESS THAN OR EQUAL TO 1)--FY 2025'' is 
corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR02OC24.011

    c. The table titled ``TABLE 1C.-- ADJUSTED OPERATING STANDARDIZED 
AMOUNTS FOR HOSPITALS IN PUERTO RICO, LABOR/NONLABOR (NATIONAL: 62 
PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE BECAUSE WAGE INDEX IS 
LESS THAN OR EQUAL TO 1)--FY 2025'' is corrected to read as follows:

[[Page 80115]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.012

    d. The table titled ``TABLE 1D.-- CAPITAL STANDARD FEDERAL PAYMENT 
RATE--FY 2025'' is corrected to read as follows:

       TABLE 1D.-- CAPITAL STANDARD FEDERAL PAYMENT RATE--FY 2025
------------------------------------------------------------------------
                                                               Rate
------------------------------------------------------------------------
National...............................................         $510.39
------------------------------------------------------------------------

D. Correction of Errors in the Appendices

    55. On page 69994, third column, first full paragraph, line 1, the 
figure ``3,082'' is corrected to read ``3,083''.
    56. On page 69996, third column:
    a. First full paragraph, line 7, the figure ``3,082'' is corrected 
to read ``3,083'',
    b. Second full paragraph, line 5, the figure ``690'' is corrected 
to read ``691''.
    c. Third full paragraph, line 11, the figure ``1,368'' is corrected 
to read ``1,369''.
    57. On page 69997:
    a. First column, first paragraph, line 4, the figure ``1,832'' is 
corrected to read ``1,833''.
    b. Second column, first paragraph, line 7, the figure ``244'' is 
corrected to read ``245''.
    4. On pages 69998 through 70000, the table titled ``Table I.--
Impact Analysis of Changes to the IPPS for Operating Costs for FY 
2025'' is corrected to read as follows:
BILLING CODE 4120-01-P

[[Page 80116]]

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[[Page 80117]]


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[[Page 80118]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.015

BILLING CODE 4120-01-C
    58. On page 70000, second column, second full paragraph, line 26, 
the figure ``1.000114'' is corrected to read ``0.999981''.

[[Page 80119]]

    59. On page 70001:
    a. Top of the page, the table titled, ``FY 2025 Percentage Change 
in Area Wage Index Values'' is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR02OC24.016

    b. Lower three-fourths of the page, second column:
    i. Second full paragraph, line 6, the figure ``0.977499'' is 
corrected to read ``0.977500''.
    ii. Fourth full paragraph, line 5, the figure ``0.977499'' is 
corrected to read ``0.977500''.
    60. On pages 70003 and 70004, the table titled ``Table II.--Impact 
Analysis of Changes for FY 2025 Acute Care Hospital Operating 
Prospective Payment System (Payments Per Discharge)'' is corrected to 
read as follows:
BILLING CODE 4120-01-P

[[Page 80120]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.017


[[Page 80121]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.018

    61. On page 70006, third column, last paragraph:
    a. Line 9, the figure ``$13,660.95'' is corrected to read 
``$13,661.19''.
    b. Line 12, the figure ``$21,150.86'' is corrected to read 
``$21,184.97''.
    62. On pages 70007 and 70008, the table titled ``Table III--
Provider Deciles by Beneficiary Characteristics'' is corrected to read 
as follows:

[[Page 80122]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.019


[[Page 80123]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.020


[[Page 80124]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.021

    63. On page 70011, top of the page, first column, partial 
paragraph, lines 2 and 3, the phrase ``estimates for the 6 technologies 
for which we are providing 5 new'' is corrected to read ``estimates

[[Page 80125]]

for the 5 technologies for which we are providing 4 new''.
    64. On page 70012:
    a. Second column, second paragraph, line 1, the number ``2399'' is 
corrected to ``2400'', and
    b. Third column, first paragraph, line 6, the number ``23'' is 
corrected to ``22''.
    65. On pages 70013 and 70014, the table titled ``Modeled 
Uncompensated Care Payments* and Supplemental Payments for Estimated FY 
2025 DSHs by Hospital Type'' is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR02OC24.022


[[Page 80126]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.023

BILLING CODE 4120-01-C
    66. On page 70014, first column, first paragraph, line 1 the 
language (beginning with the phrase ``The changes in projected FY 2025 
UCP and supplemental payments compared to the'' and ending with the 
sentence ``Meanwhile, hospitals with less than 25 percent Medicaid 
utilization and those with Medicaid utilization between 25-50 percent 
are projected to receive larger than average decreases of 4.44 percent 
and 4.31 percent, respectively.'') is corrected to read as follows: 
``The changes in projected FY 2025 UCP and supplemental payments 
compared to the total of UCP and supplemental payments in FY 2024 are 
driven by changes in Factor 1 and Factor 2. The Factor 1 has increased 
from the FY 2024 final rule's Factor 1 of $10.015 billion to this final 
rule's Factor 1 of $10.457 billion. The Factor 2 has decreased from FY 
2024 final rule's Factor 2 of 59.29 percent to this final rule's Factor 
2 of 54.29 percent. In addition, we note that there is a slight 
increase in the number

[[Page 80127]]

of projected DSH-eligible hospitals to 2,400 at the time of the 
development for this final rule compared to the 2,384 DSHs in the FY 
2024 IPPS/LTCH PPS final rule (88 FR 58640). Based on the changes, the 
impact analysis found that, across all projected DSH-eligible 
hospitals, FY 2025 UCP and supplemental payments are estimated at 
approximately $5.786 billion, or a decrease of approximately 3.91 
percent from FY 2024 UCP and supplemental payments (approximately 
$6.021 billion). While the changes result in a net decrease in the 
total amount available to be distributed in UCP and supplemental 
payments, the projected payment amounts vary by hospital type. This 
redistribution of payments is caused by changes in Factor 3 and the 
amount of the supplemental payment for DSH-eligible IHS/Tribal 
hospitals and Puerto Rico hospitals. As seen in the previous table, a 
percent change of less than negative 3.91 percent indicates that 
hospitals within the specified category are projected to experience a 
larger decrease in payments, on average, compared to the universe of 
projected FY 2025 DSH-eligible hospitals. Conversely, a percentage 
change greater than negative 3.91 percent indicates that a hospital 
type is projected to have a smaller decrease compared to the overall 
average. The variation in the distribution of overall payments by 
hospital characteristic is largely dependent on a given hospital's 
uncompensated care costs as reported on the Worksheet S-10 and used in 
the Factor 3 computation and whether the hospital is eligible to 
receive the supplemental payment.
    Rural hospitals, in general, are projected to experience a smaller 
decrease in UCP compared to the decrease their urban counterparts are 
projected to experience. Overall, rural hospitals are projected to 
receive a 0.68 percent decrease in payments, while urban hospitals are 
projected to receive a 4.10 percent decrease in payments, which is 
slightly larger than the overall hospital average.
    By bed size, rural hospitals with 0 to 99 beds are projected to 
receive a smaller than average decrease of 2.06 percent in payments, 
while those with 100 to 249 beds are projected to receive an increase 
of 1.11. Additionally, rural hospitals with 250+ beds are projected to 
receive a 0.56 percent increase in payments. Among urban hospitals, the 
smallest urban hospitals, those with 0 to 99 beds, are projected to 
receive a 3.40 percent increase in payments. In contrast, larger urban 
hospitals with 100-249 beds and urban hospitals with 250+ beds are 
projected to receive decreases in payments that are larger than the 
overall hospital average, at 4.83 and 4.29 percent, respectively.
    By region, rural hospitals are projected to receive a varied range 
of payment changes. Rural hospitals in the New England, West North 
Central, and Middle Atlantic regions are projected to receive larger 
than average decreases in payments. Rural hospitals in all other 
regions are projected to receive either increases in payments or 
smaller than average decreases in payments. Urban hospitals in the West 
South Central, Mountain, and Pacific regions are projected to either 
receive either increases in payments or smaller than average decreases 
in payments, while urban hospitals in all other regions are projected 
to receive larger than average decreases in payments.
    By payment classification, hospitals in urban payment areas overall 
are expected to receive a 3.74 percent decrease in UCP and supplemental 
payments. Hospitals, in large urban payment areas are projected to 
receive a smaller than average decrease in payments of 2.39 percent. In 
contrast, hospitals in other urban payment areas and hospitals in rural 
payment areas are projected to receive a larger than average decrease 
in payments of 5.72 and 4.10 percent, respectively.
    Nonteaching hospitals and teaching hospitals with 100+ residents 
are projected to receive a smaller than average payment decrease of 
3.18 percent and 3.49 percent, respectively. Teaching hospitals with 
fewer than 100 residents are projected to receive larger than average 
payment decreases of 4.90 percent. Voluntary hospitals are projected to 
receive larger than average decreases of 4.59 percent, while 
government-owned hospitals and proprietary hospitals are expected to 
receive a smaller than average payment decrease of 2.65 percent and 
3.62 percent, respectively. Hospitals with less than 25 percent 
Medicare utilization are projected to receive smaller than average 
decreases of 3.25 percent. Hospitals with Medicare utilization between 
25-50 percent, 50-65 percent, and greater than 65 percent are projected 
to receive larger than average decreases of 5.51 percent, 8.31 percent, 
and 7.09 percent, respectively. Hospitals with 50-65 percent Medicaid 
utilization are projected to receive a smaller than average decreases 
in payments of 1.96 percent, while those with greater than 65 percent 
Medicaid utilization are projected to receive a 5.76 percent increase 
in payments. Meanwhile, hospitals with less than 25 percent Medicaid 
utilization and those with Medicaid utilization between 25-50 percent 
are projected to receive larger than average decreases of 4.40 percent 
and 4.34 percent, respectively.''
    67. On pages 70021 through 70022, in the table titled TABLE I.8.-01 
IMPACT ANALYSIS OF BASE OPERATING DRG PAYMENT AMOUNTS RESULTING FROM 
THE FY 2025 HOSPITAL VBP PROGRAM, the table is corrected to read as 
follows:
BILLING CODE 4120-01-P

[[Page 80128]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.024


[[Page 80129]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.025

    68. On page 70030:
    a. Second column, first full paragraph, line 4, the figure 
``0.9856'' is corrected to read ``0.9854''.
    b. Second column, second full paragraph, line 6, the figure 
``3,082'' is corrected to read ``3,083''. c. Third column, first full 
paragraph:
    i. Line 9, the figure ``0.3'' is corrected to read ``0.4''.
    ii. Line 14, the figure ``2.2'' is corrected to read ``2.1''.
    d. Third column, second full paragraph, line 12, the figure ``2.8'' 
is corrected to read ``2.7''.
    69. On pages 70031 through 70032, the table titled ``Table III--
Comparison of Total Payments per Case'' is corrected to read as 
follows:

[[Page 80130]]

[GRAPHIC] [TIFF OMITTED] TR02OC24.026


[[Page 80131]]


[GRAPHIC] [TIFF OMITTED] TR02OC24.027

E. Corrections of Errors in the Regulations Text


Sec.  495.24   [Corrected]

0
70. On page 69914, in the first column, Sec.  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


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