Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80095 

tribes, on the relationship between the 

Federal Government and Indian tribes, 

or on the distribution of power and 

responsibilities between the Federal 

Government and Indian tribes. 

E. Unfunded Mandates Reform Act 

The Unfunded Mandates Reform Act 

of 1995 (2 U.S.C. 1531–1538) requires 

Federal agencies to assess the effects of 

their discretionary regulatory actions. In 

particular, the Act addresses actions 

that may result in the expenditure by a 

State, local, or tribal government, in the 

aggregate, or by the private sector of 

$100,000,000 (adjusted for inflation) or 

more in any one year. Though this rule 

will not result in such an expenditure, 

we do discuss the effects of this rule 

elsewhere in this preamble. 

F. Environment 

We have analyzed this rule under 

Department of Homeland Security 

Directive 023–01, Rev. 1, associated 

implementing instructions, and 

Environmental Planning COMDTINST 

5090.1 (series), which guide the Coast 

Guard in complying with the National 

Environmental Policy Act of 1969 (42 

U.S.C. 4321–4370f), and have 

determined that this action is one of a 

category of actions that do not 

individually or cumulatively have a 

significant effect on the human 

environment. This rule involves a 1500- 

foot safety zone around the M/V SSI 

DEFIANT for less than 7 days. It is 

categorically excluded from further 

review under paragraph L60(c) of 

appendix A, table 1 of DHS Instruction 

Manual 023–01–001–01, Rev. 1. 

G. Protest Activities 

The Coast Guard respects the First 

Amendment rights of protesters. 

Protesters are asked to call or email the 

person listed in the FOR FURTHER

INFORMATION CONTACT section to 

coordinate protest activities so that your 

message can be received without 

jeopardizing the safety or security of 

people, places, or vessels. 

List of Subjects in 33 CFR Part 165 

Harbors, Marine safety, Navigation 

(water), Reporting and recordkeeping 

requirements, Security measures, 

Waterways. 

For the reasons discussed in the 

preamble, the Coast Guard amends 33 

CFR part 165 as follows: 

PART 165—REGULATED NAVIGATION 

AREAS AND LIMITED ACCESS AREAS 

■ 1. The authority citation for part 165 

continues to read as follows: 

Authority: 46 U.S.C. 70034, 70051, 70124; 

33 CFR 1.05–1; 6.04–1, 6.04–6, and 160.5; 

Department of Homeland Security Delegation 

No. 0170.1, Revision No. 01.3. 

■ 2. Add § 165.T05–0171 to read as 

follows: 

§ 165.T05–0171 Safety Zone; Baltimore 

Harbor, MD 

(a) Location. The following area is a 

safety zone: all navigable waters within 

1500-feet of the location of the vessel 

SSI DEFIANT located at position 39° 

13.18N, 076° 31.78W. 

(b) Enforcement period. This section 

is effective from September 27, 2024, 

through October 3, 2024. 

(c) Regulations. (1) In accordance with 

the general regulations in § 165.23 of 

this part, entry into, transiting through, 

or exiting from this area is prohibited 

unless authorized by the COTP 

Maryland-NCR or a designated 

representative. 

(2) Vessels desiring to transit the 

regulated area may do so only with prior 

approval of the COTP Maryland-NCR or 

a designated representative and when so 

directed will be operated at a minimum 

safe navigation speed in a manner that 

will not endanger pollution response 

operations in the zone or any other 

vessels. 

(3) The COTP Maryland-NCR or a 

designated representative may forbid 

and control the movement of all vessels 

in the regulated area. When hailed or 

signaled by an official patrol vessel, a 

vessel shall come to an immediate stop 

and comply with the directions given. 

Failure to do so may result in expulsion 

from the area, citation for failure to 

comply, or both. 

(4) Entry into this zone is prohibited 

unless authorized by the COTP 

Maryland-NCR or a designated 

representative. 

(5) Persons or vessels seeking to enter 

or transit through the zone must request 

permission from the COTP MarylandNCR or a designated representative. 

They may be contacted on VHF–FM 

channel 16 or by telephone at 410–576– 

2693. 

(6) If permission is granted, all 

persons and vessels must comply with 

the instructions of the COTP MarylandNCR or designated representative. 

(d) Informational broadcasts. The 

COTP Maryland-NCR or a designated 

representative will inform the public 

through Broadcast Notices to Mariners 

of the enforcement period for the 

temporary safety zone as well as any 

changes in the planned schedule. 

Dated: September 27, 2024. 

Patrick C. Burkett, 

Captain, U.S. Coast Guard, Captain of the 

Port, Sector Maryland-National Capital 

Region. 

[FR Doc. 2024–22720 Filed 10–1–24; 8:45 am] 

BILLING CODE 9110–04–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 412 

[CMS–1806–CN] 

RIN 0938–AV32 

Medicare Program; FY 2025 Inpatient 

Psychiatric Facilities Prospective 

Payment System—Rate Update; 

Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final action; correction. 

SUMMARY: This document corrects 

technical errors in the final action that 

appeared in the August 7, 2024 Federal 

Register titled ‘‘Medicare Program; FY 

2025 Inpatient Psychiatric Facilities 

Prospective Payment System—Rate 

Update’’. 

DATES: This correction is effective 

October 1, 2024. 

FOR FURTHER INFORMATION CONTACT: 

The IPF Payment Policy mailbox at 

IPFPaymentPolicy@cms.hhs.gov for 

information regarding the IPF wage 

index. 

Nick Brock (410) 786–5148, for 

general information regarding the 

inpatient psychiatric facilities 

prospective payment system (IPF PPS). 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2024–16909 of August 7, 

2024, the fiscal year (FY) 2025 Inpatient 

Psychiatric Facilities Prospective 

Payment System (IPF PPS) final rule (89 

FR 64582), there were 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 IPF PPS final 

rule. Accordingly, the corrections are 

effective October 1, 2024. 

II. Summary of Errors 

A. Summary of Errors in the Preamble 

There was a technical error in the 

calculation of the final FY 2025 IPF PPS 

wage indexes, which impacted several 

calculations. There is an impact to the 


lotter on DSK11XQN23PROD with RULES1
80096 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

wage index for twelve providers in 

Core-Based Statistical Area (CBSA) 26 

for rural Missouri due to the 

recalculated wage indexes, and thus we 

recalculated the impact analysis 

provided in Table 24 of the FY 2025 IPF 

PPS final rule (89 FR 64670 through 

64671). Therefore, changes are needed 

to the published values in Table 24. We 

also recalculated the wage index budget 

neutrality factor; however, after 

recalculating, there are no changes 

needed to the published wage index 

budget neutrality factor because the 

difference between the previously 

published factor and the newly 

calculated factor is within the margin of 

error for rounding. This means that the 

recalculated wage index budget 

neutrality factor remained 0.9996 and 

the IPF federal per diem base rate 

remained $876.53. 

On pages 64670 and 64671, Table 24 

reflects the impact to providers based on 

the inaccurate calculation of the FY 

2025 IPF PPS wage index; therefore, 

Table 24 should be updated to reflect 

the correct calculations. 

On page 64672, the payment percent 

increase for rural areas of ‘‘3.8 percent’’ 

is incorrect; therefore, ‘‘3.8 percent’’ 

should be replaced with ‘‘3.9 percent’’. 

B. Summary of Errors in and Corrections 

to the Tables Posted on the CMS website 

for the IPF PPS Wage Index 

As discussed in the FY 2025 IPF PPS 

final rule (89 FR 64582), we used the 

concurrent pre-floor, pre-reclassified 

Inpatient Prospective Payment System 

(IPPS) hospital wage index as the basis 

for the IPF wage index. For FY 2025, 

concurrent pre-floor, pre-reclassified 

IPPS hospital wage data used under the 

IPF 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 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 correction notice 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; Correction’’, published 

elsewhere in this issue of the Federal 

Register. 

In the FY 2025 Hospital Inpatient 

Prospective Payment Systems and LongTerm Care Hospital Prospective 

Payment System (IPPS/LTCH PPS) final 

rule (89 FR 68986), we finalized a policy 

to exclude hospitals that have 

subsequently converted to rural 

emergency hospitals (REHs) from the 

wage index. Specifically, 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 wage index (CMS 

Certification Number (CCN) 26–0163). 

Therefore, we restored the wage data for 

this hospital to be included in the wage 

index. 

This error affects the unadjusted, prereclassified, pre-rural floor IPPS wage 

data and thereby affects the IPF PPS 

wage data for CBSA 26 for rural 

Missouri. 

We are correcting the wage index for 

CBSA 26 rural Missouri in Table B 

setting forth the wage indexes for rural 

areas based on CBSA labor market areas 

and Table C setting forth the wage 

indexes for urban and rural areas 

without counties, which are available 

exclusively on the CMS website at 

https://www.cms.gov/medicare/ 

medicare-fee-for-service-payment/ 

inpatientpsychfacilpps/wageindex. 

The omitted wage data for the one 

hospital in CBSA 26 required the 

recalculation of the final FY 2025 IPF 

PPS wage indexes. Additionally, as 

discussed in the FY 2025 IPF PPS final 

rule (89 FR 64582), changes to the wage 

index are made in a budget neutral 

manner so that updates do not increase 

expenditures. Due to the recalculation 

and subsequent revision of the final FY 

2025 IPF PPS wage indexes, it was 

necessary to recalculate the FY 2025 IPF 

PPS wage index budget neutrality factor. 

However, as discussed above, no 

changes are needed to the published 

wage index budget neutrality factor 

since the difference between the 

previously published factor and the 

newly calculated factor is within the 

margin of error for rounding. This 

means that the recalculated wage index 

budget neutrality factor remained 

0.9996 and the IPF federal per diem 

base rate remained $876.53. 

III. Waiver of Proposed Rulemaking 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register to provide a period for public 

comment before the provisions of a rule 

take effect in accordance with section 

553(b) of the Administrative Procedure 

Act (APA) (5 U.S.C. 553(b)). However, 

we can waive this notice and comment 

procedure if the Secretary finds, for 

good cause, that the notice and 

comment process is impracticable, 

unnecessary, or contrary to the public 

interest, and incorporates a statement of 

the finding and the reasons therefore in 

the notice. 

Section 553(d) of the APA ordinarily 

requires a 30-day delay in effective date 

of final rules after the date of their 

publication in the Federal Register. 

This 30-day delay in effective date can 

be waived, however, if an agency finds 

for good cause that the delay is 

impracticable, unnecessary, or contrary 

to the public interest, and the agency 

incorporates a statement of the findings 

and its reasons in the rule issued. 

We believe that this correcting 

document does not constitute a rule that 

would be subject to the notice and 

comment or delayed effective date 

requirements. This document corrects 

technical errors in the preamble of the 

FY 2025 IPF PPS final rule, as well as 

two tables on the Centers for Medicare 

& Medicaid Services (CMS) website, but 

does not make substantive changes to 

the policies or payment methodologies 

that were adopted in the final rule. As 

a result, this correcting document is 

intended to ensure that the information 

in the FY 2025 IPF 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 IPFs to receive 

appropriate payments in a timely 

manner to ensure that the FY 2025 IPF 

PPS final rule accurately reflects our 

policies as of the date they take effect 

and are applicable. Furthermore, such 

procedures would be unnecessary, as 

we are not altering our payment 

methodologies or policies, but rather, 

we are simply correctly implementing 

the policies that we previously 


lotter on DSK11XQN23PROD with RULES1
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80097 

proposed, received comment on, and 

subsequently finalized. This correcting 

document is intended solely to ensure 

that the FY 2025 IPF PPS final rule 

accurately reflects these payment 

methodologies and policies. For these 

reasons, we believe we have good cause 

to waive the notice and comment and 

effective date requirements. 

IV. Correction of Errors in the Preamble 

In FR Doc. 2024–16909 of August 7, 

2024 (89 FR 64582), make the following 

corrections: 

1. On pages 64670 and 64671, TABLE 

24: FY 2025 IPF PPS PAYMENT 

IMPACTS is corrected to read as 

follows: 

TABLE 24—FY 2025 IPF PPS PAYMENT SYSTEMS

[Percent change in columns 3 through 6] 

Facility by type Number of 

facilities Outlier 

Refinement of 

patient-level 

adjustments 

and ECT 

Wage index 

FY25, LRS, 

and 5% Cap 

Total percent 

change 1

(1) (2) (3) (4) (5) (6) 

All Facilities .......................................................................... 1,419 ¥0.3 0.0 0.0 2.5 

Total Urban ................................................................... 1,162 ¥0.3 0.0 ¥0.2 2.3 

Urban unit .............................................................. 645 ¥0.4 0.5 ¥0.6 2.3 

Urban hospital ....................................................... 517 ¥0.1 ¥0.5 0.2 2.5 

Total Rural .................................................................... 257 ¥0.1 ¥0.3 1.4 3.9 

Rural unit ............................................................... 197 ¥0.1 0.1 1.1 4.0 

Rural hospital ......................................................... 60 ¥0.2 ¥1.1 2.1 3.6 

By Type of Ownership: 

Freestanding IPFs: 

Urban Psychiatric Hospitals: 

Government .................................................... 119 ¥0.5 1.1 ¥0.6 2.7 

Non-Profit ....................................................... 97 ¥0.1 ¥0.1 ¥0.3 2.3 

For-Profit ......................................................... 301 0.0 ¥0.9 0.6 2.5 

Rural Psychiatric Hospitals: 

Government .................................................... 30 ¥0.3 1.6 ¥0.3 3.9 

Non-Profit ....................................................... 12 ¥0.5 ¥1.5 0.3 1.0 

For-Profit ......................................................... 18 0.0 ¥2.3 3.7 4.2 

IPF Units: 

Urban: 

Government .................................................... 93 ¥0.8 0.8 ¥0.1 2.7 

Non-Profit ....................................................... 430 ¥0.4 0.7 ¥0.9 2.1 

For-Profit ......................................................... 122 ¥0.2 ¥0.5 0.1 2.3 

Rural: 

Government .................................................... 44 ¥0.1 ¥0.1 0.7 3.4 

Non-Profit ....................................................... 113 ¥0.2 0.4 1.2 4.3 

For-Profit ......................................................... 40 ¥0.1 ¥0.1 1.3 4.0 

By Teaching Status: 

Non-teaching ................................................................. 1,217 ¥0.2 ¥0.2 0.3 2.7 

Less than 10% interns and residents to beds .............. 100 ¥0.5 0.6 ¥1.1 1.9 

10% to 30% interns and residents to beds .................. 76 ¥0.6 1.2 ¥1.2 2.2 

More than 30% interns and residents to beds ............. 26 ¥0.7 1.2 ¥0.1 3.2 

By Region: 

New England ................................................................ 99 ¥0.4 0.9 ¥1.5 1.8 

Mid-Atlantic ................................................................... 191 ¥0.4 0.3 ¥1.7 0.9 

South Atlantic ................................................................ 228 ¥0.2 0.4 1.3 4.4 

East North Central ........................................................ 225 ¥0.2 0.0 0.5 3.2 

East South Central ....................................................... 140 ¥0.1 ¥0.2 2.6 5.0 

West North Central ....................................................... 95 ¥0.5 1.1 0.0 3.4 

West South Central ...................................................... 213 ¥0.1 ¥1.2 1.6 3.2 

Mountain ....................................................................... 102 ¥0.2 ¥0.3 0.8 3.1 

Pacific ........................................................................... 126 ¥0.3 ¥0.5 ¥1.8 0.1 

By Bed Size: 

Psychiatric Hospitals: 

Beds: 0–24 ............................................................ 87 ¥0.1 ¥0.9 0.8 2.5 

Beds: 25–49 .......................................................... 86 0.0 ¥1.3 1.3 2.7 

Beds: 50–75 .......................................................... 91 ¥0.1 ¥0.4 0.9 3.2 

Beds: 76 + ............................................................. 313 ¥0.1 ¥0.3 0.0 2.3 

Psychiatric Units: 

Beds: 0–24 ............................................................ 440 ¥0.2 0.0 0.3 2.9 

Beds: 25–49 .......................................................... 229 ¥0.3 0.5 ¥0.7 2.3 

Beds: 50–75 .......................................................... 103 ¥0.4 0.7 0.1 3.2 

Beds: 76 + ............................................................. 70 ¥0.7 0.6 ¥1.2 1.5 

1This column includes the impact of the updates in columns (3) through (6) above, and of the IPF market basket percentage for FY 2025 of 

3.3 percent, reduced by 0.5 percentage point for the productivity adjustment as required by section 1886(s)(2)(A)(i) of the Act. 


lotter on DSK11XQN23PROD with RULES1
80098 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

2. On page 64672, in the first column, 

in the first full paragraph, in line 6, 

‘‘3.8’’ is corrected to read ‘‘3.9’’. 

Elizabeth J. Gramling, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2024–22496 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 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 LongTerm 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 

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, DAC@cms.hhs.gov, (410) 786– 

4487, IPPS Payment Rate Issues. 

Lily Yuan, NewTech@cms.hhs.gov, 

New Technology Add-On Payments 

Issues. 

Benjamin Cohen, benjamin.cohen@

cms.hhs.gov, Provider Reimbursement 

Review Board. 

Mady Hue, marilu.hue@cms.hhs.gov, 

and Andrea Hazeley, andrea.hazeley@

cms.hhs.gov, MS–DRG Classifications 

Issues. 

Jennifer Tate, jennifer.tate@

cms.hhs.gov, Hospital-Acquired 

Condition Reduction Program— 

Administration Issues. 

Julia Venanzi, julia.venanzi@

cms.hhs.gov, Hospital Inpatient Quality 

Reporting Program and Hospital ValueBased Purchasing Program— 

Administration Issues. 

Jennifer Tate, jennifer.tate@

cms.hhs.gov, PPS-Exempt Cancer 

Hospital Quality Reporting— 

Administration Issues. 

Ariel Cress, ariel.cress@cms.hhs.gov 

or Lorraine Wickiser, lorraine.wickiser@

cms.hhs.gov, Long-Term Care Hospital 

Quality Reporting Program— 

Administration Issues. 

Jessica Warren, jessica.warren@

cms.hhs.gov and Elizabeth Holland, 

elizabeth.holland@cms.hhs.gov, 

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. 


lotter on DSK11XQN23PROD with RULES1