[Federal Register Volume 89, Number 191 (Wednesday, October 2, 2024)]
[Rules and Regulations]
[Pages 80131-80132]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-22497]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412

[CMS-1804-CN]
RIN 0938-AV31


Medicare Program; Inpatient Rehabilitation Facility Prospective 
Payment System for Federal Fiscal Year 2025 and Updates to the IRF 
Quality Reporting Program; Correction

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

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical and typographical errors in 
the final rule that appeared in the August 6, 2024 Federal Register 
entitled ``Medicare Program; Inpatient Rehabilitation Facility 
Prospective Payment System for Federal Fiscal Year 2025 and Updates to 
the IRF Quality Reporting Program'' (referred to hereafter as the ``FY 
2025 IRF final rule''). The effective date of the FY 2025 IRF final 
rule is October 1, 2024.

DATES: This correction is effective October 1, 2024.

FOR FURTHER INFORMATION CONTACT: Kia Burwell, (410) 786-7816.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2024-16911 of August 6, 2024, the FY 2025 IRF final rule 
(89 FR 64276), there were technical and typographical errors that are 
identified and corrected in this correcting document. These corrections 
are effective as if they had been included in the FY 2025 IRF final 
rule. Accordingly, the corrections are effective October 1, 2024.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 64304, we made a typographical error in the standard 
payment amount calculated following the application of the budget 
neutrality factor for the FY 2025 wage index due to the number being 
transposed in the original text.
    A technical error in the calculation of the final FY 2025 IRF PPS 
wage indexes require us to recalculate the impact analysis provided on 
pages 64335 and 64336 in Table 17. Discussions of these errors are 
found in section IV. of this document.

B. Summary of Errors and Corrections Posted on the CMS Website for the 
IRF Wage Index

    As discussed in the FY 2025 IRF PPS final rule (89 FR 64289 through 
64291), in developing the wage index to be applied to IRFs under the 
IRF PPS, we use the updated, pre-reclassified, pre-rural floor hospital 
inpatient PPS (IPPS) wage data, exclusive of the occupational mix 
adjustment. For FY 2025, the updated, unadjusted, pre-reclassified, 
pre-rural floor IPPS wage data used under the IRF PPS are for cost 
reporting periods beginning on or after October 1, 2020, and before 
October 1, 2021 (FY 2021 cost report data), as discussed in the final 
rule entitled ``Medicare and Medicaid Programs and the Children's 
Health Insurance Program; Hospital Inpatient Prospective Payment 
Systems for Acute Care Hospitals and the Long-Term Care Hospital 
Prospective Payment System and Policy Changes and Fiscal Year 2025 
Rates; Quality Programs Requirements; and Other Policy Changes'' (89 FR 
69896) (hereinafter referred to as the FY 2025 IPPS final rule). In 
calculating the wage index under the FY 2025 IPPS final rule, we made 
an inadvertent error related to the calculation of the wage index. This 
error is identified, discussed, and corrected in the document entitled 
``Medicare and Medicaid Programs and the Children's Health Insurance 
Program; Hospital Inpatient Prospective Payment Systems for Acute Care 
Hospitals and the Long-Term Care Hospital Prospective Payment System 
and Policy Changes and Fiscal Year 2025 Rates; Quality Programs

[[Page 80132]]

Requirements; and Other Policy Changes; Correction,'' published 
elsewhere in this issue of the Federal Register. The error that affects 
the unadjusted, pre-reclassified, pre-rural floor IPPS wage data and 
thereby affects the IRF PPS wage data was an error resulting from 
excluding the Medicare cost report wage data for CMS Certification 
Number (CCN) 260163, which caused a change in the wage index for rural 
Missouri. The wage data for this hospital has been restored and 
included in the wage index.
    Thus, the use of the corrected wage data for the rural Missouri 
CBSA 26 required the recalculation of the final FY 2025 IRF PPS wage 
indexes. Additionally, as discussed in the FY 2025 IRF PPS final rule, 
adjustments or updates to the IRF wage index made under section 
1886(j)(6) of the Social Security Act (the Act) must be made in a 
budget-neutral manner. Due to the recalculation and subsequent revision 
of the final FY 2025 IRF PPS wage indexes, it was necessary to 
recalculate the FY 2025 IRF PPS wage index budget neutrality factor as 
well, with no subsequent changes noted. Due to the recalculated wage 
indexes, we recalculated the impact analysis provided in Table 17 of 
the FY 2025 IRF PPS final rule (89 FR 64335 through 64337). The 
correction to this error is found in section IV. of this document.
    We are correcting the wage index in Table B setting forth the wage 
indexes for rural areas based on CBSA labor market areas (Table B), 
which is available exclusively on the CMS website at https://www.cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation. Table B has been updated to reflect the error in the 
wage index for the State of Missouri discussed in this correcting 
document, and we are republishing the wage indexes in Tables A and B 
accordingly on the CMS website at https://www.cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation.

III. Waiver of Proposed Rulemaking

    Under section 553(b) of the Administrative Procedure Act (the APA) 
(5 U.S.C. 553(b)), the agency is required to publish a notice of 
proposed rulemaking in the Federal Register before the provisions of a 
rule take effect. Similarly, section 1871(b)(1) of the Act requires the 
Secretary to provide for notice of the proposed rule in the Federal 
Register and provide a period of not less than 60 days for public 
comment. In addition, section 553(d) of the APA and section 
1871(e)(1)(B)(i) of the Act mandate a 30-day delay in effective date 
after issuance or publication of a rule. Sections 553(b)(B) and 
553(d)(3) of the APA provide for exceptions from the APA notice and 
comment, and delay in effective date requirements; in cases in which 
these exceptions apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of 
the Act provide exceptions from the notice and 60-day comment period 
and delay in effective date requirements of the Act as well. Section 
553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an 
agency to dispense with normal notice and comment rulemaking procedures 
for good cause if the agency makes a finding that the notice and 
comment process is impracticable, unnecessary, or contrary to the 
public interest, and includes a statement of the finding and the 
reasons for it in the rule. In addition, section 553(d)(3) of the APA 
and section 1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 
30-day delay in effective date where the agency finds that such delay 
is contrary to the public interest and the agency includes in the rule 
a statement of the finding and the reasons for it.
    In our view, this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This document 
merely corrects technical errors in the FY 2025 IRF final rule. The 
corrections contained in this document are consistent with, and do not 
make substantive changes to, the policies and payment methodologies 
that were proposed, subject to notice and comment procedures, and 
adopted in the FY 2025 IRF final rule. As a result, the corrections 
made through this correcting document are intended to resolve 
inadvertent errors so that the rule accurately reflects the policies 
adopted in the final rule. Even if this were a rulemaking to which the 
notice and comment and delayed effective date requirements applied, we 
find that there is good cause to waive such requirements. Undertaking 
further notice and comment procedures to incorporate the corrections in 
this document into the FY 2025 IRF final rule or delaying the effective 
date of the corrections would be contrary to the public interest 
because it is in the public interest to ensure that the rule accurately 
reflects our policies as of the date they take effect. Further, such 
procedures would be unnecessary because we are not making any 
substantive revisions to the final rule, but rather, we are simply 
correcting the Federal Register document to reflect the policies that 
we previously proposed, received public comment on, and subsequently 
finalized in the final rule. For these reasons, we believe there is 
good cause to waive the requirements for notice and comment and delay 
in effective date.

IV. Correction of Errors

    In FR Doc. 2024-16911 of August 6, 2024 (89 FR 64276), make the 
following corrections:
    1. On page 64304, third column; third full paragraph, line 20, the 
Standard Payment Amount that reads ``$18,592'' is corrected to read 
``$18,952''.
    2. On page 64335, Table 17 titled ``IRF Impact for FY 2025 (Columns 
4 through 7 in percentage)'', row 13, column 5, the FY 2025 Wage Index 
(5% cap), FY 2024 CBSA delineations, and Labor-Related Share the value 
that reads ``0.5'' is corrected to read ``0.6''.
    3. On page 64336, Table 17 titled ``IRF Impact for FY 2025 (Columns 
4 through 7 in percentage)'', row 13,
    a. Column 5, the FY 2025 Wage Index (5% cap), FY 2024 CBSA 
delineations, and Labor-Related Share value that reads ``1.1'' is 
corrected to read ''1.2''.
    b. Column 9, the Total Percent Change that reads ``3.6'' is 
corrected to read ``3.8.''

Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2024-22497 Filed 9-27-24; 4:15 pm]
BILLING CODE 4120-01-P