15032 Federal Register / Vol. 79, No. 52 / Tuesday, March 18, 2014 / Rules and Regulations 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 412, 413, 424, and 476 

[CMS–1588–CN5] 

RIN 0938–AR12 

Medicare Program; Hospital Inpatient 

Prospective Payment Systems for 

Acute Care Hospitals and the Long 

Term Care Hospital Prospective 

Payment System and Fiscal Year 2013 

Rates; Hospitals’ Resident Caps for 

Graduate Medical Education Payment 

Purposes; Quality Reporting 

Requirements for Specific Providers 

and for Ambulatory Surgical Centers; 

Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical errors that appeared in the 

final rule that appeared in the August 

31, 2012 Federal Register entitled 

‘‘Medicare Program; Hospital Inpatient 

Prospective Payment Systems for Acute 

Care Hospitals and the Long Term Care 

Hospital Prospective Payment System 

and Fiscal Year 2013 Rates; Hospitals’ 

Resident Caps for Graduate Medical 

Education Payment Purposes; Quality 

Reporting Requirements for Specific 

Providers and for Ambulatory Surgical 

Centers.’’ 

DATES: This correcting document is 

effective on March 18, 2014. 

FOR FURTHER INFORMATION CONTACT: 

Cindy Tourison (410) 786–1093. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2012–19079, which 

appeared in the August 31, 2012 

Federal Register (77 FR 53258) entitled 

‘‘Medicare Program; Hospital Inpatient 

Prospective Payment Systems for Acute 

Care Hospitals and the Long Term Care 

Hospital Prospective Payment System 

and Fiscal Year 2013 Rates; Hospitals’ 

Resident Caps for Graduate Medical 

Education Payment Purposes; Quality 

Reporting Requirements for Specific 

Providers and for Ambulatory Surgical 

Centers’’ there were technical errors that 

are identified and corrected in the 

Correction of Errors section of this 

correcting document. 

II. Summary of Errors in the Preamble 

On page 53602 and 53603, we 

inadvertently included Medicare 

Advantage (MA) claims in our 

calculation of the final performance 

standards that apply to the PSI–90 

measure for the FY 2015 and FY 2016 

Hospital Value-Based Purchasing 

Program. 

We also note that we have made 

similar corrections to the FY 2014 IPPS/ 

LTCH PPS final rule and these 

corrections are published elsewhere in 

this issue of the Federal Register. 

III. Waiver of Proposed Rulemaking 

and Delay of Effective Date 

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. 

In our view, this correcting document 

does not constitute a rule that would be 

subject to the APA notice and comment 

or delayed effective date requirements. 

This correcting document corrects 

technical errors in certain HVBP tables 

but does not make substantive changes 

to the HVBP policies that were adopted 

in the final rule. As a result, this 

correcting document is intended to 

ensure that the HVBP tables accurately 

reflect the policies adopted in that final 

rule. 

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 corrected table values in as 

timely a manner as possible, and to 

ensure that the FY 2013 IPPS/LTCH PPS 

final rule accurately reflects our HVBP 

policies. Furthermore, such procedures 

would be unnecessary, as we are not 

altering our HVBP policies, but rather, 

we are simply implementing correctly 

the policy for calculating certain HVBP 

table values that we previously 

proposed, received comment on, and 

subsequently finalized. This correcting 

document is intended solely to ensure 

that the FY 2013 IPPS/LTCH PPS final 

rule accurately reflects these HVBP 

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. 2012–19079 of August 31, 

2012 (77 FR 53258), make the following 

corrections: 

1. On pages 53601 and 53602, in the 

table entitled ‘‘FINAL PERFORMANCE 

STANDARDS FOR THE FY 2015 

HOSPITAL VBP PROGRAM CLINICAL 

PROCESS OF CARE, OUTCOME, AND 

EFFICIENCY DOMAINS,’’ the 

performance standards for the PSI–90 

Measure are corrected to read as 

follows: 

Measure ID Description Achievement 

threshold Benchmark 

Outcome Measures 

PSI–90 ........ Patient safety for selected indicators (composite) ......................................................................... 0.616248 0.449988 

2. On page 53603, in the table entitled 

‘‘FINAL PERFORMANCE STANDARDS 

FOR FY 2016 HOSPITAL VBP 

PROGRAMS OUTCOME DOMAIN: 

MORTALITY/PSI COMPOSITE 

MEASURES,’’ the performance 

standards for the PSI–90 Measure are 

corrected to read as follows: 


sroberts on DSK5SPTVN1PROD with RULES
Federal Register / Vol. 79, No. 52 / Tuesday, March 18, 2014 / Rules and Regulations 15033 

Measure ID Description Achievement 

threshold Benchmark 

Outcome Measures 

PSI–90 ........ Patient safety for selected indicators (composite) ......................................................................... 0.616248 0.449988 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program) 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: March 6, 2014. 

Jennifer M. Cannistra, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2014–05836 Filed 3–17–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF TRANSPORTATION 

Pipeline and Hazardous Materials 

Safety Administration 

49 CFR Parts 107, 171, 172, 173, 175 

and 178 

[Docket No. PHMSA–2011–0158 (HM–233C)] 

RIN 2137–AE82 

Hazardous Materials: Adoption of 

Certain Special Permits and 

Competent Authorities Into 

Regulations 

AGENCY: Pipeline and Hazardous 

Materials Safety Administration 

(PHMSA), DOT. 

ACTION: Final rule. 

SUMMARY: The Pipeline and Hazardous 

Materials Safety Administration is 

amending the Hazardous Materials 

Regulations (HMR) to adopt provisions 

contained in certain widely used or 

longstanding special permits and certain 

competent authority approvals 

(‘‘approvals’’) that have established 

safety records. Special permits allow a 

company or individual to package or 

ship a hazardous material in a manner 

that varies from the regulations 

provided an equivalent level of safety is 

maintained. An approval is a written 

consent (document) required under an 

international standard (i.e., 

International Maritime Dangerous 

Goods (IMDG) Code, International Civil 

Aviation Organization’s Technical 

Instructions for the Safe Transport of 

Dangerous Goods by Air (ICAO TI)), or 

is specifically provided for in the HMR, 

and is issued by the Associate 

Administrator for Hazardous Materials 

Safety. These revisions are intended to 

provide wider access to the regulatory 

flexibility offered in special permits and 

approvals and eliminate the need for 

numerous renewal requests, reducing 

paperwork burdens and facilitating 

commerce while maintaining an 

appropriate level of safety. 

DATES: This regulation is effective April 

17, 2014. The incorporation by reference 

of certain publications listed in the rule 

is approved by the Director of the 

Federal Register as of April 17, 2014. 

FOR FURTHER INFORMATION CONTACT: 

Steven Andrews, Office of Hazardous 

Materials Safety, Standards and 

Rulemaking Division, (202) 366–8553, 

or, Diane LaValle, Office of Hazardous 

Materials Safety, Approvals and Permits 

Division, (202) 366–4535, Pipeline and 

Hazardous Materials Safety 

Administration (PHMSA), 1200 New 

Jersey Avenue SE., Washington, DC 

20590. 

SUPPLEMENTARY INFORMATION: 

I. Executive Summary 

II. Background 

III. Overview of Amendments 

IV. List of Commenters 

V. Regulatory Analyses and Notices 

I. Executive Summary 

PHMSA is amending the Hazardous 

Materials Regulations (HMR; 49 CFR 

parts 171–180) to adopt several long 

standing special permits and competent 

authority approvals into the HMR. The 

identified special permits and 

competent authority approvals have a 

long history of safety. Special permits 

allow a company or individual to 

package or ship a hazardous material in 

a manner that varies from the HMR 

provided an equivalent level of safety is 

maintained. A competent authority (CA) 

approval is a written consent 

(document) required under an 

international standard (i.e., 

International Maritime Dangerous 

Goods (IMDG) Code or International 

Civil Aviation Organization’s Technical 

Instructions for the Safe Transport of 

Dangerous Goods by Air (ICAO TI)) and 

is issued by the Associate Administrator 

for Hazardous Materials Safety. 

In 2009, an audit of the Special 

Permits program by the Office of the 

Inspector General identified a need for 

an ongoing review of all open special 

permits with an outlook towards 

identifying those that should be made 

part of the HMR to reduce the overall 

economic burden to both affected 

industry and the government. Three 

rulemakings, HM–233A; PHMSA–2009– 

0289 (75 FR 27205), HM–245; PHMSA– 

2010–0017 (76 FR 5483), and HM–216B; 

PHMSA–2010–0018 (77 FR 37962) have 

successfully codified certain special 

permits into the HMR. These revisions 

provide wider access to the regulatory 

flexibility offered in special permits and 

eliminate the need for numerous 

renewal requests, thus reducing 

paperwork burdens and facilitating 

commerce while maintaining an 

appropriate level of safety. 

This Final Rule, HM–233C, continues 

this initiative by adopting several other 

long-standing special permits and 

competent authority approvals with 

proven safety records into the HMR. The 

special permits affected by the final rule 

represent variances from current 

regulations on topics categorized as 

follows: 

• Limited quantities of liquids and 

solids containing ethyl alcohol. 

• Transportation of solid coal tar 

pitch compounds. 

• Transportation of certain ammonia 

solutions in UN1H1 and UN6HA1 

drums. 

• Transportation of spent bleaching 

earth. 

• Requalification of non-DOT 

specification cylinders in life-saving 

appliances. 

• Use of regulated medical waste 

containers displaying alternative 

markings. 

• Adoption of special permits to 

harmonize with FAA Modernization 

and Reform Act of 2012. 

The economic impact of the final rule 

can thus be summarized as follows: 

NET COST: $0. Currently, industry 

must apply for a special permit in order 

to ship materials as described in this 

final rule. Adoption of these special 

permits into the HMR will reduce the 

burden on industry by no longer 

requiring industry to apply for a special 

permit to ship these materials. 

Therefore, this final rule does not 

impose any new costs to industry. 

NET BENEFITS: $9,900 per year. 

(Averaged over 10 years, at a 7% annual 

discount rate.) 

In addition to general positive 

economic impacts noted above, this 

final rule will eliminate the need for 


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