57166 Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 

SSA State/ 

county code County name MSA No. MSA Urban/ rural 

2006 

MSAbased WI 

2006 

CBSAbased WI 

CBSA 

No. 

CBSA Urban/ 

rural 

Transition 

wage 

index * 

44840 ........... Trousdale County, Tennessee ....... 44 Rural ........... 0.7935 0.9790 34980 Urban .......... 0.8863 

44930 ........... Williamson County, Tennessee ..... 5360 Urban .......... 0.9808 0.9790 34980 Urban .......... 0.9799 

44940 ........... Wilson County, Tennessee ............ 5360 Urban .......... 0.9808 0.9790 34980 Urban .......... 0.9799 

45070 ........... Austin County, Texas ..................... 45 Rural ........... 0.7931 0.9996 26420 Urban .......... 0.8964 

45180 ........... Brazoria County, Texas ................. 1145 Urban .......... 0.8563 0.9996 26420 Urban .......... 0.9280 

45280 ........... Chambers County, Texas .............. 3360 Urban .......... 1.0091 0.9996 26420 Urban .......... 1.0044 

45341 ........... Coryell County, Texas ................... 3810 Urban .......... 0.8526 0.8526 28660 Urban .......... 0.8526 

45530 ........... Fort Bend County, Texas ............... 3360 Urban .......... 1.0091 0.9996 26420 Urban .......... 1.0044 

45550 ........... Galveston County, Texas .............. 2920 Urban .......... 0.9635 0.9996 26420 Urban .......... 0.9816 

45610 ........... Harris County, Texas ..................... 3360 Urban .......... 1.0091 0.9996 26420 Urban .......... 1.0044 

45757 ........... Liberty County, Texas .................... 3360 Urban .......... 1.0091 0.9996 26420 Urban .......... 1.0044 

45801 ........... Montgomery County, Texas ........... 3360 Urban .......... 1.0091 0.9996 26420 Urban .......... 1.0044 

45884 ........... San Jacinto County, Texas ............ 45 Rural ........... 0.7931 0.9996 26420 Urban .......... 0.8964 

45950 ........... Waller County, Texas .................... 3360 Urban .......... 1.0091 0.9996 26420 Urban .......... 1.0044 

IV. Waiver of Proposed Rulemaking 

and Delay in 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 

notice such as this take effect in 

accordance with section 553(b) of the 

Administrative Procedure Act (APA) (5 

U.S.C. 553(b)). We also ordinarily 

provide a 30-day delay in the effective 

date of the provisions of a notice in 

accordance with section 553(d) of the 

APA (5 U.S.C. 553(d)). However, we can 

waive both the notice and comment 

procedure and the 30-day delay in 

effective date if the Secretary finds, for 

good cause, that a 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. 

We find it unnecessary to undertake 

notice and comment rulemaking 

because this notice merely provides 

technical and typographical corrections 

to the regulations. We are not making 

substantive changes to our payment 

methodologies or policies, but rather, 

are simply implementing correctly the 

payment methodologies and policies 

that we previously proposed, received 

comments on, and subsequently 

finalized. The public has already had 

the opportunity to comment on the 

payment methodology and policies 

being used to calculate wage indexes. In 

addition, this correction notice is 

intended to ensure that the FY 2006 

SNF PPS final rule accurately reflects 

the payment methodologies and policies 

adopted in the final rule. Therefore, we 

believe that undertaking further notice 

and comment procedures to incorporate 

these corrections into the final rule is 

unnecessary and contrary to the public 

interest. 

Further, we believe a delayed 

effective date is unnecessary because 

this correction notice merely corrects 

inadvertent technical and typographical 

errors. The changes noted above do not 

make any substantive changes to the 

SNF PPS payment methodologies or 

policies. Moreover, we regard imposing 

a delay in the effective date as being 

contrary to the public interest. We 

believe that it is in the public interest 

for providers to receive appropriate SNF 

PPS payments in as timely a manner as 

possible and to ensure that the FY 2006 

SNF PPS final rule accurately reflects 

our payment methodologies, payment 

rates, and policies. Therefore, we find 

good cause to waive notice and 

comment procedures, as well as the 30- 

day delay in effective date. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program). 

Dated: September 28, 2005. 

Ann C. Agnew, 

Executive Secretary to the Department. 

[FR Doc. 05–19762 Filed 9–29–05; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 412 

[CMS–1290–CN] 

RIN 0938–AN43 

Medicare Program; Inpatient 

Rehabilitation Facility Prospective 

Payment System for FY 2006; 

Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical errors that appeared in the FY 

2006 Inpatient Rehabilitation Facility 

(IRF) Prospective Payment System (PPS) 

regulation entitled ‘‘Inpatient 

Rehabilitation Facility Prospective 

Payment System for FY 2006’’ (70 FR 

47880). 

DATES: Effective Date: October 1, 2005. 

This rule applies for discharges on or 

after October 1, 2005 and on or before 

September 30, 2006 (FY 2006). 

FOR FURTHER INFORMATION CONTACT: Pete 

Diaz, (410) 786–1235. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In the FY 2006 IRF PPS final rule (70 

FR 47880), there were a number of 

technical errors that are identified and 

corrected in the ‘‘Correction of Errors’’

section below. The provisions in this 

correction notice are effective as if they 

had been included in the FY 2006 IRF 

PPS final rule (70 FR 47880). 

Accordingly, the corrections are 

effective for the payments for discharges 

occurring on or after October 1, 2005 

and on or before September 30, 2006. 

Most of the technical errors identified 

and corrected in the ‘‘Correction of 

Errors’’ section below originate from the 

same error, an inadvertent inclusion of 

incorrect data for four inpatient 

rehabilitation facilities (IRFs) in the 

analysis for the FY 2006 final rule (70 

FR 47880). In the analysis for the FY 

2006 final rule (70 FR 47880), we 

inadvertently and incorrectly neglected 

to apply any rural adjustment amount to 

estimated payments for four IRFs in our 

analysis sample that should have 

received a portion of the rural 

adjustment under the IRF hold harmless 

policy (as described below). When we 

reran the data analysis with the correct 

portion of the rural adjustment applied 

to payments for these four facilities, it 

resulted in the technical changes to the 

Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 57167 

majority of the numbers described in the 

‘‘Correction of Errors’’ section below. 

According to the hold harmless policy 

described in the FY 2006 final rule (70 

FR 47880, 47924), those existing IRFs 

that meet the definition in 42 CFR 

412.602 as rural in FY 2005 and will 

become urban under the FY 2006 CoreBased Statistical Area (CBSA)-based 

designations will qualify, under the 

hold harmless policy, for an adjustment 

to their payments in FY 2006 equal to 

all or some portion of two-thirds of the 

19.14 percent rural adjustment effective 

in FY 2005 (as described below). 

The hold harmless policy for the IRF 

PPS rural adjustment, as described in 

the FY 2006 final rule (70 FR 47880, 

47924), results in two groups of IRFs 

that are within the scope of the policy. 

Both groups must meet the hold 

harmless criteria (that is, classified as 

rural in FY 2005 and redesignated as 

urban under the CBSA-based definitions 

in FY 2006). The first group of IRFs are 

those that meet the hold harmless 

criteria and that we estimate will 

experience lower payments in FY 2006 

(with the hold harmless policy) than 

they otherwise would have if instead 

they had been paid under their rural 

designation in FY 2006, including the 

FY 2005 rural adjustment of 19.14 

percent (as described in step 2 below). 

This first group of IRFs will receive an 

adjustment to payments in FY 2006 

equal to a full two-thirds of the FY 2005 

rural adjustment of 19.14 percent. The 

second group of IRFs meets the hold 

harmless criteria (described above), and 

we estimate that they will experience 

higher payments (with the hold 

harmless policy) than they otherwise 

would have if instead they had been 

paid under their rural designation in FY 

2006, including the FY 2005 rural 

adjustment of 19.14 percent (as 

described in step 2 below). As discussed 

in the final rule (70 FR 47880, 47924), 

our intent of the hold harmless policy 

is to mitigate the negative payment 

effect upon an existing rural facility that 

is redesignated as an urban facility 

(effective FY 2006), but our intent is not 

for an IRF that comes under the hold 

harmless policy to realize greater 

payments as a result of the policy than 

the IRF would have if instead the IRF 

had been paid under its rural 

designation in FY 2006, including the 

FY 2005 rural adjustment of 19.14 

percent. Therefore, under the hold 

harmless policy as described in the final 

rule (70 FR 47880, 47924), the second 

group of IRFs will receive a portion of 

the two-thirds of the 19.14 percent rural 

adjustment (as described further below), 

rather than the full adjustment. 

The analysis for the FY 2006 final rule 

(70 FR 47880) and for this correction 

notice contained four IRFs in the second 

group (that is, facilities that would 

qualify for some portion less than the 

full two-thirds of the 19.14 percent rural 

adjustment in FY 2006). 

In conducting the analysis for the FY 

2006 final rule (70 FR 47880), we 

applied the hold harmless policy to IRF 

PPS payments using the following steps: 

Step 1. We identified IRFs that qualify 

for the hold harmless policy (that is, 

those existing IRFs that are classified as 

rural in FY 2005 under § 412.602 and 

will be redesignated as urban under the 

CBSA-based definitions in FY 2006). 

Step 2. For the IRFs that qualify for 

the hold harmless policy (identified in 

step 1), we estimated what they would 

have been paid under their rural 

designation in FY 2006, including the 

FY 2005 rural adjustment of 19.14 

percent, based on what we estimate they 

would have been paid if we had issued 

an update notice to update FY 2006 IRF 

PPS payment rates instead of a final rule 

implementing substantive policy 

changes. An update notice for FY 2006 

would have updated FY 2005 IRF PPS 

payment rates by the following: the FY 

2006 MSA-based wage index, the FY 

2006 estimate of the FY 1997-based 

excluded hospital market basket with 

capital, and the FY 2006 labor-related 

share estimated based on the FY 1997- 

based excluded hospital market basket 

with capital. Because an update notice 

would not have changed any IRF PPS 

policies, the 19.14 percent rural 

adjustment would have remained 

unchanged. Thus, to estimate what the 

IRFs that qualify for the hold harmless 

policy would have been paid under 

their rural designation in FY 2006 for 

the final rule and for this correction 

notice, we updated FY 2005 IRF PPS 

payments by the FY 2006 MSA-based 

wage index, the FY 2006 estimate of the 

FY 1997-based excluded hospital 

market basket with capital, and the FY 

2006 labor related share estimated based 

on the FY 1997-based excluded hospital 

market basket with capital. We also kept 

the rural adjustment the same as it was 

in FY 2005, at 19.14 percent. 

Step 3. We estimated what the IRFs 

that qualify for the hold harmless policy 

would have been paid in FY 2006 with 

the full two-thirds of the 19.14 percent 

hold harmless adjustment applied to 

their FY 2006 payment rates. 

Step 4. We compared the estimated 

payment rates from step 2 and step 3 for 

each of the IRFs that qualify for the hold 

harmless policy. 

Step 5. If an IRF’s FY 2006 estimated 

payment rate from step 3 was less than 

the IRF’s estimated payment rate from 

step 2, we applied the full two-thirds of 

the 19.14 percent adjustment to that 

IRF’s estimated payment rate for FY 

2006. However, if an IRF’s FY 2006 

estimated payment rate from step 3 was 

greater than that IRF’s estimated 

payment rate from step 2, our 

methodology for the FY 2006 final rule 

(70 FR 47880), which is the same 

methodology we are using in this 

correction notice, requires that we apply 

only a portion of the two-thirds of the 

19.14 percent adjustment to that IRF’s 

estimated payment rate for FY 2006. 

The portion of the two-thirds of the 

19.14 percent adjustment that we 

intended to apply in the final rule and 

in this correction notice to each of these 

facility’s estimated payments was the 

amount that would make each IRF’s 

estimated payment rate for FY 2006 

equal to the estimated payment rate we 

computed in step 2 (that is, so that the 

IRF’s estimated payment rate would 

equal, but not exceed, what we estimate 

the IRF would have been paid in FY 

2006 if we had issued an update notice 

instead of a final rule implementing 

substantive policy changes for FY 2006 

IRF PPS payments). However, in doing 

the analysis for the FY 2006 final rule, 

we inadvertently neglected to apply any 

portion of this adjustment to the 

estimated payments for these facilities. 

Although our methodology in the FY 

2006 final rule (70 FR 47880) included 

the steps discussed above, we 

inadvertently and incorrectly assigned 

no hold harmless adjustment in step 5 

to estimated payments for the four IRFs 

that should have received a portion of 

the hold harmless adjustment when 

doing the data computations (as 

described above). In light of the 

inadvertent inclusion of incorrect data 

in the analysis for the final rule 

published in the FY 2006 IRF PPS 

regulation (70 FR 47880), we are making 

the following conforming technical 

changes to some of the numbers and the 

corresponding text in the FY 2006 final 

rule (70 FR 47880). 

• The budget neutrality factor for the 

rural adjustment is reduced, from 

0.9961 to 0.9957, because the 

conforming change from initially 

applying no rural adjustment to 

estimated payments for the four IRFs 

described above to applying a portion of 

the rural adjustment to estimated 

payments for these four providers 

increases estimated total payments to 

IRFs for FY 2006. Since we are 

implementing the hold harmless policy 

(described in the FY 2006 final rule (70 

FR 47880)) in a budget neutral manner, 

we need to reduce the budget neutrality 

factor for the rural adjustment in order 

to make estimated total IRF payments in 

57168 Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 

FY 2006 the same with and without the 

hold harmless policy. Decreasing the 

budget neutrality factor for the rural 

adjustment also decreases the standard 

payment amount obtained after 

applying the budget neutrality factor, 

from $13,105 to $13,100. In addition, 

because we now apply the same budget 

neutrality factor for the low-income 

patient (LIP) adjustment (0.9851) to 

$13,100 instead of to $13,105, the 

resulting standard payment amount 

obtained after applying the budget 

neutrality factor for the LIP also 

decreases, from $12,910 to $12,905 (that 

is, now the calculation is $13,100 × 

0.9851 = $12,905, whereas before the 

change to the budget neutrality factor 

for the rural adjustment the calculation 

was $13,105 × 0.9851 = $12,910). 

• The combined budget neutrality 

factor (that is, the single budget 

neutrality factor we obtain from 

multiplying the budget neutrality factors 

for the wage index adjustment, the rural 

adjustment, the LIP adjustment, and the 

teaching status adjustment) decreases, 

from 0.9699 to 0.9695, because one of 

the four factors that make up the 

combined budget neutrality factor 

decreases (as discussed above). 

• The standard payment conversion 

factor decreases by $5, from $12,767 to 

$12,762, because the budget neutrality 

factor for the rural adjustment that is 

applied to the standard payment 

amount to calculate the standard 

payment conversion factor decreases, as 

described above. 

• The outlier threshold amount is 

reduced by $3, from $5,132 to $5,129, as 

a result of making the conforming 

changes to reduce the budget neutrality 

factor for the rural adjustment and, 

therefore, to reduce the standard 

payment conversion factor. This is 

because, when we lower the standard 

payment conversion factor by $5, we 

have to account for this change when 

we set the outlier threshold amount to 

ensure that estimated outlier payments 

will continue to equal 3 percent of 

estimated total payments in FY 2006. 

• Table 11, the example of computing 

an IRF’s Federal prospective payment 

rate, is revised because the reduction of 

the standard payment conversion factor, 

described above, changes all of the FY 

2006 Federal prospective payment rates 

(in Table 12). A change in the rates 

necessitates a change in the example 

that is constructed using those payment 

rates. We have also made conforming 

changes to the numbers in the text that 

refer to Table 11. 

• Table 12, which contains the final 

FY 2006 Federal prospective payment 

rates, is revised because we had to 

recalculate the prospective payment 

rates because we are correcting the 

standard payment conversion factor, 

described above in this correction 

notice. The Federal prospective 

payment rates are computed by 

multiplying the standard payment 

conversion factor by the relative weights 

for each case-mix group (CMG) and tier. 

Therefore, since the standard payment 

conversion factor changed, we had to 

multiply the corrected standard 

payment conversion factor by the 

relative weights for each CMG and tier. 

• Table 13, which contains the 

projected impacts of the FY 2006 

refinements to the IRF PPS, is revised 

because the distribution of payments 

among providers changes slightly due to 

the budget neutral implementation of 

the policies. That is, estimated 

payments to the four IRFs described 

above increase by an average of 11 

percent as a result of applying a portion 

of the two-thirds of the 19.14 percent 

rural adjustment to these facilities’

payments under the hold harmless 

policy. Therefore, to implement this 

policy in a budget neutral manner (that 

is, such that estimated total IRF 

payments in FY 2006 are the same with 

or without the hold harmless policy), 

estimated payments to those IRFs that 

do not qualify for the hold harmless 

policy must be lowered slightly so that 

estimated total payments to IRFs do not 

increase because of the policy. This 

produces a slight redistribution of 

estimated payments among IRFs that is 

reflected in the impact analysis (Table 

13). Because some of the numbers in 

Table 13 change, we also make 

conforming changes to the text that 

describes Table 13. 

In addition to the technical 

corrections (described above) that we 

are making because of the inadvertent 

inclusion of incorrect data for the hold 

harmless policy, we are also correcting 

some of the numbers in the FY 2006 

final rule (70 FR 47880, 47948 through 

47949) that were used to describe our 

rationale for the hold harmless policy. 

These numbers, which were intended to 

indicate the estimated dollar impacts of 

the hold harmless policy, were 

inadvertently computed using the 

incorrect standard payment conversion 

factor. That is, we inadvertently used 

the incorrect standard payment 

conversion factor to compare what 

estimated payments to the IRFs that 

would qualify for the hold harmless 

policy would have been with and 

without the hold harmless policy. In 

light of this error, we have corrected the 

standard payment conversion factor and 

are making conforming changes to the 

impact numbers used to describe our 

rationale for the hold harmless policy in 

the Correction of Errors section below. 

We are also deleting a bullet point 

summarizing our final hold harmless 

policy because it was inadvertently 

added to the section of the FY 2006 final 

rule (70 FR 47880, 47883) that was 

summarizing the proposed rule, even 

though we did not propose this policy 

in the proposed rule. In light of this, we 

are making the conforming change to 

delete the bullet point from the section 

of the final rule in which we 

summarized the proposed rule. 

We are also correcting some 

typographical errors and typesetting 

errors. 

II. Correction of Errors 

In FR Doc. 05–15419 (70 FR 47880), 

we make the following corrections as 

described above in Section I of this 

correction notice: 

1. On page 47883, in the second 

column, second paragraph, 10th bullet, 

remove the bullet ‘‘Implement a budget 

neutral 3 year hold harmless policy for 

FY 2005 rural IRFs redesignated as 

urban in FY 2006.’’ This bullet point 

was inadvertently added to the section 

of the final rule that was summarizing 

the FY 2006 proposed rule (70 FR 

30188). Since we did not propose this 

policy in the proposed rule, it is 

therefore incorrect to indicate that it 

was a proposed policy. 

2. On page 47890, in the second 

column, in the third full paragraph, line 

7, ‘‘250.1’’ is corrected to read ‘‘250.01’’. 

Commenters requested that we add code 

250.01 (insulin dependent diabetes 

without mention of complications, not 

stated as uncontrolled). When we were 

adopting the commenter’s request, we 

inadvertently typed the incorrect code 

number and corresponding description 

for this comorbidity code. Therefore, we 

are correcting typographical errors in 

the code and corresponding description. 

Furthermore, we note that code 250.1 is 

for diabetes with ketoacidosis, not 

diabetes mellitus without mention of 

complication not stated as uncontrolled. 

In addition, 250.1 (diabetes with 

ketoacidosis) makes no mention of 

controlled or uncontrolled status. This 

correction is merely a typographical 

error, and we are amending the error to 

reflect the description standard set forth 

within the ICD–9–CM manual. 

3. On page 47890, as explained above, 

in the second column, in the third full 

paragraph, line 9, ‘‘controlled’’ is 

corrected to read ‘‘uncontrolled’’. 

4. On page 47890, as explained above, 

in the second column, in the fourth full 

paragraph, line 12, ‘‘250.1’’ is corrected 

to read ‘‘250.01’’. 

Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 57169 

5. On page 47890, as explained above, 

in the second column, in the fourth full 

paragraph, line 14, ‘‘controlled’’ is 

corrected to read ‘‘uncontrolled’’. 

6. On page 47890, as explained above, 

in the second column, in the fourth full 

paragraph, line 15, ‘‘250.1’’ is corrected 

to read ‘‘250.01’’. 

7. On page 47890, as explained above, 

in the second column, in the fourth full 

paragraph, line 24, ‘‘250.1’’ is corrected 

to read ‘‘250.01’’. 

8. On page 47891, as explained above, 

in the second column, in the paragraph 

labeled ‘‘Final Decision’’, line 12, 

‘‘250.1’’ is corrected to read ‘‘250.01’’. 

9. On page 47891, as explained above, 

in the second column, in the paragraph 

labeled ‘‘Final Decision’’, line 15, 

‘‘controlled’’ is corrected to read 

‘‘uncontrolled’’. 

10. On page 47911, in the third 

column, in the paragraph labeled 

‘‘Miscellaneous Products’’, line 11, 

‘‘1.322’’ is corrected to read ‘‘1.188’’. 

This was a misprint and does not have 

any effect on the market basket cost 

structure or the FY 2006 update. 

11. On page 47933, in the third 

column, third paragraph, line 12, 

immediately before the formula, the 

following should be inserted: ‘‘where 

the DSH patient percentage =’’. This was 

inadvertently deleted in the typesetting 

process. 

12. On page 47936, in the second 

column, line 19, ‘‘$5,132’’ is corrected 

to read ‘‘$5,129’’. 

13. On page 47936, in the third 

column, second full paragraph, line 6, 

‘‘$5,132’’ is corrected to read ‘‘$5,129’’. 

14. On page 47936, in the third 

column, second full paragraph, line 14, 

‘‘$5,132’’ is corrected to read ‘‘$5,129’’. 

15. On page 47937, in the second 

column, line 31, ‘‘0.9961’’ is corrected 

to read ‘‘0.9957’’. 

16. On page 47937, in the second 

column, line 37, ‘‘0.9961’’ is corrected 

to read ‘‘0.9957’’. 

17. On page 47937, in the second 

column, line 38, ‘‘0.9699’’ is corrected 

to read ‘‘0.9695’’. 

18. On page 47937, in the second 

column, line 42, ‘‘$12,767’’ is corrected 

to read ‘‘$12,762’’. 

19. On page 47938, in the first 

column, in ‘‘Step 8’’, line 3, ‘‘0.9961’’ is 

corrected to read ‘‘0.9957’’. 

20. On page 47938, in the second 

column, in the seventh paragraph, line 

16, ‘‘0.9961’’ is corrected to read 

‘‘0.9957’’. 

21. On page 47938, in the second 

column, in the last paragraph, line 9, 

‘‘$13,105’’ is corrected to read 

‘‘$13,100’’. 

22. On page 47938, in the second 

column, in the last paragraph, line 12, 

‘‘$13,105’’ is corrected to read 

‘‘$13,100’’. 

23. On page 47938, in the second 

column, in the last paragraph, line 13, 

‘‘$12,910’’ is corrected to read 

‘‘$12,905’’. 

24. On page 47938, in the third 

column, line 1, ‘‘$12,910’’ is corrected 

to read ‘‘$12,905’’. 

25. On page 47938, in the third 

column, line 1, ‘‘$12,767’’ is corrected 

to read ‘‘$12,762’’. 

26. On page 47939, in the second 

column, line 21, ‘‘0.9699’’ is corrected 

to read ‘‘0.9695’’. 

27. On page 47939, in the second 

column, line 23, ‘‘$12,767’’ is corrected 

to read ‘‘$12,762’’. 

28. On pages 47939 through 47940, 

Table 11 is corrected with the following 

new Table 11. 

TABLE 11.—EXAMPLES OF COMPUTING AN IRF’S FEDERAL PROSPECTIVE PAYMENT

Facility A 

Dukes County, 

MA 

Facility B 

Queens County, 

NY 

Facility C 

Kings County, CA 

Federal Prospective Payment ................................................................................... $27,675.67 $27,675.67 $27,675.67 

Labor Share ............................................................................................................... × 0.75865 × 0.75865 × 0.75865 

Labor Portion of Federal Payment ............................................................................ = $20,996.15 = $20,996.15 = $20,996.15 

FY 2006 Transition Wage Index (shown in Tables 1 in the addendum) .................. × 1.0216 × 1.3449 × 0.9797 

Wage-Adjusted Amount ............................................................................................. = $21,449.66 = $28,237.72 = $20,569.93 

Nonlabor Amount ....................................................................................................... $6,679.52 $6,679.52 $6,679.52 

Wage-Adjusted Federal Payment .............................................................................. $28,129.19 $34,917.24 $27,249.45 

Rural Adjustment ....................................................................................................... × 1.2130 × 1.0000 × 1.1276 

Subtotal ............................................................................................................... = $34,120.70 = $34,917.24 = $30,726.48 

LIP Adjustment .......................................................................................................... × 1.0310 × 1.0612 × 1.1203 

FY 2006 Adjusted Rural and LIP Federal Prospective Payment Rate ..................... = $35,178.45 = $37,054.18 = $34,422.87 

Wage-Adjusted Federal Payment .............................................................................. $28,129.19 $34,917.24 $27,249.45 

Teaching status adjustment ....................................................................................... × 1.0000 × 1.0900 × 1.0000 

= $28,129.19 = $38,059.79 = $27,249.45 

Teaching Status addition to FY 2006 Adjusted Rural and LIP Federal Prospective 

Payment Rate ........................................................................................................ $0.00 $3,142.55 $0.00 

Total FY 2006 Adjusted Federal Prospective Payment ..................................... $35,178.45 $40,196.73 $34,422.87 

29. On page 47940, in the first 

column, line 2, ‘‘$35,192.24’’ is 

corrected to read ‘‘$35,178.45’’, as a 

result of correcting Table 11. 

30. On page 47940, in the second 

column, line 1, ‘‘$40,212.49’’ is 

corrected to read ‘‘$40,196.73’’, as a 

result of correcting Table 11. 

31. On page 47940, in the second 

column, line 2, ‘‘$34,436.37’’ is 

corrected to read ‘‘$34,422.87’’, as a 

result of correcting Table 11. 

32. On pages 47940 through 47941, 

Table 12 is corrected with the following 

new Table 12. 

57170 Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 

TABLE 12.—FY 2006 PAYMENT RATE TABLE BASED ON ALL REFINEMENTS

CMG Payment rate 

tier 1 

Payment rate 

tier 2 

Payment rate 

tier 3 

Payment rate 

no comorbidity 

0101 ......................................................................................... $9,815.25 $9,314.98 $8,274.88 $8,103.87 

0102 ......................................................................................... 12,086.89 11,471.76 10,190.46 9,979.88 

0103 ......................................................................................... 14,244.94 13,520.06 12,010.32 11,762.74 

0104 ......................................................................................... 15,134.46 14,363.63 12,760.72 12,496.55 

0105 ......................................................................................... 18,164.15 17,240.19 15,315.68 14,999.18 

0106 ......................................................................................... 21,142.81 20,066.97 17,827.24 17,458.42 

0107 ......................................................................................... 24,402.22 23,160.48 20,574.90 20,151.20 

0108 ......................................................................................... 28,211.68 26,775.95 23,787.09 23,295.75 

0109 ......................................................................................... 28,045.77 26,618.98 23,646.71 23,159.20 

0110 ......................................................................................... 33,515.56 31,810.56 28,258.90 27,675.67 

0201 ......................................................................................... 10,388.27 8,711.34 7,684.00 7,207.98 

0202 ......................................................................................... 13,319.70 11,170.58 9,852.26 9,240.96 

0203 ......................................................................................... 15,935.91 13,364.37 11,786.98 11,057.00 

0204 ......................................................................................... 17,044.93 14,294.72 12,607.58 11,826.55 

0205 ......................................................................................... 20,905.43 17,532.44 15,462.44 14,504.01 

0206 ......................................................................................... 27,283.88 22,882.27 20,181.83 18,929.87 

0207 ......................................................................................... 35,295.86 29,600.18 26,107.22 24,487.73 

0301 ......................................................................................... 14,412.13 12,169.84 10,771.13 9,908.42 

0302 ......................................................................................... 18,797.15 15,873.38 14,048.41 12,922.80 

0303 ......................................................................................... 22,429.22 18,940.08 16,764.16 15,420.32 

0304 ......................................................................................... 30,910.84 26,102.12 23,103.05 21,250.01 

0401 ......................................................................................... 12,622.89 10,869.40 9,770.59 8,725.38 

0402 ......................................................................................... 17,407.37 14,990.25 13,474.12 12,032.01 

0403 ......................................................................................... 30,300.82 26,093.19 23,455.28 20,944.99 

0404 ......................................................................................... 54,324.01 46,780.39 42,050.79 37,550.91 

0405 ......................................................................................... 41,447.15 35,691.49 32,082.39 28,649.41 

0501 ......................................................................................... 9,833.12 8,230.21 7,199.04 6,456.30 

0502 ......................................................................................... 13,165.28 11,018.71 9,639.14 8,644.98 

0503 ......................................................................................... 17,453.31 14,607.39 12,778.59 11,459.00 

0504 ......................................................................................... 21,848.54 18,285.39 15,995.89 14,344.49 

0505 ......................................................................................... 25,892.82 21,671.15 18,957.95 17,000.26 

0506 ......................................................................................... 35,232.05 29,487.88 25,794.55 23,132.40 

0601 ......................................................................................... 11,441.13 9,355.82 8,890.01 8,286.37 

0602 ......................................................................................... 15,218.69 12,445.50 11,826.55 11,021.26 

0603 ......................................................................................... 19,482.47 15,932.08 15,139.56 14,109.67 

0604 ......................................................................................... 24,935.67 20,392.40 19,376.54 18,059.51 

0701 ......................................................................................... 11,555.99 9,872.68 9,271.59 8,403.78 

0702 ......................................................................................... 15,004.28 12,818.15 12,037.12 10,910.23 

0703 ......................................................................................... 18,678.46 15,957.60 14,985.14 13,582.60 

0704 ......................................................................................... 22,923.10 19,583.29 18,390.04 16,669.72 

0801 ......................................................................................... 8,373.15 7,033.14 6,520.11 5,865.42 

0802 ......................................................................................... 10,937.03 9,186.09 8,516.08 7,662.30 

0803 ......................................................................................... 16,216.67 13,619.61 12,626.72 11,359.46 

0804 ......................................................................................... 14,126.26 11,863.56 10,998.29 9,895.65 

0805 ......................................................................................... 17,786.40 14,937.92 13,849.32 12,459.54 

0806 ......................................................................................... 21,345.72 17,926.78 16,619.95 14,951.96 

0901 ......................................................................................... 10,735.39 9,773.14 8,684.54 7,772.06 

0902 ......................................................................................... 14,107.11 12,842.40 11,411.78 10,212.15 

0903 ......................................................................................... 18,610.82 16,942.83 15,055.33 13,472.84 

0904 ......................................................................................... 23,330.21 21,239.80 18,872.45 16,889.23 

1001 ......................................................................................... 12,300.02 11,342.87 10,121.54 9,331.57 

1002 ......................................................................................... 16,219.23 14,955.79 13,345.22 12,303.84 

1003 ......................................................................................... 22,813.35 21,035.60 18,771.63 17,306.55 

1101 ......................................................................................... 16,008.65 13,395.00 11,727.00 10,799.20 

1102 ......................................................................................... 23,967.04 20,052.93 17,555.41 16,166.90 

1201 ......................................................................................... 12,996.82 11,222.90 10,344.88 9,337.96 

1202 ......................................................................................... 16,821.59 14,526.98 13,389.89 12,085.61 

1203 ......................................................................................... 20,722.94 17,894.88 16,494.89 14,888.15 

1301 ......................................................................................... 13,193.36 12,273.22 10,624.37 9,390.28 

1302 ......................................................................................... 18,280.29 17,005.37 14,719.69 13,010.86 

1303 ......................................................................................... 23,364.67 21,736.24 18,815.02 16,631.44 

1401 ......................................................................................... 10,429.11 9,382.62 8,162.58 7,409.62 

1402 ......................................................................................... 14,081.59 12,667.56 11,021.26 10,004.13 

1403 ......................................................................................... 17,528.61 15,768.73 13,719.15 12,454.44 

1404 ......................................................................................... 22,230.13 19,999.33 17,398.43 15,794.25 

1501 ......................................................................................... 11,769.12 11,479.42 9,810.15 9,440.05 

1502 ......................................................................................... 14,879.22 14,511.67 12,402.11 11,935.02 

1503 ......................................................................................... 18,210.10 17,760.88 15,179.12 14,606.11 

1504 ......................................................................................... 24,007.87 23,415.72 20,012.09 19,256.58 

1601 ......................................................................................... 12,844.95 10,903.85 9,866.30 8,810.88 

1602 ......................................................................................... 17,624.32 14,962.17 13,536.65 12,089.44 

Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 57171 

TABLE 12.—FY 2006 PAYMENT RATE TABLE BASED ON ALL REFINEMENTS—Continued 

CMG Payment rate 

tier 1 

Payment rate 

tier 2 

Payment rate 

tier 3 

Payment rate 

no comorbidity 

1603 ......................................................................................... 21,680.09 18,404.08 16,651.86 14,871.56 

1701 ......................................................................................... 12,892.17 12,294.91 10,621.81 9,343.06 

1702 ......................................................................................... 16,979.84 16,192.43 13,989.70 12,306.40 

1703 ......................................................................................... 20,204.80 19,268.07 16,645.48 14,643.12 

1704 ......................................................................................... 25,278.97 24,106.14 20,826.31 18,319.85 

1801 ......................................................................................... 15,464.99 12,547.60 10,522.27 9,293.29 

1802 ......................................................................................... 24,739.14 20,072.07 16,833.08 14,866.45 

1803 ......................................................................................... 44,391.34 36,016.92 30,205.10 26,676.41 

1901 ......................................................................................... 15,776.38 14,013.95 13,625.99 11,931.19 

1902 ......................................................................................... 29,559.34 26,256.54 25,529.10 22,352.64 

1903 ......................................................................................... 42,674.85 37,906.97 36,857.93 32,271.27 

2001 ......................................................................................... 11,157.82 9,427.29 8,452.27 7,717.18 

2002 ......................................................................................... 14,609.94 12,343.41 11,065.93 10,103.68 

2003 ......................................................................................... 18,873.72 15,946.12 14,295.99 13,051.70 

2004 ......................................................................................... 25,212.61 21,302.33 19,097.06 17,436.72 

2101 ......................................................................................... 27,895.18 27,895.18 20,304.34 18,839.26 

5001 ......................................................................................... 0.00 0.00 0.00 2,808.92 

5101 ......................................................................................... 0.00 0.00 0.00 8,105.15 

5102 ......................................................................................... 0.00 0.00 0.00 20,421.75 

5103 ......................................................................................... 0.00 0.00 0.00 9,193.74 

5104 ......................................................................................... 0.00 0.00 0.00 23,955.55 

33. On page 47944, in the first 

column, in the last bullet, line 2, 

‘‘D5,132’’ is corrected to read ‘‘D5,129’’. 

34. On page 47944, in the second 

column, in the second bullet, line 8, 

‘‘0.9961’’ is corrected to read ‘‘0.9957’’. 

35. On page 47944, in the second 

column, in the fourth bullet, line 3, 

‘‘D12,767’’ is corrected to read 

‘‘D12,762’’. 

36. On pages 47947, Table 13 is 

corrected with the following new Table 

13. 

57172 Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 

TABLE 13.

—

PROJECTED IMPACT OF FY 2006 REFINEMENTS TO THE IRF PPS 

Facility classification Number of IRFs Number of cases 

FY06 wage 

index and 

labor-share 

(percent) 

Outlier 

(percent) 

Market 

basket 

(percent) 

New CMG, 

new tiers, 

and motor 

score 

(percent) 

Rural 

adjust. 

(percent) 

New LIP 

adjust. 

(percent) 

Teach. status adjust. 

(percent) 

1.9 reduct. 

Total 

percent 

change 

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) 

Total .......................................................................... 1,188 461,738 0.0 1.8 3.6 0.0 0.0 0.0 0.0 

¥1.9 3.4 

Urban unit ................................................................. 802 261,229 0.1 2.3 3.6 0.9 

¥0.2 0.1 0.5 

¥1.9 5.4 

Rural unit .................................................................. 169 34,664 

¥1.3 3.1 3.6 1.7 1.2 

¥0.1 

¥0.9 

¥1.9 5.5 

Urban hospital .......................................................... 196 158,968 0.2 0.5 3.6 

¥1.7 

¥0.1 

¥0.1 

¥0.5 

¥1.9 0.0 

Rural hospital ............................................................ 21 6,877 

¥1.6 7.0 3.6 

¥0.7 1.3 0.0 

¥1.0 

¥1.9 6.5 

Urban For-Profit ........................................................ 295 154,526 0.4 0.7 3.6 

¥1.8 0.0 0.0 

¥0.8 

¥1.9 0.0 

Rural For-Profit ......................................................... 59 11,952 

¥1.9 3.8 3.6 0.2 1.3 0.2 

¥1.0 

¥1.9 4.2 

Urban Non-Profit ....................................................... 603 237,384 0.0 2.1 3.6 1.0 

¥0.2 0.0 0.5 

¥1.9 5.0 

Rural Non-Profit ........................................................ 105 23,793 

¥1.0 4.1 3.6 1.7 1.2 

¥0.3 

¥0.8 

¥1.9 6.7 

Urban Government ................................................... 100 28,287 

¥0.2 2.5 3.6 0.5 

¥0.1 0.5 1.7 

¥1.9 6.7 

Rural Government .................................................... 26 5,796 

¥1.5 2.6 3.6 1.4 1.2 0.3 

¥1.0 

¥1.9 4.8 

Urban ........................................................................ 998 420,197 0.1 1.6 3.6 

¥0.1 

¥0.1 0.0 0.1 

¥1.9 3.2 

Rural ......................................................................... 190 41,541 

¥1.4 3.8 3.6 1.2 1.3 

¥0.1 

¥0.9 

¥1.9 5.6 

Urban by region: 

New England ..................................................... 35 20,612 

¥0.3 1.7 3.6 

¥0.7 

¥0.4 

¥0.3 

¥0.6 

¥1.9 1.1 

Middle Atlantic ................................................... 156 76,962 

¥0.4 2.0 3.6 1.1 

¥0.3 0.0 1.6 

¥1.9 5.7 

South Atlantic .................................................... 124 73,677 0.4 0.6 3.6 

¥0.5 0.2 0.0 

¥0.3 

¥1.9 2.0 

East North Central ............................................. 189 69,315 0.1 2.3 3.6 1.2 

¥0.3 

¥0.2 0.1 

¥1.9 4.9 

East South Central ............................................ 54 30,473 0.2 0.0 3.6 

¥1.4 0.4 0.1 

¥0.5 

¥1.9 0.5 

West North Central ............................................ 71 22,217 

¥0.1 2.1 3.6 0.6 

¥0.2 

¥0.1 0.1 

¥1.9 4.2 

West South Central ........................................... 184 76,088 0.5 1.8 3.6 

¥0.7 

¥0.2 

¥0.1 

¥0.5 

¥1.9 2.3 

Mountain ............................................................ 69 24,287 

¥0.2 1.2 3.6 

¥2.2 

¥0.1 

¥0.1 

¥0.5 

¥1.9 

¥0.3 

Pacific ................................................................ 116 26,566 0.8 2.2 3.6 

¥0.8 

¥0.3 1.1 0.0 

¥1.9 4.7 

Rural by region: 

New England ..................................................... 4 924 0.4 2.1 3.6 1.7 1.2 

¥0.4 

¥0.9 

¥1.9 5.9 

Middle Atlantic ................................................... 19 5,377 

¥1.1 8.2 3.6 1.5 1.3 

¥0.4 

¥1.0 

¥1.9 10.3 

South Atlantic .................................................... 22 5,440 

¥1.0 2.5 3.6 1.2 1.3 0.1 

¥1.0 

¥1.9 4.7 

East North Central ............................................. 28 5,618 

¥1.0 3.0 3.6 1.9 1.2 

¥0.4 

¥0.9 

¥1.9 5.4 

East South Central ............................................ 20 5,362 

¥1.9 2.2 3.6 1.1 1.3 0.3 

¥0.7 

¥1.9 3.8 

West North Central ............................................ 30 5,351 

¥1.3 2.3 3.6 2.7 1.2 

¥0.2 

¥0.6 

¥1.9 5.8 

West South Central ........................................... 54 12,016 

¥1.7 4.3 3.6 0.3 1.3 0.1 

¥1.0 

¥1.9 4.9 

Mountain ............................................................ 9 902 

¥3.2 9.4 3.6 2.6 1.1 

¥0.4 

¥0.9 

¥1.9 10.2 

Pacific ................................................................ 4 551 0.9 2.8 3.6 

¥2.7 1.1 

¥0.8 

¥0.8 

¥1.9 2.0 

Teaching Status: 

Non-teaching ..................................................... 1,053 400,072 0.0 1.6 3.6 

¥0.1 0.1 

¥0.1 

¥0.9 

¥1.9 2.2 

Resident to ADC less than 10 .......................... 71 39,888 0.3 2.5 3.6 0.3 

¥0.3 0.2 2.2 

¥1.9 7.0 

Resident to ADC 10–19 .................................... 42 17,793 

¥0.9 2.8 3.6 0.4 

¥0.3 1.1 9.1 

¥1.9 14.2 

Resident to ADC greater than 19 ..................... 22 3,985 

¥0.1 4.1 3.6 0.0 

¥0.3 1.1 19.5 

¥1.9 27.4 

Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 57173 

37. On page 47948, in the third 

column, second full paragraph, line 12, 

‘‘$207’’ is corrected to read ‘‘$1,322’’. 

38. On page 47948, in the third 

column, second full paragraph, line 13, 

‘‘$3,070’’ is corrected to read ‘‘$2,887’’. 

39. On page 47948, in the third 

column, second full paragraph, line 14, 

‘‘$1,472’’ is corrected to read ‘‘$1,986’’. 

40. On page 47948, in the third 

column, third full paragraph, line 5, ‘‘5’’

is corrected to read ‘‘4’’. This was a 

typographical error. 

41. On page 47949, in the first 

column, in the first line of the column, 

‘‘$9’’ is corrected to read ‘‘$55’’. 

42. On page 47949, in the first 

column, in the second line of the 

column, ‘‘$380’’ is corrected to read 

‘‘$324’’. 

43. On page 47949, in the first 

column, line 8, ‘‘$32’’ is corrected to 

read ‘‘$81’’. 

44. On page 47949, in the first 

column, in the eighth line of the 

column, ‘‘$1,167’’ is corrected to read 

‘‘$1,207’’. 

45. On page 47949, in the first 

column, in the ninth line of the column, 

‘‘$426’’ is corrected to read ‘‘$512’’. 

46. On page 47949, in the first 

column, in the first paragraph under 

section heading number 7, line 5, 

‘‘$5,132’’ is corrected to read ‘‘$5,129’’. 

47. On page 47949, in the third 

column, in the last sentence of the first 

full paragraph, ‘‘1.4 percent estimated 

increase among all rural IRFs in the 

Middle Atlantic region’’ is corrected to 

read ‘‘1.3 percent estimated increase 

among all rural IRFs.’’ When we reran 

the data analysis with the correct 

portion of the rural adjustment applied 

to payments for the four IRFs described 

above, some of the numbers in Table 13 

changed slightly. These changes to some 

of the numbers in Table 13 were 

technical changes, primarily due to 

rounding. However, one of the technical 

changes in column 8 of Table 13 for 

rural IRFs in the Middle Atlantic region 

(from 1.4 percent to 1.3 percent) 

requires a conforming technical change 

to the text that explains Table 13. 

Previously, when rural IRFs in the 

Middle Atlantic region were projected 

to experience a 1.4 percent increase in 

payments for FY 2006 due to the rural 

adjustment policy for FY 2006, this 

group of IRFs was projected to receive 

the largest payment increase due to the 

rural adjustment policy for FY 2006. 

However, after we reran the numbers, 

rural IRFs in the Middle Atlantic region 

were projected to experience roughly 

the same estimated impact of the final 

rural policies as all other rural IRFs (1.3 

percent). Thus, it is no longer accurate 

to describe rural IRFs in the Middle 

Atlantic region as having a larger 

projected increase in payments for FY 

2006 than all other rural IRFs. At 1.3 

percent, all rural IRFs (including rural 

IRFs in the Middle Atlantic region) now 

have the largest estimated increase in 

payments for FY 2006. Thus, we are 

making the conforming change to the 

text that describes Table 13. 

48. On page 47949, in the third 

column, in the last sentence of the first 

full paragraph, ‘‘0.3 percent estimated 

decrease among urban facilities in the 

New England, West South Central, and 

Pacific regions, and among all categories 

of teaching facilities’’ is corrected to 

read ‘‘0.4 percent estimated decrease 

among urban facilities in the New 

England region.’’ When we reran the 

data analysis with the correct portion of 

the rural adjustment applied to 

payments for the four IRFs described 

above, some of the numbers in Table 13 

changed slightly. These changes to some 

of the numbers in Table 13 were 

technical changes, primarily due to 

rounding. However, one of the technical 

changes in column 8 of Table 13 for 

urban IRFs in the New England region 

(from ¥0.3 percent to ¥0.4 percent) 

requires a conforming technical change 

to the text that describes Table 13. The 

change from ¥0.3 percent to ¥0.4 

percent means that urban IRFs in the 

New England region are now projected 

to experience a slightly greater decrease 

in payments than the other categories of 

urban IRFs listed previously whose 

estimated impacts in column 8 

remained at ¥0.3 percent (that is, urban 

IRFs in the West South Central and 

Pacific regions and all categories of 

teaching IRFs). Thus, it is no longer 

accurate to describe urban IRFs in the 

West South Central and Pacific regions 

and all categories of teaching IRFs as 

experiencing the largest estimated 

decreases in payments due to the rural 

adjustment. At ¥0.4 percent, urban 

IRFs in the New England region now 

have a slightly larger estimated decrease 

in payments for FY 2006 than the other 

groups listed. Thus, we are making the 

conforming change to the text that 

describes Table 13. 

49. On page 47952, in the first 

column, in the first paragraph under 

section heading number 14, line 9, ‘‘5.7’’

is corrected to read ‘‘5.6’’. 

50. On page 47952, in the first 

column, in the first paragraph under 

section heading number 14, line 11, 

‘‘5.3’’ is corrected to read ‘‘5.4’’. 

51. On page 47952, in the first 

column, in the second paragraph under 

section heading number 14, line 5, 

‘‘14.3’’ is corrected to read ‘‘14.2’’. 

52. On page 47952, in the second 

column, in the ninth line of the column, 

‘‘0.2’’ is corrected to read ‘‘0.3’’. 

53. On page 47954, in the column 

titled ‘‘2006 CBSA-based WI’’ of SSA 

Code 01090, ‘‘.7628’’ is corrected to read 

‘‘0.7628’’. This was a typesetting error. 

54. On page 47954, in the column 

titled ‘‘MSA No.’’ of SSA Code 01390, 

‘‘21030’’ is corrected to read ‘‘2030’’. 

This was a typesetting error. 

55. On page 47960, in the column 

titled ‘‘CBSA No.’’ of SSA Code 11110, 

‘‘5260’’ is corrected to read ‘‘15260’’. 

This was a typesetting error. 

56. On page 47961, in the column 

titled ‘‘CBSA No.’’ of SSA Code 11703, 

‘‘5260’’ is corrected to read ‘‘15260’’. 

This was a typesetting error. 

57. On page 47964, in the column 

titled ‘‘MSA No.’’ of SSA Code 15140, 

‘‘11640’’ is corrected to read ‘‘1640’’. 

This was a typesetting error. 

58. On page 47964, in the column 

titled ‘‘CBSA No.’’ of SSA Code 15310, 

‘‘0126900’’ is corrected to read ‘‘26900’’. 

This was a typesetting error. 

59. On page 47968, in the column 

titled ‘‘MSA No.’’ of SSA Code 18090, 

‘‘13400’’ is corrected to read ‘‘3400’’. 

This was a typesetting error. 

60. On page 47972, in the column 

titled ‘‘CBSA No.’’ of SSA Code 23380, 

‘‘2820’’ is corrected to read ‘‘28020’’. 

This was a typesetting error. 

61. On page 47982, in the column 

titled ‘‘MSA No.’’ of SSA Code 34400, 

‘‘13120’’ is corrected to read ‘‘3120’’. 

This was a typesetting error. 

62. On page 47992, in the column 

titled ‘‘CBSA No.’’ of SSA Code 44740, 

‘‘4980’’ is corrected to read ‘‘34980’’. 

This was a typesetting error. 

63. On page 47992, in the column 

titled ‘‘CBSA No.’’ of SSA Code 45221, 

‘‘7780’’ is corrected to read ‘‘17780’’. 

This was a typesetting error. 

64. On page 48000, in the column 

titled ‘‘CBSA No.’’ of SSA Code 52460, 

‘‘133460’’ is corrected to read ‘‘33460’’. 

This was a typesetting error. 

III. Waiver of Proposed Rulemaking 

and Delayed 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 

notice take effect in accordance with 

section 553(b) of the Administrative 

Procedure Act (APA) (5 U.S.C. 553(b)). 

We also ordinarily provide a 30-day 

delay in the effective date of the 

provisions of a notice in accordance 

with section 553(d) of the APA (5 U.S.C. 

553(d)). However, we can waive both 

the notice and comment procedure and 

the 30-day delay in effective date if the 

Secretary finds, for good cause, that 

57174 Federal Register / Vol. 70, No. 189 / Friday, September 30, 2005 / Rules and Regulations 

notice and comment process is 

impracticable, unnecessary, or contrary 

to the public interest and incorporates a 

statement of the finding and the reasons 

for it into the notice issued. 

The policies and payment 

methodology expressed in the FY 2006 

final rule (70 FR 47880) have previously 

been subjected to notice and comment 

procedures. This correction notice 

merely provides technical corrections to 

the FY 2006 final rule that was 

promulgated through notice and 

comment rulemaking, and does not 

make substantive changes to the policies 

or payment methodology that were 

expressed in the final rule. For example, 

this notice corrects typographical errors 

and typesetting errors, revises 

inaccurate tabular data due to 

inadvertently neglecting to apply any 

rural adjustment amount to estimated 

payments for four IRFs in conformance 

with the hold harmless policy, updates 

the narrative to reflect the correct 

tabular data, corrects some estimated 

dollar impacts due to inadvertently 

computing the estimates using the 

incorrect standard payment conversion 

factor, and makes clarifications to the 

preamble text. Therefore, we find it 

unnecessary to undertake further notice 

and comment procedures with respect 

to this correction notice. We also believe 

it is in the public interest to waive 

notice and comment procedures and the 

30-day delay in effective date for this 

notice. This correction notice is 

intended to ensure that the FY 2006 

final rule accurately reflects the policies 

expressed in the final rule, and that the 

correct information is made available to 

the public prior to October 1, 2005, the 

date on which the final rule becomes 

effective. 

For the reasons stated above, we find 

that both notice and comment and the 

30-day delay in effective date for this 

correction notice are unnecessary and 

impracticable, and that it is in the 

public interest to make this notice 

effective in conjunction with the final 

rule to which the corrections apply (and 

would be contrary to the public interest 

to do otherwise). Therefore, we find 

good cause to waive notice and 

comment procedures and the 30-day 

delay in effective date for this correction 

notice. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: September 27, 2005. 

Ann C. Agnew, 

Executive Secretary to the Department. 

[FR Doc. 05–19610 Filed 9–29–05; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 418 

[CMS–1286–CN] 

RIN 0938–AN89 

Medicare Program; Hospice Wage 

Index for Fiscal Year 2006 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule, correction. 

SUMMARY: This document corrects 

technical errors that appeared in the 

final rule published in the Federal 

Register on August 4, 2005, entitled 

‘‘Hospice Wage Index for Fiscal Year 

2006.’’ This document is effective on 

October 1, 2005, the effective date of the 

provisions of the final rule. 

EFFECTIVE DATE: This notice is effective 

on October 1, 2005. 

FOR FURTHER INFORMATION CONTACT: 

Terri Deutsch, (410) 786–9462. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Federal Register Doc. 05–15290 of 

August 4, 2005 (70 FR 45130), entitled 

‘‘Hospice Wage Index for Fiscal Year 

2006,’’ includes errors that are 

identified and corrected in the 

‘‘Correction of Errors’’ section below. 

The errors in this correcting notice are 

effective as if they had been included in 

the document published on August 4, 

2005. Accordingly, the corrections are 

effective on October 1, 2005, the 

effective date of the provisions of the 

August 4, 2005 final rule. 

II. Summary of the Corrections to the 

August 4, 2005 Final Rule 

In the August 4, 2005 final rule, on 

pages 45146 through 45167, we 

published an Addendum. In Table A of 

the addendum, we published the 

updated urban and rural wage index 

values for hospices utilizing the CoreBased Statistical Areas (CBSA) 

designations. To ensure that hospice 

providers were able to identify their 

current wage index, Table A contains 

the CBSA code, CBSA wage index, 

CBSA county name, and the current 

MSA designation. There are 

typographical errors in the wage indexes 

listed in the table that were as a result 

of formatting the columns. In addition, 

in several sections throughout the table 

(that is, for the CBSA county names 

located in the urban areas of 

Gainesville, FL; Newark Union, NJ–PA; 

Waterloo-Cedar Falls, LA; and 

Wilmington, DE–MD–NJ), we 

inadvertently omitted the asterisk that 

corresponds to the footnotes that appear 

at the end of the table. 

This correction notice is consistent 

with the published hospice wage index 

values that will be used to make 

payment as of October 1, 2005. In 

section III of this notice, we provide a 

description of the errors and the 

changes being made to correct the 

errors. Thus, for clarity, we will 

republish only the section of the table 

that contains errors. 

III. Correction of Errors 

■ In Federal Register Doc. 05–15290 of 

August 4, 2005 (70 FR 45130), we are 

making the following corrections to 

Table A—Hospice Wage Index for Urban 

Areas by CBSA: 

§ 418.304 [Corrected] 

■ 1. On page 45146, in the third column, 

in lines 15 and 16, for CBSA code 

10420, indent the CBSA county name 

for ‘‘Portage, OH’’ and ‘‘Summit, OH’’ to 

follow the format of the table. 

The CBSA code for 10420 should read 

as follows: 

CBSA 

code 

Wage 

Index 1 Urban area (constituent counties or county equivalents) 2 MSA code 

10420 ..... 0.9604 Akron, OH .......................................................................................................................................................

Portage, OH 

Summit, OH 

0080 

■ 2. On page 45150, in the third column, 

in lines 25 through 27, for CBSA code 

17420, move the CBSA county name for 

‘‘Cleveland, TN’’ to line-up with the 

column and indent the CBSA county