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 Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 411, 412, 413, and 489
[CMS-1533-CN3]
RIN 0938-A070
 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
 ACTION: Correction of final rule with comment period.
 SUMMARY: This document corrects wage index, case-mix index, and geographic adjustment factor errors in the final rule with comment period that appeared in the August 22, 2007 
                        **Federal Register**
                         entitled “Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates Final Rule”; and the correction notice that appeared in the October 10, 2007 
                        **Federal Register**
                         entitled “Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction”.
 DATES: *Effective Date:*
                         October 1, 2007.
 FOR FURTHER INFORMATION CONTACT: Miechal Lefkowitz, (410) 786-5316. Valerie Miller, (410) 786-4535.


SUPPLEMENTARY INFORMATION: I. Background In FR Doc 07-3820 of August 22, 2007 (72 FR 47130) and in FR Doc. 07-4875 of October 10, 2007 (72 FR 57634), there were a number of technical and typographical errors that are identified and corrected in the Correction of Errors section of this notice. We issued the fiscal year (FY) 2008 hospital inpatient prospective payment systems (IPPS) final rule with comment period on August 1, 2007. The FY 2008 IPPS final rule with comment period appeared in the August 22, 2007 
                    **Federal Register**
                    , hereinafter referred to as the FY 2008 IPPS final rule with comment period. We issued a correction notice for the FY 2008 IPPS final rule with comment period on September 28, 2007. The correction notice appeared in the October 10, 2007 
                    **Federal Register**
                     hereinafter referred to as the second FY 2008 IPPS correction notice. The provisions in this correction notice are effective as if they had been included in the FY 2008 IPPS final rule with comment period. Accordingly, the corrections are effective October 1, 2007. II. Summary of Errors We recently discovered a small number of inadvertent technical or typographical errors. Therefore, this notice corrects the errors that appeared in the FY 2008 IPPS final rule with comment period and the second FY 2008 IPPS correction notice. In the second FY 2008 IPPS correction notice (72 FR 57637), there were typographical errors in some of the case mix indices listed in Table 2. The case mix index (CMI) values for some of the providers listed in Table 2 of that correction notice were intended to be the same as the CMI values in Table 2 of the FY 2008 IPPS final rule with comment period. However, there was an inadvertent typographical error that resulted in the CMI values for certain providers being displayed on the wrong line. Therefore, in this notice, we are correcting some of the entries in Table 2 to reflect the proper CMI values for these providers. Table 2 also contained errors in wage indices for providers 140B10 and 220074. Each hospital is a part of a multicampus hospital, and each hospital is reclassified to the labor market area where other hospitals associated with its provider number are located. We note that these hospitals were properly assigned the reclassified wage index in the FY 2008 IPPS final rule with comment period. However, in the second FY 2008 IPPS correction notice, Table 2 inadvertently listed each hospital's geographic area wage index rather than the hospital's reclassified wage index. Provider 140B10 was mistakenly assigned 1.0583, the area wage index for Lake County-Kenosha County, IL-WA (CBSA 29404). Therefore, in section III. item 1 of this notice (correction of Table 2), the wage index for provider 140B10 is corrected to 1.0472, the reclassified wage index for Chicago-Naperville-Joliet, IL (CBSA 16974). In addition, provider 220074 was mistakenly assigned 1.0533, the area wage index value for Providence-New Bedford-Fall River, RI-MA (CBSA 39300). Therefore, in section III. item 1 of this notice (correction of Table 2), the wage index for provider 220074 is corrected to 1.1304, the reclassified wage index for Boston-Quincy, MA (CBSA 14484). In Tables 2, 4A, and 4C of the FY 2008 IPPS final rule with comment period and the second FY 2008 IPPS correction notice, there was also an inadvertent error in the wage index calculation for two core-based statistical areas (CBSAs). In calculating the wage indices in the FY 2008 IPPS final rule with comment period, a provider was inadvertently included in CBSA 16180 Carson City, NV, when it is actually geographically located in CBSA 39900 Reno-Sparks, NV. The effect of this change is that the wage indices for the eight providers in these two CBSAs will change. Therefore, in section III. of this notice, we are correcting the wage indices for these providers in these two CBSAs in Tables 2, 4A, and 4C. We note that wage index corrections may be retroactive to the beginning of the Federal fiscal year if the requirements specified in § 412.64(k)(2)(ii) are met. The requirements in § 412.64(k)(2)(ii) are as follows: (1) The fiscal intermediary or Medicare Administrative Contractor (FI/MAC) or CMS made an error in tabulating data used for the wage index calculation; (2) the hospital knew about the error in its wage data and requested the FI/MAC and CMS to correct the error both within the established schedule for making corrections to the wage data (which is at least before the beginning of the fiscal year for the applicable update to the hospital inpatient prospective payment system) and using the established process; and (3) CMS agreed before October 1 that the FI/MAC or CMS made an error in tabulating the hospital's wage data and the wage index should be corrected. Since the wage indices errors that are corrected in this notice meet the requirements specified in § 412.64 of our regulations, these corrections are effective October 1, 2007. Table 4C of the second FY 2008 IPPS correction notice also contained typographical errors in the geographic adjustment factor (GAF) for two CBSAs, CBSA 13820 (Birmingham-Hoover, AL) and CBSA 26620 (Huntsville, AL). Therefore, in this notice, we are correcting the GAFs for these CBSAs. We note that the wage indices for these CBSAs were correct in the second FY 2008 IPPS correction notice and are included in this notice to provide the reader with the wage indices and along with the corrected GAFs. III. Correction of Errors In FR Doc. 07-4875 of October 10, 2007 (72 FR 57634), make the following corrections: 
                    ( print page 62586) 1. On pages 57637 through 57698, in Table 2— Hospital Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2006; Hospital Wage Indexes for Federal Fiscal Year 2008; Hospital Average Hourly Wages for Federal Fiscal Years 2006 (2002 Wage Data), 2007 (2003 Wage Data), and 2008 (2004 Wage Data); and 3-Year Average of Hospital Average Hourly Wages, the listed entries are corrected to read as follows: Table 2.—Hospital Case-Mix Indexes for Discharges Occuring in Federal Fiscal Year 2006; Hospital Wage Indexes for Federal Fiscal Year 2008; Hospital Average Hourly Wages for Federal Fiscal Years 2006 (2002 Wage Data), 2007 (2003 Wage Data), and 2008 (2004 Wage Data); and 3-Year Average of Hospital Average Hourly Wages
Provider No.
Case-mix index
FY 2008 wage index
Average hourly wage FY 2006
Average hourly wage FY 2007
Average hourly wage FY 2008
Average hourly wage (3 years)140001
1.1034
0.8715
22.3170
22.3001
22.2003
22.2726140002
1.3394
0.8983
24.6954
27.0165
27.4779
26.4101140007
1.3523
1.0588
28.3482
30.7378
31.4024
30.1866140008
1.4485
1.0588
28.5297
29.1767
31.8008
29.7872140B10 3

1.0472
35.1024
31.8806
40.1360
35.1264220001
1.1993
1.1355
29.0014
30.6070
31.2316
30.2898220002
1.3836
1.1488
30.3598
32.4356
33.6649
32.2137220003
1.1827

22.0549


22.0549220006


30.8599
30.7673
33.6438
31.7232220008
1.2814
1.1304
30.1043
31.3385
34.7924
32.1143220010
1.2471
1.1304
29.7998
30.7804
32.0925
30.8934220011
1.1289
1.1488
34.4064
34.7655
36.5640
35.2410220012
1.5403
1.2612
35.7872
37.8763
39.7564
37.8806220015
1.1909
1.0451
28.3397
29.6315
32.4903
30.2089220016
1.1221
1.0451
28.0608
30.4813
32.5863
30.3587220017
1.2751
1.1844
29.7108
31.6170
33.3020
31.5466220019
1.0840
1.1355
23.2544
24.4009
25.7855
24.4947220020
1.2035
1.1304
26.5305
28.5288
30.8458
28.6772220024
1.2983
1.0451
27.3488
28.7342
31.9491
29.2912220025
1.0403
1.1355
23.0637
25.6478
30.4369
26.1069220028


32.0980
31.7122
39.3089
34.1922220029
1.1319
1.1304
28.6970
30.6935
31.6363
30.3492220030
1.1315
1.0451
24.4289
26.8849
28.1347
26.5400220031
1.6670
1.1844
34.8183
36.8477
38.9433
36.9174220033
1.2129
1.1304
28.2539
31.8249
32.3495
30.8022220035
1.4179
1.1304
28.6238
31.4470
34.8739
32.8577220036
1.5119
1.1844
31.5184
33.1436
35.9124
33.5798220046
1.4766
1.0053
28.1396
30.4460
31.4510
30.0573220049
1.2148
1.1488
27.7518
30.4740
32.4652
30.2584220050
1.0817
1.0451
26.3768
28.3434
29.5194
28.1065220051
1.3058
0.9706
29.8380
30.2552
30.1022
30.0683220052
1.1342
1.1844
29.8577
32.4130
32.3532
31.5202220058
0.9584
1.1355
24.9642
25.7247
27.8893
26.1881220060
1.1735
1.1844
32.3362
32.5477
34.7336
33.2260220062
0.5718
1.1355
24.2779
25.0766
25.4224
24.9426220063
1.2551
1.1488
27.3968
30.2866
32.9283
30.2274220065
1.2422
1.0451
26.5513
27.6009
30.1103
28.0583220066
1.3440
1.0451
27.1317
27.8073
29.9736
28.3106220067
1.1846
1.1844
29.8911
30.2222
32.4019
30.8648220070
1.1331
1.1488
31.9283
33.1299
34.2598
33.1439220071
1.8639
1.1844
32.2936
36.5065
37.4087
35.4748220073
1.1778
1.1304
31.3566
34.2989
36.0289
33.8953220074

1.1304
28.4930
30.5607
31.4730
30.1564290001
1.8514
1.0836
31.1981
36.3129
35.5113
34.2992290002
0.9058
0.9704
18.3469
17.3876
23.9348
19.4284290006
1.1835
1.0680
27.9501
31.7301
31.9838
30.5940290009
1.7155
1.0836
29.8019
36.2724
32.3348
32.7010290019
1.4106
1.0680
28.6158
29.3650
30.5964
29.5670290032
1.4261
1.0836
31.7105
31.6711
34.6589
32.6749290049
1.3649
1.0836


26.0725
26.0725290051
1.6073
0.98653
                         This provider, 140B10, is part of a multi-campus provider, 140010, that is comprised of campuses that are located in two different CBSAs. For the FY 2008 wage index, a new provider record was created, designated with a “B” in the 4th position of the provider number, to distinguish between the portion of the wages and hours of the multi-campus facility that is being allocated between the two different CBSAs. Please refer to the FY 2008 final rule, section III.H.I.7 “Geographic Reclassification for Multi-campus Hospitals,” for more details on this provision.
 2. On pages 57698 through 57721, in Table 4A—Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA—FY 2008, the listed entries are corrected to read as follows: 
                    ( print page 62587) Table 4A.—Wage Index and Capital Geographic Adjustment Factor (GAF)
for Urban Areas by CBSA—FY 2008
CBSA code
Urban area (constituent counties)
Wage index
GAF16180
Carson City, NV2
                              
                             Carson City, NV.
0.9865
0.990739900
Reno-Sparks, NV 
                             Storey County, NV. 
                             Washoe County, NV.
1.0836
1.05652
                         Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2008. New Jersey floor is imputed as discussed in the FY 2005 IPPS final rule (69 FR 49109) and in section III.G.2 of the preamble in this final rule.
 3. On pages 57722 through 57726, in Table 4C—Wage Index and Capital Geographic Adjustment (GAF) for Hospitals that are Reclassified by CBSA, the listed entries are corrected to read as follows: Table 4C.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Hospitals That Are Reclassified by CBSA—FY 2008
CBSA code
Area
Wage index
GAF13820
Birmingham-Hoover, AL
0.8690
0.908316180
Carson City, NV
0.9704
0.979626620
Huntsville, AL
0.8725
0.910839900
Reno-Sparks, NV
1.0680
1.0461
 IV. Waiver of Proposed Rulemaking and the 30-Day Delay in the 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. For reasons noted below, we find good cause to waive proposed rulemaking and the 30-day delayed effective date for the technical corrections in this notice. This notice merely corrects typographical and technical errors in the addendum of the FY 2008 IPPS final rule with comment period and the second FY 2008 IPPS correction notice and does not make substantive changes to the policies or payment methodologies that were adopted in the final rule with comment period. As a result, this notice is intended to ensure that the FY 2008 IPPS final rule with comment period accurately reflects the policies adopted in the FY 2008 IPPS final rule with comment period. Therefore, we find that undertaking further notice and comment procedures to incorporate these corrections into the final rule or delaying the effective date of these changes is unnecessary and contrary to the public interest. (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: October 31, 2007. Ann C. Agnew, Executive Secretary to the Department.


[FR Doc. 07-5513 Filed 11-1-07; 10:12 am] BILLING CODE 4120-01-P