[Federal Register Volume 72, Number 214 (Tuesday, November 6, 2007)]
[Rules and Regulations]
[Pages 62585-62587]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-5513]


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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


Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems and Fiscal Year 2008 Rates; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Correction of final rule with comment period.

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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 Sec.  412.64(k)(2)(ii) are met. The 
requirements in Sec.  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 Sec.  
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:

[[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
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  FY 2008 wage     Average hourly    Average hourly    Average hourly    Average hourly
                Provider No.                   Case-mix index         index         wage FY 2006      wage FY 2007      wage FY 2008     wage (3 years)
--------------------------------------------------------------------------------------------------------------------------------------------------------
140001......................................            1.1034            0.8715           22.3170           22.3001           22.2003           22.2726
140002......................................            1.3394            0.8983           24.6954           27.0165           27.4779           26.4101
140007......................................            1.3523            1.0588           28.3482           30.7378           31.4024           30.1866
140008......................................            1.4485            1.0588           28.5297           29.1767           31.8008           29.7872
140B10 \3\..................................  ................            1.0472           35.1024           31.8806           40.1360           35.1264
220001......................................            1.1993            1.1355           29.0014           30.6070           31.2316           30.2898
220002......................................            1.3836            1.1488           30.3598           32.4356           33.6649           32.2137
220003......................................            1.1827  ................           22.0549  ................  ................           22.0549
220006......................................  ................  ................           30.8599           30.7673           33.6438           31.7232
220008......................................            1.2814            1.1304           30.1043           31.3385           34.7924           32.1143
220010......................................            1.2471            1.1304           29.7998           30.7804           32.0925           30.8934
220011......................................            1.1289            1.1488           34.4064           34.7655           36.5640           35.2410
220012......................................            1.5403            1.2612           35.7872           37.8763           39.7564           37.8806
220015......................................            1.1909            1.0451           28.3397           29.6315           32.4903           30.2089
220016......................................            1.1221            1.0451           28.0608           30.4813           32.5863           30.3587
220017......................................            1.2751            1.1844           29.7108           31.6170           33.3020           31.5466
220019......................................            1.0840            1.1355           23.2544           24.4009           25.7855           24.4947
220020......................................            1.2035            1.1304           26.5305           28.5288           30.8458           28.6772
220024......................................            1.2983            1.0451           27.3488           28.7342           31.9491           29.2912
220025......................................            1.0403            1.1355           23.0637           25.6478           30.4369           26.1069
220028......................................  ................  ................           32.0980           31.7122           39.3089           34.1922
220029......................................            1.1319            1.1304           28.6970           30.6935           31.6363           30.3492
220030......................................            1.1315            1.0451           24.4289           26.8849           28.1347           26.5400
220031......................................            1.6670            1.1844           34.8183           36.8477           38.9433           36.9174
220033......................................            1.2129            1.1304           28.2539           31.8249           32.3495           30.8022
220035......................................            1.4179            1.1304           28.6238           31.4470           34.8739           32.8577
220036......................................            1.5119            1.1844           31.5184           33.1436           35.9124           33.5798
220046......................................            1.4766            1.0053           28.1396           30.4460           31.4510           30.0573
220049......................................            1.2148            1.1488           27.7518           30.4740           32.4652           30.2584
220050......................................            1.0817            1.0451           26.3768           28.3434           29.5194           28.1065
220051......................................            1.3058            0.9706           29.8380           30.2552           30.1022           30.0683
220052......................................            1.1342            1.1844           29.8577           32.4130           32.3532           31.5202
220058......................................            0.9584            1.1355           24.9642           25.7247           27.8893           26.1881
220060......................................            1.1735            1.1844           32.3362           32.5477           34.7336           33.2260
220062......................................            0.5718            1.1355           24.2779           25.0766           25.4224           24.9426
220063......................................            1.2551            1.1488           27.3968           30.2866           32.9283           30.2274
220065......................................            1.2422            1.0451           26.5513           27.6009           30.1103           28.0583
220066......................................            1.3440            1.0451           27.1317           27.8073           29.9736           28.3106
220067......................................            1.1846            1.1844           29.8911           30.2222           32.4019           30.8648
220070......................................            1.1331            1.1488           31.9283           33.1299           34.2598           33.1439
220071......................................            1.8639            1.1844           32.2936           36.5065           37.4087           35.4748
220073......................................            1.1778            1.1304           31.3566           34.2989           36.0289           33.8953
220074......................................  ................            1.1304           28.4930           30.5607           31.4730           30.1564
290001......................................            1.8514            1.0836           31.1981           36.3129           35.5113           34.2992
290002......................................            0.9058            0.9704           18.3469           17.3876           23.9348           19.4284
290006......................................            1.1835            1.0680           27.9501           31.7301           31.9838           30.5940
290009......................................            1.7155            1.0836           29.8019           36.2724           32.3348           32.7010
290019......................................            1.4106            1.0680           28.6158           29.3650           30.5964           29.5670
290032......................................            1.4261            1.0836           31.7105           31.6711           34.6589           32.6749
290049......................................            1.3649            1.0836  ................  ................           26.0725           26.0725
290051......................................            1.6073            0.9865  ................  ................  ................  ................
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\3\ 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:

[[Page 62587]]



  Table 4A.--Wage Index and Capital Geographic Adjustment Factor (GAF)
                    for Urban Areas by CBSA--FY 2008
------------------------------------------------------------------------
                                   Urban area
          CBSA code               (constituent         Wage       GAF
                                    counties)         index
------------------------------------------------------------------------
16180.......................  Carson City, NV\2\..     0.9865     0.9907
                              Carson City, NV.....
39900.......................  Reno-Sparks, NV.....     1.0836    1.0565
                              Storey County, NV...
                              Washoe County, NV...
------------------------------------------------------------------------
\2\ 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
------------------------------------------------------------------------
                                                       Wage
          CBSA code                   Area            index       GAF
------------------------------------------------------------------------
13820.......................  Birmingham-Hoover,       0.8690     0.9083
                               AL.
16180.......................  Carson City, NV.....     0.9704     0.9796
26620.......................  Huntsville, AL......     0.8725     0.9108
39900.......................  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