[Federal Register Volume 61, Number 19 (Monday, January 29, 1996)]
[Rules and Regulations]
[Pages 2725-2727]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-1532]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 412 and 413

[BPD-825-FCN]
RIN 0938-AG95


Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems and Fiscal Year 1996 Rates; Corrections

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Correction to final rule.

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SUMMARY: In the September 1, 1995, issue of the Federal Register (60 FR 
45778), we published a final rule with comment period revising the 
Medicare hospital inpatient prospective payment systems for operating 
costs and capital-related costs to implement necessary changes arising 
from our continuing experience with the system. In the addendum to that 
final rule with comment period, we announced the prospective payment 
rates for Medicare hospital inpatient services for operating costs and 
capital-related costs applicable to discharges occurring on or after 
October 1, 1995, and set forth update factors for the rate-of-increase 
limits for hospitals and hospital units excluded from the prospective 
payment systems. This document corrects errors made in that document.

EFFECTIVE DATE: October 1, 1995.

FOR FURTHER INFORMATION CONTACT: Stephen Phillips (410) 786-4548.

SUPPLEMENTARY INFORMATION: In the September 1, 1995, final rule with 
comment period (60 FR 45778), we indicated that if a hospital believes 
its wage index value is incorrect as a result of an intermediary or 
HCFA error that the hospital could not have known about before 
reviewing data made available in mid-August, the hospital must notify 
the intermediary and HCFA in writing, to be received no later than 
September 21, 1995 (see 60 FR 45794). As a result of this process, we 
have identified several corrections to the wage data. Accordingly, the 
wage index values for several areas have changed and are corrected in 
this notice.
    The final rule with comment period also contained other technical 
and typographical errors. In particular, we inadvertently failed to 
correct a technical error in Sec. 412.105(d), which now indicates that 
the current method for determining the education adjustment factor for 
hospitals that incur indirect costs for graduate medical education 
(IME) programs is effective only for discharges occurring before 
October 1, 1995. Since section 4002(b)(3) of the Omnibus Budget 
Reconciliation Act of 1990 amended section 1886(d)(5)(B)(ii) of the 
Social Security Act to eliminate the requirement that the current 
method for calculating the IME adjustment was to expire as of October 
1, 1995, we needed to delete the incorrect reference to the October 1, 
1995, expiration date in our September 1, 1995, final rule with comment 
period.
    Therefore, we are making the following corrections to the September 
1, 1995, final rule with comment period:


Sec. 412.105  [Corrected]

    1. On page 45848, column one, item 10, the phrase ``paragraph (b) 
is revised to read as follows:'' is corrected to read ``paragraphs (b) 
and (d) are revised to read as follows:''
    2. On page 45848, column one, item 10, insert corrected paragraph 
(d), which reads as follows:
* * * * *
    (d) Determination of education adjustment factor. For discharges 
occurring on or after October 1, 1988, each hospital's education 
adjustment factor is calculated as follows:
* * * * *


Sec. 413.40  [Corrected]

    3. On page 45850, column one, Sec. 413.40(g)(1), in the third line 
the phrase ``under paragraph (e) of this section'' is corrected to read 
``under paragraph (g) of this section''.
    4. On pages 45867 through 45882, in Table 3C--Hospital Case Mix 
Indexes for Discharges Occurring in Federal Fiscal Year 1994, Hospital 
Average Hourly Wage for Federal Fiscal Year 1996 Wage Index, the 
average hourly wage is corrected as follows:

------------------------------------------------------------------------
                                                              Corrected 
             Provider                Case mix   Avg. hourly  avg. hourly
                                      index         wage         wage   
------------------------------------------------------------------------
090004                                 01.6239        22.47        22.45
090005                                 01.2725        25.88        25.02
090008                                 01.5653        19.96        23.02
210003                                 01.5173        26.44        26.40
210005                                 01.1988        18.75        18.50
210008                                 01.3734        19.80        19.78
210026                                 01.3603        22.97        22.82
210060                                 01.0967        21.07        21.23
230002                                 01.2674        18.51        18.81
330023                                 01.1830        21.41        21.64
340039                                 01.2728        17.98        18.05
340064                                 01.2236        15.48        17.13
340098                                 01.6534        17.84        17.68
340166                                 01.3806        18.12        18.14
390174                                 01.7096        23.29        23.19
390226                                 01.7113        22.03        21.84
450025                                 01.4725        15.12        15.36
450029                                 01.4012        11.81        12.01
450121                                 01.5746        18.89        19.39
450196                                 01.4781        13.63        14.62
------------------------------------------------------------------------


[[Page 2726]]

    5. On pages 45883 through 45889, in Table 4A--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Urban Areas, the MSA 
titles and counties are corrected as follows:

------------------------------------------------------------------------
                MSA                             Corrected MSA           
------------------------------------------------------------------------
1123 *Boston-Brockton-Nashua, MA-   *Boston-Worcester-Lawrence-Lowell-  
 NH.                                 Brockton, MA-NH.                   
1960 Davenport-Rock Island-Moline,  Davenport-Moline-Rock Island, IA-IL.
 IA-IL.                                                                 
5483 *New Haven-Bridgeport-         *New Haven-Bridgeport-Stamford-     
 Stamford-Danbury-Waterbury, CT.     Waterbury-Danbury, CT.             
6483 *Providence-Warwick, RI......  *Providence-Warwick-Pawtucket, RI.  
7440 *San Juan-Bayamon, PR........  Counties also include: Morovis, PR; 
                                     Naguabo, PR.                       
------------------------------------------------------------------------

    6. On pages 45883 through 45889, in Table 4A--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Urban Areas, the wage 
index values and GAFs are corrected as follows:

------------------------------------------------------------------------
                                                     Changed            
               Urban area        Wage       GAF        wage     Changed 
                                index                 index       GAF   
------------------------------------------------------------------------
0720       Baltimore, MD....     0.9866     0.9908     0.9865     0.9907
1520       Charlotte-            0.9668     0.9771     0.9661     0.9767
            Gastonia-Rock                                               
            Hill, NC-SC.                                                
2160       Detroit, MI......     1.0834     1.0564     1.0837     1.0566
2281       Dutchess Co., NY.     1.0697     1.0472     1.0754     1.0510
2800       Fort Worth-           1.0052     1.0036     1.0066     1.0045
            Arlington, TX.                                              
3290       Hickory-Morganton-    0.7983     0.8570     0.8002     0.8584
            Lenoir, NC.                                                 
4080       Laredo, TX.......     0.6750     0.7640     0.6834     0.7705
4640       Lynchburg, VA....     0.8205     0.8733     0.8319     0.8816
6160       Philadelphia, PA-     1.1098     1.0739     1.1092     1.0736
            NJ.                                                         
8840       Washington, DC-MD-    1.1075     1.0724     1.1116     1.0751
            VA-WV.                                                      
9080       Wichita Falls, TX     0.7763     0.8408     0.7826     0.8455
------------------------------------------------------------------------

    7. On pages 45889 through 45890, in Table 4B--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Rural Areas, the wage 
index values and the GAFs are corrected as follows:

------------------------------------------------------------------------
                                                     Changed            
       Non-urban Area            Wage       GAF        wage     Changed 
                                index                 index       GAF   
------------------------------------------------------------------------
North Carolina..............     0.7983     0.8570     0.8002     0.8584
Texas.......................     0.7302     0.8063     0.7316     0.8073
------------------------------------------------------------------------

    8. On pages 45890 through 45891, in Table 4C--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Hospitals that are 
Reclassified, the wage index values and the GAFs are corrected as 
follows:

------------------------------------------------------------------------
                                                     Changed            
    Area reclassified to         Wage       GAF        wage     Changed 
                                index                 index       GAF   
------------------------------------------------------------------------
Charlotte-Gastonia-Rock                                                 
 Hill, NC-SC................     0.9668     0.9771     0.9661     0.9767
Detroit, MI.................     1.0834     1.0564     1.0837     1.0566
Dutchess Co., NY............     1.0546     1.0371     1.0583     1.0396
Fort Worth-Arlington, TX....     1.0052     1.0036     1.0066     1.0045
Philadelphia, PA-NJ.........     1.1098     1.0739     1.1092     1.0736
Washington, DC-MD-VA-WV.....     1.1075     1.0724     1.1116     1.0751
Rural North Carolina........     0.7983     0.8570     0.8002     0.8584
------------------------------------------------------------------------

    9. On pages 45891 through 45892, in Table 4D--Average Hourly Wage 
for Urban Areas, the average hourly wage is corrected as follows:

------------------------------------------------------------------------
                                                              Corrected 
                  Urban area                      Average      average  
                                                hourly wage  hourly wage
------------------------------------------------------------------------
Baltimore, MD.................................      18.6758      18.6732
Charlotte-Gastonia-Rock Hill, NC-SC...........      18.3004      18.2886
Detroit, MI...................................      20.4975      20.5027
Dutchess Co., NY..............................      20.2495      20.3568
Fort Worth-Arlington, TX......................      19.0148      19.0420
Laredo, TX....................................      12.7772      12.9369
Lynchburg, VA.................................      15.5313      15.7477
Philadelphia, PA-NJ...........................      21.0452     21.0345 

[[Page 2727]]
                                                                        
Washington, DC-MD-VA-WV.......................      20.9642      21.0413
Wichita Falls, TX.............................      14.6944      14.8144
------------------------------------------------------------------------


    10. On pages 45892 through 45893, in Table 4E--Average Hourly Wage 
for Rural Areas, the average hourly wage is corrected as follows:

------------------------------------------------------------------------
                                                              Corrected 
                  Urban area                      Average      average  
                                                hourly wage  hourly wage
------------------------------------------------------------------------
North Carolina................................      15.1058      15.1415
Texas.........................................      13.8226      13.8482
------------------------------------------------------------------------


(Catalog of Federal Domestic Assistance Program No. 93.778, Medical 
Assistance Program; No. 93.773 Medicare--Hospital Insurance; and No. 
93.774, Medicare--Supplementary Medical Insurance)

    Dated: December 7, 1995.
Michael Carleton,
Acting Deputy Assistant Secretary for Information Resource Management.
[FR Doc. 96-1532 Filed 1-26-96; 8:45 am]
BILLING CODE 4120-01-P