[Federal Register Volume 75, Number 190 (Friday, October 1, 2010)]
[Rules and Regulations]
[Pages 60640-60642]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-24712]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 413, 415, 424, 440, 441, 482, 485, and 489

[CMS-1498-F, and CMS-1498-IFC; CMS-1406-F]
RIN 0938-AP80; RIN 0938-AP33


Medicare Program; Hospital Inpatient Prospective Payment Systems 
for Acute Care Hospitals and the Long-Term Care Hospital Prospective 
Payment System Changes and FY 2011 Rates; Provider Agreements and 
Supplier Approvals; and Hospital Conditions of Participation for 
Rehabilitation and Respiratory Care Services; Medicaid Program: 
Accreditation for Providers of Inpatient Psychiatric Services; 
Corrections

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

ACTION: Correction of final rules and interim final rule with comment 
period.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical and typographical errors in 
the final rules and interim final rule with comment period entitled 
``Medicare Program; Hospital Inpatient Prospective Payment Systems for 
Acute Care Hospitals and the Long-Term Care Hospital Prospective 
Payment System Changes and FY 2011 Rates; Provider Agreements and 
Supplier Approvals; and Hospital Conditions of Participation for 
Rehabilitation and Respiratory Care Services; Medicaid Program: 
Accreditation for Providers of Inpatient Psychiatric Services'' that 
appeared in the August 16, 2010 Federal Register.

DATES: Effective Date: This correction notice is effective October 1, 
2010.

FOR FURTHER INFORMATION CONTACT: Tzvi Hefter, (410) 786-4487.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2010-19092 of August 16, 2010 (75 FR 50042), 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 document 
entitled ``Medicare Program; Hospital Inpatient Prospective Payment 
Systems for Acute Care Hospitals and the Long-Term Care Hospital 
Prospective Payment System Changes and FY 2011 Rates; Provider 
Agreements and Supplier Approvals; and Hospital Conditions of 
Participation for Rehabilitation and Respiratory Care Services; 
Medicaid Program: Accreditation for Providers of Inpatient Psychiatric 
Services'' (hereinafter referred to as the fiscal year (FY) 2011 IPPS/
LTCH PPS final rule) that appeared in August 16, 2010 Federal Register. 
Accordingly, the corrections are effective October 1, 2010.

II. Summary of Errors

    The following is a summary of the errors identified in the FY 2011 
IPPS/LTCH PPS final rule and corrected in section III. of this notice:

A. Summary of Errors in the Preamble

    On page 50099, we are correcting errors in the present on admission 
(POA) indicator ``Y'' percentage for two previously considered hospital 
acquired conditions (HACs) that are listed in Chart H ``POA Status of 
Previously Considered `Candidate' HAC Conditions--October 2008 Through 
September 2009.''
    On page 50161, we are correcting a website reference error in the 
first footnote to the table regarding the Frontier States identified 
for the FY 2011 wage index floor adjustment.
    On page 50224, in our discussion of the data submission and 
reporting requirements for the Reporting Hospital Quality Data for 
Annual Payment Update (RHQDAPU) program, we inadvertently indicated 
that the Central Line Associated Blood Stream Infection (CLABSI) 
measure would be part of the measure set for the FY 2012 payment 
determination rather than the FY 2013 payment determination. We had 
previously, on page 50202, finalized the CLABSI measure for the FY 2013 
payment determination and the information on page 50224 should have 
reflected this policy.

B. Summary of Errors in the Addendum

    On page 50432, in the table ``Comparison of FY 2010 Standardized 
Amounts to the FY 2011 Standardized

[[Page 60641]]

Amount with Full and Reduced Update'' we inadvertently indicated the 
incorrect figures in the column headings.
    On page 50433, in our discussion of the Federal rate, we 
inadvertently indicated an incorrect amount for the low-volume payment 
adjustment.
    On pages 50451 through 50547 in Table 2, we are correcting the 
provider and wage index data to reflect corrections to Tables 4C, 4J, 
and 9A.
    On pages 50516 through 50520, Table 4C, we inadvertently made 
technical errors in several hospitals' geographic reclassifications 
that were used in calculating the wage index that was published in the 
FY 2011 IPPS/LTCH PPS final rule. As a result of reclassification 
corrections in Table 9A, the wage index for CBSA 22180 increased from 
0.9193 to 0.9254. The wage indices for CBSA 26580 (KY, OH, WV) 
decreased from 0.8726 to 0.8672. The addition of provider 360096 to 
Table 9A also results in a wage index for Ohio hospitals reclassifying 
to CBSA 49660 of 0.8558.
    On pages 50540 through 50547 in Table 4J, we inadvertently omitted 
providers located in Tarrant County, TX that are eligible to receive 
the out-migration adjustment. As a result of the reclassification 
correction to provider 360096, we are correcting Table 4J to indicate 
that the provider will be reclassified for FY 2011.
    On pages 50593 through 50604, in Table 9A.--Hospital 
Reclassifications and Redesignations--FY 2011, we are correcting an 
error in the reclassification of provider 340008; the provider was 
reclassified to CBSA 22180 rather than CBSA 26580. Also, we have added 
provider to 360096 to Table 9A.

III. Correction of Errors

    In FR Doc. 2010-19092 of August 16, 2010, make the following 
corrections:

A. Corrections to the Preamble

    1. On page 50099, in the chart, ``Chart H.--POA Status of 
Previously Considered `Candidate' HAC Conditions--October 2008 Through 
September 2009,'' column 8 (Present on Admission, POA = Y, Percent) is 
corrected for the listed entries as follows:

------------------------------------------------------------------------
                                                  Present on admission
                                               -------------------------
      Previously considered HAC condition                POA = Y
                                               -------------------------
                                                   Number      Percent
------------------------------------------------------------------------
4. Staphylococcus aureus Septicemia...........       17,330         77.3
5. Methicillin-Resistant Staphylococcus aureus       68,089         96.4
------------------------------------------------------------------------

    2. On page 50161, middle of the page, in the table entitled 
``Frontier States Indentified for the FY 2011 Wage Index Floor 
Adjustment Under Section 10324(a) of the Affordable Care Act,'' in the 
first footnote, the Web site link ``http://www.census.gov/popest/estimates.html (2009 County Total Population Estimates)'' is corrected 
to read ``http://www.census.gov/popest/counties/counties.html (County 
population, population change.)''
    3. On page 50224,
    a. Top quarter of the page, third column, first partial paragraph, 
line 4, the fiscal year ``2012'' is corrected to read ``2013''.
    b. Top third of the page, in the table ``Submission Timeframes for 
CLABSI Measure for the FY 2012 Payment Determination,''
    (1) The table heading, ``Submission Timeframes for CLABSI Measure 
for the FY 2012 Payment Determination,'' is corrected to read 
``Submission Timeframes for CLABSI Measure for the FY 2013 Payment 
Determination''.
    (2) Column 3, the column heading, ``Final Submission Deadline for 
RHQDAPU FY 2012 Payment Determination'' is corrected to read ``Final 
Submission Deadline for RHQDAPU FY 2013 Payment Determination''.

B. Corrections to the Addendum

    1. On page 50432, in the table ``Comparison of FY 2010 Standardized 
Amounts to the FY 2011 Standardized Amount with Full and Reduced 
Update,'' the column headings,
    a. Columns 2 and 3, the figure ``2.4'' is corrected to read 
``2.35''.
    b. Columns 4 and 5, the figure ``0.4'' is corrected to read 
``0.35''.
    2. On page 50433, second column, seventh paragraph, line 8, the 
phrase ``25 percent.'' is corrected to read ``the applicable percentage 
increase specified in Sec.  412.101(c).''
    3. On pages 50451 through 50504, in Table 2 ``Hospital Case-Mix 
Indexes for Discharges occurring in Federal Fiscal Year 2009; Hospital 
Wage Indexes for Federal Fiscal Year 2011; Hospital Average Hourly 
Wages for Federal Fiscal Years 2009 (2005 Wage Data), 2010 (2006 Wage 
Data), and 2011 (2007 Wage Data); and 3-Year Average Hourly Wages'' 
column 2 (FY 2011 Wage Index) is corrected for the following provider 
numbers:

------------------------------------------------------------------------
                   Provider No.                      FY 2011 Wage index
------------------------------------------------------------------------
180044............................................                0.8672
180069............................................                0.8672
180078............................................                0.8672
340008............................................                0.9254
340050............................................                0.9254
360008............................................                0.8672
360054............................................                0.8672
360096............................................                0.8558
510077............................................                0.8672
670023............................................                0.9438
670042............................................                0.9438
670046............................................                0.9438
------------------------------------------------------------------------

    4. On pages 50516 through 50520, in Table 4C ``Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Acute Care Hospitals 
that are Reclassified By CBSA and By State--FY 2011'' is correcting the 
wage index and GAF for hospitals reclassifying to the following CBSA:

----------------------------------------------------------------------------------------------------------------
                CBSA                          CBSA Name                  State           Wage index      GAF
----------------------------------------------------------------------------------------------------------------
22180..............................  Fayetteville, NC..........  NC...................       0.9254       0.9483
26580..............................  Huntington-Ashland, WV-KY-  KY...................       0.8672       0.9070
                                      OH.
26580..............................  Huntington-Ashland, WV-KY-  OH...................       0.8672       0.9070
                                      OH.
26580..............................  Huntington-Ashland, WV-KY-  WV...................       0.8672       0.9070
                                      OH.
49660..............................  Youngstown-Warren-          OH...................       0.8558       0.8989
                                      Boardman, OH-PA.
----------------------------------------------------------------------------------------------------------------


[[Page 60642]]

    5. On pages 50540 through 50547, in Table 4J ``Out Migration 
Adjustment for Acute Care Hospitals-FY 2011'' the table is corrected by 
adding the following entries:

----------------------------------------------------------------------------------------------------------------
                                                    Reclassified     Out-migration     Qualifying
                   Provider No.                      for FY 2011      adjustment       county name   County code
----------------------------------------------------------------------------------------------------------------
360096...........................................               *            0.0011      COLUMBIANA        36140
670023...........................................  ..............            0.0054         TARRANT        45910
670042...........................................  ..............            0.0054         TARRANT        45910
670046...........................................  ..............            0.0054         TARRANT        45910
----------------------------------------------------------------------------------------------------------------

    6. On pages 50593 and 50604, in Table 9A.--Hospital 
Reclassifications and Redesignations--FY 2011 the table is corrected 
by--
    a. Changing the reclassified CBSA for the following entry:

----------------------------------------------------------------------------------------------------------------
                                                                       Geographic     Reclassified
                            Provider No.                                  CBSA            CBSA          LUGAR
----------------------------------------------------------------------------------------------------------------
340008.............................................................              34           22180  ...........
----------------------------------------------------------------------------------------------------------------

    b. Adding following entry:

----------------------------------------------------------------------------------------------------------------
                                                                       Geographic     Reclassified
                            Provider No.                                  CBSA            CBSA          LUGAR
----------------------------------------------------------------------------------------------------------------
360096.............................................................              36           49660        LUGAR
----------------------------------------------------------------------------------------------------------------

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 rule take effect in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive this notice and comment procedure if the Secretary finds, for 
good cause, that the notice and comment process is impracticable, 
unnecessary, or contrary to the public interest, and incorporates a 
statement of the finding and the reasons therefore in the notice.
    Section 553(d) of the APA ordinarily requires a 30-day delay in 
effective date of final rules after the date of their publication in 
the Federal Register. This 30-day delay in effective date can be 
waived, however, if an agency finds for good cause that the delay is 
impracticable, unnecessary, or contrary to the public interest, and the 
agency incorporates a statement of the findings and its reasons in the 
rule issued.
    In our view, this notice does not constitute a rulemaking that 
would be subject to the APA notice and comment or delayed effective 
date requirements. This notice merely corrects typographical and 
technical errors in the preamble and addendum of the FY 2011 IPPS/LTCH 
PPS final rule and does not make substantive changes to the policies or 
payment methodologies that were adopted in the final rule. As a result, 
this notice is intended to ensure that the FY 2011 IPPS/LTCH PPS final 
rule accurately reflects the policies adopted in that rule.
    In addition, even if this were a rulemaking to which the notice and 
comment and delayed effective date requirements applied, we find that 
there is good cause to waive such requirements. Undertaking further 
notice and comment procedures to incorporate the corrections in this 
notice into the final rule or delaying the effective date would delay 
these corrections beyond the October 1 start of the fiscal year, and 
would be contrary to the public interest. Furthermore, such procedures 
would be unnecessary, as we are not altering the policies that were 
already subject to comment and finalized in our final rule.
    Therefore, we believe we have good cause to waive the notice and 
comment and effective date requirements.

    (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, 2010.
Dawn L. Smalls,
Executive Secretary to the Department.
[FR Doc. 2010-24712 Filed 9-30-10; 8:45 am]
BILLING CODE 4120-01-P