[Federal Register Volume 74, Number 15 (Monday, January 26, 2009)]
[Rules and Regulations]
[Pages 4343-4344]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-1519]



========================================================================
Rules and Regulations
                                                Federal Register
________________________________________________________________________

This section of the FEDERAL REGISTER contains regulatory documents 
having general applicability and legal effect, most of which are keyed 
to and codified in the Code of Federal Regulations, which is published 
under 50 titles pursuant to 44 U.S.C. 1510.

The Code of Federal Regulations is sold by the Superintendent of Documents. 
Prices of new books are listed in the first FEDERAL REGISTER issue of each 
week.

========================================================================


Federal Register / Vol. 74, No. 15 / Monday, January 26, 2009 / Rules 
and Regulations

[[Page 4343]]



DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 410, 416, and 419

[CMS-1404-CN]
RIN 0938-AP17; RIN 0938-AL80; RIN 0938-AH17


Medicare Program; Changes to the Hospital Outpatient Prospective 
Payment System and CY 2009 Payment Rates; Changes to the Ambulatory 
Surgical Center Payment System and CY 2009 Payment Rates; Hospital 
Conditions of Participation: Requirements for Approval and Re-Approval 
of Transplant Centers To Perform Organ Transplants--Clarification of 
Provider and Supplier Termination Policy Medicare and Medicaid 
Programs: Changes to the Ambulatory Surgical Center Conditions for 
Coverage

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

ACTION: Correction of final rule with comment period.

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

SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period published in the Federal Register on 
November 18, 2008, entitled ``Medicare Program; Changes to the Hospital 
Outpatient Prospective Payment System and CY 2009 Payment Rates; 
Changes to the Ambulatory Surgical Center Payment System and CY 2009 
Payment Rates; Hospital Conditions of Participation: Requirements for 
Approval and Re-Approval of Transplant Centers To Perform Organ 
Transplants--Clarification of Provider and Supplier Termination Policy 
Medicare and Medicaid Programs: Changes to the Ambulatory Surgical 
Center Conditions for Coverage'' (hereinafter referred to as the CY 
2009 OPPS/ASC final rule with comment period).

DATES: Effective Date: this document is effective on January 26, 2009.
    Applicability Date: The corrections in this document are applicable 
on and after January 1, 2009.

FOR FURTHER INFORMATION CONTACT: Alberta Dwivedi, (410) 786-0378.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. E8-26212 of November 18, 2008 (73 FR 68502), there were 
a few technical errors that are identified in the ``Summary of Errors'' 
section and corrected in the ``Correction of Errors'' section below.

II. Summary of Errors

    We incorrectly determined the CY 2009 status indicator for new CY 
2009 Healthcare Common Procedure Coding System (HCPCS) code J3300 
(Injection, triamcinolone acetonide, preservative free, 1 mg) and, as a 
result, incorrectly assigned HCPCS code J3300 status indicator ``N.'' 
Status indicator ``N'' indicates that items and services are packaged 
into ambulatory payment classification (APC) rates. Payment for those 
items and services assigned status indicator ``N'' is packaged into 
payment for other services, including, for example, outliers, and, 
therefore, there is no separate APC payment. The CY 2009 OPPS/ASC final 
rule with comment period included several Addenda. The erroneous 
assignment of status indicator ``N'' to HCPCS code J3300 appears in 
Addendum B on page 69228. On that page, we are changing the status 
indicator of HCPCS code J3300 from ``N'' to ``K'' (Nonpass-Through 
Drugs and Biologicals; Paid under OPPS; separate APC payment) to 
correctly reflect its separately payable status for CY 2009. As a 
result of our error in determining the status indicator of HCPCS code 
J3300, and the corresponding incorrect indication of status indicator 
``N'' in Addendum B, we need to make two additional conforming changes.
    Because we incorrectly packaged HCPCS code J3300 in the CY 2009 
OPPS/ASC final rule with comment period, we provided no APC assignment 
for the HCPCS code in that rule. With the correct assignment of status 
indicator ``K'' to HCPCS code J3300, an APC must be established for 
payment, because each separately payable drug or biological is assigned 
to its own unique APC under the OPPS. Therefore, in Addendum A, on page 
68831, we are adding APC 1253 (Triamcinolone A inj PRS-free) with 
status indicator ``K.'' Also, in Addendum BB, on page 69301, a similar 
change to that made in Addendum B needs to be made to correspond to the 
Ambulatory Surgical Center (ASC) payment system. Accordingly, we are 
changing the ASC payment indicator for HCPCS code J3300 from ``N1'' to 
``K2'' (Drugs and biologicals paid separately when provided integral to 
a surgical procedure on ASC list; payment based on OPPS rate) to 
correctly reflect separate payment of HCPCS code J3300 under the ASC 
payment system.

III. Correction of Errors

    In FR Doc. E8-26212 of November 18, 2008 (73 FR 68502), make the 
following corrections:

Addendum A.--Final OPPS APCs for CY 2009

    1. On page 68831, in column 1, insert between APC 1251 and APC 
1280, lines 24 and 25, the final OPPS CY 2009 entry for APC 1253 to 
read as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                           National     Minimum
              APC                    Group title          SI       Relative     Payment   unadjusted  unadjusted
                                                                    weight       rate      copayment   copayment
----------------------------------------------------------------------------------------------------------------
1253...........................  Triamcinolone A inj          K   ..........      $3.18   ..........      $0.64
                                  PRS-free.
----------------------------------------------------------------------------------------------------------------


[[Page 4344]]

Addendum B.--Final OPPS Payment by HCPCS Code for CY 2009

    2. On page 69228, in line 31, for HCPCS Code J3300--
    A. In column 4, the status indicator ``N'' is corrected to read 
``K.''
    B. In column 5, the APC is corrected to read ``1253.''
    C. In column 7, the payment rate is corrected to read ``$3.18.''
    D. In column 9, the minimum unadjusted copayment is corrected to 
read ``$0.64.''
    The HCPCS Code for J3300 should read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                   National     Minimum
           HCPCS Code                      Short descriptor               CI          SI          APC      Relative     Payment   unadjusted  unadjusted
                                                                                                            weight       rate      copayment   copayment
--------------------------------------------------------------------------------------------------------------------------------------------------------
J3300...........................  Triamcinolone A inj PRS-free......         NI           K        1253   ..........      $3.18   ..........      $0.64
--------------------------------------------------------------------------------------------------------------------------------------------------------

Addendum BB.--Final ASC Covered Ancillary Services Integral to Covered 
Surgical Procedures for CY 2009 (Including Ancillary Services for Which 
Payment Is Packaged)

    3. On page 69301, in line 37, for HCPCS Code J3300--
    A. In column 4, the payment indicator ``N1'' is corrected to read 
``K2.''
    B. In column 6, the CY 2009 second year transition payment is 
corrected to read ``$3.18.''

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 it is impracticable, unnecessary 
or contrary to the public interest to follow the notice and comment 
procedure or to comply with the 30-day delay in the effective date, and 
incorporates a statement of the finding and the reasons in the notice.
    The policies and payment methodologies finalized in the CY 2009 
OPPS/ASC final rule with comment period have previously been subjected 
to notice and comment procedures. This correction notice merely 
provides technical corrections to the CY 2009 OPPS/ASC final rule with 
comment period that was promulgated through notice and comment 
rulemaking, and does not make substantive changes to the policies or 
payment methodologies that were finalized in the final rule with 
comment period. In order to conform the document to the final policies 
of the CY 2009 OPPS/ASC final rule with comment period, this notice 
makes changes to revise inaccurate tabular information. Therefore, we 
find it unnecessary to undertake further notice and comment procedures 
with respect to this correction notice. In addition, we believe it is 
important for the public to have the correct information as soon as 
possible and find no reason to delay the dissemination of it. 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. 
Therefore, we find there is 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. 93.774, 
Medicare--Supplementary Medical Insurance Program)

    Dated: January 16, 2009.
Ann Agnew,
Executive Secretary to the Department.
[FR Doc. E9-1519 Filed 1-23-09; 8:45 am]
BILLING CODE 4120-10-P