Source: https://www.federalregister.gov/documents/2009/04/24/E9-9232/medicaid-program-disproportionate-share-hospital-payments-correcting-amendment
Timestamp: 2018-03-21 21:00:07
Document Index: 81705454

Matched Legal Cases: ['§\u2009447', '§\u2009447', '§\u2009447', '§\u2009455', '§\u2009447', '§\u2009455', 'art 447']

Federal Register :: Medicaid Program; Disproportionate Share Hospital Payments; Correcting Amendment
Medicaid Program; Disproportionate Share Hospital Payments; Correcting Amendment
A Rule by the Centers for Medicare & Medicaid Services on 04/24/2009
74 FR 18656
18656-18657 (2 pages)
CMS-2198-F2
E9-9232
II. Summary of Error in the Regulations Text
https://www.federalregister.gov/d/E9-9232 https://www.federalregister.gov/d/E9-9232
This correcting amendment corrects a technical error in the regulations text in the final rule published in the Federal Register on December 19, 2008 (73 FR 77904) entitled, “Disproportionate Share Hospital Payments.” In that final rule, we set forth data elements necessary to Start Printed Page 18657comply with the requirements of section 1923(j) of the Social Security Act (the Act) related to auditing and reporting of disproportionate share hospital payments under State Medicaid programs. The effective date was January 19, 2009.
Effective Date: This correcting amendment is effective April 24, 2009.
Venesa Day, (410) 786-8281.
Rory Howe, (410) 786-4878.
In FR Doc. E8-30000 issued on December 19, 2008 (73 FR 77904), there was a technical error that is identified and corrected in this correcting amendment. The correction in this document is effective April 24, 2009.
On page 77950 of the final rule, we made a technical error in the regulation text of § 447.299(c)(16). In this paragraph, the text provides a narrative description of how “total annual uncompensated care costs” are to be calculated from component data elements. The first sentence accurately names the component data elements and correctly describes the calculation. The last sentence attempts to condense the previous sentence by substituting references for component data elements as identified in previous paragraphs of § 447.299(c). However, the references are unintentionally incorrect.
The last sentence of the original final text indicates that the sum of paragraphs (c)(11) and (c)(15) should be subtracted from (c)(9), (c)(12), and (c)(13). This calculation would sum Medicaid uncompensated care costs and total uninsured inpatient and outpatient uncompensated care costs, then subtract this total from the sum of total Medicaid inpatient and outpatient payments, uninsured inpatient and outpatient revenue, and total applicable Section 1011 payments. This calculation is incorrect and could not be interpreted reasonably to result in “total annual uncompensated care costs”. Additionally, it erroneously contradicts section 1923(g) of the Social Security Act (the Act), § 447.299 and § 455 subpart D, and longstanding CMS policy.
The corrected text of the last sentence should read as follows: “This should equal the sum of paragraphs (c)(9), (c)(12), and (c)(13) subtracted from the sum of paragraphs (c)(10) and (c)(14) of this section.” This correction includes the correct references necessary to calculate accurately “total uncompensated care costs” consistent with section 1923(g) of the Act, § 447.299 and § 455 Subpart D, and longstanding CMS policy.
This action merely corrects a technical error in the December 19, 2008 final rule. We are not changing the policy contained in that rule, and further public comment is unnecessary. Therefore, we find there is good cause to waive notice and comment procedures and the 30-day delay in effective date for this action.
Accordingly, 42 CFR chapter IV is corrected by making the following correcting amendment to part 447:
Authority: Secs. 1102 of the Social Security Act (42 U.S.C. 1302).
2. Section 447.299 is amended by revising paragraph (c)(16) to read as follows:
(16) Total annual uncompensated care costs. The total annual uncompensated care cost equals the total cost of care for furnishing inpatient hospital and outpatient hospital services to Medicaid eligible individuals and to individuals with no source of third party coverage for the hospital services they receive less the sum of regular Medicaid FFS rate payments, Medicaid managed care organization payments, supplemental/enhanced Medicaid payments, uninsured revenues, and Section 1011 payments for inpatient and outpatient hospital services. This should equal the sum of paragraphs (c)(9),(c)(12), and (c)(13) subtracted from the sum of paragraphs (c)(10) and (c)(14) of this section.
Acting Executive Secretary to the Department.
[FR Doc. E9-9232 Filed 4-23-09; 8:45 am]