Medicare: Hospital inpatient prospective payment systems and 2006 FY rates Correction,

[Federal Register: September 30, 2005 (Volume 70, Number 189)]

[Rules and Regulations]

[Page 57161-57164]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr30se05-18]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 412, 413, 415, 419, 422, and 485

[CMS-1500-CN]

RIN 0938-AN57

Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates; Correction

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

ACTION: Correction of final rule.

SUMMARY: This document corrects technical errors in the final rule that appeared in the August 12, 2005 Federal Register entitled ``Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates.''

DATES: Effective October 1, 2005.

FOR FURTHER INFORMATION CONTACT: Marc Hartstein, (410) 786-4548.

SUPPLEMENTARY INFORMATION:

1. Background

   In FR Doc. 05-15406 (70 FR 47278), the final rule entitled ``Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2006 Rates'' (hereinafter referred to as the FY 2006 final rule), there were a number of typographical and technical errors that are identified and corrected in the ``Correction of Errors'' section (section III. of this notice). The provisions of this correction notice are effective as if they had been included in the FY 2006 final rule. Accordingly, the corrections are effective October 1, 2005.

2. Summary of the Corrections to the FY 2006 Final Rule

   On page 47292, in our preamble discussion regarding cardiac catheterizations for DRGs 535 and 536, we stated that we are removing code 37.26 from DRGs 535 and 536 and then erroneously stated that we are adding code 37.26 to DRG 515. Therefore, we are revising this discussion by deleting the phrase ``and adding the code in DRG 515.'' (See item 2 of section III.A. of this notice.)

   On page 47312, in our preamble discussion regarding the ``Tobacco Use Disorder Edit'', we stated the incorrect Medicare code editor (MCE) edit to which we added code 305.1. Although our national coverage determination on smoking cessation counseling services provides that we never cover tobacco cessation services when code 305.1 is reported as the principal diagnosis, we erroneously stated that code 305.1 would be added to the MCE edit ``Questionable Admission--Principal

   [[Page 57162]]

   Diagnosis Only.'' Therefore, we are revising this discussion by replacing the incorrect MCE edit, ``Questionable Admission--Principal Diagnosis Only,'' with the correct MCE edit, ``Unacceptable Principal Diagnosis.'' (See item 3 of section III.A. of this notice.)

   On page 47444, in our preamble discussion regarding Medicare Geographic Reclassification Review Board (MGCRB) reclassification for urban hospitals, we made typographical errors in our citations to the regulations text. In addition, on pages 47486 and 47487, our amendment to the regulations text contained technical errors. In this notice, we are revising the relevant preamble and regulations text. (See item 7 of section III.A. and items 1 and 2a of section III.B. of this notice.)

   On page 47445, we made incorrect references in our preamble discussion regarding the date by which the MGCRB has to make its reclassification decisions. We are revising this discussion to clarify that the MGCRB has 180 days in which to make its reclassification decision. (See item 8 of section III.A. of this notice.)

   On pages 47477 and 47478, in the column heading of the chart displaying information regarding diagnosis-related groups (DRGs) that recognize major cardiovascular conditions (MCVs), we erroneously included new DRGs whose titles include ``without MCV.'' We are revising this heading to include only those DRGs that recognize MCVs. (See item 10 of section III.A. of this notice.)

   On pages 47589 and 47596, in Table 4A, we made errors in the calculation of the wage indexes and geographic adjustment factors for 2 core-based statistical areas (CBSAs). Accordingly, we are correcting this table to include the correct wage indexes and geographic adjustment factors (GAFs) for these CBSAs. We are also correcting the wage index values listed in Table 2 for the affected providers. (See items 1 and 2 of section III.C. of this notice.) In addition, the wage index data for a provider were erroneously omitted from the wage index calculation. This error affects hospitals geographically located in and reclassifying to the Houston-Sugar Land-Baytown, TX CBSA. Accordingly, we are revising Tables 2, 4A, and 4C to reflect the correct information. (See items 1, 2, and 4 of section III.C. of this notice.) Similarly, another provider's wage data were erroneously omitted from the wage index calculation that affects hospitals geographically located in and reclassifying to the Nashville-Davidson-Murfreesboro, TN CBSA. Therefore, we are including the corrected data in Tables 2, 4A, and 4C. (See items 1, 2, and 4 of section III.C. of this notice.)

   On page 47604 on Table 4B we made an error in the calculation of the wage index and geographic adjustment factor for rural Washington. (See item 3 of section III.C. of this notice.) Therefore, we are correcting the wage index and GAF values listed for the 5 CBSAs in Table 4A that receive the Washington rural floor and we are also correcting the wage index values listed in Table 2 for the affected providers (See items 1 and 2 of section III.C. of this notice).

   On page 47611, in Table 4J, we made a number of typographical errors in a group of the provider numbers listed. In this notice, we are correcting these errors. (See item 5 of section III.C. of this notice.)

   On page 47675, in Table 9A, we inadvertently reclassified a provider to the incorrect CBSA. In addition, in Table 2, we also inadvertently listed the incorrect wage index for this provider. Accordingly, we are revising both of these tables to reflect the correct information for this provider. (See items 1 and 8 of section III.C. of this notice).

   We are also correcting typographical, formatting or other errors that appear on other pages of the FY 2006 final rule.

3. Correction of Errors

   In FR Doc. 05-15406 (70 FR 47278), we are making the following corrections:

   1. Corrections to Errors in the Preamble

      1. On page 47289, third column, first full paragraph, line 34 the figure ``111'' is corrected to read ``115''.

      2. On page 47292, first column, first partial paragraph, lines 1 and 2, the phrase ``and adding the code in DRG 515'' is deleted.

      3. On page 47312, second column, second full paragraph, lines 26 and 27 the phrase ``Questionable Admission-Principal Diagnosis Only'' is corrected to read ``Unacceptable Principal Diagnosis''.

      4. On page 47344,

      1. Second column, first partial paragraph, line 1, the word ``criteria'' is corrected to read ``criterion''; and

      2. Third column, first full paragraph, line 1, the word ``INFUSETM'' is corrected to read ``INFUSE''.

         5. On page 47350, third column,

      1. First partial paragraph, last line, the phrase ``Endovascular Stent Graft.'' is corrected to read ``Endovascular Stent Graft.)''; and

      2. First full paragraph, line 48, the phrase ``could not longer be'' is corrected to read ``could no longer be''.

         6. On page 47418, second column, first full paragraph, line 11, the date ``October 1, 2006'' is corrected to read ``October 1, 2005''.

         7. On page 47444, first column, third full paragraph,

      1. Line 21, the phrase ``will longer be'' is corrected to read ``will no longer be'';

      2. Line 30, the citation ``Sec. 412.230(a)(5)(iv)'' is corrected to read ``Sec. 412.230(a)(5)(iii)''; and c. Line 34, the citation ``Sec. 412.230(a)(5)(iv)'' is corrected to read ``Sec. 412.230(a)(5)(iii)''.

         8. On page 47445, second column, first paragraph,

      1. Line 25, the date ``February 1'' is corrected to read ``180 days from the September 1 application due date''; and

      2. Line 55, the date ``February 1, 2006'' is corrected to read ``180 days from the September 1 application due date''.

         9. On page 47446, first column, third paragraph, line 22, the citation ``Sec. 412.230(d)(2)(iv)'' is corrected to read ``Sec. 412.230(d)(2)(iii)''.

         10. On pages 47477 and 47478, in the chart, the fourth column, the header row, the heading ``DRGs 547, 548, 549, 550, 553, 554, 555, 556, 557, and 558'' is corrected to read ``DRGs 547, 549, 553, 555, and 557''.

   2. Corrections to Errors in the Regulations Text

      Sec. 412.230 [Corrected]

      0 1. On page 47486, third column, third line from the bottom, in the amendatory language for Sec. 412.230, the phrase ``Revising paragraph (a)(5)(iv)'' is corrected to read ``Revising paragraph (a)(5)(iii)''.

      0 2. On page 47487, first column, a. Line 10, in Sec. 412.230(a)(5), the paragraph number ``(iv)'' is corrected to read ``(iii)''.

   3. Corrections to Errors in the Addendum

      1. On pages 47510, 47524, 47531, 47552, 47561 through 47568, 47570 and 47571, in Table 2--Hospital Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2004; Hospital Wage Indexes for Federal Fiscal Year 2006; Hospital Average Hourly Wages for Federal Fiscal Years 2004 (2000 Wage Data), 2005 (2001 Wage Data), and 2006 (2002 Wage Data); Wage Indexes and 3-Year Average of Hospital Average Hourly Wages, for the listed provider numbers, the FY 2006 Wage Index (column 3) is corrected to read as follows:

      FY 2006 wage Provider No.

      index

      030012..................................................

      0.9874 130065..................................................

      0.9400 130067..................................................

      0.9400 180013..................................................

      0.9506

      [[Page 57163]]

      180066..................................................

      0.9506 180124..................................................

      0.9506 360095..................................................

      0.9564 440003..................................................

      0.9778 440006..................................................

      0.9778 440029..................................................

      0.9778 440035..................................................

      0.9506 440039..................................................

      0.9778 440046..................................................

      0.9778 440053..................................................

      0.9778 440059..................................................

      0.9506 440065..................................................

      0.9778 440073..................................................

      0.9506 440082..................................................

      0.9778 440111..................................................

      0.9778 440133..................................................

      0.9778 440148..................................................

      0.9506 440150..................................................

      0.9778 440151..................................................

      0.9506 440161..................................................

      0.9778 440175..................................................

      0.9506 440186..................................................

      0.9778 440192..................................................

      0.9506 440193..................................................

      0.9778 440194..................................................

      0.9778 440197..................................................

      0.9778 440200..................................................

      0.9778 440218..................................................

      0.9778 450018..................................................

      0.9999 450035..................................................

      0.9999 450068..................................................

      0.9999 450072..................................................

      0.9999 450097..................................................

      0.9999 450126..................................................

      0.9999 450184..................................................

      0.9999 450187..................................................

      0.9999 450193..................................................

      0.9999 450211..................................................

      0.9999 450214..................................................

      0.9999 450222..................................................

      0.9999 450253..................................................

      0.9999 450289..................................................

      0.9999 450296..................................................

      0.9999 450330..................................................

      0.9999 450347..................................................

      0.9999 450358..................................................

      0.9999 450378..................................................

      0.9999 450417..................................................

      0.9999 450418..................................................

      0.9999 450424..................................................

      0.9999 450438..................................................

      0.9999 450446..................................................

      0.9999 450484..................................................

      0.9999 450530..................................................

      0.9999 450591..................................................

      0.9999 450610..................................................

      0.9999 450617..................................................

      0.9999 450630..................................................

      0.9999 450638..................................................

      0.9999 450644..................................................

      0.9999 450659..................................................

      0.9999 450670..................................................

      0.9999 450684..................................................

      0.9999 450694..................................................

      0.9999 450709..................................................

      0.9999 450716..................................................

      0.9999 450774..................................................

      0.9999 450775..................................................

      0.9999 450795..................................................

      0.9999 450803..................................................

      0.9999 450804..................................................

      0.9999 450820..................................................

      0.9999 450831..................................................

      0.9999 450832..................................................

      0.9999 450844..................................................

      0.9999 450847..................................................

      0.9999 450848..................................................

      0.9999 450860..................................................

      0.9999 450862..................................................

      0.9999 450870..................................................

      0.9999 500002..................................................

      1.0511 500007..................................................

      1.0719 500012..................................................

      1.0511 500019..................................................

      1.0724 500033..................................................

      1.0511 500036..................................................

      1.0511 500037..................................................

      1.0511 500049..................................................

      1.0511 500122..................................................

      1.0511 500147..................................................

      1.0511 500148..................................................

      1.0511

      2. On pages 47589, 47591 through 47594, 47596, and 47602, in Table 4A--Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA, for the listed CBSA codes, the wage index (column 3) and GAF (column 4) are corrected to read as follows:

      Wage CBSA code

      index GAF

      26420............................................... 0.9999 0.9999 26820............................................... 0.9400 0.9585 30300 (WA Hospitals)................................ 1.0511 1.0347 31020............................................... 1.0511 1.0347 34580............................................... 1.0511 1.0347 34980............................................... 0.9778 0.9847 39140............................................... 0.9874 0.9914 48300............................................... 1.0511 1.0347 49420............................................... 1.0511 1.0347

      3. On page 47604, in Table 4B--Wage Index and Capital Geographic Adjustment (GAF) for Rural Areas by CBSA, for the listed CBSA code, the wage index (column 3) and GAF (column 4) are corrected to read as follows:

      Wage CBSA code

      index GAF

      50.................................................. 1.0511 1.0347

      4. On pages 47605 and 47606, in Table 4C--Wage Index and Capital Geographic Adjustment Factor (GAF) for Hospitals that are Reclassified by CBSA, for the listed CBSA codes, the wage index (column 3) and GAF (column 4) are corrected or added to read as follows:

      CBSA code

      Area

      Wage index

      GAF

      26420......................................... Houston-Sugar Land-Baytown, TX..

      0.9999

      0.9999 26820......................................... Idaho Falls, ID.................

      0.9400

      0.9585 34980......................................... Nashville-Davidson-Murfreesboro,

      0.9506

      0.9659 TN.

      5. On page 47611, in Table 4J--Out-Migration Adjustment--FY 2006, the 23rd through 45th entries, the entries in the Published Provider No. column in the chart below are corrected in the Corrected Provider No. column to read as follows:

      Corrected Published provider No.

      provider No.

      540022..................................................

      150022 540030..................................................

      150030 540035..................................................

      150035 540045..................................................

      150045 540060..................................................

      150060 540062..................................................

      150062 540065..................................................

      150065 540076..................................................

      150076 540088..................................................

      150088 540091..................................................

      150091 540102..................................................

      150102 540113..................................................

      150113 540122..................................................

      150122 640013..................................................

      160013 640026..................................................

      160026 640030..................................................

      160030 640032..................................................

      160032 640080..................................................

      160080 740137..................................................

      170137 840012..................................................

      180012 840066..................................................

      180066 840127..................................................

      180127 840128..................................................

      180128

      6. On page 47619, in Table 5--List of Diagnosis-Related Groups, Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay (LOS), the 11th and 12th entries, the DRG title (column 6) is corrected to read as follows:

      DRG

      DRG title

      68........................................ OTITIS MEDIA & URI AGE >17 W CC

      [[Page 57164]]

      69........................................ OTITIS MEDIA & URI AGE >17 W/ O CC

      7. On page 47638, in Table 6E--Revised Diagnosis Code Titles, the first entry, the CC (column 3) is corrected to read as follows:

      Diagnosis code

      CC

      285.21*................................... N

      8. On page 47675, in Table 9A--Hospital Reclassifications and Redesignations by Individual Hospital and CBSA--FY 2006, first set of entries, the 36th entry, the Reclassified CBSA is corrected to read as follows:

      Reclassified Provider No.

      CBSA

      360095.................................................

      45780

3. 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 the notice and comment procedures 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. We can also waive the 30-day delay in effective date under the APA (5 U.S.C. 553(d)) when there is good cause to do so and we publish in the rule an explanation of our good cause.

   The policies and payment methodology expressed in the FY 2006 final rule have previously been subjected to notice and comment procedures. This correction notice merely corrects typographical and technical errors in the preamble, regulations text, and addendum of the FY 2006 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 correction notice is intended to ensure that the FY 2006 final rule accurately reflects the policies adopted in the final rule. Therefore, we find that undertaking further notice and comment procedures to incorporate these corrections into the final rule is unnecessary and contrary to the public interest.

   For the same reasons, we are also waiving the 30-day delay in effective date for this correction notice. We believe that it is in the public interest to ensure that the FY 2006 final rule accurately represents our prospective payment methodology, payment rates, and policies. Thus delaying the effective date of these corrections would be contrary to the public interest. Therefore, we also find good cause to waive the 30-day delay in effective date.

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

   Dated: September 27, 2005. Ann C. Agnew, Executive Secretary to the Department.

   [FR Doc. 05-19612 Filed 9-29-05; 8:45 am]

   BILLING CODE 4120-01-P