[Federal Register Volume 59, Number 238 (Tuesday, December 13, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-30556]


[[Page Unknown]]

[Federal Register: December 13, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
42 CFR Parts 412 and 413

[BPD-802-CN]
RIN 0938-AG46

 

Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems and Fiscal Year 1995 Rates; Correction

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

ACTION: Final rule; correction.

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

SUMMARY: In the September 1, 1994 issue of the Federal Register (59 FR 
45330), 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, 1994, and set forth update factors for the rate-of-increase 
limits for hospitals and hospital units excluded from the prospective 
payment systems. This notice corrects errors made in that document.

EFFECTIVE DATE: October 1, 1994.

FOR FURTHER INFORMATION CONTACT: John Davis--Wage Index (410) 966-5654; 
Nancy Edwards--Other Issues (410) 966-4531.

SUPPLEMENTARY INFORMATION: In the September 1, 1994 final rule with 
comment period (59 FR 45330), we indicated that if a hospital believes 
its wage index value is incorrect as a result of an intermediary or 
HCFA error, the hospital must notify HCFA no later than September 23, 
1994. As a result of this process, we have identified several 
corrections to the wage data. Accordingly, the wage index values for 
several areas have been changed.
    The final rule also contained other technical and typographical 
errors. The revised wage index values, and other changes affecting 
prospective payment rates, reflect corrections that were made between 
publication of the FY 1995 prospective payment system final rule with 
comment period on September 1, 1994, and implementation of the FY 1995 
prospective payment rates on October 1, 1994. Therefore, we are making 
the following corrections to the September 1, 1994 final rule with 
comment period:
    1. On page 45361, the chart at the top of the page is corrected as 
follows:

------------------------------------------------------------------------
                                       Number of labor  Corrected number
                                        market areas     of labor market
Percentage change in area wage index ------------------       areas     
                value                                  -----------------
                                      FY 1995  FY 1994  FY 1995  FY 1994
------------------------------------------------------------------------
Increase more than 10 percent.......        2       13        5       13
Increase between 5 and 10 percent...        4       24       17       24
Decrease between 5 and 10 percent...       13       58       13       58
Decrease more than 10 percent.......       10       14       10       14
------------------------------------------------------------------------

    2. On pages 45421 through 45436, the following entries in Table 
3C--Hospital Case Mix Indexes for Discharges Occurring in Federal 
Fiscal Year 1993; Hospital Average Hourly Wage for Federal Fiscal Year 
1995 Wage Index--are corrected as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                             Corrected avg. hour
                     Provider                         Case mix index       Avg. hour wage            wage       
----------------------------------------------------------------------------------------------------------------
050030...........................................             01.3478                17.25                17.31 
050153...........................................             01.6323                26.54                26.63 
050183...........................................             01.1897                18.72                19.77 
050194...........................................             01.2188                23.01                23.15 
050457...........................................             01.9263                27.09                27.16 
050688...........................................             01.2086                25.13                25.25 
110162...........................................             00.8663   ...................               12.98 
140010...........................................             01.3097                18.77                20.61 
170037...........................................             01.1331                15.60                15.31 
170080...........................................             01.0304                11.67                11.23 
170110...........................................             00.9268                12.68                12.61 
180005...........................................             01.0444                14.66                15.54 
180138...........................................             01.2598                17.78                17.30 
190005...........................................             01.4454                14.98                13.28 
190006...........................................             01.1903                13.93                14.22 
190009...........................................             01.2947                13.88                13.73 
190011...........................................             01.1190                12.19                12.11 
190040...........................................             01.4197                17.30                17.28 
190098...........................................             01.4469                16.69                16.44 
190122...........................................             01.2075                13.84                13.57 
190176...........................................             01.5428                17.76                17.42 
220107...........................................             01.1159                16.97                17.91 
230197...........................................             01.2661                17.75                19.21 
240036...........................................             01.4910                17.88                18.16 
250001...........................................             01.5597                13.55                13.71 
310009...........................................             01.1537                19.28                20.11 
440049...........................................             01.6483                15.27                15.47 
450002...........................................             01.4852                15.52                18.57 
510047...........................................             01.1688                15.81                15.86 
520100...........................................             01.2514                14.46                14.74 
----------------------------------------------------------------------------------------------------------------

    3. On pages 45437 through 45444, in Table 4A--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Urban Areas--the wage 
index value and GAF in the following entries are corrected as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                          Changed               
                         Urban area                            Wage index      GAF       wage index  Changed GAF
----------------------------------------------------------------------------------------------------------------
0220Alexandria, LA..........................................       0.8302       0.8804       0.8284       0.8790
0600Augusta-Aiken, GA-SC....................................       0.8638       0.9046       0.8634       0.9043
0760Baton Rouge, LA.........................................       0.8617       0.9031       0.8582       0.9006
1123*Boston-Brockton-Nashua, MA-NH..........................       1.1733       1.1157       1.1732       1.1156
1600*Chicago, IL............................................       1.0666       1.0451       1.0689       1.0467
1620Chico-Paradise, CA......................................       1.0434       1.0295       1.0441       1.0300
2320El Paso, TX.............................................       0.8618       0.9032       0.9057       0.9344
2640Flint, MI...............................................       1.0252       1.0172       1.0423       1.0288
3560Jackson, MS.............................................       0.7551       0.8250       0.7569       0.8264
3620Janesville-Beloit, WI...................................       0.8541       0.8976       0.8606       0.9023
3880Lafayette, LA...........................................       0.7975       0.8565       0.7996       0.8580
4520Louisville, KY-IN.......................................       0.9485       0.9644       0.9480       0.9641
4920*Memphis, TN-AR-MS......................................       0.8508       0.8953       0.8535       0.8972
5170Modesto, CA.............................................       1.1348       1.0905       1.1415       1.0949
5200Monroe, LA..............................................       0.7723       0.8378       0.7707       0.8366
5560*New Orleans, LA........................................       0.9499       0.9654       0.9311       0.9523
5640*Newark, NJ.............................................       1.1128       1.0759       1.1156       1.0778
6323Pittsfield, MA..........................................       1.1313       1.0882       1.1413       1.0947
6980St. Cloud, MN...........................................       0.9549       0.9689       0.9680       0.9780
7360*San Francisco, CA......................................       1.4120       1.2665       1.4122       1.2666
7400*San Jose, CA...........................................       1.4272       1.2758       1.4276       1.2761
7680Shreveport-Bossier City, LA.............................       0.9036       0.9329       0.8992       0.9298
----------------------------------------------------------------------------------------------------------------

    4. On page 45444, in Table 4B--Wage Index and Capital Geographic 
Adjustment Factor (GAF) for Rural Areas--the wage index value and the 
GAF in the following entries are corrected as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                          Changed               
                       Non-urban area                          Wage index      GAF       wage index  Changed GAF
----------------------------------------------------------------------------------------------------------------
Alaska......................................................       1.2592       1.1710       1.2591       1.1709
Kansas......................................................       0.7270       0.8039       0.7267       0.8036
Kentucky....................................................       0.7487       0.8202       0.7498       0.8210
West Virginia...............................................       0.8120       0.8671       0.8121       0.8672
----------------------------------------------------------------------------------------------------------------

    5. On pages 45444 through 45445, in Table 4C--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Hospitals that are 
Reclassified--the wage index value and the GAF in the following entries 
are corrected as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                          Changed               
                    Area reclassified to                       Wage index      GAF       wage index  Changed GAF
----------------------------------------------------------------------------------------------------------------
Alexandria, LA..............................................       0.8302       0.8804       0.8284       0.8790
Baton Rouge, LA.............................................       0.8617       0.9031       0.8582       0.9006
Boston-Brockton-Nashua, MA-NH...............................       1.1733       1.1157       1.1732       1.1156
Chicago, IL.................................................       1.0666       1.0451       1.0689       1.0467
Des Moines, IA..............................................       0.8533       0.8971       0.8510       0.8954
El Paso, TX.................................................       0.8618       0.9032       0.9057       0.9344
Flint, MI...................................................       1.0252       1.0172       1.0423       1.0288
Jackson, MS.................................................       0.7551       0.8250       0.7569       0.8264
Lafayette, LA...............................................       0.7975       0.8565       0.7996       0.8580
Louisville, KY..............................................       0.9485       0.9644       0.9480       0.9641
Memphis, TN-AR-MS...........................................       0.8386       0.8864       0.8410       0.8882
Middlesex-Somerset-Hunterdon, NJ............................       1.0770       1.0521       1.0715       1.0484
Modesto, CA.................................................       1.1348       1.0905       1.1415       1.0949
Monroe, LA..................................................       0.7723       0.8378       0.7707       0.8366
New Orleans, LA.............................................       0.9499       0.9654       0.9311       0.9523
Newark, NJ..................................................       1.0848       1.0573       1.0870       1.0588
St. Cloud, MN...............................................       0.9549       0.9689       0.9535       0.9679
San Francisco, CA...........................................       1.4120       1.2665       1.4122       1.2666
San Jose, CA................................................       1.4272       1.2758       1.4276       1.2761
Rural West Virginia.........................................       0.8120       0.8671       0.8121       0.8672
----------------------------------------------------------------------------------------------------------------

    6. On pages 45445 through 45447, Table 4D--Average Hourly Wage for 
Urban Areas--the following entries are corrected as follows:

------------------------------------------------------------------------
                                                                   New  
                                                       Average   average
                     Urban area                        hourly    hourly 
                                                        wage      wage  
------------------------------------------------------------------------
Alexandria, LA......................................   15.1620   15.1288
Augusta-Aiken, GA-SC................................   15.7746   15.7680
Baton Rouge, LA.....................................   15.7376   15.6738
Chicago, IL.........................................   19.4782   19.5206
Chico-Paradise, CA..................................   19.0544   19.0673
El Paso, TX.........................................   15.7386   16.5401
Flint, MI...........................................   18.8129   19.0521
Jackson, MS.........................................   13.6437   13.6854
Janesville-Beloit, WI...............................   15.5973   15.7175
Lafayette, LA.......................................   14.4264   14.4675
Lake Charles, LA....................................   15.0433   15.0427
Louisville, KY-IN...................................   17.3214   17.3129
Memphis, TN-AR-MS...................................   15.5377   15.5871
Modesto, CA.........................................   20.7245   20.8463
Monroe, LA..........................................   13.9777   13.9494
New Orleans, LA.....................................   17.3485   17.0048
Newark, NJ..........................................   21.9178   21.9471
Pittsfield, MA......................................   20.6597   20.8427
St. Cloud, MN.......................................   17.4385   17.6778
San Francisco, CA...................................   25.7496   25.7537
San Jose, CA........................................   26.0635   26.0709
Santa Cruz-Watsonville, CA..........................   24.7020   24.7441
Shreveport-Bossier City, LA.........................   16.5027   16.4215
------------------------------------------------------------------------

    7. On page 45447, Table 4E--Average Hourly Wage for Rural Areas--
the following entries are corrected as follows:

------------------------------------------------------------------------
                                                                   New  
                                                       Average   average
                   Non-urban area                      hourly    hourly 
                                                        wage      wage  
------------------------------------------------------------------------
Kansas..............................................   13.2765   13.2707
Kentucky............................................   13.6733   13.6938
West Virginia.......................................   14.7441   14.7464
------------------------------------------------------------------------

    8. On page 45497, in Table I--Impact Analysis of Changes for FY 
1995 Operating Prospective Payment System--under Bed Size (Rural), the 
rows and corresponding figures for Pacific and Puerto Rico are moved to 
page 45498 under Rural by Region, and inserted under the row and 
corresponding figures for Mountain.
    9. On page 45498, also in Table I, under Disproportionate Share 
Hospitals (DSH), Other Rural DSH Hosp., the rows and corresponding 
figures for 100-149 Beds, 150-199 Beds, and 200 or more Beds are moved 
to page 45497 under Bed Size (Rural), and inserted under the row and 
corresponding figures for 50-99 Beds.
    10. On page 45518, the sentence beginning seven lines from the 
bottom of the first column and continuing to the second line of the 
second column is corrected to read as follows: ``However, measuring the 
actual expected price per unit of real capital, independently of any 
evaluation of the propriety of any actual purchase decisions, is 
essential to recognize that the industry has some control over the 
amount of capital it purchases but little or no control over the price 
it pays for capital.''
    11. In the outlier example that begins on page 45368, Footnote 1a 
on page 45370 is corrected to read as follows: ``If hospital X were a 
hold harmless hospital, it should use the hospital-specific ratio of 
new to total capital.''
    12. On page 45457, in Table 6A--New Diagnosis Codes--the following 
code is added:

------------------------------------------------------------------------
 Diagnosis                                                              
   code                      Description                    CC  MDC  DRG
------------------------------------------------------------------------
305.1       Tobacco use disorder.........................    N   23  467
------------------------------------------------------------------------

    13. On page 45461, Table 6C--Invalid Diagnosis Codes--the following 
entry is corrected to read as follows:

------------------------------------------------------------------------
 Diagnosis                                                              
   code                      Description                    CC  MDC  DRG
------------------------------------------------------------------------
V65.4       Other counseling.............................    N   23  467
------------------------------------------------------------------------

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance)

    Dated: December 6, 1994.
Michael W. Carleton,
Acting Deputy Assistant Secretary for Information Resources Management.

[FR Doc. 94-30556 Filed 12-12-94; 8:45 am]
BILLING CODE 4120-01-P