[Federal Register Volume 61, Number 127 (Monday, July 1, 1996)]
[Notices]
[Pages 33928-33936]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-16568]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[BPD-847-CN]
RIN 0938-AH34
Medicare Program; Changes to the Hospital Inpatient Prospective
Payment Systems and Fiscal Year 1997 Rates; Correction
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Correction notice.
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SUMMARY: On May 31, 1996, we published a proposed rule (61 FR 27444)
that would revise 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
systems. In the addendum to the proposed rule, we announced the
prospective payment rates for Medicare hospital inpatient services for
operating costs and capital-related costs that would apply to
discharges occurring on or after October 1, 1996, and set forth the
factors for determining the rate-of-increase limits for hospital and
hospital units excluded from the prospective payment system. This
notice corrects errors made in that document.
FOR FURTHER INFORMATION CONTACT: Tzvi Hefter, (410) 786-1304.
SUPPLEMENTARY INFORMATION: In the May 31, 1996 proposed rule (61 FR
27444), we indicated that the addendum would discuss our proposed
update of the factors for determining the rate-of-increase limits for
cost reporting periods beginning in Federal fiscal year 1997 for
hospitals and hospital units excluded from the prospective payment
system. This discussion was inadvertently omitted from the published
document.
In addition, there were errors in our calculations of the
Geographic Adjustment Factors (GAFs) in tables 4a and 4b. The tables
are reprinted in their entirety in this document. The GAFs set forth in
table 4c are correct.
The proposed rule also contained other technical and typographical
errors. Therefore, we are making the following corrections to the May
31, 1996 proposed rule:
1. On page 27474, in the table entitled Initial Residency Period,
after ``Allopathy'' and before ``ANESTHESIOLOGY'' insert the following
row:
ALLERGY AND IMMUNOLOGY...............................................3.
2. On page 27504, in the second column before ``V. Tables'', the
following information should be inserted:
IV. Proposed Rate-of-Increase Percentages for Excluded Hospitals and
Hospital Units
The inpatient operating costs of hospitals and hospital units
excluded from the prospective payment system are subject to rate-of-
increase limits established under the authority of section 1886(b) of
the Act, which is implemented in Sec. 413.40 of the regulations. Under
these limits, an annual target amount (expressed in terms of the
inpatient operating cost per discharge) is set for each hospital, based
on the hospital's own historical cost experience trended forward by the
applicable rate-of-increase percentages (update factors). The target
amount is multiplied by the number of Medicare discharges in a
hospital's cost reporting period, yielding the ceiling on aggregate
Medicare inpatient operating costs for the cost reporting period.
Effective with cost reporting periods beginning on or after October
1, 1991, a hospital that has Medicare inpatient operating costs in
excess of its ceiling is paid its ceiling plus 50 percent of its costs
in excess of the ceiling. Total payment may not exceed 110 percent of
the ceiling. A hospital that has inpatient operating costs less than
its ceiling is paid its costs plus the lower of--
Fifty percent of the difference between the allowable
inpatient operating costs and the ceiling; or
Five percent of the ceiling.
Each hospital's target amount is adjusted annually, at the
beginning of its cost reporting period, by an applicable rate-of-
increase percentage. Section 1886(b)(3)(B) of the Act provides that for
cost reporting periods beginning on or after October 1, 1993, and
before October 1, 1994, the applicable rate-of-increase percentage is
the market basket percentage increase minus the lesser of 1 percentage
point or the percentage point difference between 10 percent and the
hospital's ``update adjustment percentage'' of at least 10 percent. The
rate-of-increase percentage for hospitals in the latter case is the
market basket percentage increase. The ``update adjustment percentage''
is the percentage by which a hospital's allowable inpatient operating
costs exceeds the hospital's ceiling for the cost reporting period
beginning in Federal fiscal year (FY) 1990. For cost reporting periods
beginning on or after October 1, 1994, and before October 1, 1997, the
update adjustment percentage is the update adjustment percentage from
the previous year plus the previous year's applicable reduction. The
applicable reduction and applicable rate-of-increase percentage are
then determined in the same manner as for FY 1994. The most recent
forecasted market basket increase for FY 1997 for hospitals and
hospital units excluded from the prospective payment system is 2.7
percent.
3. On pages 27521 to 27527, Table 4a--Wage Index and Capital
Geographic Adjustment Factor (GAF) for Urban Areas is corrected by
replacing the table with the following table:
[[Page 33929]]
Table 4a.--Wage Index and Capital Geographic Adjustment Factor (GAF) for
Urban Areas
------------------------------------------------------------------------
Urban area (constituent counties or county Wage
equivalents) index GAF
------------------------------------------------------------------------
0040 Abilene, TX................................ 0.8055 0.8623
Taylor, TX
0060 Aguadilla, PR.............................. 0.4430 0.5726
Aguada, PR
Aguadilla, PR
Moca, PR
0080 Akron, OH.................................. 0.9875 0.9914
Portage, OH
Summit, OH
0120 Albany, GA................................. 0.8353 0.8841
Dougherty, GA
Lee, GA
0160 Albany-Schenectady-Troy, NY................ 0.8510 0.8954
Albany, NY
Montgomery, NY
Rensselaer, NY
Saratoga, NY
Schenectady, NY
Schoharie, NY
0200 Albuquerque, NM............................ 0.9390 0.9578
Bernalillo, NM
Sandoval, NM
Valencia, NM
0220 Alexandria, LA............................. 0.8213 0.8739
Rapides, LA
0240 Allentown-Bethlehem-Easton, PA............. 1.0014 1.0010
Carbon, PA
Lehigh, PA
Northampton, PA
0280 Altoona, PA................................ 0.9531 0.9676
Blair, PA
0320 Amarillo, TX............................... 0.8557 0.8988
Potter, TX
Randall, TX
0380 Anchorage, AK.............................. 1.3285 1.2147
Anchorage, AK
0440 Ann Arbor, MI.............................. 1.1688 1.1127
Lenawee, MI
Livingston, MI
Washtenaw, MI
0450 Anniston, AL............................... 0.7848 0.8471
Calhoun, AL
0460 Appleton-Oshkosh-Neenah, WI................ 0.8910 0.9240
Calumet, WI
Outagamie, WI
Winnebago, WI
0470 Arecibo, PR................................ 0.4631 0.5903
Arecibo, PR
Camuy, PR
Hatillo, PR
0480 Asheville, NC.............................. 0.9365 0.9561
Buncombe, NC
Madison, NC
0500 Athens, GA................................. 0.9259 0.9486
Clarke, GA
Madison, GA
Oconee, GA
0520 *Atlanta, GA............................... 1.0089 1.0061
Barrow, GA
Bartow, GA
Carroll, GA
Cherokee, GA
Clayton, GA
Cobb, GA
Coweta, GA
DeKalb, GA
Douglas, GA
Fayette, GA
Forsyth, GA
Fulton, GA
Gwinnett, GA
Henry, GA
Newton, GA
Paulding, GA
Pickens, GA
Rockdale, GA
Spalding, GA
Walton, GA
0560 Atlantic-Cape May, NJ......................
Atlantic, NJ
Cape May, NJ 1.1102 1.0742
0600 Augusta-Aiken, GA-SC.......................
Columbia, GA
McDuffie, GA
Richmond, GA
Aiken, SC
Edgefield, SC 0.8849 0.9197
0640 Austin-San Marcos, TX......................
Bastrop, TX
Caldwell, TX
Hays, TX
Travis, TX
Williamson, TX 0.9252 0.9482
0680 Bakersfield, CA............................
Kern, CA 1.0202 1.0138
0720 *Baltimore, MD.............................
Anne Arundel, MD
Baltimore, MD
Baltimore City, MD
Carroll, MD
Harford, MD
Howard, MD
Queen Anne's, MD 0.9820 0.9876
0733 Bangor, ME.................................
Penobscot, ME 0.9412 0.9594
0743 Barnstable-Yarmouth, MA....................
Barnstable, MA 1.3682 1.2395
0760 Baton Rouge, LA............................
Ascension, LA
East Baton Rouge, LA
Livingston, LA
West Baton Rouge, LA 0.8442 0.8905
0840 Beaumont-Port Arthur, TX...................
Hardin, TX
Jefferson, TX
Orange, TX 0.8578 0.9003
0860 Bellingham, WA.............................
Whatcom, WA 1.1342 1.0901
0870 Benton Harbor, MI..........................
Berrien, MI 0.8553 0.8985
0875 *Bergen-Passaic, NJ........................
Bergen, NJ
Passaic, NJ 1.1717 1.1146
0880 Billings, MT...............................
Yellowstone, MT 0.8903 0.9235
0920 Biloxi-Gulfport-Pascagoula, MS.............
Hancock, MS
Harrison, MS
Jackson, MS 0.8573 0.8999
0960 Binghamton, NY.............................
Broome, NY
Tioga, NY 0.8842 0.9192
1000 Birmingham, AL.............................
Blount, AL
Jefferson, AL
St. Clair, AL
Shelby, AL 0.9047 0.9337
1010 Bismarck, ND...............................
Burleigh, ND
Morton, ND 0.7976 0.8565
1020 Bloomington, IN............................
Monroe, IN 0.8619 0.9032
1040 Bloomington-Normal, IL.....................
McLean, IL 0.8921 0.9248
1080 Boise City, ID.............................
Ada, ID
Canyon, ID 0.9269 0.9493
1123 *Boston-Worcester-Lawrence-Lowell-Brockton,
MA-NH........................................... 1.1639 1.1095
Bristol, MA
Essex, MA
Middlesex, MA
Norfolk, MA
Plymouth, MA
Suffolk, MA
Worcester, MA
Hillsborough, NH
Merrimack, NH
Rockingham, NH
Strafford, NH
1125 Boulder-Longmont CO........................ 0.9383 0.9573
Boulder, CO
1145 Brazoria, TX............................... 0.8865 0.9208
Brazoria, TX
1150 Bremerton, WA.............................. 1.0926 1.0625
Kitsap, WA
[[Page 33930]]
1240 Brownsville-Harlingen-San Benito, TX....... 0.8561 0.8991
Cameron, TX
1260 Bryan-College Station, TX.................. 0.8760 0.9133
Brazos, TX
1280 *Buffalo-Niagara Falls, NY................. 0.9123 0.9391
Erie, NY
Niagara, NY
1303 Burlington, VT............................. 0.9126 0.9393
Chittenden, VT
Franklin, VT
Grand Isle, VT
1310 Caguas, PR................................. 0.4661 0.5929
Caguas, PR
Cayey, PR
Cidra, PR
Gurabo, PR
San Lorenzo, PR
1320 Canton-Massillon, OH....................... 0.8667 0.9067
Carroll, OH
Stark, OH
1350 Casper, WY................................. 0.8841 0.9191
Natrona, WY
1360 Cedar Rapids, IA........................... 0.8477 0.8930
Linn, IA
1400 Champaign-Urbana, IL....................... 0.9413 0.9594
Champaign, IL
1440 Charleston-North Charleston, SC............ 0.8984 0.9293
Berkeley, SC
Charleston, SC
Dorchester, SC
1480 Charleston, WV............................. 0.9547 0.9688
Kanawha, WV
Putnam, WV
1520 *Charlotte-Gastonia-Rock Hill, NC-SC....... 0.9631 0.9746
Cabarrus, NC
Gaston, NC
Lincoln, NC
Mecklenburg, NC
Rowan, NC
Union, NC
York, SC
1540 Charlottesville, VA........................ 0.9175 0.9427
Albemarle, VA
Charlottesville City, VA
Fluvanna, VA
Greene, VA
1560 Chattanooga, TN-GA......................... 0.8867 0.9210
Catoosa, GA
Dade, GA
Walker, GA
Hamilton, TN
Marion, TN
1580 Cheyenne, WY............................... 0.7695 0.8357
Laramie, WY
1600 *Chicago, IL............................... 1.0756 1.0512
Cook, IL
DeKalb, IL
DuPage, IL
Grundy, IL
Kane, IL
Kendall, IL
Lake, IL
McHenry, IL
Will, IL
1620 Chico-Paradise, CA......................... 1.0441 1.0300
Butte, CA
1640 *Cincinnati, OH-KY-IN...................... 0.9477 0.9639
Dearborn, IN
Ohio, IN
Boone, KY
Campbell, KY
Gallatin, KY
Grant, KY
Kenton, KY
Pendleton, KY
Brown, OH
Clermont, OH
Hamilton, OH
Warren, OH
1660 Clarksville-Hopkinsville, TN-KY............ 0.7733 0.8386
Christian, KY
Montgomery, TN
1680 *Cleveland-Lorain-Elyria, OH............... 0.9908 0.9937
Ashtabula, OH
Cuyahoga, OH
Geauga, OH
Lake, OH
Lorain, OH
Medina, OH
1720 Colorado Springs, CO....................... 0.9456 0.9624
El Paso, CO
1740 Columbia, MO 0.8919 0.9246
Boone, MO
1760 Columbia, SC............................... 0.9178 0.9430
Lexington, SC
Richland, SC
1800 Columbus, GA-AL............................ 0.7655 0.8328
Russell, AL
Chattanoochee, GA
Harris, GA
Muscogee, GA
1840 *Columbus, OH.............................. 0.9699 0.9793
Delaware, OH
Fairfield, OH
Franklin, OH
Licking, OH
Madison, OH
Pickaway, OH
1880 Corpus Christi, TX......................... 0.8641 0.9048
Nueces, TX
San Patricio, TX
1900 Cumberland, MD-WV.......................... 0.8613 0.9028
Allegany, MD
Mineral, WV
1920 *Dallas, TX................................ 0.9530 0.9676
Collin, TX
Dallas, TX
Denton, TX
Ellis, TX
Henderson, TX
Hunt, TX
Kaufman, TX
Rockwall, TX
1950 Danville, VA............................... 0.8516 0.8958
Danville City, VA
Pittsylvania, VA
1960 Davenport-Moline-Rock Island, IA-IL........ 0.8407 0.8880
Scott, IA
Henry, IL
Rock Island, IL
2000 Dayton-Springfield, OH..................... 0.9582 0.9712
Clark, OH
Greene, OH
Miami, OH
Montgomery, OH
2020 Daytona Beach, FL.......................... 0.8891 0.9227
Flagler, FL
Volusia, FL
2030 Decatur, AL................................ 0.8403 0.8877
Lawrence, AL
Morgan, AL
2040 Decatur, IL................................ 0.7866 0.8484
Macon, IL
2080 *Denver, CO................................ 1.0291 1.0198
Adams, CO
Arapahoe, CO
Denver, CO
Douglas, CO
Jefferson, CO
2120 Des Moines, IA............................. 0.8772 0.9142
Dallas, IA
Polk, IA
Warren, IA
2216 *Detroit, MI............................... 1.0748 1.0506
Lapeer, MI
Macomb, MI
Monroe, MI
Oakland, MI
St. Clair, MI
Wayne, MI
2180 Dothan, AL................................. 0.7758 0.8404
Dale, AL
Houston, AL
2190 Dover, DE.................................. 0.9017 0.9316
Kent, DE
2000 Dubuque, IA................................ 0.8149 0.8692
[[Page 33931]]
Dubuque, IA
2240 Duluth-Superior, MN-WI..................... 0.9437 0.9611
St. Louis, MN
Douglas, WI
2281 Dutchess County, NY........................ 1.0604 1.0410
Dutchess, NY
2290 Eau Claire, WI............................. 0.8698 0.9089
Chippewa, WI
Eau Claire, WI
2320 El Paso, TX................................ 0.9486 0.9645
El Paso, TX
2330 Elkhart-Goshen, IN......................... 0.8820 0.9176
Elkhart, IN
2335 Elmira, NY................................. 0.8436 0.8901
Chemung, NY
2340 Enid, OK................................... 0.7879 0.8494
Garfield, OK
2360 Erie, PA................................... 0.9137 0.9401
Erie, PA
2400 Eugene-Springfield, OR..................... 1.1503 1.1006
Lane, OR
2440 Evansville-Henderson, IN-KY................ 0.8990 0.9297
Posey, IN
Vanderburgh, IN
Warrick, IN
Henderson, KY
2520 Fargo-Moorhead, ND-MN...................... 0.9010 0.9311
Clay, MN
Cass, ND
2560 Fayetteville, NC........................... 0.9025 0.9322
Cumberland, NC
2580 Fayetteville-Springdale-Rogers, AR......... 0.7236 0.8013
Benton, AR
Washington, AR
2620 Flagstaff, AZ-UT........................... 0.9039 0.9331
Coconino, AZ
Kane, UT
2640 Flint, MI.................................. 1.1273 1.0855
Genesee, MI
2650 Florence, AL............................... 0.8157 0.8698
Colbert, AL
Lauderdale, AL
2655 Florence, SC............................... 0.8614 0.9029
Florence, SC
2670 Fort Collins-Loveland, CO.................. 1.0628 1.0426
Larimer, CO
2680 *Ft. Lauderdale, FL........................ 1.0968 1.0653
Broward, FL
2700 Fort Myers-Cape Coral, FL.................. 0.9093 0.9370
Lee, FL
2710 Fort Pierce-Port St. Lucie, FL............. 1.0192 1.0131
Martin, FL
St. Lucie, FL
2720 Fort Smith, AR-OK.......................... 0.7885 0.8498
Crawford, AR
Sebastian, AR
Sequoyah, OK
2750 Fort Walton Beach, FL...................... 0.9186 0.9435
Okaloosa, FL
2760 Fort Wayne, IN............................. 0.8819 0.9175
Adams, IN
Allen, IN
DeKalb, IN
Huntington, IN
Wells, IN
Whitley, IN
2800 *Forth Worth-Arlington, TX................. 1.0095 1.0065
Hood, TX
Johnson, TX
Parker, TX
Tarrant, TX
2840 Fresno, CA................................. 1.1202 1.0808
Fresno, CA
Madera, CA
2880 Gadsden, AL................................ 0.8901 0.9234
Etowah, AL
2900 Gainesville, FL............................ 0.9455 0.9623
Alachua, FL
2920 Galveston-Texas City, TX................... 1.1022 1.0689
Galveston, TX
2960 Gary, IN................................... 0.9176 0.9428
Lake, IN
Porter, IN
2975 Glens Falls, NY............................ 0.8560 0.8990
Warren, NY
Washington, NY
2980 Goldsboro, NC.............................. 0.8412 0.8883
Wayne, NC
2985 Grand Forks, ND-MN......................... 0.9228 0.9465
Polk, MN
Grand Forks, ND
2995 Grand Junction, CO......................... 0.8847 0.9195
Mesa, CO
3000 Grand Rapids-Muskegon-Holland, MI.......... 1.0088 1.0060
Allegan, MI
Kent, MI
Muskegon, MI
Ottawa, MI
3040 Great Falls, MT............................ 0.9007 0.9309
Cascade, MT
3060 Greeley, CO................................ 0.9712 0.9802
Weld, CO
3080 Green Bay, WI.............................. 0.9387 0.9576
Brown, WI
3120 *Greensboro-Winston-Salem-High Point, NC... 0.9327 0.9534
Alamance, NC
Davidson, NC
Davie, NC
Forsyth, NC
Guilford, NC
Randolph, NC
Stokes, NC
Yadkin, NC
3150 Greenville, NC............................. 0.9098 0.9373
Pitt, NC
3160 Greenville-Spartanburg-Anderson, SC........ 0.8947 0.9266
Anderson, SC
Cherokee, SC
Greenville, SC
Pickens, SC
Spartanburg, SC
3180 Hagerstown, MD............................. 0.9195 0.9441
Washington, MD
3200 Hamilton-Middletown, OH.................... 0.9515 0.9665
Butler, OH
3240 Harrisburg-Lebanon-Carlisle, PA Cumberland,
PA.............................................. 1.0181 1.0124
Dauphin, PA
Lebanon, PA
Perry, PA.
3283 *Hartford, CT.............................. 1.2395 1.1584
Hartford, CT
Litchfield, CT
Middlesex, CT
Tolland, CT
3285 Hattiesburg, MS............................ 0.7269 0.8038
Forrest, MS
Lamar, MS
3290 Hickory-Morganton-Lenoir, NC............... 0.7945 0.8542
Alexander, NC
Burke, NC
Caldwell, NC
Catawba, NC
3320 Honolulu, HI............................... 1.1487 1.0996
Honolulu, HI
3350 Houma, LA.................................. 0.7843 0.8467
Lafourche, LA
Terrebonne, LA
3360 *Houston, TX............................... 0.9790 0.9856
Chambers, TX
Fort Bend, TX
Harris, TX
Liberty, TX
Montgomery, TX
Waller, TX
3400 Huntington-Ashland, WV-KY-OH............... 0.9194 0.9441
Boyd, KY
Carter, KY
[[Page 33932]]
Greenup, KY
Lawrence, OH
Cabell, WV
Wayne, WV
3440 Huntsville, AL............................. 0.8145 0.8689
Limestone, AL
Madison, AL
3480 *Indianapolis, IN.......................... 0.9950 0.9966
Boone, IN
Hamilton, IN
Hancock, IN
Hendricks, IN
Johnson, IN
Madison, IN
Marion, IN
Morgan, IN
Shelby, IN
3500 Iowa City, IA.............................. 0.9382 0.9573
Johnson, IA
3520 Jackson, MI................................ 0.9066 0.9351
Jackson, MI
3560 Jackson, MS................................. 0.7906 0.8514
Hinds, MS
Madison, MS
Rankin, MS
3580 Jackson, TN................................ 0.8340 0.8831
Madison, TN
3600 Jacksonville, FL........................... 0.9018 0.9317
Clay, FL
Duval, FL
Nassau, FL
St. Johns, FL
3605 Jacksonville, NC........................... 0.7071 0.7887
Onslow, NC
3610 Jamestown, NY.............................. 0.7679 0.8346
Chautaqua, NY
3620 Janesville-Beloit, WI...................... 0.8664 0.9065
Rock, WI
3640 Jersey City, NJ............................ 1.1408 1.0944
Hudson, NJ
3660 Johnson City-Kingsport-Bristol, TN-VA...... 0.8921 0.9248
Carter, TN
Hawkins, TN
Sullivan, TN
Unicoi, TN
Washington, TN
Bristol City, VA
Scott, VA
Washington, VA
3680 Johnstown, PA.............................. 0.8417 0.8887
Cambria, PA
Somerset, PA
3710 Joplin, MO................................. 0.7409 0.8144
Jasper, MO
Newton, MO
3720 Kalamazoo-Battlecreek, MI.................. 1.0565 1.0384
Calhoun, MI
Kalamazoo, MI
Van Buren, MI
3740 Kankakee, IL............................... 0.8998 0.9302
Kankakee, IL
3760 *Kansas City, KS-MO........................ 0.9522 0.9670
Johnson, KS
Leavenworth, KS
Miami, KS
Wyandotte, KS
Cass, MO
Clay, MO
Clinton, MO
Jackson, MO
Lafayette, MO
Platte, MO
Ray, MO
3800 Kenosha, WI................................ 0.9166 0.9421
Kenosha, WI
3810 Killeen-Temple, TX......................... 1.0415 1.0282
Bell, TX
Coryell, TX
3840 Knoxville, TN.............................. 0.8520 0.8961
Anderson, TN
Blount, TN
Knox, TN
Loudon, TN
Sevier, TN
Union, TN
3850 Kokomo, IN................................. 0.8609 0.9025
Howard, IN
Tipton, IN
3870 La Crosse, WI-MN........................... 0.8638 0.9046
Houston, MN
La Crosse, WI
3880 Lafayette, LA.............................. 0.8183 0.8717
Acadia, LA
Lafayette, LA
St. Landry, LA
St. Martin, LA
3920 Lafayette, IN.............................. 0.8824 0.9179
Clinton, IN
Tippecanoe, IN
3960 Lake Charles, LA........................... 0.8052 0.8621
Calcasieu, LA
3980 Lakeland-Winter Haven, FL.................. 0.8677 0.9074
Polk, FL
4000 Lancaster, PA.............................. 0.9605 0.9728
Lancaster, PA
4040 Lansing-East Lansing, MI................... 1.0016 1.0011
Clinton, MI
Eaton, MI
Ingham, MI
4080 Laredo, TX................................. 0.7092 0.79034100
Webb, TX
4100 Las Cruces, NM............................. 0.8516 0.8958
Dona Ana, NM
4120 *Las Vegas, NV-AZ.......................... 1.0894 1.0604
Mohave, AZ
Clark, NV
Nye, NV
4150 Lawrence, KS............................... 0.8616 0.9030
Douglas, KS
4200 Lawton, OK................................. 0.8339 0.8830
Comanche, OK
4243 Lewiston-Auburn, ME........................ 0.9431 0.9607
Androscoggin, ME
4280 Lexington, KY.............................. 0.8387 0.8865
Bourbon, KY
Clark, KY
Fayette, KY
Jessamine, KY
Madison, KY
Scott, KY
Woodford, KY
4320 Lima, OH................................... 0.8752 0.9128
Allen, OH
Auglaize, OH
4360 Lincoln, NE................................ 0.9193 0.9440
Lancaster, NE
4400 Little Rock-North Little Rock, AR.......... 0.8616 0.9030
Faulkner, AR
Lonoke, AR
Pulaski, AR
Saline, AR
4420 Longview-Marshall, TX...................... 0.8633 0.9042
Gregg, TX
Harrison, TX
Upshur, TX
4480 *Los Angeles-Long Beach, CA................ 1.2396 1.1585
Los Angeles, CA
4520 Louisville, KY-IN.......................... 0.9445 0.9617
Clark, IN
Floyd, IN
Harrison, IN
Scott, IN
Bullitt, KY
Jefferson, KY
Oldham, KY
4600 Lubbock, TX................................ 0.8525 0.8965
Lubbock, TX
4640 Lynchburg, VA.............................. 0.8036 0.8609
Amherst, VA
Bedford, VA
Bedford City, VA
Campbell, VA
Lynchburg City, VA
4680 Macon, GA.................................. 0.8836 0.9187
Bibb, GA
Houston, GA
Jones, GA
Peach, GA
Twiggs, GA
4720 Madison, WI................................ 1.0048 1.0033
Dane, WI
[[Page 33933]]
4800 Mansfield, OH.............................. 0.8543 0.8978
Crawford, OH
Richland, OH
4840 Mayaguez, PR............................... 0.4186 0.5508
Anasco, PR
Cabo Rojo, PR
Hormigueros, PR
Mayaguez, PR
Sabana Grande, PR
San German, PR
4880 McAllen-Edinburg-Mission, TX............... 0.8502 0.8948
Hidalgo, TX
4890 Medford-Ashland, OR........................ 1.0213 1.0145
Jackson, OR
4900 Melbourne-Titusville-Palm Bay, FL.......... 0.9089 0.9367
Brevard, Fl
4920 *Memphis, TN-AR-MS......................... 0.8185 0.8718
Crittenden, AR
DeSoto, MS
Fayette, TN
Shelby, TN
Tipton, TN
4940 Merced, CA................................. 1.0684 1.0463
Merced, CA
5000 *Miami, FL................................. 0.9240 0.9473
Dade, FL
5015 *Middlesex-Somerset-Hunterdon, NJ.......... 1.0777 1.0526
Hunterdon, NJ
Middlesex, NJ
Somerset, NJ
5080 *Milwaukee-Waukesha, WI.................... 0.9667 0.9771
Milwaukee, WI
Ozaukee, WI
Washington, WI
Waukesha, WI
5120 *Minneapolis-St. Paul, MN-WI............... 1.0785 1.0531
Anoka, MN
Carver, MN
Chisago, MN
Dakota, MN
Hennepin, MN
Isanti, MN
Ramsey, MN
Scott, MN
Sherburne, MN
Washington, MN
Wright, MN
Pierce, WI
St. Croix, WI
5160 Mobile, AL................................. 0.7999 0.8582
Baldwin, AL
Mobile, AL
5170 Modesto, CA................................ 1.0135 1.0092
Stanislaus, CA
5190 *Monmouth-Ocean, NJ........................ 1.0842 1.0569
Monmouth, NJ
Ocean, NJ
5200 Monroe, LA................................. 0.8234 0.8754
Ouachita, LA
5240 Montgomery, AL............................. 0.7949 0.8545
Autauga, AL
Elmore, AL
Montgomery, AL
5280 Muncie, IN 0.9736 0.9818
Delaware, IN
5330 Myrtle Beach, SC........................... 0.7798 0.8434
Horry, SC
5345 Naples, FL................................. 1.0222 1.0151
Collier, FL
5360 *Nashville, TN............................. 0.9065 0.9350
Cheatham, TN
Davidson, TN
Dickson, TN
Robertson, TN
Rutherford, TN
Sumner, TN
Williamson, TN
Wilson, TN
5380 *Nassau-Suffolk, NY........................ 1.2852 1.1875
Nassau, NY
Suffolk, NY
5483 *New Haven-Bridgeport-Stamford-Waterbury... 1.2778 1.1828
Danbury, CT
Fairfield, CT
New Haven, CT
5523 New London-Norwich, CT..................... 1.2345 1.1552
New London, CT
5560 *New Orleans, LA........................... 0.9434 0.9609
Jefferson, LA
Orleans, LA
Plaquemines, LA
St. Bernard, LA
St. Charles, LA
St. James, LA
St. John The Baptist, LA
St. Tammany, LA
5600 *New York, NY.............................. 1.4041 1.2616
Bronx, NY
Kings, NY
New York, NY
Putnam, NY
Queens, NY
Richmond, NY
Rockland, NY
Westchester, NY
5640 *Newark, NJ................................ 1.1057 1.0712
Essex, NJ
Morris, NJ
Sussex, NJ
Union, NJ
Warren, NJ
5660 Newburgh, NY-PA............................ 1.0829 1.0561
Orange, NY
Pike, PA
5720 *Norfolk-Virginia Beach-Newport News, VA-NC 0.8326 0.8821
Currituck, NC
Chesapeake City, VA
Gloucester, VA
Hampton City, VA
Isle of Wight, VA
James City, VA
Mathews, VA
Newport News City, VA
Norfolk City, VA
Poquoson City, VA
Portsmouth City, VA
Suffolk City, VA
Virginia Beach City, VA
Williamsburg City, VA
York, VA
5775 *Oakland, CA............................... 1.5113 1.3268
Alameda, CA
Contra Costa, CA
5790 Ocala, FL..................................
Marion, FL 0.8999 0.9303
5800 Odessa-Midland, TX......................... 0.8552 0.8984
Ector, TX
Midland, TX
5880 *Oklahoma City, OK......................... 0.8463 0.8920
Canadian, OK
Cleveland, OK
Logan, OK
McClain, OK
Oklahoma, OK
Pottawatomie, OK
5910 Olympia, WA................................ 1.0713 1.0483
Thurston, WA
5920 Omaha, NE-IA............................... 0.9425 0.9603
Pottawattamie, IA
Cass, NE
Douglas, NE
Sarpy, NE
Washington, NE
5945 *Orange County, CA......................... 1.1929 1.1284
Orange, CA
5960 *Orlando, FL............................... 0.9491 0.9649
Lake, FL
Orange, FL
Osceola, FL
Seminole, FL
5990 Owensboro, KY.............................. 0.7578 0.8270
Daviess, KY
[[Page 33934]]
6015 Panama City, FL............................ 0.8080 0.8642
Bay, FL
6020 Parkersburg-Marietta, WV-OH................ 0.7895 0.8506
Washington, OH
Wood, WV
6080 Pensacola, FL.............................. 0.8212 0.8738
Escambia, FL
Santa Rosa, FL
6120 Peoria-Pekin, IL........................... 0.8923 0.9249
Peoria, IL
Tazewell, IL
Woodford, IL
6160 *Philadelphia, PA-NJ....................... 1.1197 1.0805
Burlington, NJ
Camden, NJ
Gloucester, NJ
Salem, NJ
Bucks, PA
Chester, PA
Delaware, PA
Montgomery, PA
Philadelphia, PA
6200 *Phoenix-Mesa, AZ.......................... 0.9832 0.9885
Maricopa, AZ
Pinal, AZ
6240 Pine Bluff, AR............................. 0.7904 0.8512
Jefferson, AR
6280 *Pittsburgh, PA............................ 0.9726 0.9812
Allegheny, PA
Beaver, PA
Butler, PA
Fayette, PA
Washington, PA
Westmoreland, PA
6323 Pittsfield, MA............................. 1.0570 1.0387
Berkshire, MA
6360 Ponce, PR.................................. 0.4500 0.5788
Guayanilla, PR
Juana Diaz, PR
Penuelas, PR
Ponce, PR
Villalba, PR
Yauco, PR
6403 Portland, ME............................... 0.9615 0.9735
Cumberland, ME
Sagadahoc, ME
York, ME
6440 *Portland-Vancouver, OR-WA................. 1.1267 1.0851
Clackamas, OR
Columbia, OR
Multnomah, OR
Washington, OR
Yamhill, OR
Clark, WA
6483 Providence-Warwick-Pawtucket, RI........... 1.1116 1.0751
Bristol, RI
Kent, RI
Newport, RI
Providence, RI
Washington, RI
6520 Provo-Orem, UT............................. 1.0139 1.0095
Utah, UT
6560 Pueblo, CO................................. 0.8302 0.8804
Pueblo, CO
6580 Punta Gorda, FL............................ 0.8284 0.8790
Charlotte, FL
6600 Racine, WI................................. 0.8855 0.9201
Racine, WI
6640 Raleigh-Durham-Chapel Hill, NC............. 0.9740 0.9821
Chatham, NC
Durham, NC
Franklin, NC
Johnston, NC
Orange, NC
Wake, NC
6660 Rapid City, SD............................. 0.8493 0.8942
Pennington, SD
6680 Reading, PA................................ 0.9467 0.9632
Berks, PA
6690 Redding, CA................................ 1.1631 1.1090
Shasta, CA
6720 Reno, NV................................... 1.1043 1.0703
Washoe, NV
6740 Richland-Kennewick-Pasco, WA............... 0.9993 0.9995
Benton, WA
Franklin, WA
6760 Richmond-Petersburg, VA.................... 0.9189 0.9437
Charles City County, VA
Chesterfield, VA
Colonial Heights City, VA
Dinwiddie, VA
Goochland, VA
Hanover, VA
Henrico, VA
Hopewell City, VA
New Kent, VA
Petersburg City, VA
Powhatan, VA
Prince George, VA
Richmond City, VA
6780 *Riverside-San Bernardino, CA.............. 1.1251 1.0841
Riverside, CA
San Bernardino, CA
6800 Roanoke, VA................................ 0.8721 0.9105
Botetourt, VA
Roanoke, VA
Roanoke City, VA
Salem City, VA
6820 Rochester, MN.............................. 1.0452 1.0307
Olmsted, MN
6840 *Rochester, NY............................. 0.9611 0.9732
Genesee, NY
Livingston, NY
Monroe, NY
Ontario, NY
Orleans, NY
Wayne, NY
6880 Rockford, IL............................... 0.9015 0.9315
Boone, IL
Ogle, IL
Winnebago, IL
6895 Rocky Mount, NC............................ 0.8951 0.9269
Edgecombe, NC
Nash, NC
6920 *Sacramento, CA............................ 1.2382 1.1576
El Dorado, CA
Placer, CA
Sacramento, CA
6960 Saginaw-Bay City-Midland, MI............... 0.9605 0.9728
Bay, MI
Midland, MI
Saginaw, MI
6980 St. Cloud, MN.............................. 0.9478 0.9640
Benton, MN
Stearns, MN
7000 St. Joseph, MO............................. 0.8570 0.8997
Andrews, MO
Buchanan, MO
7040 *St. Louis, MO-IL.......................... 0.8926 0.9251
Clinton, IL
Jersey, IL
Madison, IL
Monroe, IL
St. Clair, IL
Franklin, MO
Jefferson, MO
Lincoln, MO
St. Charles, MO
St. Louis, MO
St. Louis City, MO
Warren, MO
7080 Salem, OR.................................. 0.9749 0.9827
Marion, OR
Polk, OR
7120 Salinas, CA................................ 1.3835 1.2489
Monterey, CA
7160 *Salt Lake City-Ogden, UT.................. 0.9677 0.9778
Davis, UT
Salt Lake, UT
Weber, UT
7200 San Angelo, TX............................. 0.7594 0.8282
Tom Green, TX
[[Page 33935]]
7240 *San Antonio, TX........................... 0.8365 0.8849
Bexar, TX
Comal, TX
Guadalupe, TX
Wilson, TX
7320 *San Diego, CA............................. 1.2183 1.1448
San Diego, CA
7360 *San Francisco, CA......................... 1.4210 1.2720
Marin, CA
San Francisco, CA
San Mateo, CA
7400 *San Jose, CA.............................. 1.4435 1.2858
Santa Clara, CA
7440 *San Juan-Bayamon, PR...................... 0.4616 0.5890
Aguas Buenas, PR
Barceloneta, PR
Bayamon, PR
Canovanas, PR
Carolina, PR
Catano, PR
Ceiba, PR
Comerio, PR
Corozal, PR
Dorado, PR
Fajardo, PR
Florida, PR
Guaynabo, PR
Humacao, PR
Juncos, PR
Los Piedras, PR
Loiza, PR
Luguillo, PR
Manati, PR
Morovis, PR
Naguabo, PR
Naranjito, PR
Rio Grande, PR
San Juan, PR
Toa Alta, PR
Toa Baja, PR
Trujillo Alto, PR
Vega Alta, PR
Vega Baja, PR
Yabucoa, PR
7460 San Luis Obispo-Atascadero-Paso Robles, CA. 1.1587 1.1061
San Luis Obispo, CA
7480 Santa Barbara-Santa Maria-Lompoc, CA....... 1.1267 1.0851
Santa Barbara, CA
7485 Santa Cruz-Watsonville, CA................. 1.3551 1.2313
Santa Cruz, CA
7490 Santa Fe, NM............................... 1.0847 1.0573
Los Alamos, NM
Santa Fe, NM
7500 Santa Rosa, CA............................. 1.2558 1.1688
Sonoma, CA
7510 Sarasota-Bradenton, FL..................... 0.9770 0.9842
Manatee, FL
Sarasota, FL
7520 Savannah, GA............................... 1.0089 1.0061
Bryan, GA
Chatham, GA
Effingham, GA
7560 Scranton--Wilkes-Barre--Hazleton, PA....... 0.8767 0.9138
Columbia, PA
Lackawanna, PA
Luzerne, PA
Wyoming, PA
7600 *Seattle-Bellevue-Everett, WA.............. 1.1410 1.0945
Island, WA
King, WA
Snohomish, WA
7610 Sharon, PA................................. 0.8764 0.9136
Mercer, PA
7620 Sheboygan, WI.............................. 0.7782 0.8422
Sheboygan, WI
7640 Sherman-Denison, TX........................ 0.8650 0.9055
Grayson, TX
7680 Shreveport-Bossier City, LA................ 0.9379 0.9570
Bossier, LA
Caddo, LA
Webster, LA
7720 Sioux City, IA-NE.......................... 0.8331 0.8825
Woodbury, IA
Dakota, NE 7760
7760 Sioux Falls, SD............................ 0.8606 0.9023
Lincoln, SD
Minnehaha, SD
7800 South Bend, IN............................. 0.9957 0.9971
St. Joseph, IN
7840 Spokane, WA................................ 1.0548 1.0372
Spokane, WA
7880 Springfield, IL............................ 0.8783 0.9150
Menard, IL
Sangamon, IL
7920 Springfield, MO............................ 0.7840 0.8465
Christian, MO
Greene, MO
Webster, MO
8003 Springfield, MA............................ 1.0609 1.0413
Hampden, MA
Hampshire, MA
8050 State College, PA.......................... 0.8875 0.9215
Centre, PA
8080 Steubenville-Weirton, OH-WV................ 0.8244 0.8761
Jefferson, OH
Brooke, WV
Hancock, WV
8120 Stockton-Lodi, CA.......................... 1.1417 1.0950
San Joaquin, CA
8140 Sumter, SC................................. 0.7716 0.8373
Sumter, SC
8160 Syracuse, NY............................... 0.9406 0.9589
Cayuga, NY
Madison, NY
Onondaga, NY
Oswego, NY
8200 Tacoma, WA................................. 1.0891 1.0602
Pierce, WA
8240 Tallahassee, FL............................ 0.8332 0.8825
Gadsden, FL
Leon, FL
8280 *Tampa-St. Petersburg-Clearwater, FL....... 0.9322 0.9531
Hernando, FL
Hillsborough, FL
Pasco, FL
Pinellas, FL
8320 Terre Haute, IN............................ 0.8611 0.9027
Clay, IN
Vermillion, IN
Vigo, IN
8360 Texarkana, AR-Texarkana, TX................ 0.8484 0.8935
Miller, AR
Bowie, TX
8400 Toledo, OH................................. 1.0383 1.0261
Fulton, OH
Lucas, OH
Wood, OH
8440 Topeka, KS................................. 1.0108 1.0074
Shawnee, KS
8480 Trenton, NJ................................ 1.0572 1.0388
Mercer, NJ
8520 Tucson, AZ................................. 0.9050 0.9339
Pima, AZ
8560 Tulsa, OK.................................. 0.8113 0.8666
Creek, OK
Osage, OK
Rogers, OK
Tulsa, OK
Wagoner, OK
8600 Tuscaloosa, AL............................. 0.7723 0.8378
Tuscaloosa, AL
8640 Tyler, TX.................................. 1.0158 1.0108
Smith, TX
8680 Utica-Rome, NY............................. 0.8421 0.8890
Herkimer, NY
Oneida, NY
8720 Vallejo-Fairfield-Napa, CA................. 1.3483 1.2271
Napa, CA
Solano, CA
[[Page 33936]]
8735 Ventura, CA................................ 1.1169 1.0786
Ventura, CA
8750 Victoria, TX............................... 0.8478 0.8931
Victoria, TX
8760 Vineland-Millville-Bridgeton, NJ........... 1.0015 1.0010
Cumberland, NJ
8780 Visalia-Tulare-Porterville, CA............. 1.0174 1.0119
Tulare, CA
8800 Waco, TX................................... 0.7789 0.8427
McLennan, TX
8840 *Washington, DC-MD-VA-WV................... 1.0842 1.0569
District of Columbia, DC
Calvert, MD
Charles, MD
Frederick, MD
Montgomery, MD
Prince Georges, MD
Alexandria City, VA
Arlington, VA
Clarke, VA
Culpepper, VA
Fairfax, VA
Fairfax City, VA
Falls Church City, VA
Fauquier, VA
Fredericksburg City, VA
King George, VA
Loudoun, VA
Manassas City, VA
Manassas Park City, VA
Prince William, VA
Spotsylvania, VA
Stafford, VA
Warren, VA
Berkeley, WV
Jefferson, WV
8920 Waterloo-Cedar Falls, IA................... 0.8724 0.9108
Black Hawk, IA
8940 Wausau, WI................................. 1.0347 1.0236
Marathon, WI
8960 West Palm Beach-Boca Raton, FL............. 1.0016 1.0011
Palm Beach, FL
9000 Wheeling, OH-WV............................ 0.7580 0.8272
Belmont, OH
Marshall, WV
Ohio, WV
9040 Wichita, KS................................ 0.9447 0.9618
Butler, KS
Harvey, KS
Sedgwick, KS
9080 Wichita Falls, TX.......................... 0.8070 0.8634
Archer, TX
Wichita, TX
9140 Williamsport, PA........................... 0.8487 0.8937
Lycoming, PA
9160 Wilmington-Newark, DE-MD................... 1.1341 1.0900
New Castle, DE
Cecil, MD
9200 Wilmington, NC............................. 0.9072 0.9355
New Hanover, NC
Brunswick, NC
9260 Yakima, WA................................. 1.0049 1.0034
Yakima, WA
9270 Yolo, CA................................... 1.1470 1.0985
Yolo, CA
9280 York, PA................................... 0.9124 0.9391
York, PA
9320 Youngstown-Warren, OH...................... 0.9764 0.9838
Columbiana, OH
Mahoning, OH
Trumbull, OH
9340 Yuba City, CA.............................. 1.0437 1.0297
Sutter, CA
Yuba, CA
9360 Yuma, AZ................................... 0.9518 0.9667
Yuma, AZ
------------------------------------------------------------------------
* Large Urban Area
4. On pages 27527 to 27528, Table 4b--Wage Index and Capital
Geographic Adjustment Factor (GAF) for Rural Areas is corrected by
replacing the table with the following table:
Table 4B.--Wage Index and Capital Geographic Adjustment Factor (GAF) For
Rural Areas
------------------------------------------------------------------------
Wage
Nonurban Area index GAF
------------------------------------------------------------------------
Alabama............................................. 0.7160 0.7955
Alaska.............................................. 1.2472 1.1633
Arizona............................................. 0.7946 0.8543
Arkansas............................................ 0.7000 0.7833
California.......................................... 0.9991 0.9994
Colorado............................................ 0.8156 0.8697
Connecticut......................................... 1.2788 1.1834
Delaware............................................ 0.9464 0.9630
Florida............................................. 0.8677 0.9074
Georgia............................................. 0.7659 0.8331
Hawaii.............................................. 1.0268 1.0183
Idaho............................................... 0.8356 0.8843
Illinois............................................ 0.7567 0.8262
Indiana............................................. 0.8119 0.8670
Iowa................................................ 0.7394 0.8132
Kansas.............................................. 0.7113 0.7919
Kentucky............................................ 0.7772 0.8415
Louisiana........................................... 0.7284 0.8049
Maine............................................... 0.8335 0.8827
Maryland............................................ 0.8446 0.8908
Massachusetts....................................... 1.0794 1.0537
Michigan............................................ 0.8837 0.9188
Minnesota........................................... 0.8161 0.8701
Mississippi......................................... 0.6808 0.7685
Missouri............................................ 0.7249 0.8023
Montana............................................. 0.8137 0.8683
Nebraska............................................ 0.7245 0.8020
Nevada.............................................. 0.8795 0.9158
New Hampshire....................................... 0.9776 0.9846
New Jersey \1\...................................... ........ ........
New Mexico.......................................... 0.7873 0.8489
New York............................................ 0.8565 0.8994
North Carolina...................................... 0.7945 0.8542
North Dakota........................................ 0.7370 0.8114
Ohio................................................ 0.8349 0.8838
Oklahoma............................................ 0.6963 0.7805
Oregon.............................................. 0.9715 0.9804
Pennsylvania........................................ 0.8480 0.8932
Puerto Rico......................................... 0.4182 0.5505
Rhode Island \1\.................................... ........ ........
South Carolina...................................... 0.7679 0.8346
South Dakota........................................ 0.7085 0.7898
Tennessee........................................... 0.7372 0.8116
Texas............................................... 0.7430 0.8159
Utah................................................ 0.8854 0.9200
Vermont............................................. 0.8941 0.9262
Virginia............................................ 0.7760 0.8406
Washington.......................................... 0.9956 0.9970
West Virginia....................................... 0.7943 0.8541
Wisconsin........................................... 0.8449 0.8910
Wyoming............................................. 0.8202 0.8731
------------------------------------------------------------------------
\1\ All counties within the State are classified urban.
5. On page 27544, top of the page, the title of table 6c is
corrected to read as follows: ``TABLE 6C--INVALID DIAGNOSIS CODES.''
6. On page 27590, column two, between the end of the fifth
paragraph and the beginning of the letter to The Honorable Albert Gore,
Jr., the following text should be inserted: ``Appendix D: Report to
Congress on the Update Factor for Prospective Payment Hospitals and
Hospitals Excluded from the Prospective Payment System.''
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: June 24, 1996.
Neil J. Stillman,
Deputy Assistant Secretary for Information Resource Management.
[FR Doc. 96-16568 Filed 6-28-96; 8:45 am]
BILLING CODE 4120-01-P