[Federal Register Volume 63, Number 44 (Friday, March 6, 1998)]
[Rules and Regulations]
[Pages 11147-11159]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-5384]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
42 CFR Parts 400, 409, 410, 411, 412, 413, 424, 440, 485, 488, 489
and 498
[BPD-878-CN]
RIN 0938-AH55
Medicare Program; Changes to the Hospital Inpatient Prospective
Payment Systems and Fiscal Year 1998 Rates; Corrections
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Final rule with comment period; correction notice.
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SUMMARY: In the August 29, 1997, issue of the Federal Register (62 FR
45966), 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
resulting from the Balanced Budget Act of 1997, Pub. L. 105-33, and
changes arising from our continuing experience with the system. This
document corrects errors made in that document.
EFFECTIVE DATE: October 1, 1997.
FOR FURTHER INFORMATION CONTACT: Nancy Edwards, (410) 786-4531.
SUPPLEMENTARY INFORMATION: In the preamble of the August 29, 1997 final
rule with comment period, we indicated that if a hospital believed its
wage index value was incorrect as a result of an intermediary or HCFA
error that the hospital could not have known about before reviewing
data made available in mid-August, the hospital had to notify the
intermediary and HCFA in writing, no later than September 15, 1997 (see
62 FR 45989). As a result of this process, we have corrected the wage
data for 10 hospitals and included the wage data for 2 hospitals that
were erroneously omitted. In addition, the Balanced Budget Act of 1997,
Public Law 105-33, allowed hospitals meeting specific criteria to be
reclassified for fiscal year (FY) 1998 and subsequent years. Because
these reclassification decisions were made after publication of the
final rule with comment period, the impact on their area wage indexes
are reflected below. Accordingly, the wage index values for several
areas have changed and are corrected in this document.
The August 29, 1997 final rule with comment period also contained
technical and typographic errors. Therefore, we are making the
following corrections to the final rule with comment period:
[[Page 11148]]
1. On page 45967, third column, fourth full paragraph, fourth line,
the phrase ``are (MDH) for FY 1998 or 1999 will'' is corrected to read
``are not designated as Medicare-dependent small rural hospitals (MDHs)
for FY 1998 or 1999 will''.
2. On page 45968, second column, fifth full paragraph, first and
second lines, the phrase ``For cost reporting periods beginning on or
after'' is corrected to read ``For discharges on or after''.
3. On page 45997, third column, first paragraph, fourth through
sixth lines, the phrase ``uses the fixed loss outlier threshold of
$7,600 from the proposed rule'' is corrected to read ``uses a fixed
loss outlier threshold of $9,700''.
4. On page 46005, third column, first full paragraph, seventh line,
the phrase ``December 31, 1990'' is corrected to read ``December 31,
1998''.
5. On page 46019, first column, first paragraph, the table is
replaced with the following:
(1) Psychiatric hospital and units............................ $10,534
(2) Rehabilitation hospitals and units........................ 19,104
(3) Long-term care hospitals.................................. 37,688
6. On page 46020, second column, third full paragraph, the table is
replaced with the following:
(1) Psychiatric hospital and units............................ $8,482
(2) Rehabilitation hospitals and units........................ 16,677
(3) Long-term care hospitals.................................. 18,947
The changes in item numbers 6 and 7 reflect an update of 3.4
percent that was not included in the data published in the August 29,
1997 final rule with comment period. These changes were made through
Program Memorandum A-97-13 on September 29, 1997 and were effective
October 1, 1997.
7. On page 46042, second column, in the Table of Cost-of-Living
Adjustment Factors, Alaska and Hawaii Hospitals, the cost-of-living
adjustment for the County of Hawaii is corrected to read as follows:
County of Hawaii............................................. 1.15
8. On pages 46054 through 46069, in Table 3C--Hospital Case Mix
Indexes for Discharges Occurring in Federal Fiscal Year 1996; Hospital
Average Hourly Wages for Federal Fiscal Year 1998 Wage Index, the
average hourly wages for specified providers are corrected to read as
follows:
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Avg. hourly Corrected avg.
Provider Case mix index wage hourly wage
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09-0003......................................................... 01.3454 20.56 24.76
09-0007......................................................... 01.2828 20.38 21.23
14-0067......................................................... 01.7828 18.84 18.79
16-0029......................................................... 01.5134 18.14 18.32
22-0071......................................................... 01.9236 21.67 23.15
22-0077......................................................... 01.7917 22.92 23.28
33-0196......................................................... 01.3114 0.34 28.36
33-0385......................................................... 01.1776 -2.89 26.83
33-0396......................................................... 01.3520 24.91 31.58
39-0132......................................................... 01.3448 15.42 19.77
40-0029......................................................... 01.1383 .............. 9.92
40-0048......................................................... 01.2251 .............. 7.12
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9. On pages 46070 through 46076, in Table 4A--Wage Index and
Capital Geographic Adjustment Factor (GAF) for Urban Areas, the wage
index values and the GAFs for specified areas are corrected to read as
follows:
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Corrected Corrected
Urban area Wage index GAF wage index GAF
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0060...................... Aguadilla, PR................... 0.4224 0.5542 0.4188 0.5510
0470...................... Arecibo, PR..................... 0.4224 0.5542 0.4218 0.5537
1123...................... Boston-Worcester-Lawrence-Lowell- 1.1436 1.0962 1.1498 1.1003
Brockton, MA-NH \1\.
3500...................... Iowa City, IA................... 0.9401 0.9586 0.9413 0.9594
5600...................... New York, NY \1\................ 1.3982 1.2580 1.4449 1.2866
6120...................... Peoria-Pekin, IL................ 0.8586 0.9009 0.8571 0.8998
6160...................... Philadelphia, PA-NJ \1\......... 1.1379 1.0925 1.1398 1.0937
7440...................... San Juan-Bayamon, PR \1\........ 0.4618 0.5891 0.4625 0.5898
8840...................... Washington, DC-MD-VA-WV \1\..... 1.0780 1.0528 1.0911 1.0615
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\1\ Large Urban Area.
10. On pages 46076 through 46077, in Table 4B--Wage Index and
Capital Geographic Adjustment Factor (GAF) for Rural Areas, the wage
index value and the GAF for Puerto Rico are corrected to read as
follows:
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Corrected wage
Nonurban area Wage index GAF index Corrected GAF
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Puerto Rico................................. 0.4224 0.5542 0.3939 0.5283
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11. On pages 46077 through 46078, in Table 4C--Wage Index and
Capital Geographic Adjustment Factor (GAF) for Hospitals That Are
Reclassified, the wage index values and the GAFs for specified areas
are corrected to read as follows:
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Corrected wage
Area reclassified to Wage index GAF index Corrected GAF
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Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH 1.1436 1.0962 1.1498 1.1003
Hartford, CT.................................... .............. .............. 1.2373 1.1570
Iowa City, IA................................... 0.9198 0.9444 0.9208 0.9451
[[Page 11149]]
New York, NY.................................... 1.3982 1.2580 1.4449 1.2866
Peoria-Pekin, IL................................ 0.8586 0.9009 0.8571 0.8998
Philadelphia, PA-NJ............................. 1.1379 1.0925 1.1398 1.0937
Washington, DC-MD-VA-WV......................... 1.0780 1.0528 1.0911 1.0615
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12. On pages 46078 through 46079, in Table 4D--Average Hourly Wage
for Urban Areas, the average hourly wages for specified areas are
corrected to read as follows:
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Corrected
Urban area Average hourly average hourly
wage wage
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Boston-Worcester-Lawrence-Lowell-
Brockton, MA-NH........................ 22.9992 23.1215
Iowa City, IA........................... 18.8914 18.9163
New York, NY............................ 28.1700 29.0344
Peoria-Pekin, IL........................ 17.2543 17.2229
Philadelphia, PA-NJ..................... 22.8669 22.9042
San Juan-Bayamon, PR.................... 9.2790 9.2933
Springfield, MA......................... 21.4074 21.5827
Washington, DC-MD-VA-WV................. 21.6632 21.9255
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13. On pages 46079 through 46080, in Table 4E--Average Hourly Wage
for Rural Areas, the average hourly wage for Puerto Rico is corrected
to read as follows:
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Corrected
Nonurban area Average hourly average hourly
wage wage
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Puerto Rico........................... 8.4891 7.9149
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14. On page 46080, in Table 4F--Puerto Rico Wage Index and Capital
Geographic Adjustment Factor (GAF), the wage index values and the GAFs
for specified areas are corrected to read as follows:
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Corrected wage
Area Wage index GAF index Corrected GAF
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Aquadilla, PR................................... 0.9291 0.9509 0.9212 0.9453
Arecibo, PR..................................... 0.9291 0.9509 0.9276 0.9498
San Juan-Bayamon, PR............................ 1.0156 1.0107 1.0172 1.0117
Rural Puerto Rico............................... 0.9291 0.9509 0.8663 0.9064
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15. On pages 46099 through 46105, Table 7A--Medicare Prospective
Payment System; Selected Percentile Lengths of Stay [FY 96 MEDPAR
Update 06/97 Grouper V14.0] is corrected by replacing it with the
following:
BILLING CODE 4120-01-P
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BILLING CODE 4120-01-C
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance; and No.
93.774, Medicare--Supplementary Medical Insurance)
Dated: February 23, 1998.
Neil J. Stillman,
Deputy Assistant, Secretary for Information Resource Management.
[FR Doc. 98-5384 Filed 3-5-98; 8:45 am]
BILLING CODE 4120-01-P