[Federal Register Volume 70, Number 189 (Friday, September 30, 2005)]
[Rules and Regulations]
[Pages 57164-57166]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-19762]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1282-CN]

42 CFR Parts 411 and 424

RIN 0938-AN65


Medicare Program; Prospective Payment System and Consolidated 
Billing for Skilled Nursing Facilities; Correction

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

ACTION: Final rule; correction notice.

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SUMMARY: This document corrects typographical and technical errors that 
appeared in the August 4, 2005 Federal Register, entitled ``Medicare 
Program; Prospective Payment System and Consolidated Billing for 
Skilled Nursing Facilities for FY 2006.''

EFFECTIVE DATE: October 1, 2005.

FOR FURTHER INFORMATION CONTACT: Jeanette Kranacs, (410) 786-9385. Bill 
Ullman, (410) 786-5667. Sheila Lambowitz, (410) 786-7605.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 05-15221, (70 FR 45026), the final rule entitled 
``Medicare Program; Prospective Payment System and Consolidated Billing 
for Skilled Nursing Facilities for FY 2006'' (hereinafter referred to 
as the FY 2006 final rule), there were a number of typographical and 
technical errors that are identified and corrected in section III. 
``Correction of Errors'' below. 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 on October 1, 2005.

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

A. Corrections to the Preamble of the FY 2006 Final Rule

    On pages 45046 and 45047, in the preamble discussion of the SNF 
market basket index, we inadvertently included incorrect values in the 
column labeled ``Relative importance, labor-related, FY 2005 (97 
index).'' Therefore, we are revising the second column in Table 11 
(``Labor-Related Relative Importance, FY 2005 and FY 2006'') to include 
the correct values for the labor share estimate for FY 2005 based on 
the 2nd quarter 2004 projection. (See item 1 of section III.A of this 
notice.)

B. Corrections to the Regulations Text of the FY 2006 Final Rule

    On page 45055, we made a technical error in the regulations text of 
title 42, part 411. In this paragraph, we inadvertently excluded the 
updated statutory authority citation for this part. As revised by FR 
Doc. 05-1321 entitled ``Medicare Program; Medicare Prescription Drug 
Benefit'' (70 FR 4525, January 28, 2005), in this notice we are 
correcting the regulations text to include Secs. 1102, 1860D-1 through 
D-42, and 1871 of the Social Security Act (42 U.S.C. 1302, 1395w-101 
through 1395w-152, and 1395hh). Accordingly, we are now republishing 
the corrected statutory authority citation for part 411, as revised by 
FR Doc. 05-1321. (See item 1 of section III. B. of this notice.)
    Also on page 45055, in our revisions to two different sections of 
the regulations text in part 424 of the FY 2006 final rule, we 
inadvertently omitted a subpart heading. Specifically, revised Sec.  
424.3 and Sec.  424.20 were both displayed as being included within 
subpart B of part 424 (``Certification and Plan of Treatment 
Requirements''). In fact, only Sec.  424.20 is included within that 
subpart, while Sec.  424.3 is included within subpart A (``General 
Provisions''). (See items 2 and 3 of section III. B. of this notice.)

C. Corrections of Errors to the Addendum of the FY 2006 Final Rule

    Wage index data for two providers were erroneously omitted from the 
wage index calculation. This affected the wage index determination for 
the Houston-Sugar Land-Baytown, TX CBSA and the Nashville-Davidson-
Murfreesboro, TN CBSA. Accordingly,

[[Page 57165]]

we are revising Table 8 and Table A to reflect the correct information. 
In addition, both Table 8 and Table A contained a number of technical 
and typographical errors. Therefore, we are including the corrected 
data in Table 8 and Table A. (See items 1 and 2 of section III.C. of 
this notice.)

III. Correction of Errors

    In FR Doc. 05-15221 of August 4, 2005 (70 FR 45026), we are making 
the following corrections:

A. Corrections to Errors in the Preamble

    1. On pages 45046 and 45047, in Table 11--Labor-Related Relative 
Importance, FY 2005 is corrected to read as follows:

     Table 11.--Labor-Related Relative Importance, FY2005 and FY2006
------------------------------------------------------------------------
                                             Relative        Relative
                                           importance,*    importance,**
                                          labor-related,  labor-related,
                                            FY 2005 (97     FY 2006 (97
                                              index)          index)
------------------------------------------------------------------------
Wages and salaries......................          54.720          54.391
Employee benefits.......................          11.595          11.648
Nonmedical professional fees............           2.688           2.739
Labor-intensive services................           4.125           4.128
Capital-related.........................           3.094           3.016
                                         -----------------
    Total...............................          76.222         75.922
------------------------------------------------------------------------
* Source: Global Insights, Inc., formerly DRI-WEFA, 2nd Quarter, 2004.
** Source: Global Insights, Inc., formerly DRI-WEFA, 2nd Quarter, 2005.

B. Corrections of Errors in the Regulations Text

PART 411--[CORRECTED]

0
1. On page 45055, second column, lines 1 through 3, in part 411 
(Exclusions From Medicare and Limitations On Medicare Payment), the 
authority citation is corrected to read as follows:

    Authority: Secs. 1102, 1860D-1 through 1860D-42, and 1871 of the 
Social Security Act (42 U.S.C. 1302, 1395w-101 through 1395w-152, 
and 1395hh).

PART 424--[CORRECTED]

0
2. On page 45055, second column, above Sec.  424.3 Definitions, remove 
``Subpart B--Certification and Plan of Treatment Requirements'' and add 
in its place, ``Subpart A--General Provisions.''

0
3. On page 45055, second column, above amendatory instruction 3., add 
the subpart heading to read as follows: ``Subpart B Certification and 
Plan of Treatment Requirements.''

C. Corrections to the Addendum

    1. On pages 45065, 45069, and 45070 in Table 8.--(``FY 2006 Wage 
Index For Urban Areas Based On CBSA Labor Market Areas'') the entries 
for the Urban area and Wage index are corrected to read as follows:

------------------------------------------------------------------------
                         Urban area (constituent
     CBSA code                  counties)                 Wage index
------------------------------------------------------------------------
26420.............  Houston-Baytown-Sugar Land, TX..  0.9996
31900.............  Mansfield, OH...................  0.9891
34980.............  Nashville-Davidson Murfreesboro,  0.9790
                     TN.
------------------------------------------------------------------------

    2. On pages 45080 through 45121, the following entries identified 
in Table A.--(``FY 2006 SNF PPS Transition Wage Index'') are corrected 
to read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                              Transition
 SSA State/county code         County name        MSA No.       MSA Urban/rural      2006 MSA-  2006 CBSA-  CBSA No.     CBSA Urban/rural     wage index
                                                                                      based WI   based WI                                          *
--------------------------------------------------------------------------------------------------------------------------------------------------------
01330..................  Geneva County, Alabama         01  Rural..................     0.7432     0.7721      20020  Urban.................      0.7577
04280..................  Hempstead County,              04  Rural..................     0.7744     0.7466      99904  Rural.................      0.7605
                          Arkansas.
11451..................  Fayette County,              0520  Urban..................     0.9793     0.9793      12060  Urban.................      0.9793
                          Georgia.
11840..................  Richmond County,             0600  Urban..................     0.9808     0.9748      12260  Urban.................      0.9778
                          Georgia.
16350..................  Fremont County, Iowa..         16  Rural..................     0.8594     0.8509      99916  Rural.................      0.8552
27130..................  Fergus County, Montana         27  Rural..................     0.8762     0.8762      99927  Rural.................      0.8762
36710..................  Richland County, Ohio.       4800  Urban..................     0.9891     0.9891      31900  Urban.................      0.9891
44070..................  Cannon County,                 44  Rural..................     0.7935     0.9790      34980  Urban.................      0.8863
                          Tennessee.
44100..................  Cheatham County,             5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
44180..................  Davidson County,             5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
44210..................  Dickson County,              5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
44400..................  Hickman County,                44  Rural..................     0.7935     0.9790      34980  Urban.................      0.8863
                          Tennessee.
44550..................  Macon County,                  44  Rural..................     0.7935     0.9790      34980  Urban.................      0.8863
                          Tennessee.
44730..................  Robertson County,            5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
44740..................  Rutherford County,           5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
44790..................  Smith County,                  44  Rural..................     0.7935     0.9790      34980  Urban.................      0.8863
                          Tennessee.
44820..................  Sumner County,               5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.

[[Page 57166]]

 
44840..................  Trousdale County,              44  Rural..................     0.7935     0.9790      34980  Urban.................      0.8863
                          Tennessee.
44930..................  Williamson County,           5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
44940..................  Wilson County,               5360  Urban..................     0.9808     0.9790      34980  Urban.................      0.9799
                          Tennessee.
45070..................  Austin County, Texas..         45  Rural..................     0.7931     0.9996      26420  Urban.................      0.8964
45180..................  Brazoria County, Texas       1145  Urban..................     0.8563     0.9996      26420  Urban.................      0.9280
45280..................  Chambers County, Texas       3360  Urban..................     1.0091     0.9996      26420  Urban.................      1.0044
45341..................  Coryell County, Texas.       3810  Urban..................     0.8526     0.8526      28660  Urban.................      0.8526
45530..................  Fort Bend County,            3360  Urban..................     1.0091     0.9996      26420  Urban.................      1.0044
                          Texas.
45550..................  Galveston County,            2920  Urban..................     0.9635     0.9996      26420  Urban.................      0.9816
                          Texas.
45610..................  Harris County, Texas..       3360  Urban..................     1.0091     0.9996      26420  Urban.................      1.0044
45757..................  Liberty County, Texas.       3360  Urban..................     1.0091     0.9996      26420  Urban.................      1.0044
45801..................  Montgomery County,           3360  Urban..................     1.0091     0.9996      26420  Urban.................      1.0044
                          Texas.
45884..................  San Jacinto County,            45  Rural..................     0.7931     0.9996      26420  Urban.................      0.8964
                          Texas.
45950..................  Waller County, Texas..       3360  Urban..................     1.0091     0.9996      26420  Urban.................      1.0044
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IV. 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 notice such as this take effect in accordance with 
section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 
553(b)). We also ordinarily provide a 30-day delay in the effective 
date of the provisions of a notice in accordance with section 553(d) of 
the APA (5 U.S.C. 553(d)). However, we can waive both the notice and 
comment procedure and the 30-day delay in effective date if the 
Secretary finds, for good cause, that a 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 find it unnecessary to undertake notice and comment rulemaking 
because this notice merely provides technical and typographical 
corrections to the regulations. We are not making substantive changes 
to our payment methodologies or policies, but rather, are simply 
implementing correctly the payment methodologies and policies that we 
previously proposed, received comments on, and subsequently finalized. 
The public has already had the opportunity to comment on the payment 
methodology and policies being used to calculate wage indexes. In 
addition, this correction notice is intended to ensure that the FY 2006 
SNF PPS final rule accurately reflects the payment methodologies and 
policies adopted in the final rule. Therefore, we believe that 
undertaking further notice and comment procedures to incorporate these 
corrections into the final rule is unnecessary and contrary to the 
public interest.
    Further, we believe a delayed effective date is unnecessary because 
this correction notice merely corrects inadvertent technical and 
typographical errors. The changes noted above do not make any 
substantive changes to the SNF PPS payment methodologies or policies. 
Moreover, we regard imposing a delay in the effective date as being 
contrary to the public interest. We believe that it is in the public 
interest for providers to receive appropriate SNF PPS payments in as 
timely a manner as possible and to ensure that the FY 2006 SNF PPS 
final rule accurately reflects our payment methodologies, payment 
rates, and policies. Therefore, we find good cause to waive notice and 
comment procedures, as well as 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 28, 2005.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 05-19762 Filed 9-29-05; 8:45 am]
BILLING CODE 4120-01-P