[Federal Register Volume 71, Number 37 (Friday, February 24, 2006)]
[Proposed Rules]
[Pages 9505-9507]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-2607]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

42 CFR Parts 412 and 413

[CMS-1306-CN]
RIN 0938-AN82


Medicare Program; Inpatient Psychiatric Facilities Prospective 
Payment System Payment Update for Rate Year Beginning July 1, 2006 (RY 
2007); Correction and Extension of Comment Period

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

ACTION: Proposed rule; correction and extension of comment period.

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SUMMARY: This document corrects technical errors that appeared in the 
proposed rule entitled ``Medicare Program; Inpatient Psychiatric 
Facilities Prospective Payment System Payment Update for Rate Year 
Beginning July 1, 2006 (RY 2007).'' This correction notice also extends 
the public comment period for an additional 60 days, to allow the 
public an opportunity to comment on the correct Electroconvulsive 
Therapy (ECT) payment policy.

DATES: The comment period for the ECT payment policy is extended to 5 
p.m. on April 25, 2006.

FOR FURTHER INFORMATION CONTACT: Matthew Quarrick, (410) 786-9867.

[[Page 9506]]


SUPPLEMENTARY INFORMATION:

I. Background

    In FR. Doc. 06-488 of January 23, 2006 (71 FR 3616), there were 
several technical errors that we identify in the ``Summary of Errors'' 
section and correct in the ``Correction of Errors'' section below.
    On February 2, 2006, immediately after discovering the error in the 
ECT payment policy, we released a message on the Inpatient Psychiatric 
Facilities (IPF) Prospective Payment System (PPS) listserv. In 
addition, on February 6, 2006, we posted a message on our IPF PPS Web 
site indicating the error (http://www.cms.hhs.gov/InpatientPsychFacilPPS).
    The comment period for the proposed rule closes on March 14, 2006. 
However, we are extending the comment period for the ECT payment policy 
in order to give the public an opportunity to comment on the correct 
policy. The comment period for the ECT policy will close on April 7, 
2006.

II. Summary of Errors

    In the January 23, 2006 proposed rule, on page 3616, we 
inadvertently omitted the ``Regulations Identification Number (RIN), 
which is used to identify and track regulations. On page 3632, Table 11 
includes the adjustment factors for comorbidity categories. We 
incorrectly identified the ``Tracheostomy comorbidity'' category as the 
``Tracheotomy category.'' In the same table, we also published an 
incorrect adjustment factor of ``1.11'' for ``Severe Musculoskeletal 
and Connective Tissue Diseases.'' The correct factor is ``1.09,'' as 
published in the Comorbidity Adjustments table in Addendum A, on page 
3656. We note that in Addendum A, the correct comorbidity name for 
``Musculoskeletal & Connective Tissue Diseases'' is ``Severe 
Musculoskeletal and Connective Tissue Diseases.''
    We also stated on pages 3644 and 3645, that we apply the 
standardization factor and the wage index budget neutrality factor to 
the calendar year (CY) 2006 Outpatient Prospective Payment System 
(OPPS) median cost for ECT. We inadvertently omitted the adjustments 
for behavioral offset, stop-loss, and outliers when we calculated the 
ECT base rate. These adjustments were applied to the median cost for 
ECT in the implementation year, and we intended to be consistent with 
our methodology from last year. Because of these omissions, for rate 
year (RY) 2007, we published a proposed ECT rate of $268.21 instead of 
$254.86. As previously stated, immediately after discovering this 
error, we posted the correction on the CMS Web site at http://www.cms.hhs.gov/InpatientPsychFacilPPS/ and issued a message on our IPF 
PPS listserv.
    On page 3648 of the regulatory impact analysis, we incorrectly 
stated that ``we estimate the expenditures from the IPF PPS 
implementation year to the 2007 IPF PPS RY will be increased by $180 
million.'' The number we meant to include as the total estimated 
increase in expenditures from the implementation year to RY 2007 was 
$170 million. However, on page 3648 of the impact analysis, our 
estimate of the changes attributable to the policy changes in the 
proposed rule, primarily the market basket update and the 
standardization factor is correctly presented as approximately $180 
million for the IPF PPS RY 2007.
    In Addendum A, on page 3655, under the Variable Per Diem 
Adjustments table, for Day 1 (on both lines), we indicate an adjustment 
factor for a facility with or without a 24/7 Full-service Emergency 
Department (ED). In order to be consistent with our definition of an 
ED, and to be consistent with the November 15, 2004 IPF PPS correction 
notice (70 FR 16724), we are deleting the references to ``24/7 Full-
service ED'' and replacing it with ``Qualifying ED.''
    In Addendum B, on page 3663, we are correcting the 2006 MSA-based 
wage index values for the Social Security Administration (SSA) State 
County Codes where the numerical numbers were transposed.
    Also, in Addendum B, on page 3702, at the end of the Wage Index 
Table, we inadvertently included a sentence that refers to the 
``transition wage index value.'' Since we are not proposing a blended 
transition from Metropolitan Statistical Area (MSA)-based labor market 
definitions to Core-Based Statistical Areas-based labor market 
definitions, we are removing this sentence.
    In addition, we are correcting cross-references and typographical 
errors.

III. Correction of Errors

A. Preamble Corrections

    In the January 23, 2006 proposed rule (71 FR 3616), make the 
following corrections:
    1. On page 3616, in column 1, insert ``RIN-0938-AN82,'' above the 
title of the document.
    2. On page 3628, in column 2, in the third full paragraph, in line 
2, the cross-reference ``IV.C.5'' is corrected to read ``IV.C.4''.
    3. On page 3632, in Table 11, in column 1--
    A. In the third entry, ``Tracheotomy'' is corrected to read 
``Tracheostomy''.
    B. In column 3, in the second entry from the bottom, the figure 
``1.11'' is corrected to read ``1.09''.
    4. On page 3633, in column 2, in line 24, the cross-reference 
``IV.C.5.'' is corrected to read ``IV.C.4.''
    5. On page 3641--
    A. In column 2, in line 24, the reference to ``Sec.  
412.424(d)(1)(V)(A)'' is corrected to read ``Sec.  
412.424(d)(1)(v)(A)''.
    B. In column 3, in line 29, the reference to ``Sec.  
412.424(d)(1)(V)(B)'' is corrected to read ``Sec.  
412.424(d)(1)(v)(B)''.
    6. On page 3644, in column 3, in the fifth full paragraph, in line 
6, the words ``After applying the standardization factor and the wage 
index budget neutrality factor'' are replaced with the words ``After 
applying the standardization factor, behavior offset, stop-loss 
adjustment, outlier adjustment, and the wage index budget neutrality 
factor.''
    7. On page 3645--
    A. In column 1, in line 1, the cross-reference ``III.C.1.f.'' is 
corrected to read ``IV.C.1.f ''.
    B. In column 1, in line 3, the figure ``$268.21'' is corrected to 
read ``$254.86''.
    C. In column 3, in line 7, the reference to ``Chapter 2, Sec. Sec.  
20.1ff.)'' is corrected to read ``Chapter 2, Sec.  20.1)''.
    8. On page 3647, in column 3, in the fifth full paragraph--
    A. In line 5, the reference to ``Sec.  424.424(c)'' is corrected to 
read ``Sec.  412.424(c)''.
    B. In line 7, the reference to ``Sec.  424.424(d)'' is corrected to 
read ``Sec.  412.424(d)''.
    9. On page 3648, in column 2, in line 12, the figure ``$180'' is 
corrected to read ``$170.''

B. Corrections of Addenda

Addendum A
    1. On page 3654, in the Patient Adjustments table, the ECT--Per 
Treatment rate is corrected to read ``$254.86''.
    2. On page 3655, in the Variable Per Diem Adjustments table--
    A. In line 1, the words ``Facility Without a 24/7 Full-service 
Emergency Department'' are corrected to read ``Facility Without a 
Qualifying Emergency Department.''
    B. In line 2, the words ``Facility With a 24/7 Full-service 
Emergency Department'' are corrected to read ``Facility With a 
Qualifying Emergency Department.''
    3. On page 3656, in the Comorbidity Adjustments table, in line 13, 
the words

[[Page 9507]]

``Musculoskeletal & Connective Tissue Diseases'' is corrected to read 
``Severe Musculoskeletal and Connective Tissue Diseases.''
Addendum B
    1. On pages 3663 and 3664, in the fifth column, for the SSA State 
County Codes 11760 through 11980, correct the wage index values to 
follow the format of the table.
    The 2006 MSA-Based WI should read as follows:

------------------------------------------------------------------------
       SSA State/county code                  2006 MSA-based WI
------------------------------------------------------------------------
                  11760                               0.8166
                  11770                               0.8166
                  11771                               0.8166
                  11772                               0.8166
                  11780                               0.8560
                  11790                               0.9793
                  11800                               0.9855
                  11801                               0.8166
                  11810                               0.9793
                  11811                               0.9277
                  11812                               0.9793
                  11820                               0.8166
                  11821                               0.8166
                  11830                               0.8166
                  11831                               0.8166
                  11832                               0.8166
                  11833                               0.8166
                  11834                               0.8166
                  11835                               0.8166
                  11840                               0.9808
                  11841                               0.9793
                  11842                               0.8166
                  11850                               0.8166
                  11851                               0.8166
                  11860                               0.9793
                  11861                               0.8166
                  11862                               0.8166
                  11870                               0.8166
                  11880                               0.8166
                  11881                               0.8166
                  11882                               0.8166
                  11883                               0.8166
                  11884                               0.8166
                  11885                               0.8166
                  11890                               0.8166
                  11900                               0.8166
                  11901                               0.8166
                  11902                               0.8166
                  11903                               0.8166
                  11910                               0.8166
                  11911                               0.8166
                  11912                               0.9277
                  11913                               0.8166
                  11920                               0.8166
                  11921                               0.9088
                  11930                               0.9793
                  11940                               0.8166
                  11941                               0.8166
                  11950                               0.8166
                  11960                               0.8166
                  11961                               0.8166
                  11962                               0.8166
                  11963                               0.8166
                  11970                               0.8166
                  11971                               0.8166
                  11972                               0.8166
                  11973                               0.8166
                  11980                               0.8166
------------------------------------------------------------------------

    2. On page 3702 in the footnote, remove the sentence ``*Transition 
wage index value should be used with the CBSA urban/rural designation 
for rate calculation purposes.''

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

    Dated: February 17, 2006.
Ann C. Agnew,
Executive Secretary to the Department.
 [FR Doc. E6-2607 Filed 2-23-06; 8:45 am]
BILLING CODE 4120-01-P