[Federal Register Volume 73, Number 250 (Tuesday, December 30, 2008)]
[Rules and Regulations]
[Pages 79664-79665]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-31013]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 411, 412, 413, 422, and 489

[CMS-1390-CN2; CMS-1531-CN; CMS-1385-CN2]
RIN 0938-AP15; RIN 0938-AO35; RIN 0938-AO65


Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate 
Medical Education in Certain Emergency Situations; Changes to 
Disclosure of Physician Ownership in Hospitals and Physician Self-
Referral Rules; Updates to the Long-Term Care Prospective Payment 
System; Updates to Certain IPPS-Excluded Hospitals; and Collection of 
Information Regarding Financial Relationships Between Hospitals; 
Correction

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

ACTION: Correction of final rules.

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SUMMARY: This document corrects errors that appeared in the correction 
notice published in the October 3, 2008 Federal Register entitled 
``Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate 
Medical Education in Certain Emergency Situations; Changes to 
Disclosure of Physician Ownership in Hospitals and Physician Self-
Referral Rules; Updates to the Long-Term Care Prospective Payment 
System; Updates to Certain IPPS-Excluded Hospitals; and Collection of 
Information Regarding Financial Relationships Between Hospitals; 
Correction.''

DATES: Effective Date: This notice is effective December 30, 2008.
    Applicability Date: This correction notice is applicable to 
discharges occurring on or after October 1, 2008.

FOR FURTHER INFORMATION CONTACT: Tzvi Hefter (410) 786-4487.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. E8-23082 of October 3, 2008 (73 FR 57541), the 
correction notice entitled ``Medicare Program; Changes to the Hospital 
Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; 
Payments for Graduate Medical Education in Certain Emergency 
Situations; Changes to Disclosure of Physician Ownership in

[[Page 79665]]

Hospitals and Physician Self-Referral Rules; Updates to the Long-Term 
Care Prospective Payment System; Updates to Certain IPPS-Excluded 
Hospitals; and Collection of Information Regarding Financial 
Relationships Between Hospitals; Correction'' there were inadvertent 
errors that are identified and corrected in the Correction of Errors 
section of this correction notice.
    On page 57543, there were errors in Tables 2 and 3B. In Table 2, 
for provider number 300005, we made a typographical error and included 
erroneous average hourly wage data for this provider. Therefore, in 
section II. of this correction notice, we have corrected the FY 2009 
and 3-year average hourly wage data for this provider. In Table 3B, for 
the nonurban area of New Hampshire (CBSA 30), we inadvertently 
neglected to include the corrected average hourly wage data and instead 
included the average hourly wage data from the FY 2009 inpatient 
prospective payment systems (IPPS) final rule (73 FR 48881). Therefore, 
in section II. of this correction notice, we have corrected the FY 2009 
and 3-year average hourly wage data for this nonurban area. We note the 
corrections presented in this notice would subsequently correct the 
average hourly wage data errors in Tables 2 and 3B of the FY 2009 
inpatient prospective payment systems (IPPS) final rule. We also note 
that the FY 2009 final rates published in the October 3, 2008 Federal 
Register (73 FR 57888) reflected the correct average hourly wage data 
for provider number 30005 and the nonurban area of New Hampshire (CBSA 
code 30); therefore the payment rates associated with this data are not 
being corrected.

II. Correction of Errors

    In FR Doc. E8-23082 of October 3, 2008 (73 FR 57541), make the 
following corrections:
    1. On page 57543,
    a. Bottom of the second column and the top of the third column, 
last and first partial paragraphs, item 1, in Table 2.--Hospital Case-
Mix Indexes for Discharges Occurring in Federal Fiscal Year 2007; 
Hospital Wage Indexes for Federal Fiscal Year 2009; Hospital Average 
Hourly Wages for Federal Fiscal Years 2007 (2003 Wage Data), 2008 (2004 
Wage Data), and 2009 (2005 Wage Data); and 3-Year Average of Hospital 
Average Hourly Wages, the FY 2009 average hourly wage and the 3-year 
average hourly wage for provider number 300005 are corrected to read as 
follows:

------------------------------------------------------------------------
                                                         Average  hourly
             Provider No.               Average  hourly   wage\*\\*\ (3
                                        wage FY 2009\1\       years)
------------------------------------------------------------------------
300005................................         28.8402          28.1813
------------------------------------------------------------------------

    b. Third column, first paragraph, item 2, Table 3B.--FY 2009 and 3-
Year* Average Hourly Wage for Rural Areas by CBSA, the FY 2009 Average 
Hourly Wage and 3-Year Average Hourly wage for the CBSA Code 30 are 
corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                    FY 2009
                  CBSA code                             Nonurban area            average hourly  3-Year  average
                                                                                      wage         hourly wage
----------------------------------------------------------------------------------------------------------------
30...........................................  New Hampshire..................         33.2602          32.8266
----------------------------------------------------------------------------------------------------------------

III. Waiver of Proposed Rulemaking and Delay in Effective Date

    We do not consider this correction notice to constitute a rule 
under 5 U.S.C. 553(b). The notice corrects average hourly wage data 
based upon policies already adopted in the FY 2009 IPPS final rule. 
Nevertheless, even if this correction notice could be viewed as 
substantive rule for which a notice of proposed rulemaking and delayed 
effective date were necessary under sections 553(b) and 553(d) of the 
Administrative Procedure Act (APA) (5 U.S.C. 553(b) and 553(d)), we can 
waive this notice and comment procedure and delay in effective date if 
the Secretary finds, for good cause, that such procedures are 
impracticable, unnecessary, or contrary to the public interest, and 
incorporates a statement of the finding and the reasons therefore in 
the notice.
    Section 553(d) of the APA ordinarily requires a 30-day delay in 
effective date of final rules after the date of their publication in 
the Federal Register. This 30-day delay in effective date can be 
waived, however, if an agency finds for good cause that the delay is 
impracticable, unnecessary, or contrary to the public interest, and the 
agency incorporates a statement of the findings and its reasons in the 
rule issued. Therefore, we are waiving proposed rulemaking and the 30-
day delayed effective date for the technical corrections in this 
notice. This notice merely corrects typographical errors in entries of 
two tables of the addendum of the FY 2009 IPPS final rule and does not 
make substantive changes to the policies or payment methodologies that 
were adopted in the final rule. In addition, this notice contains 
corrections to the average hourly wage data published in the October 3, 
2008 Federal Register and does not make any changes to the final FY 
2009 payment rates. As a result, this notice is intended to ensure that 
the FY 2009 IPPS final rule accurately reflects the policies adopted in 
the final rule. Therefore, we find that undertaking further notice and 
comment procedures to incorporate these corrections into the final rule 
or delaying the effective date of these changes is unnecessary and 
contrary to the public interest.

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

    Dated: December 22, 2008.
Ann C. Agnew,
Executive Secretary to the Department.
 [FR Doc. E8-31013 Filed 12-29-08; 8:45 am]
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