[Federal Register Volume 74, Number 193 (Wednesday, October 7, 2009)]
[Rules and Regulations]
[Pages 51496-51510]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-24202]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 413, 415, 485, and 489

[CMS-1406-CN]
RINs 0938-AP33; 0938-AP39; 0938-AP76


Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and 
to the Long-Term Care Hospital Prospective Payment System and Rate Year 
2010 Rates; Corrections

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

ACTION: Correction of final rules and interim final rule with comment 
period.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical errors and typographical 
errors that appeared in the final rules and interim final rule with 
comment

[[Page 51497]]

period published in the Federal Register on August 27, 2009 entitled 
``Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and 
to the Long-Term Care Hospital Prospective Payment System and Rate Year 
2010 Rates.''

DATES: Effective Date: This correction document is effective October 2, 
2009.
    Applicability Date: This correction document is applicable to 
discharges occurring on or after October 1, 2009.

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

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. E8-18663 of August 27, 2009 (74 FR 43754), the final 
rule with comment period entitled ``Medicare Program; Changes to the 
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals 
and Fiscal Year 2010 Rates and to the Long-Term Care Hospital 
Prospective Payment System and Rate Year 2010 Rates'' (hereinafter 
referred to as the FY 2010 IPPS/RY 2010 LTCH PPS final rule) there were 
a number of technical errors that are identified and corrected in the 
Correction of Errors section below. The provisions in this correction 
notice are effective as if they had been included in the document 
published August 27, 2009. Further, changes to our rates have already 
been made through PRICER and joint signature memoranda. Accordingly, 
the corrections are effective October 1, 2009.

II. Summary of Errors

A. Errors in the Preamble

    On page 43889, in our discussion of the submission period for 
annual electronically acknowledgement of the completeness and accuracy 
of data, the submission period was incorrectly indicated as once 
between January 1, 2010 and August 15, 2010. Therefore, in section 
III.A.1. of this notice, we are correcting our discussion to require 
hospitals to electronically acknowledge their data accuracy and 
completeness once between July 1, 2010 and August 15, 2010 for the FY 
2011 payment determination.
    On page 43920, in our discussion of hospital emergency services 
under the Emergency Medical Treatment and Labor Act (EMTALA), we made a 
technical error in a parenthetical phrase by noting that emphasized 
text was underlined instead of italicized. Therefore, in section 
III.A.2. of this notice, we are correcting the phrase ``(which are 
underlined)'' to read ``(which are italicized).''
    On page 43934, in our discussion regarding critical access 
hospitals (CAHs) and provider-based entities, we inadvertently provided 
the following incorrect example ``For example, a CAH-based RHC with 50 
or more beds is a provider-based entity because it is paid based on the 
RHC payment methodology at 42 CFR 405.2462.'' In section III.A3. of 
this notice, we are correcting the example.
    On page 43994, we inadvertently misnumbered the heading for 
sections ``XI. MedPAC Recommendations'' and ``XII. Other Required 
Information'' and we are correcting these numbering errors in section 
III.A.4. of this notice.

B. Errors in the Addendum

    On pages 44011, 44015, 44017, 44019, 44020, 44021, and 44031, we 
inadvertently cited that the forecast of the FY 2006-based capital 
input price index (CIPI) for FY 2010 is 1.4 percent. However, the FY 
2006-based CIPI for FY 2010 is forecast 1.2 percent, as stated in the 
preamble of the FY 2010 IPPS/RY 2010 LTCH PPS final rule. We are 
correcting this error in the update to the capital rates. We are also 
correcting that capital outlier offset since outlier payments are 
determined based on the capital rates. (See sections III.B.3. through 
7. of this notice.)
    On page 44031, in Table 1A--National Adjusted Operating 
Standardized Amounts, Labor/Nonlabor (68.8 Percent Labor Share/31.2 
Percent Nonlabor Share If Wage Index Is Greater Than 1) and Table 1B--
National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 
Percent Labor Share/38 Percent Nonlabor Share If Wage Index Is Less 
Than or Equal to 1), we are correcting a typographical error in the 
column headings for the ``reduced update.'' Section 1886(b)(3)(B)(viii) 
of the Act provides for a reduction of 2.0 percentage points from the 
update percentage increase (also known as the market basket update) for 
FY 2007 and subsequent fiscal years. As stated in the preamble to the 
FY 2010 IPPS/RY 2010 LTCH PPS final rule, the market basket update to 
the national adjusted operating standardized amounts for FY 2010 is 2.1 
percent. Therefore, the reduced update to the national adjusted 
operating standardized amounts for hospitals that fail to submit 
quality data consistent with section 1886(b)(3)(B)(viii) of the Act for 
FY 2010 is 0.1 percent (that is, 2.1 percent minus 2.0 percent). 
However, Tables 1A and 1B erroneously cite that the reduced update is 
1.1 percent; and therefore, we are correcting this error in the column 
headings. (See section III.B.7. of this notice.)
    On page 44031, in Table 1D--Capital Standard Federal Payment Rate, 
we are correcting an inadvertent error in the update to the capital 
rates, wherein the Addendum of the FY 2010 IPPS/RY 2010 LTCH PPS final 
rule, in establishing the capital update, we erroneously cited the CIPI 
forecast for FY 2010 as 1.4 percent. However, as stated in the preamble 
of that final rule, the CIPI for FY 2010 is 1.2. We are correcting this 
error in the update to the capital rates (see section III.B.7. of this 
notice).
    On pages 44032 through 44078, in Table 2.--Acute Care Hospitals 
Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2008; 
Hospital Wage Indexes for Federal Fiscal Year 2010; Hospital Average 
Hourly Wages for Federal Fiscal Years 2008 (2004 Wage Data), 2009 (2005 
Wage Data), and 2010 (2006 Wage Data); and 3-Year Average of Hospital 
Average Hourly Wages, we are correcting technical errors in hospitals' 
wage data or geographic classifications that were used in calculating 
the wage index that was published in the FY 2010 IPPS/RY 2010 LTCH PPS 
final rule. We are correcting Table 2 by adding the wage data for 
provider 230105, which through an inadvertent typographical error was 
omitted from the table. In addition, we are correcting inadvertent 
errors in the case mix index and FY 2010 wage index for provider 
110230. We note that the correction of these errors do not require us 
to recalculate the wage indexes for other providers that are located in 
or reclassified to the same geographic area because provider 110230 is 
a new provider and has no average hourly wage data. Also, in accordance 
with our regulations regarding midyear corrections to the wage index 
(42 CFR 412.64(k)(2)(ii)), we are correcting the wage data for 4 
providers (310034, 310052, 310073, and 330005). Other corrections to 
Table 2 address the addition of a hospital's wage and occupational mix 
data that were erroneously excluded from the final FY 2010 wage index 
(provider 050335) and the removal of a hospital's wage data that were 
erroneously included in the final FY 2010 wage index (provider 050325). 
In addition, we are correcting errors in geographic classifications for 
5 providers (providers 150015, 230195, 330106, 340010, and 390201). As 
a result of the wage data, occupational mix data, and geographic 
classification corrections made for the 11 providers noted, we are also 
correcting the wage index for other providers that are located in or 
reclassified to the same

[[Page 51498]]

geographic area. (See section III.B.8. of this notice.)
    On page 44079, in Table 3A--FY 2010 and 3-Year* Average Hourly Wage 
for Acute Care Hospitals in Urban Areas by CBSA and Table 3B--FY 2010 
and 3-Year* Average Hourly Wage for Acute Care Hospitals in Rural Areas 
by CBSA, we are correcting certain area average hourly wages based on 
corrections to errors in hospital wage data for several providers. As 
discussed previously, in Table 2 we are correcting the wage data for 4 
providers. The corrections to the wage data for provider 330005 also 
require a correction in the associated area average hourly wage. 
Therefore, in section III.B.9. of this notice, we are correcting the 
area average hourly wage for CBSA 15380 (Buffalo-Niagara Falls, NY). 
(The corrections to the wage data for providers 310034, 310052, 310073 
do not result in a change to the associated area average hourly wage.)
    On page 44084, in Table 3B--FY 2010 and 3-Year* Average Hourly Wage 
for Acute Care Hospitals in Rural Areas by CBSA, we are correcting an 
area average hourly wage based on corrections to errors in the wage 
data for two providers. As discussed previously, in Table 2 we are 
correcting the wage and occupational mix data for providers 050335 and 
050325. The corrections to the wage data for these providers also 
require correction of the associated area average hourly wage. 
Therefore, in section III.B.10. of this notice, we are correcting the 
area average hourly wage for CBSA 05 (California).
    On pages 44085 through 44095, in Table 4A.--Wage Index and Capital 
Geographic Adjustment Factor (GAF) for Acute Care Hospitals in Urban 
Areas, Table 4B.--Wage Index and Capital Geographic Adjustment Factor 
(GAF) for Acute Care Hospitals in Rural Areas and Table 4C.--Wage Index 
and Capital Geographic Adjustment Factor (GAF) for Acute Care Hospitals 
that are Reclassified, we are correcting technical errors in hospitals' 
geographic classifications that were used in calculating the wage index 
that was published in the FY 2010 IPPS/RY 2010 LTCH PPS final rule. 
After correcting the geographic classification for provider 230195 
(that is, removing the provider from Table 9A), there are no longer any 
hospitals that are reclassified to CBSA 19804 for the FY 2010 wage 
index. (See sections III.B.11. through 13. of this notice.)
    On page 44121 and 44122, in Table 4J--Out-Migration Adjustment for 
Acute Care Hospitals--FY 2010, we are correcting a technical error in 
the data that were used in computing the outmigration adjustments that 
were published in the FY 2010 IPPS/RY 2010 LTCH PPS final rule. We are 
correcting the outmigration adjustment for providers in Wayne County, 
MI, only. However, this correction has no impact on the wage index 
values in Tables 2, 4A, and 4B because all of the Wayne County 
providers are reclassified instead to Ann Arbor, MI (CBSA 11460). 
Therefore, they are ineligible to receive the outmigration adjustment. 
(See section III.B.14. of this notice.)
    On page 44140, in Table 6E.--Revised Diagnosis Code Titles, we made 
a typographical error in the description of diagnosis code 793.99. 
Therefore, we are correcting the phrase ``radiological and other 
examination'' to read ``radiological and other examinations.'' (See 
section III.B.15. of this notice.)
    On page 44161 and 44173, in Table 9A.--Hospital Reclassifications 
and Redesignations--FY 2010, we are correcting technical errors in 
hospitals' geographic classifications that were used in calculating the 
wage index that was published in the FY 2010 IPPS/RY 2010 LTCH PPS 
final rule. Providers 110230, 150015, 230195, and 390201 were 
erroneously listed in Table 9A of the Addendum to that final rule as 
being reclassified; and therefore, we are correcting the table by 
removing these providers. Conversely, provider 330106 was inadvertently 
omitted from the Table 9A; and therefore, we are correcting this error 
by adding this provider. (See section III.B.16. of this notice.)
    On page 44173, in Table 9C.--Hospitals Redesignated as Rural Under 
Section 1886(d)(8)(E) of the Act--FY 2010, we inadvertently omitted 
provider 340010. Therefore we are correcting this error by adding this 
provider. (See section III.B.17. of this notice.)
    On pages 44195 and 44212, in Table 12A.--LTCH PPS Wage Index for 
Urban Areas for Discharges Occurring From October 1, 2009 Through 
September 30, 2010 and Table 12B.--LTCH PPS Wage Index for Rural Ares 
for Discharges Occurring From October 1, 2009 Through September 30, 
2010, consistent with the corrections to the IPPS wage data discussed 
in this notice, we are correcting technical errors in hospitals' wage 
data that were used in calculating the LTCH PPS wage index that was 
published in the FY 2010 IPPS/RY 2010 LTCH IPPS final rule. (See 
sections III.B.18. and 19. of this notice.)
    On pages 44213, 44228 through 44230, and 44234 through 44235, we 
are correcting the impact analysis to reflect the correct CIPI of 1.2 
percent rather than 1.4 percent and the payment estimates associated 
with the CIPI. (See sections III.B.20. through 24. of this notice.)

III. Correction of Errors

    In FR Doc. E8-18663 of August 27, 2009 (74 FR 43754), make the 
following corrections:

A. Corrections to the Preamble

    1. On page 43889, third column, seventh paragraph, line 10, the 
date ``January 1, 2010'' is corrected to read ``July 1, 2010.''
    2. On page 43920, second column, first full paragraph, line 32, the 
phrase ``(which are underlined)'' is corrected to read ``(which are 
italicized)''.
    3. On page 43934, third column, second full paragraph, the sentence 
``For example, a CAH-based RHC with 50 or more beds is a provider-based 
entity because it is paid based on the RHC payment methodology at 42 
CFR 405.2462.'' is corrected to read ``For example, a CAH-based RHC 
(that is, an RHC that is provider-based to a hospital with fewer than 
50 beds) is not subject to the per visit payment limitations under 
section 1833(f) of the Act.''
    4. On page 43994,
    a. First column, after the second full paragraph, the heading ``XI. 
MedPAC Recommendations'' is corrected to read ``XII. MedPAC 
Recommendations.''
    b. Second column, after the fourth paragraph, the heading ``XII. 
Other Required Information'' is corrected to read ``XIII. Other 
Required Information.''

B. Corrections to the Addendum

    1. On page 44011, in the second column,
    a. In the second full paragraph, line 13, the figure ``5.2'' is 
corrected to read ``5.3''.
    b. In the table following fourth paragraph, the table is corrected 
to read as follows:

------------------------------------------------------------------------
                                                              Capital
                                                           Federal Rate
------------------------------------------------------------------------
National................................................        0.947484
Puerto..................................................        0.935759
------------------------------------------------------------------------

    2. On page 44015, third column,
    a. First full paragraph,
    (1) Line 9, the figure ``1.4'' is corrected to read ``1.2.''
    (2) Line 13, the figure ``$171'' is corrected to read ``$154.''
    b. Second full paragraph,
    (1) Line 11, the figure ``1.40'' is corrected to read ``1.20.''
    (2) Line 14, the figure ``1.4'' is corrected to read ``1.2.''
    3. On page 44017,
    a. Second column,
    (1) Fourth full paragraph, line 2, the figure ``1.4'' is corrected 
to read ``1.2.''

[[Page 51499]]

    (2) Following the fourth full paragraph, in the table entitled 
``CMS FY 2010 Update to the Capital Federal Rate,'' the figures for the 
listed entries are corrected to read as follows:

------------------------------------------------------------------------
 
------------------------------------------------------------------------
Capital Input Price Index........................................    1.2
    Subtotal.....................................................    1.2
      Total Update...............................................    1.2
------------------------------------------------------------------------

    b. Third column,
    (1) Second full paragraph,
    (a) Line 10, the figure ``5.23'' is corrected to read ``5.25.''
    (b) Line 13, the figure ``0.9477'' is corrected to read ``0.9475.''
    (2) Third full paragraph,
    (a) Line 5, the figures ``0.9477'' and ``0.13'' are corrected to 
read ``0.9475'' and ``0.11,'' respectively.
    (b) Line 9, the figure ``1.0013'' is corrected to read ``1.0011.''
    (c) Line 10, the figure ``0.9477'' is corrected to read ``0.9475.''
    (d) Line 12, the figure ``0.13'' is corrected to read ``0.11.''
    4. On page 44019, third column,
    a. First full paragraph,
    (1) Line 3, the figure ``1.4'' is corrected to read ``1.2.''
    (2) Line 5, the figure ``1.4'' is corrected to read ``1.2.''
    (3) Line 8, the figure ``$430.15'' is corrected to read 
``$429.26.''
    b. Second full paragraph (first bulleted paragraph)
    (1) Line 1, the figure ``1.0140'' is corrected to read ``1.0120.''
    (2) Line 2, the figure ``1.4'' is corrected to read ``1.2.''
    c. Fourth full paragraph (third bulleted paragraph), last line, the 
figure ``0.9477'' is corrected to read ``0.9475.''
    d. Last paragraph,
    (1) Line 8, the figure ``1.4'' is corrected to read ``1.2.''
    (2) Line 14, the figure ``0.13'' is corrected to read ``0.11.''
    5. On page 44020,
    a. Top third of the page,
    (1) Third column, line 2, the figure ``1.4'' is corrected to read 
``1.2.''
    (2) The table entitled ``Comparison of Factors and Adjustments: FY 
2009 Capital Federal Rate and FY 2010 Capital Federal Rate'', the 
listed entries and footnote are corrected to read as follows:

------------------------------------------------------------------------
                                                                Percent
                                          FY 2010     Change     change
------------------------------------------------------------------------
Update Factor \1\......................     1.0120     1.0120       1.20
Outlier Adjustment Factor \2\..........     0.9475     1.0011       0.11
Capital Federal Rate...................    $429.26     1.0120       1.20
------------------------------------------------------------------------
\2\ The outlier reduction factor and the exceptions adjustment factor
  are not built permanently into the capital rates; that is, these
  factors are not applied cumulatively in determining the capital rates.
  Thus, for example, the net change resulting from the application of
  the FY 2010 outlier adjustment factor is 0.9475/0.9465, or 1.0011.

    b. Middle third of the page, the table entitled ``Comparison of 
Factors and Adjustments: Proposed FY 2009 Capital Federal Rate and 
Final FY 2010 Capital Federal Rate'', the listed entries are corrected 
to read as follows:

------------------------------------------------------------------------
                                          Final FY              Percent
                                            2010      Change     change
------------------------------------------------------------------------
Update Factor..........................     1.0120     1.0000       0.00
Outlier Adjustment Factor..............     0.9475     1.0022       0.22
Capital Federal Rate...................    $429.26     1.0204       2.04
------------------------------------------------------------------------

    c. Bottom third of the page, third column, first full paragraph, 
line 4, the figure ``$204.01'' corrected ``$203.56.''
    6. On page 44021, second column, second full paragraph,
    a. Line 4, the figure ``1.4'' is corrected to read ``1.2.''
    b. Line 13, the figure ``1.4'' is corrected to read ``1.2.''
    7. On page 44031,
    a. Top half of the page,
    (1) Table 1A--National Adjusted Operating Standardized Amounts, 
Labor/Nonlabor (68.8 Percent Labor Share/31.2 Percent Nonlabor Share If 
Wage Index Is Greater Than 1), the second column heading ``Reduce 
update (1.1 percent)'' is corrected to read ``Reduce update (0.1 
percent).''
    (2) Table 1B--National Adjusted Operating Standardized Amounts, 
Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If 
Wage Index Is Less Than or Equal to 1), the second column heading 
``Reduce update (1.1 percent)'' is corrected to read ``Reduce update 
(0.1 percent).''
    b. Bottom half of the page, in Table 1D--Capital Standard Federal 
Payment Rate, the rate entries are corrected to read as follows:

------------------------------------------------------------------------
                                                                  Rate
------------------------------------------------------------------------
National.....................................................    $429.26
Puerto Rico..................................................     203.56
------------------------------------------------------------------------

    8. On pages 44032 through 44078, in Table 2.--Acute Care Hospitals 
Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2008; 
Hospital Wage Indexes for Federal Fiscal Year 2010; Hospital Average 
Hourly Wages for Federal Fiscal Years 2008 (2004 Wage Data), 2009 (2005 
Wage Data), and 2010 (2006 Wage Data); and 3-Year Average of Hospital 
Average Hourly Wages, the listed entries are corrected to read as 
follows:

[[Page 51500]]

[GRAPHIC] [TIFF OMITTED] TR07OC09.000


[[Page 51501]]


[GRAPHIC] [TIFF OMITTED] TR07OC09.001


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[[Page 51503]]


[GRAPHIC] [TIFF OMITTED] TR07OC09.003


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[[Page 51505]]


[GRAPHIC] [TIFF OMITTED] TR07OC09.005

    9. On page 44079, in Table 3A--FY 2010 and 3-Year* Average Hourly 
Wage for Acute Care Hospitals in Urban Areas by CBSA, the listed entry 
is corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                         FY 2010       3-Year
                    CBSA code                                 Urban area                 average       average
                                                                                       hourly wage   hourly wage
----------------------------------------------------------------------------------------------------------------
15380...........................................  Buffalo-Niagara Falls, NY.........       32.9408       31.2001
----------------------------------------------------------------------------------------------------------------

    10. On page 44084, in Table 3B.--FY 2010 and 3-Year* Average Hourly 
Wage for Acute Care Hospitals in Rural Areas by CBSA, the listed entry 
is corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                         FY 2010       3-Year
                    CBSA code                                Nonurban area               Average       average
                                                                                       hourly wage   hourly wage
----------------------------------------------------------------------------------------------------------------
05..............................................  California........................       39.9000       38.2787
----------------------------------------------------------------------------------------------------------------

    11. On pages 44085 through 44090, in Table 4A.--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Acute Care Hospitals in 
Urban Areas by CBSA and by State--FY 2010, the listed entries are 
corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
                   CBSA                               CBSA name               State      Wage index      GAF
----------------------------------------------------------------------------------------------------------------
12540.....................................  Bakersfield, CA..............           CA       1.1831       1.1220
15380.....................................  Buffalo-Niagara Falls, NY....           NY       0.9809       0.9869
17020.....................................  Chico, CA....................           CA       1.1831       1.1220
19804.....................................  Detroit-Livonia-Dearborn, MI.           MI       0.9777       0.9847
20940.....................................  El Centro, CA................           CA       1.1831       1.1220
23420.....................................  Fresno, CA...................           CA       1.1831       1.1220
23844.....................................  Gary, IN.....................           IN       0.9168       0.9422
25260.....................................  Hanford-Corcoran, CA.........           CA       1.1831       1.1220
27340.....................................  Jacksonville, NC.............           NC       0.8605       0.9022
31460.....................................  Madera-Chowchilla, CA........           CA       1.1831       1.1220
40140.....................................  Riverside-San Bernardino-               CA       1.1831       1.1220
                                             Ontario, CA.

[[Page 51506]]

 
41740.....................................  San Diego-Carlsbad-San                  CA       1.1831       1.1220
                                             Marcos, CA.
42044.....................................  Santa Ana-Anaheim-Irvine, CA.           CA       1.1831       1.1220
47300.....................................  Visalia-Porterville, CA......           CA       1.1831       1.1220
49700.....................................  Yuba City, CA................           CA       1.1831       1.1220
----------------------------------------------------------------------------------------------------------------

    12. On page 44091, in Table 4B--Wage Index and Capital Geographic 
Adjustment Factor (GAF) for Acute Care Hospitals in Rural Areas by CBSA 
and by State--FY 2010, the listed entries are corrected to read as 
follows:

----------------------------------------------------------------------------------------------------------------
                   CBSA                               CBSA name               State      Wage index      GAF
----------------------------------------------------------------------------------------------------------------
05........................................  California...................           CA       1.1831       1.1220
34........................................  Rural North Carolina.........           NC       0.8605       0.9022
----------------------------------------------------------------------------------------------------------------

    13. On pages 44091 through 44095, in Table 4C.--Wage Index and 
Capital Geographic Adjustment Factor (GAF) for Acute Care Hospitals 
that are Reclassified by CBSA and by State--FY 2010, the listed entries 
are corrected by--
    a. Correcting the wage indexes and GAFs for the following CBSAs:

----------------------------------------------------------------------------------------------------------------
                CBSA                         CBSA name                  State            Wage index      GAF
----------------------------------------------------------------------------------------------------------------
05..................................  California.............  CA.....................       1.1831       1.1220
34..................................  Rural North Carolina...  NC.....................       0.8605       0.9022
34..................................  Rural North Carolina...  TN.....................       0.8592       0.9013
10900...............................  Allentown-Bethlehem-     PA.....................       0.9811       0.9870
                                       Easton, PA-NJ.
15380...............................  Buffalo-Niagara Falls,   NY.....................       0.9809       0.9869
                                       NY.
23844...............................  Gary, IN...............  IN.....................       0.9168       0.9422
31084...............................  Los Angeles-Long Beach-  CA.....................       1.1831       1.1220
                                       Glendale, CA.
33700...............................  Modesto, CA............  CA.....................       1.2202       1.1460
35644...............................  New York-White Plains-   CT.....................       1.2651       1.1747
                                       Wayne, NY-NJ.
35644...............................  New York-White Plains-   NJ.....................       1.2722       1.1792
                                       Wayne, NY-NJ.
35644...............................  New York-White Plains-   NY.....................       1.2903       1.1907
                                       Wayne, NY-NJ.
42044...............................  Santa Ana-Anaheim-       CA.....................       1.1831       1.1220
                                       Irvine, CA.
----------------------------------------------------------------------------------------------------------------

    b. Removing the entry for the following CBSA:

----------------------------------------------------------------------------------------------------------------
                CBSA                         CBSA name                  State            Wage index      GAF
----------------------------------------------------------------------------------------------------------------
19804...............................  Detroit-Livonia-         MI.....................       0.9788       0.9854
                                       Dearborn, MI.
----------------------------------------------------------------------------------------------------------------

    14. On pages 44121 and 44122, in Table 4J--Out-Migration Adjustment 
for Acute Care Hospitals--FY 2010, the listed entries are corrected to 
read as follows:

----------------------------------------------------------------------------------------------------------------
                                         Reclassified    Out-migration
           Provider  number              for FY 2010      adjustment     Qualifying county name     County code
----------------------------------------------------------------------------------------------------------------
230002...............................               *           0.0043  WAYNE...................           23810
230020...............................               *           0.0043  WAYNE...................           23810
230024...............................               *           0.0043  WAYNE...................           23810
230053...............................               *           0.0043  WAYNE...................           23810
230089...............................               *           0.0043  WAYNE...................           23810
230104...............................               *           0.0043  WAYNE...................           23810
230135...............................               *           0.0043  WAYNE...................           23810
230142...............................               *           0.0043  WAYNE...................           23810
230146...............................               *           0.0043  WAYNE...................           23810
230165...............................               *           0.0043  WAYNE...................           23810
230176...............................               *           0.0043  WAYNE...................           23810
230244...............................               *           0.0043  WAYNE...................           23810
230270...............................               *           0.0043  WAYNE...................           23810
230273...............................               *           0.0043  WAYNE...................           23810
230297...............................               *           0.0043  WAYNE...................           23810
----------------------------------------------------------------------------------------------------------------


[[Page 51507]]

    15. On page 44140, in Table 6E.--Revised Diagnosis Code Titles, in 
the description (column 2) for diagnosis code 793.99 is the phrase 
``radiological and other examination'' is corrected to read 
``radiological and other examinations.''
    16. On pages 44161 and 44173, in Table 9A.--Hospital 
Reclassifications and Redesignations--FY 2010 the table is corrected 
by--
    a. Removing the following entries:

----------------------------------------------------------------------------------------------------------------
                                                                    Geographic     Reclassified
                         Provider number                               CBSA            CBSA            LUGAR
----------------------------------------------------------------------------------------------------------------
110230..........................................................              11           16860           LUGAR
150015..........................................................           33140           23844  ..............
230195..........................................................           47644           19804  ..............
390201..........................................................              39           10900           LUGAR
----------------------------------------------------------------------------------------------------------------

    b. Adding following entry:

----------------------------------------------------------------------------------------------------------------
                                                                    Geographic     Reclassified
                         Provider number                               CBSA            CBSA            LUGAR
----------------------------------------------------------------------------------------------------------------
330106..........................................................           35004           35644  ..............
----------------------------------------------------------------------------------------------------------------

    17. On page 44173, in Table 9C.--Hospitals Redesignated as Rural 
Under Section 1886(d)(8)(E) of the Act--FY2010 is corrected by adding 
the listed provider to read as follows:

------------------------------------------------------------------------
                                            Geographic     Redesignated
              Provider No.                     CBSA         rural area
------------------------------------------------------------------------
340010..................................           24140              34
------------------------------------------------------------------------

    18. On page 44195, in Table 12A.--LTCH PPS Wage Index for Urban 
Areas for Discharges Occurring From October 1, 2009 Through September 
30, 2010, the LTCH PPS wage index for the listed entry is corrected to 
read as follows:

------------------------------------------------------------------------
                                    Urban area (Constituent    LTCH PPS
            CBSA code                      Counties)          wage index
------------------------------------------------------------------------
15380............................  Buffalo-Niagara Falls,         0.9740
                                    NY.
                                    Erie County, NY........
                                    Niagara County, NY.....
------------------------------------------------------------------------

    19. On page 44212, in Table 12B.--LTCH PPS Wage Index for Rural 
Areas for Discharges Occurring From October 1, 2009 Through September 
30, 2010, the LTCH PPS wage index for the listed entry is corrected to 
read as follows:

------------------------------------------------------------------------
                                                               LTCH PPS
             CBSA code                    Nonurban area       wage index
------------------------------------------------------------------------
05.................................  California............       1.2051
------------------------------------------------------------------------

    20. On page 44213, first column, third paragraph,
    a. Line 14, the figure ``$171'' is corrected to read ``$154.''
    b. Line 15, the figure ``1.9'' is corrected to read ``1.7.''
    21. On page 44228,
    a. Second column,
    (1) First partial paragraph, line 5, the figure ``1.4'' is 
corrected to read ``1.2.''
    (2) First full paragraph, line 5, the figure ``0.9477'' is 
corrected to read ``0.9475.''
    (3) Third full paragraph, the phrase ``proposed 1.4 percent'' is 
corrected to read ``1.2 percent.''
    (4) Last paragraph, line 5, the figure ``1.4'' is corrected to read 
``1.2.''
    b. Third column,
    (1) First partial paragraph, line 9, the figure ``1.9'' is 
corrected to read ``1.7.''
    (2) First full paragraph,
    (a) Line 3, the figure ``2.0'' is corrected to read ``1.8.''
    (b) Line 7, the figure ``2.1'' is corrected to read ``1.9.''
    (c) Last line, the figure ``1.5'' is corrected to read ``1.3.''
    (3) Second full paragraph,
    (a) Line 4, the figure ``0.7'' is corrected to read ``0.5.''
    (b) Line 6, the figure ``2.8'' is corrected to read ``2.6.''
    (4) Third full paragraph,
    (a) Line 3, the figure ``1.9'' is corrected to read ``1.7.''
    (b) Line 5, the figure ``2.0'' is corrected to read ``1.8.''
    (5) Last paragraph,
    (a) Line 10, the figure ``2.0'' is corrected to read ``1.8.''
    (b) Line 13, the figures ``1.7'' and ``1.1'' are corrected to read 
``1.4'' and ``0.9,'' respectively.
    (c) Line 17, the figure ``1.9'' is corrected to read ``1.6.''
    22. On pages 44229 and 44230, in Table III--Comparison of Total 
Payments Per Case [FY 2009 Payments Compared to FY 2010 Payments], the 
table is corrected to read as follows:
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[[Page 51509]]


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    23. On page 44234, third column, third full paragraph,
    a. Line 21, the figure ``2.1'' is corrected to read ``1.7.''
    b. Line 25, the figure ``$171'' is corrected to read ``$154.''
    c. Line 28, the figure ``$1.899'' is corrected to read ``$1.892.''
    24. On page 44235, first column, in Table V.--Accounting Statement: 
Classification of Estimated Expenditures under the IPPS from FY 2009 to 
FY 2010, the listed entries are corrected to read as follows:

 
------------------------------------------------------------------------
                Category                             Transfers
------------------------------------------------------------------------
Annualized Monetized Transfers..........  $1.892 billion
Total...................................  $1.892 billion
------------------------------------------------------------------------

III. 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 rule take effect in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive this notice and comment procedure if the Secretary finds, for 
good cause, that the 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.
    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.
    We are waiving proposed rulemaking and the 30-day delayed effective 
date for the technical corrections in this notice. This notice merely 
corrects typographical and technical errors in the preamble, and 
addendum of the FY 2010 IPPS/RY 2010 LTCH PPS final rule and does not 
make substantive changes to the policies or payment methodologies that 
were adopted in that final rule. As a result, this notice is intended 
to ensure that the FY 2010 IPPS/RY 2010 LTCH PPS final rule accurately 
reflects the policies adopted in that final rule and it would be 
impracticable, unnecessary, and contrary to the public interest to 
undertake further notice and comment procedures to incorporate these 
corrections into that final rule or delaying the effective date of 
these changes, especially in light of the October 1, 2009 start date 
for FY 2010.

[[Page 51510]]

    Further, the changes that are being made to the Addendum by this 
Correction Notice, including the changes to reflect the correct CIPI of 
1.2 percent, do not constitute rules subject to notice and comment 
rulemaking under section 553 of the Administrative Procedure Act, as 
the changes merely ensure that the Addendum conforms to the rules and 
methodologies that have already been adopted through such notice and 
comment rulemaking.

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

    Dated: October 2, 2009.
Dawn L. Smalls,
Executive Secretary to the Department.
[FR Doc. E9-24202 Filed 10-2-09; 4:15 pm]
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