[Federal Register Volume 74, Number 250 (Thursday, December 31, 2009)]
[Rules and Regulations]
[Pages 69502-69676]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-30967]
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Part IV
Department of Health and Human Services
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Centers for Medicare & Medicaid Services
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42 CFR Parts 410, 416, and 419
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates; Final Rule
Federal Register / Vol. 74 , No. 250 / Thursday, December 31, 2009 /
Rules and Regulations
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 410, 416, and 419
[CMS-1414-CN]
RIN 0938-AP41
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correction of final rule with comment period.
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SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period found in the Federal Register (FR) on
November 20, 2009, entitled ``Medicare Program: Changes to the Hospital
Outpatient Prospective Payment System and CY 2010 Payment Rates;
Changes to the Ambulatory Surgical Center Payment System and CY 2010
Payment Rates.''
DATES: Effective Date: This correction document is effective January 1,
2010.
FOR FURTHER INFORMATION CONTACT: Alberta Dwivedi, (410) 786-0378.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. E9-26499 of November 20, 2009 (74 FR 60316), the final
rule with comment period entitled, ``Medicare Program: Changes to the
Hospital Outpatient Prospective Payment System and CY 2010 Payment
Rates; Changes to the Ambulatory Surgical Center Payment System and CY
2010 Payment Rates'' (hereinafter referred to as the CY 2010 OPPS/ASC
final rule), there were a few technical errors that are identified in
the ``Summary of Errors'' section 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 CY 2010 OPPS/ASC final rule appearing in the
November 20, 2009 Federal Register (74 FR 60316). Accordingly, the
corrections are effective January 1, 2010.
II. Summary of Errors
A. Errors in the Preamble
On page 60559, in our response to a comment regarding developing
and implementing standards of participation, we erred when we
referenced ``conditions for coverage'' instead of ``conditions of
participation.'' Therefore, we are deleting two references to
``conditions for coverage'' and replacing them with the phrase
``conditions of participation.''
On page 60562, in our response to a comment requesting CMS to
remove procedures from the CY 2010 inpatient list, we inadvertently
stated that we would remove ``5'' procedure codes instead of ``4''
procedure codes. Therefore, we are replacing the reference to ``5''
with a reference to ``4.'' In the same paragraph in which the
previously described error exists (paragraph one of the first
response), we list the procedure codes to be removed from the CY 2010
inpatient list. However, we inadvertently included in the list the
procedure described by Healthcare Common Procedure Coding System
(HCPCS) code 37215 (Transcatheter placement of intravascular stent(s),
cervical carotid artery, percutaneous; with distal embolic protection),
which should not have been listed. Therefore, we are deleting from the
paragraph the language that states we are removing the procedure
described by HCPCS code 37215 from the CY 2010 inpatient list. In
addition, in the second paragraph in the same response, we provided the
incorrect number of procedures for which the clinical and utilization
data did not support the appropriateness of providing the procedures to
Medicare beneficiaries in the hospital outpatient department (HOPD).
Specifically, we incorrectly cited ``11'' procedures instead of ``12''
procedures. Therefore, in the paragraph, we are replacing both
references to the number ``11'' with references to the number ``12.''
On page 60563, in the summary paragraph following the comment
summaries and responses to comments, we inadvertently stated that we
were removing ``five'' procedures instead of ``four'' procedures from
the CY 2010 inpatient list. Therefore, we are correcting the word
``five'' to read ``four.'' In addition, in the same paragraph we listed
the procedures to be removed from the CY 2010 inpatient list. However,
we inadvertently included the procedure described by HCPCS code 37215,
which should not have been listed. Therefore, we are deleting from the
paragraph the language that states we are removing that procedure from
the CY 2010 inpatient list.
On page 60564, in the summary paragraph at the top of the page
which follows the comment summaries and responses to comments on the
previous page, we made the statement that we were displaying in Table
56 the final ``eight'' procedures we are removing from the inpatient
list. We should have indicated that we were displaying the final
``seven'' procedures we are removing from the CY 2010 inpatient list in
Table 56. Therefore, we are deleting from the paragraph the reference
to ``eight'' and replacing it with a reference to ``seven.'' In
addition, we inadvertently included a procedure in Table 56 that should
not have been included. Specifically, we incorrectly included the
procedure described by HCPCS code 37215 in the table. Therefore, we are
deleting from Table 56 the procedure described by HCPCS code 37215 as
well as all of the information associated with it in the CY 2010 long
descriptor column, the Final CY 2010 APC assignment column, and the
Final CY 2010 status indicator column.
On page 60566, in our discussion to the legislative changes related
to pulmonary rehabilitation, cardiac rehabilitation, and intensive
cardiac rehabilitation services, we inadvertently made reference to
``section II.G.8.'' of the preamble of the CY 2010 Medicare Physician
Fee Schedule (MPFS) proposed rule (74 FR 33606) instead of ``sections
II.G.8. and II.G.9.''. We also inadvertently referenced the citation
``(74 FR 33606)'' instead of the citation ``(74 FR 33606 through
33614).'' We are correcting these errors so that the reader can easily
find the appropriate sections of that proposed rule. Therefore, we are
replacing the phrase ``section II.G.8.'' with the phrase ``sections
II.G.8. and II.G.9.'' and we are replacing the citation ``(74 FR
33606)'' with the citation ``(74 FR 33606 through 33614).''
On page 60598, in our response to a comment, we inadvertently
reference ``section XII.E.'' of the preamble instead of ``section
XII.D.'' We are correcting this error so that the reader can easily
find the appropriate section of the rule to review regarding the final
CY 2010 physician supervision requirements for hospital outpatient
diagnostic and therapeutic services.
On page 60612, in our discussion of the Ambulatory Surgical Center
(ASC) treatment of surgical procedures removed from the OPPS inpatient
list for CY 2010, we inadvertently made the statement that we were
removing ``5'' procedures instead of ``4'' procedures from the OPPS
inpatient list for CY 2010. Therefore, in section XV.C.1.d., we are
replacing both references to the number ``5'' with references to the
number ``4.'' In addition, we inadvertently included the procedure
described by HCPCS Code 37215 in Table 69. We are correcting this error
by removing this procedure code from the
[[Page 69503]]
table, as well as all of the information associated with it in the CY
2010 long descriptor column.
B. Errors in the Addendum
On page 60789, in Addendum B, we made a typographical error when we
listed the letter ``T'' instead of the letter ``C'' in the payment
status indicator (SI) column for HCPCS code 37215. Therefore, we are
replacing the letter ``T'' with the letter ``C'' in the SI column for
HCPCS code 37215.
On page 60957, in Addendum E, we inadvertently omitted HCPCS code
37215 along with the short descriptor, comment indicator, and status
indicator. Therefore, we are correcting this error by including HCPCS
code 37215 as well as all of the information associated with it in the
addendum.
We are republishing Addenda AA and BB, which were published on
pages 60692 through 60752 and pages 60919 through 60943, respectively,
to take into account updated CY 2010 MPFS information. As required
under Sec. 416.171(d), the revised ASC payment system limits payment
for office-based procedures and covered ancillary radiology services to
the lesser of the ASC rate or the amount calculated by multiplying the
nonfacility practice expense (PE) relative value units (RVUs) for the
service by the conversion factor under the MPFS. However, the MPFS
conversion factor and PE RVUs listed for some CPT codes in Addendum B
to the CY 2010 MPFS final rule with comment period (74 FR 61738) were
incorrect due to methodological errors and, consequently, have been
corrected in a correction notice to that final rule (74 FR 65449).
Since the ASC payment amounts for office-based procedures and covered
ancillary services are determined using the amounts in the MPFS final
rule, we must correct the CY 2010 payment amounts for ASC procedures
and services using the corrected MPFS amounts. The revised rates
continue to reflect the negative update to the MPFS for CY 2010
authorized under current law. The corrected payment amounts are
reflected in Addenda AA and BB to this correction notice and also are
posted on the CMS Web site at: http://www.cms.hhs.gov/ASCPayment.
III. Correction of Errors
1. On page 60559, in column 1, in the first response to comment, in
lines 5 and 10 of the response, the statement ``conditions for
coverage'' is corrected to read, ``conditions of participation''.
2. On page 60562--
A. In column 1, in the first response to comment, in line 10, the
number ``5'' is corrected to read number ``4''.
B. In column 1, in the first response to comment, in lines 15
through 18, the statement ``37215 (Transcatheter placement of
intravascular stent(s), cervical carotid artery, percutaneous; with
distal embolic protection);'' is deleted.
C. In column 1, in the last paragraph of the response to comment,
in lines 2 and 7, the number ``11'' is corrected to read, ``12''.
3. On page 60563--
A. In column 3, in the last paragraph, in line 6, the word ``five''
is corrected to read ``four''.
B. In column 3, in the last paragraph, in lines 12 through 15, the
statement ``37215 (Transcatheter placement of intravascular stent(s),
cervical carotid artery, percutaneous; with distal embolic
protection);'' is deleted.
4. On page 60564--
A. In column 3, in line 1 at the top of the page before the chart,
the word ``eight'' is corrected to read ``seven''.
B. In Table 56, in row 4, the HCPCS Code ``37215'' and all
associated information is deleted.
5. On page 60566--
A. In column 2, in line 30 from the top of the page, the reference
to ``section II.G.8.'' is corrected to read ``sections II.G.8. and
II.G.9.''
B. In column 2, in line 31 from the top of the page, the reference
to ``(74 FR 33606)'' is corrected to read ``(74 FR 33606 through
33614)''.
6. On page 60598, in column 3, in line 4 from the top of the page,
the reference to ``section XII.E.'' is corrected to read ``section
XII.D.''
7. On page 60612--
A. In column 1, in line 5 from the top of the page before the
table, the number ``5'' is corrected to read number ``4''.
B. In column 2, in line 4 from the top of the page before the
table, the number ``5'' is corrected to read number ``4''.
C. In Table 69, in row 4, the HCPCS Code ``37215'' and all
associated information is deleted.
Corrections to Addenda
Addendum B.--OPPS Payment by HCPCS Code for CY 2010
On page 60789, for HCPCS code 37215, in line 36 of the second
chart, in column 4, the status indicator ``T'' is corrected to read
``C''.
Addendum E.--HCPCS Codes That Are Paid Only as Inpatient Procedures for
CY 2010
On page 60957, in the second chart, insert between HCPCS Codes
37182 and 37616 the final OPPS CY 2010 entry for HCPCS Code 37215 to
read as follows:
------------------------------------------------------------------------
HCPCS Code Short descriptor SI CI
------------------------------------------------------------------------
37215........... Transcath stent, cca w/ C .............
eps.
------------------------------------------------------------------------
Addendum AA.--Final ASC Covered Surgical Procedures for CY 2010
(Including Surgical Procedures for Which Payment Is Packaged)
We are republishing Addendum AA in its entirety. See attached
chart.
Addendum BB.--Final ASC Covered Ancillary Services Integral to Covered
Surgical Procedures for CY 2010 (Including Ancillary Services for Which
Payment Is Packaged)
We are republishing Addendum BB in its entirety. See attached
chart.
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 it is impracticable, unnecessary
or contrary to the public interest to follow the notice and comment
procedure or to comply with the 30-day delay in the effective date, and
incorporates a statement of the finding and the reasons therefore in
the notice. The policies and payment methodologies finalized in the CY
2010 OPPS/ASC final rule with comment period have previously been
subjected to notice and comment procedures. This correction notice
merely provides technical corrections to the CY 2010 OPPS/ASC final
rule with comment period that was promulgated through notice and
comment rulemaking, and does not make substantive changes to the
policies or payment methodologies that were finalized in the final rule
with comment period. For example, in order to conform the document to
the final policies of the CY 2010 OPPS/ASC final rule with comment
period, this notice makes changes to revise inaccurate tabular
information. Therefore, we find it unnecessary to undertake further
notice and comment procedures with
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respect to this correction notice. In addition, we believe it is
important for the public to have the correct information as soon as
possible and find no reason to delay the dissemination of it. For the
reasons stated above, we find that both notice and comment and the 30-
day delay in effective date for this correction notice are unnecessary.
Therefore, we find there is good cause to waive notice and comment
procedures and the 30-day delay in effective date for this correction
notice.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare-- Supplementary Medical Insurance Program)
Dated: December 24, 2009.
Dawn L. Smalls,
Executive Secretary to the Department.
BILLING CODE 4120-01-P
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[FR Doc. E9-30967 Filed 12-28-09; 11:15 am]
BILLING CODE 4120-01-C