[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]



[[Page 69501]]

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

Part IV





Department of Health and Human Services





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



Centers for Medicare & Medicaid Services



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



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  

[[Page 69502]]


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

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.

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

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

[[Page 69504]]

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

[[Page 69505]]

[GRAPHIC] [TIFF OMITTED] TR31DE09.000


[[Page 69506]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.001


[[Page 69507]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.002


[[Page 69508]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.003


[[Page 69509]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.004


[[Page 69510]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.005


[[Page 69511]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.006


[[Page 69512]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.007


[[Page 69513]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.008


[[Page 69514]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.009


[[Page 69515]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.010


[[Page 69516]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.011


[[Page 69517]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.012


[[Page 69518]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.013


[[Page 69519]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.014


[[Page 69520]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.015


[[Page 69521]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.016


[[Page 69522]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.017


[[Page 69523]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.018


[[Page 69524]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.019


[[Page 69525]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.020


[[Page 69526]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.021


[[Page 69527]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.022


[[Page 69528]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.023


[[Page 69529]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.024


[[Page 69530]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.025


[[Page 69531]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.026


[[Page 69532]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.027


[[Page 69533]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.028


[[Page 69534]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.029


[[Page 69535]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.030


[[Page 69536]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.031


[[Page 69537]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.032


[[Page 69538]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.033


[[Page 69539]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.034


[[Page 69540]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.035


[[Page 69541]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.036


[[Page 69542]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.037


[[Page 69543]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.038


[[Page 69544]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.039


[[Page 69545]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.040


[[Page 69546]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.041


[[Page 69547]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.042


[[Page 69548]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.043


[[Page 69549]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.044


[[Page 69550]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.045


[[Page 69551]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.046


[[Page 69552]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.047


[[Page 69553]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.048


[[Page 69554]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.049


[[Page 69555]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.050


[[Page 69556]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.051


[[Page 69557]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.052


[[Page 69558]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.053


[[Page 69559]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.054


[[Page 69560]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.055


[[Page 69561]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.056


[[Page 69562]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.057


[[Page 69563]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.058


[[Page 69564]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.059


[[Page 69565]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.060


[[Page 69566]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.061


[[Page 69567]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.062


[[Page 69568]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.063


[[Page 69569]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.064


[[Page 69570]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.065


[[Page 69571]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.066


[[Page 69572]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.067


[[Page 69573]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.068


[[Page 69574]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.069


[[Page 69575]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.070


[[Page 69576]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.071


[[Page 69577]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.072


[[Page 69578]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.073


[[Page 69579]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.074


[[Page 69580]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.075


[[Page 69581]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.076


[[Page 69582]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.077


[[Page 69583]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.078


[[Page 69584]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.079


[[Page 69585]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.080


[[Page 69586]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.081


[[Page 69587]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.082


[[Page 69588]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.083


[[Page 69589]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.084


[[Page 69590]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.085


[[Page 69591]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.086


[[Page 69592]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.087


[[Page 69593]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.088


[[Page 69594]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.089


[[Page 69595]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.090


[[Page 69596]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.091


[[Page 69597]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.092


[[Page 69598]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.093


[[Page 69599]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.094


[[Page 69600]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.095


[[Page 69601]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.096


[[Page 69602]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.097


[[Page 69603]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.098


[[Page 69604]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.099


[[Page 69605]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.100


[[Page 69606]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.101


[[Page 69607]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.102


[[Page 69608]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.103


[[Page 69609]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.104


[[Page 69610]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.105


[[Page 69611]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.106


[[Page 69612]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.107


[[Page 69613]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.108


[[Page 69614]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.109


[[Page 69615]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.110


[[Page 69616]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.111


[[Page 69617]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.112


[[Page 69618]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.113


[[Page 69619]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.114


[[Page 69620]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.115


[[Page 69621]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.116


[[Page 69622]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.117


[[Page 69623]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.118


[[Page 69624]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.119


[[Page 69625]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.120


[[Page 69626]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.121


[[Page 69627]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.122


[[Page 69628]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.123


[[Page 69629]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.124


[[Page 69630]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.125


[[Page 69631]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.126


[[Page 69632]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.127


[[Page 69633]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.128


[[Page 69634]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.129


[[Page 69635]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.130


[[Page 69636]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.131


[[Page 69637]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.132


[[Page 69638]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.133


[[Page 69639]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.134


[[Page 69640]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.135


[[Page 69641]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.136


[[Page 69642]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.137


[[Page 69643]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.138


[[Page 69644]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.139


[[Page 69645]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.140


[[Page 69646]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.141


[[Page 69647]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.142


[[Page 69648]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.143


[[Page 69649]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.144


[[Page 69650]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.145


[[Page 69651]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.146


[[Page 69652]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.147


[[Page 69653]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.148


[[Page 69654]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.149


[[Page 69655]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.150


[[Page 69656]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.151


[[Page 69657]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.152


[[Page 69658]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.153


[[Page 69659]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.154


[[Page 69660]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.155


[[Page 69661]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.156


[[Page 69662]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.157


[[Page 69663]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.158


[[Page 69664]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.159


[[Page 69665]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.160


[[Page 69666]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.161


[[Page 69667]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.162


[[Page 69668]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.163


[[Page 69669]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.164


[[Page 69670]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.165


[[Page 69671]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.166


[[Page 69672]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.167


[[Page 69673]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.168


[[Page 69674]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.169


[[Page 69675]]


[GRAPHIC] [TIFF OMITTED] TR31DE09.170


[[Page 69676]]


[FR Doc. E9-30967 Filed 12-28-09; 11:15 am]
BILLING CODE 4120-01-C