[Federal Register Volume 79, Number 1 (Thursday, January 2, 2014)]
[Rules and Regulations]
[Pages 61-63]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-31432]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 482, 485, and 489

[CMS-1599 & 1455-CN3]
RINs 0938-AR53 and 0938-AR73


Medicare Program; Hospital Inpatient Prospective Payment Systems 
for Acute Care Hospitals and the Long-Term Care Hospital Prospective 
Payment System and Fiscal Year 2014 Rates; Quality Reporting 
Requirements for Specific Providers; Hospital Conditions of 
Participation; Payment Policies Related to Patient Status; Corrections

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

ACTION: Notification of correction to tables.

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

SUMMARY: This document corrects technical errors in the final rules 
that appeared in the August 19, 2013 Federal Register titled ``Medicare 
Program; Hospital Inpatient Prospective Payment Systems for Acute Care 
Hospitals and the Long-Term Care Hospital Prospective Payment System 
and Fiscal Year 2014 Rates; Quality Reporting Requirements for Specific 
Providers; Hospital Conditions of Participation; Payment Policies 
Related to Patient Status.''

DATES: Effective Date: This correcting document is effective on January 
2, 2014.

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

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2013-18956, which appeared in the August 19, 2013 
Federal Register (78 FR 50496) entitled ``Medicare Program; Hospital 
Inpatient Prospective Payment Systems for Acute

[[Page 62]]

Care Hospitals and the Long Term Care Hospital Prospective Payment 
System and Fiscal Year 2014 Rates; Quality Reporting Requirements for 
Specific Providers; Hospital Conditions of Participation; Payment 
Policies Related to Patient Status'' (hereinafter referred to as the FY 
2014 IPPS/LTCH PPS final rule), there were a number of technical and 
typographical errors. Therefore, in the October 3, 2013 Federal 
Register (78 FR 61197), we published a correcting document to correct 
those errors. The provisions of the correcting document were effective 
as if they had been included in the FY 2014 IPPS/LTCH PPS final rule 
that appeared in the August 19, 2013 Federal Register. Accordingly, 
those corrections were effective October 1, 2013.
    We have learned of an additional technical error that appeared in 
FY 2014 IPPS/LTCH PPS final rule. Specifically, the wage data of 
provider 220153 in core-based statistical area (CBSA) 44140, 
Springfield, MA should not have been included in the wage index data. 
The inclusion of this data resulted in an error in the pre-
reclassified, unadjusted wage index, which is used in the IPPS, for 
CBSA 44140 as well as to determine the LTCH PPS wage index, which is 
computed using wage data from inpatient acute care hospitals without 
regard to reclassification under section 1886(d)(8) or section 
1886(d)(10) of the Act. Section 412.64(k) of the regulations provides 
for making midyear corrections to the wage index. Under this provision, 
we make a midyear correction to the wage index for an area only if a 
hospital can show that the--(1) intermediary or CMS made an error in 
tabulating its data; and (2) hospital could not have known about the 
error or did not have the opportunity to correct the error before the 
beginning of the Federal fiscal year (that is, October 1). A midyear 
correction to the wage index is effective prospectively from the date 
the change is made to the wage index rather than retroactively to the 
beginning of the Federal fiscal year, unless several conditions are 
met, including the requirement, under Sec.  412.64(k)(2)(ii)(C), that 
CMS agreed before October 1st that the fiscal intermediary or CMS made 
an error in tabulating the hospital's wage data and the wage index 
should be corrected. CMS did not agree that there was an error in the 
IPPS wage index until after October 1, 2013; therefore, under the 
authority of Sec.  412.64(k), the effective date of this correction is 
prospective, January 2, 2014. Furthermore, as the IPPS wage data is 
also used to compute the LTCH PPS wage index, these corrections will 
also apply prospectively to the LTCH PPS wage index as of January 2, 
2014.

II. Summary of Errors and Corrections to Tables Posted on the CMS Web 
Site

A. Errors in and Corrections to the IPPS Tables

    We are correcting the errors in the following IPPS tables that are 
listed on 78 FR 51002 of FY 2014 IPPS/LTCH PPS final rule and are 
available on the Internet on the CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2014-IPPS-Final-Rule-Home-Page.html.
    In Table 2--Acute Care Hospitals Case-Mix Indexes for Discharges 
Occurring in Federal Fiscal Year 2012; Hospital Wage Indexes for 
Federal Fiscal Year 2014; Hospital Average Hourly Wages for Federal 
Fiscal Years 2012 (2008 Wage Data), 2013 (2009 Wage Data), and 2014 
(2010 Wage Data); and 3-Year Average of Hospital Average Hourly Wages. 
We inadvertently included the wage data of provider 220153 in CBSA 
44140, Springfield, MA in the FY 2014 wage index. Therefore, we are 
correcting Table 2 by removing the wage data for provider 220153.
    In Table 3A--FY 2014 and 3-Year Average Hourly Wage for Acute Care 
Hospitals in Urban Areas by CBSA. We inadvertently included provider 
220153 in the wage index of CBSA 44140. Therefore, we are correcting 
the FY 2014 average hourly wage and the 3-year average hourly wage for 
CBSA 44140, Springfield, MA by removing the wage data for provider 
220153, and recomputing the FY 2014 average hourly wage and the 3-year 
average hourly wage for CBSA 44140.

B. Error in and Correction to a LTCH PPS Table

    We are also correcting the error in the following LTCH PPS table 
that is listed on 78 FR 51002 of the FY 2014 IPPS/LTCH PPS final rule 
and is available on the Internet on the CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index.html.
    Table 12A--LTCH PPS Wage Index for Urban Areas for Discharges 
Occurring from October 1, 2013 through September 30, 2014. Due to a 
technical error found in the data of a provider in CBSA 44140, we are 
correcting the LTCH PPS wage index value for that CBSA.

III. Waiver of Proposed Rulemaking and Delay of 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.
    In our view, this correcting document does not constitute a rule 
that would be subject to the APA notice and comment or delayed 
effective date requirements. This correcting document corrects 
technical errors in tables posted on the CMS Web site but does not make 
substantive changes to the policies or payment methodologies that were 
adopted in the final rule. As a result, this correcting document is 
intended to ensure that the tables posted on the CMS Web site 
accurately reflect the policies adopted in that final rule.
    In addition, even if this were a rule to which the notice and 
comment procedures and delayed effective date requirements applied, we 
find that there is good cause to waive such requirements. Undertaking 
further notice and comment procedures to incorporate the corrections in 
this document into the final rule or delaying the effective date would 
be contrary to the public interest because it is in the public's 
interest for providers to receive appropriate payments in as timely a 
manner as possible, and to ensure that the FY 2014 IPPS/LTCH PPS final 
rule accurately reflects our payment methodologies, payment rates, and 
policies. Furthermore, such procedures would be unnecessary, as we are 
not altering our payment methodologies or policies, but rather, we are 
simply implementing correctly the payment methodologies and policies 
that we previously proposed, received comment on, and subsequently 
finalized. This correcting document is intended solely to ensure that 
the FY 2014 IPPS/LTCH PPS final rule accurately reflects these payment 
methodologies and policies. Therefore, we believe we have good

[[Page 63]]

cause to waive the notice and comment and effective date requirements.

(Catalog of Federal Domestic Assistance Program No. 93.778, Medical 
Assistance Program)

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

    Dated: December 26, 2013.
Oliver Potts,
Deputy Executive Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2013-31432 Filed 12-31-13; 8:45 am]
BILLING CODE 4120-01-P