[Federal Register Volume 79, Number 146 (Wednesday, July 30, 2014)]
[Rules and Regulations]
[Pages 44128-44129]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-17937]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 482

[CMS-1599-F2]
RIN 0938-AR53


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; Correcting 
Amendment

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

ACTION: Final rule; correcting amendment.

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

SUMMARY: This document corrects technical errors in the final rule that 
appeared in the August 19, 2013 Federal Register, entitled ``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: This correcting amendment is effective July 29, 2014.

FOR FURTHER INFORMATION CONTACT: Ronisha Davis, (410) 786-6882.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2013-18956 which appeared in the August 19, 2013 final 
rule entitled ``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'' (78 FR 
50495) (hereinafter referred to as the FY 2014 IPPS/LTCH PPS final 
rule) there was a technical error that is identified and corrected in 
the regulations text of this correcting amendment.

II. Summary of Errors in the Regulations Text

    On page 50906 of the FY 2014 IPPS/LTCH PPS final rule in our 
discussion of the change to the Medicare Hospital Conditions of 
Participation (CoPs) relating to the administration of pneumococcal 
vaccines, we stated that we were finalizing our proposal to remove the 
term ``polyscaccharide'' from the regulatory language at Sec.  
482.23(c). Therefore on page 50970 in the amendatory instructions for 
Sec.  482.23, we stated that we were revising paragraph (c)(3). In 
stating that we were revising paragraph (c)(3), we revised the language 
to remove the term ``polyscaccharide,'' but we also removed paragraphs 
(c)(3)(i), (ii), and (iii). To correct this error, in the regulations 
text of this correcting amendment, we are adding the inadvertently 
removed paragraphs (that is, paragraphs (c)(3)(i) through (c)(3)(iii)).

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.
    In our view, this correcting amendment does not constitute a rule

[[Page 44129]]

that would be subject to the APA notice and comment or delayed 
effective date requirements. This correcting amendment corrects a 
technical error in the regulation text, but does not make substantive 
changes to the policy regarding the CoPs relating to the administration 
of pneumococcal vaccines that was adopted in the final rule. As a 
result, this correcting amendment is intended to ensure that the 
regulations text at Sec.  482.23(c) accurately reflects the policy 
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 have access to the appropriate regulations 
text in as timely a manner as possible, and to ensure that the FY 2014 
IPPS/LTCH PPS final rule accurately reflects our CoPs relating to the 
administration of pneumococcal vaccines policy. Furthermore, such 
procedures would be unnecessary, as we are not altering our policy, but 
rather we are simply providing the corrected regulations text that we 
previously proposed, received comment on, and subsequently finalized. 
This correcting amendment is intended solely to ensure that the FY 2014 
IPPS/LTCH PPS final rule accurately reflects this policy. Therefore, we 
believe we have good cause to waive the notice and comment and 
effective date requirements.

List of Subjects in 42 CFR Part 482

    Grant programs, Health, Hospitals, Medicaid, Medicare, Reporting 
and recordkeeping requirements.

    Accordingly, 42 CFR chapter IV is corrected by making the following 
correcting amendments to part 482:

PART 482--CONDITIONS OF PARTICIPATION FOR HOSPITALS

0
1. The authority citation for part 482 continues to reads as follows:

    Authority: Secs. 1102, 1871, and 1881 of the Social Security Act 
(42 U.S.C. 1302, 1395hh, and 1395rr), unless otherwise noted.


0
2. In Sec.  482.23, revise paragraph (c)(3) to read as follows:


Sec.  482.23  Condition of participation: Nursing services.

* * * * *
    (c) * * *
    (3) With the exception of influenza and pneumococcal vaccines, 
which may be administered per physician-approved hospital policy after 
an assessment of contraindications, orders for drugs and biologicals 
must be documented and signed by a practitioner who is authorized to 
write orders in accordance with State law and hospital policy, and who 
is responsible for the care of the patient as specified under Sec.  
482.12(c).
    (i) If verbal orders are used, they are to be used infrequently.
    (ii) When verbal orders are used, they must only be accepted by 
persons who are authorized to do so by hospital policy and procedures 
consistent with Federal and State law.
    (iii) Orders for drugs and biologicals may be documented and signed 
by other practitioners not specified under Sec.  482.12(c) only if such 
practitioners are acting in accordance with State law, including scope-
of-practice laws, hospital policies, and medical staff bylaws, rules, 
and regulations.
* * * * *
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical 
Assistance Program No. 93.773, Medicare--Hospital Insurance; and 
Program No. 93.774, Medicare--Supplementary Medical Insurance 
Program)

    Dated: July 24, 2014.
C'Reda Weeden,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2014-17937 Filed 7-29-14; 8:45 am]
BILLING CODE 4120-01-P