[Federal Register Volume 80, Number 192 (Monday, October 5, 2015)]
[Rules and Regulations]
[Pages 60055-60069]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-25269]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 412

[CMS-1632-CN]
RIN 0938-AS41


Medicare Program; Hospital Inpatient Prospective Payment Systems 
for Acute Care Hospitals and the Long-Term Care Hospital Prospective 
Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of 
Quality Reporting Requirements for Specific Providers, including 
Changes Related to the Electronic Health Record Incentive Program; 
Extensions of the Medicare-Dependent, Small Rural Hospital Program and 
the Low-Volume Payment Adjustment for Hospitals; Correction

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

ACTION: Final rule and interim final rule with comment period; 
correction.

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SUMMARY: This document corrects technical and typographical errors in 
the final rule and interim final rule with comment period that appeared 
in the Federal Register on August 17, 2015 titled ``Medicare Program; 
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals 
and the Long-Term Care Hospital Prospective Payment System Policy 
Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting 
Requirements for Specific Providers, including Changes Related to the 
Electronic Health Record Incentive Program; Extensions of the Medicare-
Dependent, Small Rural Hospital Program and the Low-Volume Payment 
Adjustment for Hospitals.''

DATES: This document is effective October 1, 2015.

FOR FURTHER INFORMATION CONTACT: Donald Thompson, (410) 786-4487.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2015-19049 which appeared in the August 17, 2015 Federal 
Register, titled ``Medicare Program; Hospital Inpatient Prospective 
Payment Systems for Acute Care Hospitals and the Long-Term Care 
Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 
Rates; Revisions of Quality Reporting Requirements for Specific 
Providers, including Changes Related to the Electronic Health Record 
Incentive Program; Extensions of the Medicare-Dependent, Small Rural 
Hospital Program and the Low-Volume Payment Adjustment for Hospitals'' 
(hereinafter referred to as the FY 2016 IPPS/LTCH PPS final rule), 
there were a number of technical and typographical errors that are 
identified and corrected in section IV. of this correcting document. 
The provisions in this correction document are effective as if they had 
been included in the document that appeared in the August 17, 2015 
Federal Register. Accordingly, the corrections are effective October 1, 
2015.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 49412, we made a typographical error with regards to an MS-
DRG code. We made inadvertent and technical errors related to the 
employment cost index (ECI) used in the wage index, the MS-DRG 
reclassification and recalibration budget neutrality adjustment factor 
(as discussed in section II.B. of this correcting document), and the 
MGCRB reclassification status of certain providers (as discussed in 
section II.B. of this correcting document), each of which resulted in 
additional conforming corrections. Specifically, on page 49492, we 
inadvertently miscalculated the estimated percentage change in the ECI 
for compensation for the 30-day increment after March 14, 2013 and 
before April 15, 2013 for private industry hospital workers from the 
Bureau of Labor Statistics' (BLS') ``Compensation and Working 
Conditions.'' The ECI is used to adjust a hospital's wage data to 
calculate the wage index, and is based on the midpoint of a cost 
reporting period.
    On page 49498, we are making conforming changes to the number of 
hospitals in New Jersey that will be receiving the imputed rural floor 
and to the FY 2016 rural floor value for Nevada as a result of 
correcting the ECI error, the technical error in the calculation of the 
MS-DRG reclassification and recalibration budget neutrality adjustment 
factor (discussed in section II.B. of this correcting document), and 
the error in the reclassification status of 50 providers (discussed in 
section II.B. of this correcting document).
    On page 49619, consistent with the conforming corrections to the 
IPPS outlier fixed-loss cost threshold for FY 2016 discussed in section 
II.B. of this correcting document, we are making further conforming 
corrections to the FY 2016 outlier fixed-loss amount for site neutral 
cases in the context of our discussion regarding LTCH PPS high-cost 
outliers.

B. Summary of Errors in the Addendum

    On page 49776, we are correcting the MS-DRG reclassification and

[[Page 60056]]

recalibration budget neutrality adjustment factor as a result of a 
technical error made in the calculation of this factor. We are also 
making conforming changes to the affected rates and factors on pages 
49787, 49788 and 49790 as a result of this error.
    In addition, as discussed in section II.A. of this correcting 
document, we inadvertently miscalculated the percentage change in the 
ECI. The correction to the ECI necessitated recalculation of the pre-
reclassified unadjusted and occupational-mix adjusted wage indexes and 
Geographic Adjustment Factors (GAFs) of certain core-based statistical 
areas (CBSAs). As a result of the corrections to the ECI and the MS-DRG 
reclassification and recalibration budget neutrality adjustment factor, 
on page 49776, we recalculated the wage index budget neutrality 
adjustment and are making conforming changes to the tables on pages 
49787 and 49788.
    On pages 49776, we recalculated the reclassification hospital 
budget neutrality adjustment because the reclassification status in the 
FY 2016 IPPS/LTCH PPS final rule did not properly reflect one of the 
following for 50 providers:
     Withdrawal or termination of a Medicare Geographic 
Classification Review Board (MGCRB) reclassification for FY 2016.
     Assignment to the reclassified CBSA approved by the MGCRB 
or CMS Administrator.
    As a result of the MS-DRG reclassification and recalibration budget 
neutrality adjustment factor error, the ECI error, and reclassification 
error, we are making conforming technical changes to tables on pages 
49787 and 49788. The technical errors discussed previously (the 
percentage change in the ECI error, MS-DRG reclassification and 
recalibration budget neutrality adjustment factor error, and 
reclassification error) directly affected and required the 
recalculation of the wage index, the recalculation of certain budget 
neutrality adjustments, and also indirectly resulted in errors to other 
factors and rates. Specifically, on pages 49777, 49778, 49787, and 
49788, we are making conforming corrections to the following:
     The rural floor budget neutrality adjustment.
     The wage index transition budget neutrality adjustment.
     The Rural Community Hospital Demonstration program budget 
neutrality adjustment.
    In addition, as discussed in section II.D. of this correcting 
document, we are making corrections to the uncompensated care payments. 
As a result of these errors (the percentage change in the ECI error, 
MS-DRG reclassification and recalibration budget neutrality adjustment 
factor error, reclassification error, and uncompensated care error) and 
conforming corrections, on page 49785, we are making conforming 
corrections to the calculation of the outlier fixed-loss cost threshold 
and the national and Puerto Rico-specific outlier budget neutrality 
factors. We are making further conforming corrections to the tables on 
pages 49787 and 49788 as a result of these changes, including 
conforming corrections in the calculation of the national and Puerto 
Rico specific operating standardized amounts, as a result of the 
conforming corrections to the operating IPPS budget neutrality factors 
and outlier threshold described previously.
    On pages 49791, 49793, 49794, and 49795, in our discussion of the 
determination of the Federal hospital inpatient capital related 
prospective payment rate update, we are making conforming corrections 
to the national GAF/MS-DRG budget neutrality adjustment factor (due to 
the errors in our calculation of the GAFs, which are computed from the 
wage index) and to the outlier threshold, and outlier budget neutrality 
adjustment factors (as discussed previously).
    Also, as a result of these errors, on page 49794, we are making 
conforming corrections in the table showing the comparison of factors 
and adjustments for the FY2015 capital Federal rate and FY 2016 capital 
Federal rate and in the table showing the comparison of factors and 
adjustments for the proposed FY 2016 capital Federal rate and final FY 
2016 capital Federal rate.
    On page 49804, in our discussion regarding LTCH PPS high-cost 
outlier payments for site neutral payment rate cases, we are making 
conforming corrections in the FY 2016 fixed-loss amount for site 
neutral cases, due to the conforming correction to the IPPS outlier 
fixed-loss cost threshold for FY 2016 (as discussed previously).
    On page 49808, we are correcting the information on how to access 
the LTCH PPS tables for the FY 2016 final rule on the CMS Web Site.
    On page 49809, we are making conforming corrections to the national 
and Puerto Rico specific operating standardized amounts and capital 
standard Federal payment rates in Tables 1A, 1B, 1C, and 1D as a result 
of the corrections to certain budget neutrality factors and the outlier 
threshold (as described previously).

C. Summary of Errors in the Appendices

    On page 49809, we are correcting our estimate of the increase in FY 
2016 operating payments and capital payments as a result of the 
technical errors that led to corrections to certain budget neutrality 
factors and the outlier threshold (as described previously). On pages 
49813 through 49821, 49823, 49828 through 49830, and 49840, in our 
regulatory impact analyses, we are making conforming corrections in the 
discussion of the analysis of the changes in operating and capital IPPS 
payments for FY 2016 and the effects of certain budget neutrality 
factors as a result of the technical errors (as discussed previously) 
that lead to conforming corrections to the calculation of the operating 
and capital IPPS budget neutrality factors, outlier threshold, 
operating standardized amounts, and capital Federal rates.
    On page 49823, in the table titled ``Modeled Disproportionate Share 
Hospital Payments for Estimated FY 2016 DSH Hospitals by Hospital Type: 
Model DSH $ (In Millions) From FY 2015 To FY 2016'' and the 
accompanying discussion, we made technical and formatting errors in the 
estimated impacts resulting from inadvertent errors in the calculation 
of Factor 3 for certain hospitals.
    On pages 49829 through 49830, we are making conforming corrections 
to Table III--Comparison of Total Payments Per Case (FY 2015 Payments 
Compared to FY 2016 Payments).
    On page 49841, we are making conforming corrections to the 
accounting statements and tables for acute care hospitals that arose 
from the corrections of errors as described in section II.B. of this 
correcting document.

D. Summary of Errors in and Corrections to Files and Tables Posted on 
the CMS Web site

1. Errors and Corrections to IPPS and LTCH PPS Tables
    We are correcting the errors in the following IPPS tables that are 
listed on page 49808 of the FY 2016 IPPS/LTCH PPS final rule and are 
available on the Internet on the CMS Web Site at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2016-IPPS-Final-Rule-Home-Page.html:
    Table 2--Final Case-Mix Index and Wage Index Table by CCN, because 
of the ECI error discussed in section II.A. of this correction 
document, we are correcting the values in the columns titled FY 2016 
Wage Index, Average Hourly Wage FY 2016, and 3-Year Average Hourly Wage 
(2014, 2015,

[[Page 60057]]

2016) for 4 providers located in CBSAs 04, 20, and 12620. Because the 
average hourly wage changed for these four providers which affects the 
area wage index, we are also correcting the FY 2016 wage indexes for 
other providers geographically located in, or reclassified into, CBSAs 
04, 20, and 12620.
    As discussed in section II.B. of this correcting document, we are 
also correcting the reclassification status of 50 providers. Thus, we 
are correcting the FY 2016 wage index values for these providers to 
reflect assignment to their geographic CBSAs or reclassified CBSAs, as 
applicable.
    Furthermore, because we are revising the national rural floor 
budget neutrality adjustment as discussed in section II.B. of this 
correcting document, the wage index values for numerous providers in 
Table 2 are corrected as well.
    Table 3--Final Wage Index Table by CBSA, by correcting the ECI 
error, we are making corresponding changes to the wage indexes and GAFs 
of CBSAs 04, 20, and 12620 listed in Table 3. Specifically, we are 
correcting the values in the columns titled FY 2016 Average Hourly 
Wage, 3-Year Average Hourly Wage (2014, 2015, 2016), Wage Index, 
Reclassified Wage Index, GAF, and Reclassified GAF, for CBSAs 04, 20, 
and 12620.
    Also, by correcting Table 2 to properly indicate the withdrawal, 
termination, or reclassification status of the 50 providers, we are 
making corresponding changes to the wage indexes and GAFs listed in 
Table 3. Specifically, we are correcting the values in the columns 
titled Wage Index, Reclassified Wage Index, GAF, and Reclassified GAF. 
Furthermore, because we are revising the national rural floor budget 
neutrality adjustment as discussed in section II.B. of this correcting 
document, we are making corrections to the wage index values for 
numerous CBSAs in Table 3 as well.
    Table 5--List of Medicare Severity Diagnosis-Related Groups (MS-
DRGs), Relative Weighting Factors, and Geometric and Arithmetic Mean 
Length of Stay--FY 2016, in the column labeled 'TYPE', to be consistent 
with previous fiscal years, we are revising the entries labeled 'P' to 
SURG and the entries labeled 'M' to MED.
    Table 10--New Technology Add-On Payment Thresholds for Applications 
for FY 2017. We are correcting the thresholds in this table as a result 
of the corrections to the operating standardized amounts discussed in 
section II.B. of this correcting document.
    Table 11--MS-LTC-DRGs, Relative Weights, Geometric Average Length 
of Stay, Short Stay Outlier (SSO) Threshold, and ''IPPS Comparable 
Threshold'' for LTCH PPS Discharges Occurring from October 1, 2015 
through September 30, 2016. We are correcting this table by correcting 
typographical errors for certain MS-LTC-DRGs in the columns titled 
``Relative Weight,'' ``Geometric Average Length of Stay,'' ``Short-Stay 
Outlier (SSO) Threshold,'' and ``IPPS Comparable Threshold.''
    Table 12A--LTCH PPS Wage Index for Urban Areas for Discharges 
Occurring From October 1, 2015 through September 30, 2016. We are 
correcting this table by correcting the values in the column titled 
``LTCH PPS Wage Index'' as result of the error in the miscalculation 
percentage change in the ECI, which affected the wage data for CBSA 
12620, as discussed in section II.A. of this correcting document.
    Table 12B--LTCH PPS Wage Index for Rural Areas for Discharges 
Occurring From October 1, 2015 through September 30, 2016. We are 
correcting this table by correcting the values in the column titled 
``LTCH PPS Wage Index'' as result of the technical error in the 
percentage change in the ECI, which affected the wage data for CBSAs 04 
and 20, as discussed in section II.A. of this correcting document.
    Table 14--List of Hospitals with Fewer Than 1,600 Medicare 
Discharges Based on the March 2015 Update of the FY 2014 MedPAR File 
and Potentially Eligible Hospitals for the FY 2016 Low-Volume Hospital 
Payment Adjustment (Eligibility for the low-volume hospital payment 
adjustment is also dependent upon meeting the mileage criteria 
specified at Sec.  412.101(b)(2)(ii)). We are correcting this table by 
correcting typographical and technical errors for certain hospitals in 
the column titled ``FY 2016 Low-Volume Payment Adjustment (Percentage 
Add-on).
    Table 18--FY 2016 Medicare DSH Uncompensated Care Payment Factor 3 
and Projected DSH Eligibility. For the FY 2016 IPPS/LTCH PPS final 
rule, we published a list of hospitals that we identified to be 
subsection (d) hospitals and subsection (d) Puerto Rico hospitals 
eligible to receive empirically justified Medicare DSH payment 
adjustments and uncompensated care payments for FY 2016. We also 
published, in the Supplemental Medicare DSH File located in the FY 2016 
IPPS/LTCH PPS final rule data files page at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2016-IPPS-Final-Rule-Home-Page-Items/FY2016-IPPS-Final-Rule-Data-Files.html, 
the data used to calculate each hospital's Factor 3, total 
uncompensated care payment, and uncompensated care payment per 
discharge. Shortly after the publication of the FY2016 IPPS/LTCH PPS 
final rule, we discovered that in calculating Factor 3 of the 
uncompensated care payment methodology, we inadvertently excluded the 
Medicaid days from the most recently available 2012 or 2011 cost report 
for certain providers that were projected to receive Medicare DSH in FY 
2016. As a result, these providers had no Medicaid days included in the 
calculation of Factor 3. In order to correct these errors, we have 
Factor 3 for all hospitals to incorporate the changes to the data for 
these providers whose Medicare hospital cost report data were 
inadvertently excluded. These corrections to the uncompensated care 
payments impacted the calculation of the outlier fixed-loss cost 
threshold for outlier payments.
    In addition, we discovered that we had--
     Inadvertently calculated Factor 3 for several providers 
using Medicaid days from a cost report that was less than a full year 
when a cost report that was a full year or closer to being a full year 
was available;
     Erroneously provided Factor 3 values for certain new 
providers; and
     Calculated a Factor 3 for a hospital that has ceased 
operations.
    We are revising Factor 3 for all hospitals to correct these errors; 
however, unlike the error in which Medicaid days for certain providers 
were excluded, the impacts of these three errors (specified in the 
bulleted list) are too small to change other aspects of the IPPS 
ratesetting, such as the calculation of the fixed-loss threshold for 
outlier payments.

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

[[Page 60058]]

to the public interest, and the agency incorporates a statement of the 
findings and its reasons in the rule issued.
    We believe that 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 and typographic errors in the preamble, addendum, payment 
rates, tables, and appendices included or referenced in the FY 2016 
IPPS/LTCH PPS final rule 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 
information in the FY 2016 IPPS/LTCH PPS final rule accurately reflects 
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 2016 IPPS/LTCH PPS final 
rule accurately reflects our 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 
policies that we previously proposed, received comment on, and 
subsequently finalized. This correcting document is intended solely to 
ensure that the FY 2016 IPPS/LTCH PPS final rule accurately reflects 
these payment methodologies and policies. Therefore, we believe we have 
good cause to waive the notice and comment and effective date 
requirements.

IV. Correction of Errors

    In FR Doc. 2015-19049 of August 17, 2015 (80 FR 49325), we are 
making the following corrections:

A. Corrections of Errors in the Preamble

    1. On page 49412, first column, third bulleted paragraph, the 
phrase ``MS-DRG 007'' is corrected to read ``MS-DRG 207''.
    2. On page 49492, first column, after the first partial paragraph, 
in the table titled ``Midpoint of Cost Reporting Period'', last entry 
(After 03/14/2013) is corrected to read as follows:

                    Midpoint of Cost Reporting Period
------------------------------------------------------------------------
         After                    Before             Adjustment factor
------------------------------------------------------------------------
       03/14/2013               04/15/2013                 0.99851
------------------------------------------------------------------------

    3. On page 49498, first column, second full paragraph, line 9, the 
figure ``21'' is corrected to read ``19''.
    3. On page 49498, second column, first partial paragraph, line 13, 
the figure ``1.0194'' is corrected to read ``1.0190''.
    4. On page 49619, third column, third full paragraph, line 4, the 
figure ``22,544'' is corrected to read ``22,539''.

B. Correction of Errors in the Addendum

    1. On page 49776:
    a. First column:
    (1) Fourth full paragraph, line 3, the figure ``0.998399'' is 
corrected to read ``0.998405''.
    (2) Fourth full paragraph, line 8, the figure ``0.998399'' is 
corrected to read ``0.998405''.
    (3) Fifth full paragraph, line 16, the figure ``0.998399'' is 
corrected to read ``0.998405''.
    b. Second column, third full paragraph:
    (1) Line 9, the figure ``0.998749'' is corrected to read 
``0.998738''.
    (2) Line 13, the figure ``0.998399'' is corrected to read 
``0.998405''.
    (3) Line 15, the figure ``0.998749'' is corrected to read 
``0.998738''.
    (4) Line 21, the figure ``0.997150'' is corrected to read 
``0.997145''.
    c. Third column, third full paragraph, line 12, the figure 
``0.987905'' is corrected to read ``0.988168''.
    2. On page 49777, second column, last paragraph, line 3, the figure 
``0.990298'' is corrected to read ``0.989859''.
    3. On page 49778:
    a. First column, second full paragraph:
    (1) Line 3, the figure ``0.999996'' is corrected to read 
``0.999997''.
    (2) Line 6, the figure ``0.999996'' is corrected to read 
``0.999997''.
    b. Third column, last paragraph, line 36, the figure ``0.999861'' 
is corrected to read ``0.999837''.
    4. On page 49785:
    a. Top third of the page, second column, first full paragraph, last 
line, the figure ``22,544'' is corrected to read ``22,539''.
    b. Middle of the page, the untitled table, is corrected to read as 
follows:

------------------------------------------------------------------------
                                          Operating
                                        standardized    Capital  Federal
                                           amounts            rate
------------------------------------------------------------------------
National............................          0.948999          0.936503
Puerto Rico.........................          0.935570          0.919204
------------------------------------------------------------------------

    5. On pages 49787 and 49788, the table titled ``Comparison of FY 
2015 Standardized Amounts to the FY 2016 Standardized Amounts'', is 
corrected to read as follows:

                 Comparison of FY 2015 Standardized Amounts to the FY 2016 Standardized Amounts
----------------------------------------------------------------------------------------------------------------
                                                      Hospital submitted   Hospital did NOT    Hospital did NOT
                                  Hospital submitted   quality data and     submit quality      submit quality
                                   quality data and        is NOT a          data and is a     data and is NOT a
                                    is a meaningful     meaningful EHR      meaningful EHR      meaningful EHR
                                       EHR user              user                user                user
----------------------------------------------------------------------------------------------------------------
FY 2015 Base Rate after
 removing:
    1. FY 2015 Geographic         If Wage Index is    If Wage Index is    If Wage Index is    If Wage Index is
     Reclassification Budget       Greater Than        Greater Than        Greater Than        Greater Than
     Neutrality (0.990429)         1.0000: Labor       1.0000: Labor       1.0000: Labor       1.0000: Labor
                                   (69.6%):            (69.6%):            (69.6%):            (69.6%):
                                   $4,324.23           $4,324.23           $4,324.23           $4,324.23
                                   Nonlabor (30.4%):   Nonlabor (30.4%):   Nonlabor (30.4%):   Nonlabor (30.4%):
                                   $1,888.74.          $1,888.74.          $1,888.74.          $1,888.74.

[[Page 60059]]

 
    2. FY 2015 Rural Community
     Hospital Demonstration
     Program Budget Neutrality
     (0.999313)
    3. Cumulative FY 2008, FY     If Wage Index is    If Wage Index is    If Wage Index is    If Wage Index is
     2009, FY 2012, FY 2013 and    less Than or        less Than or        less Than or        less Than or
     FY 2014, FY 2015              Equal to 1.0000:    Equal to 1.0000:    Equal to 1.0000:    Equal to 1.0000:
     Documentation and Coding      Labor (62%):        Labor (62%):        Labor (62%):        Labor (62%):
     Adjustment as Required        $3,852.04           $3,852.04           $3,852.04           $3,852.04
     under Sections 7(b)(1)(A)     Nonlabor (38%):     Nonlabor (38%):     Nonlabor (38%):     Nonlabor (38%):
     and 7(b)(1)(B) of Pub. L.     $2,360.93.          $2,360.93.          $2,360.93.          $2,360.93.
     110-90 and Documentation
     and Coding Recoupment
     Adjustment as required
     under Section 631 of the
     American Taxpayer Relief
     Act of 2012 (0.9329)
    4. FY 2015 Operating Outlier
     Offset (0.948999)
    5. FY 2015 New Labor Market
     Delineation Wage Index
     Transition Budget
     Neutrality Factor
     (0.998854)
FY 2016 Update Factor...........  1.017.............  1.005.............  1.011.............  0.999.
FY 2016 MS-DRG Recalibration and  0.997145..........  0.997145..........  0.997145..........  0.997145.
 Wage Index Budget Neutrality
 Factor.
FY 2016 Reclassification Budget   0.988168..........  0.988168..........  0.988168..........  0.988168.
 Neutrality Factor.
FY 2016 Rural Community           0.999837..........  0.999837..........  0.999837..........  0.999837.
 Demonstration Program Budget
 Neutrality Factor.
FY 2016 Operating Outlier Factor  0.948999..........  0.948999..........  0.948999..........  0.948999.
Cumulative Factor: FY 2008, FY    0.9255............  0.9255............  0.9255............  0.9255.
 2009, FY 2012, FY 2013, FY
 2014, FY 2015 and FY 2016
 Documentation and Coding
 Adjustment as Required under
 Sections 7(b)(1)(A) and
 7(b)(1)(B) of Pub. L. 110-90
 and Documentation and Coding
 Recoupment Adjustment as
 required under Section 631 of
 the American Taxpayer Relief
 Act of 2012.
FY 2016 New Labor Market          0.999997..........  0.999997..........  0.999997..........  0.999997.
 Delineation Wage Index 3-Year
 Hold Harmless Transition Budget
 Neutrality Factor.
National Standardized Amount for  Labor: $3,805.30..  Labor: $3,760.40..  Labor: $3,782.85..  Labor: $3,737.95.
 FY 2016 if Wage Index is         Nonlabor:           Nonlabor:           Nonlabor:           Nonlabor:
 Greater Than 1.0000; Labor/Non-   $1,662.09.          $1,642.48.          $1,652.28.          $1,632.67.
 Labor Share Percentage (69.6/
 30.4).
National Standardized Amount for  Labor: $3,389.78..  Labor: $3,349.79..  Labor: $3,369.78..  Labor: $3,329.78.
 FY 2016 if Wage Index is less    Nonlabor:           Nonlabor:           Nonlabor:           Nonlabor:
 Than or Equal to 1.0000; Labor/   $2,077.61.          $2,053.09.          $2,065.35.          $2,040.84.
 Non-Labor Share Percentage (62/
 38).
----------------------------------------------------------------------------------------------------------------

    6. On page 49788, in the center of the page, the table titled 
``Comparison of FY 2015 Puerto Rico-Specific Payment Rate to the FY 
2016 Puerto Rico-Specific Payment Rate'' is corrected to read as 
follows:

 Comparison of FY 2015 Puerto Rico-Specific Payment Rate to the FY 2016
                    Puerto Rico-Specific Payment Rate
------------------------------------------------------------------------
                                      Update (1.7         Update (1.7
                                    percent); Wage      percent); Wage
                                   index is greater   index is less than
                                  than 1.0000; Labor/     or equal to
                                    Non-Labor Share   1.0000; Labor/Non-
                                   Percentage (63.2/      Labor Share
                                         36.8)        Percentage (62/38)
------------------------------------------------------------------------
FY 2015 Puerto Rico Base Rate,    Labor: $1,758.02..  Labor: $1,724.64
 after removing:                  Nonlabor:           Nonlabor:
                                   $1,023.66..         $1,057.04.
    1. FY 2015 Geographic
     Reclassification Budget
     Neutrality (0.990429).
    2. FY 2015 Rural Community
     Hospital Demonstration
     Program Budget Neutrality
     (0.999313)
    3. FY 2015 Puerto Rico
     Operating Outlier Offset
     (0.926334)
    4. FY 2015 New Labor Market
     Delineation Wage Index
     Transition Budget
     Neutrality Factor
     (0.998854)
FY 2016 Update Factor...........  1.017.............  1.017.

[[Page 60060]]

 
FY 2016 MS[dash]DRG               0.998405..........  0.998405.
 Recalibration Budget Neutrality
 Factor.
FY 2016 Reclassification Budget   0.988168..........  0.988168.
 Neutrality Factor.
FY 2016 Rural Community Hospital  0.999837..........  0.999837.
 Demonstration Program Budget
 Neutrality Factor.
FY 2016 New Labor Market          0.999997..........  0.999997.
 Delineation Wage Index 3-Year
 Hold Harmless Transition Budget
 Neutrality Factor.
FY 2016 Puerto Rico Operating     0.935570..........  0.935570.
 Outlier Factor.
Puerto Rico[dash]Specific         Labor: $1,650.00..  Labor: $1,618.68
 Payment Rate for FY 2016.        Nonlabor: $960.77.  Nonlabor: $992.09.
------------------------------------------------------------------------

    7. On page 49790, first column, last paragraph, line 15, the figure 
``0.998399'' is corrected to read ``0.998405''.
    8. On page 49791, third column, first full paragraph, line 6, the 
figure ``0.85'' is corrected to read ``0.87''.
    9. On page 49793:
    a. Second column:
    (1) First full paragraph:
    (a) Line 16, the figure ``0.9979'' is corrected to read ``0.9982''.
    (b) Line 19, the figure ``0.9864'' is corrected to read ``0.9866''.
    (2) Second full paragraph, line 17, the figure ``0.9858'' is 
corrected to read ``0.9860''.
    b. In third column:
    (1) Second full paragraph:
    (a) Line 2, the figure ``0.9973'' is corrected to read ``0.9976''.
    (b) Line 4, the figure ``0.9979'' is corrected to read ``0.9982''.
    (2) Third full paragraph:
    (a) Line 9, the figure ``438.65'' is corrected to read ``438.75''.
    (b) Line 19, the figure ``0.9973'' is corrected to read ``0.9976''.
    10. On page 49794:
    a. Third column, first partial paragraph:
    (1) Line 3, the figure ``0.27'' is corrected to read ``0.24''.
    (2) Line 10, the figure ``0.85'' is corrected to read ``0.87''.
    b. The table titled entitled ``Comparison of Factors and 
Adjustments: FY 2015 Capital Federal Rate and FY 2016 Capital Federal 
Rate'' is corrected to read as follows:

      Comparison of Factors and Adjustments: FY 2015 Capital Federal Rate and FY 2016 Capital Federal Rate
----------------------------------------------------------------------------------------------------------------
                                                                                                      Percent
                                                      FY 2015         FY 2016         Change          change
----------------------------------------------------------------------------------------------------------------
Update Factor \1\...............................          1.0150          1.0130          1.0130             1.3
GAF/DRG Adjustment Factor \1\...................          0.9993          0.9976          0.9976           -0.24
Outlier Adjustment Factor \2\...................          0.9382          0.9365          0.9982           -0.18
Capital Federal Rate............................         $434.97         $438.75          1.0087            0.87
----------------------------------------------------------------------------------------------------------------
\1\ The update factor and the GAF/DRG budget neutrality adjustment factors are built permanently into the
  capital Federal rates. Thus, for example, the incremental change from FY 2015 to FY 2016 resulting from the
  application of the 0.9976 GAF/DRG budget neutrality adjustment factor for FY 2016 is a net change of 0.9976
  (or -0.24 percent).
\2\ The outlier reduction factor is not built permanently into the capital Federal rate; that is, the factor is
  not applied cumulatively in determining the capital Federal rate. Thus, for example, the net change resulting
  from the application of the FY 2016 outlier adjustment factor is 0.9365/0.9382, or 0.9982 (or -0.18 percent).

    c. The table titled entitled ``Comparison of Factors and 
Adjustments: Proposed FY 2016 Capital Federal Rate and Final FY 2016 
Capital Federal Rate'' is corrected to read as follows:

 Comparison of Factors and Adjustments: Proposed FY 2016 Capital Federal Rate and Final FY 2016 Capital Federal
                                                      Rate
----------------------------------------------------------------------------------------------------------------
                                                    Proposed FY
                                                       2016        Final FY 2016      Change      Percent change
----------------------------------------------------------------------------------------------------------------
Update Factor...................................          1.0130          1.0130          1.0000            0.00
GAF/DRG Adjustment Factor.......................          0.9976          0.9976          1.0000            0.00
Outlier Adjustment Factor.......................          0.9357          0.9365          1.0008            0.08
Capital Federal Rate............................         $438.40         $438.75          1.0008            0.08
----------------------------------------------------------------------------------------------------------------

    11. On page 49795, first column:
    a. First paragraph, line 7, the figure ``212.56'' is corrected to 
read ``212.55''.
    b. Third paragraph, line 21, the figure ``22,544'' is corrected to 
read ``22,539''.
    12. On page 49804, second column, first full paragraph:
    a. Line 16, the figure ``22,544'' is corrected to read ``22,539''.
    b. Line 27, the figure ``22,544'' is corrected to read ``22,539''.
    13. On page 49808, third column, first full paragraph, lines 6 and 
7, the phrase ``index.html under the list item for Regulation Number'' 
is corrected to read ``index.html. Click on the link on the left side 
of the screen titled, ``LTCHPPS Regulations and Notices'' and select 
the list item for Regulation Number CMS-1632-F. ``.
    13. On page 49809:
    a. Table 1A titled ``National Adjusted Operating Standardized 
Amounts,

[[Page 60061]]

Labor/Nonlabor (69.6 Percent Labor Share/30.4 Percent Nonlabor Share if 
Wage Index is Greater than 1)--FY 2016'' is corrected to read as 
follows:

    Table 1A--National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.6 Percent Labor Share/30.4 Percent Nonlabor Share If Wage Index Is
                                                                Greater Than 1)--FY 2016
--------------------------------------------------------------------------------------------------------------------------------------------------------
Hospital submitted quality data and is  Hospital did NOT submit quality data   Hospital submitted quality data and  Hospital did NOT submit quality data
  a meaningful EHR user (update = 1.7   and is a meaningful EHR user (update  is NOT a meaningful EHR user (update    and is NOT a meaningful EHR user
               percent)                            = 1.1 percent)                        = 0.5 percent)                    (update = -0.1 percent)
--------------------------------------------------------------------------------------------------------------------------------------------------------
       Labor             Nonlabor             Labor             Nonlabor            Labor             Nonlabor            Labor             Nonlabor
--------------------------------------------------------------------------------------------------------------------------------------------------------
       $3,805.30           $1,662.09          $3,782.85          $1,652.28          $3,760.40          $1,642.48          $3,737.95          $1,632.67
--------------------------------------------------------------------------------------------------------------------------------------------------------

    b. Table 1B titled ``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)--FY 2016'' is corrected 
to read as follows:

 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)--FY 2016
--------------------------------------------------------------------------------------------------------------------------------------------------------
Hospital submitted quality data and is  Hospital did NOT submit quality data   Hospital submitted quality data and  Hospital did NOT submit quality data
  a meaningful EHR user (update = 1.7   and is a meaningful EHR user (update  is NOT a meaningful EHR user (update    and is NOT a meaningful EHR user
               percent)                            = 1.1 percent)                        = 0.5 percent)                    (update = -0.1 percent)
--------------------------------------------------------------------------------------------------------------------------------------------------------
       Labor             Nonlabor             Labor             Nonlabor            Labor             Nonlabor            Labor             Nonlabor
--------------------------------------------------------------------------------------------------------------------------------------------------------
       $3,389.78           $2,077.61          $3,369.78          $2,065.35          $3,349.79          $2,053.09          $3,329.78          $2,040.84
--------------------------------------------------------------------------------------------------------------------------------------------------------

    c. Table 1C titled ``Adjusted Operating Standardized Amounts for 
Puerto Rico, Labor/Nonlabor (National: 62 Percent Labor Share/38 
Percent Nonlabor Share Because Wage Index is Less than or Equal to 1; 
Puerto Rico: 63.2 Percent Labor Share/36.8 Percent Nonlabor Share if 
Wage Index is Greater Than 1 or 62 Percent Labor Share/38 Percent 
Nonlabor Share if Wage Index is Less than or Equal to 1--FY 2016'' is 
corrected to read as follows:

  Table 1C--Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor (National: 62 Percent Labor
 Share/38 Percent Nonlabor Share Because Wage Index Is Less Than or Equal to 1; Puerto Rico: 63.2 Percent Labor
 Share/36.8 Percent Nonlabor Share If Wage Index Is Greater Than 1 or 62 Percent Labor Share/38 Percent Nonlabor
                             Share If Wage Index Is Less Than or Equal to 1--FY 2016
----------------------------------------------------------------------------------------------------------------
                                        Rates if wage index is greater than 1       Rates if wage index is less
                                   ----------------------------------------------       than or equal to 1
        Standardized amount                                                      -------------------------------
                                            Labor                 Nonlabor             Labor         Nonlabor
----------------------------------------------------------------------------------------------------------------
National \1\......................  Not Applicable.......  Not Applicable.......       $3,389.78       $2,077.61
Puerto Rico.......................  $1,650.00............  $960.77..............        1,618.68          992.09
----------------------------------------------------------------------------------------------------------------
\1\ For FY 2016, there are no CBSAs in Puerto Rico with a national wage index greater than 1.

    d. Table 1D titled ``Capital Standard Federal Payment Rates--FY 
2016'' is corrected as follows:

        Table 1D--Capital Standard Federal Payment Rates--FY 2016
------------------------------------------------------------------------
                                                               Rate
------------------------------------------------------------------------
National................................................         $438.75
Puerto Rico.............................................          212.55
------------------------------------------------------------------------

C. Corrections of Errors in the Appendices

    1. On page 49809, third column, first full paragraph:
    a. Line 10, the figure ``$378'' is corrected to read ``$391''.
    b. Line 12, the figure ``$187'' is corrected to read ``$188''.
    2. On pages 49813 through 49815, the table titled ``Impact Analysis 
of Changes to the IPPS for Operating Costs for FY 2016'' is corrected 
to read as follows:

[[Page 60062]]



                                                         Table I--Impact Analysis of Changes to the Ipps for Operating Costs for FY 2016
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                         Rural and
                                                                                         FY 2016 Wage data                                             imputed floor
                                                     Hospital rate     FY 2016 Weights     under new CBSA   FY 2016 DRG, Rel.                               with        Application of
                                       Number of       update and      and DRG changes   designations with   wts., wage index      FY 2016 MGCRB       application of    the frontier    All FY
                                       hospitals   documentation and   with application    application of   changes with wage    Reclassifications     national rural   wage index and    2016
                                          \1\      coding adjustment   of recalibration     wage budget     and recalibration                           and imputed     out-migration    changes
                                                                      budget neutrality      neutrality     budget neutrality                           floor budget      adjustment
                                                                                                                                                         neutrality
                                      ...........         (1) \ 2\           (2) \ 3\           (3) \ 4\           (4) \ 5\               (5) \ 6\         (6) \ 7\         (7) \ 8\    (8) \ 9\
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
All Hospitals.......................        3,369                0.9                0                  0                  0                      0                0                0.1       0.4
By Geographic Location:
    Urban hospitals.................        2,533                0.9                0                  0                  0.1                   -0.1              0                0.1       0.4
    Large urban areas...............        1,393                0.9                0.1                0.1                0.2                   -0.3              0                0.1       0.4
    Other urban areas...............        1,140                0.9                0                 -0.1               -0.2                    0.1              0.1              0.2       0.4
    Rural hospitals.................          836                1.3               -0.2               -0.3               -0.5                    1.4             -0.3              0.1       0.2
Bed Size (Urban):
    0-99 beds.......................          668                0.9               -0.3               -0.2               -0.4                   -0.6              0.1              0.3       0.2
    100-199 beds....................          778                0.9               -0.1                0.1                0.1                    0                0.3              0.2       0.4
    200-299 beds....................          445                0.9                0                  0                  0                      0.1              0.1              0.1       0.4
    300-499 beds....................          428                0.9                0                  0                  0                     -0.2              0.1              0.2       0.4
    500 or more beds................          214                0.9                0.1                0.1                0.2                   -0.2             -0.2              0.1       0.4
Bed Size (Rural):
    0-49 beds.......................          329                1.3               -0.2               -0.3               -0.5                    0.3             -0.2              0.3      -0.1
    50-99 beds......................          297                1.4               -0.3               -0.2               -0.5                    0.8             -0.2              0.1       0.2
    100-149 beds....................          121                1.4               -0.2               -0.2               -0.4                    1.7             -0.3              0.2       0.4
    150-199 beds....................           48                1.2               -0.2               -0.4               -0.5                    1.9             -0.3              0.1       0.3
    200 or more beds................           41                1.1               -0.1               -0.5               -0.5                    2.5             -0.2              0         0.1
Urban by Region:
    New England.....................          120                0.9                0                  0.7                0.8                    0.9              2                0.1       0
    Middle Atlantic.................          318                0.9                0.1                0.2                0.3                    0.8             -0.4              0.2       1
    South Atlantic..................          407                0.9                0                  0.1                0.1                   -0.5             -0.4              0.1       0.2
    East North Central..............          396                0.9                0                  0                  0.1                   -0.3             -0.6              0         0.5
    East South Central..............          150                0.9                0                 -0.4               -0.4                   -0.6             -0.4              0.1      -0.4
    West North Central..............          166                0.9                0                 -0.6               -0.5                   -0.8             -0.5              0.8       0.3
    West South Central..............          384                0.9                0                 -0.5               -0.4                   -0.6             -0.5              0        -0.4
    Mountain........................          161                1                 -0.1               -0.3               -0.3                    0               -0.1              0.2       0.2
    Pacific.........................          380                0.9                0                  0.4                0.3                   -0.2              1.7              0.1       1
    Puerto Rico.....................           51                1                  0.1               -0.9               -0.7                   -1                0.1              0.1      -1.9
Rural by Region:
    New England.....................           22                1.2               -0.1               -0.6               -0.7                    1.7             -0.4              0        -0.1
    Middle Atlantic.................           55                1.4               -0.1                0.2                0                      0.8             -0.2              0.2       0.2
    South Atlantic..................          128                1.2               -0.2               -0.1               -0.3                    2.4             -0.2              0.1       0.6
    East North Central..............          116                1.4               -0.2               -0.1               -0.4                    1               -0.2              0.1       0.9
    East South Central..............          164                0.9                0                 -0.7               -0.7                    2.5             -0.5              0.1      -1
    West North Central..............          101                1.7               -0.4               -0.2               -0.5                    0.2              0                0.3       0.8
    West South Central..............          165                1.2               -0.1               -0.9               -0.9                    1.5             -0.3              0.1      -0.8
    Mountain........................           61                1.4               -0.3               -0.1               -0.4                    0.2             -0.1              0.2       0.7
    Pacific.........................           24                1.4               -0.4                0.1               -0.3                    0.7             -0.2              0         1.5
By Payment Classification:
    Urban hospitals.................        2,476                0.9                0                  0                  0.1                   -0.1              0                0.1       0.4
    Large urban areas...............        1,386                0.9                0.1                0.1                0.2                   -0.3              0                0.1       0.4
    Other urban areas...............        1,090                0.9                0                 -0.1               -0.1                    0.1              0.1              0.2       0.4
    Rural areas.....................          893                1.3               -0.2               -0.3               -0.4                    1.2             -0.2              0.3       0.3
Teaching Status:
    Nonteaching.....................        2,326                1                 -0.1               -0.1               -0.1                    0.1              0.2              0.1       0.3
    Fewer than 100 residents........          794                0.9                0                 -0.1               -0.1                   -0.1              0                0.2       0.4
    100 or more residents...........          249                0.9                0.2                0.1                0.3                    0               -0.2              0.1       0.4
Urban DSH:
    Non-DSH.........................          653                0.9               -0.2                0.1               -0.1                   -0.1              0.1              0.2       1.1
    100 or more beds................        1,593                0.9                0.1                0                  0.1                   -0.1              0                0.1       0.3
    Less than 100 beds..............          328                0.9               -0.1                0                 -0.1                   -0.7              0                0.3       0.3
Rural DSH:
    SCH.............................          260                1.6               -0.3                0                 -0.4                    0                0                0         0.7
    RRC.............................          347                1.3               -0.2               -0.3               -0.4                    1.6             -0.2              0.4       0.4
    100 or more beds................           31                0.7                0.1               -0.6               -0.5                    2.4             -0.6              0.1      -0.9
    Less than 100 beds..............          157                0.8                0                 -0.7               -0.6                    1.7             -0.6              0.6      -1.2
Urban teaching and DSH:
    Both teaching and DSH...........          855                0.9                0.1                0                  0.1                   -0.1             -0.2              0.1       0.4
    Teaching and no DSH.............          122                0.9               -0.1                0                 -0.1                    0.5              0.4              0.1       1.3
    No teaching and DSH.............        1,066                0.9                0                  0                 -0.1                   -0.1              0.4              0.1       0.2
    No teaching and no DSH..........          433                0.9               -0.2                0.1               -0.1                   -0.4             -0.1              0.2       1.1

[[Page 60063]]

 
Special Hospital Types:
    RRC.............................          189                0.9               -0.1               -0.6               -0.6                    2.2             -0.4              0.6      -0.4
    SCH.............................          327                1.6               -0.3               -0.1               -0.3                   -0.1             -0.1              0         0.8
    MDH.............................          150                1.3               -0.3               -0.2               -0.4                    0.3             -0.2              0.2       0.6
    SCH and RRC.....................          126                1.6               -0.3               -0.1               -0.4                    0.4              0                0         0.9
    MDH and RRC.....................           13                1.5               -0.3                0                 -0.4                    0.2             -0.2              0         0.6
Type of Ownership:
    Voluntary.......................        1,934                0.9                0                  0                  0                      0.1              0                0.2       0.5
    Proprietary.....................          879                0.9                0                 -0.1               -0.1                   -0.1              0.1              0.1      -0.1
    Government......................          529                0.9                0.1               -0.1                0                     -0.2              0.1              0.1       0
Medicare Utilization as a Percent of
 Inpatient Days:
    0-25............................          533                0.9                0.1               -0.1                0                     -0.3              0.2              0        -0.6
    25-50...........................        2,134                0.9                0                  0                  0                      0                0                0.2       0.5
    50-65...........................          571                1                 -0.1                0.1                0                      0.6              0                0.2       0.8
    Over 65.........................           97                1.1               -0.1               -0.2               -0.4                   -0.3              0.3              0.1       0.4
FY 2016 Reclassifications by the
 Medicare Geographic Classification
 Review Board:
    All Reclassified Hospitals......          789                1                  0                 -0.1               -0.1                    2.4             -0.1              0         0.8
    Non-Reclassified Hospitals......        2,580                0.9                0                  0                  0.1                   -0.9              0                0.2       0.2
    Urban Hospitals Reclassified....          509                0.9                0                 -0.1               -0.1                    2.4             -0.1              0.1       0.9
    Urban Nonreclassified Hospitals.        1,967                0.9                0                  0.1                0.1                   -0.9              0.1              0.1       0.2
    Rural Hospitals Reclassified              280                1.2               -0.2               -0.3               -0.5                    2.3             -0.3              0         0.4
     Full Year......................
    Rural Nonreclassified Hospitals           503                1.4               -0.3               -0.3               -0.5                   -0.3             -0.2              0.3       0
     Full Year......................
    All Section 401 Reclassified               64                1.4               -0.3                0                 -0.2                   -0.4             -0.1              1.4       0.6
     Hospitals:.....................
    Other Reclassified Hospitals               53                1                 -0.1               -0.5               -0.6                    3.4             -0.5              0        -0.4
     (Section 1886(d)(8)(B) of the
     Act)...........................
Specialty Hospitals
    Cardiac Specialty Hospitals.....           14                0.9                0.2               -0.9               -0.6                   -1.1              0                0.9       0.7
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Because data necessary to classify some hospitals by category were missing, the total number of hospitals in each category may not equal the national total. Discharge data are from FY
  2014, and hospital cost report data are from reporting periods beginning in FY 2013 and FY 2012.
\2\ This column displays the payment impact of the hospital rate update and the documentation and coding adjustment including the 1.7 percent adjustment to the national standardized amount and
  hospital-specific rate (the estimated 2.4 percent market basket update reduced by the 0.5 percentage point for the multifactor productivity adjustment and the 0.2 percentage point reduction
  under the Affordable Care Act) and the -0.8 percent documentation and coding adjustment to the national standardized amount.
\3\ This column displays the payment impact of the changes to the Version 33 GROUPER, the changes to the relative weights and the recalibration of the MS-DRG weights based on FY 2014 MedPAR
  data in accordance with section 1886(d)(4)(C)(iii) of the Act. This column displays the application of the recalibration budget neutrality factor of 0.998405 in accordance with section
  1886(d)(4)(C)(iii) of the Act.
\4\ This column displays the payment impact of the update to wage index data using FY 2012 cost report data and the OMB labor market area delineations based on 2010 Decennial Census data. This
  column displays the payment impact of the application of the wage budget neutrality factor, which is calculated separately from the recalibration budget neutrality factor, and is calculated
  in accordance with section 1886(d)(3)(E)(i) of the Act. The wage budget neutrality factor is 0.998738.
\5\ This column displays the combined payment impact of the changes in Columns 2 through 3 and the cumulative budget neutrality factor for MS-DRG and wage changes in accordance with section
  1886(d)(4)(C)(iii) of the Act and section 1886(d)(3)(E) of the Act. The cumulative wage and recalibration budget neutrality factor of 0.997145 is the product of the wage budget neutrality
  factor and the recalibration budget neutrality factor.
\6\ Shown here are the effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB) along with the effects of the continued implementation of the new
  OMB labor market area delineations on these reclassifications. The effects demonstrate the FY 2016 payment impact of going from no reclassifications to the reclassifications scheduled to be
  in effect for FY 2016. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflects the geographic budget neutrality factor of 0.988168.
\7\ This column displays the effects of the rural floor and imputed floor based on the continued implementation of the new OMB labor market area delineations. The Affordable Care Act requires
  the rural floor budget neutrality adjustment to be 100 percent national level adjustment. The rural floor budget neutrality factor (which includes the imputed floor) applied to the wage
  index is 0.989859. This column also shows the effect of the 3-year transition for hospitals that were located in urban counties that became rural under the new OMB delineations or hospitals
  deemed urban where the urban area became rural under the new OMB delineations, with a budget neutrality factor of 0.999997.
\8\ This column shows the combined impact of the policy required under section 10324 of the Affordable Care Act that hospitals located in frontier States have a wage index no less than 1.0 and
  of section 1886(d)(13) of the Act, as added by section 505 of Pub. L. 108-173, which provides for an increase in a hospital's wage index if a threshold percentage of residents of the county
  where the hospital is located commute to work at hospitals in counties with higher wage indexes. These are nonbudget neutral policies.
\9\ This column shows the changes in payments from FY 2015 to FY 2016. It reflects the impact of the FY 2016 hospital update and the adjustment for documentation and coding. It also reflects
  changes in hospitals' reclassification status in FY 2016 compared to FY 2015. It incorporates all of the changes displayed in Columns 1, 4, 5, 6, and 7, (the changes displayed in Columns 2
  and 3 are included in Column 4). The sum of these impacts may be different from the percentage changes shown here due to rounding and interactive effects.


[[Page 60064]]

    3. On page 49816:
    a. First column, last paragraph, line 6, the figure ``0.998399'' is 
corrected to read ``0.998405''.
    b. Third column, first partial paragraph, line 16, the figure 
``0.998749'' is corrected to read ``0.998738''.
    4. On page 49817:
    a. First column, first full paragraph:
    (1) Line 9, the figure ``0.998749'' is corrected to read 
``0.998738''.
    (2) Line 11, the figure ``0.998399'' is corrected to read 
``0.998405''.
    (3) Line 18, the figure ``0.997150'' is corrected to read 
``0.997145''.
    b. Second column, first full paragraph, line 6, the figure 
``0.987905'' is corrected to read ``0.988168''.
    c. Third column:
    (1) First partial paragraph, line 7, the figure ``21'' is corrected 
to read ``19''.
    (2) First full paragraph, line 8, the figure ``0.990298'' is 
corrected to read ``0.989859''.
    (3) Last paragraph:
    (a) Line 1, the figure ``371'' is corrected to read ``375''.
    (b) Line 3, the figure ``2,998'' is corrected to read ``2,994''.
    (c) Line 6, the figure ``0.990298'' is corrected to read 
``0.989859''.
    (d) Line 8, the figure ``0.2'' is corrected to read ``0.3''.
    5. On page 49818:
    a. First column, first partial paragraph:
    (1) Line 10, the figure ``1.6'' is corrected to read ``2.0''.
    (2) Line 16, the figure ``0.990298'' is corrected to read 
``0.989859''.
    (3) Line 17, the figure ``$98'' is corrected to read ``$115''.
    (4) Line 19, the figure ``3.1'' is corrected to read ``3.6''.
    b. Second column, first full paragraph:
    (1) Line 1, the figure ``21'' is corrected to read ``19''.
    (2) Line 7, the figure ``0.990298'' is corrected to read 
``0.989859''.
    (3) Line 9, the figure ``$27'' is corrected to read ``$29''.
    (4) Line 10, the figure ``$9'' is corrected to read ``$10''.
    (5) Line 18, the figure ``$4.5'' is corrected to read ``$4.3''.
    (6) Line 19, the figure ``$2.6'' is corrected to read ``$2.3''.
    c. Third column, first partial paragraph, line 15, the figure 
``0.999996'' is corrected to read ``0.999997''.
    6. On pages 49818 and 49819, the table titled ``FY 2016 IPPS 
Estimated Payments Due to Rural Floor and Imputed Floor with National 
Budget Neutrality'' is corrected to read as follows:

      FY 2016 IPPS Estimated Payments Due to Rural Floor and Imputed Floor With National Budget Neutrality
----------------------------------------------------------------------------------------------------------------
                                                                                  Percent change
                                                                    Number of    in payments due
                                                                 hospitals that  to  application
                                                    Number of     will receive    of rural floor  Difference (in
                     State                          hospitals       the rural      and imputed       millions)
                                                                    floor or        floor with
                                                                  imputed floor       budget
                                                                                    neutrality
                                                            (1)             (2)            (3)            (4)
----------------------------------------------------------------------------------------------------------------
Alabama........................................              86               3             -0.4          $-7.08
Alaska.........................................               6               1             -0.3           -0.53
Arizona........................................              55               5             -0.3           -6
Arkansas.......................................              46               0             -0.5           -4.66
California.....................................             303             203              2.2          218.44
Colorado.......................................              47               5              0.4            4.25
Connecticut....................................              31               7             -0.5           -8.49
Delaware.......................................               6               0             -0.6           -2.54
Washington, D.C................................               7               0             -0.5           -2.48
Florida........................................             170              14             -0.3          -19.9
Georgia........................................             105               0             -0.5          -12.47
Hawaii.........................................              12               1             -0.4           -1.16
Idaho..........................................              14               0             -0.4           -1.21
Illinois.......................................             127               2             -0.6          -25.22
Indiana........................................              91               0             -0.5          -12.1
Iowa...........................................              35               0             -0.5           -4.33
Kansas.........................................              53               0             -0.4           -3.67
Kentucky.......................................              65               1             -0.4           -7.05
Louisiana......................................              99               3             -0.5           -6.67
Maine..........................................              20               0             -0.5           -2.36
Massachusetts..................................              61              39              3.6          114.58
Michigan.......................................              96               0             -0.5          -22.38
Minnesota......................................              50               0             -0.3           -6.33
Mississippi....................................              64               0             -0.5           -4.94
Missouri.......................................              78               0             -0.4           -9.98
Montana........................................              12               2              0.1            0.15
Nebraska.......................................              26               0             -0.4           -2.53
Nevada.........................................              24               3              0.2            1.63
New Hampshire..................................              13               9              1.2            5.91
New Jersey.....................................              64              19              0.3           10.01
New Mexico.....................................              25               0             -0.3           -1.41
New York.......................................             156               2             -0.6          -45.17
North Carolina.................................              84               0             -0.4          -14.6
North Dakota...................................               6               0             -0.3           -0.83
Ohio...........................................             132               6             -0.5          -17.56
Oklahoma.......................................              86               4             -0.4           -4.47

[[Page 60065]]

 
Oregon.........................................              34               0             -0.5           -4.85
Pennsylvania...................................             153               3             -0.5          -22.99
Puerto Rico....................................              51              10              0.1            0.14
Rhode Island...................................              11               4              0.6            2.29
South Carolina.................................              56               5             -0.2           -3.02
South Dakota...................................              19               0             -0.3           -1.02
Tennessee......................................              99              10             -0.5          -10.2
Texas..........................................             318               3             -0.5          -30.68
Utah...........................................              34               2             -0.4           -2.02
Vermont........................................               6               0             -0.3           -0.6
Virginia.......................................              78               1             -0.4          -11.68
Washington.....................................              49               6              0              0.93
West Virginia..................................              29               2              0.1            0.89
Wisconsin......................................              66               0             -0.5           -8.19
Wyoming........................................              11               0             -0.2           -0.23
----------------------------------------------------------------------------------------------------------------

    7. On page 49819:
    a. Second column, last paragraph, line 18, the figure ``336'' is 
corrected to read ``367''.
    b. Third column, first partial paragraph, line 8, the figure 
``$45'' is corrected to read ``$55''.
    8. On pages 49820 and 49821, the table titled ``Table II--Impact 
Analysis of Changes for FY 2016 Acute Care Hospital Operating 
Prospective Payment System (Payments per Discharge)'' is corrected as 
follows:

    Table II--Impact Analysis of Changes for FY 2016 Acute Care Hospital Operating Prospective Payment System
                                            [Payments per discharge]
----------------------------------------------------------------------------------------------------------------
                                                                    Estimated       Estimated
                                                    Number of      average FY      average FY
                                                    hospitals     2015 payment    2016 payment   FY 2016 changes
                                                                  per discharge   per discharge
                                                            (1)             (2)             (3)            (4)
----------------------------------------------------------------------------------------------------------------
All Hospitals..................................           3,369          11,329          11,372              0.4
By Geographic Location:
    Urban hospitals............................           2,533          11,680          11,725              0.4
    Large urban areas..........................           1,393          12,434          12,484              0.4
    Other urban areas..........................           1,140          10,766          10,806              0.4
    Rural hospitals............................             836           8,424           8,442              0.2
Bed Size (Urban):
    0-99 beds..................................             668           9,254           9,276              0.2
    100-199 beds...............................             778           9,863           9,902              0.4
    200-299 beds...............................             445          10,589          10,636              0.4
    300-499 beds...............................             428          11,927          11,973              0.4
    500 or more beds...........................             214          14,285          14,340              0.4
Bed Size (Rural):
    0-49 beds..................................             329           7,048           7,043             -0.1
    50-99 beds.................................             297           7,972           7,989              0.2
    100-149 beds...............................             121           8,290           8,325              0.4
    150-199 beds...............................              48           9,109           9,132              0.3
    200 or more beds...........................              41           9,996          10,006              0.1
Urban by Region:
New England....................................             120          12,850          12,853              0
    Middle Atlantic............................             318          13,156          13,283              1
    South Atlantic.............................             407          10,387          10,410              0.2
    East North Central.........................             396          10,950          11,009              0.5
    East South Central.........................             150           9,998           9,958             -0.4
    West North Central.........................             166          11,438          11,469              0.3
    West South Central.........................             384          10,590          10,548             -0.4
    Mountain...................................             161          12,013          12,035              0.2

[[Page 60066]]

 
    Pacific....................................             380          14,889          15,039              1
    Puerto Rico................................              51           7,648           7,504             -1.9
Rural by Region:
    New England................................              22          11,441          11,432             -0.1
    Middle Atlantic............................              55           8,545           8,565              0.2
    South Atlantic.............................             128           7,868           7,918              0.6
    East North Central.........................             116           8,775           8,853              0.9
    East South Central.........................             164           7,524           7,449             -1
    West North Central.........................             101           9,280           9,351              0.8
    West South Central.........................             165           7,218           7,159             -0.8
    Mountain...................................              61           9,730           9,796              0.7
    Pacific....................................              24          11,500          11,671              1.5
By Payment Classification:
    Urban hospitals............................           2,476          11,700          11,745              0.4
    Large urban areas..........................           1,386          12,440          12,490              0.4
    Other urban areas..........................           1,090          10,771          10,811              0.4
    Rural areas................................             893           8,687           8,710              0.3
Teaching Status:
    Nonteaching................................           2,326           9,450           9,480              0.3
    Fewer than 100 residents...................             794          10,999          11,043              0.4
    100 or more residents......................             249          16,424          16,494              0.4
Urban DSH:
    Non-DSH....................................             653           9,946          10,057              1.1
    100 or more beds...........................           1,593          12,080          12,115              0.3
    Less than 100 beds.........................             328           8,526           8,548              0.3
Rural DSH:
    SCH........................................             260           8,859           8,918              0.7
    RRC........................................             347           9,023           9,056              0.4
    100 or more beds...........................              31           7,544           7,476             -0.9
    Less than 100 beds.........................             157           6,774           6,695             -1.2
Urban teaching and DSH:
    Both teaching and DSH......................             855          13,217          13,262              0.4
    Teaching and no DSH........................             122          11,161          11,305              1.3
    No teaching and DSH........................           1,066           9,878           9,895              0.2
    No teaching and no DSH.....................             433           9,415           9,516              1.1
Special Hospital Types:
    RRC........................................             189           9,449           9,409             -0.4
    SCH........................................             327           9,951          10,034              0.8
    MDH........................................             150           6,968           7,011              0.6
    SCH and RRC................................             126          10,591          10,691              0.9
    MDH and RRC................................              13           8,621           8,673              0.6
Type of Ownership:
Voluntary......................................           1,934          11,498          11,560              0.5
    Proprietary................................             879           9,997           9,986             -0.1
    Government.................................             529          12,240          12,244              0
Medicare Utilization as a Percent of Inpatient
 Days:
    0-25.......................................             533          14,719          14,625             -0.6
    25-50......................................           2,134          11,265          11,322              0.5
    50-65......................................             571           9,180           9,252              0.8
    Over 65....................................              97           6,883           6,910              0.4
FY 2016 Reclassifications by the Medicare
 Geographic Classification Review Board:
    All Reclassified Hospitals.................             789          11,209          11,297              0.8
    Non-Reclassified Hospitals.................           2,580          11,374          11,400              0.2
    Urban Hospitals Reclassified...............             509          11,877          11,982              0.9
    Urban Nonreclassified Hospitals............           1,967          11,643          11,669              0.2
    Rural Hospitals Reclassified Full Year.....             280           8,829           8,861              0.4
    Rural Nonreclassified Hospitals Full Year..             503           7,931           7,933              0
    All Section 401 Reclassified Hospitals:....              64          10,427          10,492              0.6
    Other Reclassified Hospitals (Section                    53           7,855           7,828             -0.4
     1886(d)(8)(B) of the Act).................
Specialty Hospitals
    Cardiac Specialty Hospitals................              14          12,640          12,723              0.7
----------------------------------------------------------------------------------------------------------------


[[Page 60067]]

    9. On page 49823:
    a. Top of the page:
    (1) First column, second partial paragraph, line 1 the figure 
``2,418'' is corrected to read ``2,408''.
    (2) Second column, first partial paragraph, lines 1 and 2, the 
phrase, ``It did not include hospitals in the Rural Community Hospital 
Demonstration,'' is corrected to read ``It did not include new 
hospitals, hospitals in the Rural Community Hospital Demonstration,''.
    b. Lower three-fourths of the page, the table titled ``Modeled 
Disproportionate Share Hospital Payments for Estimated FY 2016 DSH 
Hospitals by Hospital Type: Model DSH $ (In Millions) From FY 2015 to 
FY 2016'' is corrected as follows:

Modeled Disproportionate Share Hospital Payments for Estimated FY 2016 DSH Hospitals by Hospital Type: Model DSH
                                     $ (In Millions) From FY 2015 to FY 2016
----------------------------------------------------------------------------------------------------------------
                                                     Number of
                                                   estimated FY       FY 2015         FY 2016       Percentage
                                                     2016 DSH      estimated DSH   estimated DSH     change **
                                                     hospitals          $ *             $ *
                                                             (1)             (2)             (3)             (4)
----------------------------------------------------------------------------------------------------------------
Total...........................................           2,408         $10,993          $9,733           -11.5
By Geographic Location:
    Urban Hospitals.............................           1,886          10,453           9,258           -11.4
        Large Urban Areas.......................           1,019           6,629           5,855           -11.7
        Other Urban Areas.......................             867           3,823           3,403           -11.0
    Rural Hospitals.............................             522             540             475           -12.1
Bed Size (Urban):
    0 to 99 Beds................................             323             211             186           -11.7
    100 to 249 Beds.............................             825           2,514           2,195           -12.7
    250 to 499 Beds.............................             738           7,728           6,877           -11.0
Bed Size (Rural):
    0 to 99 Beds................................             388             235             208           -11.3
    100 to 249 Beds.............................             120             246             211           -14.5
    250 to 499 Beds.............................              14              59              56            -5.6
Urban by Region:
    East North Central..........................             307           1,421           1,268           -10.8
    East South Central..........................             131             649             572           -11.8
    Middle Atlantic.............................             230           1,804           1,603           -11.2
    Mountain....................................             115             504             447           -11.3
    New England.................................              86             440             388           -11.9
    Pacific.....................................             298           1,649           1,455           -11.8
    Puerto Rico.................................              39             108             101            -7.3
    South Atlantic..............................             315           2,012           1,770           -12.0
    West North Central..........................             104             507             455           -10.2
    West South Central..........................             261           1,357           1,198           -11.7
Rural by Region:
    East North Central..........................              66              55              49           -10.9
    East South Central..........................             146             174             151           -12.9
    Middle Atlantic.............................              27              40              34           -14.5
    Mountain....................................              22              18              16           -13.1
    New England.................................              10              17              15           -13.7
    Pacific.....................................              10               6               8            35.3
    South Atlantic..............................              88             107              96            -9.5
    West North Central..........................              37              27              21           -20.1
    West South Central..........................             116              97              84           -13.6
By Payment Classification:
    Urban Hospitals.............................           1,854          10,448           9,204           -11.9
        Large Urban Areas.......................           1,016           6,640           5,853           -11.9
        Other Urban Areas.......................             838           3,809           3,351           -12.0
    Rural Hospitals.............................             554             545             529            -2.8
Teaching Status:
    Nonteaching.................................           1,539           3,578           3,111           -13.0
    Fewer than 100 residents....................             629           3,585           3,190           -11.0
    100 or more residents.......................             240           3,831           3,432           -10.4
Type of Ownership:
    Voluntary...................................           1,382           6,770           6,025           -11.0
    Proprietary.................................             539           1,904           1,660           -12.8
    Government..................................             485           2,290           2,021           -11.7
    Unknown.....................................               2              30              27           -10.4
----------------------------------------------------------------------------------------------------------------
Source: Dobson DaVanzo analysis of 2011-2012 Hospital Cost Reports, 2015 Provider of Services File, FY 2015 IPPS
  Final Rule CN Impact File, and FY 2016 NPRM Impact File.
* Dollar DSH calculated by [0.25 * estimated section 1886(d)(5)(F) payments] + [0.75 * estimated section
  1886(d)(5)(F) payments * Factor 2 * Factor 3]. When summed across all hospitals projected to receive DSH
  payments, the estimated DSH is $10,993 million in FY 2015 and $9,733 million in FY 2016.
** Percentage change is determined as the difference between Medicare DSH payments modeled for the FY 2016 IPPS/
  LTCH PPS final rule (column 3) and Medicare DSH payments modeled for the FY 2015 IPPS/LTCH PPS final rule
  (column 2) divided by Medicare DSH payments modeled for the FY 2015 final rule (column 3) times 100 percent.


[[Page 60068]]

    10. On page 49828, in third column, last paragraph, line 4, the 
figure ``0.9973'' is corrected to read ``0.9976''.
    11. On page 49829:
    a. Second column, last paragraph:
    (1) Line 4, the figure ``3.1'' is corrected to read ``3.2''
    (2) Line 5, the figure ``1.1'' is corrected to read ``1.3''
    b. Third column; last paragraph, last line, the figure ``1.1'' is 
corrected to read ``1.2''.
    12. On pages 49829 and 49830, table titled ``Table III.--Comparison 
of Total Payments Per Case [FY 2015 Payments Compared To FY 2016 
Payments]'' is corrected to read as follows:

                                Table III--Comparison of Total Payments per Case
                                 [FY 2015 payments compared to FY 2016 payments]
----------------------------------------------------------------------------------------------------------------
                                                                    Average FY      Average FY
                                                     Number of    2015 payments/  2016 payments/      Change
                                                     hospitals         case            case
----------------------------------------------------------------------------------------------------------------
By Geographic Location:
    All hospitals...............................           3,369             871             890             2.3
    Large urban areas (populations over 1                  1,393             963             987             2.5
     million)...................................
    Other urban areas (populations of 1 million            1,140             833             851             2.1
     of fewer)..................................
    Rural areas.................................             836             591             599             1.4
    Urban hospitals.............................           2,533             904             925             2.4
        0-99 beds...............................             668             736             751             1.9
        100-199 beds............................             778             788             806             2.2
        200-299 beds............................             445             825             844             2.3
        300-499 beds............................             428             920             943             2.4
        500 or more beds........................             214           1,080           1,106             2.4
    Rural hospitals.............................             836             591             599             1.4
        0-49 beds...............................             329             490             497             1.5
        50-99 beds..............................             297             549             558             1.7
        100-149 beds............................             121             591             598             1.2
        150-199 beds............................              48             645             652             1.0
        200 or more beds........................              41             706             715             1.3
By Region:
    Urban by Region.............................           2,533             904             925             2.4
        New England.............................             120             996           1,009             1.3
        Middle Atlantic.........................             318           1,001           1,032             3.1
        South Atlantic..........................             407             805             823             2.2
        East North Central......................             396             868             889             2.3
        East South Central......................             150             768             780             1.6
        West North Central......................             166             887             902             1.6
        West South Central......................             384             817             835             2.1
        Mountain................................             161             936             956             2.1
        Pacific.................................             380           1,150           1,187             3.2
        Puerto Rico.............................              51             403             408             1.4
    Rural by Region.............................             836             591             599             1.4
        New England.............................              22             822             828             0.7
        Middle Atlantic.........................              55             580             582             0.3
        South Atlantic..........................             128             554             567             2.3
        East North Central......................             116             616             626             1.6
        East South Central......................             164             536             542             1.1
        West North Central......................             101             635             643             1.3
        West South Central......................             165             524             524             0.1
        Mountain................................              61             660             674             2.1
        Pacific.................................              24             768             791             3.0
By Payment Classification:
    All hospitals...............................           3,369             871             890             2.3
    Large urban areas (populations over 1                  1,386             964             988             2.5
     million)...................................
    Other urban areas (populations of 1 million            1,090             837             855             2.2
     of fewer)..................................
    Rural areas.................................             893             608             615             1.1
Teaching Status:
    Non-teaching................................           2,326             739             754             2.1
    Fewer than 100 Residents....................             794             848             866             2.2
    100 or more Residents.......................             249           1,227           1,259             2.6
    Urban DSH:
        100 or more beds........................           1,593             928             950             2.4
        Less than 100 beds......................             328             662             677             2.2
    Rural DSH:
        Sole Community (SCH/EACH)...............             260             576             580             0.7
        Referral Center (RRC/EACH)..............             347             639             647             1.2
        Other Rural:
            100 or more beds....................              31             575             572            -0.5
            Less than 100 beds..................             157             504             512             1.7
    Urban teaching and DSH:
        Both teaching and DSH...................             855           1,003           1,028             2.5
    Urban teaching and DSH:
        Both teaching and DSH...................             855           1,003           1,028             2.5

[[Page 60069]]

 
        Teaching and no DSH.....................             122             899             920             2.3
        No teaching and DSH.....................           1,066             780             797             2.3
        No teaching and no DSH..................             433             797             816             2.4
    Rural Hospital Types:
        Non special status hospitals............           2,562             904             926             2.4
        RRC/EACH................................             189             729             737             1.1
        SCH/EACH................................             327             665             672             1.1
        SCH, RRC and EACH.......................             126             721             733             1.6
Hospitals Reclassified by the Medicare
 Geographic Classification Review Board:
    FY 2016 Reclassifications:
        All Urban Reclassified..................             551             923             949             2.8
        All Urban Non-Reclassified..............           1,925             902             922             2.2
        All Rural Reclassified..................             279             623             634             1.8
        All Rural Non-Reclassified..............             504             545             551             1.2
        Other Reclassified Hospitals (Section                 46             600             589            -1.9
         1886(d)(8)(B) of the Act)..............
    Type of Ownership:
        Voluntary...............................           1,934             884             904             2.3
        Proprietary.............................             879             785             803             2.3
        Government..............................             529             917             938             2.4
    Medicare Utilization as a Percent of
     Inpatient Days:
        0-25....................................             533           1,046           1,074             2.7
        25-50...................................           2,134             876             896             2.3
        50-65...................................             571             717             731             2.0
        Over 65.................................              97             523             534             2.1
----------------------------------------------------------------------------------------------------------------

    13. On page 49840, third column, third paragraph:
    a. Line 11, the figure ``$378'' is corrected to read ``$391''.
    b. Line 23, the figure ``$75'' is corrected to read ``$88''.
    c. Line 33, the figure ``$75'' is corrected to read ``$88''.
    d. Line 34, the figure ``$85'' is corrected to read ``$98''.
    e. Line 39, the figure ``$187'' is corrected to read ``$188''.
    f. Line 43, the figure ``$272'' is corrected to read ``$285''.
    14. On page 49841, first column:
    a. Third paragraph, line 3, the figure ``$272'' is corrected to 
read ``$285''.
    b. In the table titled ``Table V--Accounting Statement: 
Classification of Estimated Expenditures Under the IPPS From FY 2015 to 
FY 2016'', the first entry is corrected as follows:

 Table V--Accounting Statement: Classification of Estimated Expenditures
                 Under the IPPS From FY 2015 to FY 2016
------------------------------------------------------------------------
                 Category                             Transfers
------------------------------------------------------------------------
Annualized Monetized Transfers............  -$285 million.
------------------------------------------------------------------------


    Dated: September 30, 2015.
Madhura Valverde,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2015-25269 Filed 9-30-15; 4:15 pm]
BILLING CODE 4120-01-P