[Federal Register Volume 82, Number 1 (Tuesday, January 3, 2017)]
[Rules and Regulations]
[Pages 24-37]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31774]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 414, 416, 419, 482, 486, 488, and 495

[CMS-1656-CN]
RIN 0938-AS82


Medicare Program: Hospital Outpatient Prospective Payment and 
Ambulatory Surgical Center Payment Systems and Quality Reporting 
Programs; Organ Procurement Organization Reporting and Communication; 
Transplant Outcome Measures and Documentation Requirements; Electronic 
Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-
Campus Provider-Based Department of a Hospital; Hospital Value-Based 
Purchasing (VBP) Program; Establishment of Payment Rates Under the 
Medicare Physician Fee Schedule for Nonexcepted Items and Services 
Furnished by an Off-Campus Provider-Based Department of a Hospital; 
Correction and Extension of Comment Period

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

ACTION: Correction and extension of comment period for final rule and 
interim final rule.

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SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period and interim final rule with comment 
period published in the Federal Register on November 14, 2016, entitled 
``Hospital Outpatient Prospective Payment and Ambulatory Surgical 
Center Payment Systems and Quality Reporting Programs; Organ 
Procurement Organization Reporting and Communication; Transplant 
Outcome Measures and Documentation Requirements; Electronic Health 
Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus 
Provider-Based Department of a Hospital; Hospital Value-Based 
Purchasing (VBP) Program; Establishment of Payment Rates under the 
Medicare Physician Fee Schedule for Nonexcepted Items and Services 
Furnished by an Off-Campus Provider-Based Department of a Hospital.''
    This document extends the comment period to January 3, 2017 for 
both the final rule with comment period and the interim final rule with 
comment period.

DATES: Effective date: This correction is effective January 1, 2017.
    Comment period: The comment period for the final rule and interim 
final rule, published November 14, 2016 (81 FR 79562), is extended to 5 
p.m. E.S.T. on January 3, 2017.

FOR FURTHER INFORMATION CONTACT: 
    Hospital Outpatient Prospective Payment System (OPPS), contact Lela 
Strong (410) 786-3213.
    Electronic Health Record (EHR) Incentive Programs, contact Kathleen 
Johnson (410) 786-3295 or Steven Johnson (410) 786-3332.
    Hospital Outpatient Quality Reporting (OQR) Program Administration, 
Validation, and Reconsideration Issues, contact Elizabeth Bainger at 
(410) 786-0529

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2016-26515 of November 14, 2016 (81 FR 79562), titled 
``Medicare Program: Hospital Outpatient Prospective Payment and 
Ambulatory Surgical Center Payment Systems and Quality Reporting 
Programs; Organ Procurement Organization Reporting and Communication; 
Transplant Outcome Measures and Documentation Requirements; Electronic 
Health Record (EHR) Incentive Programs; Payment to Certain Off-Campus 
Outpatient Departments of a Provider; Hospital Value-Based Purchasing 
(VBP) Program; Establishment of Payment Rates Under the Medicare 
Physician Fee Schedule for Nonexcepted Items and Services Furnished by 
an Off-Campus Provider-Based Department of a Hospital'' (hereinafter 
referred to as the CY 2017 OPPS/ASC final rule), there were a number of 
technical errors that are identified and corrected in the Correction of 
Errors section below. The provisions in this correction document are 
effective as if they had been included in the document published 
November 14, 2016. Accordingly, the corrections are effective January 
1, 2017.

II. Extension of Comment Period

    We are extending the comment period. We inadvertently scheduled the 
comment period to end on December 31, 2016, a Saturday. We ordinarily 
do not end the comment period on a weekend or federal holiday. 
Therefore, we are extending the comment period for the final rule and 
interim final rule to end on the next business day, January 3, 2017.

III. Summary of Errors

A. Errors in the Preamble

1. Hospital Outpatient Prospective Payment System (OPPS) Corrections
    On page 79566, in the Table of Contents, we inadvertently included 
a title that referred to the CY 2017 OPPS/ASC proposed rule instead of 
the final rule with comment period. We are correcting the title in this 
correcting document. On the same page, in the table of contents, we 
made a typographical error in the title of the sixth item, which we are 
correcting to match the title in the preamble of the document.
    On page 79569, we incorrectly stated estimated total payments to 
OPPS providers as $773 million. We have corrected this figure to be $64 
billion.
    On page 79582, we incorrectly stated that status indicator ``J1'' 
procedure claims with modifier ``50'' were included in the C-APC claims 
accounting and the complexity adjustment evaluations as of January 1, 
2015.'' Instead, these claims were included in the C-APC complexity 
adjustment evaluations presented in the CY 2017 OPPS/ASC final rule 
with comment period. The results of these evaluations were included in 
the C-APC complexity adjustment evaluations tab of Addendum J to the CY 
2017 OPPS/ASC final rule with comment period.
    On pages 79584, we inadvertently omitted discussion of one of the 
recommendations from the August 2016 meeting of the Advisory Panel on

[[Page 25]]

Hospital Outpatient Payment (HOP Panel). The HOP Panel recommended 
that, ``CMS provide further information and data for stakeholders to 
review on how comprehensive APCs are created and their effects; and CMS 
provide more time for the public to review the information and make 
proposals to the Panel.'' In this correcting document, we address this 
recommendation.
    On page 79587, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rate listed for C-APC 5244 (Level 4 Blood Product Exchange and Related 
Services).
    On page 79595, we made technical errors by inadvertently excluding 
the wage index data for 6 providers in Alaska, Virginia, Ohio, 
Mississippi, and Puerto Rico when calculating the weight scaler for 
budget neutrality. We have corrected the weight scaler for budget 
neutrality to include the wage index data for those 6 providers, which 
results in a change of the weight scaler from 1.4208 to 1.4214. This 
revised weight scaler affects all payments that are scaled for budget 
neutrality. As a result we are also providing corrected addenda as 
described in the ``Summary of Errors and Corrections to the OPPS and 
ASC Addenda Posted on the CMS Web site'' section below.
    On pages 79607 through 79608, we use the payment rates available in 
Addenda A and B to display calculation of adjusted payment and 
copayment. Due to the change in OPPS payment rates as a result of the 
updated OPPS weight scaler, we are also updating the payment and 
copayment numbers used in the example to reflect the corrections.
    On page 79621, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 13--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for the Auditory Osseointegrated 
Procedures (81 FR 79621) for CPT codes 69714, 69715, 69717, and 69718.
    On page 79622, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 14--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for CPT Codes 28297 and 28740.
    On page 79624, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 16--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for the Percutaneous Vertebral 
Augmentation/Kyphoplasty Procedures.
    On page 79627, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 18--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for the Transcranial Magnetic 
Stimulation (TMS) Therapy Codes.
    On page 79629, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are updating the payment rates 
for CPT code 75571 to $59.86, for CPT code 77080 to $112.73, and for 
APC 5822 (Level 2 Health and Behavior Services) to $70.26 for CY 2017.
    On pages 79636 through 79637, due to the change in OPPS payment 
rates as a result of the updated OPPS weight scaler, we are also 
updating the payment rates in Table 23--Final CY 2017 Status Indicator 
(SI), APC Assignments, and Payment Rates for the Transprostatic 
Urethral Implant Procedures.
    On pages 79638 through 79639, due to the change in OPPS payment 
rates as a result of the updated OPPS weight scaler, we are also 
updating the payment rates in Table 25--Final CY 2017 Status Indicator 
(SI), APC Assignments, and Payment Rates Certain Cryoablation 
Procedures.
    On page 79641, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 28--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for the Dialysis Circuit Procedures.
    On page 79643, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rate for CPT code 77371 to $7,455.99 as well as the payment rates in 
Table 30--Final CY 2017 Status Indicator (SI), APC Assignments, and 
Payment Rates for the Magnetic Resonance Image Guided High Intensity 
Focused Ultrasound (MRgFUS) Procedures.
    On page 79645, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 32--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for the Smoking and Tobacco Use 
Cessation Counseling Services.
    On page 79647, we used imprecise language in describing HCPCS codes 
G0237, G0238, and G0239. Specifically, we stated that ``we believe that 
we should reassign HCPCS codes G0237, G0238, and G0239 to status 
indictor ``S'' because these codes also describe pulmonary 
rehabilitation services.'' We are clarifying that these codes describe 
respiratory treatment services. We acknowledge that the original 
language could be interpreted to mean that these codes describe 
pulmonary rehabilitation services, which was not our intent.
    On page 79648, due to the change in OPPS payment rates as a result 
of the updated OPPS weight scaler, we are also updating the payment 
rates in Table 34--Final CY 2017 Status Indicator (SI), APC 
Assignments, and Payment Rates for the Pulmonary Rehabilitation 
Services.
    On page 79662, we incorrectly made certain Status Indicator (SI) 
and APC assignments in Table 35--Drugs and Biologicals For Which Pass-
Through Payment Status Expires December 31, 2016. Specifically, we 
incorrectly assigned a SI of ``N'' (Items and Services Packaged into 
APC Rates) to a number of drugs that should have been assigned a SI of 
``K'' (Nonpass-Through Drugs and Nonimplantable Biologicals, Including 
Therapeutic Radiopharmaceuticals). These drugs have also been assigned 
to APCs for CY 2017. Additionally, on page 79662, we incorrectly 
described two Long Descriptors (for HCPCS codes J7181 and 7201) that 
were displayed in Table 35. These Long Descriptors have been revised 
for CY 2017.
    On page 79664, we incorrectly described two Long Descriptors (for 
HCPCS codes A9587 and A9588) that were displayed in Table 36--Drugs and 
Biologicals With Pass-Through Payment Status in CY 2017. These Long 
Descriptors have been revised for CY 2017.
    On page 79671, we made technical errors to the description of 
certain Healthcare Common Procedure Coding System (HCPCS) codes that 
appeared in Table 37--Skin Substitute Assignments to High Cost and Low 
Cost Groups for CY 2017. Specifically, we are removing HCPCS codes 
Q4119, Q4120, and Q4129 to accurately show that these codes were 
deleted on December 31, 2016, and should not have appeared in Table 37. 
These codes were correctly assigned to OPPS SI ``D'' in the OPPS 
Addendum B that was released with the CY 2017 OPPS/ASC final rule.
    On page 79708, we used imprecise language in the summary of final 
policy on how we would apply the ``billing .-. . prior to November 2, 
2015,'' statutory language in determining whether an off-campus PBD is 
excepted or not. Specifically, we stated in the preamble that ``off 
campus PBDs would be eligible to receive OPPS payment as excepted off- 
campus PBDs for services that were furnished prior to November 2, 2015, 
and billed under the OPPS in accordance with timely filing limits.'' We 
are clarifying that the policy is not specific to services, but rather 
so long as an off-campus PBD furnished a covered

[[Page 26]]

OPD service prior to November 2, 2015 and billed the OPPS within timely 
filing limits for that service that the off-campus PBD would be 
excepted from payment adjustment under the final section 603 payment 
policy for the items and services the off-campus PBD furnishes on or 
after January 1, 2017. As noted in the sentence prior (81 FR 79708), we 
agreed with the commenters that an interpretation of the ``billing 
under this subsection with respect to covered OPD services furnished 
prior to [November 2, 2015]'' statutory language could allow for an 
exception for off-campus PBDs that furnished a covered OPD service 
prior to November 2, 2015, but had not submitted a bill to Medicare for 
such service prior to November 2, 2015.
    On page 79719, we described the changes to regulation and 
incorrectly stated the effective date to implement section 603 of 
Public Law 114-74 is effective January 1, 2017, for cost reporting 
periods beginning January 1, 2017. The effective date is for items and 
services furnished on or after January 1, 2017, regardless of when the 
cost reporting period begins. We have corrected this language to delete 
the reference to cost reporting periods.
    On pages 79869 through 79870, we provided and described Table 52--
Estimated Impact of the CY 2017 Changes for the Hospital Outpatient 
Prospective Payment System, based on rates which applied the incorrect 
scaler. We have updated the impact table and the description of the 
table to reflect these corrections.
    On Page 79877, we incorrectly described implementation of Section 
603 of the Bipartisan Budget Act of 2015 as reducing OPPS payments by 
$500 million in 2017. We have corrected this estimate to be a reduction 
of total Part B payments by $50 million in 2017.
2. Ambulatory Surgical Center (ASC) Payment System Corrections
    On pages 79741 through 79742, in the discussion of additions to the 
list of ASC covered surgical procedures, we incorrectly stated that CPT 
code 22851 (Application of intervertebral biomechanical device(s) 
(e.g., synthetic cage(s), methlmethacrylate) to vertebral defect or 
interspace (List separately in addition to code for primary procedure)) 
was deleted effective April 13, 2016. This code was deleted effective 
December 31, 2016.
    On page 79743 in Table 51--Additions to the List of ASC Covered 
Surgical Procedures for CY 2017 (81 FR 79743), we inadvertently 
excluded CPT code 22585 (Arthrodesis, anterior interbody technique, 
including minimal discectomy to prepare interspace (other than for 
decompression); each additional interspace (List separately in addition 
to code for primary procedure)). This code has a CY 2017 ASC payment 
indicator of N1.
    On pages 79752 through 79753, we inadvertently published an 
incorrect ASC conversion factor of $45.030 for ASCs that meet the 
quality reporting requirements. Also, on pages 79752 through 79753, we 
inadvertently published an incorrect ASC wage index budget neutrality 
adjustment of 0.9996 that is being corrected to 0.9997. For ASCs that 
do not meet the quality reporting requirements, we finalized an ASC 
conversion factor of $44.330. The ASC conversion factor for ASCs that 
meet the quality reporting requirements is the product of the CY 2016 
conversion factor multiplied by the wage index budget neutrality 
adjustment of 0.9997 and the MFP-adjusted CPI-U payment update (81 FR 
79752 to 79753). We have since determined that the 2016 conversion 
factor of $44.190 used to calculate the CY 2017 conversion factor is 
incorrect. The corrected 2016 ASC conversion factor for ASCs that meet 
the quality reporting requirements is $44.177, as finalized in the CY 
2016 final rule with comment period (80 FR 70501). Using the correct 
2016 ASC conversion factor of $44.177, we have recalculated the 2017 
ASC conversion factor to be $45.003 for ASCs that meet quality 
reporting requirements and a conversion factor of $44.120 for ASCs that 
do not meet quality reporting requirements. The corrected conversion 
factor will slightly change payment for some ASC services; therefore we 
have revised payment rates in ASC addendum AA and addendum BB.
3. Interim Final Rule with Comment Period Corrections
    On page 79725, we referenced table X.B.2, but did not include the 
table in the interim final rule with comment period. This table, 
Payment for Nonexcepted Items and Services by OPPS Status Indicator, 
has been posted to the CMS Web site at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/CMS-1656-FC-2017-OPPS-Status-Indicator.zip.
4. Hospital Outpatient Quality Reporting Program Correction
    On page 79784, there was a typographical error in the table 
entitled ``Previously Finalized and Newly Finalized Hospital OQR 
Program Measure Set for the CY 2020 Payment Determination and 
Subsequent Years''. As listed in the table, the measure OP-30: 
Colonoscopy Interval for Patients with a History of Adenomatous 
Polyps--Avoidance of Inappropriate Use incorrectly included three 
asterisks after the name Three asterisks indicates that a measure is 
voluntary. This measure should have had only two asterisks to indicate 
that the measure name was updated to reflect the National Quality Forum 
title, not three, as it is not a voluntary measure. Accordingly, we are 
correcting the table and updating the number of asterisks next to OP-30 
from three to two asterisks.

B. Regulation Text Corrections

1. OPPS Corrections
    To implement the provisions of section 1833(t) of the Act, as 
amended by section 603 of Public Law 114-74, in the CY 2017 OPPS/ASC 
final rule with comment period, we amended the Medicare regulations by 
(1) adding a new paragraph (v) to Sec.  419.22 to specify that, 
effective January 1, 2017, for cost reporting periods beginning January 
1, 2017, excluded from payment under the OPPS are items and services 
that are furnished by an off-campus provider-based department that do 
not meet the definition of excepted items and services; and (2) adding 
a new Sec.  419.48 that sets forth the definition of excepted items and 
services, and also the definition of ``excepted off-campus provider-
based department''. On page 79879, we incorrectly stated that the 
effective date was based on cost reporting periods and are striking 
that language. Also, on page 79880, we incorrectly implied that on-
campus provider-based departments that furnish services after November 
2, 2015, could no longer bill under the OPPS in the regulation text at 
419.48(b). In addition, on page 79880, in the regulation text at 
419.48(b), the definition of an ``excepted off-campus provider-based 
department'' does not accurately state that the department of a 
provider must also have billed within timely filing limits. The revised 
regulation text corrects these technical errors.
2. Electronic Health Record (EHR) Incentive Programs Corrections
    In the CY 2017 OPPS/ASC final rule, we inadvertently omitted 
amendments to Sec.  495.40 that were included in an earlier-published 
final rule with comment period titled ``Medicare Program; Merit-Based 
Incentive Payment System (MIPS) and Alternative Payment Model (APM) 
Incentive Under the Physician Fee Schedule, and Criteria

[[Page 27]]

for Physician-Focused Payment Models'' (referred to as the Quality 
Payment Program (QPP) final rule) (81 FR 77008, 77556-77557, November 
4, 2016). We are making the corrections to Sec.  495.40 described below 
in order to preserve the earlier amendments to that section as 
finalized in the QPP final rule.
    On page 79892, in Sec.  495.40, ``Demonstration of meaningful use 
criteria,'' paragraph (a), ``Demonstration by EPs,'' we inadvertently 
omitted a reference to Sec.  495.22 in the introductory text. We are 
correcting the introductory text to state that an EP must demonstrate 
that he or she satisfies each of the applicable objectives and 
associated measures under Sec.  495.20, Sec.  495.22, or Sec.  495.24. 
Additionally, we are correcting the introductory text to include the 
phrase ``supports information exchange and the prevention of health 
information blocking, and engages in activities related to supporting 
providers with the performance of CEHRT:'' as finalized in the QPP 
final rule (81 FR 77556), which updates requirements for demonstration 
of meaningful use to include activities related to health information 
technology.
    On page 79892, in Sec.  495.40, ``Demonstration of meaningful use 
criteria,'' we are correcting the inadvertent omission of Sec.  
495.40(a)(2)(i)(H) and (I) as finalized in the QPP final rule (81 FR 
77556), which revise attestation requirements and require EPs to attest 
their cooperation with certain authorized health IT surveillance and 
direct review activities as part of demonstrating meaningful use under 
the Medicare and Medicaid EHR Incentive Programs.
    On page 79892, in Sec.  495.40, ``Demonstration of meaningful use 
criteria,'' paragraph (b), ``Demonstration by eligible hospitals and 
CAHs,'' we inadvertently omitted a cross reference to Sec.  495.22 in 
the introductory text. We are correcting the introductory text to state 
that an eligible hospital or CAH must demonstrate that it satisfies 
each of the applicable objectives and associated measures under Sec.  
495.20, Sec.  495.22, or Sec.  495.24. Additionally, we are correcting 
the introductory text to include the phrase ``supports information 
exchange and the prevention of health information blocking, and engages 
in activities related to supporting providers with the performance of 
CEHRT:'' as finalized in the QPP (81 FR 77556), which updates the 
requirements for demonstration of meaningful use to include activities 
related to health information technology.
    On page 79892, in Sec.  495.40 (b), ``Demonstration by eligible 
hospitals and CAHs,'' we are correcting the inadvertent omission of 
Sec.  495.40 (b)(2)(i)(H) and (I) as finalized in the QPP final rule 
(81 FR 77556 through 77557), which revises attestation requirements and 
requires eligible hospitals and CAHs to attest their cooperation with 
certain authorized health IT surveillance and direct review activities 
as part of demonstrating meaningful use under the Medicare and Medicaid 
EHR Incentive Programs.

C. Summary of Errors and Corrections to the OPPS and ASC Addenda Posted 
on the CMS Web site

    In Addendum J, on the Complexity Adjustment tab, CPT code 36908--
Transcatheter placement of an intravascular stent(s), central dialysis 
segment, performed through dialysis circuit, including all imaging 
radiological supervision and interpretation required to perform the 
stenting, and all angioplasty in the central dialysis segment (List 
separately in addition to code for primary procedure) was incorrectly 
written as 368x8. Also, CPT code 24200 (Removal of foreign body, upper 
arm or elbow; subcutaneous) was incorrectly excluded from Addendum J. 
The revised version of Addendum J is available via the Internet on the 
CMS Web site.
    The payment and copayment rates in Addendum A (Final OPPS APCs for 
CY 2017), Addendum B (Final OPPS Payment by HCPCS Code for CY 2017), 
Addendum C (Final HCPCS Codes Payable Under the 2017 OPPS by APC), ASC 
Addendum AA (Final ASC Covered Surgical Procedures for CY 2016 
(Including Surgical Procedures for Which Payment is Packaged)), ASC 
Addendum BB (Final ASC Covered Ancillary Services Integral to Covered 
Surgical Procedures for CY 2016 (Including Ancillary Services for Which 
Payment is Packaged)) and the payment rates in the 2017 Drug, Blood, 
Brachytherapy Costs Statistics file that were published on the CMS Web 
site in conjunction with the CY 2017 OPPS/ASC Final Rule with comment 
period have been updated to reflect corrections to the weight scaler. 
The payment rates included in the corrected versions of the Addenda 
have also been corrected within the text of the CY 2017 OPPS/ASC Final 
Rule with comment period, as well as under the columns titled ``Final 
CY 2017 OPPS Payment Rate'' in Tables 13, 14, 16, 18, 23, 25, 28, 30, 
32, and 34.

IV. Waiver of Proposed Rulemaking and Delay in Effective Date

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), 
the agency is required to publish a notice of the proposed rule in the 
Federal Register before the provisions of a rule take effect. 
Similarly, section 1871(b)(1) of the Act requires the Secretary to 
provide for notice of the proposed rule in the Federal Register and 
provide a period of not less than 60 days for public comment. In 
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) 
mandate a 30-day delay in effective date after issuance or publication 
of a rule. Sections 553(b)(B) and 553(d)(3) of the APA provide for 
exceptions from the notice and comment and delay in effective date APA 
requirements; in cases in which these exceptions apply, sections 
1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide exceptions from 
the notice and 60-day comment period and delay in effective date 
requirements of the Act as well. Section 553(b)(B) of the APA and 
section 1871(b)(2)(C) of the Act authorize an agency to dispense with 
normal rulemaking requirements for good cause if the agency makes a 
finding that the notice and comment process are impracticable, 
unnecessary, or contrary to the public interest. In addition, both 
section 553(d)(3) of the APA and section 1871(e)(1)(B)(ii) of the Act 
allow the agency to avoid the 30-day delay in effective date where such 
delay is contrary to the public interest and an agency includes a 
statement of support.
    We believe that this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This correcting 
document corrects technical and typographic errors in the preamble, 
addenda, payment rates, tables, and appendices included or referenced 
in the CY 2017 OPPS/ASC final rule with comment period and interim 
final rule with comment period but does not make substantive changes to 
the policies or payment methodologies that were adopted in the final 
rule with comment period and interim final rule with comment period. As 
a result, the corrections made through this correcting document are 
intended to ensure that the information in the CY 2017 OPPS/ASC final 
rule with comment period and interim final rule with comment period 
accurately reflects the policies adopted in those rules.
    In addition, even if this were a rulemaking to which the notice and 
comment procedures and delayed effective date requirements applied, we

[[Page 28]]

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 with comment period and interim final 
rule with comment period 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 CY 2017 OPPS/ASC final rule with 
comment period and interim final rule with comment period accurately 
reflect our policies as of the date they take effect and are 
applicable.
    Furthermore, such procedures would be unnecessary, as we are not 
altering our payment methodologies or policies, but rather, we are 
simply correctly implementing the policies that we previously proposed, 
received comment on, and subsequently finalized. This correcting 
document is intended solely to ensure that the CY 2017 OPPS/ASC final 
rule with comment period and interim final rule with comment period 
accurately reflects these payment methodologies and policies. For these 
reasons, we believe we have good cause to waive the notice and comment 
and effective date requirements.

V. Correction of Errors

    In FR Doc. 2016-26515 of November 14, 2016 (81 FR 79562), make the 
following corrections:

Preamble Corrections

    1. On page 79566, third column,
    a. In line 44, Table of Contents, the title ``5. Summary of 
Proposals'' is corrected to read ``5. Summary of Final Policies''.
    b. In line 45, Table of Contents, the title ``6. Final Changes to 
Regulations'' is corrected to read ``6. Changes to Regulations''.
    2. On page 79569, second column, second full paragraph, under the 
bulleted item, ``OPPS Update,'' in line 20, replace ``$773 million'' 
with ``$64 billion''.
    3. On page 79582, third column, second full paragraph, under a 
response to public comment, in lines 29 through 34, the last sentence 
of the paragraph is corrected to read ``Status indicator ``J1'' 
procedure claims with modifier ``50'' will be included in the 
complexity adjustment evaluation for CY 2017. This evaluation can be 
found in Addendum J to the CY 2017 OPPS/ASC final rule with comment 
period.''
    4. On page 79584, first column, first partial paragraph, in line 
21, the following language is inserted after ``. . . analyses of the C-
APC payment policy.'' and before ``Regarding the comment about 
creating. . . .'': We are accepting the recommendation that the HOP 
Panel made at the August 22, 2016 meeting to ``provide further 
information and data for stakeholders to review on how comprehensive 
APCs are created and their effects and to provide more time for the 
public to review the information and make proposals to the Panel.'' We 
plan to provide the results of an analysis of our comprehensive 
packaging policies in CY 2017. In addition, we will consider scheduling 
future HOP Panel meetings on a date that allows stakeholders as much 
time as is practicable subsequent to display of the proposed rule to 
analyze and review our proposed policies and other data prior to the 
meeting.
    5. On page 79587, third column, first full paragraph, in line 16, 
replace ``$27,752'' with ``$27,764''.
    6. On page 79595, third column, third paragraph, replace ``1.4208'' 
with ``1.4214.''
    7. On page 79607,
    a. First column, bottom half of the page, last full paragraph--
    (1) In line 17, replace ``$538.88'' with ``$539.11.''
    (2) In line 21, replace ``$528.10'' with ``$528.33.''
    b. In the second column, first partial paragraph,
    (1) In lines 1 and 2, replace ``$418.26 (.60 * $538.88 * 1.2936).'' 
with ``$418.44 (.60 * $539.11 * 1.2936).''
    (2) In line 5, replace ``$409.89 (.60 * $528.10 * 1.2936).'' with 
``$410.07 (.60 * $528.33 * 1.2936).''
    (3) In line 8, replace ``$215.55 (.40 * $538.88).'' with ``$215.64 
(.40 * $539.11).''
    (4) In line, replace ``$211.24 (.40 * $528.10).'' with ``$211.33 
(.40 * $528.33).''
    (5) In lines 15 and 16, replace ``$633.81 ($418.26 +$215.55).'' 
with ``$634.08 ($418.44 +$215.64).''
    (6) In lines 18 and 19, replace ``$621.13 ($409.89 + $211.24).'' 
with ``$621.40 ($410.07 + $211.33).''
    8. On page 79608, second column, third full paragraph, under ``Step 
1,'' in lines 5 and 8, replace ``$107.78'' with $107.83'' and 
``$538.88'' with ``$539.11.''
    9. On page 79621, Table 13--Final CY 2017 Status Indicator (SI), 
APC, and Payment Rates for the Auditory Osseointegrated Procedures, is 
corrected to read as follows:

              Table 13--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for the Auditory Osseointegrated Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
           CPT code                      Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
69714........................  Implantation, osseointegrated                 J1          5125      $10,537.90           J1          5115       $9,561.23
                                implant, temporal bone, with
                                percutaneous attachment to
                                external speech processor/cochlear
                                stimulator; without mastoidectomy.
69715........................  Implantation, osseointegrated                 J1          5125       10,537.90           J1          5116       14,704.13
                                implant, temporal bone, with
                                percutaneous attachment to
                                external speech processor/cochlear
                                stimulator; with mastoidectomy.
69717........................  Replacement (including removal of             J1          5123        4,969.26           J1          5114        5,221.57
                                existing device), osseointegrated
                                implant, temporal bone, with
                                percutaneous attachment to
                                external speech processor/cochlear
                                stimulator; without mastoidectomy.

[[Page 29]]

 
69718........................  Replacement (including removal of             J1          5124        7,064.07           J1          5115        9,561.23
                                existing device), osseointegrated
                                implant, temporal bone, with
                                percutaneous attachment to
                                external speech processor/cochlear
                                stimulator; with mastoidectomy.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    10. On page 79622, Table 14--Final CY 2017 Status Indicator (SI), 
APC Assignments, and Payment Rates for CPT Codes 28297 and 28740, is 
corrected to read as follows:

                     Table 14--Final CY 2017 Staus Indicator (SI), APC Assignments, and Payment Rates for CPT Codes 28297 and 28740
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
           CPT code                      Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
28297........................  Correction, hallux valgus (bunion),           J1          5124       $7,064.07           J1          5114       $5,221.57
                                with or without sesamoidectomy;
                                lapidus-type procedure.
28740........................  Arthrodesis, midtarsal or                     J1          5124        7,064.07           J1          5114        5,221.57
                                tarsometatarsal, single joint.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    11. On page 79624, Table 16--Final CY 2017 Status Indicator (SI), 
APC Assignments, and Payment Rates for the Percutaneous Vertebral 
Augmentation/Kyphoplasty Procedures, is corrected to read as follows:

  Table 16--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for the Percutaneous Vertebral Augmentation/Kyphoplasty Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
           CPT code                      Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
22513........................  Percutaneous vertebral                        J1          5124       $7,064.07           J1          5114       $5,221.57
                                augmentation, including cavity
                                creation (fracture reduction and
                                bone biopsy included when
                                performed) using mechanical device
                                (eg, kyphoplasty), 1 vertebral
                                body, unilateral or bilateral
                                cannulation, inclusive of all
                                imaging guidance; thoracic.
22514........................  Percutaneous vertebral                        J1          5124        7,064.07           J1          5114        5,221.57
                                augmentation, including cavity
                                creation (fracture reduction and
                                bone biopsy included when
                                performed) using mechanical device
                                (eg, kyphoplasty), 1 vertebral
                                body, unilateral or bilateral
                                cannulation, inclusive of all
                                imaging guidance; lumbar.
22515........................  Percutaneous vertebral                         N           N/A        Packaged            N           N/A        Packaged
                                augmentation, including cavity
                                creation (fracture reduction and
                                bone biopsy included when
                                performed) using mechanical device
                                (eg, kyphoplasty), 1 vertebral
                                body, unilateral or bilateral
                                cannulation, inclusive of all
                                imaging guidance; each additional
                                thoracic or lumbar vertebral body
                                (list separately in addition to
                                code for primary procedure).
--------------------------------------------------------------------------------------------------------------------------------------------------------


[[Page 30]]

    12. On page 79627, Table 18--Final CY 2017 Status Indicator (SI), 
APC Assignments, and Payment Rates for the Transcranial Magnetic 
Stimulation (TMS) Therapy Codes, is corrected to read as follows:

     Table 18--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for the Transcranial Magnetic Stimulation (TMS) Therapy Codes
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
           CPT code                      Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
90867........................  Therapeutic repetitive transcranial            S          5722         $220.35            S          5722         $232.31
                                magnetic stimulation (tms)
                                treatment; initial, including
                                cortical mapping, motor threshold
                                determination, delivery and
                                management.
90868........................  Therapeutic repetitive transcranial            S          5722          220.35            S          5722          232.31
                                magnetic stimulation (tms)
                                treatment; subsequent delivery and
                                management, per session.
90869........................  Therapeutic repetitive transcranial            S          5722         $220.35            S          5721         $127.10
                                magnetic stimulation (tms)
                                treatment; subsequent motor
                                threshold re-determination with
                                delivery and management.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    13. On page 79629,
    a. Second column,
    1. First partial paragraph, last sentence, in line 19, replace 
``$59.84'' with $59.86
    2. Second full paragraph, last sentence, in line 27, replace 
``$112.69'' with ``$112.73''.
    b. Third column, first full paragraph, in line 16, replace 
``70.23.'' with ``$70.26.''
    14. On pages 79636 through 79637, Table 23--Final CY 2017 Status 
Indicator (SI), APC Assignments, and Payment Rates for the 
Transprostatic Urethral Implant Procedures, is corrected to read as 
follows:

           Table 23--Final CY 2017 Status Indicator (SI), APC Assignments and Payment Rates for the Transprostatic Urethral Implant Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
        CPT/HCPCS code                   Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
C9739........................  Cystourethroscopy, with insertion             J1          5375       $3,393.73           J1          5375       $3,484.01
                                of transprostatic implant; 1 to 3
                                implants.
C9740........................  Cystourethroscopy, with insertion              T          1565        5,250.00           J1          5376        7,452.66
                                of transprostatic implant; 4 or
                                more implants.
52441........................  Cystourethroscopy, with insertion              B           N/A             N/A            B           N/A             N/A
                                of permanent adjustable
                                transprostatic implant; single
                                implant.
52442........................  Cystourethroscopy, with insertion              B           N/A             N/A            B           N/A             N/A
                                of permanent adjustable
                                transprostatic implant; each
                                additional permanent adjustable
                                transprostatic implant (list
                                separately in addition to code for
                                primary procedure).
--------------------------------------------------------------------------------------------------------------------------------------------------------

    15. On pages 79638 through 79639, Table 25--Final CY 2017 Status 
Indicator (SI), APC Assignments, and Payment Rates Certain Cryoablation 
Procedures, is corrected to read as follows:

[[Page 31]]



                  Table 25--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for Certain Cryoablation Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
        CPT/HCPCS code                   Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
20983........................  Ablation therapy for reduction or              T          5352       $4,118.23           J1          5114       $5,221.57
                                eradication of 1 or more bone
                                tumors (eg, metastasis) including
                                adjacent soft tissue when involved
                                by tumor extension, percutaneous,
                                including imaging guidance when
                                performed; cryoablation.
47383........................  Ablation, 1 or more liver tumor(s),            T          5352        4,118.23           J1          5361        4,199.13
                                percutaneous, cryoablation.
50593........................  Ablation, renal tumor(s),                      T          5352        4,118.23           J1          5362        6,969.84
                                unilateral, percutaneous,
                                cryotherapy.
0340T........................  Ablation, pulmonary tumor(s),                  T          5352        4,118.23           J1          5361        4,199.13
                                including pleura or chest wall
                                when involved by tumor extension,
                                percutaneous, cryoablation,
                                unilateral, includes imaging
                                guidance.
0440T........................  Ablation, percutaneous,                       J1          5361        4,001.15           J1          5432        4,151.86
                                cryoablation, includes imaging
                                guidance; upper extremity distal/
                                peripheral nerve.
0441T........................  Ablation, percutaneous,                       J1          5361        4,001.15           J1          5432        4,151.86
                                cryoablation, includes imaging
                                guidance; lower extremity distal/
                                peripheral nerve.
0442T........................  Ablation, percutaneous,                        T          5352        4,118.23           J1          5432        4,151.86
                                cryoablation, includes imaging
                                guidance; nerve plexus or other
                                truncal nerve (eg, brachial
                                plexus, pudendal nerve).
--------------------------------------------------------------------------------------------------------------------------------------------------------

    16. On page 79641, Table 28--Final CY 2017 Status Indicator (SI), 
APC Assignments, and Payment Rates for the Dialysis Circuit Procedures, 
is corrected to read as follows:

                  Table 28--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for the Dialysis Circuit Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
  Proposed CY 2017 CPT    Final CY 2017      Short descriptors      CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
          code              CPT code                                     SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
36147..................           36147  Access av dial grft for              T          5181         $862.51            D   ...........  ..............
                                          eval.
36148..................           36148  Access av dial grft for              N   ...........  ..............            D   ...........  ..............
                                          proc.
369X1..................           36901  Intro cath dialysis        ............  ...........  ..............            T          5181         $684.13
                                          circuit.
369X2..................           36902  Intro cath dialysis        ............  ...........  ..............           J1          5192        4,825.20
                                          circuit.
369X3..................           36903  Intro cath dialysis        ............  ...........  ..............           J1          5193        9,752.43
                                          circuit.
369X4..................           36904  Thrmbc/nfs dialysis        ............  ...........  ..............           J1          5192        4,825.20
                                          circuit.
369X5..................           36905  Thrmbc/nfs dialysis        ............  ...........  ..............           J1          5193        9,752.43
                                          circuit.
369X6..................           36906  Thrmbc/nfs dialysis        ............  ...........  ..............           J1          5194       14,782.14
                                          circuit.
369X7..................           36907  Balo angiop ctr dialysis   ............  ...........  ..............            N           N/A             N/A
                                          seg.
369X8..................           36908  Stent plmt ctr dialysis    ............  ...........  ..............            N           N/A             N/A
                                          seg.
369X9..................           36909  Dialysis circuit embolj..  ............  ...........  ..............            N           N/A             N/A
--------------------------------------------------------------------------------------------------------------------------------------------------------

    17. On page 79643,
    a. First column, first partial paragraph, in line 14, replace ``$7, 
453.'' with ``$7,456.''
    b. Table 30--Final CY 2017 Status Indicator (SI), APC Assignments, 
and Payment Rates for the Magnetic Resonance Image Guided High 
Intensity Focused Ultrasound (MRgFUS) Procedures, is corrected to read 
as follows:

    Table 30--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for the Magnetic Resonance Image Guided High Intensity Focused
                                                             Ultrasound (MRgFUS) Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
        CPT/HCPCS code                   Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
0071T........................  Focused ultrasound ablation of                 T          5414       $1,861.18           J1          5414       $2,085.47
                                uterine leiomyomata, including mr
                                guidance; total leiomyomata volume
                                less than 200 cc of tissue.

[[Page 32]]

 
0072T........................  Focused ultrasound ablation of                 T          5414        1,861.18           J1          5414        2,085.47
                                uterine leiomyomata, including mr
                                guidance; total leiomyomata volume
                                greater or equal to 200 cc of
                                tissue.
0398T........................  Magnetic resonance image guided                E           N/A             N/A            S          1537        9,750.50
                                high intensity focused ultrasound
                                (mrgfus), stereotactic ablation
                                lesion, intracranial for movement
                                disorder including stereotactic
                                navigation and frame placement
                                when performed.
C9734........................  Focused ultrasound ablation/                   T          5122        2,395.59           J1          5114        2,085.47
                                therapeutic intervention, other
                                than uterine leiomyomata, with
                                magnetic resonance (mr) guidance.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    18. On page 79645, Table 32--Final CY 2017 Status Indicator (SI), 
APC Assignments, and Payment Rates for the Smoking and Tobacco Use 
Cessation Counseling Services, is corrected to read as follows:

      Table 32--Final CY 2017 Status Indicator (SI), APC Assignment, and Payment Rate for the Smoking and Tobacco Use Cessation Counseling Services
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY    Final CY 2017
        CPT/HCPCS code                   Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    OPPS payment
                                                                         SI         OPPS APC    payment rate   2017 OPPS SI      APC           rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
99406........................  Smoking and tobacco use cessation              S          5821          $27.12            S          5821          $25.23
                                counseling visit; intermediate,
                                greater than 3 minutes up to 10
                                minutes.
99407........................  Smoking and tobacco use cessation              S          5821           27.12            S          5821           25.23
                                counseling visit; intensive,
                                greater than 10 minutes.
G0436........................  Smoking and tobacco cessation                  S          5821           27.12            D           N/A             N/A
                                counseling visit for the
                                asymptomatic patient;
                                intermediate, greater than 3
                                minutes, up to 10 minutes.
G0437........................  Smoking and tobacco cessation                  S          5822           69.65            D           N/A             N/A
                                counseling visit for the
                                asymptomatic patient; intensive,
                                greater than 10 minutes.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    19. On page 79647, first column, second full paragraph, under a 
response to public comment, the last two sentences of the paragraph are 
corrected to read ``However, the rationale for this modification of the 
proposal for these codes is not related to the statutory provision of 
section 144 of the Medicare Improvements for Patients and Providers Act 
of 2008. We believe that pulmonary rehabilitation (and the related 
respiratory treatment services) are not typically ancillary to the 
other HOPD services that may be furnished to beneficiaries. These 
services are typically part of a course of treatment that is prescribed 
after a diagnosis is made and often after other treatments are 
initiated or completed.''
    20. On page 79648, Table 34--Final CY 2017 Status Indicator (SI), 
APC Assignments, and Payment Rates for the Pulmonary Rehabilitation 
Services, is corrected to read as follows:

[[Page 33]]



               Table 34--Final CY 2017 Status Indicator (SI), APC Assignments, and Payment Rates for the Pulmonary Rehabilitation Services
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                               Final CY
          HCPCS code                     Long descriptors           CY 2016 OPPS    CY 2016     CY 2016 OPPS     Final CY     2017 OPPS    Final CY 2017
                                                                         SI         OPPS APC       payment     2017 OPPS SI      APC       OPPS payment
--------------------------------------------------------------------------------------------------------------------------------------------------------
G0237........................  Therapeutic procedures to increase            Q1          5734          $91.18            S          5732          $28.38
                                strength or endurance of
                                respiratory muscles, face to face,
                                one on one, each 15 minutes
                                (includes monitoring).
G0238........................  Therapeutic procedures to improve             Q1          5733           55.94            S          5732           28.38
                                respiratory function, other than
                                described by g0237, one on one,
                                face to face, per 15 minutes
                                (includes monitoring).
G0239........................  Therapeutic procedures to improve             Q1          5732           30.51            S          5732           28.38
                                respiratory function or increase
                                strength or endurance of
                                respiratory muscles, two or more
                                individuals (includes monitoring).
G0424........................  Pulmonary rehabilitation, including           Q1          5733           55.94            S          5733           54.55
                                exercise (includes monitoring),
                                one hour, per session, up to two
                                sessions per day.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    21. On page 79662, Table 35--Drugs and Biologicals for Which Pass-
Through Payment Status Expires December 31, 2016, is corrected to read 
as follows:

  Table 35--Drugs and Biologicals for Which Pass-Through Payment Status
                        Expires December 31, 2016
------------------------------------------------------------------------
                                          Final CY 2017
  CY 2017 HCPCS code     CY 2017 Long         status       Final CY 2017
                          descriptor        indicator           APC
------------------------------------------------------------------------
C9497................  Loxapine,                      K             9497
                        inhalation
                        powder, 10 mg.
J1322................  Injection,                     K             1480
                        elosulfase
                        alfa, 1mg.
J1439................  Injection,                     K             9441
                        ferric
                        carboxymaltose,
                        1 mg.
J1447................  Injection, TBO-                K             1748
                        Filgrastim, 1
                        micrograms.
J3145................  Injection,                     N              N/A
                        testosterone
                        undecanoate, 1
                        mg.
J3380................  Injection,                     K             1489
                        vedolizumab, 1
                        mg.
J7181................  Factor XIII                    K             1746
                        (antihemophilic
                        factor,
                        recombinant),
                        Tretten, per
                        i.u.
J7200................  Factor ix                      K             1467
                        (antihemophilic
                        factor,
                        recombinant),
                        Rixubus, per
                        i.u.
J7201................  Factor ix                      K             1486
                        (antihemophilic
                        factor,
                        recombinant),
                        Alprolix, per
                        i.u.
J7205................  Injection,                     K             1656
                        factor viii, fc
                        fusion protein,
                        (recombinant),
                        per i.u.
J7508................  Tacrolimus,                    N              N/A
                        Extended
                        Release, Oral,
                        0.1 mg.
J9301................  Injection,                     K             1476
                        obinutuzumab,
                        10 mg.
J9308................  Injection,                     K             1488
                        ramucirumab, 5
                        mg.
J9371................  Injection,                     K             1466
                        Vincristine
                        Sulfate
                        Liposome, 1 mg.
Q4121................  Theraskin, per                 N              N/A
                        square
                        centimeter.
------------------------------------------------------------------------

    22. On page 79664, Table 36--Drugs and Biologicals with Pass-
Through Payment Status in CY 2017, the Long Descriptors for CY HCPCS 
codes A9588 and A9587 are revised to read as follows:

           Corrections To Table 36--Drugs and Biologicals With Pass-Through Payment Status in CY 2017
----------------------------------------------------------------------------------------------------------------
                                                                                       CY 2017
         CY 2016 HCPCS code              CY 2017        CY 2017 Long descriptor        status       CY 2017 APC
                                       HCPCS code                                     indicator
----------------------------------------------------------------------------------------------------------------
N/A.................................        A9588   Fluciclovine f-18, diagnostic,            G             9052
                                                     1 mCi.
N/A.................................        A9587   Gallium Ga-68, dotatate,                  G             9056
                                                     diagnostic, 0.1 mCi.
----------------------------------------------------------------------------------------------------------------

    23. On page 79671, in Table 37--Assignments to High Cost and Low 
Cost Groups for CY 2017, remove HCPCS codes Q4119, Q4120, and Q4129.
    24. On page 79708, third column, in lines 28 through 31, the words 
``for services that were furnished prior to November 2, 2015, and 
billed under the OPPS in accordance with timely filing limits.'' are 
corrected to read ``if the PBD furnished a covered OPD service prior to 
November 2, 2015 and billed the OPPS within timely filing limits for 
that service.''
    25. On page 79719, third column, first partial paragraph, in lines 
6 and 7, remove the words ``for cost reporting periods beginning 
January 1, 2017,''.

[[Page 34]]

    26. On page 79741, third column, fourth full paragraph, in lines 10 
and 11, the words ``was deleted by the AMA Editorial Panel in April 
2016.'' are corrected to read ``will be deleted effective December 31, 
2016.''
    27. On page 79742, first column, first full paragraph, in lines 2 
and 3, the words ``was deleted effective April 13, 2016,'' are 
corrected to read ``will be deleted effective December 31, 2016,''.
    28. On page 79743, Table 51--Additions To The List of ASC Covered 
Surgical Procedures For CY 2017, CPT code 22585 is added in numerical 
order to read as follows:

 Corrections To Table 51--Additions To The List of ASC Covered Surgical
                         Procedures For CY 2017
------------------------------------------------------------------------
                                                          CY 2017 ASC
     CY 2017 CPT code       CY 2017 long descriptor   payment  indicator
------------------------------------------------------------------------
22585....................  Arthrodesis, anterior      N1
                            interbody technique,
                            including minimal
                            discectomy to prepare
                            interspace (other than
                            for decompression); each
                            additional interspace
                            (List separately in
                            addition to code for
                            primary procedure).
------------------------------------------------------------------------

    29. On page 79752, third column, bottom half of the page, first 
full paragraph,
    a. In line 11, replace ``0.9996'' with ``0.9997.''
    b. In line 27, replace ``$45.030'' with ``$45.003.''
    c. In line 30, replace ``$44.190'' with ``$44.177.''
    d. In line 32, replace ``0.9996'' with ``0.9997.''
    30. On page 79753,
    a. First column, first partial paragraph,
    (1) In line 9, replace ``$44.330'' with ``$44.120.''
    (2) In line 12, replace ``$44.190'' with ``$44.177.''
    (3) In line 14, replace ``0.9996'' with ``0.9997.''
    b. Second column, second full paragraph, in line 7, replace 
``$45.030'' with ``$45.003.''
    31. On page 79784, the un-numbered table--PREVIOUSLY FINALIZED AND 
NEWLY FINALIZED HOSPITAL OQR PROGRAM MEASURE SET FOR THE CY 2020 
PAYMENT DETERMINATION AND SUBSEQUENT YEARS, is corrected by removing 
the three asterisks, ``***'' after the OP-30 measure name and adding in 
its place two asterisks, ``**'' to read as follows:

------------------------------------------------------------------------
 
------------------------------------------------------------------------
0659..........................  OP-30: Colonoscopy Interval for Patients
                                 with a History of Adenomatous Polyps--
                                 Avoidance of Inappropriate Use. **
------------------------------------------------------------------------

    32. On page 79868,
    a. Second column, first full paragraph, in line 3, replace ``1.7'' 
with ``1.8.''
    b. Third column, first paragraph, in lines 15 and 16, ``an increase 
of 0.1 percent to 0.3 percent'' is corrected to read ``no change to an 
increase of 0.3 percent.''
    33. On page 79869,
    a. Second column, first full paragraph, in line 11, replace ``1.7'' 
with ``1.8.''
    b. Third column, first full paragraph, in line 2, replace ``1.7'' 
with ``1.8.''
    34. On pages 79869 through 79870, Table 52--Estimated Impact of the 
CY 2017
    Changes for the Hospital Outpatient Prospective Payment System, is 
corrected to read as follows:

                              Table 52--Impact of Changes for Final CY 2017 Hospital Outpatient Prospective Payment System
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        All budget
                                                                                                   New wage index    neutral changes
                                                                 Number of    APC recalibration     and provider      (combined cols      All changes
                                                                 hospitals       (all changes)      adjustments      2,3) with market
                                                                                                                      basket update
                                                                         (1)                (2)                (3)                (4)                (5)
--------------------------------------------------------------------------------------------------------------------------------------------------------
All Providers *.............................................            3906                0.0                0.0                1.7                1.8
All Hospitals (excludes hospitals held harmless and CMHCs)..            3789                0.0                0.0                1.8                1.8
Urban Hospitals.............................................            2958                0.0                0.0                1.7                1.8
    Large Urban (GT 1 Mill.)................................            1616                0.0               -0.1                1.6                1.7
    Other Urban (LE 1 Mill.)................................            1342                0.1                0.1                1.8                1.8
Rural Hospitals.............................................             831                0.2                0.3                2.2                2.2
    Sole Community..........................................             376                0.2                0.4                2.3                2.2
    Other Rural.............................................             455                0.2                0.2                2.1                2.1
Beds (Urban):
    0-99 Beds...............................................            1045               -0.3                0.2                1.6                1.7
    100-199 Beds............................................             834                0.2               -0.1                1.8                1.8
    200-299 Beds............................................             465                0.2                0.0                1.9                1.9
    300-499 Beds............................................             405                0.1                0.0                1.8                1.9
    500 + Beds..............................................             209               -0.2                0.0                1.4                1.5
Beds (Rural):
    0-49 Beds...............................................             340                0.3                0.5                2.6                2.5
    50-100 Beds.............................................             299                0.2                0.4                2.4                2.3
    101-149 Beds............................................             108                0.1               -0.2                1.6                1.7
    150-199 Beds............................................              45                0.0                0.4                2.2                2.1
    200 + Beds..............................................              39                0.2                0.2                2.1                2.1

[[Page 35]]

 
Region (Urban):
    New England.............................................             146                0.0               -1.1                0.6                0.6
    Middle Atlantic.........................................             350                0.0                0.1                1.7                1.7
    South Atlantic..........................................             465                0.1                0.0                1.7                1.8
    East North Cent.........................................             473                0.1                0.1                1.8                1.9
    East South Cent.........................................             177               -0.4                0.3                1.6                1.7
    West North Cent.........................................             182               -0.1                0.0                1.6                1.5
    West South Cent.........................................             527               -0.2                0.3                1.8                1.9
    Mountain................................................             206                0.2                1.0                2.9                3.0
    Pacific.................................................             383                0.4               -0.3                1.7                1.8
    Puerto Rico.............................................              49                0.5               -0.3                1.8                1.8
Region (Rural):
    New England.............................................              21                0.9                0.5                3.1                3.0
    Middle Atlantic.........................................              55                0.1                1.2                3.0                3.0
    South Atlantic..........................................             126                0.3               -0.3                1.7                1.7
    East North Cent.........................................             121                0.2                0.3                2.2                2.2
    East South Cent.........................................             158                0.0                0.2                1.9                1.9
    West North Cent.........................................             100                0.0                0.4                2.1                2.0
    West South Cent.........................................             168                0.2                0.7                2.6                2.6
    Mountain................................................              58                0.2               -0.1                1.9                1.8
    Pacific.................................................              24                0.3               -0.1                1.9                1.9
Teaching Status:
    Non-Teaching............................................            2712                0.1                0.1                1.9                2.0
    Minor...................................................             731                0.1                0.0                1.9                1.9
    Major...................................................             346               -0.2               -0.1                1.4                1.5
DSH Patient Percent:
    0.......................................................              10               -1.7               -0.2               -0.2               -0.1
    GT 0-0.10...............................................             305               -0.4                0.0                1.2                1.3
    0.10-0.16...............................................             270                0.1                0.1                1.8                1.8
    0.16-0.23...............................................             600                0.1                0.1                2.0                2.0
    0.23-0.35...............................................            1135                0.1                0.1                1.9                1.9
    GE 0.35.................................................             895                0.1               -0.1                1.7                1.7
    DSH not Available **....................................             574               -1.4               -0.2                0.1                0.2
Urban Teaching/DSH:
    Teaching & DSH..........................................             975                0.0                0.0                1.6                1.7
    No Teaching/DSH.........................................            1425                0.1                0.1                1.9                1.9
    No Teaching/No DSH......................................              10               -1.7               -0.2               -0.2               -0.1
    DSH Not Available2......................................             548               -1.4               -0.3                0.0                0.1
Type of Ownership:
    Voluntary...............................................            1983                0.1                0.1                1.8                1.9
    Proprietary.............................................            1306                0.0                0.1                1.7                1.8
    Government..............................................             500               -0.1               -0.1                1.5                1.6
CMHCs.......................................................              50              -15.0               -0.4              -13.9              -13.7
--------------------------------------------------------------------------------------------------------------------------------------------------------
Column (1) shows total hospitals and/or CMHCs.
Column (2) includes all final CY 2017 OPPS policies and compares those to the CY 2016 OPPS.
Column (3) shows the budget neutral impact of updating the wage index by applying the final FY 2017 hospital inpatient wage index, including all hold
  harmless policies and transitional wages. The rural adjustment continues our current policy of 7.1 percent so the budget neutrality factor is 1. The
  budget neutrality adjustment for the cancer hospital adjustment is 1.003 because the payment-to-cost ratio target changes from 0.92 in CY 2016 to 0.91
  in CY 2017.
Column (4) shows the impact of all budget neutrality adjustments and the addition of the final 1.65 percent OPD fee schedule update factor (2.7 percent
  reduced by 0.3 percentage points for the final productivity adjustment and further reduced by 0.75 percentage point in order to satisfy statutory
  requirements set forth in the Affordable Care Act). It also includes the impact of the additional adjustment of 1.0004 for Lab services with L1
  Modifiers packaged into the OPPS.
Column (5) shows the additional adjustments to the conversion factor resulting from the frontier adjustment, a change in the pass-through estimate, and
  adding estimated outlier payments.
These 3,906 providers include children and cancer hospitals, which are held harmless to pre-BBA amounts, and CMHCs.
** Complete DSH numbers are not available for providers that are not paid under IPPS, including rehabilitation, psychiatric, and long-term care
  hospitals.


0
35. On page 79871, third column, first partial paragraph, in the last 
line, replace ``$45.016'' with ``$45.003.''
0
36. On page 79877, third column, last paragraph, in lines 2 and 3, the 
phrase ``OPPS payments by $500 million'' is corrected to read ``Part B 
payments by $50 million.''

Regulations Text Corrections


Sec.  419.22  [Corrected]

0
37. On page 79879, second column, in Sec.  419.22, ``Hospital services 
excluded

[[Page 36]]

from payment under the hospital outpatient prospective payment 
system,'' the words ``for cost reporting periods beginning on or after 
January 1, 2017,'' are removed.

0
38. On page 79880, first column, in Sec.  419.48, paragraph (b) is 
corrected to read as follows:


Sec.  419.48,  ``Definition of excepted items and services

* * * * *
    (b) For the purpose of this section, ``excepted off-campus 
provider-based department'' means a ``department of a provider'' (as 
defined at Sec.  413.65(a)(2) of this chapter) that is located on the 
campus (as defined in Sec.  413.65(a)(2) of this chapter) or within the 
distance described in such definition from a ``remote location of a 
hospital'' (as defined in Sec.  413.65(a)(2) of this chapter) that 
meets the requirements for provider-based status under Sec.  413.65 of 
this chapter. This definition also includes an off-campus department of 
a provider that was furnishing services prior to November 2, 2015 that 
were billed under the OPPS in accordance with timely filing limits.
* * * * *

0
39. Section 495.40 is corrected as follows:
0
a. On page 79892, in the first column, in amendment 27, redesignate 
instructions d through f as instructions e through g respectively and 
add a new instruction d to read ``d. Adding paragraphs (a)(2)(i)(H) and 
(I).''
0
b. On page 79892, in the second column, in amendment 27, correct 
redesignated instruction g to read ``g. Adding new paragraphs 
(b)(2)(i)(G), (H), and (I).''
0
c. On page 79892, in the second column, paragraph (a) introductory text 
is correctly revised.
0
d. On page 79892, in the second column, paragraphs (a)(2)(i)(H) and (I) 
are added.
0
e. On page 79892, in the second column, paragraph (b) introductory text 
is correctly revised.
0
f. On page 79892, in the third column paragraphs (b)(2)(i)(H) and (I) 
are added.
    The revisions and additions read as follows:


Sec.  495.40  Demonstration of meaningful use criteria.

    (a) Demonstration by EPs. An EP must demonstrate that he or she 
satisfies each of the applicable objectives and associated measures 
under Sec.  495.20, Sec.  495.22 or Sec.  495.24, supports information 
exchange and the prevention of health information blocking, and engages 
in activities related to supporting providers with the performance of 
CEHRT:
* * * * *
    (2) * * *
    (i) * * *
    (H) Supporting providers with the performance of CEHRT (SPPC). To 
engage in activities related to supporting providers with the 
performance of CEHRT, the EP--
    (1) Must attest that he or she:
    (i) Acknowledges the requirement to cooperate in good faith with 
ONC direct review of his or her health information technology certified 
under the ONC Health IT Certification Program if a request to assist in 
ONC direct review is received; and
    (ii) If requested, cooperated in good faith with ONC direct review 
of his or her health information technology certified under the ONC 
Health IT Certification Program as authorized by 45 CFR part 170, 
subpart E, to the extent that such technology meets (or can be used to 
meet) the definition of CEHRT, including by permitting timely access to 
such technology and demonstrating its capabilities as implemented and 
used by the EP in the field.
    (2) Optionally, may also attest that he or she:
    (i) Acknowledges the option to cooperate in good faith with ONC-ACB 
surveillance of his or her health information technology certified 
under the ONC Health IT Certification Program if a request to assist in 
ONC-ACB surveillance is received; and
    (ii) If requested, cooperated in good faith with ONC-ACB 
surveillance of his or her health information technology certified 
under the ONC Health IT Certification Program as authorized by 45 CFR 
part 170, subpart E, to the extent that such technology meets (or can 
be used to meet) the definition of CEHRT, including by permitting 
timely access to such technology and demonstrating capabilities as 
implemented and used by the EP in the field.
    (I) Support for health information exchange and the prevention of 
information blocking. For an EHR reporting period in CY 2017 and 
subsequent years, the EP must attest that he or she--
    (1) Did not knowingly and willfully take action (such as to disable 
functionality) to limit or restrict the compatibility or 
interoperability of certified EHR technology.
    (2) Implemented technologies, standards, policies, practices, and 
agreements reasonably calculated to ensure, to the greatest extent 
practicable and permitted by law, that the certified EHR technology 
was, at all relevant times--
    (i) Connected in accordance with applicable law;
    (ii) Compliant with all standards applicable to the exchange of 
information, including the standards, implementation specifications, 
and certification criteria adopted at 45 CFR part 170;
    (iii) Implemented in a manner that allowed for timely access by 
patients to their electronic health information; and
    (iv) Implemented in a manner that allowed for the timely, secure, 
and trusted bidirectional exchange of structured electronic health 
information with other health care providers (as defined by 42 U.S.C. 
300jj(3)), including unaffiliated providers, and with disparate 
Certified EHR technology and vendors.
    (3) Responded in good faith and in a timely manner to requests to 
retrieve or exchange electronic health information, including from 
patients, health care providers (as defined by 42 U.S.C. 300jj(3)), and 
other persons, regardless of the requestor's affiliation or technology 
vendor.''
* * * * *
    (b) Demonstration by eligible hospitals and CAHs. An eligible 
hospital or CAH must demonstrate that it satisfies each of the 
applicable objectives and associated measures under Sec.  495.20, Sec.  
495.22, or Sec.  495.24, supports information exchange and the 
prevention of health information blocking, and engages in activities 
related to supporting providers with the performance of CEHRT:
* * * * *
    (2) * * *
    (i) * * *
    (H) Supporting providers with the performance of CEHRT (SPPC). To 
engage in activities related to supporting providers with the 
performance of CEHRT, the eligible hospital or CAH--
    (1) Must attest that it:
    (i) Acknowledges the requirement to cooperate in good faith with 
ONC direct review of his or her health information technology certified 
under the ONC Health IT Certification Program if a request to assist in 
ONC direct review is received; and
    (ii) If requested, cooperated in good faith with ONC direct review 
of its health information technology certified under the ONC Health IT 
Certification Program as authorized by 45 CFR part 170, subpart E, to 
the extent that such technology meets (or can be used to meet) the 
definition of CEHRT, including by permitting timely access to such 
technology and demonstrating its capabilities as implemented and used 
by the eligible hospital or CAH in the field.

[[Page 37]]

    (2) Optionally, may attest that it:
    (i) Acknowledges the option to cooperate in good faith with ONC-ACB 
surveillance of his or her health information technology certified 
under the ONC Health IT Certification Program if a request to assist in 
ONC-ACB surveillance is received; and
    (ii) If requested, cooperated in good faith with ONC-ACB 
surveillance of his or her health information technology certified 
under the ONC Health IT Certification Program as authorized by 45 CFR 
part 170, subpart E, to the extent that such technology meets (or can 
be used to meet) the definition of CEHRT, including by permitting 
timely access to such technology and demonstrating its capabilities as 
implemented and used by the eligible hospital or CAH in the field.
    (I) Support for health information exchange and the prevention of 
information blocking. For an EHR reporting period in CY 2017 and 
subsequent years, the eligible hospital or CAH must attest that it--
    (1) Did not knowingly and willfully take action (such as to disable 
functionality) to limit or restrict the compatibility or 
interoperability of certified EHR technology.
    (2) Implemented technologies, standards, policies, practices, and 
agreements reasonably calculated to ensure, to the greatest extent 
practicable and permitted by law, that the certified EHR technology 
was, at all relevant times--
    (i) Connected in accordance with applicable law;
    (ii) Compliant with all standards applicable to the exchange of 
information, including the standards, implementation specifications, 
and certification criteria adopted at 45 CFR part 170;
    (iii) Implemented in a manner that allowed for timely access by 
patients to their electronic health information; and
    (iv) Implemented in a manner that allowed for the timely, secure, 
and trusted bidirectional exchange of structured electronic health 
information with other health care providers (as defined by 42 U.S.C. 
300jj(3)), including unaffiliated providers, and with disparate 
certified EHR technology and vendors.
    (3) Responded in good faith and in a timely manner to requests to 
retrieve or exchange electronic health information, including from 
patients, health care providers (as defined by 42 U.S.C. 300jj(3)), and 
other persons, regardless of the requestor's affiliation or technology 
vendor.''.
* * * * *

    Dated: December 27, 2016.
Madhura Valverde,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2016-31774 Filed 12-30-16; 8:45 am]
 BILLING CODE 4120-01-P