[Federal Register Volume 85, Number 167 (Thursday, August 27, 2020)]
[Rules and Regulations]
[Pages 52923-52924]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-18902]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412 and 482

[CMS-1731-CN and CMS-1744-CN]
RIN-0938-AU07 and 0938-AU31


Medicare Program; FY 2021 Inpatient Psychiatric Facilities 
Prospective Payment System (IPF PPS) and Special Requirements for 
Psychiatric Hospitals for Fiscal Year Beginning October 1, 2020 (FY 
2021); Correction

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

ACTION: Final rule; correction.

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SUMMARY: In the August 4, 2020 issue of the Federal Register, we 
published a final rule entitled ``FY 2021 Inpatient Psychiatric 
Facilities Prospective Payment System (IPF PPS) and Special 
Requirements for Psychiatric Hospitals for Fiscal Year Beginning 
October 1, 2020 (FY 2021)''. The August 4, 2020 final rule updates the 
prospective payment rates, the outlier threshold, and the wage index 
for Medicare inpatient hospital services provided by Inpatient 
Psychiatric Facilities (IPF), which include psychiatric hospitals and 
excluded psychiatric units of an Inpatient Prospective Payment System 
(IPPS) hospital or critical access hospital. In addition, we adopted 
more recent Office of Management and Budget (OMB) statistical area 
delineations, and applied a 2-year transition for all providers 
negatively impacted by wage index changes. This correction document 
corrects the statement of economic significance in the August 4, 2020 
final rule.

DATES: This correction is effective October 1, 2020.

FOR FURTHER INFORMATION CONTACT: The IPF Payment Policy mailbox at 
[email protected] for general information.
    Nicolas Brock, (410) 786-5148, for information regarding the 
statement of economic significance.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2020-16990 (85 FR 47042), the final rule entitled ``FY 
2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF 
PPS) and Special Requirements for Psychiatric Hospitals for Fiscal Year 
Beginning October 1, 2020 (FY 2021)'' (hereinafter referred to as the 
FY 2021 IPF PPS final rule) there was an error in the statement of 
economic significance and status as major under the Congressional 
Review Act (5 U.S.C. 801 et seq.). Based on an estimated total impact 
of $95 million in increased transfers from the federal government to 
IPF providers, we previously stated that the final rule was not 
economically significant under Executive Order (E.O.) 12866, and that 
the rule was not a major rule under the Congressional Review Act. 
However, the Office of Management and Budget designated this rule as 
economically significant under E.O. 12866 and major under the 
Congressional Review Act. We are correcting our previous statement in 
the August 4, 2020 final rule accordingly. This correction is effective 
October 1, 2020.

II. Summary of Errors

    On page 47064, in the third column, the third full paragraph under 
B. Overall Impact should be replaced entirely. The entire paragraph 
stating:
    ``We estimate that this rulemaking is not economically significant 
as measured by the $100 million threshold, and hence not a major rule 
under the Congressional Review Act. Accordingly, we have prepared a 
Regulatory Impact Analysis that to the best of our ability presents the 
costs and benefits of the rulemaking.''

should be replaced with:
    ``We estimate that the total impact of this final rule is close to 
the $100 million threshold. The Office of Management and Budget has 
designated this rule as economically significant under E.O. 12866 and a 
major rule under the Congressional Review Act (5 U.S.C. 801 et seq.). 
Accordingly, we have prepared a Regulatory Impact Analysis that to the 
best of our ability presents the costs and benefits of the 
rulemaking.''

III. Waiver of Proposed Rulemaking and Delay in Effective Date

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a rule take effect in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive this notice and comment procedure if the Secretary of the 
Department of Human Services finds, for good cause, that the notice and 
comment process is impracticable, unnecessary, or contrary to the 
public interest, and incorporates a statement of the finding and the 
reasons therefore in the notice.
    This correction document does not constitute a rulemaking that 
would be subject to these requirements because it corrects only the 
statement of economic significance included in the FY 2021 IPF PPS 
final rule. The corrections contained in this document are consistent 
with, and do not make substantive changes to, the policies and payment 
methodologies that were adopted and subjected to notice and comment 
procedures in the FY 2021 IPF PPS final rule. Rather, the corrections 
made through this correction document are intended to ensure that the 
FY 2021 IPF PPS final rule accurately reflects OMB's determination 
about its economic significance and major status under the 
Congressional Review Act (CRA). Executive Order 12866 and CRA 
determinations are functions of the Office of Management and Budget, 
not the Department of Health and Human Services, and are not rules as 
defined by the Administrative Procedure Act (5 U.S. Code 551(4)).
    We ordinarily provide a 60-day delay in the effective date of final 
rules after the date they are issued, in accordance with the CRA (5 
U.S.C. 801(a)(3)). However, section 808(2) of the CRA provides that, if 
an agency finds good cause that notice and public procedure are 
impracticable, unnecessary, or contrary to the public interest, the 
rule shall take effect at such time as the agency determines. Even if 
this were a rulemaking to which the delayed effective date requirement 
applied, we found, in the FY 2021 IPF PPS Final Rule (85 FR 47043), 
good cause to waive the 60-day delay in the effective date of the IPF 
PPS final rule. In the final rule, we explained that, due to CMS 
prioritizing efforts in support of containing and combatting the COVID-

[[Page 52924]]

19 public health emergency by devoting significant resources to that 
end, the work needed on the IPF PPS final rule was not completed in 
accordance with our usual rulemaking schedule. We noted that it is 
critical, however, to ensure that the IPF PPS payment policies are 
effective on the first day of the fiscal year to which they are 
intended to apply and therefore, it would be contrary to the public 
interest to not waive the 60-day delay in the effective date. 
Undertaking further notice and comment procedures to incorporate the 
corrections in this document into the FY 2021 IPF PPS final rule or 
delaying the effective date would be contrary to the public interest 
because it is in the public's interest to ensure that the policies 
finalized in the FY 2021 IPF PPS are effective as of the first day of 
the fiscal year to ensure providers and suppliers receive timely and 
appropriate payments. Further, such procedures would be unnecessary, 
because we are not altering the payment methodologies or policies. 
Rather, the correction we are making is only to indicate that the FY 
2021 IPF PPS final rule is economically significant and a major rule 
under the CRA. For these reasons, we find we have good cause to waive 
the notice and comment and effective date requirements.

IV. Correction of Errors in the Preamble

    In FR Doc. 2020-16990, appearing on page 47042 in the Federal 
Register of Tuesday, August 4, 2020, the following correction is made:
    1. On page 47064, in the 3rd column, under B. Overall Impact, 
correct the third full paragraph to read as follows:
    We estimate that the total impact of this final rule is very close 
to the $100 million threshold. The Office of Management and Budget has 
designated this rule as economically significant under E.O. 12866 and a 
major rule under the Congressional Review Act (5 U.S.C. 801 et seq.). 
Accordingly, we have prepared a Regulatory Impact Analysis that to the 
best of our ability presents the costs and benefits of the rulemaking.

    Dated: August 24, 2020.
Wilma M. Robinson,
Deputy Executive Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2020-18902 Filed 8-26-20; 8:45 am]
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