[Federal Register Volume 85, Number 232 (Wednesday, December 2, 2020)]
[Rules and Regulations]
[Pages 77404-77406]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-26512]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 512

[CMS-5527-CN]
RIN 0938-AT89


Medicare Program; Specialty Care Models To Improve Quality of 
Care and Reduce Expenditures; Correction

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

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical and typographical errors that 
appeared in the final rule published in the September 29, 2020 Federal 
Register entitled ``Medicare Program; Specialty Care Models To Improve 
Quality of Care and Reduce Expenditures,'' which established the 
Radiation Oncology Model and the End-Stage Renal Disease Treatment 
Choices Model.

DATES: Effective date: This correcting document is effective on 
December 2, 2020.

FOR FURTHER INFORMATION CONTACT: Rebecca Cole, (410) 786-1589.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2020-20907 of September 29, 2020 (85 FR 61114), there 
were a number of technical errors that are identified and corrected in 
this correcting document. The provisions in this correction document 
are effective as if they had been included in the document published 
September 29, 2020. Accordingly, the corrections are effective November 
30, 2020.

II. Summary of Errors

    On page 61159, in our discussion of the entitled ``Episode Length'' 
there is an error in an in-text citation to the proposed rule, so 84 FR 
3499 is corrected to 84 FR 34499, along with the correct link to the 
proposed rule.
    On pages 61289, 61292, 61295, 61296, 61297, 61319, 61327, 61328, 
61329, 61349, 61350, 61353, and 61354, we made errors in the numbering 
and reference numbers for several tables.
    On pages 61357, 61358, and 61359 in our discussion of the effects 
on Radiation Oncology (RO) Participants, we made errors in wage-related 
information. On page 61359, in our discussion of the Regulatory 
Flexibility Act requirements for the Radiation Oncology Model, we made 
a calculation error regarding the distribution of payment changes. 
Under Medicare FFS, physician group practices (PGPs) are largely paid 
through the Medicare Physician Fee Schedule (PFS) for radiotherapy 
services while hospital outpatient departments (HOPDs) are paid through 
the Outpatient Prospective Payment System (OPPS). Unit-cost increases 
under the PFS are projected to be lower than under the OPPS. Therefore, 
the RO Model will affect payments to RO participants that are PGPs and 
HOPDs differentially over time through the use of a site neutral update 
factor. The referenced calculations are revised to properly value this 
effect.

III. Waiver of Proposed Rulemaking, 60-Day Comment Period, 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 proposed rulemaking in 
the Federal Register to provide a period for public comment before the 
provisions of a rule take effect. Similarly, section 1871(b)(1) of the 
Social Security Act (the Act) requires the Secretary to provide for 
notice of the proposed rulemaking 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 (5 U.S.C. 553(d)) and section 
1871(e)(1)(B)(i) of the Act 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 the 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 rulemaking 
processes 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 the agency includes a statement of support.
    We believe that this correcting document does not constitute a rule 
that would be subject to the notice and comment or delayed effective 
date requirements. This document corrects technical and typographic 
errors in the Medicare Program; Specialty Care Models To Improve 
Quality of Care and Reduce Expenditures final rule (the Specialty Care 
Models final rule), but does not make substantive changes to the 
policies or payment methodologies that were adopted in the final rule. 
As a result, this corrective document is intended to ensure that the 
information in the Specialty Care Models final rule accurately reflects 
the policies adopted in that document.
    In addition, even if this was a rulemaking to which the notice and 
comment procedures and delayed effective date requirements applied, we 
find that there is good cause to waive such requirements. Undertaking 
further notice and comment procedures to incorporate the corrections in 
this document into the final rule would be contrary to the public 
interest because it is in the public's interest for model participants 
to receive appropriate payments in as timely a manner as possible and 
to ensure that the Specialty Care Models final rule accurately reflects 
our methodologies and policies as of the date they take effect and are 
applicable.
    Furthermore, such procedures would be unnecessary, as we are not 
altering the implementation of the models or the way participants in 
the models will perform, 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 Specialty Care Models final rule 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.

IV. Correction of Errors

    In FR Doc. 2020-20907 of September 29, 2020 (85 FR 61114), make the 
following corrections:

[[Page 77405]]

    1. On page 61159, first column, last paragraph, lines 1 and 2, the 
reference ``(84 FR 3499)'' is corrected to read ``(84 FR 34499)''.
    2. On page 61289, lower one-fourth of the page, the table title 
``TABLE 11: PROPOSED HDPA SCHEDULE'' is corrected to read ``TABLE 15: 
PROPOSED HDPA SCHEDULE''.
    3. On page 61292, in the middle of the page, the table title 
``TABLE 11.a: HDPA SCHEDULE'' is corrected to read ``TABLE 15.a: HDPA 
SCHEDULE''.
    4. On page 61295, third column, last partial paragraph, line 1, the 
reference ``Table 12'' is corrected to read ``Table 16''.
    5. On page 61296--
    a. Top of the page, the table title ``TABLE 12: PROPOSED ETC MODEL 
SCHEDULE OF MEASUREMENT YEARS AND PPA PERIODS'' is corrected to read 
``TABLE 16: PROPOSED ETC MODEL SCHEDULE OF MEASUREMENT YEARS AND PPA 
PERIODS''.
    b. Lower half of the page, second column, partial paragraph, line 
2, the table reference ``Table 12.a'' is corrected to read ``Table 
16.a''.
    6. On page 61297, the table title, ``TABLE 12.a: ETC MODEL SCHEDULE 
OF MEASUREMENT YEARS AND PPA PERIODS'' is corrected to read ``TABLE 
16.a: ETC MODEL SCHEDULE OF MEASUREMENT YEARS AND PPA PERIODS''.
    7. On page 61319, the table title, ``TABLE 13: PROPOSED SCORING 
METHODOLOGY FOR ASSESSMENT OF MEASUREMENT YEARS 1 AND 2 ACHIEVEMENT 
SCORES AND IMPROVEMENT SCORES ON THE HOME DIALYSIS RATE AND TRANSPLANT 
RATE'' is corrected to read ``TABLE 17: PROPOSED SCORING METHODOLOGY 
FOR ASSESSMENT OF MEASUREMENT YEARS 1 AND 2 ACHIEVEMENT SCORES AND 
IMPROVEMENT SCORES ON THE HOME DIALYSIS RATE AND TRANSPLANT RATE''.
    8. On page 61327, the table title, ``TABLE 14: PROPOSED FACILITY 
PERFORMANCE PAYMENT ADJUSTMENT AMOUNTS AND SCHEDULE'' is corrected to 
read ``TABLE 18: PROPOSED FACILITY PERFORMANCE PAYMENT ADJUSTMENT 
AMOUNTS AND SCHEDULE''.
    9. On page 61328--
    a. Top of the page, first column, first full paragraph, line 8, the 
phrase ``Table 14.a'' should read ``Table 18.a''.
    b. Middle of the page, the table title ``TABLE 14a: FACILITY 
PERFORMANCE PAYMENT ADJUSTMENT AMOUNTS AND SCHEDULE'' is corrected to 
read ``TABLE 18.a: FACILITY PERFORMANCE PAYMENT ADJUSTMENT AMOUNTS AND 
SCHEDULE''.
    c. In the third column, first full paragraph, line 1, the table 
reference, ``Table 15'' is corrected to read ``Table 19''.
    10. On page 61329--
    a. Top of the page, the table title, ``TABLE 15: PROPOSED CLINICIAN 
PERFORMANCE PAYMENT ADJUSTMENT AMOUNTS AND SCHEDULE'' is corrected to 
read ``TABLE 19: PROPOSED CLINICIAN PERFORMANCE PAYMENT ADJUSTMENT 
AMOUNTS AND SCHEDULE''
    b. Top half of page (after Table 15), second column, partial 
paragraph, line 5, the table reference ``Table 15.a'' is corrected to 
read ``Table 19.a''.
    c. Lower half of the page, the table title, ``TABLE 15a: CLINICIAN 
PERFORMANCE PAYMENT ADJUSTMENT AMOUNTS AND SCHEDULE'' is corrected to 
read ``TABLE 19.a: CLINICIAN PERFORMANCE PAYMENT ADJUSTMENT AMOUNTS AND 
SCHEDULE''.
    11. On page 61349, first column, first full paragraph, last line, 
the table reference ``Table 2'' is corrected to read ``Table 21''.
    12. On page 61350--
    a. First column, last full paragraph, line 1, the table reference 
``Table 1'' is corrected to read ``Table 20''.
    b. Second column; first paragraph, line 35, the table reference 
``Table 1'' is corrected to read ``Table 20''.
    13. On page 61351, top of the page, the table title, ``TABLE 1. 
ESTIMATES OF MEDICARE PROGRAM SAVINGS (MILLIONS $) FOR RADIATION 
ONCOLOGY MODEL (Starting January 1, 2021)'' is corrected to read 
``TABLE 20: ESTIMATES OF MEDICARE PROGRAM SAVINGS (MILLIONS $) FOR 
RADIATION ONCOLOGY MODEL (Starting January 1, 2021)''
    14. On page 61353, first column, first paragraph--,
    a. Line 1, the table reference ``Table 2'' is corrected to read 
``Table 21''.
    b. Line 16, the table reference ``Table 2'' is corrected to read 
``Table 21''.
    15. On page 61354--
    a. Top of the page, the table title, ``TABLE 2. ESTIMATES OF 
MEDICARE PROGRAM SAVINGS (ROUNDED $M) FOR ESRD TREATMENT CHOICES 
MODEL'' is corrected to read ``TABLE 21: ESTIMATES OF MEDICARE PROGRAM 
SAVINGS (ROUNDED $M) FOR ESRD TREATMENT CHOICES MODEL''.
    b. Lower half of the page, first column, last paragraph, line 4, 
the table reference ``Table 2'' is corrected to read ``Table 21''.
    16. On page 61355, first column, first full paragraph--
    a. Line 9, the table reference, ``Table 2'' is corrected to read 
``Table 21''.
    b. Line 21, the table reference, ``Table 2'' is corrected to read 
``Table 21''.
    17. On page 61357, third column--
    a. Last paragraph, line 19, the figure ``$19.40'' is corrected to 
read ``$20.50''
    b. Last paragraph, line 21, the figure ``$38.80'' is corrected to 
read ``$41.00''
    c. Last footnote (footnote 175), line 2, the figure ``$19.40'' is 
corrected to read ``$20.50''.
    18. On page 61358--
    a. First column, in the first partial paragraph,
    (1) Line 2, the figure ``$183.14'' should be replaced with 
``$193.52''
    (2) Line 4, the figure ``$173,983'' should be replaced with 
``$183,844.00'',
    (3) Line 5, the figure ``$183.14'' should be replaced with 
``$193.52''
    (4) Line 6, the figure ``$173,983'' should be replaced with 
``$183,844.00''.
    b. First column, fourth full paragraph--
    (1) Line 12, the figure ``$1,743.07'' is corrected to read 
``$1,845.00''.
    (2) Line 18, the figure ``$1,655,916.50'' is corrected to read 
``$1,752,750.00''.
    c. Second column, first full paragraph--
    (1) Line 11, the figure ``$1,093.26'' is corrected to read 
``$1,106.94''.
    (2) Line 13, the figure ``$3,170,454.00'' is corrected to read 
``$3,210,126.00''.
    (3) Line 14, the phrase ``$1,093.269/participant'' is corrected to 
read ``$1,106.94/participant''.
    (4) Line 20, the figure ``$3,019.47'' is corrected to read 
``$3,145.46'' and ``$1,093.26'' is corrected to read $1,106.94''.
    (5) Line 21, the figure ``$183.14'' is corrected to read 
``$193.52''.
    (6) Line 23, the figure ``$1,743.07'' is corrected to read 
``$1,845.00''.
    (7) Line 25, the figure ``$2,868,496.50'' is corrected to read 
``$2,988,187.00''.
    (8) Line 27 the figure ``$2,131,350.00'' is corrected to read 
``$2,158,533.00''.
    (9) Line 30, the figure ``$4,999,846.50'' is corrected to read 
``$5,146,720.50''.
    19. On page 61359--
    a. First column, first full paragraph--
    (1) Line 4, the phrase ``reduced by 6.0'' is corrected to read 
``increased by 1.6''.
    (2) Line 6 the phrase ``reduced by 4.7'' is corrected to read 
``reduced by 8.7''.
    (3) Line 22, the figure ``$1,743.06'' is corrected to read 
``$1,845.00''.
    (3) Line 23 to 26, the sentence ``We assume that our estimate for 
the

[[Page 77406]]

submission of quality measures remains an accurate estimate at $310.40 
per year.'' is corrected to read, ``We revise our estimate for the 
submission of quality measures to an estimated $328.00 per year.''
    (5) Line 28, ``$1,432.67'' is corrected to read ``$1,517.00'', and 
``$38.80'' is corrected to read ``$41.00''.
    c. Second column--
    (1) First full paragraph--
    (a) Line 6, the figure ``$1,093.26'' is corrected to read 
``$1,106.94''.
    (b) Line 8, the figure ``$183.14'' is corrected to read 
``$193.52''.
    (c) Line 16, the figure ``$95.90'' is corrected to read ``$97.10''.
    (d) Line 28, the parenthetical expression (``$1,093.26 = ($95.20 * 
11.4))'' is corrected to read ``($1,106.94 = ($95.20 * 11.4))''.
    (e) Line 31, the figure ``$183.14'' is corrected to read 
``$193.52''.
    (2) Last footnoted paragraph (footnote 181), line 2, the figure 
``$47.95'' is corrected to read ``$48.55''.
    20. On page 61361, third column, last paragraph, line 4, the phrase 
``Tables E3 and E4'' is corrected to read ``Tables 22 and 23''.
    21. On page 61362, top of the page--
    a. The table title, ``TABLE 3: ACCOUNTING STATEMENT ESTIMATED 
IMPACTS FOR THE RADIATION ONCOLOGY MODEL'' is corrected to read ``TABLE 
22: ACCOUNTING STATEMENT ESTIMATED IMPACTS FOR THE RADIATION ONCOLOGY 
MODEL''.
    b. The table title, ``TABLE 4: ACCOUNTING STATEMENT ESTIMATED 
IMPACTS FOR END STAGE RENAL DISEASE (ESRD) TREATMENT CHOICES MODEL'' is 
corrected to read ``TABLE 23: ACCOUNTING STATEMENT ESTIMATED IMPACTS 
FOR END STAGE RENAL DISEASE (ESRD) TREATMENT CHOICES MODEL''

Wilma M. Robinson,
Deputy Executive Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2020-26512 Filed 11-30-20; 11:15 am]
BILLING CODE 4120-01-P