[Federal Register Volume 87, Number 213 (Friday, November 4, 2022)]
[Rules and Regulations]
[Pages 66558-66575]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-24077]



[[Page 66558]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 413, 482, 485, and 495

[CMS-1771-F2]
RIN 0938-AU84


Medicare Program; Hospital Inpatient Prospective Payment Systems 
for Acute Care Hospitals and the Long-Term Care Hospital Prospective 
Payment System and Policy Changes and Fiscal Year 2023 Rates; Quality 
Programs and Medicare Promoting Interoperability Program Requirements 
for Eligible Hospitals and Critical Access Hospitals; Costs Incurred 
for Qualified and Non-Qualified Deferred Compensation Plans; and 
Changes to Hospital and Critical Access Hospital Conditions of 
Participation; Corrections

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (HHS).

ACTION: Final rule; correction and correcting amendment.

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SUMMARY: This document corrects technical and typographical errors in 
the final rule that appeared in the August 10, 2022 Federal Register. 
The final rule was titled ``Medicare Program; Hospital Inpatient 
Prospective Payment Systems for Acute Care Hospitals and the Long Term 
Care Hospital Prospective Payment System and Policy Changes and Fiscal 
Year 2023 Rates; Quality Programs and Medicare Promoting 
Interoperability Program Requirements for Eligible Hospitals and 
Critical Access Hospitals; Costs Incurred for Qualified and Non-
qualified Deferred Compensation Plans; and Changes to Hospital and 
Critical Access Hospital Conditions of Participation''.

DATES: 
    Effective date: The final rule corrections and correcting amendment 
are effective on November 3, 2022.
    Applicability date: The final rule corrections and correcting 
amendment are applicable for discharges occurring on or after October 
1, 2022.

FOR FURTHER INFORMATION CONTACT: 
    Donald Thompson, and Michele Hudson, (410) 786-4487 or 
[email protected], Operating Prospective Payment.
    Adina Hersko, [email protected] and [email protected], New 
Technology Add-on Payments Issues.
    Dawn Linn, [email protected], Lela Strong, 
[email protected], and Alpha Wilson, [email protected], 
Conditions of Participation (CoP) Requirements for Hospitals and 
Critical Access Hospitals (CAHs) to Continue Reporting Data for COVID-
19 and Influenza After the PHE ends as Determined by the Secretary.
    Julia Venanzi, [email protected], Hospital Inpatient 
Quality Reporting Program and Hospital Value-Based Purchasing Program--
Administration Issues
    Ariel Cress, [email protected], Long-Term Care Hospital 
Quality Reporting Program--Data Reporting Issues.
    Jessica Warren, [email protected], Medicare Promoting 
Interoperability Program.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2022-48780 of August 10, 2022 (87 FR 48780), there were 
a number of technical and typographical errors that are identified and 
corrected in this final rule correction and correcting amendment. The 
final rule corrections and correcting amendment are applicable to 
discharges occurring on or after October 1, 2022, as if they had been 
included in the document that appeared in the August 10, 2022 Federal 
Register.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On pages 48781, 48785, and 49313, we made typographical and 
technical errors in specifying certain fiscal years.
    On pages 49195, 49197, 49207, 49217, 49223, 49229, 49263, 49267, 
and 49311, we made typographical errors in referencing a statutory 
citation.
    On page 48789, in the table of the summary of costs and benefits of 
certain major provisions, we are making conforming corrections to the 
estimates discussed in the ``Update to the IPPS Payment Rates and Other 
Payment Policies'' row resulting from the correction to the maximum new 
technology add-on payment for cases involving the use of 
DefencathTM discussed later in this section of this final 
rule correction and correcting amendment.
    On page 48790, in the table of the summary of costs and benefits of 
certain major provisions, we are making corrections to the description 
of the estimates discussed for the Hospital-Acquired Condition Program.
    On pages 48790, 49308, 49327, 49335, 49377, and 49398, we made 
technical and typographical errors in Federal Register citations and 
cross-references.
    On pages 48981 through 48982, in our discussion of new medical 
services and technologies, we are correcting the cost per case and 
maximum new technology add-on payment for a case involving the use of 
DefencathTM.
    On page 49071, we made typographical errors and an omission in our 
discussion of revisions to Worksheet E-4 of the hospital cost report 
instructions.
    On page 49087, we made and are correcting a typographical error in 
our discussion of the Hospital Readmission Reduction Program.
    On pages 49095, 49106, 49129, 49248, 49266, 49283, and 49295, we 
made and are correcting typographical errors in several footnotes and 
footnote references.
    On pages 49201, 49230, 49232, 49233, 49297, and 49308, in the 
discussion of the Hospital Inpatient Quality Reporting (IQR) Program, 
we are correcting inadvertent omissions as well as typographical and 
technical errors.
    On pages 49315, 49317, and 49318, in the discussion of the Long-
term Care Hospital Quality Reporting Program (LTCH QRP) we are 
correcting several technical and typographical errors.
    On pages 49347 and 49362, in the discussion of the Medicare 
Promoting Interoperability Program, we made and are correcting 
typographical and technical errors.

B. Summary of Errors in the Regulations Text

    On page 49410, we inadvertently made a typographical error in the 
paragraph numbering for a paragraph in Sec.  482.42(f)(2).

C. Summary of Errors in the Addendum

    As discussed further in section II.D. of this final rule correction 
and correcting amendment, we made updates to the calculation of Factor 
3 of the uncompensated care payment methodology to reflect updated 
information on hospital mergers received in response to the final rule 
and made corrections for report upload errors and an update to the DSH 
eligibility for one provider that was inadvertently projected not DSH 
eligible in the final rule. Based on the March 2022 Provider Specific 
File's Medicaid fraction and the FY 2020 SSI fractions, this provider 
is projected DSH eligible for purposes of interim uncompensated care 
payments during FY 2023. Specifically, there were two merger updates, 
one update on a report upload

[[Page 66559]]

discrepancy, and one update on DSH eligibility projection. We 
recalculated the total uncompensated care amount for all DSH-eligible 
hospitals to reflect these updates. In addition, because the Factor 3 
for each hospital reflects that hospital's uncompensated care amount 
relative to the uncompensated care amount for all DSH hospitals, we 
also recalculated Factor 3 for all DSH-eligible hospitals. The 
hospital-specific Factor 3 determines the total amount of the 
uncompensated care payment a hospital is eligible to receive for a 
fiscal year. This hospital-specific payment amount is then used to 
calculate the amount of the interim uncompensated care payments a 
hospital receives per discharge. Given the small number of updates to 
the information used in the calculation of Factor 3, the change to the 
previously calculated Factor 3 for the majority of hospitals is of 
limited magnitude.
    We note that the fixed-loss cost threshold was unchanged after 
these Factor 3 recalculations. (As discussed elsewhere, however, we 
incorporated the revised uncompensated care payment amounts into our 
recalculation of the FY 2023 fixed-loss threshold and related figures 
to reflect the use of supplemental outlier reconciliation data.) We 
further note that while for certain prior years, we have also 
recalculated the budget neutrality factors to reflect revisions to the 
calculation of Factor 3, in combination with the correction of other 
errors, given the limited magnitude of the changes to uncompensated 
care payments, and because we are not making corrections to any other 
components of the calculation of these budget neutrality factors for FY 
2023, we did not recalculate any budget neutrality factors due to the 
changes to Factor 3.
    On pages 49420 through 49421 and 49427 through 49428, we are 
revising the calculation of the percentage of operating outlier 
reconciliation dollars to total Federal operating payments based on the 
FY 2017 cost reports, which is used in our projection of operating 
outlier reconciliation payments for the FY 2023 outlier threshold 
calculation, to reflect the use of supplemental outlier reconciliation 
data, as discussed in the FY 2023 IPPS/LTCH PPS final rule, including 
additional supplemental data from some hospitals that had an outlier 
reconciliation amount recorded on Worksheet E, Part A, Line 2.01. In 
addition to revising the percentage of operating outlier reconciliation 
dollars to total Federal operating payments, we are also revising the 
percentage of capital outlier payments to total capital Federal 
payments for FY 2017 to reflect these additional supplemental data for 
hospitals that had an outlier reconciliation amount recorded on 
Worksheet E, Part A, Line 93, Column 1. Accordingly, under our 
established methodology, this correction to the percentage of operating 
outlier reconciliation dollars to total Federal operating payments 
results in a change in the targeted operating outlier percentage and 
the FY 2023 outlier threshold. In addition, under our established 
methodology, the correction to the percentage of capital outlier 
payments to total capital Federal payments and the change in the FY 
2023 outlier threshold results in a change in the estimated capital 
outlier percentage. We note that these recalculations also reflect the 
revisions to Factor 3 of the uncompensated care payment methodology 
described previously.
    On pages 49433 through 49437, in our discussion of the 
determination of the Federal hospital inpatient capital related 
prospective payment rate update, due to the correction of the 
combination of errors listed previously (the revisions to Factor 3 of 
the uncompensated care payment methodology, and, in particular, the 
corrections to the outlier reconciliation projections and outlier 
threshold), we have made conforming corrections to the capital outlier 
adjustment, capital Federal rate and related figures. On page 49453, we 
are also making conforming corrections to the capital standard Federal 
payment rate in Table 1D.
    On page 49438, we made a typographical error in referencing a 
statutory citation.
    In addition, on page 49450, we are making conforming changes to the 
fixed-loss amount for FY 2023 site neutral payment rate discharges, and 
the high cost outlier threshold (based on the corrections to the IPPS 
outlier threshold (that is, fixed-loss amount) discussed previously).

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

    We are correcting the errors in the following IPPS table that is 
listed on page 49453 of the FY 2023 IPPS/LTCH PPS final rule and is 
available on the internet on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/AcuteInpatientPPS/index.html. 
The tables that are available on the internet have been updated to 
reflect the revisions discussed in this final rule correction and 
correcting amendment.
    Table 18--FY 2023 Medicare DSH Uncompensated Care Payment Factor 3. 
For the FY 2023 IPPS/LTCH PPS final rule, we published a list of 
hospitals that we identified to be subsection (d) hospitals and 
subsection (d) Puerto Rico hospitals projected to be eligible to 
receive interim uncompensated care payments for FY 2023. As stated in 
the FY 2023 IPPS/LTCH PPS final rule (87 FR 49046) we allowed the 
public an additional period after the issuance of the final rule to 
review and submit via email any updated information on mergers and/or 
to report upload discrepancies. We are updating this table to reflect 
the information on mergers, upload discrepancy, and DSH eligibility 
received in response to the final rule and to revise the Factor 3 
calculations for purposes of determining uncompensated care payments 
for the FY 2023 IPPS/LTCH PPS final rule. We are revising Factor 3 for 
all hospitals to reflect the updated merger information, upload 
discrepancy information, and DSH eligibility information received in 
response to the final rule. We are also revising the amount of the 
total uncompensated care payment calculated for each DSH eligible 
hospital. The total uncompensated care payment that a hospital receives 
is used to calculate the amount of the interim uncompensated care 
payments the hospital receives per discharge. As previously discussed, 
given the limited magnitude of these uncompensated care payment 
corrections, and because we are not making corrections to any other 
components of the calculation of the budget neutrality factors for FY 
2023, we do not believe the revisions to the uncompensated care payment 
amounts merit recalculating all budget neutrality factors. However, the 
revised uncompensated care payment amounts were incorporated into our 
recalculation of the outlier fixed-loss cost threshold and related 
figures to reflect the corrections to the outlier reconciliation 
projections used in the FY 2023 outlier threshold calculation, as 
described previously.

E. Summary of Errors in the Appendices

    On pages 49457, 49494, and 49495 we are making conforming 
corrections to the estimated overall impact, estimated overall change 
in new technology add-on payments, and the accounting statement and 
table for acute care hospitals under the IPPS, resulting from the 
correction to the maximum new technology add-on payment for cases 
involving the use of DefencathTM discussed in section II.A. 
of this final rule correction and correcting amendment.

[[Page 66560]]

    On pages 49461 through 49463, 49467 through 49468, and 49482 
through 49485 in our regulatory impact analyses, we have made 
conforming corrections to certain factors, values, tables and 
accompanying discussion of the changes in operating and capital IPPS 
payments for FY 2023 as a result of the technical errors that lead to 
changes in our calculation of the outlier threshold and capital Federal 
rate (as discussed in section II.B. of this final rule correction and 
correcting amendment). These conforming corrections include changes to 
the following:
     On pages 49461 through 49463, the table titled ``Table I--
Impact Analysis of Changes to the IPPS for Operating Costs for FY 
2023''.
     On pages 49467 through 49468, the table titled ``Table 
II--Impact Analysis of Changes for FY 2023 Acute Care Hospital 
Operating Prospective Payment System (Payments per discharge)''.
     On pages 49484 and 49485, the table titled ``TABLE III.--
COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2022 PAYMENTS COMPARED TO FY 
2023 PAYMENTS]''.
    On pages 49469 through 49470, we are correcting values in tables 
and estimated total payment values in accompanying discussion resulting 
from the correction to the maximum new technology add-on payment for 
cases involving the use of DefencathTM.
    On page 49470, under the table displaying the FY 2023 Estimates for 
New Technology Add-On Payments for FY 2023, we are correcting the 
inadvertent omission of the heading for the next section.
    On pages 49471 through 49474 we are correcting the discussion of 
the ``2. Effects of Changes to Medicare DSH and Uncompensated Care 
Payments for FY 2023 and the New Supplemental Payment for Indian Health 
Service Hospitals and Tribal Hospitals and Hospitals Located in Puerto 
Rico'' for purposes of the Regulatory Impact Analysis in Appendix A of 
the FY 2023 IPPS/LTCH PPS final rule, including the table titled 
``Modeled Uncompensated Care Payments* and Supplemental Payments for 
Estimated FY 2023 DSHs by Hospital Type*'' on pages 49472 and 49473, in 
light of the corrections discussed in section II.D. of this final rule 
correction and correcting amendment.

III. 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 rulemaking 
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 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, 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 
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 rule 
that would be subject to the notice and comment or delayed effective 
date requirements. This document corrects technical and typographical 
errors in the preamble, regulations text, addendum, payment rates, 
tables, and appendices included or referenced in the FY 2023 IPPS/LTCH 
PPS final rule, but does not make substantive changes to the policies 
or payment methodologies that were adopted in the final rule. As a 
result, this correcting document is intended to ensure that the 
information in the FY 2023 IPPS/LTCH PPS final rule accurately reflects 
the policies adopted in that document.
    In addition, even if this were a rule to which the notice and 
comment procedures and delayed effective date requirements applied, we 
find that there is good cause to waive such requirements. Undertaking 
further notice and comment procedures to incorporate the corrections in 
this document into the final rule or delaying the effective date would 
be contrary to the public interest because it is in the public's 
interest for providers to receive appropriate payments in as timely a 
manner as possible, and to ensure that the FY 2023 IPPS/LTCH PPS final 
rule accurately reflects our policies. Furthermore, such procedures 
would be unnecessary, as we are not altering our payment methodologies 
or policies, but rather, we are simply implementing correctly the 
methodologies and policies that we previously proposed, requested 
comment on, and subsequently finalized. This correcting document is 
intended solely to ensure that the FY 2023 IPPS/LTCH PPS final rule 
accurately reflects these payment methodologies and policies. 
Therefore, we believe we have good cause to waive the notice and 
comment and effective date requirements. Moreover, even if these 
corrections were considered to be retroactive rulemaking, they would be 
authorized under section 1871(e)(1)(A)(ii) of the Act, which permits 
the Secretary to issue a rule for the Medicare program with retroactive 
effect if the failure to do so would be contrary to the public 
interest. As we have explained previously, we believe it would be 
contrary to the public interest not to implement the corrections in 
this final rule correction for discharges occurring on or after October 
1, 2022, because it is in the public's interest for providers to 
receive appropriate payments in as timely a manner as possible, and to 
ensure that the FY 2023 IPPS/LTCH PPS final rule accurately reflects 
our policies.

IV. Correction of Errors

    In FR Doc. 2022-16472 of August 10, 2022 (87 FR 48780), we are 
making the following corrections:

A. Correction of Errors in the Preamble

    1. On page 48781, first column,
    a. Lines 23 and 24, the phrase ``S-3 Wage Data for the FY 2022 Wage 
Index'' is corrected to read ``S-3 Wage Data for the FY 2023 Wage 
Index''.
    b. Lines 27 and 28, the phrase, ``Computing the FY 2022 Unadjusted 
Wage Index'' is corrected to read ``Computing the FY 2023 Unadjusted 
Wage Index''.
    c. Line 74, the phrase '' Updates for FY 2022 (Sec.  412.64(d))'' 
is corrected to read ``Updates for FY 2023 (Sec.  412.64(d))''.
    2. On page 48785, second column, third paragraph, the phrase ``FY 
2024'' is corrected to read ``FY 2023''.
    3. On page 48789, in the untitled table, second column (Description 
of Costs, Transfers, Savings, and Benefits), third row (Update to the 
IPPS Payment Rates and Other Payment Policies),
    a. Line 2, the figure ``$1.4 billion'' is corrected to read ``$1.5 
billion''.
    b. Line 4, the figure ``$1.0 billion'' is corrected to read ``$0.9 
billion''.
    4. On page 48790, in the untitled table,

[[Page 66561]]

    a. Second column (Description of Costs, Transfers, Savings, and 
Benefits),
    (1) First row, lines 3 and 4, the phrase, ``specific HSRs and a 30-
day preview period for the NHSN CDC HAI measures.'' is corrected to 
read ``specific HSRs and a 30-day preview period.''.
    (2) Last row, line 1, the reference, ``section XII.B.10.'' is 
corrected to read ``section XII.B.11.''
    b. Following the table (Table Note 1), the sentence beginning with 
the phrase ``\1\For the purpose'' and ending with the phrase ``and 
CABG).'' is corrected by removing the sentence.
    5. On page 48981,
    a. First column, fourth full paragraph, lines 14 and 15, the phrase 
``$5,850 to the hospital, per patient'' is corrected to read ``$1,950 
per 5mL vial. ``
    b. Third column, last partial paragraph, lines 2 and 3, the 
language ``the cost per case of the DefenCathTM is $5,850'' 
is corrected to read ``the cost of DefenCathTM is $1,950 per 
vial. Per the applicant, the average utilization of 
DefenCathTM is 9.75 vials per patient, resulting in an 
average cost per case of $19,012.50.''
    6. On page 48982, first column, first partial paragraph, line 5, 
the figure ``$4,387.50'' is corrected to read ``$14,259.38''.
    7. On page 49071,
    a. Second column, last partial paragraph,
    (1) Line 15, the phrase ``line 9 minus line 8'' is corrected to 
read ``line 8 minus line 9''.
    (2) Lines 18 and 19, the phrase ``line 9 minus line 8'' is 
corrected to read ``line 8 minus line 9''.
    (3) Lines 19 and 20, the phrase ``line 9 minus line 8'' is 
corrected to read ``line 8 minus line 9''.
    b. Third column, first partial paragraph, lines 1 and 2, the phrase 
``minus line 8 on line 20,' but we believe they meant to say `on line 
22').'' is corrected to read ``minus line 8' but we believe they meant 
to state `line 8 minus line 9.' We also note that the commenters 
indicated to enter the result `on line 20,' but we believe they meant 
to state `on line 22').''.
    8. On page 49087, second column, third full paragraph, line 13, the 
phrase ``COVID-10 specific ICD-10'' is corrected to read ``COVID-19 
specific ICD-10''.
    9. On page 49095, first column, third footnote paragraph (footnote 
232), the parenthetical web address, ``(statnews.com)'' is corrected to 
read ``https://www.statnews.com/2021/09/20/covid-19-set-to-overtake-1918-spanish-flu-as-deadliest-disease-in-american-history/''.
    10. On page 49106,
    a. First column, first paragraph (footnote 275), lines 3 through 5, 
the phrase, ``Fleisher et al. (2022). New England Journal of Medicine. 
Article available here:'' is corrected to read ``Fleisher et al. 
(2022). Health Care Safety During the Pandemic and Beyond--Building a 
System That Ensures Resilience. New England Journal of Medicine. 
Available at:''
    b. Second column--
    (1) Sixth footnote paragraph (footnote 283), lines 4 through 10, 
the hyperlink, https://www.fda.gov/news-events/press-announcements/
coronavirus-covid-19-update-fda-authorizes-additional-oral-antiviral-
treatment-covid-19-
certain#:~:text=Today%2C%20the%20U.S.%20Food%20and,progression%20to%20se
vere%20COVID%2D19%2C is corrected to read: https://www.fda.gov/news-
events/press-announcements/coronavirus-covid-19-update-fda-authorizes-
additional-oral-antiviral-treatment-covid-19-certain
    (2) Eighth footnote paragraph (footnote 285), lines 3 through 7, 
the hyperlink, ``https://www.washingtonpost.com/politics/biden-to-give-away-400-million-n95-masks-starting-next-week/2022/01/19/5095c050-
;7915-11ec-9dce-7313579de434_story.html'' is corrected to read 
``https://www.washingtonpost.com/kidspost/2022/01/19/biden-give-away-400-million-n95-masks/''.
    11. On page 49129, first column, footnote paragraph (Footnote 314), 
line 5 and 6, the hyperlink ``https://oig.hhs.govAd/oei/reports/OEI-06-18-00400.asp'' is corrected to read https://oig.hhs.gov/oei/reports/OEI-06-18-00400.asp.
    12. On page 49195, third column, first full paragraph, lines 3 and 
4, the reference ``section 1866'' is corrected to read ``section 
1886''.
    13. On page 49197, second column, third full paragraph, lines 11 
and 12, the reference ``section 1866'' is corrected to read ``section 
1886''.
    14. On page 49201, first column, second full paragraph, lines 11 
through 17, the sentence ``First, because social risk factors 
disproportionately impact historically \481\'' is corrected to read 
``First, because social risk factors disproportionately impact 
underserved communities, promoting screening for these factors could 
serve as evidence-based building blocks for supporting hospitals and 
health systems in actualizing commitment to address disparities, 
improve health equity through addressing the social needs with 
community partners, and implement associated equity measures to track 
progress.''.
    15. On page 49207, first column, second full paragraph, lines 3 and 
4, the reference ``section 1866'' is corrected to read ``section 
1886''.
    16. On page 49217, first column, second full paragraph, line 3, the 
reference ``section 1866'' is corrected to read ``section 1886''.
    17. On page 49223, second column, first full paragraph, lines 7 and 
8, the reference ``section 1866'' is corrected to read ``section 
1886''.
    18. On page 49229, first column, first full paragraph, lines 4 and 
5, the reference ``section 1866'' is corrected to read ``section 
1886''.
    19. On page 49230, top third of the page, second column, second 
full paragraph, lines 2 through 6, the sentence ``The measure is 
designed to be calculated by the hospitals' CEHRT using the patient-
level data and then submitted by hospitals to CMS.'' is corrected to 
read ``Patient-level data is to be submitted to CMS where risk-
adjustment and measure calculation will occur.''.
    20. On page 49232, lower two-thirds of the page, first column, last 
full paragraph, lines 5 and 6, the phrase ``an additional hospital 
unaffiliated with the first 25'' is corrected to read '' an additional 
5 hospitals unaffiliated with the first 25''.
    21. On page 49233, third column, first full paragraph, lines 1 
through 5, the sentence ``We reiterate that this is an eCQM in which 
the data is collected through hospitals' EHR and designed to be 
calculated by the hospital's CEHRT (87 FR 28513).'' is corrected to 
read ``We reiterate that this is an eCQM in which the data is collected 
through hospitals' EHR (87 FR 28514). The measure is designed for 
patient-level data to be submitted to CMS where risk-adjustment and 
measure calculation will occur.''.
    22. On page 49248, first column, 10th footnote paragraph (Footnote 
919), lines 1 and 2, the phrase, ``Ma kela K.T., Peltola M., Sund R, 
Malmivaara A., Ha kkinen U., Remes V.'' is corrected to read 
``M[auml]kel[auml] K.T., Peltola M., Sund R., Malmivaara A., 
H[auml]kkinen U., Remes V.''.
    23. On page 49263, third column, second full paragraph, lines 5 and 
6, the reference ``section 1866'' is corrected to read ``section 
1886''.
    24. On page 49266, third column, before the first footnote 
paragraph (Footnote 981), the footnote paragraphs are corrected by 
adding a footnote (Footnote 980) to read as follows:
    ``National Quality Forum. Surgery Fall Cycle 2020. Measure Testing 
(subcriteria 2a2, 2b1-2b6) Document. November 3, 2020. Available at: 
https://

[[Page 66562]]

nqfappservicesstorage.blob.core.windows.net/proddocs/22/Fall/2020/
measures/1550/shared/1550.zip.''.
    25. On page 49267, third column, second full paragraph, lines 4 and 
5, the reference ``section 1866'' is corrected to read ``section 
1886''.
    26. On page 49283, first column, sixth footnote paragraph (footnote 
1021), lines 6 and 7, the hyperlink ``https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787181'' is corrected to read ``https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787184''.
    27. On page 49295, second column, first partial footnote paragraph 
(footnote 1074), lines 1 through 4, the hyperlink ``Accessed on 
Available at: https://arpsp.cdc.gov/profile/infections/clabsi?year-select-report=year2019&year-select-hai-state-list=year2019'' is 
corrected to read ``Accessed July 27, 2021. Available at: https://arpsp.cdc.gov/profile/nhsn/clabsi.''
    28. On page 49297, second column, first full paragraph, lines 17 
and 18, the phrase ``increase the risk of developing CDIs. '' is 
corrected to read ``increase the risk of contracting HAIs.''.
    29. On page 49308, second column, last partial paragraph, line 18, 
the citation (85 FR 58952 through 58944)'' is corrected read ``(85 FR 
58942 through 58953)''.
    30. On page 49311, first column, first full paragraph, line 3, the 
reference ``section 1866'' is corrected to read ``section 1886''.
    31. On page 49312, first column, last partial paragraph, line 1, 
the reference ``section 1866'' is corrected to read ``section 1886''.
    32. On page 49313, third column, third full paragraph, line 7, the 
phrase ``FY 2021 confidential'' is corrected to read ``FY 2022 
confidential''.
    33. On page 49315, middle of the page, in the table titled ``Table 
IX.G.-01. Quality Measures Currently Adopted for the FY 2023 LTCH 
QRP'', the entries in rows 3 and 4 are corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR04NO22.082

    34. On page 49317, first column, fifth paragraph, lines 10 and 11, 
the phrase, ``This commenter also suggested CMS to work with CMS to 
determine'' is corrected to read ``This commenter also suggested CMS 
determine''.
    35. On page 49318--
    a. Second column, third full paragraph, line 1, the phrase, ``A 
number of commenters provider'' is corrected to read ``A number of 
commenters provided''.
    b. Third column, first full paragraph, lines 36 through 40, the 
sentence, ``We also received one comment recommending CMS use a 
combination of peer group benchmarking and statistical significance. '' 
is corrected read ``A commenter also suggested additional guiding 
principles.''
    36. On page 49327, third column, first partial paragraph, line 3, 
the reference ``[TABLE XX]'' is corrected to read ``Table IX.H.-07''.
    37. On page 49335, third column, second full paragraph, line 14, 
the citation ``(87 FR 28586 through 28587)'' is corrected to read ``(87 
FR 28585 through 28587)''.
    38. On page 49347, third column, first partial paragraph, line 15, 
the phrase, ``We finalized our proposal'' should read ``We are 
finalizing our proposal''.
    39. On page 49362, second column, first partial paragraph, lines 11 
through 15, the sentence ``Testing established the feasibility of the 
measure, first in 25 hospitals across eight healthcare sites and then 
in additional hospital unaffiliated with the first 25.'' is corrected 
to read ``The measure developer's testing established the feasibility 
of the measure, first in 25 hospitals across 8 healthcare sites and 
then in an additional 5 hospitals unaffiliated with the first 25, and 
across several different electronic health record systems.''.
    40. On page 49377, third column, first partial paragraph, lines 31 
and 32, the reference ``sections XII.B.10. and XII.H.11, '' is 
corrected to read ``sections XII.B.11. of the preamble and I.H.11. of 
the Appendix,''.
    41. On page 49398, second column, first full paragraph, lines 1 and 
2, the reference, ``section XX.B.2.'' is corrected to read ``section 
X.B.2.''.

B. Corrections to the Addendum

    1. On page 49420, first column, second full paragraph,
    a. Line 24, the phrase ``2 additional'' is corrected to ``8 
additional''.
    b. Line 32, the phrase ``2 hospitals' '' is corrected to ``8 
hospitals' '' .
    c. Line 40, the phrase ``2 additional'' is corrected to ``8 
additional''.
    d. Lines 42 and 43, the phrase ``2 hospitals, a total of 17 
hospitals'' is corrected to read as follows ``8 hospitals, a total of 
23 hospitals''.
    e. Line 47, the phrase ``negative $17,153,313 (Step 2)'' is 
corrected to read as follows ``negative $25,475,549 (Step 2)''.
    f. Line 50, the phrase, ``2 hospitals is $88,414,357,653 (Step 3)'' 
is corrected to read as follows ``8 hospitals is $88,407,788,794 (Step 
3)''.
    g. Lines 51 and 52, the phrase ``negative 0.019401 percent'' is 
corrected to read ``negative 0.028816 percent''.
    h. Line 53, the phrase ``negative 0.02 percent'' is corrected to 
read ``negative 0.03 percent''.
    i. Lines 57 and 58, ``5.12 percent [5.1 percent-(- 0.02 percent)]'' 
is corrected to read ``5.13 percent [5.1 percent-(- 0.03 percent)]''.
    2. On page 49421,
    a. Second column,
    (1) First partial paragraph, lines 4 and 5, the phrase 
``supplemented for 2 hospitals for a total of 14 hospitals,'' is 
corrected to read ``supplemented for 8 hospitals for a total of 20 
hospitals,''.
    (2) First full paragraph,
    (a) Lines 2 and 3, the phrase ``2 hospitals, 14 hospitals'' is 
corrected to read ``8 hospitals, 20 hospitals''.
    (b) Line 6, the figure ``$1,101,225'' is corrected to read 
``$2,556,541''.

[[Page 66563]]

    (c) Line 9, the figure ``$7,995,731,783'' is corrected to read 
``$7,994,424,546''.
    (d) Line 10, the figure, ``0.013773'' is corrected to read 
``0.031979''.
    (e) Line 11, the figure, ``0.01'' is corrected to read ``0.03''.
    (f) Line 17, the figure ``0.01'' is corrected to read ``0.03''.
    (g) Line 20, the figure ``0.01'' is corrected to read ``0.03''.
    b. Third column, last full paragraph,
    (1) Line 2, the figure ``5.66 percent'' is corrected to read ``5.67 
percent''.
    (2) Line 4, the phrase ``$406,733,862 divided by $7,190,928,057'' 
is corrected to read ``$407,648,341 divided by ``$7,190,718,976''.
    (3) Line 6, the figure ``$406,733,862'' is corrected to read 
``$407,648,341''.
    (4) Line 7, the figure ``$6,784,194,195'' is corrected to read 
``$6,783,070,635''.
    (5) Line 11, the figure ``5.40 percent'' is corrected to read 
``5.41 percent''.
    (6) Line 12, the figure ``$346,066,050'' is corrected to read 
``$346,855,738''.
    (7) Line 13, the figure ``$6,412,816,596'' is corrected to read 
``$6,412,729,550''.
    (8) Line 14, the figure ``$346,066,050'' is corrected to read 
``$346,855,738''.
    (9) Line 16, the figure ``$6,066,750,547'' is corrected to read 
``$6,065,873,812''.
    (10) Line 20, the figure ``5.53 percent'' is corrected to read 
``5.54 percent''.
    (11) Line 26, the figure ``0.01 percent'' is corrected to read 
``0.03 percent''.
    (12) Line 30, the figure ``5.53 percent'' is corrected to read 
``5.54 percent''.
    (13) Lines 34 and 35, the equation ``5.52 percent (5.53 percent-
0.01 percent)'' is corrected to read 5.51 percent (5.54 percent-0.03 
percent)''.
    3. On page 49427, third column, second full paragraph, line 31, the 
figure ``5.12'' is corrected to ``5.13''.
    4. On page 49428,
    a. Top of the page,
    (1) First column,
    (a) First partial paragraph,
    (i) Lines 3 through 5, the phrase ``0.019401 percent, which when 
rounded to the second digit, is 0.02 percent'' is corrected to 
``0.028816 percent, which when rounded to the second digit, is 0.03 
percent''
    (ii) Lines 8 and 9, the mathematical expression ``5.12 percent [5.1 
percent-(0.02 percent)]'' is corrected to read ``5.13 percent [5.1 
percent-(-0.03 percent)]''.
    (b) Third full paragraph,
    (i) Line 4, the figure ``$39,389'' is corrected to read 
``$39,317''.
    (ii) Line 6, the figure ``$4,658,400,549'' is corrected to read 
``$4,667,954,052''.
    (iii) Line 7, the figure ``$86,325,462,972'' is corrected to read 
``$86,324,951,579''.
    (iv) Line 11, the figure ``5.12'' is corrected to read ``5.13''.
    (c) Second partial paragraph, line 2, the figure ``$38,328'' is 
corrected to read ``$38,259''.
    (2) Second column,
    (a) First partial paragraph,
    (i) Line 2, the figure ``$4,073,729,554'' is corrected to read 
``$4,081,975,259''
    (ii) Line 3, ``$75,488,568,943'' is corrected to 
``$75,488,113,785''
    (iii) Line 7, the figure ``5.12'' is corrected to read ``5.13''.
    (b) First full paragraph, last line, the mathematical expression 
``$38,859 (($39,389 + $38,328)/2)).'' is corrected to read ``$38,788 
(($39,317 + $38,259)/2)).''
    (3) Third column, first partial paragraph, lines 33 and 34, the 
figure ``5.52 percent'' is corrected to read ``5.51 percent''.
    b. Lower fourth of the page, in the untitled table, the figure 
``0.944837'' is corrected to read ``0.944910''.
    4. On page 49433, second column, first full paragraph, line 6, the 
figure ``2.36 percent'' is corrected to read ``2.37 percent''.
    5. On page 49435, first column,
    a. First partial paragraph, line 22, the figure ``5.53 percent'' is 
corrected to read ``5.54 percent''.
    b. First full paragraph,
    (1) Line 6, the figure ``0.01 percent'' is corrected to read ``0.03 
percent''.
    (2) Lines 8 through 12, the phrase ``estimated outlier payments for 
capital-related PPS payments would equal 5.52 percent (5.53 percent -
0.01 percent) of inpatient capital-related payments'' is corrected to 
read ``estimated outlier payments for capital-related PPS payments 
would equal 5.51 percent (5.54 percent-0.03 percent) of inpatient 
capital-related payments''.
    (3) Line 14, the figure ``0.9448'' is corrected to read ``0.9449''.
    c. Second full paragraph,
    (1) Lines 4 through 7, the sentence ``The FY 2023 outlier 
adjustment of 0.9448 is a -0.24 percent change from the FY 2022 outlier 
adjustment of 0.9471'' is corrected to read ``The FY 2023 outlier 
adjustment of 0.9449 is a -0.23 percent change from the FY 2022 outlier 
adjustment of 0.9471''.
    (2) Lines 9 and 10, the mathematical phrase ``0.9976 (0.9448/
0.9471)'' is corrected to read ``0.9977 (0.9449/0.9471)''.
    (3) Line 12, the figure ``-0.24'' is corrected to read ``-0.23''.
    6. On page 49436, third column,
    a. First full paragraph,
    (1) Line 9, the figure $483.76'' is corrected to read ``$483.79''.
    (2) Last line, the figure ``0.9448'' is corrected to read 
``0.9449''.
    b. Last paragraph,
    (1) Line 18, the figure ``0.24'' is corrected to read ``0.23''.
    (2) Line 22, the figure ``2.36'' is corrected to read ``2.37''.
    7. On page 49437,
    a. Top of the page, the table ``Comparison of Factors and 
Adjustments: FY 2022 Capital Federal Rate and the FY 2023 Capital 
Federal Rate'' is corrected to read as follows:

[[Page 66564]]

[GRAPHIC] [TIFF OMITTED] TR04NO22.083

    b. Lower two-thirds of the page, first column, second full 
paragraph, last line, the figure ``38,859'' is corrected to read 
``$38,788''.
    8. On page 49438, second column, first full paragraph, lines 45 and 
46, the reference ``section 1866(m)(5)'' is corrected to read ``section 
1886(m)(5)''.
    9. On page 49450, first full paragraph,
    a. Line 11, the figure ``$38,859'' is corrected to read 
``$38,788''.
    b. Last line, the figure ``$38,859'' is corrected to read 
``$38,788''.
    10. On page 49453, bottom of the page, the table titled ``TABLE 
1D--CAPITAL STANDARD FEDERAL PAYMENT RATE--FY 2023'' is corrected to 
read as follows:
[GRAPHIC] [TIFF OMITTED] TR04NO22.084

D. Corrections to the Appendices

    1. On page 49457, third column, last paragraph,
    a. Line 8, the figure ``$1.4 billion'' is corrected to read ``$1.5 
billion''.
    b. Line 14, the figure ``$1.0 billion'' is corrected to read ``$0.9 
billion''.
    2. On pages 49461 through 49463, the column titled ``All FY 2023 
Changes'' in the table titled, ``Table I--Impact Analysis of Changes to 
the IPPS for Operating Costs for FY 2023'' is corrected to read as 
follows:
BILLING CODE 4120-01-P

[[Page 66565]]

[GRAPHIC] [TIFF OMITTED] TR04NO22.085


[[Page 66566]]


[GRAPHIC] [TIFF OMITTED] TR04NO22.086

    3. On pages 49467 through 49468, the table titled ``Table II--
Impact Analysis of Changes for FY 2023 Acute Care Hospital Operating 
Prospective Payment System (Payments per discharge)'' is corrected to 
read as follows:

[[Page 66567]]

[GRAPHIC] [TIFF OMITTED] TR04NO22.087


[[Page 66568]]


[GRAPHIC] [TIFF OMITTED] TR04NO22.088


[[Page 66569]]


    4. On page 49469, lower half of the page, third column, first 
partial paragraph,
    a. Line 9, the figure ``$88.45 million'' is corrected to read 
``$164.72 million''.
    b. Line 12, the figure ``$33.9 million'' is corrected to read 
``$110.17 million''.
    5. On page 49470,
    a. Top of the page, in the table titled ``FY 2023 Estimates for New 
Technology Add-On Payments for Technologies under the Alternative 
Pathway for FY 2023'', the table is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR04NO22.089

    b. Lower one-third of the page, in the table titled ``FY 2023 
Estimates for New Technology Add-On Payments for FY 2023'', the table 
is corrected to read as follows:

    FY 2023 Estimates for New Technology Add-On Payments for FY 2023
------------------------------------------------------------------------
                                               Estimated Total FY 2023
                 Category                              Impact
------------------------------------------------------------------------
Technologies Continuing New Technology Add-              $619,943,190.45
 On Payments in FY 2023...................
                                           -----------------------------
Alternative Pathway Applications..........                164,724,777.38
Traditional Pathway Applications..........                 75,161,627.94
                                           -----------------------------
    Aggregate Estimated Total FY 2023                    $859,829,595.77
     Impact...............................
------------------------------------------------------------------------

    c. Bottom of the page, first column, partial paragraph, before line 
1, the text is corrected by adding a heading to read as follows: ``2. 
Effects of Changes to Medicare DSH and Uncompensated Care Payments for 
FY 2023 and the New Supplemental Payment for Indian Health Service 
Hospitals and Tribal Hospitals and Hospitals Located in Puerto Rico''.
    6. On page 49471, third column, first full paragraph, line 1, the 
number ``2,368'' is corrected to ``2,367''.
    7. On pages 49472 and 49473, the table titled ``Modeled 
Uncompensated Care Payments* and Supplemental Payments for Estimated FY 
2023 DSHs by Hospital Type'' is corrected to read as follows:

[[Page 66570]]

[GRAPHIC] [TIFF OMITTED] TR04NO22.091


[[Page 66571]]


[GRAPHIC] [TIFF OMITTED] TR04NO22.092

BILLING CODE 4120-01-C
    8. On page 49473, lower one-fourth of the page, second column, 
partial paragraph, line 6, the figure ``2,368'' is corrected to 
``2,367''.
    9. On page 49474, first column, second full paragraph, line 5 
through the second column, second full paragraph, last line, the 
language (beginning with the phrase ``Rural hospitals with 250+ beds 
are projected to receive'' and ending with the sentence ``Hospitals 
with greater than 65 percent Medicaid utilization are projected to 
receive an increase of 6.67 percent.'') is corrected to read as 
follows: ``Rural hospitals, in general, are projected to experience 
larger decreases in uncompensated care payments and supplemental 
payments compared to their uncompensated care payments in FY 2022, as 
compared to their urban counterparts. Overall, rural hospitals are 
projected to receive a 6.00 percent decrease in payments, which is a 
greater decrease than the overall hospital average, while urban 
hospitals are projected to receive a 2.90 percent decrease in payments, 
which is a slightly smaller decrease than the overall hospital average.
    Among rural hospitals, by bed size, larger rural hospitals are 
projected to receive the smallest decreases in uncompensated care 
payments and supplemental payments. Rural hospitals with 250+ beds are 
projected to receive a 4.53 percent payment decrease, and rural 
hospitals with 100-249 beds are projected to receive a 6.82 percent 
decrease. Smaller rural hospitals with 0-99 beds are projected to 
receive a 5.81 percent payment decrease. Among urban hospitals, the 
smallest hospitals, those with 0-99 beds, are projected to receive a 
6.55 percent decrease in payments, which is a greater decrease than the 
overall hospital average. In contrast, urban hospitals with 100-249 
beds and those with 250+ beds are projected to receive decreases in 
payments of 2.68 and 2.76 percent, respectively, which are smaller 
decreases than the overall hospital average.
    In most regions, rural hospitals are generally expected to receive 
larger than average decreases in uncompensated care payments and 
supplemental payments. The exceptions are rural hospitals in the South 
Atlantic Region, which are projected to receive a smaller than average 
decrease of 1.81 percent in payments and rural hospitals in the East 
North Central Region and the Pacific Region, which are projected to 
receive payment increases of 8.09 and 24.44 percent, respectively. 
Regionally, urban hospitals are projected to receive a more varied 
range of payment changes. Urban hospitals in the New England, Middle 
Atlantic, and South Atlantic Regions, as well as hospitals in Puerto 
Rico, are projected to receive larger than average decreases in 
payments. Urban hospitals in the East South Central, West North 
Central, West South Central, and Mountain Regions are projected to 
receive smaller than average decreases in payments. Urban hospitals in 
the East North Central and Pacific Regions are projected to receive 
increases in payments of 1.02 percent and 0.54 percent, respectively.
    By payment classification, although hospitals in urban payment 
areas overall are expected to receive a 2.50 percent decrease in 
uncompensated care payments and supplemental payments, hospitals in 
large urban payment areas are expected to see a decrease in payments of 
1.26 percent, while hospitals in other urban payment areas are 
projected to receive the largest decrease of 4.88 percent. Hospitals in 
rural payment areas are expected to

[[Page 66572]]

receive a decrease in payments of 4.03 percent.
    Nonteaching hospitals are projected to receive a payment decrease 
of 2.82 percent, teaching hospitals with fewer than 100 residents are 
projected to receive a decrease of 2.46 percent, and teaching hospitals 
with 100+ residents have a projected payment decrease of 3.82 percent. 
Proprietary and voluntary hospitals are projected to receive smaller 
than average decreases of 2.38 and 1.95 percent respectively, while 
government hospitals are expected to receive a larger than average 
payment decrease of 5.65 percent. Hospitals with less than 25 percent 
Medicare utilization and hospitals with 50 to 65 percent Medicare 
utilization are projected to receive smaller than average payment 
decreases of 2.89 and 0.38 percent, respectively, while hospitals with 
25-50 percent and hospitals with greater than 65 percent Medicare 
utilization are projected to receive larger than average payment 
decreases of 3.29 and 23.83 percent, respectively. All hospitals with 
less than 50 percent Medicaid utilization are projected to receive 
smaller decreases in uncompensated care payments and supplemental 
payments than the overall hospital average percent change, while 
hospitals with 50-65 percent Medicaid utilization are projected to 
receive a larger than average decrease of 10.49 percent. Hospitals with 
greater than 65 percent Medicaid utilization are projected to receive 
an increase of 6.66 percent.''
    10. On page 49482, third column, first full paragraph, last line, 
the figure ``0.9448'' is corrected to read ``0.9449''.
    11. On page 49483,
    a. First column, first partial paragraph, line 1, the figure ``5.52 
percent'' is corrected to read ``5.51 percent''.
    b. Second column, second full paragraph,
    (1) Line 5, the figure ``1.6 percent'' is corrected to read ``1.7 
percent''.
    (2) Line 10, the figure ``1.2 percent'' is corrected to read ``1.4 
percent''.
    c. Third column, last paragraph, last line, the figure ``0.3 
percent'' is corrected to read ``0.1 percent''.
    12. On pages 49484 and 49485, the table titled ``TABLE III.--
COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2022 PAYMENTS COMPARED TO FY 
2023 PAYMENTS]'' is corrected to read as follows:
BILLING CODE 4120-01-P

[[Page 66573]]

[GRAPHIC] [TIFF OMITTED] TR04NO22.093


[[Page 66574]]


[GRAPHIC] [TIFF OMITTED] TR04NO22.094

    13. On page 49494, third column, third full paragraph,
    a. Lines 2 and 3, the figure ``$1.4 billion'' is corrected to read 
``$1.5 billion''.
    b. Line 14, the figure ``$0.039 billion'' is corrected to read 
``0.040 billion''.
    c. Lines 17 and 18, the figure ``-$0.747 billion'' is corrected to 
read ``-$0.671 billion''.
    14. On page 49495,
    a. First column, first line, the figure ``$39 million'' is 
corrected to read ``$40 million''.
    b. Third column, second full paragraph, last line, the figure 
``$1.4 billion'' is corrected to read ``$1.5 billion''.
    c. Middle of page, Table V. ``ACCOUNTING STATEMENT: CLASSIFICATION 
OF ESTIMATED EXPENDITURES UNDER THE IPPS FROM FY 2022 TO FY 2023'' is 
corrected to read as follows:

[[Page 66575]]

[GRAPHIC] [TIFF OMITTED] TR04NO22.095

BILLING CODE 4120-01-C

List of Subjects in 42 CFR Part 482

    Grant programs--health, Hospitals, Medicaid, Medicare, Reporting 
and recordkeeping requirements.

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

PART 482--CONDITIONS OF PARTICIPATION FOR HOSPITALS

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

    Authority:  42 U.S.C. 1302, 1395hh, and 1395rr, unless otherwise 
noted.


Sec.  482.42   [Amended]

0
2. In Sec.  482.42, redesignate the second paragraph (f)(2)(ii) as 
paragraph (f)(2)(iii).

Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2022-24077 Filed 11-3-22; 8:45 am]
BILLING CODE 4120-01-P