[Federal Register Volume 88, Number 191 (Wednesday, October 4, 2023)]
[Rules and Regulations]
[Pages 68491-68493]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-22053]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 412

[CMS-1783-CN]
RIN 0938-AV06


Medicare Program; FY 2024 Inpatient Psychiatric Facilities 
Prospective Payment System--Rate Update; Correction

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

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical errors that appeared in the 
final rule published in the Federal Register on August 2, 2023 entitled 
``Medicare Program; FY 2024 Inpatient Psychiatric Facilities 
Prospective Payment System--Rate Update''.

DATES: This correction is effective October 1, 2023.

FOR FURTHER INFORMATION CONTACT: The IPF Payment Policy mailbox at 
[email protected] for information regarding the IPF wage 
index.
    Lauren Lowenstein-Turner, (410) 786-4507, for information regarding 
the inpatient psychiatric facilities quality reporting program.

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2023-16083 of August 2, 2023, the fiscal year (FY) 2024 
Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) 
final rule (88 FR 51054), there were technical errors that are 
identified and corrected in this correcting document. These corrections 
are effective as if they had been included in the FY 2024 IPF PPS final 
rule. Accordingly, the corrections are effective October 1, 2023.

II. Summary of Errors

    On page 51115, in the first line of the first column, we omitted a 
link after the phrase ``available at.''
    On page 51122, in the first paragraph of the first column, we 
omitted a link after the phrase ``we refer readers to the description 
of the survey in the Journal of Patient Experience:''.
    On page 51122, in item (4) in the last paragraph of the second 
column, there is an extra ``of''.
    On page 51129, in footnote 218, the link is incorrect.
    On page 51129, in footnote 219, the link is incorrect.
    On page 51129, in footnote 223, we omitted a link after ``. . . 
Bivalent Vaccine Boosters.''.
    On page 51136, in the first partial paragraph of the third column, 
we incorrectly included the phrase ``and patient.''
    On page 51136, in the first full paragraph of the third column, we 
incorrectly included the phrase ``prior

[[Page 68492]]

to during the patient's discharge planning.''
    On page 51138, in the notes following Table 21, ``IPFQR Program 
Measure Set for the FY 2025 Payment Determination'', the ``\1\'' is 
missing from in front of the last sentence.
    On page 51141, the title of Table 24, ``IPFQR Program Measure Set 
for the FY 2029 Payment Determination'', is incorrect.
    On page 51142, in the second paragraph under section 1 (Procedural 
Requirements for the FY 2024 Payment Determination and Subsequent 
Years) of the first column, there is a grammatical error.
    On page 51143, in the fourth full paragraph of the third column, 
there is a missing apostrophe.
    On page 51149, in Table 27, ``Updates to Burden Associated with 
Measure Removals'', the total annual cost in the total row is 
incorrect.
    On page 51150, in Table 30, ``Total CY 2024 Facility Information 
Collection Burden Changes'', the table title should be bold font. In 
addition, the change in total responses associated with the updated 
case estimate, the total cost associated with removing two measures, 
total number of responses, and the total annual cost are incorrect.
    On page 51151, in the single partial paragraph in the third column, 
we incorrectly included '')''.
    On page 51154, in Table 37, ``Incremental Changes in Facility 
Burden'', the total number of responses is incorrect.
    On page 51154, in the paragraph between Table 37 and Table 38, 
``Incremental Changes in Survey Burden for Patients'', there is a 
typographical error in the description of Table 38.
    On page 51159, in the first full paragraph of the first column, 
there is an extra period.
    On page 51159, in the first full paragraph of the second column, 
there is a missing apostrophe.

III. Waiver of Proposed Rulemaking

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a rule take effect in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive this notice and comment procedure if the Secretary finds, for 
good cause, that the notice and comment process is impracticable, 
unnecessary, or contrary to the public interest, and incorporates a 
statement of the finding and the reasons therefore in the document.
    Section 553(d) of the APA ordinarily requires a 30-day delay in 
effective date of final rules after the date of their publication in 
the Federal Register. This 30-day delay in effective date can be 
waived, however, if an agency finds for good cause that the delay is 
impracticable, unnecessary, or contrary to the public interest, and the 
agency incorporates a statement of the findings and its reasons in the 
rule issued.
    We believe that this correcting document does not constitute a rule 
that would be subject to the notice and comment or delayed effective 
date requirements. This document corrects technical and typographic 
errors in the preamble of the FY 2024 IPF PPS final rule, as well as 
two tables on the Centers for Medicare and Medicaid Services (CMS) 
website, 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 2024 IPF 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 IPFs to receive appropriate payments in a timely manner to 
ensure that the FY 2024 IPF PPS final rule accurately reflects 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 FY 2024 IPF PPS 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

A. Correction of Errors in the Preamble

    In FR Doc. 2023-16083 of August 2, 2023 (88 FR 51054), make the 
following corrections:
    1. On page 51115, first column, first partial paragraph, in line 1, 
add the following link after the phrase ``available at:'': ``https://
www.qualityreportingcenter.com/globalassets/2023/04/iqr/sdoh-measure_
faqs_vfinal_04012023508.pdf''.
    2. On page 51122:
    a. First column, first paragraph, in the last line, add the 
following link after the phrase ``we refer readers to the description 
of the survey in the Journal of Patient Experience:'': ``https://journals.sagepub.com/doi/full/10.1177/23743735221105671''.
    b. Second column, last paragraph, in item (4) on lines 21 and 22, 
replace the phrase ``data regarding of mode of administration'' with 
``data regarding mode of administration''.
    3. On page 51129:
    a. In footnote 218, replace the link with ``https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7037e1-H.pdf''.
    b. In footnote 219, replace the link with ``https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7037e1-H.pdf''.
    c. In footnote 223 after ``. . . Bivalent Vaccine Boosters.'', add 
the following: ``Available at: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-bivalent-vaccines''.
    4. On page 51136, third column:
    a. In the first partial paragraph, line 1, remove the phrase ``and 
patient''.
    b. In the first full paragraph, in lines 12 and 13, remove the 
phrase ``prior to during the patient's discharge planning''.
    5. On page 51138, in the notes following Table 21, add ``\1\'' 
prior to the last sentence, which reads ``We are modifying the COVID-19 
Vaccination Coverage Among Healthcare Personnel (HCP) measure in 
section VI.E of this final rule.''
    6. On Page 51141, replace the title of Table 24 ``TABLE 24: IPFQR 
MEASURE SET FOR THE FY 2029 PAYMENT DETERMINATION'' with ``TABLE 24: 
IPFQR MEASURE SET FOR THE FY 2028 PAYMENT DETERMINATION''.
    7. On page 51142, first column, under the section titled, ``1. 
Procedural Requirements for the FY 2024 Payment Determination and 
Subsequent Years'', in the second paragraph, in lines 5 through 8, 
replace the phrase ``procedural requirements for an IPF to register 
for, or withdraw from, participation in the IPFQR Program'' with 
``procedural requirements for an IPF to register for, withdraw from, or 
participate in the IPFQR Program''.
    8. On page 51143, third column, in the fourth full paragraph, in 
lines 1 and 2, replace the phrase ``We understand the commenters 
concern'' with ``We understand the commenter's concern''.

[[Page 68493]]

    9. On page 51149, in Table 27, the total annual cost in the total 
row, which currently reads ``(20,339,673)'' should read 
``(20,399,673)''.
    10. On page 51150, in Table 30:
    a. Correct the table title to be bold font.
    b. Replace the change in total responses associated with updating 
the case estimate, which currently reads ``(277,280)'' with 
``(277,780)'', consistent with the discussion at the top of page 51150 
in which the number of cases for each of the two removed measures is 
138,890 (138,890 x 2 = 277,780).
    c. Replace the change in total annual cost associated with removing 
two measures, which currently reads ``(20,339,673)'' with 
``(20,399,673)''.
    d. Replace the total number of responses, which currently reads 
``(2,502,332),'' with ``(2,502,832)''.
    e. Replace the total annual cost, which currently reads 
``(16,071,360),'' with ``(16,131,359)''.
    11. On page 51151, third column, in the single partial paragraph, 
in the second to last sentence, replace the phrase ``for a medical 
records specialist) for the voluntary reporting period.'' with ``for a 
medical records specialist for the voluntary reporting period.''
    12. On page 51154:
    a. In Table 37, replace the total number of responses which 
currently reads ``(2,018,244),'' with ``(2,019,244)''.
    b. Third column, in the paragraph between Table 37 and Table 38 
replace ``in CYs 2024 through CY 2026'' with ``in CY 2024 through CY 
2027''.
    13. On page 51159:
    a. First column, first full paragraph, in lines 16 through 24, 
replace the phrase ``(including, but not limited to helping patients 
select facilities in which to receive care, providing patients an 
opportunity to be heard, and increasing alignment between general acute 
and acute psychiatric settings). We believe that our PIX survey measure 
will have positive effects on patients and their caregivers.'' with 
``(including, but not limited to helping patients select facilities in 
which to receive care, providing patients an opportunity to be heard, 
and increasing alignment between general acute and acute psychiatric 
settings), we believe that our PIX survey measure will have positive 
effects on patients and their caregivers.''
    b. Second column, first full paragraph, in lines 8 and 9, replace 
the phrase ``providers workflows or information systems'' with 
``providers' workflows or information systems.''

B. Summary of Errors in and Corrections to the Tables Posted on the CMS 
Website for the IPF PPS Wage Index

    As discussed in the FY 2024 IPF PPS final rule (88 FR 51085), we 
used the concurrent pre-floor, pre-reclassified Inpatient Prospective 
Payment System (IPPS) hospital wage index as the basis for the IPF wage 
index. For FY 2024, concurrent pre-floor, pre-reclassified IPPS 
hospital wage data used under the IPF PPS are for cost reporting 
periods beginning on or after October 1, 2019, and before October 1, 
2020 (FY 2020 cost report data), as discussed in the final rule 
entitled ``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 2024 
Rates; Quality Programs and Medicare Promoting Interoperability Program 
Requirements for Eligible Hospitals and Critical Access Hospitals; 
Rural Emergency Hospital and Physician-Owned Hospital Requirements; and 
Provider and Supplier Disclosure of Ownership; and Medicare 
Disproportionate Share Hospital (DSH) Payments: Counting Certain Days 
Associated with Section 1115 Demonstrations in the Medicaid Fraction'' 
(88 FR 58640) (hereinafter referred to as the FY 2024 IPPS final rule). 
In calculating the wage index under the FY 2024 IPPS final rule, we 
made an inadvertent error related to the calculation of the wage index. 
This error is identified, discussed and corrected in the document 
entitled ``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 2024 
Rates; Quality Programs and Medicare Promoting Interoperability Program 
Requirements for Eligible Hospitals and Critical Access Hospitals; 
Rural Emergency Hospital and Physician-Owned Hospital Requirements; and 
Provider and Supplier Disclosure of Ownership; and Medicare 
Disproportionate Share Hospital (DSH) Payments: Counting Certain Days 
Associated with Section 1115 Demonstrations in the Medicaid Fraction; 
Correction,'' published elsewhere in this issue of the Federal 
Register. The error that affects the unadjusted, pre-reclassified, pre-
rural floor IPPS wage data and thereby affects the IPF PPS wage data 
was an error in the wage data collected from the Medicare cost reports 
of one hospital CMS Certification Number (CCN) 340064--Core-Based 
Statistical Areas (CBSA) 34 rural North Carolina).
    The use of the corrected wage data for the one hospital in CBSA 34 
required the recalculation of the final FY 2024 IPF PPS wage indexes. 
Additionally, as discussed in the FY 2024 IPF PPS final rule (88 FR 
51087), changes to the wage index are made in a budget-neutral manner 
so that updates do not increase expenditures. Due to the recalculation 
and subsequent revision of the final FY 2024 IPF PPS wage indexes, it 
was necessary to recalculate the FY 2024 IPF PPS wage index budget 
neutrality factor. However, CMS has determined there are no changes 
needed to the published wage index budget neutrality factor since the 
difference between the previously published factor and the newly 
calculated factor is within the margin of error for rounding. 
Additionally, due to the recalculated wage indexes, we recalculated the 
impact analysis provided in Table 40 of the FY 2024 IPF PPS final rule 
(88 FR 51157 through 51158). However, similar to the budget neutrality 
factor calculation, there are no changes needed to the published values 
in Table 40, since all changes were within the margin of error for 
rounding.
    As discussed above, there were no errors noted to the IPF PPS wage 
index budget neutrality factor or the facility impacts in Table 40. We 
are correcting the wage index in Table B setting forth the wage indexes 
for rural areas based on CBSA labor market areas Table B and Table C 
setting forth the wage indexes for urban and rural areas without 
counties (Table C), which are available exclusively on the CMS website 
at https://www.cms.gov/medicare/medicare-fee-for-service-payment/inpatientpsychfacilpps/wageindex.

    Dated: September 27, 2023.
Wilma Robinson,
Deputy Executive Secretary, Department of Health and Human Services.
[FR Doc. 2023-22053 Filed 9-29-23; 4:15 pm]
BILLING CODE 4120-01-P