[Federal Register Volume 89, Number 29 (Monday, February 12, 2024)]
[Rules and Regulations]
[Pages 9776-9784]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-02705]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 410, 411, 414, 415, 418, 422, 423, 424, 425, 455, 
489, 491, 495, 498, and 600

[CMS-1784-F2]
RIN 0938-AV07


Medicare and Medicaid Programs; CY 2024 Payment Policies Under 
the Physician Fee Schedule and Other Changes to Part B Payment and 
Coverage Policies; Medicare Shared Savings Program Requirements; 
Medicare Advantage; Medicare and Medicaid Provider and Supplier 
Enrollment Policies; and Basic Health Program; 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 November 16, 2023 issue of the 
Federal Register, entitled ``Medicare and Medicaid Programs; CY 2024 
Payment Policies Under the Physician Fee Schedule and Other Changes to 
Part B Payment and Coverage Policies; Medicare Shared Savings Program 
Requirements; Medicare Advantage; Medicare and Medicaid Provider and 
Supplier Enrollment Policies; and Basic Health Program'' (referred to 
hereafter as the ``CY 2024 PFS final rule''). The effective date was 
January 1, 2024.

DATES: This correcting document is effective February 12, 2024 and is 
applicable beginning January 1, 2024.

FOR FURTHER INFORMATION CONTACT: 
    [email protected], for any issues not 
identified below. Please indicate the specific issue in the subject 
line of the email.
    [email protected], for the following issues: 
caregiver training services, community health integration services, and 
principal illness navigation services; telehealth and other services 
involving communications technology; PFS conversion factor; and PFS 
payment for evaluation and management services.
    Sabrina Ahmed, (410) 786-7499, or [email protected], 
for issues related to the Medicare Shared Savings Program (Shared 
Savings Program) Quality performance standard and quality reporting 
requirements.
    Janae James, (410) 786-0801, or [email protected], 
for issues related to Shared Savings Program beneficiary assignment.
    Frank Whelan (410) 786-1302, for issues related to Medicare and 
Medicaid Provider and Supplier Enrollment
    Renee O'Neill, (410) 786-8821, [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2023-24184 of November 16, 2023, the CY 2024 PFS final 
rule (88 FR 78818), there were technical errors that are identified and 
corrected in this correcting document. These corrections are applicable 
as if they had been included in the CY 2024 PFS final rule, which was 
effective January 1, 2024.

II. Summary of Errors

A. Summary of Errors in the Preamble

    1. On page 78867, in the table titled ``TABLE 11: CY 2024 Medicare 
Telehealth Services List'' which continues through page 78871, we 
inadvertently omitted four rows of services.
    2. On page 78876, second column, fourth full paragraph, line 2, we 
inadvertently omitted qualifying language before the reference to 
telehealth services and neglected to include a reference to further 
background information.
    3. On page 78918, third column, second full paragraph, second 
sentence, we neglected to include a clarifying phrase.
    4. On page 78920, first column, first full paragraph, we 
inadvertently omitted a clarifying phrase.
    5. On page 78944, first column, first full paragraph we 
inadvertently included incorrect language in the final code descriptor 
for HCPCS code G0023.
    6. On page 78949, first column, first full paragraph, we made a 
typographical error when finalizing limitations on PIN services.
    7. On pages 78956 through 78957 in the table titled ``TABLE 14: CY 
2024 Work RVUs for New, Revised, and Potentially Misvalued Codes,'' the 
code descriptor listed for HCPCS code G0019 inadvertently was not 
updated to reflect the final code descriptors as stated in the preamble 
text.
    8. On pages 78958 through 78959 in the table titled ``TABLE 14: CY 
2024 Work RVUs for New, Revised, and Potentially Misvalued Codes,'' the 
code descriptors listed for HCPCS codes G0022 and G0023 inadvertently 
were not updated to reflect the final code descriptors as stated in the 
preamble text.
    9. On pages 78959 through 78960 in the table titled ``TABLE 14: CY 
2024 Work RVUs for New, Revised, and Potentially Misvalued Codes,'' the 
code descriptor listed for HCPCS code G0140 inadvertently was not 
updated to reflect the final code descriptor as stated in the preamble 
text.
    10. On page 78975, we inadvertently omitted a sentence to restate 
the final policy we adopted for the inherent complexity add-on code 
(G2211).
    11. On page 79075, third column, first full paragraph, line 19, two 
G-codes for PIN services were inadvertently omitted.
    12. On page 79112 in the table titled, ``TABLE 28: Final APP 
Reporting Requirements and Quality Performance Standard for Performance 
Year 2024 and Subsequent Performance Years'', we inadvertently included 
language regarding a MIPS Quality performance category score.
    13. On page 79112 in the table titled, ``TABLE 28: Final APP 
Reporting Requirements and Quality Performance Standard for Performance 
Year 2024 and Subsequent Performance Years'', we made a typographical 
error in identifying the APP measure.
    14. On page 79113 in the table titled, ``TABLE 29: Measures 
included in the APP Measure Set for Performance Year 2024 and 
Subsequent Performance

[[Page 9777]]

Years'', we made a typographical error in identifying the Quality ID#: 
321 for the Measure Type. We also inadvertently included a related 
incorrect footnote.
    15. On page 79121, we inadvertently included language referencing 
Table 30: 40th Percentile MIPS Quality Performance Category Scores 
Using Current and Finalized Methodology.
    16. On page 79121 in the table titled, ``TABLE 30: 40th Percentile 
MIPS Quality Performance Category Scores Using Current and Finalized 
Methodology'', the last row of the table for Performance Year 2022 is 
incorrect due to a formatting error.
    17. On page 79131, we made a typographical error in reference to 42 
CFR part 414, subpart O.
    18. On page 79144, we made a typographical error in the section 
reference to the Regulatory Impact Analysis in the CY 2024 PFS proposed 
rule.
    19. On page 79172, there is an error in the description of the 
definition of ACO professional in section 1899(c)(1)(A) of the Act.
    20. On page 79189, there are typographical errors in the references 
to Table numbers in the final rule.
    21. On page 79240, we inadvertently included language that 
referenced Tables.
    22. On page 79379, in the table titled ``TABLE 60: Illustration of 
Point System and Associated Adjustments Comparison between the CY 2023 
Performance Period/2025 MIPS Payment Year and the CY 2024 Performance 
Period/2026 MIPS Payment Year'', we made typographical errors in the 
MIPS Adjustment columns for the 2023 and 2024 Performance Periods.
    23. On page 79437, in the table titled ``TABLE 83: Summary of 
Quality Measure Inventory Finalized for the CY 2024 Performance 
Period'',
    a. We made typographical errors in the # Measures heading titles.
    b. We made typographical errors in the number of eCQM 
Specifications measures finalized for CY 2024.
    24. On page 79467, there are two typographical errors in the table 
titled ``TABLE 116: Calculation of the CY 2024 PFS Conversion Factor''.
    25. On page 79506, there is a typographical error in the title of 
``TABLE 131: Description of MIPS Eligibility Status for CY 2023 
Performance Period/2025 MIPS Payment Year Using CY 2023 PFS Final Rule 
Assumptions''.
    26. On page 79506, there is a typographical error in two footnotes 
of the table titled ``TABLE 131: Description of MIPS Eligibility Status 
for CY 2023 Performance Period/2025 MIPS Payment Year Using CY 2023 PFS 
Final Rule Assumptions''.
    27. On page 79519, we made a typographical error in the reference 
to the MIPS payment year.
    28. On page 79522, in the table titled ``TABLE 143: Accounting 
Statement for Provisions for Medicare Shared Savings Program (CYs 2024-
2033)'', there are typographical errors in the references to Table 
numbers.

B. Summary of Errors in the Regulations Text

    1. On page 79538, at Sec.  414.1405(b)(9)(iii), there is a 
typographical error in the reference to the MIPS payment year.
    2. On page 79542, third column, lines 19, 23, and 26 contain 
typographical errors.

C. Summary of Errors in the Addenda

    1. On page 79939 of APPENDIX 1: MIPS QUALITY MEASURES, TABLE D.45: 
One-Time Screening for Hepatitis C Virus (HCV) for all Patients 
includes incorrect language to be removed in the substantive changes 
row.
    2. On page 80015 of APPENDIX 3: MVP INVENTORY, TABLE B.2: Optimal 
Care for Kidney Health MVP we inadvertently omitted language in the 
last paragraph of the Comments and Responses section.
    3. On pages 80013, 80016, and 80026 of APPENDIX 3: MVP INVENTORY, 
corresponding to TABLE B.2: Optimal Care for Kidney Health MVP, TABLE 
B.3: Optimal Care for Patients with Episodic Neurological Conditions 
MVP, and TABLE B.6: Advancing Rheumatology Patient Care MVP, 
respectively, we included an incorrect collection type for measure 
Q130: Documentation of Current Medications in the Medical Record.

III. Waiver of Proposed Rulemaking

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (the 
APA), the agency is required to publish a notice of the proposed rule 
in the Federal Register before the provisions of a rule take effect. 
Similarly, section 1871(b)(1) of the Social Security Act (the Act) 
requires the Secretary to provide for notice of the proposed rule in 
the Federal Register and provide a period of not less than 60 days for 
public comment. In addition, section 553(d) of the APA and section 
1871(e)(1)(B)(i) 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 APA notice and 
comment, and delay in effective date 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, 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 notice and comment rulemaking procedures 
for good cause if the agency makes a finding that the notice and 
comment process is impracticable, unnecessary, or contrary to the 
public interest, and includes a statement of the finding and the 
reasons for it in the rule. In addition, section 553(d)(3) of the APA 
and section 1871(e)(1)(B)(ii) 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 in the rule a statement of the finding 
and the reasons for it.
    In our view, this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This document 
merely corrects technical errors in the CY 2024 PFS 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 proposed, subject to notice and comment procedures, and 
adopted in the CY 2024 PFS final rule. As a result, the corrections 
made through this correcting document are intended to resolve 
inadvertent errors so that the rule accurately reflects the policies 
adopted in the final rule. Even if this were a rulemaking to which the 
notice and comment 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 CY 2024 PFS final rule or delaying the effective 
date of the corrections would be contrary to the public interest 
because it is in the public interest to ensure that the rule accurately 
reflects our policies as of the date they take effect. Further, such 
procedures would be unnecessary because we are not making any 
substantive revisions to the final rule, but rather, we are simply 
correcting the Federal Register document to reflect the policies that 
we previously proposed, received public comment on, and subsequently 
finalized in the final rule. For these reasons, we believe there is 
good cause to waive the requirements for notice and comment and delay 
in effective date.

[[Page 9778]]

IV. Correction of Errors

    In FR Doc. 2023-24184 of November 16, 2023 (88 FR 78818), make the 
following corrections:

A. Correction of Errors in the Preamble

    1. On page 78867, the table titled ``TABLE 11: CY 2024 Medicare 
Telehealth Services List'', the table is corrected to insert the 
following additional rows after the row for HCPCS code 0373T:
[GRAPHIC] [TIFF OMITTED] TR12FE24.000

    2. On page 78876, second column, fourth full paragraph,
    a. Line 2, the phrase ``telehealth services'' is corrected to read 
``DSMT and therapy telehealth services''.
    b. Line 6, the language ``modifier `95.' '' is corrected to read 
``modifier `95.' For further background, we refer readers to pgs. 44-
45, 80-81 of our FAQ available at https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf.''
    3. On page 78918, third column, second full paragraph, second 
sentence that reads ``If caregivers are trained in a group, 
practitioners would not bill individually for each caregiver''. is 
corrected to read: ``If caregivers for the same beneficiary are trained 
in a group, practitioners would not bill individually for each 
caregiver''.
    4. On page 78920, first column, first full paragraph, line 9, that 
reads ``a median group size of five caregivers'' is corrected to read 
``a median group size of caregivers for five beneficiaries''.
    5. On page 78944, first column, first full paragraph for code 
G0023, lines 5 and 6, the phrase ``certified peer specialist'' is 
deleted.
    6. On page 78949, first column, first full paragraph, line 3 that 
reads ``services can be provided more than'' is corrected to read 
``services cannot be provided more than''.
    7. Beginning on page 78956, in the last row and continuing on page 
78957, in the table titled, ``TABLE 14: CY 2024 Work RVUs for New, 
Revised, and Potentially Misvalued Codes'', the entry for HCPCS code 
G0019 is replaced in its entirety with the following:
BILLING CODE P

[[Page 9779]]

[GRAPHIC] [TIFF OMITTED] TR12FE24.001

    8. Beginning on page 78958, in the second and third rows and 
continuing on page 78959, in the table titled, ``TABLE 14: CY 2024 Work 
RVUs for New, Revised, and Potentially Misvalued Codes'', the entries 
for HCPCS codes G0022 and G0023 are replaced in their entirety with the 
following:

[[Page 9780]]

[GRAPHIC] [TIFF OMITTED] TR12FE24.002

    9. Beginning on page 78959, in the last row and continuing on page 
78960, in the table titled, ``TABLE 14: CY 2024 Work RVUs for New, 
Revised, and Potentially Misvalued Codes'', the entry for HCPCS code 
G0140 is replaced in its entirety with the following:

[[Page 9781]]

[GRAPHIC] [TIFF OMITTED] TR12FE24.003

BILLING CODE C
    10. On page 78975, first column, first full paragraph, line 26, the 
phrase that reads ``this policy is implemented.'' is corrected to read, 
``this policy is implemented. We are finalizing as proposed that 
payment will not be made for the inherent complexity add-on code 
(G2211) when billed with an O/O E/M service reported with modifier -
25.''
    11. On page 79075, third column, first full paragraph, line 19 that 
reads ``G0022, G0023, and G0024 respectively'' is corrected to read 
``G0022, G0023, G0024, G0140 and G0146, respectively.''
    12. On page 79112, in the table titled, ``TABLE 28: Final APP 
Reporting Requirements and Quality Performance Standard for Performance 
Year 2024 and Subsequent Performance Years'', second column, third row, 
second paragraph, lines 4 through 6, the phrase that reads ``and 
receives a MIPS Quality performance category score under Sec.  
414.1380(b)(1)'' is removed.
    13. On page 79112, in the table titled ``TABLE 28: Final APP 
Reporting Requirements and Quality Performance Standard for Performance 
Year 2024 and Subsequent Performance Years'', second column, third row, 
third paragraph, line 6, the phrase that reads ``in the APP measure 
would'' is corrected to read ``in the APP measure set would''.
    14. On page 79113, in the table titled ``TABLE 29: Measures 
included in the APP Measure Set for Performance Year 2024 and 
Subsequent Performance Years'', sixth column, second row, the 
identifier ``PRO-PM *'' is corrected to read ``Patient Engagement/
Experience''.

[[Page 9782]]

The related footnote ``* Patient-reported outcome-based performance 
measure (PRO-PM) is a performance measure that is based on patient-
reported outcome measure (PROM) data aggregated for an accountable 
healthcare entity.'' is removed.
    15. On page 79121, third column, lines 4 through 6, the sentence 
that reads ``We note that Table 30 is same as Table 29 that was 
included in the CY 2024 PFS proposed rule (88 FR 52432).'' is removed.
    16. On page 79121, in the table titled ``TABLE 30: 40th Percentile 
MIPS Quality Performance Category Scores Using Current and Finalized 
Methodology'', that reads:
[GRAPHIC] [TIFF OMITTED] TR12FE24.004

is corrected to read:
[GRAPHIC] [TIFF OMITTED] TR12FE24.005

    17. On page 79131, second column, second full paragraph, first 
bullet, line 5 that reads ``subpart Oat the individual, group,'' is 
corrected to read ``subpart O at the individual, group,''.
    18. On page 79144, third column, line 23, the reference that reads 
``section VI.E.'' is corrected to read ``section VII.E.''.
    19. On page 79172, third column, second full paragraph, lines 10 
through 14, that reads ``furnished by an ACO professional who is a 
physician (as defined in section 1861(r)(1)) of the Act), or a 
practitioner that is a PA, NP, CNS (as defined in section 
1842(b)(18)(C)(i) of the Act).'' is corrected to read ``furnished by an 
ACO professional who is a physician.''
    20. On page 79189:
    a. The third column, first full paragraph, line 1 the phrase that 
reads ``Tables 41 and 42'' is corrected to read ``Tables 42 and 43''.
    b. The third column, first full paragraph, line 8, the phrase that 
reads ``Tables 39 and 40'' is corrected to read ``Tables 40 and 41''.
    21. On page 79240, the first column, first paragraph, lines 8 and 9 
the phrase that reads ``as displayed in Tables 46A and 46B'' is 
deleted.
    22. On page 79379, in the table titled ``TABLE 60: Illustration of 
Point System and Associated Adjustments Comparison between the CY 2023 
Performance Period/2025 MIPS Payment Year and the CY 2024 Performance 
Period/2026 MIPS Payment Year'':
    a. Second column, fourth row, line 3 that reads ``sliding scale 
ranges from 0 to 9% for scores from 75.00 to 100.00'' is corrected to 
read ``sliding scale ranges from greater than 0% to 9% for scores from 
75.01 to 100.00.''; and
    b. Fourth column, fourth row, line 3 that reads ``linear sliding 
scale ranges from 0 to 9% for scores from 86.00 to 100.00'' is 
corrected to read ``linear sliding scale ranges from greater than 0% to 
9% for scores from 75.01 to 100.00.''.
    23. On page 79437, in the table titled ``TABLE 83: Summary of 
Quality Measure Inventory Finalized for the CY 2024 Performance 
Period'', fifth column, row 4, that reads:

[[Page 9783]]

[GRAPHIC] [TIFF OMITTED] TR12FE24.006

is corrected to read:
[GRAPHIC] [TIFF OMITTED] TR12FE24.007

    24. On page 79467, in the table titled ``TABLE 116: Calculation of 
the CY 2024 PFS Conversion Factor'', that reads:
[GRAPHIC] [TIFF OMITTED] TR12FE24.008

is corrected to read:
[GRAPHIC] [TIFF OMITTED] TR12FE24.009

    25. On page 79506, in the table titled ``TABLE 131: Description of 
MIPS Eligibility Status for CY 2023 Performance Period/2025 MIPS 
Payment Year Using CY 2023 PFS Final Rule Assumptions'', the title of 
the table is corrected to read ``TABLE 131: Description of MIPS 
Eligibility Status for CY 2024 Performance Period/2026 MIPS Payment 
Year Using CY 2023 PFS Final Rule Assumptions''.
    26. On page 79506, in the table titled ``TABLE 131: Description of 
MIPS Eligibility Status for CY 2023 Performance Period/2025 MIPS 
Payment Year Using CY 2023 PFS Final Rule Assumptions'', the first and 
second footnotes which read:

``* Participation excludes facility-based clinicians who do not have 
scores in the 2021 MIPS submission data.
** Allowed charges estimated in 2021 dollars. Low-volume threshold 
is calculated using allowed charges. MIPS payment adjustments are 
applied to the paid amount.''

are corrected to read:

    ``* Participation excludes facility-based clinicians who do not 
have scores in 2022 MIPS submission data.
    ** Allowed charges estimated in 2022 dollars. Low-volume 
threshold is calculated using allowed charges. MIPS payment 
adjustments are applied to the paid amount.''

    27. On page 79519, third column, first full paragraph, line 7, the 
phrase that reads ``2025 MIPS payment year.'' is corrected to read 
``2026 MIPS payment year.''
    28. On page 79522, in the table titled ``TABLE 143: Accounting 
Statement for Provisions for Medicare Shared Savings Program (CYs 2024-
2033)'', fifth column, third and fourth full rows, the phrase that 
reads ``Tables 120 through 123'' is corrected to read ``Tables 123 
through 126''.

B. Correction of Errors in the Addenda

    29. On page 79939 of APPENDIX 1: MIPS QUALITY MEASURES, TABLE D.45: 
One-Time Screening for Hepatitis C Virus (HCV) for all Patients, row 6, 
Substantive Change: in the section titled:
    Updated denominator: Updated:
    THERE ARE TWO SUBMISSION CRITERIA FOR THIS MEASURE:
    First full paragraph, lines 6 through 8 that read: ``For 
accountability reporting in the CMS MIPS program, the rate for 
submission criteria 2 is used for performance, however, both 
performance rates must be submitted.'' is to be removed.
    30. On page 80015 of APPENDIX 3: MVP INVENTORY, TABLE B.2: Optimal 
Care for Kidney Health MVP language in the last paragraph of the 
Comments and Responses section should read: ``After consideration of 
public comments, we are finalizing the Optimal Care for Kidney Health 
MVP with modifications in Table B.2 for the CY 2024 performance period/
2026 MIPS payment year and future years.''

[[Page 9784]]

    31. On pages 80013, 80016, and 80026 of APPENDIX 3: MVP INVENTORY, 
corresponding to TABLE B.2: Optimal Care for Kidney Health MVP, TABLE 
B.3: Optimal Care for Patients with Episodic Neurological Conditions 
MVP, and TABLE B.6: Advancing Rheumatology Patient Care MVP, 
respectively, the Collection Type for measure Q130 is corrected by 
removing ``Medicare Part B Claims Measure Specifications'' and reads 
``eCQM Specifications, MIPS CQMs Specifications)''.

List of Subjects

42 CFR Part 414

    Administrative practice and procedure, Biologics, Diseases, Drugs, 
Health facilities, Health professions, Medicare, Reporting and 
recordkeeping requirements.

42 CFR 424

    Emergency medical services, Health facilities, Health professions, 
Medicare, Reporting and recordkeeping requirements.

    For the reasons set forth in the preamble, CMS corrects 42 CFR 
parts 414 and 424 by making the following correcting amendments:

PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES

0
1. The authority citation for part 414 continues to read as follows:

    Authority:  42 U.S.C. 1302, 1395hh, and 1395rr(b)(1).


Sec.  414.1405   [Amended]

0
2. Amend Sec.  414.1405 in paragraph (b)(9)(iii) by removing the phrase 
``2025 MIPS payment year'' and adding in its place the phrase ``2026 
MIPS payment year''.

PART 424--CONDITIONS FOR MEDICARE PAYMENT

0
3. The authority citation for part 424 continues to read as follows:

    Authority:  42 U.S.C. 1302 and 1395hh.


0
4. Amend Sec.  424.541 by--
0
a. Removing paragraphs (a)(2)(ii)(B)(3) through (5); and
0
b. Adding paragraphs (a)(3) through (5).
    The additions read as follows:


Sec.  424.541   Stay of enrollment.

    (a) * * *
    (3) A stay of enrollment lasts no longer than 60 days from the 
postmark date of the notification letter, which is the effective date 
of the stay.
    (4) CMS notifies the affected provider or supplier in writing of 
the imposition of the stay.
    (5) A stay of enrollment ends on the date on which CMS or its 
contractor determines that the provider or supplier has resumed 
compliance with all Medicare enrollment requirements in Title 42 or the 
day after the 60-day stay period expires, whichever occurs first.
* * * * *

Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2024-02705 Filed 2-8-24; 4:15 pm]
BILLING CODE P