Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005: Correcting Amendment, 16720-16724 [05-6131]
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16720
Federal Register / Vol. 70, No. 62 / Friday, April 1, 2005 / Rules and Regulations
C. Petitions for Judicial Review
Under section 307(b)(1) of the Clean
Air Act, petitions for judicial review of
this action must be filed in the United
States Court of Appeals for the
appropriate circuit by May 31, 2005.
Filing a petition for reconsideration by
the Administrator of this final rule
approving source-specific RACT
requirements for three sources in the
Commonwealth of Pennsylvania does
not affect the finality of this rule for the
purposes of judicial review nor does it
extend the time within which a petition
for judicial review may be filed, and
shall not postpone the effectiveness of
such rule or action. This action may not
be challenged later in proceedings to
enforce its requirements. (See section
307(b)(2)).
Environmental protection, Air
pollution control, Ozone, Reporting and
recordkeeping requirements, Volatile
organic compounds.
Dated: March 24, 2005.
Donald S. Welsh,
Regional Administrator, Region III.
I
40 CFR part 52 is amended as follows:
County
*
*
SGL Carbon Corporation ..... OP 24–131 ..
*
Elk ................
Salem Tube, Inc. .................
OP 43–142 ..
Mercer ..........
Dominion Trans, Inc ............
18–0006 .......
Clinton ..........
*
*
*
*
*
State effective date
FOR FURTHER INFORMATION CONTACT:
Diane Milstead, (410) 786–3355.
BILLING CODE 6560–50–P
SUPPLEMENTARY INFORMATION:
I. Background
Centers for Medicare & Medicaid
Services
42 CFR Parts 403, 405, 410, 411, 414,
418, 424, 484, and 486
[CMS–1429–F2]
Medicare Program; Revisions to
Payment Policies Under the Physician
Fee Schedule for Calendar Year 2005:
Correcting Amendment
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Correcting amendment.
AGENCY:
SUMMARY: This document corrects
technical errors that appeared in the
final rule with comment period
published in the Federal Register on
November 15, 2004 entitled ‘‘Revisions
to Payment Policies Under the
Physician Fee Schedule for Calendar
Year 2005.’’
DATES: Effective Date: This rule is
effective January 1, 2005.
VerDate jul<14>2003
15:42 Mar 31, 2005
In FR Doc. 04–24758 of November 15,
2004 (69 FR 66236), there were a
number of technical errors that we are
identifying and correcting in the
‘‘Correction of Errors’’ section of this
correcting amendment. Additionally,
there are various revisions to Addenda
B, C and F.
Discussion of Addenda B, C and F
RIN 0938–AM90
Jkt 205001
Authority: 42 U.S.C. 7401 et seq.
In Addenda B and C, we assigned
incorrect status indicators to the
following CPT and HCPCS codes: Page
66429 for CPT codes 0066T and 0074T,
page 66502 for CPT code 36415, page
66504 for CPT code 37195, pages 66682
and 66688 for HCPCS code G0363. We
also assigned incorrect global periods
for the following CPT and HCPCS codes:
Page 66539 for CPT code 54150; pages
66638 and 66687 for CPT codes 91034,
91034–26, 91034–TC, 91035, 91035–26,
91035–TC, 91037, 91037–26, 91037–TC,
91038 91038–26, 91038–TC, 91040,
91040–26, 91040–TC; and pages 66682
and 66688 for G0350, G0354 and G0358.
These corrections are reflected in
section II.C.1 of this correcting
amendment.
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Frm 00030
Subpart NN—Pennsylvania
2. In § 52.2020, the table in paragraph
(d)(1) is amended by adding the entries
for Salem Tube, Inc., SGL Carbon
Corporation, and Dominion Trans, Inc. at
the end of the table to read as follows:
I
§ 52.2020
*
Identification of plan.
*
*
(d) * * *
*
EPA approval date
*
*
*
5/12/95; 5/31/95 .................. 4/1/05, [Insert page number
where the document begins].
2/16/99 ................................ [4/1/05, [Insert page number
where the document begins].
6/15/99; 9/29/03 .................. 4/1/05, [Insert page number
where the document begins].
[FR Doc. 05–6378 Filed 3–31–05; 8:45 am]
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
1. The authority citation for part 52
continues to read as follows:
I
List of Subjects in 40 CFR Part 52
Permit
No.
Name of source
PART 52—[AMENDED]
Fmt 4700
Sfmt 4700
*
Additional
explanation/
§ 52.2063 citation
*
52.2020(d)(1)(e).
52.2020(d)(1)(e).
52.2020(d)(1)(e).
The short descriptors for the
following HCPCS codes were listed
incorrectly on page 66681: G0324,
G0325, G0326 and G0327. The corrected
descriptors are shown in section II.C.1
of this correcting amendment.
Incorrect practice expense relative
value units (RVUs) were shown for the
following CPT codes: Pages 66546 and
66685 for CPT code 58356; page 66557
for CPT codes 62367 and 62368; page
66614 for CPT code 77418; pages 66627
and 66686 for CPT codes 78811–26,
78812–26, 78813–26, 78814–26, 78815–
26 and 78816–26; page 66629 for CPT
code 88125 and 88125–TC; pages 66633
and 66687 for CPT codes 88367, 88367–
TC, 88368, 88368–TC and 89220; and
page 66665 for CPT code 96567. The
corrected RVUS are shown in section
II.C.2 of this correcting amendment.
On page 66666, we inadvertently
included work and malpractice RVUs
for acupuncture services, CPT codes
97810, 97811, 97813 and 97814 and
there services are not covered by
Medicare. We typically do not publish
RVUs for services that Medicare does
not cover. Instead, we list these services
with ‘‘0.00’s’’ in the RVU columns. This
correction is reflected in section II.C.2 of
this correcting amendment.
The following HCPCS codes were
discussed on page 66308 of the rule but
were inadvertently omitted from page
E:\FR\FM\01APR1.SGM
01APR1
Federal Register / Vol. 70, No. 62 / Friday, April 1, 2005 / Rules and Regulations
66683 of Addendum B: G9021, G9022,
G9023, G9024, G0925, G9026, G9027,
G9028, G9029, G9030, G09031 and
G9032. The HCPCS codes are shown in
section II.C.3 of this correcting
amendment.
On page 66900, the title should be
corrected to read ‘‘Addendum L.’’
Discussion of Regulation Text Errors
In the regulation text we made
technical omissions that should have
been included in §§ 403.766, 414.39,
and 424.80. The corrections are
reflected in section II.B. of this
correcting amendment.
II. Correction of Errors
In FR Doc. 02–37639 of November 15,
2004 (69 FR 66236), make the following
corrections—
A. Correction of Preamble Errors
1. Under ‘‘For Further Information
Contact’’ on page 66236, third column
and on page 66237 in the first column
make the following corrections:
Bill Larson (410) 786–4639 or Tiffany
Sanders (410) 786–1948 for issues
UAF =
related to coverage of an initial
preventive physical exam.
Joyce Eng (410) 786–4619 for issues
related to coverage of cardiovascular
screening tests.
Betty Shaw (410) 786–4165 for issues
related to coverage of diabetes screening
tests.
Steve Berkowitz (410) 786–0277 for
issues related to coverage of routine
costs associated with certain clinical
trials.
Karen Daily (410) 786–0189 for issues
related to clinical conditions for
payment of covered items of durable
medical equipment.
2. On page 66237, third column, start
a new line after ‘‘Section VI. Five-Year
Refinement of Relative Value Units’’
and before ‘‘Section VII. Update to the
Codes for Physician Self-Referral
Prohibition’’.
3. In Table 2, ‘‘Equipment Items
Needing Specialty Input for Pricing and
Proposed Deletions’’, on page 66252
under the column labeled ‘‘Commenter
response’’, the price referenced for
neurobehavioral status instrumentaverage was listed incorrectly. This
16721
should be corrected to read ‘‘Submitted
price of $13,635’’.
4. In table 5 and table 7 on pages
66268 and 66270, we incorrectly used
the specialty description ‘‘Osteopathic
Manipulative Therapy.’’ This should be
revised to read ‘‘Osteopathic
Manipulative Medicine.’’
5. On page 66306, first column, last
sentence, in the response, we
erroneously stated ‘‘Physicians should
use HCPCS code G0352 for injections
previously billed under CPT code
90783.’’ This is incorrect. This sentence
should be corrected to read ‘‘Physicians
should continue using CPT code 90783
when billing for an intra-arterial
therapeutic or diagnostic injection.
6. On page 66369, in the first column,
first paragraph, third sentence, ‘‘CRP
codes’’ should be corrected to read
‘‘CPT codes’’ and in the first line of the
second column, ‘‘work PVUs’’ should be
corrected to read ‘‘work RVUs.’’
7. On page 66385, the statutory
formula that follows the first sentence in
the third column did not print legibly.
The referenced formula and information
should read as follows:
Target 4 / 96 −12 / 04 − Actual 4 / 96 −12 / 04
Target 04 − Actual 04
× .75 +
× .33
Actual 04
Actual 04 × SGR 05
UAF = Update Adjustment Factor.
Target04 = Allowed Expenditures for
2004 or $77.1 billion.
Actual04 = Estimated Actual
Expenditures for 2004 = $84.9 billion.
Target 4/96–12/04 = Allowed Expenditures
from 4/1/1996–12/31/2004 = $531.8
billion.
Actual 4/96–12/04 = Estimated Actual
Expenditures from 4/1/1996–12/31/
2003 = $545.5 billion.
SGR05 = 4.3 percent (1.043).
$77.1 − $84.9
$531.8 − $545.5
× .75 +
× .33 = −0.120
$84.9
$84.9 × 1.043
VerDate jul<14>2003
17:23 Mar 31, 2005
Jkt 205001
a supplying fee of $50 for the initial
immunosuppressive prescription in the
first month after a beneficiary has a
transplant and a per prescription
supplying fee of $24 for each supplied
immunosuppressive prescription
thereafter and for each supplied oral
anti-cancer and oral anti-emetic
prescription.’’
B. Correction of Regulation Text Errors
Authority: 42 U.S.C. 1359b–3 and secs.
1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
§ 403.766
[Corrected]
2. Section 403.766 is amended by
revising paragraph (a) introductory text
to read as follows:
I
§ 403.766 Requirements for coverage and
payment of RNHCI home services.
(a) Medicare Part A pays for RNHCI
Accordingly, 42 CFR chapter IV is
home services if the RNHCI provider
corrected by making the following
correcting amendments to parts 403, 414, does the following:
*
*
*
*
*
and 424:
PART 403—[CORRECTED]
PART 414—[CORRECTED]
1. The authority citation for part 403
continues to read as follows:
I
I
PO 00000
Frm 00031
Fmt 4700
Sfmt 4700
3. The authority citation for part 414
continues to read as follows:
E:\FR\FM\01APR1.SGM
01APR1
ER01AP05.001
I
ER01AP05.000
8. In the first column, second
paragraph, second sentence on page
66404 we state ‘‘Payment in 2005 for
G0351 (the comparable code) will be
$125.69.’’ This should be corrected to
read as follows ‘‘Payment in 2005 for
G0357 (the comparable code) will be
$125.69.’’
9. On page 66408, the second column,
the last sentence in the first full
paragraph, the referenced estimate
related to utilization growth for
rheumatology is incorrectly stated as 9
percent. This should be corrected to
read ‘‘would increase by 16 percent.’’
10. On page 66412, third column,
following table 46, line 4, the discussion
concerning sections 303–304, the first
complete sentence beginning ‘‘In
addition, we are also paying a supplying
fee * * *’’ is corrected to read as
follows: ‘‘In addition, we are also paying
16722
Federal Register / Vol. 70, No. 62 / Friday, April 1, 2005 / Rules and Regulations
§ 414.39
[Corrected]
PART 424—[CORRECTED]
5. The authority citation for part 424
continues to read as follows:
I
I
4. Section 414.39 is amended by
revising paragraph (c)(1) to read as
follows:
Authority: Secs. 1102 and 1871 of the
Social Security Act (42 U.S.C. 1302 and
1395hh).
§ 414.39 Special rules for payment of care
plan oversight.
§ 424.80
*
*
*
*
*
(c) * * *
(1) An NPP can furnish physician care
plan oversight (but may not certify a
patient as needing home health services)
only if the physician who signs the plan
of care provides regular ongoing care
under the same plan of care as does the
NPP billing for care plan oversight and
either—
*
*
*
*
*
VerDate jul<14>2003
15:42 Mar 31, 2005
Jkt 205001
[Corrected]
6. Section 424.80 is amended by
revising paragraph (a) to read as follows:
I
§ 424.80 Prohibition of reassignment of
claims by suppliers.
(a) Basic prohibition. Except as
specified in paragraph (b) of this
section, Medicare does not pay amounts
that are due a supplier under an
assignment to any other person under
reassignment, power of attorney, or any
other direct arrangement. Nothing in
PO 00000
Frm 00032
Fmt 4700
Sfmt 4725
this section alters a party’s obligations
under the anti-kickback statute (section
1128B(b) of the Act), the physician selfreferral prohibition (section 1877 of the
Act), the rules regarding physician
billing for purchased diagnostic tests
(§ 414.50 of this chapter), the rules
regarding payment for services and
supplies incident to a physician’s
professional services (§ 410.26 of this
chapter), or any other applicable
Medicare laws, rules, or regulations.
*
*
*
*
*
C. Correction of Errors in the Addendum
1. In Addenda B and C, the following
CPT and HCPCS codes are corrected to
read as follows:
[BILLING CODE 4120–01–P]
E:\FR\FM\01APR1.SGM
01APR1
ER01AP05.002
Authority: Secs. 1102, 1871, and 1881(b)(1)
of the Social Security Act (42 U.S.C. 1302,
1395hh, and 1395rr(b)(1).
Federal Register / Vol. 70, No. 62 / Friday, April 1, 2005 / Rules and Regulations
16723
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15:42 Mar 31, 2005
Jkt 205001
PO 00000
Frm 00033
Fmt 4700
Sfmt 4725
E:\FR\FM\01APR1.SGM
01APR1
ER01AP05.003
2. In Addenda B and C, the following
CPT and HCPCS codes are corrected to
read as follows:
16724
Federal Register / Vol. 70, No. 62 / Friday, April 1, 2005 / Rules and Regulations
3. In Addendum B, the following
HCPCS codes are included to read as
follows:
We ordinarily publish a notice of
proposed rulemaking in the Federal
Register to provide a period for public
comment prior to publication of a final
notice. We can waive this procedure,
however, if we find good cause that
notice and comment procedure is
impracticable, unnecessary, or contrary
to the public interest and incorporate a
statement of the finding and the reasons
for it into the notice issued. In
accordance with section 903 of the
MMA, failure to retroactively apply the
corrections would be contrary to the
public interest.
We find it unnecessary to undertake
notice and comment rulemaking
because this notice merely provides
technical corrections to the regulations.
Therefore, we find good cause to waive
notice and comment procedures.
(Catalog of Federal Domestic Assistance
Program No. 93.774, Medicare—
Supplementary Medical Insurance Program)
Dated: March 16, 2005.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 05–6131 Filed 3–25–05; 8:45 am]
BILLING CODE 4120–01–C
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 412 and 413
[CMS–1213–CN]
RIN 0938–AL50
Medicare Program; Prospective
Payment System for Inpatient
Psychiatric Facilities; Final Rule;
Correction
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Correction of final rule.
AGENCY:
SUMMARY: This document corrects errors
that appeared in the final rule published
in the Federal Register on November 15,
2004, entitled ‘‘Medicare Program;
Prospective Payment System for
Inpatient Psychiatric Facilities.’’ This
document also supplements the
November 15, 2004 final rule.
DATES: Effective January 1, 2005.
FOR FURTHER INFORMATION CONTACT:
Janet Samen, (410) 786–9161.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 04–24787 of November 15,
2004 (69 FR 66922), there were several
errors that are identified in the
‘‘Summary of Errors’’ section and
corrected in the ‘‘Correction of Errors’’
section below. In addition to clarifying
ambiguities and correcting
typographical errors and incorrect
references, this document is a
supplement to the document published
on November 15, 2004, entitled
VerDate jul<14>2003
15:42 Mar 31, 2005
Jkt 205001
PO 00000
Frm 00034
Fmt 4700
Sfmt 4700
‘‘Medicare Program; Prospective
Payment System for Inpatient
Psychiatric Facilities’’ (hereinafter
referred to as the IPF PPS final rule or
final rule) because it includes a timely
submitted comment and our response
that we inadvertently failed to include
in the final rule. The provisions of this
correction notice are effective as if they
had been included in the final rule.
Accordingly, the corrections are
effective January 1, 2005.
II. Summary of Errors
In the November 15, 2004 final rule,
in payment calculation examples, we
stated that we computed a wage
adjustment factor for each case by
multiplying the Medicare 2005 hospital
wage index for each facility by the
labor-related share and adding the nonlabor share. We used the correct labor
share value of 72.247 percent on page
66953 in Table 8 of the final rule.
However, we inadvertently did not use
the correct labor-related and non-labor
share values in other portions of the
final rule. Instead of using 72.247
percent for the labor share and 27.753
percent for the non-labor share, we used
a value of 72.528 percent for the labor
share and 27.472 percent for the nonlabor share. This error only affected the
values in the payment calculation
examples on pages 66942, 66943, 66960,
and 66961 of the final rule (See sections
III.A.9, III.A.10 and the values in the
outlier calculation example in section
III.A.25 of this correction notice). These
errors did not have any effect on actual
payments. The table in Addendum A on
page 66982 of the final rule that
contains the labor and non-labor portion
of the Per Diem Rate is also corrected in
section III.C of this correction notice.
E:\FR\FM\01APR1.SGM
01APR1
ER01AP05.004
III. Waiver of Proposed Rulemaking
Agencies
[Federal Register Volume 70, Number 62 (Friday, April 1, 2005)]
[Rules and Regulations]
[Pages 16720-16724]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-6131]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 403, 405, 410, 411, 414, 418, 424, 484, and 486
[CMS-1429-F2]
RIN 0938-AM90
Medicare Program; Revisions to Payment Policies Under the
Physician Fee Schedule for Calendar Year 2005: Correcting Amendment
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correcting amendment.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the Federal Register on
November 15, 2004 entitled ``Revisions to Payment Policies Under the
Physician Fee Schedule for Calendar Year 2005.''
DATES: Effective Date: This rule is effective January 1, 2005.
FOR FURTHER INFORMATION CONTACT: Diane Milstead, (410) 786-3355.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 04-24758 of November 15, 2004 (69 FR 66236), there were
a number of technical errors that we are identifying and correcting in
the ``Correction of Errors'' section of this correcting amendment.
Additionally, there are various revisions to Addenda B, C and F.
Discussion of Addenda B, C and F
In Addenda B and C, we assigned incorrect status indicators to the
following CPT and HCPCS codes: Page 66429 for CPT codes 0066T and
0074T, page 66502 for CPT code 36415, page 66504 for CPT code 37195,
pages 66682 and 66688 for HCPCS code G0363. We also assigned incorrect
global periods for the following CPT and HCPCS codes: Page 66539 for
CPT code 54150; pages 66638 and 66687 for CPT codes 91034, 91034-26,
91034-TC, 91035, 91035-26, 91035-TC, 91037, 91037-26, 91037-TC, 91038
91038-26, 91038-TC, 91040, 91040-26, 91040-TC; and pages 66682 and
66688 for G0350, G0354 and G0358. These corrections are reflected in
section II.C.1 of this correcting amendment.
The short descriptors for the following HCPCS codes were listed
incorrectly on page 66681: G0324, G0325, G0326 and G0327. The corrected
descriptors are shown in section II.C.1 of this correcting amendment.
Incorrect practice expense relative value units (RVUs) were shown
for the following CPT codes: Pages 66546 and 66685 for CPT code 58356;
page 66557 for CPT codes 62367 and 62368; page 66614 for CPT code
77418; pages 66627 and 66686 for CPT codes 78811-26, 78812-26, 78813-
26, 78814-26, 78815-26 and 78816-26; page 66629 for CPT code 88125 and
88125-TC; pages 66633 and 66687 for CPT codes 88367, 88367-TC, 88368,
88368-TC and 89220; and page 66665 for CPT code 96567. The corrected
RVUS are shown in section II.C.2 of this correcting amendment.
On page 66666, we inadvertently included work and malpractice RVUs
for acupuncture services, CPT codes 97810, 97811, 97813 and 97814 and
there services are not covered by Medicare. We typically do not publish
RVUs for services that Medicare does not cover. Instead, we list these
services with ``0.00's'' in the RVU columns. This correction is
reflected in section II.C.2 of this correcting amendment.
The following HCPCS codes were discussed on page 66308 of the rule
but were inadvertently omitted from page
[[Page 16721]]
66683 of Addendum B: G9021, G9022, G9023, G9024, G0925, G9026, G9027,
G9028, G9029, G9030, G09031 and G9032. The HCPCS codes are shown in
section II.C.3 of this correcting amendment.
On page 66900, the title should be corrected to read ``Addendum
L.''
Discussion of Regulation Text Errors
In the regulation text we made technical omissions that should have
been included in Sec. Sec. 403.766, 414.39, and 424.80. The
corrections are reflected in section II.B. of this correcting
amendment.
II. Correction of Errors
In FR Doc. 02-37639 of November 15, 2004 (69 FR 66236), make the
following corrections--
A. Correction of Preamble Errors
1. Under ``For Further Information Contact'' on page 66236, third
column and on page 66237 in the first column make the following
corrections:
Bill Larson (410) 786-4639 or Tiffany Sanders (410) 786-1948 for
issues related to coverage of an initial preventive physical exam.
Joyce Eng (410) 786-4619 for issues related to coverage of
cardiovascular screening tests.
Betty Shaw (410) 786-4165 for issues related to coverage of
diabetes screening tests.
Steve Berkowitz (410) 786-0277 for issues related to coverage of
routine costs associated with certain clinical trials.
Karen Daily (410) 786-0189 for issues related to clinical
conditions for payment of covered items of durable medical equipment.
2. On page 66237, third column, start a new line after ``Section
VI. Five-Year Refinement of Relative Value Units'' and before ``Section
VII. Update to the Codes for Physician Self-Referral Prohibition''.
3. In Table 2, ``Equipment Items Needing Specialty Input for
Pricing and Proposed Deletions'', on page 66252 under the column
labeled ``Commenter response'', the price referenced for
neurobehavioral status instrument-average was listed incorrectly. This
should be corrected to read ``Submitted price of $13,635''.
4. In table 5 and table 7 on pages 66268 and 66270, we incorrectly
used the specialty description ``Osteopathic Manipulative Therapy.''
This should be revised to read ``Osteopathic Manipulative Medicine.''
5. On page 66306, first column, last sentence, in the response, we
erroneously stated ``Physicians should use HCPCS code G0352 for
injections previously billed under CPT code 90783.'' This is incorrect.
This sentence should be corrected to read ``Physicians should continue
using CPT code 90783 when billing for an intra-arterial therapeutic or
diagnostic injection.
6. On page 66369, in the first column, first paragraph, third
sentence, ``CRP codes'' should be corrected to read ``CPT codes'' and
in the first line of the second column, ``work PVUs'' should be
corrected to read ``work RVUs.''
7. On page 66385, the statutory formula that follows the first
sentence in the third column did not print legibly. The referenced
formula and information should read as follows:
[GRAPHIC] [TIFF OMITTED] TR01AP05.000
UAF = Update Adjustment Factor.
Target04 = Allowed Expenditures for 2004 or $77.1 billion.
Actual04 = Estimated Actual Expenditures for 2004 = $84.9
billion.
Target 4/96-12/04 = Allowed Expenditures from 4/1/1996-12/
31/2004 = $531.8 billion.
Actual 4/96-12/04 = Estimated Actual Expenditures from 4/1/
1996-12/31/2003 = $545.5 billion.
SGR05 = 4.3 percent (1.043).
[GRAPHIC] [TIFF OMITTED] TR01AP05.001
8. In the first column, second paragraph, second sentence on page
66404 we state ``Payment in 2005 for G0351 (the comparable code) will
be $125.69.'' This should be corrected to read as follows ``Payment in
2005 for G0357 (the comparable code) will be $125.69.''
9. On page 66408, the second column, the last sentence in the first
full paragraph, the referenced estimate related to utilization growth
for rheumatology is incorrectly stated as 9 percent. This should be
corrected to read ``would increase by 16 percent.''
10. On page 66412, third column, following table 46, line 4, the
discussion concerning sections 303-304, the first complete sentence
beginning ``In addition, we are also paying a supplying fee * * *'' is
corrected to read as follows: ``In addition, we are also paying a
supplying fee of $50 for the initial immunosuppressive prescription in
the first month after a beneficiary has a transplant and a per
prescription supplying fee of $24 for each supplied immunosuppressive
prescription thereafter and for each supplied oral anti-cancer and oral
anti-emetic prescription.''
B. Correction of Regulation Text Errors
0
Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments to parts 403, 414, and 424:
PART 403--[CORRECTED]
0
1. The authority citation for part 403 continues to read as follows:
Authority: 42 U.S.C. 1359b-3 and secs. 1102 and 1871 of the
Social Security Act (42 U.S.C. 1302 and 1395hh).
Sec. 403.766 [Corrected]
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2. Section 403.766 is amended by revising paragraph (a) introductory
text to read as follows:
Sec. 403.766 Requirements for coverage and payment of RNHCI home
services.
(a) Medicare Part A pays for RNHCI home services if the RNHCI
provider does the following:
* * * * *
PART 414--[CORRECTED]
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3. The authority citation for part 414 continues to read as follows:
[[Page 16722]]
Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1).
Sec. 414.39 [Corrected]
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4. Section 414.39 is amended by revising paragraph(c)(1) to read as
follows:
Sec. 414.39 Special rules for payment of care plan oversight.
* * * * *
(c) * * *
(1) An NPP can furnish physician care plan oversight (but may not
certify a patient as needing home health services) only if the
physician who signs the plan of care provides regular ongoing care
under the same plan of care as does the NPP billing for care plan
oversight and either--
* * * * *
PART 424--[CORRECTED]
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5. The authority citation for part 424 continues to read as follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
Sec. 424.80 [Corrected]
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6. Section 424.80 is amended by revising paragraph (a) to read as
follows:
Sec. 424.80 Prohibition of reassignment of claims by suppliers.
(a) Basic prohibition. Except as specified in paragraph (b) of this
section, Medicare does not pay amounts that are due a supplier under an
assignment to any other person under reassignment, power of attorney,
or any other direct arrangement. Nothing in this section alters a
party's obligations under the anti-kickback statute (section 1128B(b)
of the Act), the physician self-referral prohibition (section 1877 of
the Act), the rules regarding physician billing for purchased
diagnostic tests (Sec. 414.50 of this chapter), the rules regarding
payment for services and supplies incident to a physician's
professional services (Sec. 410.26 of this chapter), or any other
applicable Medicare laws, rules, or regulations.
* * * * *
C. Correction of Errors in the Addendum
1. In Addenda B and C, the following CPT and HCPCS codes are
corrected to read as follows:
[BILLING CODE 4120-01-P]
[GRAPHIC] [TIFF OMITTED] TR01AP05.002
[[Page 16723]]
2. In Addenda B and C, the following CPT and HCPCS codes are
corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR01AP05.003
[[Page 16724]]
3. In Addendum B, the following HCPCS codes are included to read as
follows:
[GRAPHIC] [TIFF OMITTED] TR01AP05.004
III. Waiver of Proposed Rulemaking
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment prior to
publication of a final notice. We can waive this procedure, however, if
we find good cause that notice and comment procedure is impracticable,
unnecessary, or contrary to the public interest and incorporate a
statement of the finding and the reasons for it into the notice issued.
In accordance with section 903 of the MMA, failure to retroactively
apply the corrections would be contrary to the public interest.
We find it unnecessary to undertake notice and comment rulemaking
because this notice merely provides technical corrections to the
regulations. Therefore, we find good cause to waive notice and comment
procedures.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program)
Dated: March 16, 2005.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 05-6131 Filed 3-25-05; 8:45 am]
BILLING CODE 4120-01-C