Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2007 and Deficit Reduction Act of 2005 Changes to Medicare Payment for Oxygen Equipment and Capped Rental Durable Medical Equipment; Proposed Rule, 44082-44180 [06-6614]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 414 and 484
[CMS–1304–P]
RIN 0938–AN76
Medicare Program; Home Health
Prospective Payment System Rate
Update for Calendar Year 2007 and
Deficit Reduction Act of 2005 Changes
to Medicare Payment for Oxygen
Equipment and Capped Rental Durable
Medical Equipment; Proposed Rule
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Proposed rule.
hsrobinson on PROD1PC69 with PROPOSALS2
AGENCY:
SUMMARY: This proposed rule would set
forth an update to the 60-day national
episode rates and the national per-visit
amounts under the Medicare
prospective payment system for home
health agencies. In addition, this
proposed rule would set forth policy
changes related to Medicare payment for
certain durable medical equipment for
the purpose of implementing sections
1834(a)(5) and 1834(a)(7) of the Social
Security Act, as amended by section
5101 of the Deficit Reduction Act of
2005. We are also inviting comments on
a number of issues including payments
based on reporting quality data and
health information technology, as well
as how to improve data transparency for
consumers.
DATES: To be assured consideration,
comments must be received at one of
the addresses provided below, no later
than 5 p.m. on September 25, 2006.
ADDRESSES: In commenting, please refer
to file code CMS–1304–P. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
You may submit comments in one of
four ways (no duplicates, please):
1. Electronically. You may submit
electronic comments on specific issues
in this regulation to https://
www.cms.hhs.gov/eRulemaking. Click
on the link ‘‘Submit electronic
comments on CMS regulations with an
open comment period.’’ (Attachments
should be in Microsoft Word,
WordPerfect, or Excel; however, we
prefer Microsoft Word.)
2. By regular mail. You may mail
written comments (one original and two
copies) to the following address ONLY:
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Attention: CMS–
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1304–P, P.O. Box 8014, Baltimore,
MD 21244–8014.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments (one
original and two copies) to the following
address ONLY:
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Attention: CMS–
1304–P, Mail Stop C4–26–05, 7500
Security Boulevard, Baltimore, MD
21244–1850.
4. By hand or courier. If you prefer,
you may deliver (by hand or courier)
your written comments (one original
and two copies) before the close of the
comment period to one of the following
addresses. If you intend to deliver your
comments to the Baltimore address,
please call telephone number (410) 786–
7195 in advance to schedule your
arrival with one of our staff members.
Room 445–G, Hubert H. Humphrey
Building, 200 Independence Avenue,
SW., Washington, DC 20201; or 7500
Security Boulevard, Baltimore, MD
21244–1850.
(Because access to the interior of the
HHH Building is not readily available to
persons without Federal Government
identification, commenters are
encouraged to leave their comments in
the CMS drop slots located in the main
lobby of the building. A stamp-in clock
is available for persons wishing to retain
a proof of filing by stamping in and
retaining an extra copy of the comments
being filed.)
Comments mailed to the addresses
indicated as appropriate for hand or
courier delivery may be delayed and
received after the comment period.
Submission of comments on
paperwork requirements. You may
submit comments on this document’s
paperwork requirements by mailing
your comments to the addresses
provided at the end of the ‘‘Collection
of Information Requirements’’ section in
this document.
For information on viewing public
comments, see the beginning of the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Randy Throndset, (410) 786–0131, or
Sharon Ventura, (410) 786–1985 (for
issues related to the home health
prospective payment system).
Doug Brown, (410) 786–0028 (for
issues related to reporting quality data).
Alexis Meholic, (410) 786–2300 (for
issues related to implementation of
section 5101 of the Deficit Reduction
Act of 2005).
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SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome
comments from the public on all issues
set forth in this rule to assist us in fully
considering issues and developing
policies. You can assist us by
referencing the file code CMS–1304–P
and the specific ‘‘issue identifier’’ that
precedes the section on which you
choose to comment.
Inspection of Public Comments: All
comments received before the close of
the comment period are available for
viewing by the public, including any
personally identifiable or confidential
business information that is included in
a comment. We post all comments
received before the close of the
comment period on the following Web
site as soon as possible after they have
been received: https://www.cms.hhs.gov/
eRulemaking. Click on the link
‘‘Electronic Comments on CMS
Regulations’’ on that Web site to view
public comments.
Comments received timely would also
be available for public inspection as
they are received, generally beginning
approximately 3 weeks after publication
of a document, at the headquarters of
the Centers for Medicare & Medicaid
Services, 7500 Security Boulevard,
Baltimore, Maryland 21244, Monday
through Friday of each week from 8:30
a.m. to 4 p.m. To schedule an
appointment to view public comments,
phone 1–800–743–3951.
I. Background
[If you choose to comment on issues
in this section, please include the
caption ‘‘BACKGROUND’’ at the
beginning of your comments.]
A. Statutory Background
The Balanced Budget Act of 1997
(BBA) (Pub. L. 105–33), enacted on
August 5, 1997, significantly changed
the way Medicare pays for Medicare
home health services. Until the
implementation of a home health
prospective payment system (HH PPS)
on October 1, 2000, home health
agencies (HHAs) received payment
under a cost-based reimbursement
system. Section 4603 of the BBA
governed the development of the HH
PPS.
Section 4603(a) of the BBA provides
the authority for the development of a
PPS for all Medicare-covered home
health services provided under a plan of
care that were paid on a reasonable cost
basis by adding section 1895, entitled
‘‘Prospective Payment For Home Health
Services,’’ to the Social Security Act
(the Act).
Section 1895(b)(1) of the Act requires
the Secretary to establish a PPS for all
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costs of home health services paid
under Medicare.
Section 1895(b)(3)(A) of the Act
requires that (1) the computation of a
standard prospective payment amount
include all costs of home health services
covered and paid for on a reasonable
cost basis and be initially based on the
most recent audited cost report data
available to the Secretary, and (2) the
prospective payment amounts be
standardized to eliminate the effects of
case-mix and wage levels among HHAs.
Section 1895(b)(3)(B) of the Act
addresses the annual update to the
standard prospective payment amounts
by the home health applicable increase
percentage as specified in the statute.
Section 1895(b)(4) of the Act governs
the payment computation. Sections
1895(b)(4)(A)(i) and (b)(4)(A)(ii) of the
Act require the standard prospective
payment amount to be adjusted for casemix and geographic differences in wage
levels. Section 1895(b)(4)(B) of the Act
requires the establishment of an
appropriate case-mix adjustment factor
that explains a significant amount of the
variation in cost among different units
of services. Similarly, section
1895(b)(4)(C) of the Act requires the
establishment of wage-adjustment
factors that reflect the relative level of
wages and wage-related costs applicable
to the furnishing of home health
services in a geographic area compared
to the national average applicable level.
These wage-adjustment factors may be
the factors used by the Secretary for the
different area wage levels for purposes
of section 1886(d)(3)(E) of the Act.
Section 1895(b)(5) of the Act gives the
Secretary the option to grant additions
or adjustments to the payment amount
otherwise made in the case of outliers
because of unusual variations in the
type or amount of medically necessary
care. Total outlier payments in a given
fiscal year cannot exceed 5 percent of
total payments projected or estimated.
On December 8, 2003, the Congress
enacted the Medicare Prescription Drug,
Improvement, and Modernization Act
(MMA) of 2003 (Pub. L. 108–173). This
legislation affected how we make
updates to HH payment rates.
Section 701 of the MMA changed the
yearly update cycle of the HH PPS rates
from that of a fiscal year to a calendar
year update cycle for 2004 and any
subsequent year. Generally, section
701(a) of the MMA changed the
references in the statute to refer to the
calendar year for 2004 and any
subsequent year. The changes resulted
in updates to the HH PPS rates
described as ‘‘fiscal year’’ updates for
2002 and 2003 and as ‘‘calendar year’’
updates for 2004 and any subsequent
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year (section 1895(b)(3)(B)(i) of the Act).
Beginning on January 1, 2005, HH PPS
would now be updated on a calendar
year update cycle.
In addition to changing the update
cycle for HH PPS rates, section 701 of
the MMA made adjustments to the
home health applicable increase
percentage for 2004, 2005, and 2006.
Specifically, section 701(a)(2)(D) of the
MMA left unchanged the home health
market basket update for the last
calendar year quarter of 2003 and the
first calendar year quarter of 2004
(section 1895(b)(3)(B)(ii)(II) of the Act).
Furthermore, section 701(b)(4) of the
MMA set the home health applicable
percentage increase for the last 3
quarters of 2004 as the home health
market basket (3.1 percent) minus 0.8
percentage point (section
1895(b)(3)(B)(ii)(III) of the Act). We
implemented this provision through
Pub. 100–20, One Time Notification,
Transmittal 59, issued February 20,
2004. Section 701(b)(4) of the MMA also
provided that updates for CY 2005 and
CY 2006 would equal the applicable
home health market basket percentage
increase minus 0.8 percentage point.
Lastly, section 701(b)(3) of the MMA
revised the statute to provide that HH
PPS rates for CY 2007 and any
subsequent year would be updated by
that year’s home health market basket
percentage increase (section
1895(b)(3)(B)(ii)(IV) of the Act).
On February 8, 2006, the Congress
enacted the Deficit Reduction Act (DRA)
of 2005 (Pub. L. 109–171). This
legislation made additional changes to
HH PPS.
Section 5201 of the DRA changed the
CY 2006 update from the applicable
home health market basket percentage
increase minus 0.8 percentage point to
a 0 percent update.
Section 5201 of the DRA amended
section 421(a) of the MMA. The
amended section 421(a) of the MMA
requires for home health services
furnished in a rural area (as defined in
section 1886(d)(2)(D) of the Act) on or
after January 1, 2006 and before January
1, 2007, that the Secretary increase the
payment amount otherwise made under
section 1895 of the Act for those
services by 5 percent. The statute
waives budget neutrality for purposes of
this increase as it specifically requires
that the Secretary not reduce the
standard prospective payment amount
(or amounts) under section 1895 of the
Act applicable to home health services
furnished during a period to offset the
increase in payments resulting in the
application of this section of the statute.
The 0 percent update to the payment
rates and the rural add-on provisions of
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the DRA were implemented through
Pub. 100–20, One Time Notification,
Transmittal 211 issued February 10,
2006.
In addition, section 5201(c) of the
DRA amends the statute to add section
1895(b)(3)(B)(v) to the Act, requiring
HHAs to submit data for purposes of
measuring health care quality. This
requirement is applicable for 2007 and
each subsequent year. For 2007 and
each subsequent year, in the case of a
HHA that does not submit quality data,
the home health market basket
percentage increase would be reduced
by 2 percentage points.
B. Updates
On July 3, 2000, we published a final
rule (65 FR 41128) in the Federal
Register to implement the HH PPS
legislation. That final rule established
requirements for the new PPS for HHAs
as required by section 4603 of the BBA,
and as subsequently amended by
section 5101 of the Omnibus
Consolidated and Emergency
Supplemental Appropriations Act
(OCESAA) for Fiscal Year 1999 (Pub. L.
105–277), enacted on October 21, 1998;
and by sections 302, 305, and 306 of the
Medicare, Medicaid, and SCHIP
Balanced Budget Refinement Act
(BBRA) of 1999 (Pub. L. 106–113),
enacted on November 29, 1999. The
requirements include the
implementation of a PPS for HHAs,
consolidated billing requirements, and a
number of other related changes. The
PPS described in that rule replaced the
retrospective reasonable-cost-based
system that was used by Medicare for
the payment of home health services
under Part A and Part B.
On November 9, 2005, we published
a final rule (70 FR 68132), which set
forth an update to the 60-day national
episode rates and the national per-visit
amounts under the Medicare
prospective payment system for home
health agencies. As part of that final
rule, we adopted revised area labor
market Metropolitan Statistical Area
designations for CY 2006. In
implementing the new area labor market
designations, we allowed for a one-year
transition period. This transition
consists of a blend of 50 percent of the
new area labor market designations’
wage index and 50 percent of the
previous area labor market designations’
wage index. In addition, we revised the
fixed dollar loss ratio, which is used in
the calculation of outlier payments.
C. System for Payment of Home Health
Services
Generally, Medicare makes payment
under the HH PPS on the basis of a
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national standardized 60-day episode
payment, adjusted for case mix and
wage index. For episodes with four or
fewer visits, Medicare pays on the basis
of a national per-visit amount by
discipline, referred to as a low
utilization payment adjustment (LUPA).
Medicare also adjusts the 60-day
episode payment for certain intervening
events that give rise to a partial episode
payment adjustment (PEP adjustment)
or a significant change in condition
adjustment (SCIC). For certain cases that
exceed a specific cost threshold, an
outlier adjustment may also be
available. For a complete and full
description of the HH PPS as required
by the BBA and as amended by
OCESAA and BBRA, see the July 3,
2000 HH PPS final rule (65 FR 41128).
D. Changes in Payment for Oxygen and
Oxygen Equipment and Other Durable
Medical Equipment (Capped Rental
Items)
The Medicare payment rules for
durable medical equipment (DME) are
set forth in section 1834(a) of the Act
and 42 CFR part 414, subpart D of our
regulations. General payment rules for
DME are set forth in section 1834(a)(1)
of the Act and § 414.210 of our
regulations, and § 414.210 also contains
paragraphs relating to maintenance and
servicing of items and replacement of
items. Specific rules for oxygen and
oxygen equipment are set forth in
section 1834(a)(5) of the Act and
§ 414.226 of our regulations, and
specific rules for capped rental items are
set forth in section 1834(a)(7) of the Act
and § 414.229 of our regulations. Rules
for determining a period of continuous
use for the rental of DME are set forth
in § 414.230 of our regulations. The
Medicare payment basis for DME is
equal to 80 percent of either the lower
of the actual charge or the fee schedule
amount for the item. The beneficiary
coinsurance is equal to 20 percent of
either the lower of the actual charge or
the fee schedule amount for the item.
In accordance with the rules set forth
in section 1834(a)(5) of the Act and
§ 414.226 of our regulations, since 1989,
suppliers have been paid monthly for
furnishing oxygen and oxygen
equipment to Medicare beneficiaries.
Suppliers have also been paid an addon fee for furnishing portable oxygen
equipment to patients when medically
necessary. Before the enactment of the
DRA, these monthly payments
continued for the duration of use of the
equipment, provided that Medicare Part
B coverage and eligibility criteria were
met. Medicare covers three types of
oxygen delivery systems: (1) Stationary
or portable oxygen concentrators, which
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concentrate oxygen in room air; (2)
stationary or portable liquid oxygen
systems, which use oxygen stored as a
very cold liquid in cylinders and tanks;
and (3) stationary or portable gaseous
oxygen systems, which administer
compressed oxygen directly from
cylinders. Both liquid and gaseous
oxygen systems require delivery of
oxygen contents.
Medicare payment for furnishing
oxygen and oxygen equipment is made
on a monthly basis and the fee schedule
amounts vary by State. Payment for
oxygen contents for both stationary and
portable equipment is included in the
fee schedule allowances for stationary
equipment. Medicare fee schedules for
home oxygen equipment are modality
neutral; meaning that in a given State,
there is one fee schedule amount that
applies to all stationary systems and one
fee schedule amount that applies to all
portable systems.
Effective January 1, 2006, section
5101(b) of the DRA amended the Act at
section 1834(a)(5) of the Act, limiting to
36 months the total number of
continuous months for which Medicare
will pay for oxygen equipment on a
rental basis. At the end of the 36-month
period, this section mandates that the
supplier transfer title to the stationary
and portable oxygen equipment to the
beneficiary. Section 5101(b) of the DRA
does not, however, limit the number of
months for which Medicare will pay for
oxygen contents for beneficiary-owned
stationary or portable gaseous or liquid
systems, and payment will continue to
be made as long as the oxygen remains
medically necessary. Section 5101(b) of
the DRA also provides that payment for
reasonable and necessary maintenance
and servicing of beneficiary-owned
oxygen equipment will be made for
parts and labor not covered by a
supplier’s or manufacturer’s warranty.
In the case of beneficiaries using oxygen
equipment on December 31, 2005, the
36-month rental period prescribed by
the DRA begins on January 1, 2006.
In accordance with the rules set forth
in section 1834(a)(7) of the Act and
§ 414.229 of our regulations, before the
enactment of the DRA, suppliers of
capped rental items (that is, other DME
not described in paragraphs (2) through
(6) of section 1834(a) of the Act) were
paid on a rental or purchase option
basis. Payment for most items in the
capped rental category was made on a
monthly rental basis, with rental
payments being capped at 15 months or
13 months, depending on whether the
beneficiary chose to continue renting
the item or to take over ownership of the
item through the ‘‘purchase option.’’ For
all capped rental items, the supplier was
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required to inform the beneficiary of his
or her purchase option, during the 10th
rental month, to enter into a purchase
agreement under which the supplier
would transfer title to the item to the
beneficiary on the first day after the
13th continuous month during which
payment was made for the rental of the
item. Therefore, if the beneficiary chose
the purchase option, rental payments to
the supplier would continue through
the 13th month of continuous use of the
equipment, after which time title to the
equipment would transfer from the
supplier to the beneficiary. Medicare
would also make payment for any
reasonable and necessary repair or
maintenance and servicing of the
equipment following the transfer of title.
If the beneficiary did not choose the
purchase option, rental payments would
continue through the 15th month of
continuous use. In these cases, suppliers
would maintain title to the equipment
but would have to continue furnishing
the item to the beneficiary as long as
medically necessity continued.
Beginning 6 months after the 15th
month of continuous use in which
payment was made, Medicare would
also make semi-annual maintenance and
servicing payments to suppliers. These
payments were approximately equal to
10 percent of the purchase price for the
equipment as determined by the statute.
Total Medicare payments made through
the 13th and 15th months of rental
equal 105 and 120 percent, respectively,
of the purchase price for the equipment.
In the case of power-driven
wheelchairs, since 1989 payment has
also been made on a lump-sum
purchase basis at the time that the item
is initially furnished to the beneficiary
if the beneficiary chooses to obtain the
item in this manner. Most beneficiaries
choose to obtain power-driven
wheelchairs via this lump-sum purchase
option.
Effective for items for which the first
rental month occurs on or after January
1, 2006, section 5101(a) of the DRA of
2005 amended section 1834(a)(7) of the
Act, limiting to 13 months the total
number of continuous months for which
Medicare will pay for DME in this
category. After a 13-month period of
continuous use during which rental
payments are made, the statute requires
that the supplier transfer title to the
equipment to the beneficiary.
Beneficiaries may still elect to obtain
power-driven wheelchairs on a lumpsum purchase agreement basis. In all
cases, payment for reasonable and
necessary maintenance and servicing of
beneficiary-owned equipment will be
made for parts and labor not covered by
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the supplier’s or manufacturer’s
warranty.
II. Provisions of the Proposed
Regulations
[If you choose to comment on issues
in this section, please include the
caption ‘‘PROVISIONS OF THE
PROPOSED REGULATIONS’’ at the
beginning of your comments.]
A. National Standardized 60-Day
Episode Rate
Medicare HH PPS has been effective
since October 1, 2000. As set forth in the
final rule published July 3, 2000 in the
Federal Register (65 FR 41128), the unit
of payment under Medicare HH PPS is
a national standardized 60-day episode
rate. As set forth in § 484.220, we adjust
the national standardized 60-day
episode rate by a case mix grouping and
a wage index value based on the site of
service for the beneficiary. The
proposed CY 2007 HH PPS rates use the
same case-mix methodology and
application of the wage index
adjustment to the labor portion of the
HH PPS rates as set forth in the July 3,
2000 final rule. In the October 22, 2004
final rule, we rebased and revised the
home health market basket, resulting in
a labor-related share of 76.775 percent
and a non-labor portion of 23.225
percent (69 FR 62126). We multiply the
national 60-day episode rate by the
patient’s applicable case-mix weight.
We divide the case-mix adjusted
amount into a labor and non-labor
portion. We multiply the labor portion
by the applicable wage index based on
the site of service of the beneficiary.
As required by section 1895(b)(3)(B)
of the Act, we have updated the HH PPS
rates annually in a separate Federal
Register document. Section 484.225 sets
forth the specific annual percentage
update. To reflect section
1895(b)(3)(B)(v) of the Act, as added by
section 5201 of the DRA, in § 484.225,
we are proposing to revise paragraph (g)
as follows:
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(g) For 2007 and subsequent calendar
years, the unadjusted national rate is equal to
the rate for the previous calendar year
increased by the applicable home health
market basket index amount unless the HHA
has not submitted quality data in which case
the unadjusted national rate is equal to the
rate for the previous calendar year increased
by the applicable home health market basket
index amount minus 2 percentage points.
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For CY 2007, we are proposing to use
again the design and case-mix
methodology described in section III.G
of the HH PPS July 3, 2000 final rule (65
FR 41192 through 41203). For CY 2007,
we are proposing to base the wage index
adjustment to the labor portion of the
PPS rates on the most recent pre-floor
and pre-reclassified hospital wage index
as discussed in section II.F. of this
proposed rule (not including any
reclassifications under section
1886(d)(8)(B) of the Act).
As discussed in the July 3, 2000 HH
PPS final rule, for episodes with four or
fewer visits, Medicare pays the national
per-visit amount by discipline, referred
to as a LUPA. We update the national
per-visit amounts by discipline annually
by the applicable home health market
basket percentage. We adjust the
national per-visit amount by the
appropriate wage index based on the
site of service for the beneficiary as set
forth in § 484.230. We propose to adjust
the labor portion of the updated
national per-visit amounts by discipline
used to calculate the LUPA by the most
recent pre-floor and pre-reclassified
hospital wage index, as discussed in
section II.F of this proposed rule.
Medicare pays the 60-day case-mix
and wage-adjusted episode payment on
a split percentage payment approach.
The split percentage payment approach
includes an initial percentage payment
and a final percentage payment as set
forth in § 484.205(b)(1) and
§ 484.205(b)(2). We may base the initial
percentage payment on the submission
of a request for anticipated payment
(RAP) and the final percentage payment
on the submission of the claim for the
episode, as discussed in § 409.43. The
claim for the episode that the HHA
submits for the final percentage
payment determines the total payment
amount for the episode and whether we
make an applicable adjustment to the
60-day case-mix and wage-adjusted
episode payment. The end date of the
60-day episode as reported on the claim
determines which calendar year rates
Medicare would use to pay the claim.
We may also adjust the 60-day casemix and wage-adjusted episode
payment based on the information
submitted on the claim to reflect the
following:
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• A low utilization payment provided
on a per-visit basis as set forth in
§ 484.205(c) and § 484.230.
• A partial episode payment
adjustment as set forth in § 484.205(d)
and § 484.235.
• A significant change in condition
adjustment as set forth in § 484.205(e)
and § 484.237.
• An outlier payment as set forth in
§ 484.205(f) and § 484.240.
This proposed rule reflects the
proposed updated CY 2007 rates that
would be effective January 1, 2007.
B. Proposed CY 2007 Update to the
Home Health Market Basket Index
Section 1895(b)(3)(B) of the Act, as
amended by section 5201 of the DRA,
requires for CY 2007 that the standard
prospective payment amounts be
increased by a factor equal to the
applicable home health market basket
update.
• Proposed CY 2007 Adjustments.
In calculating the annual update for
the CY 2007 60-day episode rates, we
are proposing to first look at the CY
2006 rates as a starting point. The CY
2006 national 60-day episode rate, as
modified by section 5201(a)(4) of the
DRA (and implemented through Pub.
100–20, One Time Notification,
Transmittal 211 issued February 10,
2006) is $2,264.28.
In order to calculate the CY 2007
national 60-day episode rate, we are
proposing to multiply the CY 2006
national 60-day episode rate ($2,264.28)
by the proposed estimated home health
market basket update of 3.1 percent for
CY 2007. The proposed estimated home
health market basket percentage
increase reflects changes over time in
the prices of an appropriate mix of
goods and services included in covered
home health services. The estimated
home health market basket percentage
increase is generally used to update the
HH PPS rates on an annual basis.
We would increase the 60-day
episode payment rate for CY 2007
(episodes ending on or after January 1,
2007, and before January 1, 2008) by the
proposed estimated home health market
basket update (3.1 percent) ($2,264.28 ×
1.031) to yield the proposed updated CY
2007 national 60-day episode rate
($2,334.47) (see Table 1 below).
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TABLE 1.—PROPOSED NATIONAL 60-DAY EPISODE AMOUNTS UPDATED BY THE ESTIMATED HOME HEALTH MARKET
BASKET UPDATE FOR CY 2007, BEFORE CASE-MIX ADJUSTMENT
Multiply by the proposed estimated home health market
basket update
(3.1 Percent) 1
Total CY 2006 prospective payment amount per 60-day episode
Proposed CY 2007 updated
national 60-day episode rate
× 1.031
$2,264.28 .............................................................................................................
$2,334.47
1 The
estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc, 2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
National Per-visit Amounts Used To Pay
LUPAs and Compute Imputed Costs
Used in Outlier Calculations
As discussed previously in this
proposed rule, the policies governing
the LUPAs and outlier calculations set
forth in the July 3, 2000 HH PPS final
rule would continue during CY 2007. In
calculating the annual update for the CY
2007 national per-visit amounts we use
to pay LUPAs and to compute the
imputed costs in outlier calculations,
we are proposing to look again at the CY
2006 rates as a starting point. We then
are proposing to multiply those amounts
by the proposed estimated home health
market basket update (3.1 percent) for
CY 2007 to yield the updated per-visit
amounts for each home health
discipline for CY 2007 (episodes ending
on or after January 1, 2007, and before
January 1, 2008) (see Table 2 below).
TABLE 2.—PROPOSED NATIONAL PER-VISIT AMOUNTS FOR LUPAS AND OUTLIER CALCULATIONS UPDATED BY THE
ESTIMATED HOME HEALTH MARKET BASKET UPDATE FOR CY 2007
Final CY 2006
per-visit amounts
per 60-day episode for LUPAs
Home health discipline type
Home health aide ......................................................................................................
Medical social services ..............................................................................................
Occupational therapy .................................................................................................
Physical therapy ........................................................................................................
Skilled nursing ...........................................................................................................
Speech-language pathology ......................................................................................
Multiply by the
proposed estimated home
health market
basket
(3.1 percent) 1
×
×
×
×
×
×
$44.76
158.45
108.81
108.08
98.85
117.44
1.031
1.031
1.031
1.031
1.031
1.031
Proposed CY
2007 per-visit payment amount per
discipline for
LUPAs
$46.15
163.36
112.18
111.43
101.91
121.08
1 The estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc, 2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
hsrobinson on PROD1PC69 with PROPOSALS2
C. Rural Add-On
As stated above, section 5201(b) of the
DRA requires, for home health services
furnished in a rural area (as defined in
section 1886(d)(2)(D) of the Act) with
respect to episodes and visits beginning
on or after January 1, 2006 and before
January 1, 2007, that the Secretary
increase by 5 percent the payment
amount otherwise made under section
1895 of the Act. The statute waives
budget neutrality related to this
provision as it specifically states that
the Secretary shall not reduce the
standard prospective payment amount
(or amounts) under section 1895 of the
Act applicable to home health services
furnished during a period to offset the
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increase in payments resulting in the
application of this section of the statute.
While the rural add-on would
primarily affect those episodes paid
based on CY 2006 rates, it would also
affect a number of episodes that would
be paid based on CY 2007 rates. For
example, an episode that begins on
December 20, 2006 and ends on
February 17, 2007, for services
furnished in a rural area, would be paid
based on CY 2007 rates because the
episode ends on or after January 1, 2007
and before January 1, 2008; and the
episode would also receive the rural
add-on because the episode begins on or
after January 1, 2006 and before January
1, 2007.
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The applicable case-mix and wage
index adjustment is subsequently
applied to the 60-day episode amount
for the provision of home health
services where the site of service is the
non-Metropolitan Statistical Area (MSA)
of the beneficiary. Similarly, the
applicable wage index adjustment is
subsequently applied to the LUPA pervisit amounts adjusted for the provision
of home health services where the site
of service for the beneficiary is a nonMSA area. We implemented this
provision for CY 2006 on February 13,
2006 through Pub. 100–20, One Time
Notification, Transmittal 211 issued
February 10, 2006. The 5 percent rural
add-on is noted in tables 3 and 4 below.
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TABLE 3.—PROPOSED PAYMENT AMOUNTS FOR 60-DAY EPISODES BEGINNING IN CY 2006 AND ENDING IN CY 2007 UPDATED BY THE ESTIMATED HOME HEALTH MARKET BASKET UPDATE FOR CY 2007 WITH RURAL ADD-ON, BEFORE
CASE-MIX ADJUSTMENT
Proposed CY 2007 total prospective payment amount per 60-day episode
Proposed CY 2007 payment
amount per 60-day episode
beginning in CY 2006 and before January 1, 2007 and ending in CY 2007 for a beneficiary who resides in a nonMSA area
5 percent rural add-on
× 1.05
2,334.47 ...............................................................................................................
$2,451.20
TABLE 4.—PROPOSED NATIONAL PER-VISIT AMOUNTS FOR EPISODES BEGINNING IN CY 2006 AND ENDING IN CY 2007
UPDATED BY THE ESTIMATED HOME HEALTH MARKET BASKET UPDATE FOR CY 2007 WITH RURAL ADD-ON
Proposed CY
2007 per-visit
amounts
Home health discipline type
hsrobinson on PROD1PC69 with PROPOSALS2
Home health aide ......................................................................................................
Medical social services ..............................................................................................
Occupational therapy .................................................................................................
Physical therapy ........................................................................................................
Skilled nursing ...........................................................................................................
Speech-language pathology ......................................................................................
Section 5201(c)(2) of the DRA added
section 1895(b)(3)(B)(v)(II) to the Act,
requiring that ‘‘each home health agency
shall submit to the Secretary such data
that the Secretary determines are
appropriate for the measurement of
health care quality. Such data shall be
submitted in a form and manner, and at
a time, specified by the Secretary for
purposes of this clause.’’ In addition,
section 1895(b)(3)(B)(v)(I) of the Act, as
also added by section 5201(c)(2) of the
DRA, dictates that ‘‘for 2007 and each
subsequent year, in the case of a home
health agency that does not submit data
to the Secretary in accordance with
subclause (II) with respect to such a
year, the home health market basket
percentage increase applicable under
such clause for such year shall be
reduced by 2 percentage points.’’
The Omnibus Budget Reconciliation
Act of 1987 (OBRA 87) required the use
of a standardized assessment instrument
for quality oversight of HHAs. A
standardized assessment instrument
provides an HHA with a uniform
mechanism to assess the needs of their
patients and provide CMS with a
uniform mechanism to assess the HHA’s
ability to adequately address those
needs. To fulfill the OBRA 87 mandate,
CMS required that, as part of their
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×
×
×
×
×
×
$46.15
163.36
112.18
111.43
101.91
121.08
comprehensive assessment process,
HHAs collect and report Outcome and
Assessment Information Set (OASIS)
data and later mandated the submission
of this data as an HHA condition of
participation at 42 CFR 484.20 and
484.55.
The OASIS data provide consumers
and HHAs with ten, publicly-reported
home health quality measures which
have been endorsed by the National
Quality Forum (NQF). Reporting this
quality data has also required the
development of several supporting
mechanisms such as the HAVEN
software used to encode and transmit
data using a CMS standard electronic
record layout, edit specifications, and
data dictionary. The HAVEN software,
which includes the OASIS, has become
a standard practice within HHA
operations. These early investments in
data infrastructure and supporting
software that CMS and HHAs have
made over the past several years in
order to create this quality reporting
structure, have made quality reporting
and measurement an important
component of the HHA industry. The
ten measures are:
(1) Improvement in ambulation/
locomotion.
(2) Improvement in bathing.
(3) Improvement in transferring.
PO 00000
Multiply by the
5 percent rural
add-on
1.05
1.05
1.05
1.05
1.05
1.05
Proposed CY
2007 per-visit payment amount per
discipline for 60day episodes beginning on or after
January 1 in CY
2006 and ending
in CY 2007 for a
beneficiary who
resides in a nonmsa area
$48.46
171.53
117.79
117.00
107.01
127.13
(4) Improvement in management of
oral medications.
(5) Improvement in pain interfering
with activity.
(6) Acute care hospitalization.
(7) Emergent care.
(8) Improvement in dyspnea.
(9) Improvement in urinary
incontinence.
(10) Discharge to community.
We propose to use OASIS data and
the ten quality measures based on those
data as the appropriate measure on
home health quality. Continuing to use
the OASIS instrument would minimize
the burden to providers and ensure that
costs associated with the development
and testing of a new reporting
mechanism are not incurred. We believe
that at this time the noted ten quality
measures are the most appropriate
measure of home health quality.
Accordingly, for the calendar year (CY)
2007, we propose that the OASIS data,
specifically, the ten quality measures, be
submitted by HHAs, to meet the
requirement that each HHA submit data
appropriate for the measurement of
health care quality, as determined by
the Secretary.
Additionally, section
1895(b)(3)(B)(v)(II) of the Act provides
the Secretary with the discretion to
submit the required data in a form,
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manner, and time specified by him. For
CY 2007, we are proposing to consider
OASIS data submitted by HHAs to CMS
for episodes beginning on or after July
1, 2005 and before July 1, 2006 as
meeting the reporting requirement. This
reporting time period will allow a full
12 months of data and will provide CMS
the time necessary to analyze and make
any necessary payment adjustments to
the CY 2007 payment rates. HHAs that
meet the reporting requirement would
be eligible for the full home health
market basket percentage increase.
During the next few years, we will be
pursuing the development of patient
level process measures for home health
agencies, as well as continuing to refine
the current OASIS tool in response to
recommendations from a Technical
Expert Panel conducted to review the
data elements that make up the OASIS
tool. These process measures will refer
to specific care practices that are, or are
not, followed by the home health agency
for each patient. An example of this
type of measure may be: the percentage
of patients at risk of falls for whom
prevention of falls was addressed in the
care plan. We expect to introduce these
additional measures over 2008 and 2009
so as to complement the existing OASIS
outcome measures. During the years
leading to calendar year 2010 payments,
we will test and refine these measures
to determine if they can more accurately
reflect the level of quality care being
provided at HHAs without being overly
burdensome with the data collection
instrument. Some process measures are
in the very early stages of development.
To the extent that evidence-based data
are available on which to determine the
appropriate measure specifications, and
adequate risk-adjustments are made, we
anticipate collecting and reporting these
measures as part of each agency’s home
health quality plan. We believe that
future modifications to the current
OASIS tool including reducing the
numbers of questions on the tool,
refining possible responses, as well as
adding new process measures will be
made. In all cases, we anticipate that
any future quality measures should be
evidence-based, clearly linked to
improved outcomes, and able to be
reliably captured with the least burden
to the provider. We are also beginning
work in order to measure patient
experience (in the form of a patient
satisfaction survey) of care in the home
health setting.
We recognize, however, that the
conditions of participation (42 CFR part
484) that require OASIS submission also
provide for exclusions from this
requirement. Generally, agencies are not
subject to the OASIS submission
requirement, and thus do not receive
Medicare payments, for patients that are
not Medicare Beneficiaries or the
patients are not receiving Medicarecovered home health services. Under
the conditions of participation, agencies
are excluded from the OASIS reporting
requirement on individual patients if:
• Those patients are receiving only
non-skilled services,
• Neither Medicare nor Medicaid is
paying for home health care (patients
receiving care under a Medicare or
Medicaid Managed Care Plan are not
excluded from the OASIS reporting
requirement),
• Those patients are receiving pre- or
post-partum services,
• Those patients are under the age of
18 years.
We believe that the rationale behind
the exclusion of these agencies from
submitting OASIS on patients excluded
from OASIS submission as a condition
of participation is equally applicable to
HHAs for purposes of meeting the DRA
quality requirement. If an agency is not
submitting OASIS for patients excluded
from OASIS submission as a condition
of participation, we believe that the
submission of OASIS for quality
measures for Medicare payment
purposes is also not necessary.
Therefore, we propose that HHAs do not
need to submit quality measures for
DRA reporting purposes, for those
patients who are excluded from OASIS
submission as a condition of
participation.
Additionally, we propose that
agencies newly certified (on or after
May 31, 2006 for payments to be made
in CY 2007) be excluded from the DRA
reporting requirement as data
submission and analysis will not be
possible for an agency certified this late
in the reporting time period. We
propose that in future years, agencies
that certify on or after May 31 of the
preceding year involved be excluded
from any payment penalty under the
DRA for the following calendar year. For
example, if HHA ‘‘X’’ were to enroll in
the Medicare Program on May 30 2007,
CMS would expect them to submit the
required quality data (unless covered by
another exclusion protocol) on or before
June 30 2006 (the end of the reporting
period for payments effectuated in
calendar year 2007. However, if HHA
‘‘X’’ were to enroll in the Medicare
Program on May 31, 2006, CMS would
automatically exclude them from the
requirements under the DRA and the
agency would be entitled to the full
market basket increase for calendar year
2007. We note these exclusions only
affect reporting requirements under the
DRA and do not affect the agency’s
OASIS reporting responsibilities under
the conditions of participation.
We propose to require that all HHAs,
unless covered by these specific
exclusions, meet the reporting
requirement, or be subject to a 2 percent
reduction in the home health market
basket percentage increase in
accordance with section
1895(b)(3)(B)(v)(I) of the Act. The 2
percent reduction would apply to all
episodes ending on or before December
31, 2007. We provide the reduced
payment rates in tables 5, 6, 7, and 8
below.
TABLE 5.—FOR HHAS THAT DO NOT SUBMIT THE REQUIRED QUALITY DATA—PROPOSED NATIONAL 60-DAY EPISODE
AMOUNT UPDATED BY THE ESTIMATED HOME HEALTH MARKET BASKET UPDATE FOR CY 2007, MINUS 2 PERCENTAGE POINTS, BEFORE CASE-MIX ADJUSTMENT
Multiply by the proposed estimated home health market
basket update
(3.1 percent 1 minus 2 percent)
hsrobinson on PROD1PC69 with PROPOSALS2
Total CY 2006 prospective payment amount per 60-day episode
× 1.011
$2,264.28 .............................................................................................................
1 The
Proposed CY 2007 updated
national 60-day episode rate
for HHAs that do not submit
required quality data
$2,289.19
estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc, 2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
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44089
TABLE 6.—FOR HHAS THAT DO NOT SUBMIT THE REQUIRED QUALITY DATA—PROPOSED NATIONAL PER-VISIT AMOUNTS
UPDATED BY THE ESTIMATED HOME HEALTH MARKET BASKET UPDATE FOR CY 2007, MINUS 2 PERCENTAGE POINTS
Final CY 2006
per-visit amounts
per 60-day
episode
Home health discipline type
Home health aide ......................................................................................................
Medical social services ..............................................................................................
Occupational therapy .................................................................................................
Physical therapy ........................................................................................................
Skilled nursing ...........................................................................................................
Speech-language pathology ......................................................................................
Multiply by the
proposed estimated home
health market basket update
(3.1 percent 1
minus 2 percent)
×
×
×
×
×
×
$44.76
158.45
108.81
108.08
98.85
117.44
1.011
1.011
1.011
1.011
1.011
1.011
Proposed CY
2007 per-visit payment amount per
discipline for
HHAs that do not
submit required
quality data
$45.25
160.19
110.01
109.27
99.94
118.73
1 The estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc, 2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
TABLE 7.—FOR HHAS THAT DO NOT SUBMIT THE REQUIRED QUALITY DATA—PROPOSED PAYMENT AMOUNT FOR 60-DAY
EPISODES BEGINNING IN CY 2006 AND ENDING IN CY 2007 UPDATED BY THE ESTIMATED HOME HEALTH MARKET
BASKET FOR CY 2007, MINUS 2 PERCENTAGE POINTS, WITH RURAL ADD-ON, BEFORE CASE-MIX ADJUSTMENT
Proposed CY 2007 updated national 60-day episode rate for HHAs that do not
submit required quality data
Proposed CY 2007 payment
amount per 60-day episode
beginning in CY 2006 and
ending in CY 2007 for a beneficiary who resides in a nonMSA area for HHAs that do
not submit required quality
data
5 percent rural add-on
× 1.05
$2,289.19 .............................................................................................................
$2,403.65
TABLE 8.—FOR HHAS THAT DO NOT SUBMIT THE REQUIRED QUALITY DATA—PROPOSED PER-VISIT PAYMENT AMOUNTS
FOR EPISODES BEGINNING IN CY 2006 AND ENDING IN CY 2007 UPDATED BY THE ESTIMATED HOME HEALTH MARKET BASKET FOR CY 2007, MINUS 2 PERCENTAGE POINTS, WITH RURAL ADD-ON
Proposed CY
2007 per-visit
amounts for HHAs
that do not submit
required quality
data
Home health discipline type
hsrobinson on PROD1PC69 with PROPOSALS2
Home health aide ......................................................................................................
Medical social services ..............................................................................................
Occupational therapy .................................................................................................
Physical therapy ........................................................................................................
Skilled nursing ...........................................................................................................
Speech-language pathology ......................................................................................
Section 1895(b)(3)(B)(v)(III) of the Act
further requires that the ‘‘Secretary shall
establish procedures for making data
submitted under subclause (II) available
to the public.’’ Additionally, the statute
requires that ‘‘such procedures shall
ensure that a home health agency has
the opportunity to review the data that
is to be made public with respect to the
agency prior to such data being made
public.’’ To meet the requirement for
making such data public, we are
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×
×
×
×
×
×
$45.25
160.19
110.01
109.27
99.94
118.73
proposing to continue to use the CMS
Home Health Compare Web site
whereby HHAs are listed
geographically. Currently the 10
proposed quality measures are posted
on the CMS Home Health Compare Web
site. Consumers can search for all
Medicare-approved home health
providers that serve their city or zip
code and then find the agencies offering
the types of services they need as well
as the proposed quality measures. See
PO 00000
5 percent rural
add-on
1.05
1.05
1.05
1.05
1.05
1.05
Proposed CY
2007 per-visit payment amounts for
episodes beginning in CY 2006
and ending in CY
2007 for a beneficiary who resides
in a non-MSA
area for HHAs
that do not submit
required quality
data
$47.51
168.20
115.51
114.73
104.93
124.67
https://www.medicare.gov/HHCompare/
Home/. HHAs currently have access
(through the Home Health Compare
contractor) to their own agency’s quality
data (updated periodically) and we
propose to continue this process thus
enabling each agency to know how it is
performing before public posting of
agency quality data on the CMS Home
Health Compare Web site.
Currently, the CMS Home Health
Compare Web site does not publicly
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report data when agencies have fewer
than 20 episodes of care within a
reporting period. In light of the DRA
requirements we recognize the need to
provide the required data to the public
and propose to make these statistics
available through expansion of the CMS
Home Health Compare Web site.
In the July 27, 2005 Medicare
Payment Advisory Commission
(MedPAC) testimony before the U.S.
Senate Committee on Finance, MedPAC
expressed support for the concept of
differential payments for Medicare
providers, which could create
incentives to improve quality. To
support this initiative, MedPAC stated
that ‘‘outcome measures from CMS’
Outcome-based Quality Indicators’’
(currently collected through the OASIS
instrument) ‘‘could form the starter set.’’
MedPAC further states ‘‘* * * the
Agency for Healthcare Research and
Quality concur(s) that a set of these
measures is reliable and adequately risk
adjusted.’’
The MedPAC testimony recognizes
that while the goal of care for many
home health patients is improving
health and functioning, for some
patients the goal of the HHA is to
simply stabilize their conditions and
prevent further decline. Additionally,
the MedPAC testimony reflects that
measures of structure and process could
also be considered.
Various home health outcome
measures are now in common use and
have been studied for some time. A
number of these measures have been
endorsed by the National Quality Forum
(NQF) and are evidence-based, well
accepted, and not unduly burdensome.
When determining outcome measures
that would be most appropriate it is
important to measure aspects of care
that providers can control and are
adequately risk-adjusted. Home-based
care presents particular difficulties for
provider control because patient
conditions are compounded by a variety
of home environment and support
system issues.
We are currently pursuing the
development of patient-level process
measures for HHAs, as well as refining
the current OASIS tool in response to
recommendations from a Technical
Expert Panel conducted to review the
data elements that make up the OASIS
tool. These additional measures would
complement the existing OASIS
outcome measures and would assist us
in identifying processes of care that lead
to improvements for certain populations
of patients. These process measures are
currently in the very early stages of
development. As we stated previously,
to the extent that evidence-based data
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are available on which to determine the
appropriate measure specifications, and
adequate risk-adjustments are made, we
anticipate collecting and reporting these
measures as part of our home health
quality plan. Possible modifications to
the current OASIS tool include reducing
the numbers of questions on the tool,
refining possible responses, as well as
adding new process measures.
We are soliciting comments on how to
make the outcome measures more
useful. We would also like comments on
measures of home health care processes
for which there is evidence or improved
care to beneficiaries. In all cases,
measures should be evidence-based,
clearly linked to improved outcomes,
and able to be reliably captured with the
least burden to the provider. We are also
considering measures of patient
experience of care in the home health
setting, as well as efficiency measures,
and soliciting comment on the use of
the measures and their importance in
the home health setting. We would
address any changes to the HH PPS
quality data submission requirement in
future rulemaking.
It is also our intent to provide
guidance on the specifications,
definitions, and reporting requirements
of any additional measures through the
standard protocol for measure
development.
We are proposing to revise the
regulations at 42 CFR § 484.225 to
reflect these new payment requirements
which require submission of quality
data.
E. Outliers and Fixed Dollar Loss Ratio
Outlier payments are payments made
in addition to regular 60-day case-mix
and wage-adjusted episode payments for
episodes that incur unusually large
costs due to patient home health care
needs. Outlier payments are made for
episodes for which the estimated cost
exceeds a threshold amount. The
episode’s estimated cost is the sum of
the national wage-adjusted per-visit
payment amounts for all visits delivered
during the episode. The outlier
threshold for each case-mix group, PEP
adjustment, or total SCIC adjustment is
defined as the 60-day episode payment
amount, PEP adjustment, or total SCIC
adjustment for that group plus a fixed
dollar loss amount. Both components of
the outlier threshold are wage-adjusted.
The wage-adjusted fixed dollar loss
(FDL) amount represents the amount of
loss that an agency must bear before an
episode becomes eligible for outlier
payments. The FDL is computed by
multiplying the wage-adjusted 60-day
episode payment amount by the FDL
ratio, which is a proportion expressed in
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terms of the national standardized
episode payment amount. The outlier
payment is defined to be a proportion of
the wage-adjusted estimated costs
beyond the wage-adjusted threshold.
The proportion of additional costs paid
as outlier payments is referred to as the
loss-sharing ratio.
Section 1895(b)(5) of the Act requires
that estimated total outlier payments are
no more than 5 percent of total
estimated HH PPS payments. In
response to the concerns about potential
financial losses that might result from
unusually expensive cases expressed in
comments to the October 28, 1999
proposed rule (64 FR 58133), the July
2000 final rule set the target for
estimated outlier payments at the 5
percent level. The FDL ratio and the
loss-sharing ratio were then selected so
that estimated total outlier payments
would meet the 5 percent target.
For a given level of outlier payments,
there is a trade-off between the values
selected for the FDL ratio and the losssharing ratio. A high FDL ratio reduces
the number of episodes that can receive
outlier payments, but makes it possible
to select a higher loss-sharing ratio and,
therefore, increase outlier payments for
outlier episodes. Alternatively, a lower
FDL ratio means that more episodes can
qualify for outlier payments, but outlier
payments per episode must be lower. As
a result of public comments on the
October 28, 1999 proposed rule, in our
July 2000 final rule, we made the
decision to attempt to cover a relatively
high proportion of the costs of outlier
cases for the most expensive episodes
that would qualify for outlier payments
within the 5 percent constraint.
In the July 2000 final rule, we chose
a value of 0.80 for the loss-sharing ratio,
which preserves incentives for agencies
to attempt to provide care efficiently for
outlier cases. A loss-sharing ratio of 0.80
was also consistent with the losssharing ratios used in other Medicare
PPS outlier policies. Furthermore, we
estimated the value of the FDL ratio that
would yield estimated total outlier
payments that were 5 percent of total
home health PPS payments. The
resulting value for the FDL ratio, for the
July 2000 final rule, was 1.13.
Our CY 2005 update to the HH PPS
rates (69 FR 62124) changed the FDL
ratio from the original 1.13 to 0.70 to
allow more home health episodes to
qualify for outlier payments and to
better meet the estimated 5 percent
target of outlier payments to total HH
PPS payments. We stated in that CY
2005 update that we planned to
continue to monitor the outlier
expenditures on a yearly basis and to
make adjustments as necessary (69 FR
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62129). To do so, we planned on using
the best Medicare data available at the
time of publication. For the CY 2005
update, we used CY 2003 home health
claims data.
Our CY 2006 update to the HH PPS
rates (70 FR 68132) changed the FDL
ratio from 0.70 to 0.65 to allow even
more home health episodes to qualify
for outlier payments and to better meet
the estimated 5 percent target of outlier
payments to total HH PPS payments.
For the CY 2006 update, we used CY
2004 home health claims data.
At this time, we do not have sufficient
data to propose any update to the FDL
ratio for the CY 2007 update to the HH
PPS rates. However, depending on the
availability of more recent data at the
time of publication of the HH PPS rate
update for the CY 2007 final rule, we
may, if necessary, implement an update
to the FDL ratio for the CY 2007 update
to the HH PPS rates. If so, we plan on
using the same methodology performed
in updating to the current FDL ratio
described in the June 2, 2004 proposed
rule using any more recent available
data.
F. Hospital Wage Index—Revised OMB
Definition for Geographical Statistical
Areas
Sections 1895(b)(4)(A)(ii) and (b)(4)(C)
of the Act require the Secretary to
establish area wage adjustment factors
that reflect the relative level of wages
and wage-related costs applicable to the
furnishing of home health services and
to provide appropriate adjustments to
the episode payment amounts under HH
PPS to account for area wage
differences. We apply the appropriate
wage index value to the labor portion
(76.775 percent; see 60 FR 62126) of the
HH PPS rates based on the geographic
area in which the beneficiary received
home health services as discussed in
section II.A of this proposed rule.
Generally, we determine each HHA’s
labor market area based on definitions
of Metropolitan Statistical Areas (MSAs)
issued by the Office of Management and
Budget (OMB).
We acknowledged in our October 22,
2004 final rule that on June 6, 2003, the
OMB issued an OMB Bulletin (No. 0304) announcing revised definitions for
MSAs, new definitions for Micropolitan
Statistical Areas and Combined
Statistical Areas, and guidance on using
the statistical definitions. A copy of the
Bulletin may be obtained at the
following Internet address: https://
www.whitehouse.gov/omb/bulletins/
b03-04.html. At that time, we did not
propose to apply these new definitions
known as Core-Based Statistical Areas
(CBSAs). In the November 9, 2005 final
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rule, we adopted the OMB-revised
definitions to adjust the CY 2006 HH
PPS payment rates and revised the
regulations at § 484.202 to reflect this
proposed change. The Hospital
Inpatient PPS (IPPS) also applied these
revised definitions as discussed in the
August 11, 2004 IPPS final rule (68 FR
49207).
1. Background
As discussed previously and set forth
in the July 3, 2000 final rule, the statute
provides that the wage adjustment
factors may be the factors used by the
Secretary for purposes of section
1886(d)(3)(E) of the Act for hospital
wage adjustment factors. As discussed
in the July 3, 2000 final rule, we are
proposing to again use the pre-floor and
pre-reclassified hospital wage index
data to adjust the labor portion of the
HH PPS rates based on the geographic
area in which the beneficiary receives
the home health services. We believe
the use of the pre-floor and prereclassified hospital wage index data
results in the appropriate adjustment to
the labor portion of the costs as required
by statute. For the CY 2007 update to
the home health payment rates, we
would continue to use the most recent
pre-floor and pre-reclassified hospital
wage index available at the time of
publication. See Addenda A and B of
this proposed rule, respectively, for the
rural and urban hospital wage indices
using the CBSA designations. For HH
PPS rates addressed in this proposed
rule, we use preliminary 2007 pre-floor
and pre-reclassified hospital wage index
data. We are proposing to incorporate
updated hospital wage index data for
the 2007 pre-floor and pre-reclassified
hospital wage index for use in the final
rule for the CY 2007 HH PPS update
(not including any reclassifications
under section 1886(d)(8)(B) of the Act).
As implemented under the HH PPS in
the July 3, 2000 HH PPS final rule, each
HHA’s labor market is determined based
on definitions of MSAs issued by OMB.
In general, an urban area is defined as
an MSA or New England County
Metropolitan Area (NECMA) as defined
by OMB. Under § 412.62(f)(1)(iii), a
rural area is defined as any area outside
of the urban area. The urban and rural
area geographic classifications are
defined in § 412.62(f)(1)(ii) and
§ 412.62(f)(1)(iii), respectively, and have
been used under HH PPS since it was
implemented.
Under the HH PPS, the wage index
value is based upon the site of service
(defined by section 1861(m) of the Act
as the beneficiary’s place of residence)
for the beneficiary. As has been our
longstanding practice, any area not
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included in an MSA (urban area) is
considered to be nonurban
(§ 412.64(b)(1)(ii)(C)) and receives the
statewide rural wage index value (see,
for example, 65 FR 41173).
2. Current Labor Market Areas Based on
MSAs, Including CBSAs
In the August 11, 2004 IPPS final rule
(69 FR 49206 through 49034), revised
labor market area definitions were
adopted at § 412.64(b), which were
effective October 1, 2004 for acute care
hospitals. The new definitions,
including CBSAs, were announced by
OMB in late 2000 and were also
discussed in greater detail in the July
14, 2005 HH PPS proposed rule in
which we proposed to move from MSAbased to CBSA-based wage area
designations. For the purposes of this
proposed rule, the term ‘‘MSA-based’’
refers to wage index values and
designations based on the previous
MSA designations. Conversely, the term
‘‘CBSA-based’’ refers to wage index
values and designations based on the
new OMB revised MSA designations
which now include CBSAs. Recently
other payment systems such as the
inpatient rehabilitation facility PPS, the
skilled nursing facility PPS, and
Medicare payment for hospice care have
been updated to use the new revised
labor market area definitions.
Based on public comments received
in response to the July 14, 2005 HH PPS
proposed rule, we decided to adopt a 1year transition policy consisting of a 50/
50 blend of the CBSA-based wage index
values and the MSA-based wage index
values. This transition policy is
discussed in the November 9, 2005 HH
PPS final rule (70 FR 68132, 68138). In
the final rule, we also noted that for CY
2007, the HH PPS wage index
adjustment would be solely based on a
CBSA-based wage index.
3. Proposed Revision to the HH PPS
Labor Market Areas
For CY 2007, we are proposing to end
the 1 year transition policy
(implemented for CY 2006) of using a
50/50 blend of MSA-based and CBSAbased wage area designations. For CY
2007, we are proposing to use 100
percent of the CBSA-based wage area
designations for purposes of
determining the HH PPS wage index
adjustment.
In adopting the CBSA designations,
we identified some geographic areas
where there were no hospitals, and thus
no hospital wage data on which to base
the calculation of the CY 2006 home
health wage index. For CY 2006, we
adopted a policy in the HH PPS final
rule (70 FR 68132) to use the CY 2005
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pre-floor, pre-reclassified hospital wage
index value for rural areas when no
rural hospital wage data is available. We
also adopted the policy that for urban
labor markets without an urban hospital
from which a hospital wage index can
be derived, all of the urban CBSAs
within the State would be used to
calculate a statewide urban average
wage index to use as a reasonable proxy
for these areas. As we stated in the CY
2006 Home Health PPS Final Rule, we
believe that this approach serves as a
proxy for hospital wage data and
provides an appropriate standard that
accounts for area wage differences.
For this CY 2007 proposed rule, we
are again proposing to apply our policy
to use the CY 2005 pre-floor/prereclassified hospital wage index for
rural areas where no hospital wage data
is available.
We have not received any concerns
from the industry regarding our policy
to calculate a statewide urban average
wage index, using all of the urban
CBSAs wage index values within the
State, for urban labor markets without
an urban hospital from which a hospital
wage index can be derived.
Consequently, for this CY 2007
proposed rule, we again propose to
apply our policy to calculate a statewide
urban average wage index for urban
areas with no hospital wage data
available. For this CY 2007 proposed
rule, the following areas will be affected
by these policies:
Rural Massachusetts—proposed
assigned wage index value of 1.0216;
Rural Puerto Rico—proposed assigned
wage index value of 0.4047; and
Hinesville, GA (CBSA 25980)—
proposed assigned wage index value
of 0.9163.
We recognize that since the
publication of the CY 2006 HH PPS final
rule, representatives of the home health
industry have expressed concerns with
the policy we apply for rural areas
where no hospital wage data is
available, particularly as applied to
rural Massachusetts facilities. In
response to these concerns and in
recognition that there may be additional
rural areas in the future similarly
impacted by a lack of hospital wage data
on which to derive a hospital wage
index, we are considering alternative
methodologies to the methodology
proposed above, for imputing a rural
wage index for areas in States where no
hospital wage data are available. We
believe that an evaluation of alternative
methodologies for imputing a rural wage
index in these areas should adhere to
four basic policy criteria. First, an
alternative methodology should retain
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our current longstanding policy to use
pre-floor, pre-reclassified hospital wage
data to compute wage index values for
post acute care facilities, including
home health agencies. Second, any
methodology to impute a rural wage
index should use rural wage data to
derive the rural wage index value.
Third, any methodology to impute a
rural wage index should be easy to
evaluate. Fourth, any methodology to
impute a rural wage index would be
able to update wage data from year-toyear.
We are specifically considering one
alternative to the proposal that meets all
of the above policy criteria. Under this
alternative, we would impute a rural
wage index value by using a simple
average CBSA-based rural wage index
value at the Census Division level.
Census Divisions are defined by the U.S.
Census Bureau and may be found at
(https://www.census.gov/geo/www/
us_regdiv.pdf). As stated above, for CY
2007, hospital wage data are not
available to compute a rural wage index
for HHAs in rural Massachusetts, and
this alternative methodology could be
applied in this case. Massachusetts is
located in Census Division I (New
England). The states in this Census
Division, and their respective rural wage
index values (using hospital cost report
wage data for FY 2003) include:
Connecticut (1.1753), Maine (0.8410),
New Hampshire (1.0800), Vermont
(0.9944), Rhode Island (all five counties
classified as urban) and Massachusetts.
Using this alternative methodology, the
states in Census Division I for which
rural wage index values are available, as
shown above, would be used resulting
in a simple average rural wage index
value of 1.0227. Although this
methodology results in a rural
Massachusetts wage index that is
currently greater than the value under
the current proposed policy (1.0216), we
believe this methodology may be able to
accurately reflect future increases and/
or decreases of wage data for the States
within the applicable census division.
Wage indices are intended to be
redistributive and should not increase
total Medicare spending. We believe
that the alternative methodology could
be a reasonable proxy as it uses current
rural wage index values (using rural
hospital wage data) from States within
the same census bureau divisions, with
similar economics.
As defined by the Census Bureau:
‘‘Census divisions are grouping of states
and the District of Columbia that are
subdivisions of the four census
regions.’’ The Census Bureau further
specifically states: ‘‘Puerto Rico and the
Island Areas are not part of any census
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region or census division.’’ Therefore,
because the Census Bureau does not
recognize Puerto Rico as part of any of
the Census Bureau divisions, we do not
believe that it is appropriate to compute
the wage index for rural Puerto Rico
using the methodology described in the
alternative described above.
Consequently, as stated above, we
propose to continue to apply the CY
2005 wage index (0.4047) for Puerto
Rico to payments for home health
services provided to beneficiaries who
reside in rural areas of Puerto Rico for
CY 2007.
We solicit comments on maintaining
our current policy for establishing wage
index values for rural and urban areas
without hospitals, the alternative
approach outlined above in developing
wage index values for rural areas
without hospitals for CY 2007 and
subsequent years, as well as suggestions
for determining the wage index for rural
Puerto Rico. We note that there are
sufficient economic differences between
the hospitals in the United States and
those in Puerto Rico, and that hospitals
in Puerto Rico are paid on a blended
Federal/Commonwealth-specific rates.
Consequently, any alternative approach/
methodology to computing a wage index
for rural Puerto Rico would need to take
into account those differences. We will
also continue to evaluate existing
hospital wage data and, possibly, wage
data from other sources, such as the
Bureau of Labor Statistics, to determine
if other methodologies of imputing a
wage index value where hospital wage
data are not available may be feasible.
G. Payment for Oxygen, Oxygen
Equipment and Capped Rental DME
Items
This proposed rule would amend our
regulations at § 414.226 by revising the
payment rules for oxygen and oxygen
equipment in paragraph (a), adding a
new paragraph (f) that provides that the
beneficiary assumes ownership of
oxygen equipment on the first day that
begins after the 36th continuous month
in which rental payments are made, and
adding a new paragraph (g) that
contains new supplier requirements that
we believe are necessary in light of the
amendments made to section 1834(a)(5)
of the Act by section 5101(b) of the
DRA. This proposed rule would amend
our regulations at § 414.226 by adding a
new paragraph (c) that establishes new
classes and national payment amounts
for oxygen and oxygen equipment based
on our authority in section 1834(a)(9)(D)
of the Act. We are also revising
paragraph (b) of this section to
incorporate the special payment rules
for oxygen equipment mandated by
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section 1834(a)(21) of the Act. The
provisions of section 1834(a)(21), which
we believe are self-implementing,
resulted in adjustments to Medicare
payment amounts for oxygen contents
and stationary oxygen equipment as
well as portable oxygen equipment in
2005, which were implemented through
program instructions. We are now
seeking to codify these changes to make
our regulations consistent with the
payment methodology for these items in
2005 and 2006, and because the
payment reductions mandated by
section 1834(a)(21) are incorporated into
our proposal, as more fully discussed in
section I below, to create new payment
classes for oxygen and oxygen
equipment. This proposed rule would
redesignate old paragraph (c) of this
section as paragraph (d) and would
amend this paragraph to indicate under
what situations payments would be
made for the items and services
described in new paragraph (c). Finally,
this proposed rule would redesignate
old paragraph (d) of this section as
paragraph (e) and would make technical
changes to this paragraph so that the
cross-references are accurate in light of
the other changes we are proposing to
make to § 414.226.
This proposed rule would also amend
our regulations at § 414.229 by revising
the payment rules for capped rental
durable medical equipment (DME) items
(also called capped rental items) in
paragraph (a), revising paragraph (f) to
provide for new payment rules for
capped rental items furnished beginning
on or after January 1, 2006, revising
paragraph (g) to provide for supplier
requirements that we believe are
necessary in light of the amendments
made to section 1834(a)(7)(A) of the Act
by section 5101(a) of the DRA, and
adding a new paragraph (h) to address
the lump-sum purchase option for
power-driven wheelchairs furnished on
or after January 1, 2006. The language in
current paragraphs (f) and (g) of this
section is obsolete, and therefore, we
would propose to delete this language.
This proposed rule would amend our
regulations at § 414.210 by revising the
maintenance and servicing rules in
paragraph (e) and the replacement of
equipment rules in paragraph (f) to
further implement the new supplier
requirements that we are proposing
below.
Finally, we are proposing to revise
§ 414.230(b) to incorporate section
5101(b)(2)(B) of the DRA, which
provides that for all beneficiaries
receiving oxygen equipment paid for
under section 1834(a) on December 31,
2005, the period of continuous use
begins on January 1, 2006. We are also
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proposing to revise § 414.230(f), which
governs when a new period of
continuous use begins if a beneficiary
receives new equipment, to account for
the fact that oxygen equipment is paid
on a modality neutral basis.
Section 5101(a) of the DRA changes
the Medicare payment methodology for
capped rental equipment to beneficiary
ownership after 13 months of
continuous use, for those beneficiaries
who need the equipment for more than
13 months. This section also makes the
transfer of title for the capped rental
items a requirement rather than a
beneficiary option after 13 months of
continuous use. The changes made by
this section of the DRA apply to capped
rental items, including rented powerdriven wheelchairs, for which the first
rental month occurs on or after January
1, 2006. We are proposing to update
§ 414.229 of our regulations to reflect
these new statutory requirements.
However, for capped rental items and
rented power-driven wheelchairs for
which the first rental month occurred
before January 1, 2006, the existing rules
in § 414.229 would continue to apply. In
addition, as was the case before
enactment of the DRA, beneficiaries
may elect to obtain power-driven
wheelchairs furnished on or after
January 1, 2006, on a lump-sum
purchase basis.
Section 5101(b) of the DRA changes
the Medicare payment methodology for
oxygen equipment from continuous
rental to beneficiary ownership after 36
months of continuous use, for those
beneficiaries who medically need the
oxygen equipment for more than 36
months. For beneficiaries who were
receiving oxygen equipment on
December 31, 2005 for which payment
was made under section 1834(a) of the
Act, the 36-month rental period began
on January 1, 2006. For beneficiaries
who begin to rent oxygen equipment on
or after January 1, 2006, the 36-month
rental period commences at the time
they begin to rent the equipment. We
are proposing to update § 414.226 of our
regulations to incorporate these new
requirements.
In light of the changes made by
sections 5101(a) and (b) of the DRA, we
believe it is necessary to propose
additional supplier requirements in
order to maintain beneficiary
protections and access to oxygen,
oxygen equipment, and capped rental
DME items under section 1834(a) of the
Act. For both capped rental DME items
and oxygen equipment, the DRA
amendments make the transfer of title
from the supplier to the beneficiary a
requirement rather than an option after
the statutorily-prescribed rental period
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ends for each category of items.
Therefore, suppliers and beneficiaries
should be aware that title to these items
will automatically transfer to the
beneficiary if the medical need for the
equipment continues for a period of
continuous use that is longer than 36
months for oxygen equipment and 13
months for capped rental items. We are
concerned that there may be incentives
for suppliers to avoid having to transfer
title to equipment to beneficiaries as
required by the DRA. For example, we
are aware of cases where a supplier has
informed beneficiaries that it would
decline to accept assignment for capped
rental items and would charge
beneficiaries who elected the purchase
option the full retail price for the item
during the 13th rental month (which
was right before the supplier would be
required to transfer title under the
purchase option). In these cases, the
beneficiary would become financially
liable for the total retail price for the
equipment in the 13th month if they
elected the purchase option. We are
making several proposals relating to the
furnishing of oxygen equipment and
capped rental items which we believe
protect beneficiaries from these types of
abusive practices and which we believe
are reasonable for a supplier to comply
with. Our authority to promulgate these
requirements stems from our authority
to administer the payment rules at
section 1834(a)(5) of the Act for oxygen
equipment and section 1834(a)(7) of the
Act for capped rental items, as well as
the general authority provided in
section 1871 of the Act for prescribing
regulations necessary for administering
the Medicare program. Other than the
length of the rental periods, which the
DRA made effective beginning on
January 1, 2006 for all oxygen
equipment and for capped rental items
for which the first rental period began
on or after that date, we are proposing
that the requirements presented in this
section of the regulations would be
effective on January 1, 2007, and would
apply to suppliers that furnish oxygen
equipment or capped rental items on a
rental basis.
We believe that a supplier of an item
that is subject to these new payment
rules that furnishes the item in the first
month for which a rental payment is
made has an obligation to continue
furnishing the item to the beneficiary for
the entire period of medical need in
which payments are made, up to and
including the time when title to the
equipment transfers to the beneficiary.
We believe it is reasonable for the
beneficiary to have an expectation that
he or she will not be forced to change
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equipment or suppliers during the
period of medical need unless he or she
wants to. Therefore, we are proposing
that unless an exception applies, the
supplier that furnishes oxygen
equipment or a capped rental item for
the first month of the statutorily
prescribed rental period must continue
to furnish the oxygen equipment or the
capped rental item for as long as the
equipment remains medically
necessary, up to and including the last
month for which a rental payment is
made by Medicare. We believe that this
proposal is necessary to ensure
beneficiary access to equipment during
a period of medical need, which we
believe could be jeopardized if suppliers
have the option to take back the rented
equipment just before the rental period
expires in order to retain title to that
equipment. We propose that this
requirement would be subject to the
following exceptions: (1) Cases where
the item becomes subject to a
competitive acquisition program
implemented in accordance with
section 1847(a) of the Act; (2) cases
where a beneficiary relocates on either
a temporary or permanent basis to an
area that is outside the normal service
area of the initial supplier; (3) cases
where the beneficiary chooses to obtain
equipment from a different supplier;
and (4) other cases where CMS or the
carrier determine that an exception is
warranted. We have proposed rules in
connection with the first exception in
our Notice of Proposed Rulemaking for
Competitive Acquisition for Certain
Durable Medical Equipment,
Prosthetics, Orthotics, and Supplies
(DMEPOS) and Other Issues. These
proposed rules are addressed beginning
on page 25662 of the May 1, 2006,
Federal Register. If the second
exception applies, we propose that the
supplier or beneficiary would need to
arrange for another supplier in the new
area to furnish the item on either a
temporary or permanent basis. This
proposed exception is consistent with
what currently happens when
beneficiaries move outside a supplier’s
service area on either a temporary or
permanent basis. The third exception is
intended to protect a beneficiary’s right
to obtain the equipment from the
supplier of his or her choice. Finally, we
are proposing to allow other exceptions
to this proposed requirement on a caseby-case basis at the discretion of CMS or
the Medicare contractor. CMS will be
monitoring the case-by-case
determinations made by the Medicare
contractor.
We are concerned that there might be
potential incentives for a supplier to
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replace more valuable or newer
equipment used by the beneficiary with
less valuable or older equipment from
its inventory at some point before the
36th rental month for oxygen equipment
or 13th rental month for capped rental
DME expires in order to avoid losing
title to the more valuable equipment. In
order to avoid such potential situations,
we propose that the supplier may not
provide different equipment from that
which was initially furnished to the
beneficiary at any time during the 36month period for oxygen equipment or
13th rental month for capped rental
DME unless one of the following
exceptions applies: (1) The equipment is
lost, stolen, or irreparably damaged; (2)
the equipment is being repaired while
loaner equipment is in use; (3) there is
a change in the beneficiary’s medical
condition such that the equipment
initially furnished is no longer
appropriate or medically necessary; or
(4) the carrier determines that a change
in equipment is warranted. However,
we are proposing that a change from one
oxygen equipment modality to another
without physician documentation that
such a change is medically necessary for
the individual would not be considered
a change in equipment that is warranted
under the fourth exception stated above
since there is no medical basis for the
change. In those cases where the
equipment is replaced, we propose that
the replacement item must be
equipment that is, at minimum, in the
same condition as the equipment being
replaced. This proposal is intended to
safeguard beneficiary access to quality
oxygen equipment and capped rental
items throughout the duration of the
rental period.
Under Medicare, suppliers who
furnish items of DME can accept
assignment on all claims for Medicare
services or on a claim-by-claim basis.
Assignment is an agreement between
the supplier and the beneficiary under
which the supplier agrees to request
direct payment from Medicare for the
item, to accept 80 percent of the
Medicare allowed payment amount for
the item from the carrier, and to charge
the beneficiary not more than the
remaining 20 percent of the Medicare
approved payment amount, plus any
unmet deductible. If a supplier elects
not to accept assignment, Medicare pays
the beneficiary 80 percent of the
Medicare allowed payment amount,
after subtracting any unmet deductible,
and there is no limit under Title XVIII
of the Act on the amount the supplier
can charge the beneficiary for rental of
the DME item. The beneficiary, in these
situations, is financially responsible for
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the difference between 80 percent of the
Medicare allowed payment amount and
the amount the supplier charges for the
rental of the DME item.
Section 1842(h) allows suppliers to
sign a participation agreement where
the supplier agrees voluntarily, before a
calendar year, to accept assignment for
all Medicare items and services
furnished to a beneficiary for the
following calendar year. Current
supplier participation agreements are
renewable annually. However, the
agreements do not apply for a full
period of medical need for specific
beneficiaries in cases where such need
extends for more than a calendar year.
Nor do current participation agreements
apply to periods of medical need where
such a period overlaps calendar years.
In the latter case, while a supplier may
renew its participation agreement
annually, a beneficiary would not know
before choosing a supplier whether the
supplier would be willing to accept
assignment of all claims during the 13month or 36-month rental period.
In order for the beneficiary to make an
informed choice, we propose that before
furnishing the oxygen equipment or a
capped rental item, the supplier must
disclose to the beneficiary its intentions
regarding whether it will accept
assignment of all monthly rental claims
for the equipment during the period of
medical necessity, up to and including
the 36th month of continuous use for
oxygen equipment or the 13th rental
month of continuous use for capped
rental DME in which rental payments
could potentially be made. We believe
that it is reasonable for the supplier to
disclose to each beneficiary its
intentions regarding assignment of
claims for all months during a rental
period as this decision has a direct
financial effect on the beneficiary. A
supplier’s intentions could be expressed
in the form of a written agreement
between the supplier and a beneficiary.
This proposal would require suppliers
to give beneficiaries advance notice of
the possible extent of their financial
liability during the period of medical
need in which monthly rental payments
are made for the equipment, so that they
can use this information to help select
a supplier. Additionally, to promote
informed beneficiary choices, we plan
to post information on a CMS and/or
CMS contractor Web site(s) indicating
supplier specific information on oxygen
equipment and capped rental items
such as (1) the percentage of
beneficiaries for whom each supplier
accepted assignment during a prior
period of time (for example, a quarter),
and/or (2) the percentage of cases in
which the supplier accepted assignment
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during the beneficiary’s entire rental
period. We believe that these proposals
create reasonable rules for suppliers that
furnish oxygen equipment and capped
rental items and ensure that
beneficiaries have information
necessary to make informed choices that
could have significant financial
consequences for them.
hsrobinson on PROD1PC69 with PROPOSALS2
H. Payment for Oxygen Contents for
Beneficiary-Owned Oxygen Equipment
Section 1834(a)(5) of the Act, as
amended by section 5101(b)(1) of the
DRA, requires that Medicare continue to
make monthly payments for the delivery
and refilling of oxygen contents for the
period of medical need after
beneficiaries own their own gaseous or
liquid oxygen stationary or portable
equipment. Before the enactment of the
DRA, Medicare made monthly payments
for the delivery and refilling of oxygen
contents for beneficiaries who own their
own stationary and/or portable
equipment (equipment they obtained on
a purchase basis before June 1, 1989,
out-of-pocket, or before they enrolled in
Medicare Part B). In accordance with
the DRA, we propose that after the
supplier transfers title to the stationary
and/or portable oxygen equipment to
the beneficiary, Medicare would
continue to make separate monthly
payments for gaseous or liquid oxygen
contents until medical necessity ends.
We are also proposing that if the
beneficiary-owned equipment is
replaced, and Medicare pays for the
replacement in accordance with
proposed revised § 414.210(f) (see
section K of this proposed rule for a
more complete discussion of our
proposed oxygen equipment
replacement policies), a new 36-month
rental period start and the payment for
oxygen contents would be included in
the monthly rental payments. We are
proposing that all oxygen content
payment amounts would be based on
new rates developed in accordance with
our proposal to establish new payment
classes, as discussed in section I below.
In transferring title to gaseous or
liquid oxygen equipment used during
the 36-month rental period, we propose
that suppliers must transfer title for all
equipment that will meet the
beneficiary’s continued medical need,
including those oxygen cylinders or
vessels that are refilled at the supplier’s
place of business. Customary practice by
suppliers for refilling oxygen contents is
to deliver to the beneficiary cylinders
filled with contents and take back the
empty cylinders to the supplier’s place
of business to refill the oxygen contents.
Under our proposal, title would transfer
for both sets of cylinders, meaning the
ones that are being used by the
beneficiary for the month and the ones
that the supplier refills in its business
location and delivers for use during the
next subsequent month. This policy
would apply to both gaseous and liquid
oxygen stationary equipment and
portable systems. Similarly, in those
cases where the beneficiary uses an
oxygen equipment system which
includes a compressor which fills
portable gaseous cylinders in the
beneficiary’s home, we propose that
suppliers must transfer title for this
equipment to the beneficiary.
Concerns have been raised regarding
beneficiary access to, and safety issues
associated with, the delivery of oxygen
contents for beneficiary-owned
stationary and portable gaseous or
liquid equipment. We believe that these
concerns are based on the
misconception that beneficiaries
become responsible for filling their own
cylinders. To the contrary, there are
numerous State and Federal regulations
governing the safe handling, filling, and
transport of oxygen and those
regulations are unaffected by the DRA
oxygen provisions. We expect that
suppliers will continue to furnish
replacement contents for beneficiaryowned gaseous and liquid systems in
the same way that they have furnished
replacement contents for beneficiaryowned equipment in the past. For
example, suppliers that deliver a onemonth supply of gaseous cylinders to a
beneficiary’s home at the same time that
they are picking up empty cylinders that
the beneficiary used during the previous
month could continue this practice
under section 5101(b) of the DRA.
I. Classes of Oxygen and Oxygen
Equipment
Based on information from paid
Medicare claims with dates of service in
calendar year 2004, distribution of usage
among the four general categories of
oxygen systems was: (a) 69 percent of
beneficiaries used both a stationary
concentrator (which does not require
delivery of oxygen contents) and a
portable system that requires delivery of
Equipment & contents
15:25 Aug 02, 2006
Jkt 208001
PO 00000
gaseous or liquid oxygen, (b) 5 percent
of beneficiaries used a stationary system
that requires delivery of gaseous or
liquid oxygen and a portable system that
requires delivery of gaseous or liquid
oxygen, (c) 24 percent of beneficiaries
used a stationary concentrator system
only, and (d) 2 percent of beneficiaries
used only a stationary system that
requires delivery of liquid or gaseous
oxygen. The prevalent use of stationary
concentrator systems is due, in part, to
the fact that this system is the most costeffective and dependable of the
stationary oxygen modalities. The main
reason that the concentrator system is
the most cost-effective system is that the
oxygen is concentrated from room air,
and therefore, the high cost of delivering
contents to the beneficiary’s residence is
removed when this system is used.
Medicare’s current payment structure
results in two separate payments for
beneficiaries using both stationary and
portable systems, both of which are
modality neutral, meaning that the
payment amount does not differ
depending on the type of oxygen
delivery system (gaseous, liquid, or
concentrator) that is furnished. One
payment, hereinto referred to as the
‘‘stationary payment,’’ includes
payment for the rental of stationary
equipment, delivery of stationary
oxygen contents (for gaseous or liquid
systems), and delivery of portable
oxygen contents (for gaseous or liquid
systems). A separate add-on payment,
hereinto referred to as the ‘‘portable
add-on,’’ is also made in cases where
the beneficiary is renting portable
oxygen equipment. As a result of this
payment methodology which has been
in place since 1989, suppliers have a
financial incentive to furnish low cost
concentrator systems as opposed to
more expensive gaseous or liquid
systems because the monthly payment
is the same regardless of which system
is used. Finally, in implementing
section 1834(a)(5) and (9) of the Act,
monthly payment amounts were
established through regulations at
§ 414.226 for (1) stationary and portable
oxygen contents (for beneficiaries who
use stationary and, if applicable,
portable equipment), and (2) portable
oxygen contents only (for beneficiaries
who only use portable oxygen
equipment).
The current average statewide
monthly payment amounts are:
Oxygen contents only
Stationary pmt ...........................................................................
Portable add-on ........................................................................
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$199
32
Fmt 4701
Stationary & portable ...............................................................
Portable only ............................................................................
Sfmt 4702
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$156
21
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Based on our data, 36 percent of
Medicare beneficiaries continue using
oxygen equipment for more than three
years, that is, beyond the 36th month
after which title for the equipment
would transfer to the beneficiary in
accordance with the DRA.
We have heard concerns about the
appropriateness of the current payment
structure for oxygen and oxygen
equipment in light of changes in the
technologies for oxygen delivery
systems that have occurred since 1989,
and these concerns have been amplified
in light of the recent changes made by
the DRA. The specific concerns pertain
to beneficiary access to (1) portable
oxygen contents after title to the
equipment transfers to the beneficiary,
(2) devices that allow a beneficiary to
fill portable tanks at home (otherwise
referred to in the oxygen equipment
industry as transfilling systems), and (3)
portable oxygen concentrators. As we
implement the DRA provisions for
oxygen equipment and propose to
promulgate additional supplier
requirements, we want to ensure that
the Medicare payment methodology
results in payments for oxygen and
oxygen equipment that are accurate, do
not impede beneficiary access to
innovations in technology, and do not
create inappropriate incentives for
suppliers.
Some believe that Medicare’s
stationary payment for equipment and
contents (average of $199) is ‘‘too high’’
and that Medicare’s payment for
portable oxygen contents only for
beneficiary-owned portable equipment
(average of $21) is ‘‘too low’’. While
some contend that the overall payment
(stationary payment plus portable addon) for oxygen and oxygen equipment is
adequate as long as the beneficiary
continues to rent the equipment, they
are concerned about the adequacy of
Medicare’s $21 monthly payment for
furnishing oxygen contents for
beneficiary-owned portable equipment.
Some believe that Medicare’s current
average monthly payment of $156 for
oxygen contents, which includes
payment for both stationary and
portable systems, is high enough to
create an incentive for suppliers to
furnish stationary oxygen systems that
require the ongoing delivery of oxygen
contents, rather than stationary
concentrator systems that do not require
delivery of oxygen contents.
Some technologies provide an
attachment to a stationary oxygen
concentrator that allows beneficiaries to
fill their own portable tanks at home.
Delivery of portable oxygen contents to
the beneficiary’s home is, therefore, not
necessary since this equipment refills
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15:25 Aug 02, 2006
Jkt 208001
the beneficiary’s rented or owned
portable oxygen tanks. This transfilling
technology eliminates the need for
frequent and costly trips by a supplier
to a beneficiary’s home to refill portable
oxygen tanks and would save the
Medicare program and beneficiaries
who use portable equipment the
expense of paying for delivery of
portable oxygen contents. We note that
we are not aware that a similar
‘‘transfilling’’ technology has been
developed that would be capable of
filling stationary tanks in the
beneficiary’s home. Therefore, there
remains a need for ongoing delivery of
gaseous or liquid oxygen contents for
stationary equipment. In accordance
with the DRA, after 36 months of
continuous use, title for the transfilling
equipment and accompanying portable
oxygen tanks would transfer to the
beneficiary who would then own a
portable equipment system that selfgenerates oxygen in their home.
However, some are concerned that
current Medicare payment rules that
allow payment for oxygen contents for
stationary equipment creates an
incentive for suppliers to furnish
stationary oxygen equipment that
require liquid or gaseous oxygen
deliveries, rather than concentrators and
transfilling equipment that self-generate
oxygen in the beneficiary’s home. In
addition, portable oxygen concentrators
are now available that meet both the
beneficiary’s stationary and portable
oxygen needs. Some have raised
concern about whether the combination
of the Medicare stationary payment and
portable add-on payment
(approximately $231 per month), which
is what is currently paid for portable
oxygen concentrators, is sufficient to
facilitate use of this new technology
which, like a transfilling system,
eliminates the need for delivery of
oxygen contents, but is more expensive
than a ‘‘standard’’ or ‘‘non-portable’’
concentrator.
In light of these concerns, we are
proposing regulatory changes to address
the Medicare payment rates for oxygen
and oxygen equipment. We are
proposing to address these issues by
using our authority under section
1834(a)(9)(D) of the Act to establish
separate classes and monthly payment
rates for items of oxygen and oxygen
equipment. Specifically, there are two
changes we are proposing for oxygen
and oxygen equipment:
1. We propose to establish a new class
and monthly payment amount for
oxygen generating portable oxygen
equipment (for example, portable
concentrators and transfilling systems).
PO 00000
Frm 00016
Fmt 4701
Sfmt 4702
2. We propose to establish separate
classes and monthly payment amounts
for gaseous and liquid oxygen contents
that must be delivered for beneficiaryowned stationary and portable oxygen
equipment.
The first change involves creating a
new separate class for portable oxygen
systems that generate their own oxygen
and therefore eliminate the need for
delivery of oxygen contents (for
example, portable concentrator systems
or transfilling systems). A higher
monthly payment amount would be
allowed, as described below, for these
systems to account for the increased,
up-front costs to the supplier of
furnishing these more expensive
concentrator or transfilling systems,
which would be partially offset by the
reduced payments that the supplier
would receive from the Medicare
program and beneficiaries due to the
fact that these systems do not require
the delivery of oxygen contents.
The second change involves creating
two separate classes (stationary contents
only and portable contents only) and
monthly payment rates for furnishing
oxygen contents for beneficiary-owned
stationary and portable systems.
Currently, the combined average
monthly payment amount of $156 for
furnishing oxygen contents for
beneficiary-owned stationary and
portable systems includes payment for
both stationary contents and portable
contents. The current fee schedule
amounts for oxygen contents are based
on calendar year data from 1986 for the
combined average Medicare monthly
payment for both stationary and
portable contents divided by number of
rental months for stationary liquid and
gaseous oxygen equipment. As a result,
the current combined stationary/
portable contents payment results in
Medicare payments for portable
contents even in those cases where the
beneficiary does not use portable
oxygen equipment. Under our proposal
to create one payment class for oxygen
contents used for stationary equipment,
and a separate class for oxygen contents
used for portable equipment, new
national monthly payment amounts for
stationary contents delivery and
portable contents delivery would be
established by splitting the combined
payment of $156 into two new
payments as explained below. This
change would increase the monthly
payment for furnishing portable oxygen
contents and would address the
concerns that the monthly payment rate
of $21 is too low for the delivery and
filling of portable tanks after the
beneficiary assumes ownership of the
equipment in accordance with the DRA.
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03AUP2
In order to achieve budget neutrality
for the new classes of oxygen and
increase payment amounts for
furnishing portable contents, we would
need to reduce other Medicare oxygen
payment rates. Budget neutrality would
require that Medicare’s total spending
for all modalities of stationary and
portable systems, including contents, be
the same under the proposed change as
they would be without the change.
We would propose to achieve budget
neutrality by reducing the current
monthly payment amounts (the
stationary payment) for stationary
oxygen equipment and oxygen contents
(for stationary or portable equipment)
made during the rental period. This
reduction in payment is necessary to
offset increased payments for the
changes identified above and to meet
the requirement in section
1834(a)(9)(D)(ii) that the classes and
payments be established in a budget
neutral fashion. In most cases, suppliers
furnish Medicare beneficiaries with
stationary oxygen concentrators. These
devices can be purchased for $1,000 or
less and the current, average Medicare
payment of $199 pays suppliers $1,990
over 10 months. We believe that these
facts indicate that making a reduction
(from $199 on average to $177) in
Medicare payment for this relatively
inexpensive oxygen equipment in order
to pay oxygen suppliers adequately for
furnishing portable oxygen contents and
more expensive portable oxygen
equipment technologies is warranted.
With this approach, the proposed new
classes, as well as proposed new
national monthly payment rates, would
be as follows:
1. Stationary Payment: $177.
2. Portable Add-On: $32.
3. Oxygen Generating Portable
Equipment Add-On (portable
concentrators or transfilling systems):
$64.
4. Stationary Contents Delivery: $101.
5. Portable Contents Delivery: $55.
We provide a detailed discussion of
the payment rate calculations/
adjustments in the paragraphs that
follow. Under the proposed new oxygen
and oxygen equipment class structure
described above, in those cases where
the beneficiary needs both stationary
and portable oxygen, monthly payments
of $241 or $209 (proposed revised
stationary payment of $177 plus one of
two proposed portable equipment
payments, $32 or $64) would be made
during rental months 1 through 36. The
stationary payment (which includes
payment for stationary equipment, as
well as oxygen contents for stationary
and portable systems) of $177 would be
made during rental months 1 through 36
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Jkt 208001
for beneficiaries who only need
stationary oxygen and oxygen
equipment. Monthly payments of $101
for stationary oxygen contents and/or
$55 for portable oxygen contents would
be made in cases where beneficiaries
own their stationary and/or portable
oxygen equipment. As explained in
more detail in the paragraphs that
follow, the $101 payment is for
stationary oxygen contents only and is
derived from the current payment of
$156, which is made for both stationary
and portable oxygen contents. The $55
payment for portable oxygen contents
only is also derived from the current
payment of $156 that is made for both
stationary and portable oxygen contents
and would replace the current statewide
portable oxygen contents fees (average
of $21), which was based on a relatively
small number of claims and allowed
services compared to the number of
claims and allowed services that were
used in computing the statewide fees
(average of $156) for a combination of
stationary and portable oxygen contents.
As noted above, the proposed national
payment rates for delivery of oxygen
contents for beneficiary owned gaseous/
liquid equipment were derived from the
current average payment for a combined
oxygen contents delivery of $156. We
propose to establish $101, or 65 percent
of $156, as the monthly payment rate for
delivery of larger, heavier, beneficiaryowned stationary gaseous oxygen
cylinders or liquid oxygen vessels and
$55, or 35 percent of $156, as the
monthly payment rate for delivery of
smaller, lighter, beneficiary-owned
portable gaseous oxygen cylinders or
liquid oxygen vessels. The 65/35 split is
based on our understanding that there
are higher costs associated with
delivering stationary tanks (cylinders of
gaseous oxygen and vessels of liquid
oxygen) which are approximately twice
as large as the portable tanks. Such costs
include supplier overhead costs,
including the costs to purchase,
maintain, and dispatch trucks, obtain
insurance, and purchase fuel. The 65/35
split is intended to account for the
difference in costs associated with the
size of the tanks. Larger tanks take up
more space on the trucks, take longer to
fill, are harder to move, and result in
increased fuel costs.
We estimate that the increase from
$21 to $55 in the monthly payment rate
for delivery of oxygen contents for
beneficiary-owned portable equipment
will result in increased expenditures of
approximately $22 million over a 24
month period, or $11 million annually.
This figure is based on current data on
utilization of portable oxygen by
Medicare beneficiaries.
PO 00000
Frm 00017
Fmt 4701
Sfmt 4702
44097
The add-on payment amount of $64
for the oxygen generating portable
equipment class was calculated based
on data indicating long term savings
generated from use of equipment that
eliminated the need for payment of $55
per month for portable oxygen contents.
The first step in calculating the
proposed $64 payment for oxygen
generating portable equipment involves
the computation of a national,
enhanced, modality neutral monthly
payment amount of $241 for new
technology systems (stationary
concentrators and transfilling systems,
as well as portable concentrators),
which was derived from the sum of the
current average stationary payment
($199), the current average portable addon payment ($32), and an additional $10
to pay suppliers for furnishing more
expensive equipment that eliminates the
need for delivery of portable oxygen
contents. Specifically, we calculated the
modality neutral increased payment
(that is, $10 above the current
combination of the stationary payment
and portable add-on payment) by
estimating potential savings that the
Medicare program would realize as a
result of not having to pay for delivery
of oxygen contents for beneficiaryowned portable oxygen systems in the
fourth and fifth years of use. We
calculated the increased payment to be
equal to potential savings from not
delivering oxygen contents. In
calculating this increased payment, we
are only factoring in savings from the
fourth and fifth years of use since we
assume that most beneficiaries will elect
to obtain replacement equipment after
the 5-year reasonable useful lifetime for
their equipment has expired. Since our
data indicates that 35.8 percent of
beneficiaries will use oxygen equipment
for more than three years, and that
approximately 74 percent of these
beneficiaries use portable equipment,
the $10 amount is calculated based on
the following formula, and is rounded to
the nearest dollar:
((.358 × $55) × 24 months) × .74
36 months
We estimate that the additional $10
payment per month for oxygen
generating portable equipment
(transfilling units and portable
concentrators) will result in increased
expenditures of approximately $15
million over a 36 month period, or $5
million annually. This figure is based on
current data on utilization of stationary
and portable oxygen by Medicare
beneficiaries over 36 months.
The second step in calculating the
proposed $64 add-on payment for the
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proposed new class of oxygen
generating portable equipment involves
subtracting the proposed new stationary
payment. Therefore, the national
monthly payment of $241 computed in
the first step above would be reduced by
$177, the proposed new adjusted
stationary payment amount, to arrive at
the proposed add-on payment of $64 for
just the oxygen generating portable
equipment. In addition, to offset the
increased annual payments of
approximately $16 million that will
result from increased payments for
portable oxygen contents ($11 million)
and newer technology oxygen
generating portable equipment ($5
million), we would propose to decrease
the current stationary payment by $22
($199 ¥ $177). We estimate that this
offset would result in annual Medicare
savings of approximately $16 million,
and would therefore offset the increased
payments for new technology oxygen
generating portable equipment and
delivery of oxygen contents for other
beneficiary-owned portable equipment.
We are proposing that these fees be
established on a nationwide basis due to
the fact that the variation in the current
statewide fee schedule amounts for
oxygen and oxygen equipment, as well
as the portable equipment add-on
payment, are currently only 3 percent
and 5 percent, respectively.
We are proposing that the $64 add-on
payment would be made for oxygen
generating portable equipment only if
the equipment eliminates the need for
delivery or portable oxygen contents.
However, if transfilling equipment is
used in connection with a stationary
oxygen concentrator (whether as an
integrated system component or as a
separate part) to both deliver stationary
oxygen and fill portable oxygen tanks,
Medicare would make both a $177
stationary payment for the stationary
oxygen concentrator and stationary
oxygen contents, and a separate $64
oxygen generating portable equipment
payment for the portable oxygen
transfilling equipment.
There are also portable oxygen
transfilling products that are not part of
or used in conjunction with a stationary
oxygen concentrator. These products are
only used to fill portable oxygen tanks
in the beneficiary’s home. If the
beneficiary is using one of these
products, Medicare would make a $64
oxygen generating portable equipment
payment. If the patient is also renting
any type of stationary oxygen
equipment (gaseous, liquid, or
concentrator), Medicare would make a
separate, additional $177 stationary
equipment payment for that equipment.
If a portable oxygen concentrator is
furnished, Medicare would make the
$64 oxygen generating portable
equipment add-on payment if the
portable oxygen concentrator is used as
both the beneficiary’s stationary oxygen
equipment and portable oxygen
equipment. In this case, the portable
oxygen concentrator equipment would
fall under both the stationary oxygen
equipment class and the oxygen
generating portable equipment class.
Therefore, the $177 stationary payment
would also be made in this situation,
since the equipment being furnished
meets the beneficiary’s needs for both
stationary and portable oxygen
equipment. In this case, it would be
necessary for the supplier to use two
HCPCS codes to bill for this device
since it is being used as both the
stationary and portable oxygen
equipment for the beneficiary. If the
beneficiary owns any type of stationary
equipment (concentrator, liquid, or
gaseous), and is also furnished with a
portable oxygen concentrator, only the
oxygen generating payment of $64
would be made (that is, the supplier
would not also receive the $177
payment) and the portable oxygen
concentrator equipment would fall
Equipment rental and
contents
Category
hsrobinson on PROD1PC69 with PROPOSALS2
A ...............................................................................................................................................
B ...............................................................................................................................................
C ..............................................................................................................................................
D ..............................................................................................................................................
E ...............................................................................................................................................
F ...............................................................................................................................................
We are proposing to revise our
regulations in order to implement these
new payment classes and payment
amounts, effective for claims with dates
of service on or after January 1, 2007.
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15:25 Aug 02, 2006
Jkt 208001
J. Payment for Maintenance and
Servicing of Oxygen and Oxygen
Equipment and Capped Rental Items
Immediately following passage of the
DRA, concerns were raised regarding
the ability of a beneficiary to obtain
PO 00000
under the oxygen generating portable
equipment class because it is only being
used to meet the beneficiary’s need for
portable oxygen equipment. Finally, if,
the beneficiary is renting any type of
stationary equipment (concentrator,
liquid, or gaseous), and is also furnished
with a portable oxygen concentrator, the
oxygen generating add-on payment of
$64 would be paid for the portable
oxygen concentrator and the stationary
payment of $177 would be paid
separately for the stationary oxygen
equipment and contents.
In summary, we are proposing new
payment classes for oxygen contents for
beneficiary-owned stationary
equipment, oxygen contents for
beneficiary-owned portable equipment,
and oxygen generating portable
equipment. Payments for oxygen
contents for beneficiary-owned portable
equipment and oxygen generating
portable equipment would exceed what
is currently paid for these items to
ensure access to portable oxygen
regardless of the type of equipment
used. These increased payments would
be offset by a reduction in the stationary
payment. The six broad categories of
oxygen equipment used by beneficiaries
are as follows:
A. Concentrator and liquid or gaseous
portable equipment
B. Concentrator and/or oxygen
generating portable equipment
C. Liquid or gaseous stationary
equipment and liquid or gaseous
portable equipment
D. Liquid or gaseous stationary
equipment and oxygen generating
portable equipment
E. Concentrator only
F. Liquid or gaseous stationary
equipment only
Based on our proposed new payment
classes, Medicare payment under these
six categories would be as follows:
Frm 00018
Fmt 4701
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$209
241
209
241
($177
($177
($177
($177
+
+
+
+
$32)
$64)
$32)
$64)
177
177
Contents for beneficiaryowned
equipment
$55
0
156 ($101 + $55)
101
0
101
maintenance and servicing of his or her
DME once he or she has taken title to
it. We believe that these concerns are
largely based on misconceptions that
the beneficiary will ‘‘be on his or her
own’’ in terms of maintenance and
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servicing of equipment and submission
of claims for payment for these services.
We believe that these concerns are
unfounded because Medicare payment
has traditionally been made for
reasonable and necessary repair and
maintenance of beneficiary-owned
DME. In addition, section
1834(a)(5)(F)(ii)(II)(bb) of the Act, as
amended by section 5101(b)(1)(B) of the
DRA, requires that Medicare continue to
pay for reasonable and necessary
maintenance and servicing for parts and
labor that is not covered under a
manufacturer’s or supplier’s warranty in
amounts determined to be appropriate
by the Secretary.
Medicare has also traditionally paid
for loaner equipment used while the
beneficiary’s equipment is being
repaired, or in some cases, when the
beneficiary does not have access to the
equipment (for example, in cases when
a natural disaster such as a hurricane
forces the beneficiary to be evacuated
from his or her home). We are proposing
to continue Medicare payment for such
loaner equipment.
We are not aware of instances where
beneficiaries have encountered
problems in finding suppliers to provide
maintenance and servicing of
beneficiary-owned DME. Section
414.210(e) of our regulations currently
provides that reasonable and necessary
charges for maintenance and servicing
of DME are those charges made for parts
and labor not otherwise covered under
a manufacturer’s or supplier’s warranty.
This definition has been applied in
paying claims for maintenance and
servicing of beneficiary-owned DME for
several years, and the wording of this
regulatory definition is parallel to that
used in amended sections
1834(a)(7)(A)(iv) and (a)(5)(F)(ii)(II)(bb)
of the Act in describing the
‘‘maintenance and servicing’’ payments
that are permitted for capped rental
DME and oxygen equipment after title
has transferred to the beneficiary. We
are proposing to continue use of this
existing regulatory definition to define
‘‘maintenance and servicing’’ in section
5101 of the DRA. We would, however,
also propose to apply our existing
policy of not covering certain routine
maintenance or periodic servicing of
purchased equipment, such as testing,
cleaning, regulating, changing filters,
and general inspection of beneficiaryowned DME that can be done by the
beneficiary or caregiver, to beneficiaryowned oxygen equipment and to
continue that policy for beneficiaryowned capped rental equipment. As
specified in current program
instructions at section 110.2.B of
chapter 15 of the Medicare Benefit
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Policy Manual (Pub. 100–02), ‘‘the
owner [of the equipment] is expected to
perform such routine maintenance
rather than a retailer or some other
person who charges the beneficiary.’’
We expect that the supplier, when
transferring title to the equipment to the
beneficiary, would also provide to the
beneficiary any operating manuals
published by the manufacturer which
describe the servicing an owner may
perform to properly maintain the
equipment. We also believe that these
owner manuals are commonly available
at the various manufacturer Web sites.
In addition, the Durable Medical
Equipment, Prosthetics, Orthotics and
Supplies (DMEPOS) supplier standards
at § 424.57(c)(12) require suppliers to
provide the beneficiary with necessary
information and instructions on how to
use DME items safely and effectively.
We believe that after receiving this
information, and after becoming familiar
with the equipment during the 13 or 36
month rental period, the beneficiary
and/or caregiver should be very
knowledgeable regarding the routine
maintenance required for the item. All
non-routine maintenance of beneficiaryowned oxygen equipment and capped
rental items which would need to be
performed by authorized technicians
would be covered as reasonable and
necessary maintenance and servicing.
Examples of the types of maintenance
that would be covered are currently
listed in program instructions at section
110.2.B of chapter 15 of the Medicare
Benefit Policy Manual (Pub. 100–02)
and include ‘‘breaking down sealed
components and performing tests which
require specialized testing equipment
not available to the beneficiary.’’
We are proposing that maintenance
and servicing of beneficiary-owned
oxygen equipment and capped rental
items would be reasonable and
necessary if it is non-routine
maintenance and servicing necessary to
make the equipment serviceable.
Payment is currently made under the
Medicare program for parts and labor
associated with repairing beneficiaryowned DME. Medicare allowed
payment amounts for replacement parts
are currently paid based on the carrier’s
individual consideration of the item.
With regard to replacement parts for
beneficiary-owned oxygen equipment or
capped rental equipment, we propose
that the carrier pay for the parts in a
lump sum amount based on its
consideration of the cost of the item, as
is consistent with what our carriers
currently do when evaluating
maintenance and servicing claims for
other beneficiary-owned DME.
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Currently, payment for labor is based on
15-minute increments in amounts that
are established by the carriers and
updated on an annual basis by the same
factor specified in section 1834(a)(14) of
the Act, which is used to update fee
schedule amounts for DME. We are
proposing that the carriers use the same
fee for labor that is currently used in
paying for labor associated with
repairing, maintaining, and servicing
other beneficiary-owned DME, as we are
not aware of any past problems
associated with access to these services
paid at these rates. We believe that the
current methods and fees used by
carriers in paying for maintenance and
servicing of beneficiary-owned DME are
reasonable given that we are not aware
of any past problems associated with
access to these services paid at these
rates. In most cases, neither the
Medicare program nor the beneficiary
actually pays the full amount for
repairing or maintaining an item since
manufacturer warranties that cover all
or part of these costs are widespread.
For example, some manufacturers of
commonly used oxygen concentrators
offer full warranties that cover all parts
and labor for 5 years. Rules in
§ 414.210(f) regarding replacement of
DME that has been in continuous use for
the equipment’s reasonable useful
lifetime provide that the beneficiary can
elect to obtain replacement equipment
after the reasonable useful lifetime for
the equipment has expired. Therefore,
we believe that the beneficiary should
incur little, if any, expense for repair or
maintenance of necessary equipment in
cases where manufacturer warranties
exist that cover parts and labor
necessary to repair a new item during a
5-year period.
K. Payment for Replacement of
Beneficiary-Owned Oxygen Equipment,
Capped Rental Items, and Associated
Supplies and Accessories
Medicare has traditionally paid for
replacement beneficiary-owned DME
after the expiration of the equipment’s
useful lifetime (see § 414.210(f) and
§ 414.229(g) of our regulations), and for
replacement supplies and accessories
used in conjunction with beneficiaryowned DME when these supplies and
accessories are necessary for the
effective use of the DME (see § 110.3 of
Chapter 15 of the Medicare Benefit
Policy Manual (Pub. 100–02)). Examples
of supplies include drugs and
administration sets used with infusion
pumps. Examples of accessories include
masks and tubing used with respiratory
equipment. We are proposing to apply
these policies to beneficiary-owned
oxygen equipment, as well as the
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supplies and accessories used in
conjunction with this equipment, and to
continue to apply these policies to
beneficiary-owned capped rental items,
as well as the supplies and accessories
used in conjunction with these items.
Specifically, we are proposing to
update § 414.210(f) and § 414.229(g) of
our regulations to reflect that payment
may be made for the replacement of
beneficiary-owned oxygen equipment
and capped rental DME in cases where
the item is lost, stolen, or irreparably
damaged, or in cases where the item has
been in continuous use for its
reasonable useful lifetime. We propose
that payment for the replacement be
made on a rental basis in accordance
with the payment rules in § 414.226 for
oxygen equipment and § 414.229 for
capped rental items. We also propose to
revise § 414.229 to reflect that these
proposed changes to the replacement
policy for beneficiary-owned capped
rental items only apply to those items
for which the first rental month occurs
on or after January 1, 2007 since the
DRA does not apply to capped rental
items for which the first rental month
occurs before January 1, 2006. The
current rules will remain in place for
capped rental items to which the DRA
does not apply.
We are aware that some manufacturer
warranties may cover replacement of
oxygen or capped rental equipment
within a certain time period after the
item is furnished. As was our policy
prior to the enactment of DRA (see
§ 110.2.C of Chapter 15 of the Medicare
Benefit Policy Manual (Pub. 100–02)),
we are proposing that Medicare not pay
for the replacement of beneficiaryowned oxygen equipment or capped
rental items covered by a manufacturer’s
or supplier’s warranty. In cases where
equipment replacement is not covered
by a manufacturer’s or supplier’s
warranty, we propose that the supplier
must still replace beneficiary-owned
oxygen equipment or beneficiary-owned
capped rental items at no cost to the
beneficiary or to the Medicare program
if: (1) The total accumulated costs, as
illustrated in the example below, to
repair the item after transfer of title to
the beneficiary exceed 60 percent of the
replacement cost; and (2) the item has
been in continuous use for less than its
reasonable useful lifetime, as
established in accordance with the
procedures set forth in proposed revised
§ 414.210(f). For example, a capped
rental item that can be replaced for
$1,000 (total of fee schedule payments
after 13 rental months) and for which
title has transferred to the beneficiary in
accordance with section
1834(a)(7)(A)(ii) of the Act can be used
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to illustrate what we mean when we use
the term ‘‘accumulated costs’’ above. In
this example, if Medicare has paid a
total of $500 for 3 repairs necessary to
make the item functional, and a fourth
repair costing $200 is needed in order
to make the item functional, the
accumulated costs for repair in this case
will equal $700, which exceeds $600 or
60 percent of the $1,000 cost to replace
the item. In this case, and therefore the
supplier would be required to furnish a
replacement item. The greater than 60
percent of cost threshold for
replacement is consistent with the
threshold repair costs that can result in
the replacement of prosthetics (artificial
limbs) in accordance with section
1834(h)(1)(G) of the Act. We believe this
threshold should apply to oxygen
equipment and capped rental items as
well, because artificial limbs, like these
items, are built to withstand repeated
use.
We propose that the supplier be
responsible for the cost of the
replacement equipment because we
believe that the item in this case did not
last for the entire reasonable useful
lifetime. After the beneficiary acquires
title to the item, the supplier that
transferred title would be responsible
for furnishing the replacement item. We
are proposing this provision to
safeguard the beneficiary from
receiving, and the Medicare program
from paying for, substandard
equipment, and to avoid creating an
incentive for suppliers to increase the
number of claims submitted for repairs
in an effort to recover revenue lost as a
result of DRA section 5101. We believe
that this requirement is not
unreasonable since suppliers should be
furnishing items in good working order
and are otherwise bound by regulations
at § 424.57(c)(15) to accept returns from
beneficiaries of substandard items.
Exceptions to this rule may be granted
by CMS or the carrier as appropriate (for
example, the supplier would not be
responsible for replacing an item in
need of repair due to beneficiary neglect
or abuse).
L. Periods of Continuous Use
Rules that apply in determining a
period of continuous use for rental of
DME are found at § 414.230 of our
regulations. We are proposing that these
rules would continue to apply in
implementing section 5101 of the DRA,
with one exception. The rules in
§ 414.230(f) provide that a new period of
continuous use begins for new or
additional equipment prescribed by a
physician and found to be medically
necessary, even if the new or additional
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equipment is similar to the old
equipment.
Medicare payments for stationary and
portable oxygen and oxygen equipment
are currently modality neutral, which
means that the same payment amounts
apply to the different types of oxygen
equipment furnished to Medicare
beneficiaries. Since there is no
distinction made between oxygen
equipment modalities for payment
purposes under the Medicare program,
we do not believe that it is necessary or
appropriate to begin a new period of
continuous use when the beneficiary
changes from one oxygen equipment
modality to another. We are proposing
to revise § 414.230(f) of our regulations
to designate the existing language in this
section as paragraph (f)(1) and to add a
new paragraph (f)(2) to reflect this
exception, effective for oxygen
equipment furnished on or after January
1, 2007. We are also proposing to revise
§ 414.230(b) to incorporate section
5101(b)(2)(B) of the DRA, which
provides that for all beneficiaries
receiving oxygen equipment paid for
under section 1834(a) on December 31,
2005, the period of continuous use
begins on January 1, 2006.
M. Health Care Information
Transparency and Health Information
Technology
(If you choose to comment on issues
in this section, please include the
caption ‘‘Health Care Information
Transparency and Health Information
Technology’’ at the beginning of your
comment.)
In the April 25, 2006 Inpatient
Prospective Payment Systems proposed
rule (71 FR 23996), we discussed in
detail the Health Care Information
Transparency Initiative and our efforts
to promote effective use of health
information technology (HIT) as a
means to help improve health care
quality and improve efficiency.
Specifically, with regard to the
transparency initiative, we discussed
several potential options for making
pricing and quality information
available to the public (71 FR 24120
through 24121). We solicited comments
on ways the Department can encourage
transparency in health care quality and
pricing whether through its leadership
on voluntary initiatives or through
regulatory requirements. We also sought
comments on the Department’s statutory
authority to impose such requirements.
In addition, we discussed the potential
for HIT to facilitate improvements in the
quality and efficiency of health care
services (71 FR 24100 through 24101).
We solicited comments on our statutory
authority to encourage the adoption and
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use of HIT. The 2007 Budget states that
‘‘the Administration supports the
adoption of health information
technology (IT) as a normal cost of
doing business to ensure patients
receive high quality care.’’ We also
sought comments on the appropriate
role of HIT in potential value-based
purchasing programs, beyond the
intrinsic incentives of a PPS to provide
efficient care, encourage the avoidance
of unnecessary costs, and increase
quality of care. In addition, we sought
comments on promotion of the use of
effective HIT and how CMS can
encourage its use in HHAs.
We intend to consider both the health
care information transparency initiative
and the use of HIT as we refine and
update all Medicare payment systems.
Therefore, we seek comments on these
initiatives as applied to HH PPS in this
proposed rule, including the
Department’s statutory authority to
impose any such requirements. We may
address these initiatives in the final HH
PPS rule. For example, a HIT proposal
could include adding a requirement that
HHAs use HIT that is compliant with
and certified by the Certification
Commission for Health Information
Technology (CCHIT) in the areas in
which the technology is available. As
noted previously, we currently collect
home health quality information and
propose to collect additional quality
data and report it on the CMS Home
Health Compare Web site. We note that
we are in the process of seeking input
on these initiatives in various proposed
Medicare payment rules being issued
this year.
III. Collection of Information
Requirements
Under the Paperwork Reduction Act
of 1995, we are required to provide 60day notice in the Federal Register and
solicit public comment before a
collection of information requirement is
submitted to the Office of Management
and Budget (OMB) for review and
approval. In order to fairly evaluate
whether an information collection
should be approved by OMB, section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995 requires that we
solicit comment on the following issues:
• The need for the information
collection and its usefulness in carrying
out the proper functions of our agency.
• The accuracy of our estimate of the
information collection burden.
• The quality, utility, and clarity of
the information to be collected.
• Recommendations to minimize the
information collection burden on the
affected public, including automated
collection techniques.
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We are soliciting public comment on
each of these issues for the following
sections of this document that contain
information collection requirements:
Section 414.226—Oxygen and Oxygen
Equipment
This section proposes to require a
supplier to disclose to the beneficiary
whether or not the supplier will accept
assignment of all monthly rental claims
for oxygen equipment for the duration
of the 36-month rental period.
The burden associated with this
requirement is the time and effort put
forth by the supplier to disclose this
information. While this information
collection is subject to the PRA, we
believe this requirement meets the
requirements of 5 CFR 1320.3(b)(2), and
as such, the burden associated with this
requirement is exempt from the PRA.
Section 414.229—Other Durable
Medical Equipment-Capped Rental
Items
This section proposes to require a
supplier to disclose to the beneficiary
whether or not the supplier will accept
assignment of all monthly rental claims
for capped rental DME for the duration
of the 13-month rental period.
The burden associated with this
requirement is the time and effort put
forth by the supplier to disclose this
information. While this information
collection is subject to the PRA, we
believe this requirement meets the
requirements of 5 CFR 1320.3(b)(2), and
as such, the burden associated with this
requirement is exempt from the PRA.
We have submitted a copy of this
proposed rule to OMB for its review of
the information collection requirements
described above. These requirements are
not effective until they have been
approved by OMB.
If you comment on these information
collection and recordkeeping
requirements, please mail copies
directly to the following:
Centers for Medicare & Medicaid
Services, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attn: Melissa Musotto, [CMS–1304–
P], Room C4–26–05, 7500 Security
Boulevard, Baltimore, MD 21244–
1850; and
Office of Information and Regulatory
Affairs, Office of Management and
Budget, Room 10235, New Executive
Office Building, Washington, DC
20503, Attn: Carolyn Lovette, CMS
Desk Officer, CMS–1304–P,
carolyn_lovett@omb.eop.gov. Fax
(202) 395–6974.
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44101
IV. Response to Comments
Because of the large number of public
comments we normally receive on
Federal Register documents, we are not
able to acknowledge or respond to them
individually. We would consider all
comments we receive by the date and
time specified in the DATES section of
this preamble, and, when we proceed
with a subsequent document, we would
respond to the comments in the
preamble to that document.
V. Regulatory Impact Analysis
[If you choose to comment on issues
in this section, please include the
caption ‘‘REGULATORY IMPACT
ANALYSIS’’ at the beginning of your
comments.]
A. Overall Impact
We have examined the impacts of this
rule as required by Executive Order
12866 (September 1993, Regulatory
Planning and Review), the Regulatory
Flexibility Act (RFA) (September 19,
1980, Pub. L. 96–354), section 1102(b) of
the Social Security Act, the Unfunded
Mandates Reform Act of 1995 (Pub. L.
104–4), and Executive Order 13132.
Executive Order 12866 (as amended
by Executive Order 13258, which
merely reassigns responsibility of
duties) directs agencies to assess all
costs and benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety
effects, distributive impacts, and
equity). A regulatory impact analysis
(RIA) must be prepared for major rules
with economically significant effects
($100 million or more in any 1 year).
This proposed rule would be a major
rule, as defined in Title 5, United States
Code, section 804(2), because we
estimate the impact to the Medicare
Program, and the annual effects to the
overall economy, would be more than
$100 million. The update set forth in
this proposed rule would apply to
Medicare payments under HH PPS in
CY 2007. Accordingly, the following
analysis describes the impact in CY
2007 only. We estimate that there would
be an additional $420 million in CY
2007 expenditures attributable to the CY
2007 proposed estimated home health
market basket update of 3.1 percent.
The RFA requires agencies to analyze
options for regulatory relief of small
businesses. For purposes of the RFA,
small entities include small businesses,
nonprofit organizations, and small
government agencies. Most hospitals
and most other providers and suppliers
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are small entities, either by nonprofit
status or by having revenues of $6
million to $29 million in any 1 year. For
purposes of the RFA, approximately 75
percent of HHAs are considered small
businesses according to the Small
Business Administration’s size
standards with total revenues of $11.5
million or less in any 1 year. Individuals
and States are not included in the
definition of a small entity. As stated
above, this proposed rule would provide
an update to all HHAs for CY 2007 as
required by statute. This proposed rule
would have a significant positive effect
upon small entities that are HHAs.
Based on our analysis of 2003 claims
data, we also estimate that
approximately 90 percent of registered
DME suppliers are considered small
businesses according to the Small
Business Administration’s size
standards. The size standard for NAICS
code, 532291, Home Health Equipment
Rental is $6 million. (see https://
www.sba.gov/size/sizetable2002.html,
read May 9, 2005.) This proposed rule
would reduce payments for oxygen
equipment and capped rental items; and
therefore, would have a significant
negative effect upon small entities that
are DME suppliers overall. However, as
explained in detail below, we believe
that Medicare payments would still be
adequate for the items affected by this
rule and that suppliers whose primary
line of business involves furnishing
these items will remain profitable.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 603 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area and has
fewer than 100 beds. We have
determined that this proposed rule
would not have a significant economic
impact on the operations of a substantial
number of small rural hospitals.
Section 202 of the Unfunded
Mandates Reform Act of 1995 (Pub. L.
104–4) also requires that agencies assess
anticipated costs and benefits before
issuing any rule that may result in
expenditure in any 1 year by State,
local, or tribal governments, in the
aggregate, or by the private sector, of
$120 million. We believe this proposed
rule would not mandate expenditures in
that amount.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it promulgates a
proposed rule (and subsequent final
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rule) that imposes substantial direct
requirement costs on State and local
governments, preempts State law, or
otherwise has Federalism implications.
We have reviewed this rule under the
threshold criteria of Executive Order
13132, Federalism. We have determined
that this proposed rule would not have
substantial direct effects on the rights,
roles, and responsibilities of States.
B. Anticipated Effects
1. Home Health PPS
This proposed rule would update the
HH PPS rates contained in Pub. 100–20,
One Time Notification, Transmittal 211,
published February 10, 2006. We
updated the rates in the CY 2006 final
rule (70 FR 68132, November 9, 2005)
through Transmittal 211 to take account
of the DRA changes, specifically the 0
percent update and the rural add-on.
The impact analysis of this proposed
rule presents the projected effects of the
proposed change from the CY 2006
transition wage index (50/50 blend of
MSA-based and CBSA-based
designations) to the CY 2007 proposed
CBSA-based designations in
determining the wage index used to
calculate the HH PPS rates for CY 2007.
We estimate the effects by estimating
payments while holding all other
payment variables constant. We use the
best data available, but we do not
attempt to predict behavioral responses
to these changes, and we do not make
adjustments for future changes in such
variables as days or case-mix.
This analysis incorporates the latest
estimates of growth in service use and
payments under the Medicare home
health benefit, based on the latest
available Medicare claims from 2004.
We note that certain events may
combine to limit the scope or accuracy
of our impact analysis, because such an
analysis is future-oriented and, thus,
susceptible to forecasting errors due to
other changes in the forecasted impact
time period. Some examples of such
possible events are newly-legislated
general Medicare program funding
changes made by the Congress, or
changes specifically related to HHAs. In
addition, changes to the Medicare
program may continue to be made as a
result of the BBA, the BBRA, the
Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection
Act of 2000, the MMA, the DRA, or new
statutory provisions. Although these
changes may not be specific to HH PPS,
the nature of the Medicare program is
such that the changes may interact, and
the complexity of the interaction of
these changes could make it difficult to
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predict accurately the full scope of the
impact upon HHAs.
Our discussion for this proposed rule
will focus on the impact of changes in
the wage index, most notably the
adoption of the full CBSA designations.
The impacts of the updated wage data
are shown in Table 9 below. The
breakdown of the various impacts
displayed in the table follows.
The rows display the estimated effect
of the proposed changes on different
categories. The first row of figures
represents the estimated effects on all
facilities. The next 2 rows show the
effect on urban and rural facilities. This
is followed, in the next 4 rows, by
impacts on urban and rural facilities
based on whether they are a hospitalbased or freestanding facility. The next
20 rows show the effect on urban and
rural facilities based on the census
region in which they are located.
The first column shows the
breakdown of all HHAs by urban or
rural status, hospital-based or
freestanding status, and census division.
The second column in the table shows
the number of facilities in the impact
database. A facility is considered urban
if it is located in a CBSA and,
conversely, rural if it is not located in
a CBSA.
The third column of the table shows
the effect of the proposed annual update
to the wage index. This represents the
effect of using the most recent wage data
available to determine the proposed
estimated home health market basket
update. The total impact of this change
is ¥0.1 percent; however, there are
distributional effects of the change.
The fourth column of the table shows
the effect of all the changes on the
proposed CY 2007 payments. The
proposed estimated market basket
update of 3.1 percentage points is
constant for all providers and, though
not shown individually, is included in
this column. It is projected that total
aggregate payments would increase by
3.0 percent, assuming facilities do not
change their care delivery and billing
practices in response.
As can be seen from this table, the
combined effects of all of the changes
would vary by specific types of
providers and by location. For example,
HHAs in the rural Pacific show the
largest estimated increase in payment at
10.3 percent, while HHAs in the rural
Mountain census division show the
smallest increase in payments at 0.5
percent. Rural HHAs do somewhat
better than urban HHAs, seeing an
estimated increase in payments of 3.3
percent and 2.9 percent respectively.
Amongst the different type of facility
categories, freestanding rural HHAs do
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best, with an estimated increase in
payments of 3.5 percent. Hospital-based
urban HHAs are next with an estimated
increase in payments of 3.2 percent with
hospital-based rural and freestanding
urban HHAs with estimated increases of
44103
3.1 percent and 2.8 percent,
respectively.
TABLE 9.—PROJECTED IMPACT OF CY 2007 UPDATE TO THE HH PPS
Updated wage
data
(percent)
Total CY 2007
change
(percent)
7,370
2,097
5,273
1,988
3,285
1,201
896
¥0.1
¥0.2
0.2
0.1
¥0.3
0.0
0.4
3.0
2.9
3.3
3.2
2.8
3.1
3.5
254
423
913
886
222
304
1,300
281
649
41
¥1.1
0.0
¥0.5
0.3
¥0.4
0.3
¥0.6
1.7
0.2
¥4.8
2.0
3.1
2.6
3.5
2.7
3.4
2.4
4.8
3.3
¥1.8
43
82
239
284
215
488
475
173
88
10
¥0.7
0.3
¥0.6
1.5
¥0.3
0.3
¥0.3
¥2.5
6.9
7.7
2.3
3.4
2.5
4.6
2.8
3.4
2.8
0.5
10.3
11.1
Number of
facilities
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Total .............................................................................................................................................
Urban ...........................................................................................................................................
Rural ............................................................................................................................................
Hospital based urban ...................................................................................................................
Freestanding urban ......................................................................................................................
Hospital based rural .....................................................................................................................
Freestanding rural ........................................................................................................................
Urban by region:
New England ........................................................................................................................
Middle Atlantic ......................................................................................................................
South Atlantic .......................................................................................................................
East North Central ................................................................................................................
East South Central ...............................................................................................................
West North Central ...............................................................................................................
West South Central ..............................................................................................................
Mountain ...............................................................................................................................
Pacific ...................................................................................................................................
Outlying .................................................................................................................................
Rural by region:
New England ........................................................................................................................
Middle Atlantic ......................................................................................................................
South Atlantic .......................................................................................................................
East North Central ................................................................................................................
East South Central ...............................................................................................................
West North Central ...............................................................................................................
West South Central ..............................................................................................................
Mountain ...............................................................................................................................
Pacific ...................................................................................................................................
Outlying .................................................................................................................................
The impact of the proposed wage
index for CY 2007 is shown in
Addendum C to this document.
Addendum C to this document shows a
side-by-side comparison, by State and
county code, of the CY 2006 transition
wage index, which was a 50/50 blend of
MSA-based and CBSA-based pre-floor,
pre-reclassified hospital wage indexes,
and the proposed CY 2007 pre-floor,
pre-reclassified hospital wage index for
the CY 2007 HH PPS update. In the last
column of Addendum C to this
document, we show the percentage
change in the wage index from CY 2006
to the proposed wage index for CY 2007.
We estimate that there would be an
additional $420 million in CY 2007
expenditures attributable to the CY 2007
proposed estimated market basket (3.1
percent) increase. Thus, the anticipated
expenditures outlined in this proposed
rule would exceed the $100 million
annual threshold for a major rule as
defined in Title 5, USC, section 804(2).
This proposed rule would have a
positive effect on providers of Medicare
home health services by increasing their
Medicare payment rates. It is
anticipated that very few HHAs will not
submit the quality data required by
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section 1895(b)(3)(B)(v)(II)of the Act
necessary to receive the full market
basket percentage increase. Submission
of OASIS data is a Medicare condition
of participation for HHAs. Therefore,
one would expect that no HHA would
be subject to the 2 percent reduction in
payments in CY 2007. As indicated in
the rule, most HHAs that do not report
OASIS provide pediatric, non-Medicare,
or personal care only. However, CMS is
aware of instances of non-compliance
among a very small portion of HHAs
with regard to OASIS submission.
For the purposes of the CY 2007
impact analysis, we anticipate that less
than 1 percent of HHAs, involving less
than 1 percent of total Medicare HH
payments, would fail to submit quality
data and hence would be subject to the
2 percent reduction. This is not enough
to impact the estimated $420 million in
additional expenditures. Finally, we do
not believe there is a differential impact
due to the aggregate nature of the
update. We do not anticipate specific
effects on other providers.
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2. Oxygen and Oxygen Equipment
Provisions
As mandated by the DRA of 2005, this
proposed rule limits to 36 months the
total number of continuous months for
which Medicare would pay for oxygen
equipment, after which the title to the
oxygen equipment would be transferred
from the supplier to the beneficiary.
Since Medicare currently pays for
oxygen equipment on a monthly basis
for as long as it is medically necessary,
this change would result in savings to
Medicare. In addition, the DRA
mandates that Medicare continue to
make monthly payments for furnishing
contents for beneficiary-owned oxygen
equipment.
Close to a million patients now
receive oxygen therapy. Although
monthly rental payments already have
been reduced by 30 percent by section
4552 of the Balanced Budget Act of 1997
and approximately 10 percent by
section 302(c)(2) of the Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003, Medicare
allowed charges rose to $2.78 billion by
2004, a 71 percent increase since 1998
that reflects the growing use. Before the
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amendments to section 1834(a)(5) of the
Act made by the DRA, Medicare
continued to make rental payments for
as long as medical necessity continued,
even when the total payments greatly
exceeded the cost of purchasing the
equipment and the supplier retained
title to the equipment. We believe the
DRA amendments to the Act will result
in a loss of revenue to suppliers that
will no longer receive payments for
oxygen equipment after the 36th month
of continuous use.
Based on data for items furnished in
calendar year 2004, oxygen
concentrators accounted for over 93
percent of Medicare utilization for
stationary oxygen systems, in terms of
both allowed charges and allowed
services. Since oxygen concentrators
can typically be purchased for $1,000 or
less, we believe that 36 months of
payment at approximately $200 per
month would ensure the supplier is
reimbursed for its cost for furnishing the
equipment. The $200 allowed payment
amount may be re-adjusted in the future
to assure that payments are adequate,
but not excessive. This could be
accomplished though the competitive
acquisition programs mandated by
section 1847 of the Act or in accordance
with our authority for adjusting fee
schedule amounts at section 1842(b)(8)
and (9) of the Act. Based on our data,
approximately 36 percent of Medicare
beneficiaries use oxygen equipment for
more than 3 years and approximately 20
percent of Medicare beneficiaries use
oxygen equipment for more than 5
years. In section K of the ‘‘provisions of
the proposed regulation section of this
preamble,’’ we propose to allow
beneficiaries to obtain replacement
oxygen equipment in cases where their
equipment has been in continuous use
for the reasonable useful lifetime of the
equipment. Unless CMS or its carriers
establish a specific reasonable useful
lifetime for oxygen equipment, the
default lifetime for DME of 5 years
would apply. The main effect of this
rule on suppliers is that they will not be
able to receive payment for the
equipment beyond 36 months for
approximately 36 percent of Medicare
patients. They will also not be able to
receive payment for furnishing the same
item to subsequent patients in these
cases since they lose title to the
equipment. In the case of oxygen
concentrator systems and portable
oxygen transfilling systems, delivery of
oxygen contents is not necessary, and
therefore, payment will not be made for
the furnishing of contents for these
types of beneficiary owned equipment.
Under the old payment rules, payment
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for oxygen concentrators used for
stationary equipment purposes would
have continued at approximately $200
per month for the entire period of
medical need. Section 5101(b) of the
DRA mandates that payment for oxygen
equipment end and that title to the
equipment transfer after 36 months of
continuous use.
In the case of liquid and gaseous
oxygen systems, suppliers will continue
to be paid for furnishing oxygen
contents for beneficiary-owned systems.
The current statewide monthly payment
amounts for oxygen and oxygen
equipment that would be paid during
the 36-month period of continuous use
for beneficiaries who only use stationary
equipment range from $194.48 to
$200.41, with the average statewide fee
being $199.36. The current statewide
monthly payment amount for furnishing
oxygen contents for beneficiary owned
equipment range from $137.54 to
$198.12, with the average statewide fee
being $156.07. The average decrease in
Medicare fee schedule amounts that
may result from the DRA changes for
liquid and gaseous systems after the 36month period (that is, shift from
monthly payments for equipment and
contents to monthly payments for
contents only), is expected to be $43.29
($199.36¥$156.07). Therefore, this is
the level of monthly reimbursement that
would be lost after the 36-month period
for suppliers that furnish oxygen and
oxygen equipment to beneficiaries in
these situations and who continue to
furnish contents to these beneficiaries.
Based on current fee schedule amounts
for all oxygen and oxygen equipment,
this equates to an average reduction in
payment (from $199.36 to $156.07) of
approximately 22 percent.
At the current monthly statewide fee
schedule rates, which range from
$194.48 to $200.41, suppliers of oxygen
equipment are expected to be paid from
$7,001.28 to $7,214.76 over 36 months.
By comparison, a medical center
operated by the Department of Veterans
Affairs (VA) in Tampa, Florida, is the
largest VA center in terms of number of
veterans on oxygen therapy and services
approximately 1,000 patients on oxygen
by contracting with a locally based
manufacturer to purchase the oxygen
concentrators for $895 each. The
medical center contracts with a local
supplier for $90 to deliver and set up
the concentrator to the patient’s home.
This local supplier also provides service
and maintenance of the equipment at
any time throughout the year for $48 per
service episode. If the equipment needs
to be replaced, the local supplier will
furnish another concentrator for a $90
fee. The VA total payments over 5 years
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for an oxygen concentrator used by a
veteran in this center plus payment for
ten episodes of maintenance and
servicing, assuming servicing every 6
months, would be $1,435, compared to
total Medicare allowed charges of
$7,164, on average, for a Medicare
beneficiary. Based on this comparison,
the Medicare payment amounts and
methodology appear to be more than
adequate.
We do not anticipate that transfer of
ownership for oxygen equipment to the
beneficiary after 36 months of
continuous use would be a significant
financial burden to suppliers because
the effect is limited to a maximum of 36
percent of a supplier’s Medicare
business and because suppliers of
oxygen equipment primarily furnish
lower cost oxygen concentrators. We
also do not anticipate a significant
change in the rate of assignment of
claims for oxygen equipment based on
our belief that suppliers will be
adequately reimbursed for furnishing
the oxygen equipment.
Finally, if new oxygen and oxygen
equipment classes and payment
amounts are established in accordance
with the proposed provisions in section
I of this rule, there could potentially be
a shift in utilization between the various
oxygen equipment modalities, which
could impact supplier revenues and
sales volume for certain oxygen
equipment manufacturers. However,
since use of the authority to create such
classes under section 1834(a)(9)(D) of
the Act requires that these changes be
budget-neutral, there would not a
significant impact on overall Medicare
payments to suppliers.
3. Capped Rental DME
This proposed rule, which limits to 13
months the total number of continuous
months for which Medicare would pay
for capped rental DME, after which the
ownership of the capped rental item
would be transferred from the supplier
to the beneficiary, would result in
significant savings for the Medicare
program. Savings would be realized
through: (1) The gradual elimination of
rental payments for the 14th and 15th
months of continuous use; and (2)
changing the semi-annual payment for
maintenance and servicing to payment
only when reasonable and necessary
maintenance and servicing is needed.
We anticipate that suppliers may lose
money due to the loss of 1 to 2 months
rental in cases where beneficiaries need
the item for more than 13 months and
would not have otherwise selected the
purchase option currently described in
§ 414.229(d). The average of the 2006 fee
schedule amounts for all capped rental
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items for months 14 and 15 is
approximately $152. We do not believe
suppliers will suffer financially as a
result of this provision based on data
which shows that in 2004, 97 percent of
suppliers accepted assignment for
beneficiaries who chose the purchase
option (§ 414.229(d)) in the 11th month
of a capped rental period. This is an
indication that suppliers were willing to
accept the Medicare payment as
payment in full for the capped rental
item, even though they had been
informed that the beneficiary would
take over ownership of the item after the
13th month of continuous use.
Therefore, we do not anticipate that
transfer of ownership for capped rental
equipment to the beneficiary after 13
months of continuous use would be a
significant financial burden to
suppliers.
For items for which the first rental
payment falls on or after January 1,
2006, Medicare would only pay for
maintenance and servicing as necessary.
In a June 2002 report (OEI–03–00–
00410), the Office of Inspector General
(OIG) indicated that only 9 percent of
the capped rental equipment with a
June 2000 service date actually received
any servicing between June and
December 2000. Out of the $7.3 million
Medicare paid for maintenance services
from June 2000, we estimate that $6.5
million was paid for equipment that
received no actual servicing. The OIG
recommended to CMS in 2002 that we
eliminate the semi-annual maintenance
payment currently allowed for capped
rental equipment and pay only for
repairs when needed.
The combination of these two factors
provides strong evidence that the
Medicare rules for paying for
maintenance and servicing of capped
rental equipment furnished before
January 1, 2006, were not cost-effective.
Impact on Beneficiaries
The DRA provisions and this
proposed rule would result in savings
for Medicare beneficiaries using oxygen
equipment and capped rental items. For
capped rental items, Medicare payments
will be made for 13 continuous months
and for oxygen equipment, payments
will be made for 36 continuous months.
After the rental period for each category
of equipment expires, ownership of the
equipment will transfer from the
suppliers to the beneficiaries.
Beneficiaries will continue to be
financially responsible for a 20 percent
coinsurance payment during the 13 or
36 month rental periods for capped
rental items and oxygen equipment,
respectively. However, beneficiaries
will no longer have to make a monthly
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20 percent coinsurance payment for the
equipment after they own it. This will
result in significant savings to
beneficiaries.
For example, before the DRA,
Medicare and the beneficiary made
continuous payments for the rental of
oxygen equipment that totaled about
$200 per month. Of this amount, the
beneficiary paid coinsurance of $40
which would equal $480 for a single
year’s rental, $1,440 over 36 months,
and $2,400 over 5 years. After the DRA,
beneficiaries will only pay a
coinsurance amount for up to 36 months
for the rental of oxygen equipment, after
which time they will own the
equipment. Thus, the DRA oxygen
provisions result in savings of
approximately $480 if beneficiaries use
the equipment for 4 years, and $960 if
they use the equipment for 5 years.
For capped rental items, beneficiaries
will save coinsurance by not being
responsible for any equipment payment
after the 13th rental month or the semiannual maintenance and servicing
payment that was approximately equal
to 10 percent of the purchase price for
the equipment. Before the DRA,
Medicare and the beneficiary would pay
up to 15 months for capped rental items,
and Medicare and the beneficiary would
also pay for maintenance and servicing
every six months. Thus, beneficiaries
will save coinsurance payments related
to both the equipment itself and the
maintenance and servicing of that
equipment.
The proposed rule would assure
beneficiaries that suppliers that furnish
the equipment for the first month would
continue to furnish the equipment for
the entire 36-month period of
continuous use for oxygen equipment or
the 13-month period of continuous use
for capped rental.
Beneficiaries would also be assured
that their oxygen and capped rental
equipment would not be impermissibly
swapped by the supplier at any time
during the rental period. Under the
proposed rule, we propose that a
supplier may not provide different
rented equipment to the beneficiary at
any time during the 36 rental months for
oxygen equipment or the 13 rental
months for capped rental DME unless
one of the following exceptions apply:
The equipment is lost, stolen, or
irreparably damaged; the equipment is
being repaired while loaner equipment
is in use; there is a change in the
beneficiary’s medical condition; or the
carrier determines that a change in
equipment is otherwise warranted.
We are proposing that suppliers
inform beneficiaries whether they will
accept or not accept assignment on all
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44105
monthly rental claims during the 13month rental period for capped rental
items or the 36-month rental period for
oxygen equipment in an upfront
manner.
The proposed rule would also assure
beneficiaries that following the transfer
of title, the supplier would replace the
item at no cost to the beneficiary in
cases where the accumulated costs of
repair exceed 60 percent of the cost of
replacement, if the reasonable useful
lifetime of the item (currently a default
period of 5 years) has not expired.
C. Accounting Statement
As required by OMB Circular A–4
(available at ), https://
www.whitehouse.gov/omb/circulars/
a004/a-4.pdf) in Table 10 below, we
have prepared an accounting statement
showing the classification of the
expenditures associated with the
provisions of this proposed rule. This
table provides our best estimate of the
increase in Medicare payments under
the HH PPS as a result of the changes
presented in this final rule based on the
data for 7,370 HHAs in our database. All
expenditures are classified as transfers
to Medicare providers (that is, HHAs).
TABLE 10.—ACCOUNTING STATEMENT:
CLASSIFICATION OF ESTIMATED EXPENDITURES, FROM CY 2006 TO CY
2007
[In millions]
Category
Transfers
Annualized monetized
transfers.
From whom to
whom?
$420
Federal Government
to HHAs.
In Table 11 below, we have prepared
an accounting statement showing the
classification of the expenditures
associated with the DME provisions of
this final rule. This table provides our
best estimate of the decrease in
Medicare payments under the DME
benefit as a result of the changes
presented in this final rule based on the
2004 allowed charge data for oxygen
and capped rental DME in our database.
All expenditures are classified as
transfers to the Medicare program and
its beneficiaries.
TABLE 11.—ACCOUNTING STATEMENT:
CLASSIFICATION OF ESTIMATED EXPENDITURES
[In millions]
Category
Monetized transfers in
FY 2007.
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Transfers
$80
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TABLE 11.—ACCOUNTING STATEMENT: servicing of beneficiary-owned
CLASSIFICATION OF ESTIMATED EX- equipment. Reasonable and necessary
charges are those made for parts and
PENDITURES—Continued
[In millions]
Category
Monetized transfers
FY 2008.
Monetized transfers
FY 2009.
Monetized transfers
FY 2010.
Monetized transfers
FY 2011.
From whom to
whom?
Transfers
in
130
in
170
in
220
in
280
Suppliers to Federal
Government and
beneficiaries.
In accordance with the provisions of
Executive Order 12866, this regulation
was reviewed by the Office of
Management and Budget.
List of Subjects
42 CFR Part 414
Administrative practice and
procedure, Health facilities, Health
professions, Kidney diseases, Medicare,
Reporting and recordkeeping
requirements.
42 CFR Part 484
Health facilities, Health professions,
Medicare, Reporting and recordkeeping
requirements.
For the reasons set forth in the
preamble, the Centers for Medicare &
Medicaid Services would amend 42 CFR
chapter IV as set forth below:
PART 414—PAYMENT FOR PART B
MEDICAL AND OTHER HEALTH
SERVICES
Subpart D—Payment for Durable
Medical Equipment and Prosthetic and
Orthotic Devices
1. The authority citation for part 414
continues to read as follows:
Authority: Secs. 1102, 1871, and 1881(b)(1)
of the Social Security Act (42 U.S.C. 1302,
1395(hh), and 1395rr(b)(1)).
hsrobinson on PROD1PC69 with PROPOSALS2
2. Amend § 414.210 as follows:
A. Revise paragraph (e).
B. Revise the introductory text to
paragraph (f).
C. Revise paragraph (f)(2)
D. Add new paragraphs (f)(3) and
(f)(4).
The revisions read as follows:
§ 414.210
General payment rules.
*
*
*
*
*
(e) Maintenance and servicing.—(1)
General rule. Except as provided in
paragraph (e)(2) of this section, the
carrier pays the reasonable and
necessary charges for maintenance and
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labor not otherwise covered under a
manufacturer’s or supplier’s warranty.
Payment is made for replacement parts
in a lump sum based on the carrier’s
consideration of the item. The carrier
establishes a reasonable fee for labor
associated with repairing, maintaining,
and servicing the item. Payment is not
made for maintenance and servicing of
a rented item other than the
maintenance and servicing fee for other
durable medical equipment as described
in § 414.229(e).
(2) Exception. For items purchased on
or after June 1, 1989, no payment is
made under the provisions of paragraph
(e)(1) of this section for the maintenance
and servicing of:
(i) Items requiring frequent and
substantial servicing, as defined in
§ 414.222(a);
(ii) Capped rental items, as defined in
§ 414.229(a), that are not beneficiaryowned in accordance with § 414.229(d)
or § 414.229(h); and
(iii) Oxygen equipment, as described
in § 414.226, that is not beneficiaryowned in accordance with § 414.226(e).
(3) Supplier replacement of
beneficiary-owned equipment based on
accumulated repair costs. A supplier
that transfers title to oxygen equipment
or a capped rental item to a beneficiary
in accordance with § 414.226(f) or
§ 414.229(f)(2) is responsible for
furnishing replacement equipment at no
cost to the beneficiary or to the
Medicare program if the total repair
costs that accumulate for the equipment
after transfer of title exceed 60 percent
of the cost to replace the equipment and
the equipment has been in use for less
than its reasonable useful lifetime, as
determined under § 414.210(f)(1).
(f) Payment for replacement of
equipment. If a beneficiary-owned item
of DME or a prosthetic or orthotic
device paid for under this subpart has
been in continuous use by the patient
for the equipment’s reasonable useful
lifetime or if the carrier determines that
the item is lost, stolen, or irreparably
damaged, the patient may elect to obtain
a new piece of equipment.
*
*
*
*
*
(2) If the beneficiary elects to obtain
replacement oxygen equipment,
payment is made in accordance with
§ 414.226(a).
(3) If the beneficiary elects to obtain
a replacement capped rental item,
payment is made in accordance with
§ 414.229(a)(2) or (a)(3).
(4) For all other beneficiary-owned
items, if the beneficiary elects to obtain
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replacement equipment, payment is
made on a purchase basis.
3. Amend § 414.226 by—
A. Revising paragraph (a) and the
heading of paragraph (b).
B. Revising paragraph (b)(3).
C. Adding paragraphs (b)(4) and
(b)(5).
D. Redesignating paragraph (d) as
paragraph (e).
E. Redesignating paragraph (c) as
paragraph (d).
F. Revising newly redesignated
paragraph (d).
G. Adding a new paragraph (c).
H. Revising newly redesignated
paragraph (e)(1) introductory text.
I. Revising newly redesignated
paragraph (e)(1)(i).
. Revising newly redesignated
paragraph (e)(2)(i).
K. Revising newly redesignated
paragraph (e)(2)(ii).
L. Adding new paragraphs (f) and (g).
The revisions and additions read as
follows:
§ 414.226
Oxygen and oxygen equipment.
(a) Payment rules. (1) Oxygen
equipment. Payment for rental of
oxygen equipment is made based on a
monthly fee schedule amount during
the period of medical need, but for no
longer than a period of continuous use
of 36 months. A period of continuous
use is determined under the provisions
in § 414.230.
(2) Oxygen contents. Payment for
purchase of oxygen contents is made
based on a monthly fee schedule
amount until medical necessity ends.
(b) Monthly fee schedule amount for
items furnished prior to 2007.
*
*
*
*
*
(3) For 1991 through 2006, the fee
schedule amounts for items described in
paragraphs (b)(1)(iii) and (iv) of this
section are determined using the
methodology contained in § 414.220 (d),
(e), and (f).
(4) For 1991 through 2006, the fee
schedule amounts for items described in
paragraphs (b)(1)(i) and (ii) of this
section are determined using the
methodology contained in § 414.220 (d),
(e), and (f).
(5) For 2005 and 2006, the fee
schedule amounts determined under
paragraph (b)(4) of this section are
reduced using the methodology
described in § 1834(a)(21)(A) of the Act.
(c) Monthly fee schedule amount for
items furnished for years after 2006. (1)
Monthly fee schedule amounts are
separately calculated for the following
items:
(i) Stationary oxygen equipment
(including stationary concentrators) and
oxygen contents (stationary and
portable).
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(ii) Portable equipment only (gaseous
or liquid tanks).
(iii) Oxygen generating portable
equipment only.
(iv) Stationary oxygen contents only.
(v) Portable oxygen contents only.
(2) The nationwide fee schedule
amount for items described in paragraph
(c)(1)(i) of this section is equal to the
average fee schedule amount established
under paragraph (b)(5) of this section
reduced by $22.
(3) The nationwide fee schedule
amount for items described in paragraph
(c)(1)(ii) of this section is equal to the
average of the fee schedule amounts
established under paragraph (b)(5) of
this section.
(4) The nationwide fee schedule
amount for items described in paragraph
(c)(1)(iii) of this section is equal to the
sum of the average of the fee schedule
amounts established under paragraph
(b)(5) of this section for items described
in paragraph (b)(1)(i) of this section and
the average of the fee schedule amounts
established under paragraph (b)(5) of
this section for items described in
paragraph (b)(1)(ii) of this section,
increased by $10, and reduced by the
nationwide fee schedule amount
established under paragraph (c)(2) of
this section.
(5) The nationwide fee schedule
amount for items described in paragraph
(c)(1)(iv) of this section is equal to 65
percent of the average fee schedule
amount established under paragraph
(b)(3) of this section for items described
in paragraph (b)(1)(iii) of this section.
(6) The nationwide fee schedule
amount for items described in paragraph
(c)(1)(v) of this section is equal to 35
percent of the average fee schedule
amount established under paragraph
(b)(3) of this section for items described
in paragraph (b)(1)(iii) of this section.
(d) Application of monthly fee
schedule amounts. (1) The fee schedule
amount for items described in paragraph
(c)(1)(i) of this section is paid when the
beneficiary rents stationary oxygen
equipment.
(2) Subject to the limitation set forth
in paragraph (e)(2) of this section, the
fee schedule amount for items described
in paragraph (c)(1)(ii) and (iii) of this
section is paid when the beneficiary
rents portable oxygen equipment.
(3) The fee schedule amount for items
described in paragraph (c)(1)(iv) of this
section is paid when the beneficiary
owns stationary oxygen equipment that
requires delivery of gaseous or liquid
oxygen contents.
(4) The fee schedule amount for items
described in paragraph (c)(1)(v) of this
section is paid when the beneficiary
owns portable oxygen equipment
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described in paragraph (c)(1)(ii) of this
section, or rents portable oxygen
equipment described in paragraph
(c)(1)(ii) of this section and does not
rent stationary oxygen equipment.
(e) Volume adjustments. (1) The fee
schedule amount for an item described
in paragraph (c)(1)(i) of this section is
adjusted as follows:
(i) If the attending physician
prescribes an oxygen flow rate
exceeding four liters per minute, the fee
schedule amount is increased by 50
percent, subject to the limit in
paragraph (e)(2) of this section.
*
*
*
*
*
(2) * * *
(i) The sum of the monthly fee
schedule amount for the items described
in paragraphs (c)(1)(i) and (ii) or (iii) of
this section; or
(ii) The adjusted fee schedule amount
described in paragraph (e)(1)(i) of this
section.
*
*
*
*
*
(f) Ownership of equipment. On the
first day that begins after the 36th
continuous month in which payment is
made for oxygen equipment under
paragraph (a)(1) of this section, the
supplier must transfer title to the
oxygen equipment to the beneficiary.
(g) Additional supplier requirements
for rentals that begin on or after January
1, 2007. (1) The supplier that furnishes
oxygen equipment for the first month
during which payment is made under
this section must continue to furnish the
equipment until medical necessity ends,
or the 36-month period of continuous
use ends, whichever is earlier, unless-(i)
The item becomes subject to a
competitive acquisition program
implemented in accordance with
section 1847(a) of the Act;
(ii) The beneficiary relocates to an
area that is outside the normal service
area of the supplier that initially
furnished the equipment;
(iii) The beneficiary elects to obtain
oxygen equipment from a different
supplier prior to the expiration of the
36-month rental period; or
(iv) CMS or the carrier determines
that an exception should apply in an
individual case based on the
circumstances.
(2) Oxygen equipment furnished
under this section may not be replaced
by the supplier prior to the expiration
of the 36-month rental period unless:
(i) The equipment is lost, stolen, or
irreparably damaged;
(ii) The furnishing of loaner
equipment is necessary while the
equipment is being repaired;
(iii) The equipment is no longer
medically necessary; or
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44107
(iv) The equipment is replaced in
accordance with § 414.210(e)(3) or (f).
(3) Before furnishing oxygen
equipment, the supplier must disclose
to the beneficiary its intentions
regarding whether it will accept
assignment of all monthly rental claims
for the duration of the rental period. A
supplier’s intentions could be expressed
in the form of a written agreement
between the supplier and the
beneficiary.
4. Amend § 414.229 by—
A. Revising paragraphs (a), (f) and (g).
B. Adding paragraph (h).
The revisions and additions read as
follows:
§ 414.229 Other durable medical
equipment-capped rental items.
(a) General payment rule. Payment is
made for other durable medical
equipment that is not subject to the
payment provisions set forth in
§§ 414.220 through 414.228 as follows:
(1) For items furnished prior to
January 1, 2006, payment is made on a
rental or purchase option basis in
accordance with the rules set forth in
paragraphs (b) through (e) of this
section.
(2) For items other than power-driven
wheelchairs furnished on or after
January 1, 2006, payment is made in
accordance with the rules set forth in
paragraph (f) of this section.
(3) For power-driven wheelchairs
furnished on or after January 1, 2006,
payment is made in accordance with the
rules set forth in paragraphs (f) or (h) of
this section.
*
*
*
*
*
(f) Rules for Capped Rental Items
Furnished Beginning on or after January
1, 2006. (1) For items furnished on or
after January 1, 2006, payment is made
based on a monthly rental fee schedule
amount during the period of medical
need, but for no longer than a period of
continuous use of 13 months. A period
of continuous use is determined under
the provisions in § 414.230.
(2) The supplier must transfer title to
the item to the beneficiary on the first
day that begins after the 13th
continuous month in which payments
are made under paragraph (f)(1) of this
section.
(3) Payment for maintenance and
servicing of beneficiary-owned
equipment is made in accordance with
§ 414.210(e).
(g) Additional supplier requirements
for capped rental items that are
furnished beginning on or after January
1, 2007. (1) The supplier that furnishes
an item for the first month during which
payment is made using the methodology
described in paragraph (f)(1) of this
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44108
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
hsrobinson on PROD1PC69 with PROPOSALS2
section must continue to furnish the
equipment until medical necessity ends,
or the 13-month period of continuous
use ends, whichever is earlier, unless—
(i) The item becomes subject to a
competitive acquisition program
implemented in accordance with
section 1847(a) of the Act;
(ii) The beneficiary relocates to an
area that is outside the normal service
area of the supplier that initially
furnished the equipment;
(iii) The beneficiary elects to obtain
the equipment from a different supplier
prior to the expiration of the 13-month
rental period; or
(iv) CMS or the carrier determines
that an exception should apply in an
individual case based on the
circumstances.
(2) A capped rental item furnished
under this section may not be replaced
by the supplier prior to the expiration
of the 13-month rental period unless:
(i) The item is lost, stolen, or
irreparably damaged;
(ii) The furnishing of a loaner item is
necessary while the item is being
repaired;
(iii) The item is no longer medically
necessary; or
(iv) The item is replaced in
accordance with § 414.210(e)(3) or (f).
(3) Before furnishing a capped rental
item, the supplier must disclose to the
beneficiary its intentions regarding
whether it will accept assignment of all
monthly rental claims for the duration
of the rental period. A supplier’s
intentions could be expressed in the
form of a written agreement between the
supplier and the beneficiary.
(h) Purchase of power-driven
wheelchairs furnished on or after
January 1, 2006. Suppliers must offer
beneficiaries the option to purchase
power-driven wheelchairs at the time
the equipment is initially furnished.
Payment is made on a lump-sum
purchase basis if the beneficiary chooses
this option.
5. Amend § 414.230 by—
VerDate Aug<31>2005
15:25 Aug 02, 2006
Jkt 208001
A. Revising paragraphs (b)(1) and
(b)(2).
B. Revising paragraph (f).
The revisions read as follows:
§ 414.230 Determining a period of
continuous use.
*
*
*
*
*
(b) Continuous use. (1) A period of
continuous use begins with the first
month of medical need and lasts until
a beneficiary’s medical need for a
particular item of durable medical
equipment ends.
(2) In the case of a beneficiary
receiving oxygen equipment on
December 31, 2005, the period of
continuous use for the equipment
begins on January 1, 2006.
*
*
*
*
*
(f) New equipment. (1) If a beneficiary
changes equipment or requires
additional equipment based on a
physician’s prescription, and the new or
additional equipment is found to be
necessary, a new period of continuous
use begins for the new or additional
equipment. A new period of continuous
use does not begin for base equipment
that is modified by an addition.
(2) A new period of continuous use
does not begin when a beneficiary
changes from one oxygen equipment
modality to another.
*
*
*
*
*
PART 484—HOME HEALTH SERVICES
6. The authority citation for part 484
continues to read as follows:
Authority: Secs. 1102 and 1871 of the
Social Security Act (42 U.S.C. 1302 and
1395(hh)) unless otherwise indicated.
7. Amend § 484.225 as follows:
A. Revise paragraph (f).
B. Redesignate paragraph (g) as
paragraph (h).
C. Add new paragraph (g).
D. Revise newly redesignated
paragraph (h).
E. Add new paragraph (i).
The revisions and additions read as
follows:
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§ 484.225 Annual update of the unadjusted
national prospective 60-day episode
payment rate.
*
*
*
*
*
(f) For calendar year 2005, the
unadjusted national prospective 60-day
episode payment rate is equal to the rate
from the previous calendar year,
increased by the applicable home health
market basket minus 0.8 percentage
points.
(g) For calendar year 2006, the
unadjusted national prospective 60-day
episode payment rate is equal to the rate
from calendar year 2005.
(h) For 2007 and subsequent calendar
years, in the case of a home health
agency that submits home health quality
data, as specified by the Secretary, the
unadjusted national prospective 60-day
episode rate is equal to the rate for the
previous calendar year increased by the
applicable home health market basket
index amount.
(i) For 2007 and subsequent calendar
years, in the case of a home health
agency that does not submit home
health quality data, as specified by the
Secretary, the unadjusted national
prospective 60-day episode rate is equal
to the rate for the previous calendar year
increased by the applicable home health
market basket index amount minus 2
percentage points. Any reduction of the
percentage change will apply only to the
calendar year involved and will not be
taken into account in computing the
prospective payment amount for a
subsequent calendar year.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: June 16, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare &
Medicaid Services.
Approved: July 14, 2006.
Michael O. Leavitt,
Secretary.
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Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44109
ADDENDUM A.—PROPOSED CY 2007
WAGE INDEX FOR RURAL AREAS BY
CBSA; APPLICABLE PRE-FLOOR AND
PRE-RECLASSIFIED HOSPITAL WAGE
INDEX
ADDENDUM A.—PROPOSED CY 2007
WAGE INDEX FOR RURAL AREAS BY
CBSA; APPLICABLE PRE-FLOOR AND
PRE-RECLASSIFIED HOSPITAL WAGE
INDEX—Continued
ADDENDUM A.—PROPOSED CY 2007
WAGE INDEX FOR RURAL AREAS BY
CBSA; APPLICABLE PRE-FLOOR AND
PRE-RECLASSIFIED HOSPITAL WAGE
INDEX—Continued
CBSA
code
CBSA
code
CBSA
code
01
02
03
04
05
06
07
08
10
11
12
13
14
15
16
17
18
19
20
21
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
Wage
index
Nonurban Area
Alabama ........................
Alaska ...........................
Arizona ..........................
Arkansas .......................
California .......................
Colorado .......................
Connecticut ...................
Delaware .......................
Florida ...........................
Georgia .........................
Hawaii ...........................
Idaho .............................
Illinois ............................
Indiana ..........................
Iowa ..............................
Kansas ..........................
Kentucky .......................
Louisiana .......................
Maine ............................
Maryland .......................
0.7652
1.0680
0.8924
0.7335
1.1302
0.9342
1.1753
0.9723
0.8595
0.7560
1.0467
0.8134
0.8327
0.8477
0.8697
0.8000
0.7780
0.7450
0.8410
0.8942
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
Nonurban Area
Wage
index
Massachusetts1 .............
Michigan ........................
Minnesota .....................
Mississippi .....................
Missouri .........................
Montana ........................
Nebraska .......................
Nevada ..........................
New Hampshire ............
New Jersey1 ..................
New Mexico ..................
New York ......................
North Carolina ...............
North Dakota .................
Ohio ..............................
Oklahoma ......................
Oregon ..........................
Pennsylvania .................
Puerto Rico 1 .................
Rhode Island 1 ...............
1.0216
0.9052
0.9167
0.7565
0.7934
0.8605
0.8693
0.8960
1.0800
..............
0.8347
0.8250
0.8599
0.7228
0.8674
0.7640
0.9770
0.8332
0.4047
..............
42
43
44
45
46
47
48
49
50
51
52
53
65
Nonurban Area
........
........
........
........
........
........
........
........
........
........
........
........
........
South Carolina ..............
South Dakota ................
Tennessee ....................
Texas ............................
Utah ..............................
Vermont ........................
Virgin Islands ................
Virginia ..........................
Washington ...................
West Virginia .................
Wisconsin ......................
Wyoming .......................
Guam ............................
Wage
index
0.8583
0.8496
0.7841
0.7973
0.8154
0.9944
0.7615
0.7954
1.0281
0.7620
0.9468
0.9311
0.9611
1All counties within the State are classified
as
urban,
with
the
exception
of
Massaschusetts and Puerto Pico. Massachusetts and Puerto Rico have areas designated
as rural, however, no short-term, acute care
hospitals are located in the area(s) for CY
2007.
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX
Wage
index
CBSA code
Urban area (constituent counties)
10180 ........................
Abilene, TX ..........................................................................................................................................................
Callahan County, TX.
Jones County, TX.
Taylor County, TX.
´
Aguadilla-Isabela-San Sebastian, PR .................................................................................................................
Aguada Municipio, PR.
Aguadilla Municipio, PR.
˜
Anasco Municipio, PR.
Isabela Municipio, PR.
Lares Municipio, PR.
Moca Municipio, PR.
´
Rincon Municipio, PR.
´
San Sebastian Municipio, PR.
Akron, OH ............................................................................................................................................................
Portage County, OH.
Summit County, OH.
Albany, GA ...........................................................................................................................................................
Baker County, GA.
Dougherty County, GA.
Lee County, GA.
Terrell County, GA.
Worth County, GA.
Albany-Schenectady-Troy, NY ............................................................................................................................
Albany County, NY.
Rensselaer County, NY.
Saratoga County, NY.
Schenectady County, NY.
Schoharie County, NY.
Albuquerque, NM .................................................................................................................................................
Bernalillo County, NM.
Sandoval County, NM.
Torrance County, NM.
Valencia County, NM.
Alexandria, LA .....................................................................................................................................................
Grant Parish, LA.
Rapides Parish, LA.
Allentown-Bethlehem-Easton, PA-NJ ..................................................................................................................
Warren County, NJ.
Carbon County, PA.
10380 ........................
10420 ........................
10500 ........................
10580 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
10740 ........................
10780 ........................
10900 ........................
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E:\FR\FM\03AUP2.SGM
03AUP2
0.8014
0.3922
0.8639
0.8962
0.8735
0.9474
0.8020
0.9910
44110
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
11020 ........................
11100 ........................
11180 ........................
11260 ........................
11300 ........................
11340 ........................
11460 ........................
11500 ........................
11540 ........................
11700 ........................
12020 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
12060 ........................
12100 ........................
12220 ........................
12260 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Lehigh County, PA.
Northampton County, PA.
Altoona, PA ..........................................................................................................................................................
Blair County, PA.
Amarillo, TX .........................................................................................................................................................
Armstrong County, TX.
Carson County, TX.
Potter County, TX.
Randall County, TX.
Ames, IA ..............................................................................................................................................................
Story County, IA.
Anchorage, AK .....................................................................................................................................................
Anchorage Municipality, AK.
Matanuska-Susitna Borough, AK.
Anderson, IN ........................................................................................................................................................
Madison County, IN.
Anderson, SC ......................................................................................................................................................
Anderson County, SC.
Ann Arbor, MI ......................................................................................................................................................
Washtenaw County, MI.
Anniston-Oxford, AL ............................................................................................................................................
Calhoun County, AL.
Appleton, WI ........................................................................................................................................................
Calumet County, WI.
Outagamie County, WI.
Asheville, NC .......................................................................................................................................................
Buncombe County, NC.
Haywood County, NC.
Henderson County, NC.
Madison County, NC.
Athens-Clarke County, GA ..................................................................................................................................
Clarke County, GA.
Madison County, GA.
Oconee County, GA.
Oglethorpe County, GA.
Atlanta-Sandy Springs-Marietta, GA ...................................................................................................................
Barrow County, GA.
Bartow County, GA.
Butts County, GA.
Carroll County, GA.
Cherokee County, GA.
Clayton County, GA.
Cobb County, GA.
Coweta County, GA.
Dawson County, GA.
DeKalb County, GA.
Douglas County, GA.
Fayette County, GA.
Forsyth County, GA.
Fulton County, GA.
Gwinnett County, GA.
Haralson County, GA.
Heard County, GA.
Henry County, GA.
Jasper County, GA.
Lamar County, GA.
Meriwether County, GA.
Newton County, GA.
Paulding County, GA.
Pickens County, GA.
Pike County, GA.
Rockdale County, GA.
Spalding County, GA.
Walton County, GA.
Atlantic City, NJ ...................................................................................................................................................
Atlantic County, NJ.
Auburn-Opelika, AL .............................................................................................................................................
Lee County, AL.
Augusta-Richmond County, GA-SC ....................................................................................................................
Burke County, GA.
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Jkt 208001
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E:\FR\FM\03AUP2.SGM
03AUP2
0.8727
0.9177
0.9777
1.2045
0.8790
0.8959
1.0838
0.7868
0.9472
0.9093
0.9857
0.9772
1.1751
0.8110
0.9678
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44111
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
12420 ........................
12540 ........................
12580 ........................
12620 ........................
12700 ........................
12940 ........................
12980 ........................
13020 ........................
13140 ........................
13380 ........................
13460 ........................
13644 ........................
13740 ........................
13780 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
13820 ........................
13900 ........................
13980 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Columbia County, GA.
McDuffie County, GA.
Richmond County, GA.
Aiken County, SC.
Edgefield County, SC.
Austin-Round Rock, TX .......................................................................................................................................
Bastrop County, TX.
Caldwell County, TX.
Hays County, TX.
Travis County, TX.
Williamson County, TX.
Bakersfield, CA ....................................................................................................................................................
Kern County, CA.
Baltimore-Towson, MD ........................................................................................................................................
Anne Arundel County, MD.
Baltimore County, MD.
Carroll County, MD.
Harford County, MD.
Howard County, MD.
Queen Anne’s County, MD.
Baltimore City, MD.
Bangor, ME ..........................................................................................................................................................
Penobscot County, ME.
Barnstable Town, MA ..........................................................................................................................................
Barnstable County, MA.
Baton Rouge, LA .................................................................................................................................................
Ascension Parish, LA.
East Baton Rouge Parish, LA.
East Feliciana Parish, LA.
Iberville Parish, LA.
Livingston Parish, LA.
Pointe Coupee Parish, LA.
St. Helena Parish, LA.
West Baton Rouge Parish, LA.
West Feliciana Parish, LA.
Battle Creek, MI ...................................................................................................................................................
Calhoun County, MI.
Bay City, MI .........................................................................................................................................................
Bay County, MI.
Beaumont-Port Arthur, TX ...................................................................................................................................
Hardin County, TX.
Jefferson County, TX.
Orange County, TX.
Bellingham, WA ...................................................................................................................................................
Whatcom County, WA.
Bend, OR .............................................................................................................................................................
Deschutes County, OR.
Bethesda-Frederick-Gaithersburg, MD ................................................................................................................
Frederick County, MD.
Montgomery County, MD.
Billings, MT ..........................................................................................................................................................
Carbon County, MT.
Yellowstone County, MT.
Binghamton, NY ...................................................................................................................................................
Broome County, NY.
Tioga County, NY.
Birmingham-Hoover, AL ......................................................................................................................................
Bibb County, AL.
Blount County, AL.
Chilton County, AL.
Jefferson County, AL.
St. Clair County, AL.
Shelby County, AL.
Walker County, AL.
Bismarck, ND .......................................................................................................................................................
Burleigh County, ND.
Morton County, ND.
Blacksburg-Christiansburg-Radford, VA ..............................................................................................................
Giles County, VA.
Montgomery County, VA.
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E:\FR\FM\03AUP2.SGM
03AUP2
0.9360
1.0605
1.0106
0.9719
1.2561
0.8099
0.9746
0.9271
0.8610
1.1124
1.0762
1.0923
0.8728
0.8798
0.8919
0.7253
0.8227
44112
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
14020 ........................
14060 ........................
14260 ........................
14484 ........................
14500 ........................
14540 ........................
14740 ........................
14860 ........................
15180 ........................
15260 ........................
15380 ........................
15500 ........................
15540 ........................
15764 ........................
15804 ........................
15940 ........................
15980 ........................
16180 ........................
16220 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
16300 ........................
16580 ........................
16620 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Pulaski County, VA.
Radford City, VA.
Bloomington, IN ...................................................................................................................................................
Greene County, IN.
Monroe County, IN.
Owen County, IN.
Bloomington-Normal, IL .......................................................................................................................................
McLean County, IL.
Boise City-Nampa, ID ..........................................................................................................................................
Ada County, ID.
Boise County, ID.
Canyon County, ID.
Gem County, ID.
Owyhee County, ID.
Boston-Quincy, MA ..............................................................................................................................................
Norfolk County, MA.
Plymouth County, MA.
Suffolk County, MA.
Boulder, CO .........................................................................................................................................................
Boulder County, CO.
Bowling Green, KY ..............................................................................................................................................
Edmonson County, KY.
Warren County, KY.
Bremerton-Silverdale, WA ...................................................................................................................................
Kitsap County, WA.
Bridgeport-Stamford-Norwalk, CT .......................................................................................................................
Fairfield County, CT.
Brownsville-Harlingen, TX ...................................................................................................................................
Cameron County, TX.
Brunswick, GA .....................................................................................................................................................
Brantley County, GA.
Glynn County, GA.
McIntosh County, GA.
Buffalo-Niagara Falls, NY ....................................................................................................................................
Erie County, NY.
Niagara County, NY.
Burlington, NC .....................................................................................................................................................
Alamance County, NC.
Burlington-South Burlington, VT ..........................................................................................................................
Chittenden County, VT.
Franklin County, VT.
Grand Isle County, VT.
Cambridge-Newton-Framingham, MA .................................................................................................................
Middlesex County, MA.
Camden, NJ .........................................................................................................................................................
Burlington County, NJ.
Camden County, NJ.
Gloucester County, NJ.
Canton-Massillon, OH ..........................................................................................................................................
Carroll County, OH.
Stark County, OH.
Cape Coral-Fort Myers, FL ..................................................................................................................................
Lee County, FL.
Carson City, NV ...................................................................................................................................................
Carson City, NV.
Casper, WY .........................................................................................................................................................
Natrona County, WY.
Cedar Rapids, IA .................................................................................................................................................
Benton County, IA.
Jones County, IA.
Linn County, IA.
Champaign-Urbana, IL ........................................................................................................................................
Champaign County, IL.
Ford County, IL.
Piatt County, IL.
Charleston, WV ....................................................................................................................................................
Boone County, WV.
Clay County, WV.
Kanawha County, WV.
Lincoln County, WV.
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E:\FR\FM\03AUP2.SGM
03AUP2
0.8548
0.8960
0.9417
1.1693
1.0368
0.8162
1.0932
1.2681
0.9446
1.0097
0.9483
0.8689
0.9491
1.0918
1.0411
0.9047
0.9359
1.0043
0.9161
0.8903
0.9661
0.8558
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
16700 ........................
16740 ........................
16820 ........................
16860 ........................
16940 ........................
16974 ........................
17020 ........................
17140 ........................
17300 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
17420 ........................
17460 ........................
17660 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Putnam County, WV.
Charleston-North Charleston, SC ........................................................................................................................
Berkeley County, SC.
Charleston County, SC.
Dorchester County, SC.
Charlotte-Gastonia-Concord, NC-SC ..................................................................................................................
Anson County, NC.
Cabarrus County, NC.
Gaston County, NC.
Mecklenburg County, NC.
Union County, NC.
York County, SC.
Charlottesville, VA ...............................................................................................................................................
Albemarle County, VA.
Fluvanna County, VA.
Greene County, VA.
Nelson County, VA.
Charlottesville City, VA.
Chattanooga, TN-GA ...........................................................................................................................................
Catoosa County, GA.
Dade County, GA.
Walker County, GA.
Hamilton County, TN.
Marion County, TN.
Sequatchie County, TN.
Cheyenne, WY .....................................................................................................................................................
Laramie County, WY.
Chicago-Naperville-Joliet, IL ................................................................................................................................
Cook County, IL.
DeKalb County, IL.
DuPage County, IL.
Grundy County, IL.
Kane County, IL.
Kendall County, IL.
McHenry County, IL.
Will County, IL.
Chico, CA .............................................................................................................................................................
Butte County, CA.
Cincinnati-Middletown, OH-KY-IN .......................................................................................................................
Dearborn County, IN.
Franklin County, IN.
Ohio County, IN.
Boone County, KY.
Bracken County, KY.
Campbell County, KY.
Gallatin County, KY.
Grant County, KY.
Kenton County, KY.
Pendleton County, KY.
Brown County, OH.
Butler County, OH.
Clermont County, OH.
Hamilton County, OH.
Warren County, OH.
Clarksville, TN-KY ................................................................................................................................................
Christian County, KY.
Trigg County, KY.
Montgomery County, TN.
Stewart County, TN.
Cleveland, TN ......................................................................................................................................................
Bradley County, TN.
Polk County, TN.
Cleveland-Elyria-Mentor, OH ...............................................................................................................................
Cuyahoga County, OH.
Geauga County, OH.
Lake County, OH.
Lorain County, OH.
Medina County, OH.
Coeur d’Alene, ID ................................................................................................................................................
Kootenai County, ID.
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1.1073
0.9617
0.8451
0.8124
0.9385
0.9360
44114
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
Wage
index
CBSA code
Urban area (constituent counties)
17780 ........................
College Station-Bryan, TX ...................................................................................................................................
Brazos County, TX.
Burleson County, TX.
Robertson County, TX.
Colorado Springs, CO .........................................................................................................................................
El Paso County, CO.
Teller County, CO.
Columbia, MO ......................................................................................................................................................
Boone County, MO.
Howard County, MO.
Columbia, SC .......................................................................................................................................................
Calhoun County, SC.
Fairfield County, SC.
Kershaw County, SC.
Lexington County, SC.
Richland County, SC.
Saluda County, SC.
Columbus, GA-AL ................................................................................................................................................
Russell County, AL.
Chattahoochee County, GA.
Harris County, GA.
Marion County, GA.
Muscogee County, GA.
Columbus, IN .......................................................................................................................................................
Bartholomew County, IN.
Columbus, OH .....................................................................................................................................................
Delaware County, OH.
Fairfield County, OH.
Franklin County, OH.
Licking County, OH.
Madison County, OH.
Morrow County, OH.
Pickaway County, OH.
Union County, OH.
Corpus Christi, TX ...............................................................................................................................................
Aransas County, TX.
Nueces County, TX.
San Patricio County, TX.
Corvallis, OR ........................................................................................................................................................
Benton County, OR.
Cumberland, MD-WV ...........................................................................................................................................
Allegany County, MD.
Mineral County, WV.
Dallas-Plano-Irving, TX ........................................................................................................................................
Collin County, TX.
Dallas County, TX.
Delta County, TX.
Denton County, TX.
Ellis County, TX.
Hunt County, TX.
Kaufman County, TX.
Rockwall County, TX.
Dalton, GA ...........................................................................................................................................................
Murray County, GA.
Whitfield County, GA.
Danville, IL ...........................................................................................................................................................
Vermilion County, IL.
Danville, VA .........................................................................................................................................................
Pittsylvania County, VA.
Danville City, VA.
Davenport-Moline-Rock Island, IA-IL ...................................................................................................................
Henry County, IL.
Mercer County, IL.
Rock Island County, IL.
Scott County, IA.
Dayton, OH ..........................................................................................................................................................
Greene County, OH.
Miami County, OH.
Montgomery County, OH.
Preble County, OH.
17820 ........................
17860 ........................
17900 ........................
17980 ........................
18020 ........................
18140 ........................
18580 ........................
18700 ........................
19060 ........................
19124 ........................
19140 ........................
19180 ........................
19260 ........................
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19380 ........................
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0.9718
0.8557
0.8028
0.8254
0.9334
1.0122
0.8579
1.1566
0.8859
1.0093
0.9061
0.9283
0.8466
0.8557
0.9053
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
Wage
index
CBSA code
Urban area (constituent counties)
19460 ........................
Decatur, AL ..........................................................................................................................................................
Lawrence County, AL.
Morgan County, AL.
Decatur, IL ...........................................................................................................................................................
Macon County, IL.
Deltona-Daytona Beach-Ormond Beach, FL .......................................................................................................
Volusia County, FL.
Denver-Aurora, CO ..............................................................................................................................................
Adams County, CO.
Arapahoe County, CO.
Broomfield County, CO.
Clear Creek County, CO.
Denver County, CO.
Douglas County, CO.
Elbert County, CO.
Gilpin County, CO.
Jefferson County, CO.
Park County, CO.
Des Moines, IA ....................................................................................................................................................
Dallas County, IA.
Guthrie County, IA.
Madison County, IA.
Polk County, IA.
Warren County, IA.
Detroit-Livonia-Dearborn, MI ...............................................................................................................................
Wayne County, MI.
Dothan, AL ...........................................................................................................................................................
Geneva County, AL.
Henry County, AL.
Houston County, AL.
Dover, DE ............................................................................................................................................................
Kent County, DE.
Dubuque, IA .........................................................................................................................................................
Dubuque County, IA.
Duluth, MN-WI .....................................................................................................................................................
Carlton County, MN.
St. Louis County, MN.
Douglas County, WI.
Durham, NC .........................................................................................................................................................
Chatham County, NC.
Durham County, NC.
Orange County, NC.
Person County, NC.
Eau Claire, WI .....................................................................................................................................................
Chippewa County, WI.
Eau Claire County, WI.
Edison, NJ ...........................................................................................................................................................
Middlesex County, NJ.
Monmouth County, NJ.
Ocean County, NJ.
Somerset County, NJ.
El Centro, CA .......................................................................................................................................................
Imperial County, CA.
Elizabethtown, KY ................................................................................................................................................
Hardin County, KY.
Larue County, KY.
Elkhart-Goshen, IN ..............................................................................................................................................
Elkhart County, IN.
Elmira, NY ............................................................................................................................................................
Chemung County, NY.
El Paso, TX ..........................................................................................................................................................
El Paso County, TX.
Erie, PA ................................................................................................................................................................
Erie County, PA.
Essex County, MA ...............................................................................................................................................
Essex County, MA.
Eugene-Springfield, OR .......................................................................................................................................
Lane County, OR.
Evansville, IN-KY .................................................................................................................................................
Gibson County, IN.
19500 ........................
19660 ........................
19740 ........................
19780 ........................
19804 ........................
20020 ........................
20100 ........................
20220 ........................
20260 ........................
20500 ........................
20740 ........................
20764 ........................
20940 ........................
21060 ........................
21140 ........................
21300 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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21500 ........................
21604 ........................
21660 ........................
21780 ........................
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0.8220
0.8187
0.9280
1.0947
0.9136
1.0223
0.7438
0.9865
0.9150
1.0070
0.9843
0.9647
1.1207
0.9092
0.8713
0.9442
0.8213
0.9069
0.8704
1.0437
1.0896
0.8830
44116
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
21820 ........................
21940 ........................
22020 ........................
22140 ........................
22180 ........................
22220 ........................
22380 ........................
22420 ........................
22500 ........................
22520 ........................
22540 ........................
22660 ........................
22744 ........................
22900 ........................
23020 ........................
23060 ........................
23104 ........................
23420 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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23540 ........................
23580 ........................
23844 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Posey County, IN.
Vanderburgh County, IN.
Warrick County, IN.
Henderson County, KY.
Webster County, KY.
Fairbanks, AK ......................................................................................................................................................
Fairbanks North Star Borough, AK.
Fajardo, PR ..........................................................................................................................................................
Ceiba Municipio, PR.
Fajardo Municipio, PR.
Luquillo Municipio, PR.
Fargo, ND-MN .....................................................................................................................................................
Cass County, ND.
Clay County, MN.
Farmington, NM ...................................................................................................................................................
San Juan County, NM.
Fayetteville, NC ...................................................................................................................................................
Cumberland County, NC.
Hoke County, NC.
Fayetteville-Springdale-Rogers, AR-MO .............................................................................................................
Benton County, AR.
Madison County, AR.
Washington County, AR.
McDonald County, MO.
Flagstaff, AZ ........................................................................................................................................................
Coconino County, AZ.
Flint, MI ................................................................................................................................................................
Genesee County, MI.
Florence, SC ........................................................................................................................................................
Darlington County, SC.
Florence County, SC.
Florence-Muscle Shoals, AL ................................................................................................................................
Colbert County, AL.
Lauderdale County, AL.
Fond du Lac, WI ..................................................................................................................................................
Fond du Lac County, WI.
Fort Collins-Loveland, CO ...................................................................................................................................
Larimer County, CO.
Fort Lauderdale-Pompano Beach-Deerfield ........................................................................................................
Beach, FL.
Broward County, FL.
Fort Smith, AR-OK ...............................................................................................................................................
Crawford County, AR.
Franklin County, AR.
Sebastian County, AR.
Le Flore County, OK.
Sequoyah County, OK.
Fort Walton Beach-Crestview-Destin, FL ............................................................................................................
Okaloosa County, FL.
Fort Wayne, IN ....................................................................................................................................................
Allen County, IN.
Wells County, IN.
Whitley County, IN.
Fort Worth-Arlington, TX ......................................................................................................................................
Johnson County, TX.
Parker County, TX.
Tarrant County, TX.
Wise County, TX.
Fresno, CA ...........................................................................................................................................................
Fresno County, CA.
Gadsden, AL ........................................................................................................................................................
Etowah County, AL.
Gainesville, FL .....................................................................................................................................................
Alachua County, FL.
Gilchrist County, FL.
Gainesville, GA ....................................................................................................................................................
Hall County, GA.
Gary, IN ...............................................................................................................................................................
Jasper County, IN.
Lake County, IN.
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0.8265
0.8604
0.8961
0.8761
1.1621
1.0988
0.8421
0.7967
1.0081
0.9561
1.0151
0.7745
0.8658
0.9504
0.9587
1.0965
0.8080
0.9312
0.8974
0.9281
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
24020 ........................
24140 ........................
24220 ........................
24300 ........................
24340 ........................
24500 ........................
24540 ........................
24580 ........................
24660 ........................
24780 ........................
24860 ........................
25020 ........................
25060 ........................
25180 ........................
25260 ........................
25420 ........................
25500 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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25620 ........................
25860 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Newton County, IN.
Porter County, IN.
Glens Falls, NY ....................................................................................................................................................
Warren County, NY.
Washington County, NY.
Goldsboro, NC .....................................................................................................................................................
Wayne County, NC.
Grand Forks, ND-MN ...........................................................................................................................................
Polk County, MN.
Grand Forks County, ND.
Grand Junction, CO .............................................................................................................................................
Mesa County, CO.
Grand Rapids-Wyoming, MI ................................................................................................................................
Barry County, MI.
Ionia County, MI.
Kent County, MI.
Newaygo County, MI.
Great Falls, MT ....................................................................................................................................................
Cascade County, MT.
Greeley, CO .........................................................................................................................................................
Weld County, CO.
Green Bay, WI .....................................................................................................................................................
Brown County, WI.
Kewaunee County, WI.
Oconto County, WI.
Greensboro-High Point, NC .................................................................................................................................
Guilford County, NC.
Randolph County, NC.
Rockingham County, NC.
Greenville, NC .....................................................................................................................................................
Greene County, NC.
Pitt County, NC.
Greenville, SC ......................................................................................................................................................
Greenville County, SC.
Laurens County, SC.
Pickens County, SC.
Guayama, PR ......................................................................................................................................................
Arroyo Municipio, PR.
Guayama Municipio, PR.
Patillas Municipio, PR.
Gulfport-Biloxi, MS ...............................................................................................................................................
Hancock County, MS.
Harrison County, MS.
Stone County, MS.
Hagerstown-Martinsburg, MD-WV .......................................................................................................................
Washington County, MD.
Berkeley County, WV.
Morgan County, WV.
Hanford-Corcoran, CA .........................................................................................................................................
Kings County, CA.
Harrisburg-Carlisle, PA ........................................................................................................................................
Cumberland County, PA.
Dauphin County, PA.
Perry County, PA.
Harrisonburg, VA .................................................................................................................................................
Rockingham County, VA.
Harrisonburg City, VA.
Hartford-West Hartford-East Hartford, CT ...........................................................................................................
Hartford County, CT.
Litchfield County, CT.
Middlesex County, CT.
Tolland County, CT.
Hattiesburg, MS ...................................................................................................................................................
Forrest County, MS.
Lamar County, MS.
Perry County, MS.
Hickory-Lenoir-Morganton, NC ............................................................................................................................
Alexander County, NC.
Burke County, NC.
Caldwell County, NC.
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0.9685
0.9470
0.8613
0.9619
0.9804
0.8735
0.9449
0.9733
0.3241
0.8931
0.9054
1.0142
0.9419
0.9090
1.0916
0.7443
0.9021
44118
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
25980 ......................
26100 ........................
26180 ........................
26300 ........................
26380 ........................
26420 ........................
26580 ........................
26620 ........................
26820 ........................
26900 ........................
26980 ........................
27060 ........................
27100 ........................
27140 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
27180 ........................
27260 ........................
27340 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Catawba County, NC.
Hinesville-Fort Stewart, GA ..............................................................................................................................
Liberty County, GA.
Long County, GA.
Holland-Grand Haven, MI ....................................................................................................................................
Ottawa County, MI.
Honolulu, HI .........................................................................................................................................................
Honolulu County, HI.
Hot Springs, AR ...................................................................................................................................................
Garland County, AR.
Houma-Bayou Cane-Thibodaux, LA ....................................................................................................................
Lafourche Parish, LA.
Terrebonne Parish, LA.
Houston-Baytown-Sugar Land, TX ......................................................................................................................
Austin County, TX.
Brazoria County, TX.
Chambers County, TX.
Fort Bend County, TX.
Galveston County, TX.
Harris County, TX.
Liberty County, TX.
Montgomery County, TX.
San Jacinto County, TX.
Waller County, TX.
Huntington-Ashland, WV-KY-OH .........................................................................................................................
Boyd County, KY.
Greenup County, KY.
Lawrence County, OH.
Cabell County, WV.
Wayne County, WV.
Huntsville, AL .......................................................................................................................................................
Limestone County, AL.
Madison County, AL.
Idaho Falls, ID .....................................................................................................................................................
Bonneville County, ID.
Jefferson County, ID.
Indianapolis, IN ....................................................................................................................................................
Boone County, IN.
Brown County, IN.
Hamilton County, IN.
Hancock County, IN.
Hendricks County, IN.
Johnson County, IN.
Marion County, IN.
Morgan County, IN.
Putnam County, IN.
Shelby County, IN.
Iowa City, IA ........................................................................................................................................................
Johnson County, IA.
Washington County, IA.
Ithaca, NY ............................................................................................................................................................
Tompkins County, NY.
Jackson, MI ..........................................................................................................................................................
Jackson County, MI.
Jackson, MS ........................................................................................................................................................
Copiah County, MS.
Hinds County, MS.
Madison County, MS.
Rankin County, MS.
Simpson County, MS.
Jackson, TN .........................................................................................................................................................
Chester County, TN.
Madison County, TN.
Jacksonville, FL ...................................................................................................................................................
Baker County, FL.
Clay County, FL.
Duval County, FL.
Nassau County, FL.
St. Johns County, FL.
Jacksonville, NC ..................................................................................................................................................
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1.0026
0.9013
0.9051
0.9104
0.9766
0.9731
0.9831
0.9577
0.8286
0.8869
0.9042
0.8245
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
27500 ........................
27620 ........................
27740 ........................
27780 ........................
27860 ........................
27900 ........................
28020 ........................
28100 ........................
28140 ........................
28420 ........................
28660 ........................
28700 ........................
28740 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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29020 ........................
29100 ........................
29140 ........................
VerDate Aug<31>2005
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index
Urban area (constituent counties)
Onslow County, NC.
Janesville, WI .......................................................................................................................................................
Rock County, WI.
Jefferson City, MO ...............................................................................................................................................
Callaway County, MO.
Cole County, MO.
Moniteau County, MO.
Osage County, MO.
Johnson City, TN .................................................................................................................................................
Carter County, TN.
Unicoi County, TN.
Washington County, TN.
Johnstown, PA .....................................................................................................................................................
Cambria County, PA.
Jonesboro, AR .....................................................................................................................................................
Craighead County, AR.
Poinsett County, AR.
Joplin, MO ............................................................................................................................................................
Jasper County, MO.
Newton County, MO.
Kalamazoo-Portage, MI .......................................................................................................................................
Kalamazoo County, MI.
Van Buren County, MI.
Kankakee-Bradley, IL ..........................................................................................................................................
Kankakee County, IL.
Kansas City, MO-KS ............................................................................................................................................
Franklin County, KS.
Johnson County, KS.
Leavenworth County, KS.
Linn County, KS.
Miami County, KS.
Wyandotte County, KS.
Bates County, MO.
Caldwell County, MO.
Cass County, MO.
Clay County, MO.
Clinton County, MO.
Jackson County, MO.
Lafayette County, MO.
Platte County, MO.
Ray County, MO.
Kennewick-Richland-Pasco, WA .........................................................................................................................
Benton County, WA.
Franklin County, WA.
Killeen-Temple-Fort Hood, TX .............................................................................................................................
Bell County, TX.
Coryell County, TX.
Lampasas County, TX.
Kingsport-Bristol-Bristol, TN-VA ..........................................................................................................................
Hawkins County, TN.
Sullivan County, TN.
Bristol City, VA.
Scott County, VA.
Washington County, VA.
Kingston, NY ........................................................................................................................................................
Ulster County, NY.
Knoxville, TN ........................................................................................................................................................
Anderson County, TN.
Blount County, TN.
Knox County, TN.
Loudon County, TN.
Union County, TN.
Kokomo, IN ..........................................................................................................................................................
Howard County, IN.
Tipton County, IN.
La Crosse, WI-MN ...............................................................................................................................................
Houston County, MN.
La Crosse County, WI.
Lafayette, IN ........................................................................................................................................................
Benton County, IN.
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0.8620
1.0723
0.9990
0.9514
1.0361
0.9098
0.7975
0.9383
0.8263
0.9460
0.9442
0.8972
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Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
29180 ........................
29340 ........................
29404 ........................
29460 ........................
29540 ........................
29620 ........................
29700 ........................
29740 ........................
29820 ........................
29940 ........................
30020 ........................
30140 ........................
30300 ........................
30340 ........................
30460 ........................
30620 ........................
30700 ........................
30780 ........................
30860 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
30980 ........................
31020 ........................
31084 ........................
31140 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Carroll County, IN.
Tippecanoe County, IN.
Lafayette, LA ........................................................................................................................................................
Lafayette Parish, LA.
St. Martin Parish, LA.
Lake Charles, LA .................................................................................................................................................
Calcasieu Parish, LA.
Cameron Parish, LA.
Lake County-Kenosha County, IL-WI ..................................................................................................................
Lake County, IL.
Kenosha County, WI.
Lakeland, FL ........................................................................................................................................................
Polk County, FL.
Lancaster, PA ......................................................................................................................................................
Lancaster County, PA.
Lansing-East Lansing, MI ....................................................................................................................................
Clinton County, MI.
Eaton County, MI.
Ingham County, MI.
Laredo, TX ...........................................................................................................................................................
Webb County, TX.
Las Cruces, NM ...................................................................................................................................................
Dona Ana County, NM.
Las Vegas-Paradise, NV .....................................................................................................................................
Clark County, NV.
Lawrence, KS ......................................................................................................................................................
Douglas County, KS.
Lawton, OK ..........................................................................................................................................................
Comanche County, OK.
Lebanon, PA ........................................................................................................................................................
Lebanon County, PA.
Lewiston, ID-WA ..................................................................................................................................................
Nez Perce County, ID.
Asotin County, WA.
Lewiston-Auburn, ME ..........................................................................................................................................
Androscoggin County, ME.
Lexington-Fayette, KY .........................................................................................................................................
Bourbon County, KY.
Clark County, KY.
Fayette County, KY.
Jessamine County, KY.
Scott County, KY.
Woodford County, KY.
Lima, OH ..............................................................................................................................................................
Allen County, OH.
Lincoln, NE ..........................................................................................................................................................
Lancaster County, NE.
Seward County, NE.
Little Rock-North Little Rock, AR .........................................................................................................................
Faulkner County, AR.
Grant County, AR.
Lonoke County, AR.
Perry County, AR.
Pulaski County, AR.
Saline County, AR.
Logan, UT-ID .......................................................................................................................................................
Franklin County, ID.
Cache County, UT.
Longview, TX .......................................................................................................................................................
Gregg County, TX.
Rusk County, TX.
Upshur County, TX.
Longview, WA ......................................................................................................................................................
Cowlitz County, WA.
Los Angeles-Long Beach-Glendale, CA ..............................................................................................................
Los Angeles County, CA.
Louisville, KY-IN ..................................................................................................................................................
Clark County, IN.
Floyd County, IN.
Harrison County, IN.
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0.8895
0.9644
1.0102
0.7825
0.9290
1.1450
0.8353
0.8080
0.8695
0.9871
0.9148
0.9191
0.9058
1.0110
0.8906
0.9038
0.8803
1.0029
1.1752
0.9135
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
31180 ........................
31340 ........................
31420 ........................
31460 ........................
31540 ........................
31700 ........................
31900 ........................
32420 ........................
32580 ........................
32780 ........................
32820 ........................
32900 ........................
33124 ........................
33140 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
33260 ........................
33340 ........................
33460 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Washington County, IN.
Bullitt County, KY.
Henry County, KY.
Jefferson County, KY.
Meade County, KY.
Nelson County, KY.
Oldham County, KY.
Shelby County, KY.
Spencer County, KY.
Trimble County, KY.
Lubbock, TX .........................................................................................................................................................
Crosby County, TX.
Lubbock County, TX.
Lynchburg, VA .....................................................................................................................................................
Amherst County, VA.
Appomattox County, VA.
Bedford County, VA.
Campbell County, VA.
Bedford City, VA.
Lynchburg City, VA.
Macon, GA ...........................................................................................................................................................
Bibb County, GA.
Crawford County, GA.
Jones County, GA.
Monroe County, GA.
Twiggs County, GA.
Madera, CA ..........................................................................................................................................................
Madera County, CA.
Madison, WI .........................................................................................................................................................
Columbia County, WI.
Dane County, WI.
Iowa County, WI.
Manchester-Nashua, NH .....................................................................................................................................
Hillsborough County, NH.
Merrimack County, NH.
Mansfield, OH ......................................................................................................................................................
Richland County, OH.
¨
Mayaguez, PR .....................................................................................................................................................
Hormigueros Municipio, PR.
¨
Mayaguez Municipio, PR.
McAllen-Edinburg-Pharr, TX ................................................................................................................................
Hidalgo County, TX.
Medford, OR ........................................................................................................................................................
Jackson County, OR.
Memphis, TN-MS-AR ...........................................................................................................................................
Crittenden County, AR.
DeSoto County, MS.
Marshall County, MS.
Tate County, MS.
Tunica County, MS.
Fayette County, TN.
Shelby County, TN.
Tipton County, TN.
Merced, CA ..........................................................................................................................................................
Merced County, CA.
Miami-Miami Beach-Kendall, FL ..........................................................................................................................
Miami-Dade County, FL.
Michigan City-La Porte, IN ..................................................................................................................................
LaPorte County, IN.
Midland, TX ..........................................................................................................................................................
Midland County, TX.
Milwaukee-Waukesha-West Allis, WI ..................................................................................................................
Milwaukee County, WI.
Ozaukee County, WI.
Washington County, WI.
Waukesha County, WI.
Minneapolis-St. Paul-Bloomington, MN-WI .........................................................................................................
Anoka County, MN.
Carver County, MN.
Chisago County, MN.
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1.0261
0.9287
0.3857
0.8788
1.0837
0.9361
1.1415
0.9830
0.9093
0.9803
1.0236
1.0965
44122
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
33540 ........................
33660 ........................
33700 ........................
33740 ........................
33780 ........................
33860 ........................
34060 ........................
34100 ........................
34580 ........................
34620 ........................
34740 ........................
34820 ........................
34900 ........................
34940 ........................
34980 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
35004 ........................
35084 ........................
35300 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Dakota County, MN.
Hennepin County, MN.
Isanti County, MN.
Ramsey County, MN.
Scott County, MN.
Sherburne County, MN.
Washington County, MN.
Wright County, MN.
Pierce County, WI.
St. Croix County, WI.
Missoula, MT .......................................................................................................................................................
Missoula County, MT.
Mobile, AL ............................................................................................................................................................
Mobile County, AL.
Modesto, CA ........................................................................................................................................................
Stanislaus County, CA.
Monroe, LA ..........................................................................................................................................................
Ouachita Parish, LA.
Union Parish, LA.
Monroe, MI ...........................................................................................................................................................
Monroe County, MI.
Montgomery, AL ..................................................................................................................................................
Autauga County, AL.
Elmore County, AL.
Lowndes County, AL.
Montgomery County, AL.
Morgantown, WV .................................................................................................................................................
Monongalia County, WV.
Preston County, WV.
Morristown, TN ....................................................................................................................................................
Grainger County, TN.
Hamblen County, TN.
Jefferson County, TN.
Mount Vernon-Anacortes, WA .............................................................................................................................
Skagit County, WA.
Muncie, IN ............................................................................................................................................................
Delaware County, IN.
Muskegon-Norton Shores, MI ..............................................................................................................................
Muskegon County, MI.
Myrtle Beach-Conway-North Myrtle Beach, SC ..................................................................................................
Horry County, SC.
Napa, CA .............................................................................................................................................................
Napa County, CA.
Naples-Marco Island, FL .....................................................................................................................................
Collier County, FL.
Nashville-Davidson--Murfreesboro, TN ...............................................................................................................
Cannon County, TN.
Cheatham County, TN.
Davidson County, TN.
Dickson County, TN.
Hickman County, TN.
Macon County, TN.
Robertson County, TN.
Rutherford County, TN.
Smith County, TN.
Sumner County, TN.
Trousdale County, TN.
Williamson County, TN.
Wilson County, TN.
Nassau-Suffolk, NY .............................................................................................................................................
Nassau County, NY.
Suffolk County, NY.
Newark-Union, NJ-PA ..........................................................................................................................................
Essex County, NJ.
Hunterdon County, NJ.
Morris County, NJ.
Sussex County, NJ.
Union County, NJ.
Pike County, PA.
New Haven-Milford, CT .......................................................................................................................................
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0.8011
0.9725
0.8023
0.8438
0.7944
1.0536
0.8299
0.9957
0.8824
1.3496
0.9959
0.9862
1.2681
1.1890
1.1974
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
35380 ........................
35644 ........................
35660 ........................
35980 ........................
36084 ........................
36100 ........................
36140 ........................
36220 ........................
36260 ........................
36420 ........................
36500 ........................
36540 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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36780 ........................
36980 ........................
37100 ........................
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Urban area (constituent counties)
New Haven County, CT.
New Orleans-Metairie-Kenner, LA .......................................................................................................................
Jefferson Parish, LA.
Orleans Parish, LA.
Plaquemines Parish, LA.
St. Bernard Parish, LA.
St. Charles Parish, LA.
St. John the Baptist Parish, LA.
St. Tammany Parish, LA.
New York-Wayne-White Plains, NY-NJ ...............................................................................................................
Bergen County, NJ.
Hudson County, NJ.
Passaic County, NJ.
Bronx County, NY.
Kings County, NY.
New York County, NY.
Putnam County, NY.
Queens County, NY.
Richmond County, NY.
Rockland County, NY.
Westchester County, NY.
Niles-Benton Harbor, MI ......................................................................................................................................
Berrien County, MI.
Norwich-New London, CT ...................................................................................................................................
New London County, CT.
Oakland-Fremont-Hayward, CA ..........................................................................................................................
Alameda County, CA.
Contra Costa County, CA.
Ocala, FL .............................................................................................................................................................
Marion County, FL.
Ocean City, NJ ....................................................................................................................................................
Cape May County, NJ.
Odessa, TX ..........................................................................................................................................................
Ector County, TX.
Ogden-Clearfield, UT ...........................................................................................................................................
Davis County, UT.
Morgan County, UT.
Weber County, UT.
Oklahoma City, OK ..............................................................................................................................................
Canadian County, OK.
Cleveland County, OK.
Grady County, OK.
Lincoln County, OK.
Logan County, OK.
McClain County, OK.
Oklahoma County, OK.
Olympia, WA ........................................................................................................................................................
Thurston County, WA.
Omaha-Council Bluffs, NE-IA ..............................................................................................................................
Harrison County, IA.
Mills County, IA.
Pottawattamie County, IA.
Cass County, NE.
Douglas County, NE.
Sarpy County, NE.
Saunders County, NE.
Washington County, NE.
Orlando, FL ..........................................................................................................................................................
Lake County, FL.
Orange County, FL.
Osceola County, FL.
Seminole County, FL.
Oshkosh-Neenah, WI ..........................................................................................................................................
Winnebago County, WI.
Owensboro, KY ....................................................................................................................................................
Daviess County, KY.
Hancock County, KY.
McLean County, KY.
Oxnard-Thousand Oaks-Ventura, CA .................................................................................................................
Ventura County, CA.
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0.8931
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1.5420
0.8883
1.0490
1.0119
0.9011
0.8853
1.1100
0.9467
0.9422
0.9332
0.8763
1.1591
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Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
Wage
index
CBSA code
Urban area (constituent counties)
37340 ........................
Palm Bay-Melbourne-Titusville, FL ......................................................................................................................
Brevard County, FL.
Panama City-Lynn Haven, FL .............................................................................................................................
Bay County, FL.
Parkersburg-Marietta, WV-OH .............................................................................................................................
Washington County, OH.
Pleasants County, WV.
Wirt County, WV.
Wood County, WV.
Pascagoula, MS ...................................................................................................................................................
George County, MS.
Jackson County, MS.
Pensacola-Ferry Pass-Brent, FL .........................................................................................................................
Escambia County, FL.
Santa Rosa County, FL.
Peoria, IL .............................................................................................................................................................
Marshall County, IL.
Peoria County, IL.
Stark County, IL.
Tazewell County, IL.
Woodford County, IL.
Philadelphia, PA ..................................................................................................................................................
Bucks County, PA.
Chester County, PA.
Delaware County, PA.
Montgomery County, PA.
Philadelphia County, PA.
Phoenix-Mesa-Scottsdale, AZ .............................................................................................................................
Maricopa County, AZ.
Pinal County, AZ.
Pine Bluff, AR ......................................................................................................................................................
Cleveland County, AR.
Jefferson County, AR.
Lincoln County, AR.
Pittsburgh, PA ......................................................................................................................................................
Allegheny County, PA.
Armstrong County, PA.
Beaver County, PA.
Butler County, PA.
Fayette County, PA.
Washington County, PA.
Westmoreland County, PA.
Pittsfield, MA ........................................................................................................................................................
Berkshire County, MA.
Pocatello, ID ........................................................................................................................................................
Bannock County, ID.
Power County, ID.
Ponce, PR ............................................................................................................................................................
´
Juana Dıaz Municipio, PR.
Ponce Municipio, PR.
Villalba Municipio, PR.
Portland-South Portland-Biddeford, ME ..............................................................................................................
Cumberland County, ME.
Sagadahoc County, ME.
York County, ME.
Portland-Vancouver-Beaverton, OR-WA .............................................................................................................
Clackamas County, OR.
Columbia County, OR.
Multnomah County, OR.
Washington County, OR.
Yamhill County, OR.
Clark County, WA.
Skamania County, WA.
Port St. Lucie-Fort Pierce, FL ..............................................................................................................................
Martin County, FL.
St. Lucie County, FL.
Poughkeepsie-Newburgh-Middletown, NY ..........................................................................................................
Dutchess County, NY.
Orange County, NY.
Prescott, AZ .........................................................................................................................................................
37460 ........................
37620 ........................
37700 ........................
37860 ........................
37900 ........................
37964 ........................
38060 ........................
38220 ........................
38300 ........................
38340 ........................
38540 ........................
38660 ........................
38860 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
38900 ........................
38940 ........................
39100 ........................
39140 ........................
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0.9448
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0.7940
0.8230
0.8014
0.8998
1.1018
1.0305
0.8398
0.8685
1.0284
0.9417
0.4851
0.9926
1.1436
0.9851
1.0913
0.9853
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44125
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
39300 ........................
39340 ........................
39380 ........................
39460 ........................
39540 ........................
39580 ........................
39660 ........................
39740 ........................
39820 ........................
39900 ........................
40060 ........................
40140 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
40220 ........................
40340 ........................
40380 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Yavapai County, AZ.
Providence-New Bedford-Fall River, RI-MA ........................................................................................................
Bristol County, MA.
Bristol County, RI.
Kent County, RI.
Newport County, RI.
Providence County, RI.
Washington County, RI.
Provo-Orem, UT ..................................................................................................................................................
Juab County, UT.
Utah County, UT.
Pueblo, CO ..........................................................................................................................................................
Pueblo County, CO.
Punta Gorda, FL ..................................................................................................................................................
Charlotte County, FL.
Racine, WI ...........................................................................................................................................................
Racine County, WI.
Raleigh-Cary, NC .................................................................................................................................................
Franklin County, NC.
Johnston County, NC.
Wake County, NC.
Rapid City, SD .....................................................................................................................................................
Meade County, SD.
Pennington County, SD.
Reading, PA .........................................................................................................................................................
Berks County, PA.
Redding, CA ........................................................................................................................................................
Shasta County, CA.
Reno-Sparks, NV .................................................................................................................................................
Storey County, NV.
Washoe County, NV.
Richmond, VA ......................................................................................................................................................
Amelia County, VA.
Caroline County, VA.
Charles City County, VA.
Chesterfield County, VA.
Cumberland County, VA.
Dinwiddie County, VA.
Goochland County, VA.
Hanover County, VA.
Henrico County, VA.
King and Queen County, VA.
King William County, VA.
Louisa County, VA.
New Kent County, VA.
Powhatan County, VA.
Prince George County, VA.
Sussex County, VA.
Colonial Heights City, VA.
Hopewell City, VA.
Petersburg City, VA.
Richmond City, VA.
Riverside-San Bernardino-Ontario, CA ...............................................................................................................
Riverside County, CA.
San Bernardino County, CA.
Roanoke, VA ........................................................................................................................................................
Botetourt County, VA.
Craig County, VA.
Franklin County, VA.
Roanoke County, VA.
Roanoke City, VA.
Salem City, VA.
Rochester, MN .....................................................................................................................................................
Dodge County, MN.
Olmsted County, MN.
Wabasha County, MN.
Rochester, NY .....................................................................................................................................................
Livingston County, NY.
Monroe County, NY.
Ontario County, NY.
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0.9879
1.0351
0.9639
1.3221
1.1984
0.9193
1.0934
0.8662
1.1260
0.9005
44126
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
40420 ........................
40484 ........................
40580 ........................
40660 ........................
40900 ........................
40980 ........................
41060 ........................
41100 ........................
41140 ........................
41180 ........................
41420 ........................
41500 ........................
41540 ........................
41620 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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41700 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Orleans County, NY.
Wayne County, NY.
Rockford, IL .........................................................................................................................................................
Boone County, IL.
Winnebago County, IL.
Rockingham County-Strafford County, NH .........................................................................................................
Rockingham County, NH.
Strafford County, NH.
Rocky Mount, NC ................................................................................................................................................
Edgecombe County, NC.
Nash County, NC.
Rome, GA ............................................................................................................................................................
Floyd County, GA.
Sacramento-Arden-Arcade-Roseville, CA ...........................................................................................................
El Dorado County, CA.
Placer County, CA.
Sacramento County, CA.
Yolo County, CA.
Saginaw-Saginaw Township North, MI ...............................................................................................................
Saginaw County, MI.
St. Cloud, MN ......................................................................................................................................................
Benton County, MN.
Stearns County, MN.
St. George, UT ....................................................................................................................................................
Washington County, UT.
St. Joseph, MO-KS ..............................................................................................................................................
Doniphan County, KS.
Andrew County, MO.
Buchanan County, MO.
DeKalb County, MO.
St. Louis, MO-IL ...................................................................................................................................................
Bond County, IL.
Calhoun County, IL.
Clinton County, IL.
Jersey County, IL.
Macoupin County, IL.
Madison County, IL.
Monroe County, IL.
St. Clair County, IL.
Crawford County, MO.
Franklin County, MO.
Jefferson County, MO.
Lincoln County, MO.
St. Charles County, MO.
St. Louis County, MO.
Warren County, MO.
Washington County, MO.
St. Louis City, MO.
Salem, OR ...........................................................................................................................................................
Marion County, OR.
Polk County, OR.
Salinas, CA ..........................................................................................................................................................
Monterey County, CA.
Salisbury, MD ......................................................................................................................................................
Somerset County, MD.
Wicomico County, MD.
Salt Lake City, UT ...............................................................................................................................................
Salt Lake County, UT.
Summit County, UT.
Tooele County, UT.
San Angelo, TX ...................................................................................................................................................
Irion County, TX.
Tom Green County, TX.
San Antonio, TX ..................................................................................................................................................
Atascosa County, TX.
Bandera County, TX.
Bexar County, TX.
Comal County, TX.
Guadalupe County, TX.
Kendall County, TX.
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0.8889
1.0380
0.9281
1.0136
0.9013
1.0457
1.4459
0.8969
0.9418
0.8377
0.8860
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
41740 ........................
41780 ........................
41884 ........................
41900 ........................
41940 ........................
41980 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
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42044 ........................
42060 ........................
42100 ........................
42140 ........................
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index
Urban area (constituent counties)
Medina County, TX.
Wilson County, TX.
San Diego-Carlsbad-San Marcos, CA .................................................................................................................
San Diego County, CA.
Sandusky, OH ......................................................................................................................................................
Erie County, OH.
San Francisco-San Mateo-Redwood City, CA ....................................................................................................
Marin County, CA.
San Francisco County, CA.
San Mateo County, CA.
´
San German-Cabo Rojo, PR ...............................................................................................................................
Cabo Rojo Municipio, PR.
Lajas Municipio, PR.
Sabana Grande Municipio, PR.
´
San German Municipio, PR.
San Jose-Sunnyvale-Santa Clara, CA ................................................................................................................
San Benito County, CA.
Santa Clara County, CA.
San Juan-Caguas-Guaynabo, PR .......................................................................................................................
Aguas Buenas Municipio, PR.
Aibonito Municipio, PR.
Arecibo Municipio, PR.
Barceloneta Municipio, PR.
Barranquitas Municipio, PR.
´
Bayamon Municipio, PR.
Caguas Municipio, PR.
Camuy Municipio, PR.
´
Canovanas Municipio, PR.
Carolina Municipio, PR.
˜
Catano Municipio, PR.
Cayey Municipio, PR.
Ciales Municipio, PR.
Cidra Municipio, PR.
´
Comerıo Municipio, PR.
Corozal Municipio, PR.
Dorado Municipio, PR.
Florida Municipio, PR.
Guaynabo Municipio, PR.
Gurabo Municipio, PR.
Hatillo Municipio, PR.
Humacao Municipio, PR.
Juncos Municipio, PR.
Las Piedras Municipio, PR.
´
Loıza Municipio, PR.
´
Manatı Municipio, PR.
Maunabo Municipio, PR.
Morovis Municipio, PR.
Naguabo Municipio, PR.
Naranjito Municipio, PR.
Orocovis Municipio, PR.
Quebradillas Municipio, PR.
´
Rıo Grande Municipio, PR.
San Juan Municipio, PR.
San Lorenzo Municipio, PR.
Toa Alta Municipio, PR.
Toa Baja Municipio, PR.
Trujillo Alto Municipio, PR.
Vega Alta Municipio, PR.
Vega Baja Municipio, PR.
Yabucoa Municipio, PR.
San Luis Obispo-Paso Robles, CA .....................................................................................................................
San Luis Obispo County, CA.
Santa Ana-Anaheim-Irvine, CA ...........................................................................................................................
Orange County, CA.
Santa Barbara-Santa Maria-Goleta, CA ..............................................................................................................
Santa Barbara County, CA.
Santa Cruz-Watsonville, CA ................................................................................................................................
Santa Cruz County, CA.
Santa Fe, NM ......................................................................................................................................................
Santa Fe County, NM.
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1.5293
0.4397
1.1619
1.1294
1.1075
1.5531
1.0843
44128
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ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
Wage
index
CBSA code
Urban area (constituent counties)
42220 ........................
Santa Rosa-Petaluma, CA ..................................................................................................................................
Sonoma County, CA.
Sarasota-Bradenton-Venice, FL ..........................................................................................................................
Manatee County, FL.
Sarasota County, FL.
Savannah, GA .....................................................................................................................................................
Bryan County, GA.
Chatham County, GA.
Effingham County, GA.
Scranton--Wilkes-Barre, PA .................................................................................................................................
Lackawanna County, PA.
Luzerne County, PA.
Wyoming County, PA.
Seattle-Bellevue-Everett, WA ..............................................................................................................................
King County, WA.
Snohomish County, WA.
Sebastian-Vero Beach, FL ..................................................................................................................................
Sheboygan, WI ....................................................................................................................................................
Sheboygan County, WI.
Sherman-Denison, TX .........................................................................................................................................
Grayson County, TX.
Shreveport-Bossier City, LA ................................................................................................................................
Bossier Parish, LA.
Caddo Parish, LA.
De Soto Parish, LA.
Sioux City, IA-NE-SD ...........................................................................................................................................
Woodbury County, IA.
Dakota County, NE.
Dixon County, NE.
Union County, SD.
Sioux Falls, SD ....................................................................................................................................................
Lincoln County, SD.
McCook County, SD.
Minnehaha County, SD.
Turner County, SD.
South Bend-Mishawaka, IN-MI ............................................................................................................................
St. Joseph County, IN.
Cass County, MI.
Spartanburg, SC ..................................................................................................................................................
Spartanburg County, SC.
Spokane, WA .......................................................................................................................................................
Spokane County, WA.
Springfield, IL .......................................................................................................................................................
Menard County, IL.
Sangamon County, IL.
Springfield, MA ....................................................................................................................................................
Franklin County, MA.
Hampden County, MA.
Hampshire County, MA.
Springfield, MO ....................................................................................................................................................
Christian County, MO.
Dallas County, MO.
Greene County, MO.
Polk County, MO.
Webster County, MO.
Springfield, OH ....................................................................................................................................................
Clark County, OH.
State College, PA ................................................................................................................................................
Centre County, PA.
Stockton, CA ........................................................................................................................................................
San Joaquin County, CA.
Sumter, SC ..........................................................................................................................................................
Sumter County, SC.
Syracuse, NY .......................................................................................................................................................
Madison County, NY.
Onondaga County, NY.
Oswego County, NY.
Tacoma, WA ........................................................................................................................................................
Pierce County, WA.
Tallahassee, FL ...................................................................................................................................................
42260 ........................
42340 ........................
42540 ........................
42644 ........................
42680 ........................
43100 ........................
43300 ........................
43340 ........................
43580 ........................
43620 ........................
43780 ........................
43900 ........................
44060 ........................
44100 ........................
44140 ........................
44180 ........................
44220 ........................
44300 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
44700 ........................
44940 ........................
45060 ........................
45104 ........................
45220 ........................
VerDate Aug<31>2005
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1.4489
0.9885
0.9087
0.8521
1.1454
0.9590
0.9042
0.8517
0.8881
0.9217
0.9587
0.9690
0.9190
1.0465
0.8905
1.0080
0.8484
0.8462
0.8799
1.1462
0.8098
0.9709
1.0808
0.9299
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44129
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
45300 ........................
45460 ........................
45500 ........................
45780 ........................
45820 ........................
45940 ........................
46060 ........................
46140 ........................
46220 ........................
46340 ........................
46540 ........................
46660 ........................
46700 ........................
47020 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
47220 ........................
47260 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Gadsden County, FL.
Jefferson County, FL.
Leon County, FL.
Wakulla County, FL.
Tampa-St. Petersburg-Clearwater, FL ................................................................................................................
Hernando County, FL.
Hillsborough County, FL.
Pasco County, FL.
Pinellas County, FL.
Terre Haute, IN ....................................................................................................................................................
Clay County, IN.
Sullivan County, IN.
Vermillion County, IN.
Vigo County, IN.
Texarkana, TX-Texarkana, AR ............................................................................................................................
Miller County, AR.
Bowie County, TX.
Toledo, OH ..........................................................................................................................................................
Fulton County, OH.
Lucas County, OH.
Ottawa County, OH.
Wood County, OH.
Topeka, KS ..........................................................................................................................................................
Jackson County, KS.
Jefferson County, KS.
Osage County, KS.
Shawnee County, KS.
Wabaunsee County, KS.
Trenton-Ewing, NJ ...............................................................................................................................................
Mercer County, NJ.
Tucson, AZ ..........................................................................................................................................................
Pima County, AZ.
Tulsa, OK .............................................................................................................................................................
Creek County, OK.
Okmulgee County, OK.
Osage County, OK.
Pawnee County, OK.
Rogers County, OK.
Tulsa County, OK.
Wagoner County, OK.
Tuscaloosa, AL ....................................................................................................................................................
Greene County, AL.
Hale County, AL.
Tuscaloosa County, AL.
Tyler, TX ..............................................................................................................................................................
Smith County, TX.
Utica-Rome, NY ...................................................................................................................................................
Herkimer County, NY.
Oneida County, NY.
Valdosta, GA ........................................................................................................................................................
Brooks County, GA.
Echols County, GA.
Lanier County, GA.
Lowndes County, GA.
Vallejo-Fairfield, CA .............................................................................................................................................
Solano County, CA.
Victoria, TX ..........................................................................................................................................................
Calhoun County, TX.
Goliad County, TX.
Victoria County, TX.
Vineland-Millville-Bridgeton, NJ ...........................................................................................................................
Cumberland County, NJ.
Virginia Beach-Norfolk-Newport News, VA-NC ...................................................................................................
Currituck County, NC.
Gloucester County, VA.
Isle of Wight County, VA.
James City County, VA.
Mathews County, VA.
Surry County, VA.
York County, VA.
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0.9160
0.8661
0.8118
0.9599
0.8746
1.0877
0.9219
0.8104
0.8641
0.8827
0.8402
0.8344
1.5164
0.8575
0.9849
0.8805
44130
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
CBSA code
47300 ........................
47380 ........................
47580 ........................
47644 ........................
47894 ........................
47940 ........................
48140 ........................
48260 ........................
48300 ........................
48424 ........................
hsrobinson on PROD1PC69 with PROPOSALS2
48540 ........................
48620 ........................
48660 ........................
VerDate Aug<31>2005
Wage
index
Urban area (constituent counties)
Chesapeake City, VA.
Hampton City, VA.
Newport News City, VA.
Norfolk City, VA.
Poquoson City, VA.
Portsmouth City, VA.
Suffolk City, VA.
Virginia Beach City, VA.
Williamsburg City, VA.
Visalia-Porterville, CA ..........................................................................................................................................
Tulare County, CA.
Waco, TX .............................................................................................................................................................
McLennan County, TX.
Warner Robins, GA .............................................................................................................................................
Houston County, GA.
Warren-Farmington Hills-Troy, MI .......................................................................................................................
Lapeer County, MI.
Livingston County, MI.
Macomb County, MI.
Oakland County, MI.
St. Clair County, MI.
Washington-Arlington-Alexandria, DC-VA-MD-WV .............................................................................................
District of Columbia, DC.
Calvert County, MD.
Charles County, MD.
Prince George’s County, MD.
Arlington County, VA.
Clarke County, VA.
Fairfax County, VA.
Fauquier County, VA.
Loudoun County, VA.
Prince William County, VA.
Spotsylvania County, VA.
Stafford County, VA.
Warren County, VA.
Alexandria City, VA.
Fairfax City, VA.
Falls Church City, VA.
Fredericksburg City, VA.
Manassas City, VA.
Manassas Park City, VA.
Jefferson County, WV.
Waterloo-Cedar Falls, IA .....................................................................................................................................
Black Hawk County, IA.
Bremer County, IA.
Grundy County, IA.
Wausau, WI .........................................................................................................................................................
Marathon County, WI.
Weirton-Steubenville, WV-OH .............................................................................................................................
Jefferson County, OH.
Brooke County, WV.
Hancock County, WV.
Wenatchee, WA ...................................................................................................................................................
Chelan County, WA.
Douglas County, WA.
West Palm Beach-Boca Raton-Boynton Beach, FL ............................................................................................
Palm Beach County, FL.
Wheeling, WV-OH ...............................................................................................................................................
Belmont County, OH.
Marshall County, WV.
Ohio County, WV.
Wichita, KS ..........................................................................................................................................................
Butler County, KS.
Harvey County, KS.
Sedgwick County, KS.
Sumner County, KS.
Wichita Falls, TX ..................................................................................................................................................
Archer County, TX.
Clay County, TX.
Wichita County, TX.
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0.9986
0.8648
0.8394
1.0126
1.1074
0.8422
0.9740
0.8078
1.0365
0.9657
0.7022
0.9079
0.8326
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44131
ADDENDUM B.—PROPOSED CY 2007 WAGE INDEX FOR URBAN AREAS BY CBSA; APPLICABLE PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX—Continued
Wage
index
CBSA code
Urban area (constituent counties)
48700 ........................
Williamsport, PA ..................................................................................................................................................
Lycoming County, PA.
Wilmington, DE-MD-NJ ........................................................................................................................................
New Castle County, DE.
Cecil County, MD.
Salem County, NJ.
Wilmington, NC ....................................................................................................................................................
Brunswick County, NC.
New Hanover County, NC.
Pender County, NC.
Winchester, VA-WV .............................................................................................................................................
Frederick County, VA.
Winchester City, VA.
Hampshire County, WV.
Winston-Salem, NC .............................................................................................................................................
Davie County, NC.
Forsyth County, NC.
Stokes County, NC.
Yadkin County, NC.
Worcester, MA .....................................................................................................................................................
Worcester County, MA.
Yakima, WA .........................................................................................................................................................
Yakima County, WA.
Yauco, PR ............................................................................................................................................................
´
Guanica Municipio, PR.
Guayanilla Municipio, PR.
˜
Penuelas Municipio, PR.
Yauco Municipio, PR.
York-Hanover, PA ................................................................................................................................................
York County, PA.
Youngstown-Warren-Boardman, OH-PA .............................................................................................................
Mahoning County, OH.
Trumbull County, OH.
Mercer County, PA.
Yuba City, CA ......................................................................................................................................................
Sutter County, CA.
Yuba County, CA.
Yuma, AZ .............................................................................................................................................................
Yuma County, AZ.
48864 ........................
48900 ........................
49020 ........................
49180 ........................
49340 ........................
49420 ........................
49500 ........................
49620 ........................
49660 ........................
49700 ........................
49740 ........................
0.8126
1.0703
0.9853
1.0109
0.9293
1.0741
0.9865
0.3861
0.9414
0.8817
1.0749
0.9125
2 At this time, there are no hospitals in these urban areas on which to base a wage index. Therefore, the urban wage index value is based on
the average wage index of all urban areas within the State.
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
01000
01010
01020
01030
01040
01050
01060
01070
01080
01090
01100
01110
01120
01130
01140
01150
01160
01170
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Autauga County, Alabama ........................................................................
Baldwin County, Alabama .........................................................................
Barbour County, Alabama .........................................................................
Bibb County, Alabama ..............................................................................
Blount County, Alabama ...........................................................................
Bullock County, Alabama ..........................................................................
Butler County, Alabama ............................................................................
Calhoun County, Alabama ........................................................................
Chambers County, Alabama .....................................................................
Cherokee County, Alabama ......................................................................
Chilton County, Alabama ..........................................................................
Choctaw County, Alabama ........................................................................
Clarke County, Alabama ...........................................................................
Clay County, Alabama ..............................................................................
Cleburne County, Alabama .......................................................................
Coffee County, Alabama ...........................................................................
Colbert County, Alabama ..........................................................................
Conecuh County, Alabama .......................................................................
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CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8618
0.7654
0.7439
0.8196
0.8980
0.7439
0.7439
0.7682
0.7439
0.7439
0.8196
0.7439
0.7439
0.7439
0.7439
0.7439
0.8272
0.7439
0.8023
0.7652
0.7652
0.8919
0.8919
0.7652
0.7652
0.7868
0.7652
0.7652
0.8919
0.7652
0.7652
0.7652
0.7652
0.7652
0.7967
0.7652
-6.90
-0.03
2.86
8.82
-0.68
2.86
2.86
2.42
2.86
2.86
8.82
2.86
2.86
2.86
2.86
2.86
-3.69
2.86
33860
99901
99901
13820
13820
99901
99901
11500
99901
99901
13820
99901
99901
99901
99901
99901
22520
99901
E:\FR\FM\03AUP2.SGM
03AUP2
44132
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
01180
01190
01200
01210
01220
01230
01240
01250
01260
01270
01280
01290
01300
01310
01320
01330
01340
01350
01360
01370
01380
01390
01400
01410
01420
01430
01440
01450
01460
01470
01480
01490
01500
01510
01520
01530
01540
01550
01560
01570
01580
01590
01600
01610
01620
01630
01640
01650
01660
02013
02016
02020
02030
02040
02050
02060
02068
02070
02080
02090
02100
02110
02120
02122
02130
02140
02150
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Coosa County, Alabama ...........................................................................
Covington County, Alabama .....................................................................
Crenshaw County, Alabama .....................................................................
Cullman County, Alabama ........................................................................
Dale County, Alabama ..............................................................................
Dallas County, Alabama ............................................................................
De Kalb County, Alabama .........................................................................
Elmore County, Alabama ..........................................................................
Escambia County, Alabama ......................................................................
Etowah County, Alabama ..........................................................................
Fayette County, Alabama ..........................................................................
Franklin County, Alabama .........................................................................
Geneva County, Alabama .........................................................................
Greene County, Alabama ..........................................................................
Hale County, Alabama ..............................................................................
Henry County, Alabama ............................................................................
Houston County, Alabama ........................................................................
Jackson County, Alabama ........................................................................
Jefferson County, Alabama .......................................................................
Lamar County, Alabama ...........................................................................
Lauderdale County, Alabama ....................................................................
Lawrence County, Alabama ......................................................................
Lee County, Alabama ................................................................................
Limestone County, Alabama .....................................................................
Lowndes County, Alabama .......................................................................
Macon County, Alabama ...........................................................................
Madison County, Alabama ........................................................................
Marengo County, Alabama .......................................................................
Marion County, Alabama ...........................................................................
Marshall County, Alabama ........................................................................
Mobile County, Alabama ...........................................................................
Monroe County, Alabama .........................................................................
Montgomery County, Alabama ..................................................................
Morgan County, Alabama .........................................................................
Perry County, Alabama .............................................................................
Pickens County, Alabama .........................................................................
Pike County, Alabama ...............................................................................
Randolph County, Alabama ......................................................................
Russell County, Alabama ..........................................................................
St Clair County, Alabama ..........................................................................
Shelby County, Alabama ...........................................................................
Sumter County, Alabama ..........................................................................
Talladega County, Alabama ......................................................................
Tallapoosa County, Alabama ....................................................................
Tuscaloosa County, Alabama ...................................................................
Walker County, Alabama ..........................................................................
Washington County, Alabama ...................................................................
Wilcox County, Alabama ...........................................................................
Winston County, Alabama .........................................................................
Aleutians County East, Alaska ..................................................................
Aleutians County West, Alaska .................................................................
Anchorage County, Alaska ........................................................................
Angoon County, Alaska .............................................................................
Barrow-North Slope County, Alaska .........................................................
Bethel County, Alaska ...............................................................................
Bristol Bay Borough County, Alaska .........................................................
Denali County, Alaska ...............................................................................
Bristol Bay County, Alaska ........................................................................
Cordova-Mc Carthy County, Alaska ..........................................................
Fairbanks County, Alaska .........................................................................
Haines County, Alaska ..............................................................................
Juneau County, Alaska .............................................................................
Kenai-Cook Inlet County, Alaska ..............................................................
Kenai Peninsula Borough, Alaska .............................................................
Ketchikan County, Alaska .........................................................................
Kobuk County, Alaska ...............................................................................
Kodiak County, Alaska ..............................................................................
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CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7439
0.7439
0.7439
0.7439
0.7574
0.7439
0.7439
0.8618
0.7439
0.7938
0.7439
0.7439
0.7577
0.8039
0.8039
0.7577
0.7711
0.7439
0.8980
0.7439
0.8272
0.8469
0.8100
0.9146
0.8025
0.7439
0.9146
0.7439
0.7439
0.7439
0.7876
0.7439
0.8618
0.8469
0.7439
0.7439
0.7439
0.7439
0.8560
0.8980
0.8980
0.7439
0.7439
0.7439
0.8705
0.8196
0.7439
0.7439
0.7439
1.1933
1.1933
1.1840
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1648
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
0.7652
0.7652
0.7652
0.7652
0.7652
0.7652
0.7652
0.8023
0.7652
0.8080
0.7652
0.7652
0.7438
0.8641
0.8641
0.7438
0.7438
0.7652
0.8919
0.7652
0.7967
0.8220
0.8110
0.9051
0.8023
0.7652
0.9051
0.7652
0.7652
0.7652
0.7947
0.7652
0.8023
0.8220
0.7652
0.7652
0.7652
0.7652
0.8254
0.8919
0.8919
0.7652
0.7652
0.7652
0.8641
0.8919
0.7652
0.7652
0.7652
1.0680
1.0680
1.2045
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.1079
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
2.86
2.86
2.86
2.86
1.03
2.86
2.86
-6.90
2.86
1.79
2.86
2.86
-1.83
7.49
7.49
-1.83
-3.54
2.86
-0.68
2.86
-3.69
-2.94
0.12
-1.04
-0.02
2.86
-1.04
2.86
2.86
2.86
0.90
2.86
-6.90
-2.94
2.86
2.86
2.86
2.86
-3.57
-0.68
-0.68
2.86
2.86
2.86
-0.74
8.82
2.86
2.86
2.86
-10.50
-10.50
1.73
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-4.88
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
99901
99901
99901
99901
99901
99901
99901
33860
99901
23460
99901
99901
20020
46220
46220
20020
20020
99901
13820
99901
22520
19460
12220
26620
33860
99901
26620
99901
99901
99901
33660
99901
33860
19460
99901
99901
99901
99901
17980
13820
13820
99901
99901
99901
46220
13820
99901
99901
99901
99902
99902
11260
99902
99902
99902
99902
99902
99902
99902
21820
99902
99902
99902
99902
99902
99902
99902
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44133
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
02160
02164
02170
02180
02185
02188
02190
02200
02201
02210
02220
02230
02231
02232
02240
02250
02260
02261
02270
02280
02282
02290
03000
03010
03020
03030
03040
03050
03055
03060
03070
03080
03090
03100
03110
03120
03130
04000
04010
04020
04030
04040
04050
04060
04070
04080
04090
04100
04110
04120
04130
04140
04150
04160
04170
04180
04190
04200
04210
04220
04230
04240
04250
04260
04270
04280
04290
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Kuskokwin County, Alaska ........................................................................
Lake and Peninsula Borough, Alaska .......................................................
Matanuska County, Alaska .......................................................................
Nome County, Alaska ...............................................................................
North Slope Borough, Alaska ....................................................................
Northwest Arctic Borough, Alaska ............................................................
Outer Ketchikan County, Alaska ...............................................................
Prince Of Wales County, Alaska ...............................................................
Prince of Wales-Outer Ketchikan Census Area,AK ..................................
Seward County, Alaska .............................................................................
Sitka County, Alaska .................................................................................
Skagway-Yakutat County, Alaska .............................................................
Skagway-Yakutat-Angoon Census Area, Alaska ......................................
Skagway-Hoonah-Angoon Census Area, Alaska .....................................
Southeast Fairbanks County, Alaska ........................................................
Upper Yukon County, Alaska ....................................................................
Valdz-Chitna-Whitier County, Alaska ........................................................
Valdex-Cordove Census Area, Alaska ......................................................
Wade Hampton County, Alaska ................................................................
Wrangell-Petersburg County, Alaska ........................................................
Yakutat Borough, Alaska ...........................................................................
Yukon-Koyukuk County, Alaska ................................................................
Apache County, Arizona ...........................................................................
Cochise County, Arizona ...........................................................................
Coconino County, Arizona ........................................................................
Gila County, Arizona .................................................................................
Graham County, Arizona ...........................................................................
Greenlee County, Arizona .........................................................................
La Paz County, Arizona ............................................................................
Maricopa County, Arizona .........................................................................
Mohave County, Arizona ...........................................................................
Navajo County, Arizona ............................................................................
Pima County, Arizona ...............................................................................
Pinal County, Arizona ................................................................................
Santa Cruz County, Arizona .....................................................................
Yavapai County, Arizona ...........................................................................
Yuma County, Arizona ..............................................................................
Arkansas County, Arkansas ......................................................................
Ashley County, Arkansas ..........................................................................
Baxter County, Arkansas ..........................................................................
Benton County, Arkansas .........................................................................
Boone County, Arkansas ..........................................................................
Bradley County, Arkansas .........................................................................
Calhoun County, Arkansas .......................................................................
Carroll County, Arkansas ..........................................................................
Chicot County, Arkansas ...........................................................................
Clark County, Arkansas ............................................................................
Clay County, Arkansas ..............................................................................
Cleburne County, Arkansas ......................................................................
Cleveland County, Arkansas .....................................................................
Columbia County, Arkansas ......................................................................
Conway County, Arkansas ........................................................................
Craighead County, Arkansas ....................................................................
Crawford County, Arkansas ......................................................................
Crittenden County, Arkansas ....................................................................
Cross County, Arkansas ...........................................................................
Dallas County, Arkansas ...........................................................................
Desha County, Arkansas ..........................................................................
Drew County, Arkansas ............................................................................
Faulkner County, Arkansas .......................................................................
Franklin County, Arkansas ........................................................................
Fulton County, Arkansas ...........................................................................
Garland County, Arkansas ........................................................................
Grant County, Arkansas ............................................................................
Greene County, Arkansas .........................................................................
Hempstead County, Arkansas ..................................................................
Hot Spring County, Arkansas ....................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00053
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
1.1933
1.1933
1.1892
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
1.1933
0.8907
0.8907
1.1969
0.8907
0.8907
0.8907
0.8907
1.0127
0.9962
0.8907
0.9007
1.0127
0.8907
0.9457
0.9126
0.7605
0.7605
0.7605
0.8661
0.7605
0.7605
0.7605
0.7605
0.7605
0.7605
0.7605
0.7605
0.8212
0.7605
0.7605
0.7911
0.8238
0.9407
0.7605
0.7605
0.7605
0.7605
0.8747
0.7987
0.7605
0.8375
0.8246
0.7605
0.7605
0.7605
1.0680
1.0680
1.2045
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
1.0680
0.8924
0.8924
1.1621
0.8924
0.8924
0.8924
0.8924
1.0305
0.8924
0.8924
0.9219
1.0305
0.8924
0.9853
0.9125
0.7335
0.7335
0.7335
0.8761
0.7335
0.7335
0.7335
0.7335
0.7335
0.7335
0.7335
0.7335
0.8398
0.7335
0.7335
0.7609
0.7745
0.9361
0.7335
0.7335
0.7335
0.7335
0.8906
0.7745
0.7335
0.8797
0.8906
0.7335
0.7335
0.7335
-10.50
-10.50
1.29
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
-10.50
0.19
0.19
-2.91
0.19
0.19
0.19
0.19
1.76
-10.42
0.19
2.35
1.76
0.19
4.19
-0.01
-3.55
-3.55
-3.55
1.15
-3.55
-3.55
-3.55
-3.55
-3.55
-3.55
-3.55
-3.55
2.26
-3.55
-3.55
-3.82
-5.98
-0.49
-3.55
-3.55
-3.55
-3.55
1.82
-3.03
-3.55
5.04
8.00
-3.55
-3.55
-3.55
99902
99902
11260
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99902
99903
99903
22380
99903
99903
99903
99903
38060
99903
99903
46060
38060
99903
39140
49740
99904
99904
99904
22220
99904
99904
99904
99904
99904
99904
99904
99904
38220
99904
99904
27860
22900
32820
99904
99904
99904
99904
30780
22900
99904
26300
30780
99904
99904
99904
E:\FR\FM\03AUP2.SGM
03AUP2
44134
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
04300
04310
04320
04330
04340
04350
04360
04370
04380
04390
04400
04410
04420
04430
04440
04450
04460
04470
04480
04490
04500
04510
04520
04530
04540
04550
04560
04570
04580
04590
04600
04610
04620
04630
04640
04650
04660
04670
04680
04690
04700
04710
04720
04730
04740
05000
05010
05020
05030
05040
05050
05060
05070
05080
05090
05100
05110
05120
05130
05140
05150
05160
05170
05200
05210
05300
05310
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Howard County, Arkansas ........................................................................
Independence County, Arkansas ..............................................................
Izard County, Arkansas .............................................................................
Jackson County, Arkansas ........................................................................
Jefferson County, Arkansas ......................................................................
Johnson County, Arkansas .......................................................................
Lafayette County, Arkansas ......................................................................
Lawrence County, Arkansas .....................................................................
Lee County, Arkansas ...............................................................................
Lincoln County, Arkansas .........................................................................
Little River County, Arkansas ....................................................................
Logan County, Arkansas ...........................................................................
Lonoke County, Arkansas .........................................................................
Madison County, Arkansas .......................................................................
Marion County, Arkansas ..........................................................................
Miller County, Arkansas ............................................................................
Mississippi County, Arkansas ...................................................................
Monroe County, Arkansas .........................................................................
Montgomery County, Arkansas .................................................................
Nevada County, Arkansas ........................................................................
Newton County, Arkansas .........................................................................
Ouachita County, Arkansas ......................................................................
Perry County, Arkansas ............................................................................
Phillips County, Arkansas .........................................................................
Pike County, Arkansas ..............................................................................
Poinsett County, Arkansas ........................................................................
Polk County, Arkansas ..............................................................................
Pope County, Arkansas ............................................................................
Prairie County, Arkansas ..........................................................................
Pulaski County, Arkansas .........................................................................
Randolph County, Arkansas .....................................................................
St Francis County, Arkansas ....................................................................
Saline County, Arkansas ...........................................................................
Scott County, Arkansas .............................................................................
Searcy County, Arkansas ..........................................................................
Sebastian County, Arkansas .....................................................................
Sevier County, Arkansas ...........................................................................
Sharp County, Arkansas ...........................................................................
Stone County, Arkansas ...........................................................................
Union County, Arkansas ...........................................................................
Van Buren County, Arkansas ....................................................................
Washington County, Arkansas ..................................................................
White County, Arkansas ............................................................................
Woodruff County, Arkansas ......................................................................
Yell County, Arkansas ...............................................................................
Alameda County, California ......................................................................
Alpine County, California ...........................................................................
Amador County, California ........................................................................
Butte County, California ............................................................................
Calaveras County, California ....................................................................
Colusa County, California .........................................................................
Contra Costa County, California ...............................................................
Del Norte County, California .....................................................................
Eldorado County, California ......................................................................
Fresno County, California .........................................................................
Glenn County, California ...........................................................................
Humboldt County, California .....................................................................
Imperial County, California ........................................................................
Inyo County, California ..............................................................................
Kern County, California .............................................................................
Kings County, California ............................................................................
Lake County, California .............................................................................
Lassen County, California .........................................................................
Los Angeles County, California .................................................................
Los Angeles County, California .................................................................
Madera County, California ........................................................................
Marin County, California ............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00054
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7605
0.7605
0.7605
0.7605
0.8680
0.7605
0.7605
0.7605
0.7605
0.8212
0.7605
0.7605
0.8747
0.8203
0.7605
0.8283
0.7605
0.7605
0.7605
0.7605
0.7605
0.7605
0.8246
0.7605
0.7605
0.7828
0.7605
0.7605
0.7605
0.8747
0.7605
0.7605
0.8747
0.7605
0.7605
0.8238
0.7605
0.7605
0.7605
0.7605
0.7605
0.8661
0.7605
0.7605
0.7605
1.5346
1.0915
1.0915
1.0511
1.0915
1.0915
1.5346
1.0915
1.3056
1.0483
1.0915
1.0915
0.9841
1.0915
1.0470
1.0406
1.0915
1.0915
1.1783
1.1783
0.9571
1.4994
0.7335
0.7335
0.7335
0.7335
0.8398
0.7335
0.7335
0.7335
0.7335
0.8398
0.7335
0.7335
0.8906
0.8761
0.7335
0.8118
0.7335
0.7335
0.7335
0.7335
0.7335
0.7335
0.8906
0.7335
0.7335
0.7609
0.7335
0.7335
0.7335
0.8906
0.7335
0.7335
0.8906
0.7335
0.7335
0.7745
0.7335
0.7335
0.7335
0.7335
0.7335
0.8761
0.7335
0.7335
0.7335
1.5420
1.1302
1.1302
1.1073
1.1302
1.1302
1.5420
1.1302
1.3373
1.0965
1.1302
1.1302
0.9092
1.1302
1.0605
1.0142
1.1302
1.1302
1.1752
1.1752
0.8169
1.5071
-3.55
-3.55
-3.55
-3.55
-3.25
-3.55
-3.55
-3.55
-3.55
2.26
-3.55
-3.55
1.82
6.80
-3.55
-1.99
-3.55
-3.55
-3.55
-3.55
-3.55
-3.55
8.00
-3.55
-3.55
-2.80
-3.55
-3.55
-3.55
1.82
-3.55
-3.55
1.82
-3.55
-3.55
-5.98
-3.55
-3.55
-3.55
-3.55
-3.55
1.15
-3.55
-3.55
-3.55
0.48
3.55
3.55
5.35
3.55
3.55
0.48
3.55
2.43
4.60
3.55
3.55
-7.61
3.55
1.29
-2.54
3.55
3.55
-0.26
-0.26
-14.65
0.51
99904
99904
99904
99904
38220
99904
99904
99904
99904
38220
99904
99904
30780
22220
99904
45500
99904
99904
99904
99904
99904
99904
30780
99904
99904
27860
99904
99904
99904
30780
99904
99904
30780
99904
99904
22900
99904
99904
99904
99904
99904
22220
99904
99904
99904
36084
99905
99905
17020
99905
99905
36084
99905
40900
23420
99905
99905
20940
99905
12540
25260
99905
99905
31084
31084
31460
41884
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44135
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
05320
05330
05340
05350
05360
05370
05380
05390
05400
05410
05420
05430
05440
05450
05460
05470
05480
05490
05500
05510
05520
05530
05540
05550
05560
05570
05580
05590
05600
05610
05620
05630
05640
05650
05660
05670
05680
06000
06010
06020
06030
06040
06050
06060
06070
06080
06090
06100
06110
06120
06130
06140
06150
06160
06170
06180
06190
06200
06210
06220
06230
06240
06250
06260
06270
06280
06290
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Mariposa County, California ......................................................................
Mendocino County, California ...................................................................
Merced County, California .........................................................................
Modoc County, California ..........................................................................
Mono County, California ............................................................................
Monterey County, California ......................................................................
Napa County, California ............................................................................
Nevada County, California ........................................................................
Orange County, California .........................................................................
Placer County, California ..........................................................................
Plumas County, California .........................................................................
Riverside County, California ......................................................................
Sacramento County, California .................................................................
San Benito County, California ...................................................................
San Bernardino County, California ...........................................................
San Diego County, California ....................................................................
San Francisco County, California .............................................................
San Joaquin County, California ................................................................
San Luis Obispo County, California ..........................................................
San Mateo County, California ...................................................................
Santa Barbara County, California .............................................................
Santa Clara County, California .................................................................
Santa Cruz County, California ..................................................................
Shasta County, California .........................................................................
Sierra County, California ...........................................................................
Siskiyou County, California .......................................................................
Solano County, California .........................................................................
Sonoma County, California .......................................................................
Stanislaus County, California ....................................................................
Sutter County, California ...........................................................................
Tehama County, California .......................................................................
Trinity County, California ...........................................................................
Tulare County, California ..........................................................................
Tuolumne County, California .....................................................................
Ventura County, California ........................................................................
Yolo County, California .............................................................................
Yuba County, California ............................................................................
Adams County, Colorado ..........................................................................
Alamosa County, Colorado .......................................................................
Arapahoe County, Colorado ......................................................................
Archuleta County, Colorado ......................................................................
Baca County, Colorado .............................................................................
Bent County, Colorado ..............................................................................
Boulder County, Colorado .........................................................................
Chaffee County, Colorado .........................................................................
Cheyenne County, Colorado .....................................................................
Clear Creek County, Colorado ..................................................................
Conejos County, Colorado ........................................................................
Costilla County, Colorado .........................................................................
Crowley County, Colorado ........................................................................
Custer County, Colorado ...........................................................................
Delta County, Colorado .............................................................................
Denver County, Colorado ..........................................................................
Dolores County, Colorado .........................................................................
Douglas County, Colorado ........................................................................
Eagle County, Colorado ............................................................................
Elbert County, Colorado ............................................................................
El Paso County, Colorado .........................................................................
Fremont County, Colorado ........................................................................
Garfield County, Colorado .........................................................................
Gilpin County, Colorado ............................................................................
Grand County, Colorado ...........................................................................
Gunnison County, Colorado ......................................................................
Hinsdale County, Colorado .......................................................................
Huerfano County, Colorado ......................................................................
Jackson County, Colorado ........................................................................
Jefferson County, Colorado ......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00055
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
1.0915
1.0915
1.1109
1.0915
1.0915
1.4128
1.3313
1.0915
1.1559
1.3056
1.0915
1.1027
1.3056
1.2937
1.1027
1.1413
1.4994
1.1307
1.1349
1.4994
1.1694
1.5109
1.5166
1.2203
1.0915
1.0915
1.4460
1.3493
1.1885
1.0921
1.0915
1.0915
1.0123
1.0915
1.1622
1.1460
1.0921
1.0723
0.9380
1.0723
0.9380
0.9380
0.9380
0.9734
0.9380
0.9380
1.0052
0.9380
0.9380
0.9380
0.9380
0.9380
1.0723
0.9380
1.0723
0.9380
1.0052
0.9468
0.9380
0.9380
1.0052
0.9380
0.9380
0.9380
0.9380
0.9380
1.0723
1.1302
1.1302
1.1415
1.1302
1.1302
1.4459
1.3496
1.1302
1.1294
1.3373
1.1302
1.0934
1.3373
1.5293
1.0934
1.1374
1.5071
1.1462
1.1619
1.5071
1.1075
1.5293
1.5531
1.3221
1.1302
1.1302
1.5164
1.4489
1.1590
1.0749
1.1302
1.1302
0.9986
1.1302
1.1591
1.3373
1.0749
1.0947
0.9342
1.0947
0.9342
0.9342
0.9342
1.0368
0.9342
0.9342
1.0947
0.9342
0.9342
0.9342
0.9342
0.9342
1.0947
0.9342
1.0947
0.9342
1.0947
0.9718
0.9342
0.9342
1.0947
0.9342
0.9342
0.9342
0.9342
0.9342
1.0947
3.55
3.55
2.75
3.55
3.55
2.34
1.37
3.55
-2.29
2.43
3.55
-0.84
2.43
18.21
-0.84
-0.34
0.51
1.37
2.38
0.51
-5.29
1.22
2.41
8.34
3.55
3.55
4.87
7.38
-2.48
-1.57
3.55
3.55
-1.35
3.55
-0.27
16.69
-1.57
2.09
-0.41
2.09
-0.41
-0.41
-0.41
6.51
-0.41
-0.41
8.90
-0.41
-0.41
-0.41
-0.41
-0.41
2.09
-0.41
2.09
-0.41
8.90
2.64
-0.41
-0.41
8.90
-0.41
-0.41
-0.41
-0.41
-0.41
2.09
99905
99905
32900
99905
99905
41500
34900
99905
42044
40900
99905
40140
40900
41940
40140
41740
41884
44700
42020
41884
42060
41940
42100
39820
99905
99905
46700
42220
33700
49700
99905
99905
47300
99905
37100
40900
49700
19740
99906
19740
99906
99906
99906
14500
99906
99906
19740
99906
99906
99906
99906
99906
19740
99906
19740
99906
19740
17820
99906
99906
19740
99906
99906
99906
99906
99906
19740
E:\FR\FM\03AUP2.SGM
03AUP2
44136
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
06300
06310
06320
06330
06340
06350
06360
06370
06380
06390
06400
06410
06420
06430
06440
06450
06460
06470
06480
06490
06500
06510
06520
06530
06540
06550
06560
06570
06580
06590
06600
06610
06620
06630
07000
07010
07020
07030
07040
07050
07060
07070
08000
08010
08020
09000
10000
10010
10020
10030
10040
10050
10060
10070
10080
10090
10100
10110
10120
10130
10140
10150
10160
10170
10180
10190
10200
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Kiowa County, Colorado ...........................................................................
Kit Carson County, Colorado ....................................................................
Lake County, Colorado .............................................................................
La Plata County, Colorado ........................................................................
Larimer County, Colorado .........................................................................
Las Animas County, Colorado ..................................................................
Lincoln County, Colorado ..........................................................................
Logan County, Colorado ...........................................................................
Mesa County, Colorado ............................................................................
Mineral County, Colorado .........................................................................
Moffat County, Colorado ...........................................................................
Montezuma County, Colorado ..................................................................
Montrose County, Colorado ......................................................................
Morgan County, Colorado .........................................................................
Otero County, Colorado ............................................................................
Ouray County, Colorado ...........................................................................
Park County, Colorado ..............................................................................
Phillips County, Colorado ..........................................................................
Pitkin County, Colorado ............................................................................
Prowers County, Colorado ........................................................................
Pueblo County, Colorado ..........................................................................
Rio Blanco County, Colorado ....................................................................
Rio Grande County, Colorado ...................................................................
Routt County, Colorado .............................................................................
Saguache County, Colorado .....................................................................
San Juan County, Colorado ......................................................................
San Miguel County, Colorado ...................................................................
Sedgwick County, Colorado ......................................................................
Summit County, Colorado .........................................................................
Teller County, Colorado ............................................................................
Washington County, Colorado ..................................................................
Weld County, Colorado .............................................................................
Yuma County, Colorado ............................................................................
Broomfield County, Colorado ....................................................................
Fairfield County, Connecticut ....................................................................
Hartford County, Connecticut ....................................................................
Litchfield County, Connecticut ...................................................................
Middlesex County, Connecticut .................................................................
New Haven County, Connecticut ..............................................................
New London County, Connecticut ............................................................
Tolland County, Connecticut .....................................................................
Windham County, Connecticut ..................................................................
Kent County, Delaware .............................................................................
New Castle County, Delaware ..................................................................
Sussex County, Delaware .........................................................................
Washington Dc County, Dist Of Col .........................................................
Alachua County, Florida ............................................................................
Baker County, Florida ...............................................................................
Bay County, Florida ...................................................................................
Bradford County, Florida ...........................................................................
Brevard County, Florida ............................................................................
Broward County, Florida ...........................................................................
Calhoun County, Florida ...........................................................................
Charlotte County, Florida ..........................................................................
Citrus County, Florida ...............................................................................
Clay County, Florida ..................................................................................
Collier County, Florida ...............................................................................
Columbia County, Florida ..........................................................................
Dade County, Florida ................................................................................
De Soto County, Florida ............................................................................
Dixie County, Florida .................................................................................
Duval County, Florida ................................................................................
Escambia County, Florida .........................................................................
Flagler County, Florida ..............................................................................
Franklin County, Florida ............................................................................
Gadsden County, Florida ..........................................................................
Gilchrist County, Florida ............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00056
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9380
0.9380
0.9380
0.9380
1.0122
0.9380
0.9380
0.9380
0.9550
0.9380
0.9380
0.9380
0.9380
0.9380
0.9380
0.9380
1.0052
0.9380
0.9380
0.9380
0.8623
0.9380
0.9380
0.9380
0.9380
0.9380
0.9380
0.9380
0.9380
0.9424
0.9380
0.9570
0.9380
1.0723
1.2394
1.1073
1.1073
1.1073
1.2042
1.1345
1.1073
1.1730
0.9776
1.0499
0.9579
1.0951
0.9388
0.8984
0.8005
0.8623
0.9839
1.0432
0.8623
0.9255
0.8623
0.9295
1.0139
0.8623
0.9750
0.8623
0.8623
0.9295
0.8096
0.8947
0.8623
0.8688
0.9033
0.9342
0.9342
0.9342
0.9342
0.9561
0.9342
0.9342
0.9342
0.9685
0.9342
0.9342
0.9342
0.9342
0.9342
0.9342
0.9342
1.0947
0.9342
0.9342
0.9342
0.8552
0.9342
0.9342
0.9342
0.9342
0.9342
0.9342
0.9342
0.9342
0.9718
0.9342
0.9619
0.9342
1.0947
1.2681
1.0916
1.0916
1.0916
1.1974
1.1953
1.0916
1.1753
0.9865
1.0703
0.9723
1.1074
0.9312
0.9042
0.8087
0.8595
0.9448
1.0151
0.8595
0.9421
0.8595
0.9042
0.9959
0.8595
0.9830
0.8595
0.8595
0.9042
0.8014
0.8595
0.8595
0.9299
0.9312
-0.41
-0.41
-0.41
-0.41
-5.54
-0.41
-0.41
-0.41
1.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
8.90
-0.41
-0.41
-0.41
-0.82
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
3.12
-0.41
0.51
-0.41
2.09
2.32
-1.42
-1.42
-1.42
-0.56
5.36
-1.42
0.20
0.91
1.94
1.50
1.12
-0.81
0.65
1.02
-0.32
-3.97
-2.69
-0.32
1.79
-0.32
-2.72
-1.78
-0.32
0.82
-0.32
-0.32
-2.72
-1.01
-3.93
-0.32
7.03
3.09
99906
99906
99906
99906
22660
99906
99906
99906
24300
99906
99906
99906
99906
99906
99906
99906
19740
99906
99906
99906
39380
99906
99906
99906
99906
99906
99906
99906
99906
17820
99906
24540
99906
19740
14860
25540
25540
25540
35300
35980
25540
99907
20100
48864
99908
47894
23540
27260
37460
99910
37340
22744
99910
39460
99910
27260
34940
99910
33124
99910
99910
27260
37860
99910
99910
45220
23540
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44137
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
10210
10220
10230
10240
10250
10260
10270
10280
10290
10300
10310
10320
10330
10340
10350
10360
10370
10380
10390
10400
10410
10420
10430
10440
10450
10460
10470
10480
10490
10500
10510
10520
10530
10540
10550
10560
10570
10580
10590
10600
10610
10620
10630
10640
10650
10660
11000
11010
11011
11020
11030
11040
11050
11060
11070
11080
11090
11100
11110
11120
11130
11140
11150
11160
11161
11170
11180
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Glades County, Florida .............................................................................
Gulf County, Florida ..................................................................................
Hamilton County, Florida ...........................................................................
Hardee County, Florida .............................................................................
Hendry County, Florida .............................................................................
Hernando County, Florida .........................................................................
Highlands County, Florida .........................................................................
Hillsborough County, Florida .....................................................................
Holmes County, Florida .............................................................................
Indian River County, Florida .....................................................................
Jackson County, Florida ............................................................................
Jefferson County, Florida ..........................................................................
Lafayette County, Florida ..........................................................................
Lake County, Florida .................................................................................
Lee County, Florida ...................................................................................
Leon County, Florida .................................................................................
Levy County, Florida .................................................................................
Liberty County, Florida ..............................................................................
Madison County, Florida ...........................................................................
Manatee County, Florida ...........................................................................
Marion County, Florida ..............................................................................
Martin County, Florida ...............................................................................
Monroe County, Florida .............................................................................
Nassau County, Florida .............................................................................
Okaloosa County, Florida ..........................................................................
Okeechobee County, Florida ....................................................................
Orange County, Florida .............................................................................
Osceola County, Florida ............................................................................
Palm Beach County, Florida .....................................................................
Pasco County, Florida ...............................................................................
Pinellas County, Florida ............................................................................
Polk County, Florida ..................................................................................
Putnam County, Florida ............................................................................
Johns County, Florida ...............................................................................
St Lucie County, Florida ............................................................................
Santa Rosa County, Florida ......................................................................
Sarasota County, Florida ..........................................................................
Seminole County, Florida ..........................................................................
Sumter County, Florida .............................................................................
Suwannee County, Florida ........................................................................
Taylor County, Florida ...............................................................................
Union County, Florida ...............................................................................
Volusia County, Florida .............................................................................
Wakulla County, Florida ............................................................................
Walton County, Florida ..............................................................................
Washington County, Florida ......................................................................
Appling County, Georgia ...........................................................................
Atkinson County, Georgia .........................................................................
Bacon County, Georgia .............................................................................
Baker County, Georgia ..............................................................................
Baldwin County, Georgia ..........................................................................
Banks County, Georgia .............................................................................
Barrow County, Georgia ............................................................................
Bartow County, Georgia ............................................................................
Ben Hill County, Georgia ..........................................................................
Berrien County, Georgia ...........................................................................
Bibb County, Georgia ................................................................................
Bleckley County, Georgia ..........................................................................
Brantley County, Georgia ..........................................................................
Brooks County, Georgia ............................................................................
Bryan County, Georgia ..............................................................................
Bulloch County, Georgia ...........................................................................
Burke County, Georgia ..............................................................................
Butts County, Georgia ...............................................................................
Calhoun County, Georgia ..........................................................................
Camden County, Georgia .........................................................................
Candler County, Georgia ..........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00057
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8623
0.8623
0.8623
0.8623
0.8623
0.9233
0.8623
0.9233
0.8623
0.9056
0.8623
0.8683
0.8623
0.9464
0.9356
0.8688
0.8623
0.8623
0.8623
0.9639
0.8925
1.0123
0.8623
0.9295
0.8872
0.8623
0.9464
0.9464
1.0067
0.9233
0.9233
0.8912
0.8623
0.9295
1.0123
0.8096
0.9639
0.9464
0.8623
0.8623
0.8623
0.8623
0.9312
0.8683
0.8623
0.8623
0.7914
0.7914
0.7914
0.8397
0.7914
0.7914
0.9793
0.9793
0.7914
0.7914
0.9360
0.7914
0.8739
0.8516
0.9461
0.7914
0.8957
0.8980
0.7914
0.7914
0.7914
0.8595
0.8595
0.8595
0.8595
0.8595
0.9160
0.8595
0.9160
0.8595
0.9590
0.8595
0.9299
0.8595
0.9422
0.9359
0.9299
0.8595
0.8595
0.8595
0.9885
0.8883
0.9851
0.8595
0.9042
0.8658
0.8595
0.9422
0.9422
0.9657
0.9160
0.9160
0.8895
0.8595
0.9042
0.9851
0.8014
0.9885
0.9422
0.8595
0.8595
0.8595
0.8595
0.9280
0.9299
0.8595
0.8595
0.7560
0.7560
0.7560
0.8962
0.7560
0.7560
0.9772
0.9772
0.7560
0.7560
0.9518
0.7560
1.0097
0.8344
0.9087
0.7560
0.9678
0.9772
0.7560
0.7560
0.7560
-0.32
-0.32
-0.32
-0.32
-0.32
-0.79
-0.32
-0.79
-0.32
5.90
-0.32
7.09
-0.32
-0.44
0.03
7.03
-0.32
-0.32
-0.32
2.55
-0.47
-2.69
-0.32
-2.72
-2.41
-0.32
-0.44
-0.44
-4.07
-0.79
-0.79
-0.19
-0.32
-2.72
-2.69
-1.01
2.55
-0.44
-0.32
-0.32
-0.32
-0.32
-0.34
7.09
-0.32
-0.32
-4.47
-4.47
-4.47
6.73
-4.47
-4.47
-0.21
-0.21
-4.47
-4.47
1.69
-4.47
15.54
-2.02
-3.95
-4.47
8.05
8.82
-4.47
-4.47
-4.47
99910
99910
99910
99910
99910
45300
99910
45300
99910
42680
99910
45220
99910
36740
15980
45220
99910
99910
99910
42260
36100
38940
99910
27260
23020
99910
36740
36740
48424
45300
45300
29460
99910
27260
38940
37860
42260
36740
99910
99910
99910
99910
19660
45220
99910
99910
99911
99911
99911
10500
99911
99911
12060
12060
99911
99911
31420
99911
15260
46660
42340
99911
12260
12060
99911
99911
99911
E:\FR\FM\03AUP2.SGM
03AUP2
44138
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
11190
11200
11210
11220
11230
11240
11250
11260
11270
11280
11281
11290
11291
11300
11310
11311
11320
11330
11340
11341
11350
11360
11370
11380
11381
11390
11400
11410
11420
11421
11430
11440
11441
11450
11451
11460
11461
11462
11470
11471
11480
11490
11500
11510
11520
11530
11540
11550
11560
11570
11580
11581
11590
11591
11600
11601
11610
11611
11612
11620
11630
11640
11650
11651
11652
11660
11670
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Carroll County, Georgia ............................................................................
Catoosa County, Georgia ..........................................................................
Charlton County, Georgia .........................................................................
Chatham County, Georgia ........................................................................
Chattahoochee County, Georgia ...............................................................
Chattooga County, Georgia ......................................................................
Cherokee County, Georgia .......................................................................
Clarke County, Georgia .............................................................................
Clay County, Georgia ................................................................................
Clayton County, Georgia ...........................................................................
Clinch County, Georgia .............................................................................
Cobb County, Georgia ..............................................................................
Coffee County, Georgia ............................................................................
Colquitt County, Georgia ...........................................................................
Columbia County, Georgia ........................................................................
Cook County, Georgia ...............................................................................
Coweta County, Georgia ...........................................................................
Crawford County, Georgia ........................................................................
Crisp County, Georgia ...............................................................................
Dade County, Georgia ..............................................................................
Dawson County, Georgia ..........................................................................
Decatur County, Georgia ..........................................................................
De Kalb County, Georgia ..........................................................................
Dodge County, Georgia ............................................................................
Dooly County, Georgia ..............................................................................
Dougherty County, Georgia ......................................................................
Douglas County, Georgia ..........................................................................
Early County, Georgia ...............................................................................
Echols County, Georgia ............................................................................
Effingham County, Georgia .......................................................................
Elbert County, Georgia ..............................................................................
Emanuel County, Georgia .........................................................................
Evans County, Georgia .............................................................................
Fannin County, Georgia ............................................................................
Fayette County, Georgia ...........................................................................
Floyd County, Georgia ..............................................................................
Forsyth County, Georgia ...........................................................................
Franklin County, Georgia ..........................................................................
Fulton County, Georgia .............................................................................
Gilmer County, Georgia ............................................................................
Glascock County, Georgia ........................................................................
Glynn County, Georgia ..............................................................................
Gordon County, Georgia ...........................................................................
Grady County, Georgia .............................................................................
Greene County, Georgia ...........................................................................
Gwinnett County, Georgia .........................................................................
Habersham County, Georgia ....................................................................
Hall County, Georgia .................................................................................
Hancock County, Georgia .........................................................................
Haralson County, Georgia .........................................................................
Harris County, Georgia .............................................................................
Hart County, Georgia ................................................................................
Heard County, Georgia .............................................................................
Henry County, Georgia .............................................................................
Houston County, Georgia ..........................................................................
Irwin County, Georgia ...............................................................................
Jackson County, Georgia ..........................................................................
Jasper County, Georgia ............................................................................
Jeff Davis County, Georgia .......................................................................
Jefferson County, Georgia ........................................................................
Jenkins County, Georgia ...........................................................................
Johnson County, Georgia .........................................................................
Jones County, Georgia .............................................................................
Lamar County, Georgia .............................................................................
Lanier County, Georgia .............................................................................
Laurens County, Georgia ..........................................................................
Lee County, Georgia .................................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00058
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9793
0.9088
0.7914
0.9461
0.8560
0.7914
0.9793
0.9855
0.7914
0.9793
0.7914
0.9793
0.7914
0.7914
0.9778
0.7914
0.9793
0.8805
0.7914
0.9088
0.8980
0.7914
0.9793
0.7914
0.7914
0.8628
0.9793
0.7914
0.8516
0.9461
0.7914
0.7914
0.7914
0.7914
0.9793
0.8790
0.9793
0.7914
0.9793
0.7914
0.7914
0.8739
0.7914
0.7914
0.7914
0.9793
0.7914
0.8520
0.7914
0.8980
0.8560
0.7914
0.8980
0.9793
0.8961
0.7914
0.7914
0.8980
0.7914
0.7914
0.7914
0.7914
0.9360
0.8980
0.8516
0.7914
0.8628
0.9772
0.8963
0.7560
0.9087
0.8254
0.7560
0.9772
0.9857
0.7560
0.9772
0.7560
0.9772
0.7560
0.7560
0.9678
0.7560
0.9772
0.9518
0.7560
0.8963
0.9772
0.7560
0.9772
0.7560
0.7560
0.8962
0.9772
0.7560
0.8344
0.9087
0.7560
0.7560
0.7560
0.7560
0.9772
0.9316
0.9772
0.7560
0.9772
0.7560
0.7560
1.0097
0.7560
0.7560
0.7560
0.9772
0.7560
0.8974
0.7560
0.9772
0.8254
0.7560
0.9772
0.9772
0.8394
0.7560
0.7560
0.9772
0.7560
0.7560
0.7560
0.7560
0.9518
0.9772
0.8344
0.7560
0.8962
-0.21
-1.38
-4.47
-3.95
-3.57
-4.47
-0.21
0.02
-4.47
-0.21
-4.47
-0.21
-4.47
-4.47
-1.02
-4.47
-0.21
8.10
-4.47
-1.38
8.82
-4.47
-0.21
-4.47
-4.47
3.87
-0.21
-4.47
-2.02
-3.95
-4.47
-4.47
-4.47
-4.47
-0.21
5.98
-0.21
-4.47
-0.21
-4.47
-4.47
15.54
-4.47
-4.47
-4.47
-0.21
-4.47
5.33
-4.47
8.82
-3.57
-4.47
8.82
-0.21
-6.33
-4.47
-4.47
8.82
-4.47
-4.47
-4.47
-4.47
1.69
8.82
-2.02
-4.47
3.87
12060
16860
99911
42340
17980
99911
12060
12020
99911
12060
99911
12060
99911
99911
12260
99911
12060
31420
99911
16860
12060
99911
12060
99911
99911
10500
12060
99911
46660
42340
99911
99911
99911
99911
12060
40660
12060
99911
12060
99911
99911
15260
99911
99911
99911
12060
99911
23580
99911
12060
17980
99911
12060
12060
47580
99911
99911
12060
99911
99911
99911
99911
31420
12060
46660
99911
10500
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44139
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
11680
11690
11691
11700
11701
11702
11703
11710
11720
11730
11740
11741
11750
11760
11770
11771
11772
11780
11790
11800
11801
11810
11811
11812
11820
11821
11830
11831
11832
11833
11834
11835
11840
11841
11842
11850
11851
11860
11861
11862
11870
11880
11881
11882
11883
11884
11885
11890
11900
11901
11902
11903
11910
11911
11912
11913
11920
11921
11930
11940
11941
11950
11960
11961
11962
11963
11970
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Liberty County, Georgia ............................................................................
Lincoln County, Georgia ............................................................................
Long County, Georgia ...............................................................................
Lowndes County, Georgia .........................................................................
Lumpkin County, Georgia .........................................................................
Mc Duffie County, Georgia ........................................................................
Mc Intosh County, Georgia .......................................................................
Macon County, Georgia ............................................................................
Madison County, Georgia .........................................................................
Marion County, Georgia ............................................................................
Meriwether County, Georgia .....................................................................
Miller County, Georgia ..............................................................................
Mitchell County, Georgia ...........................................................................
Monroe County, Georgia ...........................................................................
Montgomery County, Georgia ...................................................................
Morgan County, Georgia ...........................................................................
Murray County, Georgia ............................................................................
Muscogee County, Georgia ......................................................................
Newton County, Georgia ...........................................................................
Oconee County, Georgia ..........................................................................
Oglethorpe County, Georgia .....................................................................
Paulding County, Georgia .........................................................................
Peach County, Georgia .............................................................................
Pickens County, Georgia ..........................................................................
Pierce County, Georgia .............................................................................
Pike County, Georgia ................................................................................
Polk County, Georgia ................................................................................
Pulaski County, Georgia ...........................................................................
Putnam County, Georgia ...........................................................................
Quitman County, Georgia .........................................................................
Rabun County, Georgia ............................................................................
Randolph County, Georgia ........................................................................
Richmond County, Georgia .......................................................................
Rockdale County, Georgia ........................................................................
Schley County, Georgia ............................................................................
Screven County, Georgia ..........................................................................
Seminole County, Georgia ........................................................................
Spalding County, Georgia .........................................................................
Stephens County, Georgia ........................................................................
Stewart County, Georgia ...........................................................................
Sumter County, Georgia ...........................................................................
Talbot County, Georgia .............................................................................
Taliaferro County, Georgia ........................................................................
Tattnall County, Georgia ...........................................................................
Taylor County, Georgia .............................................................................
Telfair County, Georgia .............................................................................
Terrell County, Georgia .............................................................................
Thomas County, Georgia ..........................................................................
Tift County, Georgia ..................................................................................
Toombs County, Georgia ..........................................................................
Towns County, Georgia ............................................................................
Treutlen County, Georgia ..........................................................................
Troup County, Georgia ..............................................................................
Turner County, Georgia ............................................................................
Twiggs County, Georgia ............................................................................
Union County, Georgia ..............................................................................
Upson County, Georgia .............................................................................
Walker County, Georgia ............................................................................
Walton County, Georgia ............................................................................
Ware County, Georgia ..............................................................................
Warren County, Georgia ...........................................................................
Washington County, Georgia ....................................................................
Wayne County, Georgia ............................................................................
Webster County, Georgia ..........................................................................
Wheeler County, Georgia ..........................................................................
White County, Georgia ..............................................................................
Whitfield County, Georgia .........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00059
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8973
0.7914
0.8973
0.8516
0.7914
0.9778
0.8739
0.7914
0.9855
0.8363
0.8980
0.7914
0.7914
0.8805
0.7914
0.7914
0.8623
0.8560
0.9793
0.9855
0.9011
0.9793
0.8470
0.9793
0.7914
0.8980
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.9778
0.9793
0.7914
0.7914
0.7914
0.9793
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.8397
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.9360
0.7914
0.7914
0.9088
0.9793
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.7914
0.8623
0.9163
0.7560
0.9163
0.8344
0.7560
0.9678
1.0097
0.7560
0.9857
0.8254
0.9772
0.7560
0.7560
0.9518
0.7560
0.7560
0.9061
0.8254
0.9772
0.9857
0.9857
0.9772
0.7560
0.9772
0.7560
0.9772
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.9678
0.9772
0.7560
0.7560
0.7560
0.9772
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.8962
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.9518
0.7560
0.7560
0.8963
0.9772
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.7560
0.9061
2.12
-4.47
2.12
-2.02
-4.47
-1.02
15.54
-4.47
0.02
-1.30
8.82
-4.47
-4.47
8.10
-4.47
-4.47
5.08
-3.57
-0.21
0.02
9.39
-0.21
-10.74
-0.21
-4.47
8.82
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
-1.02
-0.21
-4.47
-4.47
-4.47
-0.21
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
6.73
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
1.69
-4.47
-4.47
-1.38
-0.21
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
-4.47
5.08
25980
99911
25980
46660
99911
12260
15260
99911
12020
17980
12060
99911
99911
31420
99911
99911
19140
17980
12060
12020
12020
12060
99911
12060
99911
12060
99911
99911
99911
99911
99911
99911
12260
12060
99911
99911
99911
12060
99911
99911
99911
99911
99911
99911
99911
99911
10500
99911
99911
99911
99911
99911
99911
99911
31420
99911
99911
16860
12060
99911
99911
99911
99911
99911
99911
99911
19140
E:\FR\FM\03AUP2.SGM
03AUP2
44140
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
11971
11972
11973
11980
12005
12010
12020
12040
12050
13000
13010
13020
13030
13040
13050
13060
13070
13080
13090
13100
13110
13120
13130
13140
13150
13160
13170
13180
13190
13200
13210
13220
13230
13240
13250
13260
13270
13280
13290
13300
13310
13320
13330
13340
13350
13360
13370
13380
13390
13400
13410
13420
13430
14000
14010
14020
14030
14040
14050
14060
14070
14080
14090
14100
14110
14120
14130
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Wilcox County, Georgia ............................................................................
Wilkes County, Georgia ............................................................................
Wilkinson County, Georgia ........................................................................
Worth County, Georgia .............................................................................
Kalawao County, Hawaii ...........................................................................
Hawaii County, Hawaii ..............................................................................
Honolulu County, Hawaii ...........................................................................
Kauai County, Hawaii ................................................................................
Maui County, Hawaii .................................................................................
Ada County, Idaho ....................................................................................
Adams County, Idaho ................................................................................
Bannock County, Idaho .............................................................................
Bear Lake County, Idaho ..........................................................................
Benewah County, Idaho ............................................................................
Bingham County, Idaho .............................................................................
Blaine County, Idaho .................................................................................
Boise County, Idaho ..................................................................................
Bonner County, Idaho ...............................................................................
Bonneville County, Idaho ..........................................................................
Boundary County, Idaho ...........................................................................
Butte County, Idaho ..................................................................................
Camas County, Idaho ...............................................................................
Canyon County, Idaho ..............................................................................
Caribou County, Idaho ..............................................................................
Cassia County, Idaho ................................................................................
Clark County, Idaho ..................................................................................
Clearwater County, Idaho .........................................................................
Custer County, Idaho ................................................................................
Elmore County, Idaho ...............................................................................
Franklin County, Idaho ..............................................................................
Fremont County, Idaho .............................................................................
Gem County, Idaho ...................................................................................
Gooding County, Idaho .............................................................................
Idaho County, Idaho ..................................................................................
Jefferson County, Idaho ............................................................................
Jerome County, Idaho ...............................................................................
Kootenai County, Idaho .............................................................................
Latah County, Idaho ..................................................................................
Lemhi County, Idaho .................................................................................
Lewis County, Idaho ..................................................................................
Lincoln County, Idaho ...............................................................................
Madison County, Idaho .............................................................................
Minidoka County, Idaho ............................................................................
Nez Perce County, Idaho ..........................................................................
Oneida County, Idaho ...............................................................................
Owyhee County, Idaho ..............................................................................
Payette County, Idaho ...............................................................................
Power County, Idaho .................................................................................
Shoshone County, Idaho ...........................................................................
Teton County, Idaho ..................................................................................
Twin Falls County, Idaho ..........................................................................
Valley County, Idaho .................................................................................
Washington County, Idaho ........................................................................
Adams County, Illinois ...............................................................................
Alexander County, Illinois ..........................................................................
Bond County, Illinois .................................................................................
Boone County, Illinois ...............................................................................
Brown County, Illinois ................................................................................
Bureau County, Illinois ..............................................................................
Calhoun County, Illinois ............................................................................
Carroll County, Illinois ...............................................................................
Cass County, Illinois ..................................................................................
Champaign County, Illinois .......................................................................
Christian County, Illinois ............................................................................
Clark County, Illinois .................................................................................
Clay County, Illinois ...................................................................................
Clinton County, Illinois ...............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00060
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7914
0.7914
0.7914
0.8397
1.0551
1.0551
1.1214
1.0551
1.0551
0.9052
0.8567
0.9351
0.8567
0.8567
0.8567
0.8567
0.9075
0.8567
0.9259
0.8567
0.8567
0.8567
0.9052
0.8567
0.8567
0.8567
0.8567
0.8567
0.8567
0.9131
0.8567
0.9075
0.8567
0.8567
0.9259
0.8567
0.9372
0.8567
0.8567
0.8567
0.8567
0.8567
0.8567
0.9492
0.8567
0.9075
0.8567
0.9224
0.8567
0.8567
0.8567
0.8567
0.8567
0.8286
0.8286
0.8628
0.9984
0.8286
0.8286
0.8628
0.8286
0.8286
0.9594
0.8286
0.8286
0.8286
0.8958
0.7560
0.7560
0.7560
0.8962
1.0467
1.0467
1.1067
1.0467
1.0467
0.9417
0.8134
0.9417
0.8134
0.8134
0.8134
0.8134
0.9417
0.8134
0.9104
0.8134
0.8134
0.8134
0.9417
0.8134
0.8134
0.8134
0.8134
0.8134
0.8134
0.9038
0.8134
0.9417
0.8134
0.8134
0.9104
0.8134
0.9360
0.8134
0.8134
0.8134
0.8134
0.8134
0.8134
0.9871
0.8134
0.9417
0.8134
0.9417
0.8134
0.8134
0.8134
0.8134
0.8134
0.8327
0.8327
0.9013
1.0007
0.8327
0.8327
0.9013
0.8327
0.8327
0.9661
0.8327
0.8327
0.8327
0.9013
-4.47
-4.47
-4.47
6.73
-0.80
-0.80
-1.31
-0.80
-0.80
4.03
-5.05
0.71
-5.05
-5.05
-5.05
-5.05
3.77
-5.05
-1.67
-5.05
-5.05
-5.05
4.03
-5.05
-5.05
-5.05
-5.05
-5.05
-5.05
-1.02
-5.05
3.77
-5.05
-5.05
-1.67
-5.05
-0.13
-5.05
-5.05
-5.05
-5.05
-5.05
-5.05
3.99
-5.05
3.77
-5.05
2.09
-5.05
-5.05
-5.05
-5.05
-5.05
0.49
0.49
4.46
0.23
0.49
0.49
4.46
0.49
0.49
0.70
0.49
0.49
0.49
0.61
99911
99911
99911
10500
99912
99912
26180
99912
99912
14260
99913
38540
99913
99913
99913
99913
14260
99913
26820
99913
99913
99913
14260
99913
99913
99913
99913
99913
99913
30860
99913
14260
99913
99913
26820
99913
17660
99913
99913
99913
99913
99913
99913
30300
99913
14260
99913
38540
99913
99913
99913
99913
99913
99914
99914
41180
40420
99914
99914
41180
99914
99914
16580
99914
99914
99914
41180
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44141
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
14140
14141
14150
14160
14170
14180
14190
14250
14310
14320
14330
14340
14350
14360
14370
14380
14390
14400
14410
14420
14421
14440
14450
14460
14470
14480
14490
14500
14510
14520
14530
14540
14550
14560
14570
14580
14590
14600
14610
14620
14630
14640
14650
14660
14670
14680
14690
14700
14710
14720
14730
14740
14750
14760
14770
14780
14790
14800
14810
14820
14830
14831
14850
14860
14870
14880
14890
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Coles County, Illinois .................................................................................
Cook County, Illinois .................................................................................
Crawford County, Illinois ...........................................................................
Cumberland County, Illinois ......................................................................
De Kalb County, Illinois .............................................................................
De Witt County, Illinois ..............................................................................
Douglas County, Illinois .............................................................................
Du Page County, Illinois ............................................................................
Edgar County, Illinois ................................................................................
Edwards County, Illinois ............................................................................
Effingham County, Illinois ..........................................................................
Fayette County, Illinois ..............................................................................
Ford County, Illinois ..................................................................................
Franklin County, Illinois .............................................................................
Fulton County, Illinois ................................................................................
Gallatin County, Illinois ..............................................................................
Greene County, Illinois ..............................................................................
Grundy County, Illinois ..............................................................................
Hamilton County, Illinois ............................................................................
Hancock County, Illinois ............................................................................
Hardin County, Illinois ...............................................................................
Henderson County, Illinois ........................................................................
Henry County, Illinois ................................................................................
Iroquois County, Illinois .............................................................................
Jackson County, Illinois .............................................................................
Jasper County, Illinois ...............................................................................
Jefferson County, Illinois ...........................................................................
Jersey County, Illinois ...............................................................................
Jo Daviess County, Illinois ........................................................................
Johnson County, Illinois ............................................................................
Kane County, Illinois .................................................................................
Kankakee County, Illinois ..........................................................................
Kendall County, Illinois ..............................................................................
Knox County, Illinois ..................................................................................
Lake County, Illinois ..................................................................................
La Salle County, Illinois .............................................................................
Lawrence County, Illinois ..........................................................................
Lee County, Illinois ....................................................................................
Livingston County, Illinois ..........................................................................
Logan County, Illinois ................................................................................
Mc Donough County, Illinois .....................................................................
Mc Henry County, Illinois ..........................................................................
Mclean County, Illinois ..............................................................................
Macon County, Illinois ...............................................................................
Macoupin County, Illinois ..........................................................................
Madison County, Illinois ............................................................................
Marion County, Illinois ...............................................................................
Marshall County, Illinois ............................................................................
Mason County, Illinois ...............................................................................
Massac County, Illinois .............................................................................
Menard County, Illinois ..............................................................................
Mercer County, Illinois ...............................................................................
Monroe County, Illinois ..............................................................................
Montgomery County, Illinois ......................................................................
Morgan County, Illinois ..............................................................................
Moultrie County, Illinois .............................................................................
Ogle County, Illinois ..................................................................................
Peoria County, Illinois ...............................................................................
Perry County, Illinois .................................................................................
Piatt County, Illinois ...................................................................................
Pike County, Illinois ...................................................................................
Pope County, Illinois .................................................................................
Pulaski County, Illinois ..............................................................................
Putnam County, Illinois .............................................................................
Randolph County, Illinois ..........................................................................
Richland County, Illinois ............................................................................
Rock Island County, Illinois .......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00061
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8286
1.0787
0.8286
0.8286
1.0787
0.8286
0.8286
1.0787
0.8286
0.8286
0.8286
0.8286
0.8948
0.8286
0.8286
0.8286
0.8286
1.0787
0.8286
0.8286
0.8286
0.8286
0.8724
0.8286
0.8286
0.8286
0.8286
0.8958
0.8286
0.8286
1.0787
1.0721
1.0787
0.8286
1.0606
0.8286
0.8286
0.8286
0.8286
0.8286
0.8286
1.0787
0.9075
0.8067
0.8628
0.8958
0.8286
0.8586
0.8286
0.8286
0.8792
0.8513
0.8958
0.8286
0.8286
0.8286
0.9128
0.8870
0.8286
0.8948
0.8286
0.8286
0.8286
0.8286
0.8286
0.8286
0.8724
0.8327
1.0745
0.8327
0.8327
1.0745
0.8327
0.8327
1.0745
0.8327
0.8327
0.8327
0.8327
0.9661
0.8327
0.8327
0.8327
0.8327
1.0745
0.8327
0.8327
0.8327
0.8327
0.8557
0.8327
0.8327
0.8327
0.8327
0.9013
0.8327
0.8327
1.0745
0.9990
1.0745
0.8327
1.0406
0.8327
0.8327
0.8327
0.8327
0.8327
0.8327
1.0745
0.8960
0.8187
0.9013
0.9013
0.8327
0.8998
0.8327
0.8327
0.8905
0.8557
0.9013
0.8327
0.8327
0.8327
0.8327
0.8998
0.8327
0.9661
0.8327
0.8327
0.8327
0.8327
0.8327
0.8327
0.8557
0.49
-0.39
0.49
0.49
-0.39
0.49
0.49
-0.39
0.49
0.49
0.49
0.49
7.97
0.49
0.49
0.49
0.49
-0.39
0.49
0.49
0.49
0.49
-1.91
0.49
0.49
0.49
0.49
0.61
0.49
0.49
-0.39
-6.82
-0.39
0.49
-1.89
0.49
0.49
0.49
0.49
0.49
0.49
-0.39
-1.27
1.49
4.46
0.61
0.49
4.80
0.49
0.49
1.29
0.52
0.61
0.49
0.49
0.49
-8.78
1.44
0.49
7.97
0.49
0.49
0.49
0.49
0.49
0.49
-1.91
99914
16974
99914
99914
16974
99914
99914
16974
99914
99914
99914
99914
16580
99914
99914
99914
99914
16974
99914
99914
99914
99914
19340
99914
99914
99914
99914
41180
99914
99914
16974
28100
16974
99914
29404
99914
99914
99914
99914
99914
99914
16974
14060
19500
41180
41180
99914
37900
99914
99914
44100
19340
41180
99914
99914
99914
99914
37900
99914
16580
99914
99914
99914
99914
99914
99914
19340
E:\FR\FM\03AUP2.SGM
03AUP2
44142
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
14900
14910
14920
14921
14940
14950
14960
14970
14980
14981
14982
14983
14984
14985
14986
14987
14988
14989
14990
14991
14992
15000
15010
15020
15030
15040
15050
15060
15070
15080
15090
15100
15110
15120
15130
15140
15150
15160
15170
15180
15190
15200
15210
15220
15230
15240
15250
15260
15270
15280
15290
15300
15310
15320
15330
15340
15350
15360
15370
15380
15390
15400
15410
15420
15430
15440
15450
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
St Clair County, Illinois ..............................................................................
Saline County, Illinois ................................................................................
Sangamon County, Illinois ........................................................................
Schuyler County, Illinois ............................................................................
Scott County, Illinois ..................................................................................
Shelby County, Illinois ...............................................................................
Stark County, Illinois .................................................................................
Stephenson County, Illinois .......................................................................
Tazewell County, Illinois ............................................................................
Union County, Illinois ................................................................................
Vermilion County, Illinois ...........................................................................
Wabash County, Illinois .............................................................................
Warren County, Illinois ..............................................................................
Washington County, Illinois .......................................................................
Wayne County, Illinois ...............................................................................
White County, Illinois .................................................................................
Whiteside County, Illinois ..........................................................................
Will County, Illinois ....................................................................................
Williamson County, Illinois ........................................................................
Winnebago County, Illinois ........................................................................
Woodford County, Illinois ..........................................................................
Adams County, Indiana .............................................................................
Allen County, Indiana ................................................................................
Bartholomew County, Indiana ...................................................................
Benton County, Indiana .............................................................................
Blackford County, Indiana .........................................................................
Boone County, Indiana ..............................................................................
Brown County, Indiana ..............................................................................
Carroll County, Indiana .............................................................................
Cass County, Indiana ................................................................................
Clark County, Indiana ................................................................................
Clay County, Indiana .................................................................................
Clinton County, Indiana .............................................................................
Crawford County, Indiana .........................................................................
Daviess County, Indiana ...........................................................................
Dearborn County, Indiana .........................................................................
Decatur County, Indiana ...........................................................................
De Kalb County, Indiana ...........................................................................
Delaware County, Indiana .........................................................................
Dubois County, Indiana .............................................................................
Elkhart County, Indiana .............................................................................
Fayette County, Indiana ............................................................................
Floyd County, Indiana ...............................................................................
Fountain County, Indiana ..........................................................................
Franklin County, Indiana ...........................................................................
Fulton County, Indiana ..............................................................................
Gibson County, Indiana .............................................................................
Grant County, Indiana ...............................................................................
Greene County, Indiana ............................................................................
Hamilton County, Indiana ..........................................................................
Hancock County, Indiana ..........................................................................
Harrison County, Indiana ..........................................................................
Hendricks County, Indiana ........................................................................
Henry County, Indiana ..............................................................................
Howard County, Indiana ............................................................................
Huntington County, Indiana .......................................................................
Jackson County, Indiana ...........................................................................
Jasper County, Indiana .............................................................................
Jay County, Indiana ..................................................................................
Jefferson County, Indiana .........................................................................
Jennings County, Indiana ..........................................................................
Johnson County, Indiana ..........................................................................
Knox County, Indiana ................................................................................
Kosciusko County, Indiana ........................................................................
Lagrange County, Indiana .........................................................................
Lake County, Indiana ................................................................................
La Porte County, Indiana ..........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00062
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8958
0.8286
0.8792
0.8286
0.8286
0.8286
0.8586
0.8286
0.8870
0.8286
0.8665
0.8286
0.8286
0.8286
0.8286
0.8286
0.8286
1.0787
0.8286
0.9984
0.8870
0.9165
0.9750
0.9164
0.8738
0.8682
0.9893
0.9330
0.8738
0.8682
0.9272
0.8321
0.8680
0.8682
0.8682
0.9675
0.8682
0.9165
0.8930
0.8682
0.9627
0.8682
0.9272
0.8682
0.9177
0.8682
0.8726
0.8682
0.8593
0.9893
0.9893
0.9272
0.9893
0.8682
0.9508
0.9165
0.8682
0.9067
0.8682
0.8682
0.8682
0.9893
0.8682
0.8682
0.8682
0.9395
0.9069
0.9013
0.8327
0.8905
0.8327
0.8327
0.8327
0.8998
0.8327
0.8998
0.8327
0.9283
0.8327
0.8327
0.8327
0.8327
0.8327
0.8327
1.0745
0.8327
1.0007
0.8998
0.8477
0.9504
0.9334
0.8972
0.8477
0.9766
0.9766
0.8972
0.8477
0.9135
0.8661
0.8477
0.8477
0.8477
0.9617
0.8477
0.8477
0.8299
0.8477
0.9442
0.8477
0.9135
0.8477
0.9617
0.8477
0.8830
0.8477
0.8548
0.9766
0.9766
0.9135
0.9766
0.8477
0.9460
0.8477
0.8477
0.9281
0.8477
0.8477
0.8477
0.9766
0.8477
0.8477
0.8477
0.9281
0.9093
0.61
0.49
1.29
0.49
0.49
0.49
4.80
0.49
1.44
0.49
7.13
0.49
0.49
0.49
0.49
0.49
0.49
-0.39
0.49
0.23
1.44
-7.51
-2.52
1.86
2.68
-2.36
-1.28
4.67
2.68
-2.36
-1.48
4.09
-2.34
-2.36
-2.36
-0.60
-2.36
-7.51
-7.07
-2.36
-1.92
-2.36
-1.48
-2.36
4.79
-2.36
1.19
-2.36
-0.52
-1.28
-1.28
-1.48
-1.28
-2.36
-0.50
-7.51
-2.36
2.36
-2.36
-2.36
-2.36
-1.28
-2.36
-2.36
-2.36
-1.21
0.26
41180
99914
44100
99914
99914
99914
37900
99914
37900
99914
19180
99914
99914
99914
99914
99914
99914
16974
99914
40420
37900
99915
23060
18020
29140
99915
26900
26900
29140
99915
31140
45460
99915
99915
99915
17140
99915
99915
34620
99915
21140
99915
31140
99915
17140
99915
21780
99915
14020
26900
26900
31140
26900
99915
29020
99915
99915
23844
99915
99915
99915
26900
99915
99915
99915
23844
33140
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44143
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
15460
15470
15480
15490
15500
15510
15520
15530
15540
15550
15560
15570
15580
15590
15600
15610
15620
15630
15640
15650
15660
15670
15680
15690
15700
15710
15720
15730
15740
15750
15760
15770
15780
15790
15800
15810
15820
15830
15840
15850
15860
15870
15880
15890
15900
15910
16000
16010
16020
16030
16040
16050
16060
16070
16080
16090
16100
16110
16120
16130
16140
16150
16160
16170
16180
16190
16200
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Lawrence County, Indiana ........................................................................
Madison County, Indiana ..........................................................................
Marion County, Indiana .............................................................................
Marshall County, Indiana ..........................................................................
Martin County, Indiana ..............................................................................
Miami County, Indiana ..............................................................................
Monroe County, Indiana ............................................................................
Montgomery County, Indiana ....................................................................
Morgan County, Indiana ............................................................................
Newton County, Indiana ............................................................................
Noble County, Indiana ...............................................................................
Ohio County, Indiana ................................................................................
Orange County, Indiana ............................................................................
Owen County, Indiana ...............................................................................
Parke County, Indiana ...............................................................................
Perry County, Indiana ...............................................................................
Pike County, Indiana .................................................................................
Porter County, Indiana ..............................................................................
Posey County, Indiana ..............................................................................
Pulaski County, Indiana ............................................................................
Putnam County, Indiana ............................................................................
Randolph County, Indiana .........................................................................
Ripley County, Indiana ..............................................................................
Rush County, Indiana ................................................................................
St Joseph County, Indiana ........................................................................
Scott County, Indiana ................................................................................
Shelby County, Indiana .............................................................................
Spencer County, Indiana ...........................................................................
Starke County, Indiana ..............................................................................
Steuben County, Indiana ...........................................................................
Sullivan County, Indiana ...........................................................................
Switzerland County, Indiana .....................................................................
Tippecanoe County, Indiana .....................................................................
Tipton County, Indiana ..............................................................................
Union County, Indiana ...............................................................................
Vanderburgh County, Indiana ...................................................................
Vermillion County, Indiana ........................................................................
Vigo County, Indiana .................................................................................
Wabash County, Indiana ...........................................................................
Warren County, Indiana ............................................................................
Warrick County, Indiana ............................................................................
Washington County, Indiana .....................................................................
Wayne County, Indiana .............................................................................
Wells County, Indiana ...............................................................................
White County, Indiana ...............................................................................
Whitley County, Indiana ............................................................................
Adair County, Iowa ....................................................................................
Adams County, Iowa .................................................................................
Allamakee County, Iowa ...........................................................................
Appanoose County, Iowa ..........................................................................
Audubon County, Iowa ..............................................................................
Benton County, Iowa .................................................................................
Black Hawk County, Iowa .........................................................................
Boone County, Iowa ..................................................................................
Bremer County, Iowa ................................................................................
Buchanan County, Iowa ............................................................................
Buena Vista County, Iowa .........................................................................
Butler County, Iowa ...................................................................................
Calhoun County, Iowa ...............................................................................
Carroll County, Iowa ..................................................................................
Cass County, Iowa ....................................................................................
Cedar County, Iowa ..................................................................................
Cerro Gordo County, Iowa ........................................................................
Cherokee County, Iowa .............................................................................
Chickasaw County, Iowa ...........................................................................
Clarke County, Iowa ..................................................................................
Clay County, Iowa .....................................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00063
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8682
0.9226
0.9893
0.8682
0.8682
0.8682
0.8447
0.8682
0.9893
0.9067
0.8682
0.9675
0.8682
0.8593
0.8682
0.8682
0.8682
0.9395
0.8713
0.8682
0.9330
0.8682
0.8682
0.8682
0.9788
0.8959
0.9893
0.8682
0.8682
0.8682
0.8522
0.8682
0.8736
0.9508
0.8682
0.8713
0.8321
0.8321
0.8682
0.8682
0.8713
0.8995
0.8682
0.9750
0.8682
0.9750
0.8552
0.8552
0.8552
0.8552
0.8552
0.8710
0.8557
0.8552
0.8576
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8477
0.8790
0.9766
0.8477
0.8477
0.8477
0.8548
0.8477
0.9766
0.9281
0.8477
0.9617
0.8477
0.8548
0.8477
0.8477
0.8477
0.9281
0.8830
0.8477
0.9766
0.8477
0.8477
0.8477
0.9690
0.8477
0.9766
0.8477
0.8477
0.8477
0.8661
0.8477
0.8972
0.9460
0.8477
0.8830
0.8661
0.8661
0.8477
0.8477
0.8830
0.9135
0.8477
0.9504
0.8477
0.9504
0.8697
0.8697
0.8697
0.8697
0.8697
0.8903
0.8422
0.8697
0.8422
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
-2.36
-4.73
-1.28
-2.36
-2.36
-2.36
1.20
-2.36
-1.28
2.36
-2.36
-0.60
-2.36
-0.52
-2.36
-2.36
-2.36
-1.21
1.34
-2.36
4.67
-2.36
-2.36
-2.36
-1.00
-5.38
-1.28
-2.36
-2.36
-2.36
1.63
-2.36
2.70
-0.50
-2.36
1.34
4.09
4.09
-2.36
-2.36
1.34
1.56
-2.36
-2.52
-2.36
-2.52
1.70
1.70
1.70
1.70
1.70
2.22
-1.58
1.70
-1.80
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
99915
11300
26900
99915
99915
99915
14020
99915
26900
23844
99915
17140
99915
14020
99915
99915
99915
23844
21780
99915
26900
99915
99915
99915
43780
99915
26900
99915
99915
99915
45460
99915
29140
29020
99915
21780
45460
45460
99915
99915
21780
31140
99915
23060
99915
23060
99916
99916
99916
99916
99916
16300
47940
99916
47940
99916
99916
99916
99916
99916
99916
99916
99916
99916
99916
99916
99916
E:\FR\FM\03AUP2.SGM
03AUP2
44144
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
16210
16220
16230
16240
16250
16260
16270
16280
16290
16300
16310
16320
16330
16340
16350
16360
16370
16380
16390
16400
16410
16420
16430
16440
16450
16460
16470
16480
16490
16500
16510
16520
16530
16540
16550
16560
16570
16580
16590
16600
16610
16620
16630
16640
16650
16660
16670
16680
16690
16700
16710
16720
16730
16740
16750
16760
16770
16780
16790
16800
16810
16820
16830
16840
16850
16860
16870
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Clayton County, Iowa ................................................................................
Clinton County, Iowa .................................................................................
Crawford County, Iowa ..............................................................................
Dallas County, Iowa ..................................................................................
Davis County, Iowa ...................................................................................
Decatur County, Iowa ................................................................................
Delaware County, Iowa .............................................................................
Des Moines County, Iowa .........................................................................
Dickinson County, Iowa .............................................................................
Dubuque County, Iowa ..............................................................................
Emmet County, Iowa .................................................................................
Fayette County, Iowa ................................................................................
Floyd County, Iowa ...................................................................................
Franklin County, Iowa ...............................................................................
Fremont County, Iowa ...............................................................................
Greene County, Iowa ................................................................................
Grundy County, Iowa ................................................................................
Guthrie County, Iowa ................................................................................
Hamilton County, Iowa ..............................................................................
Hancock County, Iowa ..............................................................................
Hardin County, Iowa ..................................................................................
Harrison County, Iowa ...............................................................................
Henry County, Iowa ...................................................................................
Howard County, Iowa ................................................................................
Humboldt County, Iowa .............................................................................
Ida County, Iowa .......................................................................................
Iowa County, Iowa .....................................................................................
Jackson County, Iowa ...............................................................................
Jasper County, Iowa .................................................................................
Jefferson County, Iowa .............................................................................
Johnson County, Iowa ...............................................................................
Jones County, Iowa ...................................................................................
Keokuk County, Iowa ................................................................................
Kossuth County, Iowa ...............................................................................
Lee County, Iowa ......................................................................................
Linn County, Iowa .....................................................................................
Louisa County, Iowa ..................................................................................
Lucas County, Iowa ...................................................................................
Lyon County, Iowa ....................................................................................
Madison County, Iowa ...............................................................................
Mahaska County, Iowa ..............................................................................
Marion County, Iowa .................................................................................
Marshall County, Iowa ...............................................................................
Mills County, Iowa .....................................................................................
Mitchell County, Iowa ................................................................................
Monona County, Iowa ...............................................................................
Monroe County, Iowa ................................................................................
Montgomery County, Iowa ........................................................................
Muscatine County, Iowa ............................................................................
O Brien County, Iowa ................................................................................
Osceola County, Iowa ...............................................................................
Page County, Iowa ....................................................................................
Palo Alto County, Iowa ..............................................................................
Plymouth County, Iowa .............................................................................
Pocahontas County, Iowa .........................................................................
Polk County, Iowa .....................................................................................
Pottawattamie County, Iowa .....................................................................
Poweshiek County, Iowa ...........................................................................
Ringgold County, Iowa ..............................................................................
Sac County, Iowa ......................................................................................
Scott County, Iowa ....................................................................................
Shelby County, Iowa .................................................................................
Sioux County, Iowa ...................................................................................
Story County, Iowa ....................................................................................
Tama County, Iowa ...................................................................................
Taylor County, Iowa ..................................................................................
Union County, Iowa ...................................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00064
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8552
0.8552
0.8552
0.9669
0.8552
0.8552
0.8552
0.8552
0.8552
0.9024
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8576
0.9132
0.8552
0.8552
0.8552
0.9077
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.9747
0.8710
0.8552
0.8552
0.8552
0.8825
0.8552
0.8552
0.8552
0.9132
0.8552
0.8552
0.8552
0.9077
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.8552
0.9669
0.9560
0.8552
0.8552
0.8552
0.8724
0.8552
0.8552
0.9065
0.8552
0.8552
0.8552
0.8697
0.8697
0.8697
0.9136
0.8697
0.8697
0.8697
0.8697
0.8697
0.9150
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8422
0.9136
0.8697
0.8697
0.8697
0.9467
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.9731
0.8903
0.8697
0.8697
0.8697
0.8903
0.8697
0.8697
0.8697
0.9136
0.8697
0.8697
0.8697
0.9467
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.8697
0.9136
0.9467
0.8697
0.8697
0.8697
0.8557
0.8697
0.8697
0.9777
0.8697
0.8697
0.8697
1.70
1.70
1.70
-5.51
1.70
1.70
1.70
1.70
1.70
1.40
1.70
1.70
1.70
1.70
1.70
1.70
-1.80
0.04
1.70
1.70
1.70
4.30
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
-0.16
2.22
1.70
1.70
1.70
0.88
1.70
1.70
1.70
0.04
1.70
1.70
1.70
4.30
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
-5.51
-0.97
1.70
1.70
1.70
-1.91
1.70
1.70
7.85
1.70
1.70
1.70
99916
99916
99916
19780
99916
99916
99916
99916
99916
20220
99916
99916
99916
99916
99916
99916
47940
19780
99916
99916
99916
36540
99916
99916
99916
99916
99916
99916
99916
99916
26980
16300
99916
99916
99916
16300
99916
99916
99916
19780
99916
99916
99916
36540
99916
99916
99916
99916
99916
99916
99916
99916
99916
99916
99916
19780
36540
99916
99916
99916
19340
99916
99916
11180
99916
99916
99916
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44145
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
16880
16890
16900
16910
16920
16930
16940
16950
16960
16970
16980
17000
17010
17020
17030
17040
17050
17060
17070
17080
17090
17100
17110
17120
17130
17140
17150
17160
17170
17180
17190
17200
17210
17220
17230
17240
17250
17260
17270
17280
17290
17300
17310
17320
17330
17340
17350
17360
17370
17380
17390
17391
17410
17420
17430
17440
17450
17451
17470
17480
17490
17500
17510
17520
17530
17540
17550
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Van Buren County, Iowa ...........................................................................
Wapello County, Iowa ...............................................................................
Warren County, Iowa ................................................................................
Washington County, Iowa .........................................................................
Wayne County, Iowa .................................................................................
Webster County, Iowa ...............................................................................
Winnebago County, Iowa ..........................................................................
Winneshiek County, Iowa ..........................................................................
Woodbury County, Iowa ............................................................................
Worth County, Iowa ...................................................................................
Wright County, Iowa ..................................................................................
Allen County, Kansas ................................................................................
Anderson County, Kansas ........................................................................
Atchison County, Kansas ..........................................................................
Barber County, Kansas .............................................................................
Barton County, Kansas .............................................................................
Bourbon County, Kansas ..........................................................................
Brown County, Kansas ..............................................................................
Butler County, Kansas ..............................................................................
Chase County, Kansas .............................................................................
Chautauqua County, Kansas ....................................................................
Cherokee County, Kansas ........................................................................
Cheyenne County, Kansas .......................................................................
Clark County, Kansas ...............................................................................
Clay County, Kansas .................................................................................
Cloud County, Kansas ..............................................................................
Coffey County, Kansas .............................................................................
Comanche County, Kansas ......................................................................
Cowley County, Kansas ............................................................................
Crawford County, Kansas .........................................................................
Decatur County, Kansas ...........................................................................
Dickinson County, Kansas ........................................................................
Doniphan County, Kansas ........................................................................
Douglas County, Kansas ...........................................................................
Edwards County, Kansas ..........................................................................
Elk County, Kansas ...................................................................................
Ellis County, Kansas .................................................................................
Ellsworth County, Kansas .........................................................................
Finney County, Kansas .............................................................................
Ford County, Kansas ................................................................................
Franklin County, Kansas ...........................................................................
Geary County, Kansas ..............................................................................
Gove County, Kansas ...............................................................................
Graham County, Kansas ...........................................................................
Grant County, Kansas ...............................................................................
Gray County, Kansas ................................................................................
Greeley County, Kansas ...........................................................................
Greenwood County, Kansas .....................................................................
Hamilton County, Kansas ..........................................................................
Harper County, Kansas .............................................................................
Harvey County, Kansas ............................................................................
Haskell County, Kansas ............................................................................
Hodgeman County, Kansas ......................................................................
Jackson County, Kansas ...........................................................................
Jefferson County, Kansas .........................................................................
Jewell County, Kansas ..............................................................................
Johnson County, Kansas ..........................................................................
Kearny County, Kansas ............................................................................
Kingman County, Kansas ..........................................................................
Kiowa County, Kansas ..............................................................................
Labette County, Kansas ............................................................................
Lane County, Kansas ................................................................................
Leavenworth County, Kansas ...................................................................
Lincoln County, Kansas ............................................................................
Linn County, Kansas .................................................................................
Logan County, Kansas ..............................................................................
Lyon County, Kansas ................................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00065
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8552
0.8552
0.9669
0.9171
0.8552
0.8552
0.8552
0.8552
0.9399
0.8552
0.8552
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.9164
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8780
0.8537
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8758
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.9164
0.8038
0.8038
0.8480
0.8480
0.8038
0.9483
0.8038
0.8038
0.8038
0.8038
0.8038
0.9483
0.8038
0.8758
0.8038
0.8038
0.8697
0.8697
0.9136
0.9731
0.8697
0.8697
0.8697
0.8697
0.9217
0.8697
0.8697
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.9079
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
1.0136
0.8353
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.9514
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.9079
0.8000
0.8000
0.8746
0.8746
0.8000
0.9514
0.8000
0.8000
0.8000
0.8000
0.8000
0.9514
0.8000
0.9514
0.8000
0.8000
1.70
1.70
-5.51
6.11
1.70
1.70
1.70
1.70
-1.94
1.70
1.70
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.93
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
15.44
-2.16
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
8.63
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.93
-0.47
-0.47
3.14
3.14
-0.47
0.33
-0.47
-0.47
-0.47
-0.47
-0.47
0.33
-0.47
8.63
-0.47
-0.47
99916
99916
19780
26980
99916
99916
99916
99916
43580
99916
99916
99917
99917
99917
99917
99917
99917
99917
48620
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
41140
29940
99917
99917
99917
99917
99917
99917
28140
99917
99917
99917
99917
99917
99917
99917
99917
99917
48620
99917
99917
45820
45820
99917
28140
99917
99917
99917
99917
99917
28140
99917
28140
99917
99917
E:\FR\FM\03AUP2.SGM
03AUP2
44146
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
17560
17570
17580
17590
17600
17610
17620
17630
17640
17650
17660
17670
17680
17690
17700
17710
17720
17730
17740
17750
17760
17770
17780
17790
17800
17810
17820
17830
17840
17841
17860
17870
17880
17890
17900
17910
17920
17921
17940
17950
17960
17970
17980
17981
17982
17983
17984
17985
17986
18000
18010
18020
18030
18040
18050
18060
18070
18080
18090
18100
18110
18120
18130
18140
18150
18160
18170
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Mc Pherson County, Kansas ....................................................................
Marion County, Kansas .............................................................................
Marshall County, Kansas ..........................................................................
Meade County, Kansas .............................................................................
Miami County, Kansas ..............................................................................
Mitchell County, Kansas ............................................................................
Montgomery County, Kansas ....................................................................
Morris County, Kansas ..............................................................................
Morton County, Kansas .............................................................................
Nemaha County, Kansas ..........................................................................
Neosho County, Kansas ...........................................................................
Ness County, Kansas ................................................................................
Norton County, Kansas .............................................................................
Osage County, Kansas .............................................................................
Osborne County, Kansas ..........................................................................
Ottawa County, Kansas ............................................................................
Pawnee County, Kansas ...........................................................................
Phillips County, Kansas ............................................................................
Pottawatomie County, Kansas ..................................................................
Pratt County, Kansas ................................................................................
Rawlins County, Kansas ...........................................................................
Reno County, Kansas ...............................................................................
Republic County, Kansas ..........................................................................
Rice County, Kansas .................................................................................
Riley County, Kansas ................................................................................
Rooks County, Kansas ..............................................................................
Rush County, Kansas ...............................................................................
Russell County, Kansas ............................................................................
Saline County, Kansas ..............................................................................
Scott County, Kansas ................................................................................
Sedgwick County, Kansas ........................................................................
Seward County, Kansas ............................................................................
Shawnee County, Kansas .........................................................................
Sheridan County, Kansas .........................................................................
Sherman County, Kansas .........................................................................
Smith County, Kansas ...............................................................................
Stafford County, Kansas ...........................................................................
Stanton County, Kansas ...........................................................................
Stevens County, Kansas ...........................................................................
Sumner County, Kansas ...........................................................................
Thomas County, Kansas ...........................................................................
Trego County, Kansas ..............................................................................
Wabaunsee County, Kansas .....................................................................
Wallace County, Kansas ...........................................................................
Washington County, Kansas .....................................................................
Wichita County, Kansas ............................................................................
Wilson County, Kansas .............................................................................
Woodson County, Kansas .........................................................................
Wyandotte County, Kansas .......................................................................
Adair County, Kentucky .............................................................................
Allen County, Kentucky .............................................................................
Anderson County, Kentucky ......................................................................
Ballard County, Kentucky ..........................................................................
Barren County, Kentucky ..........................................................................
Bath County, Kentucky ..............................................................................
Bell County, Kentucky ...............................................................................
Boone County, Kentucky ...........................................................................
Bourbon County, Kentucky .......................................................................
Boyd County, Kentucky .............................................................................
Boyle County, Kentucky ............................................................................
Bracken County, Kentucky ........................................................................
Breathitt County, Kentucky ........................................................................
Breckinridge County, Kentucky .................................................................
Bullitt County, Kentucky ............................................................................
Butler County, Kentucky ............................................................................
Caldwell County, Kentucky .......................................................................
Calloway County, Kentucky ......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00066
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8038
0.8038
0.8038
0.8038
0.9483
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8480
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.9164
0.8038
0.8920
0.8038
0.8038
0.8038
0.8038
0.8038
0.8038
0.8597
0.8038
0.8038
0.8480
0.8038
0.8038
0.8038
0.8038
0.8038
0.9483
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.9675
0.9032
0.9477
0.7812
0.8737
0.7812
0.7812
0.9272
0.7812
0.7812
0.7812
0.8000
0.8000
0.8000
0.8000
0.9514
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8746
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.9079
0.8000
0.8746
0.8000
0.8000
0.8000
0.8000
0.8000
0.8000
0.9079
0.8000
0.8000
0.8746
0.8000
0.8000
0.8000
0.8000
0.8000
0.9514
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.9617
0.9191
0.9013
0.7780
0.9617
0.7780
0.7780
0.9135
0.7780
0.7780
0.7780
-0.47
-0.47
-0.47
-0.47
0.33
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
3.14
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
-0.93
-0.47
-1.95
-0.47
-0.47
-0.47
-0.47
-0.47
-0.47
5.61
-0.47
-0.47
3.14
-0.47
-0.47
-0.47
-0.47
-0.47
0.33
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.60
1.76
-4.90
-0.41
10.07
-0.41
-0.41
-1.48
-0.41
-0.41
-0.41
99917
99917
99917
99917
28140
99917
99917
99917
99917
99917
99917
99917
99917
45820
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
99917
48620
99917
45820
99917
99917
99917
99917
99917
99917
48620
99917
99917
45820
99917
99917
99917
99917
99917
28140
99918
99918
99918
99918
99918
99918
99918
17140
30460
26580
99918
17140
99918
99918
31140
99918
99918
99918
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44147
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
18180
18190
18191
18210
18220
18230
18240
18250
18260
18270
18271
18290
18291
18310
18320
18330
18340
18350
18360
18361
18362
18390
18400
18410
18420
18421
18440
18450
18460
18470
18480
18490
18500
18510
18511
18530
18540
18550
18560
18570
18580
18590
18600
18610
18620
18630
18640
18650
18660
18670
18680
18690
18700
18710
18720
18730
18740
18750
18760
18770
18780
18790
18800
18801
18802
18830
18831
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Campbell County, Kentucky ......................................................................
Carlisle County, Kentucky .........................................................................
Carroll County, Kentucky ..........................................................................
Carter County, Kentucky ...........................................................................
Casey County, Kentucky ...........................................................................
Christian County, Kentucky .......................................................................
Clark County, Kentucky .............................................................................
Clay County, Kentucky ..............................................................................
Clinton County, Kentucky ..........................................................................
Crittenden County, Kentucky ....................................................................
Cumberland County, Kentucky .................................................................
Daviess County, Kentucky ........................................................................
Edmonson County, Kentucky ....................................................................
Elliott County, Kentucky ............................................................................
Estill County, Kentucky .............................................................................
Fayette County, Kentucky .........................................................................
Fleming County, Kentucky ........................................................................
Floyd County, Kentucky ............................................................................
Franklin County, Kentucky ........................................................................
Fulton County, Kentucky ...........................................................................
Gallatin County, Kentucky .........................................................................
Garrard County, Kentucky .........................................................................
Grant County, Kentucky ............................................................................
Graves County, Kentucky .........................................................................
Grayson County, Kentucky .......................................................................
Green County, Kentucky ...........................................................................
Greenup County, Kentucky .......................................................................
Hancock County, Kentucky .......................................................................
Hardin County, Kentucky ..........................................................................
Harlan County, Kentucky ..........................................................................
Harrison County, Kentucky .......................................................................
Hart County, Kentucky ..............................................................................
Henderson County, Kentucky ...................................................................
Henry County, Kentucky ...........................................................................
Hickman County, Kentucky .......................................................................
Hopkins County, Kentucky ........................................................................
Jackson County, Kentucky ........................................................................
Jefferson County, Kentucky ......................................................................
Jessamine County, Kentucky ....................................................................
Johnson County, Kentucky .......................................................................
Kenton County, Kentucky ..........................................................................
Knott County, Kentucky .............................................................................
Knox County, Kentucky .............................................................................
Larue County, Kentucky ............................................................................
Laurel County, Kentucky ...........................................................................
Lawrence County, Kentucky .....................................................................
Lee County, Kentucky ...............................................................................
Leslie County, Kentucky ............................................................................
Letcher County, Kentucky .........................................................................
Lewis County, Kentucky ............................................................................
Lincoln County, Kentucky ..........................................................................
Livingston County, Kentucky .....................................................................
Logan County, Kentucky ...........................................................................
Lyon County, Kentucky .............................................................................
Mc Cracken County, Kentucky ..................................................................
Mc Creary County, Kentucky ....................................................................
Mc Lean County, Kentucky .......................................................................
Madison County, Kentucky .......................................................................
Magoffin County, Kentucky .......................................................................
Marion County, Kentucky ..........................................................................
Marshall County, Kentucky .......................................................................
Martin County, Kentucky ...........................................................................
Mason County, Kentucky ..........................................................................
Meade County, Kentucky ..........................................................................
Menifee County, Kentucky ........................................................................
Mercer County, Kentucky ..........................................................................
Metcalfe County, Kentucky .......................................................................
15:25 Aug 02, 2006
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Frm 00067
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9675
0.7812
0.7812
0.8622
0.7812
0.8284
0.9032
0.7812
0.7812
0.7812
0.7812
0.8780
0.8035
0.7812
0.7812
0.9032
0.7812
0.7812
0.7812
0.7812
0.9675
0.7812
0.9675
0.7812
0.7812
0.7812
0.9477
0.8319
0.8330
0.7812
0.7812
0.7812
0.8713
0.8555
0.7812
0.7812
0.7812
0.9272
0.9032
0.7812
0.9675
0.7812
0.7812
0.8330
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.8319
0.8377
0.7812
0.7812
0.7812
0.7812
0.7812
0.8555
0.7812
0.7812
0.7812
0.9617
0.7780
0.7780
0.7780
0.7780
0.8451
0.9191
0.7780
0.7780
0.7780
0.7780
0.8763
0.8162
0.7780
0.7780
0.9191
0.7780
0.7780
0.7780
0.7780
0.9617
0.7780
0.9617
0.7780
0.7780
0.7780
0.9013
0.8763
0.8713
0.7780
0.7780
0.7780
0.8830
0.9135
0.7780
0.7780
0.7780
0.9135
0.9191
0.7780
0.9617
0.7780
0.7780
0.8713
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.8763
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.9135
0.7780
0.7780
0.7780
-0.60
-0.41
-0.41
-9.77
-0.41
2.02
1.76
-0.41
-0.41
-0.41
-0.41
-0.19
1.58
-0.41
-0.41
1.76
-0.41
-0.41
-0.41
-0.41
-0.60
-0.41
-0.60
-0.41
-0.41
-0.41
-4.90
5.34
4.60
-0.41
-0.41
-0.41
1.34
6.78
-0.41
-0.41
-0.41
-1.48
1.76
-0.41
-0.60
-0.41
-0.41
4.60
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
5.34
-7.13
-0.41
-0.41
-0.41
-0.41
-0.41
6.78
-0.41
-0.41
-0.41
17140
99918
99918
99918
99918
17300
30460
99918
99918
99918
99918
36980
14540
99918
99918
30460
99918
99918
99918
99918
17140
99918
17140
99918
99918
99918
26580
36980
21060
99918
99918
99918
21780
31140
99918
99918
99918
31140
30460
99918
17140
99918
99918
21060
99918
99918
99918
99918
99918
99918
99918
99918
99918
99918
99918
99918
36980
99918
99918
99918
99918
99918
99918
31140
99918
99918
99918
E:\FR\FM\03AUP2.SGM
03AUP2
44148
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
18850
18860
18861
18880
18890
18900
18910
18920
18930
18931
18932
18960
18970
18971
18972
18973
18974
18975
18976
18977
18978
18979
18980
18981
18982
18983
18984
18985
18986
18987
18988
18989
18990
18991
18992
19000
19010
19020
19030
19040
19050
19060
19070
19080
19090
19100
19110
19120
19130
19140
19150
19160
19170
19180
19190
19200
19210
19220
19230
19240
19250
19260
19270
19280
19290
19300
19310
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Monroe County, Kentucky .........................................................................
Montgomery County, Kentucky .................................................................
Morgan County, Kentucky .........................................................................
Muhlenberg County, Kentucky ..................................................................
Nelson County, Kentucky ..........................................................................
Nicholas County, Kentucky .......................................................................
Ohio County, Kentucky .............................................................................
Oldham County, Kentucky ........................................................................
Owen County, Kentucky ............................................................................
Owsley County, Kentucky .........................................................................
Pendleton County, Kentucky .....................................................................
Perry County, Kentucky ............................................................................
Pike County, Kentucky ..............................................................................
Powell County, Kentucky ..........................................................................
Pulaski County, Kentucky .........................................................................
Robertson County, Kentucky ....................................................................
Rockcastle County, Kentucky ...................................................................
Rowan County, Kentucky ..........................................................................
Russell County, Kentucky .........................................................................
Scott County, Kentucky .............................................................................
Shelby County, Kentucky ..........................................................................
Simpson County, Kentucky .......................................................................
Spencer County, Kentucky ........................................................................
Taylor County, Kentucky ...........................................................................
Todd County, Kentucky .............................................................................
Trigg County, Kentucky .............................................................................
Trimble County, Kentucky .........................................................................
Union County, Kentucky ............................................................................
Warren County, Kentucky .........................................................................
Washington County, Kentucky ..................................................................
Wayne County, Kentucky ..........................................................................
Webster County, Kentucky ........................................................................
Whitley County, Kentucky .........................................................................
Wolfe County, Kentucky ............................................................................
Woodford County, Kentucky .....................................................................
Acadia County, Louisiana .........................................................................
Allen County, Louisiana ............................................................................
Ascension County, Louisiana ....................................................................
Assumption County, Louisiana ..................................................................
Avoyelles County, Louisiana .....................................................................
Beauregard County, Louisiana ..................................................................
Bienville County, Louisiana .......................................................................
Bossier County, Louisiana ........................................................................
Caddo County, Louisiana ..........................................................................
Calcasieu County, Louisiana .....................................................................
Caldwell County, Louisiana .......................................................................
Cameron County, Louisiana ......................................................................
Catahoula County, Louisiana ....................................................................
Claiborne County, Louisiana .....................................................................
Concordia County, Louisiana ....................................................................
De Soto County, Louisiana .......................................................................
East Baton Rouge County, Louisiana .......................................................
East Carroll County, Louisiana .................................................................
East Feliciana County, Louisiana ..............................................................
Evangeline County, Louisiana ...................................................................
Franklin County, Louisiana ........................................................................
Grant County, Louisiana ...........................................................................
Iberia County, Louisiana ...........................................................................
Iberville County, Louisiana ........................................................................
Jackson County, Louisiana .......................................................................
Jefferson County, Louisiana ......................................................................
Jefferson Davis County, Louisiana ...........................................................
Lafayette County, Louisiana ......................................................................
Lafourche County, Louisiana ....................................................................
La Salle County, Louisiana .......................................................................
Lincoln County, Louisiana .........................................................................
Livingston County, Louisiana ....................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00068
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7812
0.7812
0.7812
0.7812
0.8555
0.7812
0.7812
0.9272
0.7812
0.7812
0.9675
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.7812
0.9032
0.8555
0.7812
0.8555
0.7812
0.7812
0.8071
0.8555
0.7812
0.8035
0.7812
0.7812
0.8286
0.7812
0.7812
0.9032
0.7831
0.7376
0.8618
0.7376
0.7376
0.7376
0.7376
0.8749
0.8749
0.7846
0.7376
0.7587
0.7376
0.7376
0.7376
0.8050
0.8618
0.7376
0.7967
0.7376
0.7376
0.7687
0.7376
0.7967
0.7376
0.8995
0.7376
0.8340
0.7894
0.7376
0.7376
0.8618
0.7780
0.7780
0.7780
0.7780
0.9135
0.7780
0.7780
0.9135
0.7780
0.7780
0.9617
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.7780
0.9191
0.9135
0.7780
0.9135
0.7780
0.7780
0.8451
0.9135
0.7780
0.8162
0.7780
0.7780
0.8830
0.7780
0.7780
0.9191
0.7450
0.7450
0.8099
0.7450
0.7450
0.7450
0.7450
0.8881
0.8881
0.7928
0.7450
0.7928
0.7450
0.7450
0.7450
0.8881
0.8099
0.7450
0.8099
0.7450
0.7450
0.8020
0.7450
0.8099
0.7450
0.8858
0.7450
0.8293
0.8003
0.7450
0.7450
0.8099
-0.41
-0.41
-0.41
-0.41
6.78
-0.41
-0.41
-1.48
-0.41
-0.41
-0.60
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
-0.41
1.76
6.78
-0.41
6.78
-0.41
-0.41
4.71
6.78
-0.41
1.58
-0.41
-0.41
6.57
-0.41
-0.41
1.76
-4.87
1.00
-6.02
1.00
1.00
1.00
1.00
1.51
1.51
1.05
1.00
4.49
1.00
1.00
1.00
10.32
-6.02
1.00
1.66
1.00
1.00
4.33
1.00
1.66
1.00
-1.52
1.00
-0.56
1.38
1.00
1.00
-6.02
99918
99918
99918
99918
31140
99918
99918
31140
99918
99918
17140
99918
99918
99918
99918
99918
99918
99918
99918
30460
31140
99918
31140
99918
99918
17300
31140
99918
14540
99918
99918
21780
99918
99918
30460
99919
99919
12940
99919
99919
99919
99919
43340
43340
29340
99919
29340
99919
99919
99919
43340
12940
99919
12940
99919
99919
10780
99919
12940
99919
35380
99919
29180
26380
99919
99919
12940
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44149
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
19320
19330
19340
19350
19360
19370
19380
19390
19400
19410
19420
19430
19440
19450
19460
19470
19480
19490
19500
19510
19520
19530
19540
19550
19560
19570
19580
19590
19600
19610
19620
19630
20000
20010
20020
20030
20040
20050
20060
20070
20080
20090
20100
20110
20120
20130
20140
20150
21000
21010
21020
21030
21040
21050
21060
21070
21080
21090
21100
21110
21120
21130
21140
21150
21160
21170
21180
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Madison County, Louisiana .......................................................................
Morehouse County, Louisiana ..................................................................
Natchitoches County, Louisiana ................................................................
Orleans County, Louisiana ........................................................................
Ouachita County, Louisiana ......................................................................
Plaquemines County, Louisiana ................................................................
Pointe Coupee County, Louisiana ............................................................
Rapides County, Louisiana .......................................................................
Red River County, Louisiana ....................................................................
Richland County, Louisiana ......................................................................
Sabine County, Louisiana .........................................................................
St Bernard County, Louisiana ...................................................................
St Charles County, Louisiana ...................................................................
St Helena County, Louisiana ....................................................................
St James County, Louisiana .....................................................................
St John Baptist County, Louisiana ............................................................
St Landry County, Louisiana .....................................................................
St Martin County, Louisiana ......................................................................
St Mary County, Louisiana ........................................................................
St Tammany County, Louisiana ................................................................
Tangipahoa County, Louisiana .................................................................
Tensas County, Louisiana .........................................................................
Terrebonne County, Louisiana ..................................................................
Union County, Louisiana ...........................................................................
Vermilion County, Louisiana .....................................................................
Vernon County, Louisiana .........................................................................
Washington County, Louisiana .................................................................
Webster County, Louisiana .......................................................................
West Baton Rouge County, Louisiana ......................................................
West Carroll County, Louisiana ................................................................
West Feliciana County, Louisiana .............................................................
Winn County, Louisiana ............................................................................
Androscoggin County, Maine ....................................................................
Aroostook County, Maine ..........................................................................
Cumberland County, Maine ......................................................................
Franklin County, Maine .............................................................................
Hancock County, Maine ............................................................................
Kennebec County, Maine ..........................................................................
Knox County, Maine ..................................................................................
Lincoln County, Maine ...............................................................................
Oxford County, Maine ...............................................................................
Penobscot County, Maine .........................................................................
Piscataquis County, Maine ........................................................................
Sagadahoc County, Maine ........................................................................
Somerset County, Maine ...........................................................................
Waldo County, Maine ................................................................................
Washington County, Maine .......................................................................
York County, Maine ...................................................................................
Allegany County, Maryland .......................................................................
Anne Arundel County, Maryland ...............................................................
Baltimore County, Maryland ......................................................................
Baltimore City County, Maryland ..............................................................
Calvert County, Maryland ..........................................................................
Caroline County, Maryland ........................................................................
Carroll County, Maryland ..........................................................................
Cecil County, Maryland .............................................................................
Charles County, Maryland .........................................................................
Dorchester County, Maryland ...................................................................
Frederick County, Maryland ......................................................................
Garrett County, Maryland ..........................................................................
Harford County, Maryland .........................................................................
Howard County, Maryland .........................................................................
Kent County, Maryland ..............................................................................
Montgomery County, Maryland .................................................................
Prince Georges County, Maryland ............................................................
Queen Annes County, Maryland ...............................................................
St Marys County, Maryland .......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00069
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7376
0.7376
0.7376
0.8995
0.8038
0.8995
0.7967
0.8033
0.7376
0.7376
0.7376
0.8995
0.8995
0.7967
0.8203
0.8995
0.7831
0.8340
0.7376
0.8995
0.7376
0.7376
0.7894
0.7686
0.7376
0.7376
0.7376
0.8074
0.8618
0.7376
0.7967
0.7376
0.9331
0.8843
1.0382
0.8843
0.8843
0.8843
0.8843
0.8843
0.8843
0.9993
0.8843
1.0382
0.8843
0.8843
0.8843
1.0382
0.9317
0.9897
0.9897
0.9897
1.0951
0.9292
0.9897
1.0499
1.0951
0.9292
1.1230
0.9292
0.9897
0.9897
0.9292
1.1230
1.0951
0.9897
0.9292
0.7450
0.7450
0.7450
0.8858
0.8011
0.8858
0.8099
0.8020
0.7450
0.7450
0.7450
0.8858
0.8858
0.8099
0.7450
0.8858
0.7450
0.8293
0.7450
0.8858
0.7450
0.7450
0.8003
0.8011
0.7450
0.7450
0.7450
0.7450
0.8099
0.7450
0.8099
0.7450
0.9148
0.8410
0.9926
0.8410
0.8410
0.8410
0.8410
0.8410
0.8410
0.9719
0.8410
0.9926
0.8410
0.8410
0.8410
0.9926
0.8859
1.0106
1.0106
1.0106
1.1074
0.8942
1.0106
1.0703
1.1074
0.8942
1.0923
0.8942
1.0106
1.0106
0.8942
1.0923
1.1074
1.0106
0.8942
1.00
1.00
1.00
-1.52
-0.34
-1.52
1.66
-0.16
1.00
1.00
1.00
-1.52
-1.52
1.66
-9.18
-1.52
-4.87
-0.56
1.00
-1.52
1.00
1.00
1.38
4.23
1.00
1.00
1.00
-7.73
-6.02
1.00
1.66
1.00
-1.96
-4.90
-4.39
-4.90
-4.90
-4.90
-4.90
-4.90
-4.90
-2.74
-4.90
-4.39
-4.90
-4.90
-4.90
-4.39
-4.92
2.11
2.11
2.11
1.12
-3.77
2.11
1.94
1.12
-3.77
-2.73
-3.77
2.11
2.11
-3.77
-2.73
1.12
2.11
-3.77
99919
99919
99919
35380
33740
35380
12940
10780
99919
99919
99919
35380
35380
12940
99919
35380
99919
29180
99919
35380
99919
99919
26380
33740
99919
99919
99919
99919
12940
99919
12940
99919
30340
99920
38860
99920
99920
99920
99920
99920
99920
12620
99920
38860
99920
99920
99920
38860
19060
12580
12580
12580
47894
99921
12580
48864
47894
99921
13644
99921
12580
12580
99921
13644
47894
12580
99921
E:\FR\FM\03AUP2.SGM
03AUP2
44150
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
21190
21200
21210
21220
21230
22000
22010
22020
22030
22040
22060
22070
22080
22090
22120
22130
22150
22160
22170
23000
23010
23020
23030
23040
23050
23060
23070
23080
23090
23100
23110
23120
23130
23140
23150
23160
23170
23180
23190
23200
23210
23220
23230
23240
23250
23260
23270
23280
23290
23300
23310
23320
23330
23340
23350
23360
23370
23380
23390
23400
23410
23420
23430
23440
23450
23460
23470
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Somerset County, Maryland ......................................................................
Talbot County, Maryland ...........................................................................
Washington County, Maryland ..................................................................
Wicomico County, Maryland .....................................................................
Worcester County, Maryland .....................................................................
Barnstable County, Massachusetts ...........................................................
Berkshire County, Massachusetts .............................................................
Bristol County, Massachusetts ..................................................................
Dukes County, Massachusetts ..................................................................
Essex County, Massachusetts ..................................................................
Franklin County, Massachusetts ...............................................................
Hampden County, Massachusetts ............................................................
Hampshire County, Massachusetts ..........................................................
Middlesex County, Massachusetts ............................................................
Nantucket County, Massachusetts ............................................................
Norfolk County, Massachusetts ................................................................
Plymouth County, Massachusetts .............................................................
Suffolk County, Massachusetts .................................................................
Worcester County, Massachusetts ...........................................................
Alcona County, Michigan ..........................................................................
Alger County, Michigan .............................................................................
Allegan County, Michigan .........................................................................
Alpena County, Michigan ..........................................................................
Antrim County, Michigan ...........................................................................
Arenac County, Michigan ..........................................................................
Baraga County, Michigan ..........................................................................
Barry County, Michigan .............................................................................
Bay County, Michigan ...............................................................................
Benzie County, Michigan ..........................................................................
Berrien County, Michigan ..........................................................................
Branch County, Michigan ..........................................................................
Calhoun County, Michigan ........................................................................
Cass County, Michigan .............................................................................
Charlevoix County, Michigan ....................................................................
Cheboygan County, Michigan ...................................................................
Chippewa County, Michigan .....................................................................
Clare County, Michigan .............................................................................
Clinton County, Michigan ..........................................................................
Crawford County, Michigan .......................................................................
Delta County, Michigan .............................................................................
Dickinson County, Michigan ......................................................................
Eaton County, Michigan ............................................................................
Emmet County, Michigan ..........................................................................
Genesee County, Michigan .......................................................................
Gladwin County, Michigan ........................................................................
Gogebic County, Michigan ........................................................................
Grand Traverse County, Michigan ............................................................
Gratiot County, Michigan ...........................................................................
Hillsdale County, Michigan ........................................................................
Houghton County, Michigan ......................................................................
Huron County, Michigan ............................................................................
Ingham County, Michigan .........................................................................
Ionia County, Michigan ..............................................................................
Iosco County, Michigan .............................................................................
Iron County, Michigan ...............................................................................
Isabella County, Michigan .........................................................................
Jackson County, Michigan ........................................................................
Kalamazoo County, Michigan ...................................................................
Kalkaska County, Michigan .......................................................................
Kent County, Michigan ..............................................................................
Keweenaw County, Michigan ....................................................................
Lake County, Michigan ..............................................................................
Lapeer County, Michigan ..........................................................................
Leelanau County, Michigan .......................................................................
Lenawee County, Michigan .......................................................................
Livingston County, Michigan .....................................................................
Luce County, Michigan ..............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00070
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9147
0.9292
0.9679
0.9147
0.9292
1.2600
1.0181
1.1072
1.0216
1.0858
1.0232
1.0256
1.0256
1.1175
1.0216
1.1368
1.1368
1.1368
1.1103
0.8860
0.8860
0.9170
0.8860
0.8860
0.8860
0.8860
0.9107
0.9292
0.8860
0.8879
0.8860
0.9826
0.9306
0.8860
0.8860
0.8860
0.8860
0.9794
0.8860
0.8860
0.8860
0.9794
0.8860
1.0655
0.8860
0.8860
0.8860
0.8860
0.8860
0.8860
0.8860
0.9794
0.9107
0.8860
0.8860
0.8860
0.9304
1.0262
0.8860
0.9418
0.8860
0.8860
1.0009
0.8860
0.9801
1.0289
0.8860
0.8969
0.8942
0.9054
0.8969
0.8942
1.2561
1.0284
1.0804
1.0216
1.0437
1.0080
1.0080
1.0080
1.0918
1.0216
1.1693
1.1693
1.1693
1.0741
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
0.9470
0.9271
0.9052
0.8931
0.9052
0.9746
0.9690
0.9052
0.9052
0.9052
0.9052
1.0102
0.9052
0.9052
0.9052
1.0102
0.9052
1.0988
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
1.0102
0.9470
0.9052
0.9052
0.9052
0.9577
1.0723
0.9052
0.9470
0.9052
0.9052
1.0126
0.9052
0.9052
1.0126
0.9052
-1.95
-3.77
-6.46
-1.95
-3.77
-0.31
1.01
-2.42
0.00
-3.88
-0.63
-1.72
-1.72
-2.30
0.00
2.86
2.86
2.86
-3.26
2.17
2.17
-1.29
2.17
2.17
2.17
2.17
3.99
-0.23
2.17
0.59
2.17
-0.81
4.13
2.17
2.17
2.17
2.17
3.14
2.17
2.17
2.17
3.14
2.17
3.13
2.17
2.17
2.17
2.17
2.17
2.17
2.17
3.14
3.99
2.17
2.17
2.17
2.93
4.49
2.17
0.55
2.17
2.17
1.17
2.17
-7.64
-1.58
2.17
41540
99921
25180
41540
99921
12700
38340
39300
99922
21604
44140
44140
44140
15764
99922
14484
14484
14484
49340
99923
99923
99923
99923
99923
99923
99923
24340
13020
99923
35660
99923
12980
43780
99923
99923
99923
99923
29620
99923
99923
99923
29620
99923
22420
99923
99923
99923
99923
99923
99923
99923
29620
24340
99923
99923
99923
27100
28020
99923
24340
99923
99923
47644
99923
99923
47644
99923
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44151
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
23480
23490
23500
23510
23520
23530
23540
23550
23560
23570
23580
23590
23600
23610
23620
23630
23640
23650
23660
23670
23680
23690
23700
23710
23720
23730
23740
23750
23760
23770
23780
23790
23800
23810
23830
24000
24010
24020
24030
24040
24050
24060
24070
24080
24090
24100
24110
24120
24130
24140
24150
24160
24170
24180
24190
24200
24210
24220
24230
24240
24250
24260
24270
24280
24290
24300
24310
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Mackinac County, Michigan ......................................................................
Macomb County, Michigan ........................................................................
Manistee County, Michigan .......................................................................
Marquette County, Michigan .....................................................................
Mason County, Michigan ...........................................................................
Mecosta County, Michigan ........................................................................
Menominee County, Michigan ...................................................................
Midland County, Michigan .........................................................................
Missaukee County, Michigan ....................................................................
Monroe County, Michigan .........................................................................
Montcalm County, Michigan ......................................................................
Montmorency County, Michigan ................................................................
Muskegon County, Michigan .....................................................................
Newaygo County, Michigan ......................................................................
Oakland County, Michigan ........................................................................
Oceana County, Michigan .........................................................................
Ogemaw County, Michigan .......................................................................
Ontonagon County, Michigan ....................................................................
Osceola County, Michigan ........................................................................
Oscoda County, Michigan .........................................................................
Otsego County, Michigan ..........................................................................
Ottawa County, Michigan ..........................................................................
Presque Isle County, Michigan .................................................................
Roscommon County, Michigan .................................................................
Saginaw County, Michigan ........................................................................
St Clair County, Michigan .........................................................................
St Joseph County, Michigan .....................................................................
Sanilac County, Michigan ..........................................................................
Schoolcraft County, Michigan ...................................................................
Shiawassee County, Michigan ..................................................................
Tuscola County, Michigan .........................................................................
Van Buren County, Michigan ....................................................................
Washtenaw County, Michigan ...................................................................
Wayne County, Michigan ..........................................................................
Wexford County, Michigan ........................................................................
Aitkin County, Minnesota ..........................................................................
Anoka County, Minnesota .........................................................................
Becker County, Minnesota ........................................................................
Beltrami County, Minnesota ......................................................................
Benton County, Minnesota ........................................................................
Big Stone County, Minnesota ...................................................................
Blue Earth County, Minnesota ..................................................................
Brown County, Minnesota .........................................................................
Carlton County, Minnesota ........................................................................
Carver County, Minnesota ........................................................................
Cass County, Minnesota ...........................................................................
Chippewa County, Minnesota ...................................................................
Chisago County, Minnesota ......................................................................
Clay County, Minnesota ............................................................................
Clearwater County, Minnesota ..................................................................
Cook County, Minnesota ...........................................................................
Cottonwood County, Minnesota ................................................................
Crow Wing County, Minnesota .................................................................
Dakota County, Minnesota ........................................................................
Dodge County, Minnesota .........................................................................
Douglas County, Minnesota ......................................................................
Faribault County, Minnesota .....................................................................
Fillmore County, Minnesota ......................................................................
Freeborn County, Minnesota .....................................................................
Goodhue County, Minnesota ....................................................................
Grant County, Minnesota ..........................................................................
Hennepin County, Minnesota ....................................................................
Houston County, Minnesota ......................................................................
Hubbard County, Minnesota .....................................................................
Isanti County, Minnesota ...........................................................................
Itasca County, Minnesota ..........................................................................
Jackson County, Minnesota ......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00071
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8860
1.0009
0.8860
0.8860
0.8860
0.8860
0.8860
0.9068
0.8860
0.9808
0.8860
0.8860
0.9555
0.9107
1.0009
0.8860
0.8860
0.8860
0.8860
0.8860
0.8860
0.9250
0.8860
0.8860
0.9165
1.0009
0.8860
0.8860
0.8860
0.8860
0.8860
1.0262
1.0783
1.0286
0.8860
0.9132
1.1075
0.9132
0.9132
0.9965
0.9132
0.9132
0.9132
0.9673
1.1075
0.9132
0.9132
1.1075
0.8486
0.9132
0.9132
0.9132
0.9132
1.1075
1.0132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
1.1075
0.9564
0.9132
1.1075
0.9132
0.9132
0.9052
1.0126
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
0.9725
0.9052
0.9052
0.9957
0.9470
1.0126
0.9052
0.9052
0.9052
0.9052
0.9052
0.9052
0.9205
0.9052
0.9052
0.8889
1.0126
0.9052
0.9052
0.9052
0.9052
0.9052
1.0723
1.0838
1.0223
0.9052
0.9167
1.0965
0.9167
0.9167
1.0380
0.9167
0.9167
0.9167
1.0070
1.0965
0.9167
0.9167
1.0965
0.8265
0.9167
0.9167
0.9167
0.9167
1.0965
1.1260
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
1.0965
0.9442
0.9167
1.0965
0.9167
0.9167
2.17
1.17
2.17
2.17
2.17
2.17
2.17
-0.18
2.17
-0.85
2.17
2.17
4.21
3.99
1.17
2.17
2.17
2.17
2.17
2.17
2.17
-0.49
2.17
2.17
-3.01
1.17
2.17
2.17
2.17
2.17
2.17
4.49
0.51
-0.61
2.17
0.38
-0.99
0.38
0.38
4.16
0.38
0.38
0.38
4.10
-0.99
0.38
0.38
-0.99
-2.60
0.38
0.38
0.38
0.38
-0.99
11.13
0.38
0.38
0.38
0.38
0.38
0.38
-0.99
-1.28
0.38
-0.99
0.38
0.38
99923
47644
99923
99923
99923
99923
99923
99923
99923
33780
99923
99923
34740
24340
47644
99923
99923
99923
99923
99923
99923
26100
99923
99923
40980
47644
99923
99923
99923
99923
99923
28020
11460
19804
99923
99924
33460
99924
99924
41060
99924
99924
99924
20260
33460
99924
99924
33460
22020
99924
99924
99924
99924
33460
40340
99924
99924
99924
99924
99924
99924
33460
29100
99924
33460
99924
99924
E:\FR\FM\03AUP2.SGM
03AUP2
44152
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
24320
24330
24340
24350
24360
24370
24380
24390
24400
24410
24420
24430
24440
24450
24460
24470
24480
24490
24500
24510
24520
24530
24540
24550
24560
24570
24580
24590
24600
24610
24620
24630
24640
24650
24660
24670
24680
24690
24700
24710
24720
24730
24740
24750
24760
24770
24780
24790
24800
24810
24820
24830
24840
24850
24860
25000
25010
25020
25030
25040
25050
25060
25070
25080
25090
25100
25110
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Kanabec County, Minnesota .....................................................................
Kandiyohi County, Minnesota ...................................................................
Kittson County, Minnesota ........................................................................
Koochiching County, Minnesota ................................................................
Lac Qui Parle County, Minnesota .............................................................
Lake County, Minnesota ...........................................................................
Lake Of Woods County, Minnesota ..........................................................
Le Sueur County, Minnesota ....................................................................
Lincoln County, Minnesota ........................................................................
Lyon County, Minnesota ...........................................................................
Mc Leod County, Minnesota .....................................................................
Mahnomen County, Minnesota .................................................................
Marshall County, Minnesota ......................................................................
Martin County, Minnesota .........................................................................
Meeker County, Minnesota .......................................................................
Mille Lacs County, Minnesota ...................................................................
Morrison County, Minnesota .....................................................................
Mower County, Minnesota ........................................................................
Murray County, Minnesota ........................................................................
Nicollet County, Minnesota .......................................................................
Nobles County, Minnesota ........................................................................
Norman County, Minnesota ......................................................................
Olmsted County, Minnesota ......................................................................
Otter Tail County, Minnesota ....................................................................
Pennington County, Minnesota .................................................................
Pine County, Minnesota ............................................................................
Pipestone County, Minnesota ...................................................................
Polk County, Minnesota ............................................................................
Pope County, Minnesota ...........................................................................
Ramsey County, Minnesota ......................................................................
Red Lake County, Minnesota ....................................................................
Redwood County, Minnesota ....................................................................
Renville County, Minnesota ......................................................................
Rice County, Minnesota ............................................................................
Rock County, Minnesota ...........................................................................
Roseau County, Minnesota .......................................................................
St Louis County, Minnesota ......................................................................
Scott County, Minnesota ...........................................................................
Sherburne County, Minnesota ..................................................................
Sibley County, Minnesota .........................................................................
Stearns County, Minnesota .......................................................................
Steele County, Minnesota .........................................................................
Stevens County, Minnesota ......................................................................
Swift County, Minnesota ...........................................................................
Todd County, Minnesota ...........................................................................
Traverse County, Minnesota .....................................................................
Wabasha County, Minnesota ....................................................................
Wadena County, Minnesota ......................................................................
Waseca County, Minnesota ......................................................................
Washington County, Minnesota ................................................................
Watonwan County, Minnesota ..................................................................
Wilkin County, Minnesota ..........................................................................
Winona County, Minnesota .......................................................................
Wright County, Minnesota .........................................................................
Yellow Medicine County, Minnesota .........................................................
Adams County, Mississippi .......................................................................
Alcorn County, Mississippi ........................................................................
Amite County, Mississippi .........................................................................
Attala County, Mississippi .........................................................................
Benton County, Mississippi .......................................................................
Bolivar County, Mississippi .......................................................................
Calhoun County, Mississippi .....................................................................
Carroll County, Mississippi ........................................................................
Chickasaw County, Mississippi .................................................................
Choctaw County, Mississippi ....................................................................
Claiborne County, Mississippi ...................................................................
Clarke County, Mississippi ........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00072
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
1.1131
0.9132
0.9132
0.9132
0.9132
0.7901
0.9132
1.1075
0.9132
0.9132
0.9132
0.9132
0.9132
0.9132
1.0213
1.1075
1.1075
0.9132
0.9965
0.9132
0.9132
0.9132
0.9132
0.9132
1.0132
0.9132
0.9132
1.1075
0.9132
0.9132
0.9132
1.1075
0.9132
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
1.1260
0.9167
0.9167
0.9167
0.9167
0.7963
0.9167
1.0965
0.9167
0.9167
0.9167
0.9167
0.9167
0.9167
1.0070
1.0965
1.0965
0.9167
1.0380
0.9167
0.9167
0.9167
0.9167
0.9167
1.1260
0.9167
0.9167
1.0965
0.9167
0.9167
0.9167
1.0965
0.9167
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
0.38
1.16
0.38
0.38
0.38
0.38
0.78
0.38
-0.99
0.38
0.38
0.38
0.38
0.38
0.38
-1.40
-0.99
-0.99
0.38
4.16
0.38
0.38
0.38
0.38
0.38
11.13
0.38
0.38
-0.99
0.38
0.38
0.38
-0.99
0.38
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
99924
40340
99924
99924
99924
99924
24220
99924
33460
99924
99924
99924
99924
99924
99924
20260
33460
33460
99924
41060
99924
99924
99924
99924
99924
40340
99924
99924
33460
99924
99924
99924
33460
99924
99925
99925
99925
99925
99925
99925
99925
99925
99925
99925
99925
99925
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44153
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
25120
25130
25140
25150
25160
25170
25180
25190
25200
25210
25220
25230
25240
25250
25260
25270
25280
25290
25300
25310
25320
25330
25340
25350
25360
25370
25380
25390
25400
25410
25420
25430
25440
25450
25460
25470
25480
25490
25500
25510
25520
25530
25540
25550
25560
25570
25580
25590
25600
25610
25620
25630
25640
25650
25660
25670
25680
25690
25700
25710
25720
25730
25740
25750
25760
25770
25780
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Clay County, Mississippi ...........................................................................
Coahoma County, Mississippi ...................................................................
Copiah County, Mississippi .......................................................................
Covington County, Mississippi ..................................................................
Desoto County, Mississippi .......................................................................
Forrest County, Mississippi .......................................................................
Franklin County, Mississippi ......................................................................
George County, Mississippi ......................................................................
Greene County, Mississippi ......................................................................
Grenada County, Mississippi ....................................................................
Hancock County, Mississippi ....................................................................
Harrison County, Mississippi .....................................................................
Hinds County, Mississippi .........................................................................
Holmes County, Mississippi ......................................................................
Humphreys County, Mississippi ................................................................
Issaquena County, Mississippi ..................................................................
Itawamba County, Mississippi ...................................................................
Jackson County, Mississippi .....................................................................
Jasper County, Mississippi ........................................................................
Jefferson County, Mississippi ....................................................................
Jefferson Davis County, Mississippi .........................................................
Jones County, Mississippi .........................................................................
Kemper County, Mississippi ......................................................................
Lafayette County, Mississippi ....................................................................
Lamar County, Mississippi ........................................................................
Lauderdale County, Mississippi ................................................................
Lawrence County, Mississippi ...................................................................
Leake County, Mississippi .........................................................................
Lee County, Mississippi ............................................................................
Leflore County, Mississippi .......................................................................
Lincoln County, Mississippi .......................................................................
Lowndes County, Mississippi ....................................................................
Madison County, Mississippi .....................................................................
Marion County, Mississippi .......................................................................
Marshall County, Mississippi .....................................................................
Monroe County, Mississippi ......................................................................
Montgomery County, Mississippi ..............................................................
Neshoba County, Mississippi ....................................................................
Newton County, Mississippi ......................................................................
Noxubee County, Mississippi ....................................................................
Oktibbeha County, Mississippi ..................................................................
Panola County, Mississippi .......................................................................
Pearl River County, Mississippi ................................................................
Perry County, Mississippi ..........................................................................
Pike County, Mississippi ...........................................................................
Pontotoc County, Mississippi ....................................................................
Prentiss County, Mississippi .....................................................................
Quitman County, Mississippi .....................................................................
Rankin County, Mississippi .......................................................................
Scott County, Mississippi ..........................................................................
Sharkey County, Mississippi .....................................................................
Simpson County, Mississippi ....................................................................
Smith County, Mississippi .........................................................................
Stone County, Mississippi .........................................................................
Sunflower County, Mississippi ..................................................................
Tallahatchie County, Mississippi ...............................................................
Tate County, Mississippi ...........................................................................
Tippah County, Mississippi .......................................................................
Tishomingo County, Mississippi ................................................................
Tunica County, Mississippi ........................................................................
Union County, Mississippi .........................................................................
Walthall County, Mississippi ......................................................................
Warren County, Mississippi .......................................................................
Washington County, Mississippi ...............................................................
Wayne County, Mississippi .......................................................................
Webster County, Mississippi .....................................................................
Wilkinson County, Mississippi ...................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00073
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7654
0.7654
0.7973
0.7654
0.9407
0.7601
0.7654
0.7895
0.7654
0.7654
0.8818
0.8818
0.8347
0.7654
0.7654
0.7654
0.7654
0.8431
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7601
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.8347
0.7654
0.8516
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7618
0.7654
0.7654
0.7654
0.7654
0.8347
0.7654
0.7654
0.7973
0.7654
0.8282
0.7654
0.7654
0.8516
0.7654
0.7654
0.8516
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7654
0.7565
0.7565
0.8286
0.7565
0.9361
0.7443
0.7565
0.8230
0.7565
0.7565
0.8931
0.8931
0.8286
0.7565
0.7565
0.7565
0.7565
0.8230
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7443
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.8286
0.7565
0.9361
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7443
0.7565
0.7565
0.7565
0.7565
0.8286
0.7565
0.7565
0.8286
0.7565
0.8931
0.7565
0.7565
0.9361
0.7565
0.7565
0.9361
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
0.7565
-1.16
-1.16
3.93
-1.16
-0.49
-2.08
-1.16
4.24
-1.16
-1.16
1.28
1.28
-0.73
-1.16
-1.16
-1.16
-1.16
-2.38
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-2.08
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-0.73
-1.16
9.92
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-2.30
-1.16
-1.16
-1.16
-1.16
-0.73
-1.16
-1.16
3.93
-1.16
7.84
-1.16
-1.16
9.92
-1.16
-1.16
9.92
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
-1.16
99925
99925
27140
99925
32820
25620
99925
37700
99925
99925
25060
25060
27140
99925
99925
99925
99925
37700
99925
99925
99925
99925
99925
99925
25620
99925
99925
99925
99925
99925
99925
99925
27140
99925
32820
99925
99925
99925
99925
99925
99925
99925
99925
25620
99925
99925
99925
99925
27140
99925
99925
27140
99925
25060
99925
99925
32820
99925
99925
32820
99925
99925
99925
99925
99925
99925
99925
E:\FR\FM\03AUP2.SGM
03AUP2
44154
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
25790
25800
25810
26000
26010
26020
26030
26040
26050
26060
26070
26080
26090
26100
26110
26120
26130
26140
26150
26160
26170
26180
26190
26200
26210
26220
26230
26240
26250
26260
26270
26280
26290
26300
26310
26320
26330
26340
26350
26360
26370
26380
26390
26400
26410
26411
26412
26440
26450
26460
26470
26480
26490
26500
26510
26520
26530
26540
26541
26560
26570
26580
26590
26600
26601
26620
26630
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Winston County, Mississippi .....................................................................
Yalobusha County, Mississippi .................................................................
Yazoo County, Mississippi ........................................................................
Adair County, Missouri ..............................................................................
Andrew County, Missouri ..........................................................................
Atchison County, Missouri .........................................................................
Audrain County, Missouri ..........................................................................
Barry County, Missouri ..............................................................................
Barton County, Missouri ............................................................................
Bates County, Missouri .............................................................................
Benton County, Missouri ...........................................................................
Bollinger County, Missouri ........................................................................
Boone County, Missouri ............................................................................
Buchanan County, Missouri ......................................................................
Butler County, Missouri .............................................................................
Caldwell County, Missouri .........................................................................
Callaway County, Missouri ........................................................................
Camden County, Missouri .........................................................................
Cape Girardeau County, Missouri .............................................................
Carroll County, Missouri ............................................................................
Carter County, Missouri ............................................................................
Cass County, Missouri ..............................................................................
Cedar County, Missouri .............................................................................
Chariton County, Missouri .........................................................................
Christian County, Missouri ........................................................................
Clark County, Missouri ..............................................................................
Clay County, Missouri ...............................................................................
Clinton County, Missouri ...........................................................................
Cole County, Missouri ...............................................................................
Cooper County, Missouri ...........................................................................
Crawford County, Missouri ........................................................................
Dade County, Missouri ..............................................................................
Dallas County, Missouri ............................................................................
Daviess County, Missouri ..........................................................................
De Kalb County, Missouri .........................................................................
Dent County, Missouri ...............................................................................
Douglas County, Missouri .........................................................................
Dunklin County, Missouri ..........................................................................
Franklin County, Missouri ..........................................................................
Gasconade County, Missouri ....................................................................
Gentry County, Missouri ............................................................................
Greene County, Missouri ..........................................................................
Grundy County, Missouri ...........................................................................
Harrison County, Missouri .........................................................................
Henry County, Missouri .............................................................................
Hickory County, Missouri ..........................................................................
Holt County, Missouri ................................................................................
Howard County, Missouri ..........................................................................
Howell County, Missouri ............................................................................
Iron County, Missouri ................................................................................
Jackson County, Missouri .........................................................................
Jasper County, Missouri ............................................................................
Jefferson County, Missouri ........................................................................
Johnson County, Missouri .........................................................................
Knox County, Missouri ..............................................................................
Laclede County, Missouri ..........................................................................
Lafayette County, Missouri ........................................................................
Lawrence County, Missouri .......................................................................
Lewis County, Missouri .............................................................................
Lincoln County, Missouri ...........................................................................
Linn County, Missouri ................................................................................
Livingston County, Missouri ......................................................................
Mc Donald County, Missouri .....................................................................
Macon County, Missouri ............................................................................
Madison County, Missouri .........................................................................
Maries County, Missouri ............................................................................
Marion County, Missouri ...........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00074
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7654
0.7654
0.7654
0.7930
0.9519
0.7930
0.7930
0.7930
0.7930
0.8718
0.7930
0.7930
0.8345
0.9519
0.7930
0.8718
0.8173
0.7930
0.7930
0.7930
0.7930
0.9483
0.7930
0.7930
0.8244
0.7930
0.9483
0.9483
0.8173
0.7930
0.8457
0.7930
0.8098
0.7930
0.8739
0.7930
0.7930
0.7930
0.8958
0.7930
0.7930
0.8244
0.7930
0.7930
0.7930
0.7930
0.7930
0.8152
0.7930
0.7930
0.9483
0.8582
0.8958
0.7930
0.7930
0.7930
0.9483
0.7930
0.7930
0.8958
0.7930
0.7930
0.8310
0.7930
0.7930
0.7930
0.7930
0.7565
0.7565
0.7565
0.7934
1.0136
0.7934
0.7934
0.7934
0.7934
0.9514
0.7934
0.7934
0.8557
1.0136
0.7934
0.9514
0.8347
0.7934
0.7934
0.7934
0.7934
0.9514
0.7934
0.7934
0.8484
0.7934
0.9514
0.9514
0.8347
0.7934
0.9013
0.7934
0.8484
0.7934
1.0136
0.7934
0.7934
0.7934
0.9013
0.7934
0.7934
0.8484
0.7934
0.7934
0.7934
0.7934
0.7934
0.8557
0.7934
0.7934
0.9514
0.8620
0.9013
0.7934
0.7934
0.7934
0.9514
0.7934
0.7934
0.9013
0.7934
0.7934
0.8761
0.7934
0.7934
0.7934
0.7934
-1.16
-1.16
-1.16
0.05
6.48
0.05
0.05
0.05
0.05
9.13
0.05
0.05
2.54
6.48
0.05
9.13
2.13
0.05
0.05
0.05
0.05
0.33
0.05
0.05
2.91
0.05
0.33
0.33
2.13
0.05
6.57
0.05
4.77
0.05
15.99
0.05
0.05
0.05
0.61
0.05
0.05
2.91
0.05
0.05
0.05
0.05
0.05
4.97
0.05
0.05
0.33
0.44
0.61
0.05
0.05
0.05
0.33
0.05
0.05
0.61
0.05
0.05
5.43
0.05
0.05
0.05
0.05
99925
99925
99925
99926
41140
99926
99926
99926
99926
28140
99926
99926
17860
41140
99926
28140
27620
99926
99926
99926
99926
28140
99926
99926
44180
99926
28140
28140
27620
99926
41180
99926
44180
99926
41140
99926
99926
99926
41180
99926
99926
44180
99926
99926
99926
99926
99926
17860
99926
99926
28140
27900
41180
99926
99926
99926
28140
99926
99926
41180
99926
99926
22220
99926
99926
99926
99926
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44155
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
26631
26650
26660
26670
26680
26690
26700
26710
26720
26730
26740
26750
26751
26770
26780
26790
26800
26810
26820
26821
26840
26850
26860
26870
26880
26881
26900
26910
26911
26930
26940
26950
26960
26970
26980
26981
26982
26983
26984
26985
26986
26987
26988
26989
26990
26991
26992
26993
26994
26995
26996
27000
27010
27020
27030
27040
27050
27060
27070
27080
27090
27100
27110
27113
27120
27130
27140
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Mercer County, Missouri ...........................................................................
Miller County, Missouri ..............................................................................
Mississippi County, Missouri .....................................................................
Moniteau County, Missouri ........................................................................
Monroe County, Missouri ..........................................................................
Montgomery County, Missouri ..................................................................
Morgan County, Missouri ..........................................................................
New Madrid County, Missouri ...................................................................
Newton County, Missouri ..........................................................................
Nodaway County, Missouri .......................................................................
Oregon County, Missouri ..........................................................................
Osage County, Missouri ............................................................................
Ozark County, Missouri .............................................................................
Pemiscot County, Missouri ........................................................................
Perry County, Missouri ..............................................................................
Pettis County, Missouri .............................................................................
Phelps County, Missouri ...........................................................................
Pike County, Missouri ...............................................................................
Platte County, Missouri .............................................................................
Polk County, Missouri ...............................................................................
Pulaski County, Missouri ...........................................................................
Putnam County, Missouri ..........................................................................
Ralls County, Missouri ..............................................................................
Randolph County, Missouri .......................................................................
Ray County, Missouri ................................................................................
Reynolds County, Missouri .......................................................................
Ripley County, Missouri ............................................................................
St Charles County, Missouri .....................................................................
St Clair County, Missouri ..........................................................................
St Francois County, Missouri ....................................................................
St Louis County, Missouri .........................................................................
St Louis City County, Missouri ..................................................................
Ste Genevieve County, Missouri ...............................................................
Saline County, Missouri ............................................................................
Schuyler County, Missouri ........................................................................
Scotland County, Missouri ........................................................................
Scott County, Missouri ..............................................................................
Shannon County, Missouri ........................................................................
Shelby County, Missouri ...........................................................................
Stoddard County, Missouri ........................................................................
Stone County, Missouri .............................................................................
Sullivan County, Missouri ..........................................................................
Taney County, Missouri ............................................................................
Texas County, Missouri .............................................................................
Vernon County, Missouri ...........................................................................
Warren County, Missouri ...........................................................................
Washington County, Missouri ...................................................................
Wayne County, Missouri ...........................................................................
Webster County, Missouri .........................................................................
Worth County, Missouri .............................................................................
Wright County, Missouri ............................................................................
Beaverhead County, Montana ..................................................................
Big Horn County, Montana ........................................................................
Blaine County, Montana ............................................................................
Broadwater County, Montana ...................................................................
Carbon County, Montana ..........................................................................
Carter County, Montana ............................................................................
Cascade County, Montana ........................................................................
Chouteau County, Montana ......................................................................
Custer County, Montana ...........................................................................
Daniels County, Montana ..........................................................................
Dawson County, Montana .........................................................................
Deer Lodge County, Montana ...................................................................
Yellowstone National Park, Montana ........................................................
Fallon County, Montana ............................................................................
Fergus County, Montana ...........................................................................
Flathead County, Montana ........................................................................
15:25 Aug 02, 2006
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PO 00000
Frm 00075
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7930
0.7930
0.7930
0.8173
0.7930
0.7930
0.7930
0.7930
0.8582
0.7930
0.7930
0.8173
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.9483
0.8098
0.7930
0.7930
0.7930
0.7930
0.9483
0.7930
0.7930
0.8958
0.7930
0.7930
0.8958
0.8958
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.7930
0.8958
0.8457
0.7930
0.8244
0.7930
0.7930
0.8762
0.8762
0.8762
0.8762
0.8798
0.8762
0.9052
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.7934
0.7934
0.7934
0.8347
0.7934
0.7934
0.7934
0.7934
0.8620
0.7934
0.7934
0.8347
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.9514
0.8484
0.7934
0.7934
0.7934
0.7934
0.9514
0.7934
0.7934
0.9013
0.7934
0.7934
0.9013
0.9013
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.7934
0.9013
0.9013
0.7934
0.8484
0.7934
0.7934
0.8605
0.8605
0.8605
0.8605
0.8728
0.8605
0.8613
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.05
0.05
0.05
2.13
0.05
0.05
0.05
0.05
0.44
0.05
0.05
2.13
0.05
0.05
0.05
0.05
0.05
0.05
0.33
4.77
0.05
0.05
0.05
0.05
0.33
0.05
0.05
0.61
0.05
0.05
0.61
0.61
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.05
0.61
6.57
0.05
2.91
0.05
0.05
-1.79
-1.79
-1.79
-1.79
-0.80
-1.79
-4.85
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
99926
99926
99926
27620
99926
99926
99926
99926
27900
99926
99926
27620
99926
99926
99926
99926
99926
99926
28140
44180
99926
99926
99926
99926
28140
99926
99926
41180
99926
99926
41180
41180
99926
99926
99926
99926
99926
99926
99926
99926
99926
99926
99926
99926
99926
41180
41180
99926
44180
99926
99926
99927
99927
99927
99927
13740
99927
24500
99927
99927
99927
99927
99927
99927
99927
99927
99927
E:\FR\FM\03AUP2.SGM
03AUP2
44156
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
27150
27160
27170
27180
27190
27200
27210
27220
27230
27240
27250
27260
27270
27280
27290
27300
27310
27320
27330
27340
27350
27360
27370
27380
27390
27400
27410
27420
27430
27440
27450
27460
27470
27480
27490
27500
27510
27520
27530
27540
27550
28000
28010
28020
28030
28040
28050
28060
28070
28080
28090
28100
28110
28120
28130
28140
28150
28160
28170
28180
28190
28200
28210
28220
28230
28240
28250
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Gallatin County, Montana ..........................................................................
Garfield County, Montana .........................................................................
Glacier County, Montana ..........................................................................
Golden Valley County, Montana ...............................................................
Granite County, Montana ..........................................................................
Hill County, Montana .................................................................................
Jefferson County, Montana .......................................................................
Judith Basin County, Montana ..................................................................
Lake County, Montana ..............................................................................
Lewis And Clark County, Montana ...........................................................
Liberty County, Montana ...........................................................................
Lincoln County, Montana ..........................................................................
Mc Cone County, Montana .......................................................................
Madison County, Montana ........................................................................
Meagher County, Montana ........................................................................
Mineral County, Montana ..........................................................................
Missoula County, Montana ........................................................................
Musselshell County, Montana ...................................................................
Park County, Montana ..............................................................................
Petroleum County, Montana .....................................................................
Phillips County, Montana ..........................................................................
Pondera County, Montana ........................................................................
Powder River County, Montana ................................................................
Powell County, Montana ...........................................................................
Prairie County, Montana ...........................................................................
Ravalli County, Montana ...........................................................................
Richland County, Montana ........................................................................
Roosevelt County, Montana ......................................................................
Rosebud County, Montana .......................................................................
Sanders County, Montana ........................................................................
Sheridan County, Montana .......................................................................
Silver Bow County, Montana .....................................................................
Stillwater County, Montana .......................................................................
Sweet Grass County, Montana .................................................................
Teton County, Montana .............................................................................
Toole County, Montana .............................................................................
Treasure County, Montana .......................................................................
Valley County, Montana ............................................................................
Wheatland County, Montana .....................................................................
Wibaux County, Montana ..........................................................................
Yellowstone County, Montana ..................................................................
Adams County, Nebraska .........................................................................
Antelope County, Nebraska ......................................................................
Arthur County, Nebraska ...........................................................................
Banner County, Nebraska .........................................................................
Blaine County, Nebraska ..........................................................................
Boone County, Nebraska ..........................................................................
Box Butte County, Nebraska .....................................................................
Boyd County, Nebraska ............................................................................
Brown County, Nebraska ..........................................................................
Buffalo County, Nebraska .........................................................................
Burt County, Nebraska ..............................................................................
Butler County, Nebraska ...........................................................................
Cass County, Nebraska ............................................................................
Cedar County, Nebraska ...........................................................................
Chase County, Nebraska ..........................................................................
Cherry County, Nebraska ..........................................................................
Cheyenne County, Nebraska ....................................................................
Clay County, Nebraska .............................................................................
Colfax County, Nebraska ..........................................................................
Cuming County, Nebraska ........................................................................
Custer County, Nebraska ..........................................................................
Dakota County, Nebraska .........................................................................
Dawes County, Nebraska .........................................................................
Dawson County, Nebraska .......................................................................
Deuel County, Nebraska ...........................................................................
Dixon County, Nebraska ...........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00076
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.9473
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8762
0.8834
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.9560
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.9399
0.8657
0.8657
0.8657
0.9019
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8944
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8605
0.8728
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.9467
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.9217
0.8693
0.8693
0.8693
0.9217
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-5.58
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.79
-1.20
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
-0.97
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
-1.94
0.42
0.42
0.42
2.20
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
33540
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
99927
13740
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
36540
99928
99928
99928
99928
99928
99928
99928
99928
43580
99928
99928
99928
43580
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44157
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
28260
28270
28280
28290
28300
28310
28320
28330
28340
28350
28360
28370
28380
28390
28400
28410
28420
28430
28440
28450
28460
28470
28480
28490
28500
28510
28520
28530
28540
28550
28560
28570
28580
28590
28600
28610
28620
28630
28640
28650
28660
28670
28680
28690
28700
28710
28720
28730
28740
28750
28760
28770
28780
28790
28800
28810
28820
28830
28840
28850
28860
28870
28880
28890
28900
28910
28920
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Dodge County, Nebraska ..........................................................................
Douglas County, Nebraska .......................................................................
Dundy County, Nebraska ..........................................................................
Fillmore County, Nebraska ........................................................................
Franklin County, Nebraska ........................................................................
Frontier County, Nebraska ........................................................................
Furnas County, Nebraska .........................................................................
Gage County, Nebraska ............................................................................
Garden County, Nebraska ........................................................................
Garfield County, Nebraska ........................................................................
Gosper County, Nebraska .........................................................................
Grant County, Nebraska ...........................................................................
Greeley County, Nebraska ........................................................................
Hall County, Nebraska ..............................................................................
Hamilton County, Nebraska ......................................................................
Harlan County, Nebraska ..........................................................................
Hayes County, Nebraska ..........................................................................
Hitchcock County, Nebraska .....................................................................
Holt County, Nebraska ..............................................................................
Hooker County, Nebraska .........................................................................
Howard County, Nebraska ........................................................................
Jefferson County, Nebraska ......................................................................
Johnson County, Nebraska .......................................................................
Kearney County, Nebraska .......................................................................
Keith County, Nebraska ............................................................................
Keya Paha County, Nebraska ...................................................................
Kimball County, Nebraska .........................................................................
Knox County, Nebraska ............................................................................
Lancaster County, Nebraska .....................................................................
Lincoln County, Nebraska .........................................................................
Logan County, Nebraska ..........................................................................
Loup County, Nebraska ............................................................................
Mc Pherson County, Nebraska .................................................................
Madison County, Nebraska .......................................................................
Merrick County, Nebraska .........................................................................
Morrill County, Nebraska ...........................................................................
Nance County, Nebraska ..........................................................................
Nemaha County, Nebraska .......................................................................
Nuckolls County, Nebraska .......................................................................
Otoe County, Nebraska .............................................................................
Pawnee County, Nebraska .......................................................................
Perkins County, Nebraska ........................................................................
Phelps County, Nebraska .........................................................................
Pierce County, Nebraska ..........................................................................
Platte County, Nebraska ...........................................................................
Polk County, Nebraska .............................................................................
Redwillow County, Nebraska ....................................................................
Richardson County, Nebraska ..................................................................
Rock County, Nebraska ............................................................................
Saline County, Nebraska ..........................................................................
Sarpy County, Nebraska ...........................................................................
Saunders County, Nebraska .....................................................................
Scotts Bluff County, Nebraska ..................................................................
Seward County, Nebraska ........................................................................
Sheridan County, Nebraska ......................................................................
Sherman County, Nebraska ......................................................................
Sioux County, Nebraska ...........................................................................
Stanton County, Nebraska ........................................................................
Thayer County, Nebraska .........................................................................
Thomas County, Nebraska .......................................................................
Thurston County, Nebraska ......................................................................
Valley County, Nebraska ...........................................................................
Washington County, Nebraska .................................................................
Wayne County, Nebraska .........................................................................
Webster County, Nebraska .......................................................................
Wheeler County, Nebraska .......................................................................
York County, Nebraska .............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00077
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8657
0.9560
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
1.0214
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.9560
0.9109
0.8657
0.9436
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.8657
0.9560
0.8657
0.8657
0.8657
0.8657
0.8693
0.9467
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
1.0110
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.9467
0.9467
0.8693
1.0110
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.8693
0.9467
0.8693
0.8693
0.8693
0.8693
0.42
-0.97
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
-1.02
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
-0.97
3.93
0.42
7.14
0.42
0.42
0.42
0.42
0.42
0.42
0.42
0.42
-0.97
0.42
0.42
0.42
0.42
99928
36540
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
30700
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
99928
36540
36540
99928
30700
99928
99928
99928
99928
99928
99928
99928
99928
36540
99928
99928
99928
99928
E:\FR\FM\03AUP2.SGM
03AUP2
44158
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
29000
29010
29020
29030
29040
29050
29060
29070
29080
29090
29100
29110
29120
29130
29140
29150
29160
30000
30010
30020
30030
30040
30050
30060
30070
30080
30090
31000
31100
31150
31160
31180
31190
31200
31220
31230
31250
31260
31270
31290
31300
31310
31320
31340
31350
31360
31370
31390
32000
32010
32020
32025
32030
32040
32050
32060
32070
32080
32090
32100
32110
32120
32130
32131
32140
32150
32160
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Churchill County, Nevada .........................................................................
Clark County, Nevada ...............................................................................
Douglas County, Nevada ..........................................................................
Elko County, Nevada ................................................................................
Esmeralda County, Nevada ......................................................................
Eureka County, Nevada ............................................................................
Humboldt County, Nevada ........................................................................
Lander County, Nevada ............................................................................
Lincoln County, Nevada ............................................................................
Lyon County, Nevada ................................................................................
Mineral County, Nevada ............................................................................
Nye County, Nevada .................................................................................
Carson City County, Nevada ....................................................................
Pershing County, Nevada .........................................................................
Storey County, Nevada .............................................................................
Washoe County, Nevada ..........................................................................
White Pine County, Nevada ......................................................................
Belknap County, New Hampshire .............................................................
Carroll County, New Hampshire ...............................................................
Cheshire County, New Hampshire ............................................................
Coos County, New Hampshire ..................................................................
Grafton County, New Hampshire ..............................................................
Hillsboro County, New Hampshire ............................................................
Merrimack County, New Hampshire .........................................................
Rockingham County, New Hampshire ......................................................
Strafford County, New Hampshire ............................................................
Sullivan County, New Hampshire .............................................................
Atlantic County, New Jersey .....................................................................
Bergen County, New Jersey .....................................................................
Burlington County, New Jersey .................................................................
Camden County, New Jersey ...................................................................
Cape May County, New Jersey ................................................................
Cumberland County, New Jersey .............................................................
Essex County, New Jersey .......................................................................
Gloucester County, New Jersey ...............................................................
Hudson County, New Jersey ....................................................................
Hunterdon County, New Jersey ................................................................
Mercer County, New Jersey ......................................................................
Middlesex County, New Jersey .................................................................
Monmouth County, New Jersey ................................................................
Morris County, New Jersey .......................................................................
Ocean County, New Jersey ......................................................................
Passaic County, New Jersey ....................................................................
Salem County, New Jersey .......................................................................
Somerset County, New Jersey .................................................................
Sussex County, New Jersey .....................................................................
Union County, New Jersey .......................................................................
Warren County, New Jersey .....................................................................
Bernalillo County, New Mexico .................................................................
Catron County, New Mexico .....................................................................
Chaves County, New Mexico ....................................................................
Cibola County, New Mexico ......................................................................
Colfax County, New Mexico ......................................................................
Curry County, New Mexico .......................................................................
De Baca County, New Mexico ..................................................................
Dona Ana County, New Mexico ................................................................
Eddy County, New Mexico ........................................................................
Grant County, New Mexico .......................................................................
Guadalupe County, New Mexico ..............................................................
Harding County, New Mexico ...................................................................
Hidalgo County, New Mexico ....................................................................
Lea County, New Mexico ..........................................................................
Lincoln County, New Mexico .....................................................................
Los Alamos County, New Mexico .............................................................
Luna County, New Mexico ........................................................................
Mc Kinley County, New Mexico ................................................................
Mora County, New Mexico ........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00078
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9376
1.1296
0.9376
0.9376
0.9376
0.9376
0.9376
0.9376
0.9376
0.9376
0.9376
1.0110
0.9961
0.9376
1.0335
1.0982
0.9376
1.0817
1.0817
1.0817
1.0817
1.0817
1.0766
1.0766
1.0776
1.0776
1.0817
1.1556
1.2420
1.0720
1.0720
1.1254
0.9827
1.1859
1.0720
1.2263
1.1525
1.0834
1.1208
1.1255
1.1859
1.1255
1.2420
1.0697
1.1208
1.1859
1.1859
1.0826
0.9684
0.8599
0.8599
0.8599
0.8599
0.8599
0.8599
0.8467
0.8599
0.8599
0.8599
0.8599
0.8599
0.8599
0.8599
0.9692
0.8599
0.8599
0.8599
0.8960
1.1450
0.8960
0.8960
0.8960
0.8960
0.8960
0.8960
0.8960
0.8960
0.8960
0.8960
1.0043
0.8960
1.1984
1.1984
0.8960
1.0800
1.0800
1.0800
1.0800
1.0800
1.0261
1.0261
1.0177
1.0177
1.0800
1.1751
1.3208
1.0411
1.0411
1.0490
0.9849
1.1890
1.0411
1.3208
1.1890
1.0877
1.1207
1.1207
1.1890
1.1207
1.3208
1.0703
1.1207
1.1890
1.1890
0.9910
0.9474
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
0.9290
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
0.8347
-4.44
1.36
-4.44
-4.44
-4.44
-4.44
-4.44
-4.44
-4.44
-4.44
-4.44
-11.37
0.82
-4.44
15.96
9.12
-4.44
-0.16
-0.16
-0.16
-0.16
-0.16
-4.69
-4.69
-5.56
-5.56
-0.16
1.69
6.34
-2.88
-2.88
-6.79
0.22
0.26
-2.88
7.71
3.17
0.40
-0.01
-0.43
0.26
-0.43
6.34
0.06
-0.01
0.26
0.26
-8.46
-2.17
-2.93
-2.93
-2.93
-2.93
-2.93
-2.93
9.72
-2.93
-2.93
-2.93
-2.93
-2.93
-2.93
-2.93
-13.88
-2.93
-2.93
-2.93
99929
29820
99929
99929
99929
99929
99929
99929
99929
99929
99929
99929
16180
99929
39900
39900
99929
99930
99930
99930
99930
99930
31700
31700
40484
40484
99930
12100
35644
15804
15804
36140
47220
35084
15804
35644
35084
45940
20764
20764
35084
20764
35644
48864
20764
35084
35084
10900
10740
99932
99932
99932
99932
99932
99932
29740
99932
99932
99932
99932
99932
99932
99932
99932
99932
99932
99932
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44159
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
32170
32180
32190
32200
32210
32220
32230
32240
32250
32260
32270
32280
32290
32300
33000
33010
33020
33030
33040
33050
33060
33070
33080
33090
33200
33210
33220
33230
33240
33260
33270
33280
33290
33300
33310
33320
33330
33331
33340
33350
33360
33370
33380
33400
33420
33500
33510
33520
33530
33540
33550
33560
33570
33580
33590
33600
33610
33620
33630
33640
33650
33660
33670
33680
33690
33700
33710
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Otero County, New Mexico .......................................................................
Quay County, New Mexico .......................................................................
Rio Arriba County, New Mexico ................................................................
Roosevelt County, New Mexico ................................................................
Sandoval County, New Mexico .................................................................
San Juan County, New Mexico .................................................................
San Miguel County, New Mexico ..............................................................
Santa Fe County, New Mexico .................................................................
Sierra County, New Mexico ......................................................................
Socorro County, New Mexico ...................................................................
Taos County, New Mexico ........................................................................
Torrance County, New Mexico ..................................................................
Union County, New Mexico .......................................................................
Valencia County, New Mexico ..................................................................
Albany County, New York .........................................................................
Allegany County, New York ......................................................................
Bronx County, New York ...........................................................................
Broome County, New York .......................................................................
Cattaraugus County, New York ................................................................
Cayuga County, New York ........................................................................
Chautauqua County, New York ................................................................
Chemung County, New York ....................................................................
Chenango County, New York ...................................................................
Clinton County, New York .........................................................................
Columbia County, New York .....................................................................
Cortland County, New York ......................................................................
Delaware County, New York .....................................................................
Dutchess County, New York .....................................................................
Erie County, New York ..............................................................................
Essex County, New York ..........................................................................
Franklin County, New York .......................................................................
Fulton County, New York ..........................................................................
Genesee County, New York .....................................................................
Greene County, New York ........................................................................
Hamilton County, New York ......................................................................
Herkimer County, New York .....................................................................
Jefferson County, New York .....................................................................
Kings County, New York ...........................................................................
Lewis County, New York ...........................................................................
Livingston County, New York ....................................................................
Madison County, New York ......................................................................
Monroe County, New York ........................................................................
Montgomery County, New York ................................................................
Nassau County, New York ........................................................................
New York County, New York ....................................................................
Niagara County, New York .......................................................................
Oneida County, New York ........................................................................
Onondaga County, New York ...................................................................
Ontario County, New York ........................................................................
Orange County, New York ........................................................................
Orleans County, New York .......................................................................
Oswego County, New York .......................................................................
Otsego County, New York ........................................................................
Putnam County, New York ........................................................................
Queens County, New York .......................................................................
Rensselaer County, New York ..................................................................
Richmond County, New York ....................................................................
Rockland County, New York .....................................................................
St Lawrence County, New York ................................................................
Saratoga County, New York .....................................................................
Schenectady County, New York ...............................................................
Schoharie County, New York ....................................................................
Schuyler County, New York ......................................................................
Seneca County, New York ........................................................................
Steuben County, New York .......................................................................
Suffolk County, New York .........................................................................
Sullivan County, New York .......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00079
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8599
0.8599
0.8599
0.8599
0.9684
0.8536
0.8599
1.0834
0.8599
0.8599
0.8599
0.9124
0.8599
0.9684
0.8574
0.8275
1.3326
0.8562
0.8275
0.8823
0.7849
0.8250
0.8275
0.8275
0.8275
0.8275
0.8275
1.0683
0.9511
0.8275
0.8275
0.8275
0.8602
0.8275
0.8275
0.8358
0.8275
1.3326
0.8275
0.9085
0.9533
0.9085
0.8357
1.2719
1.3326
0.9511
0.8358
0.9533
0.9085
1.1049
0.9085
0.9533
0.8275
1.3326
1.3326
0.8574
1.3326
1.3326
0.8275
0.8574
0.8574
0.8574
0.8275
0.8275
0.8275
1.2719
0.8275
0.8347
0.8347
0.8347
0.8347
0.9474
0.8604
0.8347
1.0843
0.8347
0.8347
0.8347
0.9474
0.8347
0.9474
0.8735
0.8250
1.3208
0.8798
0.8250
0.8250
0.8250
0.8213
0.8250
0.8250
0.8250
0.8250
0.8250
1.0913
0.9483
0.8250
0.8250
0.8250
0.8250
0.8250
0.8250
0.8402
0.8250
1.3208
0.8250
0.9005
0.9709
0.9005
0.8250
1.2681
1.3208
0.9483
0.8402
0.9709
0.9005
1.0913
0.9005
0.9709
0.8250
1.3208
1.3208
0.8735
1.3208
1.3208
0.8250
0.8735
0.8735
0.8735
0.8250
0.8250
0.8250
1.2681
0.8250
-2.93
-2.93
-2.93
-2.93
-2.17
0.80
-2.93
0.08
-2.93
-2.93
-2.93
3.84
-2.93
-2.17
1.88
-0.30
-0.89
2.76
-0.30
-6.49
5.11
-0.45
-0.30
-0.30
-0.30
-0.30
-0.30
2.15
-0.29
-0.30
-0.30
-0.30
-4.09
-0.30
-0.30
0.53
-0.30
-0.89
-0.30
-0.88
1.85
-0.88
-1.28
-0.30
-0.89
-0.29
0.53
1.85
-0.88
-1.23
-0.88
1.85
-0.30
-0.89
-0.89
1.88
-0.89
-0.89
-0.30
1.88
1.88
1.88
-0.30
-0.30
-0.30
-0.30
-0.30
99932
99932
99932
99932
10740
22140
99932
42140
99932
99932
99932
10740
99932
10740
10580
99933
35644
13780
99933
99933
99933
21300
99933
99933
99933
99933
99933
39100
15380
99933
99933
99933
99933
99933
99933
46540
99933
35644
99933
40380
45060
40380
99933
35004
35644
15380
46540
45060
40380
39100
40380
45060
99933
35644
35644
10580
35644
35644
99933
10580
10580
10580
99933
99933
99933
35004
99933
E:\FR\FM\03AUP2.SGM
03AUP2
44160
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
33720
33730
33740
33750
33760
33770
33800
33900
33910
34000
34010
34020
34030
34040
34050
34060
34070
34080
34090
34100
34110
34120
34130
34140
34150
34160
34170
34180
34190
34200
34210
34220
34230
34240
34250
34251
34270
34280
34290
34300
34310
34320
34330
34340
34350
34360
34370
34380
34390
34400
34410
34420
34430
34440
34450
34460
34470
34480
34490
34500
34510
34520
34530
34540
34550
34560
34570
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Tioga County, New York ...........................................................................
Tompkins County, New York ....................................................................
Ulster County, New York ...........................................................................
Warren County, New York ........................................................................
Washington County, New York .................................................................
Wayne County, New York .........................................................................
Westchester County, New York ................................................................
Wyoming County, New York .....................................................................
Yates County, New York ...........................................................................
Alamance County, N Carolina ...................................................................
Alexander County, N Carolina ..................................................................
Alleghany County, N Carolina ...................................................................
Anson County, N Carolina ........................................................................
Ashe County, N Carolina ..........................................................................
Avery County, N Carolina .........................................................................
Beaufort County, N Carolina .....................................................................
Bertie County, N Carolina .........................................................................
Bladen County, N Carolina .......................................................................
Brunswick County, N Carolina ..................................................................
Buncombe County, N Carolina .................................................................
Burke County, N Carolina .........................................................................
Cabarrus County, N Carolina ....................................................................
Caldwell County, N Carolina .....................................................................
Camden County, N Carolina .....................................................................
Carteret County, N Carolina ......................................................................
Caswell County, N Carolina ......................................................................
Catawba County, N Carolina ....................................................................
Chatham County, N Carolina ....................................................................
Cherokee County, N Carolina ...................................................................
Chowan County, N Carolina .....................................................................
Clay County, N Carolina ...........................................................................
Cleveland County, N Carolina ...................................................................
Columbus County, N Carolina ..................................................................
Craven County, N Carolina .......................................................................
Cumberland County, N Carolina ...............................................................
Currituck County, N Carolina ....................................................................
Dare County, N Carolina ...........................................................................
Davidson County, N Carolina ....................................................................
Davie County, N Carolina .........................................................................
Duplin County, N Carolina ........................................................................
Durham County, N Carolina ......................................................................
Edgecombe County, N Carolina ...............................................................
Forsyth County, N Carolina .......................................................................
Franklin County, N Carolina ......................................................................
Gaston County, N Carolina .......................................................................
Gates County, N Carolina .........................................................................
Graham County, N Carolina ......................................................................
Granville County, N Carolina ....................................................................
Greene County, N Carolina .......................................................................
Guilford County, N Carolina ......................................................................
Halifax County, N Carolina ........................................................................
Harnett County, N Carolina .......................................................................
Haywood County, N Carolina ....................................................................
Henderson County, N Carolina .................................................................
Hertford County, N Carolina ......................................................................
Hoke County, N Carolina ..........................................................................
Hyde County, N Carolina ..........................................................................
Iredell County, N Carolina .........................................................................
Jackson County, N Carolina .....................................................................
Johnston County, N Carolina ....................................................................
Jones County, N Carolina .........................................................................
Lee County, N Carolina .............................................................................
Lenoir County, N Carolina .........................................................................
Lincoln County, N Carolina .......................................................................
Mc Dowell County, N Carolina ..................................................................
Macon County, N Carolina ........................................................................
Madison County, N Carolina .....................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00080
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8562
0.9094
0.8825
0.8559
0.8559
0.9085
1.3326
0.8275
0.8275
0.8962
0.8921
0.8501
0.9106
0.8501
0.8501
0.8501
0.8501
0.8501
0.9582
0.9511
0.8921
0.9733
0.8921
0.8501
0.8501
0.8501
0.8921
1.0139
0.8501
0.8501
0.8501
0.8501
0.8501
0.8501
0.9416
0.8799
0.8501
0.8779
0.8981
0.8501
1.0139
0.8915
0.8981
0.9863
0.9733
0.8501
0.8501
0.8501
0.8944
0.9061
0.8501
0.8501
0.8874
0.8874
0.8501
0.8939
0.8501
0.8501
0.8501
0.9863
0.8501
0.8501
0.8501
0.9128
0.8501
0.8501
0.9511
0.8798
0.9831
0.9383
0.8339
0.8339
0.9005
1.3208
0.8250
0.8250
0.8689
0.9021
0.8599
0.9564
0.8599
0.8599
0.8599
0.8599
0.8599
0.9853
0.9093
0.9021
0.9564
0.9021
0.8599
0.8599
0.8599
0.9021
0.9843
0.8599
0.8599
0.8599
0.8599
0.8599
0.8599
0.8961
0.8805
0.8599
0.8599
0.9293
0.8599
0.9843
0.8869
0.9293
0.9879
0.9564
0.8599
0.8599
0.8599
0.9449
0.8735
0.8599
0.8599
0.9093
0.9093
0.8599
0.8961
0.8599
0.8599
0.8599
0.9879
0.8599
0.8599
0.8599
0.8599
0.8599
0.8599
0.9093
2.76
8.10
6.32
-2.57
-2.57
-0.88
-0.89
-0.30
-0.30
-3.05
1.12
1.15
5.03
1.15
1.15
1.15
1.15
1.15
2.83
-4.39
1.12
-1.74
1.12
1.15
1.15
1.15
1.12
-2.92
1.15
1.15
1.15
1.15
1.15
1.15
-4.83
0.07
1.15
-2.05
3.47
1.15
-2.92
-0.52
3.47
0.16
-1.74
1.15
1.15
1.15
5.65
-3.60
1.15
1.15
2.47
2.47
1.15
0.25
1.15
1.15
1.15
0.16
1.15
1.15
1.15
-5.80
1.15
1.15
-4.39
13780
27060
28740
24020
24020
40380
35644
99933
99933
15500
25860
99934
16740
99934
99934
99934
99934
99934
48900
11700
25860
16740
25860
99934
99934
99934
25860
20500
99934
99934
99934
99934
99934
99934
22180
47260
99934
99934
49180
99934
20500
40580
49180
39580
16740
99934
99934
99934
24780
24660
99934
99934
11700
11700
99934
22180
99934
99934
99934
39580
99934
99934
99934
99934
99934
99934
11700
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44161
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
34580
34590
34600
34610
34620
34630
34640
34650
34660
34670
34680
34690
34700
34710
34720
34730
34740
34750
34760
34770
34780
34790
34800
34810
34820
34830
34840
34850
34860
34870
34880
34890
34900
34910
34920
34930
34940
34950
34960
34970
34980
34981
35000
35010
35020
35030
35040
35050
35060
35070
35080
35090
35100
35110
35120
35130
35140
35150
35160
35170
35180
35190
35200
35210
35220
35230
35240
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Martin County, N Carolina .........................................................................
Mecklenburg County, N Carolina ..............................................................
Mitchell County, N Carolina ......................................................................
Montgomery County, N Carolina ...............................................................
Moore County, N Carolina ........................................................................
Nash County, N Carolina ..........................................................................
New Hanover County, N Carolina .............................................................
Northampton County, N Carolina ..............................................................
Onslow County, N Carolina .......................................................................
Orange County, N Carolina .......................................................................
Pamlico County, N Carolina ......................................................................
Pasquotank County, N Carolina ................................................................
Pender County, N Carolina .......................................................................
Perquimans County, N Carolina ...............................................................
Person County, N Carolina .......................................................................
Pitt County, N Carolina .............................................................................
Polk County, N Carolina ............................................................................
Randolph County, N Carolina ...................................................................
Richmond County, N Carolina ..................................................................
Robeson County, N Carolina ....................................................................
Rockingham County, N Carolina ...............................................................
Rowan County, N Carolina .......................................................................
Rutherford County, N Carolina ..................................................................
Sampson County, N Carolina ...................................................................
Scotland County, N Carolina .....................................................................
Stanly County, N Carolina .........................................................................
Stokes County, N Carolina ........................................................................
Surry County, N Carolina ..........................................................................
Swain County, N Carolina .........................................................................
Transylvania County, N Carolina ..............................................................
Tyrrell County, N Carolina .........................................................................
Union County, N Carolina .........................................................................
Vance County, N Carolina ........................................................................
Wake County, N Carolina .........................................................................
Warren County, N Carolina .......................................................................
Washington County, N Carolina ................................................................
Watauga County, N Carolina ....................................................................
Wayne County, N Carolina .......................................................................
Wilkes County, N Carolina ........................................................................
Wilson County, N Carolina ........................................................................
Yadkin County, N Carolina ........................................................................
Yancey County, N Carolina .......................................................................
Adams County, N Dakota .........................................................................
Barnes County, N Dakota .........................................................................
Benson County, N Dakota ........................................................................
Billings County, N Dakota .........................................................................
Bottineau County, N Dakota .....................................................................
Bowman County, N Dakota .......................................................................
Burke County, N Dakota ...........................................................................
Burleigh County, N Dakota .......................................................................
Cass County, N Dakota ............................................................................
Cavalier County, N Dakota .......................................................................
Dickey County, N Dakota ..........................................................................
Divide County, N Dakota ...........................................................................
Dunn County, N Dakota ............................................................................
Eddy County, N Dakota ............................................................................
Emmons County, N Dakota ......................................................................
Foster County, N Dakota ..........................................................................
Golden Valley County, N Dakota ..............................................................
Grand Forks County, N Dakota ................................................................
Grant County, N Dakota ............................................................................
Griggs County, N Dakota ..........................................................................
Hettinger County, N Dakota ......................................................................
Kidder County, N Dakota ..........................................................................
La Moure County, N Dakota .....................................................................
Logan County, N Dakota ...........................................................................
Mc Henry County, N Dakota .....................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00081
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8501
0.9733
0.8501
0.8501
0.8501
0.8915
0.9582
0.8501
0.8236
1.0139
0.8501
0.8501
0.9022
0.8501
0.9353
0.9425
0.8501
0.9061
0.8501
0.8501
0.8783
0.9128
0.8501
0.8501
0.8501
0.8501
0.8981
0.8501
0.8501
0.8501
0.8501
0.9733
0.8501
0.9863
0.8501
0.8501
0.8501
0.8775
0.8501
0.8501
0.8981
0.8501
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7574
0.8486
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7901
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.8599
0.9564
0.8599
0.8599
0.8599
0.8869
0.9853
0.8599
0.8245
0.9843
0.8599
0.8599
0.9853
0.8599
0.9843
0.9449
0.8599
0.8735
0.8599
0.8599
0.8735
0.8599
0.8599
0.8599
0.8599
0.8599
0.9293
0.8599
0.8599
0.8599
0.8599
0.9564
0.8599
0.9879
0.8599
0.8599
0.8599
0.9187
0.8599
0.8599
0.9293
0.8599
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7253
0.8265
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7963
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
1.15
-1.74
1.15
1.15
1.15
-0.52
2.83
1.15
0.11
-2.92
1.15
1.15
9.21
1.15
5.24
0.25
1.15
-3.60
1.15
1.15
-0.55
-5.80
1.15
1.15
1.15
1.15
3.47
1.15
1.15
1.15
1.15
-1.74
1.15
0.16
1.15
1.15
1.15
4.70
1.15
1.15
3.47
1.15
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-4.24
-2.60
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
0.78
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
99934
16740
99934
99934
99934
40580
48900
99934
27340
20500
99934
99934
48900
99934
20500
24780
99934
24660
99934
99934
24660
99934
99934
99934
99934
99934
49180
99934
99934
99934
99934
16740
99934
39580
99934
99934
99934
24140
99934
99934
49180
99934
99935
99935
99935
99935
99935
99935
99935
13900
22020
99935
99935
99935
99935
99935
99935
99935
99935
24220
99935
99935
99935
99935
99935
99935
99935
E:\FR\FM\03AUP2.SGM
03AUP2
44162
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
35250
35260
35270
35280
35290
35300
35310
35320
35330
35340
35350
35360
35370
35380
35390
35400
35410
35420
35430
35440
35450
35460
35470
35480
35490
35500
35510
35520
36000
36010
36020
36030
36040
36050
36060
36070
36080
36090
36100
36110
36120
36130
36140
36150
36160
36170
36190
36200
36210
36220
36230
36240
36250
36260
36270
36280
36290
36300
36310
36330
36340
36350
36360
36370
36380
36390
36400
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Mc Intosh County, N Dakota .....................................................................
Mc Kenzie County, N Dakota ....................................................................
Mc Lean County, N Dakota .......................................................................
Mercer County, N Dakota .........................................................................
Morton County, N Dakota .........................................................................
Mountrail County, N Dakota ......................................................................
Nelson County, N Dakota .........................................................................
Oliver County, N Dakota ...........................................................................
Pembina County, N Dakota ......................................................................
Pierce County, N Dakota ..........................................................................
Ramsey County, N Dakota .......................................................................
Ransom County, N Dakota .......................................................................
Renville County, N Dakota ........................................................................
Richland County, N Dakota .......................................................................
Rolette County, N Dakota .........................................................................
Sargent County, N Dakota ........................................................................
Sheridan County, N Dakota ......................................................................
Sioux County, N Dakota ............................................................................
Slope County, N Dakota ...........................................................................
Stark County, N Dakota ............................................................................
Steele County, N Dakota ..........................................................................
Stutsman County, N Dakota .....................................................................
Towner County, N Dakota .........................................................................
Traill County, N Dakota .............................................................................
Walsh County, N Dakota ...........................................................................
Ward County, N Dakota ............................................................................
Wells County, N Dakota ............................................................................
Williams County, N Dakota .......................................................................
Adams County, Ohio .................................................................................
Allen County, Ohio ....................................................................................
Ashland County, Ohio ...............................................................................
Ashtabula County, Ohio ............................................................................
Athens County, Ohio .................................................................................
Auglaize County, Ohio ..............................................................................
Belmont County, Ohio ...............................................................................
Brown County, Ohio ..................................................................................
Butler County, Ohio ...................................................................................
Carroll County, Ohio ..................................................................................
Champaign County, Ohio ..........................................................................
Clark County, Ohio ....................................................................................
Clermont County, Ohio ..............................................................................
Clinton County, Ohio .................................................................................
Columbiana County, Ohio .........................................................................
Coshocton County, Ohio ...........................................................................
Crawford County, Ohio ..............................................................................
Cuyahoga County, Ohio ............................................................................
Darke County, Ohio ...................................................................................
Defiance County, Ohio ..............................................................................
Delaware County, Ohio .............................................................................
Erie County, Ohio ......................................................................................
Fairfield County, Ohio ...............................................................................
Fayette County, Ohio ................................................................................
Franklin County, Ohio ...............................................................................
Fulton County, Ohio ..................................................................................
Gallia County, Ohio ...................................................................................
Geauga County, Ohio ...............................................................................
Greene County, Ohio ................................................................................
Guernsey County, Ohio .............................................................................
Hamilton County, Ohio ..............................................................................
Hancock County, Ohio ..............................................................................
Hardin County, Ohio ..................................................................................
Harrison County, Ohio ...............................................................................
Henry County, Ohio ...................................................................................
Highland County, Ohio ..............................................................................
Hocking County, Ohio ...............................................................................
Holmes County, Ohio ................................................................................
Huron County, Ohio ..................................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00082
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7261
0.7261
0.7261
0.7261
0.7574
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.7261
0.8874
0.9172
0.8874
0.9005
0.8874
0.8973
0.7161
0.9675
0.9283
0.8935
0.8874
0.8688
0.9675
0.8874
0.8837
0.8874
0.9359
0.9198
0.8874
0.8874
0.9867
0.8970
0.9867
0.8874
0.9867
0.9574
0.8874
0.9198
0.9022
0.8874
0.9675
0.8874
0.8874
0.8874
0.8874
0.8874
0.8874
0.8874
0.8874
0.7228
0.7228
0.7228
0.7228
0.7253
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.7228
0.8674
0.9058
0.8674
0.8674
0.8674
0.8674
0.7022
0.9617
0.9617
0.9047
0.8674
0.8462
0.9617
0.8674
0.8674
0.8674
0.8674
0.9385
0.8674
0.8674
1.0122
0.9319
1.0122
0.8674
1.0122
0.9599
0.8674
0.9385
0.9053
0.8674
0.9617
0.8674
0.8674
0.8674
0.8674
0.8674
0.8674
0.8674
0.8674
-0.45
-0.45
-0.45
-0.45
-4.24
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-0.45
-2.25
-1.24
-2.25
-3.68
-2.25
-3.33
-1.94
-0.60
3.60
1.25
-2.25
-2.60
-0.60
-2.25
-1.84
-2.25
-7.32
2.03
-2.25
-2.25
2.58
3.89
2.58
-2.25
2.58
0.26
-2.25
2.03
0.34
-2.25
-0.60
-2.25
-2.25
-2.25
-2.25
-2.25
-2.25
-2.25
-2.25
99935
99935
99935
99935
13900
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99935
99936
30620
99936
99936
99936
99936
48540
17140
17140
15940
99936
44220
17140
99936
99936
99936
99936
17460
99936
99936
18140
41780
18140
99936
18140
45780
99936
17460
19380
99936
17140
99936
99936
99936
99936
99936
99936
99936
99936
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44163
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
36410
36420
36430
36440
36450
36460
36470
36480
36490
36500
36510
36520
36530
36540
36550
36560
36570
36580
36590
36600
36610
36620
36630
36640
36650
36660
36670
36680
36690
36700
36710
36720
36730
36740
36750
36760
36770
36780
36790
36800
36810
36820
36830
36840
36850
36860
36870
36880
36890
37000
37010
37020
37030
37040
37050
37060
37070
37080
37090
37100
37110
37120
37130
37140
37150
37160
37170
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Jackson County, Ohio ...............................................................................
Jefferson County, Ohio .............................................................................
Knox County, Ohio ....................................................................................
Lake County, Ohio ....................................................................................
Lawrence County, Ohio .............................................................................
Licking County, Ohio .................................................................................
Logan County, Ohio ..................................................................................
Lorain County, Ohio ..................................................................................
Lucas County, Ohio ...................................................................................
Madison County, Ohio ...............................................................................
Mahoning County, Ohio ............................................................................
Marion County, Ohio .................................................................................
Medina County, Ohio ................................................................................
Meigs County, Ohio ...................................................................................
Mercer County, Ohio .................................................................................
Miami County, Ohio ...................................................................................
Monroe County, Ohio ................................................................................
Montgomery County, Ohio ........................................................................
Morgan County, Ohio ................................................................................
Morrow County, Ohio ................................................................................
Muskingum County, Ohio ..........................................................................
Noble County, Ohio ...................................................................................
Ottawa County, Ohio .................................................................................
Paulding County, Ohio ..............................................................................
Perry County, Ohio ....................................................................................
Pickaway County, Ohio .............................................................................
Pike County, Ohio .....................................................................................
Portage County, Ohio ................................................................................
Preble County, Ohio ..................................................................................
Putnam County, Ohio ................................................................................
Richland County, Ohio ..............................................................................
Ross County, Ohio ....................................................................................
Sandusky County, Ohio ............................................................................
Scioto County, Ohio ..................................................................................
Seneca County, Ohio ................................................................................
Shelby County, Ohio .................................................................................
Stark County, Ohio ....................................................................................
Summit County, Ohio ................................................................................
Trumbull County, Ohio ..............................................................................
Tuscarawas County, Ohio .........................................................................
Union County, Ohio ...................................................................................
Van Wert County, Ohio .............................................................................
Vinton County, Ohio ..................................................................................
Warren County, Ohio ................................................................................
Washington County, Ohio .........................................................................
Wayne County, Ohio .................................................................................
Williams County, Ohio ...............................................................................
Wood County, Ohio ...................................................................................
Wyandot County, Ohio ..............................................................................
Adair County, Oklahoma ...........................................................................
Alfalfa County, Oklahoma .........................................................................
Atoka County, Oklahoma ..........................................................................
Beaver County, Oklahoma ........................................................................
Beckham County, Oklahoma ....................................................................
Blaine County, Oklahoma .........................................................................
Bryan County, Oklahoma ..........................................................................
Caddo County, Oklahoma .........................................................................
Canadian County, Oklahoma ....................................................................
Carter County, Oklahoma .........................................................................
Cherokee County, Oklahoma ....................................................................
Choctaw County, Oklahoma .....................................................................
Cimarron County, Oklahoma .....................................................................
Cleveland County, Oklahoma ...................................................................
Coal County, Oklahoma ............................................................................
Comanche County, Oklahoma ..................................................................
Cotton County, Oklahoma .........................................................................
Craig County, Oklahoma ...........................................................................
15:25 Aug 02, 2006
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PO 00000
Frm 00083
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8874
0.7819
0.8874
0.9198
0.9477
0.9867
0.8874
0.9198
0.9574
0.9867
0.8726
0.8874
0.9198
0.8874
0.8874
0.9022
0.8874
0.9022
0.8874
0.9391
0.8874
0.8874
0.9248
0.8874
0.8874
0.9867
0.8874
0.8982
0.8993
0.8874
0.8902
0.8874
0.8874
0.8874
0.8874
0.8874
0.8935
0.8982
0.8726
0.8874
0.9391
0.8874
0.8874
0.9675
0.8270
0.8874
0.8874
0.9574
0.8874
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.9028
0.7512
0.7512
0.7512
0.7512
0.9028
0.7512
0.7872
0.7512
0.7512
0.8674
0.8078
0.8674
0.9385
0.9013
1.0122
0.8674
0.9385
0.9599
1.0122
0.8817
0.8674
0.9385
0.8674
0.8674
0.9053
0.8674
0.9053
0.8674
1.0122
0.8674
0.8674
0.9599
0.8674
0.8674
1.0122
0.8674
0.8639
0.9053
0.8674
0.9287
0.8674
0.8674
0.8674
0.8674
0.8674
0.9047
0.8639
0.8817
0.8674
1.0122
0.8674
0.8674
0.9617
0.7940
0.8674
0.8674
0.9599
0.8674
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.8853
0.7640
0.7640
0.7640
0.7640
0.8853
0.7640
0.8080
0.7640
0.7640
-2.25
3.31
-2.25
2.03
-4.90
2.58
-2.25
2.03
0.26
2.58
1.04
-2.25
2.03
-2.25
-2.25
0.34
-2.25
0.34
-2.25
7.78
-2.25
-2.25
3.80
-2.25
-2.25
2.58
-2.25
-3.82
0.67
-2.25
4.32
-2.25
-2.25
-2.25
-2.25
-2.25
1.25
-3.82
1.04
-2.25
7.78
-2.25
-2.25
-0.60
-3.99
-2.25
-2.25
0.26
-2.25
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
-1.94
1.70
1.70
1.70
1.70
-1.94
1.70
2.64
1.70
1.70
99936
48260
99936
17460
26580
18140
99936
17460
45780
18140
49660
99936
17460
99936
99936
19380
99936
19380
99936
18140
99936
99936
45780
99936
99936
18140
99936
10420
19380
99936
31900
99936
99936
99936
99936
99936
15940
10420
49660
99936
18140
99936
99936
17140
37620
99936
99936
45780
99936
99937
99937
99937
99937
99937
99937
99937
99937
36420
99937
99937
99937
99937
36420
99937
30020
99937
99937
E:\FR\FM\03AUP2.SGM
03AUP2
44164
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
37180
37190
37200
37210
37220
37230
37240
37250
37260
37270
37280
37290
37300
37310
37320
37330
37340
37350
37360
37370
37380
37390
37400
37410
37420
37430
37440
37450
37460
37470
37480
37490
37500
37510
37520
37530
37540
37550
37560
37570
37580
37590
37600
37610
37620
37630
37640
37650
37660
37670
37680
37690
37700
37710
37720
37730
37740
37750
37760
38000
38010
38020
38030
38040
38050
38060
38070
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Creek County, Oklahoma ..........................................................................
Custer County, Oklahoma .........................................................................
Delaware County, Oklahoma ....................................................................
Dewey County, Oklahoma ........................................................................
Ellis County, Oklahoma .............................................................................
Garfield County, Oklahoma .......................................................................
Garvin County, Oklahoma .........................................................................
Grady County, Oklahoma ..........................................................................
Grant County, Oklahoma ..........................................................................
Greer County, Oklahoma ..........................................................................
Harmon County, Oklahoma .......................................................................
Harper County, Oklahoma ........................................................................
Haskell County, Oklahoma ........................................................................
Hughes County, Oklahoma .......................................................................
Jackson County, Oklahoma ......................................................................
Jefferson County, Oklahoma .....................................................................
Johnston County, Oklahoma .....................................................................
Kay County, Oklahoma .............................................................................
Kingfisher County, Oklahoma ...................................................................
Kiowa County, Oklahoma ..........................................................................
Latimer County, Oklahoma .......................................................................
Le Flore County, Oklahoma ......................................................................
Lincoln County, Oklahoma ........................................................................
Logan County, Oklahoma .........................................................................
Love County, Oklahoma ............................................................................
Mc Clain County, Oklahoma .....................................................................
Mc Curtain County, Oklahoma ..................................................................
Mc Intosh County, Oklahoma ....................................................................
Major County, Oklahoma ..........................................................................
Marshall County, Oklahoma ......................................................................
Mayes County, Oklahoma .........................................................................
Murray County, Oklahoma ........................................................................
Muskogee County, Oklahoma ...................................................................
Noble County, Oklahoma ..........................................................................
Nowata County, Oklahoma .......................................................................
Okfuskee County, Oklahoma ....................................................................
Oklahoma County, Oklahoma ...................................................................
Okmulgee County, Oklahoma ...................................................................
Osage County, Oklahoma .........................................................................
Ottawa County, Oklahoma ........................................................................
Pawnee County, Oklahoma ......................................................................
Payne County, Oklahoma .........................................................................
Pittsburg County, Oklahoma .....................................................................
Pontotoc County, Oklahoma .....................................................................
Pottawatomie County, Oklahoma ..............................................................
Pushmataha County, Oklahoma ...............................................................
Roger Mills County, Oklahoma .................................................................
Rogers County, Oklahoma ........................................................................
Seminole County, Oklahoma ....................................................................
Sequoyah County, Oklahoma ...................................................................
Stephens County, Oklahoma ....................................................................
Texas County, Oklahoma ..........................................................................
Tillman County, Oklahoma ........................................................................
Tulsa County, Oklahoma ...........................................................................
Wagoner County, Oklahoma .....................................................................
Washington County, Oklahoma ................................................................
Washita County, Oklahoma ......................................................................
Woods County, Oklahoma ........................................................................
Woodward County, Oklahoma ..................................................................
Baker County, Oregon ..............................................................................
Benton County, Oregon ............................................................................
Clackamas County, Oregon ......................................................................
Clatsop County, Oregon ............................................................................
Columbia County, Oregon .........................................................................
Coos County, Oregon ...............................................................................
Crook County, Oregon ..............................................................................
Curry County, Oregon ...............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00084
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8565
0.7512
0.7512
0.7512
0.7512
0.8124
0.7512
0.8237
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7836
0.8237
0.9028
0.7512
0.9028
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.7512
0.9028
0.7993
0.8565
0.7512
0.7993
0.7512
0.7512
0.7512
0.8303
0.7512
0.7512
0.8565
0.7512
0.8238
0.7512
0.7512
0.7512
0.8565
0.8565
0.7512
0.7512
0.7512
0.7512
0.9939
1.0729
1.1266
0.9939
1.1266
0.9939
0.9939
0.9939
0.8104
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.8853
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7745
0.8853
0.8853
0.7640
0.8853
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.8853
0.8104
0.8104
0.7640
0.8104
0.7640
0.7640
0.7640
0.7640
0.7640
0.7640
0.8104
0.7640
0.7745
0.7640
0.7640
0.7640
0.8104
0.8104
0.7640
0.7640
0.7640
0.7640
0.9770
1.1566
1.1436
0.9770
1.1436
0.9770
0.9770
0.9770
-5.38
1.70
1.70
1.70
1.70
-5.96
1.70
7.48
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
-1.16
7.48
-1.94
1.70
-1.94
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
1.70
-1.94
1.39
-5.38
1.70
1.39
1.70
1.70
1.70
-7.99
1.70
1.70
-5.38
1.70
-5.98
1.70
1.70
1.70
-5.38
-5.38
1.70
1.70
1.70
1.70
-1.70
7.80
1.51
-1.70
1.51
-1.70
-1.70
-1.70
46140
99937
99937
99937
99937
99937
99937
36420
99937
99937
99937
99937
99937
99937
99937
99937
99937
99937
99937
99937
99937
22900
36420
36420
99937
36420
99937
99937
99937
99937
99937
99937
99937
99937
99937
99937
36420
46140
46140
99937
46140
99937
99937
99937
99937
99937
99937
46140
99937
22900
99937
99937
99937
46140
46140
99937
99937
99937
99937
99938
18700
38900
99938
38900
99938
99938
99938
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44165
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
38080
38090
38100
38110
38120
38130
38140
38150
38160
38170
38180
38190
38200
38210
38220
38230
38240
38250
38260
38270
38280
38290
38300
38310
38320
38330
38340
38350
39000
39010
39070
39080
39100
39110
39120
39130
39140
39150
39160
39180
39190
39200
39210
39220
39230
39240
39250
39260
39270
39280
39290
39310
39320
39330
39340
39350
39360
39370
39380
39390
39400
39410
39420
39440
39450
39460
39470
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Deschutes County, Oregon .......................................................................
Douglas County, Oregon ...........................................................................
Gilliam County, Oregon .............................................................................
Grant County, Oregon ...............................................................................
Harney County, Oregon ............................................................................
Hood River County, Oregon ......................................................................
Jackson County, Oregon ...........................................................................
Jefferson County, Oregon .........................................................................
Josephine County, Oregon .......................................................................
Klamath County, Oregon ...........................................................................
Lake County, Oregon ................................................................................
Lane County, Oregon ................................................................................
Lincoln County, Oregon ............................................................................
Linn County, Oregon .................................................................................
Malheur County, Oregon ...........................................................................
Marion County, Oregon .............................................................................
Morrow County, Oregon ............................................................................
Multnomah County, Oregon ......................................................................
Polk County, Oregon .................................................................................
Sherman County, Oregon .........................................................................
Tillamook County, Oregon ........................................................................
Umatilla County, Oregon ...........................................................................
Union County, Oregon ..............................................................................
Wallowa County, Oregon ..........................................................................
Wasco County, Oregon .............................................................................
Washington County, Oregon .....................................................................
Wheeler County, Oregon ..........................................................................
Yamhill County, Oregon ............................................................................
Adams County, Pennsylvania ...................................................................
Allegheny County, Pennsylvania ...............................................................
Armstrong County, Pennsylvania ..............................................................
Beaver County, Pennsylvania ...................................................................
Bedford County, Pennsylvania ..................................................................
Berks County, Pennsylvania .....................................................................
Blair County, Pennsylvania .......................................................................
Bradford County, Pennsylvania .................................................................
Bucks County, Pennsylvania .....................................................................
Butler County, Pennsylvania .....................................................................
Cambria County, Pennsylvania .................................................................
Cameron County, Pennsylvania ................................................................
Carbon County, Pennsylvania ...................................................................
Centre County, Pennsylvania ....................................................................
Chester County, Pennsylvania ..................................................................
Clarion County, Pennsylvania ...................................................................
Clearfield County, Pennsylvania ...............................................................
Clinton County, Pennsylvania ...................................................................
Columbia County, Pennsylvania ...............................................................
Crawford County, Pennsylvania ................................................................
Cumberland County, Pennsylvania ...........................................................
Dauphin County, Pennsylvania .................................................................
Delaware County, Pennsylvania ...............................................................
Elk County, Pennsylvania .........................................................................
Erie County, Pennsylvania ........................................................................
Fayette County, Pennsylvania ..................................................................
Forest County, Pennsylvania ....................................................................
Franklin County, Pennsylvania ..................................................................
Fulton County, Pennsylvania ....................................................................
Greene County, Pennsylvania ..................................................................
Huntingdon County, Pennsylvania ............................................................
Indiana County, Pennsylvania ...................................................................
Jefferson County, Pennsylvania ................................................................
Juniata County, Pennsylvania ...................................................................
Lackawanna County, Pennsylvania ..........................................................
Lancaster County, Pennsylvania ...............................................................
Lawrence County, Pennsylvania ...............................................................
Lebanon County, Pennsylvania ................................................................
Lehigh County, Pennsylvania ....................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00085
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
1.0419
0.9939
0.9939
0.9939
0.9939
0.9939
1.0225
0.9939
0.9939
0.9939
0.9939
1.0818
0.9939
0.9939
0.9939
1.0442
0.9939
1.1266
1.0442
0.9939
0.9939
0.9939
0.9939
0.9939
0.9939
1.1266
0.9939
1.1266
0.8305
0.8853
0.8582
0.8853
0.8305
0.9686
0.8944
0.8305
1.0980
0.8853
0.8220
0.8305
0.9832
0.8356
1.0980
0.8305
0.8305
0.8305
0.8408
0.8305
0.9273
0.9273
1.0980
0.8305
0.8737
0.8853
0.8305
0.8305
0.8305
0.8305
0.8305
0.8305
0.8305
0.8305
0.8532
0.9694
0.8305
0.8846
0.9832
1.0762
0.9770
0.9770
0.9770
0.9770
0.9770
1.0837
0.9770
0.9770
0.9770
0.9770
1.0896
0.9770
0.9770
0.9770
1.0457
0.9770
1.1436
1.0457
0.9770
0.9770
0.9770
0.9770
0.9770
0.9770
1.1436
0.9770
1.1436
0.8332
0.8685
0.8685
0.8685
0.8332
0.9639
0.8727
0.8332
1.1018
0.8685
0.8635
0.8332
0.9910
0.8799
1.1018
0.8332
0.8332
0.8332
0.8332
0.8332
0.9419
0.9419
1.1018
0.8332
0.8704
0.8685
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8521
0.9644
0.8332
0.8695
0.9910
3.29
-1.70
-1.70
-1.70
-1.70
-1.70
5.99
-1.70
-1.70
-1.70
-1.70
0.72
-1.70
-1.70
-1.70
0.14
-1.70
1.51
0.14
-1.70
-1.70
-1.70
-1.70
-1.70
-1.70
1.51
-1.70
1.51
0.33
-1.90
1.20
-1.90
0.33
-0.49
-2.43
0.33
0.35
-1.90
5.05
0.33
0.79
5.30
0.35
0.33
0.33
0.33
-0.90
0.33
1.57
1.57
0.35
0.33
-0.38
-1.90
0.33
0.33
0.33
0.33
0.33
0.33
0.33
0.33
-0.13
-0.52
0.33
-1.71
0.79
13460
99938
99938
99938
99938
99938
32780
99938
99938
99938
99938
21660
99938
99938
99938
41420
99938
38900
41420
99938
99938
99938
99938
99938
99938
38900
99938
38900
99939
38300
38300
38300
99939
39740
11020
99939
37964
38300
27780
99939
10900
44300
37964
99939
99939
99939
99939
99939
25420
25420
37964
99939
21500
38300
99939
99939
99939
99939
99939
99939
99939
99939
42540
29540
99939
30140
10900
E:\FR\FM\03AUP2.SGM
03AUP2
44166
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
39480
39510
39520
39530
39540
39550
39560
39580
39590
39600
39610
39620
39630
39640
39650
39670
39680
39690
39700
39710
39720
39730
39740
39750
39760
39770
39790
39800
40010
40020
40030
40040
40050
40060
40070
40080
40090
40100
40110
40120
40130
40140
40145
40150
40160
40170
40180
40190
40200
40210
40220
40230
40240
40250
40260
40265
40270
40280
40290
40300
40310
40320
40330
40340
40350
40360
40370
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Luzerne County, Pennsylvania .................................................................
Lycoming County, Pennsylvania ...............................................................
Mc Kean County, Pennsylvania ................................................................
Mercer County, Pennsylvania ...................................................................
Mifflin County, Pennsylvania .....................................................................
Monroe County, Pennsylvania ..................................................................
Montgomery County, Pennsylvania ..........................................................
Montour County, Pennsylvania .................................................................
Northampton County, Pennsylvania ..........................................................
Northumberland County, Pennsylvania .....................................................
Perry County, Pennsylvania ......................................................................
Philadelphia County, Pennsylvania ...........................................................
Pike County, Pennsylvania .......................................................................
Potter County, Pennsylvania .....................................................................
Schuylkill County, Pennsylvania ...............................................................
Snyder County, Pennsylvania ...................................................................
Somerset County, Pennsylvania ...............................................................
Sullivan County, Pennsylvania ..................................................................
Susquehanna County, Pennsylvania ........................................................
Tioga County, Pennsylvania .....................................................................
Union County, Pennsylvania .....................................................................
Venango County, Pennsylvania ................................................................
Warren County, Pennsylvania ...................................................................
Washington County, Pennsylvania ...........................................................
Wayne County, Pennsylvania ...................................................................
Westmoreland County, Pennsylvania .......................................................
Wyoming County, Pennsylvania ...............................................................
York County, Pennsylvania .......................................................................
Adjuntas County, Puerto Rico ...................................................................
Aguada County, Puerto Rico ....................................................................
Aguadilla County, Puerto Rico ..................................................................
Aguas Buenas County, Puerto Rico .........................................................
Aibonito County, Puerto Rico ....................................................................
Anasco County, Puerto Rico .....................................................................
Arecibo County, Puerto Rico .....................................................................
Arroyo County, Puerto Rico ......................................................................
Barceloneta County, Puerto Rico ..............................................................
Barranquitas County, Puerto Rico ............................................................
Bayamon County, Puerto Rico ..................................................................
Cabo Rojo County, Puerto Rico ................................................................
Caguas County, Puerto Rico ....................................................................
Camuy County, Puerto Rico .....................................................................
Canovanas County, Puerto Rico ...............................................................
Carolina County, Puerto Rico ...................................................................
Catano County, Puerto Rico .....................................................................
Cayey County, Puerto Rico .......................................................................
Ceiba County, Puerto Rico .......................................................................
Ciales County, Puerto Rico .......................................................................
Cidra County, Puerto Rico ........................................................................
Coamo County, Puerto Rico .....................................................................
Comerio County, Puerto Rico ...................................................................
Corozal County, Puerto Rico ....................................................................
Culebra County, Puerto Rico ....................................................................
Dorado County, Puerto Rico .....................................................................
Fajardo County, Puerto Rico .....................................................................
Florida County, Puerto Rico ......................................................................
Guanica County, Puerto Rico ...................................................................
Guayama County, Puerto Rico .................................................................
Guayanilla County, Puerto Rico ................................................................
Guaynabo County, Puerto Rico ................................................................
Gurabo County, Puerto Rico .....................................................................
Hatillo County, Puerto Rico .......................................................................
Hormigueros County, Puerto Rico ............................................................
Humacao County, Puerto Rico .................................................................
Isabela County, Puerto Rico .....................................................................
Jayuya County, Puerto Rico .....................................................................
Juana Diaz County, Puerto Rico ...............................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00086
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8532
0.8364
0.8305
0.8198
0.8305
0.8305
1.0980
0.8305
0.9832
0.8305
0.9273
1.0980
1.1545
0.8305
0.8305
0.8305
0.8189
0.8305
0.8305
0.8305
0.8305
0.8305
0.8305
0.8853
0.8305
0.8853
0.8532
0.9347
0.3826
0.4807
0.4807
0.4687
0.4113
0.4491
0.4367
0.3393
0.4687
0.4113
0.4687
0.4447
0.4371
0.4367
0.4687
0.4687
0.4687
0.4371
0.4453
0.4113
0.4371
0.3826
0.4687
0.4687
0.3826
0.4687
0.4453
0.4687
0.4006
0.3393
0.4645
0.4687
0.4371
0.4367
0.4132
0.4687
0.4171
0.3826
0.4910
0.8521
0.8126
0.8332
0.8817
0.8332
0.8332
1.1018
0.8332
0.9910
0.8332
0.9419
1.1018
1.1890
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8332
0.8685
0.8332
0.8685
0.8521
0.9414
0.4047
0.3922
0.3922
0.4397
0.4397
0.3922
0.4397
0.3241
0.4397
0.4397
0.4397
0.4893
0.4397
0.4397
0.4397
0.4397
0.4397
0.4397
0.4044
0.4397
0.4397
0.4047
0.4397
0.4397
0.4047
0.4397
0.4044
0.4397
0.3861
0.3241
0.3861
0.4397
0.4397
0.4397
0.3857
0.4397
0.3922
0.4047
0.4851
-0.13
-2.85
0.33
7.55
0.33
0.33
0.35
0.33
0.79
0.33
1.57
0.35
2.99
0.33
0.33
0.33
1.75
0.33
0.33
0.33
0.33
0.33
0.33
-1.90
0.33
-1.90
-0.13
0.72
5.78
-18.41
-18.41
-6.19
6.90
-12.67
0.69
-4.48
-6.19
6.90
-6.19
10.03
0.59
0.69
-6.19
-6.19
-6.19
0.59
-9.18
6.90
0.59
5.78
-6.19
-6.19
5.78
-6.19
-9.18
-6.19
-3.62
-4.48
-16.88
-6.19
0.59
0.69
-6.66
-6.19
-5.97
5.78
-1.20
42540
48700
99939
49660
99939
99939
37964
99939
10900
99939
25420
37964
35084
99939
99939
99939
99939
99939
99939
99939
99939
99939
99939
38300
99939
38300
42540
49620
99940
10380
10380
41980
41980
10380
41980
25020
41980
41980
41980
41900
41980
41980
41980
41980
41980
41980
21940
41980
41980
99940
41980
41980
99940
41980
21940
41980
49500
25020
49500
41980
41980
41980
32420
41980
10380
99940
38660
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44167
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
40380
40390
40400
40410
40420
40430
40440
40450
40460
40470
40480
40490
40500
40510
40520
40530
40540
40550
40560
40570
40580
40590
40610
40620
40630
40640
40650
40660
40670
40680
40690
40700
40710
40720
40730
40740
40750
40760
40770
41000
41010
41020
41030
41050
42000
42010
42020
42030
42040
42050
42060
42070
42080
42090
42100
42110
42120
42130
42140
42150
42160
42170
42180
42190
42200
42210
42220
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Juncos County, Puerto Rico .....................................................................
Lajas County, Puerto Rico ........................................................................
Lares County, Puerto Rico ........................................................................
Las Marias County, Puerto Rico ...............................................................
Las Piedras County, Puerto Rico ..............................................................
Loiza County, Puerto Rico ........................................................................
Luquillo County, Puerto Rico ....................................................................
Manati County, Puerto Rico ......................................................................
Maricao County, Puerto Rico ....................................................................
Maunabo County, Puerto Rico ..................................................................
Mayaguez County, Puerto Rico ................................................................
Moca County, Puerto Rico ........................................................................
Morovis County, Puerto Rico ....................................................................
Naguabo County, Puerto Rico ..................................................................
Naranjito County, Puerto Rico ..................................................................
Orocovis County, Puerto Rico ...................................................................
Patillas County, Puerto Rico .....................................................................
Penuelas County, Puerto Rico ..................................................................
Ponce County, Puerto Rico .......................................................................
Quebradillas County, Puerto Rico .............................................................
Rincon County, Puerto Rico ......................................................................
Rio Grande County, Puerto Rico ..............................................................
Sabana Grande County, Puerto Rico .......................................................
Salinas County, Puerto Rico .....................................................................
San German County, Puerto Rico ............................................................
San Juan County, Puerto Rico .................................................................
San Lorenzo County, Puerto Rico ............................................................
San Sebastian County, Puerto Rico .........................................................
Santa Isabel County, Puerto Rico .............................................................
Toa Alta County, Puerto Rico ...................................................................
Toa Baja County, Puerto Rico ..................................................................
Trujillo Alto County, Puerto Rico ...............................................................
Utuado County, Puerto Rico .....................................................................
Vega Alta County, Puerto Rico .................................................................
Vega Baja County, Puerto Rico ................................................................
Vieques County, Puerto Rico ....................................................................
Villalba County, Puerto Rico .....................................................................
Yabucoa County, Puerto Rico ...................................................................
Yauco County, Puerto Rico .......................................................................
Bristol County, Rhode Island ....................................................................
Kent County, Rhode Island .......................................................................
Newport County, Rhode Island .................................................................
Providence County, Rhode Island ............................................................
Washington County, Rhode Island ...........................................................
Abbeville County, S Carolina ....................................................................
Aiken County, S Carolina ..........................................................................
Allendale County, S Carolina ....................................................................
Anderson County, S Carolina ...................................................................
Bamberg County, S Carolina ....................................................................
Barnwell County, S Carolina .....................................................................
Beaufort County, S Carolina .....................................................................
Berkeley County, S Carolina .....................................................................
Calhoun County, S Carolina .....................................................................
Charleston County, S Carolina .................................................................
Cherokee County, S Carolina ...................................................................
Chester County, S Carolina ......................................................................
Chesterfield County, S Carolina ................................................................
Clarendon County, S Carolina ..................................................................
Colleton County, S Carolina ......................................................................
Darlington County, S Carolina ..................................................................
Dillon County, S Carolina ..........................................................................
Dorchester County, S Carolina .................................................................
Edgefield County, S Carolina ....................................................................
Fairfield County, S Carolina ......................................................................
Florence County, S Carolina .....................................................................
Georgetown County, S Carolina ...............................................................
Greenville County, S Carolina ...................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00087
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.4687
0.4127
0.4171
0.3826
0.4687
0.4687
0.4453
0.4687
0.3826
0.4113
0.4132
0.4807
0.4687
0.4687
0.4687
0.4113
0.3393
0.4645
0.4910
0.4113
0.4171
0.4687
0.4447
0.3826
0.4447
0.4687
0.4371
0.4171
0.3826
0.4687
0.4687
0.4687
0.3826
0.4687
0.4687
0.3826
0.4910
0.4687
0.4645
1.1012
1.1012
1.1012
1.1012
1.1012
0.8635
0.9778
0.8635
0.9306
0.8635
0.8635
0.8635
0.9245
0.8844
0.9245
0.9127
0.8635
0.8635
0.8635
0.8635
0.8789
0.8635
0.9245
0.9778
0.8844
0.8995
0.8635
0.9821
0.4397
0.4893
0.3922
0.4047
0.4397
0.4397
0.4044
0.4397
0.4047
0.4397
0.3857
0.3922
0.4397
0.4397
0.4397
0.4397
0.3241
0.3861
0.4851
0.4397
0.3922
0.4397
0.4893
0.4047
0.4893
0.4397
0.4397
0.3922
0.4047
0.4397
0.4397
0.4397
0.4047
0.4397
0.4397
0.4047
0.4851
0.4397
0.3861
1.0804
1.0804
1.0804
1.0804
1.0804
0.8583
0.9678
0.8583
0.8959
0.8583
0.8583
0.8583
0.9156
0.8028
0.9156
0.8583
0.8583
0.8583
0.8583
0.8583
0.8421
0.8583
0.9156
0.9678
0.8028
0.8421
0.8583
0.9733
-6.19
18.56
-5.97
5.78
-6.19
-6.19
-9.18
-6.19
5.78
6.90
-6.66
-18.41
-6.19
-6.19
-6.19
6.90
-4.48
-16.88
-1.20
6.90
-5.97
-6.19
10.03
5.78
10.03
-6.19
0.59
-5.97
5.78
-6.19
-6.19
-6.19
5.78
-6.19
-6.19
5.78
-1.20
-6.19
-16.88
-1.89
-1.89
-1.89
-1.89
-1.89
-0.60
-1.02
-0.60
-3.73
-0.60
-0.60
-0.60
-0.96
-9.23
-0.96
-5.96
-0.60
-0.60
-0.60
-0.60
-4.19
-0.60
-0.96
-1.02
-9.23
-6.38
-0.60
-0.90
41980
41900
10380
99940
41980
41980
21940
41980
99940
41980
32420
10380
41980
41980
41980
41980
25020
49500
38660
41980
10380
41980
41900
99940
41900
41980
41980
10380
99940
41980
41980
41980
99940
41980
41980
99940
38660
41980
49500
39300
39300
39300
39300
39300
99942
12260
99942
11340
99942
99942
99942
16700
17900
16700
99942
99942
99942
99942
99942
22500
99942
16700
12260
17900
22500
99942
24860
E:\FR\FM\03AUP2.SGM
03AUP2
44168
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
42230
42240
42250
42260
42270
42280
42290
42300
42310
42320
42330
42340
42350
42360
42370
42380
42390
42400
42410
42420
42430
42440
42450
43010
43020
43030
43040
43050
43060
43070
43080
43090
43100
43110
43120
43130
43140
43150
43160
43170
43180
43190
43200
43210
43220
43230
43240
43250
43260
43270
43280
43290
43300
43310
43320
43330
43340
43350
43360
43370
43380
43390
43400
43410
43420
43430
43440
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Greenwood County, S Carolina ................................................................
Hampton County, S Carolina ....................................................................
Horry County, S Carolina ..........................................................................
Jasper County, S Carolina ........................................................................
Kershaw County, S Carolina .....................................................................
Lancaster County, S Carolina ...................................................................
Laurens County, S Carolina ......................................................................
Lee County, S Carolina .............................................................................
Lexington County, S Carolina ...................................................................
Mc Cormick County, S Carolina ................................................................
Marion County, S Carolina ........................................................................
Marlboro County, S Carolina .....................................................................
Newberry County, S Carolina ...................................................................
Oconee County, S Carolina ......................................................................
Orangeburg County, S Carolina ................................................................
Pickens County, S Carolina ......................................................................
Richland County, S Carolina .....................................................................
Saluda County, S Carolina ........................................................................
Spartanburg County, S Carolina ...............................................................
Sumter County, S Carolina .......................................................................
Union County, S Carolina .........................................................................
Williamsburg County, S Carolina ..............................................................
York County, S Carolina ...........................................................................
Aurora County, S Dakota ..........................................................................
Beadle County, S Dakota ..........................................................................
Bennett County, S Dakota ........................................................................
Bon Homme County, S Dakota .................................................................
Brookings County, S Dakota .....................................................................
Brown County, S Dakota ...........................................................................
Brule County, S Dakota ............................................................................
Buffalo County, S Dakota ..........................................................................
Butte County, S Dakota ............................................................................
Campbell County, S Dakota ......................................................................
Charles Mix County, S Dakota ..................................................................
Clark County, S Dakota ............................................................................
Clay County, S Dakota ..............................................................................
Codington County, S Dakota ....................................................................
Corson County, S Dakota .........................................................................
Custer County, S Dakota ..........................................................................
Davison County, S Dakota ........................................................................
Day County, S Dakota ..............................................................................
Deuel County, S Dakota ...........................................................................
Dewey County, S Dakota ..........................................................................
Douglas County, S Dakota ........................................................................
Edmunds County, S Dakota ......................................................................
Fall River County, S Dakota .....................................................................
Faulk County, S Dakota ............................................................................
Grant County, S Dakota ............................................................................
Gregory County, S Dakota ........................................................................
Haakon County, S Dakota ........................................................................
Hamlin County, S Dakota ..........................................................................
Hand County, S Dakota ............................................................................
Hanson County, S Dakota ........................................................................
Harding County, S Dakota ........................................................................
Hughes County, S Dakota ........................................................................
Hutchinson County, S Dakota ...................................................................
Hyde County, S Dakota ............................................................................
Jackson County, S Dakota ........................................................................
Jerauld County, S Dakota .........................................................................
Jones County, S Dakota ...........................................................................
Kingsbury County, S Dakota .....................................................................
Lake County, S Dakota .............................................................................
Lawrence County, S Dakota .....................................................................
Lincoln County, S Dakota .........................................................................
Lyman County, S Dakota ..........................................................................
Mc Cook County, S Dakota ......................................................................
Mc Pherson County, S Dakota .................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00088
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8635
0.8635
0.8934
0.8635
0.8844
0.8635
0.9329
0.8635
0.9070
0.8635
0.8635
0.8635
0.8635
0.8635
0.8635
0.9821
0.9070
0.8844
0.9394
0.8377
0.8635
0.8635
0.9733
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.9635
0.8556
0.9093
0.8556
0.8583
0.8583
0.8824
0.8583
0.8028
0.8583
0.9733
0.8583
0.8028
0.8583
0.8583
0.8583
0.8583
0.8583
0.8583
0.9733
0.8028
0.8028
0.9190
0.8098
0.8583
0.8583
0.9564
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.9587
0.8496
0.9587
0.8496
-0.60
-0.60
-1.23
-0.60
-9.23
-0.60
4.33
-0.60
-11.49
-0.60
-0.60
-0.60
-0.60
-0.60
-0.60
-0.90
-11.49
-9.23
-2.17
-3.33
-0.60
-0.60
-1.74
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.50
-0.70
5.43
-0.70
99942
99942
34820
99942
17900
99942
24860
99942
17900
99942
99942
99942
99942
99942
99942
24860
17900
17900
43900
44940
99942
99942
16740
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
43620
99943
43620
99943
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44169
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
43450
43460
43470
43480
43490
43500
43510
43520
43530
43540
43550
43560
43570
43580
43590
43600
43610
43620
43630
43640
43650
43670
43680
44000
44010
44020
44030
44040
44050
44060
44070
44080
44090
44100
44110
44120
44130
44140
44150
44160
44170
44180
44190
44200
44210
44220
44230
44240
44250
44260
44270
44280
44290
44300
44310
44320
44330
44340
44350
44360
44370
44380
44390
44400
44410
44420
44430
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Marshall County, S Dakota .......................................................................
Meade County, S Dakota ..........................................................................
Mellette County, S Dakota ........................................................................
Miner County, S Dakota ............................................................................
Minnehaha County, S Dakota ...................................................................
Moody County, S Dakota ..........................................................................
Pennington County, S Dakota ...................................................................
Perkins County, S Dakota .........................................................................
Potter County, S Dakota ...........................................................................
Roberts County, S Dakota ........................................................................
Sanborn County, S Dakota .......................................................................
Shannon County, S Dakota ......................................................................
Spink County, S Dakota ............................................................................
Stanley County, S Dakota .........................................................................
Sully County, S Dakota .............................................................................
Todd County, S Dakota .............................................................................
Tripp County, S Dakota .............................................................................
Turner County, S Dakota ..........................................................................
Union County, S Dakota ...........................................................................
Walworth County, S Dakota ......................................................................
Washabaugh County, S Dakota ................................................................
Yankton County, S Dakota ........................................................................
Ziebach County, S Dakota ........................................................................
Anderson County, Tennessee ...................................................................
Bedford County, Tennessee .....................................................................
Benton County, Tennessee .......................................................................
Bledsoe County, Tennessee .....................................................................
Blount County, Tennessee ........................................................................
Bradley County, Tennessee ......................................................................
Campbell County, Tennessee ...................................................................
Cannon County, Tennessee .....................................................................
Carroll County, Tennessee .......................................................................
Carter County, Tennessee ........................................................................
Cheatham County, Tennessee .................................................................
Chester County, Tennessee .....................................................................
Claiborne County, Tennessee ...................................................................
Clay County, Tennessee ...........................................................................
Cocke County, Tennessee ........................................................................
Coffee County, Tennessee .......................................................................
Crockett County, Tennessee .....................................................................
Cumberland County, Tennessee ..............................................................
Davidson County, Tennessee ...................................................................
Decatur County, Tennessee .....................................................................
De Kalb County, Tennessee .....................................................................
Dickson County, Tennessee .....................................................................
Dyer County, Tennessee ..........................................................................
Fayette County, Tennessee ......................................................................
Fentress County, Tennessee ....................................................................
Franklin County, Tennessee .....................................................................
Gibson County, Tennessee .......................................................................
Giles County, Tennessee ..........................................................................
Grainger County, Tennessee ....................................................................
Greene County, Tennessee ......................................................................
Grundy County, Tennessee ......................................................................
Hamblen County, Tennessee ....................................................................
Hamilton County, Tennessee ....................................................................
Hancock County, Tennessee ....................................................................
Hardeman County, Tennessee .................................................................
Hardin County, Tennessee .......................................................................
Hawkins County, Tennessee ....................................................................
Haywood County, Tennessee ...................................................................
Henderson County, Tennessee ................................................................
Henry County, Tennessee ........................................................................
Hickman County, Tennessee ....................................................................
Houston County, Tennessee .....................................................................
Humphreys County, Tennessee ................................................................
Jackson County, Tennessee .....................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00089
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8556
0.8769
0.8556
0.8556
0.9635
0.8556
0.8987
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.8556
0.9093
0.8966
0.8556
0.8556
0.8556
0.8556
0.8419
0.7915
0.7915
0.7915
0.8419
0.8037
0.7915
0.8838
0.7915
0.7972
0.9751
0.8964
0.7915
0.7915
0.7915
0.7915
0.7915
0.7915
0.9751
0.7915
0.7915
0.9751
0.7915
0.9407
0.7915
0.7915
0.7915
0.7915
0.7948
0.7915
0.7915
0.7948
0.9088
0.7915
0.7915
0.7915
0.8031
0.7915
0.7915
0.7915
0.8838
0.7915
0.7915
0.7915
0.8496
1.0351
0.8496
0.8496
0.9587
0.8496
1.0351
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.8496
0.9587
0.9217
0.8496
0.8496
0.8496
0.8496
0.8263
0.7841
0.7841
0.7841
0.8263
0.8124
0.7841
0.9862
0.7841
0.8057
0.9862
0.8869
0.7841
0.7841
0.7841
0.7841
0.7841
0.7841
0.9862
0.7841
0.7841
0.9862
0.7841
0.9361
0.7841
0.7841
0.7841
0.7841
0.7944
0.7841
0.7841
0.7944
0.8963
0.7841
0.7841
0.7841
0.7975
0.7841
0.7841
0.7841
0.9862
0.7841
0.7841
0.7841
-0.70
18.04
-0.70
-0.70
-0.50
-0.70
15.18
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
-0.70
5.43
2.80
-0.70
-0.70
-0.70
-0.70
-1.85
-0.93
-0.93
-0.93
-1.85
1.08
-0.93
11.59
-0.93
1.07
1.14
-1.06
-0.93
-0.93
-0.93
-0.93
-0.93
-0.93
1.14
-0.93
-0.93
1.14
-0.93
-0.49
-0.93
-0.93
-0.93
-0.93
-0.05
-0.93
-0.93
-0.05
-1.38
-0.93
-0.93
-0.93
-0.70
-0.93
-0.93
-0.93
11.59
-0.93
-0.93
-0.93
99943
39660
99943
99943
43620
99943
39660
99943
99943
99943
99943
99943
99943
99943
99943
99943
99943
43620
43580
99943
99943
99943
99943
28940
99944
99944
99944
28940
17420
99944
34980
99944
27740
34980
27180
99944
99944
99944
99944
99944
99944
34980
99944
99944
34980
99944
32820
99944
99944
99944
99944
34100
99944
99944
34100
16860
99944
99944
99944
28700
99944
99944
99944
34980
99944
99944
99944
E:\FR\FM\03AUP2.SGM
03AUP2
44170
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
44440
44450
44460
44470
44480
44490
44500
44510
44520
44530
44540
44550
44560
44570
44580
44590
44600
44610
44620
44630
44640
44650
44660
44670
44680
44690
44700
44710
44720
44730
44740
44750
44760
44770
44780
44790
44800
44810
44820
44830
44840
44850
44860
44870
44880
44890
44900
44910
44920
44930
44940
45000
45010
45020
45030
45040
45050
45060
45070
45080
45090
45100
45110
45113
45120
45130
45140
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Jefferson County, Tennessee ...................................................................
Johnson County, Tennessee ....................................................................
Knox County, Tennessee ..........................................................................
Lake County, Tennessee ..........................................................................
Lauderdale County, Tennessee ................................................................
Lawrence County, Tennessee ..................................................................
Lewis County, Tennessee .........................................................................
Lincoln County, Tennessee .......................................................................
Loudon County, Tennessee ......................................................................
Mc Minn County, Tennessee ....................................................................
Mc Nairy County, Tennessee ....................................................................
Macon County, Tennessee .......................................................................
Madison County, Tennessee ....................................................................
Marion County, Tennessee .......................................................................
Marshall County, Tennessee ....................................................................
Maury County, Tennessee ........................................................................
Meigs County, Tennessee ........................................................................
Monroe County, Tennessee ......................................................................
Montgomery County, Tennessee ..............................................................
Moore County, Tennessee ........................................................................
Morgan County, Tennessee ......................................................................
Obion County, Tennessee ........................................................................
Overton County, Tennessee .....................................................................
Perry County, Tennessee .........................................................................
Pickett County, Tennessee .......................................................................
Polk County, Tennessee ...........................................................................
Putnam County, Tennessee ......................................................................
Rhea County, Tennessee .........................................................................
Roane County, Tennessee .......................................................................
Robertson County, Tennessee .................................................................
Rutherford County, Tennessee .................................................................
Scott County, Tennessee ..........................................................................
Sequatchie County, Tennessee ................................................................
Sevier County, Tennessee ........................................................................
Shelby County, Tennessee .......................................................................
Smith County, Tennessee .........................................................................
Stewart County, Tennessee ......................................................................
Sullivan County, Tennessee .....................................................................
Sumner County, Tennessee .....................................................................
Tipton County, Tennessee ........................................................................
Trousdale County, Tennessee ..................................................................
Unicoi County, Tennessee ........................................................................
Union County, Tennessee .........................................................................
Van Buren County, Tennessee .................................................................
Warren County, Tennessee ......................................................................
Washington County, Tennessee ...............................................................
Wayne County, Tennessee .......................................................................
Weakley County, Tennessee ....................................................................
White County, Tennessee .........................................................................
Williamson County, Tennessee .................................................................
Wilson County, Tennessee .......................................................................
Anderson County, Texas ...........................................................................
Andrews County, Texas ............................................................................
Angelina County, Texas ............................................................................
Aransas County, Texas .............................................................................
Archer County, Texas ...............................................................................
Armstrong County, Texas .........................................................................
Atascosa County, Texas ...........................................................................
Austin County, Texas ................................................................................
Bailey County, Texas ................................................................................
Bandera County, Texas ............................................................................
Bastrop County, Texas ..............................................................................
Baylor County, Texas ................................................................................
Bee County, Texas ....................................................................................
Bell County, Texas ....................................................................................
Bexar County, Texas .................................................................................
Blanco County, Texas ...............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00090
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7948
0.7915
0.8419
0.7915
0.7915
0.7915
0.7915
0.7915
0.8419
0.7915
0.7915
0.8838
0.8964
0.9088
0.7915
0.7915
0.7915
0.7915
0.8284
0.7915
0.7915
0.7915
0.7915
0.7915
0.7915
0.8037
0.7915
0.7915
0.7915
0.9751
0.9751
0.7915
0.8512
0.8146
0.9407
0.8838
0.8110
0.8031
0.9751
0.9407
0.8838
0.7972
0.8419
0.7915
0.7915
0.7972
0.7915
0.7915
0.7915
0.9751
0.9751
0.7967
0.7967
0.7967
0.8241
0.8325
0.8544
0.8456
0.8962
0.7967
0.8456
0.9437
0.7967
0.7967
0.8526
0.8982
0.7967
0.7944
0.7841
0.8263
0.7841
0.7841
0.7841
0.7841
0.7841
0.8263
0.7841
0.7841
0.9862
0.8869
0.8963
0.7841
0.7841
0.7841
0.7841
0.8451
0.7841
0.7841
0.7841
0.7841
0.7841
0.7841
0.8124
0.7841
0.7841
0.7841
0.9862
0.9862
0.7841
0.8963
0.7841
0.9361
0.9862
0.8451
0.7975
0.9862
0.9361
0.9862
0.8057
0.8263
0.7841
0.7841
0.8057
0.7841
0.7841
0.7841
0.9862
0.9862
0.7973
0.7973
0.7973
0.8579
0.8326
0.9177
0.8860
1.0026
0.7973
0.8860
0.9360
0.7973
0.7973
0.9098
0.8860
0.7973
-0.05
-0.93
-1.85
-0.93
-0.93
-0.93
-0.93
-0.93
-1.85
-0.93
-0.93
11.59
-1.06
-1.38
-0.93
-0.93
-0.93
-0.93
2.02
-0.93
-0.93
-0.93
-0.93
-0.93
-0.93
1.08
-0.93
-0.93
-0.93
1.14
1.14
-0.93
5.30
-3.74
-0.49
11.59
4.20
-0.70
1.14
-0.49
11.59
1.07
-1.85
-0.93
-0.93
1.07
-0.93
-0.93
-0.93
1.14
1.14
0.08
0.08
0.08
4.10
0.01
7.41
4.78
11.87
0.08
4.78
-0.82
0.08
0.08
6.71
-1.36
0.08
34100
99944
28940
99944
99944
99944
99944
99944
28940
99944
99944
34980
27180
16860
99944
99944
99944
99944
17300
99944
99944
99944
99944
99944
99944
17420
99944
99944
99944
34980
34980
99944
16860
99944
32820
34980
17300
28700
34980
32820
34980
27740
28940
99944
99944
27740
99944
99944
99944
34980
34980
99945
99945
99945
18580
48660
11100
41700
26420
99945
41700
12420
99945
99945
28660
41700
99945
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44171
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
45150
45160
45170
45180
45190
45200
45201
45210
45220
45221
45222
45223
45224
45230
45240
45250
45251
45260
45270
45280
45281
45290
45291
45292
45300
45301
45310
45311
45312
45320
45321
45330
45340
45341
45350
45360
45361
45362
45370
45380
45390
45391
45392
45400
45410
45420
45421
45430
45431
45440
45450
45451
45460
45470
45480
45490
45500
45510
45511
45520
45521
45522
45530
45531
45540
45541
45542
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Borden County, Texas ..............................................................................
Bosque County, Texas ..............................................................................
Bowie County, Texas ................................................................................
Brazoria County, Texas .............................................................................
Brazos County, Texas ...............................................................................
Brewster County, Texas ............................................................................
Briscoe County, Texas ..............................................................................
Brooks County, Texas ...............................................................................
Brown County, Texas ................................................................................
Burleson County, Texas ............................................................................
Burnet County, Texas ...............................................................................
Caldwell County, Texas ............................................................................
Calhoun County, Texas .............................................................................
Callahan County, Texas ............................................................................
Cameron County, Texas ...........................................................................
Camp County, Texas ................................................................................
Carson County, Texas ..............................................................................
Cass County, Texas ..................................................................................
Castro County, Texas ...............................................................................
Chambers County, Texas .........................................................................
Cherokee County, Texas ..........................................................................
Childress County, Texas ...........................................................................
Clay County, Texas ...................................................................................
Cochran County, Texas ............................................................................
Coke County, Texas ..................................................................................
Coleman County, Texas ............................................................................
Collin County, Texas .................................................................................
Collingsworth County, Texas ....................................................................
Colorado County, Texas ...........................................................................
Comal County, Texas ................................................................................
Comanche County, Texas .........................................................................
Concho County, Texas ..............................................................................
Cooke County, Texas ................................................................................
Coryell County, Texas ...............................................................................
Cottle County, Texas .................................................................................
Crane County, Texas ................................................................................
Crockett County, Texas .............................................................................
Crosby County, Texas ...............................................................................
Culberson County, Texas ..........................................................................
Dallam County, Texas ...............................................................................
Dallas County, Texas ................................................................................
Dawson County, Texas .............................................................................
Deaf Smith County, Texas ........................................................................
Delta County, Texas ..................................................................................
Denton County, Texas ..............................................................................
De Witt County, Texas ..............................................................................
Dickens County, Texas .............................................................................
Dimmit County, Texas ...............................................................................
Donley County, Texas ...............................................................................
Duval County, Texas .................................................................................
Eastland County, Texas ............................................................................
Ector County, Texas ..................................................................................
Edwards County, Texas ............................................................................
Ellis County, Texas ...................................................................................
El Paso County, Texas .............................................................................
Erath County, Texas .................................................................................
Falls County, Texas ..................................................................................
Fannin County, Texas ...............................................................................
Fayette County, Texas ..............................................................................
Fisher County, Texas ................................................................................
Floyd County, Texas .................................................................................
Foard County, Texas .................................................................................
Fort Bend County, Texas ..........................................................................
Franklin County, Texas .............................................................................
Freestone County, Texas ..........................................................................
Frio County, Texas ....................................................................................
Gaines County, Texas ...............................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00091
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7967
0.7967
0.8283
0.9278
0.8900
0.7967
0.7967
0.7967
0.7967
0.8416
0.7967
0.9437
0.8046
0.7914
0.9804
0.7967
0.8544
0.7967
0.7967
1.0040
0.7967
0.7967
0.8108
0.7967
0.7967
0.7967
1.0217
0.7967
0.7967
0.8982
0.7967
0.7967
0.7967
0.8526
0.7967
0.7967
0.7967
0.8357
0.7967
0.7967
1.0217
0.7967
0.7967
0.9080
1.0217
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.9813
0.7967
1.0217
0.8977
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
1.0040
0.7967
0.7967
0.7967
0.7967
0.7973
0.7973
0.8118
1.0026
0.9061
0.7973
0.7973
0.7973
0.7973
0.9061
0.7973
0.9360
0.8575
0.8014
0.9446
0.7973
0.9177
0.7973
0.7973
1.0026
0.7973
0.7973
0.8326
0.7973
0.7973
0.7973
1.0093
0.7973
0.7973
0.8860
0.7973
0.7973
0.7973
0.9098
0.7973
0.7973
0.7973
0.8628
0.7973
0.7973
1.0093
0.7973
0.7973
1.0093
1.0093
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
1.0119
0.7973
1.0093
0.9069
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
1.0026
0.7973
0.7973
0.7973
0.7973
0.08
0.08
-1.99
8.06
1.81
0.08
0.08
0.08
0.08
7.66
0.08
-0.82
6.57
1.26
-3.65
0.08
7.41
0.08
0.08
-0.14
0.08
0.08
2.69
0.08
0.08
0.08
-1.21
0.08
0.08
-1.36
0.08
0.08
0.08
6.71
0.08
0.08
0.08
3.24
0.08
0.08
-1.21
0.08
0.08
11.16
-1.21
0.08
0.08
0.08
0.08
0.08
0.08
3.12
0.08
-1.21
1.02
0.08
0.08
0.08
0.08
0.08
0.08
0.08
-0.14
0.08
0.08
0.08
0.08
99945
99945
45500
26420
17780
99945
99945
99945
99945
17780
99945
12420
47020
10180
15180
99945
11100
99945
99945
26420
99945
99945
48660
99945
99945
99945
19124
99945
99945
41700
99945
99945
99945
28660
99945
99945
99945
31180
99945
99945
19124
99945
99945
19124
19124
99945
99945
99945
99945
99945
99945
36220
99945
19124
21340
99945
99945
99945
99945
99945
99945
99945
26420
99945
99945
99945
99945
E:\FR\FM\03AUP2.SGM
03AUP2
44172
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
45550
45551
45552
45560
45561
45562
45563
45564
45570
45580
45581
45582
45583
45590
45591
45592
45600
45610
45620
45621
45630
45631
45632
45640
45650
45651
45652
45653
45654
45660
45661
45662
45670
45671
45672
45680
45681
45690
45691
45700
45710
45711
45720
45721
45722
45730
45731
45732
45733
45734
45740
45741
45742
45743
45744
45750
45751
45752
45753
45754
45755
45756
45757
45758
45759
45760
45761
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Galveston County, Texas ..........................................................................
Garza County, Texas ................................................................................
Gillespie County, Texas ............................................................................
Glasscock County, Texas .........................................................................
Goliad County, Texas ................................................................................
Gonzales County, Texas ...........................................................................
Gray County, Texas ..................................................................................
Grayson County, Texas ............................................................................
Gregg County, Texas ................................................................................
Grimes County, Texas ..............................................................................
Guadaloupe County, Texas ......................................................................
Hale County, Texas ...................................................................................
Hall County, Texas ....................................................................................
Hamilton County, Texas ............................................................................
Hansford County, Texas ...........................................................................
Hardeman County, Texas .........................................................................
Hardin County, Texas ...............................................................................
Harris County, Texas ................................................................................
Harrison County, Texas ............................................................................
Hartley County, Texas ...............................................................................
Haskell County, Texas ..............................................................................
Hays County, Texas ..................................................................................
Hemphill County, Texas ............................................................................
Henderson County, Texas ........................................................................
Hidalgo County, Texas ..............................................................................
Hill County, Texas .....................................................................................
Hockley County, Texas .............................................................................
Hood County, Texas .................................................................................
Hopkins County, Texas .............................................................................
Houston County, Texas .............................................................................
Howard County, Texas ..............................................................................
Hudspeth County, Texas ...........................................................................
Hunt County, Texas ..................................................................................
Hutchinson County, Texas ........................................................................
Irion County, Texas ...................................................................................
Jack County, Texas ...................................................................................
Jackson County, Texas .............................................................................
Jasper County, Texas ...............................................................................
Jeff Davis County, Texas ..........................................................................
Jefferson County, Texas ...........................................................................
Jim Hogg County, Texas ...........................................................................
Jim Wells County, Texas ..........................................................................
Johnson County, Texas ............................................................................
Jones County, Texas ................................................................................
Karnes County, Texas ...............................................................................
Kaufman County, Texas ............................................................................
Kendall County, Texas ..............................................................................
Kenedy County, Texas ..............................................................................
Kent County, Texas ...................................................................................
Kerr County, Texas ...................................................................................
Kimble County, Texas ...............................................................................
King County, Texas ...................................................................................
Kinney County, Texas ...............................................................................
Kleberg County, Texas ..............................................................................
Knox County, Texas ..................................................................................
Lamar County, Texas ................................................................................
Lamb County, Texas .................................................................................
Lampasas County, Texas .........................................................................
La Salle County, Texas .............................................................................
Lavaca County, Texas ..............................................................................
Lee County, Texas ....................................................................................
Leon County, Texas ..................................................................................
Liberty County, Texas ...............................................................................
Limestone County, Texas .........................................................................
Lipscomb County, Texas ...........................................................................
Live Oak County, Texas ............................................................................
Llano County, Texas .................................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00092
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9814
0.7967
0.7967
0.7967
0.8046
0.7967
0.7967
0.9507
0.8809
0.7967
0.8982
0.7967
0.7967
0.7967
0.7967
0.7967
0.8412
1.0040
0.8446
0.7967
0.7967
0.9437
0.7967
0.9104
0.8934
0.7967
0.7967
0.8763
0.7967
0.7967
0.7967
0.7967
1.0217
0.7967
0.8101
0.7967
0.7967
0.7967
0.7967
0.8412
0.7967
0.7967
0.9504
0.7914
0.7967
1.0217
0.8456
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.8229
0.7967
0.7967
0.7967
0.7967
1.0040
0.7967
0.7967
0.7967
0.7967
1.0026
0.7973
0.7973
0.7973
0.8575
0.7973
0.7973
0.8517
0.8803
0.7973
0.8860
0.7973
0.7973
0.7973
0.7973
0.7973
0.8610
1.0026
0.7973
0.7973
0.7973
0.9360
0.7973
0.7973
0.8788
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
1.0093
0.7973
0.8377
0.7973
0.7973
0.7973
0.7973
0.8610
0.7973
0.7973
0.9587
0.8014
0.7973
1.0093
0.8860
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.9098
0.7973
0.7973
0.7973
0.7973
1.0026
0.7973
0.7973
0.7973
0.7973
2.16
0.08
0.08
0.08
6.57
0.08
0.08
-10.41
-0.07
0.08
-1.36
0.08
0.08
0.08
0.08
0.08
2.35
-0.14
-5.60
0.08
0.08
-0.82
0.08
-12.42
-1.63
0.08
0.08
-9.02
0.08
0.08
0.08
0.08
-1.21
0.08
3.41
0.08
0.08
0.08
0.08
2.35
0.08
0.08
0.87
1.26
0.08
-1.21
4.78
0.08
0.08
0.08
0.08
0.08
0.08
0.08
0.08
0.08
0.08
10.56
0.08
0.08
0.08
0.08
-0.14
0.08
0.08
0.08
0.08
26420
99945
99945
99945
47020
99945
99945
43300
30980
99945
41700
99945
99945
99945
99945
99945
13140
26420
99945
99945
99945
12420
99945
99945
32580
99945
99945
99945
99945
99945
99945
99945
19124
99945
41660
99945
99945
99945
99945
13140
99945
99945
23104
10180
99945
19124
41700
99945
99945
99945
99945
99945
99945
99945
99945
99945
99945
28660
99945
99945
99945
99945
26420
99945
99945
99945
99945
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44173
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
45762
45770
45771
45772
45780
45781
45782
45783
45784
45785
45790
45791
45792
45793
45794
45795
45796
45797
45800
45801
45802
45803
45804
45810
45820
45821
45822
45830
45831
45832
45840
45841
45842
45843
45844
45845
45850
45860
45861
45870
45871
45872
45873
45874
45875
45876
45877
45878
45879
45880
45881
45882
45883
45884
45885
45886
45887
45888
45889
45890
45891
45892
45893
45900
45901
45902
45903
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Loving County, Texas ...............................................................................
Lubbock County, Texas ............................................................................
Lynn County, Texas ..................................................................................
Mc Culloch County, Texas ........................................................................
Mc Lennan County, Texas ........................................................................
Mc Mullen County, Texas .........................................................................
Madison County, Texas ............................................................................
Marion County, Texas ...............................................................................
Martin County, Texas ................................................................................
Mason County, Texas ...............................................................................
Matagorda County, Texas .........................................................................
Maverick County, Texas ............................................................................
Medina County, Texas ..............................................................................
Menard County, Texas ..............................................................................
Midland County, Texas .............................................................................
Milam County, Texas ................................................................................
Mills County, Texas ...................................................................................
Mitchell County, Texas ..............................................................................
Montague County, Texas ..........................................................................
Montgomery County, Texas ......................................................................
Moore County, Texas ................................................................................
Morris County, Texas ................................................................................
Motley County, Texas ...............................................................................
Nacogdoches County, Texas ....................................................................
Navarro County, Texas .............................................................................
Newton County, Texas ..............................................................................
Nolan County, Texas .................................................................................
Nueces County, Texas ..............................................................................
Ochiltree County, Texas ............................................................................
Oldham County, Texas .............................................................................
Orange County, Texas ..............................................................................
Palo Pinto County, Texas .........................................................................
Panola County, Texas ...............................................................................
Parker County, Texas ...............................................................................
Parmer County, Texas ..............................................................................
Pecos County, Texas ................................................................................
Polk County, Texas ...................................................................................
Potter County, Texas ................................................................................
Presidio County, Texas .............................................................................
Rains County, Texas .................................................................................
Randall County, Texas ..............................................................................
Reagan County, Texas .............................................................................
Real County, Texas ...................................................................................
Red River County, Texas ..........................................................................
Reeves County, Texas ..............................................................................
Refugio County, Texas ..............................................................................
Roberts County, Texas .............................................................................
Robertson County, Texas .........................................................................
Rockwall County, Texas ............................................................................
Runnels County, Texas .............................................................................
Rusk County, Texas ..................................................................................
Sabine County, Texas ...............................................................................
San Augustine County, Texas ..................................................................
San Jacinto County, Texas .......................................................................
San Patricio County, Texas ......................................................................
San Saba County, Texas ..........................................................................
Schleicher County, Texas .........................................................................
Scurry County, Texas ................................................................................
Shackelford County, Texas .......................................................................
Shelby County, Texas ...............................................................................
Sherman County, Texas ...........................................................................
Smith County, Texas .................................................................................
Somervell County, Texas ..........................................................................
Starr County, Texas ..................................................................................
Stephens County, Texas ...........................................................................
Sterling County, Texas ..............................................................................
Stonewall County, Texas ..........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00093
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7967
0.8783
0.7967
0.7967
0.8518
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.8456
0.7967
0.9628
0.7967
0.7967
0.7967
0.7967
1.0040
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.8550
0.7967
0.7967
0.8412
0.7967
0.7967
0.9504
0.7967
0.7967
0.7967
0.9156
0.7967
0.7967
0.9156
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.8416
1.0217
0.7967
0.8331
0.7967
0.7967
0.8962
0.8550
0.7967
0.7967
0.7967
0.7967
0.7967
0.7967
0.9168
0.7967
0.7967
0.7967
0.7967
0.7967
0.7973
0.8628
0.7973
0.7973
0.8648
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.8860
0.7973
0.9803
0.7973
0.7973
0.7973
0.7973
1.0026
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.8579
0.7973
0.7973
0.8610
0.7973
0.7973
0.9587
0.7973
0.7973
0.7973
0.9177
0.7973
0.7973
0.9177
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.9061
1.0093
0.7973
0.8803
0.7973
0.7973
1.0026
0.8579
0.7973
0.7973
0.7973
0.7973
0.7973
0.7973
0.8827
0.7973
0.7973
0.7973
0.7973
0.7973
0.08
-1.76
0.08
0.08
1.53
0.08
0.08
0.08
0.08
0.08
0.08
0.08
4.78
0.08
1.82
0.08
0.08
0.08
0.08
-0.14
0.08
0.08
0.08
0.08
0.08
0.08
0.08
0.34
0.08
0.08
2.35
0.08
0.08
0.87
0.08
0.08
0.08
0.23
0.08
0.08
0.23
0.08
0.08
0.08
0.08
0.08
0.08
7.66
-1.21
0.08
5.67
0.08
0.08
11.87
0.34
0.08
0.08
0.08
0.08
0.08
0.08
-3.72
0.08
0.08
0.08
0.08
0.08
99945
31180
99945
99945
47380
99945
99945
99945
99945
99945
99945
99945
41700
99945
33260
99945
99945
99945
99945
26420
99945
99945
99945
99945
99945
99945
99945
18580
99945
99945
13140
99945
99945
23104
99945
99945
99945
11100
99945
99945
11100
99945
99945
99945
99945
99945
99945
17780
19124
99945
30980
99945
99945
26420
18580
99945
99945
99945
99945
99945
99945
46340
99945
99945
99945
99945
99945
E:\FR\FM\03AUP2.SGM
03AUP2
44174
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
45904
45905
45910
45911
45912
45913
45920
45921
45930
45940
45941
45942
45943
45944
45945
45946
45947
45948
45949
45950
45951
45952
45953
45954
45955
45960
45961
45962
45970
45971
45972
45973
45974
45980
45981
45982
45983
46000
46010
46020
46030
46040
46050
46060
46070
46080
46090
46100
46110
46120
46130
46140
46150
46160
46170
46180
46190
46200
46210
46220
46230
46240
46250
46260
46270
46280
47000
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Sutton County, Texas ................................................................................
Swisher County, Texas .............................................................................
Tarrant County, Texas ..............................................................................
Taylor County, Texas ................................................................................
Terrell County, Texas ................................................................................
Terry County, Texas ..................................................................................
Throckmorton County, Texas ....................................................................
Titus County, Texas ..................................................................................
Tom Green County, Texas ........................................................................
Travis County, Texas ................................................................................
Trinity County, Texas ................................................................................
Tyler County, Texas ..................................................................................
Upshur County, Texas ..............................................................................
Upton County, Texas ................................................................................
Uvalde County, Texas ...............................................................................
Val Verde County, Texas ..........................................................................
Van Zandt County, Texas .........................................................................
Victoria County, Texas ..............................................................................
Walker County, Texas ...............................................................................
Waller County, Texas ................................................................................
Ward County, Texas .................................................................................
Washington County, Texas .......................................................................
Webb County, Texas .................................................................................
Wharton County, Texas ............................................................................
Wheeler County, Texas .............................................................................
Wichita County, Texas ..............................................................................
Wilbarger County, Texas ...........................................................................
Willacy County, Texas ...............................................................................
Williamson County, Texas .........................................................................
Wilson County, Texas ...............................................................................
Winkler County, Texas ..............................................................................
Wise County, Texas ..................................................................................
Wood County, Texas .................................................................................
Yoakum County, Texas .............................................................................
Young County, Texas ................................................................................
Zapata County, Texas ...............................................................................
Zavala County, Texas ...............................................................................
Beaver County, Utah .................................................................................
Box Elder County, Utah ............................................................................
Cache County, Utah ..................................................................................
Carbon County, Utah ................................................................................
Daggett County, Utah ................................................................................
Davis County, Utah ...................................................................................
Duchesne County, Utah ............................................................................
Emery County, Utah ..................................................................................
Garfield County, Utah ................................................................................
Grand County, Utah ..................................................................................
Iron County, Utah ......................................................................................
Juab County, Utah ....................................................................................
Kane County, Utah ....................................................................................
Millard County, Utah ..................................................................................
Morgan County, Utah ................................................................................
Piute County, Utah ....................................................................................
Rich County, Utah .....................................................................................
Salt Lake County, Utah .............................................................................
San Juan County, Utah .............................................................................
Sanpete County, Utah ...............................................................................
Sevier County, Utah ..................................................................................
Summit County, Utah ................................................................................
Tooele County, Utah .................................................................................
Uintah County, Utah ..................................................................................
Utah County, Utah .....................................................................................
Wasatch County, Utah ..............................................................................
Washington County, Utah .........................................................................
Wayne County, Utah .................................................................................
Weber County, Utah ..................................................................................
Addison County, Vermont .........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00094
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7967
0.7967
0.9504
0.7975
0.7967
0.7967
0.7967
0.7967
0.8271
0.9437
0.7967
0.7967
0.8809
0.7967
0.7967
0.7967
0.7967
0.8160
0.7967
1.0040
0.7967
0.7967
0.8068
0.7967
0.7967
0.8325
0.7967
0.7967
0.9437
0.8982
0.7967
0.8709
0.7967
0.7967
0.7967
0.7967
0.7967
0.8440
0.8440
0.8963
0.8440
0.8440
0.9185
0.8440
0.8440
0.8440
0.8440
0.8440
0.9131
0.9982
0.8440
0.8896
0.8440
0.8440
0.9381
0.8440
0.8440
0.8440
0.9092
0.9092
0.8440
0.9500
0.8440
0.9077
0.8440
0.9185
0.9830
0.7973
0.7973
0.9587
0.8014
0.7973
0.7973
0.7973
0.7973
0.8377
0.9360
0.7973
0.7973
0.8803
0.7973
0.7973
0.7973
0.7973
0.8575
0.7973
1.0026
0.7973
0.7973
0.7825
0.7973
0.7973
0.8326
0.7973
0.7973
0.9360
0.8860
0.7973
0.9587
0.7973
0.7973
0.7973
0.7973
0.7973
0.8154
0.8154
0.9038
0.8154
0.8154
0.9011
0.8154
0.8154
0.8154
0.8154
0.8154
0.9554
0.8154
0.8154
0.9011
0.8154
0.8154
0.9418
0.8154
0.8154
0.8154
0.9418
0.9418
0.8154
0.9554
0.8154
0.9281
0.8154
0.9011
0.9944
0.08
0.08
0.87
0.49
0.08
0.08
0.08
0.08
1.28
-0.82
0.08
0.08
-0.07
0.08
0.08
0.08
0.08
5.09
0.08
-0.14
0.08
0.08
-3.01
0.08
0.08
0.01
0.08
0.08
-0.82
-1.36
0.08
10.08
0.08
0.08
0.08
0.08
0.08
-3.39
-3.39
0.84
-3.39
-3.39
-1.89
-3.39
-3.39
-3.39
-3.39
-3.39
4.63
-18.31
-3.39
1.29
-3.39
-3.39
0.39
-3.39
-3.39
-3.39
3.59
3.59
-3.39
0.57
-3.39
2.25
-3.39
-1.89
1.16
99945
99945
23104
10180
99945
99945
99945
99945
41660
12420
99945
99945
30980
99945
99945
99945
99945
47020
99945
26420
99945
99945
29700
99945
99945
48660
99945
99945
12420
41700
99945
23104
99945
99945
99945
99945
99945
99946
99946
30860
99946
99946
36260
99946
99946
99946
99946
99946
39340
99946
99946
36260
99946
99946
41620
99946
99946
99946
41620
41620
99946
39340
99946
41100
99946
36260
99947
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44175
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
47010
47020
47030
47040
47050
47060
47070
47080
47090
47100
47110
47120
47130
48010
48020
49000
49010
49011
49020
49030
49040
49050
49060
49070
49080
49088
49090
49100
49110
49111
49120
49130
49140
49141
49150
49160
49170
49180
49190
49191
49194
49200
49210
49211
49212
49213
49220
49230
49240
49241
49250
49260
49270
49280
49288
49290
49291
49300
49310
49320
49328
49330
49340
49342
49343
49350
49360
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Bennington County, Vermont ....................................................................
Caledonia County, Vermont ......................................................................
Chittenden County, Vermont .....................................................................
Essex County, Vermont ............................................................................
Franklin County, Vermont .........................................................................
Grand Isle County, Vermont .....................................................................
Lamoille County, Vermont .........................................................................
Orange County, Vermont ..........................................................................
Orleans County, Vermont ..........................................................................
Rutland County, Vermont ..........................................................................
Washington County, Vermont ...................................................................
Windham County, Vermont .......................................................................
Windsor County, Vermont .........................................................................
St Croix County, Virgin Islands .................................................................
St Thomas-John County, Virgin Islands ...................................................
Accomack County, Virginia .......................................................................
Albemarle County, Virginia ........................................................................
Alexandria City County, Virginia ...............................................................
Alleghany County, Virginia ........................................................................
Amelia County, Virginia .............................................................................
Amherst County, Virginia ..........................................................................
Appomattox County, Virginia .....................................................................
Arlington County, Virginia ..........................................................................
Augusta County, Virginia ...........................................................................
Bath County, Virginia ................................................................................
Bedford City County, Virginia ....................................................................
Bedford County, Virginia ...........................................................................
Bland County, Virginia ...............................................................................
Botetourt County, Virginia .........................................................................
Bristol City County, Virginia ......................................................................
Brunswick County, Virginia .......................................................................
Buchanan County, Virginia ........................................................................
Buckingham County, Virginia ....................................................................
Buena Vista City County, Virginia .............................................................
Campbell County, Virginia .........................................................................
Caroline County, Virginia ..........................................................................
Carroll County, Virginia .............................................................................
Charles City County, Virginia ....................................................................
Charlotte County, Virginia .........................................................................
Charlottesville City County, Virginia ..........................................................
Chesapeake County, Virginia ....................................................................
Chesterfield County, Virginia .....................................................................
Clarke County, Virginia .............................................................................
Clifton Forge City County, Virginia ............................................................
Colonial Heights County, Virginia .............................................................
Covington City County, Virginia ................................................................
Craig County, Virginia ...............................................................................
Culpeper County, Virginia .........................................................................
Cumberland County, Virginia ....................................................................
Danville City County, Virginia ....................................................................
Dickenson County, Virginia .......................................................................
Dinniddie County, Virginia .........................................................................
Emporia County, Virginia ..........................................................................
Essex County, Virginia ..............................................................................
Fairfax City County, Virginia .....................................................................
Fairfax County, Virginia .............................................................................
Falls Church City County, Virginia ............................................................
Fauquier County, Virginia ..........................................................................
Floyd County, Virginia ...............................................................................
Fluvanna County, Virginia .........................................................................
Franklin City County, Virginia ....................................................................
Franklin County, Virginia ...........................................................................
Frederick County, Virginia .........................................................................
Fredericksburg City County, Virginia ........................................................
Galax City County, Virginia .......................................................................
Giles County, Virginia ................................................................................
Gloucester County, Virginia ......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00095
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9830
0.9830
0.9410
0.9830
0.9410
0.9410
0.9830
0.9830
0.9830
0.9830
0.9830
0.9830
0.9830
0.7615
0.7615
0.8215
1.0187
1.0951
0.8215
0.8873
0.8691
0.8554
1.0951
0.8215
0.8215
0.8691
0.8691
0.8215
0.8381
0.8031
0.8215
0.8215
0.8215
0.8215
0.8691
0.8873
0.8215
0.9328
0.8215
1.0187
0.8799
0.9328
1.0951
0.8215
0.9328
0.8215
0.8396
0.9495
0.8873
0.8489
0.8215
0.9328
0.8215
0.8215
1.0951
1.0951
1.0951
1.0951
0.8215
1.0187
0.8215
0.8396
0.9316
1.0951
0.8215
0.8186
0.8799
0.9944
0.9944
0.9491
0.9944
0.9491
0.9491
0.9944
0.9944
0.9944
0.9944
0.9944
0.9944
0.9944
0.7615
0.7615
0.7954
1.0143
1.1074
0.7954
0.9193
0.8710
0.8710
1.1074
0.7954
0.7954
0.8710
0.8710
0.7954
0.8662
0.7975
0.7954
0.7954
0.7954
0.7954
0.8710
0.9193
0.7954
0.9193
0.7954
1.0143
0.8805
0.9193
1.1074
0.7954
0.9193
0.7954
0.8662
0.7954
0.9193
0.8466
0.7954
0.9193
0.7954
0.7954
1.1074
1.1074
1.1074
1.1074
0.7954
1.0143
0.7954
0.8662
1.0109
1.1074
0.7954
0.8227
0.8805
1.16
1.16
0.86
1.16
0.86
0.86
1.16
1.16
1.16
1.16
1.16
1.16
1.16
0.00
0.00
-3.18
-0.43
1.12
-3.18
3.61
0.22
1.82
1.12
-3.18
-3.18
0.22
0.22
-3.18
3.35
-0.70
-3.18
-3.18
-3.18
-3.18
0.22
3.61
-3.18
-1.45
-3.18
-0.43
0.07
-1.45
1.12
-3.18
-1.45
-3.18
3.17
-16.23
3.61
-0.27
-3.18
-1.45
-3.18
-3.18
1.12
1.12
1.12
1.12
-3.18
-0.43
-3.18
3.17
8.51
1.12
-3.18
0.50
0.07
99947
99947
15540
99947
15540
15540
99947
99947
99947
99947
99947
99947
99947
99948
99948
99949
16820
47894
99949
40060
31340
31340
47894
99949
99949
31340
31340
99949
40220
28700
99949
99949
99949
99949
31340
40060
99949
40060
99949
16820
47260
40060
47894
99949
40060
99949
40220
99949
40060
19260
99949
40060
99949
99949
47894
47894
47894
47894
99949
16820
99949
40220
49020
47894
99949
13980
47260
E:\FR\FM\03AUP2.SGM
03AUP2
44176
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
49370
49380
49390
49400
49410
49411
49420
49421
49430
49440
49450
49451
49460
49470
49480
49490
49500
49510
49520
49522
49530
49540
49550
49551
49560
49561
49563
49565
49570
49580
49590
49600
49610
49620
49621
49622
49641
49650
49660
49661
49670
49680
49690
49700
49701
49710
49711
49712
49720
49730
49740
49750
49770
49771
49780
49790
49791
49800
49801
49810
49820
49830
49838
49840
49850
49860
49867
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Goochland County, Virginia ......................................................................
Grayson County, Virginia ..........................................................................
Greene County, Virginia ............................................................................
Greensville County, Virginia ......................................................................
Halifax County, Virginia .............................................................................
Hampton City County, Virginia ..................................................................
Hanover County, Virginia ..........................................................................
Harrisonburg City County, Virginia ............................................................
Henrico County, Virginia ...........................................................................
Henry County, Virginia ..............................................................................
Highland County, Virginia ..........................................................................
Hopewell City County, Virginia ..................................................................
Isle Of Wight County, Virginia ...................................................................
James City County, Virginia ......................................................................
King And Queen County, Virginia .............................................................
King George County, Virginia ...................................................................
King William County, Virginia ....................................................................
Lancaster County, Virginia ........................................................................
Lee County, Virginia ..................................................................................
Lexington County, Virginia ........................................................................
Loudoun County, Virginia ..........................................................................
Louisa County, Virginia .............................................................................
Lunenburg County, Virginia .......................................................................
Lynchburg City County, Virginia ................................................................
Madison County, Virginia ..........................................................................
Martinsville City County, Virginia ..............................................................
Manassas City County, Virginia ................................................................
Manassas Park City County, Virginia .......................................................
Mathews County, Virginia .........................................................................
Mecklenburg County, Virginia ...................................................................
Middlesex County, Virginia ........................................................................
Montgomery County, Virginia ....................................................................
Nansemond, Virginia .................................................................................
Nelson County, Virginia .............................................................................
New Kent County, Virginia ........................................................................
Newport News City County, Virginia .........................................................
Norfolk City County, Virginia .....................................................................
Northampton County, Virginia ...................................................................
Northumberland County, Virginia ..............................................................
Norton City County, Virginia ......................................................................
Nottoway County, Virginia .........................................................................
Orange County, Virginia ............................................................................
Page County, Virginia ...............................................................................
Patrick County, Virginia .............................................................................
Petersburg City County, Virginia ...............................................................
Pittsylvania County, Virginia ......................................................................
Portsmouth City County, Virginia ..............................................................
Poquoson City County, Virginia ................................................................
Powhatan County, Virginia ........................................................................
Prince Edward County, Virginia ................................................................
Prince George County, Virginia ................................................................
Prince William County, Virginia .................................................................
Pulaski County, Virginia ............................................................................
Radford City County, Virginia ....................................................................
Rappahannock County, Virginia ................................................................
Richmond County, Virginia ........................................................................
Richmond City County, Virginia ................................................................
Roanoke County, Virginia .........................................................................
Roanoke City County, Virginia ..................................................................
Rockbridge County, Virginia ......................................................................
Rockingham County, Virginia ....................................................................
Russell County, Virginia ............................................................................
Salem County, Virginia ..............................................................................
Scott County, Virginia ................................................................................
Shenandoah County, Virginia ...................................................................
Smyth County, Virginia ..............................................................................
South Boston City County, Virginia ...........................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00096
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9328
0.8215
1.0187
0.8215
0.8215
0.8799
0.9328
0.8753
0.9328
0.8215
0.8215
0.9328
0.8799
0.8799
0.8873
0.9495
0.8873
0.8215
0.8215
0.8215
1.0951
0.8873
0.8215
0.8691
0.8215
0.8215
1.0951
1.0951
0.8799
0.8215
0.8215
0.8186
0.8215
0.9302
0.9328
0.8799
0.8799
0.8215
0.8215
0.8215
0.8215
0.8215
0.8215
0.8215
0.9328
0.8489
0.8799
0.8799
0.9328
0.8215
0.9328
1.0951
0.8186
0.8186
0.8215
0.8215
0.9328
0.8381
0.8381
0.8215
0.8753
0.8215
0.8381
0.8031
0.8215
0.8215
0.8215
0.9193
0.7954
1.0143
0.7954
0.7954
0.8805
0.9193
0.9090
0.9193
0.7954
0.7954
0.9193
0.8805
0.8805
0.9193
0.7954
0.9193
0.7954
0.7954
0.7954
1.1074
0.9193
0.7954
0.8710
0.7954
0.7954
1.1074
1.1074
0.8805
0.7954
0.7954
0.8227
0.7954
1.0143
0.9193
0.8805
0.8805
0.7954
0.7954
0.7954
0.7954
0.7954
0.7954
0.7954
0.9193
0.8466
0.8805
0.8805
0.9193
0.7954
0.9193
1.1074
0.8227
0.8227
0.7954
0.7954
0.9193
0.8662
0.8662
0.7954
0.9090
0.7954
0.8662
0.7975
0.7954
0.7954
0.7954
-1.45
-3.18
-0.43
-3.18
-3.18
0.07
-1.45
3.85
-1.45
-3.18
-3.18
-1.45
0.07
0.07
3.61
-16.23
3.61
-3.18
-3.18
-3.18
1.12
3.61
-3.18
0.22
-3.18
-3.18
1.12
1.12
0.07
-3.18
-3.18
0.50
-3.18
9.04
-1.45
0.07
0.07
-3.18
-3.18
-3.18
-3.18
-3.18
-3.18
-3.18
-1.45
-0.27
0.07
0.07
-1.45
-3.18
-1.45
1.12
0.50
0.50
-3.18
-3.18
-1.45
3.35
3.35
-3.18
3.85
-3.18
3.35
-0.70
-3.18
-3.18
-3.18
40060
99949
16820
99949
99949
47260
40060
25500
40060
99949
99949
40060
47260
47260
40060
99949
40060
99949
99949
99949
47894
40060
99949
31340
99949
99949
47894
47894
47260
99949
99949
13980
99949
16820
40060
47260
47260
99949
99949
99949
99949
99949
99949
99949
40060
19260
47260
47260
40060
99949
40060
47894
13980
13980
99949
99949
40060
40220
40220
99949
25500
99949
40220
28700
99949
99949
99949
E:\FR\FM\03AUP2.SGM
03AUP2
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44177
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
49870
49880
49890
49891
49892
49900
49910
49920
49921
49930
49950
49951
49960
49961
49962
49970
49980
49981
50000
50010
50020
50030
50040
50050
50060
50070
50080
50090
50100
50110
50120
50130
50140
50150
50160
50170
50180
50190
50200
50210
50220
50230
50240
50250
50260
50270
50280
50290
50300
50310
50320
50330
50340
50350
50360
50370
50380
51000
51010
51020
51030
51040
51050
51060
51070
51080
51090
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Southampton County, Virginia ..................................................................
Spotsylvania County, Virginia ...................................................................
Stafford County, Virginia ...........................................................................
Staunton City County, Virginia ..................................................................
Suffolk City County, Virginia .....................................................................
Surry County, Virginia ...............................................................................
Sussex County, Virginia ............................................................................
Tazewell County, Virginia ..........................................................................
Virginia Beach City County, Virginia .........................................................
Warren County, Virginia ............................................................................
Washington County, Virginia .....................................................................
Waynesboro City County, Virginia ............................................................
Westmoreland County, Virginia .................................................................
Williamsburg City County, Virginia ............................................................
Winchester City County, Virginia ..............................................................
Wise County, Virginia ................................................................................
Wythe County, Virginia ..............................................................................
York County, Virginia ................................................................................
Adams County, Washington ......................................................................
Asotin County, Washington .......................................................................
Benton County, Washington .....................................................................
Chelan County, Washington .....................................................................
Clallam County, Washington .....................................................................
Clark County, Washington ........................................................................
Columbia County, Washington ..................................................................
Cowlitz County, Washington .....................................................................
Douglas County, Washington ....................................................................
Ferry County, Washington ........................................................................
Franklin County, Washington ....................................................................
Garfield County, Washington ....................................................................
Grant County, Washington ........................................................................
Grays Harbor County, Washington ...........................................................
Island County, Washington .......................................................................
Jefferson County, Washington ..................................................................
King County, Washington ..........................................................................
Kitsap County, Washington .......................................................................
Kittitas County, Washington ......................................................................
Klickitat County, Washington ....................................................................
Lewis County, Washington ........................................................................
Lincoln County, Washington .....................................................................
Mason County, Washington ......................................................................
Okanogan County, Washington ................................................................
Pacific County, Washington ......................................................................
Pend Oreille County, Washington .............................................................
Pierce County, Washington .......................................................................
San Juan County, Washington .................................................................
Skagit County, Washington .......................................................................
Skamania County, Washington .................................................................
Snohomish County, Washington ...............................................................
Spokane County, Washington ...................................................................
Stevens County, Washington ....................................................................
Thurston County, Washington ...................................................................
Wahkiakum County, Washington ..............................................................
Walla Walla County, Washington ..............................................................
Whatcom County, Washington ..................................................................
Whitman County, Washington ...................................................................
Yakima County, Washington .....................................................................
Barbour County, W Virginia ......................................................................
Berkeley County, W Virginia .....................................................................
Boone County, W Virginia .........................................................................
Braxton County, W Virginia .......................................................................
Brooke County, W Virginia ........................................................................
Cabell County, W Virginia .........................................................................
Calhoun County, W Virginia ......................................................................
Clay County, W Virginia ............................................................................
Doddridge County, W Virginia ...................................................................
Fayette County, W Virginia .......................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00097
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.8215
1.0951
1.0951
0.8215
0.8799
0.8608
0.8873
0.8215
0.8799
1.0951
0.8031
0.8215
0.8215
0.8799
0.9316
0.8215
0.8215
0.8799
1.0364
1.0052
1.0619
1.0144
1.0364
1.1266
1.0364
0.9898
1.0144
1.0364
1.0619
1.0364
1.0364
1.0364
1.1039
1.0364
1.1572
1.0675
1.0364
1.0364
1.0364
1.0364
1.0364
1.0364
1.0364
1.0364
1.0742
1.0364
1.0336
1.0742
1.1572
1.0905
1.0364
1.0927
1.0364
1.0364
1.1731
1.0364
1.0155
0.7809
1.0233
0.8173
0.7809
0.7819
0.9477
0.7809
0.8173
0.7809
0.7809
0.7954
1.1074
1.1074
0.7954
0.8805
0.8805
0.9193
0.7954
0.8805
1.1074
0.7975
0.7954
0.7954
0.8805
1.0109
0.7954
0.7954
0.8805
1.0281
0.9871
1.0361
1.0365
1.0281
1.1436
1.0281
1.0029
1.0365
1.0281
1.0361
1.0281
1.0281
1.0281
1.0281
1.0281
1.1454
1.0932
1.0281
1.0281
1.0281
1.0281
1.0281
1.0281
1.0281
1.0281
1.0808
1.0281
1.0536
1.1436
1.1454
1.0465
1.0281
1.1100
1.0281
1.0281
1.1124
1.0281
0.9865
0.7620
0.9054
0.8558
0.7620
0.8078
0.9013
0.7620
0.8558
0.7620
0.7620
-3.18
1.12
1.12
-3.18
0.07
2.29
3.61
-3.18
0.07
1.12
-0.70
-3.18
-3.18
0.07
8.51
-3.18
-3.18
0.07
-0.80
-1.80
-2.43
2.18
-0.80
1.51
-0.80
1.32
2.18
-0.80
-2.43
-0.80
-0.80
-0.80
-6.87
-0.80
-1.02
2.41
-0.80
-0.80
-0.80
-0.80
-0.80
-0.80
-0.80
-0.80
0.61
-0.80
1.93
6.46
-1.02
-4.03
-0.80
1.58
-0.80
-0.80
-5.17
-0.80
-2.86
-2.42
-11.52
4.71
-2.42
3.31
-4.90
-2.42
4.71
-2.42
-2.42
99949
47894
47894
99949
47260
47260
40060
99949
47260
47894
28700
99949
99949
47260
49020
99949
99949
47260
99950
30300
28420
48300
99950
38900
99950
31020
48300
99950
28420
99950
99950
99950
99950
99950
42644
14740
99950
99950
99950
99950
99950
99950
99950
99950
45104
99950
34580
38900
42644
44060
99950
36500
99950
99950
13380
99950
49420
99951
25180
16620
99951
48260
26580
99951
16620
99951
99951
E:\FR\FM\03AUP2.SGM
03AUP2
44178
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
51100
51110
51120
51130
51140
51150
51160
51170
51180
51190
51200
51210
51220
51230
51240
51250
51260
51270
51280
51290
51300
51310
51320
51330
51340
51350
51360
51370
51380
51390
51400
51410
51420
51430
51440
51450
51460
51470
51480
51490
51500
51510
51520
51530
51540
52000
52010
52020
52030
52040
52050
52060
52070
52080
52090
52100
52110
52120
52130
52140
52150
52160
52170
52180
52190
52200
52210
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Gilmer County, W Virginia .........................................................................
Grant County, W Virginia ..........................................................................
Greenbrier County, W Virginia ..................................................................
Hampshire County, W Virginia ..................................................................
Hancock County, W Virginia .....................................................................
Hardy County, W Virginia ..........................................................................
Harrison County, W Virginia ......................................................................
Jackson County, W Virginia ......................................................................
Jefferson County, W Virginia ....................................................................
Kanawha County, W Virginia ....................................................................
Lewis County, W Virginia ..........................................................................
Lincoln County, W Virginia ........................................................................
Logan County, W Virginia .........................................................................
Mc Dowell County, W Virginia ..................................................................
Marion County, W Virginia ........................................................................
Marshall County, W Virginia ......................................................................
Mason County, W Virginia ........................................................................
Mercer County, W Virginia ........................................................................
Mineral County, W Virginia .......................................................................
Mingo County, W Virginia .........................................................................
Monongalia County, W Virginia .................................................................
Monroe County, W Virginia .......................................................................
Morgan County, W Virginia .......................................................................
Nicholas County, W Virginia .....................................................................
Ohio County, W Virginia ............................................................................
Pendleton County, W Virginia ...................................................................
Pleasants County, W Virginia ...................................................................
Pocahontas County, W Virginia ................................................................
Preston County, W Virginia .......................................................................
Putnam County, W Virginia .......................................................................
Raleigh County, W Virginia .......................................................................
Randolph County, W Virginia ....................................................................
Ritchie County, W Virginia ........................................................................
Roane County, W Virginia .........................................................................
Summers County, W Virginia ....................................................................
Taylor County, W Virginia .........................................................................
Tucker County, W Virginia ........................................................................
Tyler County, W Virginia ...........................................................................
Upshur County, W Virginia ........................................................................
Wayne County, W Virginia ........................................................................
Webster County, W Virginia ......................................................................
Wetzel County, W Virginia ........................................................................
Wirt County, W Virginia .............................................................................
Wood County, W Virginia ..........................................................................
Wyoming County, W Virginia ....................................................................
Adams County, Wisconsin ........................................................................
Ashland County, Wisconsin ......................................................................
Barron County, Wisconsin .........................................................................
Bayfield County, Wisconsin .......................................................................
Brown County, Wisconsin .........................................................................
Buffalo County, Wisconsin ........................................................................
Burnett County, Wisconsin ........................................................................
Calumet County, Wisconsin ......................................................................
Chippewa County, Wisconsin ...................................................................
Clark County, Wisconsin ...........................................................................
Columbia County, Wisconsin ....................................................................
Crawford County, Wisconsin .....................................................................
Dane County, Wisconsin ...........................................................................
Dodge County, Wisconsin .........................................................................
Door County, Wisconsin ............................................................................
Douglas County, Wisconsin ......................................................................
Dunn County, Wisconsin ...........................................................................
Eau Claire County, Wisconsin ..................................................................
Florence County, Wisconsin .....................................................................
Fond Du Lac County, Wisconsin ..............................................................
Forest County, Wisconsin .........................................................................
Grant County, Wisconsin ..........................................................................
15:25 Aug 02, 2006
Jkt 208001
PO 00000
Frm 00098
Fmt 4701
Sfmt 4702
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.7809
0.7809
0.7809
0.9057
0.7819
0.7809
0.7809
0.7809
1.0951
0.8445
0.7809
0.8173
0.7809
0.7809
0.7809
0.7161
0.7809
0.7809
0.9317
0.7809
0.8160
0.7809
0.8695
0.7809
0.7161
0.7809
0.8085
0.7809
0.8160
0.8445
0.7809
0.7809
0.7809
0.7809
0.7809
0.7809
0.7809
0.7809
0.7809
0.9477
0.7809
0.7809
0.8085
0.8270
0.7809
0.9494
0.9494
0.9494
0.9494
0.9483
0.9494
0.9494
0.9264
0.9201
0.9494
1.0069
0.9494
1.0707
0.9494
0.9494
1.0213
0.9494
0.9201
0.9494
0.9559
0.9494
0.9494
0.7620
0.7620
0.7620
1.0109
0.8078
0.7620
0.7620
0.7620
1.1074
0.8558
0.7620
0.8558
0.7620
0.7620
0.7620
0.7022
0.7620
0.7620
0.8859
0.7620
0.8438
0.7620
0.9054
0.7620
0.7022
0.7620
0.7940
0.7620
0.8438
0.8558
0.7620
0.7620
0.7620
0.7620
0.7620
0.7620
0.7620
0.7620
0.7620
0.9013
0.7620
0.7620
0.7940
0.7940
0.7620
0.9468
0.9468
0.9468
0.9468
0.9804
0.9468
0.9468
0.9472
0.9647
0.9468
1.0736
0.9468
1.0736
0.9468
0.9468
1.0070
0.9468
0.9647
0.9468
1.0081
0.9468
0.9468
-2.42
-2.42
-2.42
11.62
3.31
-2.42
-2.42
-2.42
1.12
1.34
-2.42
4.71
-2.42
-2.42
-2.42
-1.94
-2.42
-2.42
-4.92
-2.42
3.41
-2.42
4.13
-2.42
-1.94
-2.42
-1.79
-2.42
3.41
1.34
-2.42
-2.42
-2.42
-2.42
-2.42
-2.42
-2.42
-2.42
-2.42
-4.90
-2.42
-2.42
-1.79
-3.99
-2.42
-0.27
-0.27
-0.27
-0.27
3.39
-0.27
-0.27
2.25
4.85
-0.27
6.62
-0.27
0.27
-0.27
-0.27
-1.40
-0.27
4.85
-0.27
5.46
-0.27
-0.27
99951
99951
99951
49020
48260
99951
99951
99951
47894
16620
99951
16620
99951
99951
99951
48540
99951
99951
19060
99951
34060
99951
25180
99951
48540
99951
37620
99951
34060
16620
99951
99951
99951
99951
99951
99951
99951
99951
99951
26580
99951
99951
37620
37620
99951
99952
99952
99952
99952
24580
99952
99952
11540
20740
99952
31540
99952
31540
99952
99952
20260
99952
20740
99952
22540
99952
99952
E:\FR\FM\03AUP2.SGM
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Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
44179
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
hsrobinson on PROD1PC69 with PROPOSALS2
SSA state/
county
code
52220
52230
52240
52250
52260
52270
52280
52290
52300
52310
52320
52330
52340
52350
52360
52370
52380
52381
52390
52400
52410
52420
52430
52440
52450
52460
52470
52480
52490
52500
52510
52520
52530
52540
52550
52560
52570
52580
52590
52600
52610
52620
52630
52640
52650
52660
52670
52680
52690
52700
53000
53010
53020
53030
53040
53050
53060
53070
53080
53090
53100
53110
53120
53130
53140
53150
53160
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
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.......
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.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
VerDate Aug<31>2005
County name
CBSA No.
Green County, Wisconsin .........................................................................
Green Lake County, Wisconsin ................................................................
Iowa County, Wisconsin ............................................................................
Iron County, Wisconsin .............................................................................
Jackson County, Wisconsin ......................................................................
Jefferson County, Wisconsin .....................................................................
Juneau County, Wisconsin ........................................................................
Kenosha County, Wisconsin .....................................................................
Kewaunee County, Wisconsin ..................................................................
La Crosse County, Wisconsin ...................................................................
Lafayette County, Wisconsin .....................................................................
Langlade County, Wisconsin .....................................................................
Lincoln County, Wisconsin ........................................................................
Manitowoc County, Wisconsin ..................................................................
Marathon County, Wisconsin ....................................................................
Marinette County, Wisconsin ....................................................................
Marquette County, Wisconsin ...................................................................
Menominee County, Wisconsin .................................................................
Milwaukee County, Wisconsin ..................................................................
Monroe County, Wisconsin .......................................................................
Oconto County, Wisconsin ........................................................................
Oneida County, Wisconsin ........................................................................
Outagamie County, Wisconsin ..................................................................
Ozaukee County, Wisconsin .....................................................................
Pepin County, Wisconsin ..........................................................................
Pierce County, Wisconsin .........................................................................
Polk County, Wisconsin ............................................................................
Portage County, Wisconsin .......................................................................
Price County, Wisconsin ...........................................................................
Racine County, Wisconsin ........................................................................
Richland County, Wisconsin .....................................................................
Rock County, Wisconsin ...........................................................................
Rusk County, Wisconsin ...........................................................................
St Croix County, Wisconsin ......................................................................
Sauk County, Wisconsin ...........................................................................
Sawyer County, Wisconsin .......................................................................
Shawano County, Wisconsin ....................................................................
Sheboygan County, Wisconsin .................................................................
Taylor County, Wisconsin .........................................................................
Trempealeau County, Wisconsin ..............................................................
Vernon County, Wisconsin ........................................................................
Vilas County, Wisconsin ............................................................................
Walworth County, Wisconsin ....................................................................
Washburn County, Wisconsin ...................................................................
Washington County, Wisconsin ................................................................
Waukesha County, Wisconsin ..................................................................
Waupaca County, Wisconsin ....................................................................
Waushara County, Wisconsin ...................................................................
Winnebago County, Wisconsin .................................................................
Wood County, Wisconsin ..........................................................................
Albany County, Wyoming ..........................................................................
Big Horn County, Wyoming .......................................................................
Campbell County, Wyoming ......................................................................
Carbon County, Wyoming .........................................................................
Converse County, Wyoming .....................................................................
Crook County, Wyoming ...........................................................................
Fremont County, Wyoming .......................................................................
Goshen County, Wyoming ........................................................................
Hot Springs County, Wyoming ..................................................................
Johnson County, Wyoming .......................................................................
Laramie County, Wyoming ........................................................................
Lincoln County, Wyoming .........................................................................
Natrona County, Wyoming ........................................................................
Niobrara County, Wyoming .......................................................................
Park County, Wyoming .............................................................................
Platte County, Wyoming ............................................................................
Sheridan County, Wyoming ......................................................................
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CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9494
0.9494
1.0069
0.9494
0.9494
0.9494
0.9494
1.0095
0.9481
0.9564
0.9494
0.9494
0.9494
0.9494
0.9590
0.9494
0.9494
0.9494
1.0146
0.9494
0.9481
0.9494
0.9264
1.0146
0.9494
1.1075
0.9494
0.9494
0.9494
0.8997
0.9494
0.9538
0.9494
1.1075
0.9494
0.9494
0.9494
0.8911
0.9494
0.9494
0.9494
0.9494
0.9494
0.9494
1.0146
1.0146
0.9494
0.9494
0.9211
0.9494
0.9257
0.9257
0.9257
0.9257
0.9257
0.9257
0.9257
0.9257
0.9257
0.9257
0.8775
0.9257
0.9026
0.9257
0.9257
0.9257
0.9257
0.9468
0.9468
1.0736
0.9468
0.9468
0.9468
0.9468
1.0406
0.9804
0.9442
0.9468
0.9468
0.9468
0.9468
0.9740
0.9468
0.9468
0.9468
1.0236
0.9468
0.9804
0.9468
0.9472
1.0236
0.9468
1.0965
0.9468
0.9468
0.9468
0.9192
0.9468
0.9672
0.9468
1.0965
0.9468
0.9468
0.9468
0.9042
0.9468
0.9468
0.9468
0.9468
0.9468
0.9468
1.0236
1.0236
0.9468
0.9468
0.9332
0.9468
0.9311
0.9311
0.9311
0.9311
0.9311
0.9311
0.9311
0.9311
0.9311
0.9311
0.9076
0.9311
0.9161
0.9311
0.9311
0.9311
0.9311
-0.27
-0.27
6.62
-0.27
-0.27
-0.27
-0.27
3.08
3.41
-1.28
-0.27
-0.27
-0.27
-0.27
1.56
-0.27
-0.27
-0.27
0.89
-0.27
3.41
-0.27
2.25
0.89
-0.27
-0.99
-0.27
-0.27
-0.27
2.17
-0.27
1.40
-0.27
-0.99
-0.27
-0.27
-0.27
1.47
-0.27
-0.27
-0.27
-0.27
-0.27
-0.27
0.89
0.89
-0.27
-0.27
1.31
-0.27
0.58
0.58
0.58
0.58
0.58
0.58
0.58
0.58
0.58
0.58
3.43
0.58
1.50
0.58
0.58
0.58
0.58
99952
99952
31540
99952
99952
99952
99952
29404
24580
29100
99952
99952
99952
99952
48140
99952
99952
99952
33340
99952
24580
99952
11540
33340
99952
33460
99952
99952
99952
39540
99952
27500
99952
33460
99952
99952
99952
43100
99952
99952
99952
99952
99952
99952
33340
33340
99952
99952
36780
99952
99953
99953
99953
99953
99953
99953
99953
99953
99953
99953
16940
99953
16220
99953
99953
99953
99953
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03AUP2
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Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 / Proposed Rules
ADDENDUM C.—COMPARISON OF HH PPS TRANSITION WAGE INDEX FOR CY 2006 AND PRE-FLOOR AND PRERECLASSIFIED HOSPITAL WAGE INDEX FOR CY 2007—Continued
SSA state/
county
code
53170
53180
53190
53200
53210
53220
65010
65020
65030
65040
65050
65060
65070
65080
65090
65100
65110
65120
65130
65140
65150
65160
65170
65180
65190
65200
65210
65220
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
.......
County name
CBSA No.
Sublette County, Wyoming ........................................................................
Sweetwater County, Wyoming ..................................................................
Teton County, Wyoming ............................................................................
Uinta County, Wyoming ............................................................................
Washakie County, Wyoming .....................................................................
Weston County, Wyoming .........................................................................
Agana County, Guam ................................................................................
Agana Heights County, Guam ..................................................................
Agat County, Guam ...................................................................................
Asan County, Guam ..................................................................................
Barrigada County, Guam ..........................................................................
Chalan Pago County, Guam .....................................................................
Dededo County, Guam .............................................................................
Inarajan County, Guam .............................................................................
Maite County, Guam .................................................................................
Mangilao County, Guam ...........................................................................
Merizo County, Guam ...............................................................................
Mongmong County, Guam ........................................................................
Ordot County, Guam .................................................................................
Piti County, Guam .....................................................................................
Santa Rita County, Guam .........................................................................
Sinajana County, Guam ............................................................................
Talofofo County, Guam .............................................................................
Tamuning County, Guam ..........................................................................
Toto County, Guam ...................................................................................
Umatac County, Guam ..............................................................................
Yigo County, Guam ...................................................................................
Yona County, Guam ..................................................................................
CY 2006
HH PPS
transition
wage index
Proposed
CY 2007
CBSAbased wage
index
Percent
change CY
2006–CY
2007
0.9257
0.9257
0.9257
0.9257
0.9257
0.9257
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9311
0.9311
0.9311
0.9311
0.9311
0.9311
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.9611
0.58
0.58
0.58
0.58
0.58
0.58
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
99953
99953
99953
99953
99953
99953
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
99965
[FR Doc. 06–6614 Filed 7–27–06; 4:00 pm]
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03AUP2
]]>Agencies
[Federal Register Volume 71, Number 149 (Thursday, August 3, 2006)]
[Proposed Rules]
[Pages 44082-44180]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-6614]
[[Page 44081]]
-----------------------------------------------------------------------
Part II
Department of Health and Human Services
-----------------------------------------------------------------------
Centers for Medicare & Medicaid Services
-----------------------------------------------------------------------
42 CFR Parts 414 and 484
Medicare Program; Home Health Prospective Payment System Rate Update
for Calendar Year 2007 and Deficit Reduction Act of 2005 Changes to
Medicare Payment for Oxygen Equipment and Capped Rental Durable Medical
Equipment; Proposed Rule
Federal Register / Vol. 71, No. 149 / Thursday, August 3, 2006 /
Proposed Rules
[[Page 44082]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 414 and 484
[CMS-1304-P]
RIN 0938-AN76
Medicare Program; Home Health Prospective Payment System Rate
Update for Calendar Year 2007 and Deficit Reduction Act of 2005 Changes
to Medicare Payment for Oxygen Equipment and Capped Rental Durable
Medical Equipment; Proposed Rule
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: This proposed rule would set forth an update to the 60-day
national episode rates and the national per-visit amounts under the
Medicare prospective payment system for home health agencies. In
addition, this proposed rule would set forth policy changes related to
Medicare payment for certain durable medical equipment for the purpose
of implementing sections 1834(a)(5) and 1834(a)(7) of the Social
Security Act, as amended by section 5101 of the Deficit Reduction Act
of 2005. We are also inviting comments on a number of issues including
payments based on reporting quality data and health information
technology, as well as how to improve data transparency for consumers.
DATES: To be assured consideration, comments must be received at one of
the addresses provided below, no later than 5 p.m. on September 25,
2006.
ADDRESSES: In commenting, please refer to file code CMS-1304-P. Because
of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit comments in one of four ways (no duplicates,
please):
1. Electronically. You may submit electronic comments on specific
issues in this regulation to https://www.cms.hhs.gov/eRulemaking. Click
on the link ``Submit electronic comments on CMS regulations with an
open comment period.'' (Attachments should be in Microsoft Word,
WordPerfect, or Excel; however, we prefer Microsoft Word.)
2. By regular mail. You may mail written comments (one original and
two copies) to the following address ONLY:
Centers for Medicare & Medicaid Services, Department of Health and
Human Services, Attention: CMS-1304-P, P.O. Box 8014, Baltimore, MD
21244-8014.
Please allow sufficient time for mailed comments to be received
before the close of the comment period.
3. By express or overnight mail. You may send written comments (one
original and two copies) to the following address ONLY:
Centers for Medicare & Medicaid Services, Department of Health and
Human Services, Attention: CMS-1304-P, Mail Stop C4-26-05, 7500
Security Boulevard, Baltimore, MD 21244-1850.
4. By hand or courier. If you prefer, you may deliver (by hand or
courier) your written comments (one original and two copies) before the
close of the comment period to one of the following addresses. If you
intend to deliver your comments to the Baltimore address, please call
telephone number (410) 786-7195 in advance to schedule your arrival
with one of our staff members.
Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW.,
Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD 21244-
1850.
(Because access to the interior of the HHH Building is not readily
available to persons without Federal Government identification,
commenters are encouraged to leave their comments in the CMS drop slots
located in the main lobby of the building. A stamp-in clock is
available for persons wishing to retain a proof of filing by stamping
in and retaining an extra copy of the comments being filed.)
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and received after the comment
period.
Submission of comments on paperwork requirements. You may submit
comments on this document's paperwork requirements by mailing your
comments to the addresses provided at the end of the ``Collection of
Information Requirements'' section in this document.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Randy Throndset, (410) 786-0131, or
Sharon Ventura, (410) 786-1985 (for issues related to the home health
prospective payment system).
Doug Brown, (410) 786-0028 (for issues related to reporting quality
data).
Alexis Meholic, (410) 786-2300 (for issues related to
implementation of section 5101 of the Deficit Reduction Act of 2005).
SUPPLEMENTARY INFORMATION: Submitting Comments: We welcome comments
from the public on all issues set forth in this rule to assist us in
fully considering issues and developing policies. You can assist us by
referencing the file code CMS-1304-P and the specific ``issue
identifier'' that precedes the section on which you choose to comment.
Inspection of Public Comments: All comments received before the
close of the comment period are available for viewing by the public,
including any personally identifiable or confidential business
information that is included in a comment. We post all comments
received before the close of the comment period on the following Web
site as soon as possible after they have been received: https://
www.cms.hhs.gov/eRulemaking. Click on the link ``Electronic Comments on
CMS Regulations'' on that Web site to view public comments.
Comments received timely would also be available for public
inspection as they are received, generally beginning approximately 3
weeks after publication of a document, at the headquarters of the
Centers for Medicare & Medicaid Services, 7500 Security Boulevard,
Baltimore, Maryland 21244, Monday through Friday of each week from 8:30
a.m. to 4 p.m. To schedule an appointment to view public comments,
phone 1-800-743-3951.
I. Background
[If you choose to comment on issues in this section, please include
the caption ``BACKGROUND'' at the beginning of your comments.]
A. Statutory Background
The Balanced Budget Act of 1997 (BBA) (Pub. L. 105-33), enacted on
August 5, 1997, significantly changed the way Medicare pays for
Medicare home health services. Until the implementation of a home
health prospective payment system (HH PPS) on October 1, 2000, home
health agencies (HHAs) received payment under a cost-based
reimbursement system. Section 4603 of the BBA governed the development
of the HH PPS.
Section 4603(a) of the BBA provides the authority for the
development of a PPS for all Medicare-covered home health services
provided under a plan of care that were paid on a reasonable cost basis
by adding section 1895, entitled ``Prospective Payment For Home Health
Services,'' to the Social Security Act (the Act).
Section 1895(b)(1) of the Act requires the Secretary to establish a
PPS for all
[[Page 44083]]
costs of home health services paid under Medicare.
Section 1895(b)(3)(A) of the Act requires that (1) the computation
of a standard prospective payment amount include all costs of home
health services covered and paid for on a reasonable cost basis and be
initially based on the most recent audited cost report data available
to the Secretary, and (2) the prospective payment amounts be
standardized to eliminate the effects of case-mix and wage levels among
HHAs.
Section 1895(b)(3)(B) of the Act addresses the annual update to the
standard prospective payment amounts by the home health applicable
increase percentage as specified in the statute.
Section 1895(b)(4) of the Act governs the payment computation.
Sections 1895(b)(4)(A)(i) and (b)(4)(A)(ii) of the Act require the
standard prospective payment amount to be adjusted for case-mix and
geographic differences in wage levels. Section 1895(b)(4)(B) of the Act
requires the establishment of an appropriate case-mix adjustment factor
that explains a significant amount of the variation in cost among
different units of services. Similarly, section 1895(b)(4)(C) of the
Act requires the establishment of wage-adjustment factors that reflect
the relative level of wages and wage-related costs applicable to the
furnishing of home health services in a geographic area compared to the
national average applicable level. These wage-adjustment factors may be
the factors used by the Secretary for the different area wage levels
for purposes of section 1886(d)(3)(E) of the Act.
Section 1895(b)(5) of the Act gives the Secretary the option to
grant additions or adjustments to the payment amount otherwise made in
the case of outliers because of unusual variations in the type or
amount of medically necessary care. Total outlier payments in a given
fiscal year cannot exceed 5 percent of total payments projected or
estimated.
On December 8, 2003, the Congress enacted the Medicare Prescription
Drug, Improvement, and Modernization Act (MMA) of 2003 (Pub. L. 108-
173). This legislation affected how we make updates to HH payment
rates.
Section 701 of the MMA changed the yearly update cycle of the HH
PPS rates from that of a fiscal year to a calendar year update cycle
for 2004 and any subsequent year. Generally, section 701(a) of the MMA
changed the references in the statute to refer to the calendar year for
2004 and any subsequent year. The changes resulted in updates to the HH
PPS rates described as ``fiscal year'' updates for 2002 and 2003 and as
``calendar year'' updates for 2004 and any subsequent year (section
1895(b)(3)(B)(i) of the Act). Beginning on January 1, 2005, HH PPS
would now be updated on a calendar year update cycle.
In addition to changing the update cycle for HH PPS rates, section
701 of the MMA made adjustments to the home health applicable increase
percentage for 2004, 2005, and 2006. Specifically, section 701(a)(2)(D)
of the MMA left unchanged the home health market basket update for the
last calendar year quarter of 2003 and the first calendar year quarter
of 2004 (section 1895(b)(3)(B)(ii)(II) of the Act). Furthermore,
section 701(b)(4) of the MMA set the home health applicable percentage
increase for the last 3 quarters of 2004 as the home health market
basket (3.1 percent) minus 0.8 percentage point (section
1895(b)(3)(B)(ii)(III) of the Act). We implemented this provision
through Pub. 100-20, One Time Notification, Transmittal 59, issued
February 20, 2004. Section 701(b)(4) of the MMA also provided that
updates for CY 2005 and CY 2006 would equal the applicable home health
market basket percentage increase minus 0.8 percentage point. Lastly,
section 701(b)(3) of the MMA revised the statute to provide that HH PPS
rates for CY 2007 and any subsequent year would be updated by that
year's home health market basket percentage increase (section
1895(b)(3)(B)(ii)(IV) of the Act).
On February 8, 2006, the Congress enacted the Deficit Reduction Act
(DRA) of 2005 (Pub. L. 109-171). This legislation made additional
changes to HH PPS.
Section 5201 of the DRA changed the CY 2006 update from the
applicable home health market basket percentage increase minus 0.8
percentage point to a 0 percent update.
Section 5201 of the DRA amended section 421(a) of the MMA. The
amended section 421(a) of the MMA requires for home health services
furnished in a rural area (as defined in section 1886(d)(2)(D) of the
Act) on or after January 1, 2006 and before January 1, 2007, that the
Secretary increase the payment amount otherwise made under section 1895
of the Act for those services by 5 percent. The statute waives budget
neutrality for purposes of this increase as it specifically requires
that the Secretary not reduce the standard prospective payment amount
(or amounts) under section 1895 of the Act applicable to home health
services furnished during a period to offset the increase in payments
resulting in the application of this section of the statute.
The 0 percent update to the payment rates and the rural add-on
provisions of the DRA were implemented through Pub. 100-20, One Time
Notification, Transmittal 211 issued February 10, 2006.
In addition, section 5201(c) of the DRA amends the statute to add
section 1895(b)(3)(B)(v) to the Act, requiring HHAs to submit data for
purposes of measuring health care quality. This requirement is
applicable for 2007 and each subsequent year. For 2007 and each
subsequent year, in the case of a HHA that does not submit quality
data, the home health market basket percentage increase would be
reduced by 2 percentage points.
B. Updates
On July 3, 2000, we published a final rule (65 FR 41128) in the
Federal Register to implement the HH PPS legislation. That final rule
established requirements for the new PPS for HHAs as required by
section 4603 of the BBA, and as subsequently amended by section 5101 of
the Omnibus Consolidated and Emergency Supplemental Appropriations Act
(OCESAA) for Fiscal Year 1999 (Pub. L. 105-277), enacted on October 21,
1998; and by sections 302, 305, and 306 of the Medicare, Medicaid, and
SCHIP Balanced Budget Refinement Act (BBRA) of 1999 (Pub. L. 106-113),
enacted on November 29, 1999. The requirements include the
implementation of a PPS for HHAs, consolidated billing requirements,
and a number of other related changes. The PPS described in that rule
replaced the retrospective reasonable-cost-based system that was used
by Medicare for the payment of home health services under Part A and
Part B.
On November 9, 2005, we published a final rule (70 FR 68132), which
set forth an update to the 60-day national episode rates and the
national per-visit amounts under the Medicare prospective payment
system for home health agencies. As part of that final rule, we adopted
revised area labor market Metropolitan Statistical Area designations
for CY 2006. In implementing the new area labor market designations, we
allowed for a one-year transition period. This transition consists of a
blend of 50 percent of the new area labor market designations' wage
index and 50 percent of the previous area labor market designations'
wage index. In addition, we revised the fixed dollar loss ratio, which
is used in the calculation of outlier payments.
C. System for Payment of Home Health Services
Generally, Medicare makes payment under the HH PPS on the basis of
a
[[Page 44084]]
national standardized 60-day episode payment, adjusted for case mix and
wage index. For episodes with four or fewer visits, Medicare pays on
the basis of a national per-visit amount by discipline, referred to as
a low utilization payment adjustment (LUPA). Medicare also adjusts the
60-day episode payment for certain intervening events that give rise to
a partial episode payment adjustment (PEP adjustment) or a significant
change in condition adjustment (SCIC). For certain cases that exceed a
specific cost threshold, an outlier adjustment may also be available.
For a complete and full description of the HH PPS as required by the
BBA and as amended by OCESAA and BBRA, see the July 3, 2000 HH PPS
final rule (65 FR 41128).
D. Changes in Payment for Oxygen and Oxygen Equipment and Other Durable
Medical Equipment (Capped Rental Items)
The Medicare payment rules for durable medical equipment (DME) are
set forth in section 1834(a) of the Act and 42 CFR part 414, subpart D
of our regulations. General payment rules for DME are set forth in
section 1834(a)(1) of the Act and Sec. 414.210 of our regulations, and
Sec. 414.210 also contains paragraphs relating to maintenance and
servicing of items and replacement of items. Specific rules for oxygen
and oxygen equipment are set forth in section 1834(a)(5) of the Act and
Sec. 414.226 of our regulations, and specific rules for capped rental
items are set forth in section 1834(a)(7) of the Act and Sec. 414.229
of our regulations. Rules for determining a period of continuous use
for the rental of DME are set forth in Sec. 414.230 of our
regulations. The Medicare payment basis for DME is equal to 80 percent
of either the lower of the actual charge or the fee schedule amount for
the item. The beneficiary coinsurance is equal to 20 percent of either
the lower of the actual charge or the fee schedule amount for the item.
In accordance with the rules set forth in section 1834(a)(5) of the
Act and Sec. 414.226 of our regulations, since 1989, suppliers have
been paid monthly for furnishing oxygen and oxygen equipment to
Medicare beneficiaries. Suppliers have also been paid an add-on fee for
furnishing portable oxygen equipment to patients when medically
necessary. Before the enactment of the DRA, these monthly payments
continued for the duration of use of the equipment, provided that
Medicare Part B coverage and eligibility criteria were met. Medicare
covers three types of oxygen delivery systems: (1) Stationary or
portable oxygen concentrators, which concentrate oxygen in room air;
(2) stationary or portable liquid oxygen systems, which use oxygen
stored as a very cold liquid in cylinders and tanks; and (3) stationary
or portable gaseous oxygen systems, which administer compressed oxygen
directly from cylinders. Both liquid and gaseous oxygen systems require
delivery of oxygen contents.
Medicare payment for furnishing oxygen and oxygen equipment is made
on a monthly basis and the fee schedule amounts vary by State. Payment
for oxygen contents for both stationary and portable equipment is
included in the fee schedule allowances for stationary equipment.
Medicare fee schedules for home oxygen equipment are modality neutral;
meaning that in a given State, there is one fee schedule amount that
applies to all stationary systems and one fee schedule amount that
applies to all portable systems.
Effective January 1, 2006, section 5101(b) of the DRA amended the
Act at section 1834(a)(5) of the Act, limiting to 36 months the total
number of continuous months for which Medicare will pay for oxygen
equipment on a rental basis. At the end of the 36-month period, this
section mandates that the supplier transfer title to the stationary and
portable oxygen equipment to the beneficiary. Section 5101(b) of the
DRA does not, however, limit the number of months for which Medicare
will pay for oxygen contents for beneficiary-owned stationary or
portable gaseous or liquid systems, and payment will continue to be
made as long as the oxygen remains medically necessary. Section 5101(b)
of the DRA also provides that payment for reasonable and necessary
maintenance and servicing of beneficiary-owned oxygen equipment will be
made for parts and labor not covered by a supplier's or manufacturer's
warranty. In the case of beneficiaries using oxygen equipment on
December 31, 2005, the 36-month rental period prescribed by the DRA
begins on January 1, 2006.
In accordance with the rules set forth in section 1834(a)(7) of the
Act and Sec. 414.229 of our regulations, before the enactment of the
DRA, suppliers of capped rental items (that is, other DME not described
in paragraphs (2) through (6) of section 1834(a) of the Act) were paid
on a rental or purchase option basis. Payment for most items in the
capped rental category was made on a monthly rental basis, with rental
payments being capped at 15 months or 13 months, depending on whether
the beneficiary chose to continue renting the item or to take over
ownership of the item through the ``purchase option.'' For all capped
rental items, the supplier was required to inform the beneficiary of
his or her purchase option, during the 10th rental month, to enter into
a purchase agreement under which the supplier would transfer title to
the item to the beneficiary on the first day after the 13th continuous
month during which payment was made for the rental of the item.
Therefore, if the beneficiary chose the purchase option, rental
payments to the supplier would continue through the 13th month of
continuous use of the equipment, after which time title to the
equipment would transfer from the supplier to the beneficiary. Medicare
would also make payment for any reasonable and necessary repair or
maintenance and servicing of the equipment following the transfer of
title. If the beneficiary did not choose the purchase option, rental
payments would continue through the 15th month of continuous use. In
these cases, suppliers would maintain title to the equipment but would
have to continue furnishing the item to the beneficiary as long as
medically necessity continued. Beginning 6 months after the 15th month
of continuous use in which payment was made, Medicare would also make
semi-annual maintenance and servicing payments to suppliers. These
payments were approximately equal to 10 percent of the purchase price
for the equipment as determined by the statute. Total Medicare payments
made through the 13th and 15th months of rental equal 105 and 120
percent, respectively, of the purchase price for the equipment.
In the case of power-driven wheelchairs, since 1989 payment has
also been made on a lump-sum purchase basis at the time that the item
is initially furnished to the beneficiary if the beneficiary chooses to
obtain the item in this manner. Most beneficiaries choose to obtain
power-driven wheelchairs via this lump-sum purchase option.
Effective for items for which the first rental month occurs on or
after January 1, 2006, section 5101(a) of the DRA of 2005 amended
section 1834(a)(7) of the Act, limiting to 13 months the total number
of continuous months for which Medicare will pay for DME in this
category. After a 13-month period of continuous use during which rental
payments are made, the statute requires that the supplier transfer
title to the equipment to the beneficiary. Beneficiaries may still
elect to obtain power-driven wheelchairs on a lump-sum purchase
agreement basis. In all cases, payment for reasonable and necessary
maintenance and servicing of beneficiary-owned equipment will be made
for parts and labor not covered by
[[Page 44085]]
the supplier's or manufacturer's warranty.
II. Provisions of the Proposed Regulations
[If you choose to comment on issues in this section, please include
the caption ``PROVISIONS OF THE PROPOSED REGULATIONS'' at the beginning
of your comments.]
A. National Standardized 60-Day Episode Rate
Medicare HH PPS has been effective since October 1, 2000. As set
forth in the final rule published July 3, 2000 in the Federal Register
(65 FR 41128), the unit of payment under Medicare HH PPS is a national
standardized 60-day episode rate. As set forth in Sec. 484.220, we
adjust the national standardized 60-day episode rate by a case mix
grouping and a wage index value based on the site of service for the
beneficiary. The proposed CY 2007 HH PPS rates use the same case-mix
methodology and application of the wage index adjustment to the labor
portion of the HH PPS rates as set forth in the July 3, 2000 final
rule. In the October 22, 2004 final rule, we rebased and revised the
home health market basket, resulting in a labor-related share of 76.775
percent and a non-labor portion of 23.225 percent (69 FR 62126). We
multiply the national 60-day episode rate by the patient's applicable
case-mix weight. We divide the case-mix adjusted amount into a labor
and non-labor portion. We multiply the labor portion by the applicable
wage index based on the site of service of the beneficiary.
As required by section 1895(b)(3)(B) of the Act, we have updated
the HH PPS rates annually in a separate Federal Register document.
Section 484.225 sets forth the specific annual percentage update. To
reflect section 1895(b)(3)(B)(v) of the Act, as added by section 5201
of the DRA, in Sec. 484.225, we are proposing to revise paragraph (g)
as follows:
(g) For 2007 and subsequent calendar years, the unadjusted
national rate is equal to the rate for the previous calendar year
increased by the applicable home health market basket index amount
unless the HHA has not submitted quality data in which case the
unadjusted national rate is equal to the rate for the previous
calendar year increased by the applicable home health market basket
index amount minus 2 percentage points.
For CY 2007, we are proposing to use again the design and case-mix
methodology described in section III.G of the HH PPS July 3, 2000 final
rule (65 FR 41192 through 41203). For CY 2007, we are proposing to base
the wage index adjustment to the labor portion of the PPS rates on the
most recent pre-floor and pre-reclassified hospital wage index as
discussed in section II.F. of this proposed rule (not including any
reclassifications under section 1886(d)(8)(B) of the Act).
As discussed in the July 3, 2000 HH PPS final rule, for episodes
with four or fewer visits, Medicare pays the national per-visit amount
by discipline, referred to as a LUPA. We update the national per-visit
amounts by discipline annually by the applicable home health market
basket percentage. We adjust the national per-visit amount by the
appropriate wage index based on the site of service for the beneficiary
as set forth in Sec. 484.230. We propose to adjust the labor portion
of the updated national per-visit amounts by discipline used to
calculate the LUPA by the most recent pre-floor and pre-reclassified
hospital wage index, as discussed in section II.F of this proposed
rule.
Medicare pays the 60-day case-mix and wage-adjusted episode payment
on a split percentage payment approach. The split percentage payment
approach includes an initial percentage payment and a final percentage
payment as set forth in Sec. 484.205(b)(1) and Sec. 484.205(b)(2). We
may base the initial percentage payment on the submission of a request
for anticipated payment (RAP) and the final percentage payment on the
submission of the claim for the episode, as discussed in Sec. 409.43.
The claim for the episode that the HHA submits for the final percentage
payment determines the total payment amount for the episode and whether
we make an applicable adjustment to the 60-day case-mix and wage-
adjusted episode payment. The end date of the 60-day episode as
reported on the claim determines which calendar year rates Medicare
would use to pay the claim.
We may also adjust the 60-day case-mix and wage-adjusted episode
payment based on the information submitted on the claim to reflect the
following:
A low utilization payment provided on a per-visit basis as
set forth in Sec. 484.205(c) and Sec. 484.230.
A partial episode payment adjustment as set forth in Sec.
484.205(d) and Sec. 484.235.
A significant change in condition adjustment as set forth
in Sec. 484.205(e) and Sec. 484.237.
An outlier payment as set forth in Sec. 484.205(f) and
Sec. 484.240.
This proposed rule reflects the proposed updated CY 2007 rates that
would be effective January 1, 2007.
B. Proposed CY 2007 Update to the Home Health Market Basket Index
Section 1895(b)(3)(B) of the Act, as amended by section 5201 of the
DRA, requires for CY 2007 that the standard prospective payment amounts
be increased by a factor equal to the applicable home health market
basket update.
Proposed CY 2007 Adjustments.
In calculating the annual update for the CY 2007 60-day episode
rates, we are proposing to first look at the CY 2006 rates as a
starting point. The CY 2006 national 60-day episode rate, as modified
by section 5201(a)(4) of the DRA (and implemented through Pub. 100-20,
One Time Notification, Transmittal 211 issued February 10, 2006) is
$2,264.28.
In order to calculate the CY 2007 national 60-day episode rate, we
are proposing to multiply the CY 2006 national 60-day episode rate
($2,264.28) by the proposed estimated home health market basket update
of 3.1 percent for CY 2007. The proposed estimated home health market
basket percentage increase reflects changes over time in the prices of
an appropriate mix of goods and services included in covered home
health services. The estimated home health market basket percentage
increase is generally used to update the HH PPS rates on an annual
basis.
We would increase the 60-day episode payment rate for CY 2007
(episodes ending on or after January 1, 2007, and before January 1,
2008) by the proposed estimated home health market basket update (3.1
percent) ($2,264.28 x 1.031) to yield the proposed updated CY 2007
national 60-day episode rate ($2,334.47) (see Table 1 below).
[[Page 44086]]
Table 1.--Proposed National 60-Day Episode Amounts Updated by the Estimated Home Health Market Basket Update for
CY 2007, Before Case-Mix Adjustment
----------------------------------------------------------------------------------------------------------------
Multiply by the proposed
Total CY 2006 prospective payment amount per 60-day estimated home health market Proposed CY 2007 updated
episode basket update (3.1 Percent) national 60-day episode rate
\1\
----------------------------------------------------------------------------------------------------------------
$2,264.28........................................... x 1.031 $2,334.47
----------------------------------------------------------------------------------------------------------------
\1\ The estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc,
2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
National Per-visit Amounts Used To Pay LUPAs and Compute Imputed Costs
Used in Outlier Calculations
As discussed previously in this proposed rule, the policies
governing the LUPAs and outlier calculations set forth in the July 3,
2000 HH PPS final rule would continue during CY 2007. In calculating
the annual update for the CY 2007 national per-visit amounts we use to
pay LUPAs and to compute the imputed costs in outlier calculations, we
are proposing to look again at the CY 2006 rates as a starting point.
We then are proposing to multiply those amounts by the proposed
estimated home health market basket update (3.1 percent) for CY 2007 to
yield the updated per-visit amounts for each home health discipline for
CY 2007 (episodes ending on or after January 1, 2007, and before
January 1, 2008) (see Table 2 below).
Table 2.--Proposed National Per-Visit Amounts for LUPAs and Outlier Calculations Updated by the Estimated Home
Health Market Basket Update for CY 2007
----------------------------------------------------------------------------------------------------------------
Multiply by the
Final CY 2006 per- proposed Proposed CY 2007
visit amounts per estimated home per-visit payment
Home health discipline type 60-day episode health market amount per
for LUPAs basket (3.1 discipline for
percent) \1\ LUPAs
----------------------------------------------------------------------------------------------------------------
Home health aide....................................... $44.76 x 1.031 $46.15
Medical social services................................ 158.45 x 1.031 163.36
Occupational therapy................................... 108.81 x 1.031 112.18
Physical therapy....................................... 108.08 x 1.031 111.43
Skilled nursing........................................ 98.85 x 1.031 101.91
Speech-language pathology.............................. 117.44 x 1.031 121.08
----------------------------------------------------------------------------------------------------------------
\1\ The estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc,
2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
C. Rural Add-On
As stated above, section 5201(b) of the DRA requires, for home
health services furnished in a rural area (as defined in section
1886(d)(2)(D) of the Act) with respect to episodes and visits beginning
on or after January 1, 2006 and before January 1, 2007, that the
Secretary increase by 5 percent the payment amount otherwise made under
section 1895 of the Act. The statute waives budget neutrality related
to this provision as it specifically states that the Secretary shall
not reduce the standard prospective payment amount (or amounts) under
section 1895 of the Act applicable to home health services furnished
during a period to offset the increase in payments resulting in the
application of this section of the statute.
While the rural add-on would primarily affect those episodes paid
based on CY 2006 rates, it would also affect a number of episodes that
would be paid based on CY 2007 rates. For example, an episode that
begins on December 20, 2006 and ends on February 17, 2007, for services
furnished in a rural area, would be paid based on CY 2007 rates because
the episode ends on or after January 1, 2007 and before January 1,
2008; and the episode would also receive the rural add-on because the
episode begins on or after January 1, 2006 and before January 1, 2007.
The applicable case-mix and wage index adjustment is subsequently
applied to the 60-day episode amount for the provision of home health
services where the site of service is the non-Metropolitan Statistical
Area (MSA) of the beneficiary. Similarly, the applicable wage index
adjustment is subsequently applied to the LUPA per-visit amounts
adjusted for the provision of home health services where the site of
service for the beneficiary is a non-MSA area. We implemented this
provision for CY 2006 on February 13, 2006 through Pub. 100-20, One
Time Notification, Transmittal 211 issued February 10, 2006. The 5
percent rural add-on is noted in tables 3 and 4 below.
[[Page 44087]]
Table 3.--Proposed Payment Amounts for 60-Day Episodes Beginning in CY 2006 and Ending in CY 2007 Updated by the
Estimated Home Health Market Basket Update for CY 2007 With Rural Add-On, Before Case-Mix Adjustment
----------------------------------------------------------------------------------------------------------------
Proposed CY 2007 payment
amount per 60-day episode
beginning in CY 2006 and
Proposed CY 2007 total prospective payment amount 5 percent rural add-on before January 1, 2007 and
per 60-day episode ending in CY 2007 for a
beneficiary who resides in a
non-MSA area
----------------------------------------------------------------------------------------------------------------
2,334.47............................................ x 1.05 $2,451.20
----------------------------------------------------------------------------------------------------------------
Table 4.--Proposed National Per-Visit Amounts for Episodes Beginning in CY 2006 and Ending in CY 2007 Updated by
the Estimated Home Health Market Basket Update for CY 2007 With Rural Add-On
----------------------------------------------------------------------------------------------------------------
Proposed CY 2007
per-visit payment
amount per
discipline for 60-
day episodes
Proposed CY 2007 Multiply by the beginning on or
Home health discipline type per-visit amounts 5 percent rural after January 1
add-on in CY 2006 and
ending in CY 2007
for a beneficiary
who resides in a
non-msa area
----------------------------------------------------------------------------------------------------------------
Home health aide....................................... $46.15 x 1.05 $48.46
Medical social services................................ 163.36 x 1.05 171.53
Occupational therapy................................... 112.18 x 1.05 117.79
Physical therapy....................................... 111.43 x 1.05 117.00
Skilled nursing........................................ 101.91 x 1.05 107.01
Speech-language pathology.............................. 121.08 x 1.05 127.13
----------------------------------------------------------------------------------------------------------------
Section 5201(c)(2) of the DRA added section 1895(b)(3)(B)(v)(II) to
the Act, requiring that ``each home health agency shall submit to the
Secretary such data that the Secretary determines are appropriate for
the measurement of health care quality. Such data shall be submitted in
a form and manner, and at a time, specified by the Secretary for
purposes of this clause.'' In addition, section 1895(b)(3)(B)(v)(I) of
the Act, as also added by section 5201(c)(2) of the DRA, dictates that
``for 2007 and each subsequent year, in the case of a home health
agency that does not submit data to the Secretary in accordance with
subclause (II) with respect to such a year, the home health market
basket percentage increase applicable under such clause for such year
shall be reduced by 2 percentage points.''
The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) required
the use of a standardized assessment instrument for quality oversight
of HHAs. A standardized assessment instrument provides an HHA with a
uniform mechanism to assess the needs of their patients and provide CMS
with a uniform mechanism to assess the HHA's ability to adequately
address those needs. To fulfill the OBRA 87 mandate, CMS required that,
as part of their comprehensive assessment process, HHAs collect and
report Outcome and Assessment Information Set (OASIS) data and later
mandated the submission of this data as an HHA condition of
participation at 42 CFR 484.20 and 484.55.
The OASIS data provide consumers and HHAs with ten, publicly-
reported home health quality measures which have been endorsed by the
National Quality Forum (NQF). Reporting this quality data has also
required the development of several supporting mechanisms such as the
HAVEN software used to encode and transmit data using a CMS standard
electronic record layout, edit specifications, and data dictionary. The
HAVEN software, which includes the OASIS, has become a standard
practice within HHA operations. These early investments in data
infrastructure and supporting software that CMS and HHAs have made over
the past several years in order to create this quality reporting
structure, have made quality reporting and measurement an important
component of the HHA industry. The ten measures are:
(1) Improvement in ambulation/locomotion.
(2) Improvement in bathing.
(3) Improvement in transferring.
(4) Improvement in management of oral medications.
(5) Improvement in pain interfering with activity.
(6) Acute care hospitalization.
(7) Emergent care.
(8) Improvement in dyspnea.
(9) Improvement in urinary incontinence.
(10) Discharge to community.
We propose to use OASIS data and the ten quality measures based on
those data as the appropriate measure on home health quality.
Continuing to use the OASIS instrument would minimize the burden to
providers and ensure that costs associated with the development and
testing of a new reporting mechanism are not incurred. We believe that
at this time the noted ten quality measures are the most appropriate
measure of home health quality. Accordingly, for the calendar year (CY)
2007, we propose that the OASIS data, specifically, the ten quality
measures, be submitted by HHAs, to meet the requirement that each HHA
submit data appropriate for the measurement of health care quality, as
determined by the Secretary.
Additionally, section 1895(b)(3)(B)(v)(II) of the Act provides the
Secretary with the discretion to submit the required data in a form,
[[Page 44088]]
manner, and time specified by him. For CY 2007, we are proposing to
consider OASIS data submitted by HHAs to CMS for episodes beginning on
or after July 1, 2005 and before July 1, 2006 as meeting the reporting
requirement. This reporting time period will allow a full 12 months of
data and will provide CMS the time necessary to analyze and make any
necessary payment adjustments to the CY 2007 payment rates. HHAs that
meet the reporting requirement would be eligible for the full home
health market basket percentage increase.
During the next few years, we will be pursuing the development of
patient level process measures for home health agencies, as well as
continuing to refine the current OASIS tool in response to
recommendations from a Technical Expert Panel conducted to review the
data elements that make up the OASIS tool. These process measures will
refer to specific care practices that are, or are not, followed by the
home health agency for each patient. An example of this type of measure
may be: the percentage of patients at risk of falls for whom prevention
of falls was addressed in the care plan. We expect to introduce these
additional measures over 2008 and 2009 so as to complement the existing
OASIS outcome measures. During the years leading to calendar year 2010
payments, we will test and refine these measures to determine if they
can more accurately reflect the level of quality care being provided at
HHAs without being overly burdensome with the data collection
instrument. Some process measures are in the very early stages of
development. To the extent that evidence-based data are available on
which to determine the appropriate measure specifications, and adequate
risk-adjustments are made, we anticipate collecting and reporting these
measures as part of each agency's home health quality plan. We believe
that future modifications to the current OASIS tool including reducing
the numbers of questions on the tool, refining possible responses, as
well as adding new process measures will be made. In all cases, we
anticipate that any future quality measures should be evidence-based,
clearly linked to improved outcomes, and able to be reliably captured
with the least burden to the provider. We are also beginning work in
order to measure patient experience (in the form of a patient
satisfaction survey) of care in the home health setting.
We recognize, however, that the conditions of participation (42 CFR
part 484) that require OASIS submission also provide for exclusions
from this requirement. Generally, agencies are not subject to the OASIS
submission requirement, and thus do not receive Medicare payments, for
patients that are not Medicare Beneficiaries or the patients are not
receiving Medicare-covered home health services. Under the conditions
of participation, agencies are excluded from the OASIS reporting
requirement on individual patients if:
Those patients are receiving only non-skilled services,
Neither Medicare nor Medicaid is paying for home health
care (patients receiving care under a Medicare or Medicaid Managed Care
Plan are not excluded from the OASIS reporting requirement),
Those patients are receiving pre- or post-partum services,
Those patients are under the age of 18 years.
We believe that the rationale behind the exclusion of these
agencies from submitting OASIS on patients excluded from OASIS
submission as a condition of participation is equally applicable to
HHAs for purposes of meeting the DRA quality requirement. If an agency
is not submitting OASIS for patients excluded from OASIS submission as
a condition of participation, we believe that the submission of OASIS
for quality measures for Medicare payment purposes is also not
necessary. Therefore, we propose that HHAs do not need to submit
quality measures for DRA reporting purposes, for those patients who are
excluded from OASIS submission as a condition of participation.
Additionally, we propose that agencies newly certified (on or after
May 31, 2006 for payments to be made in CY 2007) be excluded from the
DRA reporting requirement as data submission and analysis will not be
possible for an agency certified this late in the reporting time
period. We propose that in future years, agencies that certify on or
after May 31 of the preceding year involved be excluded from any
payment penalty under the DRA for the following calendar year. For
example, if HHA ``X'' were to enroll in the Medicare Program on May 30
2007, CMS would expect them to submit the required quality data (unless
covered by another exclusion protocol) on or before June 30 2006 (the
end of the reporting period for payments effectuated in calendar year
2007. However, if HHA ``X'' were to enroll in the Medicare Program on
May 31, 2006, CMS would automatically exclude them from the
requirements under the DRA and the agency would be entitled to the full
market basket increase for calendar year 2007. We note these exclusions
only affect reporting requirements under the DRA and do not affect the
agency's OASIS reporting responsibilities under the conditions of
participation.
We propose to require that all HHAs, unless covered by these
specific exclusions, meet the reporting requirement, or be subject to a
2 percent reduction in the home health market basket percentage
increase in accordance with section 1895(b)(3)(B)(v)(I) of the Act. The
2 percent reduction would apply to all episodes ending on or before
December 31, 2007. We provide the reduced payment rates in tables 5, 6,
7, and 8 below.
Table 5.--For HHAs That Do Not Submit the Required Quality Data--Proposed National 60-Day Episode Amount Updated
by the Estimated Home Health Market Basket Update for CY 2007, Minus 2 Percentage Points, Before Case-Mix
Adjustment
----------------------------------------------------------------------------------------------------------------
Multiply by the proposed Proposed CY 2007 updated
Total CY 2006 prospective payment amount per 60-day estimated home health market national 60-day episode rate
episode basket update (3.1 percent for HHAs that do not submit
\1\ minus 2 percent) required quality data
----------------------------------------------------------------------------------------------------------------
$2,264.28........................................... x 1.011 $2,289.19
----------------------------------------------------------------------------------------------------------------
\1\ The estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc,
2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
[[Page 44089]]
Table 6.--For HHAs That Do Not Submit the Required Quality Data--Proposed National Per-Visit Amounts Updated by
the Estimated Home Health Market Basket Update for CY 2007, Minus 2 Percentage Points
----------------------------------------------------------------------------------------------------------------
Multiply by the Proposed CY 2007
proposed per-visit payment
Final CY 2006 per- estimated home amount per
Home health discipline type visit amounts per health market discipline for
60-day episode basket update HHAs that do not
(3.1 percent \1\ submit required
minus 2 percent) quality data
----------------------------------------------------------------------------------------------------------------
Home health aide....................................... $44.76 x 1.011 $45.25
Medical social services................................ 158.45 x 1.011 160.19
Occupational therapy................................... 108.81 x 1.011 110.01
Physical therapy....................................... 108.08 x 1.011 109.27
Skilled nursing........................................ 98.85 x 1.011 99.94
Speech-language pathology.............................. 117.44 x 1.011 118.73
----------------------------------------------------------------------------------------------------------------
\1\ The estimated home health market basket update of 3.1 percent for CY 2007 is based on Global Insight, Inc,
2nd Qtr, 2006 forecast with historical data through 1st Qtr, 2006.
Table 7.--For HHAs That Do Not Submit the Required Quality Data--Proposed Payment Amount for 60-Day Episodes
Beginning in CY 2006 and Ending in CY 2007 Updated by the Estimated Home Health Market Basket for CY 2007, Minus
2 Percentage Points, With Rural Add-On, Before Case-Mix Adjustment
----------------------------------------------------------------------------------------------------------------
Proposed CY 2007 payment
amount per 60-day episode
beginning in CY 2006 and
Proposed CY 2007 updated national 60-day episode ending in CY 2007 for a
rate for HHAs that do not submit required quality 5 percent rural add-on beneficiary who resides in a
data non-MSA area for HHAs that
do not submit required
quality data
----------------------------------------------------------------------------------------------------------------
$2,289.19........................................... x 1.05 $2,403.65
----------------------------------------------------------------------------------------------------------------
Table 8.--For HHAs That Do Not Submit the Required Quality Data--Proposed Per-Visit Payment Amounts for Episodes
Beginning in CY 2006 and Ending in CY 2007 Updated by the Estimated Home Health Market Basket for CY 2007, Minus
2 Percentage Points, With Rural Add-On
----------------------------------------------------------------------------------------------------------------
Proposed CY 2007
per-visit payment
amounts for
episodes
Proposed CY 2007 beginning in CY
per-visit amounts 2006 and ending
Home health discipline type for HHAs that do 5 percent rural in CY 2007 for a
not submit add-on beneficiary who
required quality resides in a non-
data MSA area for HHAs
that do not
submit required
quality data
----------------------------------------------------------------------------------------------------------------
Home health aide....................................... $45.25 x 1.05 $47.51
Medical social services................................ 160.19 x 1.05 168.20
Occupational therapy................................... 110.01 x 1.05 115.51
Physical therapy....................................... 109.27 x 1.05 114.73
Skilled nursing........................................ 99.94 x 1.05 104.93
Speech-language pathology.............................. 118.73 x 1.05 124.67
----------------------------------------------------------------------------------------------------------------
Section 1895(b)(3)(B)(v)(III) of the Act further requires that the
``Secretary shall establish procedures for making data submitted under
subclause (II) available to the public.'' Additionally, the statute
requires that ``such procedures shall ensure that a home health agency
has the opportunity to review the data that is to be made public with
respect to the agency prior to such data being made public.'' To meet
the requirement for making such data public, we are proposing to
continue to use the CMS Home Health Compare Web site whereby HHAs are
listed geographically. Currently the 10 proposed quality measures are
posted on the CMS Home Health Compare Web site. Consumers can search
for all Medicare-approved home health providers that serve their city
or zip code and then find the agencies offering the types of services
they need as well as the proposed quality measures. See https://
www.medicare.gov/HHCompare/Home/. HHAs currently have access (through
the Home Health Compare contractor) to their own agency's quality data
(updated periodically) and we propose to continue this process thus
enabling each agency to know how it is performing before public posting
of agency quality data on the CMS Home Health Compare Web site.
Currently, the CMS Home Health Compare Web site does not publicly
[[Page 44090]]
report data when agencies have fewer than 20 episodes of care within a
reporting period. In light of the DRA requirements we recognize the
need to provide the required data to the public and propose to make
these statistics available through expansion of the CMS Home Health
Compare Web site.
In the July 27, 2005 Medicare Payment Advisory Commission (MedPAC)
testimony before the U.S. Senate Committee on Finance, MedPAC expressed
support for the concept of differential payments for Medicare
providers, which could create incentives to improve quality. To support
this initiative, MedPAC stated that ``outcome measures from CMS'
Outcome-based Quality Indicators'' (currently collected through the
OASIS instrument) ``could form the starter set.'' MedPAC further states
``* * * the Agency for Healthcare Research and Quality concur(s) that a
set of these measures is reliable and adequately risk adjusted.''
The MedPAC testimony recognizes that while the goal of care for
many home health patients is improving health and functioning, for some
patients the goal of the HHA is to simply stabilize their conditions
and prevent further decline. Additionally, the MedPAC testimony
reflects that measures of structure and process could also be
considered.
Various home health outcome measures are now in common use and have
been studied for some time. A number of these measures have been
endorsed by the National Quality Forum (NQF) and are evidence-based,
well accepted, and not unduly burdensome. When determining outcome
measures that would be most appropriate it is important to measure
aspects of care that providers can control and are adequately risk-
adjusted. Home-based care presents particular difficulties for provider
control because patient conditions are compounded by a variety of home
environment and support system issues.
We are currently pursuing the development of patient-level process
measures for HHAs, as well as refining the current OASIS tool in
response to recommendations from a Technical Expert Panel conducted to
review the data elements that make up the OASIS tool. These additional
measures would complement the existing OASIS outcome measures and would
assist us in identifying processes of care that lead to improvements
for certain populations of patients. These process measures are
currently in the very early stages of development. As we stated
previously, to the extent that evidence-based data are available on
which to determine the appropriate measure specifications, and adequate
risk-adjustments are made, we anticipate collecting and reporting these
measures as part of our home health quality plan. Possible
modifications to the current OASIS tool include reducing the numbers of
questions on the tool, refining possible responses, as well as adding
new process measures.
We are soliciting comments on how to make the outcome measures more
useful. We would also like comments on measures of home health care
processes for which there is evidence or improved care to
beneficiaries. In all cases, measures should be evidence-based, clearly
linked to improved outcomes, and able to be reliably captured with the
least burden to the provider. We are also considering measures of
patient experience of care in the home health setting, as well as
efficiency measures, and soliciting comment on the use of the measures
and their importance in the home health setting. We would address any
changes to the HH PPS quality data submission requirement in future
rulemaking.
It is also our intent to provide guidance on the specifications,
definitions, and reporting requirements of any additional measures
through the standard protocol for measure development.
We are proposing to revise the regulations at 42 CFR Sec. 484.225
to reflect these new payment requirements which require submission of
quality data.
E. Outliers and Fixed Dollar Loss Ratio
Outlier payments are payments made in addition to regular 60-day
case-mix and wage-adjusted episode payments for episodes that incur
unusually large costs due to patient home health care needs. Outlier
payments are made for episodes for which the estimated cost exceeds a
threshold amount. The episode's estimated cost is the sum of the
national wage-adjusted per-visit payment amounts for all visits
delivered during the episode. The outlier threshold for each case-mix
group, PEP adjustment, or total SCIC adjustment is defined as the 60-
day episode payment amount, PEP adjustment, or total SCIC adjustment
for that group plus a fixed dollar loss amount. Both components of the
outlier threshold are wage-adjusted.
The wage-adjusted fixed dollar loss (FDL) amount represents the
amount of loss that an agency must bear before an episode becomes
eligible for outlier payments. The FDL is computed by multiplying the
wage-adjusted 60-day episode payment amount by the FDL ratio, which is
a proportion expressed in terms of the national standardized episode
payment amount. The outlier payment is defined to be a proportion of
the wage-adjusted estimated costs beyond the wage-adjusted threshold.
The proportion of additional costs paid as outlier payments is referred
to as the loss-sharing ratio.
Section 1895(b)(5) of the Act requires that estimated total outlier
payments are no more than 5 percent of total estimated HH PPS payments.
In response to the concerns about potential financial losses that might
result from unusually expensive cases expressed in comments to the
October 28, 1999 proposed rule (64 FR 58133), the July 2000 final rule
set the target for estimated outlier payments at the 5 percent level.
The FDL ratio and the loss-sharing ratio were then selected so that
estimated total outlier payments would meet the 5 percent target.
For a given level of outlier payments, there is a trade-off between
the values selected for the FDL ratio and the loss-sharing ratio. A
high FDL ratio reduces the number of episodes that can receive outlier
payments, but makes it possible to select a higher loss-sharing ratio
and, therefore, increase outlier payments for outlier episodes.
Alternatively, a lower FDL ratio means that more episodes can qualify
for outlier payments, but outlier payments per episode must be lower.
As a result of public comments on the October 28, 1999 proposed rule,
in our July 2000 final rule, we made the decision to attempt to cover a
relatively high proportion of the costs of outlier cases for the most
expensive episodes that would qualify for outlier payments within the 5
percent constraint.
In the July 2000 final rule, we chose a value of 0.80 for the loss-
sharing ratio, which preserves incentives for agencies to attempt to
provide care efficiently for outlie
