Medicare Program; Extension of Certain Hospital Wage Index Reclassifications, 9807-9810 [E8-2798]
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9807
Federal Register / Vol. 73, No. 36 / Friday, February 22, 2008 / Notices
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State, local, or tribal governments, nonprofits .................................................
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200
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[FR Doc. E8–3294 Filed 2–21–08; 8:45 am]
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[FR Doc. 08–824 Filed 2–20–08; 10:32 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1491–N]
Medicare Program; Extension of
Certain Hospital Wage Index
Reclassifications
Centers for Medicare &
Medicaid Services (CMS) HHS.
ACTION: Notice.
AGENCY:
SUMMARY: This notice announces the
extension of the expiration date for
certain wage index geographic
reclassifications and special exceptions
as implemented by section 117 of the
Medicare, Medicaid and SCHIP
Extension Act of 2007 (Pub. L. 110–
173). Certain geographic
reclassifications and special exception
PO 00000
Frm 00051
Fmt 4703
Sfmt 4703
hospitals’ wage indices that were set to
expire on September 30, 2007 are now
extended through September 30, 2008.
In addition, for hospital reclassifications
extended by Division B, Title I, section
106(a) of the Tax Relief and Health Care
Act of 2006, Pub. L. 109–432, that
resulted in a lower wage index for the
second half of FY 2007, we will apply
the higher wage index that was
applicable to such hospitals during the
first half of FY 2007, for the entire fiscal
year.
DATES: Effective date: This notice is
effective on February 22, 2008.
Applicability date: This notice is
applicable to the hospitals identified in
section II.A. of this notice on October 1,
2007 and to the hospitals identified in
section II.B. of this notice on April 1,
2007.
FOR FURTHER INFORMATION CONTACT:
Brian Slater, (410) 786–5229.
SUPPLEMENTARY INFORMATION:
I. Background
Section 508 of the Medicare
Prescription Drug, Improvement and
Modernization Act of 2003 (MMA) (Pub.
L. 108–173) permitted a qualifying
hospital to appeal the wage index
classification otherwise applicable to
the hospital and apply for
reclassification to another area of the
State in which the hospital was located
(or, at the discretion of the Secretary, to
an area within a contiguous State).
Hospitals were required to submit their
applications by February 15, 2004. In
the February 13, 2004 Federal Register
(69 FR 7340), we published a notice that
described our implementation of section
508 of MMA. The Congress limited the
reclassifications under section 508 of
MMA to a 3-year period beginning April
1, 2004 and ending March 31, 2007.
Section 106(a) of the Medicare
Improvements and Extension Act,
Division B of the Tax Relief and Health
Care Act of 2006 (MIEA–TRHCA) (Pub.
L. 109–432) extended any geographic
reclassification that was set to expire on
March 31, 2007 by 6 months until
September 30, 2007. In the March 23,
2007 Federal Register (72 FR 13799), we
published a notice explaining how we
would implement section 106 of MIEA–
TRHCA. We also explained that for a
subset of hospitals whose
E:\FR\FM\22FEN1.SGM
22FEN1
9808
Federal Register / Vol. 73, No. 36 / Friday, February 22, 2008 / Notices
reclassifications were extended, the
wage index for the second half of fiscal
year (FY) 2007 would decrease from the
first half of the year.
II. Provisions of the Notice
A. Reclassifications for Hospitals
Affected by Section 117(a) of the
Medicare, Medicaid, and SCHIP
Extension Act of 2007
Section 117(a) of the Medicare,
Medicaid, and SCHIP Extension Act of
2007 (MMSEA) (Pub. L. 110–173)
extends through September 30, 2008
both the reclassifications that were
extended by section 106 of MIEA–
TRCHA as well as certain special
exception wage indices referenced in
the FY 2005 inpatient prospective
payment system (IPPS) final rule (69 FR
49105 and 49107). Consistent with how
section 508 of MMA and special
exceptions were implemented in FY
2005, hospitals receiving extensions
under section 117(a) of MMSEA may
not receive an out-migration adjustment.
Such hospitals are treated in a manner
consistent to reclassified hospitals, and
section 1886(d)(13) of the Act specifies
that a reclassified hospital is not eligible
for the out-migration adjustment. In
addition, the special exceptions granted
in FY 2005 provided for the complete
wage index to be assigned the specified
hospitals without any addition of an
out-migration adjustment. Further, we
mstockstill on PROD1PC66 with NOTICES
Fiscal intermediary No.
52280
00322
00454
52280
52280
00308
00011
52280
00450
00450
00452
00450
00450
00452
00450
00452
00452
00450
00450
00230
52280
03201
03201
03201
03201
00390
00390
00390
00390
00390
00390
00308
00308
00308
00308
00308
00308
00308
77002
03301
03301
03301
03301
03301
03301
03301
03301
00325
00363
00363
00363
52280
Provider No.
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only extended the reclassification or
special exception in cases where it
benefited the hospital. If, in FY 2008,
the hospital is already receiving a
reclassification or wage index that
results in a higher wage index than
would be received under the
reclassification or special exception
extension, then we did not change the
hospital’s wage index value that was
published in the October 10, 2007, or
subsequent notice.
The following table lists providers
affected by section 117(a) of MMSEA,
which extends certain reclassifications
and special exceptions through FY 2008
(October 1, 2007 through September 30,
2008):
Fmt 4703
Sfmt 4703
010150
020008
050494
050549
060075
070036
160064
220046
230003
230004
230036
230038
230059
230066
230072
230097
230106
230174
230236
250002
250122
2 270002
270023
270032
270057
310021
310028
310051
310060
310115
310120
2 330023
330049
2 330067
330106
3 330135
3 330205
3 330264
340002
350002
350003
350006
350010
350014
350015
350017
350030
380090
390001
390003
1 390045
390072
E:\FR\FM\22FEN1.SGM
22FEN1
FY 2008 wage
index
FY 2008 GAF
0.8588
1.2727
1.4147
1.4147
1.2164
1.3696
0.9194
1.1304
1.0147
1.0147
1.0244
1.0147
1.0147
1.0147
1.0147
1.0147
1.0147
1.0147
1.0147
0.8217
0.8217
0.8738
0.8871
0.8871
0.8871
1.3003
1.3003
1.3003
1.3003
1.3003
1.3003
1.3003
1.3003
1.3003
1.4999
1.3003
1.3003
1.3003
0.9342
0.7944
0.7944
0.7944
0.7944
0.7944
0.7944
0.7944
0.7944
1.1501
1.0004
1.0004
1.0004
1.0004
0.9010
1.1795
1.2682
1.2682
1.1436
1.2403
0.9441
1.0876
1.0100
1.0100
1.0166
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
0.8742
0.8742
0.9118
0.9212
0.9212
0.9212
1.1970
1.1970
1.1970
1.1970
1.1970
1.1970
1.1970
1.1970
1.1970
1.3200
1.1970
1.1970
1.1970
0.9545
0.8542
0.8542
0.8542
0.8542
0.8542
0.8542
0.8542
0.8542
1.1005
1.0003
1.0003
1.0003
1.0003
9809
Federal Register / Vol. 73, No. 36 / Friday, February 22, 2008 / Notices
Fiscal intermediary No.
00363
00363
00363
00363
00363
00363
00363
00363
03401
03401
52280
03401
03401
03401
03401
03401
00400
00270
00453
03601
03601
03601
Provider No.
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390095
390119
390137
390169
390185
390192
390237
390270
430005
2 430008
430015
3 430048
430060
430064
430077
430091
450010
470003
490001
2 530008
2 530010
530015
FY 2008 wage
index
FY 2008 GAF
1.0004
1.0004
1.0004
1.0004
0.9650
1.0004
1.0004
0.9650
0.8686
0.9373
0.9373
0.9373
0.9373
0.9373
0.9373
0.9373
0.9136
1.1304
0.8606
0.9271
0.9271
0.9650
1.0003
1.0003
1.0003
1.0003
0.9759
1.0003
1.0003
0.9759
0.9080
0.9566
0.9566
0.9566
0.9566
0.9566
0.9566
0.9566
0.9400
1.0876
0.9023
0.9495
0.9495
0.9759
1 This
hospital has been assigned a wage index under a special exceptions policy (See the August 18, 2006 final rule (71 FR 48070)).
hospitals are assigned a wage index value under a special exceptions policy (See Table 9B of the August 11, 2004 final rule (69 FR
49105) and the December 30, 2004 correction notice, (69 FR 78705)).
3 The hospital originally received an out-migration adjustment for FY 2008. However, due to the extension of the hospital’s special reclassification or exception, the hospital no longer qualifies for the out-migration adjustment for FY 2008.
2 These
B. Reclassifications for Hospitals
Affected by Section 117(c) of the
Medicare, Medicaid, and SCHIP
Extension Act of 2007
Section 117(c) of MMSEA requires
that, for hospital reclassifications
extended by section 106(a) of MIEA–
TRHCA that resulted in a lower wage
index for the period April 1, 2007
through September 30, 2007, we will
apply the higher wage index that was
applicable to such hospitals during the
mstockstill on PROD1PC66 with NOTICES
Fiscal intermediary No.
00308
00308
00308
00308
00308
00308
00308
00308
00308
00308
00011
00011
00011
00450
00452
00450
00450
00452
00450
00450
00450
00450
00450
00450
00452
00390
00390
00390
00390
00390
00390
Provider No.
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VerDate Aug<31>2005
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Frm 00053
Current wage
index 4/1/
2007–9/30/
2007
Current GAF
4/1/2007–9/30/
2007
Revised wage
index 4/1/
2007–9/30/
2007
Revised GAF
4/1/2007–9/30/
2007
1.2730
1.2730
1.3113
1.2730
1.2730
1.2730
1.2730
1.3113
1.2730
1.2730
0.8708
0.8708
0.8708
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.0440
1.3113
1.3113
1.3113
1.3113
1.3113
1.3113
1.1797
1.1797
1.2039
1.1797
1.1797
1.1797
1.1797
1.2039
1.1797
1.1797
0.9096
0.9096
0.9096
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.0299
1.2039
1.2039
1.2039
1.2039
1.2039
1.2039
1.2971
1.2971
1.3134
1.2971
1.2971
1.2971
1.2971
1.3134
1.2971
1.2971
0.8803
0.8803
0.8803
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.0563
1.3134
1.3134
1.3134
1.3134
1.3134
1.3134
1.1950
1.1950
1.2053
1.1950
1.1950
1.1950
1.1950
1.2053
1.1950
1.1950
0.9164
0.9164
0.9164
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.0382
1.2053
1.2053
1.2053
1.2053
1.2053
1.2053
070001
070005
070010
070016
070017
070019
070022
070028
070031
070039
160040
160067
160110
230020
230024
230053
230089
230104
230119
230135
230146
230165
230176
230270
230273
310021
310028
310051
310060
310115
310120
Fmt 4703
period October 1, 2006 through March
31, 2007, for the entire FY 2007.
The following table lists providers
affected by section 117(c), which revises
the FY 2007 wage index from April 1,
2007 through September 30, 2007:
Sfmt 4703
E:\FR\FM\22FEN1.SGM
22FEN1
9810
Federal Register / Vol. 73, No. 36 / Friday, February 22, 2008 / Notices
Fiscal intermediary No.
00308
00308
00308
00308
00308
00308
Provider No.
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mstockstill on PROD1PC66 with NOTICES
We have implemented these
provisions through instructions to the
Medicare Administrative Contractors
(MAC) (CMS Joint Signature
Memorandum, JSM/TDL–08149,
January 28, 2008). CMS has instructed
FIs/MACs to reprocess claims for the
affected providers FY 2007 and FY
2008.
When originally applying section 508
of MMA, we required each hospital to
submit a request in writing by February
15, 2004, to the Medicare Geographic
Classification Review Board (MGCRB),
with a copy to CMS. We will neither
require nor accept written requests for
the extension required by section 117 of
MMSEA, since that section, by
providing a 1-year extension for certain
special exceptions and reclassifications
set to expire September 30, 2007,
already specifies the affected hospitals.
III. Regulatory Impact Statement
We have examined the impact of this
notice using the requirements of
Executive Order 12866 (September
1993, Regulatory Planning and Review),
and Executive Order 13132.
Executive Order 12866 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 notice implements
a statutory provision that would
increase payments to hospitals by less
than $100 million and is therefore, not
a major rule. This notice also is not a
legislative rulemaking under the
Administrative Procedure Act, but
rather interprets and applies a statutory
mandate.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it promulgates a
proposed rule (and subsequent final
rule) that imposes substantial direct
requirement costs on State and local
governments, preempts State law, or
VerDate Aug<31>2005
16:38 Feb 21, 2008
Jkt 214001
Current wage
index 4/1/
2007–9/30/
2007
Current GAF
4/1/2007–9/30/
2007
Revised wage
index 4/1/
2007–9/30/
2007
Revised GAF
4/1/2007–9/30/
2007
1.3113
1.3113
1.3113
1.3113
1.2730
1.2730
1.2039
1.2039
1.2039
1.2039
1.1797
1.1797
1.3134
1.3134
1.3134
1.3134
1.2971
1.2971
1.2053
1.2053
1.2053
1.2053
1.1950
1.1950
330049
330126
330135
330205
330209
330264
otherwise has Federalism implications.
Again, although we do not consider this
notice to be a substantive rule subject to
notice and comment rulemaking, we
note that this notice does not impose
any costs on State or local governments.
Therefore, the requirements of
Executive Order 13132 would not be
applicable.
We estimate the impact of sections
117(a) and (c) of MMSEA is to increase
payments to hospitals by $24 million for
FY 2007 and by $57 million for FY
2008.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
Authority: Section 117(a) and (c) of Public
Law 110–173. Section 106(a) of Division B,
Title 1, Public Law 109–432. Section 508(a)
of Public Law 108–173.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: February 7, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. E8–2798 Filed 2–21–08; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1395–N]
Medicare Program; Request for
Nominations to the Advisory Panel on
Ambulatory Payment Classification
Groups
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (DHHS).
ACTION: Notice.
AGENCY:
SUMMARY: This notice solicits the
nominations of three individuals for
consideration as members on the
Advisory Panel on Ambulatory Payment
Classification (APC) Groups (the Panel).
PO 00000
Frm 00054
Fmt 4703
Sfmt 4703
There will be three vacancies on the
Panel: One vacancy as of June 1 and two
additional vacancies as of September 30,
2008. The purpose of the Panel is to
review the APC groups and their
associated weights and to advise the
Secretary of the Department of Health
and Human Services (DHHS), and the
Administrator of the Centers for
Medicare & Medicaid Services (CMS),
concerning the clinical integrity of the
APC groups and their associated
weights. We consider the Panel’s advice
as we prepare the annual updates of the
Medicare hospital outpatient
prospective payment system (OPPS).
The Secretary rechartered the Panel in
2006 for a 2-year period effective
through November 21, 2008.
Submission Date of Nominations:
Nominations will be considered if
postmarked by 5 p.m. E.S.T. on April 1,
2008, and sent to the designated address
provided in the ADDRESSES section of
this notice.
You may mail or hand
deliver nominations for membership to:
Center for Medicare and Medicaid
Services; Attn: Shirl Ackerman-Ross,
Designated Federal Official (DFO),
Advisory Panel on APC Groups; Center
for Medicare Management, Hospital &
Ambulatory Policy Group, Division of
Outpatient Care; 7500 Security
Boulevard, Mail Stop C4–05–17;
Baltimore, MD 21244–1850.
For Additional Information:
Contacts: Persons wishing to
nominate individuals to serve on the
Panel or to obtain further information
may also contact Shirl Ackerman-Ross,
the DFO, at CMSAPCPanel@
cms.hhs.gov (NOTE: There is NO
underscore in this e-mail address; there
is a SPACE between CMS and
APCPanel.), or call 410–786–4474.
(Note: Please advise couriers of the
following: When delivering hardcopies
of presentations to CMS, if no one
answers at the above phone number,
please call (410) 786–4532 or (410) 786–
9316.)
News media representatives should
contact the CMS Press Office at 202–
690–6145.
ADDRESSES:
E:\FR\FM\22FEN1.SGM
22FEN1
Agencies
[Federal Register Volume 73, Number 36 (Friday, February 22, 2008)]
[Notices]
[Pages 9807-9810]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-2798]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1491-N]
Medicare Program; Extension of Certain Hospital Wage Index
Reclassifications
AGENCY: Centers for Medicare & Medicaid Services (CMS) HHS.
ACTION: Notice.
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SUMMARY: This notice announces the extension of the expiration date for
certain wage index geographic reclassifications and special exceptions
as implemented by section 117 of the Medicare, Medicaid and SCHIP
Extension Act of 2007 (Pub. L. 110-173). Certain geographic
reclassifications and special exception hospitals' wage indices that
were set to expire on September 30, 2007 are now extended through
September 30, 2008. In addition, for hospital reclassifications
extended by Division B, Title I, section 106(a) of the Tax Relief and
Health Care Act of 2006, Pub. L. 109-432, that resulted in a lower wage
index for the second half of FY 2007, we will apply the higher wage
index that was applicable to such hospitals during the first half of FY
2007, for the entire fiscal year.
DATES: Effective date: This notice is effective on February 22, 2008.
Applicability date: This notice is applicable to the hospitals
identified in section II.A. of this notice on October 1, 2007 and to
the hospitals identified in section II.B. of this notice on April 1,
2007.
FOR FURTHER INFORMATION CONTACT: Brian Slater, (410) 786-5229.
SUPPLEMENTARY INFORMATION:
I. Background
Section 508 of the Medicare Prescription Drug, Improvement and
Modernization Act of 2003 (MMA) (Pub. L. 108-173) permitted a
qualifying hospital to appeal the wage index classification otherwise
applicable to the hospital and apply for reclassification to another
area of the State in which the hospital was located (or, at the
discretion of the Secretary, to an area within a contiguous State).
Hospitals were required to submit their applications by February 15,
2004. In the February 13, 2004 Federal Register (69 FR 7340), we
published a notice that described our implementation of section 508 of
MMA. The Congress limited the reclassifications under section 508 of
MMA to a 3-year period beginning April 1, 2004 and ending March 31,
2007.
Section 106(a) of the Medicare Improvements and Extension Act,
Division B of the Tax Relief and Health Care Act of 2006 (MIEA-TRHCA)
(Pub. L. 109-432) extended any geographic reclassification that was set
to expire on March 31, 2007 by 6 months until September 30, 2007. In
the March 23, 2007 Federal Register (72 FR 13799), we published a
notice explaining how we would implement section 106 of MIEA-TRHCA. We
also explained that for a subset of hospitals whose
[[Page 9808]]
reclassifications were extended, the wage index for the second half of
fiscal year (FY) 2007 would decrease from the first half of the year.
II. Provisions of the Notice
A. Reclassifications for Hospitals Affected by Section 117(a) of the
Medicare, Medicaid, and SCHIP Extension Act of 2007
Section 117(a) of the Medicare, Medicaid, and SCHIP Extension Act
of 2007 (MMSEA) (Pub. L. 110-173) extends through September 30, 2008
both the reclassifications that were extended by section 106 of MIEA-
TRCHA as well as certain special exception wage indices referenced in
the FY 2005 inpatient prospective payment system (IPPS) final rule (69
FR 49105 and 49107). Consistent with how section 508 of MMA and special
exceptions were implemented in FY 2005, hospitals receiving extensions
under section 117(a) of MMSEA may not receive an out-migration
adjustment. Such hospitals are treated in a manner consistent to
reclassified hospitals, and section 1886(d)(13) of the Act specifies
that a reclassified hospital is not eligible for the out-migration
adjustment. In addition, the special exceptions granted in FY 2005
provided for the complete wage index to be assigned the specified
hospitals without any addition of an out-migration adjustment. Further,
we only extended the reclassification or special exception in cases
where it benefited the hospital. If, in FY 2008, the hospital is
already receiving a reclassification or wage index that results in a
higher wage index than would be received under the reclassification or
special exception extension, then we did not change the hospital's wage
index value that was published in the October 10, 2007, or subsequent
notice.
The following table lists providers affected by section 117(a) of
MMSEA, which extends certain reclassifications and special exceptions
through FY 2008 (October 1, 2007 through September 30, 2008):
----------------------------------------------------------------------------------------------------------------
FY 2008 wage
Fiscal intermediary No. Provider No. index FY 2008 GAF
----------------------------------------------------------------------------------------------------------------
52280........................................................... 010150 0.8588 0.9010
00322........................................................... 020008 1.2727 1.1795
00454........................................................... 050494 1.4147 1.2682
52280........................................................... 050549 1.4147 1.2682
52280........................................................... 060075 1.2164 1.1436
00308........................................................... 070036 1.3696 1.2403
00011........................................................... 160064 0.9194 0.9441
52280........................................................... 220046 1.1304 1.0876
00450........................................................... 230003 1.0147 1.0100
00450........................................................... 230004 1.0147 1.0100
00452........................................................... 230036 1.0244 1.0166
00450........................................................... 230038 1.0147 1.0100
00450........................................................... 230059 1.0147 1.0100
00452........................................................... 230066 1.0147 1.0100
00450........................................................... 230072 1.0147 1.0100
00452........................................................... 230097 1.0147 1.0100
00452........................................................... 230106 1.0147 1.0100
00450........................................................... 230174 1.0147 1.0100
00450........................................................... 230236 1.0147 1.0100
00230........................................................... 250002 0.8217 0.8742
52280........................................................... 250122 0.8217 0.8742
03201........................................................... \2\ 270002 0.8738 0.9118
03201........................................................... 270023 0.8871 0.9212
03201........................................................... 270032 0.8871 0.9212
03201........................................................... 270057 0.8871 0.9212
00390........................................................... 310021 1.3003 1.1970
00390........................................................... 310028 1.3003 1.1970
00390........................................................... 310051 1.3003 1.1970
00390........................................................... 310060 1.3003 1.1970
00390........................................................... 310115 1.3003 1.1970
00390........................................................... 310120 1.3003 1.1970
00308........................................................... \2\ 330023 1.3003 1.1970
00308........................................................... 330049 1.3003 1.1970
00308........................................................... \2\ 330067 1.3003 1.1970
00308........................................................... 330106 1.4999 1.3200
00308........................................................... \3\ 330135 1.3003 1.1970
00308........................................................... \3\ 330205 1.3003 1.1970
00308........................................................... \3\ 330264 1.3003 1.1970
77002........................................................... 340002 0.9342 0.9545
03301........................................................... 350002 0.7944 0.8542
03301........................................................... 350003 0.7944 0.8542
03301........................................................... 350006 0.7944 0.8542
03301........................................................... 350010 0.7944 0.8542
03301........................................................... 350014 0.7944 0.8542
03301........................................................... 350015 0.7944 0.8542
03301........................................................... 350017 0.7944 0.8542
03301........................................................... 350030 0.7944 0.8542
00325........................................................... 380090 1.1501 1.1005
00363........................................................... 390001 1.0004 1.0003
00363........................................................... 390003 1.0004 1.0003
00363........................................................... \1\ 390045 1.0004 1.0003
52280........................................................... 390072 1.0004 1.0003
[[Page 9809]]
00363........................................................... 390095 1.0004 1.0003
00363........................................................... 390119 1.0004 1.0003
00363........................................................... 390137 1.0004 1.0003
00363........................................................... 390169 1.0004 1.0003
00363........................................................... 390185 0.9650 0.9759
00363........................................................... 390192 1.0004 1.0003
00363........................................................... 390237 1.0004 1.0003
00363........................................................... 390270 0.9650 0.9759
03401........................................................... 430005 0.8686 0.9080
03401........................................................... \2\ 430008 0.9373 0.9566
52280........................................................... 430015 0.9373 0.9566
03401........................................................... \3\ 430048 0.9373 0.9566
03401........................................................... 430060 0.9373 0.9566
03401........................................................... 430064 0.9373 0.9566
03401........................................................... 430077 0.9373 0.9566
03401........................................................... 430091 0.9373 0.9566
00400........................................................... 450010 0.9136 0.9400
00270........................................................... 470003 1.1304 1.0876
00453........................................................... 490001 0.8606 0.9023
03601........................................................... \2\ 530008 0.9271 0.9495
03601........................................................... \2\ 530010 0.9271 0.9495
03601........................................................... 530015 0.9650 0.9759
----------------------------------------------------------------------------------------------------------------
\1\ This hospital has been assigned a wage index under a special exceptions policy (See the August 18, 2006
final rule (71 FR 48070)).
\2\ These hospitals are assigned a wage index value under a special exceptions policy (See Table 9B of the
August 11, 2004 final rule (69 FR 49105) and the December 30, 2004 correction notice, (69 FR 78705)).
\3\ The hospital originally received an out-migration adjustment for FY 2008. However, due to the extension of
the hospital's special reclassification or exception, the hospital no longer qualifies for the out-migration
adjustment for FY 2008.
B. Reclassifications for Hospitals Affected by Section 117(c) of the
Medicare, Medicaid, and SCHIP Extension Act of 2007
Section 117(c) of MMSEA requires that, for hospital
reclassifications extended by section 106(a) of MIEA-TRHCA that
resulted in a lower wage index for the period April 1, 2007 through
September 30, 2007, we will apply the higher wage index that was
applicable to such hospitals during the period October 1, 2006 through
March 31, 2007, for the entire FY 2007.
The following table lists providers affected by section 117(c),
which revises the FY 2007 wage index from April 1, 2007 through
September 30, 2007:
----------------------------------------------------------------------------------------------------------------
Current wage Current GAF 4/ Revised wage Revised GAF 4/
Fiscal intermediary No. Provider No. index 4/1/2007- 1/2007-9/30/ index 4/1/2007- 1/2007-9/30/
9/30/2007 2007 9/30/2007 2007
----------------------------------------------------------------------------------------------------------------
00308........................... 070001 1.2730 1.1797 1.2971 1.1950
00308........................... 070005 1.2730 1.1797 1.2971 1.1950
00308........................... 070010 1.3113 1.2039 1.3134 1.2053
00308........................... 070016 1.2730 1.1797 1.2971 1.1950
00308........................... 070017 1.2730 1.1797 1.2971 1.1950
00308........................... 070019 1.2730 1.1797 1.2971 1.1950
00308........................... 070022 1.2730 1.1797 1.2971 1.1950
00308........................... 070028 1.3113 1.2039 1.3134 1.2053
00308........................... 070031 1.2730 1.1797 1.2971 1.1950
00308........................... 070039 1.2730 1.1797 1.2971 1.1950
00011........................... 160040 0.8708 0.9096 0.8803 0.9164
00011........................... 160067 0.8708 0.9096 0.8803 0.9164
00011........................... 160110 0.8708 0.9096 0.8803 0.9164
00450........................... 230020 1.0440 1.0299 1.0563 1.0382
00452........................... 230024 1.0440 1.0299 1.0563 1.0382
00450........................... 230053 1.0440 1.0299 1.0563 1.0382
00450........................... 230089 1.0440 1.0299 1.0563 1.0382
00452........................... 230104 1.0440 1.0299 1.0563 1.0382
00450........................... 230119 1.0440 1.0299 1.0563 1.0382
00450........................... 230135 1.0440 1.0299 1.0563 1.0382
00450........................... 230146 1.0440 1.0299 1.0563 1.0382
00450........................... 230165 1.0440 1.0299 1.0563 1.0382
00450........................... 230176 1.0440 1.0299 1.0563 1.0382
00450........................... 230270 1.0440 1.0299 1.0563 1.0382
00452........................... 230273 1.0440 1.0299 1.0563 1.0382
00390........................... 310021 1.3113 1.2039 1.3134 1.2053
00390........................... 310028 1.3113 1.2039 1.3134 1.2053
00390........................... 310051 1.3113 1.2039 1.3134 1.2053
00390........................... 310060 1.3113 1.2039 1.3134 1.2053
00390........................... 310115 1.3113 1.2039 1.3134 1.2053
00390........................... 310120 1.3113 1.2039 1.3134 1.2053
[[Page 9810]]
00308........................... 330049 1.3113 1.2039 1.3134 1.2053
00308........................... 330126 1.3113 1.2039 1.3134 1.2053
00308........................... 330135 1.3113 1.2039 1.3134 1.2053
00308........................... 330205 1.3113 1.2039 1.3134 1.2053
00308........................... 330209 1.2730 1.1797 1.2971 1.1950
00308........................... 330264 1.2730 1.1797 1.2971 1.1950
----------------------------------------------------------------------------------------------------------------
We have implemented these provisions through instructions to the
Medicare Administrative Contractors (MAC) (CMS Joint Signature
Memorandum, JSM/TDL-08149, January 28, 2008). CMS has instructed FIs/
MACs to reprocess claims for the affected providers FY 2007 and FY
2008.
When originally applying section 508 of MMA, we required each
hospital to submit a request in writing by February 15, 2004, to the
Medicare Geographic Classification Review Board (MGCRB), with a copy to
CMS. We will neither require nor accept written requests for the
extension required by section 117 of MMSEA, since that section, by
providing a 1-year extension for certain special exceptions and
reclassifications set to expire September 30, 2007, already specifies
the affected hospitals.
III. Regulatory Impact Statement
We have examined the impact of this notice using the requirements
of Executive Order 12866 (September 1993, Regulatory Planning and
Review), and Executive Order 13132.
Executive Order 12866 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 notice
implements a statutory provision that would increase payments to
hospitals by less than $100 million and is therefore, not a major rule.
This notice also is not a legislative rulemaking under the
Administrative Procedure Act, but rather interprets and applies a
statutory mandate.
Executive Order 13132 establishes certain requirements that an
agency must meet when it promulgates a proposed rule (and subsequent
final rule) that imposes substantial direct requirement costs on State
and local governments, preempts State law, or otherwise has Federalism
implications. Again, although we do not consider this notice to be a
substantive rule subject to notice and comment rulemaking, we note that
this notice does not impose any costs on State or local governments.
Therefore, the requirements of Executive Order 13132 would not be
applicable.
We estimate the impact of sections 117(a) and (c) of MMSEA is to
increase payments to hospitals by $24 million for FY 2007 and by $57
million for FY 2008.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
Authority: Section 117(a) and (c) of Public Law 110-173. Section
106(a) of Division B, Title 1, Public Law 109-432. Section 508(a) of
Public Law 108-173.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: February 7, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E8-2798 Filed 2-21-08; 8:45 am]
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