Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric Units; Correction, 59256-59263 [2011-24671]
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59256
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
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[FR Doc. 2011–24516 Filed 9–23–11; 8:45 am]
BILLING CODE 6560–50–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Part 412
[CMS–1349–CN]
RIN 0938–AQ28
Medicare Program; Inpatient
Rehabilitation Facility Prospective
Payment System for Federal Fiscal
Year 2012; Changes in Size and Square
Footage of Inpatient Rehabilitation
Units and Inpatient Psychiatric Units;
Correction
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; correction.
AGENCY:
This document corrects
technical errors that appeared in the
final rule published in the Federal
Register on August 5, 2011 entitled
‘‘Medicare Program; Inpatient
Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year
2012; Changes in Size and Square
Footage of Inpatient Rehabilitation
Units and Inpatient Psychiatric Units,’’
(hereinafter FY 2012 IRF PPS final rule
(76 FR 47836)).
DATES: Effective Date. The corrections
are effective October 1, 2011.
FOR FURTHER INFORMATION CONTACT:
Susanne Seagrave, (410) 786–0044.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
There were technical errors in the
August 5, 2011 FY 2012 IRF PPS final
rule (76 FR 47836). These technical
errors are identified and corrected in the
‘‘Summary of Errors’’ and ‘‘Correction of
Errors’’ sections below. The provisions
in this correction document are effective
as if they were included in the final rule
published on August 5, 2011.
Accordingly, the corrections are
effective October 1, 2011.
II. Summary of Errors
In the August 5, 2011 final rule (76 FR
47836), we applied our established
formula for calculating the relative
weight values for case-mix groups
(CMG). The CMG relative weight values
for CMGs 1201, 1202, 1203, 1301, 1302,
and 1303 in Table 1 on pages 47842
through 47844 of the final rule did not
reflect our policy that the relative
weight values for higher-paying tiers
must always be greater than or equal to
the relative weight values for lowerpaying tiers. That is, a tier 1 payment for
a given CMG must always be at least as
PO 00000
Frm 00020
Fmt 4700
Sfmt 4700
high as a tier 2 payment for that same
CMG, the tier 2 payment must always be
at least as high as the tier 3 payment,
and the tier 3 payment must always be
at least as high as the ‘‘no-comorbidity’’
tier payment. We have used this policy
in calculating the CMG relative weights
since the inception of the IRF PPS.
However, we inadvertently did not
apply this policy correctly for CMGs
1201, 1202, 1203, 1301, 1302, and 1303
in Table 1 on pages 47842 through
47844 of the FY 2012 IRF PPS final rule.
Further, as discussed in ‘‘Step 4’’ in
the CMG relative weights discussion,
column 1, on page 47841 of the FY 2012
IRF PPS final rule, we normalized the
FY 2012 CMG relative weights to the
same average CMG relative weight
values from the FY 2011 IRF PPS notice
(75 FR 42836). As this process utilized
the incorrect values that had been listed
for the relative weight values for CMGs
1201, 1202, 1203, 1301, 1302, and 1303,
upon correction we also needed to
reapply the normalization process to the
other CMGs using the corrected relative
weight values. This process corrects the
relative weight values for all CMGs so
that we are appropriately applying the
policy of normalizing the FY 2012 CMG
relative weights to the same average
CMG relative weight values from the FY
2011 IRF PPS notice.
Since the FY 2012 payment rates
listed in Table 11 on pages 47865
through 47866 of the final rule are based
on the CMG relative weights in Table 1
(the payment rates are equal to the CMG
relative weights multiplied by the FY
2012 Standard Payment Conversion
Factor), we are also providing
corrections to Table 11 in the final rule
to reflect the corrections to the CMG
relative weights in Table 1. In addition,
we are correcting the example of
computing the IRF FY 2012 Federal
prospective payment in Table 12 on
page 47867 of the final rule to reflect the
correction to the unadjusted Federal
prospective payment rate for CMG 0110
(without comorbidities) from Table 11.
Finally, we utilized the CMG payment
rates reflected in Table 11 of the IRF
PPS final rule to determine the FY 2012
outlier threshold. As described in the
final rule, the outlier threshold is to be
set so that the estimated total outlier
payments in FY 2012 will equal 3
percent of total estimated payments.
Since corrections to the FY 2012
payment rates result in slight
differences in the amount of outlier
payments we estimate for FY 2012, the
use of the corrected data results in an
outlier threshold for FY 2012 IRF PPS
of $10,713. Therefore, we are correcting
the outlier threshold amount for FY
2012 from $10,660 to $10,713 to ensure
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26SER1
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Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
that estimated outlier payments for FY
2012 continue to equal 3 percent of total
estimated payments.
We note that the corrections to the
CMG relative weight values in Table 1
of the FY 2012 IRF PPS final rule do not
affect the average length of stay values,
which we have republished here for
simplicity. The average length of stay
values are the same values that were
published correctly in Table 1 of the
August 5, 2011 final rule (76 FR 47836).
As a result of the corrections to Table
1 and Table 11 of the final rule, as well
as the correction to the FY 2012 outlier
threshold amount, some of the numbers
in Table 14 on page 47887 of the final
rule (the IRF Impact Table for FY 2012),
also need to be corrected. We are
correcting these numbers both in Table
14 and in the preamble text that
references Table 14.
III. Waiver of Proposed Rulemaking
and Delayed Effective Date
In accordance with the
Administrative Procedure Act (APA) (5
U.S.C. 553(b)), we ordinarily publish a
notice of proposed rulemaking in the
Federal Register to provide a period for
public comment before the provisions of
a rule take effect. We also ordinarily
provide a 30-day delay in the effective
date of the provisions of a rule in
accordance with section 553(d) of the
APA (5 U.S.C. 553(d)). However, we can
waive both notice and comment
procedures and the 30-day delay in
effective date if the Secretary finds, for
good cause, that such procedures are
impracticable, unnecessary, or contrary
to the public interest, and incorporates
a statement of the finding and the
reasons into the notice.
The corrections that are laid out in
this document were necessitated by an
inadvertent error to accurately apply our
stated policies as we calculated and laid
out the CMG relative weight values in
Table 1 of the FY 2012 IRF PPS final
rule. As a result of those calculation
errors, corrections were needed in
Tables 1, 11, 12 and 14. Corrections
were also needed as a result of these
calculation errors in the places
indicated above in the preamble
discussion.
Upon recognition of these calculation
errors, we reviewed the comments that
were submitted in response to our FY
2012 IRF PPS proposed rule. We found
that the necessary corrections would not
have altered the substantive content of
those comments.
As the corrections necessitated by the
calculation errors outlined above do not
change the stated policies in the FY
2012 IRF PPS final rule, as the policies
and payment methodology expressed in
the FY 2012 IRF PPS final rule (76 FR
47836) have previously been subjected
to notice and comment procedures, and
as the public’s comments would not
have been affected if we had published
the correctly calculated data elements,
we find it unnecessary to undertake
further notice and comment procedures
with respect to this correction
document. Further, the corrections
made in this document will not
significantly affect anticipated overall
reimbursements to IRF providers and, as
such, will only result in negligible
changes to anticipated revenues and
will not necessitate any actions on the
part of individual providers. Therefore,
we find good cause to waive notice and
comment procedures and the 30-day
delay in the effective date for this
correction document.
IV. Correction of Errors
In the August 5, 2011 FY 2012 IRF
PPS final rule (76 FR 47836), make the
following corrections:
1. On pages 47842 through 47844,
Table 1, ‘‘Relative Weights and Average
Length of Stay Values for Case-Mix
Groups,’’ is corrected as follows:
TABLE 1—RELATIVE WEIGHTS AND AVERAGE LENGTH OF STAY VALUES FOR CASE-MIX GROUPS
Relative weight
CMG
Average length of stay
CMG Description (M = motor, C = cognitive, A = age)
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Tier 1
0101
0102
0103
0104
0105
0106
0107
0108
0109
0110
0201
0202
0203
0204
0205
0206
0207
0301
0302
0303
0304
0401
0402
0403
0404
0405
0501
0502
0503
0504
0505
0506
0601
Stroke M>51.05 ..................................................................
Stroke M>44.45 and M<51.05 and C>18.5 .......................
Stroke M>44.45 and M<51.05 and C<18.5 .......................
Stroke M>38.85 and M<44.45 ...........................................
Stroke M>34.25 and M<38.85 ...........................................
Stroke M>30.05 and M<34.25 ...........................................
Stroke M>26.15 and M<30.05 ...........................................
Stroke M<26.15 and A>84.5 ..............................................
Stroke M>22.35 and M<26.15 and A<84.5 ........................
Stroke M<22.35 and A<84.5 ..............................................
Traumatic brain injury M>53.35 and C>23.5 .....................
Traumatic brain injury M>44.25 and M<53.35 and C>23.5
Traumatic brain injury M>44.25 and C<23.5 .....................
Traumatic brain injury M>40.65 and M<44.25 ...................
Traumatic brain injury M>28.75 and M<40.65 ...................
Traumatic brain injury M>22.05 and M<28.75 ...................
Traumatic brain injury M<22.05 .........................................
Non-traumatic brain injury M>41.05 ...................................
Non-traumatic brain injury M>35.05 and M<41.05 ............
Non-traumatic brain injury M>26.15 and M<35.05 ............
Non-traumatic brain injury M<26.15 ...................................
Traumatic spinal cord injury M>48.45 ................................
Traumatic spinal cord injury M>30.35 and M<48.45 .........
Traumatic spinal cord injury M>16.05 and M<30.35 .........
Traumatic spinal cord injury M<16.05 and A>63.5 ............
Traumatic spinal cord injury M<16.05 and A<63.5 ............
Non-traumatic spinal cord injury M>51.35 .........................
Non-traumatic spinal cord injury M>40.15 and M<51.35 ...
Non-traumatic spinal cord injury M>31.25 and M<40.15 ...
Non-traumatic spinal cord injury M>29.25 and M<31.25 ...
Non-traumatic spinal cord injury M>23.75 and M<29.25 ...
Non-traumatic spinal cord injury M<23.75 .........................
Neurological M>47.75 ........................................................
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Tier 2
Tier 3
None
0.7671
0.9521
1.1369
1.1812
1.3725
1.5805
1.7895
2.2165
2.0496
2.6418
0.7466
1.0607
1.2074
1.2649
1.5974
1.9887
2.6902
1.0568
1.3383
1.5912
2.2032
1.0564
1.3772
2.4588
4.3666
3.8573
0.6555
0.9809
1.2453
1.5015
1.7549
2.4598
0.9452
0.7177
0.8908
1.0637
1.1052
1.2841
1.4788
1.6743
2.0738
1.9177
2.4717
0.6128
0.8707
0.9911
1.0383
1.3113
1.6325
2.2084
0.9507
1.2039
1.4315
1.9820
0.8795
1.1465
2.0470
3.6353
3.2113
0.6294
0.9418
1.1956
1.4416
1.6848
2.3616
0.7987
0.6447
0.8002
0.9555
0.9928
1.1535
1.3284
1.5040
1.8629
1.7226
2.2203
0.5677
0.8065
0.9181
0.9618
1.2146
1.5122
2.0455
0.8434
1.0681
1.2699
1.7583
0.8001
1.0430
1.8622
3.3070
2.9213
0.5613
0.8399
1.0663
1.2856
1.5026
2.1062
0.7286
0.6098
0.7568
0.9037
0.9389
1.0910
1.2564
1.4225
1.7619
1.6292
2.1000
0.5154
0.7323
0.8336
0.8733
1.1029
1.3731
1.8574
0.7725
0.9782
1.1631
1.6104
0.7020
0.9151
1.6339
2.9016
2.5632
0.4975
0.7444
0.9450
1.1394
1.3317
1.8667
0.6586
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E:\FR\FM\26SER1.SGM
Tier 1
10
12
14
15
16
20
20
31
24
33
8
12
16
16
17
23
35
12
12
21
29
14
17
29
52
52
10
13
16
18
20
34
10
26SER1
Tier 2
10
13
14
14
17
18
20
25
23
29
8
12
11
12
18
19
27
12
15
17
23
14
14
26
39
39
10
13
14
16
21
28
11
Tier 3
9
10
12
13
14
16
18
23
20
26
7
10
13
12
15
19
25
11
13
15
20
11
13
23
38
36
7
11
13
16
18
24
9
None
8
10
12
12
14
16
18
22
20
25
8
10
12
12
14
18
22
10
13
14
19
10
12
20
35
29
7
10
12
14
17
23
9
59258
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
TABLE 1—RELATIVE WEIGHTS AND AVERAGE LENGTH OF STAY VALUES FOR CASE-MIX GROUPS—Continued
Relative weight
CMG
Average length of stay
CMG Description (M = motor, C = cognitive, A = age)
Tier 1
0602
0603
0604
0701
0702
0703
0704
0801
0802
0803
0804
0805
0806
0901
0902
0903
0904
1001
1002
1003
1101
1102
1201
1202
1203
1301
1302
1303
1401
1402
1403
1404
1501
1502
1503
1504
1601
1602
1603
1701
1702
1703
1704
1801
1802
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1803
1901
1902
1903
2001
2002
2003
2004
2101
5001
5101
5102
5103
Neurological M>37.35 and M<47.75 ..................................
Neurological M>25.85 and M<37.35 ..................................
Neurological M<25.85 ........................................................
Fracture of lower extremity M>42.15 .................................
Fracture of lower extremity M>34.15 and M<42.15 ...........
Fracture of lower extremity M>28.15 and M<34.15 ...........
Fracture of lower extremity M<28.15 .................................
Replacement of lower extremity joint M>49.55 ..................
Replacement of lower extremity joint M>37.05 and
M<49.55.
Replacement of lower extremity joint M>28.65 and
M<37.05 and A>83.5.
Replacement of lower extremity joint M>28.65 and
M<37.05 and A<83.5.
Replacement of lower extremity joint M>22.05 and
M<28.65.
Replacement of lower extremity joint M<22.05 ..................
Other orthopedic M>44.75 .................................................
Other orthopedic M>34.35 and M<44.75 ...........................
Other orthopedic M>24.15 and M<34.35 ...........................
Other orthopedic M<24.15 .................................................
Amputation, lower extremity M>47.65 ................................
Amputation, lower extremity M>36.25 and M<47.65 .........
Amputation, lower extremity M<36.25 ................................
Amputation, non-lower extremity M>36.35 ........................
Amputation, non-lower extremity M<36.35 ........................
Osteoarthritis M>37.65 .......................................................
Osteoarthritis M>30.75 and M<37.65 ................................
Osteoarthritis M<30.75 .......................................................
Rheumatoid, other arthritis M>36.35 ..................................
Rheumatoid, other arthritis M>26.15 and M<36.35 ...........
Rheumatoid, other arthritis M<26.15 ..................................
Cardiac M>48.85 ................................................................
Cardiac M>38.55 and M<48.85 .........................................
Cardiac M>31.15 and M<38.55 .........................................
Cardiac M<31.15 ................................................................
Pulmonary M>49.25 ...........................................................
Pulmonary M>39.05 and M<49.25 .....................................
Pulmonary M>29.15 and M<39.05 .....................................
Pulmonary M<29.15 ...........................................................
Pain syndrome M>37.15 ....................................................
Pain syndrome M>26.75 and M<37.15 ..............................
Pain syndrome M<26.75 ....................................................
Major multiple trauma without brain or spinal cord injury
M>39.25.
Major multiple trauma without brain or spinal cord injury
M>31.05 and M<39.25.
Major multiple trauma without brain or spinal cord injury
M>25.55 and M<31.05.
Major multiple trauma without brain or spinal cord injury
M<25.55.
Major multiple trauma with brain or spinal cord injury
M>40.85.
Major multiple trauma with brain or spinal cord injury
M>23.05 and M<40.85.
Major multiple trauma with brain or spinal cord injury
M<23.05.
Guillian Barre M>35.95 ......................................................
Guillian Barre M>18.05 and M<35.95 ................................
Guillian Barre M<18.05 ......................................................
Miscellaneous M>49.15 ......................................................
Miscellaneous M>38.75 and M<49.15 ...............................
Miscellaneous M>27.85 and M<38.75 ...............................
Miscellaneous M<27.85 ......................................................
Burns M>0 ..........................................................................
Short-stay cases, length of stay is 3 days or fewer ..........
Expired, orthopedic, length of stay is 13 days or fewer ....
Expired, orthopedic, length of stay is 14 days or more .....
Expired, not orthopedic, length of stay is 15 days or
fewer.
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Tier 2
Tier 3
None
1.2511
1.6157
2.1425
0.7996
1.0462
1.2589
1.6270
0.5777
0.7792
1.0572
1.3654
1.8106
0.7871
1.0299
1.2393
1.6017
0.5777
0.7792
0.9644
1.2455
1.6515
0.7581
0.9919
1.1937
1.5426
0.5383
0.7262
0.8717
1.1258
1.4929
0.6767
0.8854
1.0654
1.3769
0.4915
0.6630
12
17
24
10
12
15
18
7
8
13
16
21
12
13
15
19
8
11
12
14
19
10
12
14
18
7
9
11
14
18
9
12
14
17
7
9
1.0718
1.0718
0.9988
0.9119
11
14
13
12
0.9510
0.9510
0.8863
0.8092
10
12
11
10
1.1734
1.1734
1.0936
0.9984
11
14
13
13
1.4368
0.8460
1.1316
1.4493
1.8779
1.0321
1.3551
2.0018
1.0375
1.5611
0.8554
1.1152
1.3737
0.8929
1.1759
1.5198
0.9405
1.2630
1.5254
1.9757
0.9606
1.2091
1.4911
1.8836
1.1167
1.4957
1.9322
1.0424
1.4368
0.7455
0.9971
1.2770
1.6547
0.9074
1.1914
1.7600
1.0375
1.5611
0.8554
1.1152
1.3737
0.8929
1.1759
1.5198
0.7530
1.0112
1.2213
1.5818
0.8970
1.1290
1.3923
1.7589
0.8790
1.1773
1.5210
0.9277
1.3390
0.6746
0.9023
1.1556
1.4973
0.8107
1.0645
1.5725
0.9841
1.4808
0.8088
1.0544
1.2989
0.8833
1.1632
1.5035
0.6659
0.8941
1.0799
1.3987
0.7731
0.9732
1.2001
1.5160
0.7713
1.0331
1.3347
0.8419
1.2225
0.6112
0.8175
1.0470
1.3566
0.7246
0.9514
1.4055
0.9236
1.3897
0.7645
0.9966
1.2277
0.7875
1.0370
1.3403
0.6022
0.8087
0.9767
1.2651
0.7308
0.9198
1.1343
1.4330
0.7211
0.9658
1.2477
0.7360
13
10
12
16
21
13
16
21
11
14
13
16
13
11
17
15
10
13
18
24
10
13
16
22
12
19
22
10
18
10
13
16
20
12
14
21
11
18
13
16
19
10
17
19
10
12
14
19
11
13
16
18
12
13
18
11
16
9
12
14
18
10
13
18
12
16
11
14
15
11
14
18
9
11
13
16
8
11
13
17
10
13
16
11
15
8
11
13
17
10
12
17
11
16
10
13
15
10
13
16
8
10
12
15
9
11
13
16
10
13
15
10
1.3755
1.2242
1.1110
0.9712
13
15
14
13
1.6223
1.4439
1.3104
1.1455
15
16
15
15
2.0766
1.8482
1.6773
1.4663
26
22
20
18
1.1991
0.9837
0.9497
0.8687
14
15
12
11
1.6464
1.3507
1.3040
1.1927
18
20
15
15
2.8188
2.3124
2.2325
2.0420
34
32
26
24
1.1440
2.1760
3.6334
0.8533
1.1420
1.4421
1.9337
2.4686
............
............
............
............
1.0078
1.9170
3.2009
0.7540
1.0091
1.2742
1.7086
2.1368
............
............
............
............
0.9143
1.7390
2.9037
0.6760
0.9047
1.1425
1.5319
1.7017
............
............
............
............
0.8879
1.6888
2.8199
0.6073
0.8128
1.0264
1.3763
1.3793
0.1474
0.5851
1.4705
0.6965
13
22
48
9
12
15
24
34
............
............
............
............
14
22
29
10
12
15
20
23
............
............
............
............
12
21
34
9
11
13
18
19
............
............
............
............
12
21
32
8
10
13
16
18
3
7
18
8
Fmt 4700
Sfmt 4700
E:\FR\FM\26SER1.SGM
Tier 1
26SER1
Tier 2
Tier 3
None
59259
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
TABLE 1—RELATIVE WEIGHTS AND AVERAGE LENGTH OF STAY VALUES FOR CASE-MIX GROUPS—Continued
Relative weight
CMG
Average length of stay
CMG Description (M = motor, C = cognitive, A = age)
Tier 1
5104
Expired, not orthopedic, length of stay is 16 days or more
Tier 2
Tier 3
None
Tier 1
Tier 2
Tier 3
None
............
............
............
1.8764
............
............
............
23
2. On pages 47865 through 47866,
Table 11, ‘‘FY 2012 Payment Rates,’’ is
corrected as follows:
TABLE 11—FY 2012 PAYMENT RATES
Payment rate
tier 1
bjneal on DSK5VPTVN1PROD with RULES
CMG
0101
0102
0103
0104
0105
0106
0107
0108
0109
0110
0201
0202
0203
0204
0205
0206
0207
0301
0302
0303
0304
0401
0402
0403
0404
0405
0501
0502
0503
0504
0505
0506
0601
0602
0603
0604
0701
0702
0703
0704
0801
0802
0803
0804
0805
0806
0901
0902
0903
0904
1001
1002
1003
1101
1102
1201
1202
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
VerDate Mar<15>2010
06:33 Sep 24, 2011
Jkt 223001
PO 00000
Frm 00023
Fmt 4700
Payment rate
tier 2
$10,797.70
13,401.76
16,003.00
16,626.57
19,319.31
22,247.12
25,189.00
31,199.45
28,850.17
37,185.98
10,509.14
14,930.41
16,995.36
17,804.73
22,485.00
27,992.94
37,867.26
14,875.52
18,837.91
22,397.73
31,012.24
14,869.89
19,385.47
34,610.07
61,464.26
54,295.35
9,226.82
13,807.15
17,528.84
21,135.11
24,701.97
34,624.14
13,304.64
17,610.48
22,742.59
30,157.83
11,255.17
14,726.31
17,720.28
22,901.65
8,131.71
10,968.02
15,086.66
13,386.28
16,516.78
20,224.40
11,908.30
15,928.40
20,400.35
26,433.32
14,527.84
19,074.39
28,177.34
14,603.85
21,974.04
12,040.61
15,697.56
Sfmt 4700
Payment rate
tier 3
$10,102.35
12,538.90
14,972.64
15,556.80
18,074.99
20,815.59
23,567.45
29,190.81
26,993.55
34,791.65
8,625.77
12,255.97
13,950.72
14,615.11
18,457.86
22,979.07
31,085.44
13,382.05
16,946.10
20,149.79
27,898.63
12,379.84
16,138.13
28,813.57
51,170.48
45,202.26
8,859.43
13,256.78
16,829.27
20,291.96
23,715.24
33,241.88
11,242.50
14,881.15
19,219.37
25,486.01
11,079.22
14,496.87
17,444.39
22,545.53
8,131.71
10,968.02
15,086.66
13,386.28
16,516.78
20,224.40
10,493.66
14,035.18
17,975.05
23,291.56
12,772.56
16,770.15
24,773.76
14,603.85
21,974.04
12,040.61
15,697.56
E:\FR\FM\26SER1.SGM
$9,074.80
11,263.62
13,449.62
13,974.65
16,236.67
18,698.56
21,170.30
26,222.18
24,247.32
31,252.94
7,990.95
11,352.29
12,923.18
13,538.30
17,096.71
21,285.73
28,792.46
11,871.70
15,034.58
17,875.11
24,749.83
11,262.21
14,681.27
26,212.33
46,549.33
41,120.22
7,900.86
11,822.43
15,009.24
18,096.11
21,150.60
29,646.87
10,255.77
13,574.89
17,531.66
23,246.51
10,671.02
13,961.98
16,802.52
21,713.64
7,577.11
10,221.99
14,059.11
12,475.56
15,393.51
18,847.76
9,495.67
12,700.77
16,266.23
21,075.99
11,411.41
14,983.90
22,134.51
13,852.19
20,843.74
11,384.67
14,841.73
26SER1
Payment rate
no comorbidity
$8,583.54
10,652.72
12,720.48
13,215.96
15,356.92
17,685.09
20,023.11
24,800.50
22,932.62
29,559.60
7,254.77
10,307.85
11,733.75
12,292.57
15,524.42
19,327.76
26,144.76
10,873.71
13,769.14
16,371.80
22,667.99
9,881.35
12,880.95
22,998.78
40,842.92
36,079.60
7,002.81
10,478.17
13,301.82
16,038.19
18,745.01
26,275.67
9,270.45
12,270.05
15,846.76
21,014.06
9,525.23
12,462.89
14,996.57
19,381.24
6,918.35
9,332.39
12,835.90
11,390.30
14,053.48
17,207.91
8,603.25
11,507.13
14,737.57
19,095.50
10,199.47
13,391.91
19,783.82
13,000.59
19,561.42
10,761.10
14,028.14
59260
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
TABLE 11—FY 2012 PAYMENT RATES—Continued
Payment rate
tier 1
CMG
1203
1301
1302
1303
1401
1402
1403
1404
1501
1502
1503
1504
1601
1602
1603
1701
1702
1703
1704
1801
1802
1803
1901
1902
1903
2001
2002
2003
2004
2101
5001
5101
5102
5103
5104
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
.................................................................................................
3. On page 47867:
a. In table 12, ‘‘Example of Computing
the IRF FY 2012 Federal Prospective
Payment rate
tier 2
Payment rate
tier 3
19,336.20
12,568.46
16,551.97
21,392.70
13,238.48
17,777.99
21,471.53
27,809.95
13,521.41
17,019.29
20,988.72
26,513.55
15,718.67
21,053.47
27,197.65
14,672.82
19,361.54
22,835.49
29,230.22
16,878.53
23,174.73
39,677.43
16,102.94
30,629.38
51,143.74
12,011.05
16,074.79
20,299.00
27,218.76
34,748.01
............................
............................
............................
............................
............................
19,336.20
12,568.46
16,551.97
21,392.70
10,599.23
14,233.65
17,191.02
22,265.42
12,626.17
15,891.80
19,598.01
24,758.28
12,372.80
16,571.67
21,409.60
13,058.31
17,231.84
20,324.34
26,015.26
13,846.56
19,012.45
32,549.34
14,185.79
26,983.69
45,055.87
10,613.30
14,204.09
17,935.64
24,050.25
30,077.60
............................
............................
............................
............................
............................
Payment rate
no comorbidity
18,283.32
12,433.33
16,373.20
21,163.27
9,373.21
12,585.35
15,200.67
19,688.10
10,882.16
13,698.76
16,892.61
21,339.22
10,856.82
14,541.92
18,787.24
11,850.58
15,638.44
18,445.19
23,609.67
13,367.98
18,355.10
31,424.67
12,869.69
24,478.16
40,872.48
9,515.38
12,734.56
16,081.83
21,563.02
23,953.13
............................
............................
............................
............................
............................
17,281.11
11,084.85
14,596.81
18,866.06
8,476.57
11,383.26
13,748.03
17,807.55
10,286.74
12,947.10
15,966.41
20,170.91
10,150.20
13,594.60
17,562.63
10,359.94
13,670.61
16,124.06
20,639.64
12,227.82
16,788.45
28,743.19
12,498.08
23,771.55
39,692.91
8,548.35
11,440.97
14,447.61
19,372.80
19,415.03
2,074.80
8,235.87
20,698.76
9,803.93
26,412.21
Payment,’’ correct the entire table to
read as follows:
TABLE 12—EXAMPLE OF COMPUTING THE IRF PPS FY 2012 FEDERAL PROSPECTIVE PAYMENT
Rural
Facility A
(Spencer
Co., IN)
bjneal on DSK5VPTVN1PROD with RULES
Steps
1 ...........
2 ...........
3 ...........
4 ...........
5 ...........
6 ...........
7 ...........
8 ...........
9 ...........
10 .........
11 .........
12 .........
13 .........
14 .........
15 .........
16 .........
Unadjusted Federal Prospective Payment ....................................................................................
Labor Share ...................................................................................................................................
Labor Portion of Federal Payment ................................................................................................
CBSA Based Wage Index (shown in the Addendum , Tables 1 and 2) .......................................
Wage-Adjusted Amount .................................................................................................................
Nonlabor Amount ...........................................................................................................................
Wage-Adjusted Federal Payment ..................................................................................................
Rural Adjustment ...........................................................................................................................
Wage- and Rural-Adjusted Federal Payment ...............................................................................
LIP Adjustment ..............................................................................................................................
FY 2012 Wage-, Rural- and LIP-Adjusted Federal Prospective Payment Rate ...........................
FY 2012 Wage- and Rural-Adjusted Federal Prospective Payment ............................................
Teaching Status Adjustment ..........................................................................................................
Teaching Status Adjustment Amount ............................................................................................
FY2012 Wage-, Rural-, and LIP-Adjusted Federal Prospective Payment Rate ...........................
Total FY 2012 Adjusted Federal Prospective Payment ................................................................
b. In the 1st column, the 4th
paragraph, in line 2, the amount
VerDate Mar<15>2010
06:33 Sep 24, 2011
Jkt 223001
‘‘$31,771.45’’ is corrected to read
‘‘$31,753.31.’’
PO 00000
Frm 00024
Fmt 4700
Sfmt 4700
29,559.60
0.70199
$20,750.54
0.8391
$17,411.78
$8,809.06
$26,220.84
1.184
$31,045.47
1.0228
$31,753.31
$31,045.47
0.0000
$0.00
$31,753.31
$31,753.31
Urban
Facility B
(Harrison
Co., IN)
29,559.60
0.70199
$20,750.54
0.8896
$18,459.68
$8,809.06
$27,268.74
1.0000
$27,268.74
1.0666
$29,084.84
$27,268.74
0.0610
$1,663.39
$29,084.84
$30,748.23
c. In the 1st column, the 2nd
paragraph, in line 4, the amount
E:\FR\FM\26SER1.SGM
26SER1
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
bjneal on DSK5VPTVN1PROD with RULES
‘‘$30,765.80’’ is corrected to read
‘‘$30,748.23.’’
4. On page 47868, in the 3rd column,
in the 1st full paragraph, in line 6, the
VerDate Mar<15>2010
06:33 Sep 24, 2011
Jkt 223001
amount ‘‘$10,660’’ is corrected to read
‘‘$10,713.’’
PO 00000
Frm 00025
Fmt 4700
Sfmt 4700
59261
5. On page 47887, Table 14, ‘‘IRF
Impact Table for FY 2012,’’ is corrected
as follows:
E:\FR\FM\26SER1.SGM
26SER1
VerDate Mar<15>2010
(1)
Facility classification
06:33 Sep 24, 2011
Jkt 223001
PO 00000
Frm 00026
Fmt 4700
Sfmt 4700
E:\FR\FM\26SER1.SGM
26SER1
1,354
3,232
5,988
5,776
4,017
3,945
9,261
670
387
16,393
66,363
63,793
57,269
26,375
18,118
66,313
23,834
24,300
32
142
132
188
49
73
169
70
102
345,500
36,878
12,497
2,513
10,534
62,434
134,694
123,398
66,328
6
16
25
33
23
31
50
7
4
397,388
200,587
27,997
162,171
6,633
151,821
12,437
199,313
20,442
11,624
1,751
362,758
34,630
1,152
752
175
205
20
317
63
596
122
44
10
957
195
(3)
Number
of cases
1,036
69
33
14
39
208
342
330
233
(4)
0.4
0.4
0.3
0.4
0.5
0.4
0.5
0.6
0.7
1.0
0.2
0.3
0.4
0.2
0.7
0.5
0.6
1.4
0.4
0.3
0.4
0.5
0.2
0.6
0.4
0.4
0.7
0.4%
0.6
0.5
0.2
0.2
0.2
0.4
0.5
0.5
0.7
0.9
0.4
0.5
Outlier
(5)
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.9
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8%
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
1.8
FY 2012
adjusted
market
basket
increase
factor 1
(6)
0.4
¥0.2
0.0
0.0
0.0
0.1
¥0.4
¥0.3
¥0.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
¥0.1
0.1
0.1
0.0
0.1
0.0
0.1
0.1
0.2
¥0.1
¥1.2
¥0.7
0.0
0.0
0.4
0.0
0.5
0.2
¥0.3
0.7
1.8
0.8
0.1
1.4
¥0.2
1.6
0.3
¥0.4
0.0
0.0
0.0
0.0
¥0.1
0.0
0.0
¥0.1
0.0
0.0%
¥0.1
0.8
0.0
1.6
0.1
1.1
¥0.3
0.7
0.2
1.3
¥0.1
0.9
(7)
CMG
0.0%
0.0
0.1
0.0
¥0.1
¥0.1
0.1
0.0
0.1
0.0
0.1
0.0
0.1
FY 2012
CBSA wage
index and
labor-share
(8)
2.7
2.0
2.2
2.2
2.3
2.3
2.0
2.2
1.8
3.7
4.0
2.9
2.4
3.4
2.5
4.0
2.9
2.7
1.0
1.4
2.2
2.4
2.2
2.3
2.7
2.3
2.2
2.2%
2.3
3.2
1.9
3.5
2.1
3.4
2.1
3.1
2.8
4.1
2.1
3.2
Total percent
change
1 This column reflects the impact of the rebased RPL market basket increase factor for FY 2012 of 1.8 percent, which includes a market basket update of 2.9 percent, a 0.1 percentage
point reduction in accordance with sections 1886(j)(3)(C)(ii)(II) and 1886(j)(3)(D)(ii) of the Act and a 1.0 percent reduction for the productivity adjustment as required by section
1886(j)(3)(C)(ii)(I) of the Act, as finalized in 76 FR 47860.
2 A map of States that comprise the 9 geographic regions can be found at: https://www.census.gov/geo/www/us_regdiv.pdf.
(2)
Number of
IRFs
TABLE 14—IRF IMPACT TABLE FOR FY 2012
Total .....................................................................................................
Urban unit ............................................................................................
Rural unit .............................................................................................
Urban hospital .....................................................................................
Rural hospital .......................................................................................
Urban For-Profit ...................................................................................
Rural For-Profit ....................................................................................
Urban Non-Profit ..................................................................................
Rural Non-Profit ...................................................................................
Urban Government ..............................................................................
Rural Government ...............................................................................
Urban ...................................................................................................
Rural ....................................................................................................
Urban by region: 2
Urban New England .....................................................................
Urban Middle Atlantic ...................................................................
Urban South Atlantic ....................................................................
Urban East North Central .............................................................
Urban East South Central ............................................................
Urban West North Central ............................................................
Urban West South Central ...........................................................
Urban Mountain ............................................................................
Urban Pacific ................................................................................
Rural by region: 2
Rural New England ......................................................................
Rural Middle Atlantic ....................................................................
Rural South Atlantic .....................................................................
Rural East North Central ..............................................................
Rural East South Central .............................................................
Rural West North Central .............................................................
Rural West South Central ............................................................
Rural Mountain .............................................................................
Rural Pacific .................................................................................
Teaching status:
Non-teaching ................................................................................
Resident to ADC less than 10% ..................................................
Resident to ADC 10%–19% .........................................................
Resident to ADC greater than 19% .............................................
Disproportionate Share Patient Percentage (DSH):
DSH = 0% ....................................................................................
DSH <5% .....................................................................................
DSH 5%–10% ..............................................................................
DSH 10%–20% ............................................................................
DSH >20% ...................................................................................
bjneal on DSK5VPTVN1PROD with RULES
59262
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations
6. On page 47888:
a. In the 1st column, in the 1st full
paragraph, in line 18, the amount
‘‘$10,660’’ is corrected to read
‘‘$10,713.’’
b. In the 1st column, in the 2nd full
paragraph, in line 9, the value ‘‘1.5’’ is
corrected to read ‘‘1.4.’’
c. In the 2nd column, the 2nd full
paragraph, lines 9 through 14, the
sentence: ‘‘The largest decrease in
payments as a result of these updates is
a 0.1 percent decrease to rural
freestanding IRFs, urban IRFs in the East
South Central and Mountain regions,
and rural IRFs in the Pacific region.’’ is
corrected to read, ‘‘The largest decrease
in payments as a result of these updates
is a 0.1 percent decrease to rural IRF
hospitals, urban for-profit IRFs, urban
IRFs in the East South Central and
Mountain regions, rural IRFs in the
Pacific region, and teaching IRFs with
resident to ADC ratios greater than 19
percent.’’
7. On page 47890, in the 1st column,
the 2nd full paragraph, lines 1 through
4, the sentence, ‘‘Overall the largest
payment increase is estimated at 4.1
percent for rural government-owned
IRFs and rural IRFs in the West South
Central region.’’ is corrected to read,
‘‘Overall, the largest payment increases
are estimated at 4.1 percent for rural
government-owned IRFs, and 4.0
percent for rural IRFs in the Middle
Atlantic and West South Central
regions.’’
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: September 19, 2011.
Barbara J. Holland,
Deputy Executive Secretary to the
Department.
[FR Doc. 2011–24671 Filed 9–23–11; 8:45 am]
bjneal on DSK5VPTVN1PROD with RULES
BILLING CODE 4120–01–P
VerDate Mar<15>2010
06:33 Sep 24, 2011
Jkt 223001
59263
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
II. Summary of Errors and Corrections
Posted on the CMS Web Site
Centers for Medicare & Medicaid
Services
A. Errors in the Preamble
On page 51745, in our discussion of
quality reporting for long-term care
hospitals (LTCHs) for FY 2014 payment
determinations, Measure #1, we
inadvertently miscounted and omitted a
footnote.
On pages 51746 and 51747, in our
discussion of the technical expert panel
(TEP) we made typographical errors and
made a technical error in a footnote.
On page 51747, in our discussion of
the TEP, the acronym for Center Line
Catheter-Associated Bloodstream
Infection (CLABSI) was inadvertently
misspelled.
On page 51748, in our discussion of
quality reporting for LTCHs for FY 2014
payment determinations, Measure #2,
we inadvertently included an incorrect
Web site link for detailed information
on the Standardized Infection Ratio
(SIR).
On page 51752, in our discussion of
quality reporting for LTCHs data
submission, we made an error in
referencing the number of States in
which healthcare associated infections
(HAIs) reporting is already or soon will
be mandated.
On page 51754, in our discussion of
the method of data collection and
submission for the pressure ulcer
measure, we made typographical and
technical errors.
On page 51755, in our discussion of
Continuity Assessment Record &
Evaluation (CARE), we made a
grammatical error.
On page 51780, in our discussion of
the information collection requirements
(ICRs) for the quality reporting program
for LTCHs, we made an error in the
number of States that already submitted
HAI data to National Healthcare Safety
Network (NHSN).
On page 51813, in our discussion of
the Web site location for the LTCH PPS
tables for the FY 2012 IPPS/FY 2012
LTCH PPS final rule, we made a
typographical error in the regulation
number.
42 CFR Parts 412, 413, and 476
[CMS–1518–CN3]
RIN 0938–AQ24; 0938–AQ92
Medicare Program; Hospital Inpatient
Prospective Payment Systems for
Acute Care Hospitals and the LongTerm Care Hospital Prospective
Payment System and Fiscal Year 2012
Rates; Hospitals’ FTE Resident Caps
for Graduate Medical Education
Payment; Corrections
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Correction of final rule.
AGENCY:
This document corrects
technical errors and typographical
errors in the final rule entitled
‘‘Medicare Program; Hospital Inpatient
Prospective Payment Systems for Acute
Care Hospitals and the Long-Term Care
Hospital Prospective Payment System
and FY 2012 Rates; Hospitals’ FTE
Resident Caps for Graduate Medical
Education Payment; Corrections’’ which
appeared in the August 18, 2011
Federal Register.
DATES: This correction document is
effective October 1, 2011.
FOR FURTHER INFORMATION CONTACT:
Brian Slater, (410) 786–5229, Hospital
inpatient wage data.
Michele Hudson, (410) 786–4487, Longterm care hospital wage data.
Caroline Gallaher, (410) 786–8705,
Long-term care hospital quality
measures.
SUMMARY:
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2011–19719 of August 18,
2011 (76 FR 51476), the final rule
entitled ‘‘Medicare Program; Hospital
Inpatient Prospective Payment Systems
for Acute Care Hospitals and the LongTerm Care Hospital Prospective
Payment System and FY 2012 Rates;
Hospitals’ FTE Resident Caps for
Graduate Medical Education Payment;
Corrections’’ (hereinafter referred to as
the FY 2012 IPPS/FY 2012 LTCH PPS
final rule) there were a number of
technical errors that are identified and
corrected in the Correction of Errors
section. We have already made changes
to our rates through PRICER and joint
signature memoranda. Accordingly, the
corrections are effective October 1,
2011.
PO 00000
Frm 00027
Fmt 4700
Sfmt 4700
B. Corrections Posted on the CMS Web
Site
On pages 51812 and 51813, we list
tables 2, 3A, 3B, 3C, 4A, 4B, 4C, 4J, 9A,
9C, 12A, and 12B as tables that are
available only through the Internet.
In Table 2.—Acute Care Hospitals
Case-Mix Indexes for Discharges
Occurring in Federal Fiscal Year 2010;
Hospital Wage Indexes for Federal
Fiscal Year 2012; Hospital Average
Hourly Wages for Federal Fiscal Years
2010 (2006 Wage Data), 2011 (2007
E:\FR\FM\26SER1.SGM
26SER1
]]>Agencies
[Federal Register Volume 76, Number 186 (Monday, September 26, 2011)]
[Rules and Regulations]
[Pages 59256-59263]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-24671]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 412
[CMS-1349-CN]
RIN 0938-AQ28
Medicare Program; Inpatient Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year 2012; Changes in Size and Square
Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric
Units; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; correction.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical errors that appeared in the
final rule published in the Federal Register on August 5, 2011 entitled
``Medicare Program; Inpatient Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year 2012; Changes in Size and Square
Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric
Units,'' (hereinafter FY 2012 IRF PPS final rule (76 FR 47836)).
DATES: Effective Date. The corrections are effective October 1, 2011.
FOR FURTHER INFORMATION CONTACT: Susanne Seagrave, (410) 786-0044.
SUPPLEMENTARY INFORMATION:
I. Background
There were technical errors in the August 5, 2011 FY 2012 IRF PPS
final rule (76 FR 47836). These technical errors are identified and
corrected in the ``Summary of Errors'' and ``Correction of Errors''
sections below. The provisions in this correction document are
effective as if they were included in the final rule published on
August 5, 2011. Accordingly, the corrections are effective October 1,
2011.
II. Summary of Errors
In the August 5, 2011 final rule (76 FR 47836), we applied our
established formula for calculating the relative weight values for
case-mix groups (CMG). The CMG relative weight values for CMGs 1201,
1202, 1203, 1301, 1302, and 1303 in Table 1 on pages 47842 through
47844 of the final rule did not reflect our policy that the relative
weight values for higher-paying tiers must always be greater than or
equal to the relative weight values for lower-paying tiers. That is, a
tier 1 payment for a given CMG must always be at least as high as a
tier 2 payment for that same CMG, the tier 2 payment must always be at
least as high as the tier 3 payment, and the tier 3 payment must always
be at least as high as the ``no-comorbidity'' tier payment. We have
used this policy in calculating the CMG relative weights since the
inception of the IRF PPS. However, we inadvertently did not apply this
policy correctly for CMGs 1201, 1202, 1203, 1301, 1302, and 1303 in
Table 1 on pages 47842 through 47844 of the FY 2012 IRF PPS final rule.
Further, as discussed in ``Step 4'' in the CMG relative weights
discussion, column 1, on page 47841 of the FY 2012 IRF PPS final rule,
we normalized the FY 2012 CMG relative weights to the same average CMG
relative weight values from the FY 2011 IRF PPS notice (75 FR 42836).
As this process utilized the incorrect values that had been listed for
the relative weight values for CMGs 1201, 1202, 1203, 1301, 1302, and
1303, upon correction we also needed to reapply the normalization
process to the other CMGs using the corrected relative weight values.
This process corrects the relative weight values for all CMGs so that
we are appropriately applying the policy of normalizing the FY 2012 CMG
relative weights to the same average CMG relative weight values from
the FY 2011 IRF PPS notice.
Since the FY 2012 payment rates listed in Table 11 on pages 47865
through 47866 of the final rule are based on the CMG relative weights
in Table 1 (the payment rates are equal to the CMG relative weights
multiplied by the FY 2012 Standard Payment Conversion Factor), we are
also providing corrections to Table 11 in the final rule to reflect the
corrections to the CMG relative weights in Table 1. In addition, we are
correcting the example of computing the IRF FY 2012 Federal prospective
payment in Table 12 on page 47867 of the final rule to reflect the
correction to the unadjusted Federal prospective payment rate for CMG
0110 (without comorbidities) from Table 11.
Finally, we utilized the CMG payment rates reflected in Table 11 of
the IRF PPS final rule to determine the FY 2012 outlier threshold. As
described in the final rule, the outlier threshold is to be set so that
the estimated total outlier payments in FY 2012 will equal 3 percent of
total estimated payments. Since corrections to the FY 2012 payment
rates result in slight differences in the amount of outlier payments we
estimate for FY 2012, the use of the corrected data results in an
outlier threshold for FY 2012 IRF PPS of $10,713. Therefore, we are
correcting the outlier threshold amount for FY 2012 from $10,660 to
$10,713 to ensure
[[Page 59257]]
that estimated outlier payments for FY 2012 continue to equal 3 percent
of total estimated payments.
We note that the corrections to the CMG relative weight values in
Table 1 of the FY 2012 IRF PPS final rule do not affect the average
length of stay values, which we have republished here for simplicity.
The average length of stay values are the same values that were
published correctly in Table 1 of the August 5, 2011 final rule (76 FR
47836).
As a result of the corrections to Table 1 and Table 11 of the final
rule, as well as the correction to the FY 2012 outlier threshold
amount, some of the numbers in Table 14 on page 47887 of the final rule
(the IRF Impact Table for FY 2012), also need to be corrected. We are
correcting these numbers both in Table 14 and in the preamble text that
references Table 14.
III. Waiver of Proposed Rulemaking and Delayed Effective Date
In accordance with the Administrative Procedure Act (APA) (5 U.S.C.
553(b)), we ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a rule take effect. We also ordinarily provide a 30-day
delay in the effective date of the provisions of a rule in accordance
with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive
both notice and comment procedures and the 30-day delay in effective
date if the Secretary finds, for good cause, that such procedures are
impracticable, unnecessary, or contrary to the public interest, and
incorporates a statement of the finding and the reasons into the
notice.
The corrections that are laid out in this document were
necessitated by an inadvertent error to accurately apply our stated
policies as we calculated and laid out the CMG relative weight values
in Table 1 of the FY 2012 IRF PPS final rule. As a result of those
calculation errors, corrections were needed in Tables 1, 11, 12 and 14.
Corrections were also needed as a result of these calculation errors in
the places indicated above in the preamble discussion.
Upon recognition of these calculation errors, we reviewed the
comments that were submitted in response to our FY 2012 IRF PPS
proposed rule. We found that the necessary corrections would not have
altered the substantive content of those comments.
As the corrections necessitated by the calculation errors outlined
above do not change the stated policies in the FY 2012 IRF PPS final
rule, as the policies and payment methodology expressed in the FY 2012
IRF PPS final rule (76 FR 47836) have previously been subjected to
notice and comment procedures, and as the public's comments would not
have been affected if we had published the correctly calculated data
elements, we find it unnecessary to undertake further notice and
comment procedures with respect to this correction document. Further,
the corrections made in this document will not significantly affect
anticipated overall reimbursements to IRF providers and, as such, will
only result in negligible changes to anticipated revenues and will not
necessitate any actions on the part of individual providers. Therefore,
we find good cause to waive notice and comment procedures and the 30-
day delay in the effective date for this correction document.
IV. Correction of Errors
In the August 5, 2011 FY 2012 IRF PPS final rule (76 FR 47836),
make the following corrections:
1. On pages 47842 through 47844, Table 1, ``Relative Weights and
Average Length of Stay Values for Case-Mix Groups,'' is corrected as
follows:
Table 1--Relative Weights and Average Length of Stay Values for Case-Mix Groups
----------------------------------------------------------------------------------------------------------------
Relative weight Average length of stay
CMG CMG Description (M = motor, C = -----------------------------------------------------------------------
cognitive, A = age) Tier 1 Tier 2 Tier 3 None Tier 1 Tier 2 Tier 3 None
----------------------------------------------------------------------------------------------------------------
0101... Stroke M>51.05................. 0.7671 0.7177 0.6447 0.6098 10 10 9 8
0102... Stroke M>44.45 and M<51.05 and 0.9521 0.8908 0.8002 0.7568 12 13 10 10
C>18.5.
0103... Stroke M>44.45 and M<51.05 and 1.1369 1.0637 0.9555 0.9037 14 14 12 12
C<18.5.
0104... Stroke M>38.85 and M<44.45..... 1.1812 1.1052 0.9928 0.9389 15 14 13 12
0105... Stroke M>34.25 and M<38.85..... 1.3725 1.2841 1.1535 1.0910 16 17 14 14
0106... Stroke M>30.05 and M<34.25..... 1.5805 1.4788 1.3284 1.2564 20 18 16 16
0107... Stroke M>26.15 and M<30.05..... 1.7895 1.6743 1.5040 1.4225 20 20 18 18
0108... Stroke M<26.15 and A>84.5...... 2.2165 2.0738 1.8629 1.7619 31 25 23 22
0109... Stroke M>22.35 and M<26.15 and 2.0496 1.9177 1.7226 1.6292 24 23 20 20
A<84.5.
0110... Stroke M<22.35 and A<84.5...... 2.6418 2.4717 2.2203 2.1000 33 29 26 25
0201... Traumatic brain injury M>53.35 0.7466 0.6128 0.5677 0.5154 8 8 7 8
and C>23.5.
0202... Traumatic brain injury M>44.25 1.0607 0.8707 0.8065 0.7323 12 12 10 10
and M<53.35 and C>23.5.
0203... Traumatic brain injury M>44.25 1.2074 0.9911 0.9181 0.8336 16 11 13 12
and C<23.5.
0204... Traumatic brain injury M>40.65 1.2649 1.0383 0.9618 0.8733 16 12 12 12
and M<44.25.
0205... Traumatic brain injury M>28.75 1.5974 1.3113 1.2146 1.1029 17 18 15 14
and M<40.65.
0206... Traumatic brain injury M>22.05 1.9887 1.6325 1.5122 1.3731 23 19 19 18
and M<28.75.
0207... Traumatic brain injury M<22.05. 2.6902 2.2084 2.0455 1.8574 35 27 25 22
0301... Non-traumatic brain injury 1.0568 0.9507 0.8434 0.7725 12 12 11 10
M>41.05.
0302... Non-traumatic brain injury 1.3383 1.2039 1.0681 0.9782 12 15 13 13
M>35.05 and M<41.05.
0303... Non-traumatic brain injury 1.5912 1.4315 1.2699 1.1631 21 17 15 14
M>26.15 and M<35.05.
0304... Non-traumatic brain injury 2.2032 1.9820 1.7583 1.6104 29 23 20 19
M<26.15.
0401... Traumatic spinal cord injury 1.0564 0.8795 0.8001 0.7020 14 14 11 10
M>48.45.
0402... Traumatic spinal cord injury 1.3772 1.1465 1.0430 0.9151 17 14 13 12
M>30.35 and M<48.45.
0403... Traumatic spinal cord injury 2.4588 2.0470 1.8622 1.6339 29 26 23 20
M>16.05 and M<30.35.
0404... Traumatic spinal cord injury 4.3666 3.6353 3.3070 2.9016 52 39 38 35
M<16.05 and A>63.5.
0405... Traumatic spinal cord injury 3.8573 3.2113 2.9213 2.5632 52 39 36 29
M<16.05 and A<63.5.
0501... Non-traumatic spinal cord 0.6555 0.6294 0.5613 0.4975 10 10 7 7
injury M>51.35.
0502... Non-traumatic spinal cord 0.9809 0.9418 0.8399 0.7444 13 13 11 10
injury M>40.15 and M<51.35.
0503... Non-traumatic spinal cord 1.2453 1.1956 1.0663 0.9450 16 14 13 12
injury M>31.25 and M<40.15.
0504... Non-traumatic spinal cord 1.5015 1.4416 1.2856 1.1394 18 16 16 14
injury M>29.25 and M<31.25.
0505... Non-traumatic spinal cord 1.7549 1.6848 1.5026 1.3317 20 21 18 17
injury M>23.75 and M<29.25.
0506... Non-traumatic spinal cord 2.4598 2.3616 2.1062 1.8667 34 28 24 23
injury M<23.75.
0601... Neurological M>47.75........... 0.9452 0.7987 0.7286 0.6586 10 11 9 9
[[Page 59258]]
0602... Neurological M>37.35 and 1.2511 1.0572 0.9644 0.8717 12 13 12 11
M<47.75.
0603... Neurological M>25.85 and 1.6157 1.3654 1.2455 1.1258 17 16 14 14
M<37.35.
0604... Neurological M<25.85........... 2.1425 1.8106 1.6515 1.4929 24 21 19 18
0701... Fracture of lower extremity 0.7996 0.7871 0.7581 0.6767 10 12 10 9
M>42.15.
0702... Fracture of lower extremity 1.0462 1.0299 0.9919 0.8854 12 13 12 12
M>34.15 and M<42.15.
0703... Fracture of lower extremity 1.2589 1.2393 1.1937 1.0654 15 15 14 14
M>28.15 and M<34.15.
0704... Fracture of lower extremity 1.6270 1.6017 1.5426 1.3769 18 19 18 17
M<28.15.
0801... Replacement of lower extremity 0.5777 0.5777 0.5383 0.4915 7 8 7 7
joint M>49.55.
0802... Replacement of lower extremity 0.7792 0.7792 0.7262 0.6630 8 11 9 9
joint M>37.05 and M<49.55.
0803... Replacement of lower extremity 1.0718 1.0718 0.9988 0.9119 11 14 13 12
joint M>28.65 and M<37.05 and
A>83.5.
0804... Replacement of lower extremity 0.9510 0.9510 0.8863 0.8092 10 12 11 10
joint M>28.65 and M<37.05 and
A<83.5.
0805... Replacement of lower extremity 1.1734 1.1734 1.0936 0.9984 11 14 13 13
joint M>22.05 and M<28.65.
0806... Replacement of lower extremity 1.4368 1.4368 1.3390 1.2225 13 18 16 15
joint M<22.05.
0901... Other orthopedic M>44.75....... 0.8460 0.7455 0.6746 0.6112 10 10 9 8
0902... Other orthopedic M>34.35 and 1.1316 0.9971 0.9023 0.8175 12 13 12 11
M<44.75.
0903... Other orthopedic M>24.15 and 1.4493 1.2770 1.1556 1.0470 16 16 14 13
M<34.35.
0904... Other orthopedic M<24.15....... 1.8779 1.6547 1.4973 1.3566 21 20 18 17
1001... Amputation, lower extremity 1.0321 0.9074 0.8107 0.7246 13 12 10 10
M>47.65.
1002... Amputation, lower extremity 1.3551 1.1914 1.0645 0.9514 16 14 13 12
M>36.25 and M<47.65.
1003... Amputation, lower extremity 2.0018 1.7600 1.5725 1.4055 21 21 18 17
M<36.25.
1101... Amputation, non-lower extremity 1.0375 1.0375 0.9841 0.9236 11 11 12 11
M>36.35.
1102... Amputation, non-lower extremity 1.5611 1.5611 1.4808 1.3897 14 18 16 16
M<36.35.
1201... Osteoarthritis M>37.65......... 0.8554 0.8554 0.8088 0.7645 13 13 11 10
1202... Osteoarthritis M>30.75 and 1.1152 1.1152 1.0544 0.9966 16 16 14 13
M<37.65.
1203... Osteoarthritis M<30.75......... 1.3737 1.3737 1.2989 1.2277 13 19 15 15
1301... Rheumatoid, other arthritis 0.8929 0.8929 0.8833 0.7875 11 10 11 10
M>36.35.
1302... Rheumatoid, other arthritis 1.1759 1.1759 1.1632 1.0370 17 17 14 13
M>26.15 and M<36.35.
1303... Rheumatoid, other arthritis 1.5198 1.5198 1.5035 1.3403 15 19 18 16
M<26.15.
1401... Cardiac M>48.85................ 0.9405 0.7530 0.6659 0.6022 10 10 9 8
1402... Cardiac M>38.55 and M<48.85.... 1.2630 1.0112 0.8941 0.8087 13 12 11 10
1403... Cardiac M>31.15 and M<38.55.... 1.5254 1.2213 1.0799 0.9767 18 14 13 12
1404... Cardiac M<31.15................ 1.9757 1.5818 1.3987 1.2651 24 19 16 15
1501... Pulmonary M>49.25.............. 0.9606 0.8970 0.7731 0.7308 10 11 8 9
1502... Pulmonary M>39.05 and M<49.25.. 1.2091 1.1290 0.9732 0.9198 13 13 11 11
1503... Pulmonary M>29.15 and M<39.05.. 1.4911 1.3923 1.2001 1.1343 16 16 13 13
1504... Pulmonary M<29.15.............. 1.8836 1.7589 1.5160 1.4330 22 18 17 16
1601... Pain syndrome M>37.15.......... 1.1167 0.8790 0.7713 0.7211 12 12 10 10
1602... Pain syndrome M>26.75 and 1.4957 1.1773 1.0331 0.9658 19 13 13 13
M<37.15.
1603... Pain syndrome M<26.75.......... 1.9322 1.5210 1.3347 1.2477 22 18 16 15
1701... Major multiple trauma without 1.0424 0.9277 0.8419 0.7360 10 11 11 10
brain or spinal cord injury
M>39.25.
1702... Major multiple trauma without 1.3755 1.2242 1.1110 0.9712 13 15 14 13
brain or spinal cord injury
M>31.05 and M<39.25.
1703... Major multiple trauma without 1.6223 1.4439 1.3104 1.1455 15 16 15 15
brain or spinal cord injury
M>25.55 and M<31.05.
1704... Major multiple trauma without 2.0766 1.8482 1.6773 1.4663 26 22 20 18
brain or spinal cord injury
M<25.55.
1801... Major multiple trauma with 1.1991 0.9837 0.9497 0.8687 14 15 12 11
brain or spinal cord injury
M>40.85.
1802... Major multiple trauma with 1.6464 1.3507 1.3040 1.1927 18 20 15 15
brain or spinal cord injury
M>23.05 and M<40.85.
1803... Major multiple trauma with 2.8188 2.3124 2.2325 2.0420 34 32 26 24
brain or spinal cord injury
M<23.05.
1901... Guillian Barre M>35.95......... 1.1440 1.0078 0.9143 0.8879 13 14 12 12
1902... Guillian Barre M>18.05 and 2.1760 1.9170 1.7390 1.6888 22 22 21 21
M<35.95.
1903... Guillian Barre M<18.05......... 3.6334 3.2009 2.9037 2.8199 48 29 34 32
2001... Miscellaneous M>49.15.......... 0.8533 0.7540 0.6760 0.6073 9 10 9 8
2002... Miscellaneous M>38.75 and 1.1420 1.0091 0.9047 0.8128 12 12 11 10
M<49.15.
2003... Miscellaneous M>27.85 and 1.4421 1.2742 1.1425 1.0264 15 15 13 13
M<38.75.
2004... Miscellaneous M<27.85.......... 1.9337 1.7086 1.5319 1.3763 24 20 18 16
2101... Burns M>0...................... 2.4686 2.1368 1.7017 1.3793 34 23 19 18
5001... Short-stay cases, length of ....... ....... ....... 0.1474 ....... ....... ....... 3
stay is 3 days or fewer.
5101... Expired, orthopedic, length of ....... ....... ....... 0.5851 ....... ....... ....... 7
stay is 13 days or fewer.
5102... Expired, orthopedic, length of ....... ....... ....... 1.4705 ....... ....... ....... 18
stay is 14 days or more.
5103... Expired, not orthopedic, length ....... ....... ....... 0.6965 ....... ....... ....... 8
of stay is 15 days or fewer.
[[Page 59259]]
5104... Expired, not orthopedic, length ....... ....... ....... 1.8764 ....... ....... ....... 23
of stay is 16 days or more.
----------------------------------------------------------------------------------------------------------------
2. On pages 47865 through 47866, Table 11, ``FY 2012 Payment
Rates,'' is corrected as follows:
Table 11--FY 2012 Payment Rates
----------------------------------------------------------------------------------------------------------------
Payment rate Payment rate Payment rate Payment rate no
CMG tier 1 tier 2 tier 3 comorbidity
----------------------------------------------------------------------------------------------------------------
0101.................................... $10,797.70 $10,102.35 $9,074.80 $8,583.54
0102.................................... 13,401.76 12,538.90 11,263.62 10,652.72
0103.................................... 16,003.00 14,972.64 13,449.62 12,720.48
0104.................................... 16,626.57 15,556.80 13,974.65 13,215.96
0105.................................... 19,319.31 18,074.99 16,236.67 15,356.92
0106.................................... 22,247.12 20,815.59 18,698.56 17,685.09
0107.................................... 25,189.00 23,567.45 21,170.30 20,023.11
0108.................................... 31,199.45 29,190.81 26,222.18 24,800.50
0109.................................... 28,850.17 26,993.55 24,247.32 22,932.62
0110.................................... 37,185.98 34,791.65 31,252.94 29,559.60
0201.................................... 10,509.14 8,625.77 7,990.95 7,254.77
0202.................................... 14,930.41 12,255.97 11,352.29 10,307.85
0203.................................... 16,995.36 13,950.72 12,923.18 11,733.75
0204.................................... 17,804.73 14,615.11 13,538.30 12,292.57
0205.................................... 22,485.00 18,457.86 17,096.71 15,524.42
0206.................................... 27,992.94 22,979.07 21,285.73 19,327.76
0207.................................... 37,867.26 31,085.44 28,792.46 26,144.76
0301.................................... 14,875.52 13,382.05 11,871.70 10,873.71
0302.................................... 18,837.91 16,946.10 15,034.58 13,769.14
0303.................................... 22,397.73 20,149.79 17,875.11 16,371.80
0304.................................... 31,012.24 27,898.63 24,749.83 22,667.99
0401.................................... 14,869.89 12,379.84 11,262.21 9,881.35
0402.................................... 19,385.47 16,138.13 14,681.27 12,880.95
0403.................................... 34,610.07 28,813.57 26,212.33 22,998.78
0404.................................... 61,464.26 51,170.48 46,549.33 40,842.92
0405.................................... 54,295.35 45,202.26 41,120.22 36,079.60
0501.................................... 9,226.82 8,859.43 7,900.86 7,002.81
0502.................................... 13,807.15 13,256.78 11,822.43 10,478.17
0503.................................... 17,528.84 16,829.27 15,009.24 13,301.82
0504.................................... 21,135.11 20,291.96 18,096.11 16,038.19
0505.................................... 24,701.97 23,715.24 21,150.60 18,745.01
0506.................................... 34,624.14 33,241.88 29,646.87 26,275.67
0601.................................... 13,304.64 11,242.50 10,255.77 9,270.45
0602.................................... 17,610.48 14,881.15 13,574.89 12,270.05
0603.................................... 22,742.59 19,219.37 17,531.66 15,846.76
0604.................................... 30,157.83 25,486.01 23,246.51 21,014.06
0701.................................... 11,255.17 11,079.22 10,671.02 9,525.23
0702.................................... 14,726.31 14,496.87 13,961.98 12,462.89
0703.................................... 17,720.28 17,444.39 16,802.52 14,996.57
0704.................................... 22,901.65 22,545.53 21,713.64 19,381.24
0801.................................... 8,131.71 8,131.71 7,577.11 6,918.35
0802.................................... 10,968.02 10,968.02 10,221.99 9,332.39
0803.................................... 15,086.66 15,086.66 14,059.11 12,835.90
0804.................................... 13,386.28 13,386.28 12,475.56 11,390.30
0805.................................... 16,516.78 16,516.78 15,393.51 14,053.48
0806.................................... 20,224.40 20,224.40 18,847.76 17,207.91
0901.................................... 11,908.30 10,493.66 9,495.67 8,603.25
0902.................................... 15,928.40 14,035.18 12,700.77 11,507.13
0903.................................... 20,400.35 17,975.05 16,266.23 14,737.57
0904.................................... 26,433.32 23,291.56 21,075.99 19,095.50
1001.................................... 14,527.84 12,772.56 11,411.41 10,199.47
1002.................................... 19,074.39 16,770.15 14,983.90 13,391.91
1003.................................... 28,177.34 24,773.76 22,134.51 19,783.82
1101.................................... 14,603.85 14,603.85 13,852.19 13,000.59
1102.................................... 21,974.04 21,974.04 20,843.74 19,561.42
1201.................................... 12,040.61 12,040.61 11,384.67 10,761.10
1202.................................... 15,697.56 15,697.56 14,841.73 14,028.14
[[Page 59260]]
1203.................................... 19,336.20 19,336.20 18,283.32 17,281.11
1301.................................... 12,568.46 12,568.46 12,433.33 11,084.85
1302.................................... 16,551.97 16,551.97 16,373.20 14,596.81
1303.................................... 21,392.70 21,392.70 21,163.27 18,866.06
1401.................................... 13,238.48 10,599.23 9,373.21 8,476.57
1402.................................... 17,777.99 14,233.65 12,585.35 11,383.26
1403.................................... 21,471.53 17,191.02 15,200.67 13,748.03
1404.................................... 27,809.95 22,265.42 19,688.10 17,807.55
1501.................................... 13,521.41 12,626.17 10,882.16 10,286.74
1502.................................... 17,019.29 15,891.80 13,698.76 12,947.10
1503.................................... 20,988.72 19,598.01 16,892.61 15,966.41
1504.................................... 26,513.55 24,758.28 21,339.22 20,170.91
1601.................................... 15,718.67 12,372.80 10,856.82 10,150.20
1602.................................... 21,053.47 16,571.67 14,541.92 13,594.60
1603.................................... 27,197.65 21,409.60 18,787.24 17,562.63
1701.................................... 14,672.82 13,058.31 11,850.58 10,359.94
1702.................................... 19,361.54 17,231.84 15,638.44 13,670.61
1703.................................... 22,835.49 20,324.34 18,445.19 16,124.06
1704.................................... 29,230.22 26,015.26 23,609.67 20,639.64
1801.................................... 16,878.53 13,846.56 13,367.98 12,227.82
1802.................................... 23,174.73 19,012.45 18,355.10 16,788.45
1803.................................... 39,677.43 32,549.34 31,424.67 28,743.19
1901.................................... 16,102.94 14,185.79 12,869.69 12,498.08
1902.................................... 30,629.38 26,983.69 24,478.16 23,771.55
1903.................................... 51,143.74 45,055.87 40,872.48 39,692.91
2001.................................... 12,011.05 10,613.30 9,515.38 8,548.35
2002.................................... 16,074.79 14,204.09 12,734.56 11,440.97
2003.................................... 20,299.00 17,935.64 16,081.83 14,447.61
2004.................................... 27,218.76 24,050.25 21,563.02 19,372.80
2101.................................... 34,748.01 30,077.60 23,953.13 19,415.03
5001.................................... ................ ................ ................ 2,074.80
5101.................................... ................ ................ ................ 8,235.87
5102.................................... ................ ................ ................ 20,698.76
5103.................................... ................ ................ ................ 9,803.93
5104.................................... ................ ................ ................ 26,412.21
----------------------------------------------------------------------------------------------------------------
3. On page 47867:
a. In table 12, ``Example of Computing the IRF FY 2012 Federal
Prospective Payment,'' correct the entire table to read as follows:
Table 12--Example of Computing the IRF PPS FY 2012 Federal Prospective Payment
----------------------------------------------------------------------------------------------------------------
Rural Facility Urban Facility
Steps A (Spencer B (Harrison
Co., IN) Co., IN)
----------------------------------------------------------------------------------------------------------------
1........................... Unadjusted Federal Prospective Payment.......... 29,559.60 29,559.60
2........................... Labor Share..................................... 0.70199 0.70199
3........................... Labor Portion of Federal Payment................ $20,750.54 $20,750.54
4........................... CBSA Based Wage Index (shown in the Addendum , 0.8391 0.8896
Tables 1 and 2).
5........................... Wage-Adjusted Amount............................ $17,411.78 $18,459.68
6........................... Nonlabor Amount................................. $8,809.06 $8,809.06
7........................... Wage-Adjusted Federal Payment................... $26,220.84 $27,268.74
8........................... Rural Adjustment................................ 1.184 1.0000
9........................... Wage- and Rural-Adjusted Federal Payment........ $31,045.47 $27,268.74
10.......................... LIP Adjustment.................................. 1.0228 1.0666
11.......................... FY 2012 Wage-, Rural- and LIP-Adjusted Federal $31,753.31 $29,084.84
Prospective Payment Rate.
12.......................... FY 2012 Wage- and Rural-Adjusted Federal $31,045.47 $27,268.74
Prospective Payment.
13.......................... Teaching Status Adjustment...................... 0.0000 0.0610
14.......................... Teaching Status Adjustment Amount............... $0.00 $1,663.39
15.......................... FY2012 Wage-, Rural-, and LIP-Adjusted Federal $31,753.31 $29,084.84
Prospective Payment Rate.
16.......................... Total FY 2012 Adjusted Federal Prospective $31,753.31 $30,748.23
Payment.
----------------------------------------------------------------------------------------------------------------
b. In the 1st column, the 4th paragraph, in line 2, the amount
``$31,771.45'' is corrected to read ``$31,753.31.''
c. In the 1st column, the 2nd paragraph, in line 4, the amount
[[Page 59261]]
``$30,765.80'' is corrected to read ``$30,748.23.''
4. On page 47868, in the 3rd column, in the 1st full paragraph, in
line 6, the amount ``$10,660'' is corrected to read ``$10,713.''
5. On page 47887, Table 14, ``IRF Impact Table for FY 2012,'' is
corrected as follows:
[[Page 59262]]
Table 14--IRF Impact Table for FY 2012
--------------------------------------------------------------------------------------------------------------------------------------------------------
FY 2012
adjusted FY 2012 CBSA
Facility classification Number of IRFs Number of Outlier market basket wage index CMG Total percent
cases increase and labor- change
factor \1\ share
(1) (2) (3) (4) (5) (6) (7) (8)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total................................... 1,152 397,388 0.4% 1.8% 0.0% 0.0% 2.2%
Urban unit.............................. 752 200,587 0.6 1.8 -0.1 0.0 2.3
Rural unit.............................. 175 27,997 0.5 1.8 0.8 0.1 3.2
Urban hospital.......................... 205 162,171 0.2 1.8 0.0 0.0 1.9
Rural hospital.......................... 20 6,633 0.2 1.8 1.6 -0.1 3.5
Urban For-Profit........................ 317 151,821 0.2 1.8 0.1 -0.1 2.1
Rural For-Profit........................ 63 12,437 0.4 1.8 1.1 0.1 3.4
Urban Non-Profit........................ 596 199,313 0.5 1.8 -0.3 0.0 2.1
Rural Non-Profit........................ 122 20,442 0.5 1.8 0.7 0.1 3.1
Urban Government........................ 44 11,624 0.7 1.8 0.2 0.0 2.8
Rural Government........................ 10 1,751 0.9 1.8 1.3 0.1 4.1
Urban................................... 957 362,758 0.4 1.8 -0.1 0.0 2.1
Rural................................... 195 34,630 0.5 1.8 0.9 0.1 3.2
Urban by region: \2\
Urban New England................... 32 16,393 0.4 1.8 -1.2 0.0 1.0
Urban Middle Atlantic............... 142 66,363 0.3 1.8 -0.7 0.0 1.4
Urban South Atlantic................ 132 63,793 0.4 1.8 0.0 0.0 2.2
Urban East North Central............ 188 57,269 0.5 1.8 0.0 0.0 2.4
Urban East South Central............ 49 26,375 0.2 1.8 0.4 -0.1 2.2
Urban West North Central............ 73 18,118 0.6 1.8 0.0 0.0 2.3
Urban West South Central............ 169 66,313 0.4 1.8 0.5 0.0 2.7
Urban Mountain...................... 70 23,834 0.4 1.8 0.2 -0.1 2.3
Urban Pacific....................... 102 24,300 0.7 1.8 -0.3 0.0 2.2
Rural by region: \2\
Rural New England................... 6 1,354 1.0 1.9 0.7 0.1 3.7
Rural Middle Atlantic............... 16 3,232 0.2 1.8 1.8 0.1 4.0
Rural South Atlantic................ 25 5,988 0.3 1.8 0.8 0.0 2.9
Rural East North Central............ 33 5,776 0.4 1.8 0.1 0.1 2.4
Rural East South Central............ 23 4,017 0.2 1.8 1.4 0.0 3.4
Rural West North Central............ 31 3,945 0.7 1.8 -0.2 0.1 2.5
Rural West South Central............ 50 9,261 0.5 1.8 1.6 0.1 4.0
Rural Mountain...................... 7 670 0.6 1.8 0.3 0.2 2.9
Rural Pacific....................... 4 387 1.4 1.8 -0.4 -0.1 2.7
Teaching status:
Non-teaching........................ 1,036 345,500 0.4 1.8 0.1 0.0 2.3
Resident to ADC less than 10%....... 69 36,878 0.5 1.8 -0.4 0.0 2.0
Resident to ADC 10%-19%............. 33 12,497 0.6 1.8 -0.3 0.1 2.2
Resident to ADC greater than 19%.... 14 2,513 0.7 1.8 -0.7 -0.1 1.8
Disproportionate Share Patient
Percentage (DSH):
DSH = 0%............................ 39 10,534 0.4 1.8 0.4 0.0 2.7
DSH <5%............................. 208 62,434 0.4 1.8 -0.2 0.0 2.0
DSH 5%-10%.......................... 342 134,694 0.3 1.8 0.0 0.0 2.2
DSH 10%-20%......................... 330 123,398 0.4 1.8 0.0 0.0 2.2
DSH >20%............................ 233 66,328 0.5 1.8 0.0 0.0 2.3
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ This column reflects the impact of the rebased RPL market basket increase factor for FY 2012 of 1.8 percent, which includes a market basket update
of 2.9 percent, a 0.1 percentage point reduction in accordance with sections 1886(j)(3)(C)(ii)(II) and 1886(j)(3)(D)(ii) of the Act and a 1.0 percent
reduction for the productivity adjustment as required by section 1886(j)(3)(C)(ii)(I) of the Act, as finalized in 76 FR 47860.
\2\ A map of States that comprise the 9 geographic regions can be found at: https://www.census.gov/geo/www/us_regdiv.pdf.
[[Page 59263]]
6. On page 47888:
a. In the 1st column, in the 1st full paragraph, in line 18, the
amount ``$10,660'' is corrected to read ``$10,713.''
b. In the 1st column, in the 2nd full paragraph, in line 9, the
value ``1.5'' is corrected to read ``1.4.''
c. In the 2nd column, the 2nd full paragraph, lines 9 through 14,
the sentence: ``The largest decrease in payments as a result of these
updates is a 0.1 percent decrease to rural freestanding IRFs, urban
IRFs in the East South Central and Mountain regions, and rural IRFs in
the Pacific region.'' is corrected to read, ``The largest decrease in
payments as a result of these updates is a 0.1 percent decrease to
rural IRF hospitals, urban for-profit IRFs, urban IRFs in the East
South Central and Mountain regions, rural IRFs in the Pacific region,
and teaching IRFs with resident to ADC ratios greater than 19
percent.''
7. On page 47890, in the 1st column, the 2nd full paragraph, lines
1 through 4, the sentence, ``Overall the largest payment increase is
estimated at 4.1 percent for rural government-owned IRFs and rural IRFs
in the West South Central region.'' is corrected to read, ``Overall,
the largest payment increases are estimated at 4.1 percent for rural
government-owned IRFs, and 4.0 percent for rural IRFs in the Middle
Atlantic and West South Central regions.''
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: September 19, 2011.
Barbara J. Holland,
Deputy Executive Secretary to the Department.
[FR Doc. 2011-24671 Filed 9-23-11; 8:45 am]
BILLING CODE 4120-01-P
