Justia Department Of Health And Human Services Centers For Medicare & Medicaid Services Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections, 34326-34331 [2012-14159]

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections, 34326-34331 [2012-14159]

Download as PDF 34326 Federal Register / Vol. 77, No. 112 / Monday, June 11, 2012 / Proposed Rules III. General Solicitation of Comment EPA encourages public participation in this rulemaking and requests comments on this notice of data availability supporting the proposed rule for cooling water intake structures. EPA invites all parties to coordinate their data collection activities with the Agency to facilitate mutually beneficial and cost-effective data submissions. Please refer to the FOR FURTHER INFORMATION CONTACT section at the beginning of this preamble for technical contacts at EPA. To ensure that EPA can properly respond to comments, the Agency prefers that commenters cite, where possible, the paragraph(s) or sections in the document or supporting documents to which each comment refers. Please submit copies of your comments and enclosures (including references) as specified in the ADDRESSES section at the beginning of this preamble. Dated: May 31, 2012. Nancy K. Stoner, Acting Assistant Administrator, Office of Water. [FR Doc. 2012–14153 Filed 6–11–12; 8:45 am] BILLING CODE 6560–50–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 412, 413, 424, 476, and 489 [CMS–1588–CN] RIN 0938–AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the LongTerm Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals’ Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers; Corrections Centers for Medicare and Medicaid Services (CMS), HHS. ACTION: Proposed rule, correction. mstockstill on DSK4VPTVN1PROD with PROPOSALS AGENCY: This document corrects technical and typographical errors in the proposed rule that appeared in the May 11, 2012 Federal Register entitled ‘‘Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System SUMMARY: VerDate Mar<15>2010 18:06 Jun 08, 2012 Jkt 226001 and Fiscal Year 2013 Rates; Hospitals’ Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers.’’ FOR FURTHER INFORMATION CONTACT: Tzvi Hefter, (410) 786–4487. SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 2012–9985 of May 11, 2012 (77 FR 27870), there were a number of technical errors that are identified and corrected in the Correction of Errors section of this correcting document. II. Summary of Errors A. Errors in the Preamble On pages 27871 and 27872, we inadvertently omitted a number of acronyms from the list of acronyms. On page 27938, in our discussion of the fiscal year (FY) 2013 applications for new technology add-on payments, we made typographical errors regarding the drug combination administered during the treatment of methotrexate (MTX)induced renal dysfunction. On page 28021, we inadvertently cited the incorrect timeframe for when certain long-term care hospitals (LTCHs) and LTCH satellite facilities must comply with § 412.534 and § 412.536. We also cited the incorrect timeframe for when those LTCHs and LTCH satellite facilities would be under the proposed moratorium on the 25-percent adjustment threshold policy. On page 28036, we made several typographical errors in our discussion of commenters’ beliefs regarding the hospital inpatient quality reporting program (HIQR) and five Agency for Healthcare Research and Quality (AHRQ) measures. On page 28039, in our discussion of the HIQR proposed new claims-based measure for the FY 2015 payment determination for hip/knee complication, we inadvertently repeated a sentence. On page 28041, in our discussion of the HIQR proposed new claims-based measure for the FY 2015 payment determination for hip/knee readmission, we made a typographical error in a section heading. On page 28072, in our discussion of the total amount available for valuebased incentive payments under the Hospital VBP Program for a fiscal year, we inadvertently included estimated reductions to the base operating DRG payment amounts for Maryland hospitals in the calculation of the total estimate for FY 2013. PO 00000 Frm 00064 Fmt 4702 Sfmt 4702 On pages 28085 and 28086, in our discussion of the proposed performance standards for the Hospital Value-Based Purchasing (VBP) Program, we inadvertently omitted data from the table entitled ‘‘Proposed Performance Standards for the FY 2015 Hospital VBP Program Clinical Process of Care and Outcome Domains, and the Medicare Spending per Beneficiary Measure.’’ On pages 28107, 28108, and 28127 in our discussion of the Inpatient Psychiatric Facilities Quality Reporting Program (IPFQR), we made technical errors in our description of the IPF facility enrollment. B. Errors in the Addendum On page 28143, we made errors in our discussion of the proposed outlier fixedloss cost threshold for FY 2013. On pages 28144, 28148, 28149, 28150, 28151, 28159, and 28178, we made technical and typographical errors in our discussion of the proposed outlier adjustment factors which affected the proposed FY 2013 Puerto Rico (specific) operating standardized amount and capital Federal rates (national and Puerto Rico). Specifically, we inadvertently applied the incorrect adjustment factors to the operating and capital cost-to-charge ratios (CCRs) from the Provider-Specific File (PSF) when performing the calculation of the FY 2013 outlier fixed-loss cost threshold for the proposed rule. The correction of this error resulted in a decrease in the proposed outlier fixed-loss cost threshold of approximately $1,000. Under our established methodology for calculating the outlier fixed-loss cost threshold, which we have proposed to continue to use for FY 2013, the corrected proposed outlier fixed-loss cost threshold continues to result in operating outlier payments being projected to be 5.1 percent of total operating payments. However, a decrease in the proposed outlier threshold results in an increase of the Puerto Rico (specific) operating outlier payments and capital (national and Puerto Rico) outlier payments. This is because a lower outlier threshold allows more cases to qualify as outlier cases and results in higher outlier payments to such cases. Because outlier payments are budget neutral, a larger reduction (that is, an increase in the outlier offsets) to the Puerto Rico and capital (national and Puerto Rico) rates is necessary. Therefore, the application of the corrected Puerto Rico and capital outlier offsets (national and Puerto Rico) lowers the proposed FY 2013 Puerto Rico (specific) operating standardized amount and capital Federal rates (national and Puerto Rico). E:\FR\FM\11JNP1.SGM 11JNP1 Federal Register / Vol. 77, No. 112 / Monday, June 11, 2012 / Proposed Rules On page 28189, in the impact analysis section for the inpatient Psychiatric Facilities Quality Reporting Program (IPFQR), we made technical errors in describing the IPF facility enrollment. C. Summary of Errors in and Corrections to Tables Posted on the CMS Web site On page 28158, we list Table 16, Proposed Hospital Inpatient ValueBased Purchasing (VBP) Program Adjustment Factors for FY 2013, as a table that will be available only through the Internet on the CMS Web site. The version of Table 16 that was posted via the Internet on the CMS Web site at the time the proposed rule was filed for public inspection at the Office of the Federal Register inadvertently included estimated reductions to the base operating DRG payment amounts for Maryland hospitals in the calculation of the proposed FY 2013 Hospital VBP Program adjustment factors. We have corrected these errors and will post the corrected Table 16 on the CMS Web site at https:// www.cms.hhs.gov/AcuteInpatientPPS/ 01_overview.asp. III. Correction of Errors In FR Doc. 2012–9985 of May 11, 2012 (77 FR 27870), make the following corrections: A. Corrections of Errors in the Preamble 1. On pages 27871 and 27872, second and third and first and second columns, respectively (Acronyms list), are corrected by adding the following acronyms in alphabetical order: ACoS American College of Surgeons’ AJCC American Joint Commission on Cancer ASCO American Society of Clinical Oncology CAUTI Catheter-Associated Urinary Tract Infection CLABSI Central Line-Associated Bloodstream Infection CEO Chief Executive Officer CCN CMS Certificate Number CFR Code of Federal Regulations CoC Commission on Cancer DACA Data Accuracy and Completeness Acknowledgement ESRD End-Stage Renal Disease FR Federal Register HAI Healthcare-Associated Infection HBIPS Hospital-Based Inpatient Psychiatric Services HICPAC Healthcare Infection Control Practices Advisory Committee ICU Intensive Care Unit IPFQR Inpatient Psychiatric Facilities Quality Reporting Program MAP Measure Application Partnership NCCN National Comprehensive Cancer Network NOP Notice of Participation OQR Outpatient Quality Reporting QAPI Quality Assessment and Performance Improvement QIP Quality Incentive Program Q Quarter TJC The Joint Commission UTI Urinary Tract Infection VTE Venous Thromboembolism 2. On page 27938, in the third column, a. First partial paragraph— (1). Line 5 the term ‘‘Thymidine’’ is corrected to read ‘‘leucovorin’’. (2). Line 9, the term ‘‘Thymidine’’ is corrected to read ‘‘leucovorin’’. (3). Lines 13 and 14, the phrase ‘‘19 to 94 years old.’’ is corrected to read ‘‘19 to 94 years old.18a’’ b. Footnoted text, before footnote 18, the footnoted text is corrected by adding the following: 18a Green and Chamberlain, Cancer Chemotherapy and Pharmacology Volume 63, Number 4, 2009. 3. On page 28021, in the third column, first partial paragraph, lines 24 through 42, the sentences beginning with the phrase ‘‘Therefore, under our proposed policy’’ and ending with the phrase ‘‘proposed extension of the moratorium’’ are corrected to read ‘‘Therefore, under our proposed policy, there will be a period during which some of the above-described LTCHs and LTCH satellite facilities must comply with §§ 412.534 and 412.536 before becoming subject to the moratoria again. 34327 The above-described LTCHs and LTCH satellite facilities with a cost reporting period beginning on or after July 1, 2012, and before October 1, 2012 would comply with §§ 412.534 and 412.536 for discharges occurring in that respective cost reporting period. Then, those same LTCHs and LTCH satellite facilities would be subject to the proposed moratorium for discharges occurring in their first cost reporting period beginning on or after July 1, 2013 and before October 1, 2013.’’ 4. On page 28036, lower half of the page, first column, first paragraph, lines 7 through 8, the phrase ‘‘some commenters still believed that’’ is corrected to read ‘‘we recognize some commenters believe that’’. 5. On page 28039, second column, third paragraph, lines 8 through 12, the sentence ‘‘Annual hospital charges are projected to increase by 340 percent to $17.4 billion for THA and by 450 percent to $40.8 billion for TKA by 2015’’ is corrected by deleting the sentence. 6. On page 28041, first column, second full paragraph, line 9, the heading that begins with the phrase ‘‘(ii) Hip/Knee Readmission:’’ is corrected by moving the phrase to line 10. 7. On page 28072, second column, first full paragraph, line 8, the figure ‘‘$956 million’’ is corrected to read ‘‘$917 million’’. 8. On pages 28085 through 28086, lower third of the page, the table entitled Proposed Performance Standards for the FY 2015 Hospital VBP Program Clinical Process of Care and Outcome Domains, and the Medicare Spending per Beneficiary Measure’’ is corrected as follows: Proposed Performance Standards for the FY 2015 Hospital VBP Program Clinical Process of Care and Outcome Domains, and the Medicare Spending per Beneficiary Measure a. Revising the following entry: CLINICAL PROCESS OF CARE MEASURES Description Achievement threshold Benchmark AMI–10 ...................................... mstockstill on DSK4VPTVN1PROD with PROPOSALS Measure ID Statin Prescribed at Discharge .............................................................................. 0.90474 1.00000 b. Adding the following entry after line 3 (Measure ID, AMI–10): VerDate Mar<15>2010 18:06 Jun 08, 2012 Jkt 226001 PO 00000 Frm 00065 Fmt 4702 Sfmt 4702 E:\FR\FM\11JNP1.SGM 11JNP1 34328 Federal Register / Vol. 77, No. 112 / Monday, June 11, 2012 / Proposed Rules CLINICAL PROCESS OF CARE MEASURES Measure ID Description Achievement threshold Benchmark HF–1 .......................................... Discharge Instructions ........................................................................................... 0.92090 1.00000 9. On page 28107, third column, footnoted text (footnote 198), line 1, the phrase ‘‘IPFs, 450 are’’ is corrected to read ‘‘IPFs, approximately 450 are’’. 10. On page 28108, first column, second full paragraph, line 6, the figure ‘‘1,100’’ is corrected to read ‘‘1,200’’. 11. On page 28127, first column, fifth full paragraph— a. Line 11, the figure ‘‘1,741’’ is corrected to read ‘‘estimated 1,700’’. b. Line 12, the figure ‘‘450’’ is corrected to read ‘‘approximately 450’’. c. Line 14, the figure ‘‘26.02’’ is corrected to read ‘‘approximately 26’’. B. Corrections of Errors in the Addendum 1. On page 28143, third column— a. Second full paragraph, line 6, the figure ‘‘$27,425’’ is corrected to read ‘‘$26,337’’ b. Third full paragraph, lines 2 and 3, the phrase ‘‘$5,040 (or 22.5 percent)’’ is corrected to read ‘‘$3,952 (or 17.7 percent)’’. 2. On page 28144— a. First column, first partial paragraph, lines 12 and 13, the phrase ‘‘welcomed comment on possible modifications to our current methodologies,’’ is corrected to read ‘‘welcome comment on possible modifications to our current methodology,’’. b. First column, second full paragraph, line 13, the figure ‘‘5.99’’ is corrected to read ‘‘6.43’’ c. Second column, before the first paragraph, the untitled table is corrected to read as follows: outlier payments and fewer cases will qualify for outlier payments.’’ are corrected by deleting the sentences. e. Second full paragraph, line 6, the Operating phrase ‘‘0.9400 is 0.19 percent’’ is Capital standardcorrected to read ‘‘0.9357 is a ¥0.27 federal ized rate percent’’ amounts f. Second full paragraph, line 10, the National ............. 0.948992 0.935720 phrase ‘‘1.0019 (0.9400/0.9832) is Puerto Rico ....... 0.953062 0.920266 corrected to read ‘‘0.9973 (0.9357/ 0.9832)’’ 3. On page 28148, second column, 5. On page 28150, third column— second full paragraph, line 6, the phrase a. First partial paragraph, line 14, the ‘‘approximately 0.7 percent’’ is figure ‘‘$424.42’’ is corrected to read corrected to read ‘‘0.25 percent’’. ‘‘$422.47’’. 4. On page 28149, third column— b. Third bulleted paragraph, line 2, a. First full paragraph, line 8, the the figure ‘‘0.9400’’ is corrected to read figure ‘‘6.00’’ is corrected to read ‘‘6.43’’ ‘‘0.9357’’. b. First full paragraph, line 12, the c. Last paragraph— figure ‘‘0.9400’’ is corrected to read (1) Line 14, the term ‘‘increasing’’ is ‘‘0.9357’’ corrected to read ‘‘decreasing’’. c. First full paragraph, line 17, the (2) Line 15, the figure ‘‘0.19’’ is phrase ‘‘lower than the percentage for corrected to read ‘‘0.27’’. FY 2012.’’ is corrected to read ‘‘higher (3) Line 26, the phrase than the percentage for FY 2012.’’. ‘‘approximately 0.7 percent’’ is d. First full paragraph, lines 17 corrected to read ‘‘0.25 percent’’. through 28, the sentences ‘‘This 6. On page 28151— decrease in estimated capital outlier a. Top third of the page— payments is primarily due to the (1) In the chart entitled Comparison of proposed increase in the outlier Factors and Adjustments: FY 2012 threshold used to identify outlier cases Capital Federal Rate and Proposed FY for both inpatient operating and 2013 Capital Federal Rate, the listed inpatient capital related payments, entries are corrected as set forth below. which is discussed in section II.A. of this Addendum. That is, because the (2) Immediately following the chart, outlier threshold used to identify outlier footnote 2 is corrected and footnote 5 is cases is higher, cases will receive lower republished as set forth below. FY 2012 Outlier Adjustment Factor 2 .............................................................................................................. Capital Federal Rate 5 ...................................................................................................................... * * * * * mstockstill on DSK4VPTVN1PROD with PROPOSALS 2 The outlier reduction factor is not built permanently into the capital rate; that is, the factor is not applied cumulatively in determining the capital rate. Thus, for example, the net change resulting from the application of the FY 2013 outlier adjustment factor is 0.9357/0.9382, or 0.9973. * * * VerDate Mar<15>2010 * * 18:06 Jun 08, 2012 Jkt 226001 5 Sum of percent change may not sum due to rounding. b. Lower two-thirds of the page, second column— (1) First full paragraph, last line, the figure ‘‘$206.82’’ is corrected to read ‘‘$206.01’’. (2) Third paragraph, last line, the figure ‘‘$27,425’’ is corrected to read ‘‘26,337’’. PO 00000 Frm 00066 Fmt 4702 Sfmt 4702 Proposed FY 2013 0.9382 $421.42 0.9357 $422.47 Change 0.9973 1.0025 Percent change ¥0.27 0.25 7. On page 28159— a. Top half of the page, in Table 1C— Proposed Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor—FY 2013, the entries for Puerto Rico are corrected to read as follows: E:\FR\FM\11JNP1.SGM 11JNP1 34329 Federal Register / Vol. 77, No. 112 / Monday, June 11, 2012 / Proposed Rules TABLE 1C—PROPOSED ADJUSTED OPERATING STANDARDIZED AMOUNTS FOR PUERTO RICO, LABOR/NONLABOR— FY 2013 Rates if wage index is greater than 1 Rates if wage index is less than or equal to 1 Labor Puerto Rico ...................................................................................................................... Labor Nonlabor $1,582.93 $966.07 $1,580.38 $968.62 9. On page 28179, a. Top third of the page, (1) First column— (a) First partial paragraph— (i) Line 2, the sentence ‘‘Capital IPPS payments per case for large urban TABLE 1D—PROPOSED CAPITAL hospitals are estimated to decrease 0.1 STANDARD FEDERAL PAYMENT percent, while other urban hospitals are RATE—FY 2013 expected to experience a 0.4 percent decrease.’’ is corrected to read ‘‘Large Rate urban hospitals are not expected to National ....................................... $422.47 experience any change in capital IPPS Puerto Rico ................................. 206.01 payments per case from FY 2012 to FY 2013, while other urban hospitals are expected to experience a 0.4 percent 8. On page 28178— a. Second column, middle of the page, decrease.’’. (ii) Line 7, the phrase ‘‘not expected fourth bullet the figure ‘‘0.9400’’ is to experience any change’’ is corrected corrected to read ‘‘0.9357’’ to read ‘‘are expected to experience a 0.2 b. Third column, second full percent decrease’’. paragraph, line 6, the phrase ‘‘approximately 0.7’’ is corrected to read (b) First full paragraph— ‘‘0.25’’. (i) Line 1, the sentence ‘‘The c. Third column, third full paragraph, comparisons by region show that most the paragraph that begins with the urban regions, except for the Pacific phrase ‘‘We also are estimating a slight region and Puerto Rico, will experience, decrease in’’ and ends with the phrase on average, decreases in capital IPPS ‘‘Federal rate.’’ is corrected to read ‘‘We payments.’’ is corrected to read ‘‘The also are estimating an increase in outlier comparisons by region show that most payments in FY 2013 as compared to FY urban regions, except for the Pacific, 2012. This estimated increase in outlier West North Central, and Puerto Rico payments is based on the FY 2011 regions, will experience, on average, claims from the December 2011 update decreases in capital IPPS payments’’. of the MedPAR file, and we currently (ii) Line 8, the figure ‘‘1.0’’ is estimate that FY 2012 capital outlier corrected to read ‘‘1.2’’. payments are more than the projected (iii) Line 10, the sentence ‘‘The two 6.18 percent that we used to determine exceptions to decreases in capital the outlier offset that we applied in payments per case are the Pacific urban determining the FY 2012 capital Federal region and the Puerto Rico urban region, rate’’. which are expected to experience a 1.1 d. Last partial paragraph— percent and 0.5 percent increase, (1) Lines 2 and 3, the phrase ‘‘all respectively.’’ sentence is corrected to hospitals are expected to experience a decrease’’ is corrected to read ‘‘hospitals read ‘‘The three exceptions to estimated decreases in capital payments per case are expected to experience either no are Pacific urban region, West North change or a decrease’’. Central urban region, and the Puerto (2) Line 5, the sentence ‘‘These decreases are primarily due to proposed Rico urban region, which are expected to experience a 1.3 percent, 0.5 percent, changes in the GAFs (primarily and 0.4 percent increase, respectively.’’. resulting from policies affecting the (2) Second column— wage index)), and the estimated (a) First full paragraph— decrease in capital outlier payments.’’ is (i) Line 3, the figure, ‘‘1.6’’ is corrected to read ‘‘The decreases are corrected read ‘‘1.7’’. primarily due to proposed changes in the GAFs (primarily resulting from (ii) Line 4, the figure, ‘‘0.7’’ is policies affecting the wage index).’’. corrected read ‘‘0.4’’. b. Lower half of the page, first column, Table 1D—Proposed Capital Standard Federal Payment Rate—FY 2013, the table is corrected to read as follows: mstockstill on DSK4VPTVN1PROD with PROPOSALS Nonlabor VerDate Mar<15>2010 20:25 Jun 08, 2012 Jkt 226001 PO 00000 Frm 00067 Fmt 4702 Sfmt 4702 (iii) Line 6, the sentence ‘‘The East South Central and Mountain rural regions are not expected to experience any change in their capital payments per discharge from FY 2012 to FY 2013.’’ is corrected by removing the sentence. (iv) Line 11, the figure ‘‘3.3’’ is corrected to read ‘‘2.9’’. (b) Second full paragraph, the paragraph ‘‘Hospitals of all type of ownership (that is, voluntary hospitals, government hospitals, and proprietary hospitals) are estimated to experience a 0.2 percent decrease in capital payments per case from FY 2012 to FY 2013.’’ is corrected to read ‘‘By type of ownership (that is, voluntary hospitals, government hospitals, and proprietary hospitals), all hospitals are estimated to experience a decrease in capital payments per case from FY 2012 to FY 2013. Voluntary hospitals and proprietary hospitals are expected to experience a 0.2 percent decrease in capital payments per case from FY 2012 to FY 2013, while government-run hospitals are expected to experience a 0.1 percent decrease in capital payments per case from FY 2012 to FY 2013.’’. (3) Third column, first paragraph, lines 14 through 26, the sentences beginning with the phrase ‘‘Urban nonreclassified hospitals are’’ and ending with the phrase ‘‘from FY 2012 to FY 2013.’’ are corrected to read ‘‘Both urban non-reclassified hospitals and rural reclassified hospitals are estimated to experience a decrease of 0.2 percent in capital payments per discharge from FY 2012 to FY 2013. Rural non-reclassified hospitals are estimated to have a 0.3 percent decrease in capital payments per case. Other reclassified hospitals (that is, hospitals reclassified under section 1886(d)(8)(B) of the Act) are expected to experience a decrease of 0.4 percent in capital payments from FY 2012 to FY 2013.’’. b. Lower two-thirds of the page, Table III—Comparison of Total Payments per Case, the table is corrected to read as follows: E:\FR\FM\11JNP1.SGM 11JNP1 34330 Federal Register / Vol. 77, No. 112 / Monday, June 11, 2012 / Proposed Rules TABLE III—COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2012 payments compared to FY 2013 payments] Average FY 2012 payments/ case mstockstill on DSK4VPTVN1PROD with PROPOSALS Number of hospitals By Geographic Location: All hospitals .............................................................................................................. Large urban areas (populations over 1 million) ....................................................... Other urban areas (populations of 1 million or fewer) ............................................. Rural areas ............................................................................................................... Urban hospitals ......................................................................................................... 0–99 beds .......................................................................................................... 100–199 beds .................................................................................................... 200–299 beds .................................................................................................... 300–499 beds .................................................................................................... 500 or more beds .............................................................................................. Rural hospitals .......................................................................................................... 0–49 beds .......................................................................................................... 50–99 beds ........................................................................................................ 100–149 beds .................................................................................................... 150–199 beds .................................................................................................... 200 or more beds .............................................................................................. By Region: Urban by Region ...................................................................................................... New England ..................................................................................................... Middle Atlantic ................................................................................................... South Atlantic .................................................................................................... East North Central ............................................................................................. East South Central ............................................................................................ West North Central ............................................................................................ West South Central ........................................................................................... Mountain ............................................................................................................ Pacific ................................................................................................................ Puerto Rico ........................................................................................................ Rural by Region ........................................................................................................ New England ..................................................................................................... Middle Atlantic ................................................................................................... South Atlantic .................................................................................................... East North Central ............................................................................................. East South Central ............................................................................................ West North Central ............................................................................................ West South Central ........................................................................................... Mountain ............................................................................................................ Pacific ................................................................................................................ Puerto Rico ........................................................................................................ By Payment Classification: All hospitals .............................................................................................................. Large urban areas (populations over 1 million) ....................................................... Other urban areas (populations of 1 million or fewer) ............................................. Rural areas ............................................................................................................... Teaching Status: Non-teaching ..................................................................................................... Fewer than 100 Residents ................................................................................ 100 or more Residents ...................................................................................... Urban DSH: 100 or more beds ....................................................................................... Less than 100 beds ................................................................................... Rural DSH: Sole Community (SCH/EACH) ................................................................... Referral Center (RRC/EACH) .................................................................... Other Rural: ................................................................................................ 100 or more beds ............................................................................... Less than 100 beds ............................................................................ Urban teaching and DSH: Both teaching and DSH .................................................................................... Teaching and no DSH ....................................................................................... No teaching and DSH ....................................................................................... No teaching and no DSH .................................................................................. Rural Hospital Types: Non special status hospitals ............................................................................. RRC/EACH ........................................................................................................ SCH/EACH ........................................................................................................ SCH, RRC and EACH ....................................................................................... VerDate Mar<15>2010 18:06 Jun 08, 2012 Jkt 226001 PO 00000 Frm 00068 Fmt 4702 Sfmt 4702 Average FY 2013 payments/ case Change 3,405 1,365 1,120 920 2,485 627 773 448 432 205 920 317 346 152 58 47 799 880 784 552 837 670 722 769 848 1,016 552 438 505 545 619 672 797 880 780 551 835 667 720 769 848 1,013 551 437 504 543 617 672 ¥0.2 0.0 ¥0.4 ¥0.2 ¥0.2 ¥0.5 ¥0.3 0.0 0.0 ¥0.3 ¥0.2 ¥0.2 ¥0.2 ¥0.4 ¥0.4 0.0 2,485 120 318 377 396 151 165 370 157 380 51 920 23 69 164 120 170 98 181 65 29 1 837 907 886 781 804 730 836 796 868 1,016 384 552 744 569 541 576 507 585 491 580 723 150 835 896 883 777 804 725 840 792 865 1,029 386 551 744 571 539 575 506 581 490 579 711 154 ¥0.2 ¥1.2 ¥0.4 ¥0.5 ¥0.1 ¥0.7 0.5 ¥0.5 ¥0.4 1.3 0.4 ¥0.2 ¥0.1 0.4 ¥0.4 ¥0.1 ¥0.2 ¥0.6 ¥0.1 ¥0.1 ¥1.7 2.9 3,405 1,375 1,125 905 799 879 783 563 797 879 780 560 ¥0.2 0.0 ¥0.3 ¥0.4 2,376 789 240 680 790 1,137 678 789 1,135 ¥0.2 ¥0.1 ¥0.2 1,523 327 863 583 862 584 ¥0.1 0.0 269 210 32 .................... 286 519 624 506 .................... 446 516 622 503 .................... 446 ¥0.6 ¥0.4 ¥0.7 .................... ¥0.1 815 147 1,035 503 933 812 720 741 933 808 720 736 ¥0.1 ¥0.4 0.0 ¥0.7 2,391 61 34 16 841 733 722 769 839 735 723 764 ¥0.2 0.3 0.1 ¥0.7 E:\FR\FM\11JNP1.SGM 11JNP1 34331 Federal Register / Vol. 77, No. 112 / Monday, June 11, 2012 / Proposed Rules TABLE III—COMPARISON OF TOTAL PAYMENTS PER CASE—Continued [FY 2012 payments compared to FY 2013 payments] Number of hospitals Hospitals Reclassified by the Medicare Geographic Classification Review Board: FY2013 Reclassifications: All Urban Reclassified ....................................................................................... All Urban Non-Reclassified ............................................................................... All Rural Reclassified ........................................................................................ All Rural Non-Reclassified ................................................................................ Other Reclassified Hospitals (Section 1886(d)(8)(B)) ....................................... Type of Ownership: Voluntary ........................................................................................................... Proprietary ......................................................................................................... Government ....................................................................................................... Medicare Utilization as a Percent of Inpatient Days: 0–25 ................................................................................................................... 25–50 ................................................................................................................. 50–65 ................................................................................................................. Over 65 .............................................................................................................. 10. On page 28189, second column, last paragraph, lines 6 and 7, the phrase ‘‘1,741 existing IPFs, of which 450’’ is corrected to read ‘‘approximately 1,700 existing IPFs, of which approximately 450’’. (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: June 5, 2012. Jennifer M. Cannistra, Executive Secretary to the Department, Department of Health and Human Services. [FR Doc. 2012–14159 Filed 6–8–12; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 665 [Docket No. 120330236–2002–01] RIN 0648–BB48 Western Pacific Pelagic Fisheries; Revised Swordfish Trip Limits in the Hawaii Deep-Set Longline Fishery National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Proposed rule; request for comments. mstockstill on DSK4VPTVN1PROD with PROPOSALS AGENCY: This proposed rule would revise the limits on the number of swordfish that fishermen may possess or land during any given Hawaii-based SUMMARY: VerDate Mar<15>2010 18:06 Jun 08, 2012 Jkt 226001 Frm 00069 Fmt 4702 Sfmt 4702 Average FY 2013 payments/ case Change 420 2,025 335 524 55 833 840 596 482 550 834 838 595 480 548 0.1 ¥0.2 ¥0.2 ¥0.3 ¥0.4 1,970 866 560 813 718 817 812 717 816 ¥0.2 ¥0.2 ¥0.1 377 1,834 968 168 1,044 839 666 611 1,047 838 664 610 0.4 ¥0.2 ¥0.3 ¥0.2 deep-set longline-fishing trip north of the Equator. This proposed rule would also revise the definition of deep-set longline fishing to be consistent with the proposed swordfish retention limits. All other measures applicable to the deep-set fishery would remain unchanged. The proposed rule intends to reduce regulatory discards and optimize the yield of swordfish. DATES: NMFS must receive comments on the proposed rule by July 2, 2012. ADDRESSES: You may send comments on the proposed rule, identified by NOAA– NMFS–2012–0097, to either of the following addresses: • Electronic Submission: Submit all electronic public comments via the Federal e-Rulemaking Portal www.regulations.gov; or • Mail: Michael D. Tosatto, Regional Administrator, NMFS, Pacific Islands Region (PIR), 1601 Kapiolani Blvd., Suite 1110, Honolulu, HI 96814–4700. Instructions: You must send any comments to one of the above two addresses to ensure that NMFS receives, documents, and considers the comments. Comments sent to any other address or individual, or received after the end of the comment period, may not be considered. All comments received are a part of the public record and NMFS will generally post them to www.regulations.gov without change. All personal identifying information (e.g., name, address, etc.) submitted voluntarily by the commenter may be publicly accessible. Do not submit confidential business information, or otherwise sensitive or protected information. NMFS will accept anonymous comments (enter ‘‘N/A’’ in the required name and organization PO 00000 Average FY 2012 payments/ case fields if you wish to remain anonymous). Attachments to electronic comments will be accepted in Microsoft Word or Excel, WordPerfect, or Adobe PDF file formats only. The Western Pacific Fishery Management Council (Council) prepared a regulatory amendment, including an environmental assessment and regulatory impact review, that provides background information on this proposed rule. The regulatory amendment is available from www.regulations.gov or the Council, 1164 Bishop St., Suite 1400, Honolulu, HI 96813, tel 808–522–8220, fax 808– 522–8226, www.wpcouncil.org. FOR FURTHER INFORMATION CONTACT: Brett Wiedoff, Sustainable Fisheries, NMFS PIR, 808–944–2272. SUPPLEMENTARY INFORMATION: The Council and NMFS manage Hawaiibased longline fisheries under the Fishery Ecosystem Plan for Pelagic Fisheries of the Western Pacific Region (FEP). Entry into the longline fisheries is limited, with a maximum of 164 vessels allowed. Longline vessels may conduct either deep-set fishing (targeting tunas) or shallow-set fishing (targeting swordfish). Prior to leaving port for a fishing trip, a vessel must declare its intended trip type, deep-set or shallow-set, so that NMFS may assign an observer. Observers collect information about the fishery and interactions with protected species, such as sea turtles. In the shallow-set fishery, NMFS places an observer on the vessel for each trip to ensure 100 percent coverage. In the deep-set fishery, NMFS places observers on at least 20 percent of deep-set trips. Once a vessel declares that it will be in the E:\FR\FM\11JNP1.SGM 11JNP1

Agencies

[Federal Register Volume 77, Number 112 (Monday, June 11, 2012)]
[Proposed Rules]
[Pages 34326-34331]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-14159]

=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 413, 424, 476, and 489

[CMS-1588-CN]
RIN 0938-AR12

Medicare Program; Hospital Inpatient Prospective Payment Systems
for Acute Care Hospitals and the Long-Term Care Hospital Prospective
Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for
Graduate Medical Education Payment Purposes; Quality Reporting
Requirements for Specific Providers and for Ambulatory Surgical
Centers; Corrections

AGENCY: Centers for Medicare and Medicaid Services (CMS), HHS.

ACTION: Proposed rule, correction.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical and typographical errors in
the proposed rule that appeared in the May 11, 2012 Federal Register
entitled ``Medicare Program; Hospital Inpatient Prospective Payment
Systems for Acute Care Hospitals and the Long-Term Care Hospital
Prospective Payment System and Fiscal Year 2013 Rates; Hospitals'
Resident Caps for Graduate Medical Education Payment Purposes; Quality
Reporting Requirements for Specific Providers and for Ambulatory
Surgical Centers.''

FOR FURTHER INFORMATION CONTACT: Tzvi Hefter, (410) 786-4487.

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 2012-9985 of May 11, 2012 (77 FR 27870), there were a
number of technical errors that are identified and corrected in the
Correction of Errors section of this correcting document.

II. Summary of Errors

A. Errors in the Preamble

On pages 27871 and 27872, we inadvertently omitted a number of
acronyms from the list of acronyms.
On page 27938, in our discussion of the fiscal year (FY) 2013
applications for new technology add-on payments, we made typographical
errors regarding the drug combination administered during the treatment
of methotrexate (MTX)-induced renal dysfunction.
On page 28021, we inadvertently cited the incorrect timeframe for
when certain long-term care hospitals (LTCHs) and LTCH satellite
facilities must comply with Sec. 412.534 and Sec. 412.536. We also
cited the incorrect timeframe for when those LTCHs and LTCH satellite
facilities would be under the proposed moratorium on the 25-percent
adjustment threshold policy.
On page 28036, we made several typographical errors in our
discussion of commenters' beliefs regarding the hospital inpatient
quality reporting program (HIQR) and five Agency for Healthcare
Research and Quality (AHRQ) measures.
On page 28039, in our discussion of the HIQR proposed new claims-
based measure for the FY 2015 payment determination for hip/knee
complication, we inadvertently repeated a sentence.
On page 28041, in our discussion of the HIQR proposed new claims-
based measure for the FY 2015 payment determination for hip/knee
readmission, we made a typographical error in a section heading.
On page 28072, in our discussion of the total amount available for
value-based incentive payments under the Hospital VBP Program for a
fiscal year, we inadvertently included estimated reductions to the base
operating DRG payment amounts for Maryland hospitals in the calculation
of the total estimate for FY 2013.
On pages 28085 and 28086, in our discussion of the proposed
performance standards for the Hospital Value-Based Purchasing (VBP)
Program, we inadvertently omitted data from the table entitled
``Proposed Performance Standards for the FY 2015 Hospital VBP Program
Clinical Process of Care and Outcome Domains, and the Medicare Spending
per Beneficiary Measure.''
On pages 28107, 28108, and 28127 in our discussion of the Inpatient
Psychiatric Facilities Quality Reporting Program (IPFQR), we made
technical errors in our description of the IPF facility enrollment.

B. Errors in the Addendum

On page 28143, we made errors in our discussion of the proposed
outlier fixed-loss cost threshold for FY 2013.
On pages 28144, 28148, 28149, 28150, 28151, 28159, and 28178, we
made technical and typographical errors in our discussion of the
proposed outlier adjustment factors which affected the proposed FY 2013
Puerto Rico (specific) operating standardized amount and capital
Federal rates (national and Puerto Rico). Specifically, we
inadvertently applied the incorrect adjustment factors to the operating
and capital cost-to-charge ratios (CCRs) from the Provider-Specific
File (PSF) when performing the calculation of the FY 2013 outlier
fixed-loss cost threshold for the proposed rule. The correction of this
error resulted in a decrease in the proposed outlier fixed-loss cost
threshold of approximately $1,000. Under our established methodology
for calculating the outlier fixed-loss cost threshold, which we have
proposed to continue to use for FY 2013, the corrected proposed outlier
fixed-loss cost threshold continues to result in operating outlier
payments being projected to be 5.1 percent of total operating payments.
However, a decrease in the proposed outlier threshold results in an
increase of the Puerto Rico (specific) operating outlier payments and
capital (national and Puerto Rico) outlier payments. This is because a
lower outlier threshold allows more cases to qualify as outlier cases
and results in higher outlier payments to such cases. Because outlier
payments are budget neutral, a larger reduction (that is, an increase
in the outlier offsets) to the Puerto Rico and capital (national and
Puerto Rico) rates is necessary. Therefore, the application of the
corrected Puerto Rico and capital outlier offsets (national and Puerto
Rico) lowers the proposed FY 2013 Puerto Rico (specific) operating
standardized amount and capital Federal rates (national and Puerto
Rico).

[[Page 34327]]

On page 28189, in the impact analysis section for the inpatient
Psychiatric Facilities Quality Reporting Program (IPFQR), we made
technical errors in describing the IPF facility enrollment.

C. Summary of Errors in and Corrections to Tables Posted on the CMS Web
site

On page 28158, we list Table 16, Proposed Hospital Inpatient Value-
Based Purchasing (VBP) Program Adjustment Factors for FY 2013, as a
table that will be available only through the Internet on the CMS Web
site. The version of Table 16 that was posted via the Internet on the
CMS Web site at the time the proposed rule was filed for public
inspection at the Office of the Federal Register inadvertently included
estimated reductions to the base operating DRG payment amounts for
Maryland hospitals in the calculation of the proposed FY 2013 Hospital
VBP Program adjustment factors.
We have corrected these errors and will post the corrected Table 16
on the CMS Web site at https://www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp.

III. Correction of Errors

In FR Doc. 2012-9985 of May 11, 2012 (77 FR 27870), make the
following corrections:

A. Corrections of Errors in the Preamble

1. On pages 27871 and 27872, second and third and first and second
columns, respectively (Acronyms list), are corrected by adding the
following acronyms in alphabetical order:

ACoS American College of Surgeons'
AJCC American Joint Commission on Cancer
ASCO American Society of Clinical Oncology
CAUTI Catheter-Associated Urinary Tract Infection
CLABSI Central Line-Associated Bloodstream Infection
CEO Chief Executive Officer
CCN CMS Certificate Number
CFR Code of Federal Regulations
CoC Commission on Cancer
DACA Data Accuracy and Completeness Acknowledgement
ESRD End-Stage Renal Disease
FR Federal Register
HAI Healthcare-Associated Infection
HBIPS Hospital-Based Inpatient Psychiatric Services
HICPAC Healthcare Infection Control Practices Advisory Committee
ICU Intensive Care Unit
IPFQR Inpatient Psychiatric Facilities Quality Reporting Program
MAP Measure Application Partnership
NCCN National Comprehensive Cancer Network
NOP Notice of Participation
OQR Outpatient Quality Reporting
QAPI Quality Assessment and Performance Improvement
QIP Quality Incentive Program
Q Quarter
TJC The Joint Commission
UTI Urinary Tract Infection
VTE Venous Thromboembolism

2. On page 27938, in the third column,
a. First partial paragraph--
(1). Line 5 the term ``Thymidine'' is corrected to read
``leucovorin''.
(2). Line 9, the term ``Thymidine'' is corrected to read
``leucovorin''.
(3). Lines 13 and 14, the phrase ``19 to 94 years old.'' is
corrected to read ``19 to 94 years old.\18a\''
b. Footnoted text, before footnote 18, the footnoted text is
corrected by adding the following:

\18a\ Green and Chamberlain, Cancer Chemotherapy and
Pharmacology Volume 63, Number 4, 2009.

3. On page 28021, in the third column, first partial paragraph,
lines 24 through 42, the sentences beginning with the phrase
``Therefore, under our proposed policy'' and ending with the phrase
``proposed extension of the moratorium'' are corrected to read
``Therefore, under our proposed policy, there will be a period during
which some of the above-described LTCHs and LTCH satellite facilities
must comply with Sec. Sec. 412.534 and 412.536 before becoming subject
to the moratoria again. The above-described LTCHs and LTCH satellite
facilities with a cost reporting period beginning on or after July 1,
2012, and before October 1, 2012 would comply with Sec. Sec. 412.534
and 412.536 for discharges occurring in that respective cost reporting
period. Then, those same LTCHs and LTCH satellite facilities would be
subject to the proposed moratorium for discharges occurring in their
first cost reporting period beginning on or after July 1, 2013 and
before October 1, 2013.''
4. On page 28036, lower half of the page, first column, first
paragraph, lines 7 through 8, the phrase ``some commenters still
believed that'' is corrected to read ``we recognize some commenters
believe that''.
5. On page 28039, second column, third paragraph, lines 8 through
12, the sentence ``Annual hospital charges are projected to increase by
340 percent to $17.4 billion for THA and by 450 percent to $40.8
billion for TKA by 2015'' is corrected by deleting the sentence.
6. On page 28041, first column, second full paragraph, line 9, the
heading that begins with the phrase ``(ii) Hip/Knee Readmission:'' is
corrected by moving the phrase to line 10.
7. On page 28072, second column, first full paragraph, line 8, the
figure ``$956 million'' is corrected to read ``$917 million''.
8. On pages 28085 through 28086, lower third of the page, the table
entitled Proposed Performance Standards for the FY 2015 Hospital VBP
Program Clinical Process of Care and Outcome Domains, and the Medicare
Spending per Beneficiary Measure'' is corrected as follows:
Proposed Performance Standards for the FY 2015 Hospital VBP Program
Clinical Process of Care and Outcome Domains, and the Medicare Spending
per Beneficiary Measure
a. Revising the following entry:

Clinical Process of Care Measures
----------------------------------------------------------------------------------------------------------------
Achievement
Measure ID Description threshold Benchmark
----------------------------------------------------------------------------------------------------------------
AMI-10...................................... Statin Prescribed at Discharge...... 0.90474 1.00000
----------------------------------------------------------------------------------------------------------------

b. Adding the following entry after line 3 (Measure ID, AMI-10):

[[Page 34328]]

Clinical Process of Care Measures
----------------------------------------------------------------------------------------------------------------
Achievement
Measure ID Description threshold Benchmark
----------------------------------------------------------------------------------------------------------------
HF-1........................................ Discharge Instructions.............. 0.92090 1.00000
----------------------------------------------------------------------------------------------------------------

9. On page 28107, third column, footnoted text (footnote 198), line
1, the phrase ``IPFs, 450 are'' is corrected to read ``IPFs,
approximately 450 are''.
10. On page 28108, first column, second full paragraph, line 6, the
figure ``1,100'' is corrected to read ``1,200''.
11. On page 28127, first column, fifth full paragraph--
a. Line 11, the figure ``1,741'' is corrected to read ``estimated
1,700''.
b. Line 12, the figure ``450'' is corrected to read ``approximately
450''.
c. Line 14, the figure ``26.02'' is corrected to read
``approximately 26''.

B. Corrections of Errors in the Addendum

1. On page 28143, third column--
a. Second full paragraph, line 6, the figure ``$27,425'' is
corrected to read ``$26,337''
b. Third full paragraph, lines 2 and 3, the phrase ``$5,040 (or
22.5 percent)'' is corrected to read ``$3,952 (or 17.7 percent)''.
2. On page 28144--
a. First column, first partial paragraph, lines 12 and 13, the
phrase ``welcomed comment on possible modifications to our current
methodologies,'' is corrected to read ``welcome comment on possible
modifications to our current methodology,''.
b. First column, second full paragraph, line 13, the figure
``5.99'' is corrected to read ``6.43''
c. Second column, before the first paragraph, the untitled table is
corrected to read as follows:

------------------------------------------------------------------------
Operating Capital
standardized federal
amounts rate
------------------------------------------------------------------------
National..................................... 0.948992 0.935720
Puerto Rico.................................. 0.953062 0.920266
------------------------------------------------------------------------

3. On page 28148, second column, second full paragraph, line 6, the
phrase ``approximately 0.7 percent'' is corrected to read ``0.25
percent''.
4. On page 28149, third column--
a. First full paragraph, line 8, the figure ``6.00'' is corrected
to read ``6.43''
b. First full paragraph, line 12, the figure ``0.9400'' is
corrected to read ``0.9357''
c. First full paragraph, line 17, the phrase ``lower than the
percentage for FY 2012.'' is corrected to read ``higher than the
percentage for FY 2012.''.
d. First full paragraph, lines 17 through 28, the sentences ``This
decrease in estimated capital outlier payments is primarily due to the
proposed increase in the outlier threshold used to identify outlier
cases for both inpatient operating and inpatient capital related
payments, which is discussed in section II.A. of this Addendum. That
is, because the outlier threshold used to identify outlier cases is
higher, cases will receive lower outlier payments and fewer cases will
qualify for outlier payments.'' are corrected by deleting the
sentences.
e. Second full paragraph, line 6, the phrase ``0.9400 is 0.19
percent'' is corrected to read ``0.9357 is a -0.27 percent''
f. Second full paragraph, line 10, the phrase ``1.0019 (0.9400/
0.9832) is corrected to read ``0.9973 (0.9357/0.9832)''
5. On page 28150, third column--
a. First partial paragraph, line 14, the figure ``$424.42'' is
corrected to read ``$422.47''.
b. Third bulleted paragraph, line 2, the figure ``0.9400'' is
corrected to read ``0.9357''.
c. Last paragraph--
(1) Line 14, the term ``increasing'' is corrected to read
``decreasing''.
(2) Line 15, the figure ``0.19'' is corrected to read ``0.27''.
(3) Line 26, the phrase ``approximately 0.7 percent'' is corrected
to read ``0.25 percent''.
6. On page 28151--
a. Top third of the page--
(1) In the chart entitled Comparison of Factors and Adjustments: FY
2012 Capital Federal Rate and Proposed FY 2013 Capital Federal Rate,
the listed entries are corrected as set forth below.
(2) Immediately following the chart, footnote 2 is corrected and
footnote 5 is republished as set forth below.

------------------------------------------------------------------------
Proposed Percent
FY 2012 FY 2013 Change change
------------------------------------------------------------------------
Outlier Adjustment Factor 0.9382 0.9357 0.9973 -0.27
\2\........................
Capital Federal Rate \5\.... $421.42 $422.47 1.0025 0.25
------------------------------------------------------------------------

* * * * *
\2\ The outlier reduction factor is not built permanently into
the capital rate; that is, the factor is not applied cumulatively in
determining the capital rate. Thus, for example, the net change
resulting from the application of the FY 2013 outlier adjustment
factor is 0.9357/0.9382, or 0.9973.
* * * * *
\5\ Sum of percent change may not sum due to rounding.

b. Lower two-thirds of the page, second column--
(1) First full paragraph, last line, the figure ``$206.82'' is
corrected to read ``$206.01''.
(2) Third paragraph, last line, the figure ``$27,425'' is corrected
to read ``26,337''.
7. On page 28159--
a. Top half of the page, in Table 1C--Proposed Adjusted Operating
Standardized Amounts for Puerto Rico, Labor/Nonlabor--FY 2013, the
entries for Puerto Rico are corrected to read as follows:

[[Page 34329]]

Table 1C--Proposed Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor-- FY 2013
----------------------------------------------------------------------------------------------------------------
Rates if wage index is Rates if wage index is
greater than 1 less than or equal to 1
-------------------------------------------------------
Labor Nonlabor Labor Nonlabor
----------------------------------------------------------------------------------------------------------------
Puerto Rico............................................. $1,582.93 $966.07 $1,580.38 $968.62
----------------------------------------------------------------------------------------------------------------

b. Lower half of the page, first column, Table 1D--Proposed Capital
Standard Federal Payment Rate--FY 2013, the table is corrected to read
as follows:

Table 1D--Proposed Capital Standard Federal Payment Rate--FY 2013
------------------------------------------------------------------------
Rate
------------------------------------------------------------------------
National.................................................... $422.47
Puerto Rico................................................. 206.01
------------------------------------------------------------------------

8. On page 28178--
a. Second column, middle of the page, fourth bullet the figure
``0.9400'' is corrected to read ``0.9357''
b. Third column, second full paragraph, line 6, the phrase
``approximately 0.7'' is corrected to read ``0.25''.
c. Third column, third full paragraph, the paragraph that begins
with the phrase ``We also are estimating a slight decrease in'' and
ends with the phrase ``Federal rate.'' is corrected to read ``We also
are estimating an increase in outlier payments in FY 2013 as compared
to FY 2012. This estimated increase in outlier payments is based on the
FY 2011 claims from the December 2011 update of the MedPAR file, and we
currently estimate that FY 2012 capital outlier payments are more than
the projected 6.18 percent that we used to determine the outlier offset
that we applied in determining the FY 2012 capital Federal rate''.
d. Last partial paragraph--
(1) Lines 2 and 3, the phrase ``all hospitals are expected to
experience a decrease'' is corrected to read ``hospitals are expected
to experience either no change or a decrease''.
(2) Line 5, the sentence ``These decreases are primarily due to
proposed changes in the GAFs (primarily resulting from policies
affecting the wage index)), and the estimated decrease in capital
outlier payments.'' is corrected to read ``The decreases are primarily
due to proposed changes in the GAFs (primarily resulting from policies
affecting the wage index).''.
9. On page 28179,
a. Top third of the page,
(1) First column--
(a) First partial paragraph--
(i) Line 2, the sentence ``Capital IPPS payments per case for large
urban hospitals are estimated to decrease 0.1 percent, while other
urban hospitals are expected to experience a 0.4 percent decrease.'' is
corrected to read ``Large urban hospitals are not expected to
experience any change in capital IPPS payments per case from FY 2012 to
FY 2013, while other urban hospitals are expected to experience a 0.4
percent decrease.''.
(ii) Line 7, the phrase ``not expected to experience any change''
is corrected to read ``are expected to experience a 0.2 percent
decrease''.
(b) First full paragraph--
(i) Line 1, the sentence ``The comparisons by region show that most
urban regions, except for the Pacific region and Puerto Rico, will
experience, on average, decreases in capital IPPS payments.'' is
corrected to read ``The comparisons by region show that most urban
regions, except for the Pacific, West North Central, and Puerto Rico
regions, will experience, on average, decreases in capital IPPS
payments''.
(ii) Line 8, the figure ``1.0'' is corrected to read ``1.2''.
(iii) Line 10, the sentence ``The two exceptions to decreases in
capital payments per case are the Pacific urban region and the Puerto
Rico urban region, which are expected to experience a 1.1 percent and
0.5 percent increase, respectively.'' sentence is corrected to read
``The three exceptions to estimated decreases in capital payments per
case are Pacific urban region, West North Central urban region, and the
Puerto Rico urban region, which are expected to experience a 1.3
percent, 0.5 percent, and 0.4 percent increase, respectively.''.
(2) Second column--
(a) First full paragraph--
(i) Line 3, the figure, ``1.6'' is corrected read ``1.7''.
(ii) Line 4, the figure, ``0.7'' is corrected read ``0.4''.
(iii) Line 6, the sentence ``The East South Central and Mountain
rural regions are not expected to experience any change in their
capital payments per discharge from FY 2012 to FY 2013.'' is corrected
by removing the sentence.
(iv) Line 11, the figure ``3.3'' is corrected to read ``2.9''.
(b) Second full paragraph, the paragraph ``Hospitals of all type of
ownership (that is, voluntary hospitals, government hospitals, and
proprietary hospitals) are estimated to experience a 0.2 percent
decrease in capital payments per case from FY 2012 to FY 2013.'' is
corrected to read ``By type of ownership (that is, voluntary hospitals,
government hospitals, and proprietary hospitals), all hospitals are
estimated to experience a decrease in capital payments per case from FY
2012 to FY 2013. Voluntary hospitals and proprietary hospitals are
expected to experience a 0.2 percent decrease in capital payments per
case from FY 2012 to FY 2013, while government-run hospitals are
expected to experience a 0.1 percent decrease in capital payments per
case from FY 2012 to FY 2013.''.
(3) Third column, first paragraph, lines 14 through 26, the
sentences beginning with the phrase ``Urban non-reclassified hospitals
are'' and ending with the phrase ``from FY 2012 to FY 2013.'' are
corrected to read ``Both urban non-reclassified hospitals and rural
reclassified hospitals are estimated to experience a decrease of 0.2
percent in capital payments per discharge from FY 2012 to FY 2013.
Rural non-reclassified hospitals are estimated to have a 0.3 percent
decrease in capital payments per case. Other reclassified hospitals
(that is, hospitals reclassified under section 1886(d)(8)(B) of the
Act) are expected to experience a decrease of 0.4 percent in capital
payments from FY 2012 to FY 2013.''.
b. Lower two-thirds of the page, Table III--Comparison of Total
Payments per Case, the table is corrected to read as follows:

[[Page 34330]]

Table III--Comparison of Total Payments per Case
[FY 2012 payments compared to FY 2013 payments]
----------------------------------------------------------------------------------------------------------------
Average FY Average FY
Number of 2012 2013
hospitals payments/ payments/ Change
case case
----------------------------------------------------------------------------------------------------------------
By Geographic Location:
All hospitals........................................... 3,405 799 797 -0.2
Large urban areas (populations over 1 million).......... 1,365 880 880 0.0
Other urban areas (populations of 1 million or fewer)... 1,120 784 780 -0.4
Rural areas............................................. 920 552 551 -0.2
Urban hospitals......................................... 2,485 837 835 -0.2
0-99 beds........................................... 627 670 667 -0.5
100-199 beds........................................ 773 722 720 -0.3
200-299 beds........................................ 448 769 769 0.0
300-499 beds........................................ 432 848 848 0.0
500 or more beds.................................... 205 1,016 1,013 -0.3
Rural hospitals......................................... 920 552 551 -0.2
0-49 beds........................................... 317 438 437 -0.2
50-99 beds.......................................... 346 505 504 -0.2
100-149 beds........................................ 152 545 543 -0.4
150-199 beds........................................ 58 619 617 -0.4
200 or more beds.................................... 47 672 672 0.0
By Region:
Urban by Region......................................... 2,485 837 835 -0.2
New England......................................... 120 907 896 -1.2
Middle Atlantic..................................... 318 886 883 -0.4
South Atlantic...................................... 377 781 777 -0.5
East North Central.................................. 396 804 804 -0.1
East South Central.................................. 151 730 725 -0.7
West North Central.................................. 165 836 840 0.5
West South Central.................................. 370 796 792 -0.5
Mountain............................................ 157 868 865 -0.4
Pacific............................................. 380 1,016 1,029 1.3
Puerto Rico......................................... 51 384 386 0.4
Rural by Region......................................... 920 552 551 -0.2
New England......................................... 23 744 744 -0.1
Middle Atlantic..................................... 69 569 571 0.4
South Atlantic...................................... 164 541 539 -0.4
East North Central.................................. 120 576 575 -0.1
East South Central.................................. 170 507 506 -0.2
West North Central.................................. 98 585 581 -0.6
West South Central.................................. 181 491 490 -0.1
Mountain............................................ 65 580 579 -0.1
Pacific............................................. 29 723 711 -1.7
Puerto Rico......................................... 1 150 154 2.9
By Payment Classification:
All hospitals........................................... 3,405 799 797 -0.2
Large urban areas (populations over 1 million).......... 1,375 879 879 0.0
Other urban areas (populations of 1 million or fewer)... 1,125 783 780 -0.3
Rural areas............................................. 905 563 560 -0.4
Teaching Status:
Non-teaching........................................ 2,376 680 678 -0.2
Fewer than 100 Residents............................ 789 790 789 -0.1
100 or more Residents............................... 240 1,137 1,135 -0.2
Urban DSH:
100 or more beds................................ 1,523 863 862 -0.1
Less than 100 beds.............................. 327 583 584 0.0
Rural DSH:
Sole Community (SCH/EACH)....................... 269 519 516 -0.6
Referral Center (RRC/EACH)...................... 210 624 622 -0.4
Other Rural:.................................... 32 506 503 -0.7
100 or more beds............................ ........... ........... ........... ...........
Less than 100 beds.......................... 286 446 446 -0.1
Urban teaching and DSH:
Both teaching and DSH............................... 815 933 933 -0.1
Teaching and no DSH................................. 147 812 808 -0.4
No teaching and DSH................................. 1,035 720 720 0.0
No teaching and no DSH.............................. 503 741 736 -0.7
Rural Hospital Types:
Non special status hospitals........................ 2,391 841 839 -0.2
RRC/EACH............................................ 61 733 735 0.3
SCH/EACH............................................ 34 722 723 0.1
SCH, RRC and EACH................................... 16 769 764 -0.7

[[Page 34331]]

Hospitals Reclassified by the Medicare Geographic
Classification Review Board:
FY2013 Reclassifications:
All Urban Reclassified.............................. 420 833 834 0.1
All Urban Non-Reclassified.......................... 2,025 840 838 -0.2
All Rural Reclassified.............................. 335 596 595 -0.2
All Rural Non-Reclassified.......................... 524 482 480 -0.3
Other Reclassified Hospitals (Section 1886(d)(8)(B)) 55 550 548 -0.4
Type of Ownership:
Voluntary........................................... 1,970 813 812 -0.2
Proprietary......................................... 866 718 717 -0.2
Government.......................................... 560 817 816 -0.1
Medicare Utilization as a Percent of Inpatient Days:
0-25................................................ 377 1,044 1,047 0.4
25-50............................................... 1,834 839 838 -0.2
50-65............................................... 968 666 664 -0.3
Over 65............................................. 168 611 610 -0.2
----------------------------------------------------------------------------------------------------------------

10. On page 28189, second column, last paragraph, lines 6 and 7,
the phrase ``1,741 existing IPFs, of which 450'' is corrected to read
``approximately 1,700 existing IPFs, of which approximately 450''.

(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)

Dated: June 5, 2012.
Jennifer M. Cannistra,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2012-14159 Filed 6-8-12; 8:45 am]
BILLING CODE 4120-01-P

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