Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2023 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Costs Incurred for Qualified and Non-Qualified Deferred Compensation Plans; and Changes to Hospital and Critical Access Hospital Conditions of Participation; Corrections, 66558-66575 [2022-24077]
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66558
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 412, 413, 482, 485, and
495
[CMS–1771–F2]
RIN 0938–AU84
Medicare Program; Hospital Inpatient
Prospective Payment Systems for
Acute Care Hospitals and the LongTerm Care Hospital Prospective
Payment System and Policy Changes
and Fiscal Year 2023 Rates; Quality
Programs and Medicare Promoting
Interoperability Program Requirements
for Eligible Hospitals and Critical
Access Hospitals; Costs Incurred for
Qualified and Non-Qualified Deferred
Compensation Plans; and Changes to
Hospital and Critical Access Hospital
Conditions of Participation;
Corrections
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (HHS).
ACTION: Final rule; correction and
correcting amendment.
AGENCY:
This document corrects
technical and typographical errors in
the final rule that appeared in the
August 10, 2022 Federal Register. The
final rule was titled ‘‘Medicare Program;
Hospital Inpatient Prospective Payment
Systems for Acute Care Hospitals and
the Long Term Care Hospital
Prospective Payment System and Policy
Changes and Fiscal Year 2023 Rates;
Quality Programs and Medicare
Promoting Interoperability Program
Requirements for Eligible Hospitals and
Critical Access Hospitals; Costs Incurred
for Qualified and Non-qualified
Deferred Compensation Plans; and
Changes to Hospital and Critical Access
Hospital Conditions of Participation’’.
DATES:
Effective date: The final rule
corrections and correcting amendment
are effective on November 3, 2022.
Applicability date: The final rule
corrections and correcting amendment
are applicable for discharges occurring
on or after October 1, 2022.
FOR FURTHER INFORMATION CONTACT:
Donald Thompson, and Michele
Hudson, (410) 786–4487 or DAC@
cms.hhs.gov, Operating Prospective
Payment.
Adina Hersko, Adina.Hersko@
cms.hhs.gov and newtech@cms.hhs.gov,
New Technology Add-on Payments
Issues.
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SUMMARY:
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Dawn Linn, dawn.linn@cms.hhs.gov,
Lela Strong, lela.strong@cms.hhs.gov,
and Alpha Wilson, alpha.wilson@
cms.hhs.gov, Conditions of Participation
(CoP) Requirements for Hospitals and
Critical Access Hospitals (CAHs) to
Continue Reporting Data for COVID–19
and Influenza After the PHE ends as
Determined by the Secretary.
Julia Venanzi, julia.venanzi@
cms.hhs.gov, Hospital Inpatient Quality
Reporting Program and Hospital ValueBased Purchasing Program—
Administration Issues
Ariel Cress, ariel.cress@cms.hhs.gov,
Long-Term Care Hospital Quality
Reporting Program—Data Reporting
Issues.
Jessica Warren, jessica.warren@
cms.hhs.gov, Medicare Promoting
Interoperability Program.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2022–48780 of August 10,
2022 (87 FR 48780), there were a
number of technical and typographical
errors that are identified and corrected
in this final rule correction and
correcting amendment. The final rule
corrections and correcting amendment
are applicable to discharges occurring
on or after October 1, 2022, as if they
had been included in the document that
appeared in the August 10, 2022
Federal Register.
II. Summary of Errors
A. Summary of Errors in the Preamble
On pages 48781, 48785, and 49313,
we made typographical and technical
errors in specifying certain fiscal years.
On pages 49195, 49197, 49207, 49217,
49223, 49229, 49263, 49267, and 49311,
we made typographical errors in
referencing a statutory citation.
On page 48789, in the table of the
summary of costs and benefits of certain
major provisions, we are making
conforming corrections to the estimates
discussed in the ‘‘Update to the IPPS
Payment Rates and Other Payment
Policies’’ row resulting from the
correction to the maximum new
technology add-on payment for cases
involving the use of DefencathTM
discussed later in this section of this
final rule correction and correcting
amendment.
On page 48790, in the table of the
summary of costs and benefits of certain
major provisions, we are making
corrections to the description of the
estimates discussed for the HospitalAcquired Condition Program.
On pages 48790, 49308, 49327, 49335,
49377, and 49398, we made technical
and typographical errors in Federal
Register citations and cross-references.
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On pages 48981 through 48982, in our
discussion of new medical services and
technologies, we are correcting the cost
per case and maximum new technology
add-on payment for a case involving the
use of DefencathTM.
On page 49071, we made
typographical errors and an omission in
our discussion of revisions to Worksheet
E–4 of the hospital cost report
instructions.
On page 49087, we made and are
correcting a typographical error in our
discussion of the Hospital Readmission
Reduction Program.
On pages 49095, 49106, 49129, 49248,
49266, 49283, and 49295, we made and
are correcting typographical errors in
several footnotes and footnote
references.
On pages 49201, 49230, 49232, 49233,
49297, and 49308, in the discussion of
the Hospital Inpatient Quality Reporting
(IQR) Program, we are correcting
inadvertent omissions as well as
typographical and technical errors.
On pages 49315, 49317, and 49318, in
the discussion of the Long-term Care
Hospital Quality Reporting Program
(LTCH QRP) we are correcting several
technical and typographical errors.
On pages 49347 and 49362, in the
discussion of the Medicare Promoting
Interoperability Program, we made and
are correcting typographical and
technical errors.
B. Summary of Errors in the Regulations
Text
On page 49410, we inadvertently
made a typographical error in the
paragraph numbering for a paragraph in
§ 482.42(f)(2).
C. Summary of Errors in the Addendum
As discussed further in section II.D. of
this final rule correction and correcting
amendment, we made updates to the
calculation of Factor 3 of the
uncompensated care payment
methodology to reflect updated
information on hospital mergers
received in response to the final rule
and made corrections for report upload
errors and an update to the DSH
eligibility for one provider that was
inadvertently projected not DSH eligible
in the final rule. Based on the March
2022 Provider Specific File’s Medicaid
fraction and the FY 2020 SSI fractions,
this provider is projected DSH eligible
for purposes of interim uncompensated
care payments during FY 2023.
Specifically, there were two merger
updates, one update on a report upload
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discrepancy, and one update on DSH
eligibility projection. We recalculated
the total uncompensated care amount
for all DSH-eligible hospitals to reflect
these updates. In addition, because the
Factor 3 for each hospital reflects that
hospital’s uncompensated care amount
relative to the uncompensated care
amount for all DSH hospitals, we also
recalculated Factor 3 for all DSHeligible hospitals. The hospital-specific
Factor 3 determines the total amount of
the uncompensated care payment a
hospital is eligible to receive for a fiscal
year. This hospital-specific payment
amount is then used to calculate the
amount of the interim uncompensated
care payments a hospital receives per
discharge. Given the small number of
updates to the information used in the
calculation of Factor 3, the change to the
previously calculated Factor 3 for the
majority of hospitals is of limited
magnitude.
We note that the fixed-loss cost
threshold was unchanged after these
Factor 3 recalculations. (As discussed
elsewhere, however, we incorporated
the revised uncompensated care
payment amounts into our recalculation
of the FY 2023 fixed-loss threshold and
related figures to reflect the use of
supplemental outlier reconciliation
data.) We further note that while for
certain prior years, we have also
recalculated the budget neutrality
factors to reflect revisions to the
calculation of Factor 3, in combination
with the correction of other errors, given
the limited magnitude of the changes to
uncompensated care payments, and
because we are not making corrections
to any other components of the
calculation of these budget neutrality
factors for FY 2023, we did not
recalculate any budget neutrality factors
due to the changes to Factor 3.
On pages 49420 through 49421 and
49427 through 49428, we are revising
the calculation of the percentage of
operating outlier reconciliation dollars
to total Federal operating payments
based on the FY 2017 cost reports,
which is used in our projection of
operating outlier reconciliation
payments for the FY 2023 outlier
threshold calculation, to reflect the use
of supplemental outlier reconciliation
data, as discussed in the FY 2023 IPPS/
LTCH PPS final rule, including
additional supplemental data from some
hospitals that had an outlier
reconciliation amount recorded on
Worksheet E, Part A, Line 2.01. In
addition to revising the percentage of
operating outlier reconciliation dollars
to total Federal operating payments, we
are also revising the percentage of
capital outlier payments to total capital
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Federal payments for FY 2017 to reflect
these additional supplemental data for
hospitals that had an outlier
reconciliation amount recorded on
Worksheet E, Part A, Line 93, Column
1. Accordingly, under our established
methodology, this correction to the
percentage of operating outlier
reconciliation dollars to total Federal
operating payments results in a change
in the targeted operating outlier
percentage and the FY 2023 outlier
threshold. In addition, under our
established methodology, the correction
to the percentage of capital outlier
payments to total capital Federal
payments and the change in the FY
2023 outlier threshold results in a
change in the estimated capital outlier
percentage. We note that these
recalculations also reflect the revisions
to Factor 3 of the uncompensated care
payment methodology described
previously.
On pages 49433 through 49437, in our
discussion of the determination of the
Federal hospital inpatient capital
related prospective payment rate
update, due to the correction of the
combination of errors listed previously
(the revisions to Factor 3 of the
uncompensated care payment
methodology, and, in particular, the
corrections to the outlier reconciliation
projections and outlier threshold), we
have made conforming corrections to
the capital outlier adjustment, capital
Federal rate and related figures. On page
49453, we are also making conforming
corrections to the capital standard
Federal payment rate in Table 1D.
On page 49438, we made a
typographical error in referencing a
statutory citation.
In addition, on page 49450, we are
making conforming changes to the
fixed-loss amount for FY 2023 site
neutral payment rate discharges, and the
high cost outlier threshold (based on the
corrections to the IPPS outlier threshold
(that is, fixed-loss amount) discussed
previously).
D. Summary of Errors in and
Corrections to Files and Tables Posted
on the CMS Website
We are correcting the errors in the
following IPPS table that is listed on
page 49453 of the FY 2023 IPPS/LTCH
PPS final rule and is available on the
internet on the CMS website at https://
www.cms.gov/Medicare/Medicare-Feefor-ServicePayment/AcuteInpatientPPS/
index.html. The tables that are available
on the internet have been updated to
reflect the revisions discussed in this
final rule correction and correcting
amendment.
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Table 18—FY 2023 Medicare DSH
Uncompensated Care Payment Factor 3.
For the FY 2023 IPPS/LTCH PPS final
rule, we published a list of hospitals
that we identified to be subsection (d)
hospitals and subsection (d) Puerto Rico
hospitals projected to be eligible to
receive interim uncompensated care
payments for FY 2023. As stated in the
FY 2023 IPPS/LTCH PPS final rule (87
FR 49046) we allowed the public an
additional period after the issuance of
the final rule to review and submit via
email any updated information on
mergers and/or to report upload
discrepancies. We are updating this
table to reflect the information on
mergers, upload discrepancy, and DSH
eligibility received in response to the
final rule and to revise the Factor 3
calculations for purposes of determining
uncompensated care payments for the
FY 2023 IPPS/LTCH PPS final rule. We
are revising Factor 3 for all hospitals to
reflect the updated merger information,
upload discrepancy information, and
DSH eligibility information received in
response to the final rule. We are also
revising the amount of the total
uncompensated care payment
calculated for each DSH eligible
hospital. The total uncompensated care
payment that a hospital receives is used
to calculate the amount of the interim
uncompensated care payments the
hospital receives per discharge. As
previously discussed, given the limited
magnitude of these uncompensated care
payment corrections, and because we
are not making corrections to any other
components of the calculation of the
budget neutrality factors for FY 2023,
we do not believe the revisions to the
uncompensated care payment amounts
merit recalculating all budget neutrality
factors. However, the revised
uncompensated care payment amounts
were incorporated into our recalculation
of the outlier fixed-loss cost threshold
and related figures to reflect the
corrections to the outlier reconciliation
projections used in the FY 2023 outlier
threshold calculation, as described
previously.
E. Summary of Errors in the Appendices
On pages 49457, 49494, and 49495 we
are making conforming corrections to
the estimated overall impact, estimated
overall change in new technology addon payments, and the accounting
statement and table for acute care
hospitals under the IPPS, resulting from
the correction to the maximum new
technology add-on payment for cases
involving the use of DefencathTM
discussed in section II.A. of this final
rule correction and correcting
amendment.
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On pages 49461 through 49463, 49467
through 49468, and 49482 through
49485 in our regulatory impact analyses,
we have made conforming corrections to
certain factors, values, tables and
accompanying discussion of the changes
in operating and capital IPPS payments
for FY 2023 as a result of the technical
errors that lead to changes in our
calculation of the outlier threshold and
capital Federal rate (as discussed in
section II.B. of this final rule correction
and correcting amendment). These
conforming corrections include changes
to the following:
• On pages 49461 through 49463, the
table titled ‘‘Table I—Impact Analysis of
Changes to the IPPS for Operating Costs
for FY 2023’’.
• On pages 49467 through 49468, the
table titled ‘‘Table II—Impact Analysis
of Changes for FY 2023 Acute Care
Hospital Operating Prospective Payment
System (Payments per discharge)’’.
• On pages 49484 and 49485, the
table titled ‘‘TABLE III.—COMPARISON
OF TOTAL PAYMENTS PER CASE [FY
2022 PAYMENTS COMPARED TO FY
2023 PAYMENTS]’’.
On pages 49469 through 49470, we
are correcting values in tables and
estimated total payment values in
accompanying discussion resulting from
the correction to the maximum new
technology add-on payment for cases
involving the use of DefencathTM.
On page 49470, under the table
displaying the FY 2023 Estimates for
New Technology Add-On Payments for
FY 2023, we are correcting the
inadvertent omission of the heading for
the next section.
On pages 49471 through 49474 we are
correcting the discussion of the ‘‘2.
Effects of Changes to Medicare DSH and
Uncompensated Care Payments for FY
2023 and the New Supplemental
Payment for Indian Health Service
Hospitals and Tribal Hospitals and
Hospitals Located in Puerto Rico’’ for
purposes of the Regulatory Impact
Analysis in Appendix A of the FY 2023
IPPS/LTCH PPS final rule, including the
table titled ‘‘Modeled Uncompensated
Care Payments* and Supplemental
Payments for Estimated FY 2023 DSHs
by Hospital Type*’’ on pages 49472 and
49473, in light of the corrections
discussed in section II.D. of this final
rule correction and correcting
amendment.
III. Waiver of Proposed Rulemaking
and Delay in Effective Date
Under 5 U.S.C. 553(b) of the
Administrative Procedure Act (APA),
the agency is required to publish a
notice of the proposed rulemaking in
the Federal Register before the
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provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Act
requires the Secretary to provide for
notice of the proposed rulemaking in
the Federal Register and provide a
period of not less than 60 days for
public comment. In addition, section
553(d) of the APA, and section
1871(e)(1)(B)(i) of the Act mandate a 30day delay in effective date after issuance
or publication of a rule. Sections
553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the notice
and comment and delay in effective date
APA requirements; in cases in which
these exceptions apply, sections
1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the
Act provide exceptions from the notice
and 60-day comment period and delay
in effective date requirements of the Act
as well. Section 553(b)(B) of the APA
and section 1871(b)(2)(C) of the Act
authorize an agency to dispense with
normal rulemaking requirements for
good cause if the agency makes a
finding that the notice and comment
process are impracticable, unnecessary,
or contrary to the public interest. In
addition, both section 553(d)(3) of the
APA and section 1871(e)(1)(B)(ii) of the
Act allow the agency to avoid the 30day delay in effective date where such
delay is contrary to the public interest
and an agency includes a statement of
support.
We believe that this correcting
document does not constitute a rule that
would be subject to the notice and
comment or delayed effective date
requirements. This document corrects
technical and typographical errors in
the preamble, regulations text,
addendum, payment rates, tables, and
appendices included or referenced in
the FY 2023 IPPS/LTCH PPS final rule,
but does not make substantive changes
to the policies or payment
methodologies that were adopted in the
final rule. As a result, this correcting
document is intended to ensure that the
information in the FY 2023 IPPS/LTCH
PPS final rule accurately reflects the
policies adopted in that document.
In addition, even if this were a rule to
which the notice and comment
procedures and delayed effective date
requirements applied, we find that there
is good cause to waive such
requirements. Undertaking further
notice and comment procedures to
incorporate the corrections in this
document into the final rule or delaying
the effective date would be contrary to
the public interest because it is in the
public’s interest for providers to receive
appropriate payments in as timely a
manner as possible, and to ensure that
the FY 2023 IPPS/LTCH PPS final rule
accurately reflects our policies.
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Furthermore, such procedures would be
unnecessary, as we are not altering our
payment methodologies or policies, but
rather, we are simply implementing
correctly the methodologies and policies
that we previously proposed, requested
comment on, and subsequently
finalized. This correcting document is
intended solely to ensure that the FY
2023 IPPS/LTCH PPS final rule
accurately reflects these payment
methodologies and policies. Therefore,
we believe we have good cause to waive
the notice and comment and effective
date requirements. Moreover, even if
these corrections were considered to be
retroactive rulemaking, they would be
authorized under section
1871(e)(1)(A)(ii) of the Act, which
permits the Secretary to issue a rule for
the Medicare program with retroactive
effect if the failure to do so would be
contrary to the public interest. As we
have explained previously, we believe it
would be contrary to the public interest
not to implement the corrections in this
final rule correction for discharges
occurring on or after October 1, 2022,
because it is in the public’s interest for
providers to receive appropriate
payments in as timely a manner as
possible, and to ensure that the FY 2023
IPPS/LTCH PPS final rule accurately
reflects our policies.
IV. Correction of Errors
In FR Doc. 2022–16472 of August 10,
2022 (87 FR 48780), we are making the
following corrections:
A. Correction of Errors in the Preamble
1. On page 48781, first column,
a. Lines 23 and 24, the phrase ‘‘S–3
Wage Data for the FY 2022 Wage Index’’
is corrected to read ‘‘S–3 Wage Data for
the FY 2023 Wage Index’’.
b. Lines 27 and 28, the phrase,
‘‘Computing the FY 2022 Unadjusted
Wage Index’’ is corrected to read
‘‘Computing the FY 2023 Unadjusted
Wage Index’’.
c. Line 74, the phrase ’’ Updates for
FY 2022 (§ 412.64(d))’’ is corrected to
read ‘‘Updates for FY 2023
(§ 412.64(d))’’.
2. On page 48785, second column,
third paragraph, the phrase ‘‘FY 2024’’
is corrected to read ‘‘FY 2023’’.
3. On page 48789, in the untitled
table, second column (Description of
Costs, Transfers, Savings, and Benefits),
third row (Update to the IPPS Payment
Rates and Other Payment Policies),
a. Line 2, the figure ‘‘$1.4 billion’’ is
corrected to read ‘‘$1.5 billion’’.
b. Line 4, the figure ‘‘$1.0 billion’’ is
corrected to read ‘‘$0.9 billion’’.
4. On page 48790, in the untitled
table,
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a. Second column (Description of
Costs, Transfers, Savings, and Benefits),
(1) First row, lines 3 and 4, the
phrase, ‘‘specific HSRs and a 30-day
preview period for the NHSN CDC HAI
measures.’’ is corrected to read ‘‘specific
HSRs and a 30-day preview period.’’.
(2) Last row, line 1, the reference,
‘‘section XII.B.10.’’ is corrected to read
‘‘section XII.B.11.’’
b. Following the table (Table Note 1),
the sentence beginning with the phrase
‘‘1For the purpose’’ and ending with the
phrase ‘‘and CABG).’’ is corrected by
removing the sentence.
5. On page 48981,
a. First column, fourth full paragraph,
lines 14 and 15, the phrase ‘‘$5,850 to
the hospital, per patient’’ is corrected to
read ‘‘$1,950 per 5mL vial. ‘‘
b. Third column, last partial
paragraph, lines 2 and 3, the language
‘‘the cost per case of the DefenCathTM is
$5,850’’ is corrected to read ‘‘the cost of
DefenCathTM is $1,950 per vial. Per the
applicant, the average utilization of
DefenCathTM is 9.75 vials per patient,
resulting in an average cost per case of
$19,012.50.’’
6. On page 48982, first column, first
partial paragraph, line 5, the figure
‘‘$4,387.50’’ is corrected to read
‘‘$14,259.38’’.
7. On page 49071,
a. Second column, last partial
paragraph,
(1) Line 15, the phrase ‘‘line 9 minus
line 8’’ is corrected to read ‘‘line 8
minus line 9’’.
(2) Lines 18 and 19, the phrase ‘‘line
9 minus line 8’’ is corrected to read
‘‘line 8 minus line 9’’.
(3) Lines 19 and 20, the phrase ‘‘line
9 minus line 8’’ is corrected to read
‘‘line 8 minus line 9’’.
b. Third column, first partial
paragraph, lines 1 and 2, the phrase
‘‘minus line 8 on line 20,’ but we
believe they meant to say ‘on line 22’).’’
is corrected to read ‘‘minus line 8’ but
we believe they meant to state ‘line 8
minus line 9.’ We also note that the
commenters indicated to enter the result
‘on line 20,’ but we believe they meant
to state ‘on line 22’).’’.
8. On page 49087, second column,
third full paragraph, line 13, the phrase
‘‘COVID–10 specific ICD–10’’ is
corrected to read ‘‘COVID–19 specific
ICD–10’’.
9. On page 49095, first column, third
footnote paragraph (footnote 232), the
parenthetical web address,
‘‘(statnews.com)’’ is corrected to read
‘‘https://www.statnews.com/2021/09/
20/covid-19-set-to-overtake-1918spanish-flu-as-deadliest-disease-inamerican-history/’’.
10. On page 49106,
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a. First column, first paragraph
(footnote 275), lines 3 through 5, the
phrase, ‘‘Fleisher et al. (2022). New
England Journal of Medicine. Article
available here:’’ is corrected to read
‘‘Fleisher et al. (2022). Health Care
Safety During the Pandemic and
Beyond—Building a System That
Ensures Resilience. New England
Journal of Medicine. Available at:’’
b. Second column—
(1) Sixth footnote paragraph (footnote
283), lines 4 through 10, the hyperlink,
https://www.fda.gov/news-events/pressannouncements/coronavirus-covid-19update-fda-authorizes-additional-oralantiviral-treatment-covid-19-certain#:
∼:text=Today%2C%20the%20
U.S.%20Food%20and,progression
%20to%20severe%20COVID
%2D19%2C is corrected to read: https://
www.fda.gov/news-events/pressannouncements/coronavirus-covid-19update-fda-authorizes-additional-oralantiviral-treatment-covid-19-certain
(2) Eighth footnote paragraph
(footnote 285), lines 3 through 7, the
hyperlink, ‘‘https://
www.washingtonpost.com/politics/
biden-to-give-away-400-million-n95masks-starting-next-week/2022/01/19/
5095c050-;7915-11ec-9dce7313579de434_story.html’’ is corrected
to read ‘‘https://
www.washingtonpost.com/kidspost/
2022/01/19/biden-give-away-400million-n95-masks/’’.
11. On page 49129, first column,
footnote paragraph (Footnote 314), line
5 and 6, the hyperlink ‘‘https://
oig.hhs.govAd/oei/reports/OEI-06-1800400.asp’’ is corrected to read https://
oig.hhs.gov/oei/reports/OEI-06-1800400.asp.
12. On page 49195, third column, first
full paragraph, lines 3 and 4, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
13. On page 49197, second column,
third full paragraph, lines 11 and 12, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
14. On page 49201, first column,
second full paragraph, lines 11 through
17, the sentence ‘‘First, because social
risk factors disproportionately impact
historically 481’’ is corrected to read
‘‘First, because social risk factors
disproportionately impact underserved
communities, promoting screening for
these factors could serve as evidencebased building blocks for supporting
hospitals and health systems in
actualizing commitment to address
disparities, improve health equity
through addressing the social needs
with community partners, and
implement associated equity measures
to track progress.’’.
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15. On page 49207, first column,
second full paragraph, lines 3 and 4, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
16. On page 49217, first column,
second full paragraph, line 3, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
17. On page 49223, second column,
first full paragraph, lines 7 and 8, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
18. On page 49229, first column, first
full paragraph, lines 4 and 5, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
19. On page 49230, top third of the
page, second column, second full
paragraph, lines 2 through 6, the
sentence ‘‘The measure is designed to be
calculated by the hospitals’ CEHRT
using the patient-level data and then
submitted by hospitals to CMS.’’ is
corrected to read ‘‘Patient-level data is
to be submitted to CMS where riskadjustment and measure calculation
will occur.’’.
20. On page 49232, lower two-thirds
of the page, first column, last full
paragraph, lines 5 and 6, the phrase ‘‘an
additional hospital unaffiliated with the
first 25’’ is corrected to read ’’ an
additional 5 hospitals unaffiliated with
the first 25’’.
21. On page 49233, third column, first
full paragraph, lines 1 through 5, the
sentence ‘‘We reiterate that this is an
eCQM in which the data is collected
through hospitals’ EHR and designed to
be calculated by the hospital’s CEHRT
(87 FR 28513).’’ is corrected to read ‘‘We
reiterate that this is an eCQM in which
the data is collected through hospitals’
EHR (87 FR 28514). The measure is
designed for patient-level data to be
submitted to CMS where riskadjustment and measure calculation
will occur.’’.
22. On page 49248, first column, 10th
footnote paragraph (Footnote 919), lines
1 and 2, the phrase, ‘‘Ma kela K.T.,
Peltola M., Sund R, Malmivaara A., Ha
kkinen U., Remes V.’’ is corrected to
read ‘‘Ma¨kela¨ K.T., Peltola M., Sund R.,
Malmivaara A., Ha¨kkinen U., Remes
V.’’.
23. On page 49263, third column,
second full paragraph, lines 5 and 6, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
24. On page 49266, third column,
before the first footnote paragraph
(Footnote 981), the footnote paragraphs
are corrected by adding a footnote
(Footnote 980) to read as follows:
‘‘National Quality Forum. Surgery
Fall Cycle 2020. Measure Testing
(subcriteria 2a2, 2b1–2b6) Document.
November 3, 2020. Available at: https://
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nqfappservicesstorage.
blob.core.windows.net/proddocs/22/
Fall/2020/measures/1550/shared/
1550.zip.’’.
25. On page 49267, third column,
second full paragraph, lines 4 and 5, the
reference ‘‘section 1866’’ is corrected to
read ‘‘section 1886’’.
26. On page 49283, first column, sixth
footnote paragraph (footnote 1021), lines
6 and 7, the hyperlink ‘‘https://
jamanetwork.com/journals/
jamanetworkopen/fullarticle/2787181’’
is corrected to read ‘‘https://
jamanetwork.com/journals/
jamanetworkopen/fullarticle/2787184’’.
27. On page 49295, second column,
first partial footnote paragraph (footnote
1074), lines 1 through 4, the hyperlink
‘‘Accessed on Available at: https://
arpsp.cdc.gov/profile/infections/
clabsi?year-select-report=year2019&
year-select-hai-state-list=year2019’’ is
corrected to read ‘‘Accessed July 27,
2021. Available at: https://
arpsp.cdc.gov/profile/nhsn/clabsi.’’
28. On page 49297, second column,
first full paragraph, lines 17 and 18, the
phrase ‘‘increase the risk of developing
CDIs. ’’ is corrected to read ‘‘increase the
risk of contracting HAIs.’’.
29. On page 49308, second column,
last partial paragraph, line 18, the
citation (85 FR 58952 through 58944)’’
is corrected read ‘‘(85 FR 58942 through
58953)’’.
30. On page 49311, first column, first
full paragraph, line 3, the reference
‘‘section 1866’’ is corrected to read
‘‘section 1886’’.
31. On page 49312, first column, last
partial paragraph, line 1, the reference
‘‘section 1866’’ is corrected to read
‘‘section 1886’’.
32. On page 49313, third column,
third full paragraph, line 7, the phrase
‘‘FY 2021 confidential’’ is corrected to
read ‘‘FY 2022 confidential’’.
33. On page 49315, middle of the
page, in the table titled ‘‘Table IX.G.-01.
Quality Measures Currently Adopted for
the FY 2023 LTCH QRP’’, the entries in
rows 3 and 4 are corrected to read as
follows:
TABLE IX.G.-01. QUALITY MEASURES CURRENTLY ADOPTED FOR
THE FY 2023 LTCH QRP
Functional Assessment
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Application of Functional
Assessment/Care Plan
34. On page 49317, first column, fifth
paragraph, lines 10 and 11, the phrase,
‘‘This commenter also suggested CMS to
work with CMS to determine’’ is
corrected to read ‘‘This commenter also
suggested CMS determine’’.
35. On page 49318—
a. Second column, third full
paragraph, line 1, the phrase, ‘‘A
number of commenters provider’’ is
corrected to read ‘‘A number of
commenters provided’’.
b. Third column, first full paragraph,
lines 36 through 40, the sentence, ‘‘We
also received one comment
recommending CMS use a combination
of peer group benchmarking and
statistical significance. ’’ is corrected
read ‘‘A commenter also suggested
additional guiding principles.’’
36. On page 49327, third column, first
partial paragraph, line 3, the reference
‘‘[TABLE XX]’’ is corrected to read
‘‘Table IX.H.-07’’.
37. On page 49335, third column,
second full paragraph, line 14, the
citation ‘‘(87 FR 28586 through 28587)’’
is corrected to read ‘‘(87 FR 28585
through 28587)’’.
38. On page 49347, third column, first
partial paragraph, line 15, the phrase,
‘‘We finalized our proposal’’ should
read ‘‘We are finalizing our proposal’’.
39. On page 49362, second column,
first partial paragraph, lines 11 through
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15, the sentence ‘‘Testing established
the feasibility of the measure, first in 25
hospitals across eight healthcare sites
and then in additional hospital
unaffiliated with the first 25.’’ is
corrected to read ‘‘The measure
developer’s testing established the
feasibility of the measure, first in 25
hospitals across 8 healthcare sites and
then in an additional 5 hospitals
unaffiliated with the first 25, and across
several different electronic health record
systems.’’.
40. On page 49377, third column, first
partial paragraph, lines 31 and 32, the
reference ‘‘sections XII.B.10. and
XII.H.11, ’’ is corrected to read ‘‘sections
XII.B.11. of the preamble and I.H.11. of
the Appendix,’’.
41. On page 49398, second column,
first full paragraph, lines 1 and 2, the
reference, ‘‘section XX.B.2.’’ is corrected
to read ‘‘section X.B.2.’’.
B. Corrections to the Addendum
1. On page 49420, first column,
second full paragraph,
a. Line 24, the phrase ‘‘2 additional’’
is corrected to ‘‘8 additional’’.
b. Line 32, the phrase ‘‘2 hospitals’ ’’
is corrected to ‘‘8 hospitals’ ’’ .
c. Line 40, the phrase ‘‘2 additional’’
is corrected to ‘‘8 additional’’.
d. Lines 42 and 43, the phrase ‘‘2
hospitals, a total of 17 hospitals’’ is
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corrected to read as follows ‘‘8
hospitals, a total of 23 hospitals’’.
e. Line 47, the phrase ‘‘negative
$17,153,313 (Step 2)’’ is corrected to
read as follows ‘‘negative $25,475,549
(Step 2)’’.
f. Line 50, the phrase, ‘‘2 hospitals is
$88,414,357,653 (Step 3)’’ is corrected to
read as follows ‘‘8 hospitals is
$88,407,788,794 (Step 3)’’.
g. Lines 51 and 52, the phrase
‘‘negative 0.019401 percent’’ is
corrected to read ‘‘negative 0.028816
percent’’.
h. Line 53, the phrase ‘‘negative 0.02
percent’’ is corrected to read ‘‘negative
0.03 percent’’.
i. Lines 57 and 58, ‘‘5.12 percent [5.1
percent¥(¥ 0.02 percent)]’’ is corrected
to read ‘‘5.13 percent [5.1 percent¥(¥
0.03 percent)]’’.
2. On page 49421,
a. Second column,
(1) First partial paragraph, lines 4 and
5, the phrase ‘‘supplemented for 2
hospitals for a total of 14 hospitals,’’ is
corrected to read ‘‘supplemented for 8
hospitals for a total of 20 hospitals,’’.
(2) First full paragraph,
(a) Lines 2 and 3, the phrase ‘‘2
hospitals, 14 hospitals’’ is corrected to
read ‘‘8 hospitals, 20 hospitals’’.
(b) Line 6, the figure ‘‘$1,101,225’’ is
corrected to read ‘‘$2,556,541’’.
E:\FR\FM\04NOR1.SGM
04NOR1
ER04NO22.082
Measure Name & Data Source
LTCH CARE Data Set
Percent of Long-Term Care Hospital (LTCH) Patients with an Admission and
Discharge Functional Assessment and a Care Plan That Addresses Function
Application of Percent ofLong-Term Care Hospital (LTCH) Patients with an
Admission and Discharge Functional Assessment and a Care Plan That Addresses
Function
Short Name
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
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(c) Line 9, the figure ‘‘$7,995,731,783’’
is corrected to read ‘‘$7,994,424,546’’.
(d) Line 10, the figure, ‘‘0.013773’’ is
corrected to read ‘‘0.031979’’.
(e) Line 11, the figure, ‘‘0.01’’ is
corrected to read ‘‘0.03’’.
(f) Line 17, the figure ‘‘0.01’’ is
corrected to read ‘‘0.03’’.
(g) Line 20, the figure ‘‘0.01’’ is
corrected to read ‘‘0.03’’.
b. Third column, last full paragraph,
(1) Line 2, the figure ‘‘5.66 percent’’
is corrected to read ‘‘5.67 percent’’.
(2) Line 4, the phrase ‘‘$406,733,862
divided by $7,190,928,057’’ is corrected
to read ‘‘$407,648,341 divided by
‘‘$7,190,718,976’’.
(3) Line 6, the figure ‘‘$406,733,862’’
is corrected to read ‘‘$407,648,341’’.
(4) Line 7, the figure ‘‘$6,784,194,195’’
is corrected to read ‘‘$6,783,070,635’’.
(5) Line 11, the figure ‘‘5.40 percent’’
is corrected to read ‘‘5.41 percent’’.
(6) Line 12, the figure ‘‘$346,066,050’’
is corrected to read ‘‘$346,855,738’’.
(7) Line 13, the figure
‘‘$6,412,816,596’’ is corrected to read
‘‘$6,412,729,550’’.
(8) Line 14, the figure ‘‘$346,066,050’’
is corrected to read ‘‘$346,855,738’’.
(9) Line 16, the figure
‘‘$6,066,750,547’’ is corrected to read
‘‘$6,065,873,812’’.
(10) Line 20, the figure ‘‘5.53 percent’’
is corrected to read ‘‘5.54 percent’’.
(11) Line 26, the figure ‘‘0.01 percent’’
is corrected to read ‘‘0.03 percent’’.
(12) Line 30, the figure ‘‘5.53 percent’’
is corrected to read ‘‘5.54 percent’’.
(13) Lines 34 and 35, the equation
‘‘5.52 percent (5.53 percent¥0.01
percent)’’ is corrected to read 5.51
percent (5.54 percent¥0.03 percent)’’.
3. On page 49427, third column,
second full paragraph, line 31, the figure
‘‘5.12’’ is corrected to ‘‘5.13’’.
4. On page 49428,
a. Top of the page,
(1) First column,
(a) First partial paragraph,
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(i) Lines 3 through 5, the phrase
‘‘0.019401 percent, which when
rounded to the second digit, is 0.02
percent’’ is corrected to ‘‘0.028816
percent, which when rounded to the
second digit, is 0.03 percent’’
(ii) Lines 8 and 9, the mathematical
expression ‘‘5.12 percent [5.1
percent¥(0.02 percent)]’’ is corrected to
read ‘‘5.13 percent [5.1 percent¥(¥0.03
percent)]’’.
(b) Third full paragraph,
(i) Line 4, the figure ‘‘$39,389’’ is
corrected to read ‘‘$39,317’’.
(ii) Line 6, the figure
‘‘$4,658,400,549’’ is corrected to read
‘‘$4,667,954,052’’.
(iii) Line 7, the figure
‘‘$86,325,462,972’’ is corrected to read
‘‘$86,324,951,579’’.
(iv) Line 11, the figure ‘‘5.12’’ is
corrected to read ‘‘5.13’’.
(c) Second partial paragraph, line 2,
the figure ‘‘$38,328’’ is corrected to read
‘‘$38,259’’.
(2) Second column,
(a) First partial paragraph,
(i) Line 2, the figure ‘‘$4,073,729,554’’
is corrected to read ‘‘$4,081,975,259’’
(ii) Line 3, ‘‘$75,488,568,943’’ is
corrected to ‘‘$75,488,113,785’’
(iii) Line 7, the figure ‘‘5.12’’ is
corrected to read ‘‘5.13’’.
(b) First full paragraph, last line, the
mathematical expression ‘‘$38,859
(($39,389 + $38,328)/2)).’’ is corrected to
read ‘‘$38,788 (($39,317 + $38,259)/2)).’’
(3) Third column, first partial
paragraph, lines 33 and 34, the figure
‘‘5.52 percent’’ is corrected to read ‘‘5.51
percent’’.
b. Lower fourth of the page, in the
untitled table, the figure ‘‘0.944837’’ is
corrected to read ‘‘0.944910’’.
4. On page 49433, second column,
first full paragraph, line 6, the figure
‘‘2.36 percent’’ is corrected to read ‘‘2.37
percent’’.
5. On page 49435, first column,
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66563
a. First partial paragraph, line 22, the
figure ‘‘5.53 percent’’ is corrected to
read ‘‘5.54 percent’’.
b. First full paragraph,
(1) Line 6, the figure ‘‘0.01 percent’’
is corrected to read ‘‘0.03 percent’’.
(2) Lines 8 through 12, the phrase
‘‘estimated outlier payments for capitalrelated PPS payments would equal 5.52
percent (5.53 percent ¥0.01 percent) of
inpatient capital-related payments’’ is
corrected to read ‘‘estimated outlier
payments for capital-related PPS
payments would equal 5.51 percent
(5.54 percent¥0.03 percent) of inpatient
capital-related payments’’.
(3) Line 14, the figure ‘‘0.9448’’ is
corrected to read ‘‘0.9449’’.
c. Second full paragraph,
(1) Lines 4 through 7, the sentence
‘‘The FY 2023 outlier adjustment of
0.9448 is a ¥0.24 percent change from
the FY 2022 outlier adjustment of
0.9471’’ is corrected to read ‘‘The FY
2023 outlier adjustment of 0.9449 is a
¥0.23 percent change from the FY 2022
outlier adjustment of 0.9471’’.
(2) Lines 9 and 10, the mathematical
phrase ‘‘0.9976 (0.9448/0.9471)’’ is
corrected to read ‘‘0.9977 (0.9449/
0.9471)’’.
(3) Line 12, the figure ‘‘¥0.24’’ is
corrected to read ‘‘¥0.23’’.
6. On page 49436, third column,
a. First full paragraph,
(1) Line 9, the figure $483.76’’ is
corrected to read ‘‘$483.79’’.
(2) Last line, the figure ‘‘0.9448’’ is
corrected to read ‘‘0.9449’’.
b. Last paragraph,
(1) Line 18, the figure ‘‘0.24’’ is
corrected to read ‘‘0.23’’.
(2) Line 22, the figure ‘‘2.36’’ is
corrected to read ‘‘2.37’’.
7. On page 49437,
a. Top of the page, the table
‘‘Comparison of Factors and
Adjustments: FY 2022 Capital Federal
Rate and the FY 2023 Capital Federal
Rate’’ is corrected to read as follows:
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COMPARISON OF FACTORS AND ADJUSTMENTS: FY 2022 CAPITAL FEDERAL
RATE AND THE FY 2023 CAPITAL FEDERAL RATE
FY2022
1.0080
1.0004
0.9974
0.9471
$472.59
Update Factor 1
GAF/DRG Adjustment Factor 1
Quartile/Cap Adjustment Factor2
Outlier Adjustment Factor3
Capital Federal Rate
FY2023
1.0250
1.0012
0.9972
0.9449
$483.79
Change
1.0250
1.0012
0.9998
0.9977
1.0237
Percent Change
2.50
0.12
-0.02
-0.23
2.37 4
1 The update factor and the GAF/DRG budget neutrality adjustment factors are built permanently into the capital Federal rate. Thus, for
example, the incremental change from FY 2022 to FY 2023 resulting from the application of the 1.0012 GAF/DRG budget neutrality adjustment
factor for FY 2023 is a net change of0.0012 (or 0.12 percent).
2 The lowest quartile/cap budget neutrality adjustment factor is not built permanently into the capital Federal rate; that is, the factor is not
applied cumulatively in determining the capital Federal rate. Thus, for example, the net change resulting from the application of the FY 2023
lowest quartile/cap budget neutrality adjustment factor is 0.9972/0.9974 or 0.9998 (or -0.02 percent).
3 The outlier reduction factor is not built permanently into the capital Federal rate; that is, the factor is not applied cumulatively in determining
the capital Federal rate. Thus, for example, the net change resulting from the application of the FY 2023 outlier adjustment factor is
0.9449/0.9471 or 0.9977 (or-0.23 percent).
4 Percent change may not sum due to rounding.
b. Lower two-thirds of the page, first
column, second full paragraph, last line,
the figure ‘‘38,859’’ is corrected to read
‘‘$38,788’’.
8. On page 49438, second column,
first full paragraph, lines 45 and 46, the
reference ‘‘section 1866(m)(5)’’ is
corrected to read ‘‘section 1886(m)(5)’’.
9. On page 49450, first full paragraph,
a. Line 11, the figure ‘‘$38,859’’ is
corrected to read ‘‘$38,788’’.
b. Last line, the figure ‘‘$38,859’’ is
corrected to read ‘‘$38,788’’.
10. On page 49453, bottom of the
page, the table titled ‘‘TABLE 1D—
CAPITAL STANDARD FEDERAL
PAYMENT RATE—FY 2023’’ is
corrected to read as follows:
TABLE lD.-CAPITAL STANDARD FEDERAL PAYMENT RATE-FY 2023
Rate
I
$483.79
National
D. Corrections to the Appendices
Analysis of Changes to the IPPS for
Operating Costs for FY 2023’’ is
corrected to read as follows:
ER04NO22.084
BILLING CODE 4120–01–P
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1. On page 49457, third column, last
paragraph,
a. Line 8, the figure ‘‘$1.4 billion’’ is
corrected to read ‘‘$1.5 billion’’.
b. Line 14, the figure ‘‘$1.0 billion’’ is
corrected to read ‘‘$0.9 billion’’.
2. On pages 49461 through 49463, the
column titled ‘‘All FY 2023 Changes’’ in
the table titled, ‘‘Table I—Impact
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66565
All FY 2023
Changes
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2.6
2.6
2.4
1.1
2.9
3.1
2.7
2.4
0.9
1.3
3.5
3.1
3.4
3.2
2.5
2.3
2.2
2.4
2.5
3.0
4.1
2.4
3.9
0.1
2.5
0.1
2.9
3.6
3.2
2.8
2.9
3.4
2.5
2.7
2.6
2.7
2.5
2.3
2.6
2.7
1.7
3.8
2.8
0.1
-4.0
Fmt 4700
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(8)9
All Hospitals
By Geographic Location:
Urban hospitals
Rural hospitals
Bed Size (Urban):
0-99 beds
100-199 beds
200-299 beds
300-499 beds
500 or more beds
Bed Size (Rural):
0-49 beds
50-99 beds
100-149 beds
150-199 beds
200 or more beds
Urban by Region:
New England
Middle Atlantic
East North Central
West North Central
South Atlantic
East South Central
West South Central
Mountain
Pacific
Puerto Rico
Rural by Region:
New England
Middle Atlantic
East North Central
West North Central
South Atlantic
East South Central
West South Central
Mountain
Pacific
By Payment Classification:
Urban hospitals
Rural areas
Teachine Status:
Nonteaching
Fewer than 100 residents
100 or more residents
UrbanDSH:
Non-DSH
100 or more beds
Less than 100 beds
RuralDSH:
Non-DSH
SCH
RRC
100 or more beds
Less than 100 beds
Urban teachine and DSH:
66566
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
AIIFY 2023
Changes
(8)9
All Hospitals
By Geographic Location:
Both teaching and DSH
Teaching and no DSH
No teaching and DSH
No teaching and no DSH
Special Hospital Types:
RRC
RRC with Section 401 Reclassification
SCH
SCH with Section 401 Reclassification
SCHandRRC
SCH and RRC with Section 401 Reclassification
Type of Ownership:
Voluntary
Proprietmy
Government
Medicare Utilization as a Percent of Inpatient Days:
0-25
25-50
50-65
Over 65
Medicaid Utilization as a Percent of Inpatient Days:
0-25
25-50
50-65
Over 65
Hospitals with 5% or more of cases that reported experiencing
homelessness
FY 2023 Reclassifications:
All Reclassified Hospitals
Non-Reclassified Hospitals
Urban Hospitals Reclassified
Urban Nonreclassified Hospitals
Rural Hospitals Reclassified Full Year
Rural N onreclassified Hospitals Full Year
All Section 401 Reclassified Hospitals
Other Reclassified Hospitals (Section 1886(d)(8)(B))
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of Changes for FY 2023 Acute Care
Hospital Operating Prospective Payment
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2.5
2.0
2.8
2.5
2.0
2.8
3.6
3.8
3.5
3.3
2.5
3.3
2.4
2.9
2.5
2.8
0.3
2.4
2.8
3.5
4.4
3.9
2.8
2.4
2.7
2.5
2.8
1.9
2.7
0.6
System (Payments per discharge)’’ is
corrected to read as follows:
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3. On pages 49467 through 49468, the
table titled ‘‘Table II—Impact Analysis
2.6
All Hospitals
Bv Geoe:raohic Location:
Urban hospitals
Rural hospitals
Bed Size (Urban):
0-99 beds
100-199 beds
200-299 beds
300-499 beds
500 or more beds
Bed Size 2014
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Number
of
Hospitals
Estimated
Average
FY2022
Payment
Per
Discharge
Estimated
Average
FY 2023
Payment
Per
Discharge
FY2023
Changes
(1)
(4)
(2)
(3)
3,142
15,064
15,454
2.6
2,420
722
15,450
11,264
15,854
11,530
2.6
2.4
653
700
411
409
245
11,638
12,336
13,921
15,259
19,035
11,762
12,694
14,346
15,678
19,494
1.1
2.9
3.1
2.7
2.4
358
201
84
46
33
9,656
10,973
10,930
12,354
12,935
9,744
11,119
11,313
12,741
13,372
0.9
1.3
3.5
3.1
3.4
107
295
373
156
402
140
362
176
359
50
16,943
18,132
14,666
14,816
13,341
12,824
13,506
15,343
19,835
9,110
17,482
18,592
15,002
15,141
13,661
13,148
13,916
15,967
20,307
9,461
3.2
2.5
2.3
2.2
2.4
2.5
3
4.1
2.4
3.9
19
49
113
86
109
141
134
47
24
16,103
11,001
11,471
11,804
10,381
10,144
9,730
13,126
15,534
16,126
11,282
11,487
12,144
10,759
10,464
10,002
13,501
16,066
0.1
2.5
0.1
2.9
3.6
3.2
2.8
2.9
3.4
1,861
1,281
14,338
15,990
14,701
16,415
2.5
2.7
1,939
929
274
11,851
13,898
21,998
12,157
14,267
22,555
2.6
2.7
2.5
369
1,129
12,491
14,828
12,783
15,207
2.3
2.6
Sfmt 4725
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04NOR1
66567
ER04NO22.087
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Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
Less than 100 beds
RuralDSH:
Non-DSH
SCH
RRC
100 or more beds
Less than 100 beds
Urban teachin2: and DSH:
Both teaching and DSH
Teaching and no DSH
No teaching and DSH
No teaching and no DSH
Special Hospital Types:
RRC
RRC with Section 401 Reclassification
SCH
SCH with Section 401 Reclassification
SCHandRRC
SCH and RRC with Section 401 Reclassification
Type of Ownership:
Voluntarv
Proprietarv
Government
Medicare Utilization as a Percent of Inpatient
Days:
0-25
25-50
50-65
Over 65
Medicaid Utilization as a Percent oflnpatient
Days:
0-25
25-50
50-65
Over 65
Hospitals with 5% or more of cases that
reported experiencin2: homelessness
FY 2023 Reclassifications:
All Reclassified Hospitals
Non-Reclassified Hospitals
Urban Hospitals Reclassified
Urban Nonreclassified Hospitals
Rural Hospitals Reclassified Full Year
Rural N onreclassified Hospitals Full Year
All Section 401 Reclassified Hospitals
Other Reclassified Hospitals (Section
1886(d)(8)(B))
VerDate Sep<11>2014
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Number
of
Hospitals
Estimated
Average
FY2022
Payment
Per
Discharge
Estimated
Average
FY2023
Payment
Per
Discharge
FY2023
Changes
(1)
(4)
(2)
(3)
363
10,749
11,039
2.7
105
264
674
22
216
14,163
12,442
16,726
13,264
9,297
14,406
12,911
17,199
13,280
8,921
1.7
3.8
2.8
0.1
-4
663
60
829
309
16,060
14,060
12,077
11,689
16,457
14,347
12,410
11,984
2.5
2
2.8
2.5
148
470
256
47
122
39
11,620
17,565
11,626
14,462
13,174
15,623
11,849
18,059
12,046
15,009
13,637
16,135
2
2.8
3.6
3.8
3.5
3.3
1,915
789
438
15,141
13,173
17,122
15,516
13,614
17,542
2.5
3.3
2.4
790
2,072
225
30
17,643
14,501
12,154
9,588
18,156
14,860
12,497
9,614
2.9
2.5
2.8
0.3
2,082
942
94
24
13,649
17,466
20,166
21,038
13,981
17,950
20,874
21,973
2.4
2.8
3.5
4.4
45
19,202
19,954
3.9
1,004
2,138
840
1,594
282
426
615
15,971
14,291
16,472
14,488
11,381
11,120
17,132
16,419
14,632
16,915
14,853
11,697
11,328
17,592
2.8
2.4
2.7
2.5
2.8
1.9
2.7
56
10,488
10,554
0.6
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ER04NO22.088
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66568
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
4. On page 49469, lower half of the
page, third column, first partial
paragraph,
a. Line 9, the figure ‘‘$88.45 million’’
is corrected to read ‘‘$164.72 million’’.
b. Line 12, the figure ‘‘$33.9 million’’
is corrected to read ‘‘$110.17 million’’.
5. On page 49470,
a. Top of the page, in the table titled
‘‘FY 2023 Estimates for New Technology
66569
Add-On Payments for Technologies
under the Alternative Pathway for FY
2023’’, the table is corrected to read as
follows:
FY 2023 Estimates for New Technolo2v Add-On Pavments for Technolo2ies under the Alternative Pathwa for FY 2023
Pathway (QIDP, LPAD,
FY2023NTAP
or Breakthrough
Estimated
Amount
Estimated Total
(65 % or 75 %)
Technolo!!v Name
Device)
FY 2023 Impact
Cases
Cerament®G
Breakthrough Device
1610
$4,918.55
$7,918,865.50
GORE® TAG® Thoracic Branch Endoprosthesis
Breakthrough Device
$27,807.00
$10,733,502.00
386
iFuse Bedrock Granite Implant Svstem
Breakthrough Device
1,480
$9,828.00
$14,545,440.00
Breakthrough Device
Thoraflex™ Hvbrid Device
800
$22,750.00
$18,200,000.00
Vivi Stirn®
Breakthrough Device
$23,400.00
$3,159,000.00
135
Defencath™
QIDP
$14,259.38
$110,167,969.88
7726
Estimated Total FY 2023 Impact
$164,724,777.38
b. Lower one-third of the page, in the
table titled ‘‘FY 2023 Estimates for New
Technology Add-On Payments for FY
2023’’, the table is corrected to read as
follows:
FY 2023 ESTIMATES FOR NEW TECHNOLOGY ADD-ON PAYMENTS FOR FY 2023
Estimated Total FY 2023 Impact
Category
Technologies Continuing New Technology Add-On Payments in FY 2023 .........................................................
$619,943,190.45
Alternative Pathway Applications ..........................................................................................................................
Traditional Pathway Applications ...........................................................................................................................
164,724,777.38
75,161,627.94
Aggregate Estimated Total FY 2023 Impact ..................................................................................................
$859,829,595.77
VerDate Sep<11>2014
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Jkt 259001
Health Service Hospitals and Tribal
Hospitals and Hospitals Located in
Puerto Rico’’.
6. On page 49471, third column, first
full paragraph, line 1, the number
‘‘2,368’’ is corrected to ‘‘2,367’’.
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7. On pages 49472 and 49473, the
table titled ‘‘Modeled Uncompensated
Care Payments* and Supplemental
Payments for Estimated FY 2023 DSHs
by Hospital Type’’ is corrected to read
as follows:
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c. Bottom of the page, first column,
partial paragraph, before line 1, the text
is corrected by adding a heading to read
as follows: ‘‘2. Effects of Changes to
Medicare DSH and Uncompensated
Care Payments for FY 2023 and the New
Supplemental Payment for Indian
66570
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
Total
By Geographic Location
Urban Hospitals
Large Urban Areas
Other Urban Areas
Rural Hospitals
Bed Size (Urban)
0 to 99 Beds
100 to 249 Beds
250+ Beds
Bed Size (Rural)
0 to 99 Beds
100 to 249 Beds
250+ Beds
Urban by Region
New England
Middle Atlantic
South Atlantic
East North Central
East South Central
West North Central
West South Central
Mountain
Pacific
Puerto Rico
Rural by Region
New England
Middle Atlantic
South Atlantic
East North Central
East South Central
West North Central
West South Central
Mountain
Pacific
Bv Payment Classification
Urban Hospitals
Large Urban Areas
Other Urban Areas
Rural Hospitals
Teaching Status
Nonteaching
Fewer than 100 residents
100 or more residents
Type of Ownership
Voluntarv
Proprietary
Government
Medicare Utilization
Percent****
VerDate Sep<11>2014
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Number of
Estimated
DSHs
(1)
2,367
Jkt 259001
FY 2022 Final
Rule Estimated
Uncompensated
Care Payments
($ in millions)
FY 2023 Uncompensated
Care Payments and
Supplemental Payments**
($ in millions)
Dollar
Difference:
FY 2022FY2023
($ in
millions)
(2)
(3)
(4)
Percent
Change**
*
(5)
$7,192
$6,971
-$221
-3.08%
1,919
1,005
914
448
6,789
4,146
2,643
403
6,592
4,073
2,519
379
-197
-73
-124
-24
-2.90
-1.76
-4.69
-6.00
363
779
777
284
1,532
4,974
265
1,491
4,836
-19
-41
-137
-6.55
-2.68
-2.76
346
90
12
219
136
47
206
127
45
-13
-9
-2
-5.81
-6.82
-4.53
88
236
313
104
322
126
236
135
316
43
186
819
800
354
1,759
439
1,434
299
607
93
176
765
762
357
1,713
428
1,401
292
611
87
-11
-54
-38
4
-45
-10
-32
-7
3
-6
-5.79
-6.58
-4.76
1.02
-2.58
-2.38
-2.27
-2.35
0.54
-6.24
7
21
66
27
77
116
105
23
6
15
12
43
23
117
85
88
14
5
11
12
43
25
107
81
81
14
6
-3
0
-1
2
-10
-4
-7
-1
1
-23.04
-3.77
-1.81
8.09
-8.75
-4.95
-8.51
-4.60
24.44
1,456
832
624
911
4,482
2,950
1,532
2,710
4,370
2,913
1,458
2,600
-112
-37
-75
-109
-2.50
-1.26
-4.88
-4.03
1,320
778
269
1,961
2,486
2,746
1,905
2,425
2,641
-55
-61
-105
-2.82
-2.46
-3.82
1,477
530
360
4,102
1,017
2,073
4,023
992
1,956
-80
-24
-117
-1.95
-2.38
-5.65
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Modeled Uncompensated Care Payments* and Supplemental Payments for Estimated FY 2023
DSHs by Hospital Type
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
66571
Modeled Uncompensated Care Payments* and Supplemental Payments for Estimated FY 2023
DSHs by Hospital Type
Number of
Estimated
DSHs
(1)
FY 2022 Final
Rule Estimated
Uncompensated
Care Payments
($ in millions)
(2)
3,434
3,685
70
2
FY 2023 Uncompensated
Care Payments and
Supplemental Payments**
($ in millions)
(3)
3,335
3,564
70
2
0 to 25
694
25 to 50
1,552
111
50 to 65
Greater than 65
9
Medicaid Utilization
Percent****
1,377
$3,346
0 to 25
25 to 50
866
3,092
674
50 to 65
100
Greater than 65
24
81
Source: Dobson I Davanzo analysis of2018 and 2019 Hospital Cost Reports.
3,260
3,021
603
86
Dollar
Difference:
FY 2022FY2023
($ in
millions)
(4)
Percent
Change**
*
(5)
-99
-121
0
0
-2.89
-3.29
-0.38
-23.83
-85
-71
-71
5
-2.55
-2.29
-10.49
6.66
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BILLING CODE 4120–01–C
8. On page 49473, lower one-fourth of
the page, second column, partial
paragraph, line 6, the figure ‘‘2,368’’ is
corrected to ‘‘2,367’’.
9. On page 49474, first column,
second full paragraph, line 5 through
the second column, second full
paragraph, last line, the language
(beginning with the phrase ‘‘Rural
hospitals with 250+ beds are projected
to receive’’ and ending with the
sentence ‘‘Hospitals with greater than 65
percent Medicaid utilization are
projected to receive an increase of 6.67
percent.’’) is corrected to read as
follows: ‘‘Rural hospitals, in general, are
projected to experience larger decreases
in uncompensated care payments and
supplemental payments compared to
their uncompensated care payments in
FY 2022, as compared to their urban
counterparts. Overall, rural hospitals are
projected to receive a 6.00 percent
decrease in payments, which is a greater
decrease than the overall hospital
average, while urban hospitals are
projected to receive a 2.90 percent
decrease in payments, which is a
slightly smaller decrease than the
overall hospital average.
Among rural hospitals, by bed size,
larger rural hospitals are projected to
VerDate Sep<11>2014
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Jkt 259001
receive the smallest decreases in
uncompensated care payments and
supplemental payments. Rural hospitals
with 250+ beds are projected to receive
a 4.53 percent payment decrease, and
rural hospitals with 100–249 beds are
projected to receive a 6.82 percent
decrease. Smaller rural hospitals with
0–99 beds are projected to receive a 5.81
percent payment decrease. Among
urban hospitals, the smallest hospitals,
those with 0–99 beds, are projected to
receive a 6.55 percent decrease in
payments, which is a greater decrease
than the overall hospital average. In
contrast, urban hospitals with 100–249
beds and those with 250+ beds are
projected to receive decreases in
payments of 2.68 and 2.76 percent,
respectively, which are smaller
decreases than the overall hospital
average.
In most regions, rural hospitals are
generally expected to receive larger than
average decreases in uncompensated
care payments and supplemental
payments. The exceptions are rural
hospitals in the South Atlantic Region,
which are projected to receive a smaller
than average decrease of 1.81 percent in
payments and rural hospitals in the East
North Central Region and the Pacific
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Region, which are projected to receive
payment increases of 8.09 and 24.44
percent, respectively. Regionally, urban
hospitals are projected to receive a more
varied range of payment changes. Urban
hospitals in the New England, Middle
Atlantic, and South Atlantic Regions, as
well as hospitals in Puerto Rico, are
projected to receive larger than average
decreases in payments. Urban hospitals
in the East South Central, West North
Central, West South Central, and
Mountain Regions are projected to
receive smaller than average decreases
in payments. Urban hospitals in the East
North Central and Pacific Regions are
projected to receive increases in
payments of 1.02 percent and 0.54
percent, respectively.
By payment classification, although
hospitals in urban payment areas overall
are expected to receive a 2.50 percent
decrease in uncompensated care
payments and supplemental payments,
hospitals in large urban payment areas
are expected to see a decrease in
payments of 1.26 percent, while
hospitals in other urban payment areas
are projected to receive the largest
decrease of 4.88 percent. Hospitals in
rural payment areas are expected to
E:\FR\FM\04NOR1.SGM
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ER04NO22.092
*Dollar uncompensated care payments calculated by [0.75 * estimated section 1886(d)(5)(F) payments* Factor 2 *
Factor 3]. When summed across all hospitals projected to receive DSH payments, uncompensated care payments are
estimated to be $7, 192 million in FY 2022 and uncompensated care payments and supplemental payments are
estimated to be $6,971 million in FY 2023.
** For !HS/Tribal hospitals and Puerto Rico hospitals, this impact table reflects the supplemental payments.
** * Percentage change is determined as the difference between Medicare uncompensated care payments and
supplemental payments modeled for this FY 2023 IPPS/LTCH PPS final rule ( column 3) and Medicare uncompensated
care payments modeled for the FY 2022 IPPS/LTCH PPS final rule correction and correcting amendment ( column 2)
divided by Medicare uncompensated care payments modeled for the FY 2022 IPPS/L TCH PPS final rule correction
and correcting amendment (column 2) times 100 percent.
****Hospitals with missing or unknown Medicare utilization or Medicaid utilization are not shown in the table.
66572
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
khammond on DSKJM1Z7X2PROD with RULES
receive a decrease in payments of 4.03
percent.
Nonteaching hospitals are projected to
receive a payment decrease of 2.82
percent, teaching hospitals with fewer
than 100 residents are projected to
receive a decrease of 2.46 percent, and
teaching hospitals with 100+ residents
have a projected payment decrease of
3.82 percent. Proprietary and voluntary
hospitals are projected to receive
smaller than average decreases of 2.38
and 1.95 percent respectively, while
government hospitals are expected to
receive a larger than average payment
decrease of 5.65 percent. Hospitals with
less than 25 percent Medicare
utilization and hospitals with 50 to 65
percent Medicare utilization are
projected to receive smaller than
average payment decreases of 2.89 and
0.38 percent, respectively, while
VerDate Sep<11>2014
20:05 Nov 03, 2022
Jkt 259001
hospitals with 25–50 percent and
hospitals with greater than 65 percent
Medicare utilization are projected to
receive larger than average payment
decreases of 3.29 and 23.83 percent,
respectively. All hospitals with less
than 50 percent Medicaid utilization are
projected to receive smaller decreases in
uncompensated care payments and
supplemental payments than the overall
hospital average percent change, while
hospitals with 50–65 percent Medicaid
utilization are projected to receive a
larger than average decrease of 10.49
percent. Hospitals with greater than 65
percent Medicaid utilization are
projected to receive an increase of 6.66
percent.’’
10. On page 49482, third column, first
full paragraph, last line, the figure
‘‘0.9448’’ is corrected to read ‘‘0.9449’’.
11. On page 49483,
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a. First column, first partial
paragraph, line 1, the figure ‘‘5.52
percent’’ is corrected to read ‘‘5.51
percent’’.
b. Second column, second full
paragraph,
(1) Line 5, the figure ‘‘1.6 percent’’ is
corrected to read ‘‘1.7 percent’’.
(2) Line 10, the figure ‘‘1.2 percent’’
is corrected to read ‘‘1.4 percent’’.
c. Third column, last paragraph, last
line, the figure ‘‘0.3 percent’’ is
corrected to read ‘‘0.1 percent’’.
12. On pages 49484 and 49485, the
table titled ‘‘TABLE III.—COMPARISON
OF TOTAL PAYMENTS PER CASE [FY
2022 PAYMENTS COMPARED TO FY
2023 PAYMENTS]’’ is corrected to read
as follows:
BILLING CODE 4120–01–P
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66573
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
Number
of
Hospitals
Average
FY2022
Payments/Case
Average
FY2023
Payments/Case
3,142
1,086
1,092
0.6
2,420
722
1,119
764
1,125
767
0.5
0.4
653
700
411
409
245
883
941
1,035
1,105
1,326
884
949
1,043
1,112
1,329
0.1
0.9
0.8
0.6
0.2
358
201
84
46
33
656
731
742
858
876
655
734
750
857
885
-0.2
0.4
1.1
-0.1
1.0
107
295
373
156
402
140
362
176
359
50
1,196
1,253
1,052
1,070
982
945
1,031
1,115
1,455
633
1,197
1,259
1,058
1,077
986
951
1,035
1,134
1,461
642
0.1
0.5
0.6
0.7
0.4
0.6
0.4
1.7
0.4
1.4
19
49
113
86
109
141
134
47
24
1,032
725
753
783
715
723
713
857
977
1,031
733
755
782
722
733
713
851
978
-0.1
1.1
0.3
-0.1
1.0
1.4
0.0
-0.7
0.1
1,861
1,281
1,080
1,094
1,088
1,098
0.7
0.4
1,939
929
274
904
1,025
1,471
909
1,032
1,477
0.6
0.7
0.4
369
1,129
970
1,112
973
1,121
0.3
0.8
All Hospitals
By Geographic Location:
Urban hospitals
Rural hospitals
Bed Size (Urban):
0-99 beds
100-199 beds
200-299 beds
300-499 beds
500 or more beds
Bed Size (Rural):
0-49 beds
50-99 beds
100-149 beds
150-199 beds
200 or more beds
Urban by Region:
New England
Middle Atlantic
East North Central
West North Central
South Atlantic
East South Central
West South Central
Mountain
Pacific
Puerto Rico
Rural by Region:
New England
Middle Atlantic
East North Central
West North Central
South Atlantic
East South Central
West South Central
Mountain
Pacific
By Payment Classification:
Urban hospitals
Rural areas
Teaching Status:
Nonteaching
Fewer than I 00 residents
100 or more residents
UrbanDSH:
Non-DSH
100 or more beds
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ER04NO22.093
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TABLE III.-- COMPARISON OF TOTAL PAYMENTS PER CASE
[FY 2022 PAYMENTS COMPARED TO FY 2023 PAYMENTS]
66574
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
Number
of
Hospitals
Average
FY2022
Payments/Case
Average
FY2023
Payments/Case
363
821
824
0.4
105
264
674
22
216
1,012
793
1,147
918
647
1,020
788
1,151
918
653
0.8
-0.6
0.3
0.0
0.9
663
60
829
309
1,175
1,044
958
932
1,184
1,050
965
934
0.8
0.6
0.7
0.2
148
470
256
47
122
39
878
1,215
745
906
844
1,005
885
1,218
744
896
849
1,017
0.8
0.2
-0.1
-1.1
0.6
1.2
1,915
789
438
1,090
1,000
1,177
1,095
1,009
1,184
0.5
0.9
0.6
790
2,072
225
30
1,220
1,061
883
690
1,228
1,065
893
690
0.7
0.4
1.1
0.0
2,082
942
94
24
1,006
1,220
1,447
1,523
1,010
1,228
1,457
1,564
0.4
0.7
0.7
2.7
45
1,379
1,404
1.8
1,004
2,138
840
1,594
282
426
615
56
1,113
1,064
1,149
1,090
781
741
1,175
754
1,118
1,070
1,153
1,098
788
740
1,178
758
0.4
0.6
0.3
0.7
0.9
-0.1
0.3
0.5
Less than 100 beds
RuralDSH:
Non-DSH
SCH
RRC
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
Special Hospital Types:
RRC
RRC with section 401 Rural Reclassification
SCH
SCH with section 401 Rural Reclassification
SCHandRRC
SCH and RRC with section 401 Rural Reclassification
Type of Ownership:
Voluntary
Proprietary
Government
Change
Medicare Utilization as a Percent oflnpatient Days:
0-25
25-50
50-65
Over65
Medicaid Utilization as a Percent oflnpatient Days:
khammond on DSKJM1Z7X2PROD with RULES
13. On page 49494, third column,
third full paragraph,
a. Lines 2 and 3, the figure ‘‘$1.4
billion’’ is corrected to read ‘‘$1.5
billion’’.
b. Line 14, the figure ‘‘$0.039 billion’’
is corrected to read ‘‘0.040 billion’’.
VerDate Sep<11>2014
17:31 Nov 03, 2022
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c. Lines 17 and 18, the figure ‘‘-$0.747
billion’’ is corrected to read ‘‘-$0.671
billion’’.
14. On page 49495,
a. First column, first line, the figure
‘‘$39 million’’ is corrected to read ‘‘$40
million’’.
b. Third column, second full
paragraph, last line, the figure ‘‘$1.4
PO 00000
Frm 00040
Fmt 4700
Sfmt 4700
billion’’ is corrected to read ‘‘$1.5
billion’’.
c. Middle of page, Table V.
‘‘ACCOUNTING STATEMENT:
CLASSIFICATION OF ESTIMATED
EXPENDITURES UNDER THE IPPS
FROM FY 2022 TO FY 2023’’ is
corrected to read as follows:
E:\FR\FM\04NOR1.SGM
04NOR1
ER04NO22.094
0-25
25-50
50-65
Over 65
Hospitals with 5% or more of cases that reported
experiencing homelessness
FY 2023 Reclassifications:
All Reclassified Hospitals
Non-Reclassified Hospitals
Urban Hospitals Reclassified
Urban Non-Reclassified Hospitals
Rural Hospitals Reclassified Full Year
Rural Non-Reclassified Hospitals Full Year
All section 401 Rural Reclassified Hospitals
Other Reclassified Hospitals (section 1886(d)(8)(B))
Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations
66575
TABLE V.-ACCOUNTING STATEMENT: CLASSIFICATION OF
ESTIMATED EXPENDITURES UNDER THE IPPS FROM FY 2022 TO FY 2023
BILLING CODE 4120–01–C
List of Subjects in 42 CFR Part 482
Grant programs—health, Hospitals,
Medicaid, Medicare, Reporting and
recordkeeping requirements.
Accordingly, 42 CFR chapter IV is
corrected by making the following
correcting amendments to part 482:
PART 482—CONDITIONS OF
PARTICIPATION FOR HOSPITALS
1. The authority citation for part 482
continues to reads as follows:
■
Authority: 42 U.S.C. 1302, 1395hh, and
1395rr, unless otherwise noted.
§ 482.42
[Amended]
2. In § 482.42, redesignate the second
paragraph (f)(2)(ii) as paragraph
(f)(2)(iii).
■
Elizabeth J. Gramling,
Executive Secretary to the Department,
Department of Health and Human Services.
[FR Doc. 2022–24077 Filed 11–3–22; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
46 CFR Parts 10, 11, and 15
[Docket No. USCG–2020–0069]
RIN 1625–AC63
Pilots’ Medical Certificate Validity
Period
Coast Guard, DHS.
Final rule.
AGENCY:
ACTION:
The Coast Guard is issuing
this final rule to extend the maximum
validity period of merchant mariner
medical certificates issued to first-class
pilots, and masters or mates serving as
pilot, from 2 years to 5 years. We are
issuing this rule in response to federal
advisory committee recommendations
and a petition for rulemaking. This rule
will reduce the frequency of medical
certificate application submissions to
the Coast Guard. The rule maintains the
requirement for pilots to complete
annual physicals and provides the Coast
khammond on DSKJM1Z7X2PROD with RULES
SUMMARY:
VerDate Sep<11>2014
20:05 Nov 03, 2022
Jkt 259001
Transfers
$1.5 billion
Federal Government to IPPS Medicare Providers
Guard opportunity to review the
medical examinations of pilots who may
become medically unqualified between
medical certificate applications;
therefore, the rule does not compromise
safety.
DATES: This final rule is effective
February 1, 2023.
ADDRESSES: To view documents
mentioned in this preamble as being
available in the docket, go to https://
www.regulations.gov, type USCG–2020–
0069 in the search box and click
‘‘Search.’’ Next, in the Document Type
column, select ‘‘Supporting & Related
Material.’’
FOR FURTHER INFORMATION CONTACT: For
information about this document call or
email Eric Malzkuhn, U.S. Coast Guard
Office of Merchant Mariner
Credentialing; telephone 202–372–1425,
email eric.f.malzkuhn@uscg.mil.
SUPPLEMENTARY INFORMATION:
Table of Contents for Preamble
I. Abbreviations
II. Purpose, Basis, and Regulatory History
III. Background
IV. Discussion of Comments and Changes
From Proposed Rule
V. Discussion of the Rule
A. 46 CFR 10.301: Pilot Medical Certificate
Period of Validity
B. 46 CFR 11.709: Annual Physical
Examination Requirements for Pilots of
Vessels of 1,600 GRT or More
C. 46 CFR 15.401: Employment and Service
Restrictions Within the Pilot Credential
D. 46 CFR 15.812, Table 1 to § 15.812(e)(1):
Masters or Mates Serving as Pilot on
Vessels of 1,600 GRT or More
VI. Regulatory Analyses
A. Regulatory Planning and Review
B. Small Entities
C. Assistance for Small Entities
D. Collection of Information
E. Federalism
F. Unfunded Mandates
G. Taking of Private Property
H. Civil Justice Reform
I. Protection of Children
J. Indian Tribal Governments
K. Energy Effects
L. Technical Standards
M. Environment
I. Abbreviations
BLS Bureau of Labor Statistics
CFR Code of Federal Regulations
DHS Department of Homeland Security
FCP First-class pilot
PO 00000
Frm 00041
Fmt 4700
Sfmt 4700
FR Federal Register
GRT Gross registered tons
GS General service
GSA General Services Administration
MMC Merchant Mariner Credential
MMLD Merchant Mariner Licensing and
Documentation database
MMD Merchant Mariner’s Document
MPH Miles per hour
NMC National Maritime Center
NPRM Notice of proposed rulemaking
OMB Office of Management and Budget
REC Regional Examination Center
§ Section
STCW Code Standards of Training,
Certification, and Watchkeeping for
Seafarers, 1978, as amended
STCW Convention International
Convention on Standards of Training,
Certification and Watchkeeping for
Seafarers
STCW final rule ‘‘Implementation of the
Amendments to the International
Convention on Standards of Training,
Certification and Watchkeeping for
Seafarers, 1978, and Changes to National
Endorsements’’ final rule
U.S.C. United States Code
USPS U.S. Postal Service
II. Purpose, Basis, and Regulatory
History
The purpose of this rule is to extend
the maximum validity period of
merchant mariner medical certificates
issued to first-class pilots (FCPs), and
masters or mates serving as pilot, from
2 years to 5 years, which will reduce the
frequency that they must submit a
medical certificate application to the
Coast Guard. Reducing the frequency of
medical certificate applications will
reduce the administrative burden on the
mariner submitting the application and
on the Coast Guard when processing the
application and issuing the medical
certificate. First-class pilots, and
masters and mates serving as pilot on
vessels of 1,600 gross registered tons or
more, will be required to submit the
results of their annual physical
examinations to the Coast Guard
between medical certificate applications
if the mariner (1) does not meet the
physical ability requirements; (2) has a
condition that does not meet the
medical, vision, or hearing
requirements; (3) is deemed ‘‘not
recommended’’ by a medical
practitioner for a medical certificate; or
(4) if the results are requested by the
Coast Guard. We are delaying the
E:\FR\FM\04NOR1.SGM
04NOR1
ER04NO22.095
Category
Annualized Monetized Transfers
From Whom to Whom
Agencies
[Federal Register Volume 87, Number 213 (Friday, November 4, 2022)]
[Rules and Regulations]
[Pages 66558-66575]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-24077]
[[Page 66558]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 412, 413, 482, 485, and 495
[CMS-1771-F2]
RIN 0938-AU84
Medicare Program; Hospital Inpatient Prospective Payment Systems
for Acute Care Hospitals and the Long-Term Care Hospital Prospective
Payment System and Policy Changes and Fiscal Year 2023 Rates; Quality
Programs and Medicare Promoting Interoperability Program Requirements
for Eligible Hospitals and Critical Access Hospitals; Costs Incurred
for Qualified and Non-Qualified Deferred Compensation Plans; and
Changes to Hospital and Critical Access Hospital Conditions of
Participation; Corrections
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Final rule; correction and correcting amendment.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical and typographical errors in
the final rule that appeared in the August 10, 2022 Federal Register.
The final rule was titled ``Medicare Program; Hospital Inpatient
Prospective Payment Systems for Acute Care Hospitals and the Long Term
Care Hospital Prospective Payment System and Policy Changes and Fiscal
Year 2023 Rates; Quality Programs and Medicare Promoting
Interoperability Program Requirements for Eligible Hospitals and
Critical Access Hospitals; Costs Incurred for Qualified and Non-
qualified Deferred Compensation Plans; and Changes to Hospital and
Critical Access Hospital Conditions of Participation''.
DATES:
Effective date: The final rule corrections and correcting amendment
are effective on November 3, 2022.
Applicability date: The final rule corrections and correcting
amendment are applicable for discharges occurring on or after October
1, 2022.
FOR FURTHER INFORMATION CONTACT:
Donald Thompson, and Michele Hudson, (410) 786-4487 or
[email protected], Operating Prospective Payment.
Adina Hersko, [email protected] and [email protected], New
Technology Add-on Payments Issues.
Dawn Linn, [email protected], Lela Strong,
[email protected], and Alpha Wilson, [email protected],
Conditions of Participation (CoP) Requirements for Hospitals and
Critical Access Hospitals (CAHs) to Continue Reporting Data for COVID-
19 and Influenza After the PHE ends as Determined by the Secretary.
Julia Venanzi, [email protected], Hospital Inpatient
Quality Reporting Program and Hospital Value-Based Purchasing Program--
Administration Issues
Ariel Cress, [email protected], Long-Term Care Hospital
Quality Reporting Program--Data Reporting Issues.
Jessica Warren, [email protected], Medicare Promoting
Interoperability Program.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2022-48780 of August 10, 2022 (87 FR 48780), there were
a number of technical and typographical errors that are identified and
corrected in this final rule correction and correcting amendment. The
final rule corrections and correcting amendment are applicable to
discharges occurring on or after October 1, 2022, as if they had been
included in the document that appeared in the August 10, 2022 Federal
Register.
II. Summary of Errors
A. Summary of Errors in the Preamble
On pages 48781, 48785, and 49313, we made typographical and
technical errors in specifying certain fiscal years.
On pages 49195, 49197, 49207, 49217, 49223, 49229, 49263, 49267,
and 49311, we made typographical errors in referencing a statutory
citation.
On page 48789, in the table of the summary of costs and benefits of
certain major provisions, we are making conforming corrections to the
estimates discussed in the ``Update to the IPPS Payment Rates and Other
Payment Policies'' row resulting from the correction to the maximum new
technology add-on payment for cases involving the use of
DefencathTM discussed later in this section of this final
rule correction and correcting amendment.
On page 48790, in the table of the summary of costs and benefits of
certain major provisions, we are making corrections to the description
of the estimates discussed for the Hospital-Acquired Condition Program.
On pages 48790, 49308, 49327, 49335, 49377, and 49398, we made
technical and typographical errors in Federal Register citations and
cross-references.
On pages 48981 through 48982, in our discussion of new medical
services and technologies, we are correcting the cost per case and
maximum new technology add-on payment for a case involving the use of
DefencathTM.
On page 49071, we made typographical errors and an omission in our
discussion of revisions to Worksheet E-4 of the hospital cost report
instructions.
On page 49087, we made and are correcting a typographical error in
our discussion of the Hospital Readmission Reduction Program.
On pages 49095, 49106, 49129, 49248, 49266, 49283, and 49295, we
made and are correcting typographical errors in several footnotes and
footnote references.
On pages 49201, 49230, 49232, 49233, 49297, and 49308, in the
discussion of the Hospital Inpatient Quality Reporting (IQR) Program,
we are correcting inadvertent omissions as well as typographical and
technical errors.
On pages 49315, 49317, and 49318, in the discussion of the Long-
term Care Hospital Quality Reporting Program (LTCH QRP) we are
correcting several technical and typographical errors.
On pages 49347 and 49362, in the discussion of the Medicare
Promoting Interoperability Program, we made and are correcting
typographical and technical errors.
B. Summary of Errors in the Regulations Text
On page 49410, we inadvertently made a typographical error in the
paragraph numbering for a paragraph in Sec. 482.42(f)(2).
C. Summary of Errors in the Addendum
As discussed further in section II.D. of this final rule correction
and correcting amendment, we made updates to the calculation of Factor
3 of the uncompensated care payment methodology to reflect updated
information on hospital mergers received in response to the final rule
and made corrections for report upload errors and an update to the DSH
eligibility for one provider that was inadvertently projected not DSH
eligible in the final rule. Based on the March 2022 Provider Specific
File's Medicaid fraction and the FY 2020 SSI fractions, this provider
is projected DSH eligible for purposes of interim uncompensated care
payments during FY 2023. Specifically, there were two merger updates,
one update on a report upload
[[Page 66559]]
discrepancy, and one update on DSH eligibility projection. We
recalculated the total uncompensated care amount for all DSH-eligible
hospitals to reflect these updates. In addition, because the Factor 3
for each hospital reflects that hospital's uncompensated care amount
relative to the uncompensated care amount for all DSH hospitals, we
also recalculated Factor 3 for all DSH-eligible hospitals. The
hospital-specific Factor 3 determines the total amount of the
uncompensated care payment a hospital is eligible to receive for a
fiscal year. This hospital-specific payment amount is then used to
calculate the amount of the interim uncompensated care payments a
hospital receives per discharge. Given the small number of updates to
the information used in the calculation of Factor 3, the change to the
previously calculated Factor 3 for the majority of hospitals is of
limited magnitude.
We note that the fixed-loss cost threshold was unchanged after
these Factor 3 recalculations. (As discussed elsewhere, however, we
incorporated the revised uncompensated care payment amounts into our
recalculation of the FY 2023 fixed-loss threshold and related figures
to reflect the use of supplemental outlier reconciliation data.) We
further note that while for certain prior years, we have also
recalculated the budget neutrality factors to reflect revisions to the
calculation of Factor 3, in combination with the correction of other
errors, given the limited magnitude of the changes to uncompensated
care payments, and because we are not making corrections to any other
components of the calculation of these budget neutrality factors for FY
2023, we did not recalculate any budget neutrality factors due to the
changes to Factor 3.
On pages 49420 through 49421 and 49427 through 49428, we are
revising the calculation of the percentage of operating outlier
reconciliation dollars to total Federal operating payments based on the
FY 2017 cost reports, which is used in our projection of operating
outlier reconciliation payments for the FY 2023 outlier threshold
calculation, to reflect the use of supplemental outlier reconciliation
data, as discussed in the FY 2023 IPPS/LTCH PPS final rule, including
additional supplemental data from some hospitals that had an outlier
reconciliation amount recorded on Worksheet E, Part A, Line 2.01. In
addition to revising the percentage of operating outlier reconciliation
dollars to total Federal operating payments, we are also revising the
percentage of capital outlier payments to total capital Federal
payments for FY 2017 to reflect these additional supplemental data for
hospitals that had an outlier reconciliation amount recorded on
Worksheet E, Part A, Line 93, Column 1. Accordingly, under our
established methodology, this correction to the percentage of operating
outlier reconciliation dollars to total Federal operating payments
results in a change in the targeted operating outlier percentage and
the FY 2023 outlier threshold. In addition, under our established
methodology, the correction to the percentage of capital outlier
payments to total capital Federal payments and the change in the FY
2023 outlier threshold results in a change in the estimated capital
outlier percentage. We note that these recalculations also reflect the
revisions to Factor 3 of the uncompensated care payment methodology
described previously.
On pages 49433 through 49437, in our discussion of the
determination of the Federal hospital inpatient capital related
prospective payment rate update, due to the correction of the
combination of errors listed previously (the revisions to Factor 3 of
the uncompensated care payment methodology, and, in particular, the
corrections to the outlier reconciliation projections and outlier
threshold), we have made conforming corrections to the capital outlier
adjustment, capital Federal rate and related figures. On page 49453, we
are also making conforming corrections to the capital standard Federal
payment rate in Table 1D.
On page 49438, we made a typographical error in referencing a
statutory citation.
In addition, on page 49450, we are making conforming changes to the
fixed-loss amount for FY 2023 site neutral payment rate discharges, and
the high cost outlier threshold (based on the corrections to the IPPS
outlier threshold (that is, fixed-loss amount) discussed previously).
D. Summary of Errors in and Corrections to Files and Tables Posted on
the CMS Website
We are correcting the errors in the following IPPS table that is
listed on page 49453 of the FY 2023 IPPS/LTCH PPS final rule and is
available on the internet on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/AcuteInpatientPPS/.
The tables that are available on the internet have been updated to
reflect the revisions discussed in this final rule correction and
correcting amendment.
Table 18--FY 2023 Medicare DSH Uncompensated Care Payment Factor 3.
For the FY 2023 IPPS/LTCH PPS final rule, we published a list of
hospitals that we identified to be subsection (d) hospitals and
subsection (d) Puerto Rico hospitals projected to be eligible to
receive interim uncompensated care payments for FY 2023. As stated in
the FY 2023 IPPS/LTCH PPS final rule (87 FR 49046) we allowed the
public an additional period after the issuance of the final rule to
review and submit via email any updated information on mergers and/or
to report upload discrepancies. We are updating this table to reflect
the information on mergers, upload discrepancy, and DSH eligibility
received in response to the final rule and to revise the Factor 3
calculations for purposes of determining uncompensated care payments
for the FY 2023 IPPS/LTCH PPS final rule. We are revising Factor 3 for
all hospitals to reflect the updated merger information, upload
discrepancy information, and DSH eligibility information received in
response to the final rule. We are also revising the amount of the
total uncompensated care payment calculated for each DSH eligible
hospital. The total uncompensated care payment that a hospital receives
is used to calculate the amount of the interim uncompensated care
payments the hospital receives per discharge. As previously discussed,
given the limited magnitude of these uncompensated care payment
corrections, and because we are not making corrections to any other
components of the calculation of the budget neutrality factors for FY
2023, we do not believe the revisions to the uncompensated care payment
amounts merit recalculating all budget neutrality factors. However, the
revised uncompensated care payment amounts were incorporated into our
recalculation of the outlier fixed-loss cost threshold and related
figures to reflect the corrections to the outlier reconciliation
projections used in the FY 2023 outlier threshold calculation, as
described previously.
E. Summary of Errors in the Appendices
On pages 49457, 49494, and 49495 we are making conforming
corrections to the estimated overall impact, estimated overall change
in new technology add-on payments, and the accounting statement and
table for acute care hospitals under the IPPS, resulting from the
correction to the maximum new technology add-on payment for cases
involving the use of DefencathTM discussed in section II.A.
of this final rule correction and correcting amendment.
[[Page 66560]]
On pages 49461 through 49463, 49467 through 49468, and 49482
through 49485 in our regulatory impact analyses, we have made
conforming corrections to certain factors, values, tables and
accompanying discussion of the changes in operating and capital IPPS
payments for FY 2023 as a result of the technical errors that lead to
changes in our calculation of the outlier threshold and capital Federal
rate (as discussed in section II.B. of this final rule correction and
correcting amendment). These conforming corrections include changes to
the following:
On pages 49461 through 49463, the table titled ``Table I--
Impact Analysis of Changes to the IPPS for Operating Costs for FY
2023''.
On pages 49467 through 49468, the table titled ``Table
II--Impact Analysis of Changes for FY 2023 Acute Care Hospital
Operating Prospective Payment System (Payments per discharge)''.
On pages 49484 and 49485, the table titled ``TABLE III.--
COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2022 PAYMENTS COMPARED TO FY
2023 PAYMENTS]''.
On pages 49469 through 49470, we are correcting values in tables
and estimated total payment values in accompanying discussion resulting
from the correction to the maximum new technology add-on payment for
cases involving the use of DefencathTM.
On page 49470, under the table displaying the FY 2023 Estimates for
New Technology Add-On Payments for FY 2023, we are correcting the
inadvertent omission of the heading for the next section.
On pages 49471 through 49474 we are correcting the discussion of
the ``2. Effects of Changes to Medicare DSH and Uncompensated Care
Payments for FY 2023 and the New Supplemental Payment for Indian Health
Service Hospitals and Tribal Hospitals and Hospitals Located in Puerto
Rico'' for purposes of the Regulatory Impact Analysis in Appendix A of
the FY 2023 IPPS/LTCH PPS final rule, including the table titled
``Modeled Uncompensated Care Payments* and Supplemental Payments for
Estimated FY 2023 DSHs by Hospital Type*'' on pages 49472 and 49473, in
light of the corrections discussed in section II.D. of this final rule
correction and correcting amendment.
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of the proposed rulemaking
in the Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Act requires the Secretary to
provide for notice of the proposed rulemaking in the Federal Register
and provide a period of not less than 60 days for public comment. In
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of
the Act mandate a 30-day delay in effective date after issuance or
publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the notice and comment and delay in
effective date APA requirements; in cases in which these exceptions
apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide
exceptions from the notice and 60-day comment period and delay in
effective date requirements of the Act as well. Section 553(b)(B) of
the APA and section 1871(b)(2)(C) of the Act authorize an agency to
dispense with normal rulemaking requirements for good cause if the
agency makes a finding that the notice and comment process are
impracticable, unnecessary, or contrary to the public interest. In
addition, both section 553(d)(3) of the APA and section
1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 30-day delay
in effective date where such delay is contrary to the public interest
and an agency includes a statement of support.
We believe that this correcting document does not constitute a rule
that would be subject to the notice and comment or delayed effective
date requirements. This document corrects technical and typographical
errors in the preamble, regulations text, addendum, payment rates,
tables, and appendices included or referenced in the FY 2023 IPPS/LTCH
PPS final rule, but does not make substantive changes to the policies
or payment methodologies that were adopted in the final rule. As a
result, this correcting document is intended to ensure that the
information in the FY 2023 IPPS/LTCH PPS final rule accurately reflects
the policies adopted in that document.
In addition, even if this were a rule to which the notice and
comment procedures and delayed effective date requirements applied, we
find that there is good cause to waive such requirements. Undertaking
further notice and comment procedures to incorporate the corrections in
this document into the final rule or delaying the effective date would
be contrary to the public interest because it is in the public's
interest for providers to receive appropriate payments in as timely a
manner as possible, and to ensure that the FY 2023 IPPS/LTCH PPS final
rule accurately reflects our policies. Furthermore, such procedures
would be unnecessary, as we are not altering our payment methodologies
or policies, but rather, we are simply implementing correctly the
methodologies and policies that we previously proposed, requested
comment on, and subsequently finalized. This correcting document is
intended solely to ensure that the FY 2023 IPPS/LTCH PPS final rule
accurately reflects these payment methodologies and policies.
Therefore, we believe we have good cause to waive the notice and
comment and effective date requirements. Moreover, even if these
corrections were considered to be retroactive rulemaking, they would be
authorized under section 1871(e)(1)(A)(ii) of the Act, which permits
the Secretary to issue a rule for the Medicare program with retroactive
effect if the failure to do so would be contrary to the public
interest. As we have explained previously, we believe it would be
contrary to the public interest not to implement the corrections in
this final rule correction for discharges occurring on or after October
1, 2022, because it is in the public's interest for providers to
receive appropriate payments in as timely a manner as possible, and to
ensure that the FY 2023 IPPS/LTCH PPS final rule accurately reflects
our policies.
IV. Correction of Errors
In FR Doc. 2022-16472 of August 10, 2022 (87 FR 48780), we are
making the following corrections:
A. Correction of Errors in the Preamble
1. On page 48781, first column,
a. Lines 23 and 24, the phrase ``S-3 Wage Data for the FY 2022 Wage
Index'' is corrected to read ``S-3 Wage Data for the FY 2023 Wage
Index''.
b. Lines 27 and 28, the phrase, ``Computing the FY 2022 Unadjusted
Wage Index'' is corrected to read ``Computing the FY 2023 Unadjusted
Wage Index''.
c. Line 74, the phrase '' Updates for FY 2022 (Sec. 412.64(d))''
is corrected to read ``Updates for FY 2023 (Sec. 412.64(d))''.
2. On page 48785, second column, third paragraph, the phrase ``FY
2024'' is corrected to read ``FY 2023''.
3. On page 48789, in the untitled table, second column (Description
of Costs, Transfers, Savings, and Benefits), third row (Update to the
IPPS Payment Rates and Other Payment Policies),
a. Line 2, the figure ``$1.4 billion'' is corrected to read ``$1.5
billion''.
b. Line 4, the figure ``$1.0 billion'' is corrected to read ``$0.9
billion''.
4. On page 48790, in the untitled table,
[[Page 66561]]
a. Second column (Description of Costs, Transfers, Savings, and
Benefits),
(1) First row, lines 3 and 4, the phrase, ``specific HSRs and a 30-
day preview period for the NHSN CDC HAI measures.'' is corrected to
read ``specific HSRs and a 30-day preview period.''.
(2) Last row, line 1, the reference, ``section XII.B.10.'' is
corrected to read ``section XII.B.11.''
b. Following the table (Table Note 1), the sentence beginning with
the phrase ``\1\For the purpose'' and ending with the phrase ``and
CABG).'' is corrected by removing the sentence.
5. On page 48981,
a. First column, fourth full paragraph, lines 14 and 15, the phrase
``$5,850 to the hospital, per patient'' is corrected to read ``$1,950
per 5mL vial. ``
b. Third column, last partial paragraph, lines 2 and 3, the
language ``the cost per case of the DefenCathTM is $5,850''
is corrected to read ``the cost of DefenCathTM is $1,950 per
vial. Per the applicant, the average utilization of
DefenCathTM is 9.75 vials per patient, resulting in an
average cost per case of $19,012.50.''
6. On page 48982, first column, first partial paragraph, line 5,
the figure ``$4,387.50'' is corrected to read ``$14,259.38''.
7. On page 49071,
a. Second column, last partial paragraph,
(1) Line 15, the phrase ``line 9 minus line 8'' is corrected to
read ``line 8 minus line 9''.
(2) Lines 18 and 19, the phrase ``line 9 minus line 8'' is
corrected to read ``line 8 minus line 9''.
(3) Lines 19 and 20, the phrase ``line 9 minus line 8'' is
corrected to read ``line 8 minus line 9''.
b. Third column, first partial paragraph, lines 1 and 2, the phrase
``minus line 8 on line 20,' but we believe they meant to say `on line
22').'' is corrected to read ``minus line 8' but we believe they meant
to state `line 8 minus line 9.' We also note that the commenters
indicated to enter the result `on line 20,' but we believe they meant
to state `on line 22').''.
8. On page 49087, second column, third full paragraph, line 13, the
phrase ``COVID-10 specific ICD-10'' is corrected to read ``COVID-19
specific ICD-10''.
9. On page 49095, first column, third footnote paragraph (footnote
232), the parenthetical web address, ``(statnews.com)'' is corrected to
read ``https://www.statnews.com/2021/09/20/covid-19-set-to-overtake-1918-spanish-flu-as-deadliest-disease-in-american-history/''.
10. On page 49106,
a. First column, first paragraph (footnote 275), lines 3 through 5,
the phrase, ``Fleisher et al. (2022). New England Journal of Medicine.
Article available here:'' is corrected to read ``Fleisher et al.
(2022). Health Care Safety During the Pandemic and Beyond--Building a
System That Ensures Resilience. New England Journal of Medicine.
Available at:''
b. Second column--
(1) Sixth footnote paragraph (footnote 283), lines 4 through 10,
the hyperlink, https://www.fda.gov/news-events/press-announcements/
coronavirus-covid-19-update-fda-authorizes-additional-oral-antiviral-
treatment-covid-19-
certain#:~:text=Today%2C%20the%20U.S.%20Food%20and,progression%20to%20se
vere%20COVID%2D19%2C is corrected to read: https://www.fda.gov/news-
events/press-announcements/coronavirus-covid-19-update-fda-authorizes-
additional-oral-antiviral-treatment-covid-19-certain
(2) Eighth footnote paragraph (footnote 285), lines 3 through 7,
the hyperlink, ``https://www.washingtonpost.com/politics/biden-to-give-away-400-million-n95-masks-starting-next-week/2022/01/19/5095c050-
;7915-11ec-9dce-7313579de434_story.html'' is corrected to read
``https://www.washingtonpost.com/kidspost/2022/01/19/biden-give-away-400-million-n95-masks/''.
11. On page 49129, first column, footnote paragraph (Footnote 314),
line 5 and 6, the hyperlink ``https://oig.hhs.govAd/oei/reports/OEI-06-18-00400.asp'' is corrected to read https://oig.hhs.gov/oei/reports/OEI-06-18-00400.asp.
12. On page 49195, third column, first full paragraph, lines 3 and
4, the reference ``section 1866'' is corrected to read ``section
1886''.
13. On page 49197, second column, third full paragraph, lines 11
and 12, the reference ``section 1866'' is corrected to read ``section
1886''.
14. On page 49201, first column, second full paragraph, lines 11
through 17, the sentence ``First, because social risk factors
disproportionately impact historically \481\'' is corrected to read
``First, because social risk factors disproportionately impact
underserved communities, promoting screening for these factors could
serve as evidence-based building blocks for supporting hospitals and
health systems in actualizing commitment to address disparities,
improve health equity through addressing the social needs with
community partners, and implement associated equity measures to track
progress.''.
15. On page 49207, first column, second full paragraph, lines 3 and
4, the reference ``section 1866'' is corrected to read ``section
1886''.
16. On page 49217, first column, second full paragraph, line 3, the
reference ``section 1866'' is corrected to read ``section 1886''.
17. On page 49223, second column, first full paragraph, lines 7 and
8, the reference ``section 1866'' is corrected to read ``section
1886''.
18. On page 49229, first column, first full paragraph, lines 4 and
5, the reference ``section 1866'' is corrected to read ``section
1886''.
19. On page 49230, top third of the page, second column, second
full paragraph, lines 2 through 6, the sentence ``The measure is
designed to be calculated by the hospitals' CEHRT using the patient-
level data and then submitted by hospitals to CMS.'' is corrected to
read ``Patient-level data is to be submitted to CMS where risk-
adjustment and measure calculation will occur.''.
20. On page 49232, lower two-thirds of the page, first column, last
full paragraph, lines 5 and 6, the phrase ``an additional hospital
unaffiliated with the first 25'' is corrected to read '' an additional
5 hospitals unaffiliated with the first 25''.
21. On page 49233, third column, first full paragraph, lines 1
through 5, the sentence ``We reiterate that this is an eCQM in which
the data is collected through hospitals' EHR and designed to be
calculated by the hospital's CEHRT (87 FR 28513).'' is corrected to
read ``We reiterate that this is an eCQM in which the data is collected
through hospitals' EHR (87 FR 28514). The measure is designed for
patient-level data to be submitted to CMS where risk-adjustment and
measure calculation will occur.''.
22. On page 49248, first column, 10th footnote paragraph (Footnote
919), lines 1 and 2, the phrase, ``Ma kela K.T., Peltola M., Sund R,
Malmivaara A., Ha kkinen U., Remes V.'' is corrected to read
``M[auml]kel[auml] K.T., Peltola M., Sund R., Malmivaara A.,
H[auml]kkinen U., Remes V.''.
23. On page 49263, third column, second full paragraph, lines 5 and
6, the reference ``section 1866'' is corrected to read ``section
1886''.
24. On page 49266, third column, before the first footnote
paragraph (Footnote 981), the footnote paragraphs are corrected by
adding a footnote (Footnote 980) to read as follows:
``National Quality Forum. Surgery Fall Cycle 2020. Measure Testing
(subcriteria 2a2, 2b1-2b6) Document. November 3, 2020. Available at:
https://
[[Page 66562]]
nqfappservicesstorage.blob.core.windows.net/proddocs/22/Fall/2020/
measures/1550/shared/1550.zip.''.
25. On page 49267, third column, second full paragraph, lines 4 and
5, the reference ``section 1866'' is corrected to read ``section
1886''.
26. On page 49283, first column, sixth footnote paragraph (footnote
1021), lines 6 and 7, the hyperlink ``https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787181'' is corrected to read ``https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787184''.
27. On page 49295, second column, first partial footnote paragraph
(footnote 1074), lines 1 through 4, the hyperlink ``Accessed on
Available at: https://arpsp.cdc.gov/profile/infections/clabsi?year-select-report=year2019&year-select-hai-state-list=year2019'' is
corrected to read ``Accessed July 27, 2021. Available at: https://arpsp.cdc.gov/profile/nhsn/clabsi.''
28. On page 49297, second column, first full paragraph, lines 17
and 18, the phrase ``increase the risk of developing CDIs. '' is
corrected to read ``increase the risk of contracting HAIs.''.
29. On page 49308, second column, last partial paragraph, line 18,
the citation (85 FR 58952 through 58944)'' is corrected read ``(85 FR
58942 through 58953)''.
30. On page 49311, first column, first full paragraph, line 3, the
reference ``section 1866'' is corrected to read ``section 1886''.
31. On page 49312, first column, last partial paragraph, line 1,
the reference ``section 1866'' is corrected to read ``section 1886''.
32. On page 49313, third column, third full paragraph, line 7, the
phrase ``FY 2021 confidential'' is corrected to read ``FY 2022
confidential''.
33. On page 49315, middle of the page, in the table titled ``Table
IX.G.-01. Quality Measures Currently Adopted for the FY 2023 LTCH
QRP'', the entries in rows 3 and 4 are corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR04NO22.082
34. On page 49317, first column, fifth paragraph, lines 10 and 11,
the phrase, ``This commenter also suggested CMS to work with CMS to
determine'' is corrected to read ``This commenter also suggested CMS
determine''.
35. On page 49318--
a. Second column, third full paragraph, line 1, the phrase, ``A
number of commenters provider'' is corrected to read ``A number of
commenters provided''.
b. Third column, first full paragraph, lines 36 through 40, the
sentence, ``We also received one comment recommending CMS use a
combination of peer group benchmarking and statistical significance. ''
is corrected read ``A commenter also suggested additional guiding
principles.''
36. On page 49327, third column, first partial paragraph, line 3,
the reference ``[TABLE XX]'' is corrected to read ``Table IX.H.-07''.
37. On page 49335, third column, second full paragraph, line 14,
the citation ``(87 FR 28586 through 28587)'' is corrected to read ``(87
FR 28585 through 28587)''.
38. On page 49347, third column, first partial paragraph, line 15,
the phrase, ``We finalized our proposal'' should read ``We are
finalizing our proposal''.
39. On page 49362, second column, first partial paragraph, lines 11
through 15, the sentence ``Testing established the feasibility of the
measure, first in 25 hospitals across eight healthcare sites and then
in additional hospital unaffiliated with the first 25.'' is corrected
to read ``The measure developer's testing established the feasibility
of the measure, first in 25 hospitals across 8 healthcare sites and
then in an additional 5 hospitals unaffiliated with the first 25, and
across several different electronic health record systems.''.
40. On page 49377, third column, first partial paragraph, lines 31
and 32, the reference ``sections XII.B.10. and XII.H.11, '' is
corrected to read ``sections XII.B.11. of the preamble and I.H.11. of
the Appendix,''.
41. On page 49398, second column, first full paragraph, lines 1 and
2, the reference, ``section XX.B.2.'' is corrected to read ``section
X.B.2.''.
B. Corrections to the Addendum
1. On page 49420, first column, second full paragraph,
a. Line 24, the phrase ``2 additional'' is corrected to ``8
additional''.
b. Line 32, the phrase ``2 hospitals' '' is corrected to ``8
hospitals' '' .
c. Line 40, the phrase ``2 additional'' is corrected to ``8
additional''.
d. Lines 42 and 43, the phrase ``2 hospitals, a total of 17
hospitals'' is corrected to read as follows ``8 hospitals, a total of
23 hospitals''.
e. Line 47, the phrase ``negative $17,153,313 (Step 2)'' is
corrected to read as follows ``negative $25,475,549 (Step 2)''.
f. Line 50, the phrase, ``2 hospitals is $88,414,357,653 (Step 3)''
is corrected to read as follows ``8 hospitals is $88,407,788,794 (Step
3)''.
g. Lines 51 and 52, the phrase ``negative 0.019401 percent'' is
corrected to read ``negative 0.028816 percent''.
h. Line 53, the phrase ``negative 0.02 percent'' is corrected to
read ``negative 0.03 percent''.
i. Lines 57 and 58, ``5.12 percent [5.1 percent-(- 0.02 percent)]''
is corrected to read ``5.13 percent [5.1 percent-(- 0.03 percent)]''.
2. On page 49421,
a. Second column,
(1) First partial paragraph, lines 4 and 5, the phrase
``supplemented for 2 hospitals for a total of 14 hospitals,'' is
corrected to read ``supplemented for 8 hospitals for a total of 20
hospitals,''.
(2) First full paragraph,
(a) Lines 2 and 3, the phrase ``2 hospitals, 14 hospitals'' is
corrected to read ``8 hospitals, 20 hospitals''.
(b) Line 6, the figure ``$1,101,225'' is corrected to read
``$2,556,541''.
[[Page 66563]]
(c) Line 9, the figure ``$7,995,731,783'' is corrected to read
``$7,994,424,546''.
(d) Line 10, the figure, ``0.013773'' is corrected to read
``0.031979''.
(e) Line 11, the figure, ``0.01'' is corrected to read ``0.03''.
(f) Line 17, the figure ``0.01'' is corrected to read ``0.03''.
(g) Line 20, the figure ``0.01'' is corrected to read ``0.03''.
b. Third column, last full paragraph,
(1) Line 2, the figure ``5.66 percent'' is corrected to read ``5.67
percent''.
(2) Line 4, the phrase ``$406,733,862 divided by $7,190,928,057''
is corrected to read ``$407,648,341 divided by ``$7,190,718,976''.
(3) Line 6, the figure ``$406,733,862'' is corrected to read
``$407,648,341''.
(4) Line 7, the figure ``$6,784,194,195'' is corrected to read
``$6,783,070,635''.
(5) Line 11, the figure ``5.40 percent'' is corrected to read
``5.41 percent''.
(6) Line 12, the figure ``$346,066,050'' is corrected to read
``$346,855,738''.
(7) Line 13, the figure ``$6,412,816,596'' is corrected to read
``$6,412,729,550''.
(8) Line 14, the figure ``$346,066,050'' is corrected to read
``$346,855,738''.
(9) Line 16, the figure ``$6,066,750,547'' is corrected to read
``$6,065,873,812''.
(10) Line 20, the figure ``5.53 percent'' is corrected to read
``5.54 percent''.
(11) Line 26, the figure ``0.01 percent'' is corrected to read
``0.03 percent''.
(12) Line 30, the figure ``5.53 percent'' is corrected to read
``5.54 percent''.
(13) Lines 34 and 35, the equation ``5.52 percent (5.53 percent-
0.01 percent)'' is corrected to read 5.51 percent (5.54 percent-0.03
percent)''.
3. On page 49427, third column, second full paragraph, line 31, the
figure ``5.12'' is corrected to ``5.13''.
4. On page 49428,
a. Top of the page,
(1) First column,
(a) First partial paragraph,
(i) Lines 3 through 5, the phrase ``0.019401 percent, which when
rounded to the second digit, is 0.02 percent'' is corrected to
``0.028816 percent, which when rounded to the second digit, is 0.03
percent''
(ii) Lines 8 and 9, the mathematical expression ``5.12 percent [5.1
percent-(0.02 percent)]'' is corrected to read ``5.13 percent [5.1
percent-(-0.03 percent)]''.
(b) Third full paragraph,
(i) Line 4, the figure ``$39,389'' is corrected to read
``$39,317''.
(ii) Line 6, the figure ``$4,658,400,549'' is corrected to read
``$4,667,954,052''.
(iii) Line 7, the figure ``$86,325,462,972'' is corrected to read
``$86,324,951,579''.
(iv) Line 11, the figure ``5.12'' is corrected to read ``5.13''.
(c) Second partial paragraph, line 2, the figure ``$38,328'' is
corrected to read ``$38,259''.
(2) Second column,
(a) First partial paragraph,
(i) Line 2, the figure ``$4,073,729,554'' is corrected to read
``$4,081,975,259''
(ii) Line 3, ``$75,488,568,943'' is corrected to
``$75,488,113,785''
(iii) Line 7, the figure ``5.12'' is corrected to read ``5.13''.
(b) First full paragraph, last line, the mathematical expression
``$38,859 (($39,389 + $38,328)/2)).'' is corrected to read ``$38,788
(($39,317 + $38,259)/2)).''
(3) Third column, first partial paragraph, lines 33 and 34, the
figure ``5.52 percent'' is corrected to read ``5.51 percent''.
b. Lower fourth of the page, in the untitled table, the figure
``0.944837'' is corrected to read ``0.944910''.
4. On page 49433, second column, first full paragraph, line 6, the
figure ``2.36 percent'' is corrected to read ``2.37 percent''.
5. On page 49435, first column,
a. First partial paragraph, line 22, the figure ``5.53 percent'' is
corrected to read ``5.54 percent''.
b. First full paragraph,
(1) Line 6, the figure ``0.01 percent'' is corrected to read ``0.03
percent''.
(2) Lines 8 through 12, the phrase ``estimated outlier payments for
capital-related PPS payments would equal 5.52 percent (5.53 percent -
0.01 percent) of inpatient capital-related payments'' is corrected to
read ``estimated outlier payments for capital-related PPS payments
would equal 5.51 percent (5.54 percent-0.03 percent) of inpatient
capital-related payments''.
(3) Line 14, the figure ``0.9448'' is corrected to read ``0.9449''.
c. Second full paragraph,
(1) Lines 4 through 7, the sentence ``The FY 2023 outlier
adjustment of 0.9448 is a -0.24 percent change from the FY 2022 outlier
adjustment of 0.9471'' is corrected to read ``The FY 2023 outlier
adjustment of 0.9449 is a -0.23 percent change from the FY 2022 outlier
adjustment of 0.9471''.
(2) Lines 9 and 10, the mathematical phrase ``0.9976 (0.9448/
0.9471)'' is corrected to read ``0.9977 (0.9449/0.9471)''.
(3) Line 12, the figure ``-0.24'' is corrected to read ``-0.23''.
6. On page 49436, third column,
a. First full paragraph,
(1) Line 9, the figure $483.76'' is corrected to read ``$483.79''.
(2) Last line, the figure ``0.9448'' is corrected to read
``0.9449''.
b. Last paragraph,
(1) Line 18, the figure ``0.24'' is corrected to read ``0.23''.
(2) Line 22, the figure ``2.36'' is corrected to read ``2.37''.
7. On page 49437,
a. Top of the page, the table ``Comparison of Factors and
Adjustments: FY 2022 Capital Federal Rate and the FY 2023 Capital
Federal Rate'' is corrected to read as follows:
[[Page 66564]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.083
b. Lower two-thirds of the page, first column, second full
paragraph, last line, the figure ``38,859'' is corrected to read
``$38,788''.
8. On page 49438, second column, first full paragraph, lines 45 and
46, the reference ``section 1866(m)(5)'' is corrected to read ``section
1886(m)(5)''.
9. On page 49450, first full paragraph,
a. Line 11, the figure ``$38,859'' is corrected to read
``$38,788''.
b. Last line, the figure ``$38,859'' is corrected to read
``$38,788''.
10. On page 49453, bottom of the page, the table titled ``TABLE
1D--CAPITAL STANDARD FEDERAL PAYMENT RATE--FY 2023'' is corrected to
read as follows:
[GRAPHIC] [TIFF OMITTED] TR04NO22.084
D. Corrections to the Appendices
1. On page 49457, third column, last paragraph,
a. Line 8, the figure ``$1.4 billion'' is corrected to read ``$1.5
billion''.
b. Line 14, the figure ``$1.0 billion'' is corrected to read ``$0.9
billion''.
2. On pages 49461 through 49463, the column titled ``All FY 2023
Changes'' in the table titled, ``Table I--Impact Analysis of Changes to
the IPPS for Operating Costs for FY 2023'' is corrected to read as
follows:
BILLING CODE 4120-01-P
[[Page 66565]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.085
[[Page 66566]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.086
3. On pages 49467 through 49468, the table titled ``Table II--
Impact Analysis of Changes for FY 2023 Acute Care Hospital Operating
Prospective Payment System (Payments per discharge)'' is corrected to
read as follows:
[[Page 66567]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.087
[[Page 66568]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.088
[[Page 66569]]
4. On page 49469, lower half of the page, third column, first
partial paragraph,
a. Line 9, the figure ``$88.45 million'' is corrected to read
``$164.72 million''.
b. Line 12, the figure ``$33.9 million'' is corrected to read
``$110.17 million''.
5. On page 49470,
a. Top of the page, in the table titled ``FY 2023 Estimates for New
Technology Add-On Payments for Technologies under the Alternative
Pathway for FY 2023'', the table is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR04NO22.089
b. Lower one-third of the page, in the table titled ``FY 2023
Estimates for New Technology Add-On Payments for FY 2023'', the table
is corrected to read as follows:
FY 2023 Estimates for New Technology Add-On Payments for FY 2023
------------------------------------------------------------------------
Estimated Total FY 2023
Category Impact
------------------------------------------------------------------------
Technologies Continuing New Technology Add- $619,943,190.45
On Payments in FY 2023...................
-----------------------------
Alternative Pathway Applications.......... 164,724,777.38
Traditional Pathway Applications.......... 75,161,627.94
-----------------------------
Aggregate Estimated Total FY 2023 $859,829,595.77
Impact...............................
------------------------------------------------------------------------
c. Bottom of the page, first column, partial paragraph, before line
1, the text is corrected by adding a heading to read as follows: ``2.
Effects of Changes to Medicare DSH and Uncompensated Care Payments for
FY 2023 and the New Supplemental Payment for Indian Health Service
Hospitals and Tribal Hospitals and Hospitals Located in Puerto Rico''.
6. On page 49471, third column, first full paragraph, line 1, the
number ``2,368'' is corrected to ``2,367''.
7. On pages 49472 and 49473, the table titled ``Modeled
Uncompensated Care Payments* and Supplemental Payments for Estimated FY
2023 DSHs by Hospital Type'' is corrected to read as follows:
[[Page 66570]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.091
[[Page 66571]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.092
BILLING CODE 4120-01-C
8. On page 49473, lower one-fourth of the page, second column,
partial paragraph, line 6, the figure ``2,368'' is corrected to
``2,367''.
9. On page 49474, first column, second full paragraph, line 5
through the second column, second full paragraph, last line, the
language (beginning with the phrase ``Rural hospitals with 250+ beds
are projected to receive'' and ending with the sentence ``Hospitals
with greater than 65 percent Medicaid utilization are projected to
receive an increase of 6.67 percent.'') is corrected to read as
follows: ``Rural hospitals, in general, are projected to experience
larger decreases in uncompensated care payments and supplemental
payments compared to their uncompensated care payments in FY 2022, as
compared to their urban counterparts. Overall, rural hospitals are
projected to receive a 6.00 percent decrease in payments, which is a
greater decrease than the overall hospital average, while urban
hospitals are projected to receive a 2.90 percent decrease in payments,
which is a slightly smaller decrease than the overall hospital average.
Among rural hospitals, by bed size, larger rural hospitals are
projected to receive the smallest decreases in uncompensated care
payments and supplemental payments. Rural hospitals with 250+ beds are
projected to receive a 4.53 percent payment decrease, and rural
hospitals with 100-249 beds are projected to receive a 6.82 percent
decrease. Smaller rural hospitals with 0-99 beds are projected to
receive a 5.81 percent payment decrease. Among urban hospitals, the
smallest hospitals, those with 0-99 beds, are projected to receive a
6.55 percent decrease in payments, which is a greater decrease than the
overall hospital average. In contrast, urban hospitals with 100-249
beds and those with 250+ beds are projected to receive decreases in
payments of 2.68 and 2.76 percent, respectively, which are smaller
decreases than the overall hospital average.
In most regions, rural hospitals are generally expected to receive
larger than average decreases in uncompensated care payments and
supplemental payments. The exceptions are rural hospitals in the South
Atlantic Region, which are projected to receive a smaller than average
decrease of 1.81 percent in payments and rural hospitals in the East
North Central Region and the Pacific Region, which are projected to
receive payment increases of 8.09 and 24.44 percent, respectively.
Regionally, urban hospitals are projected to receive a more varied
range of payment changes. Urban hospitals in the New England, Middle
Atlantic, and South Atlantic Regions, as well as hospitals in Puerto
Rico, are projected to receive larger than average decreases in
payments. Urban hospitals in the East South Central, West North
Central, West South Central, and Mountain Regions are projected to
receive smaller than average decreases in payments. Urban hospitals in
the East North Central and Pacific Regions are projected to receive
increases in payments of 1.02 percent and 0.54 percent, respectively.
By payment classification, although hospitals in urban payment
areas overall are expected to receive a 2.50 percent decrease in
uncompensated care payments and supplemental payments, hospitals in
large urban payment areas are expected to see a decrease in payments of
1.26 percent, while hospitals in other urban payment areas are
projected to receive the largest decrease of 4.88 percent. Hospitals in
rural payment areas are expected to
[[Page 66572]]
receive a decrease in payments of 4.03 percent.
Nonteaching hospitals are projected to receive a payment decrease
of 2.82 percent, teaching hospitals with fewer than 100 residents are
projected to receive a decrease of 2.46 percent, and teaching hospitals
with 100+ residents have a projected payment decrease of 3.82 percent.
Proprietary and voluntary hospitals are projected to receive smaller
than average decreases of 2.38 and 1.95 percent respectively, while
government hospitals are expected to receive a larger than average
payment decrease of 5.65 percent. Hospitals with less than 25 percent
Medicare utilization and hospitals with 50 to 65 percent Medicare
utilization are projected to receive smaller than average payment
decreases of 2.89 and 0.38 percent, respectively, while hospitals with
25-50 percent and hospitals with greater than 65 percent Medicare
utilization are projected to receive larger than average payment
decreases of 3.29 and 23.83 percent, respectively. All hospitals with
less than 50 percent Medicaid utilization are projected to receive
smaller decreases in uncompensated care payments and supplemental
payments than the overall hospital average percent change, while
hospitals with 50-65 percent Medicaid utilization are projected to
receive a larger than average decrease of 10.49 percent. Hospitals with
greater than 65 percent Medicaid utilization are projected to receive
an increase of 6.66 percent.''
10. On page 49482, third column, first full paragraph, last line,
the figure ``0.9448'' is corrected to read ``0.9449''.
11. On page 49483,
a. First column, first partial paragraph, line 1, the figure ``5.52
percent'' is corrected to read ``5.51 percent''.
b. Second column, second full paragraph,
(1) Line 5, the figure ``1.6 percent'' is corrected to read ``1.7
percent''.
(2) Line 10, the figure ``1.2 percent'' is corrected to read ``1.4
percent''.
c. Third column, last paragraph, last line, the figure ``0.3
percent'' is corrected to read ``0.1 percent''.
12. On pages 49484 and 49485, the table titled ``TABLE III.--
COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2022 PAYMENTS COMPARED TO FY
2023 PAYMENTS]'' is corrected to read as follows:
BILLING CODE 4120-01-P
[[Page 66573]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.093
[[Page 66574]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.094
13. On page 49494, third column, third full paragraph,
a. Lines 2 and 3, the figure ``$1.4 billion'' is corrected to read
``$1.5 billion''.
b. Line 14, the figure ``$0.039 billion'' is corrected to read
``0.040 billion''.
c. Lines 17 and 18, the figure ``-$0.747 billion'' is corrected to
read ``-$0.671 billion''.
14. On page 49495,
a. First column, first line, the figure ``$39 million'' is
corrected to read ``$40 million''.
b. Third column, second full paragraph, last line, the figure
``$1.4 billion'' is corrected to read ``$1.5 billion''.
c. Middle of page, Table V. ``ACCOUNTING STATEMENT: CLASSIFICATION
OF ESTIMATED EXPENDITURES UNDER THE IPPS FROM FY 2022 TO FY 2023'' is
corrected to read as follows:
[[Page 66575]]
[GRAPHIC] [TIFF OMITTED] TR04NO22.095
BILLING CODE 4120-01-C
List of Subjects in 42 CFR Part 482
Grant programs--health, Hospitals, Medicaid, Medicare, Reporting
and recordkeeping requirements.
Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments to part 482:
PART 482--CONDITIONS OF PARTICIPATION FOR HOSPITALS
0
1. The authority citation for part 482 continues to reads as follows:
Authority: 42 U.S.C. 1302, 1395hh, and 1395rr, unless otherwise
noted.
Sec. 482.42 [Amended]
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2. In Sec. 482.42, redesignate the second paragraph (f)(2)(ii) as
paragraph (f)(2)(iii).
Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2022-24077 Filed 11-3-22; 8:45 am]
BILLING CODE 4120-01-P