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]

Download as PDF 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. khammond on DSKJM1Z7X2PROD with RULES SUMMARY: VerDate Sep<11>2014 20:05 Nov 03, 2022 Jkt 259001 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. PO 00000 Frm 00024 Fmt 4700 Sfmt 4700 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 E:\FR\FM\04NOR1.SGM 04NOR1 khammond on DSKJM1Z7X2PROD with RULES Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations 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 VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 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. PO 00000 Frm 00025 Fmt 4700 Sfmt 4700 66559 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. E:\FR\FM\04NOR1.SGM 04NOR1 66560 Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations khammond on DSKJM1Z7X2PROD with RULES 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 VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 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. PO 00000 Frm 00026 Fmt 4700 Sfmt 4700 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, E:\FR\FM\04NOR1.SGM 04NOR1 khammond on DSKJM1Z7X2PROD with RULES Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations 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, VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 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.’’. PO 00000 Frm 00027 Fmt 4700 Sfmt 4700 66561 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:// E:\FR\FM\04NOR1.SGM 04NOR1 66562 Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations 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 khammond on DSKJM1Z7X2PROD with RULES 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 VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 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 PO 00000 Frm 00028 Fmt 4700 Sfmt 4700 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</GPH> 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 khammond on DSKJM1Z7X2PROD with RULES (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, VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 (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, PO 00000 Frm 00029 Fmt 4700 Sfmt 4700 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: E:\FR\FM\04NOR1.SGM 04NOR1 66564 Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations 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</GPH> BILLING CODE 4120–01–P VerDate Sep<11>2014 20:05 Nov 03, 2022 Jkt 259001 PO 00000 Frm 00030 Fmt 4700 Sfmt 4700 E:\FR\FM\04NOR1.SGM 04NOR1 ER04NO22.083</GPH> khammond on DSKJM1Z7X2PROD with RULES 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 Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations 66565 All FY 2023 Changes VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 PO 00000 Frm 00031 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 Sfmt 4725 E:\FR\FM\04NOR1.SGM 04NOR1 ER04NO22.085</GPH> khammond on DSKJM1Z7X2PROD with RULES (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)) VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 of Changes for FY 2023 Acute Care Hospital Operating Prospective Payment PO 00000 Frm 00032 Fmt 4700 Sfmt 4700 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: E:\FR\FM\04NOR1.SGM 04NOR1 ER04NO22.086</GPH> khammond on DSKJM1Z7X2PROD with RULES 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 <Rural): 0-49 beds 50-99 beds 100-149 beds 150-199 beds 200 or more beds Urban by Ree:ion: 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 100 residents 100 or more residents UrbanDSH: Non-DSH 100 or more beds VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 PO 00000 Frm 00033 Fmt 4700 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 E:\FR\FM\04NOR1.SGM 04NOR1 66567 ER04NO22.087</GPH> khammond on DSKJM1Z7X2PROD with RULES 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 17:31 Nov 03, 2022 Jkt 259001 PO 00000 Frm 00034 Fmt 4700 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 Sfmt 4725 E:\FR\FM\04NOR1.SGM 04NOR1 ER04NO22.088</GPH> khammond on DSKJM1Z7X2PROD with RULES 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 .................................................................................................. $859,829,595.77 VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 Health Service Hospitals and Tribal Hospitals and Hospitals Located in Puerto Rico’’. 6. On page 49471, third column, first full paragraph, line 1, the number ‘‘2,368’’ is corrected to ‘‘2,367’’. PO 00000 Frm 00035 Fmt 4700 Sfmt 4700 7. On pages 49472 and 49473, the table titled ‘‘Modeled Uncompensated Care Payments* and Supplemental Payments for Estimated FY 2023 DSHs by Hospital Type’’ is corrected to read as follows: E:\FR\FM\04NOR1.SGM 04NOR1 ER04NO22.089</GPH> khammond on DSKJM1Z7X2PROD with RULES c. Bottom of the page, first column, partial paragraph, before line 1, the text is corrected by adding a heading to read as follows: ‘‘2. Effects of Changes to Medicare DSH and Uncompensated Care Payments for FY 2023 and the New Supplemental Payment for Indian 66570 Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations Total By Geographic Location Urban Hospitals Large Urban Areas Other Urban Areas Rural Hospitals Bed Size (Urban) 0 to 99 Beds 100 to 249 Beds 250+ Beds Bed Size (Rural) 0 to 99 Beds 100 to 249 Beds 250+ Beds Urban by Region New England Middle Atlantic South Atlantic East North Central East South Central West North Central West South Central Mountain Pacific Puerto Rico Rural by Region New England Middle Atlantic South Atlantic East North Central East South Central West North Central West South Central Mountain Pacific Bv Payment Classification Urban Hospitals Large Urban Areas Other Urban Areas Rural Hospitals Teaching Status Nonteaching Fewer than 100 residents 100 or more residents Type of Ownership Voluntarv Proprietary Government Medicare Utilization Percent**** VerDate Sep<11>2014 17:31 Nov 03, 2022 Number of Estimated DSHs (1) 2,367 Jkt 259001 FY 2022 Final Rule Estimated Uncompensated Care Payments ($ 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 -$221 -3.08% 1,919 1,005 914 448 6,789 4,146 2,643 403 6,592 4,073 2,519 379 -197 -73 -124 -24 -2.90 -1.76 -4.69 -6.00 363 779 777 284 1,532 4,974 265 1,491 4,836 -19 -41 -137 -6.55 -2.68 -2.76 346 90 12 219 136 47 206 127 45 -13 -9 -2 -5.81 -6.82 -4.53 88 236 313 104 322 126 236 135 316 43 186 819 800 354 1,759 439 1,434 299 607 93 176 765 762 357 1,713 428 1,401 292 611 87 -11 -54 -38 4 -45 -10 -32 -7 3 -6 -5.79 -6.58 -4.76 1.02 -2.58 -2.38 -2.27 -2.35 0.54 -6.24 7 21 66 27 77 116 105 23 6 15 12 43 23 117 85 88 14 5 11 12 43 25 107 81 81 14 6 -3 0 -1 2 -10 -4 -7 -1 1 -23.04 -3.77 -1.81 8.09 -8.75 -4.95 -8.51 -4.60 24.44 1,456 832 624 911 4,482 2,950 1,532 2,710 4,370 2,913 1,458 2,600 -112 -37 -75 -109 -2.50 -1.26 -4.88 -4.03 1,320 778 269 1,961 2,486 2,746 1,905 2,425 2,641 -55 -61 -105 -2.82 -2.46 -3.82 1,477 530 360 4,102 1,017 2,073 4,023 992 1,956 -80 -24 -117 -1.95 -2.38 -5.65 PO 00000 Frm 00036 Fmt 4700 Sfmt 4725 E:\FR\FM\04NOR1.SGM 04NOR1 ER04NO22.091</GPH> khammond on DSKJM1Z7X2PROD with RULES Modeled Uncompensated Care Payments* and Supplemental Payments for Estimated FY 2023 DSHs by Hospital Type Federal Register / Vol. 87, No. 213 / Friday, November 4, 2022 / Rules and Regulations 66571 Modeled Uncompensated Care Payments* and Supplemental Payments for Estimated FY 2023 DSHs by Hospital Type Number of Estimated DSHs (1) FY 2022 Final Rule Estimated Uncompensated Care Payments ($ 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 khammond on DSKJM1Z7X2PROD with RULES 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 20:05 Nov 03, 2022 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 PO 00000 Frm 00037 Fmt 4700 Sfmt 4700 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 04NOR1 ER04NO22.092</GPH> *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, PO 00000 Frm 00038 Fmt 4700 Sfmt 4700 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 E:\FR\FM\04NOR1.SGM 04NOR1 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 VerDate Sep<11>2014 17:31 Nov 03, 2022 Jkt 259001 PO 00000 Frm 00039 Fmt 4700 Sfmt 4725 E:\FR\FM\04NOR1.SGM 04NOR1 Change ER04NO22.093</GPH> khammond on DSKJM1Z7X2PROD with RULES 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 Jkt 259001 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</GPH> 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</GPH> 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]]

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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]

0
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


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