Justia Department Of Health And Human Services Centers For Medicare & Medicaid Services Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2024 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Provider and Supplier Disclosure of Ownership; and Medicare Disproportionate Share Hospital (DSH) Payments: Counting Certain Days Associated With Section 1115 Demonstrations in the Medicaid Fraction; Correction, 68482-68486 [2023-22060]

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 2024 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Provider and Supplier Disclosure of Ownership; and Medicare Disproportionate Share Hospital (DSH) Payments: Counting Certain Days Associated With Section 1115 Demonstrations in the Medicaid Fraction; Correction, 68482-68486 [2023-22060]

Download as PDF 68482 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 411, 412, 419, 488, 489, and 495 [CMS–1785–CN and CMS–1788–CN] RINs 0938–AV08 and 0938–AV17 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 2024 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Provider and Supplier Disclosure of Ownership; and Medicare Disproportionate Share Hospital (DSH) Payments: Counting Certain Days Associated With Section 1115 Demonstrations in the Medicaid Fraction; Correction Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: Final rule; correction. AGENCY: This document corrects technical and typographical errors in the final rule that appeared in the August 28, 2023 Federal Register 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 2024 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Provider and Supplier Disclosure of Ownership; and Medicare Disproportionate Share Hospital (DSH) Payments: Counting Certain Days Associated with Section 1115 Demonstrations in the Medicaid Fraction’’ (referred to hereafter as the ‘‘FY 2024 IPPS/LTCH PPS final rule’’). DATES: This correcting document is effective October 1, 2023. FOR FURTHER INFORMATION CONTACT: Mady Hue, (410) 786–4510, and Andrea Hazeley, (410) 786–3543, MS– DRG Classifications. Donald Thompson and Michele Hudson, DAC@cms.hhs.gov, (410) 786– 4487, Wage Index, Uncompensated Care Payments. lotter on DSK11XQN23PROD with RULES1 SUMMARY: VerDate Sep<11>2014 17:03 Oct 03, 2023 Jkt 262001 Siddhartha Mazumdar, siddhartha.mazumdar@cms.hhs.gov, Rural Community Hospital Demonstration Program. Julia Venanzi, julia.venanzi@ cms.hhs.gov, Hospital Inpatient Quality Reporting Program and Hospital Value Based Purchasing Program— Administration Issues. Melissa Hager, melissa.hager@cms.hhs.gov and Ngozi Uzokwe, ngozi.uzokwe@cms.hhs.gov— Hospital Inpatient Quality Reporting Program and Hospital Value-Based Purchasing Program—Measures Issues Except Hospital Consumer Assessment of Healthcare Providers and Systems. Adina Hersko, NewTech@ cms.hhs.gov, New Technology Add-On Payments and New COVID–19 Treatments Add-on Payments. SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 2023–16252 of August 28, 2023 (88 FR 58640), there were a number of technical and typographical errors that are identified and corrected in this correcting document. The corrections in this correcting document are applicable to discharges occurring on or after October 1, 2023, as if they had been included in the document that appeared in the August 28, 2023 Federal Register. II. Summary of Errors A. Summary of Errors in the Preamble On page 58642, we are removing a duplicative bulleted paragraph and correcting an inadvertent typographical error in another paragraph. On page 58696, we are correcting inadvertent errors in procedure code combinations listed in the table titled ‘‘ICD–10–PCS Code Pairs Added to Version 41 ICD–10 MS–DRGs 001 and 002: New Short-Term External Heart Assist ICD–10–PCS Combinations.’’ On page 58844, we are correcting an inadvertent typographical error in the definition of the acronym ‘‘PFS’’ used in the discussion of the FY 2024 application for new technology add-on payments for LunsumioTM. On page 58927, we are correcting inadvertent errors in the ICD–10–PCS procedure codes used to identify cases involving the use of the Canary Tibial Extension (CTE) with Canary Health Implanted Reporting Processor (CHIRP) System. On page 58948, we are correcting the ICD–10–CM codes used to identify cases involving the use of XACDURO® for hospital-acquired bacterial pneumonia (HABP) due to Acinetobacter baumannii and ventilator-associated bacterial pneumonia (VABP) due to PO 00000 Frm 00032 Fmt 4700 Sfmt 4700 Acinetobacter baumannii with the new ICD–10–CM codes effective for FY 2024 that specifically describe Acinetobacter baumannii-related infections. On page 59051, with regard to our discussion of the calculation of prior year IME resident to bed ratio when there is a Medicare GME affiliation agreement, we are correcting a typographical error. On pages 59064, 59065, 59071, 59095, 59139, 59174, and 59186, we are correcting technical and typographical errors in several hyperlinks. On pages 59090, 59113, 59142, 59149, 59164, and 59171, we are correcting technical and typographical errors in several cross-references. On page 59107, in our discussion of the Hospital Value-Based Purchasing Program, we made and are correcting a typographical error. On pages 59114 and 59144, we are correcting typographical and technical errors in several section headings. On pages, 59152, 59154, 59163 and 59279, we are correcting typographical and technical errors in several footnotes. On pages 59163 and 59199 in our discussion of the Hospital Impatient Quality Reporting Program, we are correcting several typographical and technical errors. On page 59326 in our discussion of the information collection requirements for the Medicare Promoting Interoperability Program, we are correcting typographical and technical errors. B. Summary of Errors in the Appendices On page 59412 in our discussion of effects of requirements under the Hospital Readmissions Reduction Program for FY 2024, we are correcting typographical error in a table reference. C. Summary of Errors and Correction to Tables Posted on the CMS Website Several tables for the FY 2024 IPPS/ LTCH PPS final rule contained inadvertent errors related to wage data collected from the Medicare cost reports of one hospital (CMS Certification Number (CCN) 340064). Specifically, some of the hours on worksheet S–3, Part II of the cost report were inadvertently double counted for CCN 340064. The use of correct wage data for this hospital (by removing the hours that were double counted) necessitated recalculating the FY 2024 area average hourly wages unadjusted for occupational mix and adjusted for occupational mix for the areas impacted by use of correct wage data for this hospital. We note that this error did not impact the FY 2024 national average hourly wages unadjusted for E:\FR\FM\04OCR1.SGM 04OCR1 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations lotter on DSK11XQN23PROD with RULES1 occupational mix and adjusted for occupational mix, and thus did not necessitate corrections to those data points. In addition, because CCN 340064 is geographically located in a rural area (Core-Based Statistical Area (CBSA) 34 North Carolina) and reclassifies to an urban area (CBSA 16740 Charlotte-Concord-Gastonia, NC– SC), it was necessary to recalculate the wage index for CBSAs 34 and 16740. In addition, the wage data and/or wage indexes are used as inputs to determine the rural floor, imputed floor and outmigration adjustment, and therefore, we made conforming changes and recalculated the rural floor for North Carolina as well as some of the imputed floors and one county out-migration adjustment. We further note that the fixed-loss cost threshold was unchanged after including the correct wage data for this hospital in our calculations. While for certain prior years we have also recalculated the budget neutrality factors to reflect revisions to the calculation of area average hourly wages and/or wage indexes due to the change in the wage data, in combination with the correction of other errors, given the limited magnitude of the changes mentioned earlier, we did not recalculate any budget neutrality factors due to the changes to the wage data. We estimate that this change would have resulted in a reduction of the standardized amount of approximately 3 cents. We are correcting the errors in the following IPPS tables that are listed on page 59381 of the FY 2024 IPPS/LTCH PPS final rule and available on the internet on the CMS website at https:// www.cms.gov/medicare/medicare-feefor-service-payment/acuteinpatientpps. The tables that are available on the internet have been updated to reflect the revisions discussed in this final rule correcting document. 1. Table 2—Case Mix Index and Wage Index Table by CCN Because of the inadvertent use of erroneous wage data for one hospital (CCN 340064), we are correcting the values in the columns titled ‘‘Average Hourly Wage FY 2024’’ and ‘‘3-Year Average Hourly Wage (2022, 2023, 2024)’’ for CCN 340064. As mentioned earlier, CCN 340064 is geographically located in a rural area (CBSA 34 North Carolina) and reclassifies to an urban area (CBSA 16740 Charlotte-ConcordGastonia, NC–SC). Therefore, we used the corrected data of CCN 340064 to recalculate the wage index for CBSA 34 and 16740. As a result, we are correcting the values in the columns titled ‘‘FY 2024 Wage Index Prior to Quartile and VerDate Sep<11>2014 17:03 Oct 03, 2023 Jkt 262001 Cap’’, ‘‘FY 2024 Wage Index With Quartile’’, and ‘‘FY 2024 Wage Index With Quartile and Cap’’, for providers geographically located in, or reclassified into, CBSAs 34 or 16740. As mentioned earlier, the wage data and/or wage indexes are used as inputs to determine the rural floor, imputed floor and outmigration adjustment. Because the average hourly wage change for this single provider impacted the North Carolina rural floor, we are correcting the values in the columns titled ‘‘FY 2024 Wage Index Prior to Quartile and Cap’’, ‘‘FY 2024 Wage Index with Quartile’’, and ‘‘FY 2024 Wage Index With Quartile and Cap’’, for North Carolina providers who receive the rural floor. Because the average hourly wage change for this single provider affects the area wage index, we are also making conforming changes to the other wage indexes that are consequently impacted, including the imputed floor and outmigration adjustment, and are therefore correcting the values in the columns titled ‘‘FY 2024 Wage Index Prior to Quartile and Cap’’, ‘‘FY 2024 Wage Index With Quartile’’, and ‘‘FY 2024 Wage Index With Quartile and Cap’’, for providers who receive the imputed floor in Delaware, the District of Columbia, or Rhode Island as well as the values in the column titled ‘‘Out-Migration Adjustment’’ for providers in Catawba, NC (Federal Information Processing Standard (FIPS) county code 37035). 2. Table 3—Wage Index Table by CBSA—FY 2024 As mentioned earlier, CCN 340064 is geographically located in a rural area (CBSA 34 North Carolina) and reclassifies to an urban area (CBSA 16740 Charlotte-Concord-Gastonia, NC– SC). Therefore, we used the corrected data of CCN 340064 to recalculate the wage index for CBSAs 34 and 16740. As mentioned earlier, the wage data and/or wage indexes are used as inputs to determine the rural floor, imputed floor and out-migration adjustment. Our use of correct wage data for the provider for which we inadvertently used incorrect wage data necessitates corrections to the values in the columns titled ‘‘FY 2024 Average Hourly Wage’’, ‘‘3-Year Average Hourly Wage (2022, 2023, 2024)’’, ‘‘Wage Index’’, ‘‘GAF’’, ‘‘Reclassified Wage Index’’, and ‘‘Reclassified GAF’’ for CBSA 34. The average hourly wage change for this single provider impacts the North Carolina rural floor, which necessitates corrections to the values in the columns titled ‘‘Wage Index’’ and ‘‘GAF’’ for CBSAs that receive the North Carolina rural floor. Because the conforming changes to the wage index impact the calculation of the imputed PO 00000 Frm 00033 Fmt 4700 Sfmt 4700 68483 floor, we are correcting the values in the columns titled ‘‘Wage Index’’, ‘‘GAF’’, and ‘‘State Imputed Floor’’ for CBSAs 08, 09, and 41, as well as the values in the columns titled ‘‘Reclassified Wage Index’’ and ‘‘Reclassified GAF’’ for CBSAs that receive the Rhode Island imputed floor. 3. Table 4A—List of Counties Eligible for the Out-Migration Adjustment Under Section 1886(D)(13) of the Act—FY 2024 Final Rule As mentioned earlier, the wage data and/or wage indexes are used as inputs to determine the out-migration adjustment. Due to the corrections previously discussed in Table 2 and 3, we made conforming changes to the outmigration adjustment based on the corrected wage indexes. Because the conforming changes to the wage index impact the out-migration adjustment, we are correcting the value for the column titled ‘‘FY 2024 Out Migration Adjustment’’ for Catawba, NC (FIPS county code 37035). We are also correcting an error in the following LTCH PPS table that is listed on page 59381 of the FY 2024 IPPS/ LTCH PPS final rule and is available on the internet on the CMS website at https://www.cms.gov/medicare/ medicare-fee-service-payment/ longtermcarehospitalpps/ltchppsregulations-and-notices/530633405/ cms-1785-f. The tables that are available on the internet have been updated to reflect the revisions discussed in this final rule correction. 4. Table 12B—LTCH PPS Wage Index for Rural Areas for Discharges Occurring From October 1, 2023 Through September 30, 2024 We are correcting the value for CBSA 34 in the column titled ‘‘LTCH PPS Wage Index’’ to reflect the correction to the hospital wage data for CCN 340064 discussed previously. The FY 2024 LTCH PPS standard Federal payment rate area wage index values are calculated using the same data used to compute the FY 2024 acute care hospital inpatient wage index, without taking into account geographic reclassification under sections 1886(d)(8) and 1886(d)(10) of the Social Security Act (the Act) (88 FR 59368). We note that the correction to the inpatient hospital wage data for CCN 340064 necessitated a correction to the FY 2024 LTCH PPS standard Federal payment rate area wage index value for CBSA 34 (rural NC); however, there are currently no LTCHs located in CBSA 34. E:\FR\FM\04OCR1.SGM 04OCR1 lotter on DSK11XQN23PROD with RULES1 68484 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 5. Table 18—FY 2024 Final Rule Medicare DSH Uncompensated Care Payment Factor 3 (Final Methodology) We further note that we also made updates to the calculation of Factor 3 of the uncompensated care payment methodology to reflect a hospital’s corrected Worksheet S–10 data that, due to a report upload error, was not included in the March 2023 Hospital Cost Report Information System (HCRIS) extract used to calculate Factor 3 for FY 2024. We recalculated the total uncompensated care amount for all DSH-eligible hospitals to reflect this correction. In addition, because the Factor 3 calculated 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 the fiscal year. This hospitalspecific payment amount is then used to calculate the amount of the interim uncompensated care payments a hospital receives per discharge. Given the very narrowly targeted update to the information used in the calculation of Factor 3, the change to the previously calculated Factor 3 is of limited magnitude for the majority of hospitals. We note that the fixed-loss cost threshold was unchanged after these Factor 3 recalculations. Similar to our discussion with regard to the wage data corrections, we note that while for certain prior years we recalculated the budget neutrality factors to reflect revisions to the calculation of Factor 3, in combination with the correction of other errors, we did not recalculate any budget neutrality factors due to the changes to Factor 3 for FY 2024 given the limited magnitude of the changes to uncompensated care payments. For example, we note that the correction to the previously described hospital’s Worksheet S–10 data resulted in an approximately $90 increase to that hospital’s interim uncompensated care payment per discharge amount. We are correcting the errors in the following IPPS table that is listed on page 59381 of the FY 2024 IPPS/LTCH PPS final rule and is available on the internet on the CMS website at https:// www.cms.gov/medicare/medicare-feefor-service-payment/acuteinpatientpps. The tables that are available on the internet have been updated to reflect the revisions discussed in this final rule correction. Table 18—FY 2024 Final Rule Medicare DSH Uncompensated Care VerDate Sep<11>2014 17:03 Oct 03, 2023 Jkt 262001 Payment Factor 3 (Final Methodology). For the FY 2024 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 2024. We are updating the calculations in this table to reflect corrected Worksheet S–10 data for one hospital that, due to a report upload error, was not included in the March 2023 HCRIS extract used to calculate Factor 3 for the FY 2024 IPPS/LTCH PPS final rule. We are revising Factor 3 for all hospitals to reflect this correction. We are also revising the amount of the total uncompensated care payment calculated for each DSHeligible 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. 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 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. PO 00000 Frm 00034 Fmt 4700 Sfmt 4700 We believe that this final rule correction 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, tables, and appendices included or referenced in the FY 2024 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 final rule correction is intended to ensure that the information in the FY 2024 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 2024 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 final rule correction is intended solely to ensure that the FY 2024 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. IV. Correction of Errors In FR Doc. 2023–16252 of August 28, 2023 (88 FR 58640), we are making the following corrections: A. Corrections of Errors in the Preamble 1. On page 58642, second column: a. Second bulleted paragraph, that begins with the phrase ‘‘Section 1814(l)(4) of the Act’’ and ends with the phrase ‘‘a payment adjustment year.’’ is corrected by removing the paragraph. b. Third bulleted paragraph, line 9, the phrase ‘‘reporting payment for’’ is corrected to read ‘‘reporting period for’’. E:\FR\FM\04OCR1.SGM 04OCR1 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 2. On page 58696, top of the page, the table titled ‘‘ICD–10–PCS Code Pairs Added to Version 41 ICD–10 MS–DRGs 001 and 002: New Short-Term External Heart Assist ICD–10–PCS 68485 Combinations’’ is corrected to read as follows: ICD–10–PCS CODE PAIRS ADDED TO VERSION 41 ICD–10 MS–DRGS 001 AND 002: NEW SHORT-TERM EXTERNAL HEART ASSIST ICD–10–PCS COMBINATIONS ICD–10–PCS code 02HA0RZ .......... 02HA3RZ .......... lotter on DSK11XQN23PROD with RULES1 02HA3RZ .......... Insertion of short-term external heart assist system into heart, open approach. Insertion of short-term external heart assist system into heart, percutaneous approach. Insertion of short-term external heart assist system into heart, percutaneous approach. 3. On page 58844, second column, first full paragraph, line 11, the phrase ‘‘median Physician Fee Schedule (PFS)’’ is corrected to read, ‘‘median progression-free survival (PFS)’’ 4. On page 58927, third column, first partial paragraph: a. Line 11 the code, ‘‘XNHG0D9’’ is corrected to read ‘‘XNHG0F9’’. b. Line 15, the code, ‘‘XNHH0D9’’ is corrected to read ‘‘XNHH0F9’’. 5. On page 58948, second column, last partial paragraph, line 15, the sentence ‘‘Cases involving the use of XACDURO® that are eligible for new technology addon payments will be identified by ICD– 10–PCS procedure codes XW033K9 (Introduction of sulbactam-durlobactam into peripheral vein, percutaneous approach, new technology group 9) or XW043K9 (Introduction of sulbactamdurlobactam into central vein, percutaneous approach, new technology group 9) in combination with one of the following ICD–10–CM codes: Y95 and J15.6 (describing HABP due to Acinetobacter baumannii); or J95.851 and B96.89 (describing VABP due to Acinetobacter baumannii).’’ is corrected to read ‘‘We note that there are new ICD–10–CM codes effective for FY 2024 to specifically describe Acinetobacter baumannii-related infections: J15.61 (Pneumonia due to Acinetobacter baumannii) and B96.83 (Acinetobacter baumannii as the cause of diseases classified elsewhere). Therefore, cases involving the use of XACDURO® that are eligible for new technology add-on payments will be identified by ICD–10– PCS procedure codes XW033K9 (Introduction of sulbactam-durlobactam into peripheral vein, percutaneous approach, new technology group 9) or XW043K9 (Introduction of sulbactamdurlobactam into central vein, percutaneous approach, new technology group 9) in combination with one of the following ICD–10–CM codes: Y95 and VerDate Sep<11>2014 ICD–10–PCS code Description and X2HX0F9 .......... and X2HL0F9 .......... and X2HM0F9 ......... Insertion of conduit to short-term external heart assist system into thoracic aorta, ascending, open approach, new technology group 9. Insertion of conduit to short-term external heart assist system into right axillary artery, open approach, new technology group 9. Insertion of conduit to short-term external heart assist system into left axillary artery, open approach, new technology group 9. Description 17:03 Oct 03, 2023 Jkt 262001 J15.61 (describing HABP due to Acinetobacter baumannii); or J95.851 and B96.83 (describing VABP due to Acinetobacter baumannii).’’. 6. On page 59051, third column, first partial paragraph: a. Line 24, the phrase ‘‘adjust the prior year numerator by +10’’ is corrected to read ‘‘adjust the prior year numerator’’. b. Line 28, the phrase ‘‘increased by 10 relative to the prior year’’ is corrected to read ‘‘increased relative to the prior year’’. 7. On page 59064, second column, first footnote paragraph (footnote 219), lines 2 through 4, the hyperlink, ‘‘https://qualitynet.cms.gov/inpatient/ measures/mspb/methodology,’’ is corrected to read, ‘‘https:// qualitynet.cms.gov/inpatient/measures/ hvbp-mspb/methodology.’’ 8. On page 59065, first column, first footnote paragraph (footnote 226), lines 2 through 4, the hyperlink, ‘‘https:// qualitynet.cms.gov/inpatient/measures/ mspb/methodology,’’ is corrected to read, ‘‘https://qualitynet.cms.gov/ inpatient/measures/hvbp-mspb/ methodology.’’ 9. On page 59071, second column, second footnote paragraph (footnote 249), lines 3 through 6, the hyperlink, ‘‘https://www.cms.gov/Medicare/ Quality-Initiatives-Patient-AssessmentInstruments/Value-Based-Programs/ CMS/Quality-Strategy,’’ is corrected to read, ‘‘https://www.cms.gov/Medicare/ Quality-Initiatives-Patient-AssessmentInstruments/Value-Based-Programs/ CMS-Quality-Strategy.’’ 10. On page 59090, third column, first paragraph, the reference, ‘‘section XXX’’ is corrected to read, ‘‘V.K.2.c.(1).’’ 11. On page 59095, first column, first footnote paragraph (footnote 292), lines 5 through 8, the hyperlink, ‘‘https:// aspe.hhs.gov/sites/default/files/ migrated_legacy_files//195046/Social- PO 00000 Frm 00035 Fmt 4700 Sfmt 4700 Risk-in-Medicare%E2%80%99s-VBP/ 2nd-Report-Executive-Summary.pdf,’’ is corrected to read, https://aspe.hhs.gov/ sites/default/files/migrated_legacy_files/ 195046/Social-Risk-inMedicare%E2%80%99s-VBP-2ndReport-Executive-Summary.pdf. 12. On page 59107, second column, first full paragraph, line 7, the phrase ‘‘A few commenters made’’ is corrected to read, ‘‘A few commenters’’. 13. On page 59113, first column, last paragraph, line 21, the reference ‘‘section X.X.’’ is corrected to ‘‘section V.L.6.a.(2)’’. 14. On page 59114, first column, first full paragraph, line 1, the section heading that begins ‘‘K. Rural’’ is corrected to read ‘‘M. Rural’’. 15. On page 59139, third column, footnote paragraph (footnote 348), lines 4 through 6, the hyperlink ‘‘https:// mmshub.cms.gov/sites/default/files/ 2022-prliminary-analysis-pacltcworkgroup.pdf’’ is corrected to read ‘‘https://mmshub.cms.gov/sites/default/ files/2022-preliminary-analysis-pacltcworkgroup.pdf’’. 16. On page 59142, first column, first paragraph, line 20, the page reference ‘‘(88 FR 38486)’’ is corrected to read ‘‘(88 FR 36488)’’. 17. On page 59144, third column, after the third full paragraph, line 1, the section heading that begins., ‘‘5. Proposed New Measures’’ is corrected to read ‘‘5. New Measures’’. 18. On page 59149, third column, second full paragraph, line 4, the reference ‘‘section IX.H.10.a.2.’’ is corrected to read ‘‘section IX.F.’’. 19. On page 59152, second column, footnote paragraph (footnote 433), line 2 and (footnote 434) line 2, the reference ‘‘(April 2022)’’ is corrected to read ‘‘(June 2023)’’. 20. On page 59154, first column, footnote paragraph (footnote 446), line E:\FR\FM\04OCR1.SGM 04OCR1 lotter on DSK11XQN23PROD with RULES1 68486 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 3, the reference ‘‘(April 2022)’’ is corrected to read ‘‘(June 2023)’’. 21. On page 59163: a. First column, last paragraph, lines 3 through 4, the phrase ‘‘Hybrid Hospital-Wide Mortality (Hybrid HWM) measure’’ is corrected to read ‘‘Hybrid Hospital-Wide All-Cause Risk Standardized Mortality (HWM) measure’’. b. Second column, second footnote paragraph (footnote 525), line 3, the footnote is corrected by adding the following sentence ‘‘Available at: https://pubmed.ncbi.nlm.nih.gov/ 25068076/.’’. 22. On page 59164, second column, second full paragraph, line 18, the reference ‘‘section B.6.d’’ is corrected to read ‘‘section XII.B.7.d.’’. 23. On page 59167, third column, third paragraph, lines 3 through 4, the phrase ‘‘Hybrid Hospital-Wide Readmission (Hybrid HWR) measure’’ is corrected to read ‘‘Hybrid HospitalWide All-Cause Readmission (HWR) measure’’. 24. On page 59171, second column, second full paragraph, line 13, the reference ‘‘section X.k’’ is corrected to read ‘‘section V.K.’’. 25. On page 59174, second column, second footnote paragraph (footnote 565), lines 3 through 4, the hyperlink, ‘‘https://manual.jointcommissionorg/ releases/TJC2023B/MIF0166.html’’ is corrected to read ‘‘https://manual.joint commission.org/releases/TJC2023B/ MIF0166.html’’. 26. On page 59180, first column, first paragraph, lines 1 through 4, the section heading, ‘‘c. Summary of Previously Finalized and Proposed Hospital IQR Program Measures’’ is corrected to read ‘‘c. Summary of Previously Finalized and Newly Adopted Hospital IQR Program Measures’’. 27. On page 59186, third column, sixth full footnote paragraph (footnote 583), lines 4 through 6, the website ‘‘https://forms.ihi.org/hubfs/ Guide%20To %20Recognition%20for%20GSV%20 Siteslowbar;FINAL.pdf’’ is corrected to read ‘‘https://forms.ihi.org/hubfs/ Guide%20To%20Recognition%20for %20GSV%20Sites_FINAL.pdf’’. 28. On page 59199, third column, fourth full paragraph, lines 3 through 4, the phrase ‘‘On commenter’’ is corrected to read ‘‘One commenter’’. 29. On page 59279, second paragraph (table key for Table IX.F.-04.), the word ‘‘pubslihing’’ is corrected to read ‘‘appearing’’. 30. On page 59326, second column, first paragraph, line 7, the phrase ‘‘per eligible.’’ is corrected to read ‘‘per eligible hospital and CAH as well as an VerDate Sep<11>2014 22:14 Oct 03, 2023 Jkt 262001 additional 4 hours annually for CAHs to report eCQMs.’’. B. Correction of Errors in the Appendices 1. On page 59412, second column, first full paragraph, line 8, the table reference ‘‘Table I.G.-01’’ is corrected to read ‘‘Table I.G.-03’’. Wilma Robinson, Deputy Executive Secretary, Department of Health and Human Services. [FR Doc. 2023–22060 Filed 9–29–23; 4:15 pm] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 411, 413, 488, and 489 [CMS–1779–CN] RIN 0938–AV02 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2024; Correction Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: Final rule; correction. AGENCY: This document corrects technical errors in the final rule that appeared in the August 7, 2023 Federal Register, entitled ‘‘Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2024’’ (referred to hereafter as the ‘‘FY 2024 SNF final rule’’). The effective date of the FY 2024 SNF final rule is October 1, 2023. DATES: This document is effective October 1, 2023. FOR FURTHER INFORMATION CONTACT: John Kane, (410) 786–0557, for information related to the SNF PPS. Kia Burwell, (410) 786–7816, for information related to the SNF wage index. Tammy Luo, (410) 786–4325, for information related to the PDPM ICD–10 mappings. SUPPLEMENTARY INFORMATION: SUMMARY: I. Background In FR Doc. 2023–16249 of August 7, 2023 (88 FR 53200), there were PO 00000 Frm 00036 Fmt 4700 Sfmt 4700 technical errors that are identified and corrected in this correcting document. These corrections are effective as if they had been included in the FY 2024 SNF final rule. Accordingly, the corrections are effective October 1, 2023. II. Summary of Errors A. Summary of Errors in the Preamble A technical error in the calculation of the final FY 2024 SNF PPS wage indexes required us to recalculate the wage index budget neutrality factor; the unadjusted SNF PPS Federal per diem rates provided on page 53209 in Tables 3 and 4; the case-mix adjusted SNF PPS rates provided on pages 53210 through 53211 in Tables 5 and 6; figures on pages 53214, 53215; Tables 8 and 9 on page 53215; Table 10 on pages 53215 through 53216; a figure on page 53333; and the impact analysis provided on pages 53333 through 53334 in Table 30. Further discussions of these errors are found in section IV. of this document. On page 53333, we made a typographical error in a percent increase. B. Summary of Errors and Corrections Posted on the CMS Website 1. SNF Wage Index As discussed in the FY 2024 SNF PPS final rule (88 FR 53211 through 53214), in developing the wage index to be applied to SNFs under the SNF PPS, we use the updated, pre-reclassified, prerural floor hospital inpatient PPS (IPPS) wage data, exclusive of the occupational mix adjustment. For FY 2024, the updated, unadjusted, pre-reclassified, pre-rural floor IPPS wage data used under the SNF PPS are for cost reporting periods beginning on or after October 1, 2019, and before October 1, 2020 (FY 2020 cost report data), as discussed in the final rule entitled ‘‘Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2024 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Provider and Supplier Disclosure of Ownership; and Medicare Disproportionate Share Hospital (DSH) Payments: Counting Certain Days Associated with Section 1115 Demonstrations in the Medicaid Fraction’’ (88 FR 58640) (hereinafter referred to as the FY 2024 IPPS final rule). In calculating the wage index under the FY 2024 IPPS final rule, we E:\FR\FM\04OCR1.SGM 04OCR1

Agencies

[Federal Register Volume 88, Number 191 (Wednesday, October 4, 2023)]
[Rules and Regulations]
[Pages 68482-68486]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-22060]



[[Page 68482]]

=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 411, 412, 419, 488, 489, and 495

[CMS-1785-CN and CMS-1788-CN]
RINs 0938-AV08 and 0938-AV17


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 2024 Rates; Quality 
Programs and Medicare Promoting Interoperability Program Requirements 
for Eligible Hospitals and Critical Access Hospitals; Rural Emergency 
Hospital and Physician-Owned Hospital Requirements; and Provider and 
Supplier Disclosure of Ownership; and Medicare Disproportionate Share 
Hospital (DSH) Payments: Counting Certain Days Associated With Section 
1115 Demonstrations in the Medicaid Fraction; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (HHS).

ACTION: Final rule; correction.

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

SUMMARY: This document corrects technical and typographical errors in 
the final rule that appeared in the August 28, 2023 Federal Register 
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 2024 
Rates; Quality Programs and Medicare Promoting Interoperability Program 
Requirements for Eligible Hospitals and Critical Access Hospitals; 
Rural Emergency Hospital and Physician-Owned Hospital Requirements; and 
Provider and Supplier Disclosure of Ownership; and Medicare 
Disproportionate Share Hospital (DSH) Payments: Counting Certain Days 
Associated with Section 1115 Demonstrations in the Medicaid Fraction'' 
(referred to hereafter as the ``FY 2024 IPPS/LTCH PPS final rule'').

DATES: This correcting document is effective October 1, 2023.

FOR FURTHER INFORMATION CONTACT: 
    Mady Hue, (410) 786-4510, and Andrea Hazeley, (410) 786-3543, MS-
DRG Classifications.
    Donald Thompson and Michele Hudson, [email protected], (410) 786-
4487, Wage Index, Uncompensated Care Payments.
    Siddhartha Mazumdar, [email protected], Rural 
Community Hospital Demonstration Program.
    Julia Venanzi, [email protected], Hospital Inpatient 
Quality Reporting Program and Hospital Value Based Purchasing Program--
Administration Issues. Melissa Hager, [email protected] and 
Ngozi Uzokwe, [email protected]--Hospital Inpatient Quality 
Reporting Program and Hospital Value-Based Purchasing Program--Measures 
Issues Except Hospital Consumer Assessment of Healthcare Providers and 
Systems.
    Adina Hersko, [email protected], New Technology Add-On Payments 
and New COVID-19 Treatments Add-on Payments.

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2023-16252 of August 28, 2023 (88 FR 58640), there were 
a number of technical and typographical errors that are identified and 
corrected in this correcting document. The corrections in this 
correcting document are applicable to discharges occurring on or after 
October 1, 2023, as if they had been included in the document that 
appeared in the August 28, 2023 Federal Register.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 58642, we are removing a duplicative bulleted paragraph and 
correcting an inadvertent typographical error in another paragraph.
    On page 58696, we are correcting inadvertent errors in procedure 
code combinations listed in the table titled ``ICD-10-PCS Code Pairs 
Added to Version 41 ICD-10 MS-DRGs 001 and 002: New Short-Term External 
Heart Assist ICD-10-PCS Combinations.''
    On page 58844, we are correcting an inadvertent typographical error 
in the definition of the acronym ``PFS'' used in the discussion of the 
FY 2024 application for new technology add-on payments for 
Lunsumio\TM\.
    On page 58927, we are correcting inadvertent errors in the ICD-10-
PCS procedure codes used to identify cases involving the use of the 
Canary Tibial Extension (CTE) with Canary Health Implanted Reporting 
Processor (CHIRP) System.
    On page 58948, we are correcting the ICD-10-CM codes used to 
identify cases involving the use of XACDURO[supreg] for hospital-
acquired bacterial pneumonia (HABP) due to Acinetobacter baumannii and 
ventilator-associated bacterial pneumonia (VABP) due to Acinetobacter 
baumannii with the new ICD-10-CM codes effective for FY 2024 that 
specifically describe Acinetobacter baumannii-related infections.
    On page 59051, with regard to our discussion of the calculation of 
prior year IME resident to bed ratio when there is a Medicare GME 
affiliation agreement, we are correcting a typographical error.
    On pages 59064, 59065, 59071, 59095, 59139, 59174, and 59186, we 
are correcting technical and typographical errors in several 
hyperlinks.
    On pages 59090, 59113, 59142, 59149, 59164, and 59171, we are 
correcting technical and typographical errors in several cross-
references.
    On page 59107, in our discussion of the Hospital Value-Based 
Purchasing Program, we made and are correcting a typographical error.
    On pages 59114 and 59144, we are correcting typographical and 
technical errors in several section headings.
    On pages, 59152, 59154, 59163 and 59279, we are correcting 
typographical and technical errors in several footnotes.
    On pages 59163 and 59199 in our discussion of the Hospital 
Impatient Quality Reporting Program, we are correcting several 
typographical and technical errors.
    On page 59326 in our discussion of the information collection 
requirements for the Medicare Promoting Interoperability Program, we 
are correcting typographical and technical errors.

B. Summary of Errors in the Appendices

    On page 59412 in our discussion of effects of requirements under 
the Hospital Readmissions Reduction Program for FY 2024, we are 
correcting typographical error in a table reference.

C. Summary of Errors and Correction to Tables Posted on the CMS Website

    Several tables for the FY 2024 IPPS/LTCH PPS final rule contained 
inadvertent errors related to wage data collected from the Medicare 
cost reports of one hospital (CMS Certification Number (CCN) 340064). 
Specifically, some of the hours on worksheet S-3, Part II of the cost 
report were inadvertently double counted for CCN 340064. The use of 
correct wage data for this hospital (by removing the hours that were 
double counted) necessitated recalculating the FY 2024 area average 
hourly wages unadjusted for occupational mix and adjusted for 
occupational mix for the areas impacted by use of correct wage data for 
this hospital. We note that this error did not impact the FY 2024 
national average hourly wages unadjusted for

[[Page 68483]]

occupational mix and adjusted for occupational mix, and thus did not 
necessitate corrections to those data points. In addition, because CCN 
340064 is geographically located in a rural area (Core-Based 
Statistical Area (CBSA) 34 North Carolina) and reclassifies to an urban 
area (CBSA 16740 Charlotte-Concord-Gastonia, NC-SC), it was necessary 
to recalculate the wage index for CBSAs 34 and 16740. In addition, the 
wage data and/or wage indexes are used as inputs to determine the rural 
floor, imputed floor and out-migration adjustment, and therefore, we 
made conforming changes and recalculated the rural floor for North 
Carolina as well as some of the imputed floors and one county out-
migration adjustment. We further note that the fixed-loss cost 
threshold was unchanged after including the correct wage data for this 
hospital in our calculations. While for certain prior years we have 
also recalculated the budget neutrality factors to reflect revisions to 
the calculation of area average hourly wages and/or wage indexes due to 
the change in the wage data, in combination with the correction of 
other errors, given the limited magnitude of the changes mentioned 
earlier, we did not recalculate any budget neutrality factors due to 
the changes to the wage data. We estimate that this change would have 
resulted in a reduction of the standardized amount of approximately 3 
cents.
    We are correcting the errors in the following IPPS tables that are 
listed on page 59381 of the FY 2024 IPPS/LTCH PPS final rule and 
available on the internet on the CMS website at https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps. The tables 
that are available on the internet have been updated to reflect the 
revisions discussed in this final rule correcting document.
1. Table 2--Case Mix Index and Wage Index Table by CCN
    Because of the inadvertent use of erroneous wage data for one 
hospital (CCN 340064), we are correcting the values in the columns 
titled ``Average Hourly Wage FY 2024'' and ``3-Year Average Hourly Wage 
(2022, 2023, 2024)'' for CCN 340064. As mentioned earlier, CCN 340064 
is geographically located in a rural area (CBSA 34 North Carolina) and 
reclassifies to an urban area (CBSA 16740 Charlotte-Concord-Gastonia, 
NC-SC). Therefore, we used the corrected data of CCN 340064 to 
recalculate the wage index for CBSA 34 and 16740. As a result, we are 
correcting the values in the columns titled ``FY 2024 Wage Index Prior 
to Quartile and Cap'', ``FY 2024 Wage Index With Quartile'', and ``FY 
2024 Wage Index With Quartile and Cap'', for providers geographically 
located in, or reclassified into, CBSAs 34 or 16740. As mentioned 
earlier, the wage data and/or wage indexes are used as inputs to 
determine the rural floor, imputed floor and out-migration adjustment. 
Because the average hourly wage change for this single provider 
impacted the North Carolina rural floor, we are correcting the values 
in the columns titled ``FY 2024 Wage Index Prior to Quartile and Cap'', 
``FY 2024 Wage Index with Quartile'', and ``FY 2024 Wage Index With 
Quartile and Cap'', for North Carolina providers who receive the rural 
floor. Because the average hourly wage change for this single provider 
affects the area wage index, we are also making conforming changes to 
the other wage indexes that are consequently impacted, including the 
imputed floor and out-migration adjustment, and are therefore 
correcting the values in the columns titled ``FY 2024 Wage Index Prior 
to Quartile and Cap'', ``FY 2024 Wage Index With Quartile'', and ``FY 
2024 Wage Index With Quartile and Cap'', for providers who receive the 
imputed floor in Delaware, the District of Columbia, or Rhode Island as 
well as the values in the column titled ``Out-Migration Adjustment'' 
for providers in Catawba, NC (Federal Information Processing Standard 
(FIPS) county code 37035).
2. Table 3--Wage Index Table by CBSA--FY 2024
    As mentioned earlier, CCN 340064 is geographically located in a 
rural area (CBSA 34 North Carolina) and reclassifies to an urban area 
(CBSA 16740 Charlotte-Concord-Gastonia, NC-SC). Therefore, we used the 
corrected data of CCN 340064 to recalculate the wage index for CBSAs 34 
and 16740. As mentioned earlier, the wage data and/or wage indexes are 
used as inputs to determine the rural floor, imputed floor and out-
migration adjustment. Our use of correct wage data for the provider for 
which we inadvertently used incorrect wage data necessitates 
corrections to the values in the columns titled ``FY 2024 Average 
Hourly Wage'', ``3-Year Average Hourly Wage (2022, 2023, 2024)'', 
``Wage Index'', ``GAF'', ``Reclassified Wage Index'', and 
``Reclassified GAF'' for CBSA 34. The average hourly wage change for 
this single provider impacts the North Carolina rural floor, which 
necessitates corrections to the values in the columns titled ``Wage 
Index'' and ``GAF'' for CBSAs that receive the North Carolina rural 
floor. Because the conforming changes to the wage index impact the 
calculation of the imputed floor, we are correcting the values in the 
columns titled ``Wage Index'', ``GAF'', and ``State Imputed Floor'' for 
CBSAs 08, 09, and 41, as well as the values in the columns titled 
``Reclassified Wage Index'' and ``Reclassified GAF'' for CBSAs that 
receive the Rhode Island imputed floor.
3. Table 4A--List of Counties Eligible for the Out-Migration Adjustment 
Under Section 1886(D)(13) of the Act--FY 2024 Final Rule
    As mentioned earlier, the wage data and/or wage indexes are used as 
inputs to determine the out-migration adjustment. Due to the 
corrections previously discussed in Table 2 and 3, we made conforming 
changes to the out-migration adjustment based on the corrected wage 
indexes. Because the conforming changes to the wage index impact the 
out-migration adjustment, we are correcting the value for the column 
titled ``FY 2024 Out Migration Adjustment'' for Catawba, NC (FIPS 
county code 37035).
    We are also correcting an error in the following LTCH PPS table 
that is listed on page 59381 of the FY 2024 IPPS/LTCH PPS final rule 
and is available on the internet on the CMS website at https://www.cms.gov/medicare/medicare-fee-service-payment/longtermcarehospitalpps/ltchpps-regulations-and-notices/530633405/cms-1785-f. The tables that are available on the internet have been updated 
to reflect the revisions discussed in this final rule correction.
4. Table 12B--LTCH PPS Wage Index for Rural Areas for Discharges 
Occurring From October 1, 2023 Through September 30, 2024
    We are correcting the value for CBSA 34 in the column titled ``LTCH 
PPS Wage Index'' to reflect the correction to the hospital wage data 
for CCN 340064 discussed previously. The FY 2024 LTCH PPS standard 
Federal payment rate area wage index values are calculated using the 
same data used to compute the FY 2024 acute care hospital inpatient 
wage index, without taking into account geographic reclassification 
under sections 1886(d)(8) and 1886(d)(10) of the Social Security Act 
(the Act) (88 FR 59368). We note that the correction to the inpatient 
hospital wage data for CCN 340064 necessitated a correction to the FY 
2024 LTCH PPS standard Federal payment rate area wage index value for 
CBSA 34 (rural NC); however, there are currently no LTCHs located in 
CBSA 34.

[[Page 68484]]

5. Table 18--FY 2024 Final Rule Medicare DSH Uncompensated Care Payment 
Factor 3 (Final Methodology)
    We further note that we also made updates to the calculation of 
Factor 3 of the uncompensated care payment methodology to reflect a 
hospital's corrected Worksheet S-10 data that, due to a report upload 
error, was not included in the March 2023 Hospital Cost Report 
Information System (HCRIS) extract used to calculate Factor 3 for FY 
2024. We recalculated the total uncompensated care amount for all DSH-
eligible hospitals to reflect this correction. In addition, because the 
Factor 3 calculated 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 
the 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 very narrowly targeted 
update to the information used in the calculation of Factor 3, the 
change to the previously calculated Factor 3 is of limited magnitude 
for the majority of hospitals.
    We note that the fixed-loss cost threshold was unchanged after 
these Factor 3 recalculations. Similar to our discussion with regard to 
the wage data corrections, we note that while for certain prior years 
we recalculated the budget neutrality factors to reflect revisions to 
the calculation of Factor 3, in combination with the correction of 
other errors, we did not recalculate any budget neutrality factors due 
to the changes to Factor 3 for FY 2024 given the limited magnitude of 
the changes to uncompensated care payments. For example, we note that 
the correction to the previously described hospital's Worksheet S-10 
data resulted in an approximately $90 increase to that hospital's 
interim uncompensated care payment per discharge amount.
    We are correcting the errors in the following IPPS table that is 
listed on page 59381 of the FY 2024 IPPS/LTCH PPS final rule and is 
available on the internet on the CMS website at https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps. The tables 
that are available on the internet have been updated to reflect the 
revisions discussed in this final rule correction.
    Table 18--FY 2024 Final Rule Medicare DSH Uncompensated Care 
Payment Factor 3 (Final Methodology). For the FY 2024 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 2024. We are updating the calculations in this table to reflect 
corrected Worksheet S-10 data for one hospital that, due to a report 
upload error, was not included in the March 2023 HCRIS extract used to 
calculate Factor 3 for the FY 2024 IPPS/LTCH PPS final rule. We are 
revising Factor 3 for all hospitals to reflect this correction. 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.

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 final rule correction 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, tables, and appendices included 
or referenced in the FY 2024 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 final rule correction 
is intended to ensure that the information in the FY 2024 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 2024 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 final rule correction is 
intended solely to ensure that the FY 2024 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.

IV. Correction of Errors

    In FR Doc. 2023-16252 of August 28, 2023 (88 FR 58640), we are 
making the following corrections:

A. Corrections of Errors in the Preamble

    1. On page 58642, second column:
    a. Second bulleted paragraph, that begins with the phrase ``Section 
1814(l)(4) of the Act'' and ends with the phrase ``a payment adjustment 
year.'' is corrected by removing the paragraph.
    b. Third bulleted paragraph, line 9, the phrase ``reporting payment 
for'' is corrected to read ``reporting period for''.

[[Page 68485]]

    2. On page 58696, top of the page, the table titled ``ICD-10-PCS 
Code Pairs Added to Version 41 ICD-10 MS-DRGs 001 and 002: New Short-
Term External Heart Assist ICD-10-PCS Combinations'' is corrected to 
read as follows:

 ICD-10-PCS Code Pairs Added to Version 41 ICD-10 MS-DRGs 001 and 002: New Short-Term External Heart Assist ICD-
                                               10-PCS Combinations
----------------------------------------------------------------------------------------------------------------
      ICD-10-PCS code              Description                      ICD-10-PCS code             Description
----------------------------------------------------------------------------------------------------------------
02HA0RZ....................  Insertion of short-        and   X2HX0F9....................  Insertion of conduit
                              term external heart                                           to short-term
                              assist system into                                            external heart
                              heart, open approach.                                         assist system into
                                                                                            thoracic aorta,
                                                                                            ascending, open
                                                                                            approach, new
                                                                                            technology group 9.
02HA3RZ....................  Insertion of short-        and   X2HL0F9....................  Insertion of conduit
                              term external heart                                           to short-term
                              assist system into                                            external heart
                              heart, percutaneous                                           assist system into
                              approach.                                                     right axillary
                                                                                            artery, open
                                                                                            approach, new
                                                                                            technology group 9.
02HA3RZ....................  Insertion of short-        and   X2HM0F9....................  Insertion of conduit
                              term external heart                                           to short-term
                              assist system into                                            external heart
                              heart, percutaneous                                           assist system into
                              approach.                                                     left axillary
                                                                                            artery, open
                                                                                            approach, new
                                                                                            technology group 9.
----------------------------------------------------------------------------------------------------------------

    3. On page 58844, second column, first full paragraph, line 11, the 
phrase ``median Physician Fee Schedule (PFS)'' is corrected to read, 
``median progression-free survival (PFS)''
    4. On page 58927, third column, first partial paragraph:
    a. Line 11 the code, ``XNHG0D9'' is corrected to read ``XNHG0F9''.
    b. Line 15, the code, ``XNHH0D9'' is corrected to read ``XNHH0F9''.
    5. On page 58948, second column, last partial paragraph, line 15, 
the sentence ``Cases involving the use of XACDURO[supreg] that are 
eligible for new technology add-on payments will be identified by ICD-
10-PCS procedure codes XW033K9 (Introduction of sulbactam-durlobactam 
into peripheral vein, percutaneous approach, new technology group 9) or 
XW043K9 (Introduction of sulbactam-durlobactam into central vein, 
percutaneous approach, new technology group 9) in combination with one 
of the following ICD-10-CM codes: Y95 and J15.6 (describing HABP due to 
Acinetobacter baumannii); or J95.851 and B96.89 (describing VABP due to 
Acinetobacter baumannii).'' is corrected to read ``We note that there 
are new ICD-10-CM codes effective for FY 2024 to specifically describe 
Acinetobacter baumannii-related infections: J15.61 (Pneumonia due to 
Acinetobacter baumannii) and B96.83 (Acinetobacter baumannii as the 
cause of diseases classified elsewhere). Therefore, cases involving the 
use of XACDURO[supreg] that are eligible for new technology add-on 
payments will be identified by ICD-10-PCS procedure codes XW033K9 
(Introduction of sulbactam-durlobactam into peripheral vein, 
percutaneous approach, new technology group 9) or XW043K9 (Introduction 
of sulbactam-durlobactam into central vein, percutaneous approach, new 
technology group 9) in combination with one of the following ICD-10-CM 
codes: Y95 and J15.61 (describing HABP due to Acinetobacter baumannii); 
or J95.851 and B96.83 (describing VABP due to Acinetobacter 
baumannii).''.
    6. On page 59051, third column, first partial paragraph:
    a. Line 24, the phrase ``adjust the prior year numerator by +10'' 
is corrected to read ``adjust the prior year numerator''.
    b. Line 28, the phrase ``increased by 10 relative to the prior 
year'' is corrected to read ``increased relative to the prior year''.
    7. On page 59064, second column, first footnote paragraph (footnote 
219), lines 2 through 4, the hyperlink, ``https://qualitynet.cms.gov/inpatient/measures/mspb/methodology,'' is corrected to read, ``https://qualitynet.cms.gov/inpatient/measures/hvbp-mspb/methodology.''
    8. On page 59065, first column, first footnote paragraph (footnote 
226), lines 2 through 4, the hyperlink, ``https://qualitynet.cms.gov/inpatient/measures/mspb/methodology,'' is corrected to read, ``https://qualitynet.cms.gov/inpatient/measures/hvbp-mspb/methodology.''
    9. On page 59071, second column, second footnote paragraph 
(footnote 249), lines 3 through 6, the hyperlink, ``https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/CMS/Quality-Strategy,'' is corrected 
to read, ``https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/CMS-Quality-Strategy.''
    10. On page 59090, third column, first paragraph, the reference, 
``section XXX'' is corrected to read, ``V.K.2.c.(1).''
    11. On page 59095, first column, first footnote paragraph (footnote 
292), lines 5 through 8, the hyperlink, ``https://aspe.hhs.gov/sites/default/files/migrated_legacy_files//195046/Social-Risk-in-Medicare%E2%80%99s-VBP/2nd-Report-Executive-Summary.pdf,'' is corrected 
to read, https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/195046/Social-Risk-in-Medicare%E2%80%99s-VBP-2nd-Report-Executive-Summary.pdf.
    12. On page 59107, second column, first full paragraph, line 7, the 
phrase ``A few commenters made'' is corrected to read, ``A few 
commenters''.
    13. On page 59113, first column, last paragraph, line 21, the 
reference ``section X.X.'' is corrected to ``section V.L.6.a.(2)''.
    14. On page 59114, first column, first full paragraph, line 1, the 
section heading that begins ``K. Rural'' is corrected to read ``M. 
Rural''.
    15. On page 59139, third column, footnote paragraph (footnote 348), 
lines 4 through 6, the hyperlink ``https://mmshub.cms.gov/sites/default/files/2022-prliminary-analysis-pacltc-workgroup.pdf'' is 
corrected to read ``https://mmshub.cms.gov/sites/default/files/2022-preliminary-analysis-pacltc-workgroup.pdf''.
    16. On page 59142, first column, first paragraph, line 20, the page 
reference ``(88 FR 38486)'' is corrected to read ``(88 FR 36488)''.
    17. On page 59144, third column, after the third full paragraph, 
line 1, the section heading that begins., ``5. Proposed New Measures'' 
is corrected to read ``5. New Measures''.
    18. On page 59149, third column, second full paragraph, line 4, the 
reference ``section IX.H.10.a.2.'' is corrected to read ``section 
IX.F.''.
    19. On page 59152, second column, footnote paragraph (footnote 
433), line 2 and (footnote 434) line 2, the reference ``(April 2022)'' 
is corrected to read ``(June 2023)''.
    20. On page 59154, first column, footnote paragraph (footnote 446), 
line

[[Page 68486]]

3, the reference ``(April 2022)'' is corrected to read ``(June 2023)''.
    21. On page 59163:
    a. First column, last paragraph, lines 3 through 4, the phrase 
``Hybrid Hospital-Wide Mortality (Hybrid HWM) measure'' is corrected to 
read ``Hybrid Hospital-Wide All-Cause Risk Standardized Mortality (HWM) 
measure''.
    b. Second column, second footnote paragraph (footnote 525), line 3, 
the footnote is corrected by adding the following sentence ``Available 
at: https://pubmed.ncbi.nlm.nih.gov/25068076/.''.
    22. On page 59164, second column, second full paragraph, line 18, 
the reference ``section B.6.d'' is corrected to read ``section 
XII.B.7.d.''.
    23. On page 59167, third column, third paragraph, lines 3 through 
4, the phrase ``Hybrid Hospital-Wide Readmission (Hybrid HWR) measure'' 
is corrected to read ``Hybrid Hospital-Wide All-Cause Readmission (HWR) 
measure''.
    24. On page 59171, second column, second full paragraph, line 13, 
the reference ``section X.k'' is corrected to read ``section V.K.''.
    25. On page 59174, second column, second footnote paragraph 
(footnote 565), lines 3 through 4, the hyperlink, ``https://
manual.jointcommissionorg/releases/TJC2023B/MIF0166.html'' is corrected 
to read ``https://manual.jointcommission.org/releases/TJC2023B/MIF0166.html''.
    26. On page 59180, first column, first paragraph, lines 1 through 
4, the section heading, ``c. Summary of Previously Finalized and 
Proposed Hospital IQR Program Measures'' is corrected to read ``c. 
Summary of Previously Finalized and Newly Adopted Hospital IQR Program 
Measures''.
    27. On page 59186, third column, sixth full footnote paragraph 
(footnote 583), lines 4 through 6, the website ``https://forms.ihi.org/hubfs/Guide%20To%20Recognition%20for%20GSV%20Siteslowbar;FINAL.pdf'' is 
corrected to read ``https://forms.ihi.org/hubfs/Guide%20To%20Recognition%20for%20GSV%20Sites_FINAL.pdf''.
    28. On page 59199, third column, fourth full paragraph, lines 3 
through 4, the phrase ``On commenter'' is corrected to read ``One 
commenter''.
    29. On page 59279, second paragraph (table key for Table IX.F.-
04.), the word ``pubslihing'' is corrected to read ``appearing''.
    30. On page 59326, second column, first paragraph, line 7, the 
phrase ``per eligible.'' is corrected to read ``per eligible hospital 
and CAH as well as an additional 4 hours annually for CAHs to report 
eCQMs.''.

B. Correction of Errors in the Appendices

    1. On page 59412, second column, first full paragraph, line 8, the 
table reference ``Table I.G.-01'' is corrected to read ``Table I.G.-
03''.

Wilma Robinson,
Deputy Executive Secretary, Department of Health and Human Services.
[FR Doc. 2023-22060 Filed 9-29-23; 4:15 pm]
BILLING CODE 4120-01-P

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