Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, Including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Formerly in Custody of Penal Authorities; Revision to Medicare Special Enrollment Period for Formerly Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian Health Service and Tribal Facilities; Correcting Amendment, 2631-2636 [2025-00081]
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Federal Register / Vol. 90, No. 7 / Monday, January 13, 2025 / Rules and Regulations
publication on the recreation area
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Shannon A. Estenoz,
Assistant Secretary for Fish and Wildlife and
Parks.
[FR Doc. 2025–00509 Filed 1–10–25; 8:45 am]
BILLING CODE 4312–52–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 406, 407, 410, 411, 416,
419, 435, 440, 457, 482, and 485
[CMS–1809–F2]
RIN 0938–AV35
Medicare and Medicaid Programs:
Hospital Outpatient Prospective
Payment and Ambulatory Surgical
Center Payment Systems; Quality
Reporting Programs, Including the
Hospital Inpatient Quality Reporting
Program; Health and Safety Standards
for Obstetrical Services in Hospitals
and Critical Access Hospitals; Prior
Authorization; Requests for
Information; Medicaid and CHIP
Continuous Eligibility; Medicaid Clinic
Services Four Walls Exceptions;
Individuals Currently or Formerly in
Custody of Penal Authorities; Revision
to Medicare Special Enrollment Period
for Formerly Incarcerated Individuals;
and All-Inclusive Rate Add-On
Payment for High-Cost Drugs Provided
by Indian Health Service and Tribal
Facilities; Correcting Amendment
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule with comment period;
correcting amendment.
AGENCY:
This document corrects
technical and typographical errors in
the final rule with comment period that
appeared in the November 27, 2024
Federal Register titled ‘‘Medicare and
Medicaid Programs: Hospital Outpatient
Prospective Payment and Ambulatory
Surgical Center Payment Systems;
Quality Reporting Programs, including
the Hospital Inpatient Quality Reporting
Program; Health and Safety Standards
for Obstetrical Services in Hospitals and
Critical Access Hospitals; Prior
Authorization; Requests for Information;
Medicaid and CHIP Continuous
Eligibility; Medicaid Clinic Services
Four Walls Exceptions; Individuals
Currently or Formerly in Custody of
Penal Authorities; Revision to Medicare
ddrumheller on DSK120RN23PROD with RULES1
SUMMARY:
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Special Enrollment Period for Formerly
Incarcerated Individuals; and AllInclusive Rate Add-On Payment for
High-Cost Drugs Provided by Indian
Health Service and Tribal Facilities’’.
DATES: This correcting amendment is
effective January 8, 2025, and is
applicable beginning January 1, 2025.
FOR FURTHER INFORMATION CONTACT:
For OPPS/ASC related questions,
contact Elise Barringer via email at
Elise.Barringer@cms.hhs.gov or at (410)
786–9222.
For OPPS Addenda questions, contact
Marina Kushnirova via email at
Marina.Kushnirova@cms.hhs.gov.
For ASC Addenda questions, contact
Scott Talaga via email at Scott.Talaga@
cms.hhs.gov.
For Health and Safety Standards for
Obstetrical Services in Hospitals and
Critical Access Hospitals questions,
contact the Clinical Standards Group via
email at HealthandSafetyInquiries@
cms.hhs.gov.
For Hospital Outpatient Quality
Reporting Program policies, contact
Kimberly Go via email at Kimberly.Go@
cms.hhs.gov or Janis Grady via email at
Janis.Grady@cms.hhs.gov.
For Medicaid Clinic Services Four
Walls Exceptions related questions,
contact Sheri Gaskins via email at
Sheri.Gaskins@cms.hhs.gov or Ryan
Tisdale via email at Ryan.Tisdale@
cms.hhs.gov.
For Medicaid and CHIP Continuous
Eligibility questions, contact Cassie
Lagorio via email at Cassandra.Lagorio@
cms.hhs.gov.
For New Technology APC questions,
contact Nicole Marcos via email at
Nicole.Marcos@cms.hhs.gov.
For Outpatient Department Prior
Authorization Process, contact Kelly
Wojciechowski via email at
Kelly.Wojciechowski@cms.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
In the FR Doc. 2024–25521 of
November 27, 2024 (89 FR 93912), 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 effective as if
they had been included in the document
that appeared in the November 27, 2024
Federal Register. Accordingly, the
corrections are effective January 1, 2025.
II. Summary of Errors
A. Summary of Errors in For Further
Information Contact
In the FOR FURTHER INFORMATION
CONTACT section, the email address for
Kelly Wojciechowski is incorrect.
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2631
B. Summary of Errors in the Preamble
1. Hospital Outpatient Prospective
Payment System (OPPS) Corrections
On pages 94054 and 94055, we are
correcting typographical errors.
Specifically, we are correcting CPT code
‘‘0899T’’ to ‘‘0889T’’.
On pages 94111 and 94114, we
referred to an incorrect APC assignment
for CPT code 15013. We inadvertently
failed to account for the impact on the
amount of payment for the skin cell
suspension autograft procedure
described by CPT code 15013
(Preparation of skin cell suspension
autograft, requiring enzymatic
processing, manual mechanical
disaggregation of skin cells, and
filtration; first 25 sq cm or less of
harvested skin) of the assignment of this
code to status indicator ‘‘T’’ (Procedure
or Service, Multiple Procedure
Reduction Applies; Paid under OPPS,
separate APC payment) when we
assigned CPT code 15013 to APC 1567
New Technology—Level 30 ($6,001–
$6,500), which has a payment rate of
$6,250.50 and status indicator ‘‘T’’.
In the final rule with comment period,
we stated that when the full service
(skin cell suspension autograft
described by CPT codes 15011 through
15018) is performed, meaning that the
harvesting (described by CPT code
15011), preparation (described by CPT
code 15013), and application (described
by CPT codes 15015 or 15017) steps are
performed, the total cost for the service
for CY 2025 would be approximately
$10,000. However, because of the effect
of the multiple procedure reduction, the
total payment for the skin cell
suspension autograft furnished using
the RECELL System would have been
approximately $8,000, contrary to the
intended target of $10,000 as stated in
the CY 2025 OPPS/ASC final rule with
comment period. To correct this error,
we are assigning CPT code 15013 to
APC 1532 New Technology—Level 32
($7,001–$7,500), which has a payment
rate of $7,250.50 and status indicator
‘‘S’’ (Procedure or Service, Not
Discounted When Multiple, Paid under
OPPS; separate APC payment.).
On page 94120, we stated ‘‘We note
that we will replace HCPCS code C9734
with CPT code 5X008 (55882) effective
January 1, 2025, as well as assign the
underlying claims associated with
HCPCS code C9734 to CPT code 5X008
(55882).’’ While we intended to
crosswalk the claims data for HCPCS
code C9734 to CPT code 5X008 (55882)
to determine the APC assignment for
CPT code 5X008 (55882) for CY 2025,
we did not intend to retire HCPCS code
C9734 because, based on its descriptor,
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C9734 can be used for services other
than those described by CPT code
5X008 (55882). We are correcting this
reference to indicate that we are using
C9734 claims data to set the payment
rate for CPT code 5X008 (55882) and
removing the reference to replacing
HCPCS code C9734. HCPCS code C9734
will remain assigned to APC 5115 (Level
5 Musculoskeletal Procedures).’’
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2. The Hospital Outpatient Quality
Reporting (OQR), Rural Emergency
Hospital Quality Reporting (REHQR),
and Ambulatory Surgical Center Quality
Reporting (ASCQR) Programs
Corrections
On pages 94368 and 94380, we are
correcting URL links in footnotes 270
and 316 (respectively) for accuracy.
On page 94407, we are making a
technical edit and removing language
for accuracy.
On pages 94411 and 94412, we are
correcting URL links in footnotes 446
and 461 (respectively) for accuracy.
On pages 94416 and 94417, we are
correcting section references for
accuracy.
On page 94417, we are correcting final
rule references for accuracy.
On page 94522, we are correcting the
number of web-based measures that are
being finalized in the rule for the
Hospital OQR program.
On pages 94561 through 94563, we
are correcting section references for
accuracy.
3. Medicaid Clinic Services Four Walls
Exceptions Corrections
On pages 94442, 94446, 94448, 94452,
and 94561, we made typographical
errors. Specifically, on page 94442 we
inadvertently included a dollar symbol
($), on page 94446 we inadvertently
repeated the word ‘‘that,’’ on page 94448
we inadvertently repeated the phrase
‘‘rely upon,’’ on page 94452 we
inadvertently omitted the word
‘‘system’’ from the phrase ‘‘mistrusted
the health care system at higher rates,’’
and on page 94561 we inadvertently
included the phrase ‘‘Four Walls:’’ at
the beginning of the title for Table 207.
On page 94455, we incorrectly stated
in footnote 586 that as of November 27,
2024, the Health Resources and Services
Administration (HRSA) had not
finalized their proposed changes to the
Federal Office of Rural Health Policy’s
(FORHP) definition of rural. However,
HRSA finalized changes to FORHP’s
definition of rural in a final notice
published in the Federal Register on
November 21, 2024 (89 FR 92131),
which post-dated CMS’s development of
the final rule. We are making
corrections to state that, as of the
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development of the OPPS final rule,
HRSA had not finalized changes to
FORHP’s definition of rural.
4. Health and Safety Standards for
Obstetrical Services in Hospitals and
Critical Access Hospitals
On pages 94481, 94483, 94542, 94569,
94571, 94572, and 94573 we are
replacing the word ‘‘biannual’’ and/or
‘‘biannually’’ with the word ‘‘biennial’’
and/or ‘‘biennially’’, to clarify that staff
training is required every other year, not
twice a year.
C. Summary of Errors in the Regulations
Text
On page 94586, in the regulations text
for § 406.27(d)(1), we are adding in a
missing word.
On page 94591, we made technical
errors in the regulations text
amendatory instructions for § 457.342,
by excluding the numbering of
paragraph (a) and the reservation of
paragraph (b).
On pages 94592 and 94594 we are
replacing the word ‘‘biannual’’ with the
word ‘‘biennial’’, to clarify that staff
training is required every other year, not
twice a year.
D. Summary of Errors and Corrections
to the OPPS and ASC Addenda Posted
on the CMS Website
1. OPPS Addenda Summary of Errors
To view any corrections or updates to
the final CY 2025 OPPS status
indicators, APC assignments, relative
weights, copayment rates, deviceintensive status, and short descriptors in
the OPPS addenda, we refer readers to
the Addenda and supporting files that
are posted on the CMS website at
https://www.cms.gov/medicare/
payment/prospective-payment-systems/
hospital-outpatient/regulations-notices.
Select ‘‘CMS–1809–F2’’ from the list of
regulations. All corrected Addenda for
this correcting document are contained
in the zipped folder titled ‘‘2025 F2
OPPS Addenda’’ at the bottom of the
CMS web page for CMS–1809–F2.
a. Errors in Addendum B
We are making a number of updates
to Addendum B (OPPS Payment by
HCPCS Code for CY 2025) to correct
typographical errors. We are also
correcting the following technical
errors:
We incorrectly deleted HCPCS code
C9734 (U/s trtmt, not leiomyomata)
from Addendum B by inadvertently
assigning it to status indicator ‘‘D’’. We
are correcting this error by replacing
status indicator ‘‘D’’ with ‘‘J1’’ for
HCPCS code C9734 and assigning it to
APC 5115 (Level 5 Musculoskeletal
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Procedures) in Column E, as well as
adding corresponding data to Columns
F–K to reflect the updated APC 5115
assignment.
In addition, due to an inadvertent
miscalculation of the payment rate for
CPT code 15013 as explained in more
detail in section II.B. Summary of Errors
in the Preamble of this notice, we
incorrectly assigned CPT code 15013
(Prepj skn cll ssp agrft 1st) status
indicator ‘‘T’’ and are correcting it to
‘‘S’’. We also incorrectly assigned CPT
code 15013 to APC 1567 (New
Technology—Level 30 ($6001–$6500))
and are correcting it to APC 1532 (New
Technology—Level 32 ($7001–$7500)).
Due to an inadvertent miscalculation
of the payment rate for HCPCS code
C8002 for the same reason as the error
for CPT code 15013, we incorrectly
assigned HCPCS code C8002 status
indicator ‘‘T’’ and we are correcting it to
‘‘S’’. We also incorrectly assigned
HCPCS code C8002 to APC 1567 (New
Technology—Level 30 ($6001–$6500))
and are correcting it to APC 1532 (New
Technology—Level 32 ($7001–$7500)).
b. Errors in Addendum C
In Addendum C (Final HCPCS Codes
Payable Under the 2025 OPPS by APC),
we are making a number of updates to
correct the following technical errors:
Due to the errors described in more
detail in section II.B Summary of Errors
in the Preamble of this notice related to
CPT code 15013 and HCPCS code
C8002, we are deleting CPT code 15013
and HCPCS code C8002 from the list of
HCPCS and CPT codes assigned to APC
1567 (New Technology—Level 30
($6001–$6500)). We are adding CPT
code 15013 and HCPCS code C8002 to
the list of HCPCS and CPT codes
assigned to APC 1532 (New
Technology—Level 32 ($7001–$7500))
in Addendum C.
Due to the incorrect deletion of
HCPCS code C9734 described in more
detail in section II.B Summary of Errors
in the Preamble of this notice, we are
adding HCPCS code C9734 back to the
list of HCPCS and CPT codes assigned
to APC 5115 (Level 5 Musculoskeletal
Procedures) in Addendum C.
c. Errors in Addendum P
In the tab titled ‘‘2025 FR Device
Intensive List’’, we inadvertently
included two rows for each of CPT
codes 0795T, 0801T, 27279, and 93656.
The additional rows for each of the
codes contain values that were
incorrectly calculated. For CPT codes
0795T and 0801T, the additional rows
included values calculated using CY
2023 data, when the codes were
assigned a status indicator of ‘‘E1.’’
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Status indicator ‘‘E1’’ is assigned to
items, codes, and services that are not
covered by any Medicare outpatient
benefit category; are statutorily
excluded; or are not reasonable and
necessarily. Because procedures
assigned status indicator ‘‘E1’’ are not
payable under the OPPS, claims data for
codes assigned this status indicator
should not be used to assign device
offset percentages. Accordingly, we are
deleting the additional rows that
contained incorrect values for these
codes. For CPT codes 27279 and 93656,
the additional rows included a Device
Offset Percentage and Device Offset
Amount for each of the codes that was
calculated using the APC Device Offset
Percentage. But because CPT codes
27279 and 93656 were separately
payable in CY 2023, the Device Offset
Percentage and Device Offset Amount
for each code should have been
calculated using CY 2023 claims data.
Therefore, we are deleting the
additional rows for these codes as well.
In the tabs titled ‘‘FR 2025 Device
Intensive List’’ and ‘‘2025 FR HCPCS
Offsets’’, we inadvertently included the
incorrect APC Device Offset Percentage
for procedures assigned to APC 5463—
Level 3 Neurostimulator and Related
Procedures. We have revised the APC
Device Offset Percentage from 26.11
percent to 26.17 percent.
In the tab titled ‘‘2025 FR HCPCS
Offsets’’, which is described as a ‘‘list of
the device offset percentages and device
offset amounts for all HCPCS codes with
CY 2023 claims data,’’ we inadvertently
included device offset percentages
based on claims data from procedures
that were assigned status indicator ‘‘E1’’
for CY 2023. Because status indicator
‘‘E1’’ is assigned to items, codes, and
services that are not covered by any
Medicare outpatient benefit category;
are statutorily excluded; or are not
reasonable and necessary, claims data
for procedures assigned this status
indicator should not be used to assign
device offset percentages as these
procedures were not payable under the
OPPS in CY 2023 and do not have OPPS
claims data. The procedures that were
assigned status indicator ‘‘E1’’ for CY
2023 but were included in the ‘‘2025 FR
HCPCS Offsets’’ tab in Addendum P
were CPT codes 0621T, 0737T, 0764T,
0795T, 0796T, 0801T, and 74263. We
corrected the 2025 FR HCPCS Offsets
file by deleting the entries for these
procedures.
2. ASC Payment System Addenda
Summary of Errors
To view the corrected final CY 2025
ASC payment indicators, payment
weights, payment rates, multiple
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procedure discounting indicators, and
device offset amounts/device portions
in Addendum AA, BB, and FF that
resulted from these technical
corrections, we refer readers to the
Addenda and supporting files on the
CMS website at: https://www.cms.gov/
Medicare/Medicare-Fee-for-ServicePayment/ASCPayment/ASCRegulations-and-Notices.html. Select
‘‘CMS–1809–F2’’ from the list of
regulations. All corrected ASC addenda
for this correcting document are
contained in the zipped folder entitled
‘‘Addendum AA, BB, DD1, DD2, and
EE’’ at the bottom of the CMS web page
for CMS–1809–F2.
a. Errors in Addendum AA
We inadvertently assigned ‘‘N’’ (No)
in column D (Subject to Multiple
Procedure Discounting) to HCPCS Codes
C7500 through C7565 in the list of ASC
complexity adjustment codes. We are
correcting this error in Addendum AA
by revising the procedure discounting
status from ‘‘N’’ (No) to ‘‘Y’’ (Yes) for
these codes, indicating that the
procedures to which these codes
correspond are subject to multiple
procedure discounting.
As a result of the correction to the
OPPS APC and status indicator
assignment for the skin cell suspension
autograft procedures described by CPT
code 15013 and HCPCS code C8002
described in this correction notice, we
are revising the multiple procedure
discounting status in Column D for CPT
code 15013 and HCPCS code C8002
from ‘‘Y’’ (Yes) to ‘‘N’’ (No) indicating
that the procedure is not subject to
multiple procedure discounting. We are
also correcting the OPPS APC
assignment from APC 1567 to APC 1532
for CPT code 15013 and HCPCS code
C8002. Therefore, in Addendum AA, as
a result of the correction to the APC
assignment for CPT code 15013 and
HCPCS code C8002, we are correcting
the Final CY 2025 Payment Weight
(Column G) and Final CY 2025 Payment
Rate (Column H) for CPT code 15013
and HCPCS code C8002 to reflect the
correct APC assignment of APC 1532—
New Technology—Level 32 ($7001–
$7500).
We inadvertently assigned a payment
rate to CPT code 53865 using APC
5374—Level 4 Urology and Related
Services—rather than APC 5376—Level
6 Urology and Related Services. In
Addendum AA, we are revising the
Final CY 2025 Payment Weight and
Final CY 2025 Payment Rate column
(Column H) to reflect the corrected APC
for CPT code 53865.
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b. Errors in Addendum BB
We inadvertently assigned a final CY
2025 ASC payment rate to
brachytherapy APCs that were not
designated as Low Volume APCs that
was based on the mean unit cost. This
affected HCPCS codes:
• C1717 (Brachytx, non-str, hdr ir192);
• C2616 (Brachytx, non-str, yttrium90);
• C2634 (Brachytx, non-str, ha, i-125);
• C2638 (Brachytx, stranded, i-125);
• C2639 (Brachytx, non-stranded, i125);
• C2640 (Brachytx, stranded, p-103);
• C2641 (Brachytx, non-stranded, p103);
• C2643 (Brachytx, non-stranded, c131);
• C2698 (Brachytx, stranded, nos),
and;
• C2699 (Brachytx, non-stranded,
nos).
We are correcting the Final CY 2025
Payment Rate column (Column H) to
reflect the geometric mean unit cost for
these brachytherapy APCs.
We inadvertently made an error in the
Short Descriptor column (Column C) for
HCPCS Code J1552 and are correcting it
from ‘‘Inj, alyglo, 100 mg’’ to read ‘‘Inj,
alyglo, 500 mg’’.
We inadvertently displayed the
incorrect payment rate for nine
diagnostic radiopharmaceuticals in the
HCPCS A9500 through A9600 range. We
are correcting the Final CY 2025
Payment Rates column (Column H) for
these radiopharmaceuticals.
c. Errors in Addendum FF
We inadvertently assigned CPT code
53865 to APC 5374—Level 4 Urology
and Related Services—rather than APC
5376—Level 6 Urology and Related
Services. We are revising the Final CY
2025 APC (Column E), Final CY 2025
APC Device Offset Percentage (Column
F). Final CY 2025 OPPS Payment Rate
(Column G), and Final CY 2025 Device
Offset Amount/Device Portion (Column
I) to reflect the corrected APC for CPT
code 53865.
We made an error in the OPPS APC
assignment for CPT code 15013 and
HCPCS Code C8002 as described
previously. As a result of the correction
to the OPPS assignment to APC 1532—
New Technology—Level 32 ($7001–
$7500)—for CPT code 15013 and
HCPCS Code C8002, we are correcting
the Final CY 2025 APC (Column E) and
Final CY 2025 OPPS Payment Rate
(Column G) for these codes to reflect
this APC correction.
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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 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 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 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,
regulations text, addenda, and tables
included or referenced in the CY 2025
OPPS/ASC final rule with comment
period but does not make substantive
changes to the policies or payment
methodologies that were adopted in the
CY 2025 OPPS/ASC final rule with
comment period. As a result, this
correction is intended to ensure that the
information in the CY 2025 OPPS/ASC
final rule with comment period
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
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incorporate the corrections in this
document into the final rule with
comment period 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 CY 2025 OPPS/ASC final rule with
comment period reflects our policies.
Furthermore, such procedures would be
unnecessary, as we are not altering our
payment methodologies or policies, but
rather, we are simply correctly
implementing the policies that we
previously proposed, requested
comment on, and subsequently
finalized. This correcting document is
intended solely to ensure that the CY
2025 OPPS/ASC final rule with
comment period accurately reflects
these payment methodologies and
policies. For these reasons, we believe
we have good cause to waive the notice
and comment and delayed 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 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 CY 2025 OPPS/ASC final rule with
comment period accurately reflects our
policies.
IV. Correction of Errors
In FR Doc. 2024–25521 of November
27, 2024 (89 FR 93912), we are making
the following corrections:
A. Correction of Errors in For Further
Contact Information
1. On page 93913, column 2, fourth
paragraph, line 4, the email address for
Kelly Wojciechowski is corrected to
read ‘‘Kelly.Wojciechowski@
cms.hhs.gov’’.
B. Correction of Errors in the Preamble
1. On page 94054, third column, last
partial paragraph, lines 3 and 4, ‘‘CPT
code 0899T’’ is corrected to read ‘‘CPT
code 0889T’’.
2. On page 94055, third column, first
partial paragraph, first line, ‘‘code
0899T’’ is corrected to read ‘‘code
0889T’’.
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3. On page 94111, in the heading
titled ‘‘54. Skin Cell Suspension
Autograft (SCSA) Procedures, CPT
Codes 15011 Through 15018 (APCs
5051, 5054, and 1567)’’, line 4, the
figure ‘‘1567’’ is corrected to read
‘‘1532’’.
4. On page 94114, second column,
a. First partial paragraph,
(1) Lines 1 through 3, ‘‘APC 1567
(New Technology—Level 30 ($6001–
6500)) with a $6,250.50 payment rate’’
is corrected to read ‘‘APC 1532 (New
Technology—Level 32 ($7001–7500))
with a $7,250.50 payment rate’’.
(2) Lines 12 through 13, ‘‘APC 1567
with a payment rate of $6,250.50’’ are
corrected to read ‘‘APC 1532 with a
payment rate of $7,250.50’’.
b. First full paragraph, lines 12
through 13 ‘‘APC 1567 ((New
Technology—Level 30 ($6001–$6500))’’
is corrected to read ‘‘APC 1532 (New
Technology—Level 32 ($7001–7500))’’.
5. On page 94120, second column,
second full paragraph, lines 4 through 9
that read ‘‘We note that we will replace
HCPCS code C9734 with CPT code
5X008 (55882) effective January 1, 2025,
as well as assign the underlying claims
associated with C9734 to CPT code
5X008 (55882)’’ are corrected in their
entirety to read, ‘‘We note that we will
crosswalk claims for HCPCS code C9734
to CPT code 5X008 (55882) to determine
the APC assignment for CPT code 5X008
(55882) for CY 2025. HCPCS C9734 will
continue to be assigned to APC 5115
(Level 5 Musculoskeletal Procedures) in
CY 2025.’’
6. On page 94368, first column,
second footnoted paragraph (footnote
270), lines 4 through 6, the link ‘‘https://
www.cms.gov/About-CMS/AgencyInformation/OMH/OMH_DwnldCMSEquityPlanforMedicare_
090615.pdf’’ is corrected to read
‘‘https://www.cms.gov/About-CMS/
Agency-Information/OMH/OMH_
Dwnld-CMS_EquityPlanforMedicare_
090615.pdf#:∼:text=The
%20Centers%20for%20Medicare%20
%26%20Medicaid%20Services%20
%28CMS%29,evidence%20base%2C
%20identifying%20opportunities
%2C%20and%20gathering
%20stakeholder%20input’’.
7. On page 94380, first column, fourth
footnoted paragraph (footnote 316),
lines 3 through 5, the link ‘‘https://
www.beckersasc.com/asc-coding-billingand-collections/hopds-vs-ascs-10considerations-for-2024.html.’’ is
corrected to read ‘‘https://
www.beckersasc.com/asc-coding-billingand-collections/hopds-vs-ascs-10considerations-for-2024.html’’.
8. On page 94407, third column, first
partial paragraph,
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a. Line 19, the punctuation mark ‘‘,’’
is replaced with ‘‘.’’
b. Lines 19 through 22, the language
‘‘which is administered on the first day
post-procedure and then followed up at
14 days.’’ is removed.
9. On page 94411, first column,
second footnoted paragraph (footnote
446), lines 4 through 8, the link ‘‘https://
p4qm.org/sites/default/files/2023-09/
Guidebook-of-Policies-and-Proceduresfor-Pre-Rulemaking-Measure-Review%28PRMR%29-and-MeasureSetReview-%28MSR%29-Final_0.pdf’’ is
corrected to read ‘‘https://p4qm.org/
sites/default/files/2023-09/Guidebookof-Policies-and-Procedures-for-PreRulemaking-Measure-Review%28PRMR%29-and-Measure-SetReview-%28MSR%29-Final_0.pdf’’.
10. On page 94412, third column, first
footnoted paragraph (footnote 461),
lines 4 through 6, the link: ‘‘https://
p4qm.org/sites/default/files/2024-02/
PRMR-Hospital-RecommendationGroup-MeetingSummary-Final.pdf’’ is
corrected to read ‘‘https://p4qm.org/
sites/default/files/2024-02/PRMRHospital-Recommendation-GroupMeeting-Summary-Final.pdf’’.
11. On page 94416, within table note
**** corresponding to Table 163 titled
‘‘NEWLY FINALIZED HOSPITAL OQR
PROGRAM MEASURE SET BEGINNING
WITH THE CY 2027 PAYMENT
DETERMINATION’’, line 3, section
reference ‘‘XV.B.3.B’’ is corrected to
read ‘‘XV.C.1.b’’.
12. On page 94417,
a. Within table note ***
corresponding to Table 164 titled
‘‘NEWLY FINALIZED HOSPITAL OQR
PROGRAM MEASURE SET BEGINNING
WITH THE CY 2031 PAYMENT
DETERMINATION’’, line 3, section
reference ‘‘XV.B.3.B’’ is corrected to
read section ‘‘XV.C.1.b’’.
b. Third column, last full paragraph,
lines 3 through 10, ‘‘(77 FR 68484; 80
FR 70521, 87 FR 72110 through 72112;
78 FR 75097 through 75100; and 88 FR
82004 through 82006, respectively) for
information regarding our claims-based,
web-based, eCQM, chart-abstracted,
PRO–PM, and survey-based data
submission and reporting
requirements.’’ is corrected to read ‘‘(78
FR 75111 and 75112; 80 FR 70521
through 70522; 86 FR 63863 through
63866; 87 FR 72110 through 72112; 88
FR 82004 through 82009, respectively)
for information regarding our claimsbased, web-based, survey-based, chartabstracted, eCQM, and PRO–PM data
submission and reporting
requirements.’’.
13. On page 94442, first column, last
paragraph, line 6, the figure ‘‘$2.8
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million’’ is corrected to read ‘‘2.8
million’’.
14. On page 94446, third column,
fourth full paragraph, line 2, ‘‘that that’’
is corrected to read ‘‘that’’.
15. On page 94448, third column,
second full paragraph, line 22,
‘‘communities that rely upon rely upon’’
is corrected to read ‘‘communities that
rely upon’’.
16. On page 94452, third column, last
paragraph, line 31 ‘‘mistrusted the
health care at higher’’ is corrected to
read as ‘‘mistrusted the health care
system at higher’’.
17. On page 94455, second column,
first fully footnoted paragraph (footnote
586), ‘‘As of November 27, 2024, HRSA
has not finalized these proposed
changes to FORHP’s definition of rural.’’
is corrected to read ‘‘As of the
development of this final rule, HRSA
had not finalized these proposed
changes to FORHP’s definition of rural.’’
18. On page 94481, third column, first
partial paragraph, line 12 the word
‘‘biannual’’ is corrected to read
‘‘biennial’’.
19. On page 94483, first column,
a. Eighth bullet, line 5, the word
‘‘biannual’’ is corrected to read
‘‘biennial’’.
b. Last bullet, line 5 the word
‘‘biannual’’ is corrected to read
‘‘biennial’’.
20. On page 94522,
a. Second column, last partial
paragraph, line 2, the figure ‘‘four’’ is
corrected to read ‘‘three’’.
b. Third column, first partial
paragraph,
(1) Line 1, the word ‘‘and’’ is inserted
before ‘‘(3)’’.
(2) Line 7, the phrase ‘‘; and (4)’’ is
corrected to read ‘‘. We are also
adopting’’.
21. On page 94542, third column,
a. First partial paragraph, line 17, the
word ‘‘biannually’’ is corrected to read
‘‘biennially’’.
b. First full paragraph, line 13 the
word ‘‘biannual’’ is corrected to read
‘‘biennial’’.
22. On page 94561,
a. The table title, ‘‘Table 207: Four
Walls: Accounting Statement: Medicaid
Clinic Services Four Walls Exceptions’’
is corrected to read as ‘‘TABLE 207:
ACCOUNTING STATEMENT:
MEDICAID CLINIC SERVICES FOUR
WALLS EXCEPTIONS’’
b. Third column, first full paragraph,
line 1, section reference ‘‘XXVI.B’’ is
corrected to ‘‘XXVI.A’’.
23. On page 94562,
a. First column,
(1) First full paragraph, line 8, section
reference ‘‘XXVI.B’’ is corrected to
‘‘XXVI.A’’.
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2635
(2) Last paragraph, line 8, section
reference ‘‘XXVI.B’’ is corrected to
‘‘XXVI.A’’.
b. Third column, first full paragraph,
line 1, section reference ‘‘XXVI.C’’ is
corrected to ‘‘XXVI.B’’.
24. On page 94563,
a. First column, first full paragraph,
line 8, section reference ‘‘XXVI.C’’ is
corrected to ‘‘XXVI.B’’.
b. Second column, second full
paragraph, line 1, section reference
‘‘XXVI.D’’ is corrected to ‘‘XXVI.C’’.
c. Third column, first full paragraph,
line 8, section reference ‘‘XXVI.D’’ is
corrected to ‘‘XXVI.C’’.
25. On page 94569, first column, first
partial paragraph, line 6 the word
‘‘biannually’’ is corrected to read
‘‘biennially.’’
26. On page 94571, bottom of the
page, first column; first partial
paragraph, line 12, the word ‘‘biannual’’
is corrected to read ‘‘biennial.’’
27. On page 94572,
a. Second column, first partial
paragraph, line 1, the word ‘‘biannual’’
is corrected to read ‘‘biennial’’.
b. Third column, first partial
paragraph, line 44, the word ‘‘biannual’’
is corrected to read ‘‘biennial’’.
28. On page 94573, third column; first
partial paragraph, line 1, the word
‘‘biannual’’ is corrected to read
‘‘biennial’’.
List of Subjects
42 CFR Part 406
Diseases, Health facilities, Medicare.
42 CFR Part 457
Administrative practice and
procedure, Grant programs—health,
Health insurance, Reporting and
recordkeeping requirements.
42 CFR Part 482
Grant programs—health, Hospitals,
Medicaid, Medicare, Reporting and
recordkeeping requirements.
42 CFR Part 485
Grant programs—health, Health
facilities, Medicaid, Privacy, Reporting
and recordkeeping requirements.
Accordingly, 42 CFR chapter IV is
corrected by making the following
correcting amendments:
PART 406—HOSPTIAL INSURANCE
ELIGIBILITY AND ENTITLEMENT
1. The authority citation for part 406
continues to read as follows:
■
Authority: 42 U.S.C. 1302, 1395i–2,
1395i–2a, 1395p, 1395q and 1395hh.
§ 406.27
[Amended]
2. Amend § 406.27 in the second
sentence of paragraph (d)(1)(i) by adding
■
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Federal Register / Vol. 90, No. 7 / Monday, January 13, 2025 / Rules and Regulations
the word ‘‘the’’ before the phrase
‘‘custody of penal authorities and . . .’’
NATIONAL FOUNDATION ON THE
ARTS AND THE HUMANITIES
PART 457—ALLOTMENTS AND
GRANTS TO STATES
National Endowment for the Arts
45 CFR Parts 1149 and 1158
3. The authority citation for part 457
continues to read as follows:
■
RIN 3135–AA33
Civil Penalties Adjustment for 2025
Authority: 42 U.S.C. 1302.
■
4. Revise § 457.342 to read as follows:
§ 457.342
children.
Continuous eligibility for
(a) A State must provide continuous
eligibility for children under a separate
CHIP in accordance with the terms of
§ 435.926 of this chapter, and subject to
a child remaining ineligible for
Medicaid, as required by section
2110(b)(1) of the Act and § 457.310
(related to the definition and standards
for being a targeted low-income child)
and the requirements of section
2102(b)(3) of the Act and § 457.350
(related to eligibility screening and
enrollment).
(b) [Reserved]
PART 482—CONDITIONS OF
PARTICIPATION FOR HOSPITALS
5. The authority citation for part 482
continues to read as follows:
■
Authority: 42 U.S.C. 1302, 1395hh, and
1395rr, unless otherwise noted.
§ 482.59
[Amended]
6. Amend § 482.59 in paragraph (c)(3)
by correcting the word ‘‘biannual’’ to
read ‘‘biennial’’.
■
PART 485—CONDITIONS OF
PARTICIPATION FOR CRITICAL
ACCESS HOSPITALS
7. The authority citation for part 485
continues to read as follows:
■
Authority: 42 U.S.C. 1302 and 1395(hh).
§ 485.649
[Amended]
8. Amend § 485.649 in paragraph
(c)(3) by correcting the word ‘‘biannual’’
to read ‘‘biennial’’.
ddrumheller on DSK120RN23PROD with RULES1
■
Elizabeth J. Gramling,
Executive Secretary to the Department,
Department of Health and Human Services.
[FR Doc. 2025–00081 Filed 1–8–25; 8:45 am]
BILLING CODE 4120–01–P
National Endowment for the
Arts, National Foundation on the Arts
and the Humanities.
ACTION: Final rule.
AGENCY:
The National Endowment for
the Arts (NEA) is adjusting the
maximum civil monetary penalties
(CMPs) that may be imposed for
violations of the Program Fraud Civil
Remedies Act (PFCRA) and the NEA’s
Restrictions on Lobbying to reflect the
requirements of the Federal Civil
Penalties Inflation Adjustment Act
Improvements Act of 2015 (the 2015
Act). The 2015 Act further amended the
Federal Civil Penalties Inflation
Adjustment Act of 1990 (the Inflation
Adjustment Act) to improve the
effectiveness of civil monetary penalties
and to maintain their deterrent effect.
This final rule provides the 2025 annual
inflation adjustments to the initial
‘‘catch-up’’ adjustments made on June
15, 2017, and reflects all other inflation
adjustments made in the interim.
DATES: This rule is effective January 13,
2025.
FOR FURTHER INFORMATION CONTACT:
William Langer, Assistant General
Counsel, National Endowment for the
Arts, 400 7th St. SW, Washington, DC
20506, Telephone: 202–682–5595.
SUPPLEMENTARY INFORMATION:
SUMMARY:
1. Background
On December 12, 2017 the NEA
issued a final rule entitled ‘‘Federal
Civil Penalties Adjustments’’ 1 which
finalized the NEA’s June 15, 2017
interim final rule entitled
‘‘Implementing the Federal Civil
Penalties Adjustment Act Improvements
Act’’,2 implementing the 2015 Act
(section 701 of Pub. L. 114–74), which
amended the Inflation Adjustment Act
(28 U.S.C. 2461 note) requiring catch-up
and annual adjustments to the NEA’s
CMPs. The 2015 Act requires agencies
make annual adjustments to its CMPs
for inflation.
A CMP is defined in the Inflation
Adjustment Act as any penalty, fine, or
other sanction that is (1) for a specific
monetary amount as provided by
Federal law, or has a maximum amount
1 82
2 82
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FR 27431.
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provided for by Federal law; (2)
assessed or enforced by an agency
pursuant to Federal law; and (3)
assessed or enforced pursuant to an
administrative proceeding or a civil
action in the Federal courts.
These annual inflation adjustments
are based on the percentage change in
the Consumer Price Index for all Urban
Consumers (CPI–U) for the month of
October preceding the date of the
adjustment, relative to the October CPI–
U in the year of the previous
adjustment. The formula for the amount
of a CMP inflation adjustment is
prescribed by law, as explained in OMB
Memorandum M–16–06 (February 24,
2016), and therefore the amount of the
adjustment is not subject to the exercise
of discretion by the Chair of the
National Endowment for the Arts.
The Office of Management and Budget
has issued guidance on implementing
and calculating the 2025 adjustment
under the 2015 Act.3 Per this guidance,
the CPI–U adjustment multiplier for this
annual adjustment is 1.02598. In its
prior rules, the NEA identified two
CMPs, which require adjustment: the
penalty for false statements under the
PFCRA and the penalty for violations of
the NEA’s Restrictions on Lobbying.
With this rule, the NEA is adjusting the
amount of those CMPs accordingly.
2. Dates of Applicability
The inflation adjustments contained
in this rule shall apply to any violations
assessed after January 15, 2025.
3. Adjustments
Two CMPs in NEA regulations require
adjustment in accordance with the 2015
Act: (1) the penalty associated with the
Program Fraud Civil Remedies Act (45
CFR 1149.9) and (2) the penalty
associated with Restrictions on
Lobbying (45 CFR 1158.400; 45 CFR part
1158, app. A).
A. Adjustments to Penalties Under the
NEA’s Program Fraud Civil Remedies
Act Regulations
The current maximum penalty under
the PFCRA for false claims and
statements is currently set at $13,945.
The post-adjustment penalty or range is
obtained by multiplying the preadjustment penalty or range by the
percent change in the CPI–U over the
relevant time period and rounding to
the nearest dollar. Between October
2023 and October 2024, the CPI–U
increased by a multiplier of 102.598%.
Therefore, the new post-adjustment
maximum penalty under the PFCRA for
3 OMB Memorandum M–25–02 (December 17,
2024).
Fmt 4700
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Agencies
[Federal Register Volume 90, Number 7 (Monday, January 13, 2025)]
[Rules and Regulations]
[Pages 2631-2636]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-00081]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 406, 407, 410, 411, 416, 419, 435, 440, 457, 482, and
485
[CMS-1809-F2]
RIN 0938-AV35
Medicare and Medicaid Programs: Hospital Outpatient Prospective
Payment and Ambulatory Surgical Center Payment Systems; Quality
Reporting Programs, Including the Hospital Inpatient Quality Reporting
Program; Health and Safety Standards for Obstetrical Services in
Hospitals and Critical Access Hospitals; Prior Authorization; Requests
for Information; Medicaid and CHIP Continuous Eligibility; Medicaid
Clinic Services Four Walls Exceptions; Individuals Currently or
Formerly in Custody of Penal Authorities; Revision to Medicare Special
Enrollment Period for Formerly Incarcerated Individuals; and All-
Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian
Health Service and Tribal Facilities; Correcting Amendment
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule with comment period; correcting amendment.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical and typographical errors in
the final rule with comment period that appeared in the November 27,
2024 Federal Register titled ``Medicare and Medicaid Programs: Hospital
Outpatient Prospective Payment and Ambulatory Surgical Center Payment
Systems; Quality Reporting Programs, including the Hospital Inpatient
Quality Reporting Program; Health and Safety Standards for Obstetrical
Services in Hospitals and Critical Access Hospitals; Prior
Authorization; Requests for Information; Medicaid and CHIP Continuous
Eligibility; Medicaid Clinic Services Four Walls Exceptions;
Individuals Currently or Formerly in Custody of Penal Authorities;
Revision to Medicare Special Enrollment Period for Formerly
Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for
High-Cost Drugs Provided by Indian Health Service and Tribal
Facilities''.
DATES: This correcting amendment is effective January 8, 2025, and is
applicable beginning January 1, 2025.
FOR FURTHER INFORMATION CONTACT:
For OPPS/ASC related questions, contact Elise Barringer via email
at [email protected] or at (410) 786-9222.
For OPPS Addenda questions, contact Marina Kushnirova via email at
[email protected].
For ASC Addenda questions, contact Scott Talaga via email at
[email protected].
For Health and Safety Standards for Obstetrical Services in
Hospitals and Critical Access Hospitals questions, contact the Clinical
Standards Group via email at [email protected].
For Hospital Outpatient Quality Reporting Program policies, contact
Kimberly Go via email at [email protected] or Janis Grady via
email at [email protected].
For Medicaid Clinic Services Four Walls Exceptions related
questions, contact Sheri Gaskins via email at [email protected]
or Ryan Tisdale via email at [email protected].
For Medicaid and CHIP Continuous Eligibility questions, contact
Cassie Lagorio via email at [email protected].
For New Technology APC questions, contact Nicole Marcos via email
at [email protected].
For Outpatient Department Prior Authorization Process, contact
Kelly Wojciechowski via email at [email protected].
SUPPLEMENTARY INFORMATION:
I. Background
In the FR Doc. 2024-25521 of November 27, 2024 (89 FR 93912), 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 effective as if they had been included in the
document that appeared in the November 27, 2024 Federal Register.
Accordingly, the corrections are effective January 1, 2025.
II. Summary of Errors
A. Summary of Errors in For Further Information Contact
In the FOR FURTHER INFORMATION CONTACT section, the email address
for Kelly Wojciechowski is incorrect.
B. Summary of Errors in the Preamble
1. Hospital Outpatient Prospective Payment System (OPPS) Corrections
On pages 94054 and 94055, we are correcting typographical errors.
Specifically, we are correcting CPT code ``0899T'' to ``0889T''.
On pages 94111 and 94114, we referred to an incorrect APC
assignment for CPT code 15013. We inadvertently failed to account for
the impact on the amount of payment for the skin cell suspension
autograft procedure described by CPT code 15013 (Preparation of skin
cell suspension autograft, requiring enzymatic processing, manual
mechanical disaggregation of skin cells, and filtration; first 25 sq cm
or less of harvested skin) of the assignment of this code to status
indicator ``T'' (Procedure or Service, Multiple Procedure Reduction
Applies; Paid under OPPS, separate APC payment) when we assigned CPT
code 15013 to APC 1567 New Technology--Level 30 ($6,001-$6,500), which
has a payment rate of $6,250.50 and status indicator ``T''.
In the final rule with comment period, we stated that when the full
service (skin cell suspension autograft described by CPT codes 15011
through 15018) is performed, meaning that the harvesting (described by
CPT code 15011), preparation (described by CPT code 15013), and
application (described by CPT codes 15015 or 15017) steps are
performed, the total cost for the service for CY 2025 would be
approximately $10,000. However, because of the effect of the multiple
procedure reduction, the total payment for the skin cell suspension
autograft furnished using the RECELL System would have been
approximately $8,000, contrary to the intended target of $10,000 as
stated in the CY 2025 OPPS/ASC final rule with comment period. To
correct this error, we are assigning CPT code 15013 to APC 1532 New
Technology--Level 32 ($7,001-$7,500), which has a payment rate of
$7,250.50 and status indicator ``S'' (Procedure or Service, Not
Discounted When Multiple, Paid under OPPS; separate APC payment.).
On page 94120, we stated ``We note that we will replace HCPCS code
C9734 with CPT code 5X008 (55882) effective January 1, 2025, as well as
assign the underlying claims associated with HCPCS code C9734 to CPT
code 5X008 (55882).'' While we intended to crosswalk the claims data
for HCPCS code C9734 to CPT code 5X008 (55882) to determine the APC
assignment for CPT code 5X008 (55882) for CY 2025, we did not intend to
retire HCPCS code C9734 because, based on its descriptor,
[[Page 2632]]
C9734 can be used for services other than those described by CPT code
5X008 (55882). We are correcting this reference to indicate that we are
using C9734 claims data to set the payment rate for CPT code 5X008
(55882) and removing the reference to replacing HCPCS code C9734. HCPCS
code C9734 will remain assigned to APC 5115 (Level 5 Musculoskeletal
Procedures).''
2. The Hospital Outpatient Quality Reporting (OQR), Rural Emergency
Hospital Quality Reporting (REHQR), and Ambulatory Surgical Center
Quality Reporting (ASCQR) Programs Corrections
On pages 94368 and 94380, we are correcting URL links in footnotes
270 and 316 (respectively) for accuracy.
On page 94407, we are making a technical edit and removing language
for accuracy.
On pages 94411 and 94412, we are correcting URL links in footnotes
446 and 461 (respectively) for accuracy.
On pages 94416 and 94417, we are correcting section references for
accuracy.
On page 94417, we are correcting final rule references for
accuracy.
On page 94522, we are correcting the number of web-based measures
that are being finalized in the rule for the Hospital OQR program.
On pages 94561 through 94563, we are correcting section references
for accuracy.
3. Medicaid Clinic Services Four Walls Exceptions Corrections
On pages 94442, 94446, 94448, 94452, and 94561, we made
typographical errors. Specifically, on page 94442 we inadvertently
included a dollar symbol ($), on page 94446 we inadvertently repeated
the word ``that,'' on page 94448 we inadvertently repeated the phrase
``rely upon,'' on page 94452 we inadvertently omitted the word
``system'' from the phrase ``mistrusted the health care system at
higher rates,'' and on page 94561 we inadvertently included the phrase
``Four Walls:'' at the beginning of the title for Table 207.
On page 94455, we incorrectly stated in footnote 586 that as of
November 27, 2024, the Health Resources and Services Administration
(HRSA) had not finalized their proposed changes to the Federal Office
of Rural Health Policy's (FORHP) definition of rural. However, HRSA
finalized changes to FORHP's definition of rural in a final notice
published in the Federal Register on November 21, 2024 (89 FR 92131),
which post-dated CMS's development of the final rule. We are making
corrections to state that, as of the development of the OPPS final
rule, HRSA had not finalized changes to FORHP's definition of rural.
4. Health and Safety Standards for Obstetrical Services in Hospitals
and Critical Access Hospitals
On pages 94481, 94483, 94542, 94569, 94571, 94572, and 94573 we are
replacing the word ``biannual'' and/or ``biannually'' with the word
``biennial'' and/or ``biennially'', to clarify that staff training is
required every other year, not twice a year.
C. Summary of Errors in the Regulations Text
On page 94586, in the regulations text for Sec. 406.27(d)(1), we
are adding in a missing word.
On page 94591, we made technical errors in the regulations text
amendatory instructions for Sec. 457.342, by excluding the numbering
of paragraph (a) and the reservation of paragraph (b).
On pages 94592 and 94594 we are replacing the word ``biannual''
with the word ``biennial'', to clarify that staff training is required
every other year, not twice a year.
D. Summary of Errors and Corrections to the OPPS and ASC Addenda Posted
on the CMS Website
1. OPPS Addenda Summary of Errors
To view any corrections or updates to the final CY 2025 OPPS status
indicators, APC assignments, relative weights, copayment rates, device-
intensive status, and short descriptors in the OPPS addenda, we refer
readers to the Addenda and supporting files that are posted on the CMS
website at https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices. Select ``CMS-1809-F2''
from the list of regulations. All corrected Addenda for this correcting
document are contained in the zipped folder titled ``2025 F2 OPPS
Addenda'' at the bottom of the CMS web page for CMS-1809-F2.
a. Errors in Addendum B
We are making a number of updates to Addendum B (OPPS Payment by
HCPCS Code for CY 2025) to correct typographical errors. We are also
correcting the following technical errors:
We incorrectly deleted HCPCS code C9734 (U/s trtmt, not
leiomyomata) from Addendum B by inadvertently assigning it to status
indicator ``D''. We are correcting this error by replacing status
indicator ``D'' with ``J1'' for HCPCS code C9734 and assigning it to
APC 5115 (Level 5 Musculoskeletal Procedures) in Column E, as well as
adding corresponding data to Columns F-K to reflect the updated APC
5115 assignment.
In addition, due to an inadvertent miscalculation of the payment
rate for CPT code 15013 as explained in more detail in section II.B.
Summary of Errors in the Preamble of this notice, we incorrectly
assigned CPT code 15013 (Prepj skn cll ssp agrft 1st) status indicator
``T'' and are correcting it to ``S''. We also incorrectly assigned CPT
code 15013 to APC 1567 (New Technology--Level 30 ($6001-$6500)) and are
correcting it to APC 1532 (New Technology--Level 32 ($7001-$7500)).
Due to an inadvertent miscalculation of the payment rate for HCPCS
code C8002 for the same reason as the error for CPT code 15013, we
incorrectly assigned HCPCS code C8002 status indicator ``T'' and we are
correcting it to ``S''. We also incorrectly assigned HCPCS code C8002
to APC 1567 (New Technology--Level 30 ($6001-$6500)) and are correcting
it to APC 1532 (New Technology--Level 32 ($7001-$7500)).
b. Errors in Addendum C
In Addendum C (Final HCPCS Codes Payable Under the 2025 OPPS by
APC), we are making a number of updates to correct the following
technical errors:
Due to the errors described in more detail in section II.B Summary
of Errors in the Preamble of this notice related to CPT code 15013 and
HCPCS code C8002, we are deleting CPT code 15013 and HCPCS code C8002
from the list of HCPCS and CPT codes assigned to APC 1567 (New
Technology--Level 30 ($6001-$6500)). We are adding CPT code 15013 and
HCPCS code C8002 to the list of HCPCS and CPT codes assigned to APC
1532 (New Technology--Level 32 ($7001-$7500)) in Addendum C.
Due to the incorrect deletion of HCPCS code C9734 described in more
detail in section II.B Summary of Errors in the Preamble of this
notice, we are adding HCPCS code C9734 back to the list of HCPCS and
CPT codes assigned to APC 5115 (Level 5 Musculoskeletal Procedures) in
Addendum C.
c. Errors in Addendum P
In the tab titled ``2025 FR Device Intensive List'', we
inadvertently included two rows for each of CPT codes 0795T, 0801T,
27279, and 93656. The additional rows for each of the codes contain
values that were incorrectly calculated. For CPT codes 0795T and 0801T,
the additional rows included values calculated using CY 2023 data, when
the codes were assigned a status indicator of ``E1.''
[[Page 2633]]
Status indicator ``E1'' is assigned to items, codes, and services that
are not covered by any Medicare outpatient benefit category; are
statutorily excluded; or are not reasonable and necessarily. Because
procedures assigned status indicator ``E1'' are not payable under the
OPPS, claims data for codes assigned this status indicator should not
be used to assign device offset percentages. Accordingly, we are
deleting the additional rows that contained incorrect values for these
codes. For CPT codes 27279 and 93656, the additional rows included a
Device Offset Percentage and Device Offset Amount for each of the codes
that was calculated using the APC Device Offset Percentage. But because
CPT codes 27279 and 93656 were separately payable in CY 2023, the
Device Offset Percentage and Device Offset Amount for each code should
have been calculated using CY 2023 claims data. Therefore, we are
deleting the additional rows for these codes as well.
In the tabs titled ``FR 2025 Device Intensive List'' and ``2025 FR
HCPCS Offsets'', we inadvertently included the incorrect APC Device
Offset Percentage for procedures assigned to APC 5463--Level 3
Neurostimulator and Related Procedures. We have revised the APC Device
Offset Percentage from 26.11 percent to 26.17 percent.
In the tab titled ``2025 FR HCPCS Offsets'', which is described as
a ``list of the device offset percentages and device offset amounts for
all HCPCS codes with CY 2023 claims data,'' we inadvertently included
device offset percentages based on claims data from procedures that
were assigned status indicator ``E1'' for CY 2023. Because status
indicator ``E1'' is assigned to items, codes, and services that are not
covered by any Medicare outpatient benefit category; are statutorily
excluded; or are not reasonable and necessary, claims data for
procedures assigned this status indicator should not be used to assign
device offset percentages as these procedures were not payable under
the OPPS in CY 2023 and do not have OPPS claims data. The procedures
that were assigned status indicator ``E1'' for CY 2023 but were
included in the ``2025 FR HCPCS Offsets'' tab in Addendum P were CPT
codes 0621T, 0737T, 0764T, 0795T, 0796T, 0801T, and 74263. We corrected
the 2025 FR HCPCS Offsets file by deleting the entries for these
procedures.
2. ASC Payment System Addenda Summary of Errors
To view the corrected final CY 2025 ASC payment indicators, payment
weights, payment rates, multiple procedure discounting indicators, and
device offset amounts/device portions in Addendum AA, BB, and FF that
resulted from these technical corrections, we refer readers to the
Addenda and supporting files on the CMS website at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/ASC-Regulations-and-Notices.html. Select ``CMS-1809-F2'' from the list of
regulations. All corrected ASC addenda for this correcting document are
contained in the zipped folder entitled ``Addendum AA, BB, DD1, DD2,
and EE'' at the bottom of the CMS web page for CMS-1809-F2.
a. Errors in Addendum AA
We inadvertently assigned ``N'' (No) in column D (Subject to
Multiple Procedure Discounting) to HCPCS Codes C7500 through C7565 in
the list of ASC complexity adjustment codes. We are correcting this
error in Addendum AA by revising the procedure discounting status from
``N'' (No) to ``Y'' (Yes) for these codes, indicating that the
procedures to which these codes correspond are subject to multiple
procedure discounting.
As a result of the correction to the OPPS APC and status indicator
assignment for the skin cell suspension autograft procedures described
by CPT code 15013 and HCPCS code C8002 described in this correction
notice, we are revising the multiple procedure discounting status in
Column D for CPT code 15013 and HCPCS code C8002 from ``Y'' (Yes) to
``N'' (No) indicating that the procedure is not subject to multiple
procedure discounting. We are also correcting the OPPS APC assignment
from APC 1567 to APC 1532 for CPT code 15013 and HCPCS code C8002.
Therefore, in Addendum AA, as a result of the correction to the APC
assignment for CPT code 15013 and HCPCS code C8002, we are correcting
the Final CY 2025 Payment Weight (Column G) and Final CY 2025 Payment
Rate (Column H) for CPT code 15013 and HCPCS code C8002 to reflect the
correct APC assignment of APC 1532--New Technology--Level 32 ($7001-
$7500).
We inadvertently assigned a payment rate to CPT code 53865 using
APC 5374--Level 4 Urology and Related Services--rather than APC 5376--
Level 6 Urology and Related Services. In Addendum AA, we are revising
the Final CY 2025 Payment Weight and Final CY 2025 Payment Rate column
(Column H) to reflect the corrected APC for CPT code 53865.
b. Errors in Addendum BB
We inadvertently assigned a final CY 2025 ASC payment rate to
brachytherapy APCs that were not designated as Low Volume APCs that was
based on the mean unit cost. This affected HCPCS codes:
C1717 (Brachytx, non-str, hdr ir-192);
C2616 (Brachytx, non-str, yttrium-90);
C2634 (Brachytx, non-str, ha, i-125);
C2638 (Brachytx, stranded, i-125);
C2639 (Brachytx, non-stranded, i-125);
C2640 (Brachytx, stranded, p-103);
C2641 (Brachytx, non-stranded, p-103);
C2643 (Brachytx, non-stranded, c-131);
C2698 (Brachytx, stranded, nos), and;
C2699 (Brachytx, non-stranded, nos).
We are correcting the Final CY 2025 Payment Rate column (Column H)
to reflect the geometric mean unit cost for these brachytherapy APCs.
We inadvertently made an error in the Short Descriptor column
(Column C) for HCPCS Code J1552 and are correcting it from ``Inj,
alyglo, 100 mg'' to read ``Inj, alyglo, 500 mg''.
We inadvertently displayed the incorrect payment rate for nine
diagnostic radiopharmaceuticals in the HCPCS A9500 through A9600 range.
We are correcting the Final CY 2025 Payment Rates column (Column H) for
these radiopharmaceuticals.
c. Errors in Addendum FF
We inadvertently assigned CPT code 53865 to APC 5374--Level 4
Urology and Related Services--rather than APC 5376--Level 6 Urology and
Related Services. We are revising the Final CY 2025 APC (Column E),
Final CY 2025 APC Device Offset Percentage (Column F). Final CY 2025
OPPS Payment Rate (Column G), and Final CY 2025 Device Offset Amount/
Device Portion (Column I) to reflect the corrected APC for CPT code
53865.
We made an error in the OPPS APC assignment for CPT code 15013 and
HCPCS Code C8002 as described previously. As a result of the correction
to the OPPS assignment to APC 1532--New Technology--Level 32 ($7001-
$7500)--for CPT code 15013 and HCPCS Code C8002, we are correcting the
Final CY 2025 APC (Column E) and Final CY 2025 OPPS Payment Rate
(Column G) for these codes to reflect this APC correction.
[[Page 2634]]
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 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 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, regulations text, addenda, and tables included or
referenced in the CY 2025 OPPS/ASC final rule with comment period but
does not make substantive changes to the policies or payment
methodologies that were adopted in the CY 2025 OPPS/ASC final rule with
comment period. As a result, this correction is intended to ensure that
the information in the CY 2025 OPPS/ASC final rule with comment period
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 with comment period 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 CY 2025 OPPS/
ASC final rule with comment period reflects our policies. Furthermore,
such procedures would be unnecessary, as we are not altering our
payment methodologies or policies, but rather, we are simply correctly
implementing the policies that we previously proposed, requested
comment on, and subsequently finalized. This correcting document is
intended solely to ensure that the CY 2025 OPPS/ASC final rule with
comment period accurately reflects these payment methodologies and
policies. For these reasons, we believe we have good cause to waive the
notice and comment and delayed 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 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 CY
2025 OPPS/ASC final rule with comment period accurately reflects our
policies.
IV. Correction of Errors
In FR Doc. 2024-25521 of November 27, 2024 (89 FR 93912), we are
making the following corrections:
A. Correction of Errors in For Further Contact Information
1. On page 93913, column 2, fourth paragraph, line 4, the email
address for Kelly Wojciechowski is corrected to read
``[email protected]''.
B. Correction of Errors in the Preamble
1. On page 94054, third column, last partial paragraph, lines 3 and
4, ``CPT code 0899T'' is corrected to read ``CPT code 0889T''.
2. On page 94055, third column, first partial paragraph, first
line, ``code 0899T'' is corrected to read ``code 0889T''.
3. On page 94111, in the heading titled ``54. Skin Cell Suspension
Autograft (SCSA) Procedures, CPT Codes 15011 Through 15018 (APCs 5051,
5054, and 1567)'', line 4, the figure ``1567'' is corrected to read
``1532''.
4. On page 94114, second column,
a. First partial paragraph,
(1) Lines 1 through 3, ``APC 1567 (New Technology--Level 30 ($6001-
6500)) with a $6,250.50 payment rate'' is corrected to read ``APC 1532
(New Technology--Level 32 ($7001-7500)) with a $7,250.50 payment
rate''.
(2) Lines 12 through 13, ``APC 1567 with a payment rate of
$6,250.50'' are corrected to read ``APC 1532 with a payment rate of
$7,250.50''.
b. First full paragraph, lines 12 through 13 ``APC 1567 ((New
Technology--Level 30 ($6001-$6500))'' is corrected to read ``APC 1532
(New Technology--Level 32 ($7001-7500))''.
5. On page 94120, second column, second full paragraph, lines 4
through 9 that read ``We note that we will replace HCPCS code C9734
with CPT code 5X008 (55882) effective January 1, 2025, as well as
assign the underlying claims associated with C9734 to CPT code 5X008
(55882)'' are corrected in their entirety to read, ``We note that we
will crosswalk claims for HCPCS code C9734 to CPT code 5X008 (55882) to
determine the APC assignment for CPT code 5X008 (55882) for CY 2025.
HCPCS C9734 will continue to be assigned to APC 5115 (Level 5
Musculoskeletal Procedures) in CY 2025.''
6. On page 94368, first column, second footnoted paragraph
(footnote 270), lines 4 through 6, the link ``https://www.cms.gov/About-CMS/Agency-Information/OMH/OMH_Dwnld-CMSEquityPlanforMedicare_090615.pdf'' is corrected to read ``https://
www.cms.gov/About-CMS/Agency-Information/OMH/OMH_Dwnld-
CMS_EquityPlanforMedicare_090615.pdf#:~:text=The%20Centers%20for%20Medic
are%20%26%20Medicaid%20Services%20%28CMS%29,evidence%20base%2C%20identif
ying%20opportunities%2C%20and%20gathering%20stakeholder%20input''.
7. On page 94380, first column, fourth footnoted paragraph
(footnote 316), lines 3 through 5, the link ``https://www.beckersasc.com/asc-coding-billing-and-collections/hopds-vs-ascs-10-considerations-for-2024.html.'' is corrected to read ``https://www.beckersasc.com/asc-coding-billing-and-collections/hopds-vs-ascs-10-considerations-for-2024.html''.
8. On page 94407, third column, first partial paragraph,
[[Page 2635]]
a. Line 19, the punctuation mark ``,'' is replaced with ``.''
b. Lines 19 through 22, the language ``which is administered on the
first day post-procedure and then followed up at 14 days.'' is removed.
9. On page 94411, first column, second footnoted paragraph
(footnote 446), lines 4 through 8, the link ``https://p4qm.org/sites/default/files/2023-09/Guidebook-of-Policies-and-Procedures-for-Pre-Rulemaking-Measure-Review-%28PRMR%29-and-Measure-SetReview-%28MSR%29-Final_0.pdf'' is corrected to read ``https://p4qm.org/sites/default/files/2023-09/Guidebook-of-Policies-and-Procedures-for-Pre-Rulemaking-Measure-Review-%28PRMR%29-and-Measure-Set-Review-%28MSR%29-Final_0.pdf''.
10. On page 94412, third column, first footnoted paragraph
(footnote 461), lines 4 through 6, the link: ``https://p4qm.org/sites/default/files/2024-02/PRMR-Hospital-Recommendation-Group-MeetingSummary-Final.pdf'' is corrected to read ``https://p4qm.org/sites/default/files/2024-02/PRMR-Hospital-Recommendation-Group-Meeting-Summary-Final.pdf''.
11. On page 94416, within table note **** corresponding to Table
163 titled ``NEWLY FINALIZED HOSPITAL OQR PROGRAM MEASURE SET BEGINNING
WITH THE CY 2027 PAYMENT DETERMINATION'', line 3, section reference
``XV.B.3.B'' is corrected to read ``XV.C.1.b''.
12. On page 94417,
a. Within table note *** corresponding to Table 164 titled ``NEWLY
FINALIZED HOSPITAL OQR PROGRAM MEASURE SET BEGINNING WITH THE CY 2031
PAYMENT DETERMINATION'', line 3, section reference ``XV.B.3.B'' is
corrected to read section ``XV.C.1.b''.
b. Third column, last full paragraph, lines 3 through 10, ``(77 FR
68484; 80 FR 70521, 87 FR 72110 through 72112; 78 FR 75097 through
75100; and 88 FR 82004 through 82006, respectively) for information
regarding our claims-based, web-based, eCQM, chart-abstracted, PRO-PM,
and survey-based data submission and reporting requirements.'' is
corrected to read ``(78 FR 75111 and 75112; 80 FR 70521 through 70522;
86 FR 63863 through 63866; 87 FR 72110 through 72112; 88 FR 82004
through 82009, respectively) for information regarding our claims-
based, web-based, survey-based, chart-abstracted, eCQM, and PRO-PM data
submission and reporting requirements.''.
13. On page 94442, first column, last paragraph, line 6, the figure
``$2.8 million'' is corrected to read ``2.8 million''.
14. On page 94446, third column, fourth full paragraph, line 2,
``that that'' is corrected to read ``that''.
15. On page 94448, third column, second full paragraph, line 22,
``communities that rely upon rely upon'' is corrected to read
``communities that rely upon''.
16. On page 94452, third column, last paragraph, line 31
``mistrusted the health care at higher'' is corrected to read as
``mistrusted the health care system at higher''.
17. On page 94455, second column, first fully footnoted paragraph
(footnote 586), ``As of November 27, 2024, HRSA has not finalized these
proposed changes to FORHP's definition of rural.'' is corrected to read
``As of the development of this final rule, HRSA had not finalized
these proposed changes to FORHP's definition of rural.''
18. On page 94481, third column, first partial paragraph, line 12
the word ``biannual'' is corrected to read ``biennial''.
19. On page 94483, first column,
a. Eighth bullet, line 5, the word ``biannual'' is corrected to
read ``biennial''.
b. Last bullet, line 5 the word ``biannual'' is corrected to read
``biennial''.
20. On page 94522,
a. Second column, last partial paragraph, line 2, the figure
``four'' is corrected to read ``three''.
b. Third column, first partial paragraph,
(1) Line 1, the word ``and'' is inserted before ``(3)''.
(2) Line 7, the phrase ``; and (4)'' is corrected to read ``. We
are also adopting''.
21. On page 94542, third column,
a. First partial paragraph, line 17, the word ``biannually'' is
corrected to read ``biennially''.
b. First full paragraph, line 13 the word ``biannual'' is corrected
to read ``biennial''.
22. On page 94561,
a. The table title, ``Table 207: Four Walls: Accounting Statement:
Medicaid Clinic Services Four Walls Exceptions'' is corrected to read
as ``TABLE 207: ACCOUNTING STATEMENT: MEDICAID CLINIC SERVICES FOUR
WALLS EXCEPTIONS''
b. Third column, first full paragraph, line 1, section reference
``XXVI.B'' is corrected to ``XXVI.A''.
23. On page 94562,
a. First column,
(1) First full paragraph, line 8, section reference ``XXVI.B'' is
corrected to ``XXVI.A''.
(2) Last paragraph, line 8, section reference ``XXVI.B'' is
corrected to ``XXVI.A''.
b. Third column, first full paragraph, line 1, section reference
``XXVI.C'' is corrected to ``XXVI.B''.
24. On page 94563,
a. First column, first full paragraph, line 8, section reference
``XXVI.C'' is corrected to ``XXVI.B''.
b. Second column, second full paragraph, line 1, section reference
``XXVI.D'' is corrected to ``XXVI.C''.
c. Third column, first full paragraph, line 8, section reference
``XXVI.D'' is corrected to ``XXVI.C''.
25. On page 94569, first column, first partial paragraph, line 6
the word ``biannually'' is corrected to read ``biennially.''
26. On page 94571, bottom of the page, first column; first partial
paragraph, line 12, the word ``biannual'' is corrected to read
``biennial.''
27. On page 94572,
a. Second column, first partial paragraph, line 1, the word
``biannual'' is corrected to read ``biennial''.
b. Third column, first partial paragraph, line 44, the word
``biannual'' is corrected to read ``biennial''.
28. On page 94573, third column; first partial paragraph, line 1,
the word ``biannual'' is corrected to read ``biennial''.
List of Subjects
42 CFR Part 406
Diseases, Health facilities, Medicare.
42 CFR Part 457
Administrative practice and procedure, Grant programs--health,
Health insurance, Reporting and recordkeeping requirements.
42 CFR Part 482
Grant programs--health, Hospitals, Medicaid, Medicare, Reporting
and recordkeeping requirements.
42 CFR Part 485
Grant programs--health, Health facilities, Medicaid, Privacy,
Reporting and recordkeeping requirements.
Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments:
PART 406--HOSPTIAL INSURANCE ELIGIBILITY AND ENTITLEMENT
0
1. The authority citation for part 406 continues to read as follows:
Authority: 42 U.S.C. 1302, 1395i-2, 1395i-2a, 1395p, 1395q and
1395hh.
Sec. 406.27 [Amended]
0
2. Amend Sec. 406.27 in the second sentence of paragraph (d)(1)(i) by
adding
[[Page 2636]]
the word ``the'' before the phrase ``custody of penal authorities and .
. .''
PART 457--ALLOTMENTS AND GRANTS TO STATES
0
3. The authority citation for part 457 continues to read as follows:
Authority: 42 U.S.C. 1302.
0
4. Revise Sec. 457.342 to read as follows:
Sec. 457.342 Continuous eligibility for children.
(a) A State must provide continuous eligibility for children under
a separate CHIP in accordance with the terms of Sec. 435.926 of this
chapter, and subject to a child remaining ineligible for Medicaid, as
required by section 2110(b)(1) of the Act and Sec. 457.310 (related to
the definition and standards for being a targeted low-income child) and
the requirements of section 2102(b)(3) of the Act and Sec. 457.350
(related to eligibility screening and enrollment).
(b) [Reserved]
PART 482--CONDITIONS OF PARTICIPATION FOR HOSPITALS
0
5. The authority citation for part 482 continues to read as follows:
Authority: 42 U.S.C. 1302, 1395hh, and 1395rr, unless otherwise
noted.
Sec. 482.59 [Amended]
0
6. Amend Sec. 482.59 in paragraph (c)(3) by correcting the word
``biannual'' to read ``biennial''.
PART 485--CONDITIONS OF PARTICIPATION FOR CRITICAL ACCESS HOSPITALS
0
7. The authority citation for part 485 continues to read as follows:
Authority: 42 U.S.C. 1302 and 1395(hh).
Sec. 485.649 [Amended]
0
8. Amend Sec. 485.649 in paragraph (c)(3) by correcting the word
``biannual'' to read ``biennial''.
Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2025-00081 Filed 1-8-25; 8:45 am]
BILLING CODE 4120-01-P