80_FR_51668 80 FR 51504 - Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services; Corrections

80 FR 51504 - Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services; Corrections

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 80, Issue 164 (August 25, 2015)

Page Range51504-51506
FR Document2015-20994

This document corrects technical and typographical errors that appeared in the proposed rule published in the July 14, 2015 Federal Register entitled ``Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services.''

Federal Register, Volume 80 Issue 164 (Tuesday, August 25, 2015)
[Federal Register Volume 80, Number 164 (Tuesday, August 25, 2015)]
[Proposed Rules]
[Pages 51504-51506]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-20994]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 510

[CMS-5516-CN]
RIN 0938-AS64


Medicare Program; Comprehensive Care for Joint Replacement 
Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint 
Replacement Services; Corrections

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

ACTION: Proposed rule; correction.

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

SUMMARY: This document corrects technical and typographical errors that 
appeared in the proposed rule published in the July 14, 2015 Federal 
Register entitled ``Medicare Program; Comprehensive Care for Joint 
Replacement Payment Model for Acute Care Hospitals Furnishing Lower 
Extremity Joint Replacement Services.''

DATES: The comment due date for the proposed rule published in the 
Federal Register on July 14, 2015 (80 FR 41198) remains September 8, 
2015.

FOR FURTHER INFORMATION CONTACT:
    Claire Schreiber, [email protected], (410) 786-8939.
    Gabriel Scott, [email protected], (410) 786-3928.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2015-17190 of July 14, 2015 (80 FR 41198), there were a 
number of technical and typographical errors that are identified and 
corrected in the Correction of Errors section of this document.

II. Summary of Errors

    On page 41210, in our discussion of the factors considered but not 
used in creating proposed strata, we inadvertently omitted a term and 
used an incorrect term.
    On pages 41212 and 41269, we made errors in referencing the name of 
the Comprehensive Care for Joint Replacement (CCJR) model.
    On pages 41223 and 41224, in our discussion of the proposed pricing 
adjustment for high payment episodes, we made errors in describing the 
distribution model presented in Figure 2.
    On page 41234, in our discussion of the proposed combination of 
CCJR episodes anchored by Medical Severity Diagnosis-Related Groups 
(MS-DRGs) 469 and 470, we made an error in the unpooled hospital-
specific historical average payments calculation for MS-DRG 469 
anchored target prices.
    On pages 41235 and 41236, in our discussion of the proposed 
approach to combine pricing features, we made an error in the placement 
and the language of a sentence that was part of the bulleted text.
    On page 41240, in the discussion of the criteria for applicable 
hospitals and performance scoring, we made errors in stating the 
percentage of eligible elective primary total hip arthroplasty/total 
knee arthoplasty (THA/TKA) patients for which hospitals must submit 
data and the timeframe for the submission of data.
    On pages 41241 and 41242, we made errors in stating a National 
Quality Forum (NQF) measure number.
    On page 41250, in the discussion of the accounting for CCJR 
reconciliation payments and repayments in other models and programs, we 
inadvertently omitted a word.
    On page 41251, in the discussion of the accounting for per 
beneficiary per month (PBPM) payments in the episode definition, we 
made an error in stating the total number of models with PBPMs.
    On pages 41268, 41270, and 41278, we made typographical errors in 
footnotes 42, 43, and 55, respectively. These errors include omitting 
the title of the article that was referenced, omitting the text of the 
footnote, and inadvertently adding a reference to a footnote.
    On page 41283, in the discussion of ``Case Mix Adjustment,'' we 
inadvertently omitted a term.
    On pages 41242, 41281, and 41284, we made technical and 
typographical errors in using the acronyms ``CCJR-,'' ``HCAHPS,'' and 
``THA''.
    On page 41285, in our discussion of pre-operative assessments, we 
made errors in our designation of several bulleted paragraphs.
    On pages 41287 and 41288, Table 16, we made errors in the table 
formatting and omitted language that would identify the entries 
pertaining to the duration of the performance period.

III. Correction of Errors

    In FR Doc. 2015-17190 of July 14, 2015 (80 FR 41198), make the 
following corrections:
    1. On page 41210, first column, fifth full paragraph, lines 1 
through 3, the phrase ``these measures are proposed to be part of the 
selection stratus'' is corrected to read ``these measures are not 
proposed to be part of the selection strata''.

[[Page 51505]]

    2. On page 41212, lower half of the page, second column, first 
paragraph, lines 1 and 2, the phrase ``Coordinated Quality Care-Joint 
Replacement'' is corrected to read ``Comprehensive Care for Joint 
Replacement''.
    3. On page 41223, third column, last paragraph, lines 7 through 12, 
the sentence ``Similarly, we believe the BPCI distribution of Model 2 
90-day LEJR episode payment amounts as displayed in Figure 1 provides 
information that is relevant to policy development regarding CCJR 
episodes.'' is corrected to read ``Similarly, we believe the 
distribution of 90-day LEJR episode payment amounts utilizing the BPCI 
Model 2 episode definition as displayed in Figure 2 provides 
information that is relevant to policy development regarding CCJR 
episodes.''.
    4. On page 41224, top of the page, in the figure heading (Figure 
2), the heading ``FIGURE 2: ESTIMATED NATIONAL DISTRIBUTION of BPCI 
MODEL 2 LEJR 90-day EPISODE PAYMENT AMOUNTS'' is corrected to read 
``FIGURE 2: ESTIMATED NATIONAL DISTRIBUTION OF LEJR 90-day EPISODE 
PAYMENT AMOUNTS''.
    5. On page 41234, first column, first full paragraph, line 11, the 
phrase ``hospital weight'' is corrected to read ``anchor factor''.
    6. On page 41235, third column--
    a. Sixth bulleted paragraph, last line, the phrase ``the previous 
step.'' is corrected to read ``the previous step. We have posted 
region-specific historical average episode payments on the CCJR 
proposed rule Web site at http://innovation.cms.gov/initiatives/ccjr/
.''.
    b. Last bulleted paragraph, lines 12 through 13, and page 41236, 
first column, first partial paragraph, lines 1 through 3, the sentence, 
``We have posted region-specific pooled historical average episode 
payments on the CCJR proposed rule Web site at http://innovation.cms.gov/initiatives/ccjr/.'' is corrected by removing the 
sentence.
    7. On page 41240--
    a. Second column, last bulleted paragraph, line 3, the figure 
``70'' is corrected to read ``80''.
    b. Third column--
    (1) First full paragraph (bulleted), line 3, the phrase ``12 
month'' is corrected to read ``performance''.
    (2) Second full paragraph, line 30, the figure ``70'' is corrected 
to read ``80''.
    8. On page 41241--
    a. Top of the page, second column, first partial paragraph, line 
27, the parenthetical reference ``(NQF #1661)'' is corrected to read 
``(NQF #0166)''.
    b. Lower third of the page, in the table titled ``TABLE 8--QUALITY 
MEASURE WEIGHTS IN COMPOSITE QUALITY SCORE'', first column of the table 
(Quality measure), line 3, the parenthetical reference ``(NQF #1661)'' 
is corrected to read ``(NQF #0166)''.
    9. On page 41242, top third of the page, third column, first full 
paragraph, line 9--
    a. The acronym ``HCAPHS'' is corrected to read ``HCAHPS''.
    b. The parenthetical reference ``(NQF #1661)'' is corrected to read 
``(NQF #0166)''.
    10. On page 41250, third column, first full paragraph, line 12, the 
phrase ``to be able make'' is corrected to read ``to be able to make''.
    11. On page 41251, second column, first full paragraph, line 2, the 
phrase ``four existing models'' is corrected to read ``active models''.
    12. On page 41268, second column, last paragraph, the footnote 
(footnote 42), `` \42\ Naylor MD, Brooten D, Campbell R, Jacobsen BS, 
Mezey MD, Pauly MV, Schwartz JS. JAMA. 1999: 281(7): 613-620. doi:10/
1001/jama.281.7.613'' is corrected to read `` \42\ Naylor MD, Brooten 
D, Campbell R, Jacobsen BS, Mezey MD, Pauly MV, Schwartz JS. 
Comprehensive discharge planning and home follow-up of hospitalized 
elders: A randomized clinical trial. JAMA. 1999: 281(7): 613-620. 
doi:10/1001/jama.281.7.6136.''.
    13. On page 41269--
    a. Second column, second full paragraph, lines 28 and 29, the 
phrase ``Coordinated quality care-joint replacement model'' is 
corrected to read ``Comprehensive Care for Joint Replacement model''.
    b. Third column, first partial paragraph, lines 5 and 6, the phrase 
``Medicare-approved coordinated quality care-Joint Replacement model)'' 
is corrected to read ``Medicare-approved Comprehensive Care for Joint 
Replacement model)''.
    14. On page 41270, third column, following the last paragraph, is 
corrected by adding the following footnoted paragraph (Footnote 43):
    `` \43\ Telehealth in an Evolving Health Care Environment: Workshop 
Summary (2012). Available at: http://www.ic4n.org/wp-content/uploads/2014/06/IoM-Telehealth-2012-Workshop-Summary.pdf. Accessed on June 7, 
2015.''
    15. On page 41278, second column, third footnoted paragraph 
(Footnote 55) `` \55\ Soohoo NF, Farng E, Lieberman JR, Chambers L, 
Zingmond DS. Factors That Predict Short-term Complication Rates After 
Total Hip Arthroplasty. Clin Orthop Relat Res. Sep 2010; 468(9): 2363-
2371. Cram P, Vaughn-Sarrazin MS, Wolf B, Katz JN, Rosenthal GE. A 
comparison of total hip and knee replacement in specialty and general 
hospitals. J Bone Joint Surg Am. Aug 2007; 89(8): 1675-1684.'' is 
corrected to read `` \55\ Soohoo NF, Farng E, Lieberman JR, Chambers L, 
Zingmond DS. Factors that predict short-term complication rates after 
total hip arthroplasty. Clin Orthop Relat Res. Sep 2010; 468(9): 2363-
2371.''.
    16. On page 41281, second column, last partial paragraph, line 1, 
the phrase ``We note that CCJR--we chose to align'' is corrected to 
read ``We note that we chose to align''.
    17. On page 41283, first column, sixth bulleted paragraph, the 
phrase ``discharge and survey.'' is corrected to read ``discharge and 
survey completion.''.
    18. On page 41284--
    a. First column, first partial paragraph, line 44, the acronym 
``HCAPHS'' is corrected to read ``HCAHPS''.
    b. Second column, first partial paragraph, line 7, the phrase ``THA 
THA/TKA patient-reported'' is corrected to read ``THA/TKA patient-
reported''.
    19. On page 41285, second column, second bulleted paragraph--
    a. Line 17, the phrase ``--PROMIS'' is corrected to read ``++ 
PROMIS''.
    b. Line 29, the phrase ``--American Society'' is corrected to read 
``++ American Society''.
    c. Line 33, the phrase ``--Total painful'' is corrected to read 
``++ Total painful''.
    d. Line 34, the phrase ``--Quantified spinal'' is corrected to read 
``++ Quantified spinal''.
    20. On pages 41287 and 41288, the table titled ``TABLE 16--EXAMPLE 
OF POTENTIAL PERFORMANCE PERIODS FOR PRE- AND POST-OPERATIVE THA/TKA 
VOLUNTARY DATA SUBMISSION'' is corrected to read as follows:

[[Page 51506]]



Table 16--Example of Potential Performance Periods for Pre- and Post-Operative THA/TKA Voluntary Data Submission
----------------------------------------------------------------------------------------------------------------
                                               Duration of
                                                   the           Patient population         Requirements for
   CCJR Model year      Performance period     performance      eligible for THA/TKA       successful THA/TKA
                                                 period      voluntary data submission       voluntary data
                                                (months)                                      submission *
----------------------------------------------------------------------------------------------------------------
2016.................  April 1, 2016                      3  All patients undergoing    Submit
                        through June 30,                      elective primary THA/TKA   PRE[dash]operative data
                        2016.                                 procedures performed       on primary elective THA/
                                                              between April 1, 2016      TKA procedures for
                                                              and June 30, 2016.         >=80% of procedures
                                                                                         performed between April
                                                                                         1, 2016 and June 30,
                                                                                         2016.
2017.................  April 1, 2016                     15  All patients undergoing    Submit
                        through June 30,                      elective primary THA/TKA   POST[dash]operative
                        2016.                                 procedures performed       data on primary
                                                              between April 1, 2016      elective THA/TKA
                                                              and June 30, 2016.         procedures for >=80% of
                                                                                         procedures performed
                                                                                         between April 1, 2016
                                                                                         and June 30, 2016.
2017.................  July 1, 2016 through  ..............  All patients undergoing    Submit
                        June 30, 2017.                        elective primary THA/TKA   PRE[dash]operative data
                                                              procedures performed       on primary elective THA/
                                                              between July 1, 2016 and   TKA procedures for
                                                              June 30, 2017.             >=80% of procedures
                                                                                         performed between July
                                                                                         1, 2016 and June 30,
                                                                                         2017.
2018.................  July 1, 2016 through              24  All patients undergoing    Submit
                        June 30, 2017.                        elective primary THA/TKA   POST[dash]operative
                                                              procedures performed       data on primary
                                                              between July 1, 2016 and   elective THA/TKA
                                                              June 30, 2017.             procedures for >=80% of
                                                                                         procedures performed
                                                                                         between July 1, 2016
                                                                                         and June 30, 2017.
2018.................  July 1, 2017 through  ..............  All patients undergoing    Submit
                        June 30, 2018.                        elective primary THA/TKA   PRE[dash]operative data
                                                              procedures performed       on primary elective THA/
                                                              between July 1, 2017 and   TKA procedures for
                                                              June 30, 2018.             >=80% of procedures
                                                                                         performed between July
                                                                                         1, 2017 and June 30,
                                                                                         2018.
2019.................  July 1, 2017 through              24  All patients undergoing    Submit
                        June 30, 2018.                        elective primary THA/TKA   POST[dash]operative
                                                              procedures performed       data on primary
                                                              between July 1, 2017 and   elective THA/TKA
                                                              June 30, 2018.             procedures for >=80% of
                                                                                         procedures performed
                                                                                         between July 1, 2017
                                                                                         and June 30, 2018.
2019.................  July 1, 2018 through  ..............  All patients undergoing    Submit
                        June 30, 2019.                        elective primary THA/TKA   PRE[dash]operative data
                                                              procedures performed       on primary elective THA/
                                                              between July 1, 2018 and   TKA procedures for
                                                              June 30, 2019.             >=80% of procedures
                                                                                         performed between July
                                                                                         1, 2018 and June 30,
                                                                                         2019.
2020.................  July 1, 2018 through              24  All patients undergoing    Submit
                        June 30, 2019.                        elective primary THA/TKA   POST[dash]operative
                                                              procedures performed       data on primary
                                                              between July 1, 2018 and   elective THA/TKA
                                                              June 30, 2019.             procedures for >=80% of
                                                                                         procedures performed
                                                                                         between July 1, 2018
                                                                                         and June 30, 2019.
2020.................  July 1, 2019 through  ..............  All patients undergoing    Submit PRE-operative
                        June 30, 2020.                        elective primary THA/TKA   data on primary
                                                              procedures performed       elective THA/TKA
                                                              between July 1, 2019 and   procedures for >=80% of
                                                              June 30, 2020.             procedures performed
                                                                                         between July 1, 2019
                                                                                         and June 30, 2020.
----------------------------------------------------------------------------------------------------------------
* Requirements for determining successful submission of THA/TKA voluntary data are located in section
  III.D.3.a.(9). of this proposed rule.


    Dated: August 19, 2015.
Madhura Valverde,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2015-20994 Filed 8-21-15; 11:15 am]
 BILLING CODE 4120-01-P



                                                      51504                  Federal Register / Vol. 80, No. 164 / Tuesday, August 25, 2015 / Proposed Rules

                                                      in the Unfunded Mandates Reform Act                     DEPARTMENT OF HEALTH AND                              469 and 470, we made an error in the
                                                      of 1995 (Pub. L. 104–4);                                HUMAN SERVICES                                        unpooled hospital-specific historical
                                                         • does not have federalism                                                                                 average payments calculation for
                                                                                                              Centers for Medicare & Medicaid                       MS–DRG 469 anchored target prices.
                                                      implications as specified in Executive
                                                                                                              Services                                                 On pages 41235 and 41236, in our
                                                      Order 13132 (64 FR 43255, August 10,
                                                                                                                                                                    discussion of the proposed approach to
                                                      1999);                                                  42 CFR Part 510                                       combine pricing features, we made an
                                                         • is not an economically significant                                                                       error in the placement and the language
                                                                                                              [CMS–5516–CN]
                                                      regulatory action based on health or                                                                          of a sentence that was part of the
                                                      safety risks subject to Executive Order                 RIN 0938–AS64                                         bulleted text.
                                                      13045 (62 FR 19885, April 23, 1997);                                                                             On page 41240, in the discussion of
                                                                                                              Medicare Program; Comprehensive
                                                         • is not a significant regulatory action             Care for Joint Replacement Payment
                                                                                                                                                                    the criteria for applicable hospitals and
                                                      subject to Executive Order 13211 (66 FR                                                                       performance scoring, we made errors in
                                                                                                              Model for Acute Care Hospitals
                                                      28355, May 22, 2001);                                                                                         stating the percentage of eligible elective
                                                                                                              Furnishing Lower Extremity Joint
                                                                                                                                                                    primary total hip arthroplasty/total knee
                                                         • is not subject to requirements of                  Replacement Services; Corrections
                                                                                                                                                                    arthoplasty (THA/TKA) patients for
                                                      Section 12(d) of the National                                                                                 which hospitals must submit data and
                                                                                                              AGENCY:  Centers for Medicare &
                                                      Technology Transfer and Advancement                     Medicaid Services (CMS), HHS.                         the timeframe for the submission of
                                                      Act of 1995 (15 U.S.C. 272 note) because                                                                      data.
                                                                                                              ACTION: Proposed rule; correction.
                                                      application of those requirements would                                                                          On pages 41241 and 41242, we made
                                                      be inconsistent with the CAA; and                       SUMMARY:  This document corrects                      errors in stating a National Quality
                                                         • does not provide EPA with the                      technical and typographical errors that               Forum (NQF) measure number.
                                                      discretionary authority to address, as                  appeared in the proposed rule                            On page 41250, in the discussion of
                                                      appropriate, disproportionate human                     published in the July 14, 2015 Federal                the accounting for CCJR reconciliation
                                                      health or environmental effects, using                  Register entitled ‘‘Medicare Program;                 payments and repayments in other
                                                      practicable and legally permissible                     Comprehensive Care for Joint                          models and programs, we inadvertently
                                                      methods, under Executive Order 12898                    Replacement Payment Model for Acute                   omitted a word.
                                                      (59 FR 7629, February 16, 1994).                        Care Hospitals Furnishing Lower                          On page 41251, in the discussion of
                                                                                                              Extremity Joint Replacement Services.’’               the accounting for per beneficiary per
                                                         In addition, the SIP is not approved                                                                       month (PBPM) payments in the episode
                                                                                                              DATES: The comment due date for the
                                                      to apply on any Indian reservation land                 proposed rule published in the Federal                definition, we made an error in stating
                                                      or in any other area where EPA or an                    Register on July 14, 2015 (80 FR 41198)               the total number of models with PBPMs.
                                                      Indian tribe has demonstrated that a                    remains September 8, 2015.                               On pages 41268, 41270, and 41278,
                                                      tribe has jurisdiction. In those areas of                                                                     we made typographical errors in
                                                                                                              FOR FURTHER INFORMATION CONTACT:
                                                      Indian country, the proposed rule does                    Claire Schreiber, Claire.Schreiber@                 footnotes 42, 43, and 55, respectively.
                                                      not have tribal implications and will not               cms.hhs.gov, (410) 786–8939.                          These errors include omitting the title of
                                                      impose substantial direct costs on tribal                 Gabriel Scott, Gabriel.Scott@                       the article that was referenced, omitting
                                                      governments or preempt tribal law as                    cms.hhs.gov, (410) 786–3928.                          the text of the footnote, and
                                                      specified by Executive Order 13175 (65                  SUPPLEMENTARY INFORMATION:                            inadvertently adding a reference to a
                                                      FR 67249, November 9, 2000).                                                                                  footnote.
                                                                                                              I. Background                                            On page 41283, in the discussion of
                                                      List of Subjects in 40 CFR Part 52
                                                                                                                In FR Doc. 2015–17190 of July 14,                   ‘‘Case Mix Adjustment,’’ we
                                                        Environmental protection, Air                         2015 (80 FR 41198), there were a                      inadvertently omitted a term.
                                                      pollution control, Carbon monoxide,                     number of technical and typographical                    On pages 41242, 41281, and 41284,
                                                      Intergovernmental relations,                            errors that are identified and corrected              we made technical and typographical
                                                      Incorporation by reference, Lead,                       in the Correction of Errors section of                errors in using the acronyms ‘‘CCJR-,’’
                                                      Nitrogen dioxide, Ozone, Particulate                    this document.                                        ‘‘HCAHPS,’’ and ‘‘THA’’.
                                                      matter, Reporting and recordkeeping                                                                              On page 41285, in our discussion of
                                                                                                              II. Summary of Errors                                 pre-operative assessments, we made
                                                      requirements, Sulfur oxides, Volatile
                                                                                                                On page 41210, in our discussion of                 errors in our designation of several
                                                      organization compounds.
                                                                                                              the factors considered but not used in                bulleted paragraphs.
                                                         Authority: 42 U.S.C. 7401 et seq.                    creating proposed strata, we                             On pages 41287 and 41288, Table 16,
                                                        Dated: August 10, 2015.                               inadvertently omitted a term and used                 we made errors in the table formatting
                                                      Debra H. Thomas,                                        an incorrect term.                                    and omitted language that would
                                                                                                                On pages 41212 and 41269, we made                   identify the entries pertaining to the
                                                      Acting Regional Administrator, Region 8.
                                                                                                              errors in referencing the name of the                 duration of the performance period.
                                                      [FR Doc. 2015–20895 Filed 8–24–15; 8:45 am]             Comprehensive Care for Joint
                                                                                                                                                                    III. Correction of Errors
                                                      BILLING CODE 6560–50–P                                  Replacement (CCJR) model.
                                                                                                                On pages 41223 and 41224, in our                       In FR Doc. 2015–17190 of July 14,
asabaliauskas on DSK5VPTVN1PROD with PROPOSALS




                                                                                                              discussion of the proposed pricing                    2015 (80 FR 41198), make the following
                                                                                                              adjustment for high payment episodes,                 corrections:
                                                                                                              we made errors in describing the                         1. On page 41210, first column, fifth
                                                                                                              distribution model presented in                       full paragraph, lines 1 through 3, the
                                                                                                              Figure 2.                                             phrase ‘‘these measures are proposed to
                                                                                                                On page 41234, in our discussion of                 be part of the selection stratus’’ is
                                                                                                              the proposed combination of CCJR                      corrected to read ‘‘these measures are
                                                                                                              episodes anchored by Medical Severity                 not proposed to be part of the selection
                                                                                                              Diagnosis-Related Groups (MS–DRGs)                    strata’’.


                                                 VerDate Sep<11>2014   16:31 Aug 24, 2015   Jkt 235001   PO 00000   Frm 00024   Fmt 4702   Sfmt 4702   E:\FR\FM\25AUP1.SGM   25AUP1


                                                                             Federal Register / Vol. 80, No. 164 / Tuesday, August 25, 2015 / Proposed Rules                                          51505

                                                         2. On page 41212, lower half of the                      a. Top of the page, second column,                2014/06/IoM-Telehealth-2012-
                                                      page, second column, first paragraph,                   first partial paragraph, line 27, the                 Workshop-Summary.pdf. Accessed on
                                                      lines 1 and 2, the phrase ‘‘Coordinated                 parenthetical reference ‘‘(NQF #1661)’’               June 7, 2015.’’
                                                      Quality Care-Joint Replacement’’ is                     is corrected to read ‘‘(NQF #0166)’’.                     15. On page 41278, second column,
                                                      corrected to read ‘‘Comprehensive Care                      b. Lower third of the page, in the table          third footnoted paragraph (Footnote 55)
                                                      for Joint Replacement’’.                                titled ‘‘TABLE 8—QUALITY MEASURE                      ‘‘ 55 Soohoo NF, Farng E, Lieberman JR,
                                                         3. On page 41223, third column, last                 WEIGHTS IN COMPOSITE QUALITY                          Chambers L, Zingmond DS. Factors That
                                                      paragraph, lines 7 through 12, the                      SCORE’’, first column of the table                    Predict Short-term Complication Rates
                                                      sentence ‘‘Similarly, we believe the                    (Quality measure), line 3, the                        After Total Hip Arthroplasty. Clin
                                                      BPCI distribution of Model 2 90-day                     parenthetical reference ‘‘(NQF #1661)’’               Orthop Relat Res. Sep 2010; 468(9):
                                                      LEJR episode payment amounts as                         is corrected to read ‘‘(NQF #0166)’’.                 2363–2371. Cram P, Vaughn-Sarrazin
                                                      displayed in Figure 1 provides                              9. On page 41242, top third of the                MS, Wolf B, Katz JN, Rosenthal GE. A
                                                      information that is relevant to policy                  page, third column, first full paragraph,             comparison of total hip and knee
                                                      development regarding CCJR episodes.’’                  line 9—                                               replacement in specialty and general
                                                      is corrected to read ‘‘Similarly, we                        a. The acronym ‘‘HCAPHS’’ is                      hospitals. J Bone Joint Surg Am. Aug
                                                      believe the distribution of 90-day LEJR                 corrected to read ‘‘HCAHPS’’.                         2007; 89(8): 1675–1684.’’ is corrected to
                                                      episode payment amounts utilizing the                       b. The parenthetical reference ‘‘(NQF             read ‘‘ 55 Soohoo NF, Farng E, Lieberman
                                                      BPCI Model 2 episode definition as                      #1661)’’ is corrected to read ‘‘(NQF                  JR, Chambers L, Zingmond DS. Factors
                                                      displayed in Figure 2 provides                          #0166)’’.                                             that predict short-term complication
                                                      information that is relevant to policy                      10. On page 41250, third column, first            rates after total hip arthroplasty. Clin
                                                      development regarding CCJR episodes.’’.                 full paragraph, line 12, the phrase ‘‘to be           Orthop Relat Res. Sep 2010; 468(9):
                                                         4. On page 41224, top of the page, in                able make’’ is corrected to read ‘‘to be              2363–2371.’’.
                                                      the figure heading (Figure 2), the                      able to make’’.
                                                                                                                  11. On page 41251, second column,                     16. On page 41281, second column,
                                                      heading ‘‘FIGURE 2: ESTIMATED                                                                                 last partial paragraph, line 1, the phrase
                                                      NATIONAL DISTRIBUTION of BPCI                           first full paragraph, line 2, the phrase
                                                                                                              ‘‘four existing models’’ is corrected to              ‘‘We note that CCJR—we chose to align’’
                                                      MODEL 2 LEJR 90-day EPISODE                                                                                   is corrected to read ‘‘We note that we
                                                      PAYMENT AMOUNTS’’ is corrected to                       read ‘‘active models’’.
                                                                                                                  12. On page 41268, second column,                 chose to align’’.
                                                      read ‘‘FIGURE 2: ESTIMATED
                                                                                                              last paragraph, the footnote (footnote                    17. On page 41283, first column, sixth
                                                      NATIONAL DISTRIBUTION OF LEJR
                                                                                                              42), ‘‘ 42 Naylor MD, Brooten D,                      bulleted paragraph, the phrase
                                                      90-day EPISODE PAYMENT
                                                                                                              Campbell R, Jacobsen BS, Mezey MD,                    ‘‘discharge and survey.’’ is corrected to
                                                      AMOUNTS’’.
                                                                                                              Pauly MV, Schwartz JS. JAMA. 1999:                    read ‘‘discharge and survey
                                                         5. On page 41234, first column, first
                                                                                                              281(7): 613–620. doi:10/1001/                         completion.’’.
                                                      full paragraph, line 11, the phrase
                                                      ‘‘hospital weight’’ is corrected to read                jama.281.7.613’’ is corrected to read                     18. On page 41284—
                                                      ‘‘anchor factor’’.                                      ‘‘ 42 Naylor MD, Brooten D, Campbell R,                   a. First column, first partial
                                                         6. On page 41235, third column—                      Jacobsen BS, Mezey MD, Pauly MV,                      paragraph, line 44, the acronym
                                                         a. Sixth bulleted paragraph, last line,              Schwartz JS. Comprehensive discharge                  ‘‘HCAPHS’’ is corrected to read
                                                      the phrase ‘‘the previous step.’’ is                    planning and home follow-up of                        ‘‘HCAHPS’’.
                                                      corrected to read ‘‘the previous step. We               hospitalized elders: A randomized                         b. Second column, first partial
                                                      have posted region-specific historical                  clinical trial. JAMA. 1999: 281(7): 613–              paragraph, line 7, the phrase ‘‘THA
                                                      average episode payments on the CCJR                    620. doi:10/1001/jama.281.7.6136.’’.                  THA/TKA patient-reported’’ is corrected
                                                      proposed rule Web site at http://                           13. On page 41269—                                to read ‘‘THA/TKA patient-reported’’.
                                                      innovation.cms.gov/initiatives/ccjr/.’’.                    a. Second column, second full                         19. On page 41285, second column,
                                                         b. Last bulleted paragraph, lines 12                 paragraph, lines 28 and 29, the phrase                second bulleted paragraph—
                                                      through 13, and page 41236, first                       ‘‘Coordinated quality care-joint                          a. Line 17, the phrase ‘‘—PROMIS’’ is
                                                      column, first partial paragraph, lines 1                replacement model’’ is corrected to read              corrected to read ‘‘++ PROMIS’’.
                                                      through 3, the sentence, ‘‘We have                      ‘‘Comprehensive Care for Joint
                                                                                                                                                                        b. Line 29, the phrase ‘‘—American
                                                      posted region-specific pooled historical                Replacement model’’.
                                                                                                                  b. Third column, first partial                    Society’’ is corrected to read ‘‘++
                                                      average episode payments on the CCJR                                                                          American Society’’.
                                                      proposed rule Web site at http://                       paragraph, lines 5 and 6, the phrase
                                                                                                              ‘‘Medicare-approved coordinated                           c. Line 33, the phrase ‘‘—Total
                                                      innovation.cms.gov/initiatives/ccjr/.’’ is
                                                                                                              quality care-Joint Replacement model)’’               painful’’ is corrected to read ‘‘++ Total
                                                      corrected by removing the sentence.
                                                                                                              is corrected to read ‘‘Medicare-approved              painful’’.
                                                         7. On page 41240—
                                                         a. Second column, last bulleted                      Comprehensive Care for Joint                              d. Line 34, the phrase ‘‘—Quantified
                                                      paragraph, line 3, the figure ‘‘70’’ is                 Replacement model)’’.                                 spinal’’ is corrected to read ‘‘++
                                                      corrected to read ‘‘80’’.                                   14. On page 41270, third column,                  Quantified spinal’’.
                                                         b. Third column—                                     following the last paragraph, is                          20. On pages 41287 and 41288, the
                                                         (1) First full paragraph (bulleted), line            corrected by adding the following                     table titled ‘‘TABLE 16—EXAMPLE OF
                                                      3, the phrase ‘‘12 month’’ is corrected to              footnoted paragraph (Footnote 43):                    POTENTIAL PERFORMANCE PERIODS
                                                                                                                  ‘‘ 43 Telehealth in an Evolving Health            FOR PRE- AND POST-OPERATIVE
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                                                      read ‘‘performance’’.
                                                         (2) Second full paragraph, line 30, the              Care Environment: Workshop Summary                    THA/TKA VOLUNTARY DATA
                                                      figure ‘‘70’’ is corrected to read ‘‘80’’.              (2012). Available at: http://                         SUBMISSION’’ is corrected to read as
                                                         8. On page 41241—                                    www.ic4n.org/wp-content/uploads/                      follows:




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                                                      51506                       Federal Register / Vol. 80, No. 164 / Tuesday, August 25, 2015 / Proposed Rules

                                                         TABLE 16—EXAMPLE OF POTENTIAL PERFORMANCE PERIODS FOR PRE- AND POST-OPERATIVE THA/TKA VOLUNTARY
                                                                                                 DATA SUBMISSION
                                                                                                         Duration of the
                                                       CCJR Model                                         performance                Patient population eligible for THA/TKA           Requirements for successful THA/TKA
                                                                              Performance period
                                                          year                                               period                        voluntary data submission                        voluntary data submission *
                                                                                                           (months)

                                                      2016 ..............     April 1, 2016 through                            3    All patients undergoing elective primary      Submit PRE-operative data on primary
                                                                                June 30, 2016.                                        THA/TKA procedures performed be-              elective THA/TKA procedures for ≥80%
                                                                                                                                      tween April 1, 2016 and June 30, 2016.        of procedures performed between April
                                                                                                                                                                                    1, 2016 and June 30, 2016.
                                                      2017 ..............     April 1, 2016 through                          15     All patients undergoing elective primary      Submit POST-operative data on primary
                                                                                June 30, 2016.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween April 1, 2016 and June 30, 2016.       of procedures performed between April
                                                                                                                                                                                    1, 2016 and June 30, 2016.
                                                      2017 ..............     July 1, 2016 through       ........................   All patients undergoing elective primary      Submit PRE-operative data on primary
                                                                                June 30, 2017.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2016 and June 30, 2017.        of procedures performed between July
                                                                                                                                                                                    1, 2016 and June 30, 2017.
                                                      2018 ..............     July 1, 2016 through                           24     All patients undergoing elective primary      Submit POST-operative data on primary
                                                                                June 30, 2017.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2016 and June 30, 2017.        of procedures performed between July
                                                                                                                                                                                    1, 2016 and June 30, 2017.
                                                      2018 ..............     July 1, 2017 through       ........................   All patients undergoing elective primary      Submit PRE-operative data on primary
                                                                                June 30, 2018.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2017 and June 30, 2018.        of procedures performed between July
                                                                                                                                                                                    1, 2017 and June 30, 2018.
                                                      2019 ..............     July 1, 2017 through                           24     All patients undergoing elective primary      Submit POST-operative data on primary
                                                                                June 30, 2018.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2017 and June 30, 2018.        of procedures performed between July
                                                                                                                                                                                    1, 2017 and June 30, 2018.
                                                      2019 ..............     July 1, 2018 through       ........................   All patients undergoing elective primary      Submit PRE-operative data on primary
                                                                                June 30, 2019.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2018 and June 30, 2019.        of procedures performed between July
                                                                                                                                                                                    1, 2018 and June 30, 2019.
                                                      2020 ..............     July 1, 2018 through                           24     All patients undergoing elective primary      Submit POST-operative data on primary
                                                                                June 30, 2019.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2018 and June 30, 2019.        of procedures performed between July
                                                                                                                                                                                    1, 2018 and June 30, 2019.
                                                      2020 ..............     July 1, 2019 through       ........................   All patients undergoing elective primary      Submit PRE-operative data on primary
                                                                                June 30, 2020.                                         THA/TKA procedures performed be-             elective THA/TKA procedures for ≥80%
                                                                                                                                       tween July 1, 2019 and June 30, 2020.        of procedures performed between July
                                                                                                                                                                                    1, 2019 and June 30, 2020.
                                                         * Requirements for determining successful submission of THA/TKA voluntary data are located in section III.D.3.a.(9). of this proposed rule.


                                                        Dated: August 19, 2015.                                       SUMMARY:   We, the U.S. Fish and                        October 26, 2015. Please note that
                                                      Madhura Valverde,                                               Wildlife Service (Service), request                     comments submitted electronically
                                                      Executive Secretary to the Department,                          public comment in regard to our                         using the Federal eRulemaking Portal
                                                      Department of Health and Human Services.                        designation of critical habitat for the                 (see ADDRESSES) must be received by
                                                      [FR Doc. 2015–20994 Filed 8–21–15; 11:15 am]                    marbled murrelet (Brachyramphus                         11:59 p.m. Eastern Time on the closing
                                                      BILLING CODE 4120–01–P                                          marmoratus) under the Endangered                        date. Any comments that we receive
                                                                                                                      Species Act of 1973, as amended (Act).                  after the closing date may not be
                                                                                                                      The current designation includes                        considered in the final determination.
                                                      DEPARTMENT OF THE INTERIOR                                      approximately 3,698,100 acres                           ADDRESSES: Comment submission: You
                                                                                                                      (1,497,000 hectares) of critical habitat in             may submit written comments by one of
                                                      Fish and Wildlife Service                                       the States of Washington, Oregon, and                   the following methods:
                                                                                                                      California. We are reconsidering this                      (1) Electronically: Go to the Federal
                                                      50 CFR Part 17                                                  designation for the purpose of assessing                eRulemaking Portal: http://
                                                                                                                      whether all of the designated areas meet                www.regulations.gov. In the Search box,
                                                      [Docket No. FWS–R1–ES–2015–                                     the statutory definition of critical
                                                      0070;4500030114]                                                                                                        enter FWS–R1–ES–2015–0070, which is
                                                                                                                      habitat. Because our proposed                           the docket number for this rulemaking.
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                                                      RIN 1018–BA91                                                   determination is that all areas currently               Then, in the Search panel on the left
                                                                                                                      designated do meet the statutory                        side of the screen, under the Document
                                                      Endangered and Threatened Wildlife                              definition, we are not proposing any                    Type heading, click on the Proposed
                                                      and Plants; Determination of Critical                           changes to the boundaries of the specific               Rules link to locate this document. You
                                                      Habitat for the Marbled Murrelet                                areas identified as critical habitat at this            may submit a comment by clicking on
                                                                                                                      time. We seek public comment on our                     ‘‘Comment Now!’’
                                                      AGENCY:   Fish and Wildlife Service,
                                                                                                                      proposed determination.                                    (2) By hard copy: Submit by U.S. mail
                                                      Interior.
                                                                                                                      DATES: We will consider comments                        or hand-delivery to: Public Comments
                                                      ACTION: Proposed rule.
                                                                                                                      received or postmarked on or before                     Processing, Attn: FWS–R1–ES–2015–


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Document Created: 2018-02-23 11:02:54
Document Modified: 2018-02-23 11:02:54
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionProposed rule; correction.
DatesThe comment due date for the proposed rule published in the Federal Register on July 14, 2015 (80 FR 41198) remains September 8, 2015.
ContactClaire Schreiber, [email protected], (410) 786-8939.
FR Citation80 FR 51504 
RIN Number0938-AS64

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