81_FR_11492 81 FR 11449 - Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services; Corrections and Correcting Amendments

81 FR 11449 - Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services; Corrections and Correcting Amendments

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

Federal Register Volume 81, Issue 43 (March 4, 2016)

Page Range11449-11451
FR Document2016-04786

In the November 24, 2015 Federal Register (80 FR 73274), we published a final rule to implement a new Medicare Part A and B payment model under section 1115A of the Social Security Act, called the Comprehensive Care for Joint Replacement (CJR) model, in which acute care hospitals in certain selected geographic areas will receive retrospective bundled payments for episodes of care for lower extremity joint replacement (LEJR) or reattachment of a lower extremity. The effective date was January 15, 2016. This correcting amendment corrects a limited number of technical and typographical errors identified in the November 24, 2015 final rule.

Federal Register, Volume 81 Issue 43 (Friday, March 4, 2016)
[Federal Register Volume 81, Number 43 (Friday, March 4, 2016)]
[Rules and Regulations]
[Pages 11449-11451]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-04786]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 510

[CMS-5516-F2]
RIN-0938-AS64


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

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

ACTION: Final rule; correction and correcting amendments.

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

SUMMARY: In the November 24, 2015 Federal Register (80 FR 73274), we 
published a final rule to implement a new Medicare Part A and B payment 
model under section 1115A of the Social Security Act, called the 
Comprehensive Care for Joint Replacement (CJR) model, in which acute 
care hospitals in certain selected geographic areas will receive 
retrospective bundled payments for episodes of care for lower extremity 
joint replacement (LEJR) or reattachment of a lower extremity. The 
effective date was January 15, 2016. This correcting amendment corrects 
a limited number of technical and typographical errors identified in 
the November 24, 2015 final rule.

DATES: This correcting amendment is effective March 4, 2016.

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

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2015-29438 of November 24, 2015 (80 FR 73274), the final 
rule

[[Page 11450]]

entitled ``Comprehensive Care for Joint Replacement Payment Model for 
Acute Care Hospitals Furnishing Lower Extremity Joint Replacement 
Services'' there were a number of technical and typographical errors 
that are identified and corrected in this correcting amendment. The 
provisions in this correcting amendment are effective as if they had 
been included in the final rule appearing in the November 24, 2015 
Federal Register.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On pages 73274 and 73282, we made an error in identifying the 
acronym ``MS-DRG''.
    On pages 73289, 73335, 73412, 73526, and 73528, we made inadvertent 
typographical errors which included the omission and addition of words, 
symbols, and lines of text.
    On pages 73324, 73381, and 73535, we made typographical errors in 
the Medicare Severity Diagnosis Related Group (MS-DRG) and National 
Quality Forum (NQF) numbers.
    On page 73324, we made typographical and grammatical errors when 
specifying several regulatory citations.
    On pages 73338, 73355, 73357, and 73358, in our discussion of the 
``Episode Price Setting Methodology'', we implied that the calculation 
of prospective target prices will incorporate the effective discount 
percentage determined by quality performance under the model. We 
clarify that target prices will be determined prospectively using a 3 
percent discount percentage, and hospitals may experience a different 
effective discount percentage at reconciliation due to quality.
    On page 73362, in our discussion of the ``Methodology To Determine 
Performance on the Quality Measures'', we made an error in the data 
submission requirements for the percentage of the eligible elective 
primary THA/TKA patients needed.

B. Summary of Errors in the Regulations Text

    On page 73543, in the regulations text for Sec.  510.300, we 
erroneously included a paragraph regarding adjustments for quality 
performance (paragraph (a)(4)). We note that as specified in the final 
rule, target prices will be determined prospectively using a 3 percent 
discount percentage, and hospitals may experience a different effective 
discount percentage at reconciliation due to quality. To correct this 
error, we have removed paragraph (a)(4) and renumbered the subsequent 
paragraph (that is, the current paragraph (a)(5)) .
    On page 73544, in the regulation text at Sec.  510.300(c)(2) 
(Determination of episode target prices) we inadvertently omitted the 
discount factor for repayment amounts in program years (PYs) 4 and 5. 
To correct this error, we have added a paragraph (c)(2)(iii).
    On page 73549, in the regulation text at Sec.  510.305, we made a 
cross-referencing error.
    The corrections to the errors summarized in this section appear in 
the regulations text of this correcting amendment.

III. Waiver of Proposed Rulemaking, 60-Day Comment Period, and Delay in 
Effective Date

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), 
the agency is required to publish a notice of the proposed rule 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 rule 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 the agency includes a statement of support.
    We believe that this document does not constitute a rulemaking that 
would be subject to these requirements. This document corrects 
technical and typographic errors in the preamble and regulation text 
included in the Medicare Program; Comprehensive Care for Joint 
Replacement Payment Model for Acute Care Hospitals Furnishing Lower 
Extremity Joint Replacement Services (80 FR 73274). The corrections 
contained in this document are consistent with, and do not make 
substantive changes to, the policies that were adopted subject to 
notice and comment procedures in the final rule. As a result, the 
corrections made through this document are intended to ensure that the 
Medicare Program; Comprehensive Care for Joint Replacement Payment 
Model for Acute Care Hospitals Furnishing Lower Extremity Joint 
Replacement Services final rule accurately reflects the policies 
adopted in that rule. In addition, even if this were a rulemaking to 
which the notice and comment procedures and delayed effective date 
requirements applied, we find that there is good cause to waive such 
requirements. Undertaking further notice and comment procedures to 
incorporate the corrections in this document into the final rule or 
delaying the effective date would be contrary to the public interest 
because it is in the public's interest for the CJR model final rule to 
accurately reflect our policies as of the date they take effect and are 
applicable. Furthermore, such procedures would be unnecessary, as we 
are not altering our policies; rather, we are simply implementing 
correctly the policies that we previously proposed, received comment 
on, and subsequently finalized. This correcting document is intended 
solely to ensure that the Medicare Program; Comprehensive Care for 
Joint Replacement Payment Model for Acute Care Hospitals Furnishing 
Lower Extremity Joint Replacement Services final rule accurately 
reflects these policies. Therefore, we believe we have good cause to 
waive the notice and comment and effective date requirements.

IV. Correction of Errors in the Preamble

    In FR Doc. 2015-29438 of November 24, 2015 (80 FR 73274), make the 
following corrections:
    1. On page 73274, third column, line 18, the phrase ``MS-DRG 
Medical Severity Diagnosis-'' is corrected to read ``MS-DRG Medicare 
Severity Diagnosis-''.
    2. On page 73282, third column, last paragraph, lines 6 and 7, the 
phrase ``Medical Severity Diagnosis-Related Group (MS-DRG)'' is 
corrected to read ``Medicare Severity Diagnosis-Related Group (MS-
DRG)''.
    3. On page 73289, third column, sixth full paragraph, line 2, the 
phrase ``that that'' is corrected to read ``that''.
    4. On page 73324--
    a. Second column, first full paragraph, lines 26 and 27, the phrase 
``MS-DRG 569'' is corrected to read ``MS-DRG 469''.
    b. Third column--

[[Page 11451]]

    (1) First partial paragraph, line 2, the phrase ``Sec.  
510.210(a)'' is corrected to read ``Sec.  510.210(a).''.
    (2) First full paragraph, line 3, the phrase ``Sec.  510.2 and'' is 
corrected to read ``Sec.  510.210.''
    (3) After the first full paragraph, the reference ``Sec.  
510.210(a).'' is corrected by removing the reference.
    5. On page 73335, first column, first paragraph, lines 4 and 5, the 
phrase ``this final,'' is corrected to read ``this final rule,''.
    6. On page 73338--
    a. First column, last partial paragraph, lines 23 and 24, the 
phrase ``will have 8 potential target prices'' is corrected to read 
``will have potential target prices at reconciliation''.
    b. Second column, first partial paragraph,
    (1) Lines 3 through 5, the phrase ``and between January 1 and 
September 30 vs. between October 1 and December 31 for performance 
years 2 through 5)'' is corrected to read ``and between January 1 and 
September 30 vs. between October 1 and December 31 for performance 
years 2 through 5), as well as different potential effective discount 
factors at reconciliation, which reflects quality performance, as 
discussed in section III.C.5.''.
    (2) Lines 6 through 16, the phrase ``Each participant hospital in 
performance years 2 and 3 will have 16 target prices for the same 
combinations in performance years 1, 4, and 5, but with one group of 8 
potential target prices for purposes of calculating reconciliation 
payments and another group of 8 potential target prices for purposes of 
determining hospital's responsibility for excess episode spending.'' is 
corrected to read ``Each participant hospital in performance years 2 
and 3 will have target prices for the same combinations as in 
performance years 1, 4, and 5, but with the potential for additional 
effective discount factors at reconciliation that reflect the reduced 
discount percentage for purposes of determining a hospital's 
responsibility for excess episode spending.''
    7. On page 73355--
    a. First column, third full paragraph, lines 6 and 7, the phrase 
``used to calculate its target prices.'' is corrected to read 
``experienced at reconciliation''.
    b. Third column, first full paragraph, lines 32 and 33, the phrase 
``discount factor for participant hospitals with'' is corrected to read 
``effective discount factor at reconciliation for participant hospitals 
with''.
    8. On page 73357, third column, last bulleted paragraph, lines 4 
through 7 and page 73358, first column, first partial paragraph, lines 
1 through 4, the phrase '' the appropriate effective discount factor 
that incorporates any quality incentive payment, as briefly described 
in section III.C.4.b.(9) of this final rule and more specifically 
detailed in the response to comments in section III.C.5. of this final 
rule and Tables 19, 20, and 21.'' is corrected to read ``a 3-percent 
discount factor, as described in section III.C.4.b.(9). of this final 
rule.''.
    9. On page 73381, second column, first full paragraph, line 38, the 
reference ``(NQF #0116)'' is corrected to read ``(NQF #0166)''.
    10. On page 73412, third column, first full paragraph, line 29, the 
phrase ``only be only'' is corrected to read ``only be''.
    11. On page 73526, third column, first full paragraph, lines 27 and 
28, the phrase ``as well as- on other methods'' is corrected to read 
``as well as other methods''.
    12. On page 73528, first column, second paragraph, line 1, the 
acronym ``CJR'' is corrected by removing the acronym.
    13. On page 73535, first column, fourth paragraph, line 14, the 
reference ``(NQF #0116)'' is corrected to read ``(NQF #0166)''.

List of Subjects for 42 CFR Part 510

    Administrative practice and procedure, Health facilities, Medicare, 
Reporting and recordkeeping requirements.

    Accordingly, 42 CFR chapter IV is corrected by making the following 
correcting amendments to part 510:

PART 510--COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL

0
1. The authority citation for part 510 continues to read as follows:

    Authority: Secs. 1102, 1115A, and 1871 of the Social Security 
Act (42 U.S.C. 1302, 1315(a), and 1395hh).


0
2. Section 510.300 is amended by--
0
a. Removing paragraph (a)(4).
0
b. Redesignating paragraph (a)(5) as new paragraph (a)(4).
0
c. Adding paragraph (c)(2)(iii).
    The addition reads as follows:


Sec.  510.300  Determination of episode target prices.

* * * * *
    (c) * * *
    (2) * * *
    (iii) In performance years 4 and 5, 3.0 percent.
* * * * *


Sec.  510.305  [Amended]

0
3. In Sec.  510.305, paragraph (f)(1)(iii) is amended by removing the 
cross-reference ``Sec.  510.410(b)(5)'' and adding in its place the 
cross-reference ``Sec.  510.410(b)''.

    Dated: February 24, 2016.
Wilma Robinson,
Deputy Executive, Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2016-04786 Filed 3-3-16; 8:45 am]
BILLING CODE 4120-01-P



                                                                     Federal Register / Vol. 81, No. 43 / Friday, March 4, 2016 / Rules and Regulations                                               11449

                                                IV. Correction of Errors                                CERTIFICATION CRITERIA FOR                            its place the phrase ‘‘for the following
                                                   In FR Doc. 2015–25595 of October 16,                 STAGE 3 IN 2018 AND SUBSEQUENT                        three clinical information sets:’’.
                                                                                                        YEARS, second column—                                 ■ b. In paragraph (d)(7)(ii)(B)(3)
                                                2015 (80 FR 62762), we are making the
                                                                                                          a. Line 17 from the bottom of the                   introductory text by removing the
                                                following corrections:
                                                   1. On page 62767, first column, first                column (Measure 1 of Objective 6), the                phrase ‘‘for two of the following three
                                                full paragraph, line 16, the phrase                     phrase ‘‘Measure 1: For 2017, during the              clinical information sets:’’ and adding in
                                                ‘‘continue to usher’’ is corrected to read              EHR reporting period’’ is corrected to                its place the phrase ‘‘for the following
                                                ‘‘continue to use’’.                                    read ‘‘Measure 1: During the EHR                      three clinical information sets:’’.
                                                   2. On page 62801, second column,                     reporting period’’.                                     Dated: February 25, 2016.
                                                first full paragraph, line 32, the phrase                 b. Line 6 from the bottom of the                    Wilma Robinson,
                                                ‘‘longer distinguishing between’’ is                    column (Measure 2 of Objective 6), the
                                                                                                                                                              Deputy Executive Secretary to the
                                                corrected to read ‘‘longer distinguish                  phrase ‘‘Measure 2: For 2017, more than               Department, Department of Health and
                                                between’’.                                              25%’’ is corrected to read ‘‘Measure 2:               Human Services.
                                                   3. On page 62806, third column, first                More than 25%’’.                                      [FR Doc. 2016–04785 Filed 3–3–16; 8:45 am]
                                                                                                          10. On page 62928, in TABLE 25—
                                                paragraph—                                                                                                    BILLING CODE 4120–01–P
                                                                                                        ESTIMATED ANNUAL INFORMATION
                                                   a. Lines 4 and 5, the phrase ‘‘must
                                                                                                        COLLECTION BURDEN, the first
                                                reasonable certainty’’ is corrected to
                                                                                                        column (Reg. Section)—                                DEPARTMENT OF HEALTH AND
                                                read ‘‘must have reasonable certainty’’.
                                                                                                          a. Line 1, the citation ‘‘§ 495.x’’ is
                                                   b. Line 9 and 10, the phrase ‘‘Instead,                                                                    HUMAN SERVICES
                                                                                                        corrected to read ‘‘§ 495.24’’
                                                r the referring provider must
                                                                                                          b. Line 3, the citation ‘‘§ 495.6’’ is              Centers for Medicare & Medicaid
                                                confirmation’’ is corrected to read
                                                                                                        corrected to read ‘‘§ 495.22’’.                       Services
                                                ‘‘Instead, the referring provider must
                                                obtain confirmation’’.                                  List of Subjects in 42 CFR Part 495
                                                   4. On page 62819, second column, last                                                                      42 CFR Part 510
                                                                                                          Administrative practice and
                                                paragraph, line 12, the phrase ‘‘a                      procedure, Electronic health records,                 [CMS–5516–F2]
                                                previous stages’’ is corrected to read ‘‘a              Health facilities, Health professions,
                                                previous stage’’.                                                                                             RIN–0938–AS64
                                                                                                        Health maintenance organizations
                                                   5. On page 62825, in TABLE 6—                        (HMO), Medicaid, Medicare, Penalties,                 Medicare Program; Comprehensive
                                                PUBLIC HEALTH REPORTING                                 Privacy, Reporting and recordkeeping                  Care for Joint Replacement Payment
                                                OBJECTIVE MEASURES FOR EPS,                             requirements.                                         Model for Acute Care Hospitals
                                                ELIGIBLE HOSPITALS, AND CAHS IN
                                                                                                          As noted in section II.B. of this                   Furnishing Lower Extremity Joint
                                                2015 THROUGH 2017, second column
                                                                                                        document, the Centers for Medicare &                  Replacement Services; Corrections
                                                (Measure specification column for
                                                                                                        Medicaid Services is making the                       and Correcting Amendments
                                                Measure 3) lines 5 and 6, the phrase
                                                                                                        following correcting amendments to 42
                                                ‘‘The EP, eligible hospital, or CAH is in                                                                     AGENCY:  Centers for Medicare &
                                                                                                        CFR part 495:
                                                active engagement with a public health                                                                        Medicaid Services (CMS), HHS.
                                                agency to submit data to a specialized                  PART 495—STANDARDS FOR THE                            ACTION: Final rule; correction and
                                                registry’’ is corrected to read ‘‘The EP,               ELECTRONIC HEALTH RECORD                              correcting amendments.
                                                eligible hospital, or CAH is in active                  TECHNOLOGY INCENTIVE PROGRAM
                                                engagement to submit data to a                                                                                SUMMARY:   In the November 24, 2015
                                                specialized registry’’.                                 ■ 1. The authority citation for part 495              Federal Register (80 FR 73274), we
                                                   6. On page 62834, first column, last                 continues to read as follows:                         published a final rule to implement a
                                                paragraph, line 22, the phrase                                                                                new Medicare Part A and B payment
                                                                                                          Authority: Secs. 1102 and 1871 of the
                                                ‘‘distinguishing between’’ is corrected to                                                                    model under section 1115A of the
                                                                                                        Social Security Act (42 U.S.C. 1302 and
                                                read ‘‘distinguish between’’.                           1395hh).                                              Social Security Act, called the
                                                   7. On page 62868, second column,                                                                           Comprehensive Care for Joint
                                                first full paragraph, lines 39 and 40, the              § 495.22    [Amended]                                 Replacement (CJR) model, in which
                                                phrase ‘‘section aII.B.2.b.x for further                ■  2. Section 495.22 is amended as                    acute care hospitals in certain selected
                                                information’’ is corrected to read                      follows:                                              geographic areas will receive
                                                ‘‘Objective 10 in section II.B.2.a. of this             ■ a. In paragraph (e)(3)(ii)(C)(3) by                 retrospective bundled payments for
                                                final rule for further information’’.                   removing the phrase ‘‘paragraph                       episodes of care for lower extremity
                                                   8. On page 62883, in Table 14—                       (e)(3)(ii)(A)(3) of this section in 2016’’            joint replacement (LEJR) or
                                                ELIGIBLE HOSPITAL/CAH                                   and adding in its place the phrase                    reattachment of a lower extremity. The
                                                OBJECTIVES, MEASURES, AND                               ‘‘paragraphs (e)(3)(ii)(A)(2) and                     effective date was January 15, 2016.
                                                CERTIFICATION CRITERIA FOR                              (e)(3)(ii)(A)(3) of this section in 2016.’’           This correcting amendment corrects a
                                                STAGE 3 IN 2017—CONTINUED,                              ■ b. In paragraph (e)(10)(ii)(C)(3)                   limited number of technical and
                                                second column—                                          introductory text by removing the                     typographical errors identified in the
                                                   a. Second set of paragraphs, second                  phrase ‘‘if the EP:’’ and adding in its               November 24, 2015 final rule.
                                                paragraph (Measure 1 of Objective 6),                   place the phrase ‘‘if the eligible hospital           DATES: This correcting amendment is
                                                line 2, the phrase ‘‘more than 10                       or CAH:’’.                                            effective March 4, 2016.
                                                percent’’ is corrected to read ‘‘more than                                                                    FOR FURTHER INFORMATION CONTACT:
jstallworth on DSK7TPTVN1PROD with RULES




                                                5 percent’’.                                            § 495.24    [Amended]                                 Claire Schreiber, cjr@cms.hhs.gov, (410)
                                                   b. Third set of paragraphs, last                     ■ 3. Section 495.24 is amended as                     786–8939.
                                                paragraph (Measure 2 of Objective 6)                    follows:                                              SUPPLEMENTARY INFORMATION:
                                                line 1, the phrase ‘‘more than 25%’’ is                 ■ a. In paragraph (d)(7)(i)(B)(3)
                                                corrected to read ‘‘more than 5%’’.                     introductory text by removing the                     I. Background
                                                   9. On page 62885, in TABLE 15—EP                     phrase ‘‘for two of the following three                  In FR Doc. 2015–29438 of November
                                                OBJECTIVES, MEASURES, AND                               clinical information sets:’’ and adding in            24, 2015 (80 FR 73274), the final rule


                                           VerDate Sep<11>2014   13:44 Mar 03, 2016   Jkt 238001   PO 00000   Frm 00043   Fmt 4700   Sfmt 4700   E:\FR\FM\04MRR1.SGM   04MRR1


                                                11450                Federal Register / Vol. 81, No. 43 / Friday, March 4, 2016 / Rules and Regulations

                                                entitled ‘‘Comprehensive Care for Joint                    On page 73544, in the regulation text              consistent with, and do not make
                                                Replacement Payment Model for Acute                     at § 510.300(c)(2) (Determination of                  substantive changes to, the policies that
                                                Care Hospitals Furnishing Lower                         episode target prices) we inadvertently               were adopted subject to notice and
                                                Extremity Joint Replacement Services’’                  omitted the discount factor for                       comment procedures in the final rule.
                                                there were a number of technical and                    repayment amounts in program years                    As a result, the corrections made
                                                typographical errors that are identified                (PYs) 4 and 5. To correct this error, we              through this document are intended to
                                                and corrected in this correcting                        have added a paragraph (c)(2)(iii).                   ensure that the Medicare Program;
                                                amendment. The provisions in this                          On page 73549, in the regulation text              Comprehensive Care for Joint
                                                correcting amendment are effective as if                at § 510.305, we made a cross-                        Replacement Payment Model for Acute
                                                they had been included in the final rule                referencing error.                                    Care Hospitals Furnishing Lower
                                                appearing in the November 24, 2015                         The corrections to the errors                      Extremity Joint Replacement Services
                                                Federal Register.                                       summarized in this section appear in                  final rule accurately reflects the policies
                                                                                                        the regulations text of this correcting               adopted in that rule. In addition, even
                                                II. Summary of Errors                                   amendment.                                            if this were a rulemaking to which the
                                                A. Summary of Errors in the Preamble                    III. Waiver of Proposed Rulemaking,                   notice and comment procedures and
                                                   On pages 73274 and 73282, we made                    60-Day Comment Period, and Delay in                   delayed effective date requirements
                                                an error in identifying the acronym                     Effective Date                                        applied, we find that there is good cause
                                                ‘‘MS–DRG’’.                                                                                                   to waive such requirements.
                                                                                                           Under 5 U.S.C. 553(b) of the                       Undertaking further notice and
                                                   On pages 73289, 73335, 73412, 73526,                 Administrative Procedure Act (APA),
                                                and 73528, we made inadvertent                                                                                comment procedures to incorporate the
                                                                                                        the agency is required to publish a                   corrections in this document into the
                                                typographical errors which included the                 notice of the proposed rule in the
                                                omission and addition of words,                                                                               final rule or delaying the effective date
                                                                                                        Federal Register before the provisions                would be contrary to the public interest
                                                symbols, and lines of text.                             of a rule take effect. Similarly, section
                                                   On pages 73324, 73381, and 73535,                                                                          because it is in the public’s interest for
                                                                                                        1871(b)(1) of the Act requires the                    the CJR model final rule to accurately
                                                we made typographical errors in the
                                                                                                        Secretary to provide for notice of the                reflect our policies as of the date they
                                                Medicare Severity Diagnosis Related
                                                                                                        proposed rule in the Federal Register                 take effect and are applicable.
                                                Group (MS–DRG) and National Quality
                                                                                                        and provide a period of not less than 60
                                                Forum (NQF) numbers.                                                                                          Furthermore, such procedures would be
                                                   On page 73324, we made                               days for public comment. In addition,
                                                                                                                                                              unnecessary, as we are not altering our
                                                typographical and grammatical errors                    section 553(d) of the APA, and section
                                                                                                                                                              policies; rather, we are simply
                                                when specifying several regulatory                      1871(e)(1)(B)(i) of the Act mandate a 30-
                                                                                                                                                              implementing correctly the policies that
                                                citations.                                              day delay in effective date after issuance
                                                                                                                                                              we previously proposed, received
                                                   On pages 73338, 73355, 73357, and                    or publication of a rule. Sections
                                                                                                                                                              comment on, and subsequently
                                                73358, in our discussion of the ‘‘Episode               553(b)(B) and 553(d)(3) of the APA
                                                                                                                                                              finalized. This correcting document is
                                                Price Setting Methodology’’, we implied                 provide for exceptions from the notice
                                                                                                                                                              intended solely to ensure that the
                                                that the calculation of prospective target              and comment and delay in effective date
                                                                                                                                                              Medicare Program; Comprehensive Care
                                                prices will incorporate the effective                   APA requirements; in cases in which
                                                                                                        these exceptions apply, sections                      for Joint Replacement Payment Model
                                                discount percentage determined by                                                                             for Acute Care Hospitals Furnishing
                                                quality performance under the model.                    1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the
                                                                                                        Act provide exceptions from the notice                Lower Extremity Joint Replacement
                                                We clarify that target prices will be                                                                         Services final rule accurately reflects
                                                determined prospectively using a 3                      and 60-day comment period and delay
                                                                                                        in effective date requirements of the Act             these policies. Therefore, we believe we
                                                percent discount percentage, and                                                                              have good cause to waive the notice and
                                                hospitals may experience a different                    as well. Section 553(b)(B) of the APA
                                                                                                        and section 1871(b)(2)(C) of the Act                  comment and effective date
                                                effective discount percentage at                                                                              requirements.
                                                reconciliation due to quality.                          authorize an agency to dispense with
                                                   On page 73362, in our discussion of                  normal rulemaking requirements for                    IV. Correction of Errors in the Preamble
                                                the ‘‘Methodology To Determine                          good cause if the agency makes a                         In FR Doc. 2015–29438 of November
                                                Performance on the Quality Measures’’,                  finding that the notice and comment                   24, 2015 (80 FR 73274), make the
                                                we made an error in the data submission                 process are impracticable, unnecessary,               following corrections:
                                                requirements for the percentage of the                  or contrary to the public interest. In                   1. On page 73274, third column, line
                                                eligible elective primary THA/TKA                       addition, both section 553(d)(3) of the               18, the phrase ‘‘MS–DRG Medical
                                                patients needed.                                        APA and section 1871(e)(1)(B)(ii) of the              Severity Diagnosis-’’ is corrected to read
                                                                                                        Act allow the agency to avoid the 30-                 ‘‘MS–DRG Medicare Severity
                                                B. Summary of Errors in the Regulations                 day delay in effective date where such
                                                Text                                                                                                          Diagnosis-’’.
                                                                                                        delay is contrary to the public interest                 2. On page 73282, third column, last
                                                   On page 73543, in the regulations text               and the agency includes a statement of                paragraph, lines 6 and 7, the phrase
                                                for § 510.300, we erroneously included                  support.                                              ‘‘Medical Severity Diagnosis-Related
                                                a paragraph regarding adjustments for                      We believe that this document does                 Group (MS–DRG)’’ is corrected to read
                                                quality performance (paragraph (a)(4)).                 not constitute a rulemaking that would                ‘‘Medicare Severity Diagnosis-Related
                                                We note that as specified in the final                  be subject to these requirements. This                Group (MS–DRG)’’.
                                                rule, target prices will be determined                  document corrects technical and                          3. On page 73289, third column, sixth
                                                prospectively using a 3 percent discount                typographic errors in the preamble and                full paragraph, line 2, the phrase ‘‘that
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                                                percentage, and hospitals may                           regulation text included in the Medicare              that’’ is corrected to read ‘‘that’’.
                                                experience a different effective discount               Program; Comprehensive Care for Joint                    4. On page 73324—
                                                percentage at reconciliation due to                     Replacement Payment Model for Acute                      a. Second column, first full paragraph,
                                                quality. To correct this error, we have                 Care Hospitals Furnishing Lower                       lines 26 and 27, the phrase ‘‘MS–DRG
                                                removed paragraph (a)(4) and                            Extremity Joint Replacement Services                  569’’ is corrected to read ‘‘MS–DRG
                                                renumbered the subsequent paragraph                     (80 FR 73274). The corrections                        469’’.
                                                (that is, the current paragraph (a)(5)) .               contained in this document are                           b. Third column—


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                                                                     Federal Register / Vol. 81, No. 43 / Friday, March 4, 2016 / Rules and Regulations                                               11451

                                                   (1) First partial paragraph, line 2, the             partial paragraph, lines 1 through 4, the             in its place the cross-reference
                                                phrase ‘‘§ 510.210(a)’’ is corrected to                 phrase ’’ the appropriate effective                   ‘‘§ 510.410(b)’’.
                                                read ‘‘§ 510.210(a).’’.                                 discount factor that incorporates any                   Dated: February 24, 2016.
                                                   (2) First full paragraph, line 3, the                quality incentive payment, as briefly                 Wilma Robinson,
                                                phrase ‘‘§ 510.2 and’’ is corrected to                  described in section III.C.4.b.(9) of this
                                                                                                                                                              Deputy Executive, Secretary to the
                                                read ‘‘§ 510.210.’’                                     final rule and more specifically detailed             Department, Department of Health and
                                                   (3) After the first full paragraph, the              in the response to comments in section                Human Services.
                                                reference ‘‘§ 510.210(a).’’ is corrected by             III.C.5. of this final rule and Tables 19,            [FR Doc. 2016–04786 Filed 3–3–16; 8:45 am]
                                                removing the reference.                                 20, and 21.’’ is corrected to read ‘‘a 3-
                                                   5. On page 73335, first column, first                                                                      BILLING CODE 4120–01–P
                                                                                                        percent discount factor, as described in
                                                paragraph, lines 4 and 5, the phrase                    section III.C.4.b.(9). of this final rule.’’.
                                                ‘‘this final,’’ is corrected to read ‘‘this                9. On page 73381, second column,
                                                final rule,’’.                                          first full paragraph, line 38, the                    DEPARTMENT OF COMMERCE
                                                   6. On page 73338—                                    reference ‘‘(NQF #0116)’’ is corrected to
                                                   a. First column, last partial paragraph,                                                                   National Oceanic and Atmospheric
                                                                                                        read ‘‘(NQF #0166)’’.
                                                lines 23 and 24, the phrase ‘‘will have                                                                       Administration
                                                                                                           10. On page 73412, third column, first
                                                8 potential target prices’’ is corrected to             full paragraph, line 29, the phrase ‘‘only
                                                read ‘‘will have potential target prices at                                                                   50 CFR Part 622
                                                                                                        be only’’ is corrected to read ‘‘only be’’.
                                                reconciliation’’.                                          11. On page 73526, third column, first             [Docket No. 101206604–1758–02]
                                                   b. Second column, first partial                      full paragraph, lines 27 and 28, the
                                                paragraph,                                                                                                    RIN 0648–XE480
                                                                                                        phrase ‘‘as well as- on other methods’’
                                                   (1) Lines 3 through 5, the phrase ‘‘and              is corrected to read ‘‘as well as other
                                                between January 1 and September 30 vs.                                                                        Fisheries of the Caribbean, Gulf of
                                                                                                        methods’’.                                            Mexico, and South Atlantic; Coastal
                                                between October 1 and December 31 for                      12. On page 73528, first column,
                                                performance years 2 through 5)’’ is                                                                           Migratory Pelagic Resources of the
                                                                                                        second paragraph, line 1, the acronym                 Gulf of Mexico and South Atlantic; Trip
                                                corrected to read ‘‘and between January                 ‘‘CJR’’ is corrected by removing the
                                                1 and September 30 vs. between October                                                                        Limit Increase
                                                                                                        acronym.
                                                1 and December 31 for performance                          13. On page 73535, first column,                   AGENCY:  National Marine Fisheries
                                                years 2 through 5), as well as different                fourth paragraph, line 14, the reference              Service (NMFS), National Oceanic and
                                                potential effective discount factors at                 ‘‘(NQF #0116)’’ is corrected to read                  Atmospheric Administration (NOAA),
                                                reconciliation, which reflects quality                  ‘‘(NQF #0166)’’.                                      Commerce.
                                                performance, as discussed in section                                                                          ACTION: Temporary rule; inseason trip
                                                III.C.5.’’.                                             List of Subjects for 42 CFR Part 510
                                                                                                                                                              limit increase.
                                                   (2) Lines 6 through 16, the phrase                     Administrative practice and
                                                ‘‘Each participant hospital in                          procedure, Health facilities, Medicare,               SUMMARY:    NMFS increases the trip limit
                                                performance years 2 and 3 will have 16                  Reporting and recordkeeping                           in the commercial sector for king
                                                target prices for the same combinations                 requirements.                                         mackerel in the Florida east coast
                                                in performance years 1, 4, and 5, but                     Accordingly, 42 CFR chapter IV is                   subzone to 75 fish per day in or from the
                                                with one group of 8 potential target                    corrected by making the following                     exclusive economic zone (EEZ). This
                                                prices for purposes of calculating                      correcting amendments to part 510:                    trip limit increase is necessary to
                                                reconciliation payments and another                                                                           maximize the socioeconomic benefits
                                                group of 8 potential target prices for                  PART 510—COMPREHENSIVE CARE                           associated with harvesting the king
                                                purposes of determining hospital’s                      FOR JOINT REPLACEMENT MODEL                           mackerel commercial quota.
                                                responsibility for excess episode                                                                             DATES: This rule is effective 12:01 a.m.,
                                                spending.’’ is corrected to read ‘‘Each                 ■ 1. The authority citation for part 510
                                                                                                        continues to read as follows:                         local time, March 1, 2016, through
                                                participant hospital in performance                                                                           March 31, 2016.
                                                years 2 and 3 will have target prices for                 Authority: Secs. 1102, 1115A, and 1871 of
                                                                                                                                                              FOR FURTHER INFORMATION CONTACT:
                                                the same combinations as in                             the Social Security Act (42 U.S.C. 1302,
                                                performance years 1, 4, and 5, but with                 1315(a), and 1395hh).                                 Susan Gerhart, NMFS Southeast
                                                the potential for additional effective                                                                        Regional Office, telephone: 727–824–
                                                                                                        ■ 2. Section 510.300 is amended by—                   5305, email: susan.gerhart@noaa.gov.
                                                discount factors at reconciliation that                 ■ a. Removing paragraph (a)(4).
                                                reflect the reduced discount percentage                                                                       SUPPLEMENTARY INFORMATION: The
                                                                                                        ■ b. Redesignating paragraph (a)(5) as
                                                for purposes of determining a hospital’s                new paragraph (a)(4).                                 fishery for coastal migratory pelagic fish
                                                responsibility for excess episode                       ■ c. Adding paragraph (c)(2)(iii).
                                                                                                                                                              (king mackerel, Spanish mackerel, and
                                                spending.’’                                               The addition reads as follows:                      cobia) is managed under the Fishery
                                                   7. On page 73355—                                                                                          Management Plan for the Coastal
                                                   a. First column, third full paragraph,               § 510.300    Determination of episode target          Migratory Pelagic Resources of the Gulf
                                                lines 6 and 7, the phrase ‘‘used to                     prices.                                               of Mexico and South Atlantic (FMP).
                                                calculate its target prices.’’ is corrected             *      *     *    *    *                              The FMP was prepared by the Gulf of
                                                to read ‘‘experienced at reconciliation’’.                (c) * * *                                           Mexico and South Atlantic Fishery
                                                   b. Third column, first full paragraph,                 (2) * * *                                           Management Councils (Councils) and is
                                                lines 32 and 33, the phrase ‘‘discount                    (iii) In performance years 4 and 5, 3.0             implemented by NMFS under the
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                                                factor for participant hospitals with’’ is              percent.                                              authority of the Magnuson-Stevens
                                                corrected to read ‘‘effective discount                  *      *     *    *    *                              Fishery Conservation and Management
                                                factor at reconciliation for participant                                                                      Act (Magnuson-Stevens Act) by
                                                                                                        § 510.305    [Amended]                                regulations at 50 CFR part 622.
                                                hospitals with’’.
                                                   8. On page 73357, third column, last                 ■ 3. In § 510.305, paragraph (f)(1)(iii) is              On January 30, 2012 (76 FR 82058,
                                                bulleted paragraph, lines 4 through 7                   amended by removing the cross-                        December 29, 2011), NMFS
                                                and page 73358, first column, first                     reference ‘‘§ 510.410(b)(5)’’ and adding              implemented a commercial quota of


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Document Created: 2018-02-02 15:05:37
Document Modified: 2018-02-02 15:05:37
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionFinal rule; correction and correcting amendments.
DatesThis correcting amendment is effective March 4, 2016.
ContactClaire Schreiber, [email protected], (410) 786-8939.
FR Citation81 FR 11449 
CFR AssociatedAdministrative Practice and Procedure; Health Facilities; Medicare and Reporting and Recordkeeping Requirements

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