83 FR 49832 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) Final Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting Program; Correction
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 83, Issue 192 (October 3, 2018)
Centers for Medicare & Medicaid Services
Federal Register Volume 83, Issue 192 (October 3, 2018)
| Page Range | 49832-49836 | |
| FR Document | 2018-21499 |
[Federal Register Volume 83, Number 192 (Wednesday, October 3, 2018)] [Rules and Regulations] [Pages 49832-49836] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-21499] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 411, 413, and 424 [CMS-1696-CN] RIN 0938-AT24 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) Final Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting Program; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final rule; correction. ----------------------------------------------------------------------- SUMMARY: This document corrects technical errors in the final rule that appeared in the August 8, 2018 Federal Register (83 FR 39162) entitled ``Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) Final Rule for FY 2019, SNF Value- Based Purchasing Program, and SNF Quality Reporting Program.'' DATES: The corrections in this document are effective October 1, 2018. FOR FURTHER INFORMATION CONTACT: John Kane, (410) 786-0557. SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 2018-16570 of August 8, 2018 (83 FR 39162 through 39290), there were a number of technical errors that are identified and corrected in Correction of Errors section (section IV. of this correction notice). The provisions in this correcting document are effective as if they had been included in the document that appeared in the August 8, 2018 Federal Register (83 FR 39162 through 39290) (hereinafter referred to as the FY 2019 SNF PPS final rule). Accordingly, the corrections in this document are effective October 1, 2018. II. Summary of Errors A. Summary of Errors in the Preamble On pages 39170 through 39172, 39222, 39285 and 39287, we made inadvertent technical errors. Specifically, in Tables 6 and 7 on pages 39170 through 39172 of the FY 2019 SNF PPS final rule, we made errors in copying values into the ``total rate'' column of the tables used in the final rule preamble, so the numbers in this column did not accurately reflect the total case-mix adjusted federal per diem rates. On page 39222, we made a typographical error in Table 27 in the MDS item number reference (column 2) associated with one of the conditions and extensive services used for NTA classification. Additionally, in Table 45 on page 39285 of the FY 2019 SNF PPS final rule, we misordered the ownership labels in the table as ``Government, Profit, Non- Profit'', instead of ``Profit, Non-Profit, Government.'' Finally, on page 39287, we inadvertently typed ``urban rural West South Central region,'' when we intended to state ``rural West South Central region.'' The corrections to these errors are found in section IV. of this document. B. Summary of Errors in and Corrections to Tables Posted on the CMS Website We are correcting the wage indexes in Tables A and B setting forth the wage indexes for urban areas based on CBSA labor market areas (Table A) and the wage indexes for rural areas based on CBSA labor market areas (Table B), which are available exclusively on the CMS website at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html. As discussed in the FY 2019 SNF PPS final rule (83 FR 39172 through 39178), in developing the wage index to be applied to SNFs under the SNF PPS, we use the updated, pre- reclassified, pre-rural floor hospital inpatient PPS (IPPS) wage data, exclusive of the occupational mix adjustment. For FY 2019, the updated, unadjusted, pre-reclassified, pre-rural floor IPPS wage data used under the SNF PPS are for cost reporting periods beginning on or after October 1, 2014 and before October 1, 2015 (FY 2015 cost report data), as discussed in the final rule entitled, ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2019 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs (Promoting Interoperability Programs) Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Medicare Cost Reporting Requirements; and Physician Certification and Recertification of Claims'' (83 FR 41144, 41364) (hereinafter referred to as the FY 2019 IPPS final rule). In calculating the wage index under the FY 2019 IPPS final rule, we made inadvertent errors related to the calculation of the wage index. These errors are identified, discussed and corrected in the correction notice entitled, ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2019 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs (Promoting Interoperability Programs) Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Medicare Cost Reporting Requirements; and Physician Certification and Recertification of Claims; Correction.'' Among the errors discussed there, the two errors that affect the unadjusted, pre-reclassified, pre-rural floor IPPS wage data, and thereby affect the SNF PPS wage data were errors in the wage data collected from the Medicare cost reports of one hospital (CMS Certification Number (CCN) 100044--CBSA 38940 Port St. Lucie, Florida) and the mistaken inclusion of a Critical Access Hospital (CAH) in the wage data (CCN 060016--CBSA 06 Colorado). Finally, in constructing Table A, we made errors in copying values into the ``wage index'' column of the table posted to the CMS website. Given these errors, we are republishing the wage indexes in Tables A and B accordingly on the CMS website at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html. [[Page 49833]] III. Waiver of Proposed Rulemaking and Delayed 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 an agency includes a statement of support. We believe that this correcting document does not constitute a rule that would be subject to the notice and comment or delayed effective date requirements. This document corrects technical errors in the FY 2019 SNF PPS final rule and in the tables referenced in the final rule, but does not make substantive changes to the policies or payment methodologies that were adopted in the final rule. As a result, this correction notice is intended to ensure that the information in the FY 2019 SNF PPS final rule accurately reflects the policies adopted in that final rule. In addition, even if this were a rule to which the notice and comment procedures and delayed effective date requirements applied, we find that there is good cause to waive such requirements. Undertaking further notice and comment procedures to incorporate the corrections in this document into the final rule or delaying the effective date would be contrary to the public interest because it is in the public's interest for providers to receive appropriate payments in as timely a manner as possible, and to ensure that the FY 2019 SNF PPS final rule and the tables referenced in the final rule accurately reflect our methodologies, payment rates, and policies. Furthermore, such procedures would be unnecessary, as we are not making substantive changes to our payment methodologies or policies, but rather, we are simply implementing correctly the methodologies and policies that we previously proposed, requested comment on, and subsequently finalized. This correcting document is intended solely to ensure that the FY 2019 SNF PPS final rule and the tables referenced in the final rule accurately reflect these methodologies and policies. Therefore, we believe we have good cause to waive the notice and comment and effective date requirements. IV. Correction of Errors In FR Doc. 2018-16570 of August 8, 2018 (83 FR 39162), make the following corrections: 1. On pages 39170 through 39171, TABLE 6--RUG-IV Case-Mix Adjusted Federal Rates and Associated Indexes--Urban is corrected to read as follows: Table 6--RUG-IV Case-Mix Adjusted Federal Rates and Associated Indexes--Urban -------------------------------------------------------------------------------------------------------------------------------------------------------- Nursing Therapy Non-case mix Non-case mix RUG-IV category Nursing index Therapy index component component therapy comp component Total rate ------------------------------------------------------------------------------------------------------------------------------------------------- RUX............................. 2.67 1.87 $484.44 $255.57 .............. $92.60 $832.61 RUL............................. 2.57 1.87 466.30 255.57 .............. 92.60 814.47 RVX............................. 2.61 1.28 473.56 174.94 .............. 92.60 741.10 RVL............................. 2.19 1.28 397.35 174.94 .............. 92.60 664.89 RHX............................. 2.55 0.85 462.67 116.17 .............. 92.60 671.44 RHL............................. 2.15 0.85 390.10 116.17 .............. 92.60 598.87 RMX............................. 2.47 0.55 448.16 75.17 .............. 92.60 615.93 RML............................. 2.19 0.55 397.35 75.17 .............. 92.60 565.12 RLX............................. 2.26 0.28 410.05 38.27 .............. 92.60 540.92 RUC............................. 1.56 1.87 283.05 255.57 .............. 92.60 631.22 RUB............................. 1.56 1.87 283.05 255.57 .............. 92.60 631.22 RUA............................. 0.99 1.87 179.63 255.57 .............. 92.60 527.80 RVC............................. 1.51 1.28 273.97 174.94 .............. 92.60 541.51 RVB............................. 1.11 1.28 201.40 174.94 .............. 92.60 468.94 RVA............................. 1.10 1.28 199.58 174.94 .............. 92.60 467.12 RHC............................. 1.45 0.85 263.09 116.17 .............. 92.60 471.86 RHB............................. 1.19 0.85 215.91 116.17 .............. 92.60 424.68 RHA............................. 0.91 0.85 165.11 116.17 .............. 92.60 373.88 RMC............................. 1.36 0.55 246.76 75.17 .............. 92.60 414.53 RMB............................. 1.22 0.55 221.36 75.17 .............. 92.60 389.13 RMA............................. 0.84 0.55 152.41 75.17 .............. 92.60 320.18 RLB............................. 1.50 0.28 272.16 38.27 .............. 92.60 403.03 RLA............................. 0.71 0.28 128.82 38.27 .............. 92.60 259.69 ES3............................. 3.58 .............. 649.56 .............. $18.00 92.60 760.16 ES2............................. 2.67 .............. 484.44 .............. 18.00 92.60 595.04 ES1............................. 2.32 .............. 420.94 .............. 18.00 92.60 531.54 HE2............................. 2.22 .............. 402.80 .............. 18.00 92.60 513.40 HE1............................. 1.74 .............. 315.71 .............. 18.00 92.60 426.31 HD2............................. 2.04 .............. 370.14 .............. 18.00 92.60 480.74 HD1............................. 1.60 .............. 290.30 .............. 18.00 92.60 400.90 HC2............................. 1.89 .............. 342.92 .............. 18.00 92.60 453.52 HC1............................. 1.48 .............. 268.53 .............. 18.00 92.60 379.13 [[Page 49834]] HB2............................. 1.86 .............. 337.48 .............. 18.00 92.60 448.08 HB1............................. 1.46 .............. 264.90 .............. 18.00 92.60 375.50 LE2............................. 1.96 .............. 355.62 .............. 18.00 92.60 466.22 LE1............................. 1.54 .............. 279.42 .............. 18.00 92.60 390.02 LD2............................. 1.86 .............. 337.48 .............. 18.00 92.60 448.08 LD1............................. 1.46 .............. 264.90 .............. 18.00 92.60 375.50 LC2............................. 1.56 .............. 283.05 .............. 18.00 92.60 393.65 LC1............................. 1.22 .............. 221.36 .............. 18.00 92.60 331.96 LB2............................. 1.45 .............. 263.09 .............. 18.00 92.60 373.69 LB1............................. 1.14 .............. 206.84 .............. 18.00 92.60 317.44 CE2............................. 1.68 .............. 304.82 .............. 18.00 92.60 415.42 CE1............................. 1.50 .............. 272.16 .............. 18.00 92.60 382.76 CD2............................. 1.56 .............. 283.05 .............. 18.00 92.60 393.65 CD1............................. 1.38 .............. 250.39 .............. 18.00 92.60 360.99 CC2............................. 1.29 .............. 234.06 .............. 18.00 92.60 344.66 CC1............................. 1.15 .............. 208.66 .............. 18.00 92.60 319.26 CB2............................. 1.15 .............. 208.66 .............. 18.00 92.60 319.26 CB1............................. 1.02 .............. 185.07 .............. 18.00 92.60 295.67 CA2............................. 0.88 .............. 159.67 .............. 18.00 92.60 270.27 CA1............................. 0.78 .............. 141.52 .............. 18.00 92.60 252.12 BB2............................. 0.97 .............. 176.00 .............. 18.00 92.60 286.60 BB1............................. 0.90 .............. 163.30 .............. 18.00 92.60 273.90 BA2............................. 0.70 .............. 127.01 .............. 18.00 92.60 237.61 BA1............................. 0.64 .............. 116.12 .............. 18.00 92.60 226.72 PE2............................. 1.50 .............. 272.16 .............. 18.00 92.60 382.76 PE1............................. 1.40 .............. 254.02 .............. 18.00 92.60 364.62 PD2............................. 1.38 .............. 250.39 .............. 18.00 92.60 360.99 PD1............................. 1.28 .............. 232.24 .............. 18.00 92.60 342.84 PC2............................. 1.10 .............. 199.58 .............. 18.00 92.60 310.18 PC1............................. 1.02 .............. 185.07 .............. 18.00 92.60 295.67 PB2............................. 0.84 .............. 152.41 .............. 18.00 92.60 263.01 PB1............................. 0.78 .............. 141.52 .............. 18.00 92.60 252.12 PA2............................. 0.59 .............. 107.05 .............. 18.00 92.60 217.65 PA1............................. 0.54 .............. 97.98 .............. 18.00 92.60 208.58 -------------------------------------------------------------------------------------------------------------------------------------------------------- 2. On pages 39171 through 39172, TABLE 7--RUG-IV Case-Mix Adjusted Federal Rates and Associated Indexes--Rural is corrected to read as follows: Table 7--RUG-IV Case-Mix Adjusted Federal Rates and Associated Indexes--Rural -------------------------------------------------------------------------------------------------------------------------------------------------------- Nursing Therapy Non-case mix Non-case Mix RUG-IV Nursing index Therapy index component component therapy comp component Total rate ------------------------------------------------------------------------------------------------------------------------------------------------- RUX............................. 2.67 1.87 $462.82 $294.71 .............. $94.31 $851.84 RUL............................. 2.57 1.87 445.48 294.71 .............. 94.31 834.50 RVX............................. 2.61 1.28 452.42 201.73 .............. 94.31 748.46 RVL............................. 2.19 1.28 379.61 201.73 .............. 94.31 675.65 RHX............................. 2.55 0.85 442.02 133.96 .............. 94.31 670.29 RHL............................. 2.15 0.85 372.68 133.96 .............. 94.31 600.95 RMX............................. 2.47 0.55 428.15 86.68 .............. 94.31 609.14 RML............................. 2.19 0.55 379.61 86.68 .............. 94.31 560.60 RLX............................. 2.26 0.28 391.75 44.13 .............. 94.31 530.19 RUC............................. 1.56 1.87 270.41 294.71 .............. 94.31 659.43 RUB............................. 1.56 1.87 270.41 294.71 .............. 94.31 659.43 RUA............................. 0.99 1.87 171.61 294.71 .............. 94.31 560.63 RVC............................. 1.51 1.28 261.74 201.73 .............. 94.31 557.78 RVB............................. 1.11 1.28 192.41 201.73 .............. 94.31 488.45 RVA............................. 1.10 1.28 190.67 201.73 .............. 94.31 486.71 RHC............................. 1.45 0.85 251.34 133.96 .............. 94.31 479.61 RHB............................. 1.19 0.85 206.27 133.96 .............. 94.31 434.54 RHA............................. 0.91 0.85 157.74 133.96 .............. 94.31 386.01 RMC............................. 1.36 0.55 235.74 86.68 .............. 94.31 416.73 RMB............................. 1.22 0.55 211.47 86.68 .............. 94.31 392.46 RMA............................. 0.84 0.55 145.61 86.68 .............. 94.31 326.60 RLB............................. 1.50 0.28 260.01 44.13 .............. 94.31 398.45 RLA............................. 0.71 0.28 123.07 44.13 .............. 94.31 261.51 ES3............................. 3.58 .............. 620.56 .............. $19.23 94.31 734.10 ES2............................. 2.67 .............. 462.82 .............. 19.23 94.31 576.36 ES1............................. 2.32 .............. 402.15 .............. 19.23 94.31 515.69 [[Page 49835]] HE2............................. 2.22 .............. 384.81 .............. 19.23 94.31 498.35 HE1............................. 1.74 .............. 301.61 .............. 19.23 94.31 415.15 HD2............................. 2.04 .............. 353.61 .............. 19.23 94.31 467.15 HD1............................. 1.60 .............. 277.34 .............. 19.23 94.31 390.88 HC2............................. 1.89 .............. 327.61 .............. 19.23 94.31 441.15 HC1............................. 1.48 .............. 256.54 .............. 19.23 94.31 370.08 HB2............................. 1.86 .............. 322.41 .............. 19.23 94.31 435.95 HB1............................. 1.46 .............. 253.08 .............. 19.23 94.31 366.62 LE2............................. 1.96 .............. 339.75 .............. 19.23 94.31 453.29 LE1............................. 1.54 .............. 266.94 .............. 19.23 94.31 380.48 LD2............................. 1.86 .............. 322.41 .............. 19.23 94.31 435.95 LD1............................. 1.46 .............. 253.08 .............. 19.23 94.31 366.62 LC2............................. 1.56 .............. 270.41 .............. 19.23 94.31 383.95 LC1............................. 1.22 .............. 211.47 .............. 19.23 94.31 325.01 LB2............................. 1.45 .............. 251.34 .............. 19.23 94.31 364.88 LB1............................. 1.14 .............. 197.61 .............. 19.23 94.31 311.15 CE2............................. 1.68 .............. 291.21 .............. 19.23 94.31 404.75 CE1............................. 1.50 .............. 260.01 .............. 19.23 94.31 373.55 CD2............................. 1.56 .............. 270.41 .............. 19.23 94.31 383.95 CD1............................. 1.38 .............. 239.21 .............. 19.23 94.31 352.75 CC2............................. 1.29 .............. 223.61 .............. 19.23 94.31 337.15 CC1............................. 1.15 .............. 199.34 .............. 19.23 94.31 312.88 CB2............................. 1.15 .............. 199.34 .............. 19.23 94.31 312.88 CB1............................. 1.02 .............. 176.81 .............. 19.23 94.31 290.35 CA2............................. 0.88 .............. 152.54 .............. 19.23 94.31 266.08 CA1............................. 0.78 .............. 135.21 .............. 19.23 94.31 248.75 BB2............................. 0.97 .............. 168.14 .............. 19.23 94.31 281.68 BB1............................. 0.90 .............. 156.01 .............. 19.23 94.31 269.55 BA2............................. 0.70 .............. 121.34 .............. 19.23 94.31 234.88 BA1............................. 0.64 .............. 110.94 .............. 19.23 94.31 224.48 PE2............................. 1.50 .............. 260.01 .............. 19.23 94.31 373.55 PE1............................. 1.40 .............. 242.68 .............. 19.23 94.31 356.22 PD2............................. 1.38 .............. 239.21 .............. 19.23 94.31 352.75 PD1............................. 1.28 .............. 221.88 .............. 19.23 94.31 335.42 PC2............................. 1.10 .............. 190.67 .............. 19.23 94.31 304.21 PC1............................. 1.02 .............. 176.81 .............. 19.23 94.31 290.35 PB2............................. 0.84 .............. 145.61 .............. 19.23 94.31 259.15 PB1............................. 0.78 .............. 135.21 .............. 19.23 94.31 248.75 PA2............................. 0.59 .............. 102.27 .............. 19.23 94.31 215.81 PA1............................. 0.54 .............. 93.60 .............. 19.23 94.31 207.14 -------------------------------------------------------------------------------------------------------------------------------------------------------- 5. On page 39222, in Table 27, column 2, line 29, the reference ``MDS Item M0300X1'' is corrected to read ``MDS Item M0300D1.'' 6. On page 39285, TABLE 45--Impact to the SNF PPS for FY 2019 is corrected to read as follows: Table 45--Impact to the SNF PPS for FY 2019 ------------------------------------------------------------------------ Number of Update Total facilities wage data change FY 2019 (%) (%) ------------------------------------------------------------------------ Group: Total............................. 15,471 0.0 2.4 Urban............................. 11,042 0.0 2.4 Rural............................. 4,429 0.1 2.5 Hospital-based urban.............. 498 0.0 2.4 Freestanding urban................ 10,544 0.0 2.4 Hospital-based rural.............. 555 0.0 2.4 Freestanding rural................ 3,874 0.2 2.6 Urban by region: New England....................... 790 -0.7 1.7 Middle Atlantic................... 1,481 0.0 2.4 South Atlantic.................... 1,869 -0.1 2.3 East North Central................ 2,127 -0.4 2.0 East South Central................ 555 -0.2 2.2 West North Central................ 920 -0.4 2.0 West South Central................ 1,346 0.3 2.7 Mountain.......................... 527 -0.8 1.6 [[Page 49836]] Pacific........................... 1,421 1.0 3.4 Outlying.......................... 6 -0.5 1.9 Rural by region: New England....................... 134 -0.7 1.6 Middle Atlantic................... 215 0.1 2.5 South Atlantic.................... 494 0.1 2.5 East North Central................ 931 0.1 2.5 East South Central................ 523 -0.3 2.1 West North Central................ 1,074 0.3 2.7 West South Central................ 734 1.0 3.5 Mountain.......................... 229 0.2 2.6 Pacific........................... 95 -0.5 1.9 Ownership: Profit............................ 10,887 0.0 2.4 Non-Profit........................ 3,570 -0.1 2.3 Government........................ 1,014 0.0 2.4 ------------------------------------------------------------------------ Note: The Total column includes the 2.4 percent market basket increase required by section 53111 of the BBA 2018. Additionally, we found no SNFs in rural outlying areas. 7. On page 39287, bottom of the page, column 2, line 6 and 7 the phrase ``urban rural West South Central region'' is corrected to read ``rural West South Central region.'' Dated: September 27, 2018. Ann C. Agnew, Executive Secretary to the Department, Department of Health and Human Services. [FR Doc. 2018-21499 Filed 9-28-18; 4:15 pm] BILLING CODE 4120-01-P
![49832 Federal Register / Vol. 83, No. 192 / Wednesday, October 3, 2018 / Rules and Regulations
EPA-APPROVED KANSAS REGULATIONS—Continued
State EPA approval
Kansas citation Title effective Explanation
date
date
* * * * * * *
* * * * * II. Summary of Errors Systems for Acute Care Hospitals and
[FR Doc. 2018–21434 Filed 10–2–18; 8:45 am] the Long Term Care Hospital
A. Summary of Errors in the Preamble
BILLING CODE 6560–50–P Prospective Payment System and Policy
On pages 39170 through 39172, Changes and Fiscal Year 2019 Rates;
39222, 39285 and 39287, we made Quality Reporting Requirements for
DEPARTMENT OF HEALTH AND inadvertent technical errors. Specific Providers; Medicare and
HUMAN SERVICES Specifically, in Tables 6 and 7 on pages Medicaid Electronic Health Record
39170 through 39172 of the FY 2019 (EHR) Incentive Programs (Promoting
Centers for Medicare & Medicaid SNF PPS final rule, we made errors in Interoperability Programs) Requirements
Services copying values into the ‘‘total rate’’ for Eligible Hospitals, Critical Access
column of the tables used in the final Hospitals, and Eligible Professionals;
42 CFR Parts 411, 413, and 424 rule preamble, so the numbers in this Medicare Cost Reporting Requirements;
column did not accurately reflect the and Physician Certification and
[CMS–1696–CN]
total case-mix adjusted federal per diem Recertification of Claims’’ (83 FR 41144,
RIN 0938–AT24 rates. On page 39222, we made a 41364) (hereinafter referred to as the FY
typographical error in Table 27 in the 2019 IPPS final rule). In calculating the
Medicare Program; Prospective MDS item number reference (column 2) wage index under the FY 2019 IPPS
Payment System and Consolidated associated with one of the conditions final rule, we made inadvertent errors
Billing for Skilled Nursing Facilities and extensive services used for NTA related to the calculation of the wage
(SNF) Final Rule for FY 2019, SNF classification. Additionally, in Table 45 index. These errors are identified,
Value-Based Purchasing Program, and on page 39285 of the FY 2019 SNF PPS discussed and corrected in the
SNF Quality Reporting Program; final rule, we misordered the ownership correction notice entitled, ‘‘Medicare
Correction labels in the table as ‘‘Government, Program; Hospital Inpatient Prospective
AGENCY: Centers for Medicare & Profit, Non-Profit’’, instead of ‘‘Profit, Payment Systems for Acute Care
Medicaid Services (CMS), HHS. Non-Profit, Government.’’ Finally, on Hospitals and the Long Term Care
page 39287, we inadvertently typed Hospital Prospective Payment System
ACTION: Final rule; correction.
‘‘urban rural West South Central and Policy Changes and Fiscal Year
SUMMARY: This document corrects region,’’ when we intended to state 2019 Rates; Quality Reporting
technical errors in the final rule that ‘‘rural West South Central region.’’ Requirements for Specific Providers;
appeared in the August 8, 2018 Federal The corrections to these errors are Medicare and Medicaid Electronic
Register (83 FR 39162) entitled found in section IV. of this document. Health Record (EHR) Incentive Programs
‘‘Medicare Program; Prospective (Promoting Interoperability Programs)
B. Summary of Errors in and Corrections Requirements for Eligible Hospitals,
Payment System and Consolidated to Tables Posted on the CMS Website
Billing for Skilled Nursing Facilities Critical Access Hospitals, and Eligible
We are correcting the wage indexes in Professionals; Medicare Cost Reporting
(SNF) Final Rule for FY 2019, SNF
Tables A and B setting forth the wage Requirements; and Physician
Value-Based Purchasing Program, and
indexes for urban areas based on CBSA Certification and Recertification of
SNF Quality Reporting Program.’’
labor market areas (Table A) and the Claims; Correction.’’ Among the errors
DATES: The corrections in this document wage indexes for rural areas based on discussed there, the two errors that
are effective October 1, 2018. CBSA labor market areas (Table B), affect the unadjusted, pre-reclassified,
FOR FURTHER INFORMATION CONTACT: John which are available exclusively on the pre-rural floor IPPS wage data, and
Kane, (410) 786–0557. CMS website at http://www.cms.gov/ thereby affect the SNF PPS wage data
SUPPLEMENTARY INFORMATION: Medicare/Medicare-Fee-for-Service- were errors in the wage data collected
Payment/SNFPPS/WageIndex.html. As from the Medicare cost reports of one
I. Background discussed in the FY 2019 SNF PPS final hospital (CMS Certification Number
In FR Doc. 2018–16570 of August 8, rule (83 FR 39172 through 39178), in (CCN) 100044—CBSA 38940 Port St.
2018 (83 FR 39162 through 39290), developing the wage index to be applied Lucie, Florida) and the mistaken
there were a number of technical errors to SNFs under the SNF PPS, we use the inclusion of a Critical Access Hospital
that are identified and corrected in updated, pre-reclassified, pre-rural floor (CAH) in the wage data (CCN 060016—
Correction of Errors section (section IV. hospital inpatient PPS (IPPS) wage data, CBSA 06 Colorado). Finally, in
of this correction notice). The exclusive of the occupational mix constructing Table A, we made errors in
provisions in this correcting document adjustment. For FY 2019, the updated, copying values into the ‘‘wage index’’
are effective as if they had been unadjusted, pre-reclassified, pre-rural column of the table posted to the CMS
included in the document that appeared floor IPPS wage data used under the
daltland on DSKBBV9HB2PROD with RULES
website.
in the August 8, 2018 Federal Register SNF PPS are for cost reporting periods Given these errors, we are
(83 FR 39162 through 39290) beginning on or after October 1, 2014 republishing the wage indexes in Tables
(hereinafter referred to as the FY 2019 and before October 1, 2015 (FY 2015 A and B accordingly on the CMS
SNF PPS final rule). cost report data), as discussed in the website at http://www.cms.gov/
Accordingly, the corrections in this final rule entitled, ‘‘Medicare Program; Medicare/Medicare-Fee-for-Service-
document are effective October 1, 2018. Hospital Inpatient Prospective Payment Payment/SNFPPS/WageIndex.html.
VerDate Sep<11>2014 16:40 Oct 02, 2018 Jkt 247001 PO 00000 Frm 00064 Fmt 4700 Sfmt 4700 E:\FR\FM\03OCR1.SGM 03OCR1](https://thefederalregister.org/doc/83_FR_50024/page/1.svg)
![49836 Federal Register / Vol. 83, No. 192 / Wednesday, October 3, 2018 / Rules and Regulations
TABLE 45—IMPACT TO THE SNF PPS FOR FY 2019—Continued
Number Update Total
of wage change
facilities data (%)
FY 2019 (%)
Pacific ........................................................................................................................................................... 1,421 1.0 3.4
Outlying ......................................................................................................................................................... 6 ¥0.5 1.9
Rural by region:
New England ................................................................................................................................................ 134 ¥0.7 1.6
Middle Atlantic .............................................................................................................................................. 215 0.1 2.5
South Atlantic ............................................................................................................................................... 494 0.1 2.5
East North Central ........................................................................................................................................ 931 0.1 2.5
East South Central ....................................................................................................................................... 523 ¥0.3 2.1
West North Central ....................................................................................................................................... 1,074 0.3 2.7
West South Central ...................................................................................................................................... 734 1.0 3.5
Mountain ....................................................................................................................................................... 229 0.2 2.6
Pacific ........................................................................................................................................................... 95 ¥0.5 1.9
Ownership:
Profit ............................................................................................................................................................. 10,887 0.0 2.4
Non-Profit ...................................................................................................................................................... 3,570 ¥0.1 2.3
Government .................................................................................................................................................. 1,014 0.0 2.4
Note: The Total column includes the 2.4 percent market basket increase required by section 53111 of the BBA 2018. Additionally, we found
no SNFs in rural outlying areas.
7. On page 39287, bottom of the page, ACTION: Final rule; correction. II. Summary of Errors
column 2, line 6 and 7 the phrase
A. Summary of Errors in the Preamble
‘‘urban rural West South Central region’’ SUMMARY: This document corrects
is corrected to read ‘‘rural West South technical and typographical errors in On page 41144, under FOR FURTHER
Central region.’’ the final rule that appeared in the INFORMATION CONTACT section, we are
August 17, 2018 issue of the Federal correcting the names of the contacts for
Dated: September 27, 2018.
Register titled ‘‘Medicare Program; Medicare Promoting Interoperability
Ann C. Agnew,
Hospital Inpatient Prospective Payment Program issues.
Executive Secretary to the Department, On page 41151, in our discussion
Department of Health and Human Services.
Systems for Acute Care Hospitals and
the Long Term Care Hospital regarding Changes to the Hospital
[FR Doc. 2018–21499 Filed 9–28–18; 4:15 pm] Readmissions Reduction Program under
Prospective Payment System and Policy
BILLING CODE 4120–01–P
Changes and Fiscal Year 2019 Rates; ‘‘Summary of Cost and Benefits’’, we
Quality Reporting Requirements for made errors in the impact figures.
Specific Providers; Medicare and On pages 41200, 41219, 41236, and
DEPARTMENT OF HEALTH AND 41313, we made a technical error in
HUMAN SERVICES Medicaid Electronic Health Record
(EHR) Incentive Programs (Promoting using the term ‘‘primary’’ rather than
Interoperability Programs) Requirements ‘‘principal’’ when in describing certain
Centers for Medicare & Medicaid
for Eligible Hospitals, Critical Access diagnosis codes or conditions.
Services On page 41254, we inadvertently
Hospitals, and Eligible Professionals;
Medicare Cost Reporting Requirements; omitted a base MS–DRG group to which
42 CFR Parts 412, 413, 424, and 495 the listed thoracoscopic procedures of
and Physician Certification and
[CMS–1694–CN2] Recertification of Claims’’. pericardium and pleura may be
assigned. Specifically, we are correcting
RIN 0938–AT27 DATES: The corrections in this document the list of MS–DRGs on page 41254 to
are effective October 1, 2018. include MS–DRGs 166, 167, and 168
Medicare Program; Hospital Inpatient
Prospective Payment Systems for FOR FURTHER INFORMATION CONTACT: (Other Respiratory System O.R.
Acute Care Hospitals and the Long Donald Thompson and Michele Procedures with MCC, with CC, and
Term Care Hospital Prospective Hudson, (410) 786–4487. without CC/MCC, respectively) in MDC
Payment System and Policy Changes 4 (Diseases and Disorders of the
SUPPLEMENTARY INFORMATION: Respiratory System), consistent with the
and Fiscal Year 2019 Rates; Quality
Reporting Requirements for Specific I. Background MS–DRGs to which other approaches
Providers; Medicare and Medicaid for procedures involving drainage or
Electronic Health Record (EHR) In FR Doc. 2018–16766 of August 17, extirpation of matter from the pleura are
Incentive Programs (Promoting 2018 (83 FR 41144) there were a number assigned.
Interoperability Programs) of technical and typographical errors On page 41299, we made a technical
Requirements for Eligible Hospitals, that are identified and corrected by the error in describing which ICD–10–PCS
Critical Access Hospitals, and Eligible Correction of Errors section of this procedure codes will be used to identify
correcting document. The provisions in cases involving the use of KYMRIAH
daltland on DSKBBV9HB2PROD with RULES
Professionals; Medicare Cost
Reporting Requirements; and this correcting document are effective as and YESCARTA that are eligible for new
Physician Certification and if they had been included in the technology add-on payments in FY
Recertification of Claims; Correction document that appeared in the August 2019. Specifically, cases involving the
17, 2018 Federal Register. Accordingly, use of KYMRIAH and YESCARTA that
AGENCY: Centers for Medicare & the corrections are effective October 1, are eligible for new technology add-on
Medicaid Services (CMS), HHS. 2018. payments will be identified by either of
VerDate Sep<11>2014 16:40 Oct 02, 2018 Jkt 247001 PO 00000 Frm 00068 Fmt 4700 Sfmt 4700 E:\FR\FM\03OCR1.SGM 03OCR1](https://thefederalregister.org/doc/83_FR_50024/page/5.svg)
Document Created: 2018-10-03 02:30:01
Document Modified: 2018-10-03 02:30:01
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Rules and Regulations | |
| Action | Final rule; correction. | |
| Dates | The corrections in this document are effective October 1, 2018. | |
| Contact | John Kane, (410) 786-0557. | |
| FR Citation | 83 FR 49832 | |
| RIN Number | 0938-AT24 | |
| CFR Citation | 42
CFR
411 42 CFR 413 42 CFR 424 |
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR