72 FR 109 pgs. 31507-31540 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction

Type: PRORULEVolume: 72Number: 109Pages: 31507 - 31540
Docket number: [CMS-1533-CN]
FR document: [FR Doc. 07-2806 Filed 6-1-07; 2:04 pm]
Agency: Health and Human Services Department
Sub Agency: Centers for Medicare Medicaid Services
Official PDF Version:  PDF Version

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare Medicaid Services

42 CFR Parts 411, 412, 413, and 489

[CMS-1533-CN]

RIN 0938-A070

Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction

AGENCY:

Centers for Medicare Medicaid Services (CMS), HHS.

ACTION:

Correction of proposed rule.

SUMMARY:

This document corrects technical errors that appeared in the proposed rule entitled "Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates" that appeared in the May 3, 2007 Federal Register .

FOR FURTHER INFORMATION CONTACT:

Marc Hartstein, (410) 786-4548.

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), there were a number of technical errors that are identified and corrected in the Correction of Errors section of this notice. We issued the fiscal year (FY) 2008 hospital inpatient prospective payment systems (IPPS) proposed rule on April 13, 2007. The FY 2008 IPPS proposed rule appeared in the May 3, 2007 Federal Register .

II. Summary of Errors

We recently discovered that an error was made in the calculation of the DRG relative weights presented in the FY 2008 IPPS proposed rule. We have revised the relative weights to correct the error and have recalculated the standardized amounts. These changes increase the standardized amounts slightly and reduce the proposed FY 2008 outlier threshold by $85. Further, these revisions affect the DRG-specific costs thresholds for new technology add-on payments. Therefore, in this notice we are correcting the following:

• Preamble language regarding the methodology used to calculate charge-based and cost-based relative weights.

• Outlier threshold.

• Recalibration, wage and recalibration, geographic reclassification, and rural floor budget neutrality factors.

• Tables 1A through 1D, 2, 4A, 4C, 4J, 5, 10.

• Impact analysis tables (Tables I and II).

In addition, we have posted these corrected tables on our Web site at http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp.

III. Correction of Errors

In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), make the following corrections:

A. Corrections to the Preamble

1. On page 24711, second column, last paragraph, sixth line from the bottom, the figure "$23,015" is corrected to read "$22,930."

2. On page 24746, second column,

a. Third full paragraph, line 9, the phrase, "in the FY 2005 MedPAR" is corrected to read "in the FY 2006 MedPAR."

b. Fifth full paragraph, last line, after the phrase "cost of living adjustment.", the following sentence is added to read as follows:

"Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well."

3. On page 24747, first column, third full paragraph, last line, after the phrase "cost of living adjustment." and before the phrase "Charges were then", the following sentence is added to read as follows:

"Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well."

B. Corrections to the Addendum

1. On page 24836,

a. First column, second full paragraph,

(1) Line 14, the figure "0.999317" is corrected to read "0.999367."

(2) Lines 19 and 29, the figure "0.998557" is corrected to read "0.998573."

b. Second column, first partial paragraph, line 17, the figure "0.991938" is corrected to read "0.991925."

2. On page 24837, second column, second full paragraph, line 6, the figure "$23,015" is corrected to read "$22,930".

3. On page 24839, top half of the page, in the table Comparison of FY 2007 Standardized Amounts to Proposed FY 2008 Single Standardized Amount with Full Update and Reduced Update, the figures in the listed entries are corrected to read as follows:

Full update (3.3 percent) Reduced update (1.3 percent)
FY 2008 DRG Recalibrations and Wage Index Budget Neutrality Factor 0.999367 0.999367
FY 2008 Reclassification Budget Neutrality Factor 0.991925 0.991925

4. On page 24846, third column, first full paragraph,

a. Line 38, the figure "$417.26" is corrected to read "$417.12."

b. Line 40, the figure "$413.87" is corrected to read "$413.73."

5. On page 24847,

a. Middle of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Urban Hospitals, third column, last row, the figure, "$413.87" is corrected to read "$413.73."

b. Lower third of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Rural Hospitals, third column, last row, the figure "$417.26" is corrected to read "$417.12."

6. On page 24848,

a. First column, fourth full paragraph,

(1) Line 10, the phrase "is $197.21" is corrected to read "is $197.11.".

(2) Line 12, the figure "$195.60" is corrected to read "$195.51."

b. Second column, third paragraph, last line, the figure "$23,015" is corrected to read "$22,930".

7. On page 24850, in Table 1A.-National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1), the table is corrected to read as follows:

Full update (3.3 percent) Labor-related Nonlabor-related Reduced update (1.3 Percent) Labor-related Nonlabor-related
$3,430.41 $1,491.27 $3,363.99 $1,462.40

8. On page 24850, in Table 1B.-National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than Or Equal To 1), the table is corrected to read as follows:

Full update (3.3 percent) Labor-related Nonlabor-related Reduced update (1.3 Percent) Labor-related Nonlabor-related
$3,051.44 $1,870.24 $2,992.36 $1,834.03

9. On page 24850, in Table 1C.-Adjusted Operating Standardized Amounts For Puerto Rico Labor, Labor/Nonlabor, the table is corrected to read as follows:

Rates if wage index greater than 1 Labor Nonlabor Rates if wage index less than or equal to 1 Labor Nonlabor
National $3,430.41 $1,491.27 $3,363.99 $1,462.40
Puerto Rico 1,442.16 883.90 1,365.40 960.66

10. On page 24850, in Table 1D.-Capital Standard Federal Payment Rate, the table is corrected to read as follows:

Urban rate Rural rate
National $413.73 $417.12
Puerto Rico 195.51 197.11

11. On pages 24851 through 24917, in Table 2.-Hospital Case-Mix Indexes For Discharges Occurring in Federal Fiscal Year 2006; Hospital Wage Indexes For Federal Fiscal Year 2008; Hospital Average Hourly Wages For Federal Fiscal Years 2006 (2002 Wage Data), 2007 (2003 Wage Data), And 2008 (2004 Wage Data); And 3-Year Average Of Hospital Average Hourly Wages, the wage index for the listed provider numbers are corrected to read as follows:

Provider No. FY 2008 wage index
010012 0.9390
010047 0.7776
010052 0.7701
010109 0.8049
010110 0.7900
010164 0.8042
040014 0.8720
040017 0.8718
040041 0.8720
040071 0.8720
040076 0.8720
040078 0.8720
040100 0.8720
040119 0.8720
050007 1.4907
050008 1.4792
050009 1.4200
050013 1.4200
050016 1.2015
050047 1.4792
050055 1.4792
050070 1.4907
050113 1.4907
050152 1.4792
050228 1.4792
050232 1.2015
050280 1.2826
050289 1.4907
050407 1.4792
050454 1.4792
050457 1.4792
050506 1.2015
050633 1.2015
050667 1.4200
050668 1.4792
050697 1.2826
050707 1.4907
050733 1.2826
050754 1.4907
060010 0.9730
060030 0.9730
080001 1.0777
080003 1.0777
100102 0.8874
100290 0.9331
110107 0.9752
110164 0.9752
110201 0.9752
130066 0.9680
130068 0.9680
150015 0.8904
160030 1.0022
180013 0.9407
180064 0.8131
180066 0.9407
180079 0.8075
180080 0.8042
180124 0.9407
190044 0.7849
190190 0.7752
190246 0.7752
200032 0.8878
210028 0.9429
230036 0.9398
230041 0.9398
230047 1.0091
230080 0.9398
230105 0.9398
230195 1.0091
230204 1.0091
230222 0.9398
230227 1.0091
230257 1.0091
230264 1.0091
230297 1.0091
230299 1.0091
230300 1.0091
240006 1.0760
240010 1.0760
240018 1.0084
240061 1.0760
240069 1.0760
240071 1.0760
270081 0.8574
280065 0.9746
310010 1.0812
310011 1.0864
310014 1.0777
310044 1.0812
310081 1.0777
310092 1.0812
310110 1.0812
320001 0.9739
320005 0.9739
320006 0.9739
320009 0.9739
320011 0.9407
320017 0.9739
320019 0.9739
320021 0.9739
320037 0.9739
320074 0.9739
320079 0.9739
320083 0.9739
330135 1.1528
330205 1.1528
330264 1.1528
340133 0.8916
360044 0.8825
370113 0.8718
380029 1.0479
380051 1.0479
380056 1.0479
390044 1.0777
390096 1.0777
390133 1.0777
410013 1.1793
430012 0.9394
430013 0.9394
430048 0.8398
440011 0.8042
440015 0.8042
440019 0.8042
440030 0.7972
440034 0.8042
440035 0.9407
440056 0.8042
440073 0.9407
440084 0.7949
440110 0.8042
440120 0.8042
440125 0.8042
440144 0.9407
440148 0.9407
440151 0.9407
440153 0.7923
440173 0.8042
440175 0.9407
440192 0.9407
440225 0.8042
440226 0.8042
450370 0.8444
450565 0.8690
450755 0.8498

12. On pages 24924, 29426, and 24941, in Table 4A.-Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA-FY 2008, the wage index and GAF for the listed CBSAs are corrected to read as follows:

CBSA code Urban area Wage index GAF
10740 Albuquerque, NM 0.9739 0.9821
Bernalillo County, NM
Sandoval County, NM
Torrance County, NM
Valencia County, NM
13020 Bay City MI 0.9398 0.9584
Bay County, MI
40340 Rochester, MN 1.0760 1.0514
Dodge County, MN
Olmsted County, MN
Wabasha County, MN

13. On pages 24948 through 24951, in Table 4C.-Wage Index And Capital Geographic Adjustment Factor (GAF) For Hospitals That Are Reclassified By CBSA FY 2008, the wage indices and GAFs for the listed areas are corrected to read as follows:

CBSA code Area Wage index GAF
10740 Albuquerque, NM 0.9739 0.9821
13020 Bay City, MI 0.9398 0.9584
22220 Fayetteville-Springdale-Rogers, AR-MO 0.8718 0.9103
35980 Norwich-New London, CT 1.1793 1.1196
40340 Rochester, MN 1.0760 1.0514
40660 Rome, GA 0.9390 0.9578
43620 Sioux Falls, SD 0.9394 0.9581

14. On pages 24952 through 24960, in Table 4J.-Out-Migration Adjustment-FY 2008, the entries for the listed providers are corrected to read as follows:

Provider No. Reclassified for FY 2008 Out-migration adjustment Qualifying county name County code
010009 * 0.0092 MORGAN 01510
010025 * 0.0235 CHAMBERS 01080
010038 0.0039 CALHOUN 01070
010047 0.0178 BUTLER 01060
010052 0.0103 TALLAPOOSA 01610
010054 * 0.0092 MORGAN 01510
010065 * 0.0103 TALLAPOOSA 01610
010078 0.0039 CALHOUN 01070
010085 * 0.0092 MORGAN 01510
010109 0.0451 PICKENS 01530
010110 0.0302 BULLOCK 01050
010146 0.0039 CALHOUN 01070
010150 * 0.0178 BUTLER 01060
050007 0.0141 SAN MATEO 05510
050008 0.0026 SAN FRANCISCO 05480
050016 0.0103 SAN LUIS OBISPO 05500
050047 0.0026 SAN FRANCISCO 05480
050055 0.0026 SAN FRANCISCO 05480
050070 0.0141 SAN MATEO 05510
050076 * 0.0026 SAN FRANCISCO 05480
050113 0.0141 SAN MATEO 05510
050152 0.0026 SAN FRANCISCO 05480
050194 * 0.0052 SANTA CRUZ 05540
050197 * 0.0141 SAN MATEO 05510
050228 0.0026 SAN FRANCISCO 05480
050232 0.0103 SAN LUIS OBISPO 05500
050242 * 0.0052 SANTA CRUZ 05540
050289 0.0141 SAN MATEO 05510
050407 0.0026 SAN FRANCISCO 05480
050454 0.0026 SAN FRANCISCO 05480
050457 0.0026 SAN FRANCISCO 05480
050506 0.0103 SAN LUIS OBISPO 05500
050541 * 0.0141 SAN MATEO 05510
050633 0.0103 SAN LUIS OBISPO 05500
050668 0.0026 SAN FRANCISCO 05480
050707 0.0141 SAN MATEO 05510
050714 * 0.0052 SANTA CRUZ 05540
050754 0.0141 SAN MATEO 05510
060010 0.0153 LARIMER 06340
060030 0.0153 LARIMER 06340
080001 * 0.0063 NEW CASTLE 08010
080003 * 0.0063 NEW CASTLE 08010
100102 0.0125 COLUMBIA 10110
100156 * 0.0125 COLUMBIA 10110
100290 0.0582 SUMTER 10590
110146 * 0.0805 CAMDEN 11170
130049 * 0.032 KOOTENAI 13270
130066 0.032 KOOTENAI 13270
130067 * 0.0696 BINGHAM 13050
130068 0.032 KOOTENAI 13270
140167 * 0.1055 IROQUOIS 14460
150006 * 0.0113 LA PORTE 15450
150015 0.0113 LA PORTE 15450
150146 * 0.0319 NOBLE 15560
160030 0.004 STORY 16840
170137 * 0.0336 DOUGLAS 17220
180064 0.0319 MONTGOMERY 18860
180066 * 0.0449 LOGAN 18700
180079 0.0263 HARRISON 18480
190044 0.0258 ACADIA 19000
190099 * 0.0188 AVOYELLES 19040
190184 * 0.0161 CALDWELL 19100
190190 0.0161 CALDWELL 19100
190246 0.0161 CALDWELL 19100
200032 0.0466 OXFORD 20080
210028 0.0512 ST. MARY'S 21180
230069 * 0.0209 LIVINGSTON 23460
230279 * 0.0209 LIVINGSTON 23460
240018 0.0872 GOODHUE 24240
270081 0.0237 MUSSELSHELL 27320
300011 * 0.0069 HILLSBOROUGH 30050
300012 * 0.0069 HILLSBOROUGH 30050
300020 * 0.0069 HILLSBOROUGH 30050
300034 * 0.0069 HILLSBOROUGH 30050
310010 0.0092 MERCER 31260
310011 0.0115 CAPE MAY 31180
310021 * 0.0092 MERCER 31260
310044 0.0092 MERCER 31260
310092 0.0092 MERCER 31260
310110 0.0092 MERCER 31260
320003 * 0.0629 SAN MIGUEL 32230
320011 0.0442 RIO ARRIBA 32190
330027 * 0.0149 NASSAU 33400
330106 * 0.0149 NASSAU 33400
330167 * 0.0149 NASSAU 33400
330181 * 0.0149 NASSAU 33400
330182 * 0.0149 NASSAU 33400
330198 * 0.0149 NASSAU 33400
330225 * 0.0149 NASSAU 33400
330259 * 0.0149 NASSAU 33400
330331 * 0.0149 NASSAU 33400
330332 * 0.0149 NASSAU 33400
330372 * 0.0149 NASSAU 33400
340133 0.0308 MARTIN 34580
360010 * 0.0076 TUSCARAWAS 36800
360013 * 0.0136 SHELBY 36760
360025 * 0.0072 ERIE 36220
360044 0.0124 DARKE 36190
360096 * 0.0072 COLUMBIANA 36140
360175 * 0.0176 CLINTON 36130
360185 * 0.0072 COLUMBIANA 36140
380022 * 0.0068 LINN 38210
380029 0.0075 MARION 38230
380051 0.0075 MARION 38230
380056 0.0075 MARION 38230
390030 * 0.0284 SCHUYLKILL 39650
390031 * 0.0284 SCHUYLKILL 39650
390065 * 0.049 ADAMS 39000
390138 * 0.0213 FRANKLIN 39350
390151 * 0.0213 FRANKLIN 39350
390162 * 0.02 NORTHAMPTON 39590
390181 * 0.0284 SCHUYLKILL 39650
390183 * 0.0284 SCHUYLKILL 39650
390313 * 0.0284 SCHUYLKILL 39650
420009 * 0.0113 OCONEE 42360
420039 * 0.0153 UNION 42430
420062 * 0.0109 CHESTERFIELD 42120
440030 0.0056 HAMBLEN 44310
440067 * 0.0056 HAMBLEN 44310
440084 0.0033 MONROE 44610
440153 0.0007 COCKE 44140
450324 * 0.0132 GRAYSON 45564
450370 0.024 COLORADO 45312
450393 * 0.0132 GRAYSON 45564
450395 * 0.0451 POLK 45850
450438 * 0.024 COLORADO 45312
450469 * 0.0132 GRAYSON 45564
450565 0.0486 PALO PINTO 45841
450755 0.0294 HOCKLEY 45652
510077 * 0.0021 MINGO 51290

15. On pages 24960 through 24977, in Table 5.-List of Proposed Medicare Severity-Diagnosis Related Groups (MS-DRGs), Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay, the table is corrected to read as follows:

BILLING CODE 4120-01-P

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BILLING CODE 4120-01-C

16. On pages 25095 through 25099, in Table 10.-Geometric Mean Plus The Lesser of .75 Of The National Adjusted Operating Standardized Payment Amount (Increased To Reflect The Difference Between Costs And Charges) Or .75 Of One Standard Deviation Of Mean Charges By Proposed Medicare Severity Diagnosis Related Group (MS-DRG) April 2007,1the table is corrected to read as follows:

Footnotes:

1 Cases taken from the FY 2006 MedPAR file; proposed MS-DRGs are from GROUPER Version 25.0.

Proposed MS-DRG Number of cases Threshold
1 629 $337,776
2 328 177,459
3 23,999 266,199
4 21,742 162,448
5 842 159,506
6 495 90,877
7 413 130,276
8 560 92,482
9 1,358 96,148
10 177 72,498
11 1,289 71,569
12 1,923 51,377
13 1,484 36,890
20 901 138,451
21 558 107,625
22 251 74,547
23 3,112 81,762
24 2,576 60,740
25 8,417 79,522
26 11,626 52,970
27 14,454 41,141
28 1,609 73,994
29 2,862 45,280
30 3,751 30,578
31 1,057 59,862
32 2,987 35,341
33 4,263 30,562
34 813 58,045
35 2,506 42,020
36 7,710 36,365
37 4,777 51,688
38 14,602 33,107
39 55,357 25,687
40 4,549 58,682
41 7,720 39,547
42 5,430 34,186
52 1,156 29,433
53 593 22,836
54 4,664 30,610
55 16,896 24,934
56 7,716 29,072
57 48,432 19,657
58 789 28,525
59 2,639 22,939
60 4,201 17,679
61 1,340 53,318
62 2,288 41,979
63 1,185 36,186
64 55,552 34,358
65 112,189 27,004
66 94,547 21,586
67 1,383 30,616
68 12,393 23,506
69 103,747 18,936
70 7,092 34,031
71 10,001 26,444
72 6,056 20,628
73 8,655 26,844
74 32,523 21,427
75 1,197 33,931
76 874 24,318
77 1,101 32,854
78 1,307 24,933
79 957 20,523
80 2,077 24,135
81 8,190 17,502
82 1,646 33,910
83 1,940 28,383
84 2,591 22,654
85 5,328 35,679
86 10,382 26,404
87 12,152 20,144
88 717 30,107
89 2,641 23,706
90 3,319 17,874
91 6,676 29,690
92 14,890 22,313
93 15,484 17,172
94 1,521 56,938
95 1,088 42,964
96 755 36,338
97 1,252 51,314
98 1,048 35,977
99 642 30,167
100 15,837 28,714
101 56,905 19,341
102 1,352 24,321
103 15,023 17,133
113 568 31,544
114 601 21,640
115 1,098 25,563
116 665 23,828
117 1,400 16,827
121 587 22,514
122 674 13,518
123 2,843 19,108
124 679 24,153
125 4,705 16,568
129 1,374 37,663
130 1,072 28,539
131 655 35,824
132 728 27,050
133 1,352 31,142
134 2,661 20,306
135 781 35,301
136 1,113 24,451
137 1,108 28,410
138 1,370 20,587
139 2,145 22,300
146 687 35,060
147 1,422 25,142
148 935 18,944
149 39,248 15,883
150 939 25,105
151 6,801 13,607
152 2,352 22,958
153 16,028 15,145
154 1,843 27,851
155 4,207 22,020
156 5,140 16,103
157 1,145 28,232
158 3,039 21,662
159 2,418 15,345
163 13,431 79,829
164 18,047 47,971
165 14,553 37,942
166 20,290 58,779
167 20,772 40,117
168 5,758 30,294
175 11,954 33,475
176 40,173 26,670
177 57,179 36,617
178 71,192 30,381
179 27,454 24,673
180 22,474 32,948
181 32,156 26,822
182 6,163 22,468
183 1,654 29,694
184 4,141 22,561
185 2,593 15,740
186 8,533 31,857
187 9,968 25,761
188 5,148 20,974
189 104,531 28,757
190 57,041 27,770
191 121,659 24,280
192 196,903 18,419
193 88,053 29,668
194 266,599 24,679
195 147,744 18,274
196 5,143 30,999
197 6,894 25,721
198 4,943 21,129
199 3,257 33,231
200 8,185 23,984
201 3,523 17,676
202 31,587 20,635
203 41,587 15,003
204 26,039 17,394
205 5,775 26,368
206 22,415 18,854
207 46,165 83,212
208 79,432 41,398
215 150 151,502
216 8,411 165,422
217 7,609 118,088
218 3,256 98,470
219 10,062 132,460
220 13,481 94,478
221 8,383 81,144
222 2,865 149,784
223 5,770 116,219
224 1,919 138,213
225 5,871 109,030
226 7,048 112,464
227 50,536 88,444
228 3,084 126,976
229 4,128 89,139
230 1,989 73,311
231 1,478 138,287
232 1,795 107,403
233 16,911 119,988
234 39,167 86,734
235 9,628 97,022
236 32,871 68,172
237 21,789 85,211
238 44,929 53,794
239 13,814 64,168
240 13,349 43,051
241 3,350 31,297
242 17,179 64,273
243 37,856 50,218
244 68,201 42,102
245 6,241 54,054
246 32,661 64,613
247 279,972 46,787
248 5,013 58,218
249 29,657 41,876
250 5,739 53,408
251 39,905 38,200
252 44,602 48,168
253 46,864 43,475
254 59,029 34,550
255 2,609 39,961
256 3,833 30,250
257 774 23,818
258 598 49,682
259 7,328 35,034
260 867 47,446
261 2,804 28,303
262 3,378 23,301
263 788 29,053
264 30,137 39,708
280 60,735 36,717
281 57,734 28,584
282 60,951 23,031
283 15,852 30,928
284 4,911 23,409
285 3,254 17,351
286 23,282 40,266
287 172,488 28,923
288 3,245 50,617
289 1,423 36,464
290 484 28,249
291 183,774 29,157
292 217,052 24,421
293 226,688 17,810
294 1,704 21,989
295 1,658 13,805
296 1,730 26,654
297 943 20,306
298 554 12,889
299 17,443 28,063
300 46,820 21,997
301 39,910 15,712
302 7,873 23,741
303 81,458 15,192
304 2,084 24,110
305 35,646 15,139
306 1,379 27,644
307 6,447 18,857
308 33,528 27,255
309 79,751 20,827
310 160,738 14,816
311 24,867 13,364
312 169,247 18,273
313 220,769 14,894
314 60,053 30,750
315 30,730 23,629
316 20,101 16,823
326 11,567 88,786
327 10,901 49,818
328 9,333 32,074
329 48,135 80,371
330 66,303 47,127
331 31,391 35,021
332 1,890 74,102
333 6,196 46,130
334 4,023 34,266
335 7,161 68,407
336 12,516 43,200
337 8,835 32,563
338 1,499 58,047
339 3,192 39,795
340 3,607 30,753
341 874 42,806
342 2,536 31,921
343 6,875 24,258
344 898 51,426
345 2,915 33,636
346 2,909 27,779
347 1,568 36,443
348 3,985 27,800
349 5,787 19,265
350 1,669 41,035
351 3,997 28,329
352 8,419 19,894
353 3,182 44,303
354 9,118 30,612
355 17,451 23,281
356 8,366 58,953
357 8,046 40,130
358 2,714 31,167
368 3,052 31,502
369 4,005 25,728
370 3,914 20,084
371 16,843 32,446
372 22,903 26,907
373 14,897 20,598
374 9,414 34,760
375 19,730 26,563
376 4,816 22,403
377 50,503 30,943
378 84,806 24,936
379 128,748 19,140
380 2,917 32,583
381 4,894 26,915
382 5,445 20,581
383 1,303 28,065
384 8,664 21,556
385 2,107 33,476
386 7,221 25,067
387 5,230 20,543
388 18,267 29,699
389 46,328 23,347
390 48,052 16,336
391 47,511 24,761
392 306,515 17,829
393 23,917 28,925
394 45,952 23,434
395 26,460 17,594
405 3,903 83,940
406 5,241 49,125
407 2,310 36,497
408 1,644 67,203
409 1,713 46,400
410 722 35,648
411 978 65,359
412 1,063 47,834
413 881 37,325
414 5,596 59,660
415 6,847 40,610
416 6,222 30,251
417 16,671 46,291
418 27,563 36,466
419 38,264 28,533
420 714 61,258
421 1,091 36,437
422 364 28,520
423 1,500 63,840
424 912 44,260
425 157 35,667
432 16,259 30,416
433 9,022 22,852
434 945 17,210
435 11,908 32,613
436 13,987 26,367
437 4,357 23,539
438 14,426 31,691
439 24,816 25,250
440 27,346 18,913
441 13,912 29,122
442 12,756 23,365
443 6,698 18,374
444 12,447 31,276
445 16,757 25,851
446 16,849 20,274
453 846 162,178
454 1,496 110,006
455 1,875 85,089
456 764 132,358
457 1,763 93,955
458 1,534 78,607
459 3,180 93,067
460 50,317 61,555
461 1,062 78,144
462 14,234 58,820
463 5,283 64,018
464 6,322 42,171
465 2,942 31,102
466 4,152 70,822
467 10,818 52,840
468 28,701 44,445
469 29,730 57,143
470 410,173 41,440
471 2,227 71,285
472 6,218 48,040
473 22,546 39,667
474 2,829 51,053
475 3,530 35,636
476 1,698 26,070
477 2,257 57,109
478 7,144 41,570
479 10,267 33,395
480 25,866 50,686
481 59,136 38,146
482 64,739 33,332
483 5,729 44,536
484 17,949 37,665
485 967 55,459
486 1,535 40,900
487 1,214 33,214
488 1,551 33,205
489 3,866 26,495
490 19,803 34,057
491 58,396 24,028
492 4,700 48,148
493 15,248 36,196
494 30,563 28,910
495 1,867 51,435
496 5,049 34,292
497 7,519 27,156
498 1,177 36,767
499 1,245 22,858
500 1,349 47,836
501 3,679 30,766
502 6,825 23,032
503 736 38,112
504 2,155 30,857
505 3,214 24,352
506 909 25,023
507 779 33,035
508 2,722 26,249
509 465 25,608
510 957 38,420
511 4,008 30,072
512 11,961 23,087
513 1,287 29,502
514 1,339 20,718
515 3,577 51,402
516 10,963 37,292
517 18,263 30,388
533 828 27,486
534 3,634 15,819
535 6,844 27,022
536 34,321 15,408
537 654 20,405
538 1,164 12,954
539 3,379 34,667
540 4,187 27,375
541 1,858 22,002
542 6,158 33,306
543 18,413 25,124
544 12,644 18,008
545 4,016 34,451
546 5,881 24,102
547 4,880 18,469
548 591 33,006
549 1,077 25,270
550 904 18,381
551 9,502 29,646
552 87,859 18,492
553 2,790 24,265
554 20,253 14,944
555 1,995 22,555
556 19,168 14,428
557 3,184 29,321
558 14,178 19,372
559 1,635 28,972
560 3,979 20,901
561 7,617 13,636
562 4,996 26,929
563 36,056 15,451
564 1,606 27,237
565 3,237 21,478
566 2,779 15,695
573 5,687 46,949
574 12,100 33,325
575 6,468 25,393
576 558 44,896
577 2,179 31,142
578 3,299 23,686
579 3,088 44,811
580 6,766 31,460
581 5,288 23,941
582 8,972 24,930
583 15,549 19,001
584 1,431 27,897
585 2,818 20,786
592 3,982 30,226
593 12,832 23,538
594 2,955 16,562
595 1,082 29,610
596 5,755 19,571
597 548 29,514
598 1,483 23,497
599 350 15,943
600 572 21,988
601 865 15,125
602 21,307 26,948
603 130,923 18,145
604 2,627 25,150
605 22,672 16,152
606 1,363 22,966
607 7,169 14,791
614 1,376 44,346
615 1,626 32,541
616 1,132 61,354
617 6,822 37,382
618 343 28,522
619 663 60,076
620 1,877 41,119
621 6,556 35,242
622 1,234 45,937
623 3,268 33,291
624 487 24,889
625 1,098 40,232
626 2,522 27,537
627 14,305 19,134
628 3,267 51,514
629 3,958 40,808
630 684 31,392
637 16,283 26,892
638 40,811 20,070
639 41,135 14,010
640 55,690 23,971
641 188,104 16,575
642 1,542 23,138
643 5,014 31,125
644 11,845 24,210
645 8,402 18,520
652 10,437 57,281
653 1,585 86,150
654 3,231 54,167
655 1,650 40,670
656 3,721 56,568
657 7,359 38,736
658 8,479 32,186
659 4,442 51,032
660 7,444 36,348
661 4,745 29,748
662 988 41,594
663 2,131 29,231
664 4,676 23,754
665 690 46,858
666 2,213 30,439
667 3,948 19,910
668 3,757 39,537
669 12,491 27,870
670 13,411 19,410
671 884 28,518
672 965 19,128
673 12,577 43,111
674 10,503 40,270
675 11,704 31,229
682 75,827 30,254
683 112,129 25,615
684 43,451 19,020
685 2,493 19,996
686 1,581 31,234
687 3,322 24,255
688 1,198 18,441
689 55,398 25,904
690 200,059 18,352
691 898 31,887
692 654 25,534
693 2,235 27,712
694 19,213 17,667
695 974 24,032
696 10,565 14,808
697 575 17,475
698 21,061 27,909
699 22,820 23,309
700 15,089 17,723
707 4,874 35,532
708 17,015 29,281
709 755 34,020
710 2,037 27,689
711 921 34,145
712 819 20,449
713 11,755 25,154
714 32,745 15,644
715 638 34,191
716 1,382 26,921
717 634 31,538
718 633 19,455
722 871 28,980
723 2,037 23,777
724 666 15,999
725 802 23,413
726 3,940 16,420
727 1,098 26,180
728 6,176 16,848
729 578 22,426
730 552 14,387
734 1,470 39,650
735 1,328 26,263
736 840 68,822
737 3,429 39,321
738 954 28,973
739 975 48,200
740 4,366 31,584
741 6,554 24,119
742 10,705 29,966
743 35,310 21,122
744 1,498 28,762
745 2,189 20,066
746 2,486 27,713
747 11,218 20,664
748 21,171 19,841
749 1,037 42,792
750 484 24,671
754 1,083 31,715
755 3,152 24,245
756 831 16,790
757 1,322 31,004
758 1,597 24,623
759 1,186 19,161
760 1,703 19,848
761 1,918 13,557
765 2,497 22,146
766 2,634 14,889
767 119 15,750
768 10 28,201
769 86 29,901
770 181 18,191
774 1,442 12,637
775 5,224 9,066
776 491 15,413
777 177 19,480
778 489 8,798
779 107 14,082
780 47 5,638
781 3,004 13,343
782 125 8,369
794 7 2,880
799 623 76,151
800 699 45,583
801 602 35,355
802 691 51,739
803 1,003 33,630
804 996 25,527
808 8,315 34,115
809 15,527 24,895
810 3,818 21,504
811 18,344 24,532
812 83,082 18,156
813 15,031 25,132
814 1,631 29,730
815 3,337 23,820
816 2,355 18,234
820 1,481 83,993
821 2,529 40,735
822 2,139 28,780
823 2,436 64,907
824 3,039 40,522
825 2,009 29,739
826 562 77,350
827 1,318 40,156
828 872 29,232
829 1,374 44,261
830 531 25,785
834 5,257 51,445
835 1,469 30,879
836 1,526 23,524
837 1,623 85,432
838 900 41,508
839 1,385 26,968
840 15,152 38,374
841 11,012 29,060
842 7,678 22,849
843 1,477 32,639
844 2,854 25,034
845 1,008 21,623
846 2,480 37,292
847 23,667 25,136
848 1,699 20,748
849 1,498 26,843
853 31,444 77,914
854 6,881 50,010
855 467 36,089
856 6,187 69,506
857 10,059 36,989
858 3,500 28,786
862 7,425 33,012
863 21,807 21,882
864 19,826 20,564
865 2,019 27,840
866 9,406 16,786
867 5,306 38,488
868 2,369 24,746
869 1,100 20,520
870 13,710 90,935
871 203,702 33,685
872 92,118 25,456
876 968 40,268
880 10,494 15,328
881 4,576 11,727
882 1,656 12,481
883 786 17,701
884 21,619 19,048
885 77,763 16,598
886 376 14,393
887 423 18,850
894 4,480 8,389
895 6,474 16,201
896 5,369 25,303
897 35,835 13,689
901 917 48,598
902 2,135 31,632
903 1,739 24,530
904 941 39,574
905 798 25,597
906 745 23,573
907 8,098 53,982
908 7,884 35,453
909 5,971 26,248
913 813 26,149
914 6,958 16,346
915 915 24,023
916 5,369 10,725
917 14,155 28,466
918 34,847 14,539
919 10,569 27,881
920 12,135 22,284
921 11,659 15,316
922 1,005 26,606
923 4,211 16,053
927 182 181,306
928 794 60,107
929 459 32,721
933 155 31,143
934 694 23,842
935 2,179 21,397
939 423 43,099
940 690 32,755
941 1,077 26,227
945 5,053 21,694
946 3,199 17,198
947 6,544 23,445
948 34,325 15,485
949 742 18,955
950 476 12,079
951 990 14,489
955 446 82,175
956 3,718 55,062
957 1,157 102,443
958 737 70,330
959 816 53,566
963 1,395 46,322
964 1,578 32,525
965 2,016 27,560
969 598 75,122
970 231 47,821
974 7,276 34,615
975 3,463 29,344
976 2,728 23,762
977 4,871 23,005
981 26,280 77,452
982 18,594 53,442
983 6,766 38,481
984 669 55,818
985 1,048 38,813
986 890 27,837
987 8,036 54,475
988 11,880 36,064
989 6,537 26,243
999 18 16,006

17. On pages 25118 through 25123, in Table I.-Impact Analysis of Proposed Changes For FY 2008, the listed entries and footnotes are corrected to read as follows:

BILLING CODE 4120-01-P

[Federal Register graphic "EP07JN07.019" is not available. Please view the graphic in the PDF version of this document.]

[Federal Register graphic "EP07JN07.020" is not available. Please view the graphic in the PDF version of this document.]

[Federal Register graphic "EP07JN07.021" is not available. Please view the graphic in the PDF version of this document.]

BILLING CODE 4120-01-C

18. On page25124,

Footnotes:

6 Shown here are the tentative effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB). The effects demonstrate the FY 2008 payment impact of going from no reclassifications to the reclassifications scheduled to be in effect for FY 2008. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflect the geographic budget neutrality factor of 0.991925.

7 This column displays the effects of the proposed changes in the rural floor budget neutrality adjustment applied on the wage index instead of on the standardized amount. The column reflects a proposed rural floor budget neutrality factor of 0.997080.

11 This column shows tentative changes in payments from FY 2007 to FY 2008 including a 0.976 case mix index adjustment for coding and documentation improvements that are anticipated with the adoption of the MS-DRGs prior to the assumed growth occurring. In incorporates all of the changes displayed in Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4).

12 This column shows tentative changes in payments from FY 2007 to FY 2008 with a case mix index adjustment and the assumed growth for improvements in documentation and coding. It incorporates all of the changes displayed inColumns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4). It also reflects the impact of the proposed FY 2008 update, and changes in hospitals' reclassification status in FY 2008 compared to FY 2007. The sum of these impacts may be different from the percentage changes shown here due to rounding and interactive effects.

a. First column, second full paragraph, line 25, the figure "0.999317" is corrected to read "0.999367."

b. Second column, last paragraph, line 3, the figure "0.999317" is corrected to read "0.999367."

19. On page 25125,

a. First column, last paragraph, line 5, the figure "0.991938" is corrected to read "0.991925."

b. Second column, first full paragraph, line 17, the figure "0.997084" is corrected to read "0.997080."

20. On pages 25126 through 25128, in Table II.-Impact Analysis of Proposed Changes For FY 2008 Operating Prospective Payment System, the listed entries are corrected to read as follows:

Number of hospitals Published average proposed FY 2008 paymentper case1 Corrected average proposed FY 2008 paymentper case1 Published all proposed FY 2008 changes Corrected all proposed FY 2008 changes
(1) (3) (3) (4) (4)
All hospitals 3535 9299 9299 3.3 3.3
By Geographic Location:
Urban hospitals 2540 9678 9680 3.6 3.6
Large urban areas (populations over 1 million) 1409 10156 10157 4.2 4.2
Other urban areas(populations of 1 million or fewer) 1131 9103 9107 2.8 2.9
Rural hospitals 995 7123 7110 0.9 0.7
Bed Size (Urban):
0-99 beds 632 7263 7261 0.4 0.3
100-199 beds 849 8170 8159 3.4 3.2
200-299 beds 480 9120 9117 3.5 3.4
300-499 beds 412 10136 10143 4.0 4.0
500 or more beds 167 12234 12254 4.0 4.2
Bed Size (Rural):
0-49 beds 342 6065 6045 -1.6 -1.9
50-99 beds 369 6588 6572 0.5 0.2
100-149 beds 172 6960 6945 1.3 1.1
150-199 beds 67 7735 7727 1.4 1.3
200 or more beds 45 8938 8937 2.0 2.0
Urban by Region:
New England 126 10001 10004 2.6 2.6
Middle Atlantic 350 10529 10532 2.8 2.8
South Atlantic 388 9175 9176 4.2 4.3
East North Central 395 9197 9199 3.4 3.5
East South Central 166 8784 8786 3.2 3.2
West North Central 156 9321 9334 2.8 3.0
West South Central 358 9174 9175 4.0 4.0
Mountain 153 9826 9836 3.3 3.5
Pacific 395 11657 11656 4.7 4.7
Puerto Rico 53 4525 4511 3.6 3.3
Rural by Region:
New England 19 9714 9716 0.4 0.4
Middle Atlantic 72 7525 7514 0.8 0.6
South Atlantic 173 6700 6683 1.8 1.6
East North Central 124 7574 7567 0.7 0.6
East South Central 177 6479 6462 1.2 1.0
West North Central 115 7792 7786 0.6 0.6
West South Central 194 6339 6322 -0.7 -0.9
Mountain 80 7834 7822 0.9 0.7
Pacific 41 8896 8881 2.0 1.8
By Payment Classification:
Urban hospitals 2619 9629 9631 3.6 3.6
Large urban areas (populations over 1 million) 1436 10127 10128 4.1 4.1
Other urban areas(populations of 1 million or fewer) 1183 9034 9038 2.8 2.8
Rural areas 916 7242 7230 0.9 0.8
Teaching Status:
Non-teaching 2479 7851 7844 2.7 2.6
Fewer than 100 Residents 816 9384 9385 3.5 3.5
100 or more Residents 240 13533 13555 4.1 4.2
Urban DSH:
Non-DSH 879 8307 8314 2.0 2.1
100 or more beds 1527 10182 10183 4.0 4.0
Less than 100 beds 359 6697 6682 1.9 1.6
Rural DSH:
SCH 391 7013 6994 0.3 0.0
RRC 189 7818 7809 1.7 1.6
100 or more beds 36 6028 6010 2.1 1.8
Less than 100 beds 154 5353 5335 0.4 0.0
Urban teaching and DSH:
Both teaching and DSH 805 11185 11192 4.0 4.1
Teaching and no DSH 192 9078 9089 2.5 2.6
No teaching and DSH 1081 8283 8273 3.7 3.5
No teaching and no DSH 541 7812 7817 1.9 2.0
Rural Hospital Types:
RRC 59 8358 8359 2.5 2.5
SCH 45 9301 9296 0.8 0.8
MDH 21 6339 6319 0.3 0.0
SCH and RRC 17 10239 10236 2.7 2.7
MDH and RRC 1 9674 9677 -0.8 -0.8
Type of Ownership:
Voluntary 2069 9424 9427 3.2 3.2
Proprietary 823 8478 8471 3.7 3.6
Government 598 9593 9589 3.5 3.4
Medicare Utilization as a Percent of Inpatient Days:
0-25 230 13443 13434 5.6 5.5
25-50 1292 10570 10576 4.0 4.1
50-65 1453 8116 8113 2.6 2.5
Over 65 441 7331 7325 1.2 1.2
Hospitals Reclassified by the Medicare Geographic Classification Review Board: FY 2008 Reclassifications:
All Reclassified Hospitals FY 2008 801 8938 8937 2.8 2.8
All Non-Reclassified Hospitals FY 2008 2734 9417 9416 3.4 3.4
Urban Reclassified Hospitals FY 2008 434 9581 9595 3.3 3.4
Urban Non-reclassified Hospitals FY 2008 2105 9701 9705 3.6 3.7
Rural Reclassified Hospitals FY 2008 367 7669 7663 1.5 1.4
Rural Nonreclassified Hospitals FY 2008 568 6392 6374 -0.3 -0.6
All Section 401 Reclassified Hospitals 31 8799 8787 1.8 1.6
Other Reclassified Hospitals (Section 1886(d)(8)(B)) 61 6729 6710 1.4 1.1
Former Section 508 Hospitals 107 9814 9823 0.5 0.6
Specialty Hospitals
Cardiac Specialty Hospitals 22 10676 10727 -0.6 -0.1
1 These payment amounts per case do not reflect any estimates of annual case-mix increase.

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare-Hospital Insurance; and Program No. 93.774, Medicare-Supplementary Medical Insurance Program)

Dated: June 1, 2007.

Ann C. Agnew,

Executive Secretary to the Department.

[FR Doc. 07-2806 Filed 6-1-07; 2:04 pm]

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