Rule2022-28517
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19; Correction
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
January 4, 2023
Effective
January 1, 2023
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This document corrects technical errors in the final rule with comment period and final rule that appeared in the Federal Register on November 23, 2022, titled "Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19."
Full Text
<html>
<head>
<title>Federal Register, Volume 88 Issue 2 (Wednesday, January 4, 2023)</title>
</head>
<body><pre>
[Federal Register Volume 88, Number 2 (Wednesday, January 4, 2023)]
[Rules and Regulations]
[Pages 297-299]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-28517]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 405, 410, 411, 412, 413, 416, 419, 424, 485, and 489
[CMS-1772-CN; CMS-3419-CN]
RIN 0938-AU82
Medicare Program: Hospital Outpatient Prospective Payment and
Ambulatory Surgical Center Payment Systems and Quality Reporting
Programs; Organ Acquisition; Rural Emergency Hospitals: Payment
Policies, Conditions of Participation, Provider Enrollment, Physician
Self-Referral; New Service Category for Hospital Outpatient Department
Prior Authorization Process; Overall Hospital Quality Star Rating;
COVID-19; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Final rule with comment period and final rule; correction.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical errors in the final rule with
comment period and final rule that appeared in the Federal Register on
November 23, 2022, titled ``Medicare Program: Hospital Outpatient
Prospective Payment and Ambulatory Surgical Center Payment Systems and
Quality Reporting Programs; Organ Acquisition; Rural Emergency
Hospitals: Payment Policies, Conditions of Participation, Provider
Enrollment, Physician Self-Referral; New Service Category for Hospital
Outpatient Department Prior Authorization Process; Overall Hospital
Quality Star Rating; COVID-19.''
DATES: This correction is effective January 1, 2023.
FOR FURTHER INFORMATION CONTACT:
Elise Barringer via email, <a href="/cdn-cgi/l/email-protection#c481a8adb7a1ea86a5b6b6adaaa3a1b684a7a9b7eaacacb7eaa3abb2"><span class="__cf_email__" data-cfemail="a7e2cbced4c289e5c6d5d5cec9c0c2d5e7c4cad489cfcfd489c0c8d1">[email protected]</span></a> or at (410)
786-9222, for general inquiries.
Kianna Banks via email, <a href="/cdn-cgi/l/email-protection#c08ba9a1aeaea1ee82a1aeabb380a3adb3eea8a8b3eea7afb6"><span class="__cf_email__" data-cfemail="c08ba9a1aeaea1ee82a1aeabb380a3adb3eea8a8b3eea7afb6">[email protected]</span></a> or at (410) 786-
3498, for issues related to REH Conditions of Participation (CoP) and
Critical Access Hospital (CAH) CoP Updates.
Nicole Hilton via email, <a href="/cdn-cgi/l/email-protection#b3fddad0dcdfd69dfbdadfc7dcddf3d0dec09ddbdbc09dd4dcc5"><span class="__cf_email__" data-cfemail="90def9f3fffcf5bed8f9fce4fffed0f3fde3bef8f8e3bef7ffe6">[email protected]</span></a> or at (410) 786-
1000, for issues related to Rural Emergency Health Quality Reporting
Program (REHQR).
Terri Postma via email, <a href="/cdn-cgi/l/email-protection#74201106061d5a241b07001915341719075a1c1c075a131b02"><span class="__cf_email__" data-cfemail="4c18293e3e25621c233f38212d0c2f213f6224243f622b233a">[email protected]</span></a> or at (410) 786-
4169, for issues related to Request for Information on Use of CMS Data
to Drive Competition in Healthcare Marketplaces.
SUPPLEMENTARY INFORMATION:
I. Background
In the final rule with comment period and final rule that appeared
in the November 23, 2022 Federal Register (87 FR 71748) titled
``Medicare Program: Hospital Outpatient Prospective Payment and
Ambulatory Surgical Center Payment Systems and Quality Reporting
Programs; Organ Acquisition; Rural Emergency Hospitals: Payment
Policies, Conditions of Participation, Provider Enrollment, Physician
Self-Referral; New Service Category for Hospital Outpatient Department
Prior Authorization Process; Overall Hospital Quality Star Rating;
COVID-19'', there were a number of technical and typographical errors
that are identified and corrected in this correcting document. The
provisions in this correction document are effective as if they had
been included in the document published November 23, 2022. Accordingly,
the corrections are effective January 1, 2023.
[[Page 298]]
II. Summary of Errors
A. Summary of Errors in the Preamble
1. Rural Emergency Health Quality Reporting Program (REHQR)
On pages 72147 and 72148, in the discussion of ``Comments on
Additional Measurement Topics and for Suggested Measures for REH
Quality Reporting,'' we are correcting typographical and technical
errors in the footnotes.
2. REH Conditions of Participation (CoP) and Critical Access Hospital
(CAH) CoP Updates (CMS-3419-F)
On page 72206, in the discussion of the addition of the definition
of ``primary roads'' to the CAH requirements at Sec. 485.610(c), we
inadverdently omitted discussion of the cross-reference making a
conforming change to the requirements at Sec. 485.610(e)(2),
``Standard: Off-campus and co-location requirements for CAHs'';
therefore, we are adding this discussion. This standard requires that
if a CAH or a necessary provider CAH that operates an off-campus
provider-based location, excluding an RHC as defined in Sec.
405.2401(b) of this chapter, but including a department or remote
location, as defined in Sec. 413.65(a)(2) of this chapter, or an off-
campus distinct part psychiatric or rehabilitation unit, as defined in
Sec. 485.647, that was created or acquired by the CAH on or after
January 1, 2008, the CAH can continue to meet the location requirement
of paragraph (c) of this section only if the off-campus provider-based
location or off-campus distinct part unit is located more than a 35-
mile drive (or, in the case of mountainous terrain or in areas with
only secondary roads available, a 15-mile drive) from a hospital or
another CAH. We are making the conforming change to note that the 35-
mile drive distance from a hospital or another CAH is on primary roads.
3. Request for Information (RFI) on Use of CMS Data To Drive
Competition in Healthcare Marketplaces
On page 72224, we incorrectly stated the number of timely pieces of
correspondence that were submitted in response to the Competition RFI
questions. We are correcting the number of timely pieces of
correspondence from ``21'' to ``22''.
B. Summary of Errors in the Regulations Text
1. On page 72306, in the REH regulations at Sec. 485.542 (e),
(e)(2), and (e)(3), we inadvertently used the term ``CAH'' when we
intended to use the term ``REH.''
2. On page 72307, we intended to amend Sec. 485.610(e)(2) to
incorporate the phrase ``on primary roads'' into the language and to
incorporate and cross-reference the change made to ``primary roads''
finalized at Sec. 485.610(c). This section requires that the off-
campus provider-based location or off-campus distinct part unit of the
CAH be located more than a 35-mile drive on primary roads (or, in the
case of mountainous terrain or in areas with only secondary roads
available, a 15-mile drive) from a hospital or another CAH. For the
purpose of determining the driving distance of an off-campus provider-
based location or off-campus distinct part unit of a CAH relative to
other facilities, ``primary roads'' are defined as a numbered federal
highway, including interstates, intrastates, expressways or any other
numbered federal highway with 2 or more lanes each way; or a numbered
State highway with 2 or more lanes each way. This technical change to
Sec. 485.610(e)(2), along with the changes made to Sec. 485.610(c),
provides clarity and consistency regarding the distance requirements.
Therefore, we are correcting Sec. 485.610(e)(2) to cross-reference the
change made at Sec. 485.610(c).
3. On page 72307, we inadvertently labeled amendatory instruction
number ``45'' amendatory instruction ``3''. Therefore, we are
correcting the instruction number to read ``45''. In addition,
instructions ``45 through 52'' beginning on page 72307 and ending on
page 72309 are corrected to read ``46 through 53''.
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of proposed rulemaking in
the Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Social Security Act (the Act)
requires the Secretary to provide notice of the proposed rulemaking in
the Federal Register and 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 sections 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
rulemaking that would be subject to these requirements. This correcting
document corrects technical and typographic errors in the preamble,
addenda, payment rates, tables, and appendices included or referenced
in the CY 2023 OPPS/ASC final rule but does not make substantive
changes to the policies or payment methodologies that were adopted in
the final rule. As a result, the corrections made through this
correcting document are intended to ensure that the information in the
CY 2023 OPPS/ASC final rule and the REH Conditions of Participation
(CoP) and Critical Access Hospital (CAH) CoP Updates final rule
accurately reflect the policies adopted in those rules.
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 providers to receive appropriate payments in as timely a
manner as possible, and to ensure that the CY 2023 OPPS/ASC final rule
and the Critical Access Hospital (CAH) CoP Updates final rule
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 payment methodologies or policies, but rather, we are
simply correctly implementing the policies that we previously proposed,
received comment on, and subsequently finalized. This correcting
document is intended solely to ensure that the CY 2023 OPPS/ASC final
rule and the Critical Access Hospital (CAH) CoP Updates final rule
accurately reflect these payment methodologies and policies. For these
reasons, we believe we have good cause
[[Page 299]]
to waive the notice and comment and effective date requirements.
IV. Correction of Errors
In FR Doc. 2022-23918 of November 23, 2022 (87 FR 71748), make the
following corrections:
A. Correction of Errors in the Preamble
1. On page 72147, third column, footnote 274 is corrected to read:
``In Brief, Rural Behavioral Health, Telehealth Challenges and
Opportunities, SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
ADMINISTRATION, (Nov 2016). <a href="https://store.samhsa.gov/product/In-Brief-Rural-Behavioral-Health-Telehealth-Challenges-and-Opportunities/SMA16-4989">https://store.samhsa.gov/product/In-Brief-Rural-Behavioral-Health-Telehealth-Challenges-and-Opportunities/SMA16-4989</a>.''.
2. On page 72148, first column, footnote 277 is corrected to read:
``Centers for Medicare and Medicaid Services Measures Inventory Tool:
Emergency Department Utilization (EDU). <a href="https://cmit.cms.gov/cmit/#/MeasureView?variantId=4866§ionNumber=1">https://cmit.cms.gov/cmit/#/MeasureView?variantId=4866§ionNumber=1</a>.''.
3. On page 72148, first column, footnote 279 is corrected to read:
``All-Cause Emergency Department (ED) Utilization for Medicaid
Beneficiaries Public Comment Framing Document. <a href="https://www.cms.gov/files/document/all-cause-ed-utilization-medicaid-beneficiaries-measure-framing-document.pdf">https://www.cms.gov/files/document/all-cause-ed-utilization-medicaid-beneficiaries-measure-framing-document.pdf</a>.''
4. On page 72148, third column, footnote 283 is corrected to read:
``Gabayan, G, et al. (January 17, 2013) Factors Associated With
Short-Term Bounce-Back Admissions After Emergency Department Discharge.
Annals of Emergency Medicine, 62(2): 136-144. <a href="https://doi.org/10.1016/j.annemergmed.2013.01.017">https://doi.org/10.1016/j.annemergmed.2013.01.017</a>.''.
5. On page 72206, under the section titled ``b. Changes for
Critical Access Hospital Conditions of Participation (Part 485, Subpart
F)''--
a. First column, the title ``(1) Conditions of Participation:
Status and Location (Sec. 485.610(c)'' is corrected to read: ``(1)
Condition of Participation: Status and Location (Sec. 485.610(c) and
485.610(e)(2))''.
b. Second column, first partial paragraph, lines 7 through 13, the
sentence ``The current regulatory requirement at Sec. 485.610(c) sets
forth the distance requirements for CAHs relative to other CAHs and
hospitals, and specific definitions as related to the distance
requirements are found in the SOM, Chapter 2, Section 2256A,'' is
corrected to read, ``The current regulatory requirement at Sec.
485.610(c) sets forth the distance requirements for CAHs relative to
other CAHs and hospitals. Additionally, the regulatory requirement at
Sec. 485.610(e)(2) sets forth the distance requirements for off-campus
provider-based locations of the CAH. Specific definitions as related to
the distance requirements are found in the SOM, Chapter 2, Section
2256A.''
6. On page 72224, third column, in the section titled ``Request for
Information on Use of CMS Data to Drive Competition in Healthcare
Marketplaces'', line 6, correct the number ``21'' to read ``22''.
B. Correction of Errors in the Regulations Text
Sec. 485.542 [Corrected]
0
7. On page 72306, first column--
0
a. Fourth paragraph, ``(e) Emergency standby and power systems,'' line
2, ``CAH'' is corrected to read ``REH''.
0
b. Sixth paragraph, ``(2) Emergency generator inspection and testing'',
line 2, ``CAH'' is corrected to read ``REH''.
0
c. Seventh paragraph, ``(3) Emergency generator fuel'', line 1,
``CAHs'' is corrected to read ``REHs''.
Sec. 485.610 [Corrected]
0
8. On page 72307,
0
a. Second column, bottom half of the page, the amendatory instruction
``3. Section 485.610 is amended by revising paragraph (c) to read as
follows:'' is corrected to read:
``45. Section 485.610 is amended by:
0
a. Revising paragraph (c); and
0
b. Amending paragraph (e)(2) by adding the phrase ``on primary roads,
as defined in paragraph (c)(2) of this section''after the phrase ``a
35-mile drive''.
The revision reads as follows:''
0
9. On pages 72307 through 72309, Amendatory instructions ``45'' through
``52'', appearing in numerical order, are corrected to read ``46''
through ``53'' respectively.
Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2022-28517 Filed 12-30-22; 11:15 am]
BILLING CODE 4120-01-P
</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>Indexed from Federal Register on January 4, 2023.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.