Rule2023-22050
Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2024; Correction
Primary source
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Published
October 4, 2023
Effective
October 1, 2023
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This document corrects technical errors in the final rule that appeared in the August 7, 2023 Federal Register, entitled "Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2024" (referred to hereafter as the "FY 2024 SNF final rule"). The effective date of the FY 2024 SNF final rule is October 1, 2023.
Full Text
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<title>Federal Register, Volume 88 Issue 191 (Wednesday, October 4, 2023)</title>
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[Federal Register Volume 88, Number 191 (Wednesday, October 4, 2023)]
[Rules and Regulations]
[Pages 68486-68491]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-22050]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 411, 413, 488, and 489
[CMS-1779-CN]
RIN 0938-AV02
Medicare Program; Prospective Payment System and Consolidated
Billing for Skilled Nursing Facilities; Updates to the Quality
Reporting Program and Value-Based Purchasing Program for Federal Fiscal
Year 2024; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Final rule; correction.
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SUMMARY: This document corrects technical errors in the final rule that
appeared in the August 7, 2023 Federal Register, entitled ``Medicare
Program; Prospective Payment System and Consolidated Billing for
Skilled Nursing Facilities; Updates to the Quality Reporting Program
and Value-Based Purchasing Program for Federal Fiscal Year 2024''
(referred to hereafter as the ``FY 2024 SNF final rule''). The
effective date of the FY 2024 SNF final rule is October 1, 2023.
DATES: This document is effective October 1, 2023.
FOR FURTHER INFORMATION CONTACT:
John Kane, (410) 786-0557, for information related to the SNF PPS.
Kia Burwell, (410) 786-7816, for information related to the SNF
wage index.
Tammy Luo, (410) 786-4325, for information related to the PDPM ICD-
10 mappings.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2023-16249 of August 7, 2023 (88 FR 53200), there were
technical errors that are identified and corrected in this correcting
document. These corrections are effective as if they had been included
in the FY 2024 SNF final rule. Accordingly, the corrections are
effective October 1, 2023.
II. Summary of Errors
A. Summary of Errors in the Preamble
A technical error in the calculation of the final FY 2024 SNF PPS
wage indexes required us to recalculate the wage index budget
neutrality factor; the unadjusted SNF PPS Federal per diem rates
provided on page 53209 in Tables 3 and 4; the case-mix adjusted SNF PPS
rates provided on pages 53210 through 53211 in Tables 5 and 6; figures
on pages 53214, 53215; Tables 8 and 9 on page 53215; Table 10 on pages
53215 through 53216; a figure on page 53333; and the impact analysis
provided on pages 53333 through 53334 in Table 30. Further discussions
of these errors are found in section IV. of this document.
On page 53333, we made a typographical error in a percent increase.
B. Summary of Errors and Corrections Posted on the CMS Website
1. SNF Wage Index
As discussed in the FY 2024 SNF PPS final rule (88 FR 53211 through
53214), 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 2024, 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, 2019, and before
October 1, 2020 (FY 2020 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
2024 Rates; Quality Programs and Medicare Promoting Interoperability
Program Requirements for Eligible Hospitals and Critical Access
Hospitals; Rural Emergency Hospital and Physician-Owned Hospital
Requirements; and Provider and Supplier Disclosure of Ownership; and
Medicare Disproportionate Share Hospital (DSH) Payments: Counting
Certain Days Associated with Section 1115 Demonstrations in the
Medicaid Fraction'' (88 FR 58640) (hereinafter referred to as the FY
2024 IPPS final rule). In calculating the wage index under the FY 2024
IPPS final rule, we
[[Page 68487]]
made an inadvertent error related to the calculation of the wage index.
This error is identified, discussed, and corrected in the document
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 2024
Rates; Quality Programs and Medicare Promoting Interoperability Program
Requirements for Eligible Hospitals and Critical Access Hospitals;
Rural Emergency Hospital and Physician-Owned Hospital Requirements; and
Provider and Supplier Disclosure of Ownership; and Medicare
Disproportionate Share Hospital (DSH) Payments: Counting Certain Days
Associated with Section 1115 Demonstrations in the Medicaid Fraction;
Correction,'' published elsewhere in this issue of the Federal
Register. The error that affects the unadjusted, pre-reclassified, pre-
rural floor IPPS wage data and thereby affects the SNF PPS wage data
was an error in the wage data collected from the Medicare cost reports
of one hospital (CMS Certification Number (CCN) 340064--Core-Based
Statistical Area (CBSA) 34 rural North Carolina).
As discussed previously in this section, we use the updated, pre-
reclassified, unadjusted IPPS wage data in developing the wage index
used under the SNF PPS. Due to the technical errors described
previously in this section, the published FY 2024 SNF PPS wage indexes
were incorrect. Thus, the use of the corrected wage data for the one
hospital in CBSA 34 required us to recalculate the final FY 2024 SNF
PPS wage indexes. Additionally, as discussed in the FY 2024 SNF PPS
final rule, section 1888(e)(4)(G)(ii) of the Social Security Act
requires that we apply the wage index in a manner that does not result
in aggregate payments under the SNF PPS that are greater or less than
would otherwise be made if the wage index adjustment had not been made
(88 FR 53214). To achieve this, we apply a budget neutrality factor to
the unadjusted SNF PPS Federal per diem base rates. This revision of
the final FY 2024 SNF PPS wage indexes requires us to recalculate wage
index budget neutrality factor; the unadjusted SNF PPS Federal per diem
rates provided in Tables 3 and 4 of the FY 2024 SNF PPS final rule (88
FR 53209); the case-mix adjusted SNF PPS rates provided in Tables 5 and
6 in the FY 2024 SNF PPS final rule (88 FR 53210 through 53211); and
the impact analysis provided in Table 30 of the FY 2024 SNF PPS final
rule (88 FR 53333 through 53334). The corrections to these errors are
found in section IV. of this document.
We are correcting the wage index in Table B setting forth the wage
indexes for rural areas based on CBSA labor market areas (Table B),
which is available exclusively on the CMS website at <a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html">https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html</a>. Table B has been updated to reflect the error discussed
in this correcting document, and we are republishing the wage indexes
in Tables A and B accordingly on the CMS website at <a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html">https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html</a>.
2. PDPM ICD-10 Mappings
We are correcting the following errors to the FY 2024 Patient
Driven Payment Model (PDPM) ICD-10-CM mappings (hereinafter referred to
as PDPM ICD-10 code mappings) that were made available on the CMS
website at <a href="https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm">https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm</a> in conjunction with the release of the FY 2024 SNF
PPS final rule. The FY 2024 PDPM ICD-10 code mappings file may be
accessed from the list of items under the ``PDPM Resources'' section of
the website with an effective date of ``10-01-2023.'' The preamble
language of FY 2024 SNF PPS final rule discussing ICD-10 mappings is
unaffected by these errors.
The first table in the FY 2024 PDPM ICD-10 code mappings file
displays the list of ICD-10 codes that are recorded in Item I0020B ICD
Code of the Minimum Data Set (MDS) assessment to determine a patient's
clinical category assignment under PDPM. First, we are correcting
errors in the clinical category assignment of 332 codes ranging from
C00.0 through C49.6 to reinstate their prior year's assignments from
the FY 2023 SNF PPS final rule, as we proposed no changes in clinical
categories in this code range in the FY 2024 SNF PPS proposed rule nor
finalized them in the FY 2024 SNF PPS final rule. Second, we are
correcting errors in the clinical category assignments of D75.84,
F43.81, F43.89, G90.A, and K76.82 to reflect the changes finalized in
the FY 2024 SNF PPS final rule (88 FR 53220 through 53221).
The second table in the FY 2024 PDPM ICD-10 code mappings file
displays a list of ICD-10 codes associated with comorbidities included
in the Speech-Language Pathology (SLP) component under PDPM.
Specifically, we are removing the following new ICD-10 codes effective
October 1, 2023, that were erroneously added, noting the addition of
any ICD-10 code to the SLP comorbidity list would amount to a change in
policy that would first need to undergo notice and comment rulemaking:
G20.A1, G20.A2, G20.B1, G20.B2, G20.C, G11.6, G23.3, G31.80, G31.86,
G37.81, G40.C01, G40.C09, G40.C11, G40.C19, G90.B, G93.42, G93.43,
G93.44.
Given these errors, we are republishing the PDPM ICD-10 code
mappings accordingly on the CMS website at <a href="https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm">https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm</a> effective October
1, 2023.
III. Waiver of Proposed Rulemaking
Under section 553(b) of the Administrative Procedure Act (the APA)
(5 U.S.C. 553(b)), 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 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 APA
notice and comment, and delay in effective date 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 notice and comment
rulemaking procedures for good cause if the agency makes a finding that
the notice and comment process is impracticable, unnecessary, or
contrary to the public interest, and includes a statement of the
finding and the reasons for it in the rule. In addition, section
553(d)(3) of the APA and section 1871(e)(1)(B)(ii) allow the agency to
avoid the 30-day delay in effective date where such delay is contrary
to the public interest and the agency includes in the rule a statement
of the finding and the reasons for it.
In our view, this correcting document does not constitute a
rulemaking that would be subject to these requirements. This document
merely corrects technical errors in the FY 2024 SNF final rule. The
corrections contained in this document are consistent with, and do not
make substantive changes to, the
[[Page 68488]]
policies and payment methodologies that were proposed, subject to
notice and comment procedures, and adopted in the FY 2024 SNF final
rule. As a result, the corrections made through this correcting
document are intended to resolve inadvertent errors so that the rule
accurately reflects the policies adopted in the final rule. Even if
this were a rulemaking to which the notice and comment 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 FY
2024 SNF final rule or delaying the effective date of the corrections
would be contrary to the public interest because it is in the public
interest to ensure that the rule accurately reflects our policies as of
the date they take effect. Further, such procedures would be
unnecessary because we are not making any substantive revisions to the
final rule, but rather, we are simply correcting the Federal Register
document to reflect the policies that we previously proposed, received
public comment on, and subsequently finalized in the final rule. For
these reasons, we believe there is good cause to waive the requirements
for notice and comment and delay in effective date.
IV. Correction of Errors in the Preamble
In FR Doc. 2023-16249 of August 7, 2023 (88 FR 53200), make the
following corrections:
1. On page 53209, middle of the page:
a. TABLE 3--FY 2024 UNADJUSTED FEDERAL RATE PER DIEM--URBAN is
corrected to read as follows:
Table 3--FY 2024 Unadjusted Federal Rate Per Diem--URBAN
--------------------------------------------------------------------------------------------------------------------------------------------------------
Rate component PT OT SLP Nursing NTA Non-case-mix
--------------------------------------------------------------------------------------------------------------------------------------------------------
Per Diem Amount................................... $70.26 $65.40 $26.23 $122.47 $92.40 $109.68
--------------------------------------------------------------------------------------------------------------------------------------------------------
b. TABLE 4--FY 2024 UNADJUSTED FEDERAL RATE PER DIEM--RURAL is
corrected to read as follows:
Table 4--FY 2024 Unadjusted Federal Rate Per Diem--RURAL
--------------------------------------------------------------------------------------------------------------------------------------------------------
Rate component PT OT SLP Nursing NTA Non-case-mix
--------------------------------------------------------------------------------------------------------------------------------------------------------
Per Diem Amount................................... $80.09 $73.56 $33.05 $117.01 88.28 $111.71
--------------------------------------------------------------------------------------------------------------------------------------------------------
2. On page 53210, bottom of the page, TABLE 5--PDPM CASE-MIX
ADJUSTED FEDERAL RATES AND ASSOCIATED INDEXES--URBAN (INCLUDING THE
PARITY ADJUSTMENT RECALIBRATION) is corrected to read as follows:
Table 5--PDPM Case-Mix Adjusted Federal Rates and Associated Indexes--URBAN (Including the Parity Adjustment Recalibration)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Nursing Nursing Nursing
PDPM group PT CMI PT rate OT CMI OT rate SLP CMI SLP rate CMG CMI rate NTA CMI NTA rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
A.............................. 1.45 $101.88 1.41 $92.21 0.64 $16.79 ES3 3.84 $470.28 3.06 $282.74
B.............................. 1.61 113.12 1.54 100.72 1.72 45.12 ES2 2.90 355.16 2.39 220.84
C.............................. 1.78 125.06 1.60 104.64 2.52 66.10 ES1 2.77 339.24 1.74 160.78
D.............................. 1.81 127.17 1.45 94.83 1.38 36.20 HDE2 2.27 278.01 1.26 116.42
E.............................. 1.34 94.15 1.33 86.98 2.21 57.97 HDE1 1.88 230.24 0.91 84.08
F.............................. 1.52 106.80 1.51 98.75 2.82 73.97 HBC2 2.12 259.64 0.68 62.83
G.............................. 1.58 111.01 1.55 101.37 1.93 50.62 HBC1 1.76 215.55 ......... .........
H.............................. 1.10 77.29 1.09 71.29 2.7 70.82 LDE2 1.97 241.27 ......... .........
I.............................. 1.07 75.18 1.12 73.25 3.34 87.61 LDE1 1.64 200.85 ......... .........
J.............................. 1.34 94.15 1.37 89.60 2.83 74.23 LBC2 1.63 199.63 ......... .........
K.............................. 1.44 101.17 1.46 95.48 3.5 91.81 LBC1 1.35 165.33 ......... .........
L.............................. 1.03 72.37 1.05 68.67 3.98 104.40 CDE2 1.77 216.77 ......... .........
M.............................. 1.20 84.31 1.23 80.44 ......... ......... CDE1 1.53 187.38 ......... .........
N.............................. 1.40 98.36 1.42 92.87 ......... ......... CBC2 1.47 180.03 ......... .........
O.............................. 1.47 103.28 1.47 96.14 ......... ......... CA2 1.03 126.14 ......... .........
P.............................. 1.02 71.67 1.03 67.36 ......... ......... CBC1 1.27 155.54 ......... .........
Q.............................. ......... ......... ......... ......... ......... ......... CA1 0.89 109.00 ......... .........
R.............................. ......... ......... ......... ......... ......... ......... BAB2 0.98 120.02 ......... .........
S.............................. ......... ......... ......... ......... ......... ......... BAB1 0.94 115.12 ......... .........
T.............................. ......... ......... ......... ......... ......... ......... PDE2 1.48 181.26 ......... .........
U.............................. ......... ......... ......... ......... ......... ......... PDE1 1.39 170.23 ......... .........
V.............................. ......... ......... ......... ......... ......... ......... PBC2 1.15 140.84 ......... .........
W.............................. ......... ......... ......... ......... ......... ......... PA2 0.67 82.05 ......... .........
X.............................. ......... ......... ......... ......... ......... ......... PBC1 1.07 131.04 ......... .........
Y.............................. ......... ......... ......... ......... ......... ......... PA1 0.62 75.93 ......... .........
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[[Page 68489]]
3. On page 53211, top of the page, TABLE 6--PDPM CASE-MIX ADJUSTED
FEDERAL RATES AND ASSOCIATED INDEXES--RURAL (INCLUDING THE PARITY
ADJUSTMENT RECALIBRATION) is corrected to read as follows:
Table 6--PDPM Case-Mix Adjusted Federal Rates and Associated Indexes--RURAL (Including the Parity Adjustment Recalibration)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Nursing Nursing Nursing
PDPM group PT CMI PT rate OT CMI OT rate SLP CMI SLP rate CMG CMI rate NTA CMI NTA rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
A.............................. 1.45 $116.13 1.41 $103.72 0.64 $21.15 ES3 3.84 $449.32 3.06 $270.14
B.............................. 1.61 128.94 1.54 113.28 1.72 56.85 ES2 2.90 339.33 2.39 210.99
C.............................. 1.78 142.56 1.60 117.70 2.52 83.29 ES1 2.77 324.12 1.74 153.61
D.............................. 1.81 144.96 1.45 106.66 1.38 45.61 HDE2 2.27 265.61 1.26 111.23
E.............................. 1.34 107.32 1.33 97.83 2.21 73.04 HDE1 1.88 219.98 0.91 80.33
F.............................. 1.52 121.74 1.51 111.08 2.82 93.20 HBC2 2.12 248.06 0.68 60.03
G.............................. 1.58 126.54 1.55 114.02 1.93 63.79 HBC1 1.76 205.94 ......... .........
H.............................. 1.10 88.10 1.09 80.18 2.7 89.24 LDE2 1.97 230.51 ......... .........
I.............................. 1.07 85.70 1.12 82.39 3.34 110.39 LDE1 1.64 191.90 ......... .........
J.............................. 1.34 107.32 1.37 100.78 2.83 93.53 LBC2 1.63 190.73 ......... .........
K.............................. 1.44 115.33 1.46 107.40 3.5 115.68 LBC1 1.35 157.96 ......... .........
L.............................. 1.03 82.49 1.05 77.24 3.98 131.54 CDE2 1.77 207.11 ......... .........
M.............................. 1.20 96.11 1.23 90.48 ......... ......... CDE1 1.53 179.03 ......... .........
N.............................. 1.40 112.13 1.42 104.46 ......... ......... CBC2 1.47 172.00 ......... .........
O.............................. 1.47 117.73 1.47 108.13 ......... ......... CA2 1.03 120.52 ......... .........
P.............................. 1.02 81.69 1.03 75.77 ......... ......... CBC1 1.27 148.60 ......... .........
Q.............................. ......... ......... ......... ......... ......... ......... CA1 0.89 104.14 ......... .........
R.............................. ......... ......... ......... ......... ......... ......... BAB2 0.98 114.67 ......... .........
S.............................. ......... ......... ......... ......... ......... ......... BAB1 0.94 109.99 ......... .........
T.............................. ......... ......... ......... ......... ......... ......... PDE2 1.48 173.17 ......... .........
U.............................. ......... ......... ......... ......... ......... ......... PDE1 1.39 162.64 ......... .........
V.............................. ......... ......... ......... ......... ......... ......... PBC2 1.15 134.56 ......... .........
W.............................. ......... ......... ......... ......... ......... ......... PA2 0.67 78.40 ......... .........
X.............................. ......... ......... ......... ......... ......... ......... PBC1 1.07 125.20 ......... .........
Y.............................. ......... ......... ......... ......... ......... ......... PA1 0.62 72.55 ......... .........
--------------------------------------------------------------------------------------------------------------------------------------------------------
4. On page 53214, first column, first full paragraph, line 27, the
figure ``0.9997'' is corrected to read ``0.9996''.
5. On page 53215, above Table 8, third column, first partial
paragraph, line 7, the figure ``$21,717.98'' is corrected to read
``$21,715.82''.
6. On page 53215, middle of the page, TABLE 8--PDPM CASE-MIX
ADJUSTED RATE COMPUTATION EXAMPLE is corrected to read as follows:
Table 8--PDPM Case-Mix Adjusted Rate Computation Example
----------------------------------------------------------------------------------------------------------------
Per diem rate calculation
-----------------------------------------------------------------------------------------------------------------
VPD adjustment
Component Component group Component rate factor VPD adj. rate
----------------------------------------------------------------------------------------------------------------
PT.................................... N $98.36 1.00 $98.36
OT.................................... N 92.87 1.00 92.87
SLP................................... H 70.82 1.00 70.82
Nursing............................... N 180.03 1.00 180.03
NTA................................... C 160.78 3.00 482.34
Non-Case-Mix.......................... ........................ 109.68 .............. 109.68
-------------------------------------------------------------------------
Total PDPM Case-Mix Adj. Per Diem. ........................ .............. .............. 1,034.10
----------------------------------------------------------------------------------------------------------------
7. On page 53215, middle of the page, TABLE 9--WAGE INDEX ADJUSTED
RATE COMPUTATION EXAMPLE is corrected to read as follows:
[[Page 68490]]
Table 9--Wage Index Adjusted Rate Computation Example
--------------------------------------------------------------------------------------------------------------------------------------------------------
PDPM wage index adjustment calculation
---------------------------------------------------------------------------------------------------------------------------------------------------------
PDPM case-mix Total case mix
HIPPS code adjusted per Labor portion Wage index Wage index Non-labor and wage index
diem adjusted rate portion adj. rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
NHNC1............................................. $1,034.10 $735.25 0.9637 $708.56 $298.85 $1,007.41
--------------------------------------------------------------------------------------------------------------------------------------------------------
8. On pages 53215 through 53216, TABLE 10--ADJUSTED RATE
COMPUTATION EXAMPLE is corrected to read as follows:
Table 10--Adjusted Rate Computation Example
----------------------------------------------------------------------------------------------------------------
Case mix and
NTA VPD PT/OT VPD wage index
Day of stay adjustment adjustment adjusted per
factor factor diem rate
----------------------------------------------------------------------------------------------------------------
1............................................................... 3.0 1.0 $1,007.41
2............................................................... 3.0 1.0 1,007.41
3............................................................... 3.0 1.0 1,007.41
4............................................................... 1.0 1.0 694.15
5............................................................... 1.0 1.0 694.15
6............................................................... 1.0 1.0 694.15
7............................................................... 1.0 1.0 694.15
8............................................................... 1.0 1.0 694.15
9............................................................... 1.0 1.0 694.15
10.............................................................. 1.0 1.0 694.15
11.............................................................. 1.0 1.0 694.15
12.............................................................. 1.0 1.0 694.15
13.............................................................. 1.0 1.0 694.15
14.............................................................. 1.0 1.0 694.15
15.............................................................. 1.0 1.0 694.15
16.............................................................. 1.0 1.0 694.15
17.............................................................. 1.0 1.0 694.15
18.............................................................. 1.0 1.0 694.15
19.............................................................. 1.0 1.0 694.15
20.............................................................. 1.0 1.0 694.15
21.............................................................. 1.0 0.98 690.42
22.............................................................. 1.0 0.98 690.42
23.............................................................. 1.0 0.98 690.42
24.............................................................. 1.0 0.98 690.42
25.............................................................. 1.0 0.98 690.42
26.............................................................. 1.0 0.98 690.42
27.............................................................. 1.0 0.98 690.42
28.............................................................. 1.0 0.96 686.70
29.............................................................. 1.0 0.96 686.70
30.............................................................. 1.0 0.96 686.70
-----------------------------------------------
Total Payment............................................... .............. .............. 21,715.82
----------------------------------------------------------------------------------------------------------------
9. On page 53333, third column, fourth full paragraph, line 6, the
figure ``3.0'' is corrected to read ``3.3''.
10. On pages 53333 through 53334, TABLE 30--IMPACT TO THE SNF PPS
FOR FY 2024 is corrected to read as follows:
Table 30--Impact to the SNF PPS for FY 2024
----------------------------------------------------------------------------------------------------------------
Parity
Number of adjustment Update wage Total change
Impact categories facilities recalibration data (%) (%)
(%)
----------------------------------------------------------------------------------------------------------------
Group
----------------------------------------------------------------------------------------------------------------
Total........................................... 15,503 -2.3 0.0 4.0
Urban........................................... 11,254 -2.3 0.1 4.1
Rural........................................... 4,249 -2.2 -0.7 3.3
Hospital-based urban............................ 366 -2.3 0.0 4.0
Freestanding urban.............................. 10,888 -2.3 0.1 4.1
Hospital-based rural............................ 378 -2.2 -0.3 3.7
[[Page 68491]]
Freestanding rural.............................. 3,871 -2.2 -0.7 3.3
----------------------------------------------------------------------------------------------------------------
Urban by region
----------------------------------------------------------------------------------------------------------------
New England..................................... 734 -2.3 -0.7 3.2
Middle Atlantic................................. 1,471 -2.4 1.3 5.3
South Atlantic.................................. 1,945 -2.3 0.1 4.1
East North Central.............................. 2,181 -2.3 -0.7 3.2
East South Central.............................. 555 -2.2 0.0 4.0
West North Central.............................. 958 -2.3 -0.4 3.6
West South Central.............................. 1,454 -2.3 0.0 4.0
Mountain........................................ 546 -2.3 -0.9 3.0
Pacific......................................... 1,404 -2.4 0.1 4.0
Outlying........................................ 6 -2.0 -2.6 1.6
----------------------------------------------------------------------------------------------------------------
Rural by region
----------------------------------------------------------------------------------------------------------------
New England..................................... 117 -2.3 -1.1 2.8
Middle Atlantic................................. 205 -2.2 -0.3 3.7
South Atlantic.................................. 489 -2.2 0.1 4.2
East North Central.............................. 907 -2.2 -0.9 3.1
East South Central.............................. 491 -2.2 -0.8 3.2
West North Central.............................. 1,011 -2.2 -0.9 3.1
West South Central.............................. 738 -2.2 -0.5 3.5
Mountain........................................ 199 -2.3 -0.7 3.3
Pacific......................................... 91 -2.3 -2.0 1.9
Outlying........................................ 1 -2.3 0.1 3.9
----------------------------------------------------------------------------------------------------------------
Ownership
----------------------------------------------------------------------------------------------------------------
For profit...................................... 10,912 -2.3 0.0 4.0
Non-profit...................................... 3,573 -2.3 0.0 3.9
Government...................................... 1,018 -2.3 -0.4 3.6
----------------------------------------------------------------------------------------------------------------
Note: The Total column includes the FY 2024 6.4 percent market basket update. The values presented in Table 30
may not sum due to rounding.
Wilma Robinson,
Deputy Executive Secretary, Department of Health and Human Services.
[FR Doc. 2023-22050 Filed 9-29-23; 4:15 pm]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on October 4, 2023.
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