Rule2023-22051
Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2024 and Updates to the IRF Quality Reporting Program; 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
October 4, 2023
Effective
October 1, 2023
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This document corrects technical and typographical errors in the final rule that appeared in the August 2, 2023 Federal Register entitled "Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2024 and Updates to the IRF Quality Reporting Program" (referred to hereafter as the "FY 2024 IRF final rule"). The effective date of the FY 2024 IRF 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 68494-68495]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-22051]
[[Page 68494]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 412
[CMS-1781-CN]
RIN 0938-AV04
Medicare Program; Inpatient Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year 2024 and Updates to the IRF
Quality Reporting Program; 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 and typographical errors in
the final rule that appeared in the August 2, 2023 Federal Register
entitled ``Medicare Program; Inpatient Rehabilitation Facility
Prospective Payment System for Federal Fiscal Year 2024 and Updates to
the IRF Quality Reporting Program'' (referred to hereafter as the ``FY
2024 IRF final rule''). The effective date of the FY 2024 IRF final
rule is October 1, 2023.
DATES: This document is effective October 1, 2023.
FOR FURTHER INFORMATION CONTACT:
Heidi Oumarou, (410) 786-7942 and Bridget Dickensheets, (410) 786-
8670, for the percentage of hospital compensation hours correction.
Ariel Cress, (410) 786-8571, for the IRF quality reporting program
corrections.
Kia Burwell, (410) 786-7816 and Catie Cooksey, (410) 786-0179 for
wage index corrections.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2023-16050 of August 2, 2023, the FY 2024 IRF final rule
(88 FR 50956), there were technical and typographical errors that are
identified and corrected in this correcting document. These corrections
are effective as if they had been included in the FY 2024 IRF final
rule. Accordingly, the corrections are effective October 1, 2023.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 50978, we made a typographical error in the estimated
percentage that hospital workers' hours represent of total compensation
hours.
On pages 51017, 51020, and 51025 we inadvertently made technical
errors in measure names.
On page 51040, we made a typographical error in identifying the
calendar year.
On page 51048, we made a technical error in the Total Percent
Change for the Rural South Atlantic region in Table 21.
B. Summary of Errors and Corrections Posted on the CMS Website for the
IRF Wage Index
As discussed in the FY 2024 IRF PPS final rule (88 FR 50988 through
50989), in developing the wage index to be applied to IRFs under the
IRF 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 IRF 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 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
IRF 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).
Given this error, 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/inpatientrehabfacpps">https://www.cms.gov/medicare/medicare-fee-for-service-payment/inpatientrehabfacpps</a>.
Thus, the use of the corrected wage data for the one hospital in
CBSA 34 required the recalculation of the final FY 2024 IRF PPS wage
indexes. Additionally, as discussed in the FY 2024 IRF PPS final rule
adjustments or updates to the IRF wage index made under section
1886(j)(6) of the Social Security Act must be made in a budget-neutral
manner. Due to the recalculation and subsequent revision of the final
FY 2024 IRF PPS wage indexes, it was necessary to recalculate the FY
2024 IRF PPS wage index budget neutrality factor as well with no
subsequent changes noted. Due to the recalculated wage indexes, we
recalculated the impact analysis provided in Table 21 of the FY 2024
IRF PPS final rule (88 FR 51047 through 51049). The correction to this
error is 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/inpatientrehabfacpps">https://www.cms.gov/medicare/medicare-fee-for-service-payment/inpatientrehabfacpps</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/inpatientrehabfacpps">https://www.cms.gov/medicare/medicare-fee-for-service-payment/inpatientrehabfacpps</a>.
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
[[Page 68495]]
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) of the Act allow the
agency to avoid the 30-day delay in effective date where the agency
finds that 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 IRF final rule. The
corrections contained in this document are consistent with, and do not
make substantive changes to, the policies and payment methodologies
that were proposed, subject to notice and comment procedures, and
adopted in the FY 2024 IRF 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 IRF 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. 2023-16050 of August 2, 2023 (88 FR 50956), make the
following corrections:
1. On page 50978, second column, last full paragraph, line 28, the
percentage that reads ``97 percent'' is corrected to read ``96
percent''.
2. On page 51017, second column, first full paragraph:
a. Line 29, the measure name that reads ``Discharge in Mobility
Score'' is corrected to read ``Discharge Mobility Score''.
b. Line 30, the measure name that reads ``Discharge in Self-Care
Score'' is corrected to read ``Discharge Self-Care Score''.
3. On page 51020, third column, second full paragraph:
a. Lines 25 and 26, the measure name that reads ``Discharge in
Mobility Score'' is corrected to read ``Discharge Mobility Score''.
b. Line 26, the measure name that reads ``Discharge in Self-Care
Score'' is corrected to read ``Discharge Self-Care Score''.
4. On page 51025, second column, first partial paragraph:
a. Lines 3 and 4, the measure name that reads ``Discharge in
Mobility Score'' is corrected to read ``Discharge Mobility Score''.
b. Line 14, the measure name that reads ``Discharge in Mobility
Score'' is corrected to read ``Discharge Mobility Score''.
5. On page 51040, third column, second to last full paragraph, line
9, the public display date of the Transfer of Health (TOH) Information
to the Provider and TOH Information to the Patient measure that reads
``September 2025'' is corrected to read ``September 2024''.
6. On page 51048, Table 21 ``titled ``IRF Impact for FY 2024
(Columns 4 through 7 in percentage)'', row 29, column 7, the Total
Percent change that reads ``3.9'' is corrected to read ``4.0''.
Wilma Robinson,
Deputy Executive Secretary, Department of Health and Human Services.
[FR Doc. 2023-22051 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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