# Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3A07-2806 ## Record - **Collection:** Federal Register - **Document type:** Proposed Rule - **Published:** June 7, 2007 - **Citation:** 72 FR 31507 ## Text 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: 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) 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: 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) 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: Table 1C.—Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor 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: Table 1D.—Capital Standard Federal Payment Rate 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 EP07JN07.000 EP07JN07.001 EP07JN07.002 EP07JN07.003 EP07JN07.004 EP07JN07.005 EP07JN07.006 EP07JN07.007 EP07JN07.008 EP07JN07.009 EP07JN07.010 EP07JN07.011 EP07JN07.012 EP07JN07.013 EP07JN07.014 EP07JN07.015 EP07JN07.016 EP07JN07.017 EP07JN07.018 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, 1 the table is corrected to read as follows: 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 EP07JN07.019 EP07JN07.020 EP07JN07.021 BILLING CODE 4120-01-C 18. On page 25124, 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 in Columns 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: Table II.—Impact Analysis of Proposed Changes for FY 2008 Operating Prospective Payment System (Payments per Case) [Percent changes in payments per case] Number of hospitals Published average proposed FY 2008 payment per case 1 Corrected average proposed FY 2008 payment per case 1 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] BILLING CODE 4120-01-P --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A07-2806. Public record. Not legal advice.