Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1996 Rates; Corrections

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 412 and 413

[BPD-825-FCN]

RIN 0938-AG95

Medicare Program; Changes to the Hospital Inpatient Prospective

Payment Systems and Fiscal Year 1996 Rates; Corrections

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Correction to final rule.

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SUMMARY: In the September 1, 1995, issue of the Federal Register (60 FR

45778), we published a final rule with comment period revising the

Medicare hospital inpatient prospective payment systems for operating

costs and capital-related costs to implement necessary changes arising

from our continuing experience with the system. In the addendum to that

final rule with comment period, we announced the prospective payment

rates for Medicare hospital inpatient services for operating costs and

capital-related costs applicable to discharges occurring on or after

October 1, 1995, and set forth update factors for the rate-of-increase

limits for hospitals and hospital units excluded from the prospective

payment systems. This document corrects errors made in that document.

EFFECTIVE DATE: October 1, 1995.

FOR FURTHER INFORMATION CONTACT: Stephen Phillips (410) 786-4548.

SUPPLEMENTARY INFORMATION: In the September 1, 1995, final rule with

comment period (60 FR 45778), we indicated that if a hospital believes

its wage index value is incorrect as a result of an intermediary or

HCFA error that the hospital could not have known about before

reviewing data made available in mid-August, the hospital must notify

the intermediary and HCFA in writing, to be received no later than

September 21, 1995 (see 60 FR 45794). As a result of this process, we

have identified several corrections to the wage data. Accordingly, the

wage index values for several areas have changed and are corrected in

this notice.

The final rule with comment period also contained other technical

and typographical errors. In particular, we inadvertently failed to

correct a technical error in Sec. 412.105(d), which now indicates that

the current method for determining the education adjustment factor for

hospitals that incur indirect costs for graduate medical education

(IME) programs is effective only for discharges occurring before

October 1, 1995. Since section 4002(b)(3) of the Omnibus Budget

Reconciliation Act of 1990 amended section 1886(d)(5)(B)(ii) of the

Social Security Act to eliminate the requirement that the current

method for calculating the IME adjustment was to expire as of October

1, 1995, we needed to delete the incorrect reference to the October 1,

1995, expiration date in our September 1, 1995, final rule with comment

period.

Therefore, we are making the following corrections to the September

1, 1995, final rule with comment period:

Sec. 412.105 [Corrected]

1. On page 45848, column one, item 10, the phrase ``paragraph (b)

is revised to read as follows:'' is corrected to read ``paragraphs (b)

and (d) are revised to read as follows:''

2. On page 45848, column one, item 10, insert corrected paragraph

(d), which reads as follows:

* * * * *

(d) Determination of education adjustment factor. For discharges

occurring on or after October 1, 1988, each hospital's education

adjustment factor is calculated as follows:

* * * * *

Sec. 413.40 [Corrected]

3. On page 45850, column one, Sec. 413.40(g)(1), in the third line

the phrase ``under paragraph (e) of this section'' is corrected to read

``under paragraph (g) of this section''.

4. On pages 45867 through 45882, in Table 3C--Hospital Case Mix

Indexes for Discharges Occurring in Federal Fiscal Year 1994, Hospital

Average Hourly Wage for Federal Fiscal Year 1996 Wage Index, the

average hourly wage is corrected as follows:

------------------------------------------------------------------------

Corrected

Provider Case mix Avg. hourly avg. hourly

index wage wage

------------------------------------------------------------------------

090004 01.6239 22.47 22.45

090005 01.2725 25.88 25.02

090008 01.5653 19.96 23.02

210003 01.5173 26.44 26.40

210005 01.1988 18.75 18.50

210008 01.3734 19.80 19.78

210026 01.3603 22.97 22.82

210060 01.0967 21.07 21.23

230002 01.2674 18.51 18.81

330023 01.1830 21.41 21.64

340039 01.2728 17.98 18.05

340064 01.2236 15.48 17.13

340098 01.6534 17.84 17.68

340166 01.3806 18.12 18.14

390174 01.7096 23.29 23.19

390226 01.7113 22.03 21.84

450025 01.4725 15.12 15.36

450029 01.4012 11.81 12.01

450121 01.5746 18.89 19.39

450196 01.4781 13.63 14.62

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[[Page 2726]]

5. On pages 45883 through 45889, in Table 4A--Wage Index and

Capital Geographic Adjustment Factor (GAF) for Urban Areas, the MSA

titles and counties are corrected as follows:

------------------------------------------------------------------------

MSA Corrected MSA

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1123 *Boston-Brockton-Nashua, MA- *Boston-Worcester-Lawrence-Lowell-

NH. Brockton, MA-NH.

1960 Davenport-Rock Island-Moline, Davenport-Moline-Rock Island, IA-IL.

IA-IL.

5483 *New Haven-Bridgeport- *New Haven-Bridgeport-Stamford-

Stamford-Danbury-Waterbury, CT. Waterbury-Danbury, CT.

6483 *Providence-Warwick, RI...... *Providence-Warwick-Pawtucket, RI.

7440 *San Juan-Bayamon, PR........ Counties also include: Morovis, PR;

Naguabo, PR.

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6. On pages 45883 through 45889, in Table 4A--Wage Index and

Capital Geographic Adjustment Factor (GAF) for Urban Areas, the wage

index values and GAFs are corrected as follows:

------------------------------------------------------------------------

Changed

Urban area Wage GAF wage Changed

index index GAF

------------------------------------------------------------------------

0720 Baltimore, MD.... 0.9866 0.9908 0.9865 0.9907

1520 Charlotte- 0.9668 0.9771 0.9661 0.9767

Gastonia-Rock

Hill, NC-SC.

2160 Detroit, MI...... 1.0834 1.0564 1.0837 1.0566

2281 Dutchess Co., NY. 1.0697 1.0472 1.0754 1.0510

2800 Fort Worth- 1.0052 1.0036 1.0066 1.0045

Arlington, TX.

3290 Hickory-Morganton- 0.7983 0.8570 0.8002 0.8584

Lenoir, NC.

4080 Laredo, TX....... 0.6750 0.7640 0.6834 0.7705

4640 Lynchburg, VA.... 0.8205 0.8733 0.8319 0.8816

6160 Philadelphia, PA- 1.1098 1.0739 1.1092 1.0736

NJ.

8840 Washington, DC-MD- 1.1075 1.0724 1.1116 1.0751

VA-WV.

9080 Wichita Falls, TX 0.7763 0.8408 0.7826 0.8455

------------------------------------------------------------------------

7. On pages 45889 through 45890, in Table 4B--Wage Index and

Capital Geographic Adjustment Factor (GAF) for Rural Areas, the wage

index values and the GAFs are corrected as follows:

------------------------------------------------------------------------

Changed

Non-urban Area Wage GAF wage Changed

index index GAF

------------------------------------------------------------------------

North Carolina.............. 0.7983 0.8570 0.8002 0.8584

Texas....................... 0.7302 0.8063 0.7316 0.8073

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8. On pages 45890 through 45891, in Table 4C--Wage Index and

Capital Geographic Adjustment Factor (GAF) for Hospitals that are

Reclassified, the wage index values and the GAFs are corrected as

follows:

------------------------------------------------------------------------

Changed

Area reclassified to Wage GAF wage Changed

index index GAF

------------------------------------------------------------------------

Charlotte-Gastonia-Rock

Hill, NC-SC................ 0.9668 0.9771 0.9661 0.9767

Detroit, MI................. 1.0834 1.0564 1.0837 1.0566

Dutchess Co., NY............ 1.0546 1.0371 1.0583 1.0396

Fort Worth-Arlington, TX.... 1.0052 1.0036 1.0066 1.0045

Philadelphia, PA-NJ......... 1.1098 1.0739 1.1092 1.0736

Washington, DC-MD-VA-WV..... 1.1075 1.0724 1.1116 1.0751

Rural North Carolina........ 0.7983 0.8570 0.8002 0.8584

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9. On pages 45891 through 45892, in Table 4D--Average Hourly Wage

for Urban Areas, the average hourly wage is corrected as follows:

------------------------------------------------------------------------

Corrected

Urban area Average average

hourly wage hourly wage

------------------------------------------------------------------------

Baltimore, MD................................. 18.6758 18.6732

Charlotte-Gastonia-Rock Hill, NC-SC........... 18.3004 18.2886

Detroit, MI................................... 20.4975 20.5027

Dutchess Co., NY.............................. 20.2495 20.3568

Fort Worth-Arlington, TX...................... 19.0148 19.0420

Laredo, TX.................................... 12.7772 12.9369

Lynchburg, VA................................. 15.5313 15.7477

Philadelphia, PA-NJ........................... 21.0452 21.0345

[[Page 2727]]

Washington, DC-MD-VA-WV....................... 20.9642 21.0413

Wichita Falls, TX............................. 14.6944 14.8144

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10. On pages 45892 through 45893, in Table 4E--Average Hourly Wage

for Rural Areas, the average hourly wage is corrected as follows:

------------------------------------------------------------------------

Corrected

Urban area Average average

hourly wage hourly wage

------------------------------------------------------------------------

North Carolina................................ 15.1058 15.1415

Texas......................................... 13.8226 13.8482

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(Catalog of Federal Domestic Assistance Program No. 93.778, Medical

Assistance Program; No. 93.773 Medicare--Hospital Insurance; and No.

93.774, Medicare--Supplementary Medical Insurance)

Dated: December 7, 1995.

Michael Carleton,

Acting Deputy Assistant Secretary for Information Resource Management.

[FR Doc. 96-1532 Filed 1-26-96; 8:45 am]

BILLING CODE 4120-01-P