[Federal Register Volume 76, Number 186 (Monday, September 26, 2011)]
[Rules and Regulations]
[Pages 59256-59263]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-24671]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 412
[CMS-1349-CN]
RIN 0938-AQ28
Medicare Program; Inpatient Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year 2012; Changes in Size and Square
Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric
Units; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; correction.
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SUMMARY: This document corrects technical errors that appeared in the
final rule published in the Federal Register on August 5, 2011 entitled
``Medicare Program; Inpatient Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year 2012; Changes in Size and Square
Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric
Units,'' (hereinafter FY 2012 IRF PPS final rule (76 FR 47836)).
DATES: Effective Date. The corrections are effective October 1, 2011.
FOR FURTHER INFORMATION CONTACT: Susanne Seagrave, (410) 786-0044.
SUPPLEMENTARY INFORMATION:
I. Background
There were technical errors in the August 5, 2011 FY 2012 IRF PPS
final rule (76 FR 47836). These technical errors are identified and
corrected in the ``Summary of Errors'' and ``Correction of Errors''
sections below. The provisions in this correction document are
effective as if they were included in the final rule published on
August 5, 2011. Accordingly, the corrections are effective October 1,
2011.
II. Summary of Errors
In the August 5, 2011 final rule (76 FR 47836), we applied our
established formula for calculating the relative weight values for
case-mix groups (CMG). The CMG relative weight values for CMGs 1201,
1202, 1203, 1301, 1302, and 1303 in Table 1 on pages 47842 through
47844 of the final rule did not reflect our policy that the relative
weight values for higher-paying tiers must always be greater than or
equal to the relative weight values for lower-paying tiers. That is, a
tier 1 payment for a given CMG must always be at least as high as a
tier 2 payment for that same CMG, the tier 2 payment must always be at
least as high as the tier 3 payment, and the tier 3 payment must always
be at least as high as the ``no-comorbidity'' tier payment. We have
used this policy in calculating the CMG relative weights since the
inception of the IRF PPS. However, we inadvertently did not apply this
policy correctly for CMGs 1201, 1202, 1203, 1301, 1302, and 1303 in
Table 1 on pages 47842 through 47844 of the FY 2012 IRF PPS final rule.
Further, as discussed in ``Step 4'' in the CMG relative weights
discussion, column 1, on page 47841 of the FY 2012 IRF PPS final rule,
we normalized the FY 2012 CMG relative weights to the same average CMG
relative weight values from the FY 2011 IRF PPS notice (75 FR 42836).
As this process utilized the incorrect values that had been listed for
the relative weight values for CMGs 1201, 1202, 1203, 1301, 1302, and
1303, upon correction we also needed to reapply the normalization
process to the other CMGs using the corrected relative weight values.
This process corrects the relative weight values for all CMGs so that
we are appropriately applying the policy of normalizing the FY 2012 CMG
relative weights to the same average CMG relative weight values from
the FY 2011 IRF PPS notice.
Since the FY 2012 payment rates listed in Table 11 on pages 47865
through 47866 of the final rule are based on the CMG relative weights
in Table 1 (the payment rates are equal to the CMG relative weights
multiplied by the FY 2012 Standard Payment Conversion Factor), we are
also providing corrections to Table 11 in the final rule to reflect the
corrections to the CMG relative weights in Table 1. In addition, we are
correcting the example of computing the IRF FY 2012 Federal prospective
payment in Table 12 on page 47867 of the final rule to reflect the
correction to the unadjusted Federal prospective payment rate for CMG
0110 (without comorbidities) from Table 11.
Finally, we utilized the CMG payment rates reflected in Table 11 of
the IRF PPS final rule to determine the FY 2012 outlier threshold. As
described in the final rule, the outlier threshold is to be set so that
the estimated total outlier payments in FY 2012 will equal 3 percent of
total estimated payments. Since corrections to the FY 2012 payment
rates result in slight differences in the amount of outlier payments we
estimate for FY 2012, the use of the corrected data results in an
outlier threshold for FY 2012 IRF PPS of $10,713. Therefore, we are
correcting the outlier threshold amount for FY 2012 from $10,660 to
$10,713 to ensure
[[Page 59257]]
that estimated outlier payments for FY 2012 continue to equal 3 percent
of total estimated payments.
We note that the corrections to the CMG relative weight values in
Table 1 of the FY 2012 IRF PPS final rule do not affect the average
length of stay values, which we have republished here for simplicity.
The average length of stay values are the same values that were
published correctly in Table 1 of the August 5, 2011 final rule (76 FR
47836).
As a result of the corrections to Table 1 and Table 11 of the final
rule, as well as the correction to the FY 2012 outlier threshold
amount, some of the numbers in Table 14 on page 47887 of the final rule
(the IRF Impact Table for FY 2012), also need to be corrected. We are
correcting these numbers both in Table 14 and in the preamble text that
references Table 14.
III. Waiver of Proposed Rulemaking and Delayed Effective Date
In accordance with the Administrative Procedure Act (APA) (5 U.S.C.
553(b)), we ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a rule take effect. We also ordinarily provide a 30-day
delay in the effective date of the provisions of a rule in accordance
with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive
both notice and comment procedures and the 30-day delay in effective
date if the Secretary finds, for good cause, that such procedures are
impracticable, unnecessary, or contrary to the public interest, and
incorporates a statement of the finding and the reasons into the
notice.
The corrections that are laid out in this document were
necessitated by an inadvertent error to accurately apply our stated
policies as we calculated and laid out the CMG relative weight values
in Table 1 of the FY 2012 IRF PPS final rule. As a result of those
calculation errors, corrections were needed in Tables 1, 11, 12 and 14.
Corrections were also needed as a result of these calculation errors in
the places indicated above in the preamble discussion.
Upon recognition of these calculation errors, we reviewed the
comments that were submitted in response to our FY 2012 IRF PPS
proposed rule. We found that the necessary corrections would not have
altered the substantive content of those comments.
As the corrections necessitated by the calculation errors outlined
above do not change the stated policies in the FY 2012 IRF PPS final
rule, as the policies and payment methodology expressed in the FY 2012
IRF PPS final rule (76 FR 47836) have previously been subjected to
notice and comment procedures, and as the public's comments would not
have been affected if we had published the correctly calculated data
elements, we find it unnecessary to undertake further notice and
comment procedures with respect to this correction document. Further,
the corrections made in this document will not significantly affect
anticipated overall reimbursements to IRF providers and, as such, will
only result in negligible changes to anticipated revenues and will not
necessitate any actions on the part of individual providers. Therefore,
we find good cause to waive notice and comment procedures and the 30-
day delay in the effective date for this correction document.
IV. Correction of Errors
In the August 5, 2011 FY 2012 IRF PPS final rule (76 FR 47836),
make the following corrections:
1. On pages 47842 through 47844, Table 1, ``Relative Weights and
Average Length of Stay Values for Case-Mix Groups,'' is corrected as
follows:
Table 1--Relative Weights and Average Length of Stay Values for Case-Mix Groups
----------------------------------------------------------------------------------------------------------------
Relative weight Average length of stay
CMG CMG Description (M = motor, C = -----------------------------------------------------------------------
cognitive, A = age) Tier 1 Tier 2 Tier 3 None Tier 1 Tier 2 Tier 3 None
----------------------------------------------------------------------------------------------------------------
0101... Stroke M>51.05................. 0.7671 0.7177 0.6447 0.6098 10 10 9 8
0102... Stroke M>44.45 and M<51.05 and 0.9521 0.8908 0.8002 0.7568 12 13 10 10
C>18.5.
0103... Stroke M>44.45 and M<51.05 and 1.1369 1.0637 0.9555 0.9037 14 14 12 12
C<18.5.
0104... Stroke M>38.85 and M<44.45..... 1.1812 1.1052 0.9928 0.9389 15 14 13 12
0105... Stroke M>34.25 and M<38.85..... 1.3725 1.2841 1.1535 1.0910 16 17 14 14
0106... Stroke M>30.05 and M<34.25..... 1.5805 1.4788 1.3284 1.2564 20 18 16 16
0107... Stroke M>26.15 and M<30.05..... 1.7895 1.6743 1.5040 1.4225 20 20 18 18
0108... Stroke M<26.15 and A>84.5...... 2.2165 2.0738 1.8629 1.7619 31 25 23 22
0109... Stroke M>22.35 and M<26.15 and 2.0496 1.9177 1.7226 1.6292 24 23 20 20
A<84.5.
0110... Stroke M<22.35 and A<84.5...... 2.6418 2.4717 2.2203 2.1000 33 29 26 25
0201... Traumatic brain injury M>53.35 0.7466 0.6128 0.5677 0.5154 8 8 7 8
and C>23.5.
0202... Traumatic brain injury M>44.25 1.0607 0.8707 0.8065 0.7323 12 12 10 10
and M<53.35 and C>23.5.
0203... Traumatic brain injury M>44.25 1.2074 0.9911 0.9181 0.8336 16 11 13 12
and C<23.5.
0204... Traumatic brain injury M>40.65 1.2649 1.0383 0.9618 0.8733 16 12 12 12
and M<44.25.
0205... Traumatic brain injury M>28.75 1.5974 1.3113 1.2146 1.1029 17 18 15 14
and M<40.65.
0206... Traumatic brain injury M>22.05 1.9887 1.6325 1.5122 1.3731 23 19 19 18
and M<28.75.
0207... Traumatic brain injury M<22.05. 2.6902 2.2084 2.0455 1.8574 35 27 25 22
0301... Non-traumatic brain injury 1.0568 0.9507 0.8434 0.7725 12 12 11 10
M>41.05.
0302... Non-traumatic brain injury 1.3383 1.2039 1.0681 0.9782 12 15 13 13
M>35.05 and M<41.05.
0303... Non-traumatic brain injury 1.5912 1.4315 1.2699 1.1631 21 17 15 14
M>26.15 and M<35.05.
0304... Non-traumatic brain injury 2.2032 1.9820 1.7583 1.6104 29 23 20 19
M<26.15.
0401... Traumatic spinal cord injury 1.0564 0.8795 0.8001 0.7020 14 14 11 10
M>48.45.
0402... Traumatic spinal cord injury 1.3772 1.1465 1.0430 0.9151 17 14 13 12
M>30.35 and M<48.45.
0403... Traumatic spinal cord injury 2.4588 2.0470 1.8622 1.6339 29 26 23 20
M>16.05 and M<30.35.
0404... Traumatic spinal cord injury 4.3666 3.6353 3.3070 2.9016 52 39 38 35
M<16.05 and A>63.5.
0405... Traumatic spinal cord injury 3.8573 3.2113 2.9213 2.5632 52 39 36 29
M<16.05 and A<63.5.
0501... Non-traumatic spinal cord 0.6555 0.6294 0.5613 0.4975 10 10 7 7
injury M>51.35.
0502... Non-traumatic spinal cord 0.9809 0.9418 0.8399 0.7444 13 13 11 10
injury M>40.15 and M<51.35.
0503... Non-traumatic spinal cord 1.2453 1.1956 1.0663 0.9450 16 14 13 12
injury M>31.25 and M<40.15.
0504... Non-traumatic spinal cord 1.5015 1.4416 1.2856 1.1394 18 16 16 14
injury M>29.25 and M<31.25.
0505... Non-traumatic spinal cord 1.7549 1.6848 1.5026 1.3317 20 21 18 17
injury M>23.75 and M<29.25.
0506... Non-traumatic spinal cord 2.4598 2.3616 2.1062 1.8667 34 28 24 23
injury M<23.75.
0601... Neurological M>47.75........... 0.9452 0.7987 0.7286 0.6586 10 11 9 9
[[Page 59258]]
0602... Neurological M>37.35 and 1.2511 1.0572 0.9644 0.8717 12 13 12 11
M<47.75.
0603... Neurological M>25.85 and 1.6157 1.3654 1.2455 1.1258 17 16 14 14
M<37.35.
0604... Neurological M<25.85........... 2.1425 1.8106 1.6515 1.4929 24 21 19 18
0701... Fracture of lower extremity 0.7996 0.7871 0.7581 0.6767 10 12 10 9
M>42.15.
0702... Fracture of lower extremity 1.0462 1.0299 0.9919 0.8854 12 13 12 12
M>34.15 and M<42.15.
0703... Fracture of lower extremity 1.2589 1.2393 1.1937 1.0654 15 15 14 14
M>28.15 and M<34.15.
0704... Fracture of lower extremity 1.6270 1.6017 1.5426 1.3769 18 19 18 17
M<28.15.
0801... Replacement of lower extremity 0.5777 0.5777 0.5383 0.4915 7 8 7 7
joint M>49.55.
0802... Replacement of lower extremity 0.7792 0.7792 0.7262 0.6630 8 11 9 9
joint M>37.05 and M<49.55.
0803... Replacement of lower extremity 1.0718 1.0718 0.9988 0.9119 11 14 13 12
joint M>28.65 and M<37.05 and
A>83.5.
0804... Replacement of lower extremity 0.9510 0.9510 0.8863 0.8092 10 12 11 10
joint M>28.65 and M<37.05 and
A<83.5.
0805... Replacement of lower extremity 1.1734 1.1734 1.0936 0.9984 11 14 13 13
joint M>22.05 and M<28.65.
0806... Replacement of lower extremity 1.4368 1.4368 1.3390 1.2225 13 18 16 15
joint M<22.05.
0901... Other orthopedic M>44.75....... 0.8460 0.7455 0.6746 0.6112 10 10 9 8
0902... Other orthopedic M>34.35 and 1.1316 0.9971 0.9023 0.8175 12 13 12 11
M<44.75.
0903... Other orthopedic M>24.15 and 1.4493 1.2770 1.1556 1.0470 16 16 14 13
M<34.35.
0904... Other orthopedic M<24.15....... 1.8779 1.6547 1.4973 1.3566 21 20 18 17
1001... Amputation, lower extremity 1.0321 0.9074 0.8107 0.7246 13 12 10 10
M>47.65.
1002... Amputation, lower extremity 1.3551 1.1914 1.0645 0.9514 16 14 13 12
M>36.25 and M<47.65.
1003... Amputation, lower extremity 2.0018 1.7600 1.5725 1.4055 21 21 18 17
M<36.25.
1101... Amputation, non-lower extremity 1.0375 1.0375 0.9841 0.9236 11 11 12 11
M>36.35.
1102... Amputation, non-lower extremity 1.5611 1.5611 1.4808 1.3897 14 18 16 16
M<36.35.
1201... Osteoarthritis M>37.65......... 0.8554 0.8554 0.8088 0.7645 13 13 11 10
1202... Osteoarthritis M>30.75 and 1.1152 1.1152 1.0544 0.9966 16 16 14 13
M<37.65.
1203... Osteoarthritis M<30.75......... 1.3737 1.3737 1.2989 1.2277 13 19 15 15
1301... Rheumatoid, other arthritis 0.8929 0.8929 0.8833 0.7875 11 10 11 10
M>36.35.
1302... Rheumatoid, other arthritis 1.1759 1.1759 1.1632 1.0370 17 17 14 13
M>26.15 and M<36.35.
1303... Rheumatoid, other arthritis 1.5198 1.5198 1.5035 1.3403 15 19 18 16
M<26.15.
1401... Cardiac M>48.85................ 0.9405 0.7530 0.6659 0.6022 10 10 9 8
1402... Cardiac M>38.55 and M<48.85.... 1.2630 1.0112 0.8941 0.8087 13 12 11 10
1403... Cardiac M>31.15 and M<38.55.... 1.5254 1.2213 1.0799 0.9767 18 14 13 12
1404... Cardiac M<31.15................ 1.9757 1.5818 1.3987 1.2651 24 19 16 15
1501... Pulmonary M>49.25.............. 0.9606 0.8970 0.7731 0.7308 10 11 8 9
1502... Pulmonary M>39.05 and M<49.25.. 1.2091 1.1290 0.9732 0.9198 13 13 11 11
1503... Pulmonary M>29.15 and M<39.05.. 1.4911 1.3923 1.2001 1.1343 16 16 13 13
1504... Pulmonary M<29.15.............. 1.8836 1.7589 1.5160 1.4330 22 18 17 16
1601... Pain syndrome M>37.15.......... 1.1167 0.8790 0.7713 0.7211 12 12 10 10
1602... Pain syndrome M>26.75 and 1.4957 1.1773 1.0331 0.9658 19 13 13 13
M<37.15.
1603... Pain syndrome M<26.75.......... 1.9322 1.5210 1.3347 1.2477 22 18 16 15
1701... Major multiple trauma without 1.0424 0.9277 0.8419 0.7360 10 11 11 10
brain or spinal cord injury
M>39.25.
1702... Major multiple trauma without 1.3755 1.2242 1.1110 0.9712 13 15 14 13
brain or spinal cord injury
M>31.05 and M<39.25.
1703... Major multiple trauma without 1.6223 1.4439 1.3104 1.1455 15 16 15 15
brain or spinal cord injury
M>25.55 and M<31.05.
1704... Major multiple trauma without 2.0766 1.8482 1.6773 1.4663 26 22 20 18
brain or spinal cord injury
M<25.55.
1801... Major multiple trauma with 1.1991 0.9837 0.9497 0.8687 14 15 12 11
brain or spinal cord injury
M>40.85.
1802... Major multiple trauma with 1.6464 1.3507 1.3040 1.1927 18 20 15 15
brain or spinal cord injury
M>23.05 and M<40.85.
1803... Major multiple trauma with 2.8188 2.3124 2.2325 2.0420 34 32 26 24
brain or spinal cord injury
M<23.05.
1901... Guillian Barre M>35.95......... 1.1440 1.0078 0.9143 0.8879 13 14 12 12
1902... Guillian Barre M>18.05 and 2.1760 1.9170 1.7390 1.6888 22 22 21 21
M<35.95.
1903... Guillian Barre M<18.05......... 3.6334 3.2009 2.9037 2.8199 48 29 34 32
2001... Miscellaneous M>49.15.......... 0.8533 0.7540 0.6760 0.6073 9 10 9 8
2002... Miscellaneous M>38.75 and 1.1420 1.0091 0.9047 0.8128 12 12 11 10
M<49.15.
2003... Miscellaneous M>27.85 and 1.4421 1.2742 1.1425 1.0264 15 15 13 13
M<38.75.
2004... Miscellaneous M<27.85.......... 1.9337 1.7086 1.5319 1.3763 24 20 18 16
2101... Burns M>0...................... 2.4686 2.1368 1.7017 1.3793 34 23 19 18
5001... Short-stay cases, length of ....... ....... ....... 0.1474 ....... ....... ....... 3
stay is 3 days or fewer.
5101... Expired, orthopedic, length of ....... ....... ....... 0.5851 ....... ....... ....... 7
stay is 13 days or fewer.
5102... Expired, orthopedic, length of ....... ....... ....... 1.4705 ....... ....... ....... 18
stay is 14 days or more.
5103... Expired, not orthopedic, length ....... ....... ....... 0.6965 ....... ....... ....... 8
of stay is 15 days or fewer.
[[Page 59259]]
5104... Expired, not orthopedic, length ....... ....... ....... 1.8764 ....... ....... ....... 23
of stay is 16 days or more.
----------------------------------------------------------------------------------------------------------------
2. On pages 47865 through 47866, Table 11, ``FY 2012 Payment
Rates,'' is corrected as follows:
Table 11--FY 2012 Payment Rates
----------------------------------------------------------------------------------------------------------------
Payment rate Payment rate Payment rate Payment rate no
CMG tier 1 tier 2 tier 3 comorbidity
----------------------------------------------------------------------------------------------------------------
0101.................................... $10,797.70 $10,102.35 $9,074.80 $8,583.54
0102.................................... 13,401.76 12,538.90 11,263.62 10,652.72
0103.................................... 16,003.00 14,972.64 13,449.62 12,720.48
0104.................................... 16,626.57 15,556.80 13,974.65 13,215.96
0105.................................... 19,319.31 18,074.99 16,236.67 15,356.92
0106.................................... 22,247.12 20,815.59 18,698.56 17,685.09
0107.................................... 25,189.00 23,567.45 21,170.30 20,023.11
0108.................................... 31,199.45 29,190.81 26,222.18 24,800.50
0109.................................... 28,850.17 26,993.55 24,247.32 22,932.62
0110.................................... 37,185.98 34,791.65 31,252.94 29,559.60
0201.................................... 10,509.14 8,625.77 7,990.95 7,254.77
0202.................................... 14,930.41 12,255.97 11,352.29 10,307.85
0203.................................... 16,995.36 13,950.72 12,923.18 11,733.75
0204.................................... 17,804.73 14,615.11 13,538.30 12,292.57
0205.................................... 22,485.00 18,457.86 17,096.71 15,524.42
0206.................................... 27,992.94 22,979.07 21,285.73 19,327.76
0207.................................... 37,867.26 31,085.44 28,792.46 26,144.76
0301.................................... 14,875.52 13,382.05 11,871.70 10,873.71
0302.................................... 18,837.91 16,946.10 15,034.58 13,769.14
0303.................................... 22,397.73 20,149.79 17,875.11 16,371.80
0304.................................... 31,012.24 27,898.63 24,749.83 22,667.99
0401.................................... 14,869.89 12,379.84 11,262.21 9,881.35
0402.................................... 19,385.47 16,138.13 14,681.27 12,880.95
0403.................................... 34,610.07 28,813.57 26,212.33 22,998.78
0404.................................... 61,464.26 51,170.48 46,549.33 40,842.92
0405.................................... 54,295.35 45,202.26 41,120.22 36,079.60
0501.................................... 9,226.82 8,859.43 7,900.86 7,002.81
0502.................................... 13,807.15 13,256.78 11,822.43 10,478.17
0503.................................... 17,528.84 16,829.27 15,009.24 13,301.82
0504.................................... 21,135.11 20,291.96 18,096.11 16,038.19
0505.................................... 24,701.97 23,715.24 21,150.60 18,745.01
0506.................................... 34,624.14 33,241.88 29,646.87 26,275.67
0601.................................... 13,304.64 11,242.50 10,255.77 9,270.45
0602.................................... 17,610.48 14,881.15 13,574.89 12,270.05
0603.................................... 22,742.59 19,219.37 17,531.66 15,846.76
0604.................................... 30,157.83 25,486.01 23,246.51 21,014.06
0701.................................... 11,255.17 11,079.22 10,671.02 9,525.23
0702.................................... 14,726.31 14,496.87 13,961.98 12,462.89
0703.................................... 17,720.28 17,444.39 16,802.52 14,996.57
0704.................................... 22,901.65 22,545.53 21,713.64 19,381.24
0801.................................... 8,131.71 8,131.71 7,577.11 6,918.35
0802.................................... 10,968.02 10,968.02 10,221.99 9,332.39
0803.................................... 15,086.66 15,086.66 14,059.11 12,835.90
0804.................................... 13,386.28 13,386.28 12,475.56 11,390.30
0805.................................... 16,516.78 16,516.78 15,393.51 14,053.48
0806.................................... 20,224.40 20,224.40 18,847.76 17,207.91
0901.................................... 11,908.30 10,493.66 9,495.67 8,603.25
0902.................................... 15,928.40 14,035.18 12,700.77 11,507.13
0903.................................... 20,400.35 17,975.05 16,266.23 14,737.57
0904.................................... 26,433.32 23,291.56 21,075.99 19,095.50
1001.................................... 14,527.84 12,772.56 11,411.41 10,199.47
1002.................................... 19,074.39 16,770.15 14,983.90 13,391.91
1003.................................... 28,177.34 24,773.76 22,134.51 19,783.82
1101.................................... 14,603.85 14,603.85 13,852.19 13,000.59
1102.................................... 21,974.04 21,974.04 20,843.74 19,561.42
1201.................................... 12,040.61 12,040.61 11,384.67 10,761.10
1202.................................... 15,697.56 15,697.56 14,841.73 14,028.14
[[Page 59260]]
1203.................................... 19,336.20 19,336.20 18,283.32 17,281.11
1301.................................... 12,568.46 12,568.46 12,433.33 11,084.85
1302.................................... 16,551.97 16,551.97 16,373.20 14,596.81
1303.................................... 21,392.70 21,392.70 21,163.27 18,866.06
1401.................................... 13,238.48 10,599.23 9,373.21 8,476.57
1402.................................... 17,777.99 14,233.65 12,585.35 11,383.26
1403.................................... 21,471.53 17,191.02 15,200.67 13,748.03
1404.................................... 27,809.95 22,265.42 19,688.10 17,807.55
1501.................................... 13,521.41 12,626.17 10,882.16 10,286.74
1502.................................... 17,019.29 15,891.80 13,698.76 12,947.10
1503.................................... 20,988.72 19,598.01 16,892.61 15,966.41
1504.................................... 26,513.55 24,758.28 21,339.22 20,170.91
1601.................................... 15,718.67 12,372.80 10,856.82 10,150.20
1602.................................... 21,053.47 16,571.67 14,541.92 13,594.60
1603.................................... 27,197.65 21,409.60 18,787.24 17,562.63
1701.................................... 14,672.82 13,058.31 11,850.58 10,359.94
1702.................................... 19,361.54 17,231.84 15,638.44 13,670.61
1703.................................... 22,835.49 20,324.34 18,445.19 16,124.06
1704.................................... 29,230.22 26,015.26 23,609.67 20,639.64
1801.................................... 16,878.53 13,846.56 13,367.98 12,227.82
1802.................................... 23,174.73 19,012.45 18,355.10 16,788.45
1803.................................... 39,677.43 32,549.34 31,424.67 28,743.19
1901.................................... 16,102.94 14,185.79 12,869.69 12,498.08
1902.................................... 30,629.38 26,983.69 24,478.16 23,771.55
1903.................................... 51,143.74 45,055.87 40,872.48 39,692.91
2001.................................... 12,011.05 10,613.30 9,515.38 8,548.35
2002.................................... 16,074.79 14,204.09 12,734.56 11,440.97
2003.................................... 20,299.00 17,935.64 16,081.83 14,447.61
2004.................................... 27,218.76 24,050.25 21,563.02 19,372.80
2101.................................... 34,748.01 30,077.60 23,953.13 19,415.03
5001.................................... ................ ................ ................ 2,074.80
5101.................................... ................ ................ ................ 8,235.87
5102.................................... ................ ................ ................ 20,698.76
5103.................................... ................ ................ ................ 9,803.93
5104.................................... ................ ................ ................ 26,412.21
----------------------------------------------------------------------------------------------------------------
3. On page 47867:
a. In table 12, ``Example of Computing the IRF FY 2012 Federal
Prospective Payment,'' correct the entire table to read as follows:
Table 12--Example of Computing the IRF PPS FY 2012 Federal Prospective Payment
----------------------------------------------------------------------------------------------------------------
Rural Facility Urban Facility
Steps A (Spencer B (Harrison
Co., IN) Co., IN)
----------------------------------------------------------------------------------------------------------------
1........................... Unadjusted Federal Prospective Payment.......... 29,559.60 29,559.60
2........................... Labor Share..................................... 0.70199 0.70199
3........................... Labor Portion of Federal Payment................ $20,750.54 $20,750.54
4........................... CBSA Based Wage Index (shown in the Addendum , 0.8391 0.8896
Tables 1 and 2).
5........................... Wage-Adjusted Amount............................ $17,411.78 $18,459.68
6........................... Nonlabor Amount................................. $8,809.06 $8,809.06
7........................... Wage-Adjusted Federal Payment................... $26,220.84 $27,268.74
8........................... Rural Adjustment................................ 1.184 1.0000
9........................... Wage- and Rural-Adjusted Federal Payment........ $31,045.47 $27,268.74
10.......................... LIP Adjustment.................................. 1.0228 1.0666
11.......................... FY 2012 Wage-, Rural- and LIP-Adjusted Federal $31,753.31 $29,084.84
Prospective Payment Rate.
12.......................... FY 2012 Wage- and Rural-Adjusted Federal $31,045.47 $27,268.74
Prospective Payment.
13.......................... Teaching Status Adjustment...................... 0.0000 0.0610
14.......................... Teaching Status Adjustment Amount............... $0.00 $1,663.39
15.......................... FY2012 Wage-, Rural-, and LIP-Adjusted Federal $31,753.31 $29,084.84
Prospective Payment Rate.
16.......................... Total FY 2012 Adjusted Federal Prospective $31,753.31 $30,748.23
Payment.
----------------------------------------------------------------------------------------------------------------
b. In the 1st column, the 4th paragraph, in line 2, the amount
``$31,771.45'' is corrected to read ``$31,753.31.''
c. In the 1st column, the 2nd paragraph, in line 4, the amount
[[Page 59261]]
``$30,765.80'' is corrected to read ``$30,748.23.''
4. On page 47868, in the 3rd column, in the 1st full paragraph, in
line 6, the amount ``$10,660'' is corrected to read ``$10,713.''
5. On page 47887, Table 14, ``IRF Impact Table for FY 2012,'' is
corrected as follows:
[[Page 59262]]
Table 14--IRF Impact Table for FY 2012
--------------------------------------------------------------------------------------------------------------------------------------------------------
FY 2012
adjusted FY 2012 CBSA
Facility classification Number of IRFs Number of Outlier market basket wage index CMG Total percent
cases increase and labor- change
factor \1\ share
(1) (2) (3) (4) (5) (6) (7) (8)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total................................... 1,152 397,388 0.4% 1.8% 0.0% 0.0% 2.2%
Urban unit.............................. 752 200,587 0.6 1.8 -0.1 0.0 2.3
Rural unit.............................. 175 27,997 0.5 1.8 0.8 0.1 3.2
Urban hospital.......................... 205 162,171 0.2 1.8 0.0 0.0 1.9
Rural hospital.......................... 20 6,633 0.2 1.8 1.6 -0.1 3.5
Urban For-Profit........................ 317 151,821 0.2 1.8 0.1 -0.1 2.1
Rural For-Profit........................ 63 12,437 0.4 1.8 1.1 0.1 3.4
Urban Non-Profit........................ 596 199,313 0.5 1.8 -0.3 0.0 2.1
Rural Non-Profit........................ 122 20,442 0.5 1.8 0.7 0.1 3.1
Urban Government........................ 44 11,624 0.7 1.8 0.2 0.0 2.8
Rural Government........................ 10 1,751 0.9 1.8 1.3 0.1 4.1
Urban................................... 957 362,758 0.4 1.8 -0.1 0.0 2.1
Rural................................... 195 34,630 0.5 1.8 0.9 0.1 3.2
Urban by region: \2\
Urban New England................... 32 16,393 0.4 1.8 -1.2 0.0 1.0
Urban Middle Atlantic............... 142 66,363 0.3 1.8 -0.7 0.0 1.4
Urban South Atlantic................ 132 63,793 0.4 1.8 0.0 0.0 2.2
Urban East North Central............ 188 57,269 0.5 1.8 0.0 0.0 2.4
Urban East South Central............ 49 26,375 0.2 1.8 0.4 -0.1 2.2
Urban West North Central............ 73 18,118 0.6 1.8 0.0 0.0 2.3
Urban West South Central............ 169 66,313 0.4 1.8 0.5 0.0 2.7
Urban Mountain...................... 70 23,834 0.4 1.8 0.2 -0.1 2.3
Urban Pacific....................... 102 24,300 0.7 1.8 -0.3 0.0 2.2
Rural by region: \2\
Rural New England................... 6 1,354 1.0 1.9 0.7 0.1 3.7
Rural Middle Atlantic............... 16 3,232 0.2 1.8 1.8 0.1 4.0
Rural South Atlantic................ 25 5,988 0.3 1.8 0.8 0.0 2.9
Rural East North Central............ 33 5,776 0.4 1.8 0.1 0.1 2.4
Rural East South Central............ 23 4,017 0.2 1.8 1.4 0.0 3.4
Rural West North Central............ 31 3,945 0.7 1.8 -0.2 0.1 2.5
Rural West South Central............ 50 9,261 0.5 1.8 1.6 0.1 4.0
Rural Mountain...................... 7 670 0.6 1.8 0.3 0.2 2.9
Rural Pacific....................... 4 387 1.4 1.8 -0.4 -0.1 2.7
Teaching status:
Non-teaching........................ 1,036 345,500 0.4 1.8 0.1 0.0 2.3
Resident to ADC less than 10%....... 69 36,878 0.5 1.8 -0.4 0.0 2.0
Resident to ADC 10%-19%............. 33 12,497 0.6 1.8 -0.3 0.1 2.2
Resident to ADC greater than 19%.... 14 2,513 0.7 1.8 -0.7 -0.1 1.8
Disproportionate Share Patient
Percentage (DSH):
DSH = 0%............................ 39 10,534 0.4 1.8 0.4 0.0 2.7
DSH <5%............................. 208 62,434 0.4 1.8 -0.2 0.0 2.0
DSH 5%-10%.......................... 342 134,694 0.3 1.8 0.0 0.0 2.2
DSH 10%-20%......................... 330 123,398 0.4 1.8 0.0 0.0 2.2
DSH >20%............................ 233 66,328 0.5 1.8 0.0 0.0 2.3
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ This column reflects the impact of the rebased RPL market basket increase factor for FY 2012 of 1.8 percent, which includes a market basket update
of 2.9 percent, a 0.1 percentage point reduction in accordance with sections 1886(j)(3)(C)(ii)(II) and 1886(j)(3)(D)(ii) of the Act and a 1.0 percent
reduction for the productivity adjustment as required by section 1886(j)(3)(C)(ii)(I) of the Act, as finalized in 76 FR 47860.
\2\ A map of States that comprise the 9 geographic regions can be found at: http://www.census.gov/geo/www/us_regdiv.pdf.
[[Page 59263]]
6. On page 47888:
a. In the 1st column, in the 1st full paragraph, in line 18, the
amount ``$10,660'' is corrected to read ``$10,713.''
b. In the 1st column, in the 2nd full paragraph, in line 9, the
value ``1.5'' is corrected to read ``1.4.''
c. In the 2nd column, the 2nd full paragraph, lines 9 through 14,
the sentence: ``The largest decrease in payments as a result of these
updates is a 0.1 percent decrease to rural freestanding IRFs, urban
IRFs in the East South Central and Mountain regions, and rural IRFs in
the Pacific region.'' is corrected to read, ``The largest decrease in
payments as a result of these updates is a 0.1 percent decrease to
rural IRF hospitals, urban for-profit IRFs, urban IRFs in the East
South Central and Mountain regions, rural IRFs in the Pacific region,
and teaching IRFs with resident to ADC ratios greater than 19
percent.''
7. On page 47890, in the 1st column, the 2nd full paragraph, lines
1 through 4, the sentence, ``Overall the largest payment increase is
estimated at 4.1 percent for rural government-owned IRFs and rural IRFs
in the West South Central region.'' is corrected to read, ``Overall,
the largest payment increases are estimated at 4.1 percent for rural
government-owned IRFs, and 4.0 percent for rural IRFs in the Middle
Atlantic and West South Central regions.''
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: September 19, 2011.
Barbara J. Holland,
Deputy Executive Secretary to the Department.
[FR Doc. 2011-24671 Filed 9-23-11; 8:45 am]
BILLING CODE 4120-01-P