[Federal Register Volume 77, Number 112 (Monday, June 11, 2012)]
[Proposed Rules]
[Pages 34326-34331]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-14159]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 413, 424, 476, and 489

[CMS-1588-CN]
RIN 0938-AR12


Medicare Program; Hospital Inpatient Prospective Payment Systems 
for Acute Care Hospitals and the Long-Term Care Hospital Prospective 
Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for 
Graduate Medical Education Payment Purposes; Quality Reporting 
Requirements for Specific Providers and for Ambulatory Surgical 
Centers; Corrections

AGENCY: Centers for Medicare and Medicaid Services (CMS), HHS.

ACTION: Proposed rule, correction.

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

SUMMARY: This document corrects technical and typographical errors in 
the proposed rule that appeared in the May 11, 2012 Federal Register 
entitled ``Medicare Program; Hospital Inpatient Prospective Payment 
Systems for Acute Care Hospitals and the Long-Term Care Hospital 
Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' 
Resident Caps for Graduate Medical Education Payment Purposes; Quality 
Reporting Requirements for Specific Providers and for Ambulatory 
Surgical Centers.''

FOR FURTHER INFORMATION CONTACT: Tzvi Hefter, (410) 786-4487.

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2012-9985 of May 11, 2012 (77 FR 27870), there were a 
number of technical errors that are identified and corrected in the 
Correction of Errors section of this correcting document.

II. Summary of Errors

A. Errors in the Preamble

    On pages 27871 and 27872, we inadvertently omitted a number of 
acronyms from the list of acronyms.
    On page 27938, in our discussion of the fiscal year (FY) 2013 
applications for new technology add-on payments, we made typographical 
errors regarding the drug combination administered during the treatment 
of methotrexate (MTX)-induced renal dysfunction.
    On page 28021, we inadvertently cited the incorrect timeframe for 
when certain long-term care hospitals (LTCHs) and LTCH satellite 
facilities must comply with Sec.  412.534 and Sec.  412.536. We also 
cited the incorrect timeframe for when those LTCHs and LTCH satellite 
facilities would be under the proposed moratorium on the 25-percent 
adjustment threshold policy.
    On page 28036, we made several typographical errors in our 
discussion of commenters' beliefs regarding the hospital inpatient 
quality reporting program (HIQR) and five Agency for Healthcare 
Research and Quality (AHRQ) measures.
    On page 28039, in our discussion of the HIQR proposed new claims-
based measure for the FY 2015 payment determination for hip/knee 
complication, we inadvertently repeated a sentence.
    On page 28041, in our discussion of the HIQR proposed new claims-
based measure for the FY 2015 payment determination for hip/knee 
readmission, we made a typographical error in a section heading.
    On page 28072, in our discussion of the total amount available for 
value-based incentive payments under the Hospital VBP Program for a 
fiscal year, we inadvertently included estimated reductions to the base 
operating DRG payment amounts for Maryland hospitals in the calculation 
of the total estimate for FY 2013.
    On pages 28085 and 28086, in our discussion of the proposed 
performance standards for the Hospital Value-Based Purchasing (VBP) 
Program, we inadvertently omitted data from the table entitled 
``Proposed Performance Standards for the FY 2015 Hospital VBP Program 
Clinical Process of Care and Outcome Domains, and the Medicare Spending 
per Beneficiary Measure.''
    On pages 28107, 28108, and 28127 in our discussion of the Inpatient 
Psychiatric Facilities Quality Reporting Program (IPFQR), we made 
technical errors in our description of the IPF facility enrollment.

B. Errors in the Addendum

    On page 28143, we made errors in our discussion of the proposed 
outlier fixed-loss cost threshold for FY 2013.
    On pages 28144, 28148, 28149, 28150, 28151, 28159, and 28178, we 
made technical and typographical errors in our discussion of the 
proposed outlier adjustment factors which affected the proposed FY 2013 
Puerto Rico (specific) operating standardized amount and capital 
Federal rates (national and Puerto Rico). Specifically, we 
inadvertently applied the incorrect adjustment factors to the operating 
and capital cost-to-charge ratios (CCRs) from the Provider-Specific 
File (PSF) when performing the calculation of the FY 2013 outlier 
fixed-loss cost threshold for the proposed rule. The correction of this 
error resulted in a decrease in the proposed outlier fixed-loss cost 
threshold of approximately $1,000. Under our established methodology 
for calculating the outlier fixed-loss cost threshold, which we have 
proposed to continue to use for FY 2013, the corrected proposed outlier 
fixed-loss cost threshold continues to result in operating outlier 
payments being projected to be 5.1 percent of total operating payments. 
However, a decrease in the proposed outlier threshold results in an 
increase of the Puerto Rico (specific) operating outlier payments and 
capital (national and Puerto Rico) outlier payments. This is because a 
lower outlier threshold allows more cases to qualify as outlier cases 
and results in higher outlier payments to such cases. Because outlier 
payments are budget neutral, a larger reduction (that is, an increase 
in the outlier offsets) to the Puerto Rico and capital (national and 
Puerto Rico) rates is necessary. Therefore, the application of the 
corrected Puerto Rico and capital outlier offsets (national and Puerto 
Rico) lowers the proposed FY 2013 Puerto Rico (specific) operating 
standardized amount and capital Federal rates (national and Puerto 
Rico).

[[Page 34327]]

    On page 28189, in the impact analysis section for the inpatient 
Psychiatric Facilities Quality Reporting Program (IPFQR), we made 
technical errors in describing the IPF facility enrollment.

C. Summary of Errors in and Corrections to Tables Posted on the CMS Web 
site

    On page 28158, we list Table 16, Proposed Hospital Inpatient Value-
Based Purchasing (VBP) Program Adjustment Factors for FY 2013, as a 
table that will be available only through the Internet on the CMS Web 
site. The version of Table 16 that was posted via the Internet on the 
CMS Web site at the time the proposed rule was filed for public 
inspection at the Office of the Federal Register inadvertently included 
estimated reductions to the base operating DRG payment amounts for 
Maryland hospitals in the calculation of the proposed FY 2013 Hospital 
VBP Program adjustment factors.
    We have corrected these errors and will post the corrected Table 16 
on the CMS Web site at http://www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp.

III. Correction of Errors

    In FR Doc. 2012-9985 of May 11, 2012 (77 FR 27870), make the 
following corrections:

A. Corrections of Errors in the Preamble

    1. On pages 27871 and 27872, second and third and first and second 
columns, respectively (Acronyms list), are corrected by adding the 
following acronyms in alphabetical order:

ACoS American College of Surgeons'
AJCC American Joint Commission on Cancer
ASCO American Society of Clinical Oncology
CAUTI Catheter-Associated Urinary Tract Infection
CLABSI Central Line-Associated Bloodstream Infection
CEO Chief Executive Officer
CCN CMS Certificate Number
CFR Code of Federal Regulations
CoC Commission on Cancer
DACA Data Accuracy and Completeness Acknowledgement
ESRD End-Stage Renal Disease
FR Federal Register
HAI Healthcare-Associated Infection
HBIPS Hospital-Based Inpatient Psychiatric Services
HICPAC Healthcare Infection Control Practices Advisory Committee
ICU Intensive Care Unit
IPFQR Inpatient Psychiatric Facilities Quality Reporting Program
MAP Measure Application Partnership
NCCN National Comprehensive Cancer Network
NOP Notice of Participation
OQR Outpatient Quality Reporting
QAPI Quality Assessment and Performance Improvement
QIP Quality Incentive Program
Q Quarter
TJC The Joint Commission
UTI Urinary Tract Infection
VTE Venous Thromboembolism

    2. On page 27938, in the third column,
    a. First partial paragraph--
    (1). Line 5 the term ``Thymidine'' is corrected to read 
``leucovorin''.
    (2). Line 9, the term ``Thymidine'' is corrected to read 
``leucovorin''.
    (3). Lines 13 and 14, the phrase ``19 to 94 years old.'' is 
corrected to read ``19 to 94 years old.\18a\''
    b. Footnoted text, before footnote 18, the footnoted text is 
corrected by adding the following:

    \18a\ Green and Chamberlain, Cancer Chemotherapy and 
Pharmacology Volume 63, Number 4, 2009.

    3. On page 28021, in the third column, first partial paragraph, 
lines 24 through 42, the sentences beginning with the phrase 
``Therefore, under our proposed policy'' and ending with the phrase 
``proposed extension of the moratorium'' are corrected to read 
``Therefore, under our proposed policy, there will be a period during 
which some of the above-described LTCHs and LTCH satellite facilities 
must comply with Sec. Sec.  412.534 and 412.536 before becoming subject 
to the moratoria again. The above-described LTCHs and LTCH satellite 
facilities with a cost reporting period beginning on or after July 1, 
2012, and before October 1, 2012 would comply with Sec. Sec.  412.534 
and 412.536 for discharges occurring in that respective cost reporting 
period. Then, those same LTCHs and LTCH satellite facilities would be 
subject to the proposed moratorium for discharges occurring in their 
first cost reporting period beginning on or after July 1, 2013 and 
before October 1, 2013.''
    4. On page 28036, lower half of the page, first column, first 
paragraph, lines 7 through 8, the phrase ``some commenters still 
believed that'' is corrected to read ``we recognize some commenters 
believe that''.
    5. On page 28039, second column, third paragraph, lines 8 through 
12, the sentence ``Annual hospital charges are projected to increase by 
340 percent to $17.4 billion for THA and by 450 percent to $40.8 
billion for TKA by 2015'' is corrected by deleting the sentence.
    6. On page 28041, first column, second full paragraph, line 9, the 
heading that begins with the phrase ``(ii) Hip/Knee Readmission:'' is 
corrected by moving the phrase to line 10.
    7. On page 28072, second column, first full paragraph, line 8, the 
figure ``$956 million'' is corrected to read ``$917 million''.
    8. On pages 28085 through 28086, lower third of the page, the table 
entitled Proposed Performance Standards for the FY 2015 Hospital VBP 
Program Clinical Process of Care and Outcome Domains, and the Medicare 
Spending per Beneficiary Measure'' is corrected as follows:
Proposed Performance Standards for the FY 2015 Hospital VBP Program 
Clinical Process of Care and Outcome Domains, and the Medicare Spending 
per Beneficiary Measure
    a. Revising the following entry:

                                        Clinical Process of Care Measures
----------------------------------------------------------------------------------------------------------------
                                                                                      Achievement
                 Measure ID                                Description                 threshold      Benchmark
----------------------------------------------------------------------------------------------------------------
AMI-10......................................  Statin Prescribed at Discharge......        0.90474       1.00000
----------------------------------------------------------------------------------------------------------------

    b. Adding the following entry after line 3 (Measure ID, AMI-10):

[[Page 34328]]



                                        Clinical Process of Care Measures
----------------------------------------------------------------------------------------------------------------
                                                                                      Achievement
                 Measure ID                                Description                 threshold      Benchmark
----------------------------------------------------------------------------------------------------------------
HF-1........................................  Discharge Instructions..............        0.92090       1.00000
----------------------------------------------------------------------------------------------------------------

    9. On page 28107, third column, footnoted text (footnote 198), line 
1, the phrase ``IPFs, 450 are'' is corrected to read ``IPFs, 
approximately 450 are''.
    10. On page 28108, first column, second full paragraph, line 6, the 
figure ``1,100'' is corrected to read ``1,200''.
    11. On page 28127, first column, fifth full paragraph--
    a. Line 11, the figure ``1,741'' is corrected to read ``estimated 
1,700''.
    b. Line 12, the figure ``450'' is corrected to read ``approximately 
450''.
    c. Line 14, the figure ``26.02'' is corrected to read 
``approximately 26''.

B. Corrections of Errors in the Addendum

    1. On page 28143, third column--
    a. Second full paragraph, line 6, the figure ``$27,425'' is 
corrected to read ``$26,337''
    b. Third full paragraph, lines 2 and 3, the phrase ``$5,040 (or 
22.5 percent)'' is corrected to read ``$3,952 (or 17.7 percent)''.
    2. On page 28144--
    a. First column, first partial paragraph, lines 12 and 13, the 
phrase ``welcomed comment on possible modifications to our current 
methodologies,'' is corrected to read ``welcome comment on possible 
modifications to our current methodology,''.
    b. First column, second full paragraph, line 13, the figure 
``5.99'' is corrected to read ``6.43''
    c. Second column, before the first paragraph, the untitled table is 
corrected to read as follows:

------------------------------------------------------------------------
                                                 Operating     Capital
                                               standardized    federal
                                                  amounts        rate
------------------------------------------------------------------------
National.....................................      0.948992     0.935720
Puerto Rico..................................      0.953062     0.920266
------------------------------------------------------------------------

    3. On page 28148, second column, second full paragraph, line 6, the 
phrase ``approximately 0.7 percent'' is corrected to read ``0.25 
percent''.
    4. On page 28149, third column--
    a. First full paragraph, line 8, the figure ``6.00'' is corrected 
to read ``6.43''
    b. First full paragraph, line 12, the figure ``0.9400'' is 
corrected to read ``0.9357''
    c. First full paragraph, line 17, the phrase ``lower than the 
percentage for FY 2012.'' is corrected to read ``higher than the 
percentage for FY 2012.''.
    d. First full paragraph, lines 17 through 28, the sentences ``This 
decrease in estimated capital outlier payments is primarily due to the 
proposed increase in the outlier threshold used to identify outlier 
cases for both inpatient operating and inpatient capital related 
payments, which is discussed in section II.A. of this Addendum. That 
is, because the outlier threshold used to identify outlier cases is 
higher, cases will receive lower outlier payments and fewer cases will 
qualify for outlier payments.'' are corrected by deleting the 
sentences.
    e. Second full paragraph, line 6, the phrase ``0.9400 is 0.19 
percent'' is corrected to read ``0.9357 is a -0.27 percent''
    f. Second full paragraph, line 10, the phrase ``1.0019 (0.9400/
0.9832) is corrected to read ``0.9973 (0.9357/0.9832)''
    5. On page 28150, third column--
    a. First partial paragraph, line 14, the figure ``$424.42'' is 
corrected to read ``$422.47''.
    b. Third bulleted paragraph, line 2, the figure ``0.9400'' is 
corrected to read ``0.9357''.
    c. Last paragraph--
    (1) Line 14, the term ``increasing'' is corrected to read 
``decreasing''.
    (2) Line 15, the figure ``0.19'' is corrected to read ``0.27''.
    (3) Line 26, the phrase ``approximately 0.7 percent'' is corrected 
to read ``0.25 percent''.
    6. On page 28151--
    a. Top third of the page--
    (1) In the chart entitled Comparison of Factors and Adjustments: FY 
2012 Capital Federal Rate and Proposed FY 2013 Capital Federal Rate, 
the listed entries are corrected as set forth below.
    (2) Immediately following the chart, footnote 2 is corrected and 
footnote 5 is republished as set forth below.

------------------------------------------------------------------------
                                          Proposed              Percent
                               FY 2012    FY 2013     Change     change
------------------------------------------------------------------------
Outlier Adjustment Factor        0.9382     0.9357     0.9973      -0.27
 \2\........................
Capital Federal Rate \5\....    $421.42    $422.47     1.0025       0.25
------------------------------------------------------------------------

* * * * *
    \2\ The outlier reduction factor is not built permanently into 
the capital rate; that is, the factor is not applied cumulatively in 
determining the capital rate. Thus, for example, the net change 
resulting from the application of the FY 2013 outlier adjustment 
factor is 0.9357/0.9382, or 0.9973.
* * * * *
    \5\ Sum of percent change may not sum due to rounding.

    b. Lower two-thirds of the page, second column--
    (1) First full paragraph, last line, the figure ``$206.82'' is 
corrected to read ``$206.01''.
    (2) Third paragraph, last line, the figure ``$27,425'' is corrected 
to read ``26,337''.
    7. On page 28159--
    a. Top half of the page, in Table 1C--Proposed Adjusted Operating 
Standardized Amounts for Puerto Rico, Labor/Nonlabor--FY 2013, the 
entries for Puerto Rico are corrected to read as follows:

[[Page 34329]]



      Table 1C--Proposed Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor-- FY 2013
----------------------------------------------------------------------------------------------------------------
                                                            Rates if wage index is      Rates if wage index is
                                                                greater than 1          less than or equal to 1
                                                         -------------------------------------------------------
                                                              Labor       Nonlabor        Labor       Nonlabor
----------------------------------------------------------------------------------------------------------------
Puerto Rico.............................................    $1,582.93       $966.07     $1,580.38       $968.62
----------------------------------------------------------------------------------------------------------------

    b. Lower half of the page, first column, Table 1D--Proposed Capital 
Standard Federal Payment Rate--FY 2013, the table is corrected to read 
as follows:

    Table 1D--Proposed Capital Standard Federal Payment Rate--FY 2013
------------------------------------------------------------------------
                                                                 Rate
------------------------------------------------------------------------
National....................................................     $422.47
Puerto Rico.................................................      206.01
------------------------------------------------------------------------

    8. On page 28178--
    a. Second column, middle of the page, fourth bullet the figure 
``0.9400'' is corrected to read ``0.9357''
    b. Third column, second full paragraph, line 6, the phrase 
``approximately 0.7'' is corrected to read ``0.25''.
    c. Third column, third full paragraph, the paragraph that begins 
with the phrase ``We also are estimating a slight decrease in'' and 
ends with the phrase ``Federal rate.'' is corrected to read ``We also 
are estimating an increase in outlier payments in FY 2013 as compared 
to FY 2012. This estimated increase in outlier payments is based on the 
FY 2011 claims from the December 2011 update of the MedPAR file, and we 
currently estimate that FY 2012 capital outlier payments are more than 
the projected 6.18 percent that we used to determine the outlier offset 
that we applied in determining the FY 2012 capital Federal rate''.
    d. Last partial paragraph--
    (1) Lines 2 and 3, the phrase ``all hospitals are expected to 
experience a decrease'' is corrected to read ``hospitals are expected 
to experience either no change or a decrease''.
    (2) Line 5, the sentence ``These decreases are primarily due to 
proposed changes in the GAFs (primarily resulting from policies 
affecting the wage index)), and the estimated decrease in capital 
outlier payments.'' is corrected to read ``The decreases are primarily 
due to proposed changes in the GAFs (primarily resulting from policies 
affecting the wage index).''.
    9. On page 28179,
    a. Top third of the page,
    (1) First column--
    (a) First partial paragraph--
    (i) Line 2, the sentence ``Capital IPPS payments per case for large 
urban hospitals are estimated to decrease 0.1 percent, while other 
urban hospitals are expected to experience a 0.4 percent decrease.'' is 
corrected to read ``Large urban hospitals are not expected to 
experience any change in capital IPPS payments per case from FY 2012 to 
FY 2013, while other urban hospitals are expected to experience a 0.4 
percent decrease.''.
    (ii) Line 7, the phrase ``not expected to experience any change'' 
is corrected to read ``are expected to experience a 0.2 percent 
decrease''.
    (b) First full paragraph--
    (i) Line 1, the sentence ``The comparisons by region show that most 
urban regions, except for the Pacific region and Puerto Rico, will 
experience, on average, decreases in capital IPPS payments.'' is 
corrected to read ``The comparisons by region show that most urban 
regions, except for the Pacific, West North Central, and Puerto Rico 
regions, will experience, on average, decreases in capital IPPS 
payments''.
    (ii) Line 8, the figure ``1.0'' is corrected to read ``1.2''.
    (iii) Line 10, the sentence ``The two exceptions to decreases in 
capital payments per case are the Pacific urban region and the Puerto 
Rico urban region, which are expected to experience a 1.1 percent and 
0.5 percent increase, respectively.'' sentence is corrected to read 
``The three exceptions to estimated decreases in capital payments per 
case are Pacific urban region, West North Central urban region, and the 
Puerto Rico urban region, which are expected to experience a 1.3 
percent, 0.5 percent, and 0.4 percent increase, respectively.''.
    (2) Second column--
    (a) First full paragraph--
    (i) Line 3, the figure, ``1.6'' is corrected read ``1.7''.
    (ii) Line 4, the figure, ``0.7'' is corrected read ``0.4''.
    (iii) Line 6, the sentence ``The East South Central and Mountain 
rural regions are not expected to experience any change in their 
capital payments per discharge from FY 2012 to FY 2013.'' is corrected 
by removing the sentence.
    (iv) Line 11, the figure ``3.3'' is corrected to read ``2.9''.
    (b) Second full paragraph, the paragraph ``Hospitals of all type of 
ownership (that is, voluntary hospitals, government hospitals, and 
proprietary hospitals) are estimated to experience a 0.2 percent 
decrease in capital payments per case from FY 2012 to FY 2013.'' is 
corrected to read ``By type of ownership (that is, voluntary hospitals, 
government hospitals, and proprietary hospitals), all hospitals are 
estimated to experience a decrease in capital payments per case from FY 
2012 to FY 2013. Voluntary hospitals and proprietary hospitals are 
expected to experience a 0.2 percent decrease in capital payments per 
case from FY 2012 to FY 2013, while government-run hospitals are 
expected to experience a 0.1 percent decrease in capital payments per 
case from FY 2012 to FY 2013.''.
    (3) Third column, first paragraph, lines 14 through 26, the 
sentences beginning with the phrase ``Urban non-reclassified hospitals 
are'' and ending with the phrase ``from FY 2012 to FY 2013.'' are 
corrected to read ``Both urban non-reclassified hospitals and rural 
reclassified hospitals are estimated to experience a decrease of 0.2 
percent in capital payments per discharge from FY 2012 to FY 2013. 
Rural non-reclassified hospitals are estimated to have a 0.3 percent 
decrease in capital payments per case. Other reclassified hospitals 
(that is, hospitals reclassified under section 1886(d)(8)(B) of the 
Act) are expected to experience a decrease of 0.4 percent in capital 
payments from FY 2012 to FY 2013.''.
    b. Lower two-thirds of the page, Table III--Comparison of Total 
Payments per Case, the table is corrected to read as follows:

[[Page 34330]]



                                Table III--Comparison of Total Payments per Case
                                 [FY 2012 payments compared to FY 2013 payments]
----------------------------------------------------------------------------------------------------------------
                                                                            Average FY   Average FY
                                                               Number of       2012         2013
                                                               hospitals    payments/    payments/      Change
                                                                               case         case
----------------------------------------------------------------------------------------------------------------
By Geographic Location:
    All hospitals...........................................        3,405          799          797         -0.2
    Large urban areas (populations over 1 million)..........        1,365          880          880          0.0
    Other urban areas (populations of 1 million or fewer)...        1,120          784          780         -0.4
    Rural areas.............................................          920          552          551         -0.2
    Urban hospitals.........................................        2,485          837          835         -0.2
        0-99 beds...........................................          627          670          667         -0.5
        100-199 beds........................................          773          722          720         -0.3
        200-299 beds........................................          448          769          769          0.0
        300-499 beds........................................          432          848          848          0.0
        500 or more beds....................................          205        1,016        1,013         -0.3
    Rural hospitals.........................................          920          552          551         -0.2
        0-49 beds...........................................          317          438          437         -0.2
        50-99 beds..........................................          346          505          504         -0.2
        100-149 beds........................................          152          545          543         -0.4
        150-199 beds........................................           58          619          617         -0.4
        200 or more beds....................................           47          672          672          0.0
By Region:
    Urban by Region.........................................        2,485          837          835         -0.2
        New England.........................................          120          907          896         -1.2
        Middle Atlantic.....................................          318          886          883         -0.4
        South Atlantic......................................          377          781          777         -0.5
        East North Central..................................          396          804          804         -0.1
        East South Central..................................          151          730          725         -0.7
        West North Central..................................          165          836          840          0.5
        West South Central..................................          370          796          792         -0.5
        Mountain............................................          157          868          865         -0.4
        Pacific.............................................          380        1,016        1,029          1.3
        Puerto Rico.........................................           51          384          386          0.4
    Rural by Region.........................................          920          552          551         -0.2
        New England.........................................           23          744          744         -0.1
        Middle Atlantic.....................................           69          569          571          0.4
        South Atlantic......................................          164          541          539         -0.4
        East North Central..................................          120          576          575         -0.1
        East South Central..................................          170          507          506         -0.2
        West North Central..................................           98          585          581         -0.6
        West South Central..................................          181          491          490         -0.1
        Mountain............................................           65          580          579         -0.1
        Pacific.............................................           29          723          711         -1.7
        Puerto Rico.........................................            1          150          154          2.9
By Payment Classification:
    All hospitals...........................................        3,405          799          797         -0.2
    Large urban areas (populations over 1 million)..........        1,375          879          879          0.0
    Other urban areas (populations of 1 million or fewer)...        1,125          783          780         -0.3
    Rural areas.............................................          905          563          560         -0.4
    Teaching Status:
        Non-teaching........................................        2,376          680          678         -0.2
        Fewer than 100 Residents............................          789          790          789         -0.1
        100 or more Residents...............................          240        1,137        1,135         -0.2
        Urban DSH:
            100 or more beds................................        1,523          863          862         -0.1
            Less than 100 beds..............................          327          583          584          0.0
        Rural DSH:
            Sole Community (SCH/EACH).......................          269          519          516         -0.6
            Referral Center (RRC/EACH)......................          210          624          622         -0.4
            Other Rural:....................................           32          506          503         -0.7
                100 or more beds............................  ...........  ...........  ...........  ...........
                Less than 100 beds..........................          286          446          446         -0.1
    Urban teaching and DSH:
        Both teaching and DSH...............................          815          933          933         -0.1
        Teaching and no DSH.................................          147          812          808         -0.4
        No teaching and DSH.................................        1,035          720          720          0.0
        No teaching and no DSH..............................          503          741          736         -0.7
    Rural Hospital Types:
        Non special status hospitals........................        2,391          841          839         -0.2
        RRC/EACH............................................           61          733          735          0.3
        SCH/EACH............................................           34          722          723          0.1
        SCH, RRC and EACH...................................           16          769          764         -0.7

[[Page 34331]]

 
Hospitals Reclassified by the Medicare Geographic
 Classification Review Board:
    FY2013 Reclassifications:
        All Urban Reclassified..............................          420          833          834          0.1
        All Urban Non-Reclassified..........................        2,025          840          838         -0.2
        All Rural Reclassified..............................          335          596          595         -0.2
        All Rural Non-Reclassified..........................          524          482          480         -0.3
        Other Reclassified Hospitals (Section 1886(d)(8)(B))           55          550          548         -0.4
    Type of Ownership:
        Voluntary...........................................        1,970          813          812         -0.2
        Proprietary.........................................          866          718          717         -0.2
        Government..........................................          560          817          816         -0.1
    Medicare Utilization as a Percent of Inpatient Days:
        0-25................................................          377        1,044        1,047          0.4
        25-50...............................................        1,834          839          838         -0.2
        50-65...............................................          968          666          664         -0.3
        Over 65.............................................          168          611          610         -0.2
----------------------------------------------------------------------------------------------------------------

    10. On page 28189, second column, last paragraph, lines 6 and 7, 
the phrase ``1,741 existing IPFs, of which 450'' is corrected to read 
``approximately 1,700 existing IPFs, of which approximately 450''.

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: June 5, 2012.
Jennifer M. Cannistra,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2012-14159 Filed 6-8-12; 8:45 am]
BILLING CODE 4120-01-P