[Federal Register Volume 77, Number 209 (Monday, October 29, 2012)]
[Rules and Regulations]
[Pages 65495-65496]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-26505]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 412, 413, 424, and 476

[CMS-1588-CN3]
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 & Medicaid Services (CMS), HHS.

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical errors that appeared in the 
final rule that appeared in the August 31, 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.''

DATES: Effective Date: October 26, 2012.

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

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2012-19079 of August 31, 2012 (77 FR 53258) (hereinafter 
referred to as the FY 2013 IPPS/LTCH PPS final rule), there were 
technical and typographical errors that are identified and corrected in 
the Correction of Errors section of this correcting document. We note 
that in the October 3, 2012 Federal Register (77 FR 60315), we 
corrected a number of the errors in the FY 2013 IPPS/LTCH PPS final 
rule including an error in the table regarding the final performance 
standards for the FY 2015 Hospital Value-Based Purchasing (HVBP) 
program. (For more detailed information, see sections II.A. and 
IV.A.11. of the October 3, 2012 correcting document).

II. Summary of Errors

A. Errors in the Preamble

    On pages 53601 and 53602, we have determined that there were also 
errors in the achievement thresholds and benchmark values presented in 
the Clinical Process of Care measures section of the final performance 
standards for the FY 2015 HVBP Program table. The omission of the label 
for the HF-1 measure resulted in the performance standards for all 
subsequent measures being shifted up one line each. The table now 
reflects the corrections for all finalized Clinical Process of Care 
measures.

B. Errors in the Addendum

    On page 53695, we made typographical errors in the charge inflation 
factor for the FY 2013 IPPS outlier threshold.

III. Waiver of Proposed Rulemaking and Delay of Effective Date

    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 in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive this notice and comment procedure if the Secretary finds, for 
good cause, that the notice and comment process is impracticable, 
unnecessary, or contrary to the public interest, and incorporates a 
statement of the finding and the reasons therefore in the notice.
    Section 553(d) of the APA ordinarily requires a 30-day delay in 
effective date of final rules after the date of their publication in 
the. This 30-day delay in effective date can be waived, however, if an 
agency finds for good cause that the delay is impracticable, 
unnecessary, or contrary to the public interest, and the agency 
incorporates a statement of the findings and its reasons in the rule 
issued.
    In our view, this correcting document does not constitute a rule 
that would be subject to the APA notice and comment or delayed 
effective date requirements. This correcting document corrects 
technical and typographical errors in the preamble and addendum, but 
does not make substantive changes to the policies or payment 
methodologies that

[[Page 65496]]

were adopted in the final rule. As a result, this correcting document 
is intended to ensure that the preamble and addendum, accurately 
reflects the policies adopted in that final rule.
    In addition, even if this were a rule to which the notice and 
comment and delayed effective date requirements applied, we find that 
there is good cause to waive such requirements. Undertaking further 
notice and comment procedures to incorporate the corrections in this 
document into the final rule or delaying the effective date would be 
contrary to the public interest. Furthermore, such procedures would be 
unnecessary, as we are not altering the policies that were already 
subject to comment and finalized in our final rule. Therefore, we 
believe we have good cause to waive the notice and comment and 
effective date requirements.

IV. Correction of Errors

    In FR Doc. 2012-19079 of August 31, 2012 (77 FR 53258), make the 
following corrections:

A. Corrections of Errors in the Preamble

    1. On pages 53601 and 53602, the table entitled ``FINAL PERFORMANCE 
STANDARDS FOR THE FY 2015 HOSPITAL VBP PROGRAM CLINICAL PROCESS OF 
CARE, OUTCOME, AND EFFICIENCY DOMAINS,'' the entries for the clinical 
process of care measures are corrected as follows:

                                        Clinical Process of Care Measures
----------------------------------------------------------------------------------------------------------------
                                                                                    Achievement
               Measure ID                              Description                   threshold       Benchmark
----------------------------------------------------------------------------------------------------------------
AMI-7a.................................  Fibrinolytic Therapy Received Within 30         0.80000         1.00000
                                          Minutes of Hospital Arrival.
AMI-8a.................................  Primary PCI Received Within 90 Minutes          0.95349         1.00000
                                          of Hospital Arrival.
HF-1...................................  Discharge Instructions.................         0.94118         1.00000
PN-3b..................................  Blood Cultures Performed in the                 0.97783         1.00000
                                          Emergency Department Prior to Initial
                                          Antibiotic Received in Hospital.
PN-6...................................  Initial Antibiotic Selection for CAP in         0.95918         1.00000
                                          Immunocompetent Patient.
SCIP-Card-2............................  Surgery Patients on Beta-Blocker                0.97175         1.00000
                                          Therapy Prior to Arrival Who Received
                                          a Beta-Blocker During the
                                          Perioperative Period.
SCIP-Inf-1.............................  Prophylactic Antibiotic Received Within         0.98639         1.00000
                                          One Hour Prior to Surgical Incision.
SCIP-Inf-2.............................  Prophylactic Antibiotic Selection for           0.98637         1.00000
                                          Surgical Patients.
SCIP-Inf-3.............................  Prophylactic Antibiotics Discontinued           0.97494         1.00000
                                          Within 24 Hours After Surgery End Time.
SCIP-Inf-4.............................  Cardiac Surgery Patients With                   0.95798         0.99767
                                          Controlled 6AM Postoperative Serum
                                          Glucose.
SCIP-Inf-9.............................  Urinary Catheter Removed on                     0.94891         0.99991
                                          Postoperative Day 1 or Postoperative
                                          Day 2.
SCIP-VTE-2.............................  Surgery Patients Who Received                   0.97403         0.99998
                                          Appropriate Venous Thromboembolism
                                          Prophylaxes Within 24 Hours Prior to
                                          Surgery to 24 Hours After Surgery.
----------------------------------------------------------------------------------------------------------------

B. Correct of Errors in the Addendum

    1. On page 53695, third column, first paragraph, line 2, the 
figures ``8.94 percent (1.0866203)'' are corrected to read ``8.66 
percent (1.0866203)''.

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


    Dated: October 18, 2012.
Oliver Potts,
Deputy Executive, Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2012-26505 Filed 10-26-12; 8:45 am]
BILLING CODE 4120-01-P