[Federal Register Volume 59, Number 238 (Tuesday, December 13, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-30556]
[[Page Unknown]]
[Federal Register: December 13, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
42 CFR Parts 412 and 413
[BPD-802-CN]
RIN 0938-AG46
Medicare Program; Changes to the Hospital Inpatient Prospective
Payment Systems and Fiscal Year 1995 Rates; Correction
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Final rule; correction.
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SUMMARY: In the September 1, 1994 issue of the Federal Register (59 FR
45330), 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, 1994, and set forth update factors for the rate-of-increase
limits for hospitals and hospital units excluded from the prospective
payment systems. This notice corrects errors made in that document.
EFFECTIVE DATE: October 1, 1994.
FOR FURTHER INFORMATION CONTACT: John Davis--Wage Index (410) 966-5654;
Nancy Edwards--Other Issues (410) 966-4531.
SUPPLEMENTARY INFORMATION: In the September 1, 1994 final rule with
comment period (59 FR 45330), we indicated that if a hospital believes
its wage index value is incorrect as a result of an intermediary or
HCFA error, the hospital must notify HCFA no later than September 23,
1994. As a result of this process, we have identified several
corrections to the wage data. Accordingly, the wage index values for
several areas have been changed.
The final rule also contained other technical and typographical
errors. The revised wage index values, and other changes affecting
prospective payment rates, reflect corrections that were made between
publication of the FY 1995 prospective payment system final rule with
comment period on September 1, 1994, and implementation of the FY 1995
prospective payment rates on October 1, 1994. Therefore, we are making
the following corrections to the September 1, 1994 final rule with
comment period:
1. On page 45361, the chart at the top of the page is corrected as
follows:
------------------------------------------------------------------------
Number of labor Corrected number
market areas of labor market
Percentage change in area wage index ------------------ areas
value -----------------
FY 1995 FY 1994 FY 1995 FY 1994
------------------------------------------------------------------------
Increase more than 10 percent....... 2 13 5 13
Increase between 5 and 10 percent... 4 24 17 24
Decrease between 5 and 10 percent... 13 58 13 58
Decrease more than 10 percent....... 10 14 10 14
------------------------------------------------------------------------
2. On pages 45421 through 45436, the following entries in Table
3C--Hospital Case Mix Indexes for Discharges Occurring in Federal
Fiscal Year 1993; Hospital Average Hourly Wage for Federal Fiscal Year
1995 Wage Index--are corrected as follows:
----------------------------------------------------------------------------------------------------------------
Corrected avg. hour
Provider Case mix index Avg. hour wage wage
----------------------------------------------------------------------------------------------------------------
050030........................................... 01.3478 17.25 17.31
050153........................................... 01.6323 26.54 26.63
050183........................................... 01.1897 18.72 19.77
050194........................................... 01.2188 23.01 23.15
050457........................................... 01.9263 27.09 27.16
050688........................................... 01.2086 25.13 25.25
110162........................................... 00.8663 ................... 12.98
140010........................................... 01.3097 18.77 20.61
170037........................................... 01.1331 15.60 15.31
170080........................................... 01.0304 11.67 11.23
170110........................................... 00.9268 12.68 12.61
180005........................................... 01.0444 14.66 15.54
180138........................................... 01.2598 17.78 17.30
190005........................................... 01.4454 14.98 13.28
190006........................................... 01.1903 13.93 14.22
190009........................................... 01.2947 13.88 13.73
190011........................................... 01.1190 12.19 12.11
190040........................................... 01.4197 17.30 17.28
190098........................................... 01.4469 16.69 16.44
190122........................................... 01.2075 13.84 13.57
190176........................................... 01.5428 17.76 17.42
220107........................................... 01.1159 16.97 17.91
230197........................................... 01.2661 17.75 19.21
240036........................................... 01.4910 17.88 18.16
250001........................................... 01.5597 13.55 13.71
310009........................................... 01.1537 19.28 20.11
440049........................................... 01.6483 15.27 15.47
450002........................................... 01.4852 15.52 18.57
510047........................................... 01.1688 15.81 15.86
520100........................................... 01.2514 14.46 14.74
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3. On pages 45437 through 45444, in Table 4A--Wage Index and
Capital Geographic Adjustment Factor (GAF) for Urban Areas--the wage
index value and GAF in the following entries are corrected as follows:
----------------------------------------------------------------------------------------------------------------
Changed
Urban area Wage index GAF wage index Changed GAF
----------------------------------------------------------------------------------------------------------------
0220Alexandria, LA.......................................... 0.8302 0.8804 0.8284 0.8790
0600Augusta-Aiken, GA-SC.................................... 0.8638 0.9046 0.8634 0.9043
0760Baton Rouge, LA......................................... 0.8617 0.9031 0.8582 0.9006
1123*Boston-Brockton-Nashua, MA-NH.......................... 1.1733 1.1157 1.1732 1.1156
1600*Chicago, IL............................................ 1.0666 1.0451 1.0689 1.0467
1620Chico-Paradise, CA...................................... 1.0434 1.0295 1.0441 1.0300
2320El Paso, TX............................................. 0.8618 0.9032 0.9057 0.9344
2640Flint, MI............................................... 1.0252 1.0172 1.0423 1.0288
3560Jackson, MS............................................. 0.7551 0.8250 0.7569 0.8264
3620Janesville-Beloit, WI................................... 0.8541 0.8976 0.8606 0.9023
3880Lafayette, LA........................................... 0.7975 0.8565 0.7996 0.8580
4520Louisville, KY-IN....................................... 0.9485 0.9644 0.9480 0.9641
4920*Memphis, TN-AR-MS...................................... 0.8508 0.8953 0.8535 0.8972
5170Modesto, CA............................................. 1.1348 1.0905 1.1415 1.0949
5200Monroe, LA.............................................. 0.7723 0.8378 0.7707 0.8366
5560*New Orleans, LA........................................ 0.9499 0.9654 0.9311 0.9523
5640*Newark, NJ............................................. 1.1128 1.0759 1.1156 1.0778
6323Pittsfield, MA.......................................... 1.1313 1.0882 1.1413 1.0947
6980St. Cloud, MN........................................... 0.9549 0.9689 0.9680 0.9780
7360*San Francisco, CA...................................... 1.4120 1.2665 1.4122 1.2666
7400*San Jose, CA........................................... 1.4272 1.2758 1.4276 1.2761
7680Shreveport-Bossier City, LA............................. 0.9036 0.9329 0.8992 0.9298
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4. On page 45444, in Table 4B--Wage Index and Capital Geographic
Adjustment Factor (GAF) for Rural Areas--the wage index value and the
GAF in the following entries are corrected as follows:
----------------------------------------------------------------------------------------------------------------
Changed
Non-urban area Wage index GAF wage index Changed GAF
----------------------------------------------------------------------------------------------------------------
Alaska...................................................... 1.2592 1.1710 1.2591 1.1709
Kansas...................................................... 0.7270 0.8039 0.7267 0.8036
Kentucky.................................................... 0.7487 0.8202 0.7498 0.8210
West Virginia............................................... 0.8120 0.8671 0.8121 0.8672
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5. On pages 45444 through 45445, in Table 4C--Wage Index and
Capital Geographic Adjustment Factor (GAF) for Hospitals that are
Reclassified--the wage index value and the GAF in the following entries
are corrected as follows:
----------------------------------------------------------------------------------------------------------------
Changed
Area reclassified to Wage index GAF wage index Changed GAF
----------------------------------------------------------------------------------------------------------------
Alexandria, LA.............................................. 0.8302 0.8804 0.8284 0.8790
Baton Rouge, LA............................................. 0.8617 0.9031 0.8582 0.9006
Boston-Brockton-Nashua, MA-NH............................... 1.1733 1.1157 1.1732 1.1156
Chicago, IL................................................. 1.0666 1.0451 1.0689 1.0467
Des Moines, IA.............................................. 0.8533 0.8971 0.8510 0.8954
El Paso, TX................................................. 0.8618 0.9032 0.9057 0.9344
Flint, MI................................................... 1.0252 1.0172 1.0423 1.0288
Jackson, MS................................................. 0.7551 0.8250 0.7569 0.8264
Lafayette, LA............................................... 0.7975 0.8565 0.7996 0.8580
Louisville, KY.............................................. 0.9485 0.9644 0.9480 0.9641
Memphis, TN-AR-MS........................................... 0.8386 0.8864 0.8410 0.8882
Middlesex-Somerset-Hunterdon, NJ............................ 1.0770 1.0521 1.0715 1.0484
Modesto, CA................................................. 1.1348 1.0905 1.1415 1.0949
Monroe, LA.................................................. 0.7723 0.8378 0.7707 0.8366
New Orleans, LA............................................. 0.9499 0.9654 0.9311 0.9523
Newark, NJ.................................................. 1.0848 1.0573 1.0870 1.0588
St. Cloud, MN............................................... 0.9549 0.9689 0.9535 0.9679
San Francisco, CA........................................... 1.4120 1.2665 1.4122 1.2666
San Jose, CA................................................ 1.4272 1.2758 1.4276 1.2761
Rural West Virginia......................................... 0.8120 0.8671 0.8121 0.8672
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6. On pages 45445 through 45447, Table 4D--Average Hourly Wage for
Urban Areas--the following entries are corrected as follows:
------------------------------------------------------------------------
New
Average average
Urban area hourly hourly
wage wage
------------------------------------------------------------------------
Alexandria, LA...................................... 15.1620 15.1288
Augusta-Aiken, GA-SC................................ 15.7746 15.7680
Baton Rouge, LA..................................... 15.7376 15.6738
Chicago, IL......................................... 19.4782 19.5206
Chico-Paradise, CA.................................. 19.0544 19.0673
El Paso, TX......................................... 15.7386 16.5401
Flint, MI........................................... 18.8129 19.0521
Jackson, MS......................................... 13.6437 13.6854
Janesville-Beloit, WI............................... 15.5973 15.7175
Lafayette, LA....................................... 14.4264 14.4675
Lake Charles, LA.................................... 15.0433 15.0427
Louisville, KY-IN................................... 17.3214 17.3129
Memphis, TN-AR-MS................................... 15.5377 15.5871
Modesto, CA......................................... 20.7245 20.8463
Monroe, LA.......................................... 13.9777 13.9494
New Orleans, LA..................................... 17.3485 17.0048
Newark, NJ.......................................... 21.9178 21.9471
Pittsfield, MA...................................... 20.6597 20.8427
St. Cloud, MN....................................... 17.4385 17.6778
San Francisco, CA................................... 25.7496 25.7537
San Jose, CA........................................ 26.0635 26.0709
Santa Cruz-Watsonville, CA.......................... 24.7020 24.7441
Shreveport-Bossier City, LA......................... 16.5027 16.4215
------------------------------------------------------------------------
7. On page 45447, Table 4E--Average Hourly Wage for Rural Areas--
the following entries are corrected as follows:
------------------------------------------------------------------------
New
Average average
Non-urban area hourly hourly
wage wage
------------------------------------------------------------------------
Kansas.............................................. 13.2765 13.2707
Kentucky............................................ 13.6733 13.6938
West Virginia....................................... 14.7441 14.7464
------------------------------------------------------------------------
8. On page 45497, in Table I--Impact Analysis of Changes for FY
1995 Operating Prospective Payment System--under Bed Size (Rural), the
rows and corresponding figures for Pacific and Puerto Rico are moved to
page 45498 under Rural by Region, and inserted under the row and
corresponding figures for Mountain.
9. On page 45498, also in Table I, under Disproportionate Share
Hospitals (DSH), Other Rural DSH Hosp., the rows and corresponding
figures for 100-149 Beds, 150-199 Beds, and 200 or more Beds are moved
to page 45497 under Bed Size (Rural), and inserted under the row and
corresponding figures for 50-99 Beds.
10. On page 45518, the sentence beginning seven lines from the
bottom of the first column and continuing to the second line of the
second column is corrected to read as follows: ``However, measuring the
actual expected price per unit of real capital, independently of any
evaluation of the propriety of any actual purchase decisions, is
essential to recognize that the industry has some control over the
amount of capital it purchases but little or no control over the price
it pays for capital.''
11. In the outlier example that begins on page 45368, Footnote 1a
on page 45370 is corrected to read as follows: ``If hospital X were a
hold harmless hospital, it should use the hospital-specific ratio of
new to total capital.''
12. On page 45457, in Table 6A--New Diagnosis Codes--the following
code is added:
------------------------------------------------------------------------
Diagnosis
code Description CC MDC DRG
------------------------------------------------------------------------
305.1 Tobacco use disorder......................... N 23 467
------------------------------------------------------------------------
13. On page 45461, Table 6C--Invalid Diagnosis Codes--the following
entry is corrected to read as follows:
------------------------------------------------------------------------
Diagnosis
code Description CC MDC DRG
------------------------------------------------------------------------
V65.4 Other counseling............................. N 23 467
------------------------------------------------------------------------
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance)
Dated: December 6, 1994.
Michael W. Carleton,
Acting Deputy Assistant Secretary for Information Resources Management.
[FR Doc. 94-30556 Filed 12-12-94; 8:45 am]
BILLING CODE 4120-01-P