Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Corrections

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Correction notice.

SUMMARY:

This document corrects technical errors that appeared in the July 30, 2004 Federal Register, entitled “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities—Update—Notice.”

EFFECTIVE DATE:

This correction is effective October 1, 2004, except for certain wage index corrections that are effective January 1, 2005.

FOR FURTHER INFORMATION CONTACT:

Jeanette Kranacs, (410) 786-9385, Bill Ullman, (410) 786-5667, or Sheila Lambowitz, (410) 786-7605.

SUPPLEMENTARY INFORMATION:

I. Background

On October 7, 2004, we published a correction notice (FR Doc. 04-22399, 69 FR 60158) to correct a number of technical errors that had appeared in the FY 2005 SNF PPS update notice published on July 30, 2004 (FR Doc. 04-17443, 69 FR 45775). In that notice we indicated that the corrected wage tables and other tables were being posted on the CMS Web site at http://www.cms.hhs.gov/providers/snfpps , and we also expressed our intent to publish them in a forthcoming Federal Register notice. In this notice we are fulfilling that intent, as well as correcting certain additional technical errors in wage index values that have been recently identified. The corrections appear in this document under the heading “Correction of Errors.” The provisions in this correction notice are effective as if they had been included in the document published in the Federal Register on July 30, 2004, that is, as of October 1, 2004, except for those wage index value corrections that we specifically note to be effective as of January 1, 2005.

In this notice, we hereby set forth the corrected versions of Tables 8, 9, 10, and 12 that were referenced in FR Doc. 04-22399 (69 FR 60158).

In addition, Table 8 is further revised to reflect the following additional corrections, which become effective as of January 1, 2005:

1. The entry of “0.7959” for Metropolitan Statistical Area (MSA) 3960 (Lake Charles, LA) is revised by adding “(0.7972, effective January 1, 2005)”.

2. The entry of “0.8053” for MSA 4280 (Lexington, KY) is revised by adding “(0.9219, effective January 1, 2005)”.

3. The entry of “1.0025” for MSA 5000 (Miami, FL) is revised by adding “(0.9870, effective January 1, 2005)”.

4. The entry of “1.2921” for MSA 5380 (Nassau-Suffolk, NY) is revised by adding “(1.2907, effective January 1, 2005)”.

5. The entry of “1.3587” for MSA 5600 (New York, NY) is revised by adding “(1.3586, effective January 1, 2005)”.

6. The entry of “1.0975” for MSA 6780 (Riverside-San Bernardino, CA) is revised by adding “(1.0970, effective January 1, 2005)”.

7. The entry of “0.9964” for MSA 8780 (Visalia-Tulare-Porterville, CA) is revised by adding “(0.9975, effective January 1, 2005)”.

8. The entry of “1.0059” for MSA 8960 (West Palm Beach-Boca Raton, FL) is revised by adding “(1.0362, effective January 1, 2005)”.

9. The entry of “0.9472” for MSA 9040 (Wichita, KS) is revised by adding “(0.9468, effective January 1, 2005)”.

II. Correction of Errors

In FR Doc. 04-17443 (69 FR 45775), make the following corrections:

1. On pages 45787 through 45814, in Table 8—Wage Index for Rural Areas the table is corrected to read as follows:

2. On page 45815, Table 9 is revised to read as follows:

3. On page 45817, Table 10 is revised to read as follows:

4. On page 45821, Table 12 is revised to read as follows:

III. Waiver of Proposed Rulemaking and Delayed 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 notice such as this take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). We also ordinarily provide a 30-day delay in the effective date of the provisions of a notice in accordance with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive both the notice and comment procedure and the 30-day delay in effective date if the Secretary finds, for good cause, that a 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.

We find it unnecessary to undertake notice-and-comment rulemaking because this notice merely provides technical corrections to the regulations. We are not changing our payment methodology, but rather, are simply implementing correctly the payment methodology that we previously proposed, received comment on, and subsequently finalized. Thus, because the public has already had the opportunity to comment on the payment methodology being used to calculate wage indexes, additional comment would be unnecessary.

Further, we believe a delayed effective date is unnecessary because this correction notice merely corrects inadvertent technical errors. Further, we believe imposing a 30-day delay in the effective date would be contrary to the public interest for SNF providers in the affected MSAs. We believe that it is imperative that these providers receive appropriate SNF PPS payments in as timely a manner as possible, and any delay in applying the appropriate wage index would be contrary to the public interest. Further, the changes noted above do not make any substantive changes to the SNF PPS payment methodology or underlying payment policies. Therefore, we find good cause to waive notice-and-comment procedures, as well as the 30-day delay in effective date.

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